RICCARDO GOMES GOBBI
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina
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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- Simultaneous anterior cruciate ligament reconstruction and computer-assisted open-wedge high tibial osteotomy: A report of eight cases(2011) DEMANGE, Marco Kawamura; CAMANHO, Gilberto Luis; PECORA, Jose Ricardo; GOBBI, Riccardo Gomes; TIRICO, Luis Eduardo Passarelli; ALBUQUERQUE, Roberto Freire da Mota eEight patients, aged 37-50 years, with chronic anterior cruciate ligament (ACL) deficiency, medial compartment osteoarthritis and varus deformity underwent simultaneous arthroscopic ACL reconstruction and open-wedge high tibial osteotomy controlled by a computer navigation system. Despite preoperative planning, the surgeon may need to choose a different osteotomy site during the procedure, invalidating the previous plans. The intraoperative wire control for osteotomies is not precise. The navigation system can help obtain precise alignment during high tibial osteotomy. The average preoperative mechanical axis was 7.5 of varum (sd +/- 1.17 degrees), the average postoperative axis was 1.2 degrees of valgus (sd +/- 1.04 degrees) (p<0.01), and the average correction of the mechanical axis was 8.7 degrees (sd +/- 0.76 degrees). The site of the osteotomy was 3.9 cm (3.5-4.8 cm, sd +/- 0.35 mm) from the articular line, with an inclination of 27.9 degrees (24-35, sd +/- 4.8). The simultaneous use of these procedures allowed proper correction of the knee axis during the surgery. The surgery can be performed concomitantly with ACL reconstruction.
- Extensor mechanism injury, infection, and an extended time between trauma and surgical approach are related to the need for total knee arthroplasty removal after traumatic dehiscence(2023) HELITO, Camilo Partezani; SOBRADO, Marcel Faraco; GOBBI, Riccardo Gomes; DEMANGE, Marco Kawamura; FRANCIOZI, Carlos Eduardo; TKA Traumatic Exposure Study GrpBackground: Surgical wound-related traumatic complications are rarely reported in the lit-erature. Traumatic dehiscence is unpredictable because of the trauma magnitude and the potential of associated injuries. This study aims to report the clinical outcomes and com-plications of a case series due to traumatic dehiscence after total knee arthroplasty (TKA) and establish possible criteria for prognosis for maintaining the implant.Methods: Patients admitted to an emergency room due to traumatic dehiscence after TKA were retrospectively evaluated. Patient data was analyzed and patients who maintained or not the arthroplasty were compared to establish prognosis factors.Results: Thirty-two patients with traumatic dehiscence after TKA were evaluated. The trauma occurred on a mean of 14.3 +/-25.0 days after the surgical procedure, and debride-ment in the operating room was performed on a mean of 6.2 +/-4.9 hours after the trauma. Twenty patients maintained the arthroplasty until the end of follow-up and did not require revision. Factors related to arthroplasty removal were associated extensor mechanism injury (p = 0.026), time from trauma to surgical debridement (p = 0.035), and infection (p = 0.0001)Conclusion: Traumatic dehiscence after total knee arthroplasty is an event with a high rate of complications. Extensor mechanism Injury, infection, and extended time between trauma and surgical intervention were poor prognostic factors for arthroplasty maintenance.
- Letter regarding ""Management of the exposed total knee prosthesis, a six-year review""(2017) HELITO, Camilo Partezani; BONADIO, Marcelo Batista; GOBBI, Riccardo Gomes; DEMANGE, Marco Kawamura
- Plateau-patella angle: An option for the evaluation of patellar height in patients with patellar instability(2017) BONADIO, Marcelo Batista; HELITO, Camilo Partezani; TORRES, Julio Augusto do Prado; GOBBI, Riccardo Gomes; PECORA, Jose Ricardo; CAMANHO, Gilberto Luis; DEMANGE, Marco KawamuraBackground: Patellar instability is a debilitating disease. An important factor related to recurrent dislocation is patellar height. A new method of patellar height measurement, the plateau-patella angle (PPA), was proposed in 2011. However, to date, there is no study evaluating the use of this method in patients with patellar instability. The aim of this study was to evaluate the PPA in patients with recurrent patellar dislocation. Methods: This was a retrospective evaluation of the radiographs of 78 knees with patellar instability. Patellar height was measured using the Insall-Salvati (VS), Caton-Deschamps (C/D) and Blackburne-Peel (B/P) indices and the PPA. The qualitative and quantitative correlations between the various methods and between observers were calculated. Results: The PPA had a Pearson correlation of 0.76 (P <0.001) with the I/S index, 0.78 (P < 0.001) with the C/D index and 0.90 (P < 0.001) with the B/P index. In the qualitative correlation using the Spearman coefficient, the PPA had a correlation of 0.52 (P < 0.001) with the I/S index, 0.72 (P < 0.001) with the C/D index and 0.70 (P < 0.001) with the B/P index. The correlations between the conventional methods were as follows: 0.57 (P < 0.001) between the I/S and C/D indices; 0.61 (P < 0.001) between the I/S and B/P indices; and 0.73 (P < 0.001) between the C/D and B/P indices. Conclusion: The determination of the PPA is a reproducible method that is consistent with the methods currently used to measure patellar height in patients with recurrent patellar dislocation.
- Comparative study of superficial medial collateral ligament reconstruction combined with posterior oblique ligament reconstruction or posteromedial capsule advance in grade III injuries of the medial compartment in a complex knee injury scenario(2022) HELITO, Camilo Partezani; SILVA, Andre Giardino Moreira da; SOBRADO, Marcel Faraco; GIGLIO, Pedro Nogueira; GOBBI, Riccardo Gomes; PECORA, Jose RicardoBackground: The purpose of this study was to compare the combined reconstruction of the superficial medial collateral ligament (sMCL) and the posterior oblique ligament (POL) with the reconstruction of the sMCL associated with the advancement of the posteromedial cap-sule in a complex knee injury scenario. We hypothesized that both techniques would pre-sent similar knee stability and failure rates.Methods: This is a retrospective case-control study designed to compare the results of the two reported techniques for grade III MCL instability. Patients undergoing MCL reconstruc-tion associated with anterior cruciate ligament, posterior cruciate ligament, or both, from 2010 to 2019, were included. The following parameters were evaluated: demographic data, type of graft, time from injury to surgery, associated meniscus injuries, follow up time, mechanism of trauma, postoperative objective IKDC, subjective IKDC and Lysholm scales, range of motion, reconstruction failure and complications.Results: Seventy-eight patients were evaluated, 37 of whom underwent reconstruction of the sMCL and POL, and 41 of whom underwent reconstruction of the sMCL with advance-ment of posteromedial structures. There was no difference in any preoperative variable. Patients undergoing reconstruction of the sMCL + advancement had greater loss of flexion (Group 1 3.4 +/- 4.6 vs Group 2 8.4 +/- 7.9; P = 0.002) and more individuals with flexion loss greater than 10 degrees (Group 1, seven patients (18.9%) vs Group 2, 17 patients (41.5%); P = 0.031). Postoperative knee stability, failures and complications were similar between groups.Conclusion: Both techniques presented good functional results and low rates of complica-tions. However, the advancement technique showed greater flexion loss, which should be considered when choosing the best surgical option.(c) 2022 Elsevier B.V. All rights reserved.