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[PMID]: 28454185 [Au] Autor: Höhne S; Gerlach K; Irlenbusch L; Schulz M; Kunze C; Finke R [Ad] Endereço: Department of Surgical and Conservative Pediatrics and Adolescent Medicine/Pediatric Surgery, Martin-Luther-University Halle-Wittenberg, Halle. [Ti] Título: Patella Dislocation in Children and Adolescents. [Ti] Título: Patellaluxation bei Kindern und Jugendlichen ­ 136 Ereignisse bei 88 Patienten und Literaturübersicht.. [So] Source: Z Orthop Unfall;155(2):169-176, 2017 Apr. [Is] ISSN: 1864-6743 [Cp] País de publicação: Germany [La] Idioma: eng [Ab] Resumo: Patellar dislocation is one of the commonest knee injuries in adolescents. Although treatment usually leads to good results, the influence of anatomical and functional factors on therapeutic strategy has been underestimated, especially in cases of recurrence. The course of treatment has been analysed in 88 patients with 136 patellar dislocations. The importance of anatomical conditions was studied using X-ray and MRI findings. The treatment results were critically evaluated in comparison with current recommendations. From 2000 to 2015, 109 patellar dislocations occurred in 88 patients; a further 27 previous dislocations were reported by the patients (mean age 14 years, 47 boys and 41 girls). About one-third of patients (35.2 %) suffered one or more recurrences. Almost half (48.6 %) of the dislocations occurred during physical exercise, particularly ball sports. Osteochondral flake fracture was found in 9 % of the patients, and a lesion of the medial patellofemoral ligament in 96 %. There was an anatomical predisposition to patellar dislocation in almost all cases. The sulcus angle, patellar and trochlear dysplasia, and patellar height were highly significantly different between the patient group and controls. The TT-TG distance was subsequently calculated, but had no impact on therapy. Seventy-seven patients were treated conservatively and 32 patients surgically. The conservative procedure included partial immobilisation for six weeks. Surgical reconstruction or tightening was performed in 27 cases; in five, in combination with other surgical procedures. Plasty of the medial patellofemoral ligament with a tendon graft was performed in five patients, and osteochondral or meniscal lesions were repaired in 10 patients. Recurrences occurred in 41.7 % of conservatively treated knees and in 29.6 % of surgically treated knees (without reconstruction with a tendon graft). No recurrence was seen after reconstruction of the medial patellofemoral ligament with a tendon graft. Fifty-four patients underwent a follow-up examination. Fourteen of these (25.9 %) had suffered a recurrence. The outcome 16 months after the end of treatment was mostly good, as were the results of self-assessment (Larson-Lauridsen Score). An anatomical predisposition is detectable in almost all cases of patellar dislocation, but frequently occurs with an accident event, e.g. in ball sports. Primary patellar dislocations without serious concomitant injuries may be treated conservatively. In the event of recurrence, the indication for surgery is given, even in young patients and in any patient with an osteochondral flake fracture. Tightening reconstruction of the MPFL used to be frequently performed, but is associated with a high rate of recurrence. [Mh] Termos MeSH primário: Artroplastia/utilização Traumatismos em Atletas/diagnóstico Traumatismos em Atletas/terapia Luxação Patelar/diagnóstico Luxação Patelar/terapia Modalidades de Fisioterapia/utilização [Mh] Termos MeSH secundário: Adolescente Traumatismos em Atletas/epidemiologia Terapia Combinada/utilização Feminino Alemanha/epidemiologia Seres Humanos Imobilização/utilização Masculino Luxação Patelar/epidemiologia Complicações Pós-Operatórias/epidemiologia Complicações Pós-Operatórias/prevenção & controle Prevalência Recuperação de Função Fisiológica Recidiva Fatores de Risco Resultado do Tratamento [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180228 [Lr] Data última revisão: 180228 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170429 [St] Status: MEDLINE [do] DOI: 10.1055/s-0042-122855

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[PMID]: 28456358 [Au] Autor: Weinheimer KT; Smuin DM; Dhawan A [Ad] Endereço: Department of Orthopaedic Surgery, Penn State Hershey Medical Center, Hershey, Pennsylvania, U.S.A.. Electronic address: kentwein2007@gmail.com. [Ti] Título: Patient Outcomes as a Function of Shoulder Surgeon Volume: A Systematic Review. [So] Source: Arthroscopy;33(7):1273-1281, 2017 Jul. [Is] ISSN: 1526-3231 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: PURPOSE: To examine surgical complications, length of stay, surgical time, cost, revision rates, clinical outcomes, current surgical trends. and minimum number of cases in relationship to surgeon volume for shoulder arthroplasty and rotator cuff repair. METHODS: We performed a systematic review of studies using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. All studies that met inclusion criteria from January 1990 to January 2016 were included. Inclusion criteria included Level IV evidence or greater, contained specific surgeon volume, and were written in or translated into English. Exclusion criteria included non-English manuscripts, abstracts, and review papers. A written protocol was used to extract relevant data and evaluate study results. Data extracted included volume-specific data pertaining to length of stay, operating time, complications, and cost. RESULTS: A total of 10 studies were included. Seven studies evaluated arthroplasty with 88,740 shoulders, and 3 studies evaluated rotator cuff repair with 63,535 shoulders. Variation was seen in how studies defined low- versus high-volume surgeon. For arthroplasty, <5 cases per year met the criteria for a low-volume surgeon and were associated with increased length of stay, longer operating room time, increased in-hospital complications, and increased cost. Mortality was not significantly increased. In rotator cuff surgery, <12 surgeries per year met the criteria for low volume and were associated with increased length of stay, increased operating room time, and increase in reoperation rate. CONCLUSIONS: Our systematic review demonstrates increased surgical complications, length of stay, surgical time, and surgical cost in shoulder arthroplasty and rotator cuff repair when performed by a low-volume shoulder surgeon, which is defined by those performing <5 arthroplasties and/or <12 rotator cuff repairs per year. LEVEL OF EVIDENCE: Level III, systematic review of Level II and III studies. [Mh] Termos MeSH primário: Artroplastia/normas Artroscopia/normas Padrões de Prática Médica/estatística & dados numéricos Lesões do Manguito Rotador/cirurgia [Mh] Termos MeSH secundário: Artroplastia/estatística & dados numéricos Artroscopia/estatística & dados numéricos Seres Humanos Cirurgiões Resultado do Tratamento [Pt] Tipo de publicação: JOURNAL ARTICLE; REVIEW [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180226 [Lr] Data última revisão: 180226 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170501 [St] Status: MEDLINE

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[PMID]: 29443741 [Au] Autor: Zhang Q; Liu L; Sun W; Gao F; Cheng L; Li Z [Ad] Endereço: Graduate School of Peking Union Medical College, China-Japan Friendship Institute of Clinical Medicine. [Ti] Título: Research progress of asymptomatic bacteriuria before arthroplasty: A systematic review. [So] Source: Medicine (Baltimore);97(7):e9810, 2018 Feb. [Is] ISSN: 1536-5964 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: A high prevalence of asymptomatic bacteriuria exists in patients prior to arthroplasty, and urinary tract infection is considered to be a source of postoperative superficial wound and prosthetic joint infections. There is no consensus whether to screen for and treat asymptomatic bacteriuria before arthroplasty. OBJECTIVE: To summarize the association between asymptomatic bacteriuria and complications after arthroplasty and to evaluate the clinical benefits of treating asymptomatic bacteriuria prior to arthroplasty. METHOD: We systematically searched PubMed, Embase, and the Cochrane Library to retrieve potentially eligible articles. By screening the titles and abstracts of retrieved records and then reading the full texts of the remaining papers, we finally included 8 English-language articles in this systematic review. RESULTS: Asymptomatic bacteriuria prior to arthroplasty is significantly associated with an increased occurrence of postoperative prosthetic joint and superficial wound infections. However, there is little evidence for direct or hematogenous seeding of urinary infections, and treating asymptomatic bacteriuria before arthroplasty did not decrease the incidence of postoperative infectious complications. CONCLUSION: Asymptomatic bacteriuria is not a contraindication for arthroplasty, and the practice of routine preoperative screening for and treatment of asymptomatic bacteriuria should not be continued. [Mh] Termos MeSH primário: Artroplastia/efeitos adversos Infecções Assintomáticas Bacteriúria/complicações Complicações Pós-Operatórias/microbiologia [Mh] Termos MeSH secundário: Idoso Bacteriúria/tratamento farmacológico Feminino Seres Humanos Masculino Meia-Idade Período Pré-Operatório [Pt] Tipo de publicação: JOURNAL ARTICLE; META-ANALYSIS; REVIEW [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180222 [Lr] Data última revisão: 180222 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 180215 [St] Status: MEDLINE [do] DOI: 10.1097/MD.0000000000009810

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[PMID]: 29437062 [Au] Autor: Gaspar MP; Pham PP; Pankiw CD; Jacoby SM; Shin EK; Osterman AL; Kane PM [Ad] Endereço: Philadelphia Hand to Shoulder Center, Thomas Jefferson University, 834 Chestnut Street, The Franklin Building, Suite G114, Philadelphia, PA 19107, USA and Darden School of Business, University of Virginia, 100 Darden Boulevard, Charlottesville, Virginia 22903, USA. [Ti] Título: Mid-term outcomes of routine proximal row carpectomy compared with proximal row carpectomy with dorsal capsular interposition arthroplasty for the treatment of late-stage arthropathy of the wrist. [So] Source: Bone Joint J;100-B(2):197-204, 2018 Feb. [Is] ISSN: 2049-4408 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: AIMS: The aims of this study were to compare the mid-term outcomes of patients with late-stage arthritis of the wrist treated with proximal row carpectomy (PRC) and dorsal capsular interposition (DCI) arthroplasty with a matched cohort treated with routine PRC alone. PATIENTS AND METHODS: A total of 25 arthritic wrists (24 patients) with pre-existing degenerative changes of the proximal capitate and/or the lunate fossa of the radius were treated with PRC + DCI over a ten-year period. This group of patients were matched 1:2 with a group of 50 wrists (48 patients) without degenerative changes in the capitate or lunate fossa that were treated with a routine PRC alone during the same period. The mean age of the patients at the time of surgery was 56.8 years (25 to 81), and the demographics and baseline range of movement of the wrist, grip strength, Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score, and Patient-Rated Wrist Evaluation (PRWE) score were similar in both groups. RESULTS: At a mean follow-up of 5.9 years (1.8 to 11.8), significant improvements in mean grip strength, the flexion-extension arc of movement of the wrist, QuickDASH, and PRWE scores were seen in both groups. There was no diifference between the groups for any of the outcomes. One patient in the PRC + DCI group required additional surgery for a deep infection, while two in the PRC group had complications (one wound dehiscence requiring revision closure, one transient radial sensory neuritis). One patient in each group required total arthrodesis of the wrist for progressive degenerative radiocarpal changes. A total of 70 patients (93%) were satisfied with the outcomes. CONCLUSION: PRC with DCI is an effective form of treatment for late-stage arthritis of the wrist involving the capitolunate joint, with mid-term outcomes that are similar to those in patients without degenerative changes affecting the capitate or lunate fossa who are treated with a routine PRC alone. Cite this article: 2018;100-B:197-204. [Mh] Termos MeSH primário: Artroplastia/métodos Ossos do Carpo/cirurgia Osteoartrite/cirurgia Articulação do Punho/cirurgia [Mh] Termos MeSH secundário: Adulto Idoso Idoso de 80 Anos ou mais Avaliação da Deficiência Feminino Seguimentos Força da Mão Seres Humanos Masculino Meia-Idade Satisfação do Paciente Amplitude de Movimento Articular Retalhos Cirúrgicos Resultado do Tratamento [Pt] Tipo de publicação: COMPARATIVE STUDY; JOURNAL ARTICLE [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180216 [Lr] Data última revisão: 180216 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 180214 [St] Status: MEDLINE [do] DOI: 10.1302/0301-620X.100B2.BJJ-2017-0816.R2

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[PMID]: 29252738 [Au] Autor: Lee DH [Ad] Endereço: Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee. [Ti] Título: Radialization of the Ulnar Component During Revision Total Elbow Arthroplasty: A Case Report. [So] Source: JBJS Case Connect;6(4):e83, 2016 Oct-Dec. [Is] ISSN: 2160-3251 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: CASE: Revision total elbow arthroplasty (TEA) is becoming more common. Revision of a failed total elbow prosthesis requires implant removal and replacement. With implant removal, substantial damage to the distal part of the humerus or the proximal part of the ulna can occur. Therefore, reconstruction may require special or custom implants with bone augmentation (e.g., allograft bone graft). This report describes the 9-year follow-up of a man who underwent revision TEA with placement of the ulnar component into the proximal part of the radial shaft (radialization) instead of into the proximal part of the ulnar shaft. CONCLUSION: Radialization of the ulnar component is a viable reconstruction option for the ulnar component during revision TEA. [Mh] Termos MeSH primário: Artroplastia/métodos Articulação do Cotovelo/cirurgia Reoperação/métodos [Mh] Termos MeSH secundário: Adulto Seres Humanos Masculino Meia-Idade [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180216 [Lr] Data última revisão: 180216 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171219 [St] Status: MEDLINE [do] DOI: 10.2106/JBJS.CC.16.00016

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[PMID]: 29252736 [Au] Autor: Jones CM; Beredjiklian PK [Ad] Endereço: Department of Hand & Upper Extremity Surgery, Rothman Institute, Philadelphia, Pennsylvania. [Ti] Título: Radial Head Arthroplasty Understuffing in the Setting of Longitudinal Radioulnar Dissociation: A Case Report. [So] Source: JBJS Case Connect;6(4):e81, 2016 Oct-Dec. [Is] ISSN: 2160-3251 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: CASE: We present a case in which underlengthening of the radius allowed proximal migration of the radius and ulnocarpal abutment in a patient with a comminuted radial head fracture and concomitant longitudinal forearm instability. CONCLUSION: Radial head arthroplasty is a common treatment for comminuted, displaced radial head fractures. Ideally, the dimensions of the radial head implant should match the native anatomy to restore elbow stability and kinematics. Underlengthening the radius by placing a small radial head implant can lead to carpal abutment at the wrist level. [Mh] Termos MeSH primário: Artroplastia/efeitos adversos Articulação do Cotovelo/cirurgia Fraturas Cominutivas/cirurgia Prótese Articular/efeitos adversos Fraturas do Rádio/cirurgia [Mh] Termos MeSH secundário: Artroplastia/instrumentação Seres Humanos Masculino Meia-Idade [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180216 [Lr] Data última revisão: 180216 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171219 [St] Status: MEDLINE [do] DOI: 10.2106/JBJS.CC.15.00258

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[PMID]: 28460192 [Au] Autor: Karampinos DC; Holwein C; Buchmann S; Baum T; Ruschke S; Gersing AS; Sutter R; Imhoff AB; Rummeny EJ; Jungmann PM [Ad] Endereço: Department of Radiology, Klinikum rechts der Isar, Technische Universitaet Muenchen, Munich, Germany. [Ti] Título: Proton Density Fat-Fraction of Rotator Cuff Muscles Is Associated With Isometric Strength 10 Years After Rotator Cuff Repair: A Quantitative Magnetic Resonance Imaging Study of the Shoulder. [So] Source: Am J Sports Med;45(9):1990-1999, 2017 Jul. [Is] ISSN: 1552-3365 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: Quantitative muscle fat-fraction magnetic resonance (MR) imaging techniques correlate with semiquantitative Goutallier scores with failure after rotator cuff (RC) repair. PURPOSE: To investigate the relationship of proton density fat fraction (PDFF) of the RC muscles with semiquantitative MR scores, cartilage T2 relaxation times, and clinical isometric strength measurements in patients 10 years after unilateral RC repair. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: Bilateral shoulder MR imaging was performed in 13 patients (11 male, 2 female; age, 72 ± 8 years) 10.9 ± 0.4 years after unilateral autologous periosteal flap augmented RC repair (total shoulders assessed, N = 26). Goutallier classification, muscle atrophy, RC tendon integrity, and cartilage defects were determined based on morphological MR sequences. A paracoronal 2D multi-slice multi-echo sequence was used for quantitative cartilage T2 mapping. A chemical shift-encoding-based water-fat separation technique (based on a 6-echo 3D spoiled gradient echo sequence) was used for quantification of the PDFF of RC muscles. Isometric shoulder abduction strength was measured clinically. Mean and SD, Pearson correlation, and partial Spearman correlation were calculated. RESULTS: There were 6 RC full-thickness retears in ipsilateral shoulders and 6 RC full-thickness tears in contralateral shoulders. Isometric shoulder abduction strength was not significantly different between ipsilateral and contralateral shoulders (50 ± 24 N vs 54 ± 24 N; P = .159). The mean PDFF of RC muscles was 11.7% ± 10.4% (ipsilateral, 14.2% ± 8.5%; contralateral, 9.2% ± 7.8%; P = .002). High supraspinatus PDFF correlated significantly with higher Goutallier scores ( R = 0.75, P < .001) and with lower isometric muscle strength ( R = -0.49, P = .011). This correlation remained significant after adjustment for muscle area measurements and tendon rupture ( R = -0.41, P = .048). More severe cartilage defects at the humerus were significantly associated with higher supraspinatus PDFF ( R = 0.44; P = .023). Cartilage T2 values did not correlate with muscle PDFF ( P > .05). CONCLUSION: MR imaging-derived RC muscle PDFF is associated with isometric strength independent of muscle atrophy and tendon rupture in shoulders with early and advanced degenerative changes. It therefore provides complementary, clinically relevant information in tracking RC muscle composition on a quantitative level. [Mh] Termos MeSH primário: Cartilagem Articular/diagnóstico por imagem Imagem por Ressonância Magnética/métodos Manguito Rotador/diagnóstico por imagem Articulação do Ombro/diagnóstico por imagem [Mh] Termos MeSH secundário: Adulto Artroplastia Estudos Transversais Feminino Seres Humanos Masculino Meia-Idade Força Muscular Atrofia Muscular/diagnóstico por imagem Prótons Manguito Rotador/cirurgia Lesões do Manguito Rotador/cirurgia Artropatia de Ruptura do Manguito Rotador/diagnóstico por imagem Ombro/cirurgia Articulação do Ombro/cirurgia Traumatismos dos Tendões/cirurgia Tendões/cirurgia [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Protons) [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180205 [Lr] Data última revisão: 180205 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170502 [St] Status: MEDLINE [do] DOI: 10.1177/0363546517703086

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[PMID]: 28448728 [Au] Autor: Kim YS; Sung CH; Chung SH; Kwak SJ; Koh YG [Ad] Endereço: Department of Orthopaedic Surgery, Center for Stem Cell & Arthritis Research, Yonsei Sarang Hospital, Seoul, Republic of Korea. [Ti] Título: Does an Injection of Adipose-Derived Mesenchymal Stem Cells Loaded in Fibrin Glue Influence Rotator Cuff Repair Outcomes? A Clinical and Magnetic Resonance Imaging Study. [So] Source: Am J Sports Med;45(9):2010-2018, 2017 Jul. [Is] ISSN: 1552-3365 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: The mesenchymal stem cell (MSC)-based tissue engineering approach has been developed to improve the treatment of rotator cuff tears. Hypothesis/Purpose: The purpose was to determine the effect of an injection of adipose-derived MSCs loaded in fibrin glue during arthroscopic rotator cuff repair on clinical outcomes and to evaluate its effect on structural integrity using magnetic resonance imaging (MRI). The hypothesis was that the application of adipose-derived MSCs would improve outcomes after the surgical repair of a rotator cuff tear. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Among 182 patients treated with arthroscopic surgery for a rotator cuff tear, 35 patients treated with arthroscopic rotator cuff repair alone (conventional group) were matched with 35 patients who underwent arthroscopic rotator cuff repair with an injection of adipose-derived MSCs loaded in fibrin glue (injection group) based on sex, age, and lesion size. Outcomes were assessed with respect to the visual analog scale (VAS) for pain, range of motion (ROM) (including forward flexion, external rotation at the side, and internal rotation at the back), and functional measures of the Constant score and University of California, Los Angeles (UCLA) shoulder rating scale. Repaired tendon structural integrity was assessed by using MRI at a minimum of 12 months after surgery, and the mean clinical follow-up was 28.8 ± 4.2 months in the conventional group and 28.3 ± 3.8 months in the injection group. RESULTS: The mean VAS score at rest and during motion improved significantly in both groups after surgery. However, there were no significant differences between the groups at the final follow-up ( P = .256 and .776, respectively). Compared with preoperative measurements, forward flexion and external rotation at the side significantly improved at the final follow-up in both groups (all P < .05). However, no significant improvements in internal rotation at the back were observed in either group ( P = .625 and .834 for the conventional and injection groups, respectively). There were also no significant differences between the groups at the final follow-up for any of the 3 ROM positions (all P > .05). The mean Constant score and UCLA score improved significantly in both groups after surgery, but there were no significant differences between the groups at the final follow-up ( P = .634 and .302, respectively). MRI indicated a retear rate of 28.5% in the conventional group and 14.3% in the injection group ( P < .001). CONCLUSION: This study revealed that an injection of adipose-derived MSCs loaded in fibrin glue during rotator cuff repair could significantly improve structural outcomes in terms of the retear rate. There were, however, no clinical differences in the 28-month period of follow-up. Although still in the early stages of application, MSC augmentation of surgical rotator cuff repair appears useful for providing an adequate biological environment around the repair site. [Mh] Termos MeSH primário: Artroscopia/métodos Adesivo Tecidual de Fibrina/administração & dosagem Transplante de Células-Tronco Mesenquimais Lesões do Manguito Rotador/cirurgia Adesivos Teciduais/administração & dosagem [Mh] Termos MeSH secundário: Tecido Adiposo/citologia Adulto Idoso Artroplastia Estudos de Coortes Feminino Seres Humanos Injeções Imagem por Ressonância Magnética Masculino Meia-Idade Medição da Dor Amplitude de Movimento Articular Manguito Rotador/diagnóstico por imagem Manguito Rotador/cirurgia Ombro/cirurgia Articulação do Ombro/diagnóstico por imagem Articulação do Ombro/cirurgia Engenharia Tecidual Resultado do Tratamento [Pt] Tipo de publicação: CLINICAL TRIAL; JOURNAL ARTICLE [Nm] Nome de substância: 0 (Fibrin Tissue Adhesive); 0 (Tissue Adhesives) [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180205 [Lr] Data última revisão: 180205 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170428 [St] Status: MEDLINE [do] DOI: 10.1177/0363546517702863

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[PMID]: 27771787 [Au] Autor: Ma Z; Ma X; Yang H; Guan X; Li X [Ad] Endereço: Department of Orthopaedics, Shanxi Academy of Medical Sciences & Shanxi DaYi Hospital, No. 99 Long Cheng Street, Taiyuan, 030032, Shanxi Province, China. [Ti] Título: Anterior cervical discectomy and fusion versus cervical arthroplasty for the management of cervical spondylosis: a meta-analysis. [So] Source: Eur Spine J;26(4):998-1008, 2017 Apr. [Is] ISSN: 1432-0932 [Cp] País de publicação: Germany [La] Idioma: eng [Ab] Resumo: PURPOSE: The aim of this study was to compare the efficacy and safety of anterior cervical discectomy and fusion (ACDF) and cervical arthroplasty for patients with cervical spondylosis. METHODS: PubMed, Embase, and Cochrane Library were used to search for relevant articles published prior to April 2016 to identify studies comparing ACDF and cervical arthroplasty involving patients with cervical spondylosis. Relative risks (RR) and mean differences (MD) were used to measure the efficacy and safety of ACDF and cervical arthroplasty using the random effects model. RESULTS: The meta-analysis of 17 studies involved 3122 patients diagnosed with cervical spondylosis. Patients undergoing ACDF showed lower overall success rate (RR 0.84; 95 % CI 0.77-0.92; P < 0.001), higher VAS score (MD 0.36; 95 % CI 0.08-0.64; P = 0.011), and shorter mean surgical duration (MD -1.62; 95 % CI -2.80 to -0.44; P = 0.007) when compared with cervical arthroplasty. However, the association between ACDF therapy and the risk of mean blood loss (MD -0.16; 95 % CI -0.34 to 0.02; P = 0.082), mean hospitalization (MD 0.02; 95 % CI -0.31 to 0.36; P = 0.901), patient satisfaction (RR 0.96; 95 % CI 0.92-1.00; P = 0.066), neck disability index (MD 0.20; 95 % CI -0.05 to 0.44; P = 0.113), reoperation (RR 1.25; 95 % CI 0.64-2.41; P = 0.514), or complication (RR 1.17; 95 % CI 0.90-1.52; P = 0.242) was not statistically significant. CONCLUSIONS: Patients undergoing ACDF therapy tended to exhibit lower overall success rate, higher VAS score, and decreased mean surgical duration when compared with patients treated with cervical arthroplasty. [Mh] Termos MeSH primário: Artroplastia/métodos Vértebras Cervicais/cirurgia Discotomia/métodos Fusão Vertebral/métodos Espondilose/cirurgia [Mh] Termos MeSH secundário: Feminino Seres Humanos Cervicalgia/etiologia Satisfação do Paciente Reoperação Espondilose/complicações Fatores de Tempo Resultado do Tratamento [Pt] Tipo de publicação: COMPARATIVE STUDY; JOURNAL ARTICLE; META-ANALYSIS; REVIEW [Em] Mês de entrada: 1801 [Cu] Atualização por classe: 180112 [Lr] Data última revisão: 180112 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161025 [St] Status: MEDLINE [do] DOI: 10.1007/s00586-016-4779-7

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[PMID]: 27776902 [Au] Autor: Chimento GF [Ad] Endereço: Department of Orthopaedic Surgery, Ochsner Clinic Foundation, New Orleans, Louisiana; Ochsner Clinical School, School of Medicine, The University of Queensland, New Orleans, Louisiana. Electronic address: gchimento@ochsner.org. [Ti] Título: Reply to Letter to the Editor on 'The Effects of a Hospitalist Comanagement Model for Joint Arthroplasty Patients in a Teaching Facility'. [So] Source: J Arthroplasty;32(2):698-699, 2017 02. [Is] ISSN: 1532-8406 [Cp] País de publicação: United States [La] Idioma: eng [Mh] Termos MeSH primário: Artroplastia Médicos Hospitalares [Mh] Termos MeSH secundário: Seres Humanos Tempo de Internação [Pt] Tipo de publicação: LETTER; COMMENT [Em] Mês de entrada: 1712 [Cu] Atualização por classe: 171225 [Lr] Data última revisão: 171225 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161026 [St] Status: MEDLINE

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1			PalavrasDescritor de assuntoDescritor de assunto primárioLimitesAutorPalavras do títuloPalavras do resumoIdiomaPaís de publicaçãoNome de substânciaNome de pessoa como assuntoRevistaAssunto de RevistaISSNTipo de publicaçãoIdentificador únicoMês de entradaAno de publicaçãoTexto completoAtualização por classeCategoria DeCSCategoria DeCS explodidaCategoria CID-10SubSetsPais de AfiliaçãoAfiliaçãoAfiliação 2
2	and or and not		PalavrasDescritor de assuntoDescritor de assunto primárioLimitesAutorPalavras do títuloPalavras do resumoIdiomaPaís de publicaçãoNome de substânciaNome de pessoa como assuntoRevistaAssunto de RevistaISSNTipo de publicaçãoIdentificador únicoMês de entradaAno de publicaçãoTexto completoAtualização por classeCategoria DeCSCategoria DeCS explodidaCategoria CID-10SubSetsPais de AfiliaçãoAfiliaçãoAfiliação 2
3	and or and not		PalavrasDescritor de assuntoDescritor de assunto primárioLimitesAutorPalavras do títuloPalavras do resumoIdiomaPaís de publicaçãoNome de substânciaNome de pessoa como assuntoRevistaAssunto de RevistaISSNTipo de publicaçãoIdentificador únicoMês de entradaAno de publicaçãoTexto completoAtualização por classeCategoria DeCSCategoria DeCS explodidaCategoria CID-10SubSetsPais de AfiliaçãoAfiliaçãoAfiliação 2

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