The treatment of large and massive rotator cuff tears remains challenging. This study evaluates the efficacy and safety of reinforcement with the long head of the biceps tendon (LHBT) in patients with large and massive repairable rotator cuff tears.

this study aimed to compare the radiographic, functional and isokinetic results of the early repair of quadriceps tendon rupture (QTR) and patellar tendon rupture (PTR).

Osteosarcoma is the most common aggressive primary bone tumor in children and adolescents. Angiogenesis, induced by vascular endothelial growth factor (VEGF) and its receptor (kinase insert domain receptor - KDR) is involved in tumor development. Both genes (VEGF and KDR) are polymorphic, and their association with osteosarcoma remains unclear. A systematic review of observational studies was performed to evaluate the association between polymorphisms in these genes and osteosarcoma development. Pubmed, Medline, Lilacs, and Scielo databases were searched for observational studies published up to April 2024. Eight publications of case-control studies were included, with quality ranging from 82% to 95%. All subjects were from the Chinese population: 1,681 cases and 2,049 controls. A total of six VEGF polymorphisms were analyzed. For osteosarcoma susceptibility, three studies found an increased risk with VEGF rs699947, four with VEGF rs2010963, two with VEGF rs3025039, one with VEGF rs833061, and no studies found an association with the VEGF rs1570360 and VEGF rs10434 SNPs. In addition, no studies evaluated SNPs in the KDR gene and osteosarcoma susceptibility. Further studies in diverse populations, particularly in Brazil, are necessary to clarify the role of VEGF and KDR polymorphisms in osteosarcoma development and prognosis. Level of evidence III; Systematic Review.

To investigate the efficacy and safety of anterior cervical mini-incision vertebroplasty in the treatment of vertebral metastases.

To evaluate isometric and isokinetic ankle strength in of dorsiflexion (DF), plantar flexion (PF), inversion (INV), and eversion (EVE) in healthy individuals.

The aim of this study is to investigate the number of surgeries necessary for an orthopedic surgeon specialized in shoulder surgery to become proficient in performing arthroscopy. This is an original article with level V evidence.

The aim of this study was to evaluate the effect of surgical procedures on maintaining ambulation for Duchenne patients.

The primary objective was to evaluate the efficacy of hyaluronic acid injections for lateral epicondylitis. Secondary objectives included assessing pain and functional outcomes at various time points following the injection.

The presence of popliteal cysts is common, although often unkown to the patient. When spontaneous rupture occurs, the clinical presentation is typically dramatic, frequently prompting the patient to seek emergency care. Eventually the condition can be mistaken for other pathologies, more commonly deep vein thrombosis, leading to inappropriate treatment. The objective of this study is to describe a case series of spontaneous Baker's cyst ruptures, with a 2-year follow-up.

To examine the relationship between place of residence, social vulnerability, and telemedicine access among orthopedic patients at a tertiary hospital in São Paulo, Brazil.

This study aimed to evaluate the use of ultrasonography (USG) compared to radiography in identifying callus formation and fracture healing in hand bones (metacarpals and phalanges).

The Achilles tendon, though the strongest in the human body, is the most commonly ruptured and frequently affected by tendinopathy, particularly in athletes. Achilles tendinopathy (AT) impacts approximately 8% of sports participants, with a lifetime incidence of over 50% in runners. Characterized by pain and tenderness, AT significantly compromises quality of life and functional performance. This narrative review explores biomechanical factors contributing to AT, focusing on both kinematic and kinetic parameters and their clinical relevance, providing a review of AT biomechanics literature, nonoperative interventions, and exercises targeting specific biomechanical risks. Studies have linked abnormal motion to AT. Key biomechanical factors include decreased plantar flexion strength, reduced gluteus medius and maximus activity, decreased peak ankle dorsiflexion, altered peak knee flexion, and decreased forward progression of the center of force, which may increase mechanical load and microtrauma, ultimately resulting in tendon damage. The effectiveness of various interventions was examined, emphasizing the integration of specific exercises aimed at addressing distinct biomechanical deficits. Effective management of AT requires addressing strength deficits and biomechanical abnormalities. Traditional rehabilitation protocols focus on strengthening but often neglect critical biomechanical issues. This review highlights the importance of incorporating specific exercises targeting kinematic and kinetic deficiencies. .

To explore the effect of calcium supplementation on the risk of fractures at various sites in older adults based on randomized controlled trials (RCTs). PubMed, Embase, and the Cochrane Library were systematically searched for eligible RCTs from their inception until May 2023. The included trials investigated the effect of calcium supplementation on the risk of fracture in individuals aged 50 years or above, regardless of the use or nonuse of vitamin D. The primary and secondary outcome measures were total, vertebral, nonvertebral, and hip fractures. Twenty-three RCTs involving 70,837 individuals were enrolled. Calcium supplementation demonstrated a significant reduction in the risk of total (RR: 0.93; 95% CI: 0.88-0.99; P=0.019) and nonvertebral (RR: 0.93; 95% CI: 0.87-0.99; P=0.023) fractures. No significant differences were observed in vertebral (RR: 0.87; 95% CI: 0.75-1.01; P=0.074) and hip (RR: 0.90; 95% CI: 0.73-1.12; P=0.355) fractures between calcium and placebo or no treatment. Calcium dose influenced total fracture risk (P=0.008), while history of fracture (P=0.044), calcium dose (P=0.041), and follow-up duration (P=0.031) affected nonvertebral fracture risk. Follow-up duration impacted hip fracture risk (P=0.001). Calcium supplementation can significantly affect the risk of fracture, particularly nonvertebral fractures, in older adults.

The classification of knee osteoarthritis allows assessment of disease severity and may be useful in guiding treatment decisions. One of the most widely used systems for this purpose is the Ahlbäck classification. This study aimed to compare the original description of the Ahlbäck classification with how it has been reported and cited by other authors in subsequent publications. We conducted a search in the PubMed, Embase, and Cochrane databases for articles containing exclusively the terms "knee", "osteoarthritis", "osteoarthrosis", and "Ahlbäck classification". After applying the inclusion and exclusion criteria, 64 articles remained. These articles were analyzed in two aspects: the description of the Ahlbäck classification (categorized as correct, partially correct, or incorrect) and the accuracy of the reference citation (correctly or incorrectly cited). Only 10 articles (15.6%) correctly described the Ahlbäck classification and cited the original source properly. In contrast, 37 publications (58.4%) contained errors both in the description of the classification and the citation. Conversely, 37 publications (58.4%) contained errors both in the description of the classification and in the bibliographic reference. The proportion of articles that accurately described and cited the Ahlbäck classification was markedly low, comprising only 15.6% of those included in this systematic review. .

To compare the clinical outcomes of children with forearm bone fractures undergoing surgical treatment with intramedullary fixation with TEN rods and Kirschner wires. A systematic review of the literature was carried out, conducting a search for data in the Pubmed/Medline, Science Direct and Scielo databases. The quality of the trials was assessed by the MINORS tool and the meta-analysis of the studies was performed using the R software (version 4.4.0). 16 studies were selected, representing 1,075 patients, with a predominance of males, where the mean age range varied from 8.32 to 14.2 years. Applying the MINORS Scale, the quality of the studies was good (≥ 11). The meta-analysis of the studies revealed a statistically significant increase in the risk of adverse events in the experimental group compared to the control group, with a risk ratio (RR) of 1.35 (95% CI: 1.03 to 1.76). The combined mean difference (raw mean) between the experimental group and the control group was -12.42 minutes (95% CI: -13.75 to -11.10) in the fixed-effect model, indicating a significant reduction in surgical time for the experimental group. In the random-effect model, the mean difference was -21.62 minutes (95% CI: -33.30 to -9.94). Regarding fracture consolidation time, the fixed-effect model indicated a raw mean difference of 0.99 (95% CI: 0.61 to 1.36). Furthermore, heterogeneity was moderate to high, with an I² of 73% (p < 0.01). Intramedullary fixation with TEN nails and Kirschner wires presents a diversity of clinical outcomes and complications. The systematic review highlighted the importance of choosing the appropriate treatment method, considering the patient characteristics and the nature of the fracture. .

In chronic hand flexor tendon reconstruction with tendon grafts, the challenge is to obtain the best resistance and tension of the suture that allows early active mobility. This experimental study of tension relaxation aims to investigate whether prior preconditioning of the tendon graft could assist to identify the ideal tendon graft tension in these reconstructions.

To identify and analyze the geographical distribution, surgical volume, and population adequacy of Orthopedic Oncology Centers (OOCs) within the Brazilian Unified Health System (SUS).

To evaluate the efficacy of bioabsorbable interbody cages in comparison with conventional techniques in animal models, with emphasis on the impact of follow-up time on developments. A systematic review and meta-analysis was performed including 11 studies on the use of bioabsorbable cages in comparison with conventional techniques. The odds ratio (OR) was calculated for range of motion (ROM), and heterogeneity was assessed by Cochran's Q test. Descriptive statistical analyses and hypothesis tests were performed to evaluate the parameters of fusion rate, intervertebral disc height and ROM. The 11 studies included totaled 244 animals. The analysis revealed a cumulative OR of 1.70 for ROM and fusion rate in the first four months of follow-up. No significant differences were found in height parameters in the study follow-ups. Heterogeneity among studies was low, indicating consistency in the results. The analysis suggests that bioabsorbable cages have advantages in periods of less than four months, and that there is no inferiority in the results in follow-up periods longer than four months in terms of fusion rate, ROM and intervertebral height in long-term experimental studies, and further research is needed to determine their clinical applicability. .

Total hip arthroplasty (THA) is a complex surgery and is indicated for the treatment of degenerative diseases such as osteoarthritis, rheumatoid arthritis and osteonecrosis, as well as femoral neck fractures. This procedure aims to restore mobility, relieve pain and improve patients' quality of life. However, infections, especially periprosthetic joint infection (PJI), are serious complications that can compromise the success of the surgery. To identify risk factors, as well as methods of preventing and treating infections in THA. An integrative literature review was carried out, selecting clinical trials published in the last 10 years that addressed the proposed topic, using the following search strategy in the PUBMED database: hip[title] AND arthroplasty[title] AND infec*[title]. The analysis involved reading and discussing 12 articles, which addressed different aspects of infection prevention and management in THA. Although some interventions, such as collagen sponges with gentamicin and triclosan-coated sutures, have not significantly reduced the incidence of infections, others, such as closed incisional negative pressure therapy (ciNPWT) and washing with diluted betadine, have shown promise in certain contexts. Diagnostic accuracy, especially for coagulase-negative staphylococci, still presents challenges, highlighting the need for advances in diagnostic and therapeutic methods. Thus, despite advances, the prevention and management of infections in THA still require improvement, and interventions must be carefully evaluated to ensure the effectiveness and safety of the procedure. .

To evaluate the epidemiological profile and waiting time for osteosynthesis in patients admitted due to intertrochanteric fracture in a public hospital in the Federal District of Brazil.

The calcaneal tendon is the strongest tendon in the human body, and therefore the most commonly injured in the lower limbs. The aim of this study is to present a rehabilitation protocol, based on the literature, according to the physiology of tissue regeneration in the postoperative period of acute rupture of the calcaneal tendon, carried out through a bibliographic survey of the last 20 years and proposed by the Physiotherapy Service of the Institute of Orthopaedics and Traumatology of the Hospital das Clínicas of the University of São Paulo. The findings demonstrated that, despite the differences in surgical techniques, the proposed rehabilitation protocol presents minimal risk of damage to the surgical site. .