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Ferreira GF, Nunes GA, Pugliese GM, Dinato MCME, Lewis TL, Sato G, Pedroso JP, Filho MVP. Minimally invasive Chevron-Akin (MICA) osteotomies without Akin fixation in hallux valgus correction: a case series with 2-year follow-up. Eur J Orthop Surg Traumatol 2024:10.1007/s00590-024-03924-8. [PMID: 38583122 DOI: 10.1007/s00590-024-03924-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 03/17/2024] [Indexed: 04/08/2024]
Abstract
PURPOSE The minimally invasive Chevron-Akin (MICA) is considered the third generation of minimally invasive hallux valgus (HV) surgery, and its original description included fixation of the Akin osteotomy with a screw. The aim of this study is to evaluate a series of patients undergoing HV correction using the MICA technique without screw fixation of the Akin osteotomy. METHODS We retrospectively evaluated 58 consecutive patients who underwent surgical correction for HV between August 2018 and March 2020. A total of 69 feet were evaluated with a minimum follow-up of 2 years. Clinical outcomes such as pain (VAS), function (AOFAS), range of movement, criteria personal satisfaction and complications were evaluated. RESULTS The AOFAS score (mean ± standard deviation) significantly improved from 57.0 ± 8.6 preoperatively to 93.9 ± 8.7 postoperatively (p < .001) with a minimum follow-up of 2 years. The VAS score improved from 6.0 ± 1.8 preoperatively to 0.6 ± 1.4 at 2-year follow-up (p < .001), and the hallux valgus angle reduced from 39.7 ± 6.9 to 8.9 ± 9.0 (p < .001). The majority of patients (95.6%) reported the result as excellent or good, and the most common complication was the need to remove the screw (7.2%). CONCLUSIONS The use of MICA without Akin osteotomy fixation resulted in successful correction of hallux valgus with improvements in clinical and radiographic parameters. LEVEL OF EVIDENCE IV, case series.
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Affiliation(s)
- Gabriel Ferraz Ferreira
- Orthopaedics and Traumatology Unit, Foot and Ankle Surgery Group, Prevent Senior, São Paulo, Brazil
- Instituto Vita, São Paulo, Brazil
- Member of Minimally Invasive Foot Ankle Society (MIFAS By GRECMIP), Merignac, France
| | - Gustavo Araujo Nunes
- Member of Minimally Invasive Foot Ankle Society (MIFAS By GRECMIP), Merignac, France
- Foot and Ankle Unit, COTE Brasília Clinic, Brasília, DF, Brazil
| | | | | | | | | | - João Paulo Pedroso
- Orthopaedics and Traumatology Unit, Foot and Ankle Surgery Group, Prevent Senior, São Paulo, Brazil
| | - Miguel Viana Pereira Filho
- Instituto Vita, São Paulo, Brazil.
- Orthopaedics and Traumatology Unit, Head of Foot and Ankle Surgery Group, Prevent Senior, São Paulo, Brazil.
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Mansur H, Ferreira GF, Ferreira-Junior JB, de Araújo BAS, Maranho DA. Leg length discrepancy is not a risk factor for plantar fasciitis. Arch Orthop Trauma Surg 2024; 144:1485-1490. [PMID: 38285221 DOI: 10.1007/s00402-024-05197-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 01/01/2024] [Indexed: 01/30/2024]
Abstract
PURPOSE Plantar fasciitis (PF) is a main source of heel pain, and only about one-third of patients have bilateral symptomatic involvement, although age, body mass index (BMI), and physical activities are known risk factors. The high prevalence of unilateral involvement is poorly understood. We aimed to assess the potential association between PF and the leg length discrepancy (LLD) in unilateral PF. METHODS A transversal case-control study was conducted from January 2019 to December 2020, including 120 participants allocated to two groups matched by BMI and sex: cases (with a diagnosis of PF; 50 ± 13 years) and control (without foot pain; 40 ± 15 years). For both groups, a difference greater than 0.64 cm in the scanometry determined the criteria for the presence of LLD. RESULTS The multivariate logistic regression analysis showed an independent association of PF only with age (p < 0.001), and no association with LLD. We did not observe differences in the mean discrepancy (1.37 ± 0.83 cm in the PF group in comparison with 1.13 ± 0.37 cm in the control group, [p > 0.05]) or in the prevalence of LLD between groups (48% [n = 29] in the PF group compared with 42% [n = 25] in the control group, [p > 0.05]). In the PF group, 80% of the participants reported unilateral pain. We observed a higher prevalence of pain in the shorter limb (p < 0.05). CONCLUSION Age was the only factor associated with the diagnosis of PF when groups were matched by sex and BMI. LLD was not an independent factor associated with the diagnosis of PF. However, when PF is unilateral, the shorter limb is more affected with 70% of prevalence. LEVEL OF EVIDENCE Level III, case-control.
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Affiliation(s)
- Henrique Mansur
- Orthopedic and Traumatology Department, Return to Play Institute, Brasília, DF, Brazil.
| | - Gabriel Ferraz Ferreira
- Foot and Ankle Surgery Group, Orthopedics and Traumatology Unit, Prevent Senior, São Paulo, SP, Brazil
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Bravin AC, Ferraz Ferreira G, Nogueira MP. Effectiveness of the Ponseti method for congenital clubfoot in patients with arthrogryposis: A systematic review and meta-analysis of observational studies. J Child Orthop 2024; 18:72-78. [PMID: 38348434 PMCID: PMC10859111 DOI: 10.1177/18632521231214778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 11/01/2023] [Indexed: 02/15/2024] Open
Abstract
Purpose The aim of this systematic review was to address the Ponseti method in arthrogrypotic clubfoot treatment and evaluate the success, complication, and recurrence rates. Method A systematic review was performed in the PubMed, Scopus, Embase, and Web of Science databases on 9 January 2023, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Success, recurrence, and complication rates were evaluated and analyzed. Risks of bias and the quality of the studies were also evaluated. Results Five case series, including 53 patients (102 feet), were identified. According to this model, the initial success rate was 91% (95% confidence interval = 0.79-0.96) with I2 = 43%, and the final success was 68% (at 5.8 years of follow-up). Recurrence rate was 30% (95% confidence interval = 0.14-0.52). Conclusion Ponseti method is indicated in the initial treatment of arthrogrypotic clubfeet, as it is a minimally invasive method with a high correction rate (91%). However, a high recurrence rate (30%) requires early detection and adequate treatment. Level of evidence Level III. PROSPERO Protocol CRD42020210373.
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Lewis TL, Ferreira GF, Nunes GA, Lam P, Ray R. Impact of Sesamoid Coverage on Clinical Foot Function Following Fourth-Generation Percutaneous Hallux Valgus Surgery. Foot Ankle Orthop 2024; 9:24730114241230560. [PMID: 38384770 PMCID: PMC10880538 DOI: 10.1177/24730114241230560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024] Open
Abstract
Background The impact of pronation and sesamoid coverage on clinical outcomes following percutaneous hallux valgus surgery are not currently known. The aim of this study was to investigate if sesamoid coverage was associated with worse clinical outcomes at 12-month follow-up following percutaneous hallux valgus surgery. Methods Retrospective comparative observational study of clinical and radiographic outcomes based on a previously published prospective dataset. Patients were stratified into 3 cohorts based on the degree of sesamoid coverage (normal, mild, or moderate) on 12-month weightbearing radiographs following fourth-generation percutaneous hallux valgus surgery. Primary outcome was a validated patient-reported outcome measure (PROM), the Manchester-Oxford Foot Questionnaire (MOXFQ). Secondary outcomes included Euroqol-5D, VAS Pain, and radiographic deformity correction. Results Forty-seven feet underwent primary fourth-generation HV surgery and were stratified into 3 cohorts. There were 19, 16, and 12 feet in the normal, mild, and moderate cohorts respectively. There was no significant difference in either pre- or postoperative foot function (all MOXFQ domains, P > .05) or health-related quality of life (EQ-5D Index or VAS, P > .05). The MOXFQ Index preoperatively was as follows: normal cohort, 56.1 ± 26.9; mild cohort, 54.1 ± 17.9; and severe cohort, 49.6 ± 23.8; and postoperatively was as follows: normal cohort, 15.6 ± 21.5; mild cohort, 11.4 ± 15.5; and severe cohort, 11.4 ± 13.6 (P = .737-.908). There was significantly worse hallux valgus angle (HVA) and intermetatarsal angle (IMA) between the cohorts (P < .01). Although HVA and IMA were corrected to normal parameters following surgery in all cohorts, there was a significantly worse postoperative HVA in the moderate sesamoid coverage (5.3 ± 3.9 vs 7.9 ± 5.3 vs 11.4 ± 3.7, P < .01); however, IMA was not significantly different (3.4 ± 2.2 vs 4.1 ± 2.7 vs 5.2 ± 2.9, P = .168). Conclusion This study found that cases where the sesamoids were not reduced had a poorer correction and had worse preoperative deformity. Clinical outcomes and foot function following fourth-generation percutaneous hallux valgus surgery were not affected by sesamoid coverage at the 12-month follow-up. The long-term implications in the difference in radiographic deformity between the 3 cohorts are not known, and further work should explore the relationship of first ray pronation and sesamoid position, particularly with regard to recurrence. Level of evidence Level III, retrospective comparative study of prospectively collected data.
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Affiliation(s)
- Thomas Lorchan Lewis
- King’s Foot and Ankle Unit, King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Gabriel Ferraz Ferreira
- Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, São Paulo, Brazil
| | | | - Peter Lam
- Orthopaedic and Arthritis Specialist Centre, Chatswood, Sydney, Australia
| | - Robbie Ray
- King’s Foot and Ankle Unit, King’s College Hospital NHS Foundation Trust, London, United Kingdom
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Ferreira GF, Pedroso JP, Nunes GA, Del Vecchio JJ, Lewis TL, Mattos E Dinato MC, Nogueira VB, Filho MVP. Treatment of hallux rigidus with percutaneous metatarsophalangeal arthrodesis: a case series with a minimum follow-up of 2 years. Arch Orthop Trauma Surg 2023; 143:6521-6526. [PMID: 37358593 DOI: 10.1007/s00402-023-04948-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 06/11/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND Percutaneous metatarsophalangeal arthrodesis is an option for the treatment of hallux rigidus in more advanced cases. The aim of this study was to investigate the clinical and radiographic results at least 2 years after percutaneous metatarsophalangeal arthrodesis in patients with hallux rigidus. METHODS This is a case series of consecutive patients undergoing percutaneous metatarsophalangeal arthrodesis in patients with hallux rigidus grades III and IV with a minimum of 24 months of clinical and radiographic follow-up. The primary outcome was clinical assessment using the Visual Analog Scale for Pain (VAS). Secondary outcomes included American Orthopedic Foot & Ankle Society (AOFAS) score, patient satisfaction, complications, and bone healing (radiographic analysis). RESULTS Between August 2017 and February 2020, 29 feet (24 patients) underwent percutaneous metatarsophalangeal arthrodesis. The mean follow-up was 38.4 (range 24-54) months. There was an improvement in the pain (VAS) from 7.8 to 0.6 (p < 0.001) and in the AOFAS score from 49.9 to 83.6 (p < 0.001). There was a rate of bone union of 82.8% and screw removal of 13.8%. All patients considered the result to be excellent or good. CONCLUSION The treatment of grade III and IV hallux rigidus with percutaneous metatarsophalangeal arthrodesis demonstrated high patient satisfaction and significantly improves in clinical outcomes but the nonunion rate was higher than reported outcomes for open 1st metatarsophalangeal joint arthrodesis. LEVEL OF EVIDENCE IV, case series.
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Affiliation(s)
- Gabriel Ferraz Ferreira
- Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, São Paulo, Brazil
- Member of Minimally Invasive Foot Ankle Society (MIFAS), Merignac, France
- Instituto Vita, São Paulo, Brazil
| | - João Paulo Pedroso
- Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, São Paulo, Brazil
| | | | | | | | - Mauro Cesar Mattos E Dinato
- Department of Orthopaedics, Rheumatology and Traumatology, State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
- Instituto Vita, São Paulo, Brazil
| | | | - Miguel Viana Pereira Filho
- Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, São Paulo, Brazil.
- Instituto Vita, São Paulo, Brazil.
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Nunes GA, de Carvalho KAM, Ferreira GF, Filho MVP, Baptista AD, Zambelli R, Vega J. Minimally invasive Chevron Akin (MICA) osteotomy for severe hallux valgus. Arch Orthop Trauma Surg 2023; 143:5507-5514. [PMID: 36977832 DOI: 10.1007/s00402-023-04849-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 03/15/2023] [Indexed: 03/30/2023]
Abstract
INTRODUCTION The minimally invasive Chevron Akin (MICA) osteotomy has been widely used to treat hallux valgus (HV). The purpose of this study was to present a case series of patients with severe HV undergoing surgical treatment using the MICA procedure and to evaluate the clinical and radiographic outcomes. MATERIALS AND METHODS Retrospective study including 60 consecutive feet (52 patients) undergoing MICA for severe HV. The data were collected pre- and post-operatively at the last follow-up. Patients were clinically evaluated by the visual analog pain scale (VAS) and AOFAS hallux MTP-IP score. Radiographic assessments included measurements of hallux valgus angle (HVA), intermetatarsal angle (IMA), metatarsal (MT) length, distal metatarsal articular angle (DMAA), and plantar translation of MT head. The complications were recorded during the follow-up. RESULTS The mean age was 59.9 years, and the mean follow-up was 20.5 months. The average AOFAS increased from 41.2 to 90.9 points, and the VAS from 8.1 to 1.3 at the last follow-up. The average HVA decreased from 41.2º to 11.6º, the IMA from 17.1º to 6.9º, and the DMAA from 17.9º to 7.8º. The average shortening of the first metatarsal and the plantar translation of the MT head was 5.1 mm and 2.8 mm, respectively. The most observed complication was hardware discomfort, observed in 5 feet (8.3%). There were two cases of recurrence (3.3%). CONCLUSION MICA technique was demonstrated in this series of cases to be an effective procedure for severe HV, with a low rate of recurrence and an acceptable rate of complications. LEVEL OF EVIDENCE IV; case series.
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Affiliation(s)
- Gustavo Araujo Nunes
- MIFAS by GRECMIP: Minimally Invasive Foot and Ankle Society, Merignac, France.
- COTE Brasília Clinic, Foot and Ankle Unit, Brasília, DF, Brazil.
- SGAS, 915 Lote 68a Salas 16/17 Centro Clínico Advance 2 - Asa Sul, Brasília, DF, 70390-150, Brasil.
| | - Kepler Alencar Mendes de Carvalho
- Department of Orthopedics and Rehabilitation, University of Iowa, Carver College of Medicine, Iowa City, IA, USA
- Nossa Senhora do Pari Beneficent Association, São Paulo, SP, Brazil
| | - Gabriel Ferraz Ferreira
- Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, São Paulo, Brazil
- Instituto Vita, São Paulo, Brazil
| | - Miguel Viana Pereira Filho
- Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, São Paulo, Brazil
- Instituto Vita, São Paulo, Brazil
| | | | | | - Jordi Vega
- MIFAS by GRECMIP: Minimally Invasive Foot and Ankle Society, Merignac, France
- Laboratory of Arthroscopic and Surgical Anatomy, Department of Pathology and Experimental Therapeutics (Human Anatomy Unit), University of Barcelona, Barcelona, Spain
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Lewis TL, Alkhalfan Y, Ferreira GF, Nunes GA, Lam P, Ray R. Optimizing the Operating Room Setup for Minimally Invasive Forefoot Surgery: Technical Tip. Foot Ankle Orthop 2023; 8:24730114231198235. [PMID: 37720565 PMCID: PMC10503294 DOI: 10.1177/24730114231198235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023] Open
Affiliation(s)
- Thomas L. Lewis
- King’s Foot and Ankle Unit, King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Yousif Alkhalfan
- Guy’s and St Thomas’ NHS Foundation Trust, Maze Pond, London, United Kingdom
| | - Gabriel Ferraz Ferreira
- Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, São Paulo, Brazil
| | | | - Peter Lam
- Orthopaedic and Arthritis Specialist Centre, Chatswood, Sydney, Australia
| | - Robbie Ray
- King’s Foot and Ankle Unit, King’s College Hospital NHS Foundation Trust, London, United Kingdom
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Ferreira GF, Nunes GA, Dorado DS, Dinato MCME, Lewis TL, Ray R, Filho MVP. Correction of First Metatarsal Pronation in Metaphyseal Extra-articular Transverse Osteotomy for Hallux Valgus Correction. Foot Ankle Orthop 2023; 8:24730114231198527. [PMID: 37736327 PMCID: PMC10510346 DOI: 10.1177/24730114231198527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023] Open
Affiliation(s)
- Gabriel Ferraz Ferreira
- Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, São Paulo, Brazil
- Instituto Vita, São Paulo, Brazil
- Member of Minimally Invasive Foot Ankle Society (MIFAS by GRECMIP)
| | - Gustavo Araujo Nunes
- Member of Minimally Invasive Foot Ankle Society (MIFAS by GRECMIP)
- COTE Brasília Clinic, Foot and Ankle Unit, Brasília, DF, Brazil
| | - Davy Sevilla Dorado
- Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, São Paulo, Brazil
| | | | | | - Robbie Ray
- King’s Foot and Ankle Unit, King's College Hospital London NHS Foundation Trust, London, United Kingdom
| | - Miguel Viana Pereira Filho
- Instituto Vita, São Paulo, Brazil
- Head of Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, São Paulo, Brazil
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Ferreira GF, Mattos E Dinato MC, Santos TFD, Miziara P, Pereira MV. CAN THE PERCUTANEOUS CHEVRON AND AKIN (PECA) TECHNIQUE CORRECT THE PRONATION OF THE FIRST METATARSAL IN HALLUX VALGUS? Acta Ortop Bras 2023; 31:e265206. [PMID: 37323155 PMCID: PMC10263439 DOI: 10.1590/1413-785220233102e265206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 09/02/2022] [Indexed: 06/17/2023]
Abstract
Objective Pronation of the first metatarsal in hallux valgus has recently been discussed among foot and ankle surgeons. This study aimed to evaluate the potential radiographic correction of moderate and severe hallux valgus using the percutaneous Chevron and Akin (PECA) technique. Methods We evaluated 45 feet in 38 patients (mean age 65.3 years old [36 - 83]; 4 men; 34 women; 7 bilateral) who underwent surgical correction using the PECA technique. The radiographic images evaluated were anteroposterior radiographs obtained pre- and postoperatively at least 6 months after surgery, including the metatarsophalangeal angle, the intermetatarsal angle, pronation of the first metatarsal, displacement of the distal fragment, medial sesamoid position and bone union. Results All parameters evaluated showed significant postoperative improvement, including correction of pronation of the first metatarsal (p < .05) and position of the sesamoid (p < .05). There was a union of osteotomies in all feet. No complications were observed, such as screw loosening or necrosis of the first metatarsal head. Conclusion The PECA technique can correct pronation of the first metatarsal in moderate and severe hallux valgus, and other deformity-associated parameters. Level of Evidence IV; Case Series.
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Affiliation(s)
- Gabriel Ferraz Ferreira
- . Prevent Senior, Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, São Paulo, Brazil
- . Instituto Vita, São Paulo, Brazil
| | | | - Tatiana Ferreira Dos Santos
- . Prevent Senior, Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, São Paulo, Brazil
- . Instituto Vita, São Paulo, Brazil
| | - Paulo Miziara
- . Prevent Senior, Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, São Paulo, Brazil
| | - Miguel Viana Pereira
- . Prevent Senior, Head of Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, São Paulo, Brazil
- . Instituto Vita, São Paulo, Brazil
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Ferreira GF, Demarzo M. Trends of Research on Mindfulness: a Bibliometric Study of an Emerging Field. Trends in Psychol 2023. [DOI: 10.1007/s43076-023-00286-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
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Bachir RM, Zaia IM, Santos GS, Fonseca LFD, Boni G, Guercia RF, Ferreira GF, Lana JFSD. Bone Marrow Aspirate Concentrate Improves Outcomes in Adults With Osteochondral Dissecans of the Talus and Achilles Rupture. Arthroscopy 2023; 39:881-886. [PMID: 36543662 DOI: 10.1016/j.arthro.2022.11.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 11/21/2022] [Accepted: 11/25/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE The objective of this systematic literature review was to investigate the effects of the clinical application of bone marrow aspirate (BMA) and/or bone marrow aspirate concentrate (BMAC) in tendon and cartilage injuries in the foot and ankle. METHODS A search of the Embase, MEDLINE/PubMed, CINAHL, and Cochrane databases was performed in January 2021. The risk of bias of the studies was assessed using the tool "A Cochrane Risk of Bias Assessment Tool for Non-Randomized Studies." The outcomes analyzed included pain reduction and functional improvement with the use of BMA/BMAC in patients with tendon and cartilage injuries in the foot and ankle. RESULTS Eleven studies met the inclusion criteria for analysis, involving a total of 527 subjects with osteochondral lesions (OCLs) of the talus, cartilage lesions of the talus, and acute Achilles tendon rupture. BMAC was applied alone in 4 studies, and in 7 studies, it was compared with other techniques such as matrix-induced autologous chondrocyte implantation, particulate juvenile articular cartilage, or microfracture. Interventions demonstrated improved function and reduced foot and ankle pain and showed no serious adverse effects. CONCLUSIONS Evidence indicates that BMAC provides good clinical results, with improved function and reduced pain in adults with OCL and cartilage lesions of the talus and acute Achilles tendon rupture. LEVEL OF EVIDENCE Level IV, systematic review of level II to IV studies.
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Affiliation(s)
| | | | | | - Lucas Furtado da Fonseca
- Brazilian Institute of Regenerative Medicine (BIRM), Indaiatuba, SP, Brazil; Universidade Federal de São Paulo (UNIFESP), São Paulo, SP Brazil
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Sato G, Ferreira GF, Sevilla D, Oliveira CN, Lewis TL, Dinato MCME, Pereira Filho MV. Treatment of Morton's neuroma with minimally invasive distal metatarsal metaphyseal osteotomy (DMMO) and percutaneous release of the deep transverse metatarsal ligament (DTML): a case series with minimum two-year follow-up. Int Orthop 2022; 46:2829-2835. [PMID: 36031662 DOI: 10.1007/s00264-022-05557-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 08/16/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND The optimal treatment of symptomatic Morton's neuroma remains unclear; conservative methods are sometimes ineffective and neurectomy has significant rates of patient dissatisfaction. The aim of this study was to evaluate the outcome of minimally invasive distal metatarsal metaphyseal osteotomy (DMMO) and percutaneous release of the deep transverse metatarsal ligament (DTML) in patients with Morton's neuroma. METHODS Between January 2018 and November 2019, 27 patients (29 feet) diagnosed with Morton's neuroma after clinical and radiological evaluation underwent DMMO and percutaneous DTML release. The primary clinical outcomes were pain (VAS) and function (AOFAS score). Secondary outcomes included patient satisfaction, complications, and radiographic outcomes. Patients were followed up for a minimum of two years. RESULTS The median age of the participants was 66 years (range 48-79) and the follow-up time was 28 months (24-47). There was a decrease of 5.7 points in the VAS for pain (p < .001) and an increase of 19.9 in AOFAS (p < .001) after the surgical procedure. There was one case of superficial infection and one patient required resection of the neuroma (neurectomy). The majority of patients (89.7%) were satisfied and considered the procedure outcome as excellent or good. CONCLUSION Treatment of Morton's neuroma with minimally invasive distal metatarsal metaphyseal osteotomy and percutaneous release of the deep transverse metatarsal ligament showed significant improvement in pain and function with a low incidence of complications and a high rate of personal satisfaction.
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Affiliation(s)
- Gustavo Sato
- Department of Orthopaedics, Rheumatology and Traumatology, State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.,Instituto Vita, São Paulo, Brazil
| | - Gabriel Ferraz Ferreira
- Instituto Vita, São Paulo, Brazil.,Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, São Paulo, Brazil.,Minimally Invasive Foot Ankle Society (MIFAS By GRECMIP), Merignac, France
| | - Davy Sevilla
- Department of Orthopaedics and Traumatology, Prevent Senior, São Paulo, Brazil
| | | | | | - Mauro Cesar Mattos E Dinato
- Department of Orthopaedics, Rheumatology and Traumatology, State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.,Instituto Vita, São Paulo, Brazil
| | - Miguel Viana Pereira Filho
- Instituto Vita, São Paulo, Brazil. .,Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, São Paulo, Brazil.
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Ferreira GF, Caruccio FRC, Guerrero Bou Assi JR, Pedroso JP, Dos Santos TF, Arliani GG, Filho MVP. Ultrasound-guided hyaluronic acid injection for the treatment of insertional Achilles tendinopathy: A prospective case series. Foot Ankle Surg 2022; 28:879-882. [PMID: 34906404 DOI: 10.1016/j.fas.2021.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 11/09/2021] [Accepted: 12/05/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Heel pain is a common condition and often involves the Achilles tendon and is classified as insertional or non-insertional. Several operative and non-operative treatments have been described, but there is no consensus on the most effective therapy. The aim of this study is to evaluate a case series of patients with insertional Achilles tendinopathy refractory to conservative treatment submitted to a single-dose ultrasound-guided injection of hyaluronic acid (40 mg/2.0 mL). METHODS We prospectively included 25 patients (29 feet) who underwent a single ultrasound-guided injection of hyaluronic acid after conservative treatment failure. Clinical outcomes such as pain (using the Visual Analog Scale - VAS), function (using the American Orthopedic Foot & Ankle Society - AOFAS score), personal satisfaction, and complications were evaluated. Statistical analysis was performed using the R software. RESULTS Most patients were female (80%) and there was a right-side predominance (55%). The median VAS was 8 points [range 4-10] at baseline, decreasing to 3 points [range 0-8] at the six-month follow-up, with statistical significance (p < .001). The median AOFAS score was 71 points [range 38-87] at baseline, increasing to 90 points [range 48-100] at the six-month follow-up (p < .001). The personal satisfaction level was 69%, and 48% of patients considered the result excellent. There were no Achilles tendon ruptures, infections, or allergic reactions post injection. CONCLUSION Single-dose injection of hyaluronic acid is a safe treatment option, improving function and reducing pain for six months in patients with insertional Achilles tendinopathy after conservative treatment failure. LEVEL OF EVIDENCE IV, case series.
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Affiliation(s)
- Gabriel Ferraz Ferreira
- Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, São Paulo, Brazil.
| | | | | | - João Paulo Pedroso
- Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, São Paulo, Brazil.
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14
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Falótico GG, Tucunduva V, Brito G, Durigon TS, Arliani GG, Ferreira GF. Assessment of Predictors of Infection in Primary Knee and Hip Arthroplasty: A Case-control Study. Rev Bras Ortop 2022; 57:1009-1013. [PMID: 36540746 PMCID: PMC9757958 DOI: 10.1055/s-0042-1750753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 08/31/2021] [Indexed: 10/17/2022] Open
Abstract
Objective This study assesses risk factors for periprosthetic joint infection after elective primary total knee or hip arthroplasty. Methods The study included 706 medical records of patients undergoing elective primary total hip or knee arthroplasty from January to December 2018. We used a multivariate analysis of infection predictors through a logistic regression model. The R software performed all statistical analysis. Results The prevalence of infection in the sample was 2.0% (14 cases). Most patients were women (79.6%), with an afflicted right side (50.6%), and underwent a total knee arthroplasty (61.3%). Significant risk factors ( p < 0.05) for infection included surgical time greater than 120 minutes ( p = 0.009) and a history of diabetes ( p = 0.025). Conclusion The risk of infection after elective primary total knee or hip arthroplasty is higher when the surgical procedure is lengthy (over 120 minutes), or the patient has a history of diabetes mellitus. Level of Evidence IIIB, retrospective, case-control study.
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Affiliation(s)
- Guilherme Guadagnini Falótico
- Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, São Paulo, Brasil,Departamento de Ortopedia e Traumatologia, Instituto Prevent Senior, São Paulo, Brasil
| | - Vitor Tucunduva
- Departamento de Ortopedia e Traumatologia, Instituto Prevent Senior, São Paulo, Brasil
| | - Gustavo Brito
- Departamento de Ortopedia e Traumatologia, Instituto Prevent Senior, São Paulo, Brasil
| | | | | | - Gabriel Ferraz Ferreira
- Departamento de Ortopedia e Traumatologia, Instituto Prevent Senior, São Paulo, Brasil,Endereço para correspondência Gabriel Ferraz Ferreira, MD, MSc Rua Cerro Corá585, Sala 605, Torre 1, São Paulo, SPBrasil
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15
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Arliani GG, Vergara JM, Mesquita Júnior ID, Oliveira VO, Lara PHS, Ferreira GF. Protocolo de solicitação de ressonância magnética do joelho em pacientes idosos com suspeita de osteoartrose: Redução da solicitação de exames e o impacto na conduta e no diagnóstico. Rev Bras Ortop 2022; 57:409-414. [PMID: 35785128 PMCID: PMC9246541 DOI: 10.1055/s-0040-1722576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 10/02/2020] [Indexed: 11/12/2022] Open
Abstract
Objective
To develop an evidence-based protocol to guide magnetic resonance imaging (MRI) requests in elderly patients with suspected knee osteoarthrosis and to evaluate its effectiveness after implementation.
Methods
The institutional protocol was developed after reviewing the literature during the first semester of 2018. The control group was defined as patients cared for in the first semester of 2018, before the implementation/dissemination of the institutional protocol, and the study group was composed by patients cared for during the second semester of 2018 after the standardization of MRI requests for suspected knee osteoarthrosis.
Results
Our sample included 826 patients undergoing knee MRI, with a mean age of 69.3 years. Protocol implementation decreased MRI requests and increased radiograph requests (
p
< 0.001). After the implementation of the protocol, the MRI changed the diagnosis or treatment in only 11.2% of the cases.
Conclusion
Protocol implementation resulted in a 47.5% reduction in the number of requests for knee MRI, with most (89%) patients with alteration in diagnosis or treatment. Level of evidence: case-control study (IIIB).
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Affiliation(s)
| | - Juliana Munhoz Vergara
- Departamento de Ortopedia e Traumatologia, Instituto Prevent Senior, São Paulo, SP, Brasil
| | | | - Victor Otávio Oliveira
- Departamento de Ortopedia e Traumatologia, Instituto Prevent Senior, São Paulo, SP, Brasil
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16
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Arliani GG, Durigon TS, Pedroso JP, Ferreira GF, Oksman D, Oliveira VO. Infiltração intraarticular de plasma rico em plaquetas versus ácido hialurônico em pacientes com osteoartrose primária do joelho: Ensaio clínico randomizado com resultados preliminares. Rev Bras Ortop 2022; 57:402-408. [PMID: 35785122 PMCID: PMC9246520 DOI: 10.1055/s-0041-1724082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 09/17/2020] [Indexed: 11/29/2022] Open
Abstract
Objective
The present study aimed to compare the effects of intraarticular infiltration of platelet-rich plasma with those of hyaluronic acid infiltration in the treatment of patients with primary knee osteoarthritis.
Methods
A randomized clinical trial was conducted with 29 patients who received an intraarticular infiltration with hyaluronic acid (control group) or platelet-rich plasma. Clinical outcomes were assessed using the visual analog scale for pain and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaire before and after the intervention. In addition, the posttreatment adverse effects were recorded. Categorical variables were analyzed using the chi-square and Fisher exact tests, whereas continuous variables were analyzed using the Student
t
test, analysis of variance, and the Wilcoxon test; all calculations were performed with the Stats package of the R software.
Results
An independent analysis of each group revealed a statistical difference within the first months, with improvement in the pain and function scores, but worsening on the 6
th
month after the procedure. There was no difference in the outcomes between the groups receiving hyaluronic acid or platelet-rich plasma. There was no serious adverse effect or allergic reaction during the entire follow-up period.
Conclusion
Intraarticular infiltration with hyaluronic acid or platelet-rich plasma in patients with primary knee gonarthrosis resulted in temporary improvement of functional symptoms and pain. There was no difference between interventions.
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Affiliation(s)
| | | | - João Paulo Pedroso
- Departamento de Ortopedia e Traumatologia, Instituto Prevent Senior, São Paulo, SP, Brasil
| | | | - Daniel Oksman
- Departamento de Ortopedia e Traumatologia, Instituto Prevent Senior, São Paulo, SP, Brasil
| | - Victor Otávio Oliveira
- Departamento de Ortopedia e Traumatologia, Instituto Prevent Senior, São Paulo, SP, Brasil
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17
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Ferreira GF, Nunes GA, Mattos E Dinato MC, Pedroso JP, Lewis TL, Lam P, Filho MVP. Technique Tip: Medial prominence bone spur resection in the third-generation percutaneous Chevron-Akin Osteotomy Technique (PECA) for hallux valgus correction. Foot Ankle Surg 2022; 28:460-463. [PMID: 34838427 DOI: 10.1016/j.fas.2021.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/12/2021] [Accepted: 11/08/2021] [Indexed: 02/04/2023]
Abstract
The third-generation percutaneous chevron and Akin osteotomy (PECA) technique for surgical management of hallux valgus has shown improvement in clinical and radiographic outcomes. During this procedure, lateral translation and fixation of the first metatarsal head results in the formation of a bony prominence on the medial side of the distal aspect of the first metatarsal which can cause pain and discomfort to the patient. We describe two techniques to address this bony prominence; either i) excision osteotomy and removal of the fragment or ii) a dorsal closing wedge osteotomy retaining the bony fragment. LEVEL OF EVIDENCE: Level V, expert opinion.
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Affiliation(s)
- Gabriel Ferraz Ferreira
- Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, São Paulo, Brazil; Minimally Invasive Foot Ankle Society (MIFAS by GRECMIP), Brazil
| | - Gustavo Araujo Nunes
- Department of Orthopaedics and Traumatology, Hospital Santa Luzia Rede D´Or, Brasília, Brazil; Minimally Invasive Foot Ankle Society (MIFAS by GRECMIP), Brazil
| | - Mauro Cesar Mattos E Dinato
- Department of Orthopaedics and Traumatology Unit, State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil; Instituto Vita, São Paulo, Brazil
| | - João Paulo Pedroso
- Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, São Paulo, Brazil
| | | | - Peter Lam
- Orthopaedic and Arthritis Specialist Centre, Chatswood, Sydney, Australia
| | - Miguel Viana Pereira Filho
- Head of Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, São Paulo, Brazil; Instituto Vita, São Paulo, Brazil.
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18
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Abstract
INTRODUCTION Minimally Invasive Chevron Akin (MICA) can be used to treat hallux valgus (HV) associated with a hypermobility of the first metatarsal-cuneiform joint (1MTCJ). The aim of this study was to perform a radiographic analysis of the MICA, focused on evaluating the 1MTCJ. METHODS Forty patients (50 feet) with moderate to severe HV underwent a MICA procedure. Radiographic analysis included hallux valgus angle (HVA), intermetatarsal angles between the first and second rays (IMA), the intermetatarsal angle between the proximal fragment of the osteotomy and the second ray (IAPF) and the distance between a point 3 cm distal from the base of the second metatarsal and a point located at the same height for the first metatarsal base (Dist 1-2). The IAPF was compared with the preoperative IMA, and the other parameters were compared preoperatively and postoperatively. The radiographic complications were also recorded. RESULTS Most patients were female (92%). The mean age was 50.4 years (SD = 16.1) and the mean follow-up was 16.1 months (SD = 3.5). The average HVA improved from 32.5° to 7.3°, and the average IMA from 14.2° to 4.2°. The IAPF and Dist1-2 values showed an increase of 4.8° and 4.0 mm respectively. There were no radiographic complications. Conclusion. Minimally invasive Chevron Akin promotes a great correction of the moderate to severe HV conventional parameters and increase the transversal stability of the 1MTCJ fixing this joint as medial as possible. LEVEL OF EVIDENCE Level IV, case series.
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Affiliation(s)
- Gustavo Araujo Nunes
- Foot and Ankle Surgery Group, COTE Brasília, DF, Brazil
- Clinical Center Orthopectus, Brasília, Brazil
- MIFAS by Grecmip (Minimally Invasive Foot and Ankle Society)
| | - Gabriel Ferraz Ferreira
- Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, São Paulo, Brazil
| | - Tiago Baumfeld
- Universidade Federal de Minas Gerais, MG, Brazil
- Hospital Felício Rocho, Belo Horizonte, Brazil
| | - Miguel Viana Pereira Filho
- Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, São Paulo, Brazil
- Instituto Vita, São Paulo, Brazil
| | - Daniel Baumfeld
- Universidade Federal de Minas Gerais, MG, Brazil
- Hospital Felício Rocho, Belo Horizonte, Brazil
| | - Peter Lam
- Orthopaedic and Arthritis Specialist Centre, Chatswood, Sydney, Australia
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19
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Nunes GA, Ferreira GF, Caetano RM, Mann TS, Guelfi M. All-inside arthroscopic repair of the anterior talofibular ligament: a case series. Int Orthop 2022; 46:273-279. [PMID: 35022814 DOI: 10.1007/s00264-021-05283-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 12/04/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The all-inside arthroscopic repair of the anterior talofibular ligament (ATFL) is a technically challenging and still-recent procedure to treat chronic ankle instability (CAI). Favourable clinical outcomes have been shown from originator centers, but this is one of the first series from a non-originator centre. The purpose of the present study is to present the clinical and functional results of patients with CAI underwent arthroscopic all-inside ATFL repair. METHODS This is a series of cases of 18 consecutive patients who underwent the all-inside arthroscopic ATFL repair, for CAI, after the failure of conservative treatment performed for six months. The evaluation was made using the American Orthopaedic Foot and Ankle Score (AOFAS), visual analog pain scale (VAS), anterior drawer, and talar tilt tests. RESULTS All 18 patients were evaluated for a mean follow-up period of 12 months. There was an improvement in the AOFAS (p < 0.001), with the mean improving from 69.6 points to 98.1, standard deviation (SD) = 11.09, and in the mean VAS score (p < 0.001), from 5.0 to 0.5 points (SD = 0.78). All ankles were stable, as assessed by the anterior drawer test and talar tilt test. The only complication found was neurapraxia of the superficial fibular nerve in one patient (5%). All of the patients classified the treatment as good or excellent and returned to sports activities without limitations. CONCLUSION Treatment of CAI by the all-inside arthroscopic ATFL repair was able to restore ankle stability and showed good clinical results and high satisfaction rates.
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Affiliation(s)
- Gustavo Araujo Nunes
- Foot and Ankle Unit, Hospital Brasília, Brasília, Distrito Federal, Brazil. .,Grecmip MIFAS (Group of Research and Study in Minimally Invasive Surgery of the Foot - Minimally Invasive Foot and Ankle Society), Barcelona, Spain. .,PHD (C) Human Anatomy and Embryology Unit, Department of Pathology and Experimental Therapeutics, University of Barcelona, Barcelona, Spain.
| | - Gabriel Ferraz Ferreira
- Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, São Paulo, Brazil
| | - Rafael Medeiros Caetano
- Orthopaedics and Traumatology Unit, Hospital Universitário Ciências Médicas (FCMMG), Belo Horizonte, MG, Brazil
| | | | - Matteo Guelfi
- Foot and Ankle Unit, Clinica Montallegro, Genoa, Italy
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20
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Ferreira GF, Costa JHA, Domingues G, Lima JPBC, Sanhudo JAV, Pereira Filho MV. Low Donor Site Morbidity Associated With Tricortical Calcaneal Bone Graft. Foot Ankle Int 2022; 43:49-54. [PMID: 34330165 DOI: 10.1177/10711007211032665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Autologous grafting is widely used in orthopaedic surgery because of its high osteogenic capacity, immunologic compatibility, for the absence of risk of disease transmission, and for not requiring a bone bank. The posterior-superior calcaneal tuberosity is an option for obtaining a cortical and cancellous structural bone. This study aims to describe the operative technique and complications observed at the donor site of the posterior-superior calcaneal tuberosity. METHODS Patients who underwent graft harvesting from the posterior-superior calcaneal tuberosity were retrospectively evaluated by pain outcomes, imaging tests, and intra- and postoperative complications. RESULTS Twenty patients with a median age of 69 years (range 48-77) and follow-up of 16 months (12-26) were assessed. Median postoperative pain at the donor site was 0 (0-6), with 2 patients reporting persistent local pain. No case of Achilles tendon rupture or intra- or postoperative calcaneal fracture were identified. One patient developed a superficial infection that was quickly resolved using oral antibiotic therapy. CONCLUSION The posterior-superior calcaneal tuberosity is an alternative source of autologous graft with low donor site morbidity. LEVEL OF EVIDENCE Level IV, case series.
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Affiliation(s)
- Gabriel Ferraz Ferreira
- Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, São Paulo, Brazil
| | | | | | | | | | - Miguel Viana Pereira Filho
- Head of Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, São Paulo, Brazil
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21
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Ferreira GF, Stéfani KC. A Global Bibliometric Analysis of Hallux Valgus Research (1999-2019). J Foot Ankle Surg 2021; 60:501-506. [PMID: 33573904 DOI: 10.1053/j.jfas.2020.09.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 09/01/2020] [Accepted: 09/30/2020] [Indexed: 02/03/2023]
Abstract
Hallux valgus (HV) is a very common deformity among foot disorders, therefore attracting strong interest from foot and ankle surgeons. We investigated publication trends on HV in the literature. The analysis was conducted through an electronic search of the Web of Science database for publications between 1999 and 2019, studying the data of origin through bibliometrics. The following search string was utilized: TI = (hallux valgus* OR hallux abductovalgus*) with filters for the English language and documents in article format. The "Bibliometrix" package of R software was used for the bibliometric analysis, and the VOSviewer was used to create graphs. A total of 789 articles were found in the electronic search, with 2,723 cited articles. The most common Web of Science category was Orthopedics (83.0%), and Coughlin M.J. was the main researcher in this field with the largest number of publications (17). The United States led in terms of the number of published articles (26.7%). An increase in the number of publications over time was noted, with 2016 being the year with the highest number of articles (78). The journal with the most articles was Foot and Ankle International, with 35.2% of the publications. The number of published studies on HV has increased rapidly since 2012. The United States ranks first in related research worldwide. The journal with the most articles was Foot and Ankle International.
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Affiliation(s)
- Gabriel Ferraz Ferreira
- Foot and Ankle Surgery Group, Orthopedics and Traumatology Department, Hospital do Servidor Público Estadual, São Paulo, SP, Brazil
| | - Kelly Cristina Stéfani
- Foot and Ankle Surgery Group, Orthopedics and Traumatology Department, Hospital do Servidor Público Estadual, São Paulo, SP, Brazil.
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22
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Ferreira GF, Sevilla D, Oliveira CN, Junior LCN, Arliani GG, Oliveira VO, Pereira Filho MV. Comparison of the effect of hyaluronic acid injection versus extracorporeal shockwave therapy on chronic plantar fasciitis: Protocol for a randomized controlled trial. PLoS One 2021; 16:e0250768. [PMID: 34166373 PMCID: PMC8224905 DOI: 10.1371/journal.pone.0250768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 03/25/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Plantar fasciitis is the most common cause of pain in the plantar region of the heel, and extracorporeal shockwave therapy (ESWT) is an option used in cases where conservative treatment fails. Hyaluronic acid (HA), initially used for osteoarthrosis, is a treatment option because it has been applied to extra-articular regions, such as tendons, ligaments, and fascia. The aim of the present study will be to evaluate the outcomes of pain, function, and personal satisfaction after a single injection of HA and to compare the results with those of ESWT in patients with chronic plantar fasciitis. METHODS The study will include 80 patients who will be randomized to receive three sessions of ESWT (n = 40) or a single ultrasound-guided HA injection in the plantar fascia (n = 40). The outcomes will include the visual analog pain scale score, American Orthopaedic Foot and Ankle Society (AOFAS) score, and Foot and Ankle Outcome Score (FAOS). All of the assessments will be performed at baseline and 3, 6, and 12 months after treatment. Statistical analysis will be performed using the repeated measures ANOVA (analysis of variance test) for primary and secondary outcomes and also Fisher's Least Significant Difference, a Post-Hoc test. We will use R software for statistical analysis, randomization, and sample size calculation. RESULTS Recruitment and data collection will begin in November 2020, with completion scheduled for November 2022 and final publication available in March 2023. CONCLUSION This trial will evaluate the effects of a single ultrasound-guided HA injection for the treatment of chronic plantar fasciitis. TRIAL REGISTRATION Brazilian Clinical Trials Registry (Register Number: RBR-97vkx4) http://www.ensaiosclinicos.gov.br/rg/RBR-97vkx4/.
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Affiliation(s)
- Gabriel Ferraz Ferreira
- Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, São Paulo, Brazil
- * E-mail:
| | - Davy Sevilla
- Department of Orthopaedics and Traumatology, Prevent Senior, São Paulo, Brazil
| | | | | | | | - Victor Otávio Oliveira
- Head of Department, Orthopaedics and Traumatology Unit, Prevent Senior, São Paulo, Brazil
| | - Miguel Viana Pereira Filho
- Head of Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, São Paulo, Brazil
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Ferreira GF, Quiles MG, Nazaré TS, Rezende SO, Demarzo M. Automation of Article Selection Process in Systematic Reviews Through Artificial Neural Network Modeling and Machine Learning: Protocol for an Article Selection Model. JMIR Res Protoc 2021; 10:e26448. [PMID: 34128820 PMCID: PMC8277371 DOI: 10.2196/26448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 04/15/2021] [Accepted: 05/07/2021] [Indexed: 11/23/2022] Open
Abstract
Background A systematic review can be defined as a summary of the evidence found in the literature via a systematic search in the available scientific databases. One of the steps involved is article selection, which is typically a laborious task. Machine learning and artificial intelligence can be important tools in automating this step, thus aiding researchers. Objective The aim of this study is to create models based on an artificial neural network system to automate the article selection process in systematic reviews related to “Mindfulness and Health Promotion.” Methods The study will be performed using Python programming software. The system will consist of six main steps: (1) data import, (2) exclusion of duplicates, (3) exclusion of non-articles, (4) article reading and model creation using artificial neural network, (5) comparison of the models, and (6) system sharing. We will choose the 10 most relevant systematic reviews published in the fields of “Mindfulness and Health Promotion” and “Orthopedics” (control group) to serve as a test of the effectiveness of the article selection. Results Data collection will begin in July 2021, with completion scheduled for December 2021, and final publication available in March 2022. Conclusions An automated system with a modifiable sensitivity will be created to select scientific articles in systematic review that can be expanded to various fields. We will disseminate our results and models through the “Observatory of Evidence” in public health, an open and online platform that will assist researchers in systematic reviews. International Registered Report Identifier (IRRID) PRR1-10.2196/26448
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Affiliation(s)
| | | | | | | | - Marcelo Demarzo
- Department of Science and Technology, Universidade Federal de São Paulo, São Paulo, Brazil
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24
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Pereira Filho MV, Stéfani KC, Ferreira GF, Nogueira MP. Risk Factors Associated With Foot and Ankle Insufficiency Fractures in Postmenopausal Sedentary Women. Foot Ankle Int 2021; 42:482-487. [PMID: 33203230 DOI: 10.1177/1071100720969654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Insufficiency fractures occur in bones with low elastic resistance. In contrast to stress fractures, which affect normal bones and have been extensively studied, insufficiency fractures of the foot and ankle have been the subject of little research. The objective of this study was to identify risk factors associated with the development of foot and ankle insufficiency fractures. METHODS The study included 55 postmenopausal sedentary women with foot and ankle insufficiency fractures and 51 women in the control group. The data collected were the fracture site, body mass index, use of corticosteroids, T scores of the femur and lumbar spine measured by bone densitometry, and serum 25-OH vitamin D level. The calcaneal pitch (CP), talar-first metatarsal, and metatarsus adductus (MA) angles were measured on radiographs. RESULTS In 49 patients (89%), fractures occurred in the metatarsals. All metatarsals were affected, and the most common fracture site was the base of the fifth metatarsal, with 21 cases (33%). Twenty patients (36%) in the study group reported chronic use of corticosteroids and had lower bone mineral density levels than controls (P < .05). The factors associated with fracture development (P < .05) were the CP and MA angles and low lumbar bone mineral density. CONCLUSION Insufficiency fractures in this population were associated with low bone mineral density and unfavorable biomechanical characteristics such as pes cavus and metatarsus adductus. LEVEL OF EVIDENCE Level IIIB, case-control study.
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Affiliation(s)
- Miguel Viana Pereira Filho
- Post-Graduation in Health Sciences Program of Instituto de Assistência Médica ao Servidor Público Estadual de São Paulo (IAMSPE), São Paulo, Brazil.,Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, São Paulo, Brazil
| | - Kelly Cristina Stéfani
- Department of Orthopedics, Hospital do Servidor Público Estadual de São Paulo (HSPE), São Paulo, Brazil
| | - Gabriel Ferraz Ferreira
- Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, São Paulo, Brazil
| | - Monica Paschoal Nogueira
- Post-Graduation in Health Sciences Program of Instituto de Assistência Médica ao Servidor Público Estadual de São Paulo (IAMSPE), São Paulo, Brazil.,Department of Orthopedics, Hospital do Servidor Público Estadual de São Paulo (HSPE), São Paulo, Brazil
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Falotico GG, Cunza JFF, Ferreira GF, Oliveira VO, Oksman D, Arliani GG. Fraturas atípicas do fêmur associadas ao uso crônico de bisfosfonatos: Uma série de casos de 66 pacientes. Rev Bras Ortop 2021; 57:851-855. [PMID: 36226208 PMCID: PMC9550375 DOI: 10.1055/s-0041-1726066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 12/01/2020] [Indexed: 10/28/2022] Open
Abstract
Resumo
Objetivo Descrever os resultados de uma série de pacientes tratados cirurgicamente com diagnóstico de fratura femoral atípica associada ao uso de bisfosfonatos, assim como correlacionar o tempo de uso prévio da medicação com o tempo de consolidação da fratura e comparar o tempo de consolidação das fraturas completas e incompletas.
Métodos Trata-se de um estudo observacional e retrospectivo de 66 pacientes com diagnóstico de fratura atípica do fêmur associada ao uso crônico de bisfosfonatos. Os pacientes foram submetidos ao tratamento cirúrgico ortopédico em hospital de referência no período de janeiro de 2018 a março de 2020.
Resultados Os pacientes incluídos no estudo eram todos do sexo feminino, com dois casos bilaterais. A consolidação da fratura ocorreu em todos os casos com tempo médio de 2,3 meses e seguimento de 5,8 meses. O tempo médio de uso de bisfosfonatos foi de 7,8 anos. Não houve correlação do tempo de uso prévio de bisfosfonatos com o tempo de consolidação das fraturas. Houve uma diferença do tempo de consolidação entre as fraturas completas e incompletas.
Conclusão Houve consolidação após tratamento cirúrgico com haste cefalomedular longa em todos os pacientes do presente estudo, sendo o tempo de consolidação maior nas fraturas completas em relação às incompletas, e não houve correlação entre o tempo de uso prévio de bisfosfonatos e o tempo de consolidação.
Nível de evidência Nível IV, série de casos
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Affiliation(s)
| | | | | | - Victor Otávio Oliveira
- Departamento de Ortopedia e Traumatologia, Instituto Prevent Senior, São Paulo, SP, Brasil
| | - Daniel Oksman
- Departamento de Ortopedia e Traumatologia, Instituto Prevent Senior, São Paulo, SP, Brasil
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Abstract
BACKGROUND Bunionette is a common foot disorder, and several types of corrective surgery have been described. With the popularization of minimally invasive surgeries, the forefoot region has become a suitable area for this type of technique. The aim of this study was to evaluate the results of oblique distal osteotomy of the fifth metatarsal adapted for a percutaneous approach. METHODS We prospectively evaluated 31 consecutive tailor's bunion patients who underwent operative correction on a total of 42 feet between 2017 and 2019 after failure of conservative treatment. Clinical outcomes such as pain (visual analog scale [VAS]), function (American Orthopaedic Foot & Ankle Society [AOFAS] Lesser Toe Metatarsophalangeal-Interphalangeal Scale scoring system), personal satisfaction, and complications were evaluated. Radiographic aspects were also examined. Shapiro and Mann-Whitney statistical tests were conducted. The average age of the patients was 69.5 years, and the average follow-up was 13.1 months. RESULTS After the operative procedure, there was a decrease of 6.6 points on the VAS for pain (P < .001) and an increase of 34.9 in the AOFAS score (P < .001). Radiographic correction was achieved for both the fifth metatarsophalangeal angle (P < .001) and the intermetatarsal angle (P < .001), which showed decreased values. There was 1 case of superficial infection and 2 cases of nonunion (asymptomatic). A large majority of patients regarded the procedure outcome as satisfactory. CONCLUSION This percutaneous oblique distal osteotomy of the fifth metatarsal for bunionette deformity produced improvements in pain and function and a high rate of satisfaction, with a low incidence of complications and a high capacity for correcting the deformity. LEVEL OF EVIDENCE Level II, prospective cohort study.
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Affiliation(s)
- Gabriel Ferraz Ferreira
- Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, São Paulo, SP, Brazil
| | | | - Daniel Oksman
- Head of Orthopedics and Traumatology, Prevent Senior, São Paulo, SP, Brazil
| | - Miguel Viana Pereira Filho
- Head of Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, São Paulo, SP, Brazil
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de Podesta Haje D, Maranho DA, Ferreira GF, Rocha Geded AC, Aroojis A, Queiroz AC, Bhatti A, Gonçalves Brandão AL, Valencia Lucero EG, Hernández EIA, Tierno GOH, Ocampo JC, Kim JH, Leite LMDS, Oyoun NA, Kumar R, Canto SJS, Nogueira MP. Ponseti Method After Walking Age - A Multi-Centric Study of 429 Feet: Results, Possible Treatment Modifications and Outcomes According to Age Groups. Iowa Orthop J 2020; 40:1-12. [PMID: 33633502 PMCID: PMC7894059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Ponseti method is suitable to treat neglected clubfoot after the walking age. However, limited evidence exists on its effectiveness, outcomes and rate of relapse. Methods: 429 clubfeet in 303 patients with no previous treatment and older than one-year were treated with the Ponseti method in 15 centers from seven countries. The median age at treatment onset was three years, and the median follow-up of 1.3 years. Standard Ponseti Method was applied. Bilateral abduction brace was recommended after casting. Patients were classified according to group ages (<2 years, 2-4 years, >4-8years, >8 years). Feet were evaluated by Pirani score and a clinical outcome classification. Relapses were described in a subset of 103 clubfeet with minimal follow-up of two years. RESULTS Ponseti method was able to correct the deformity in 87% (373 of 429) of neglected clubfeet, after a mean of 6.8 casts. Residual equinus was treated with percutaneous sectioning of the Achilles tendon in 356 (83%) of 429 clubfeet. A bilateral foot abduction brace was prescribed and used in 70% of children. Relapses occurred in 31% (32 of 103) of clubfeet and were associated with age less than 4 years at treatment onset, and bracing noncompliance. CONCLUSION The Ponseti method is effective to correct neglected clubfeet. Relapses occurred in one-third of clubfeet, mainly in children younger than four years and in noncompliance with the brace. Our study reinforces the recommendation for the Ponseti method with no major modification to treat neglected clubfoot in patients after walking age.Level of Evidence: IV.
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Affiliation(s)
- Davi de Podesta Haje
- Hospital de Base do Distrito Federal and Clinical Center Orthopectus - Brasília, DF, Brazil
- Hospital Sírio Libanês - Brasília, DF, Brazil
| | | | - Gabriel Ferraz Ferreira
- Department of Pediatric Orthopaedics and Limb Reconstruction, Hospital do Servidor Público Estadual - São Paulo, SP, Brazil
| | | | - Alaric Aroojis
- Department of Paediatric Orthopaedics, Bai Jerbai Wadia Hospital for Children - Parel, Mumbai, Maharashtra, India
| | | | - Anisuddin Bhatti
- Jinnah Postgraduate Medical Centre - J. S. Medical University - Karachi, Pakistan
| | | | | | - Erika Iliana Arana Hernández
- Department of Pediatric Orthopaedic Surgery, Benemérito Hospital Civil de Guadalajara Fray Antonio Alcalde - Guadalajara, Jalisco, México
| | | | | | - Jung Ho Kim
- Universidade Federal da Fronteira Sul - Passo Fundo, RS, Brazil
| | | | - Nariman Abol Oyoun
- Department of Orthopedic Surgery and Traumatology, Faculty of Medicine, Assiut University - Assiut, Egypt
| | - Ranjeet Kumar
- Jinnah Postgraduate Medical Centre - J. S. Medical University - Karachi, Pakistan
| | | | - Monica Paschoal Nogueira
- Department of Pediatric Orthopaedics and Limb Reconstruction, Hospital do Servidor Público Estadual - São Paulo, SP, Brazil
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Ferreira GF, Stéfani KC, Haje DDP, Nogueira MP. The Ponseti method in children with clubfoot after walking age - Systematic review and metanalysis of observational studies. PLoS One 2018; 13:e0207153. [PMID: 30457993 PMCID: PMC6245511 DOI: 10.1371/journal.pone.0207153] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 10/25/2018] [Indexed: 01/12/2023] Open
Abstract
Background The prevalence of untreated congenital clubfoot among children older than walking age is higher in developing countries due to limited resources for early care after birth. The Ponseti method represents an intervention option for older, untreated children. Methods A metanalysis was conducted of observational studies selected through a systematic review of articles included in electronic databases (Medline, Scopus, Embase, Lilacs, and the Cochrane Library) until June 2017. A pooling analysis of proportions with 95% confidence intervals (CIs) and a publication bias assessment were performed as routine. Estimates of success, recurrence, and complication rates were weighted and pooled using the random effects model. Results Twelve studies, including 654 feet diagnosed with congenital clubfoot in children older than walking age (older than 1 year old), were included for analysis. The rate of satisfactory outcomes found via a cluster metanalysis of proportions using the random effects model was 89% (95% CI = 0.82–0.94, p < 0.01), relative to the total analysed. The recurrence rate was 18% (95% CI = 0.14–0.24, p = 0.015), and the rate of casting complications was 7% (95% CI = 0.03–0.15, p = 0.19). Conclusion Application of the Ponseti method in children with untreated idiopathic clubfoot older than walking age leads to satisfactory outcomes, has a low cost, and avoids surgical procedures likely to cause complications. The results obtained exhibited considerable heterogeneity.
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Affiliation(s)
- Gabriel Ferraz Ferreira
- Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, State Hospital of São Paulo, São Paulo, SP, Brazil
| | - Kelly Cristina Stéfani
- Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, State Hospital of São Paulo, São Paulo, SP, Brazil
| | | | - Monica Paschoal Nogueira
- Children's Orthopaedics and Reconstruction Group, Orthopaedics and Traumatology Unit, State Hospital of São Paulo, São Paulo, SP, Brazil
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Abstract
BACKGROUND Anesthetic block of the peripheral nerves in the foot and ankle is generally used as anesthesia. The increased use of anesthetic blocks has made this technique an increasingly safe method, and its use has been expanded to postoperative analgesia in foot and ankle surgeries. The objective of this study was to evaluate the analgesia time and pain intensity, using objective scores, after peripheral nerve block in foot and ankle surgeries. METHODS Patients who underwent surgery by the foot and ankle group of our institution from March 2016 to January 2017 were invited to participate in this prospective, randomized, and blinded study after signing an informed consent form. The study was approved by the local ethics committee. In total, 57 patients and 59 feet (2 bilateral surgeries) were subjected to spinal anesthesia and were randomized into the group receiving peripheral nerve block in the foot and ankle (7.5 mg/mL ropivacaine) and the control group. The patients answered a questionnaire, administered by phone during the postoperative period, regarding measurement of pain intensity, using the visual analog scale (VAS), and the time of onset of pain. RESULTS Improved pain was noted in patients who received a supplemental peripheral nerve block in relation to the duration of postoperative analgesia and the intensity of pain during the immediate postoperative period. No significant difference was found between the 2 groups in terms of pain intensity on the first or second postoperative day. CONCLUSION Peripheral nerve block in the foot and ankle region can be used effectively as postoperative analgesia to reduce pain intensity during the immediate postoperative period and prolong analgesia. LEVEL OF EVIDENCE Level I, high-quality prospective randomized clinical trial.
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Affiliation(s)
- Kelly Cristina Stéfani
- 1 Foot and Ankle Surgery Group, Orthopedics and Traumatology Department, Hospital do Servidor Público Estadual, São Paulo, São Paulo (SP), Brazil
| | - Gabriel Ferraz Ferreira
- 1 Foot and Ankle Surgery Group, Orthopedics and Traumatology Department, Hospital do Servidor Público Estadual, São Paulo, São Paulo (SP), Brazil
| | - Miguel Viana Pereira Filho
- 1 Foot and Ankle Surgery Group, Orthopedics and Traumatology Department, Hospital do Servidor Público Estadual, São Paulo, São Paulo (SP), Brazil
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Gonçalves CL, Mota FV, Ferreira GF, Mendes JF, Pereira EC, Freitas CH, Vieira JN, Villarreal JP, Nascente PS. Airborne fungi in an intensive care unit. BRAZ J BIOL 2017; 78:265-270. [PMID: 28793031 DOI: 10.1590/1519-6984.06016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 11/08/2016] [Indexed: 11/21/2022] Open
Abstract
The presence of airborne fungi in Intensive Care Unit (ICUs) is associated with increased nosocomial infections. The aim of this study was the isolation and identification of airborne fungi presented in an ICU from the University Hospital of Pelotas - RS, with the attempt to know the place's environmental microbiota. 40 Petri plates with Sabouraud Dextrose Agar were exposed to an environment of an ICU, where samples were collected in strategic places during morning and afternoon periods for ten days. Seven fungi genera were identified: Penicillium spp. (15.18%), genus with the higher frequency, followed by Aspergillus spp., Cladosporium spp., Fusarium spp., Paecelomyces spp., Curvularia spp., Alternaria spp., Zygomycetes and sterile mycelium. The most predominant fungi genus were Aspergillus spp. (13.92%) in the morning and Cladosporium spp. (13.92%) in the afternoon. Due to their involvement in different diseases, the identified fungi genera can be classified as potential pathogens of inpatients. These results reinforce the need of monitoring the environmental microorganisms with high frequency and efficiently in health institutions.
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Affiliation(s)
- C L Gonçalves
- Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - F V Mota
- Programa de Pós-graduação em Medicina Veterinária, Departamento de Veterinária Preventiva, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - G F Ferreira
- Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - J F Mendes
- Programa de Pós-graduação em Medicina Veterinária, Departamento de Veterinária Preventiva, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | | | - C H Freitas
- Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - J N Vieira
- Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - J P Villarreal
- Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - P S Nascente
- Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
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Mendes JF, Gonçalves CL, Ferreira GF, Esteves IA, Freitas CH, Villarreal JPV, Mello JRB, Meireles MCA, Nascente PS. Antifungal susceptibility profile of diferent yeasts isolates from wild animals, cow's milk with subclinical mastitis and hospital environment. BRAZ J BIOL 2017; 78:68-75. [PMID: 28699964 DOI: 10.1590/1519-6984.04916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 08/12/2016] [Indexed: 11/22/2022] Open
Abstract
Yeast infections have acquired great importance due to increasing frequency in immunocompromised patients or patients undergoing invasive diagnostic and therapeutic techniques, and also because of its high morbidity and mortality. At the same time, it has been seen an increase in the emergence of new pathogenic species difficult to diagnose and treat. The aim of this study was to determine the in vitro susceptibility of 89 yeasts from different sources against the antifungals amphotericin B, voriconazole, fluconazole and flucytosine, using the VITEK® 2 Compact system. The antifungal susceptibility was performed automatically by the Vitek® 2 Compact system. The origin of the yeasts was: Group 1 - microbiota of wild animals (W) (26/89), 2 - cow's milk with subclinical mastitis (M) (27/89) and 3 - hospital enviorment (H) (36/89). Of the 89 yeasts submitted to the Vitek® 2 test, 25 (20.9%) were resistant to fluconazole, 11 (12.36%) to amphotericin B, 3 (3.37%) to voriconazole, and no sample was resistant to flucytosine. Regarding the minimum inhibitory concentration (MIC), fluconazole showed an MIC between 1 and 64 mg/mL for the three groups, voriconazole had an MIC between 0.12 and 8 mg/mL, amphotericin B had an MIC between 0.25 and 4 mg/mL for group H and group W respectively, between 0.25 and 16 mg/mL for group M and flucytosine had an MIC equal to 1μg/mL for all groups. The yeasts isolated from the H group showed the highest resistance to fluconazole 12/89 (13.49%), followed by group W (7.87%) and group M (5.62%). The more resistant group to voriconazole was followed by the M and H groups, the W group showed no resistance to this antifungal. Group H was the least resistant (2.25%) to amphotericin.
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Affiliation(s)
- J F Mendes
- Departamento de Veterinária Preventiva, Faculdade de Veterinária, Universidade Federal de Pelotas, Capão do Leão, RS, Brazil
| | - C L Gonçalves
- Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Capão do Leão, RS, Brazil
| | - G F Ferreira
- Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Capão do Leão, RS, Brazil
| | - I A Esteves
- Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Capão do Leão, RS, Brazil
| | - C H Freitas
- Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Capão do Leão, RS, Brazil
| | - J P V Villarreal
- Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Capão do Leão, RS, Brazil
| | - J R B Mello
- Departamento de Farmacologia, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - M C A Meireles
- Departamento de Veterinária Preventiva, Faculdade de Veterinária, Universidade Federal de Pelotas, Capão do Leão, RS, Brazil
| | - P S Nascente
- Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Capão do Leão, RS, Brazil
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Vicari AR, Spuldaro F, Sandes-Freitas TV, Cristelli MP, Requião-Moura LR, Reusing JO, Pierrotti LC, Oliveira ML, Girão CM, Gadonski G, Kroth LV, Deboni LM, Ferreira GF, Tedesco-Silva H, Esmeraldo R, David-Neto E, Saitovitch D, Keitel E, Garcia VD, Pacheco-Silva A, Medina-Pestana JO, Manfro RC. Renal transplantation in human immunodeficiency virus-infected recipients: a case-control study from the Brazilian experience. Transpl Infect Dis 2016; 18:730-740. [PMID: 27503081 DOI: 10.1111/tid.12592] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Revised: 05/27/2016] [Accepted: 06/24/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND Highly active antiretroviral therapy has turned human immunodeficiency virus (HIV)-infected patients with end-stage renal disease into suitable candidates for renal transplantation. We present the Brazilian experience with kidney transplantation in HIV-infected recipients observed in a multicenter study. METHODS HIV-infected kidney transplant recipients and matched controls were evaluated for the incidence of delayed graft function (DGF), acute rejection (AR), infections, graft function, and survival of patients and renal grafts. RESULTS Fifty-three HIV-infected recipients and 106 controls were enrolled. Baseline characteristics were similar, but a higher frequency of pre-transplant positivity for hepatitis C virus and cytomegalovirus infections was found in the HIV group. Immunosuppressive regimens did not differ, but a trend was observed toward lower use of anti-thymocyte globulin in the group of HIV-infected recipients (P = 0.079). The HIV-positive recipient group presented a higher incidence of treated AR (P = 0.036) and DGF (P = 0.044). Chronic Kidney Disease Epidemiology Collaboration estimated that glomerular filtration rate was similar at 6 months (P = 0.374) and at 12 months (P = 0.957). The median number of infections per patient was higher in the HIV-infected group (P = 0.018). The 1-year patient survival (P < 0.001) and graft survival (P = 0.004) were lower, but acceptable, in the group of HIV-infected patients. CONCLUSIONS In the Brazilian experience, despite somewhat inferior outcomes, kidney transplantation is an adequate therapy for selected HIV-infected recipients.
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Affiliation(s)
- A R Vicari
- Renal Transplant Unit, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - F Spuldaro
- Renal Transplant Unit, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | - M P Cristelli
- Hospital do Rim, Federal University of São Paulo, São Paulo, SP, Brazil
| | - L R Requião-Moura
- Renal Transplant Unit, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - J O Reusing
- Renal Transplant Unit, Hospital das Clínicas de São Paulo, University of São Paulo, São Paulo, SP, Brazil
| | - L C Pierrotti
- Renal Transplant Unit, Hospital das Clínicas de São Paulo, University of São Paulo, São Paulo, SP, Brazil
| | - M L Oliveira
- Renal Transplant Unit, Hospital Geral de Fortaleza, Fortaleza, CE, Brazil
| | - C M Girão
- Renal Transplant Unit, Hospital Geral de Fortaleza, Fortaleza, CE, Brazil
| | - G Gadonski
- Renal Transplant Unit, Hospital São Lucas, Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - L V Kroth
- Renal Transplant Unit, Hospital São Lucas, Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - L M Deboni
- Hospital Municipal São José e Fundação Pró-Rim, Joinville, SC, Brazil
| | - G F Ferreira
- Hospital Santa Casa de Misericórdia de Juiz de Fora, Juiz de Fora, MG, Brazil
| | - H Tedesco-Silva
- Hospital do Rim, Federal University of São Paulo, São Paulo, SP, Brazil
| | - R Esmeraldo
- Renal Transplant Unit, Hospital Geral de Fortaleza, Fortaleza, CE, Brazil
| | - E David-Neto
- Renal Transplant Unit, Hospital das Clínicas de São Paulo, University of São Paulo, São Paulo, SP, Brazil
| | - D Saitovitch
- Renal Transplant Unit, Hospital São Lucas, Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - E Keitel
- Renal Transplant Unit, Hospital Santa Casa de Porto Alegre, Federal University of Medical Sciences of Porto Alegre, Porto Alegre, RS, Brazil
| | - V D Garcia
- Renal Transplant Unit, Hospital Santa Casa de Porto Alegre, Federal University of Medical Sciences of Porto Alegre, Porto Alegre, RS, Brazil
| | - A Pacheco-Silva
- Renal Transplant Unit, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | | | - R C Manfro
- Renal Transplant Unit, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
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Abstract
1. A White Leghorn line was selected for part-record hen-housed number of eggs from 1962 to 1990. Genetic changes were estimated as deviations from its unselected control line. 2. Over the first 10 generations with selection almost exclusively for number of eggs to the age of 273 d, all traits, except rate of mortality, showed significant changes. Regressions per year were: 273 d production, 3.07 eggs; 497 d production, 5.18 eggs; production from 274 to 497 d, 2.43 eggs; age at first egg, -2.33 d; mean weight of first 10 eggs, -0.82 g; body weight at 497 d, -19.02 g and rate of mortality, 0.19%. 3. Over the rest of the period increasing selection pressure for egg weight has been applied. This resulted in positive changes for this trait and no or small negative changes in egg number. 4. In general, heritabilities and genetic correlations did not change over the period of selection. The heritability of the main trait of selection, production to 273 d was 0.19 +/- 0.04 and heritabilities of egg size traits about 0.50. 5. The genetic correlation between egg production to 273 d and mean weight of first 10 eggs was estimated as -0.37 +/- 0.06 but from the observed response a realised genetic correlation of -0.97 was calculated.
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Affiliation(s)
- D G Poggenpoel
- Department of Animal Sciences, University of Stellenbosch, Matieland, South Africa
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Ferreira GF, Rega RM, Mandarim-de-Lacerda CA. Spleen's relative growth in human fetuses. Bull Assoc Anat (Nancy) 1992; 76:23-5. [PMID: 1467559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The growth of the spleen weight was studied by bivariate allometry. It was correlated to fetal parameters of development as gestational age (in weeks), crown-rump length (mm) and weight (gm). Thirty human fetuses ranging from 16 to 36 weeks were studied. These were analysed in second and third trimesters separately and together. The growth of the spleen weight presents statistically significant positive allometry relative to age, C-R length and fetal weight. In second trimester the allometric coefficient, analysing spleen's weight and fetus' weight, calculated by reduced major axis method (RMA) was 1.21. In the third one the RMA was 1.73. Considering fetuses together the RMA = 1.65. This study presents growth curves of the spleen weight useful in medical branches such as anatomy, forensic medicine, medical imagery, fetophatology, obstetrics and pediatrics.
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Affiliation(s)
- G F Ferreira
- Department of Anatomy, State University of Rio de Janeiro (UERJ), Brazil
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Ferreira GF, Gerhard-Multhaupt R. Derivation of response equations for the nondestructive probing of charge and polarization profiles. Phys Rev B Condens Matter 1990; 42:7317-7321. [PMID: 9994871 DOI: 10.1103/physrevb.42.7317] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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Ferreira GF, Rega RM, Mandarim-De-Lacerda CA. Allometry of hepatic weight growth in human staged fetuses. Arch Ital Anat Embriol 1990; 95:223-8. [PMID: 2102072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The growth of the hepatic weight was correlated to fetal parameters of maturity (gestational age, crown-rump length and weight) in 70 human fetuses ranging from 14 to 39 weeks post-conception using the allometric method. The growth of the hepatic weight presents moderate positive allometry relative to age and C-R length, and isometry relative to fetal weight. The coefficiens of correlation are very high (p less than 0.001, Table 1). This study presents growth curves of the hepatic weight useful in medical branches such as anatomy, forensic medicine, fetopathology, medical imagery, onstetrics and pediatrics.
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Affiliation(s)
- G F Ferreira
- Department of Anatomy, State University of Rio de Janeiro (UERJ), Brazil
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