Medium-term evaluation of total knee arthroplasty without patellar replacement / Avaliacao em medio prazo da artoplastia total de joelho sem substituicao da patela

OBJECTIVE: To mid-term evaluate patients who were submitted to total knee arthroplasty without patellar resurfacing. METHODS: It was realized a retrospective cross-sectional study of patients who were submitted to total knee arthroplasty without patellar resurfacing. In all patients clinical examination was done based on the protocol of the Knee Society Scoring System, which assessed pain, range of motion, stability, contraction, knee alignment and function, and radiological evaluation. RESULTS: A total of 36 patients were evaluated. Of these, 07 were operated only on left knee, 12 only on right knee and 17 were operated bilaterally, totaling 53 knees. Ages ranged from 26 to 84 years. Of the 53 knees evaluated, 33 (62.26%) had no pain. The maximum flexion range of motion averaged 104.7°. No knee had difficulty in active extension. As to the alignment for anatomical axis twelve knees (22.64%) showed deviation between 0° and 4° varus. Thirty-nine (75.49%) knees showed pace without restriction and the femorotibial angle ranged between 3° varus and 13° valgus with an average of 5° valgus. The patellar index ranged from 0.2 to 1.1. CONCLUSION: Total knee arthroplasty whitout patellar resurfacing provides good results in mid-term evaluation. .

OBJETIVO: Avaliar, em médio prazo, pacientes submetidos a artroplastia total de joelho sem substituição da patela. MÉTODOS : Foi feito um estudo retrospectivo e transversal de pacientes submetidos a artroplastia total de joelho sem substituição patelar. Em todos os pacientes foi feito exame clínico baseado no protocolo do Knee Society Scoring System, no qual foram avaliados dor, amplitude de movimento, estabilidade, contratura, alinhamento e função do joelho, além de exame radiológico. RESULTADOS : Foram avaliados 53 joelhos operados em 36 pacientes, sendo sete à esquerda, 12 à direita e 17 bilaterais. A faixa etária variou de 26 a 84 anos. Dos 53 joelhos avaliados, 33 (62,26%) não apresentaram dor. A flexão máxima do arco de movimento teve média de 104,7º. Nenhum joelho apresentou dificuldade de extensão ativa. Quanto ao alinhamento pelo eixo anatômico, 12 joelhos apresentaram desvio (22,64%) entre 0º e 4º em varo; 39 (75,49%) apresentaram marcha sem restrição e o ângulo femorotibial teve variação entre 3º de varo e 13º de valgo com média de 5º de valgo. O índice patelar variou de 0,2 a 1,1. CONCLUSÃO : A artroplastia total de joelho sem substituição da patela proporciona bons resultados em médio prazo. .

Evaluation of simvastatin in the process of fracture healing in tibiae of rats

OBJECTIVE: Evaluate the effects of simvastatin in the process of fracture healing in rat tibia. METHODS: Thirty-six rats were subjected to diaphyseal fracture of the leg bones and divided in the statin group (GE) and control group (GC), being subdivided into three subgroups according to days post-fracture (7th, 14th and 28th day) to assess bone healing. In GE was administered by gavage a solution of simvastatin to the sacrifice. In the control group was administered saline by the same route of SG. Immobilization was not used. After the sacrifice was made to limb amputation in the distal femur and conducted the clinical, radiological and histological analysis. Clinical evaluation was made as to the mobility of the fracture. Then the samples were radiographed and evaluated for callus diameter. Histological examination was performed with cuts of 5 micrometers and stained with hematoxylin-eosin, Masson's trichrome and Alcian blue pH 2.5. The level of significance to exclude the null hypothesis was 5%. RESULTS: All GE animals showed greater stability of the fracture and higher callus area. There were no significant changes in the histological study. CONCLUSION: Simvastatin accelerates the consolidation process by increasing the callus, but does not alter the histology of the newly formed bone. .

Uso da S(+) cetamina por via intra-articular em modelo de osteoartrite em ratos: análise da imunoexpressão da ciclooxigenase 2 / Using the S (+) Ketamine in intraarticular osteoarthritis model in rats: analysis of the immunoreactivity cyclooxygenase 2

A osteoartrite (OA) é uma doença degenerativa que afeta grande parte da população e resulta em significativa morbidade e incapacidade. O presente estudo teve como objetivo investigar os efeitos periféricos da S(+) cetamina na expressão da ciclo-oxigenase 2 (COX-2). Foram utilizados modelos experimentais de osteoartrite em ratos. Inicialmente setenta e dois ratos foram utilizados no estudo. Foram divididos em três grupos de 24 animais cada. Em dois grupos foi induzida a OA através de 2mg de MIA (monoiodo acetato de sódio) por via intra-articular (i.a), em um volume máximo de 50μL e em um dos grupos não foi realizada a indução da OA. No sétimo dia após a indução, dois grupos, incluindo o sem OA, receberam injeção i.a de salina 0,9% em volume máximo de 50μL e o terceiro grupo recebeu injeção de S(+) cetamina na dose de 0,5mg/kg. Nos dias 7, 14, 21 e 28 os animais foram anestesiados e sacrificados para coleta da membrana sinovial e análise imuno-histoquímica da ciclo-oxigenase-2. Durante o estudo ocorreram 29 perdas do material a ser analisado, totalizando um n = 43. O protocolo adotado para a interpretação imuno-histoquímica foi a imunomarcação citoplasmática da COX-2 em células da membrana sinovial, tecido conjuntivo e adiposo, conforme a intensidade da coloração. A análise dos resultados foi realizada através do teste do quiquadrado. A reatividade da COX-2 foi positiva em 53,8% dos animais do grupo sem OA, em 60% do grupo OA com salina e em 80% dos animais do grupo OA com cetamina, sem diferença estatisticamente significante entre os grupos (p = 0,3069). Esse estudo sugeriu que a S(+) cetamina por via intra-articular não inibiu a expressão da COX-2 em modelos de osteoartrite em ratos

Osteoarthritis (OA) is a degenerative disease that effects a large population and results in significant morbidity and disability. The objective of the present study was to investigate the peripheral effects of S(+) ketamine on the COX-2 expression. Experimental models of OA in rats were used. At first, 72 rats were used in the study. The animals were divided into three groups of 24 each. In two groups, OA was induced through intra-articular (i.a.) injection of 2mg of monoiodine acetate (MIA), at a maximum volume of 50μL, while one of the groups was not submitted to OA induction. On the seventh day following the induction, the animals of two groups, including those form the not-induced group, received an i.a. injection of saline at 0.9% at a maximum volume of 50μL, while the third group received and injection of S(+) ketamine at 0.5mg/kg. On days 7, 14, 21 and 28 the animals were anesthetized and sacrificed, and the synovial membrane was extracted and submitted to immunohistochemistry analysis of the cyclooxygenase-2. Throughout the study, there were 29 losses of materials that were to be analyzed, totaling an n = 43. The protocol used for the immunohistochemical interpretation was cytoplasmic immunostaining of COX-2 in cells of the synovial membrane, conjunctive and adipose tissue, according to the intensity of the stain. Results were analyzed by the chi-square test. COX-2 reactivity was positive in 53.8% of animals in the group without OA, in 60% of those of the OA group with saline, and in 80% of group OA with ketamine, with no statistically significant difference between the groups (p = 0.3069). Thus, the study implies that intra-articular injections of S(+) ketamine did not inhibit the COX-2 expression in osteoarthritis models in rats