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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Lesão focal cartilaginosa do joelho comparando as técnicas de implante de hidrogel com transplante osteocondral autólogo. Ensaio clínico randomizado / Knee focal cartilage lesion: a comparison between the hydrogel implant technique and the osteochondral autologous transplantation. A randomized Clinical Trial

Queiroz, Antônio Altenor Bessa de [UNIFESP] January 2015 (has links) (PDF)
Submitted by Diogo Misoguti (diogo.misoguti@gmail.com) on 2016-06-24T14:29:57Z No. of bitstreams: 1 2015-12-doutorado-antonio-altenor-bessa-de-queiroz.pdf: 1949741 bytes, checksum: d28b78dd2eda86f83807bf487f5ffdd3 (MD5) / Approved for entry into archive by Diogo Misoguti (diogo.misoguti@gmail.com) on 2016-06-24T14:30:33Z (GMT) No. of bitstreams: 1 2015-12-doutorado-antonio-altenor-bessa-de-queiroz.pdf: 1949741 bytes, checksum: d28b78dd2eda86f83807bf487f5ffdd3 (MD5) / Made available in DSpace on 2016-06-24T14:30:33Z (GMT). No. of bitstreams: 1 2015-12-doutorado-antonio-altenor-bessa-de-queiroz.pdf: 1949741 bytes, checksum: d28b78dd2eda86f83807bf487f5ffdd3 (MD5) Previous issue date: 2015 / Introdução: A escolha do tratamento para os pacientes diagnosticados com lesão focal cartilaginosa da articulação do joelho representa uma decisão difícil, e até o momento, não há estudo clínico randomizado envolvendo o Hidrogel (Cartiva™). Objetivo: avaliar e comparar os resultados dos procedimentos Hidrogel (Cartiva™), e o transplante osteocondral autólogo (TOA) no tratamento das lesões focais cartilaginosas da articulação do joelho. Métodos: Num total de 38 pacientes, 38 joelhos, com sintomas de dor e lesão da cartilagem articular graus III ou IV de Outerbridge, foram randomizados para dois grupos iguais. O Grupo I, submetido ao transplante osteocondral autólogo e, o Grupo II, ao tratamento com implante de Hidrogel. Os pacientes foram avaliados pré e pós-operatoriamente aos seis meses, 12 meses e 24 meses, utilizando o IKDC subjetivo, EVA (escala visual analogia da dor), ADLS (Activities of Daily Living Scale) e escala de Lysholm. Resultados: Utilizando a média de pontuação dos questionários foi possível a avaliação final, analisando os resultados dentro do próprio grupo, e entre os grupos, comparados o pré e o pósoperatório. Os dois grupos melhoraram e foram estatisticamente significante (p ≤ 0,05), porém não houve diferença entre os grupos. Quanto às complicações, tivemos sintomas de dor prolongada em quatro (10,5%) pacientes, sendo dois de cada grupo, com regressão dos sintomas na avaliação de um ano. Conclusão: Os dois grupos apresentaram melhora, estatisticamente significante, e não houve superioridade de um sobre o outro. O implante de Hidrogel mostrou-se seguro, e a técnica, permite boa relação de estabilidade e função articular, num seguimento de dois anos. / Introduction: The choice for treating patients diagnosed with a focal chondral defect in the knee joint represents a difficult decision. To date, there has been no randomized controlled trial involving Hydrogel (CartivaTM). Objective: To evaluate and compare the results of the Hydrogel (CartivaTM) and the Osteochondral Autologous Transplantation (OAT) procedures for treating a focal chondral defect of the knee joint. Methods: From the total of thirty-eight (38) patients and thirty-eight (38) knees, showing pain symptoms and articular cartilage lesion at grades III or IV under the Outerbridge classification, two equal groups were randomized. Group I was submitted to Osteochondral Autograft Transplantation (TOA), while Group II underwent a Hydrogel implant. The patients were examined before and after the procedures, then respectively six, 12 and 24 months later, using the subjective IKDC score, the Visual Analogue Scale (VAS), Activities of Daily Living Scale (ADLS) and the Lysholm Knee Scoring Scale. Results: The final outcome was reached by using the average score of the questionnaire, and analyzing the results in the group itself and between groups by comparing the pre and postprocedure step. Both groups improved and were statistically significant (p < 0,05), however showing no difference between them. As for complications, we observed symptoms of long-lasting pain in four patients (10.5%) with two patients in each group showing a decrease in symptoms over a one-year evaluation period. Conclusions: Both groups had a statistically-significant improvement and none was higher than the other. The Hydrogel implant has proved to be safe and the technique has allowed a good stability and joint function relation over a two-year follow-up.

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