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Pelvic Reconstruction after Chronic Pubic Symphysis Diastasis and Bladder Herniation

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Open Journal of Orthopedics 2020年第8期10卷 161-165页

作者： carlos roberto schwartsmann Renan Castanho de Campos Leite Henrique Marquardt Lammerhirt Leandro de Freitas Spinelli Ary da Silva Ungaretti Neto Federal University of Health Sciences of Porto Alegre/RS Porto Alegre Brazil Orthopedics and Traumatology Service of the Santa Casa de Porto Alegre Hospitalar Complex Porto Alegre Brazil Department of Surgery Federal University of Health Sciences of Porto Alegre/RS Porto Alegre Brazil Laboratory of Bioengineering Biomechanics and Biomaterials Department of Mechanical Engineering University of Passo Fundo Passo Fundo Brazil

The research proposes a surgical technique for patients with chronic pubic symphysis diastasis and bladder herniation by means of a pelvic reconstruction technique. Three patients were treated initially in other hospitals and referred to us. All presented with pubic symphysis diastasis greater than 7 cm and bladder herniation. Two patients were initially treated with external fixation, and in one patient, the symphysis diastasis had been completely neglected. All cases presented good evolution with the proposed technique, which is described in details in the paper.

关键词： Pelvic Reconstruction Pelvic Disruption Pelvic Diastasis

Total Knee Arthroplasty:Patellar Replacement’s Influence in Patient Quality of Life Postoperatively

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Open Journal of Orthopedics 2017年第8期7卷 228-234页

作者： carlos roberto schwartsmann Gabriel Severo da Silva Ivan Fadanelli Simionato Flavia Magalhaes Nunes Henrique Lammerhirt Joao Pedro Farina Brunelli Leandro de Freitas Spinelli Federal University of Medical Sciences Porto AlegreBrazil Department of Orthopedics and Traumatology Irmandade Santa Casa de Misericordia de Porto AlegrePorto AlegreBrazil

Objective: To study the influence of patellar resurfacing on quality of life under a standardised score. The chosen score was the Knee Society Score (KSS), which considers range of motion, pain, contractors, alignment and stability. Methods: Retrospective review of 60 patients submitted to total knee arthroplasty (TKA) was divided into two groups: with patellar resurfacing (PR) and without patellar resurfacing (NPR). We reviewed data from these patients containing the KSS, which are routinely used in our service. Data were analysed from 2013 to 2014, with a minimal patient follow-up of 18 months. Results: There were no unsatisfactory scores in our study. Total scores (KSS) were similar between the groups (mean KSS: PR = 88.36 ± 9.64;NPR = 84.26 ± 9.44 [p = 0.1]). While stratifying into groups (poor, fair, good, excellent), we found excellent results in 84.8% of PR versus 59.3% NPR (p = 0.056). These data did not reach statistical significance and can therefore be considered a coincidental result. Conclusion: Although these results did not show statistical significance (p = 0.056), patellar resurfacing patients tend to get more “excellent” results after 18 months of follow-up in quality of life when evaluated by KSS. Perhaps a larger amount of patients would suffice to acquire statistical significance in a future study.

关键词： Knee Arthroplasty Patella Joint Instability Quality of Life

Clinical,Laboratory and Echografic Evaluation of Patients with Deep Vein Thrombosis Following Total Knee Arthroplasty

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Open Journal of Orthopedics 2019年第2期9卷 23-29页

作者： carlos roberto schwartsmann Mario Arthur Rockenbach Binz Marco Tonding Ferreira Felipe Roth Ivan Fadanelli Simionato Leandro de Freitas Spinelli Joao Pedro Farina Brunelli Universidade Federal de Ciencias Medicas de Porto Alegre Porto AlegreBrazil Orthopaedics and Traumatology Service of the Santa Casa de Porto Alegre Hospitalar Complex Porto AlegreBrazil

Introduction: Total knee arthroplasty, being a major surgery, carries a risk of post-operative deep vein thrombosis (DVT). The main objective of the present study was to elucidate the association of clinical, laboratory, and echographic findings with the occurrence of DVT. Patients and Methods: The present study was prospective and non-randomized, with restricted exclusion criteria. Forty patients were submitted to total knee arthroplasty due to osteoarthritis. Patients were clinically evaluated by laboratory tests, assessment of pain and calf circumference, and the presence of Homans’ sign. Echo Doppler was performed in each patient on postoperative day 7. The echographic evaluation divided the patients into two groups: positive (G1) and negative for thrombosis (G2). All patients received prophylactic heparin during the 7-day hospital admission. Results: Eleven patients complained of pain (analgesic medication was used during the entire admission). Leg circumference variation from the pre-operative period to post-operative day 7 was: G1, 1.70 ± 1.12 cm and G2, 0.68 ± 1.25 cm (p = 0.03). Homans’ sign was considered positive in 10 patients. Echographic evaluation was positive in 11 patients (27.5%). No cases of pulmonary embolism, infection, or death were observed. Conclusions: The incidence of DVT was 27.5%, with an increase in leg circumference being the main predictive factor (p = 0.03).

关键词： Knee Arthroplasty DVT Knee Replacement

Femoral Head Autograft to the Iliac for Use in Future Revisions of Total Hip Arthroplasty: 15-Year Follow-Up

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Open Journal of Orthopedics 2022年第11期12卷 420-431页

作者： carlos roberto schwartsmann Rafael de Luca de Lucena Ary da Silva Ungaretti Neto Esthefani Katherina Mendes Eggers Vinícius Ozuna Sampaio Alonso Ranzzi Leandro de Freitas Spinelli Department of Surgery Federal University of Health Sciences of Porto Alegre (UFCSPA) Rio Grande do Sul Brazil Orthopedics and Traumatology Santa Casa de Misericórdia Hospital of Porto Alegre Rio Grande do Sul Brazil Graduate Program of Design and Manufacturing Process Laboratory of Bioengineering Biomechanics and Biomaterials University of Passo Fundo Rio Grande do Sul Brazil

Introduction: The therapeutic success of total hip arthroplasty (THA) is unquestionable. However, in young patients, it is still a controversial topic, not because of the results obtained, but because of the presumed need for revision of the prosthetics components in the future. Objectives: The present work performs a retrospective study of patients who underwent THA surgery in the past, in which the femoral head was transferred to the iliac for use in future revisions of total hip arthroplasty (autograft), and describes the proposed technique. Methods: The research reviewed 27 patients operated on using the femoral head autograft technique for the ipsilateral iliac in total hip arthroplasty, performed from 1996 to 2005;the study considered medical records, X-rays and CT scan images, and photographs taken at the time of surgery. Results: To date, only two revisions of total hip arthroplasty have been performed, in which the patients have benefited from the technique of autografting of the femoral head. No case evolved with infection or any other type of complication. All inserted grafts are consolidated and integrated with the iliac. Conclusion: The autograft technique is cheap, simple and reproducible, making available large amounts of bone for use in future revisions of total hip arthroplasty in young patients.

关键词： Total Hip Arthroplasty Bone Graft Revision of Total Hip Arthroplasty Femoral Head

Pelvic Reconstruction after Chronic Pubic Symphysis Diastasis and Bladder Herniation

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Femoral Head Autograft to the Iliac for Use in Future Revisions of Total Hip Arthroplasty:15-Year Follow-Up

Open Journal of Orthopedics（矫形学期刊） 2020年第8期

作者： carlos roberto schwartsmann Renan Castanho de Campos Leite Henrique Marquardt Lammerhirt Leandro de Freitas Spinelli Ary da Silva Ungaretti Neto

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