ABSTRACT
ABSTRACT This review evaluated the outcomes used in clinical studies involving rotator cuff tear published in the last decade in the two leading Brazilian orthopedic journals. A literature review was performed using the journals Revista Brasileira de Ortopedia and Acta Ortopédica Brasileira. It included all original clinical articles describing at least one outcome measured before or after any clinical or surgical intervention related to rotator cuff tear, published between 2006 and 2015. The authors evaluated range of motion, muscle strength, patient satisfaction, and tendon integrity and functional outcomes scores. There were 25 clinical studies published about rotator cuff in the two principal Brazilian orthopedic journals in the last decade, 20 case series (80%), one case-control (4%), and four cohorts (16%). Objective measures such as muscle strength, patient satisfaction, and evaluation of tendon integrity were little used. Range of motion measurements were performed in 52% of the articles. Evaluations of muscle strength and patient satisfaction were reported by 28% and 16% of the studies, respectively. Only 28% of the articles evaluated tendon integrity after surgery. Of these, 16% did so by magnetic resonance imaging and 12% by , ultrasonography. The most used scale was the UCLA, present in 92% of the articles, while the Constant-Murley appeared in 20%. Scales deemed reliable, with high internal consistency and good responsiveness, were rarely used.
RESUMO Avaliamos os desfechos usados nos estudos clínicos que envolvem rotura do manguito rotador publicados na última década nos dois principais periódicos ortopédicos brasileiros. Foi feita uma revisão da literatura nos periódicosRevista Brasileira de OrtopediaeActa Ortopédica Brasileira. Foram incluídos todos os artigos clínicos originais que descreviam ao menos uma medida de desfecho antes ou após alguma intervenção clínica ou cirúrgica referente ao manguito rotador publicados entre 2006 e 2015. Os desfechos avaliados foram arco de movimento, força muscular, satisfação, integridade tendínea e escalas clínicas. Foram publicados 25 estudos clínicos sobre manguito rotador nos dois principais periódicos ortopédicos brasileiros na última década, 20 séries de casos (80%), um estudo tipo caso-controle (4%) e quatro coortes (16%). Medidas objetivas como força muscular, satisfação do paciente e avaliação da integridade tendínea foram pouco empregadas. As medidas do arco de movimento foram descritas em 52% dos artigos. A avaliação da força muscular e a satisfação do paciente foram descritas em 28% e 16% dos estudos, respectivamente. Apenas 28% dos artigos avaliaram a integridade tendínea após a cirurgia. Desses, 16% o fizeram com a ressonância magnética e 12% com a ultrassonografia. A escala mais usada foi a da UCLA, presente em 92% dos artigos, enquanto a de Constant-Murley foi usada em 20%. Escalas consideradas confiáveis, com grande consistência interna e boa responsividade, raramente foram usadas.
Subject(s)
Evaluation of Results of Therapeutic Interventions , Rotator Cuff , ShoulderABSTRACT
Objective: To evaluate the prevalence of osteoporosis in patients awaiting total hip arthroplasty. Method: Twenty-nine patients diagnosed with hip osteoarthritis awaiting primary total arthroplasty of the hip answered WOMAC questionnaire, VAS and questions about habits, osteoporosis and related diseases. Bone mineral densitometry of the lumbar spine and hips and laboratory tests (complete blood count and examination of calcium metabolism) were performed. Weight and height were measured to calculate body mass index (BMI). The evaluated quantitative characteristics were compared between patients with and without osteoporosis using the Mann-Whitney tests. Results: Thirteen men and 16 women with a mean age of 61.5 years old, WOMAC 51.4; EVA 6.4 and BMI 27.6 were evaluated. The prevalence of osteoporosis was 20.7%, and 37.9% had osteopenia. Patients with osteoporosis were older than patients without osteoporosis (p=0.006). The mean bone mineral density of the femoral neck without hip osteoarthritis was lower than the affected side (p=0.007). Thirty-five percent of patients did not know what osteoporosis is. Of these, 30% had osteopenia or osteoporosis. Conclusion: osteoarthritis and osteoporosis may coexist and the population waiting for total hip arthroplasty should be considered at risk for the presence of osteoporosis. Level of Evidence III, Observational Study.