Use of aerobic treadmill exercises on nerve regeneration after sciatic nerve injury in spontaneously hypertensive rats

Purpose: Various postoperative protocols have been proposed to improve outcomes and accelerate nerve regeneration. Recently, the use of physical exercise in a post-surgical neurorraphy procedure has shown good results when started early. We experimentally investigated the hypothesis that post-operative exercise speeds up results and improves clinical and morphologic parameters. Methods: Isogenic rats were randomly divided into four groups: 1 SHAM; 2 SHAM submitted to the exercise protocol (EP); 3 Grafting of the sciatic nerve; and 4 Grafting of the sciatic nerve associated with the EP. The EP was based on aerobic activities with a treadmill, with a progressive increase in time and intensity during 6 weeks. The results were evaluated by the sciatic functional index (SFI), morphometric and morphologic analysis of nerve distal to the lesion, and the number of spinal cord motor neurons, positive to the marker Fluoro-Gold (FG), captured retrogradely through neurorraphy. Results: Functional analysis (SFI) did not show a statistical difference between the group grafted with (­50.94) and without exercise (-65.79) after 90 days. The motoneurons count (Spinal cord histology) also showed no diference between these groups (834.5 × 833 respectively). Although functionally there is no difference between these groups, morphometric study showed a greater density (53.62) and larger fibers (7.762) in GRAFT group. When comparing both operated groups with both SHAM groups, all values were much lower. Conclusions: The experimental model that this aerobic treadmill exercises protocol did not modify nerve regeneration after sciatic nerve injury and repair with nerve graft.

Comparative analysis on arthroscopic sutures of large and extensive rotator cuff injuries in relation to the degree of osteopenia / Análise comparativa da sutura artroscópica de lesões grandes e extensas do manguito rotador com relação ao grau de osteopenia

To analyze the results from arthroscopic suturing of large and extensive rotator cuff injuries, according to the patient's degree of osteopenia. METHOD: 138 patients who underwent arthroscopic suturing of large and extensive rotator cuff injuries between 2003 and 2011 were analyzed. Those operated from October 2008 onwards formed a prospective cohort, while the remainder formed a retrospective cohort. Also from October 2008 onwards, bone densitometry evaluation was requested at the time of the surgical treatment. For the patients operated before this date, densitometry examinations performed up to two years before or after the surgical treatment were investigated. The patients were divided into three groups. Those with osteoporosis formed group 1 (n = 16); those with osteopenia, group 2 (n = 33); and normal individuals, group 3 (n = 55). RESULTS: In analyzing the University of California at Los Angeles (UCLA) scores of group 3 and comparing them with group 2, no statistically significant difference was seen (p = 0.070). Analysis on group 3 in comparison with group 1 showed a statistically significant difference (p = 0.027). CONCLUSION: The results from arthroscopic suturing of large and extensive rotator cuff injuries seem to be influenced by the patient's bone mineral density, as assessed using bone densitometry...

Analisar o resultado da sutura artroscópica das lesões grandes e extensas do manguito rotador (MR) de acordo com o grau de osteopenia do paciente. MÉTODO: coorte prospectiva nos pacientes operados a partir de outubro de 2008 e retrospectiva nos demais. Foram analisados 138 pacientes submetidos à sutura artroscópica de lesões grandes e extensas do MR entre 2003 e 2011. Aos pacientes operados a partir de outubro de 2008 era solicitada uma densitometria óssea (DO) por ocasião do tratamento cirúrgico. Nos pacientes operados antes de outubro de 2008, pesquisaram-se densitometrias feitas dois anos antes ou após o tratamento cirúrgico. Os pacientes foram divididos em três grupos. Os com osteoporose formaram o grupo 1 (n =16), os com osteopenia o 2 (n = 33) e os normais o 3 (n = 55). RESULTADOS: ao analisar o escore da Universidade da Califórnia em Los Angeles (UCLA) do Grupo 3 e compará-lo com o Grupo 2, não foi verificada uma diferença estatisticamente significativa (p = 0,070). Ao analisar o Grupo 3 e compará-lo com o Grupo 1, foi verificada uma diferença estatisticamente significativa (p = 0,027). CONCLUSÃO: o resultado da sutura artroscópica das lesões grandes e extensas do MR parece sofrer influência da densidade mineral óssea do paciente avaliada por meio...