JORGE HENRIQUE ASSUNCAO
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/41 - Laboratório de Investigação Médica do Sistema Músculoesquelético, Hospital das Clínicas, Faculdade de Medicina
LIM/41 - Laboratório de Investigação Médica do Sistema Músculoesquelético, Hospital das Clínicas, Faculdade de Medicina
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- Rotator cuff repair in patients 50 years of age or younger: A comparative study of functional outcomes in relation to older patients(2023) ASSUNçãO, J. H.; SILVEIRA, E. C.; TAKAYANAGI, O. M.; SILVA, F. B. de Andrade e; MALAVOLTA, E. A.; FERREIRA NETO, A. A.Background: Few studies have evaluated the clinical results of surgical treatment of rotator cuff tears in young patients and most of the publications are only case series and with a small number of evaluated individuals. The aim of this study is to compare the clinical outcomes of patients undergoing arthroscopic rotator cuff repair according to age at the time of the procedure. Hypothesis: Patients with 50 years of age or younger undergoing surgical treatment of rotator cuff tear have similar clinical outcomes to older patients. Materials and methods: Retrospective cohort study comparing results obtained after surgical treatment of rotator cuff tears between patients aged 50 years or younger and the older patients by the ASES and UCLA functional scales. Patients undergoing arthroscopy full-thickness rotator cuff repair were included. Results: We evaluated 390 shoulders (377 patients), 94 aged 50 years or younger (median = 46.5 years) and 296 aged over 50 years (median = 60 years). Both groups significantly improved with the procedure after 24 months of follow-up, according to the ASES and UCLA scales (p < 0.001). The groups did not differ in the scores obtained in the preoperative assessments and at 24 months of follow-up. The scores obtained on the ASES scale at 24 months of follow-up had a median of 87.2 (IQR = 38) among patients aged 50 years or younger and 90 points (IQR = 26.4) among older patients (p = 0.253). The scores obtained by the UCLA scale were 31 points (IQR = 9) and 33 points (IQR =7) respectively (p = 0.156). Discussion: Our results showed that, after 24 months, the functional results of arthroscopic full-thickness rotator cuff repair did not differ between patients younger than 50 years and older patients. These results are similar to those found by others authors. Both groups of patients achieved significant improvement after the surgical procedure, achieving approximately 90 points on the ASES scale and 32 points on the UCLA scale. Level of evidence: III Retrospective cohort study.
- Impact of proximal humerus version on neck-shaft angle: A clinical study(2017) ASSUNCAO, J. H.; MALAVOLTA, E. A.; BERALDO, R. A.; GRACITELLI, M. E. C.; BORDALO-RODRIGUES, M.; FERREIRA NETO, A. A.Background Two recent experimental studies evaluated the influence of shoulder rotation on neck-shaft angle, with conflicting results. However, there have been no clinical studies of whether this angle varies in different shoulder positions. The present study aimed to determine whether shoulder rotation affects neck-shaft angle on standard radiographs in patients with complaints of shoulder pain. Hypothesis Shoulder rotation does not affect neck-shaft angle. Materials and methods A prospective study was conducted in selected patients with shoulder pain. Three true anterior-posterior radiographic views were obtained: in neutral rotation, 30° external rotation, and internal rotation with patient's arm in a sling. The X-rays were evaluated by three shoulder and elbow surgeons. Inter- and intra-observer reliability was evaluated by Intraclass Correlation Coefficient (ICC). Results Neck-shaft angle on true AP view did not differ between neutral rotation and 30° external rotation: 132° ± 6° and 130° ± 9°, respectively (P > 0.999). In internal rotation with the hand resting on the abdomen, neck-shaft angle was 145° ± 6°: i.e., significantly different (P < 0.001) to the other two positions. Intra- and inter-observer correlation demonstrated excellent reliability. Conclusions Radiographic neck-shaft angle was significantly different in internal rotation with the patient's arm in a sling, compared with views in neutral or 30° external rotation. Intra- and inter-observer correlation showed excellent reliability. Level of evidence II Comparative prospective study. © 2017 Elsevier Masson SAS