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1.
Rev. bras. med. esporte ; 27(2): 134-137, Apr.-June 2021. graf
Article in English | LILACS | ID: biblio-1280057

ABSTRACT

ABSTRACT Introduction: The use of substances to enhance sports performance among professional and amateur athletes is increasing. Such substances may either be included in the group of dietary supplements or fall into pharmacological classes. Every substance used for this purpose is called an ergogenic agent. The number of ergogenic options available increases every day, favoring overuse and use without proper guidance. Among the dietary supplements, we highlight the use of creatine, a substance widespread in sports. Among the pharmacological groups, many drugs are used. Recently the use of sildenafil citrate by professional athletes from various predominantly aerobic sports modalities was reported in the media. Objective: To compare and demonstrate the responses caused by physical training associated with the use of creatine and sildenafil citrate in mice. Methods: A swim training protocol was applied and then an electrophysiograph was used in order to obtain parameters related to contraction intensity, the area under the curve and the percentage drop. Results: The responses obtained demonstrated the ergogenic action of creatine because it altered the parameters used for measurement. The use of sildenafil citrate did not yield satisfactory results to frame the drug as an ergogenic agent. Conclusion: Creatine has an ergogenic effect, reducing the percentage drop after 10 seconds, while sildenafil demonstrated no ergogenic potential and, interestingly, resulted in weaker responses when compared to the exercise groups. Evidence level II; Comparative prospective study .


RESUMEN Introducción: El uso de sustancias con el objetivo de aumentar el rendimiento deportivo entre atletas profesionales y amateurs es creciente. Tales sustancias pueden formar parte del grupo de suplementos alimentarios o integrar clases farmacológicas. Toda sustancia empleada para ese fin es denominada agente ergogénico. El número de opciones entre los agentes ergogénicos aumenta cada día, favoreciendo así su uso excesivo y sin la debida orientación. Entre los suplementos alimentarios, se destaca el uso de creatina, sustancia muy difundida en el medio deportivo. Ya entre los grupos farmacológicos, muchas sustancias son usadas. Recientemente, fue divulgado entre los medios de comunicación el uso de citrato de sildenafil por atletas profesionales, de varias modalidades deportivas, predominantemente las aeróbicas. Objetivos: Comparar y demostrar las respuestas ocasionadas por el entrenamiento físico, asociadas al uso de creatina y citrato de sildenafil en ratones. Métodos: Se aplicó un protocolo de entrenamiento de natación y, a continuación, se usó un electrofisiógrafo con el objetivo de obtener parámetros referentes a la intensidad de contracción, al área bajo la curva y a la caída porcentual. Resultados: Las respuestas obtenidas demuestran acción ergogénica de la creatina, visto que alteraron los parámetros empleados para la medición. Ya el uso de citrato de sildenafil no presentó resultados satisfactorios para encuadrar al fármaco como agente ergogénico. Conclusión: La creatina presenta efecto ergogénico porque reduce la caída porcentual después de 10 segundos, mientras que el sildenafil no presentó potencial ergogénico y, curiosamente, demostró respuestas inferiores cuando comparado a los grupos de ejercicio. Nivel de evidencia II; Estudio prospectivo comparativo .


RESUMO Introdução: O uso de substâncias com o objetivo de aumentar o rendimento esportivo entre atletas profissionais e amadores é crescente. Tais substâncias podem fazer parte do grupo de suplementos alimentares ou integrar classes farmacológicas. Toda substância empregada para esse fim é denominada de agente ergogênico. O número de opções entre os agentes ergogênicos aumenta a cada dia, favorecendo assim o uso em demasia e sem a devida orientação. Entre os suplementos alimentares, salientamos a utilização de creatina, substância muito difundida no meio esportivo. Já entre os grupos farmacológicos, muitas substâncias são utilizadas. Recentemente, foi divulgado entre os meios de comunicação o uso de citrato de sildenafila por atletas profissionais de várias modalidades esportivas, predominantemente as aeróbicas. Objetivos: Comparar e demonstrar as repostas ocasionadas pelo treinamento físico, associadas ao uso de creatina e citrato de sildenafila em camundongos. Métodos: Aplicou-se um protocolo de treinamento de natação e, a seguir, empregou-se um eletrofisiógrafo com objetivo de obter parâmetros referentes à intensidade de contração, à área sob a curva e à queda percentual. Resultados: As respostas obtidas demonstram ação ergogênica da creatina, visto que alteraram os parâmetros empregados para a mensuração. Já a utilização de citrato de sildenafila não apresentou resultados satisfatórios para enquadrar o fármaco como agente ergogênico. Conclusão: A creatina apresenta efeito ergogênico porque reduz a queda percentual após 10 segundos, já a sildenafila não apresentou potencial ergogênico e, curiosamente, demonstrou respostas inferiores quando comparado aos grupos de exercício. Nível de evidência II; Estudo prospectivo comparativo .


Subject(s)
Animals , Male , Mice , Swimming , Vasodilator Agents/pharmacology , Muscle Fatigue/drug effects , Creatine/pharmacology , Sildenafil Citrate/pharmacology , Physical Functional Performance , Sciatic Nerve/surgery , Tendons/surgery , Models, Animal , Electrophysiology/instrumentation
2.
Arq. bras. oftalmol ; 84(2): 133-139, Mar,-Apr. 2021. tab, graf
Article in English | LILACS | ID: biblio-1153127

ABSTRACT

ABSTRACT Purpose: This study was conducted to further define the specific clinical characteristics of patients with Brown syndrome and evaluate the outcomes of superior oblique tenotomy in its surgical management. Methods: A retrospective analysis of the medical charts of 45 patients with Brown syndrome was performed, which revealed that 11 patients underwent superior oblique tenotomy due to abnormal head posture and/or hypotropia and 1 patient underwent bilateral superior oblique tendon elongation with a silicone band due to abnormal head posture. In the last patient, silicone bands were removed at the postoperative 3rd month due to the lack of improvement in the abnormal head posture and the limitation of elevation in adduction. Simultaneous horizontal rectus muscle surgery was performed in four patients. Results: There was a predominance of female gender, right eye, congenital form, unilaterality, A-pattern, and an abnormal head posture type with a combination of chin up and head tilting. Bilateral form was observed only in female patients. Amblyopia was detected in two patients. Among patients aged >5 years, 40% had reduced stereopsis. Abnormal head posture was found in 60% of patients. More than half of them were diagnosed with a vertical and/or horizontal deviation. Tenotomy procedure eliminated the abnormal head posture in all patients and significantly improved the mean limitation of elevation in adduction and hypotropia (p=0.001, p=0.012). Two patients developed inferior oblique overaction in the operated eye. There was complete spontaneous resolution in two patients. Conclusions: The clinical features of patients with Brown syndrome in our study are considerably consistent with those of previous reports. The present study demonstrated the effectiveness of superior oblique tenotomy with less overcorrection in the surgical treatment of Brown syndrome.(AU)


RESUMO Objetivo: Definir mais detalhadamente as características clínicas específicas de pacientes com síndrome de Brown e avaliar os resultados da tenectomia do músculo oblíquo superior no manejo cirúrgico da síndrome de Brown. Métodos: Prontuários de 45 pacientes com síndrome de Brown foram analisados retrospectivamente. Onze pacientes submetidos à tenectomia do músculo oblíquo superior devido a postura anormal da cabeça ou a hipotropia e um paciente submetido ao alongamento bilateral do tendão do oblíquo superior com uma faixa de silicone devido a postura anormal da cabeça. Neste último paciente, a faixa de silicone foi removida no terceiro mês pós-operatório devido à ausência de melhora na postura anormal da cabeça e à limitação da elevação em adução. Quatro pacientes submeteram-se simultaneamente à cirurgia do músculo reto horizontal. Resultados: Houve predominância de sexo feminino, olho direito, forma congênita, acometimento unilateral, padrão em "A" e um tipo de postura anormal da cabeça combinando queixo elevado e inclinação da cabeça. A forma bilateral foi vista apenas em pacientes do sexo feminino. Foi constatada ambliopia em 2 pacientes. Dentre os pacientes acima de 5 anos de idade, 40% tinham estereopsia reduzida. Postura anormal da cabeça estava presente em 60% dos pacientes. Mais da metade dos pacientes foi diagnosticada com um desvio vertical, horizontal ou ambos. O procedimento de tenectomia eliminou a postura anormal da cabeça em todos os pacientes e melhorou significativamente a limitação média da elevação em adução e a hipotropia (p=0,001 e p=0,012). Dois pacientes desenvolveram hiperação do músculo oblíquo inferior no olho operado. Resolução completa ocorreu espontaneamente em 2 pacientes. Conclusões: O quadro clínico dos pacientes com síndrome de Brown no nosso estudo é bastante consistente com os relatos iniciais na literatura. Este estudo mostrou a eficácia da tenectomia do oblíquo superior, com menor hipercorreção no tratamento cirúrgico da síndrome de Brown.(AU)


Subject(s)
Humans , Tendons/physiopathology , Ocular Motility Disorders/physiopathology , Amblyopia/diagnosis , Retrospective Studies
3.
Rev. bras. ciênc. vet ; 28(1): 9-13, jan./mar. 2021. il.
Article in Portuguese | LILACS, VETINDEX | ID: biblio-1368235

ABSTRACT

Objetivou-se com este estudo demonstrar a influência do tipo de treinamento sobre as medidas dos tendões flexores palmares em equinos de vaquejada que correm à direita do boi na microrregião do Alto Médio Gurgueia, Sul do Piauí, Brasil. Foram utilizados oito animais, da raça quarto de milha e seus mestiços, de diferentes idades, peso e sexo, selecionados e questionados sobre o tempo que exerciam a atividade de vaquejada e o tipo de treinamento a qual eram submetidos, que refere-se a maneira como praticavam a prova correndo de que lado do boi, em uma prova de vaquejada no município de Cristino Castro, Sul do Piauí, Brasil, onde os participantes eram provenientes de diferentes haras da Microrregião do Alto Médio Gurgueia, Sul do Piauí, Brasil. Em cada animal foi realizada ultrassonografia das zonas IB, IIB e IIIB dos tendões flexores digital superficial (TFDS) e digital profundo (TFDP), obtendo-se as medidas dos diâmetros médio lateral (DML) e dorso palmar (DDP) através do plano transverso em cada uma das diferentes zonas. Os dados foram submetidos a análise estatística (ANOVA), utilizando-se o teste t a nível de significância de (p<0,05), observando-se que não houve diferença significativa entre as medidas avaliadas. De acordo com os resultados obtidos, cavalos atletas que correm a direita do boi não apresentam diferença significativa nos diâmetros médio lateral e dorso palmar dos tendões flexores entre os antímeros direito e esquerdo do membro torácico.


The objective of this study was to demonstrate the influence of the type of training on the measurements of the palmar flexor tendons in vaquejada horses that run to the right of the ox in the microregion of the Alto Médio Gurgueia, South of Piauí, Brazil. Eight animals of the quarter-mile breed and their crossbreed, of different ages, weight and sex, were selected and asked about the time they were engaged in the activity of the vaquejada and the type of training they were submitted to as they practiced running on which side of the ox, in a vaquejada test in the municipality of Cristino Castro, South of Piauí, Brazil, where the participants came from different farms of the microregion of the Alto Médio Gurgueia, South of Piauí, Brazil. The ultrasonography of the IB, IIB and IIIB zones of the superficial digital (TFDS) and deep digital flexor tendons (TFDP) were performed in each animal, obtaining the measurements of the lateral diameters (DML) and palmar dorsum (DDP) through the transverse plane in each of the different zones. Data were submitted to statistical analysis (ANOVA), using the t test at the significance level of (p <0.05), observing that there was no significant difference between the measures evaluated. According to the results, horses for vaquejada athletes do not present significant difference in the lateral diameters and palmar dorsum of the flexor tendons between the right and left thoracic limb antimeres.


Subject(s)
Animals , Tendons/diagnostic imaging , Ultrasonography/veterinary , Horses/injuries , Upper Extremity/diagnostic imaging
4.
Clinics ; 76: e2358, 2021. tab, graf
Article in English | LILACS | ID: biblio-1249574

ABSTRACT

OBJECTIVES: In the present study, a novel single knot tenorrhaphy was developed by combining the modified Kessler flexor tendon suture (MK) with the loop lock technique. METHODS: A total of 48 porcine flexor digitorum profundus tendons were collected and randomly divided into six groups. The tendons were transversely cut and then repaired using six different techniques, the MK method, double knot Kessler-loop lock flexor tendon suture (DK), and single knot Kessler-loop lock flexor tendon suture (SK), each in combination with the epitendinous suture (P), and the same three techniques without P. Furthermore, by performing the load-to-failure tests, the biomechanical properties and the time taken to complete a repair, for each tenorrhaphy, were assessed. RESULTS: Compared to the MK+P method, DK+P was more improved, thereby enhancing the ultimate tensile strength. The SK+P method, which required fewer knots than DK+P, was easier to perform. Moreover, the SK+P repair increased the force at a 2-mm gap formation, while requiring lesser knots than DK+P. CONCLUSION: As opposed to the traditional MK+P method, the SK+P method was improved and exhibited better biomechanical properties, which may facilitate early mobilization after the repair.


Subject(s)
Animals , Sutures , Suture Techniques , Swine , Tendons/surgery , Tensile Strength , Biomechanical Phenomena
5.
Article in Chinese | WPRIM | ID: wpr-879460

ABSTRACT

OBJECTIVE@#To evaluate clinical efficacy of modified kidner procedure with tendoscopy in treating painful accessory navicular.@*METHODS@#From February 2014 to April 2019, 19 patients with painful accessory navicular were admitted, including 13 males and 6 females with a mean age of 26 years old (ranged from 14 to 58 years old), all of which were unilateral symptoms. The courses of disease ranged from 6 to 60 months. All patients received excision of accessory navicular and reconstruction of posterior tibial tendon insertion on navicular with anchor, and the tendoscopy were used to examin the posterior tibial tendon. American Orthopedic Foot and Ankle Society(AOFAS) midfoot score and visual analogue scale(VAS) were used to evaluate efficacy before operation and at the latest follow-up.@*RESULTS@#All the patientswere followed up, and the duration ranged from 12 to 73 months, with an average of (35.0±20.9) months. VAS score was 0.20±0.41 at the latest follow-up, showing significant difference when compared with preoperative score of 6.33±1.95(@*CONCLUSION@#The modified kidner procedure with tendoscopy is a good choice for the treatment of painful accessory navicular, which could obviously relieve foot pain, improve foot function, and has certain clinical efficacy.


Subject(s)
Adolescent , Adult , Female , Foot Diseases , Humans , Male , Middle Aged , Pain/surgery , Pain Measurement , Tarsal Bones/surgery , Tendons , Treatment Outcome , Young Adult
6.
Chinese Medical Journal ; (24): 2316-2321, 2021.
Article in English | WPRIM | ID: wpr-921157

ABSTRACT

BACKGROUND@#Multiple techniques are commonly used for posterior cruciate ligament (PCL) reconstruction. However, the optimum method regarding the fixation of PCL reconstruction after PCL tears remains debatable. The purpose of this study was to compare the biomechanical properties among three different tibial fixation procedures for transtibial single-bundle PCL reconstruction.@*METHODS@#Thirty-six porcine tibias and porcine extensor tendons were randomized into three fixation study groups: the interference screw fixation (IS) group, the transtibial tubercle fixation (TTF) group, and TTF + IS group (n = 12 in each group). The structural properties of the three fixation groups were tested under cyclic loading and load-to-failure. The slippage after the cyclic loading test and the stiffness and ultimate failure load after load-to-failure testing were recorded.@*RESULTS@#After 1000 cycles of cyclic testing, no significant difference was observed in graft slippage among the three groups. For load-to-failure testing, the TTF + IS group showed a higher ultimate failure load than the TTF group and the IS group (876.34 ± 58.78 N vs. 660.92 ± 77.74 N [P < 0.001] vs. 556.49 ± 65.33 N [P < 0.001]). The stiffness in the TTF group was significantly lower than that in the IS group and the TTF + IS group (92.77 ± 20.16 N/mm in the TTF group vs. 120.27 ± 15.66 N/m in the IS group [P = 0.001] and 131.79 ± 17.95 N/mm in the TTF + IS group [P < 0.001]). No significant difference in the mean stiffness was found between the IS group and the TTF + IS group (P = 0.127).@*CONCLUSIONS@#In this biomechanical study, supplementary fixation with transtibial tubercle sutures increased the ultimate failure load during load-to-failure testing for PCL reconstruction.


Subject(s)
Animals , Biomechanical Phenomena , Posterior Cruciate Ligament Reconstruction , Sutures , Swine , Tendons/surgery , Tibia/surgery
7.
Article in Chinese | WPRIM | ID: wpr-888234

ABSTRACT

Robot-assisted fracture reduction usually involves fixing the proximal end of the fracture and driving the distal end of the fracture to the proximal end in a planned reduction path. In order to improve the accuracy and safety of reduction surgery, it is necessary to know the changing rule of muscle force and reduction force during reduction. Fracture reduction force was analyzed based on the muscle force of femoral. In this paper, a femoral skeletal muscle model named as PA-MTM was presented based on the four elements of skeletal muscle model. With this, pinnate angle of the skeletal muscle was considered, which had an effect on muscle force properties. Here, the muscle force of skeletal muscles in different muscle models was compared and analyzed. The muscle force and the change of the reduction force under different reduction paths were compared and simulated. The results showed that the greater the pinnate angle was, the greater the influence of muscle strength was. The biceps femoris short head played a major role in the femoral fracture reduction; the force in the


Subject(s)
Femur/surgery , Fractures, Bone , Humans , Muscle, Skeletal , Reconstructive Surgical Procedures , Tendons
8.
Article in Chinese | WPRIM | ID: wpr-887503

ABSTRACT

OBJECTIVE@#To explore the ultrasonic anatomical characteristics and needle-knife insertion approach of common tendon lesions in knee osteoarthritis (KOA), so as to provide the references for accurate release of KOA by needle- knife along tendon lesions based on meridian sinew theory.@*METHODS@#Sixty patients with one-knee KOA were selected. High-frequency musculoskeletal ultrasound was used to collect sonograms at the anatomical positions of "Hedingci" "Binwaixia" "Binneixia" and "Yinlingshang". The anatomic levels were marked on the sonograms. The anatomic levels and sonographic features of lesions were compared and analyzed, and the relevant data of needle-knife simulation approach was measured.@*RESULTS@#The "Hedingci" lesions were mainly located at the attachment of quadriceps tendon to patella and suprapatellar bursa. The "Binwaixia" and "Binneixia" lesions were mainly located at the attachment of retinaculum patellae laterale and retinaculum patellae mediale to patella and infrapatellar fat pad. The "Yinlingshang" lesions were mainly located at the attachment of goose foot tendon to medial tibial condyle and bursa of goose foot. With "Hedingci" as an example, when the needle-knife entry point was 1 cm above the patella, the attachment of quadriceps tendon to patella was released, and the average depth of needle-knife was (3.60±0.10) cm, and the needle body was perpendicular to the skin. The average depth of needle-knife for releasing suprapatellar bursa was (2.35±0.17) cm, and the needle body was 45° towards head.@*CONCLUSION@#The musculoskeletal ultrasound could clearly show the local detailed anatomical level, ultrasonic characteristics and anatomical level of common tendon lesions of KOA, and could improve the accuracy of needle-knife along tendon lesions with non-direct vision, which has important reference value for needle-knife medical standardization and standardized operation.


Subject(s)
Humans , Knee Joint/surgery , Meridians , Osteoarthritis, Knee/surgery , Patella , Tendons/surgery , Ultrasonography
10.
Acta Medica Philippina ; : 290-293, 2021.
Article in English | WPRIM | ID: wpr-886401

ABSTRACT

@#OBJECTIVE: It is common to get lost during a comminuted proximal humerus surgery, and the pectoralis major insertion is always a constant. Therefore, this study aimed to do a cadaveric study on the Filipino population to assess the distance from the pectoralis major tendon to the top of the humeral head (PMT) as a reference during proximal humerus surgery. METHODS: This study dissected the shoulders of cadavers. The distance from the pectoralis major tendon insertion to the top of the humeral head (PMT) was measured using a caliper. This PMT distance was also correlated to the cadaver's height and sex. RESULTS: This study dissected 110 shoulders (55 cadavers | 24 females, 31 males). The median PMT was 5.40 cm for males and 4.90 cm for females, with a combined value of 5.40 cm overall. There was a direct and moderate correlation between the PMT with overall height. Height and PMT of both the left and right shoulder were significantly longer among males compared to females. The study showed that for every centimeter increase in the height of males, there was a corresponding 0.02 cm increase in the PMT, adding the constant factor of 1.83. A corresponding 0.04 cm increase in the PMT for females added the constant factor of -0.81. CONCLUSION; The pectoralis major tendon insertion is a consistent landmark that can accurately restore humeral length when reconstructing complex proximal humerus fractures where landmarks are otherwise lost because of comminution.


Subject(s)
Pectoralis Muscles , Humerus , Tendons , Fractures, Bone
11.
Acta Medica Philippina ; : 290-293, 2021.
Article in English | WPRIM | ID: wpr-886400

ABSTRACT

@#OBJECTIVE: It is common to get lost during a comminuted proximal humerus surgery, and the pectoralis major insertion is always a constant. Therefore, this study aimed to do a cadaveric study on the Filipino population to assess the distance from the pectoralis major tendon to the top of the humeral head (PMT) as a reference during proximal humerus surgery. METHODS: This study dissected the shoulders of cadavers. The distance from the pectoralis major tendon insertion to the top of the humeral head (PMT) was measured using a caliper. This PMT distance was also correlated to the cadaver's height and sex. RESULTS: This study dissected 110 shoulders (55 cadavers | 24 females, 31 males). The median PMT was 5.40 cm for males and 4.90 cm for females, with a combined value of 5.40 cm overall. There was a direct and moderate correlation between the PMT with overall height. Height and PMT of both the left and right shoulder were significantly longer among males compared to females. The study showed that for every centimeter increase in the height of males, there was a corresponding 0.02 cm increase in the PMT, adding the constant factor of 1.83. A corresponding 0.04 cm increase in the PMT for females added the constant factor of -0.81. CONCLUSION; The pectoralis major tendon insertion is a consistent landmark that can accurately restore humeral length when reconstructing complex proximal humerus fractures where landmarks are otherwise lost because of comminution.


Subject(s)
Pectoralis Muscles , Humerus , Tendons , Fractures, Bone
12.
Article in Chinese | WPRIM | ID: wpr-877609

ABSTRACT

OBJECTIVE@#To observe the imaging features of focus of knee joint tendon in patients with knee osteoarthritis (KOA) by musculoskeletal ultrasound (MSUS) technique.@*METHODS@#One hundred KOA patients and 100 healthy subjects were included. All the KOA patients were palpated by the sequence of foot @*RESULTS@#The top-5 focus of knee tendon of KOA patients were located in medial inferior patella, medial tibial condyle, inferior patella, Zusanlici and Hedingci. The thickness of ligaments and tendons in extension and flexion positions in KOA patients were thicker than that in healthy subjects (@*CONCLUSION@#The focus of knee joint tendon in KOA patients shows significantly thickened musculoskeletal imaging features.


Subject(s)
Healthy Volunteers , Humans , Knee Joint/diagnostic imaging , Osteoarthritis, Knee/diagnostic imaging , Tendons/diagnostic imaging , Ultrasonography
14.
Autops. Case Rep ; 11: e2020239, 2021. graf
Article in English | LILACS | ID: biblio-1153181

ABSTRACT

The gluteal region contains important neurovascular and muscular structures with diverse clinical and surgical implications. This paper aims to describe and discuss the clinical importance of a unique variation involving not only the piriformis, gluteus medius, gluteus minimus, obturator internus, and superior gemellus muscles, but also the superior gluteal neurovascular bundle, and sciatic nerve. A routine dissection of a right hemipelvis and its gluteal region of a male cadaver fixed in 10% formalin was performed. During dissection, it was observed a rare presentation of the absence of the piriformis muscle, associated with a tendon fusion between gluteus and obturator internus, and a fusion between gluteus minimus and superior gemellus muscles, along with an unusual topography with the sciatic nerve, which passed through these group of fused muscles. This rare variation stands out with clinical manifestations that are not fully established. Knowing this anatomy is essential to avoid surgical iatrogeny.


Subject(s)
Humans , Male , Adult , Buttocks/pathology , Piriformis Muscle Syndrome/complications , Anatomic Variation , Sciatic Nerve , Tendons , Dissection , Muscles/abnormalities
15.
Rev. bras. ortop ; 55(6): 771-777, Nov.-Dec. 2020. tab, graf
Article in English | LILACS | ID: biblio-1156205

ABSTRACT

Abstract Objective To evaluate different femoral fixation devices for medial patellofemoral ligament reconstruction and compare their effectiveness regarding fixation strength up to failure in porcine knees. Methods Thirty porcine knees were used, divided into three groups of 10 knees. The removed grafts were dissected from the extensor tendons of porcine feet. In each group, the graft was fixed to the femur with an interference screw, an anchor, or adductor tenodesis. The three methods were subjected to biomechanical tests using a universal Tensile testing machine at a speed of 20 mm/minute. Results The highest average linear resistance under lateral traction occurred in group 1, "screw fixation" (185.45 ± 41.22 N), followed by group 2, "anchor fixation" (152.97 ± 49, 43 N); the lower average was observed in group 3, "tenodesis fixation" (76.69 ± 18.90 N). According to the fixed error margin (5%), there was a significant difference between groups (p < 0.001); in addition, multiple comparison tests (between group pairs) also showed significant differences. Variability was small, since the variance coefficient was lower than 33.3%. Conclusion Interference screws in bone tunnels and mountable anchors fixation with high resistance wire are strong enough for femoral fixation in porcine medial patellofemoral ligament reconstruction. Adductor tenodesis, however, was deemed fragile for such purpose.


Resumo Objetivo Avaliar diferentes dispositivos de fixação femoral na reconstrução do ligamento patelofemoral medial para comparar sua eficácia quanto à força de fixação até a falha em joelhos suínos. Métodos Foram ensaiados 30 joelhos de suínos subdivididos em 3 grupos de 10 joelhos. Os enxertos retirados foram dissecados de tendões extensores das patas dos suínos. Cada grupo teve o enxerto fixado ao fêmur com parafuso de interferência, âncora, ou tenodese no tendão adutor. Os 3 métodos foram submetidos à testes biomecânicos utilizando uma máquina universal de ensaio de tração com uma velocidade de 20 mm/min. Resultados Verificamos que a média mais elevada da resistência linear sob tração lateral (185,45 ± 41,22 N) ocorreu no grupo 1: "fixação por parafuso," seguido do grupo 2: "fixação por âncora" (152,97 ± 49,43 N), e a média foi menor no grupo 3: "fixação por tenodese" (76,69 ± 18,90 N). Para a margem de erro fixada (5%), comprovou-se a diferença significativa entre os grupos (p < 0,001) e também através dos testes de comparações múltiplas (entre os pares de grupos) verificou-se a ocorrência de diferenças significativas. A variabilidade expressada por meio do coeficiente de variação mostrou-se reduzida, já que a referida medida foi inferior a 33,3%. Conclusão O uso de parafusos de interferência no túnel ósseo de joelhos porcinos é suficientemente forte para fixação femoral na reconstrução do ligamento patelofemoral medial, assim como a fixação com âncoras montáveis com fio de alta resistência. Entretanto, a tenodese no tendão adutor mostrou-se frágil para essa finalidade.


Subject(s)
Animals , Orthopedic Fixation Devices , Swine , Tendons , Traction , Effectiveness , Biomechanical Phenomena , Bone and Bones , Suture Techniques , Transplants , Models, Animal , Tenodesis , Patellofemoral Joint , Femur , Ligaments , Methods
16.
Rev. bras. ortop ; 55(5): 564-569, Sept.-Oct. 2020. tab, graf
Article in English | LILACS | ID: biblio-1144201

ABSTRACT

Abstract Objective To verify if the subjective elbow value (SEV) scale presents similar results to those of the Patient-rated Tennis Elbow Evaluation (PRTEE) scale in the evaluation of patients with lateral elbow epicondylitis (LEE). Methods Thirty-seven patients were diagnosed with LEE in the outpatient service of our hospital through clinical history, physical examination, X-ray, and ultrasonography. The SEV and PRTEE scales were used and their results were compared using a significance level ≥ 5% (p ≥0.05). Results A statistically significant relationship was found between the values of SEV and PRTEE in the group of patients studied (p= 0.017). Conclusion Subjective elbow value presented similar results to PRTEE in the evaluation of patients with diagnosis of LEE.


Resumo Objetivo Avaliar se a aplicação das escalas subjective elbow value (SEV) e Patient-rated Tennis Elbow Evaluation (PRTEE) apresentam resultados similares na avaliação de pacientes com epicondilite lateral do cotovelo. Métodos Trinta e sete indivíduos com diagnostic de epicondilite lateral do cotovelo foram avaliados no ambulatório de cirurgia do ombro e cotovelo do nosso hospital. O diagnóstico foi realizado com a história clínica da patologia, exame físico, raio-x, e ultrassonográfia. Foram utilizadas as escalas SEV e PRTEE, e os resultados foram comparados estatisticamente, usando-se como nível de significância 5% (p ≥ 0,05). Resultados Encontramos uma relação estatisticamente significante entre os valores obtidos pelas escalas SEV e PRTEE quando aplicadas no grupo de pacientes portadores de epicondilite lateral (p= 0,017). Conclusão Subjective elbow value apresentou resultados similares ao PRTEE na avaliação de pacientes com diagnóstico de epicondilite lateral do cotovelo.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Physical Examination , Shoulder , Tendons , Tennis Elbow , Ultrasonography , Elbow , Ambulatory Care
17.
Int. j. morphol ; 38(5): 1165-1172, oct. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1134419

ABSTRACT

RESUMEN: Las conexiones intertendinosas (CIT) son bandas estrechas de tejido conectivo que unen tendones adyacentes del músculo extensor de los dedos. Dichas bandas se ubican de manera superficial en el dorso del segundo, tercer y cuarto espacios intermetacarpianos (EIMC) presentando funciones importantes como colaborar en la estabilización de la articulación metacarpofalángica y permitir la redistribución de fuerzas extensoras sobre esta articulación. El objetivo del presente estudio fue establecer la biometría de las CIT. Para ello se utilizaron 24 miembros superiores formolizados, pertenecientes al laboratorio de Anatomía, de la Universidad Andrés Bello, sede Viña del Mar, Chile. Se registraron las longitudes de inserción lateral y medial, el ancho y la longitud total de cada CIT. Siguiendo dos criterios, las CIT se clasificaron según morfología y además se localizaron según tercios del dorso de la mano. De las 69 CIT encontradas, el 39 % presentó una disposición transversa y 61 % una oblicua. En relación a la clasificación morfológica de la CIT se identificó un 29 % del tipo 1; 39 % del tipo 2. Para el caso del tipo 3, un 20 % presentó la forma "r" y en un 12 % la forma "y". Respecto a su localización se estableció que en el segundo EIMC el 18 % de las CIT se ubicaron el tercio distal del dorso y el 82 % en el tercio medio. En el tercer EIMC el 96 % de las CIT se localizó en el tercio distal y 4 % en el tercio medio. En el cuarto EIMC el 96 % se ubicó en el tercio distal y el 4 % en el tercio medio. Considerando como referencia la línea biestiloidea, las CIT en el segundo EIMC presentaron un promedio de ancho de 8,16 ± 1,94 mm y una longitud total promedio de 13,71 ± 4,70 mm. En el tercer EIMC, un promedio de 10,94 ± 4,39 mm para el ancho y 6,29 ± 3,26 mm de longitud total promedio. En el cuarto EIMC el promedio de ancho fue de 7,00 ± 3,06 mm y la longitud total promedio 7,08 ± 4,42 mm. Estos hallazgos aportan datos respecto de la biometría y localización de las CIT, lo que resulta de utilidad en procedimientos de reparación quirúrgica del dorso de la mano humana.


SUMMARY: Intertendinous connections (IC) are narrow connective tissue bands extending between the extensor digitorum (ED) tendons. These bands are located superficially on the dorsum of the second, third and fourth intermetacarpal (IMC) space, presenting important functions such as collaborating in the stabilization of the metacarpophalangeal joint (MCP) and allowing the redistribution of extensor forces on this joint. The objective of the present study was to establish the biometric characteristics of IC. To do this, 24 formalized upper limbs are used, belonging to the Anatomy laboratory of the Universidad Andrés Bello, Viña del Mar, Chile. Lateral and medial insertion lengths, width and total length of each IC were recorded. Following two criteria, IC were classified according to morphology and were also located according to thirds of the back of the hand. 69 IC were found, 39% presented a transverse arrangement and 61 % an oblique arrangement. In relation to the morphological classification of IC, 29 % of type 1 were identified, 39 % of type 2. In the case of type 3, 20 % presented the form "r" and 12 % the form "y". Regarding its location, it was established that in the second IMC space, 18 % of the IC were located in the distal third of the back and 82 % in the middle third. In the third IMC space, 96 % of the IC was located in the distal third and 4 % in the middle third. In the fourth IMC space, 96 % were located in the distal third and 4 % in the middle third. Considering the biestiloid line as a reference, the IC in the second IMC space considers an average width of 8.16 + 1.94 mm and an average total length of 13.71 + 4.70 mm. In the third IMC space, an average of 10.94 + 4.39 mm for the width and 6.29 + 3.26 mm of average total length. In the fourth IMC space the average total width of 7.00 + 3.06 mm and the average total length of 7.08 + 4.42 mm. These findings provide data regarding the biometrics and location of IC, which is useful in surgical repair procedures on the back of the human hand.


Subject(s)
Humans , Tendons/anatomy & histology , Muscle, Skeletal/anatomy & histology , Hand/anatomy & histology , Cadaver , Connective Tissue
18.
Int. j. morphol ; 38(5): 1341-1349, oct. 2020. tab, graf
Article in English | LILACS | ID: biblio-1134446

ABSTRACT

SUMMARY: The injury of Biceps Femoris long head (BFlh) and Semitendinosus (ST) is caused by over-stretch of the muscles at the back of the thigh. This condition encompasses almost one third of sports-related injuries and has severe consequences, such as pain and weakness of the muscles. This injury is related namely to quick and demanding activities, such as short distance sprinting in a limited time period. The Common Origin Tendon (COT) for these two muscles is affected in these injuries. This tendon is formed by the BFlh and ST muscles which together have a common origin in the ischial tuberosity. Given the lack of complete knowledge about the detailed structure of the COT, we dissected cadaveric limbs, describing their morphological characteristics, and discussing its functional and clinical implications.: Thirty-five human cadaveric lower limbs were dissected after fixation to analyze the morphology of the COT, focusing on their volume and muscular/tendinous proportion. We identified two subtypes of COT. The most frequent was the musculotendinous type, in which the origin of the BFlh was mainly tendinous, while the ST muscle was mainly muscular (91.4%). In the tendinous type both muscles had a tendinous origin (8.6%). In the musculotendinous type, the ST muscle ends with a microscopic connective tissue that extend into the ischial tuberosity. We conclude that there is a variability in the anatomical presentations of the COT, and we propose that this will correspond with biomechanical differences in the risks and the response to regional injuries. The connective tissue between the COT and the neighbouring structures could be a risk factor for adhesion tearing.


RESUMEN: Los desgarros de los músculos bíceps femoral cabeza larga (BFcl) y semitendinoso (ST) son causados por una tensión excesiva durante actividades que implican amplios rangos de movimiento en velocidad. Alcanzan casi a un tercio de las lesiones deportivas y tienen graves consecuencias competitivas, además generan dolor y debilidad muscular. El tendón de origen común (TOC) de estos dos músculos se ve afectado en estas lesiones. Este tendón se encuentra formado por el BFcl y el ST, originándose juntos en la tuberosidad isquiática. Debido a la falta de conocimiento completo y detallado de este tendón, se realizó un estudio cadavérico, describiendo sus características morfológicas y discutiendo sobre sus implicaciones funcionales y clínicas. Se practicó la disección anatómica de 35 miembros inferiores, lo que permitió describir la morfología del TOC, focalizando en su volumen y proporciones musculo-tendinosas. La conformación morfológica del TOC fue de 2 tipos: la musculotendinosa, donde el BFcl tenía una estructura tendinosa y el ST tenía una estructura muscular (91,4 %). La conformación tendinosa, donde ambos músculos tenían estructuración tendinosa (8,6 %). Cuando la conformación era musculotendinosa, el ST terminaba con un tejido conjuntivo microscópico, que se extendía hasta la tuberosidad isquiática. La conformación morfológica del TOC del BFcl y ST tuvo una presentación variable, lo cual podría tener implicación en su comportamiento biomecánico, y ser un factor de riesgo de lesiones. Además el tejido conjuntivo situado entre este tendón y las estructuras anatómicas vecinas podría ser un factor de riesgo de lesiones por adherencia.


Subject(s)
Humans , Tendons/anatomy & histology , Hamstring Muscles/anatomy & histology
19.
Rev. bras. ortop ; 55(4): 448-454, Jul.-Aug. 2020. tab, graf
Article in English | LILACS | ID: biblio-1138047

ABSTRACT

Abstract Objectives To evaluate the prevalence of absence of flexor digitorum superficialis muscle tendons function of the fourth and fifth fingers of the hand in the Brazilian population Methods Prospective study performed at the orthopedics and traumatology department of a university hospital. The study was conducted from October 2017 to April 2018. The sample consisted of volunteers with no history of upper limb trauma, surgery or any other condition. This study included both male and female individuals over 18 years old. The flexor digitorum superficialis muscle tendons of the fourth and fifth fingers were evaluated through clinical tests by three independent examiners. The data were analyzed using GraphPad Prism 5.0 (GraphPad Software, San Diego, CA, USA). Results A total of 2,016 hands from 1,008 volunteers were analyzed. The prevalence of absence of flexor digitorum superficialis muscle tendon function of the fourth finger was 0.56% at the right hand and 0.99% at the left hand. At the right hand, this prevalence was higher in females compared to males (p= 0.0328). No difference between genders was noted in the left hand (p= 0.7562). The prevalence of absence of flexor digitorum superficialis muscle tendon function of the fifth finger was 34.53% in the right hand and 30.06% in the left hand. This prevalence was higher in females compared to males, both at the right hand (p= 0.0001) and the left hand (p= 0.0003). Conclusion Even though there are studies performed separately in different ethnic groups, there were no data in the literature regarding the prevalence of absence of flexor digitorum superficialis muscle tendons function of the fourth and fifth fingers of the hand in a multiethnic population such as the Brazilian one.


Resumo Objetivos Avaliar a prevalência da ausência de função dos tendões do músculo flexor superficial do quarto e quinto dedos em uma população brasileira. Métodos Estudo prospectivo foi realizado no departamento de ortopedia e traumatologia de um hospital universitário. O estudo foi desenvolvido no período de outubro de 2017 a abril 2018. A amostra foi formada por voluntários sem histórico de trauma, cirurgia ou qualquer afecção dos membros superiores. Foram incluídos neste estudo indivíduos de ambos os gêneros com idade igual ou superior a 18 anos. A avaliação da função do tendão do múculo flexor superficial do quarto e quinto dedos foi realizada por meio de testes clínicos por três examinadores independentes. Para análise dos dados foi utilizado o programa GraphPad Prism 5.0 (GraphPad Software, San Diego, CA, EUA). Resultados Foram analisados 1.008 voluntários totalizando 2.016 mãos. A prevalência da ausência de função do tendão do músculo flexor superficial do quarto dedo foi de 0,56% na mão direita e 0,99% na mão esquerda. Em relação ao gênero, foi verificado na mão direita uma maior prevalência da ausência de função do flexor superficial do quarto dedo no gênero feminino quando comparado ao masculino (p= 0,0328). Na mão esquerda não foi observada diferença entre os gêneros (p= 0,7562). A ausência de função do músculo flexor superficial no quinto dedo foi de 34,53% na mão direita e de 30,06% na mão esquerda. Quando analisamos o quinto dedo em relação aos gêneros, foi verificado que a prevalência da ausência de função do músculo flexor superficial foi mais frequente no gênero feminino que no masculino, tanto na mão direita (p= 0.0001) como na mão esquerda (p= 0.0003). Conclusão Apesar de haver estudos realizados separadamente em diversas etnias, não havia na literatura dados referentes à prevalência da ausência de função do músculo flexor superficial do quarto e quinto dedos da mão em uma população miscigenada como a brasileira.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Tendons , Wounds and Injuries , Hand Deformities, Congenital , Prospective Studies , Fingers
20.
Rev. bras. ortop ; 55(4): 410-414, Jul.-Aug. 2020. tab, graf
Article in English | LILACS | ID: biblio-1138056

ABSTRACT

Abstract Objective To evaluate different decontaminants for tendon grafts, proposing an antiseptic protocol for contaminated grafts. Methods A total of 25 patients were tissue donors for the study. Each participant donated a 2.5-cm tendon sample, which was divided into 5 fragments with 5 mm each during anterior cruciate ligament (ACL) reconstruction surgery. The collected material was divided into 5 groups, totaling 125 samples. In total, four fragments of each patient were placed on the operating room floor for one minute for contamination, simulating the fall of the graft on the floor during surgery. The other fragment was immediately placed in a sterile container (group 1). One of the contaminated fragments was placed in the sterile container without being previously immersed in decontaminating solution (group 2). The remaining fragments were immersed for ten minutes in decontaminating solution: 0.5% chlorhexidine (group 3), 0.9% saline (group 4) and 0.55% ortho-phthalaldehyde (group 5), and, after this time, they were individually placed in a sterile container. The samples from the 5 groups were submitted to microbiological examination. Results Bacteria were detected in 26% of the total samples in the microbiological tests, and in group 1 there was no growth of microorganisms. In group 2, bacterial growth was observed in 16 samples. Considering the evaluation of test groups 3, 4 and 5, the percentage of decontamination was higher than the growth of microorganisms in the respective cultures. Conclusion The protocol suggested by the study showed that intraoperative graft decontamination is possible.


Resumo Objetivo Avaliar diferentes descontaminantes para enxertos de tendões, propondo um protocolo de antissepsia para o enxerto contaminado. Métodos Um total de 25 pacientes foram doadores de tecido para o estudo. Cada participante doou uma amostra de 2,5 cm de tendão, a qual foi dividida em 5 fragmentos de 5 mm durante cirurgia de reconstrução do ligamento cruzado anterior (LCA). O material coletado foi dividido em 5 grupos, totalizando 125 amostras. Ao todo, quatro fragmentos de cada paciente foram colocados sobre o piso da sala cirúrgica, durante um minuto, para contaminação, simulando a queda do enxerto no chão durante o ato operatório. O outro fragmento foi, imediatamente, colocado em um recipiente esterilizado (grupo 1). Um dos fragmentos contaminados foi colocado no recipiente esterilizado sem ser previamente imerso em solução descontaminante (grupo 2). Os demais fragmentos foram imersos, por dez minutos, em solução descontaminante: clorexidina 0,5% (grupo 3), soro fisiológico 0,9% (grupo 4) e ortoftaldeído 0,55% (grupo 5), e, após esse tempo, foram colocados individualmente em um recipiente esterilizado. As amostras dos 5 grupos foram submetidas a exame microbiológico. Resultados Houve detecção de bactérias em 26% do total de amostras nos testes microbiológicos, sendo que no grupo 1 não houve crescimento de micro-organismos. No grupo 2, observou-se crescimento bacteriano em 16 amostras. Avaliando-se os grupos de teste 3, 4 e 5, o percentual de descontaminação foi superior ao crescimento de micro-organismos nas respectivas culturas. Conclusão O protocolo sugerido pelo estudo mostrou que é possível a descontaminação transoperatória do enxerto.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Operating Rooms , Tendons , Tissue Donors , Chlorhexidine , Antisepsis , Decontamination , Anterior Cruciate Ligament , Determination , Transplants , Autografts
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