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Cunha C, Voss G, Andrade R, Delerue-Matos A. Is Formal Social Participation Associated with Cognitive Function in Middle-Aged and Older Adults? A Systematic Review with Meta-Analysis of Longitudinal Studies. Behav Sci (Basel) 2024; 14:262. [PMID: 38667058 PMCID: PMC11047523 DOI: 10.3390/bs14040262] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 03/08/2024] [Accepted: 03/20/2024] [Indexed: 04/29/2024] Open
Abstract
This systematic review with meta-analysis aimed to explore the association between formal social participation and cognitive function in middle-aged and older adults using data from longitudinal studies. A comprehensive search was conducted in Scopus, PubMed, and Web of Science for longitudinal studies that assessed the association between formal social participation and cognitive function in middle-aged and older adults published between January 2010 to 19 August 2022. Risk of bias was judged using the RoBANS tool. Meta-analysis using a random-effects model was computed with odds ratio (OR) and 95% confidence interval (CI) for cognitive decline probability. Sensitivity analyses were made to explore any changes to the pooled statistical heterogeneity and pooled effect size. Certainty of evidence was judged using the GRADE framework. We included 15 studies comprising 136,397 participants from 5 countries. Meta-analyses showed that formal social participation was associated with reduced cognitive decline (OR = 0.78, 95% CI 0.75-0.82, p < 0.001), with very low certainty of evidence. Formal social participation appears to enhance cognition in middle-aged and older adults, but further high-quality research is needed given the very low certainty of evidence.
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Affiliation(s)
- Cláudia Cunha
- Communication and Society Research Centre, Institute of Social Sciences, University of Minho, 4710-057 Braga, Portugal;
| | - Gina Voss
- Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal;
| | - Renato Andrade
- Clínica Espregueira—FIFA Medical Centre of Excellence, 4350-415 Porto, Portugal;
- Dom Henrique Research Centre, 4350-415 Porto, Portugal
- Porto Biomechanics Laboratory (LABIOMEP), Faculty of Sports, University of Porto, 4200-450 Porto, Portugal
| | - Alice Delerue-Matos
- Communication and Society Research Centre, Institute of Social Sciences, University of Minho, 4710-057 Braga, Portugal;
- Department of Sociology, Institute of Social Sciences, University of Minho, 4710-057 Braga, Portugal
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Afonso J, Andrade R, Rocha-Rodrigues S, Nakamura FY, Sarmento H, Freitas SR, Silva AF, Laporta L, Abarghoueinejad M, Akyildiz Z, Chen R, Pizarro A, Ramirez-Campillo R, Clemente FM. What We Do Not Know About Stretching in Healthy Athletes: A Scoping Review with Evidence Gap Map from 300 Trials. Sports Med 2024:10.1007/s40279-024-02002-7. [PMID: 38457105 DOI: 10.1007/s40279-024-02002-7] [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] [Subscribe] [Scholar Register] [Accepted: 02/03/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Stretching has garnered significant attention in sports sciences, resulting in numerous studies. However, there is no comprehensive overview on investigation of stretching in healthy athletes. OBJECTIVES To perform a systematic scoping review with an evidence gap map of stretching studies in healthy athletes, identify current gaps in the literature, and provide stakeholders with priorities for future research. METHODS Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 and PRISMA-ScR guidelines were followed. We included studies comprising healthy athletes exposed to acute and/or chronic stretching interventions. Six databases were searched (CINAHL, EMBASE, PubMed, Scopus, SPORTDiscus, and Web of Science) until 1 January 2023. The relevant data were narratively synthesized; quantitative data summaries were provided for key data items. An evidence gap map was developed to offer an overview of the existing research and relevant gaps. RESULTS Of ~ 220,000 screened records, we included 300 trials involving 7080 athletes [mostly males (~ 65% versus ~ 20% female, and ~ 15% unreported) under 36 years of age; tiers 2 and 3 of the Participant Classification Framework] across 43 sports. Sports requiring extreme range of motion (e.g., gymnastics) were underrepresented. Most trials assessed the acute effects of stretching, with chronic effects being scrutinized in less than 20% of trials. Chronic interventions averaged 7.4 ± 5.1 weeks and never exceeded 6 months. Most trials (~ 85%) implemented stretching within the warm-up, with other application timings (e.g., post-exercise) being under-researched. Most trials examined static active stretching (62.3%), followed by dynamic stretching (38.3%) and proprioceptive neuromuscular facilitation (PNF) stretching (12.0%), with scarce research on alternative methods (e.g., ballistic stretching). Comparators were mostly limited to passive controls, with ~ 25% of trials including active controls (e.g., strength training). The lower limbs were primarily targeted by interventions (~ 75%). Reporting of dose was heterogeneous in style (e.g., 10 repetitions versus 10 s for dynamic stretching) and completeness of information (i.e., with disparities in the comprehensiveness of the provided information). Most trials (~ 90%) reported performance-related outcomes (mainly strength/power and range of motion); sport-specific outcomes were collected in less than 15% of trials. Biomechanical, physiological, and neural/psychological outcomes were assessed sparsely and heterogeneously; only five trials investigated injury-related outcomes. CONCLUSIONS There is room for improvement, with many areas of research on stretching being underexplored and others currently too heterogeneous for reliable comparisons between studies. There is limited representation of elite-level athletes (~ 5% tier 4 and no tier 5) and underpowered sample sizes (≤ 20 participants). Research was biased toward adult male athletes of sports not requiring extreme ranges of motion, and mostly assessed the acute effects of static active stretching and dynamic stretching during the warm-up. Dose-response relationships remain largely underexplored. Outcomes were mostly limited to general performance testing. Injury prevention and other effects of stretching remain poorly investigated. These relevant research gaps should be prioritized by funding policies. REGISTRATION OSF project ( https://osf.io/6auyj/ ) and registration ( https://osf.io/gu8ya ).
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Affiliation(s)
- José Afonso
- Faculty of Sport, Centre of Research, Education, Innovation, and Intervention in Sport (CIFI2D), University of Porto, Porto, Portugal.
| | - Renato Andrade
- Clínica Espregueira-FIFA Medical Centre of Excellence, Porto, Portugal
- Dom Henrique Research Centre, Porto, Portugal
- Porto Biomechanics Laboratory (LABIOMEP), University of Porto, Porto, Portugal
| | - Sílvia Rocha-Rodrigues
- Escola Superior de Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Rua Escola Industrial e Comercial de Nun'Alvares, 4900-347, Viana do Castelo, Portugal
- Tumour and Microenvironment Interactions Group, INEB-Institute of Biomedical Engineering, i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, 4200-153, Porto, Portugal
- Sport Physical Activity and Health Research & Innovation Center, 4900-347, Viana do Castelo, Portugal
| | - Fábio Yuzo Nakamura
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University of Maia, Maia, Portugal
| | - Hugo Sarmento
- University of Coimbra, Research Unit for Sport and Physical Activity (CIDAF), Faculty of Sport Sciences and Physical Education, Coimbra, Portugal
| | - Sandro R Freitas
- Laboratório de Função Neuromuscular, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada, Portugal
| | - Ana Filipa Silva
- Escola Superior de Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Rua Escola Industrial e Comercial de Nun'Alvares, 4900-347, Viana do Castelo, Portugal
- Sport Physical Activity and Health Research & Innovation Center, 4900-347, Viana do Castelo, Portugal
| | - Lorenzo Laporta
- Núcleo de Estudos em Performance Analysis Esportiva (NEPAE/UFSM), Universidade Federal de Santa Maria, Avenida Roraima, nº 1000, Cidade Universitária, Bairro Camobi, Santa Maria, RS, CEP: 97105-900, Brazil
| | | | - Zeki Akyildiz
- Sports Science Faculty, Department of Coaching Education, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Rongzhi Chen
- Faculty of Sport, Centre of Research, Education, Innovation, and Intervention in Sport (CIFI2D), University of Porto, Porto, Portugal
| | - Andreia Pizarro
- Faculty of Sport, Research Center in Physical Activity, Health and Leisure (CIAFEL), University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Rua das Taipas, 135, 4050-600, Porto, Portugal
| | - Rodrigo Ramirez-Campillo
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy. Faculty of Rehabilitation Sciences, Universidad Andres Bello, 7591538, Santiago, Chile
| | - Filipe Manuel Clemente
- Escola Superior de Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Rua Escola Industrial e Comercial de Nun'Alvares, 4900-347, Viana do Castelo, Portugal
- Sport Physical Activity and Health Research & Innovation Center, 4900-347, Viana do Castelo, Portugal
- Gdańsk University of Physical Education and Sport, 80-336, Gdańsk, Poland
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Afonso J, Reurink G, Clemente FM, Ramirez-Campillo R, Pizzari T, Andrade R. Revisiting the hamstring injury prevention and rehabilitation literature: filling the gaps! Br J Sports Med 2024; 58:243-244. [PMID: 38071509 DOI: 10.1136/bjsports-2023-106878] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2023] [Indexed: 03/10/2024]
Affiliation(s)
- José Afonso
- Centre of Research, Education, Innovation, and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, Porto, Portugal
| | - Guus Reurink
- Department of Orthopaedic Surgery and Sports Medicine, Amsterdam Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- The Sport Physician Group, Department of Sports Medicine, OLVG, Amsterdam, The Netherlands
| | - Filipe Manuel Clemente
- Escola Superior Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Viana do Castelo, Portugal
- Gdańsk University of Physical Education and Sport, Gdańsk, Poland
| | - Rodrigo Ramirez-Campillo
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
| | - Tania Pizzari
- La Trobe University La Trobe Sport and Exercise Medicine Research Centre, Melbourne, Victoria, Australia
| | - Renato Andrade
- Porto Biomechanics Laboratory (LABIOMEP), Porto, Portugal
- Clínica Espregueira - FIFA Medical Centre of Excellence, Porto, Portugal
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Ribeiro R, Gomes E, Ferreira B, Figueiredo I, Valente C, Delgado D, Sánchez M, Andrade R, Espregueira-Mendes J. Derotational distal femoral osteotomy corrects excessive femoral anteversion in patients with patellofemoral instability: A systematic review. Knee Surg Sports Traumatol Arthrosc 2024; 32:713-724. [PMID: 38385776 DOI: 10.1002/ksa.12097] [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] [Received: 12/13/2023] [Revised: 01/25/2024] [Accepted: 02/04/2024] [Indexed: 02/23/2024]
Abstract
PURPOSE Patellofemoral instability (PFI) is a common condition that can be caused from multiple factors, including lower limb rotational malalignments. Determining precise criteria for performing corrective torsional osteotomy can be a daunting task due to the lack of consensus on normal and excessive values and the limited evidence-based data in the postoperative results. The purpose was to assess the clinical, functional and imaging outcomes following derotational distal femoral osteotomy (DDFO) in patients with PFI and/or anterior knee pain (AKP) associated with lower limb rotational malalignments. METHODS Searches were conducted on PubMed, EMBASE and Web of Science databases up to October 2023. Studies reporting outcomes after DDFO in patients with PFI and/or AKP were eligible for the systematic review. The primary outcome was imaging metrics, especially femoral anteversion. Secondary outcomes included the patient-reported outcome measures (PROMs) (clinical and functional). Quantitative synthesis involved the use of weighted averages to calculate pre- to postoperative mean differences (MD) and compare them against the minimal clinically important difference (MCID). RESULTS Ten studies (309 knees) were included with a mean follow-up of 36.1 ± 11.7 months. Imaging outcomes consistently indicated the correction of femoral anteversion (MD = -19.4 degrees, 95% confidence interval: -20.1 to -18.7) following DDFO. PROMs showed significant improvements in most studies, exceeding the MCID. Patient satisfaction with the DDFO was high (93.3%). CONCLUSIONS The DDFO was an effective treatment option for correcting excessive femoral anteversion in patients with PFI associated with clinically relevant functional and clinical improvement and a high satisfaction rate. LEVEL OF EVIDENCE Level IV, systematic review of level II-IV studies.
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Affiliation(s)
| | - Eluana Gomes
- Clínica Espregueira-FIFA Medical Centre of Excellence, Porto, Portugal
| | | | | | - Cristina Valente
- Clínica Espregueira-FIFA Medical Centre of Excellence, Porto, Portugal
- Dom Henrique Research Centre, Porto, Portugal
| | - Diego Delgado
- Advanced Biological Therapy Unit, Hospital Vithas Vitoria, Vitoria-Gasteiz, Spain
| | - Mikel Sánchez
- Advanced Biological Therapy Unit, Hospital Vithas Vitoria, Vitoria-Gasteiz, Spain
- Arthroscopic Surgery Unit, Hospital Vithas Vitoria, Vitoria-Gasteiz, Spain
| | - Renato Andrade
- Clínica Espregueira-FIFA Medical Centre of Excellence, Porto, Portugal
- Dom Henrique Research Centre, Porto, Portugal
- Porto Biomechanics Laboratory (LABIOMEP), Faculty of Sports, University of Porto, Porto, Portugal
| | - João Espregueira-Mendes
- School of Medicine, Minho University, Braga, Portugal
- Clínica Espregueira-FIFA Medical Centre of Excellence, Porto, Portugal
- Dom Henrique Research Centre, Porto, Portugal
- ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
- 3B's Research Group-Biomaterials, Biodegradables and Biomimetics, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, University of Minho, Braga, Portugal
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Ferreira B, Gomes E, Figueiredo I, Ribeiro R, Valente C, Delgado D, Sánchez M, Andrade R, Espregueira-Mendes J. Derotational high tibial osteotomy in cases of anterior knee pain and/or patellofemoral instability: a systematic review. J ISAKOS 2024:S2059-7754(24)00043-9. [PMID: 38430984 DOI: 10.1016/j.jisako.2024.02.015] [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] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/09/2024] [Accepted: 02/25/2024] [Indexed: 03/05/2024]
Abstract
IMPORTANCE Derotational high tibial osteotomy (HTO) is a surgical intervention for correcting rotational malalignments in the lower limb, which may contribute to anterior knee pain (AKP) and/or patellofemoral instability (PFI). This surgical technique is not yet widely implemented and requires a systematic evaluation of its outcomes. AIM To assess the effectiveness of derotational HTO in correcting rotational malalignments of the lower limb in patients with AKP and/or PFI through radiological, clinical, and patient-reported outcome measures. EVIDENCE REVIEW Searches were conducted in the PubMed, Embase, and Web of Science databases up to March 3, 2023, to identify studies utilizing derotational HTO in patients with AKP and/or PFI. The primary outcome measures of interest were measurements of lower limb angular correction. Other radiological, clinical, and patient-reported outcome measures were also analyzed. The risk of bias was judged with the RoBANS tool. FINDINGS A total of 8 studies were included, comprising 215 patients (27.0 ± 3.9 years) and 245 knees. The most reported angle was tibial torsion (k = 6 studies, n = 173 knees), with a mean difference between postoperative and preoperative values (postsurgical correction) ranging from -37.8° to -10.8°. Patient-reported outcome measures showed significant improvements in the postoperative moment, exceeding the minimal clinically important difference in almost all cases, and with high patient satisfaction (93.6%). CONCLUSIONS AND RELEVANCE Derotational HTO allows the correction of rotational malalignments of the lower limb (tibial torsion) and promotes patient satisfaction. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
| | - Eluana Gomes
- Clínica Espregueira-FIFA Medical Centre of Excellence, 4350-415, Porto, Portugal
| | - Inês Figueiredo
- School of Medicine, Minho University, 4710-057, Braga, Portugal
| | - Ricardo Ribeiro
- School of Medicine, Minho University, 4710-057, Braga, Portugal
| | - Cristina Valente
- Clínica Espregueira-FIFA Medical Centre of Excellence, 4350-415, Porto, Portugal; Dom Henrique Research Centre, 4350-415, Porto, Portugal
| | - Diego Delgado
- Advanced Biological Therapy Unit, Hospital Vithas Vitoria, 01008, Vitoria-Gasteiz, Spain
| | - Mikel Sánchez
- Advanced Biological Therapy Unit, Hospital Vithas Vitoria, 01008, Vitoria-Gasteiz, Spain; Arthroscopic Surgery Unit, Hospital Vithas Vitoria, 01008, Vitoria-Gasteiz, Spain
| | - Renato Andrade
- Clínica Espregueira-FIFA Medical Centre of Excellence, 4350-415, Porto, Portugal; Dom Henrique Research Centre, 4350-415, Porto, Portugal; Porto Biomechanics Laboratory (LABIOMEP), Faculty of Sports, University of Porto, 4200-450, Porto, Portugal
| | - João Espregueira-Mendes
- School of Medicine, Minho University, 4710-057, Braga, Portugal; Clínica Espregueira-FIFA Medical Centre of Excellence, 4350-415, Porto, Portugal; Dom Henrique Research Centre, 4350-415, Porto, Portugal; ICVS/3B's-PT Government Associate Laboratory, 4710-057, Braga/Guimarães, Portugal; 3B's Research Group-Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, 4806-909, Barco, Guimarães, Portugal.
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Afonso J, Ramirez-Campillo R, Clemente FM, Büttner FC, Andrade R. The Perils of Misinterpreting and Misusing "Publication Bias" in Meta-analyses: An Education Review on Funnel Plot-Based Methods. Sports Med 2024; 54:257-269. [PMID: 37684502 PMCID: PMC10933152 DOI: 10.1007/s40279-023-01927-9] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2023] [Indexed: 09/10/2023]
Abstract
Publication bias refers to a systematic deviation from the truth in the results of a meta-analysis due to the higher likelihood for published studies to be included in meta-analyses than unpublished studies. Publication bias can lead to misleading recommendations for decision and policy making. In this education review, we introduce, explain, and provide solutions to the pervasive misuses and misinterpretations of publication bias that afflict evidence syntheses in sport and exercise medicine, with a focus on the commonly used funnel-plot based methods. Publication bias is more routinely assessed by visually inspecting funnel plot asymmetry, although it has been consistently deemed unreliable, leading to the development of statistical tests to assess publication bias. However, most statistical tests of publication bias (i) cannot rule out alternative explanations for funnel plot asymmetry (e.g., between-study heterogeneity, choice of metric, chance) and (ii) are grossly underpowered, even when using an arbitrary minimum threshold of ten or more studies. We performed a cross-sectional meta-research investigation of how publication bias was assessed in systematic reviews with meta-analyses published in the top two sport and exercise medicine journals throughout 2021. This analysis highlights that publication bias is frequently misused and misinterpreted, even in top tier journals. Because of conceptual and methodological problems when assessing and interpreting publication bias, preventive strategies (e.g., pre-registration, registered reports, disclosing protocol deviations, and reporting all study findings regardless of direction or magnitude) offer the best and most efficient solution to mitigate the misuse and misinterpretation of publication bias. Because true publication bias is very difficult to determine, we recommend that future publications use the term "risk of publication bias".
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Affiliation(s)
- José Afonso
- Faculty of Sport, Centre of Research, Education, Innovation, and Intervention in Sport (CIFI2D), University of Porto, Porto, Portugal.
| | - Rodrigo Ramirez-Campillo
- Exercise and Rehabilitation Sciences Institute, Faculty of Rehabilitation Sciences, School of Physical Therapy, Universidad Andres Bello, Santiago, Chile
| | - Filipe Manuel Clemente
- Escola Superior de Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Rua Escola Industrial Comercial de Nun'Álvares, 4900-347, Viana do Castelo, Portugal
- Instituto de Telecomunicações, Delegação da Covilhã, Covilhã, Portugal
- Research Center in Sports Performance, Recreation, Innovation and Technology (SPRINT), 4960-320, Melgaço, Portugal
| | - Fionn Cléirigh Büttner
- Pragmatic Clinical Trials Unit, Centre for Evaluation and Methods, Wolfson Centre of Population Health, Queen Mary University of London, London, UK
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Renato Andrade
- Porto Biomechanics Laboratory (LABIOMEP), University of Porto, Porto, Portugal
- Clínica Espregueira, FIFA Medical Centre of Excellence, Porto, Portugal
- Dom Henrique Research Centre, Porto, Portugal
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Kuruwa DR, Andrade R, Espregueira-Mendes J. Permanent Subluxation of the Lateral Meniscus in a 10-year-old Boy: A Case Report with Short Literature Review. J Orthop Case Rep 2023; 13:21-25. [PMID: 38162352 PMCID: PMC10753661 DOI: 10.13107/jocr.2023.v13.i12.4062] [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] [Received: 09/01/2023] [Revised: 10/04/2023] [Indexed: 01/03/2024] Open
Abstract
Introduction Locking of the knee attributed to non-discoid lateral meniscus in an atraumatic setting is a rare phenomenon. One such cause is permanent subluxation of lateral meniscus (PSLM). In the entire literature, there is only one documented case of a 37-year-old female. Case Report We present a case of a 10-year-old boy who suffered two episodes of knee locking reported radiologically as a bucket handle tear of the lateral meniscus. No tear was found during arthroscopy. The lateral meniscus was malformed with meniscocapsular discontinuity and irreducibly subluxated into the intercondylar space. No salvage procedure was possible. We ended up performing a subtotal meniscectomy. Conclusion This is the first case of PSLM reported in the pediatric age group and second overall. Management options are limited. Further genetic and fetal studies are needed in this area to determine the exact causality.
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Affiliation(s)
- Deven R Kuruwa
- Department of Orthopaedics, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India
| | - Renato Andrade
- Clínica Espregueira - FIFA Medical Centre of Excellence, Porto, Portugal
- Dom Henrique Research Centre, Porto, Portugal
- Porto Biomechanics Laboratory (LABIOMEP), University of Porto, Porto, Portugal
| | - João Espregueira-Mendes
- Clínica Espregueira - FIFA Medical Centre of Excellence, Porto, Portugal
- Dom Henrique Research Centre, Porto, Portugal
- School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B’s-PT Government Associate Laboratory, Braga/Guimarães, Portugal
- B’s Research Group Biomaterials, Biodegradables and Biomimetics, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, University of Minho, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, Barco, 4805 017, Guimarães, Portugal
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Vale J, Rocha E, Lemos C, Valente C, Andrade R, Espregueira-Mendes J, Rodrigues-Pinto R. The Role of Systemic Steroids in Sciatica Due to Herniated Lumbar Disc: A Systematic Review and Meta-analysis. Spine (Phila Pa 1976) 2023; 48:E391-E400. [PMID: 37642478 DOI: 10.1097/brs.0000000000004801] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 07/13/2023] [Indexed: 08/31/2023]
Abstract
STUDY DESIGN Systematic review and meta-analysis. OBJECTIVE Evaluate the role of systemic steroids in treating patients with sciatica due to lumbar disk herniation (LDH). SUMMARY OF BACKGROUND DATA The association between LDH and sciatica has been well described. The use of steroids seems logical in this context; however, their efficacy is not well described, and their use remains controversial. METHODS A comprehensive search on PubMed, EMBASE, and Scopus databases (up to February 15, 2022) was performed to identify randomized clinical trials that included patients with symptoms of sciatica due to LDH that were treated with systemic steroids. The risk of bias was judged using the Cochrane risk-of-Bias2 tool. Meta-analysis was conducted using a random-effects model to estimate the between-group effect size for pain and functional outcomes. The risk of developing adverse events (AE) was computed using relative risks. All pooled results are reported with their 95% confidence interval (CI) and certainty of evidence analyzed using the Grading of Recommendations Assessment, Development, and Evaluation framework. RESULTS Ten studies met inclusion criteria, comprising a total of 1017 participants: 540 in the treatment group and 477 in the control group. Steroid treatment was associated with a significant superior reduction of pain (SMD = -0.42, 95% CI -0.76 to -0.08, weak effect, very-low certainty) and reduction in disability (SMD = -0.30, 95% CI -0.51 to -0.10, weak effect, very-low certainty). Corticosteroid administration was associated with a significant increased risk of developing an AE (relative risks = 2.00, 95% CI 1.40 to 2.85, low certainty). CONCLUSION The use of systemic steroids in the treatment of sciatica due to LDH seems reasonable despite a 2-fold higher risk of developing mild AEs. However, the effect size is small for reducing pain in the short term and improving functional outcomes at long-term follow-up.
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Affiliation(s)
- João Vale
- Department of Orthopaedics, Spinal Unit (UVM), Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - Eduardo Rocha
- Instituto Português de Oncologia do Porto Francisco Gentil, EPE, External Radiotherapy Department, Porto, Portugal
| | - Carolina Lemos
- Instituto de Ciências Biomédicas de Abel Salazar, Universidade do Porto, Porto, Portugal
- UnIGENe, IBMC-Instituto de Biologia Celular e Molecular, i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - Cristina Valente
- Clínica Espregueira-FIFA Medical Centre of Excellence, Porto, Portugal
- Dom Henrique Research Centre, Porto, Portugal
| | - Renato Andrade
- Clínica Espregueira-FIFA Medical Centre of Excellence, Porto, Portugal
- Dom Henrique Research Centre, Porto, Portugal
- Porto Biomechanics Laboratory (LABIOMEP), Faculty of Sports, University of Porto, Porto, Portugal
| | - João Espregueira-Mendes
- Clínica Espregueira-FIFA Medical Centre of Excellence, Porto, Portugal
- Dom Henrique Research Centre, Porto, Portugal
- School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
- 3B's Research Group - Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Barco, Guimarães, Portugal
| | - Ricardo Rodrigues-Pinto
- Department of Orthopaedics, Spinal Unit (UVM), Centro Hospitalar Universitário de Santo António, Porto, Portugal
- Instituto de Ciências Biomédicas de Abel Salazar, Universidade do Porto, Porto, Portugal
- Hospital CUF Trindade, Porto, Portugal
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Barreira F, Gomes E, Oliveira S, Valente C, Bastos R, Sánchez M, Andrade R, Espregueira-Mendes J. Meniscal extrusion in knees with and without osteoarticular pathology: A systematic review of normative values and cut-offs for diagnostic criteria. Knee 2023; 45:156-167. [PMID: 37925806 DOI: 10.1016/j.knee.2023.09.010] [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: 03/24/2023] [Revised: 07/19/2023] [Accepted: 09/21/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Meniscus extrusion is crucial for the diagnosis and treatment of meniscal injury, but the literature on this topic has not yet been systematized. The purpose of this systematic review was to compare diagnostic methods and summarize the data of medial and lateral meniscal extrusion in knees with and without osteoarticular pathology. METHODS This systematic review was conducted according to the PRISMA 2020 statement. Searches were conducted on PubMed, EMBASE and Cochrane databases to identify studies that measured meniscal extrusion using magnetic resonance imaging (MRI) or ultrasound (US). Meniscal extrusion data was summarized as weighted mean for medial and lateral meniscus, and stratified according to the method of measurement (MRI or US) and presence of knee osteoarticular pathology. RESULTS A total of 26 studies were included in this review. Weighted mean values of meniscal extrusion were always higher for the medial than the lateral meniscus, regardless of the method of measurement. The medial meniscus extrusion was always higher in knees with osteoarticular pathology than those without. For the lateral meniscus extrusion, the mean values were higher in those knees without osteoarticular pathology. When classifying pathological meniscal extrusion with pre-defined cut-off values, the higher the cut-off used, the lower the percentage of knees classified as pathological meniscal extrusion. CONCLUSIONS The medial meniscus presents on mean higher extrusion and extrusion is higher in knees with osteoarticular pathology. Based on summary data, the most suitable cut-offs for pathological meniscal extrusion for both MRI and US seem to fall within >2 and >3 mm.
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Affiliation(s)
| | - Eluana Gomes
- Clínica Espregueira - FIFA Medical Centre of Excellence, Porto, Portugal
| | - Sofia Oliveira
- Center for MicroElectroMechanical Systems (CMEMS UMINHO), University of Minho, Azurém Campus, 4800-058 Guimarães, Portugal; LABBELS - Associate Laboratory, Braga, Guimarães, Portugal
| | - Cristina Valente
- Clínica Espregueira - FIFA Medical Centre of Excellence, Porto, Portugal; Dom Henrique Research Centre, Porto, Portugal
| | - Ricardo Bastos
- Clínica Espregueira - FIFA Medical Centre of Excellence, Porto, Portugal; Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil
| | - Mikel Sánchez
- Advanced Biological Therapy Unit, Hospital Vithas Vitoria, Vitoria-Gasteiz, Spain; Arthroscopic Surgery Unit, Hospital Vithas Vitoria, Vitoria-Gasteiz, Spain
| | - Renato Andrade
- Clínica Espregueira - FIFA Medical Centre of Excellence, Porto, Portugal; Dom Henrique Research Centre, Porto, Portugal; Porto Biomechanics Laboratory (LABIOMEP), Faculty of Sports, University of Porto, Porto, Portugal
| | - João Espregueira-Mendes
- School of Medicine, University of Minho, Braga, Portugal; Clínica Espregueira - FIFA Medical Centre of Excellence, Porto, Portugal; Dom Henrique Research Centre, Porto, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal; 3B's Research Group Biomaterials, Biodegradables and Biomimetics, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, University of Minho, Guimarães, Portugal.
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Gomes E, Andrade R, Valente C, Santos JV, Nunes J, Carvalho Ó, Correlo VM, Silva FS, Oliveira JM, Reis RL, Espregueira-Mendes J. Inconsistency in Shoulder Arthrometers for Measuring Glenohumeral Joint Laxity: A Systematic Review. Bioengineering (Basel) 2023; 10:799. [PMID: 37508826 PMCID: PMC10376824 DOI: 10.3390/bioengineering10070799] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 06/27/2023] [Accepted: 06/28/2023] [Indexed: 07/30/2023] Open
Abstract
There is no consensus on how to measure shoulder joint laxity and results reported in the literature are not well systematized for the available shoulder arthrometer devices. This systematic review aims to summarize the results of currently available shoulder arthrometers for measuring glenohumeral laxity in individuals with healthy or injured shoulders. Searches were conducted on the PubMed, EMBASE, and Web of Science databases to identify studies that measure glenohumeral laxity with arthrometer-assisted assessment. The mean and standard deviations of the laxity measurement from each study were compared based on the type of population and arthrometer used. Data were organized according to the testing characteristics. A total of 23 studies were included and comprised 1162 shoulders. Populations were divided into 401 healthy individuals, 278 athletes with asymptomatic shoulder, and 134 individuals with symptomatic shoulder. Sensors were the most used method for measuring glenohumeral laxity and stiffness. Most arthrometers applied an external force to the humeral head or superior humerus by a manual-assisted mechanism. Glenohumeral laxity and stiffness were mostly assessed in the sagittal plane. There is substantial heterogeneity in glenohumeral laxity values that is mostly related to the arthrometer used and the testing conditions. This variability can lead to inconsistent results and influence the diagnosis and treatment decision-making.
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Affiliation(s)
- Eluana Gomes
- Clínica Espregueira-FIFA Medical Centre of Excellence, 4350-415 Porto, Portugal
| | - Renato Andrade
- Clínica Espregueira-FIFA Medical Centre of Excellence, 4350-415 Porto, Portugal
- Dom Henrique Research Centre, 4350-415 Porto, Portugal
- Porto Biomechanics Laboratory (LABIOMEP), Faculty of Sports, University of Porto, 4200-450 Porto, Portugal
| | - Cristina Valente
- Clínica Espregueira-FIFA Medical Centre of Excellence, 4350-415 Porto, Portugal
- Dom Henrique Research Centre, 4350-415 Porto, Portugal
| | - J Victor Santos
- Centre for Microelectromechanical Systems (CMEMS-UMINHO), Campus Azurém, University of Minho, 4800-058 Guimarães, Portugal
| | - Jóni Nunes
- Clínica Espregueira-FIFA Medical Centre of Excellence, 4350-415 Porto, Portugal
- Serviço de Ortopedia e Traumatologia do Hospital de Santa Maria Maior, 4750-333 Barcelos, Portugal
- School of Medicine, University of Minho, 4710-057 Braga, Portugal
| | - Óscar Carvalho
- Centre for Microelectromechanical Systems (CMEMS-UMINHO), Campus Azurém, University of Minho, 4800-058 Guimarães, Portugal
- LABBELS Associate Laboratory, University of Minho, 4800-058 Guimarães, Portugal
| | - Vitor M Correlo
- ICVS/3B's-PT Government Associate Laboratory, 4805-017 Guimarães, Portugal
- 3B's Research Group, I3Bs-Research Institute on Biomaterials, Biodegradables and Biomimetics Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência E Tecnologia, University of Minho, Zona Industrial da Gandra, Barco, 4805-017 Guimarães, Portugal
- Pro2B, Consultoria e Gestão de Projetos, AvePark-Parque de Ciência e Tecnologia, Zona Industrial da Gandra, Barco, 4805-017 Guimarães, Portugal
| | - Filipe S Silva
- Centre for Microelectromechanical Systems (CMEMS-UMINHO), Campus Azurém, University of Minho, 4800-058 Guimarães, Portugal
- LABBELS Associate Laboratory, University of Minho, 4800-058 Guimarães, Portugal
| | - J Miguel Oliveira
- ICVS/3B's-PT Government Associate Laboratory, 4805-017 Guimarães, Portugal
- 3B's Research Group, I3Bs-Research Institute on Biomaterials, Biodegradables and Biomimetics Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência E Tecnologia, University of Minho, Zona Industrial da Gandra, Barco, 4805-017 Guimarães, Portugal
| | - Rui L Reis
- ICVS/3B's-PT Government Associate Laboratory, 4805-017 Guimarães, Portugal
- 3B's Research Group, I3Bs-Research Institute on Biomaterials, Biodegradables and Biomimetics Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência E Tecnologia, University of Minho, Zona Industrial da Gandra, Barco, 4805-017 Guimarães, Portugal
| | - João Espregueira-Mendes
- Clínica Espregueira-FIFA Medical Centre of Excellence, 4350-415 Porto, Portugal
- Dom Henrique Research Centre, 4350-415 Porto, Portugal
- School of Medicine, University of Minho, 4710-057 Braga, Portugal
- ICVS/3B's-PT Government Associate Laboratory, 4805-017 Guimarães, Portugal
- 3B's Research Group, I3Bs-Research Institute on Biomaterials, Biodegradables and Biomimetics Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência E Tecnologia, University of Minho, Zona Industrial da Gandra, Barco, 4805-017 Guimarães, Portugal
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Afonso J, Olivares-Jabalera J, Fernandes RJ, Clemente FM, Rocha-Rodrigues S, Claudino JG, Ramirez-Campillo R, Valente C, Andrade R, Espregueira-Mendes J. Effectiveness of Conservative Interventions After Acute Hamstrings Injuries in Athletes: A Living Systematic Review. Sports Med 2023; 53:615-635. [PMID: 36622557 DOI: 10.1007/s40279-022-01783-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND Hamstrings injuries are common in sports and the reinjury risk is high. Despite the extensive literature on hamstrings injuries, the effectiveness of the different conservative (i.e., non-surgical) interventions (i.e., modalities and doses) for the rehabilitation of athletes with acute hamstrings injuries is unclear. OBJECTIVE We aimed to compare the effects of different conservative interventions in time to return to sport (TRTS) and/or time to return to full training (TRFT) and reinjury-related outcomes after acute hamstrings injuries in athletes. DATA SOURCES We searched CINAHL, Cochrane Library, EMBASE, PubMed, Scopus, SPORTDiscus, and Web of Science databases up to 1 January, 2022, complemented with manual searches, prospective citation tracking, and consultation of external experts. ELIGIBILITY CRITERIA The eligibility criteria were multi-arm studies (randomized and non-randomized) that compared conservative treatments of acute hamstrings injuries in athletes. DATA ANALYSIS We summarized the characteristics of included studies and conservative interventions and analyzed data for main outcomes (TRTS, TRFT, and rate of reinjuries). The risk of bias was judged using the Cochrane tools. Quality and completeness of reporting of therapeutic exercise programs were appraised with the i-CONTENT tool and the certainty of evidence was judged using the GRADE framework. TRTS and TRFT were analyzed using mean differences and the risk of reinjury with relative risks. RESULTS Fourteen studies (12 randomized and two non-randomized) comprising 730 athletes (mostly men with ages between 14 and 49 years) from different sports were included. Nine randomized studies were judged at high risk and three at low risk of bias, and the two non-randomized studies were judged at critical risk of bias. Seven randomized studies compared exercise-based interventions (e.g., L-protocol vs C-protocol), one randomized study compared the use of low-level laser therapy, and three randomized and two non-randomized studies compared injections of platelet-rich plasma to placebo or no injection. These low-level laser therapy and platelet-rich plasma studies complemented their interventions with an exercise program. Only three studies were judged at low overall risk of ineffectiveness (i-CONTENT). No single intervention or combination of interventions proved superior in achieving a faster TRTS/TRFT or reducing the risk of reinjury. Only eccentric lengthening exercises showed limited evidence in allowing a shorter TRFT. The platelet-rich plasma treatment did not consistently reduce the TRFT or have any effect on the risk of new hamstrings injuries. The certainty of evidence was very low for all outcomes and comparisons. CONCLUSIONS Available evidence precludes the prioritization of a particular exercise-based intervention for athletes with acute hamstrings injuries, as different exercise-based interventions showed comparable effects on TRTS/TRFT and the risk of reinjuries. Available evidence also does not support the use of platelet-rich plasma or low-level laser therapy in clinical practice. The currently available literature is limited because of the risk of bias, risk of ineffectiveness of exercise protocols (as assessed with the i-CONTENT), and the lack of comparability across existing studies. CLINICAL TRIAL REGISTRATION PROSPERO CRD42021268499 and OSF ( https://osf.io/3k4u2/ ).
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Affiliation(s)
- José Afonso
- Centre of Research, Education, Innovation, and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, R. Dr. Plácido da Costa 91, 4200-450, Porto, Portugal.
| | - Jesús Olivares-Jabalera
- Sport Research Lab, Football Science Institute, Granada, Spain
- Department of Physical and Sports Education, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Ricardo J Fernandes
- Centre of Research, Education, Innovation, and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, R. Dr. Plácido da Costa 91, 4200-450, Porto, Portugal
- Porto Biomechanics Laboratory (LABIOMEP), University of Porto, Porto, Portugal
| | - Filipe Manuel Clemente
- Escola Superior de Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Viana do Castelo, Portugal
- Delegação da Covilhã, Instituto de Telecomunicações, Covilhã, Portugal
| | - Sílvia Rocha-Rodrigues
- Escola Superior de Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Viana do Castelo, Portugal
- Tumor & Microenvironment Interactions Group, INEB-Institute of Biomedical Engineering, i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
- Research Center in Sports Performance, Recreation, Innovation and Technology (SPRINT), Melgaço, Portugal
| | - João Gustavo Claudino
- Group of Research, Innovation and Technology Applied to Sport (GSporTech), Multi-user Laboratory of the Department of Physical Education (MultiLab of the DPE), Department of Physical Education, Center for Health Sciences, Federal University of Piauí, Teresina, Piauí, Brazil
- Department of Physical Education, Center for Health Sciences, Federal University of Piauí, Teresina, Piauí, Brazil
| | - Rodrigo Ramirez-Campillo
- Exercise and Rehabilitation Sciences Laboratory, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
| | - Cristina Valente
- Clínica Espregueira - FIFA Medical Centre of Excellence, Porto, Portugal
- Dom Henrique Research Centre, Porto, Portugal
| | - Renato Andrade
- Porto Biomechanics Laboratory (LABIOMEP), University of Porto, Porto, Portugal.
- Clínica Espregueira - FIFA Medical Centre of Excellence, Porto, Portugal.
- Dom Henrique Research Centre, Porto, Portugal.
| | - João Espregueira-Mendes
- Clínica Espregueira - FIFA Medical Centre of Excellence, Porto, Portugal
- Dom Henrique Research Centre, Porto, Portugal
- School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
- 3B's Research Group Biomaterials, Biodegradables and Biomimetics, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, University of Minho, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, Barco, 4805 017, Guimarães, Portugal
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12
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Sanchez-Munoz E, Lozano Hernanz B, Zijl JAC, Passarelli Tirico LE, Angelini FJ, Verdonk PCM, Vuylsteke K, Andrade R, Espregueira-Mendes J, Valente C, Figueroa F, Figueroa D, Maestro Fernández A, Maestro Fernández A. Accuracy of Magnetic Resonance Imaging in the Diagnosis of Multiple Ligament Knee Injuries: A Multicenter Study of 178 Patients. Am J Sports Med 2023; 51:429-436. [PMID: 36625432 DOI: 10.1177/03635465221145697] [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: 01/11/2023]
Abstract
BACKGROUND Magnetic resonance imaging (MRI) has shown limited diagnostic accuracy for multiple ligament knee injuries (MLKIs), especially posterolateral corner (PLC) injuries. HYPOTHESIS The diagnostic accuracy of MRI for MLKIs will only be moderate for some knee structures. Patient-related factors and injury patterns could modify the diagnostic accuracy of MRI. STUDY DESIGN Cohort study; Level of evidence, 3. METHODS All patients with MLKIs surgically treated between January 2014 and December 2020 in the centers participating in the study were reviewed. We recorded sex, age, mechanism of injury, time from injury to MRI, and vascular and neurological associated lesions. Lesions to the anterior cruciate ligament (ACL), posterior cruciate ligament, medial collateral ligament, lateral collateral ligament (LCL), popliteus tendon, popliteofibular ligament, iliotibial band, biceps tendon, medial and lateral meniscus, and articular cartilage from MRI reports and surgical records were also collected. The sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy, diagnostic odds ratio, positive and negative likelihood ratio, and intraclass correlation coefficient of MRI were calculated for each knee structure. With logistic regression, associations between patient and injury characteristics and MRI accuracy were assessed. RESULTS A total of 178 patients (127 male; mean age, 33.1 years) were included. High-energy trauma was the most common mechanism of injury (50.6%), followed by sports trauma (38.8%) and low-energy trauma (8.4%). The ACL was the structure with the best diagnostic accuracy, diagnostic odds ratio, and positive predictive value (94.4%, 113.2, and 96.8%, respectively). PLC structures displayed the worst diagnostic accuracy among knee ligaments (popliteus tendon: 76.2%; LCL: 80.3%) and diagnostic odds ratio (popliteus tendon: 9.9; LCL: 17.0; popliteofibular ligament: 17.5). MRI was more reliable in detecting the absence of meniscal and chondral lesions than in identifying them. Logistic regression found that the diagnostic accuracy was affected by the Schenck classification, with higher Schenck grades having worse diagnostic accuracy for peripheral structures (iliotibial band, popliteus tendon, and biceps tendon) and improved diagnostic accuracy for the ACL and posterior cruciate ligament. CONCLUSION The diagnostic accuracy of MRI for MLKIs largely varied among knee structures, with many of them at risk of a misdiagnosis, especially PLC, meniscal, and chondral lesions. The severity of MLKIs lowered the diagnostic accuracy of MRI for peripheral structures.
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Affiliation(s)
- Enrique Sanchez-Munoz
- Knee Unit, Department of Traumatology and Orthopaedic Surgery, Toledo University Hospital, Toledo, Spain
| | - Beatriz Lozano Hernanz
- Knee Unit, Department of Traumatology and Orthopaedic Surgery, Toledo University Hospital, Toledo, Spain
| | - Jacco A C Zijl
- Department of Orthopaedic Surgery, St Antonius Hospital, Utrecht, the Netherlands
| | - Luís Eduardo Passarelli Tirico
- Institute of Orthopedics and Traumatology, Hospital das Clinicas, University of São Paulo Medical School, São Paulo, Brazil
| | - Fabio Janson Angelini
- Institute of Orthopedics and Traumatology, Hospital das Clinicas, University of São Paulo Medical School, São Paulo, Brazil
| | - Peter C M Verdonk
- Orthopedic Center Antwerp, AZ Monica Hospital, Antwerp, Belgium; MoRe Foundation, Antwerp, Belgium
| | | | - Renato Andrade
- Clínica Espregueira, Porto, Portugal; Dom Henrique Research Centre, Porto, Portugal; Porto Biomechanics Laboratory, Faculty of Sport, University of Porto, Porto, Portugal
| | - João Espregueira-Mendes
- Clínica Espregueira, Porto, Portugal; Dom Henrique Research Centre, Porto, Portugal; School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal; 3B's Research Group [Biomaterials, Biodegradables and Biomimetics], University of Minho, Guimarães, Portugal
| | - Cristina Valente
- Clínica Espregueira, Porto, Portugal; Dom Henrique Research Centre, Porto, Portugal
| | - Francisco Figueroa
- Clinica Alemana, Faculty of Medicine, Universidad del Desarrollo, Santiago, Chile; Hospital Sotero del Rio, Santiago, Chile
| | - David Figueroa
- Clinica Alemana, Faculty of Medicine, Universidad del Desarrollo, Santiago, Chile
| | - Antonio Maestro Fernández
- School of Medicine, University of Oviedo, Oviedo, Spain; Begoña Hospital, Gijón, Spain.,Investigation performed at Toledo University Hospital, Toledo, Spain
| | - Antonio Maestro Fernández
- School of Medicine, University of Oviedo, Oviedo, Spain; Begoña Hospital, Gijón, Spain.,Investigation performed at Toledo University Hospital, Toledo, Spain
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Falcão F, Sousa B, Pereira DSM, Andrade R, Moreira P, Quialheiro A, Jalali C, Costa P. We vote for the person, not the policies: a systematic review on how personality traits influence voting behaviour. Discov Psychol 2023. [PMCID: PMC9831368 DOI: 10.1007/s44202-022-00057-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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
AbstractWestern democracies’ voting practices have altered recently, most notably with candidates now taking center stage at the expense of the institutions. These events are the result of a phenomenon called the personalisation of politics. The present review aims to synthesize evidence regarding the impact of voters’ evaluation of candidates’ traits on political outcomes and the effects of voters’ traits on voting. Included studies were identified via electronic databases (up to July 2019). Reviewers extracted data respecting inclusion and exclusion criteria. Methodological quality was assessed independently by two reviewers. Data synthesis was executed through narrative processes. 288 studies were identified, 12 of which were selected for review. Four main outcomes were found: (i) Personality traits and voting behaviour; (ii) Implicit/explicit trait associations and political outcomes; (iii) Party identification and personality traits; and (iv) Ideology and personality traits. Data obtained suggests that political outcomes are heavily influenced by voters’ personality traits and how they perceive the personality traits of the candidates. This review advances the theory of personality trait matching and establishes a connection between traits and the personalization of politics.
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Affiliation(s)
- Filipe Falcão
- Life and Health Sciences Research Institute (ICVS), University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
- ICVS / 3B’s–P.T. Government Associate Laboratory, Braga/Guimarães, Portugal
- School of Medicine, University of Minho, Braga, Portugal
| | - Bárbara Sousa
- Life and Health Sciences Research Institute (ICVS), University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
- ICVS / 3B’s–P.T. Government Associate Laboratory, Braga/Guimarães, Portugal
- School of Psychology, University of Minho, Braga, Portugal
| | - Daniela S. M. Pereira
- Life and Health Sciences Research Institute (ICVS), University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
- ICVS / 3B’s–P.T. Government Associate Laboratory, Braga/Guimarães, Portugal
- School of Medicine, University of Minho, Braga, Portugal
| | - Renato Andrade
- Espregueira-Mendes Sports Centre—FIFA Medical Centre of Excellence, Clínica Do Dragão, Porto, Portugal
| | - Pedro Moreira
- School of Psychology, University of Minho, Braga, Portugal
| | - Anna Quialheiro
- Life and Health Sciences Research Institute (ICVS), University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
- ICVS / 3B’s–P.T. Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Carlos Jalali
- Research Unit On Governance, Competitiveness and Public Policies, Department of Social, Political and Territorial Sciences, University of Aveiro, Aveiro, Portugal
| | - Patrício Costa
- Life and Health Sciences Research Institute (ICVS), University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
- ICVS / 3B’s–P.T. Government Associate Laboratory, Braga/Guimarães, Portugal
- School of Medicine, University of Minho, Braga, Portugal
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
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Torres I, Andrade R, Apoloni R, Da Silva E, Puech-leão P, De Luccia N. In Hospital and Long Term Outcomes of Patients Who Underwent Endo or Open Repair of Axillosubclavian Arterial Injuries. EJVES Vasc Forum 2023. [DOI: 10.1016/j.ejvsvf.2023.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023] Open
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Andrade R, Cobbold CA. Heterogeneity in Behaviour and Movement can Influence the Stability of Predator-Prey Periodic Travelling Waves. Bull Math Biol 2023; 85:1. [PMID: 36418648 PMCID: PMC9684289 DOI: 10.1007/s11538-022-01101-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 05/05/2022] [Accepted: 09/27/2022] [Indexed: 11/25/2022]
Abstract
Cyclic predator-prey systems are often observed in nature. In a spatial setting, these can manifest as periodic traveling waves (PTW). Environmental change and direct human activity are known to, among other effects, increase the heterogeneity of the physical environment, which prey and predator inhabit. Aiming to understand the effects of heterogeneity on predator-prey PTWs, we consider a one-dimensional infinite landscape Rosenzweig-MacArthur reaction-diffusion model, with alternating patch types, and study the PTWs in this system. Applying the method of homogenisation, we show how heterogeneity can affect the stability of PTW solutions. We illustrate how the effects of heterogeneity can be understood and interpreted using Turchin's concept of residence index (encapsuling diffusion rate and patch preference). In particular, our results show that prey heterogeneity acts to modulate the effects of predator heterogeneity, by this we mean that as prey increasingly spend more time in one patch type over another the stability of the PTWs becomes more sensitive to heterogeneity in predator movement and behaviour.
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Affiliation(s)
- Renato Andrade
- grid.8756.c0000 0001 2193 314XSchool of Mathematics and Statistics, University of Glasgow, Glasgow, G12 8QQ UK
| | - Christina A. Cobbold
- grid.8756.c0000 0001 2193 314XSchool of Mathematics and Statistics, University of Glasgow, Glasgow, G12 8QQ UK ,grid.8756.c0000 0001 2193 314XBoyd Orr Centre for Population and Ecosystem Health, University of Glasgow, Glasgow, G12 8QW UK
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16
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Vale C, Almeida JF, Pereira B, Andrade R, Espregueira-Mendes J, Gomes TM, Oliva XM. Complications after total ankle arthroplasty- A systematic review. Foot Ankle Surg 2023; 29:32-38. [PMID: 36229330 DOI: 10.1016/j.fas.2022.09.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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] [Received: 05/09/2022] [Revised: 09/15/2022] [Accepted: 09/28/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Total ankle arthroplasty was developed as an alternative option to ankle arthrodesis in patients with end-stage ankle osteoarthritis. Multiple trials have assessed the outcomes of ankle arthroplasty, but complication risk or relative effectiveness is not systematized in literature. AIM Review complications of new designs of total ankle arthroplasty and the relationship between their severity and failure rates. METHODS We reviewed complications and revision rates of prospective studies of primary total ankle arthroplasty that included more than 50 patients and with minimum 2 years follow-up. RESULTS We included 22 studies (4412 ankles, median age of 61.9 years) with an adjusted mean follow-up time of 66.6 ± 40.9 months. The adjusted mean complication rate was 23.7 % (2.4-52 %), mostly high-grade complications (35.6 %). We found a statistically significant positive correlation between high- and medium-grade complications and revision rates. CONCLUSION Patient selection is crucial to successfully treat end-stage ankle osteoarthritis. Further multicenter clinical trials with consistent reporting of complications are warranted.
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Affiliation(s)
- Cláudia Vale
- Orthopedic Surgery Department, Hospital de Braga, Braga, Portugal.
| | - João F Almeida
- Orthopedic Surgery Department, Hospital Vila Franca de Xira, Vila Franca de Xira, Portugal
| | - Bruno Pereira
- Clínica Espregueira - FIFA Medical Centre of Excellence, Porto, Portugal; Hospital Santa Maria Maior, EPE, Barcelos, Portugal; Hospital Lusíadas Braga, Braga, Portugal; Dom Henrique Research Centre, Porto, Portugal; School of Medicine, University of Minho, Braga, Portugal; Human anatomy Unit, School of Medicine, University of Barcelona, Foot and Ankle Unit, Barcelona, Spain; INSIDE, Investigation in Orthopedics, Braga, Portugal
| | - Renato Andrade
- Clínica Espregueira - FIFA Medical Centre of Excellence, Porto, Portugal; Dom Henrique Research Centre, Porto, Portugal; Porto Biomechanics Laboratory (LABIOMEP), Faculty of Sports, University of Porto, Porto, Portugal
| | - João Espregueira-Mendes
- Clínica Espregueira - FIFA Medical Centre of Excellence, Porto, Portugal; Dom Henrique Research Centre, Porto, Portugal; School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratoryō, Braga, Guimarães, Portugal; 3B's Research Group - Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Barco, Guimarães, Portugal
| | - Tiago M Gomes
- Human anatomy Unit, School of Medicine, University of Barcelona, Foot and Ankle Unit, Barcelona, Spain; Clinica del Remei, Barcelona, Spain
| | - Xavier Martin Oliva
- Human anatomy Unit, School of Medicine, University of Barcelona, Foot and Ankle Unit, Barcelona, Spain; Clinica del Remei, Barcelona, Spain
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Oliveira S, Andrade R, Valente C, Espregueira-Mendes J, Silva F, Hinckel BB, Carvalho Ó, Leal A. Mechanical-based therapies may reduce pain and disability in some patients with knee osteoarthritis: A systematic review with meta-analysis. Knee 2022; 37:28-46. [PMID: 35660536 DOI: 10.1016/j.knee.2022.05.005] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 05/09/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Mechanical-based therapies are not yet recommended to manage osteoarthritis (OA). This systematic review and meta-analysis aim to assess the effects of passive mechanical-based therapies (isolated or combined with other therapies) on patients with knee OA compared to placebo, other isolated or combined interventions. METHODS Pubmed, Cochrane, Web of Science and EMBASE were searched up to December 2020. We included randomized and non-randomized trials using therapeutic ultrasound, phonophoresis, extracorporeal shockwave therapy (ESWT) and vibration (single or combined with other therapies) compared to placebo, and/or other physical therapies groups. Biochemical, patient-reported, physical and imaging outcome measures were retrieved. We judged risk of bias using the RoB2 tool for randomized studies, the ROBINS-I tool for non-randomized studies, and the GRADE to interpret certainty of results. RESULTS We included 77 clinical studies. Ultrasound and ESWT statistically improved pain and disability comparing to placebo (combined or not with other therapies), and when added to other therapies versus other therapies alone. Ultrasound was statistically inferior to phonophoresis (combined or not with other therapies) in reducing pain and disability for specific therapeutic gels and/or combined therapies. Vibration plus exercise statistically improved pain relief and function versus exercise alone. All meta-analyses showed very-low certainty of evidence, with 15 of 42 (38%) pooled comparisons being statistically significant (weak to large effect). CONCLUSIONS Despite the inconsistent evidence with very-low certainty, the potential benefits of passive mechanical-based therapies should not be disregard and cautiously recommended that clinicians might use them in some patients with knee OA.
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Affiliation(s)
- Sofia Oliveira
- Center for MicroElectroMechanical Systems (CMEMS‑UMINHO), University of Minho, Azurém Campus, 4800‑058 Guimarães, Portugal; LABBELS - Associate Laboratory, Braga, Guimarães, Portugal.
| | - Renato Andrade
- Clínica Espregueira - FIFA Medical Centre of Excellence, Porto, Portugal; Dom Henrique Research Centre, Porto, Portugal; Porto Biomechanics Laboratory (LABIOMEP), Faculty of Sports, University of Porto, Porto, Portugal.
| | - Cristina Valente
- Clínica Espregueira - FIFA Medical Centre of Excellence, Porto, Portugal; Dom Henrique Research Centre, Porto, Portugal.
| | - João Espregueira-Mendes
- Clínica Espregueira - FIFA Medical Centre of Excellence, Porto, Portugal; Dom Henrique Research Centre, Porto, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal; 3B's Research Group‑Biomaterials, Biodegradables and Biomimetics, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, University of Minho, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, Barco, 4805‑017 Guimarães, Portugal; School of Medicine, University of Minho, Braga, Portugal.
| | - Filipe Silva
- Center for MicroElectroMechanical Systems (CMEMS‑UMINHO), University of Minho, Azurém Campus, 4800‑058 Guimarães, Portugal; LABBELS - Associate Laboratory, Braga, Guimarães, Portugal.
| | - Betina B Hinckel
- Department of Orthopaedic Surgery, William Beaumont Hospital, Royal Oak, MI, USA.
| | - Óscar Carvalho
- Center for MicroElectroMechanical Systems (CMEMS‑UMINHO), University of Minho, Azurém Campus, 4800‑058 Guimarães, Portugal; LABBELS - Associate Laboratory, Braga, Guimarães, Portugal.
| | - Ana Leal
- Center for MicroElectroMechanical Systems (CMEMS‑UMINHO), University of Minho, Azurém Campus, 4800‑058 Guimarães, Portugal; LABBELS - Associate Laboratory, Braga, Guimarães, Portugal; Dom Henrique Research Centre, Porto, Portugal.
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18
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Bosacker L, Diaz Gutierrez I, Hordinsky M, Andrade R. LB940 A comprehensive evaluation of thoracoscopic sympathectomy for severe primary palmar hyperhidrosis. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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19
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Barbosa M, Andrade R, de Melo CA, Torres R. Community-Based Pulmonary Rehabilitation Programs in Individuals With COPD. Respir Care 2022; 67:579-593. [PMID: 35473839 PMCID: PMC9994255 DOI: 10.4187/respcare.09627] [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] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
BACKGROUND Community-based pulmonary rehabilitation (PR) programs can be offered to patients with COPD, but the literature on its effects is still not well summarized. Our purpose was to investigate the health-, physical-, and respiratory-related effects of community-based PR in individuals with COPD as compared to control groups. METHODS The PubMed and Embase databases were searched up to May 17, 2021. We included randomized control trials that compared the effects of community-based PR as compared to control groups in individuals with COPD. The risk of bias was judged using the Cochrane Risk of Bias 2 (RoB2). Meta-analysis was performed using a random-effects model to estimate the standardized mean difference (SMD) with 95% CI of the mean changes from baseline between groups. The Grading of Recommendations Assessment, Development, and Evaluation was used to interpret certainty of results. RESULTS We included 10 randomized control studies comprising a total of 9,350 participants with weighted mean age of 62.3 ± 2.38 y. The community-based interventions were based on exercise programs (resistance and/or endurance). All studies were judged as high risk and/or some concerns in one or more domains the risk of bias. All meta-analyses displayed very low certainty of evidence. The community-based PR interventions were significantly superior to control interventions in improving the St. George Respiratory Questionnaire Activity subscore (-0.40 [95% CI -0.72 to -0.08]; k = 5, n = 382) and total score (-0.73 [95% CI -1.29 to -0.18]; k = 4, n = 268) and the Chronic Respiratory Disease Questionnaire dyspnea subscore (0.36 [95% CI 0.03-0.69]; k = 6, n = 550). The mean changes from baseline were not different between the groups for all other outcomes. CONCLUSIONS Community-based PR tended to result in superior health-related quality of life and symptoms than control interventions, but the findings were inconsistent across outcomes and with very low certainty of evidence. Further studies are warranted for stronger conclusions.
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Affiliation(s)
| | | | | | - Rui Torres
- Ms Barbosa is affiliated with Gaia/Espinho Hospital Center, North Rehabilitation Center, Gaia, Portugal; and Câmara Municipal de Arouca, Complexo Municipal Desportivo de Arouca e Piscinas Municipais de Escariz. Mr Andrade is affiliated with Clínica Espregueira-FIFA Medical Centre of Excellence, Porto, Portugal; Dom Henrique Research Centre, Porto, Portugal; and Porto Biomechanics Laboratory (LABIOMEP), Faculty of Sports, University of Porto, Porto Portugal. Dr de Melo is affiliated with School of Allied Health Technologies, Polytechnic Institute of Porto, Porto, Portugal; and CIR, Center for Rehabilitation Research, Polytechnic Institute of Porto, Porto, Portugal. Dr Torres is affiliated with CESPU, North Polytechnic Institute of Health, Paredes, Portugal; and CIR, Center for Rehabilitation Research, Polytechnic Institute of Porto, Porto, Portugal
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20
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Nunes J, Andrade R, Azevedo C, Ferreira NV, Oliveira N, Calvo E, Espregueira-Mendes J, Sevivas N. Improved Clinical Outcomes After Lateralized Reverse Shoulder Arthroplasty: A Systematic Review. Clin Orthop Relat Res 2022; 480:949-957. [PMID: 34904964 PMCID: PMC9007193 DOI: 10.1097/corr.0000000000002065] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 11/05/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND Lateralized reverse shoulder arthroplasty (RSA) has emerged as an attempt to improve on some of the drawbacks of conventional RSA, such as glenoid notching and decrease in ROM. Although this new design is being used in clinical practice, the evidence is mostly limited to case series and has not been systematically reviewed. QUESTIONS/PURPOSES (1) How much did patient-reported outcome measures (PROMs) and ROM improve among patients who receive a lateralized RSA implant? (2) What proportion of shoulders experience complications, revision surgery, or scapular notching? METHODS The PubMed and EMBASE databases were searched from database inception to January 31, 2020. We included clinical studies that reported the PROMs and/or ROM of patients with insufficient rotator cuffs undergoing RSA with a lateralized implant. All other types of studies and those including patients with fractures, instability or escape, infection, rheumatologic disease, neurologic disease, or revision surgeries as an indication for RSA were excluded. PROMs and ROM were collected and are reported as mean values and ranges. Complications, revision surgery, and scapular notching are presented as proportions. The percentage of the mean change relative to the minimum clinically important difference (MCID) was calculated using the anchor-based value for each outcome. The Methodological Index for Non-randomized Studies (MINORS) was used to assess study quality. The initial search yielded 678 studies; 61 full-text articles were analyzed according to our eligibility criteria. After a detailed analysis, we included nine studies that evaluated 1670 patients (68% of whom [1130] were women) with a mean age of 71.8 ± 0.6 years. The mean follow-up period was 41.1 ± 5.6 months. The mean MINORS score was 12 ± 4. RESULTS Active ROM improved for forward flexion (mean change 47° to 82°; MCID 12°), abduction (mean change 43° to 80°; MCID 7°), external rotation (mean change 8° to 39°; MCID 3°), and internal rotation (mean change -2 to 1 points). PROM scores also improved, including the American Shoulder and Elbow Surgeons score (mean change 20 to 50; MCID 20.9 points), Constant score (mean change 28 to 40; MCID 5.7 points), Simple Shoulder Test score (mean change 3 to 7; MCID 2.4 points), and VAS score (mean change -1.8 to -4.9; MCID -1.6 points). The proportion of shoulders with complications ranged from 0% (0 of 44) to 21% (30 of 140), and the proportion of shoulders with scapular notching ranged from 0% (0 of 76) to 29% (41 of 140). The proportion of patients undergoing revision ranged from 0% (0 of 44) to 13% (10 of 76) at short-term follow-up. CONCLUSION Lateralized RSA is a reasonable alternative to medialized implants for patients with rotator cuff insufficiency because it might reduce the likelihood of scapular notching without apparently compromising PROMs or ROM. More studies are required to determine whether there is a direct correlation between the amount of lateralization and PROMs or ROM.
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Affiliation(s)
- Jóni Nunes
- Hospital de Braga, Braga, Portugal
- Clínica Espregueira - FIFA Medical Centre of Excellence, Porto, Portugal
- Dom Henrique Research Centre, Porto, Portugal
- School of Medicine, University of Minho, Braga, Portugal
| | - Renato Andrade
- Clínica Espregueira - FIFA Medical Centre of Excellence, Porto, Portugal
- Dom Henrique Research Centre, Porto, Portugal
- Porto Biomechanics Laboratory (LABIOMEP), Faculty of Sports, University of Porto, Porto, Portugal
| | - Clara Azevedo
- Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
- Hospital dos SAMS de Lisboa, Lisbon, Portugal
- Clínica GIGA Saúde, Lisbon, Portugal
- School of Medicine and ICVS/3B's PT Government Associate Laboratory, University of Minho, Braga, Portugal
| | - Nuno V. Ferreira
- School of Medicine, University of Minho, Braga, Portugal
- School of Medicine and ICVS/3B's PT Government Associate Laboratory, University of Minho, Braga, Portugal
- Trofa Saúde Group – Braga, Portugal
- Hospital Santa Maria Maior, Barcelos, Portugal
| | - Nuno Oliveira
- Hospital de Braga, Braga, Portugal
- School of Medicine, University of Minho, Braga, Portugal
| | - Emílio Calvo
- Fundacion Jimenez Diaz, Universidad Autonoma de Madrid, Madrid, Spain
| | - João Espregueira-Mendes
- Clínica Espregueira - FIFA Medical Centre of Excellence, Porto, Portugal
- Dom Henrique Research Centre, Porto, Portugal
- School of Medicine and ICVS/3B's PT Government Associate Laboratory, University of Minho, Braga, Portugal
- 3Bs Research Group – Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Barco, Guimarães, Portugal
| | - Nuno Sevivas
- School of Medicine, University of Minho, Braga, Portugal
- School of Medicine and ICVS/3B's PT Government Associate Laboratory, University of Minho, Braga, Portugal
- Trofa Saúde Group – Hospital Central, Vila do Conde, Portugal
- Centro Hospitalar Médio Ave, Famalicão, Portugal
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21
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Garcia AG, Andrade R, Afonso J, Runco JL, Maestro A, Espregueira-Mendes J. Hamstrings injuries in football. J Orthop 2022; 31:72-77. [PMID: 35464813 PMCID: PMC9026901 DOI: 10.1016/j.jor.2022.04.003] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/08/2022] [Accepted: 04/09/2022] [Indexed: 11/15/2022] Open
Abstract
Background Hamstrings injuries are a major concern in football (soccer), affecting both recreational players and professional athletes. Although being a recognized issue within the football community, its incidence has been increasing over the last years and still poses a challenge to all practitioners involved. Study objectives and rationale The goal of this narrative review is to outline hamstrings injuries epidemiology and mechanisms of injury, identify and discuss its risk factors, provide an approach to a proper early diagnosis, evaluate the efficacy of current treatment options and return to sports, and present the best strategies for hamstrings injury prevention. These guidelines will help the sports medicine staff team on how to better manage their players with or at risk of hamstrings injuries. Conclusion Despite several breakthroughs in research of hamstrings injuries, there is still heterogeneity across studies and lack of consensus in regards to classification, diagnosis, treatment and prevention. Hamstrings injuries compromise the athlete's performance with time loss due to injury, shortens their highest-level career longevity with higher risk of reinjury rates, and is a defying problem for clubs to balance financial losses due to having their players off the pitch. Further research is warranted to keep moving forward with evidence on treating and preventing hamstrings injuries to mitigate its high incidence and keep the players safe.
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Affiliation(s)
- André Gismonti Garcia
- Casa de Saúde São José, Rio de Janeiro, Brazil
- Clínica Espregueira – FIFA Medical Centre of Excellence, Porto, Portugal
| | - Renato Andrade
- Clínica Espregueira – FIFA Medical Centre of Excellence, Porto, Portugal
- Dom Henrique Research Centre, Porto, Portugal
- Porto Biomechanics Laboratory (LABIOMEP), University of Porto, Porto, Portugal
| | - José Afonso
- Centre of Research, Education Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, Portugal
| | | | - Antonio Maestro
- Instituto Asturiano de Traumatologia Real Sporting de Gijon, Gijon, Spain
- Corresponding author.
| | - João Espregueira-Mendes
- Clínica Espregueira – FIFA Medical Centre of Excellence, Porto, Portugal
- Dom Henrique Research Centre, Porto, Portugal
- School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's–PT Government Associate Laboratory, Braga/Guimarães, Portugal
- 3B's Research Group – Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Barco, Guimarães, Portugal
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22
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Pape S, Snijders RJALM, Gevers TJG, Chazouilleres O, Dalekos GN, Hirschfield GM, Lenzi M, Trauner M, Manns MP, Vierling JM, Montano-Loza AJ, Lohse AW, Schramm C, Drenth JPH, Heneghan MA, Alvarez F, Andrade R, Arikan C, Assis D, Bardou-Jacquet E, Biewenga M, Cancado E, Cazzagon N, Chazouillères O, Colloredo G, Cuarterolo M, Dalekos G, Debray D, Robles-Díaz M, Drenth J, Dyson J, Efe C, Engel B, Ferri S, Fontana R, Gatselis N, Gerussi A, Halilbasic E, Halliday N, Heneghan M, Hirschfield G, van Hoek B, Hørby Jørgensen M, Indolfini G, Iorio R, Jeong S, Jones D, Kelly D, Kerkar N, Lacaille F, Lammert C, Leggett B, Lenzi M, Levy C, Liberal R, Lleo A, Lohse A, Ines Lopez S, de Martin E, McLin V, Mieli-Vergani G, Milkiewicz P, Mohan N, Muratori L, Nebbia G, van Nieuwkerk C, Oo Y, Ortega A, Páres A, Pop T, Pratt D, Purnak T, Ranucci G, Rushbrook S, Schramm C, Stättermayer A, Swain M, Tanaka A, Taubert R, Terrabuio D, Terziroli B, Trauner M, Valentino P, van den Brand F, Villamil A, Wahlin S, Ytting H, Zachou K, Zeniya M. Systematic review of response criteria and endpoints in autoimmune hepatitis by the International Autoimmune Hepatitis Group. J Hepatol 2022; 76:841-849. [PMID: 35066089 DOI: 10.1016/j.jhep.2021.12.041] [Citation(s) in RCA: 53] [Impact Index Per Article: 26.5] [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: 04/09/2021] [Revised: 11/18/2021] [Accepted: 12/11/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS Autoimmune hepatitis (AIH) has been well characterised and codified through the development of diagnostic criteria. These criteria have been adapted and simplified and are widely used in clinical practice. However, there is a need to update and precisely define the criteria for both treatment response and treatment. METHODS A systematic review was performed and a modified Delphi consensus process was used to identify and redefine the response criteria in autoimmune hepatitis. RESULTS The consensus process initiated by the International Autoimmune Hepatitis Group proposes that the term 'complete biochemical response' defined as 'normalization of serum transaminases and IgG below the upper limit of normal' be adopted to include a time point at 6 months after initiation of treatment. An insufficient response by 6 months was a failure to meet the above definition. Non-response was defined as '<50% decrease of serum transaminases within 4 weeks after initiation of treatment'. Remission is defined as liver histology with a Hepatitis Activity Index <4/18. Intolerance to treatment was agreed to stand for 'any adverse event possibly related to treatment leading to potential drug discontinuation'. CONCLUSIONS These definitions provide a simple and reproducible framework to define treatment response and non-response, irrespective of the therapeutic intervention. A consensus on endpoints is urgently required to set a global standard for the reporting of study results and to enable inter-study comparisons. Future prospective database studies are needed to validate these endpoints. LAY SUMMARY Consensus among international experts on response criteria and endpoints in autoimmune hepatitis is lacking. A consensus on endpoints is urgently required to set a global standard for the reporting of study results and to enable the comparison of results between clinical trials. Therefore, the International Autoimmune Hepatitis Group (IAIHG) herein presents a statement on 5 agreed response criteria and endpoints: complete biochemical response, insufficient response, non-response, remission, and intolerance to treatment, which can be used to guide future reporting.
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Affiliation(s)
- Simon Pape
- Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands; European Reference Network on Hepatological Diseases (ERN RARE-LIVER)
| | - Romée J A L M Snijders
- Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands; European Reference Network on Hepatological Diseases (ERN RARE-LIVER)
| | - Tom J G Gevers
- Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands; Division of Gastroenterology and Hepatology, Maastricht University Medical Center, Maastricht 6229HX, The Netherlands; European Reference Network on Hepatological Diseases (ERN RARE-LIVER)
| | - Oliver Chazouilleres
- Hepatology Department, Reference Center for Inflammatory Biliary Diseases and Autoimmune Hepatitis, Saint-Antoine Hospital Assistance Publique-Hôpitaux de Paris, Paris, France; European Reference Network on Hepatological Diseases (ERN RARE-LIVER)
| | - George N Dalekos
- Department of Medicine and Research Laboratory of Internal Medicine, University of Thessaly Medical School, Larissa, Greece
| | - Gideon M Hirschfield
- Toronto Centre for Liver Disease, University Health Network, University of Toronto, Toronto, Canada
| | - Marco Lenzi
- Department of Medical and Surgical Sciences, Sant'Orsola-Malpighi, University of Bologna, Bologna, Italy
| | - Michael Trauner
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria; European Reference Network on Hepatological Diseases (ERN RARE-LIVER)
| | - Michael P Manns
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany; European Reference Network on Hepatological Diseases (ERN RARE-LIVER)
| | - John M Vierling
- Departments of Medicine and Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Aldo J Montano-Loza
- Division of Gastroenterology and Hepatology, University of Alberta Hospital, Edmonton, Canada
| | - Ansgar W Lohse
- 1(st) Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; European Reference Network on Hepatological Diseases (ERN RARE-LIVER)
| | - Christoph Schramm
- 1(st) Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Martin Zeitz Centre for Rare Diseases, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; European Reference Network on Hepatological Diseases (ERN RARE-LIVER)
| | - Joost P H Drenth
- Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands; European Reference Network on Hepatological Diseases (ERN RARE-LIVER)
| | - Michael A Heneghan
- Institute of Liver Studies, King's College Hospital, London, United Kingdom; European Reference Network on Hepatological Diseases (ERN RARE-LIVER).
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23
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Andrade R, Nunes J, Hinckel BB, Gruskay J, Vasta S, Bastos R, Oliveira JM, Reis RL, Gomoll AH, Espregueira-Mendes J. Cartilage Restoration of Patellofemoral Lesions: A Systematic Review. Cartilage 2021; 13:57S-73S. [PMID: 31845590 PMCID: PMC8808938 DOI: 10.1177/1947603519893076] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 01/15/2023] Open
Abstract
PURPOSE This study aimed to systematically analyze the postoperative clinical, functional, and imaging outcomes, complications, reoperations, and failures following patellofemoral cartilage restoration surgery. METHODS This review was conducted according to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). PubMed, EMBASE, and Cochrane Library databases were searched up to August 31, 2018, to identify clinical studies that assessed surgical outcomes of patellofemoral cartilage restoration surgery. The Methodological Index for Non-Randomized Studies (MINORS) was used to assess study quality. RESULTS Forty-two studies were included comprising 1,311 knees (mean age of 33.7 years and 56% males) and 1,309 patellofemoral defects (891 patella, 254 trochlear, 95 bipolar, and 69 multiple defects, including the patella or trochlea) at a mean follow-up of 59.2 months. Restoration techniques included autologous chondrocyte implantation (56%), particulated juvenile allograft cartilage (12%), autologous matrix-induced chondrogenesis (9%), osteochondral autologous transplantation (9%), and osteochondral allograft transplantation (7%). Significant improvement in at least one score was present in almost all studies and these surpassed the minimal clinically important difference threshold. There was a weighted 19%, 35%, and 6% rate of reported complications, reoperations, and failures, respectively. Concomitant patellofemoral surgery (51% of patients) mostly did not lead to statistically different postoperative outcomes. CONCLUSION Numerous patellofemoral restoration techniques result in significant functional improvement with a low rate of failure. No definitive conclusions could be made to determine the best surgical technique since comparative studies on this topic are rare, and treatment choice should be made according to specific patient and defect characteristics. LEVEL OF EVIDENCE Level IV, systematic review of level II to IV studies.
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Affiliation(s)
- Renato Andrade
- Clínica do Dragão, Espregueira-Mendes
Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal,Dom Henrique Research Centre, Porto,
Portugal,Faculty of Sports, University of Porto,
Porto, Portugal
| | | | - Betina B. Hinckel
- Brigham and Woman’s Hospital, Harvard
Medical School, Boston, MA, USA
| | | | - Sebastiano Vasta
- Orthopaedics and Trauma Surgery
Department, University Campus Bio-Medico of Rome, Rome, Italy
| | - Ricardo Bastos
- Clínica do Dragão, Espregueira-Mendes
Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal,Dom Henrique Research Centre, Porto,
Portugal,3B’s Research Group, I3Bs–Research
Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho,
Headquarters of the European Institute of Excellence on Tissue Engineering and
Regenerative Medicine, Barco, Guimarães, Portugal,ICVS/3B’s–PT Government Associate
Laboratory, Braga/Guimarães, Portugal,Fluminense Federal University,
Niterói, Rio de Janeiro, Brazil
| | - J. Miguel Oliveira
- 3B’s Research Group, I3Bs–Research
Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho,
Headquarters of the European Institute of Excellence on Tissue Engineering and
Regenerative Medicine, Barco, Guimarães, Portugal,ICVS/3B’s–PT Government Associate
Laboratory, Braga/Guimarães, Portugal,The Discoveries Centre for
Regenerative and Precision Medicine, Headquarters at University of Minho, Barco,
Guimarães, Portugal
| | - Rui L. Reis
- 3B’s Research Group, I3Bs–Research
Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho,
Headquarters of the European Institute of Excellence on Tissue Engineering and
Regenerative Medicine, Barco, Guimarães, Portugal,ICVS/3B’s–PT Government Associate
Laboratory, Braga/Guimarães, Portugal,The Discoveries Centre for
Regenerative and Precision Medicine, Headquarters at University of Minho, Barco,
Guimarães, Portugal
| | | | - João Espregueira-Mendes
- Clínica do Dragão, Espregueira-Mendes
Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal,Dom Henrique Research Centre, Porto,
Portugal,ICVS/3B’s–PT Government Associate
Laboratory, Braga/Guimarães, Portugal,Orthopaedics Department of Minho
University, Braga, Portugal,João Espregueira-Mendes, Clínica do Dragão,
Espregueira-Mendes Sports Centre, FIFA Medical Centre of Excellence, Via Futebol
Clube do Porto, F. C. Porto Stadium, Porto, Portugal.
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24
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Oliveira S, Andrade R, Hinckel BB, Silva F, Espregueira-Mendes J, Carvalho Ó, Leal A. In Vitro and In Vivo Effects of Light Therapy on Cartilage Regeneration for Knee Osteoarthritis: A Systematic Review. Cartilage 2021; 13:1700S-1719S. [PMID: 33855869 PMCID: PMC8804850 DOI: 10.1177/19476035211007902] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 12/18/2022] Open
Abstract
OBJECTIVE To analyze the effects of light therapy (LT) on cartilage repair for knee osteoarthritis (OA) treatment. DESIGN The PubMed, Embase, Scopus, and Web of Science databases were searched up to August 31, 2020 to identify in vitro and in vivo studies that analyzed the effects of LT on knee cartilage for OA treatment. The study and sample characteristics, LT intervention parameters and posttreatment outcomes were analyzed. Risk of bias was assessed using the Risk of Bias Assessment for Non-randomized Studies (RoBANS) tool. RESULTS Three in vitro and 30 in vivo studies were included. Most studies were judged as high risk of performance and detection bias. Biochemical outcomes were analyzed for both in vitro and in vivo studies, and histological and behavioral outcomes were analyzed for in vivo studies. LT reduced extracellular matrix (ECM) degradation, inflammation, and OA progression, promoting ECM synthesis. LT improved pain-like behavior in animal models, having no apparent effect on gait performance. There were conflicting findings of some of the biochemical, histological, and behavioral outcomes. CONCLUSION The included studies presented different strategies and LT parameters. LT resulted in positive effects on cartilage repair and may be an adequate therapy for OA treatment.
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Affiliation(s)
- Sofia Oliveira
- Center for Micro-ElectroMechanical
Systems (CMEMS-UMINHO), University of Minho, Guimarães, Portugal
| | - Renato Andrade
- Clínica do Dragão, Espregueira-Mendes
Sports Centre, FIFA Medical Centre of Excellence, Porto, Portugal,Dom Henrique Research Centre, Porto,
Portugal,Faculty of Sports, University of Porto,
Porto, Portugal
| | - Betina B. Hinckel
- Department of Orthopaedic Surgery,
William Beaumont Hospital, Royal Oak, MI, USA
| | - Filipe Silva
- Center for Micro-ElectroMechanical
Systems (CMEMS-UMINHO), University of Minho, Guimarães, Portugal
| | - João Espregueira-Mendes
- Clínica do Dragão, Espregueira-Mendes
Sports Centre, FIFA Medical Centre of Excellence, Porto, Portugal,Dom Henrique Research Centre, Porto,
Portugal,ICVS/3B’s-PT Government Associate
Laboratory, Braga/Guimarães, Portugal,3Bs Research Group–Biomaterials,
Biodegradables and Biomimetics, Headquarters of the European Institute of Excellence
on Tissue Engineering and Regenerative Medicine, University of Minho, AvePark,
Parque de Ciência e Tecnologia, Zona Industrial da Gandra, Barco, Guimarães,
Portugal,School of Medicine, University of
Minho, Braga, Portugal
| | - Óscar Carvalho
- Center for Micro-ElectroMechanical
Systems (CMEMS-UMINHO), University of Minho, Guimarães, Portugal
| | - Ana Leal
- Center for Micro-ElectroMechanical
Systems (CMEMS-UMINHO), University of Minho, Guimarães, Portugal,Dom Henrique Research Centre, Porto,
Portugal,Ana Leal, Center for MicroElectroMechanical
Systems (CMEMS-UMINHO), University of Minho, Azurém Campus, Guimarães, 4800-058,
Portugal.
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25
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Guerra-Pinto F, Andrade R, Diniz P, Luisa Neto A, Espregueira-Mendes J, Guimarães Consciência J. Lack of Definition of Chronic Ankle Instability With Arthrometer-Assisted Ankle Joint Stress Testing: A Systematic Review of In Vivo Studies. J Foot Ankle Surg 2021; 60:1241-1253. [PMID: 34134919 DOI: 10.1053/j.jfas.2020.04.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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] [Received: 04/10/2019] [Revised: 04/09/2020] [Accepted: 04/14/2020] [Indexed: 02/03/2023]
Abstract
Despite extensive research on ankle instability a consensual and clear objective definition for pathological mechanical lateral ankle instability is yet to be determined. This systematic review aimed to summarize current available arthrometric devices, measuring methods and lateral ankle laxity outcomes in patients with chronic ankle instability that underwent objective arthrometric stress measurement. Sixty-eight studies comprising a total of 3,235 ankles with chronic ankle instability were included. Studies reported a wide range of arthrometric devices, testing position and procedures, and measuring methods. For the anterior drawer test, the average mean differences between injured and uninjured ankles ranged from -0.9 to 4.1 mm, and total translation in the injured ankle from 3.2 to 21.0 mm. Most common pathological threshold was ≥4 mm or ≥10 mm unilaterally and ≥3 mm bilaterally. For the talar tilt test, the average mean differences between injured and uninjured ankles ranged from 0.0° to 8.0°, and total tilt from injured ankle from 3.3 to 60.2°. Most common pathological threshold was ≥ 10° unilaterally and ≥ 6° mm bilaterally. It was found high heterogeneity in the scientific literature regarding the arthrometric devices, use of concomitant imaging and measuring methods of arthrometer-assisted anterior drawer and talar tilt tests which led to variable laxity outcomes in individuals with chronic ankle instability. Future studies should focus on standardizing the testing and measuring methods for an objective definition of mechanical ankle instability.
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Affiliation(s)
- Francisco Guerra-Pinto
- NOVA Medical School, Lisbon NOVA University, Lisbon, Portugal; Hospital da Cruz Vermelha, Lisbon, Portugal; Department of Anatomy and Human Embryology, Faculty of Medicine, University of Barcelona, Spain, Portugal; Department of Orthopaedic Surgery, Hospital de Sant'Ana, Parede, Portugal.
| | - Renato Andrade
- Clínica do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal; Dom Henrique Research Centre, Porto, Portugal; Faculty of Sports, University of Porto, Porto, Portugal
| | - Pedro Diniz
- Department of Orthopaedic Surgery, Hospital de Sant'Ana, Parede, Portugal; Institute for Bioengineering and Biosciences, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal; Human Performance Department, Sport Lisboa e Benfica, Lisboa, Portugal; Fisiogaspar, Lisboa, Portugal
| | - Ana Luisa Neto
- Department of Orthopaedic Surgery, Hospital de Sant'Ana, Parede, Portugal
| | - João Espregueira-Mendes
- Clínica do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal; Dom Henrique Research Centre, Porto, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga, Guimarães, Portugal; School of Medicine, University of Minho, Braga, Portugal
| | - José Guimarães Consciência
- NOVA Medical School, Lisbon NOVA University, Lisbon, Portugal; Director of the Orthpaedic Department at CHLO - S F Xavier Central Hospital, Lisbon, Portugal
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26
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Ardern CL, Büttner F, Andrade R, Weir A, Ashe MC, Holden S, Impellizzeri FM, Delahunt E, Dijkstra HP, Mathieson S, Rathleff MS, Reurink G, Sherrington C, Stamatakis E, Vicenzino B, Whittaker JL, Wright AA, Clarke M, Moher D, Page MJ, Khan KM, Winters M. Implementing the 27 PRISMA 2020 Statement items for systematic reviews in the sport and exercise medicine, musculoskeletal rehabilitation and sports science fields: the PERSiST (implementing Prisma in Exercise, Rehabilitation, Sport medicine and SporTs science) guidance. Br J Sports Med 2021; 56:175-195. [PMID: 34625401 PMCID: PMC8862073 DOI: 10.1136/bjsports-2021-103987] [Citation(s) in RCA: 117] [Impact Index Per Article: 39.0] [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] [Accepted: 08/17/2021] [Indexed: 02/01/2023]
Abstract
Poor reporting of medical and healthcare systematic reviews is a problem from which the sports and exercise medicine, musculoskeletal rehabilitation, and sports science fields are not immune. Transparent, accurate and comprehensive systematic review reporting helps researchers replicate methods, readers understand what was done and why, and clinicians and policy-makers implement results in practice. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement and its accompanying Explanation and Elaboration document provide general reporting examples for systematic reviews of healthcare interventions. However, implementation guidance for sport and exercise medicine, musculoskeletal rehabilitation, and sports science does not exist. The Prisma in Exercise, Rehabilitation, Sport medicine and SporTs science (PERSiST) guidance attempts to address this problem. Nineteen content experts collaborated with three methods experts to identify examples of exemplary reporting in systematic reviews in sport and exercise medicine (including physical activity), musculoskeletal rehabilitation (including physiotherapy), and sports science, for each of the PRISMA 2020 Statement items. PERSiST aims to help: (1) systematic reviewers improve the transparency and reporting of systematic reviews and (2) journal editors and peer reviewers make informed decisions about systematic review reporting quality.
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Affiliation(s)
- Clare L Ardern
- Musculoskeletal & Sports Injury Epidemiology Center, Sophiahemmet University, Stockholm, Sweden .,Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia.,Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada
| | - Fionn Büttner
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Renato Andrade
- Clinical Research, Clínica do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal.,Dom Henrique Research Centre, Porto, Portugal
| | - Adam Weir
- Aspetar Sports Groin Pain Centre, Aspetar Orthopaedic & Sports Medicine Hospital, Doha, Qatar.,Department of Orthopaedics and Sports Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands.,Sport Medicine and Exercise Clinic Haarlem (SBK), Haarlem, The Netherlands
| | - Maureen C Ashe
- Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Hip Health and Mobility, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sinead Holden
- SMI, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.,Center for General Practice, Aalborg University, Aalborg, Denmark
| | - Franco M Impellizzeri
- Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Eamonn Delahunt
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - H Paul Dijkstra
- Sports Medicine, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.,Department for Continuing Education, University of Oxford, Oxford, UK
| | - Stephanie Mathieson
- Institute for Musculoskeletal Health, Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Michael Skovdal Rathleff
- SMI, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.,Center for General Practice, Aalborg University, Aalborg, Denmark
| | - Guus Reurink
- Academic Center for Evidence Based Sports Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Catherine Sherrington
- Institute for Musculoskeletal Health, Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Emmanuel Stamatakis
- Charles Perkins Centre, School of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - Bill Vicenzino
- University of Queensland School of Health and Rehabilitation Sciences: Physiotherapy, The University of Queensland, Brisbane, Queensland, Australia
| | - Jackie L Whittaker
- Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada.,Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Alexis A Wright
- Doctor of Physical Therapy Program, Tufts University School of Medicine, Tufts University, Boston, Massachusetts, USA
| | - Mike Clarke
- School of Medicine, Dentistry and Biomedical Sciences, Centre for Public Health, Queen's University, Belfast, UK
| | - David Moher
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Matthew J Page
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Karim M Khan
- Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada.,School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada.,Canadian Institutes of Health Research-Institute of Musculoskeletal Health, Vancouver, British Columbia, Canada
| | - Marinus Winters
- Center for General Practice, Aalborg University, Aalborg, Denmark
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27
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Costa PM, Learmonth DA, Gomes DB, Cautela MP, Oliveira ACN, Andrade R, Espregueira-Mendes J, Veloso TR, Cunha CB, Sousa RA. Mussel-Inspired Catechol Functionalisation as a Strategy to Enhance Biomaterial Adhesion: A Systematic Review. Polymers (Basel) 2021; 13:polym13193317. [PMID: 34641133 PMCID: PMC8513061 DOI: 10.3390/polym13193317] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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] [Received: 08/31/2021] [Revised: 09/22/2021] [Accepted: 09/22/2021] [Indexed: 11/16/2022] Open
Abstract
Biomaterials have long been explored in regenerative medicine strategies for the repair or replacement of damaged organs and tissues, due to their biocompatibility, versatile physicochemical properties and tuneable mechanical cues capable of matching those of native tissues. However, poor adhesion under wet conditions (such as those found in tissues) has thus far limited their wider application. Indeed, despite its favourable physicochemical properties, facile gelation and biocompatibility, gellan gum (GG)-based hydrogels lack the tissue adhesiveness required for effective clinical use. Aiming at assessing whether substitution of GG by dopamine (DA) could be a suitable approach to overcome this problem, database searches were conducted on PubMed® and Embase® up to 2 March 2021, for studies using biomaterials covalently modified with a catechol-containing substituent conferring improved adhesion properties. In this regard, a total of 47 reports (out of 700 manuscripts, ~6.7%) were found to comply with the search/selection criteria, the majority of which (34/47, ~72%) were describing the modification of natural polymers, such as chitosan (11/47, ~23%) and hyaluronic acid (6/47, ~13%); conjugation of dopamine (as catechol “donor”) via carbodiimide coupling chemistry was also predominant. Importantly, modification with DA did not impact the biocompatibility and mechanical properties of the biomaterials and resulting hydrogels. Overall, there is ample evidence in the literature that the bioinspired substitution of polymers of natural and synthetic origin by DA or other catechol moieties greatly improves adhesion to biological tissues (and other inorganic surfaces).
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Affiliation(s)
- Pedro M. Costa
- Stemmatters, Biotecnologia e Medicina Regenerativa SA, Parque de Ciência e Tecnologia Avepark, Zona Industrial da Gandra, 4805-017 Barco, Portugal; (D.A.L.); (D.B.G.); (M.P.C.); (A.C.N.O.); (T.R.V.); (C.B.C.); (R.A.S.)
- Correspondence: ; Tel.: +351–253–165–230
| | - David A. Learmonth
- Stemmatters, Biotecnologia e Medicina Regenerativa SA, Parque de Ciência e Tecnologia Avepark, Zona Industrial da Gandra, 4805-017 Barco, Portugal; (D.A.L.); (D.B.G.); (M.P.C.); (A.C.N.O.); (T.R.V.); (C.B.C.); (R.A.S.)
| | - David B. Gomes
- Stemmatters, Biotecnologia e Medicina Regenerativa SA, Parque de Ciência e Tecnologia Avepark, Zona Industrial da Gandra, 4805-017 Barco, Portugal; (D.A.L.); (D.B.G.); (M.P.C.); (A.C.N.O.); (T.R.V.); (C.B.C.); (R.A.S.)
| | - Mafalda P. Cautela
- Stemmatters, Biotecnologia e Medicina Regenerativa SA, Parque de Ciência e Tecnologia Avepark, Zona Industrial da Gandra, 4805-017 Barco, Portugal; (D.A.L.); (D.B.G.); (M.P.C.); (A.C.N.O.); (T.R.V.); (C.B.C.); (R.A.S.)
| | - Ana C. N. Oliveira
- Stemmatters, Biotecnologia e Medicina Regenerativa SA, Parque de Ciência e Tecnologia Avepark, Zona Industrial da Gandra, 4805-017 Barco, Portugal; (D.A.L.); (D.B.G.); (M.P.C.); (A.C.N.O.); (T.R.V.); (C.B.C.); (R.A.S.)
| | - Renato Andrade
- Clínica do Dragão, Espregueira-Mendes Sports Centre-FIFA Medical Centre of Excellence, 4350-415 Porto, Portugal; (R.A.); (J.E.-M.)
- Dom Henrique Research Centre, 4350-415 Porto, Portugal
- Faculty of Sports, University of Porto, 4200-450 Porto, Portugal
| | - João Espregueira-Mendes
- Clínica do Dragão, Espregueira-Mendes Sports Centre-FIFA Medical Centre of Excellence, 4350-415 Porto, Portugal; (R.A.); (J.E.-M.)
- Dom Henrique Research Centre, 4350-415 Porto, Portugal
- ICVS/3B’s-PT Government Associate Laboratory, Braga, Portugal
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal
| | - Tiago R. Veloso
- Stemmatters, Biotecnologia e Medicina Regenerativa SA, Parque de Ciência e Tecnologia Avepark, Zona Industrial da Gandra, 4805-017 Barco, Portugal; (D.A.L.); (D.B.G.); (M.P.C.); (A.C.N.O.); (T.R.V.); (C.B.C.); (R.A.S.)
| | - Cristiana B. Cunha
- Stemmatters, Biotecnologia e Medicina Regenerativa SA, Parque de Ciência e Tecnologia Avepark, Zona Industrial da Gandra, 4805-017 Barco, Portugal; (D.A.L.); (D.B.G.); (M.P.C.); (A.C.N.O.); (T.R.V.); (C.B.C.); (R.A.S.)
| | - Rui A. Sousa
- Stemmatters, Biotecnologia e Medicina Regenerativa SA, Parque de Ciência e Tecnologia Avepark, Zona Industrial da Gandra, 4805-017 Barco, Portugal; (D.A.L.); (D.B.G.); (M.P.C.); (A.C.N.O.); (T.R.V.); (C.B.C.); (R.A.S.)
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Abstract
Complete access to the posterior medial compartment of the knee may represent a technical challenge during arthroscopy in patients with a tight tibiofemoral joint space. Medial collateral release reduces direct iatrogenic cartilage damage in the medial compartment of the knee through manipulation with instruments. We recommend performing medial collateral release in surgeries that access the posteromedial compartment (e.g. partial meniscectomy for ruptures of the posterior horn of medial meniscus or posterior root repairs) when the patient has a tight tibiofemoral joint space. There are two main techniques to perform medial collateral release: inside-out and outside-in. Regardless of the technique used, releasing medial ligament structures is a safe and effective method to be used in the diagnosis and treatment of injuries to the medial compartment.
Cite this article: EFORT Open Rev 2021;6:669-675. DOI: 10.1302/2058-5241.6.200128
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Affiliation(s)
| | - Francisco Guerra Pinto
- Hospital Ortopédico de Sant'Ana, Hospital Cruz Vermelha Portuguesa, Universidad de Barcelona, Nova Medical School, Lisboa, Portugal
| | | | - Renato Andrade
- Clínica Do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal.,Porto Biomechanics Laboratory (LABIOMEP), Faculty of Sports, University of Porto, Porto, Portugal
| | - João Espregueira-Mendes
- Clínica Do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal.,Dom Henrique Research Centre, Porto, Portugal.,ICVS/3Bs, PT Government Associate Laboratory, Braga/Guimarães, Portugal.,School of Medicine, Minho University, Braga, Portugal
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29
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Pereira BS, Andrade R, Espregueira-Mendes J, Marano RPC, Oliva XM, Karlsson J. Current Concepts on Subtalar Instability. Orthop J Sports Med 2021; 9:23259671211021352. [PMID: 34435065 PMCID: PMC8381447 DOI: 10.1177/23259671211021352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 01/08/2021] [Accepted: 02/23/2021] [Indexed: 12/19/2022] Open
Abstract
Subtalar instability remains a topic of debate, and its precise cause is still unknown. The mechanism of injury and clinical symptoms of ankle and subtalar instabilities largely overlap, resulting in many cases of isolated or combined subtalar instability that are often misdiagnosed. Neglecting the subtalar instability may lead to failure of conservative or surgical treatment and result in chronic ankle instability. Understanding the accurate anatomy and biomechanics of the subtalar joint, their interplay, and the contributions of the different subtalar soft tissue structures is fundamental to correctly diagnose and manage subtalar instability. An accurate diagnosis is crucial to correctly identify those patients with instability who may require conservative or surgical treatment. Many different nonsurgical and surgical approaches have been proposed to manage combined or isolated subtalar instability, and the clinician should be aware of available treatment options to make an informed decision. In this current concepts narrative review, we provide a comprehensive overview of the current knowledge on the anatomy, biomechanics, clinical and imaging diagnosis, nonsurgical and surgical treatment options, and outcomes after subtalar instability treatment.
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Affiliation(s)
- Bruno S. Pereira
- Facultad de Medicina, University of Barcelona, Casanova, 143, 08036
Barcelona, Spain
- Clínica Espregueira - FIFA Medical Centre of Excellence, Porto,
Portugal
- Dom Henrique Research Centre, Porto, Portugal
- Hospital Privado de Braga, Lugar da Igreja Nogueira, Braga,
Portugal
| | - Renato Andrade
- Clínica Espregueira - FIFA Medical Centre of Excellence, Porto,
Portugal
- Dom Henrique Research Centre, Porto, Portugal
- Porto Biomechanics Laboratory (LABIOMEP), Faculty of Sports,
University of Porto, Porto, Portugal
- Porto Biomechanics Laboratory (LABIOMEP), University of Porto,
Porto, Portugal
| | - João Espregueira-Mendes
- Clínica Espregueira - FIFA Medical Centre of Excellence, Porto,
Portugal
- Dom Henrique Research Centre, Porto, Portugal
- School of Medicine, Minho University, Braga, Portugal
- 3B’s–PT Government Associate Laboratory, Braga/Guimarães,
Portugal
- 3B’s Research Group– Biomaterials, Biodegradables and Biomimetics,
University of Minho, Headquarters of the European Institute of Excellence on Tissue
Engineering and Regenerative Medicine, Barco, Guimarães, Portugal
| | | | - Xavier Martin Oliva
- Facultad de Medicina, University of Barcelona, Casanova, 143, 08036
Barcelona, Spain
- Orthopedic Surgery Department, Clínica Ntra. Sra. Del Remei,
Barcelona, Spain
| | - Jón Karlsson
- Department of Orthopaedics, Sahlgrenska Academy, Sahlgrenska
University Hospital, Gothenburg University, Gothenburg, Sweden
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30
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Afonso J, Olivares-Jabalera J, Andrade R. Time to Move From Mandatory Stretching? We Need to Differentiate "Can I?" From "Do I Have To?". Front Physiol 2021; 12:714166. [PMID: 34366900 PMCID: PMC8340604 DOI: 10.3389/fphys.2021.714166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 06/27/2021] [Indexed: 12/13/2022] Open
Affiliation(s)
- José Afonso
- Faculty of Sport of the University of Porto (FADEUP), Centre for Research, Education, Innovation and Intervention in Sport (CIFI2D), Porto, Portugal
| | - Jesús Olivares-Jabalera
- Sport Research Lab, Football Science Institute, Granada, Spain.,Department of Physical and Sports Education, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Renato Andrade
- Clínica do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal.,Dom Henrique Research Centre, Porto, Portugal.,Porto Biomechanics Laboratory (LABIOMEP), Faculty of Sport, University of Porto, Porto, Portugal
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31
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Mónico JL, Andrade R, Matos P, Mónico L, Mariano JC, Espregueira-Mendes J, Fonseca F. Tibial plateau fractures osteosynthesis—a case series of 88 patients evaluating surgical approaches, results and complications. Ann Joint 2021. [DOI: 10.21037/aoj-20-95] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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32
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Fernandes TL, Moreira HH, Andrade R, Sasaki SU, Bernardo WM, Pedrinelli A, Espregueira-Mendes J, Hernandez AJ. Clinical Outcome Evaluation of Anatomic Anterior Cruciate Ligament Reconstruction With Tunnel Positioning Using Gold Standard Techniques: A Systematic Review and Meta-analysis. Orthop J Sports Med 2021; 9:23259671211013327. [PMID: 34262978 PMCID: PMC8243110 DOI: 10.1177/23259671211013327] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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] [Indexed: 12/01/2022] Open
Abstract
Background: There have been conflicting results about the theoretical advantages of
anatomic double-bundle anterior cruciate ligament (ACL) reconstruction. Purpose: To evaluate the clinical and functional outcomes comparing anatomic single-
versus double-bundle techniques, anatomic versus nonanatomic techniques, and
transportal versus outside-in tunnel drilling for ACL reconstruction. Study Design: Systematic review; Level of evidence, 3. Methods: A search was performed in the MEDLINE and EMBASE databases up to August 2018
for clinical trials comparing anatomic ACL reconstruction (with tunnel
positioning demonstrated using gold standard radiologic techniques) with
another technique, with a minimum functional and biomechanical follow-up of
6 months. A meta-analysis was performed to compare clinical and functional
outcomes between anatomic single- versus double-bundle reconstruction and
between anatomic versus nonanatomic techniques, using the risk difference or
the mean difference. Risk of bias of the included studies was assessed using
the Newcastle-Ottawa Scale for cohort and case-control studies and the
Cochrane Risk of Bias tool and Jadad Score for randomized controlled
trials. Results: Included were 15 studies comprising 1290 patients (follow-up, 12-36 months).
No significant differences favoring anatomic double-bundle over anatomic
single-bundle reconstruction or outside-in over transportal techniques were
found. The meta-analyses showed significant differences in the International
Knee Documentation Committee (IKDC) objective score (risk difference, –0.14;
95% confidence interval, –0.27 to –0.01) favoring anatomic over nonanatomic
reconstruction. No statistically significant differences were found between
anatomic and nonanatomic surgical techniques on other functional scores or
clinical examination outcomes, including the IKDC subjective score, Lysholm
score, Tegner score, KT-1000 arthrometer test, or pivot-shift test. Conclusion: Double-bundle reconstruction was not superior to the single-bundle technique
in clinical and functional outcomes. Anatomic ACL reconstruction shows
significantly superior results over nonanatomic ACL reconstruction,
reinforcing the anatomic technique as the gold standard choice for clinical
practice.
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Affiliation(s)
- Tiago Lazzaretti Fernandes
- Group of Sports Medicine, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.,FIFA Medical Center of Excellence, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Hugo Henrique Moreira
- Group of Sports Medicine, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.,FIFA Medical Center of Excellence, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Renato Andrade
- FIFA Medical Centre of Excellence, Clínica do Dragão, Espregueira-Mendes Sports Centre, Porto, Portugal.,Dom Henrique Research Centre, Porto, Portugal.,Faculty of Sports, University of Porto, Porto, Portugal
| | - Sandra Umeda Sasaki
- Public Employee Medical Assistance Institute of São Paulo State, Universidade Cidade de São Paulo, São Paulo, Brazil
| | | | - André Pedrinelli
- Group of Sports Medicine, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.,FIFA Medical Center of Excellence, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - João Espregueira-Mendes
- FIFA Medical Centre of Excellence, Clínica do Dragão, Espregueira-Mendes Sports Centre, Porto, Portugal.,Dom Henrique Research Centre, Porto, Portugal.,School of Medicine, Minho University, Braga, Portugal.,ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal.,3B's Research Group-Biomaterials, Biodegradables and Biomimetics, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, University of Minho, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, Barco, Guimarães, Portugal
| | - Arnaldo José Hernandez
- Group of Sports Medicine, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.,FIFA Medical Center of Excellence, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
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Valente C, Andrade R, Alvarez L, Rebelo-Marques A, Stamatakis E, Espregueira-Mendes J. Effect of physical activity and exercise on telomere length: Systematic review with meta-analysis. J Am Geriatr Soc 2021; 69:3285-3300. [PMID: 34161613 DOI: 10.1111/jgs.17334] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [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: 03/31/2021] [Revised: 05/24/2021] [Accepted: 05/29/2021] [Indexed: 12/30/2022]
Abstract
PURPOSE To compare a physically active lifestyle or structured exercise program to physically inactive lifestyle or control groups on telomere length (TL). METHOD We searched PubMed, EMBASE, Cochrane Library, and Open Gray databases up to March 31, 2020. We calculated standardized mean differences (SMD) with 95% confidence intervals (CI) of TL comparing physically active to physically inactive individuals and exercise intervention to control groups. Risk of bias was judged using the Risk of Bias Assessment tool for Non-randomized Studies (RoBANS) for physical activity (PA) studies and the Cochrane risk-of-bias (RoB2) for exercise intervention studies. Certainty of evidence was judged using Grading of Recommendations Assessment, Development and Evaluation (GRADE). RESULTS We included 30 studies (24 assessing the effects of PA and 6 assessing the effects of exercise interventions) comprising 7418 individuals. Physically active individuals had longer telomeres (SMD = 0.70, 95% CI 0.12-1.28, very-low certainty), especially in middle-aged individuals (SMD = 0.90, 95% CI 0.08-1.72, very-low certainty) and when considering only athletes (SMD = 0.54, 95% CI 0.18-0.90, very-low certainty). Trim-and-fill analyses revealed that most of the pooled effects were overestimated. Exercise interventions did not yield any significant effect on TL. CONCLUSION There is very-low certainty that physically active individuals have longer telomeres with a moderate effect, but this effect is probably overestimated.
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Affiliation(s)
- Cristina Valente
- Clínica Do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal.,Dom Henrique Research Centre, Porto, Portugal
| | - Renato Andrade
- Clínica Do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal.,Dom Henrique Research Centre, Porto, Portugal.,Porto Biomechanics Laboratory (LABIOMEP), Faculty of Sports, University of Porto, Porto, Portugal
| | - Luis Alvarez
- Dpto. Producción y Sanidad Animal, Salud Pública Veterinaria y Ciencia y Tecnología de los Alimentos, Facultad de Veterinaria, Universidad CEU Cardenal Herrera, Valencia, Spain.,I3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.,IPATIMUP, Institute of Molecular Pathology and Immunology, University of Porto, Porto, Portugal
| | - Alexandre Rebelo-Marques
- Clínica Do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal.,Dom Henrique Research Centre, Porto, Portugal.,Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Clinical Academic Center of Coimbra, Coimbra, Portugal
| | - Emmanuel Stamatakis
- Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - João Espregueira-Mendes
- Clínica Do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal.,Dom Henrique Research Centre, Porto, Portugal.,ICVS/3B's-PT Government Associate Laboratory, Guimarães, Portugal.,3B's Research Group-Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Guimarães, Portugal.,School of Medicine, Minho University, Braga, Portugal
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Mota Gomes T, Guerra-Pinto F, Soares S, Andrade R, Pereira B, Espregueira-Mendes J, Oliva XM. The vascularization of the peroneal tendons: An anatomic study. Foot Ankle Surg 2021; 27:450-456. [PMID: 32600968 DOI: 10.1016/j.fas.2020.06.004] [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: 04/07/2020] [Revised: 05/22/2020] [Accepted: 06/04/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND Arterial vascularization is intimately related to the peroneal tendon ruptures. Our purpose is to describe the vascular anatomy of peroneal tendons and assess differences in the vascularization patterns between peroneus brevis tendon (PBT) and peroneus longus tendon (PLT). METHODS Anatomical study of 22 cadaveric lower extremities. We exposed tendons' vascularization by injecting latex. To systematize the vascular description, we considered four anatomical regions in the PBT and six in the PLT. RESULTS Vascularization was supplied by the peroneal, anterior tibial and lateral plantar arteries and from the deep plantar arch through the vincula connecting the tendons. No avascular areas were found in the PLT. 22.7% of specimens had avascular areas in the PBT. Two visual vascularization patterns were found (arcuate and weblike). Increasing age and a web-like vascularization were associated with a lower number of blood vessels at the tendons' post malleolus area. CONCLUSION Peroneal tendons are well vascularized throughout their course, running through a common vincula, with vascularization provided by various arteries. Avascular areas were observed in the PBT, but none at the PLT.
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Affiliation(s)
- Tiago Mota Gomes
- Foot and Ankle Unit, Department of Anatomy and Human Embryology, Faculty of Medicine, University of Barcelona, Barcelona, Spain.
| | - Francisco Guerra-Pinto
- Foot and Ankle Unit, Department of Anatomy and Human Embryology, Faculty of Medicine, University of Barcelona, Barcelona, Spain; Department of Orthopaedic Surgery, Hospital de Cascais Dr. Jose de Almeida, Alcabideche, Portugal.
| | - Sérgio Soares
- Foot and Ankle Unit, Department of Anatomy and Human Embryology, Faculty of Medicine, University of Barcelona, Barcelona, Spain; Department of Orthopaedic Surgery, Hôpital du Valais, Sion, Switzerland.
| | - Renato Andrade
- Clínica do Dragão, Espregueira-Mendes Sports Centre, FIFA Medical Centre of Excellence, Porto, Portugal; Dom Henrique Research Centre, Porto, Portugal; Faculty of Sports, University of Porto, Porto, Portugal.
| | - Bruno Pereira
- Foot and Ankle Unit, Department of Anatomy and Human Embryology, Faculty of Medicine, University of Barcelona, Barcelona, Spain; Department of Orthopedic Surgery, Hospital de Braga, Braga, Portugal; Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal; Clinica do Dragão, Espregueira-Mendes Sports Center, FIFA Medical Centre of Excellence, Minho University, Porto, Portugal; University of Porto Research Center, Porto, Portugal.
| | - João Espregueira-Mendes
- Clínica do Dragão, Espregueira-Mendes Sports Centre, FIFA Medical Centre of Excellence, Porto, Portugal; Dom Henrique Research Centre, Porto, Portugal; School of Medicine, Minho University, Braga, Portugal; 3B's Research Group, I3Bs - Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805-017 Barco, Guimarães, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga, Guimarães, Portugal.
| | - Xavier Martin Oliva
- Foot and Ankle Unit, Department of Anatomy and Human Embryology, Faculty of Medicine, University of Barcelona, Barcelona, Spain; Department of Orthopedics, Clinica Del Remei, Barcelona, Spain.
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Coutinho FM, Rebelo-Marques A, Andrade R, Espregueira-Mendes J, Bombas T, Moura P. Menstrual pattern and contraceptive choices of Portuguese athletes. EUR J CONTRACEP REPR 2021; 26:240-245. [PMID: 33615943 DOI: 10.1080/13625187.2021.1879780] [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] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Menstrual symptoms are commonly cited barriers to physical activity in women. Delay or avoidance of menstruation through hormonal contraceptives may mitigate those barriers. Our purpose is to identify the uterine bleeding patterns of Portuguese athletes, their contraceptive choices and the impact of contraceptive methods in sports performance. We aim also to compare the outcomes between users and non-users of contraception. METHODS Observational, descriptive and comparative study based on a customised self-assessment online survey aimed at Portuguese athletes. Athletes had to be at least 16 years old and competing at a national, international or professional level. RESULTS A total of 256 athletes from 18 modalities were eligible. The mean age was 29 years and the mean age of menarche was 12.8 years. Monthly bleeding pattern was prevailing and 50% presented dysmenorrhoea. More than 85% experience fluctuations in sports performance throughout the month. The majority (71.5%) used contraceptive methods. Only 16% believed that contraception decreased sports performance. Contraceptive users exhibit a lower mean body mass index, blood loss and percentage of dysmenorrhoea than the non-users. CONCLUSION Most athletes had the perception that performance varies throughout the month. The majority of participants do not report amenorrhoea and have monthly menses. The use of contraceptive methods is reportedly high, benefit cycle control and apparently without any physical inconvenience.
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Affiliation(s)
| | - Alexandre Rebelo-Marques
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal.,Clínica do Dragão, Espregueira-Mendes Sports Centre, FIFA Medical Centre of Excellence, Porto, Portugal.,Dom Henrique Research Centre, Porto, Portugal
| | - Renato Andrade
- Clínica do Dragão, Espregueira-Mendes Sports Centre, FIFA Medical Centre of Excellence, Porto, Portugal.,Dom Henrique Research Centre, Porto, Portugal.,Faculty of Sports, University of Porto, Porto, Portugal
| | - João Espregueira-Mendes
- Clínica do Dragão, Espregueira-Mendes Sports Centre, FIFA Medical Centre of Excellence, Porto, Portugal.,Dom Henrique Research Centre, Porto, Portugal.,School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's-PT Government Associate Laboratory, Braga, Portugal.,3B's Research Group - Biomaterials, Biodegradables and Biomimetics, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, University of Minho, Barco, Portugal
| | - Teresa Bombas
- Obstetrics Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Paulo Moura
- Obstetrics Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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Soltani P, Andrade R. The Influence of Virtual Reality Head-Mounted Displays on Balance Outcomes and Training Paradigms: A Systematic Review. Front Sports Act Living 2021; 2:531535. [PMID: 33634259 PMCID: PMC7902044 DOI: 10.3389/fspor.2020.531535] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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] [Received: 02/18/2020] [Accepted: 12/31/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Falls are the leading causes of (non)fatal injuries in older adults. Recent research has developed interventions that aim to improve balance in older adults using virtual reality (VR). Purpose: We aimed to investigate the validity, reliability, safety, feasibility, and efficacy of head mounted display (HMD) systems for assessing and training balance in older adults. Methods: We searched EBSCOhost, Scopus, Web of Science, and PubMed databases until 1 September 2020 to find studies that used HMD systems for assessing or training balance. The methodological quality was assessed using a modified version of Downs and Black. We also appraised the risk of bias using Risk of Bias Assessment tool for Non-randomized Studies (RoBANS). Results: A total of 19 articles (637 participants) were included for review. Despite heterogenous age ranges and clinical conditions across studies, VR HMD systems were valid to assess balance and could be useful for fall prevention and for improving postural control and gait patterns. These systems also have the capacity to differentiate healthy and balance-impaired individuals. During VR versions of traditional balance tests, older adults generally acquire a cautious behavior and take more time to complete the tasks. Conclusion: VR HMD systems can offer ecologically valid scenarios to assess and train functional balance and can be used alone or in addition to other interventions. New norms and protocols should be defined according to participants' age, health status, and severity of their illness when using VR HMD systems for balance assessment and training. For safe and feasible training, attention must be given to display type, VR elements and scenarios, duration of exposure, and system usability. Due to high risk of bias and overall poor quality of the studies, further research is needed on the effectiveness of HMD VR training in older adults.
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Affiliation(s)
- Pooya Soltani
- Department of Computer Science, Department of Health, Centre for the Analysis of Motion, Entertainment Research and Applications (CAMERA), University of Bath, Bath, United Kingdom.,Department of Physical Education and Sport Sciences, School of Education and Psychology, Shiraz University, Shiraz, Iran
| | - Renato Andrade
- Clínica do Dragão, Espregueira-Mendes Sports Centre, FIFA Medical Centre of Excellence, Porto, Portugal.,Dom Henrique Research Centre, Porto, Portugal.,Faculty of Sport, University of Porto, Porto, Portugal
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França G, Nunes J, Pinho P, Freitas D, Andrade R, Espregueira-Mendes J, Pereira B, Oliva XM. Is arthrodesis still the best treatment option for first metatarsophalangeal joint arthritis?—a systematic review of arthrodesis and arthroplasty outcomes. Ann Joint 2021. [DOI: 10.21037/aoj-20-88] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Resende VAC, Neto AC, Nunes C, Andrade R, Espregueira-Mendes J, Lopes S. Higher age, female gender, osteoarthritis and blood transfusion protect against periprosthetic joint infection in total hip or knee arthroplasties: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc 2021; 29:8-43. [PMID: 30413860 DOI: 10.1007/s00167-018-5231-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [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: 06/27/2018] [Accepted: 10/17/2018] [Indexed: 01/20/2023]
Abstract
PURPOSE The goal of this systematic review and meta-analysis was to identify the main risk factors for periprosthetic joint infection (PJI) in patients undergoing total hip or knee arthroplasties. METHODS A systematic review was conducted of the potential risk factors for PJI in total hip or total knee arthroplasty. Risk factors were compared and grouped according to demographics, comorbidities, behavior, infections, native joint diseases and other patient-related and procedure-related factors. Meta-analysis (random-effects models) was conducted using odds ratio (OR) and mean difference (MD). Risk of bias (ROBBINS-I) and strength of the evidence (GRADE) were assessed. RESULTS The study included 37 studies (2,470,827 patients). Older age was a protective factor (MD = - 1.18). Male gender (OR 1.34), coagulopathy (3.05), congestive heart failure (2.36), diabetes mellitus (1.80), obesity (1.61), systemic neoplasia (1.57), chronic lung disease (1.52), and hypertension (1.21) increased the risk for PJI. Behavioral risk factors comprised alcohol abuse (2.95), immunosuppressive therapy (2.81), steroid therapies (1.88), and tobacco (1.82). Infectious risk factors included surgical site infections (6.14), postoperative urinary tract infections (2.85), and prior joint infections (2.15). Rheumatoid arthritis, posttraumatic native joint disease, high National Nosocomial Infections Surveillance (NNIS) system surgical patient index score, prior joint operation, American Society of Anesthesiologists score ≥ 3 and obesity were also significantly associated with higher risk of PJI. Osteoarthritis and blood transfusion were protective factors. CONCLUSIONS The main risk factors for PJI in each category were male gender, coagulopathy, alcohol abuse, surgical site infection (highest score) and high NNIS system surgical patient index score. Protective factors were age, female gender in TKA, osteoarthritis and blood transfusion. Optimization of modifiable risk factors for PJI should be attempted in clinical practice. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Vera Alice Correia Resende
- Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal.
- Centro Hospitalar de Entre o Douro e Vouga, Rua Dr. Cândido de Pinho, 4520-211, Santa Maria da Feira, Portugal.
| | - Artur Costa Neto
- Centro Hospitalar de Entre o Douro e Vouga, Rua Dr. Cândido de Pinho, 4520-211, Santa Maria da Feira, Portugal
| | - Carla Nunes
- Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
- Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Renato Andrade
- Clínica do Dragão, Espregueira-Mendes Sports Centre-FIFA Medical Centre of Excellence, Porto, Portugal
- Faculty of Sports, University of Porto, Porto, Portugal
- Dom Henrique Research Centre, Porto, Portugal
| | - João Espregueira-Mendes
- Clínica do Dragão, Espregueira-Mendes Sports Centre-FIFA Medical Centre of Excellence, Porto, Portugal
- Dom Henrique Research Centre, Porto, Portugal
- 3B's Research Group-Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, Barco, 4805-017, Guimarães, Portugal
- ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Orthopaedics Department of Minho University, Braga, Portugal
| | - Sílvia Lopes
- Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
- Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
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Correia RM, Andrade R, Tosato F, Nascimento MT, Pereira LL, Araújo JB, Pinto FE, Endringer DC, Padovan MP, Castro EV, Partelli FL, Filgueiras PR, Lacerda V, Romão W. Analysis of Robusta coffee cultivated in agroforestry systems (AFS) by ESI-FT-ICR MS and portable NIR associated with sensory analysis. J Food Compost Anal 2020. [DOI: 10.1016/j.jfca.2020.103637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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da Cunha CB, Andrade R, Veloso TR, Learmonth DA, Espregueira-Mendes J, Sousa RA. Enhanced microfracture using acellular scaffolds improves results after treatment of symptomatic focal grade III/IV knee cartilage lesions but current clinical evidence does not allow unequivocal recommendation. Knee Surg Sports Traumatol Arthrosc 2020; 28:3245-3257. [PMID: 31894366 DOI: 10.1007/s00167-019-05832-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 07/12/2019] [Accepted: 12/12/2019] [Indexed: 12/26/2022]
Abstract
PURPOSE To systematically analyse post-operative outcomes following enhanced microfracture procedures in focal cartilage injuries of the knee. METHODS Database searches were conducted in PubMed, EMBASE and Cochrane Library databases up to 30 November 2018, for clinical studies in humans that assessed surgical outcomes of enhanced microfracture procedures in focal cartilage injuries of the knee. The clinical, functional and imaging outcomes were assessed and summarized. The MINORS scale was used to assess the methodological quality of the studies included. RESULTS Ten studies were included comprising a total of 331 patients (mean age of 37.0 ± 5.5 years, body mass 25.2 ± 1.7 kg m2, 56% male and 42% left knee), 278 femoral condyle chondral defects (147 medial, 35 lateral and 78 undefined) and 43 chondral defects distributed by the tibial plateau, patella and femoral trochlea. The chondral defects were mostly Outerbridge grade III or IV and the mean defect size was 3.2 ± 0.6 cm2. Studies consistently demonstrated significant improvement in the patient-reported outcome measures from baseline to final follow-up. Overall, imaging outcomes showed inconsistent results. Treatment-related adverse events were poorly reported. CONCLUSION Enhanced microfracture techniques significantly result in improved patient-reported outcome measures over the MCID, but provide inconsistent imaging results. Current clinical evidence does not allow for unequivocal recommendation of enhanced microfracture to treat symptomatic focal grade III/IV knee cartilage lesions. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Cristiana Branco da Cunha
- Stemmatters, Biotecnologia e Medicina Regenerativa SA, Parque de Ciência e Tecnologia Avepark, Zona Industrial da Gandra, 4805-017, Barco, Guimarães, Portugal.
| | - Renato Andrade
- Clínica do Dragão, Espregueira-Mendes Sports Centre-FIFA Medical Centre of Excellence, Porto, Portugal.,Dom Henrique Research Centre, Porto, Portugal.,Faculty of Sports, University of Porto, Porto, Portugal
| | - Tiago Rafael Veloso
- Stemmatters, Biotecnologia e Medicina Regenerativa SA, Parque de Ciência e Tecnologia Avepark, Zona Industrial da Gandra, 4805-017, Barco, Guimarães, Portugal
| | - David A Learmonth
- Stemmatters, Biotecnologia e Medicina Regenerativa SA, Parque de Ciência e Tecnologia Avepark, Zona Industrial da Gandra, 4805-017, Barco, Guimarães, Portugal
| | - João Espregueira-Mendes
- Clínica do Dragão, Espregueira-Mendes Sports Centre-FIFA Medical Centre of Excellence, Porto, Portugal.,Dom Henrique Research Centre, Porto, Portugal.,ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
| | - Rui A Sousa
- Stemmatters, Biotecnologia e Medicina Regenerativa SA, Parque de Ciência e Tecnologia Avepark, Zona Industrial da Gandra, 4805-017, Barco, Guimarães, Portugal
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Guerra-Pinto F, Cunha J, Sousa L, Gomes TM, Andrade R, Oliva XM, Consciência JG, Fernandes PR. Gravity stress tibiotalar laxity evaluation with a biomedical gyroscopes device - cadaver study with progressive sectioning of lateral ankle ligaments. J Exp Orthop 2020; 7:53. [PMID: 32696272 PMCID: PMC7374536 DOI: 10.1186/s40634-020-00269-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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 07/01/2020] [Indexed: 11/29/2022] Open
Abstract
Purpose Despite the evidence on the role of gravity stress test to access the instability of other ankle injuries, there is limited literature regarding gravity stress on the lateral ankle ligament’s insufficiency. The objective of our study was to objectively measure the tibiotalar angular movement under gravity stress after progressive sectioning of the lateral ankle ligaments. Methods We performed sequential sectioning of the anterior talofibular (ATFL), calcaneofibular (CFL), and posterior talofibular ligaments (PTFL) in twelve ankle specimens. Under gravity stress, we measured the angular movement of the talus in relation to the tibia. The measuring device is based on a three-axis gyroscope and accelerometer. Results Comparing to the intact condition, the plantar flexion increased on average 1.78° (95% confidence interval [CI] 1.15;2.42), 5.13° (95%CI 3.10;7.16) and 8.63° (95%CI 6.05;11.22), the rotation increased by 1.00° (95 CI -0.51;2.51), 3.68° (95%CI 1.97;5.40) and 15.62° (95%CI 10.09;21.14), and the varus increased 2.89° (95% CI 1.39, 4.39), 8.12° (95% CI 5.16, 11.07) and 11.68° (95% CI 7.91, 15.46), after sectioning the ATFL, CFL, and PTFL, respectively. The overall changes were statistically significant. Conclusions There was a significant tibiotalar laxity after sectioning of lateral ankle ligaments when the foot position is influenced only by gravity. The tibiotalar angular displacement was significant when the CFL and PTFL were cut which suggests that the gravity test could be used to assess combined lateral ankle ligament injury. This evidence might be a step forward in the development of lateral ankle ligaments gravity stress tests. Level of evidence 5 (cadaver study)
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Affiliation(s)
- F Guerra-Pinto
- Department of Orthopaedics, Hospital Ortopédico de Sant'Ana, R. Benguela 501, 2775-229, Parede, Portugal. .,Department of Orthopaedics, Hospital da Cruz Vermelha Portuguesa, Lisbon, Portugal. .,NOVA Medical School, Lisbon NOVA University, Lisbon, Portugal. .,Department of Anatomy and Human Embryology, Faculty of Medicine, University of Barcelona, Barcelona, Spain.
| | - J Cunha
- IDMEC, Instituto Superior Técnico, Lisbon University, Lisbon, Portugal
| | - L Sousa
- IDMEC, Instituto Superior Técnico, Lisbon University, Lisbon, Portugal
| | - T M Gomes
- Department of Anatomy and Human Embryology, Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - R Andrade
- Clínica do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal. Dom Henrique Research Centre, Porto, Portugal.,Faculty of Sports, University of Porto, Porto, Portugal
| | - X M Oliva
- Department of Orthopedics, Clinica Del Remei, Barcelona, Spain.,Department of Anatomy and Human Embryology, Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - J G Consciência
- NOVA Medical School, Lisbon NOVA University, Lisbon, Portugal.,Head of Orthopaedics Departement at CHLO - S. F. Xavier Hospital, Lisbon, Portugal
| | - P R Fernandes
- IDMEC, Instituto Superior Técnico, Lisbon University, Lisbon, Portugal
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Xará-Leite F, Pereira AD, Andrade R, Sarmento A, Sousa R, Ayeni OR, Espregueira-Mendes J, Soares D. The cement-in-cement technique is a reliable option in hip arthroplasty revision surgery: a systematic review. Eur J Orthop Surg Traumatol 2020; 31:7-22. [PMID: 32666308 DOI: 10.1007/s00590-020-02736-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 07/01/2020] [Indexed: 02/06/2023]
Abstract
INTRODUCTION The cement-in-cement technique for revision hip arthroplasty has many potential advantages and has recently gained widespread interest but still lacks evidence to support it. Our aim was to examine the surgical and patient-reported outcomes after cement-in-cement revision hip arthroplasty. MATERIALS AND METHODS A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed and EMBASE databases were searched up to February 2019 for original studies reporting the outcomes of revision hip arthroplasty surgeries using the cement-in-cement technique. The methodological quality was assessed using the methodological index for non-randomized studies scale. RESULTS Sixteen non-comparative studies met the eligibility criteria, comprising 1899 hips in 1856 patients (72.2 mean age, 37% male), with a mean follow-up of 7.2 years. Most studies reported only primary revisions and focused on the stem component. Intraoperative complications such as femoral or acetabular fractures (5.3%) were low and easily manageable with no relevant sequelae, as were dislocation rates (2.8% of uncomplicated events and 1.6% of cases requiring re-revision). Failure (considered if there was aseptic loosening of the cement-in-cement revised component, 2%), re-revision (9.3%), implant survival and late complication rates were favourable. Functional patient-reported outcomes showed an overall improvement above the minimal clinically important difference at final follow-up. CONCLUSION The cement-in-cement technique is a viable option for hip arthroplasty revision surgery with low intraoperative and late complication rates, dislocations and immediate post-operative morbidity, resulting in good functional patient-reported outcomes and favourable medium-term implant survival.
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Affiliation(s)
- Francisco Xará-Leite
- GRIP Unit, Orthopaedics Department, Centro Hospitalar e Universitário do Porto, Largo do Prof Abel Salazar, 4099-001, Porto, Portugal.
| | | | - Renato Andrade
- Clínica do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal.,Dom Henrique Research Centre, Porto, Portugal.,Faculty of Sports, University of Porto, Porto, Portugal
| | - André Sarmento
- Clínica do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal.,Orthopaedics Department, Centro Hospitalar de Vila Nova de Gaia e Espinho, Vila Nova de Gaia, Portugal
| | - Ricardo Sousa
- GRIP Unit, Orthopaedics Department, Centro Hospitalar e Universitário do Porto, Largo do Prof Abel Salazar, 4099-001, Porto, Portugal
| | - Olufemi R Ayeni
- Division of Orthopaedic Surgery, McMaster University, Hamilton, ON, Canada
| | - João Espregueira-Mendes
- Clínica do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal.,Dom Henrique Research Centre, Porto, Portugal.,Orthopaedics Department, Minho University, Minho, Portugal.,ICVS/3B's-PT Government Associate Laboratory, Braga, Guimarães, Portugal
| | - Daniel Soares
- GRIP Unit, Orthopaedics Department, Centro Hospitalar e Universitário do Porto, Largo do Prof Abel Salazar, 4099-001, Porto, Portugal
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Bastos R, Mathias M, Andrade R, Amaral RJFC, Schott V, Balduino A, Bastos R, Miguel Oliveira J, Reis RL, Rodeo S, Espregueira-Mendes J. Intra-articular injection of culture-expanded mesenchymal stem cells with or without addition of platelet-rich plasma is effective in decreasing pain and symptoms in knee osteoarthritis: a controlled, double-blind clinical trial. Knee Surg Sports Traumatol Arthrosc 2020; 28:1989-1999. [PMID: 31587091 DOI: 10.1007/s00167-019-05732-8] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [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: 07/03/2019] [Accepted: 09/25/2019] [Indexed: 12/16/2022]
Abstract
PURPOSE To compare the clinical and laboratory outcomes of intra-articular injections of culture-expanded bone-derived mesenchymal stem cells (MSCs) with or without platelet-rich plasma (PRP) to intra-articular corticosteroid injections for the treatment of knee osteoarthritis (OA). METHODS Forty-seven patients with radiographic and symptomatic knee OA were randomized into three groups for intra-articular injections: autologous bone marrow-derived culture-expanded MSCs (n = 16); autologous bone marrow-derived culture-expanded MSCs + PRP (n = 14); and corticosteroid (n = 17). The outcomes were assessed by the Knee Injury and Osteoarthritis Outcome Score (KOOS) and range of motion (ROM) at baseline, 1, 2, 3, 6, 9 and 12 months and intra-articular cytokines analysis at baseline, 6 and 12 months postoperatively. RESULTS The three groups showed significant improvement in most KOOS domains and global score at 1st month and all domains and global score at 12-month follow-up (p < 0.05). At the 1st month, only the MSCs group showed significant differences in KOOS symptoms domain (p = 0.003). The MSCs and MSCs + PRP groups showed the highest percentage of improvement in most KOOS domains and global score compared to the corticosteroid group. All three groups showed a significant reduction in intra-articular levels of human interleukin-10 cytokine, from baseline to 12 months (p < 0.05). CONCLUSION An intra-articular injection of bone marrow-derived culture-expanded MSCs with or without the addiction of PRP is effective in improving the function and decreasing symptoms caused by knee OA at 12-month follow-up. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Ricardo Bastos
- Clínica do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal.,Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil.,Dom Henrique Research Centre, Porto, Portugal.,3B's Research Group-Biomaterials, Biodegradables and Biomimetics, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, University of Minho, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, Barco, 4805-017, Guimarães, Portugal.,ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal.,The Biomechanics Group, Department of Mechanical Engineering, Imperial College London, London, England
| | - Marcelo Mathias
- Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil
| | - Renato Andrade
- Clínica do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal.,Dom Henrique Research Centre, Porto, Portugal.,Faculty of Sports, University of Porto, Porto, Portugal
| | - Ronaldo J F C Amaral
- Kearney Lab, Department of Anatomy, Royal College of Surgeons in Ireland (RCSI), Dublin 2, Ireland.,Tissue Engineering Research Group, Department of Anatomy, RCSI, Dublin 2, Ireland.,Centre for Research in Medical Devices (CURAM), National University of Ireland Galway, Galway, Ireland
| | - Vinicius Schott
- Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil
| | | | | | - J Miguel Oliveira
- 3B's Research Group-Biomaterials, Biodegradables and Biomimetics, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, University of Minho, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, Barco, 4805-017, Guimarães, Portugal.,ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal.,The Discoveries Centre for Regenerative and Precision Medicine, Headquarters at University of Minho, Avepark, Barco, 4805-017, Guimarães, Portugal
| | - Rui L Reis
- 3B's Research Group-Biomaterials, Biodegradables and Biomimetics, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, University of Minho, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, Barco, 4805-017, Guimarães, Portugal.,ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal.,The Discoveries Centre for Regenerative and Precision Medicine, Headquarters at University of Minho, Avepark, Barco, 4805-017, Guimarães, Portugal
| | - Scott Rodeo
- Sports Medicine and Shoulder Surgery, Hospital for Special Surgery, New York, NY, USA
| | - João Espregueira-Mendes
- Clínica do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal. .,Dom Henrique Research Centre, Porto, Portugal. .,ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal. .,Orthopaedics Department of Minho University, Braga, Portugal.
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Silva M, Freitas B, Andrade R, Espregueira-Mendes J, Silva F, Carvalho Ó, Flores P. Computational Modelling of the Bioheat Transfer Process in Human Skin Subjected to Direct Heating and/or Cooling Sources: A Systematic Review. Ann Biomed Eng 2020; 48:1616-1639. [PMID: 32377981 DOI: 10.1007/s10439-020-02515-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 04/11/2020] [Indexed: 12/15/2022]
Abstract
The purpose of this systematic review is to analyze characteristics and methodologies utilized in bioheat transfer models of human skin to provide state-of-the-art knowledge on the topic. This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. PubMed, EMBASE and Web of Science databases were searched up to May 30th, 2019 for bioheat transfer models focusing on direct contact between skin and temperature (heat and/or cold) source. Ten studies were included. A 16-item checklist was used to assess their methodological quality. Four studies analyzed healthy skin and six included pathological conditions. All determined skin's thermal behavior, and studies including pathological conditions also analyzed burn damage. Studies did not present a wide variety of mathematical formulation, emphasizing on modelling equations of well-established models from the literature, such as the Pennes' bioheat transfer equation, and the Henriques and Moritz model to quantify skin damage. Reporting of modelling characteristics and formulation of the computational models is not standardized and there is shortage of implementation of validation procedures, hindering representative conclusions. The lack of validation procedures led to low methodological quality. However, all studies provided strategies and parameters as starting points for future developments in this research area.
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Affiliation(s)
- Mariana Silva
- Center for MicroElectroMechanical Systems (CMEMS-UMINHO), University of Minho, Azurém Campus, 4800-058, Guimarães, Portugal.
| | - Bruno Freitas
- Center for MicroElectroMechanical Systems (CMEMS-UMINHO), University of Minho, Azurém Campus, 4800-058, Guimarães, Portugal
| | - Renato Andrade
- Clínica do Dragão, Espregueira-Mendes Sports Centre, FIFA Medical Centre of Excellence, Porto, Portugal
- Dom Henrique Research Centre, Porto, Portugal
- Faculty of Sports, University of Porto, Porto, Portugal
| | - João Espregueira-Mendes
- Clínica do Dragão, Espregueira-Mendes Sports Centre, FIFA Medical Centre of Excellence, Porto, Portugal
- Dom Henrique Research Centre, Porto, Portugal
- ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
- 3B's Research Group-Biomaterials, Biodegradables and Biomimetics, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, University of Minho, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, Barco, 4805-017, Guimarães, Portugal
- School of Medicine, University of Minho, Braga, Portugal
| | - Filipe Silva
- Center for MicroElectroMechanical Systems (CMEMS-UMINHO), University of Minho, Azurém Campus, 4800-058, Guimarães, Portugal
| | - Óscar Carvalho
- Center for MicroElectroMechanical Systems (CMEMS-UMINHO), University of Minho, Azurém Campus, 4800-058, Guimarães, Portugal
| | - Paulo Flores
- Center for MicroElectroMechanical Systems (CMEMS-UMINHO), University of Minho, Azurém Campus, 4800-058, Guimarães, Portugal
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Leal A, Andrade R, Hinckel B, Tompkins M, Bastos R, Flores P, Samuel F, Espregueira-Mendes J, Arendt E. Patients with different patellofemoral disorders display a distinct ligament stiffness pattern under instrumented stress testing. J ISAKOS 2020. [DOI: 10.1136/jisakos-2019-000409] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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de Campos Azevedo CI, Andrade R, Leiria Pires Gago Ângelo AC, Espregueira-Mendes J, Ferreira N, Sevivas N. Fascia Lata Autograft Versus Human Dermal Allograft in Arthroscopic Superior Capsular Reconstruction for Irreparable Rotator Cuff Tears: A Systematic Review of Clinical Outcomes. Arthroscopy 2020; 36:579-591.e2. [PMID: 31839214 DOI: 10.1016/j.arthro.2019.08.033] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [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: 03/21/2019] [Revised: 08/07/2019] [Accepted: 08/14/2019] [Indexed: 02/02/2023]
Abstract
PURPOSE To determine the clinical outcomes of arthroscopic superior capsular reconstruction (ASCR) using either fascia lata autograft or human dermal allograft for irreparable rotator cuff tears (IRCTs). METHODS A systematic review was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines by searching the MEDLINE, Embase, and Cochrane Library databases through January 31, 2019. The inclusion criteria were as follows: 5 or more consecutive patients who underwent ASCR for IRCTs; clinical outcome measures reported at a minimum follow-up of 12 months; and magnetic resonance imaging assessment at a minimum follow-up of 6 months. The methodologic quality was evaluated using the Methodological Index for Non-randomized Studies (MINORS). A narrative synthesis of data was performed. Mean outcome improvements were compared with minimal clinically important differences. RESULTS We identified 7 eligible studies that included 344 shoulders in 338 patients who underwent ASCR for IRCTs (all Level IV studies). The mean MINORS score was 12.3 ± 1.60. Of the 7 studies, 5 had a high risk of bias (MINORS score ≤12): 2 studies using only fascia lata autograft and 3 studies using only human dermal allograft. The mean age of patients ranged from 59.4 to 66.9 years. The mean follow-up time ranged from 12 to 48 months. All studies reported statistically significant and clinically important mean improvements in active elevation (range of means, 28°-56°), the Constant score (range of means, 12-47.1 points), or the American Shoulder and Elbow Surgeons score (range of means, 29.3-56 points). In total, 218 shoulders underwent postoperative magnetic resonance imaging. The graft tear rate reported in studies using fascia lata autograft (181 shoulders) ranged from 5% to 32%, whereas the values reported in studies using human dermal allograft (37 shoulders) ranged from 20% to 75%. CONCLUSIONS ASCR using either fascia lata autograft or human dermal allograft leads to significant and clinically important improvements in clinical outcomes in IRCT patients at 12 months or later. LEVEL OF EVIDENCE Level IV, systematic review of Level IV studies.
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Affiliation(s)
- Clara Isabel de Campos Azevedo
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães; Centro Hospitalar de Lisboa Ocidental, Lisbon; Hospital dos SAMS de Lisboa, Lisbon; Clínica GIGA Saúde, Lisbon.
| | - Renato Andrade
- Clínica do Dragão, Espregueira-Mendes Sports Centre-FIFA Medical Centre of Excellence, Porto; Dom Henrique Research Centre, Porto; Faculty of Sports, University of Porto, Porto
| | | | - João Espregueira-Mendes
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães; Clínica do Dragão, Espregueira-Mendes Sports Centre-FIFA Medical Centre of Excellence, Porto
| | - Nuno Ferreira
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães; Grupo Trofa Saúde, Portugal; Hospital de Santa Maria Maior, Barcelos, Portugal
| | - Nuno Sevivas
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães; Clínica do Dragão, Espregueira-Mendes Sports Centre-FIFA Medical Centre of Excellence, Porto; Grupo Trofa Saúde, Portugal
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Leal A, Andrade R, Flores P, Silva FS, Fulkerson J, Neyret P, Arendt E, Espregueira-Mendes J. Unilateral anterior knee pain is associated with increased patellar lateral position after stressed lateral translation. Knee Surg Sports Traumatol Arthrosc 2020; 28:454-462. [PMID: 31375878 DOI: 10.1007/s00167-019-05652-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 03/14/2019] [Accepted: 07/26/2019] [Indexed: 12/28/2022]
Abstract
PURPOSE To objectively compare side-to-side patellar position and mobility in patients with idiopathic unilateral anterior knee pain (AKP) using a stress-testing device concomitantly with magnetic resonance imaging. It is hypothesized that the painful knees present greater patellar mobility than the contralateral non-painful knees. METHODS From a total sample of 359 patients, 23 patients with idiopathic unilateral AKP (30.9 years, 23.4 kg/m2, 43% males) were included within the present study. Both knees of all the patients were examined by conventional imaging, including the measurement of trochlear sulcus angle, Caton-Deschamps index, tibial tuberosity to trochlear groove distance, patellar tilt angle and patellar subluxation (both at rest and upon quadriceps contraction). Additionally, the same patients underwent stress testing (Porto Patella Testing Device); these measurements were taken with the patella at rest, after lateral patellar translation and after lateral patellar tilt. Clinical and functional outcomes were obtained using physical examination and the Kujala and Lysholm scores. RESULTS Painful knees showed statistically significant higher patellar lateral position after stressed lateral translation than non-painful knees (p = 0.028), 9.8 ± 3.6 mm and 7.1 ± 6.3 mm, respectively. The adjusted multivariate logistic model identified the patellar position after lateral displacement to be significantly associated with AKP (OR = 1.165) and the model (AUC = 0.807, p < 0.001) showed reasonable sensitivity (67%) and specificity (73%). CONCLUSION Patients with idiopathic unilateral AKP with morphologically equivalent knees showed statistically significant increased patellar lateral position after stressed lateral displacement in their painful knee. The greater lateral patellar mobility quantified by the PPTD testing brings more objectivity to the diagnosis. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Ana Leal
- Mechanical Engineering Department, CMEMS Center for MicroElectroMechanical Systems, University of Minho, Guimarães, Portugal.,Dom Henrique Research Centre, Porto, Portugal
| | - Renato Andrade
- Dom Henrique Research Centre, Porto, Portugal.,Clínica Do Dragão, Espregueira-Mendes Sports Centre, FIFA Medical Centre of Excellence, Porto, Portugal.,Faculty of Sports of Porto University, Porto, Portugal
| | - Paulo Flores
- Mechanical Engineering Department, CMEMS Center for MicroElectroMechanical Systems, University of Minho, Guimarães, Portugal
| | - Filipe S Silva
- Mechanical Engineering Department, CMEMS Center for MicroElectroMechanical Systems, University of Minho, Guimarães, Portugal
| | - John Fulkerson
- University of Connecticut School of Medicine, Farmington, CT, USA
| | - Philippe Neyret
- Department of Orthopaedic Surgery, Centre Albert-Trillat, Hôpital de La Croix-Rousse, Lyon, France
| | - Elizabeth Arendt
- Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA
| | - João Espregueira-Mendes
- Dom Henrique Research Centre, Porto, Portugal. .,Clínica Do Dragão, Espregueira-Mendes Sports Centre, FIFA Medical Centre of Excellence, Porto, Portugal. .,ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal. .,School of Medicine, Minho University, Braga, Portugal.
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Xará-Leite F, Andrade R, Moreira PS, Coutinho L, Ayeni OR, Sevivas N, Espregueira-Mendes J. Anatomic and non-anatomic reconstruction improves post-operative outcomes in chronic acromio-clavicular instability: a systematic review. Knee Surg Sports Traumatol Arthrosc 2019; 27:3779-3796. [PMID: 30806755 DOI: 10.1007/s00167-019-05408-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 10/30/2018] [Accepted: 02/06/2019] [Indexed: 12/27/2022]
Abstract
PURPOSE To systematize the surgical outcomes of anatomic and non-anatomic reconstruction in patients with chronic acromio-clavicular joint (ACJ) instability and determine which technique is superior. METHODS This review was conducted according to the PRISMA guidelines. PubMed and Cochrane Library databases were searched up to April 30th, 2018 for original articles that assessed the outcomes of one or more surgical techniques of anatomic and non-anatomic reconstruction in patients with chronic ACJ instability. The Methodological Index for Non-randomized Studies (MINORS) was used to assess study quality. Pre-to-post meta-analysis was performed for both anatomic and non-anatomic reconstructions. RESULTS Twenty-eight studies were included comprising 799 patients (mean age of 36.6 years old and 84% males) with a mean follow-up of 34.6 months (range 13 to 74). Surgical techniques included anatomic (tendinous or synthetic grafts/constructs) and non-anatomic reconstruction (Weaver-Dunn or Modified Weaver-Dunn, conjoined tendon transfer, or temporary hook plate). There were significant pre-to-post improvements on the constant score with an average improvement ranging from 11.1 to 50.7 (p < 0.01). Average failure rate was 7.6% (7.5% for anatomic and 8.5% for non-anatomic reconstruction). Non-comparative studies had a mean MINORS score of 9 points (out of 16) and comparative studies 17 (out of 24) with excellent interrater agreement (k = 0.910). CONCLUSION Both anatomic and non-anatomic ACJ reconstructions provide significant post-operative improvements, but definitive conclusions on optimal technique remain elusive. Notwithstanding, comparative studies support the use of anatomic ACJ reconstruction which should be preferably used. However, until superiority is demonstrated by robust studies, surgeons should supplement their decision-making with experience and patient preference. LEVEL OF EVIDENCE IV.
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Affiliation(s)
| | - Renato Andrade
- Clínica do Dragão, Espregueira-Mendes Sports Centre-FIFA Medical Centre of Excellence, Porto, Portugal
- Dom Henrique Research Centre, Porto, Portugal
- Faculty of Sports, University of Porto, Porto, Portugal
| | - Pedro Silva Moreira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, Braga, Portugal
- ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | | | - Olufemi R Ayeni
- Division of Orthopaedic Surgery, McMaster University, Hamilton, Canada
| | - Nuno Sevivas
- Clínica do Dragão, Espregueira-Mendes Sports Centre-FIFA Medical Centre of Excellence, Porto, Portugal
- Dom Henrique Research Centre, Porto, Portugal
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, Braga, Portugal
- ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Orthopaedics Department, Hospital de Braga, Braga, Portugal
| | - João Espregueira-Mendes
- Clínica do Dragão, Espregueira-Mendes Sports Centre-FIFA Medical Centre of Excellence, Porto, Portugal.
- Dom Henrique Research Centre, Porto, Portugal.
- ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal.
- School of Medicine, University of Minho, Braga, Portugal.
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Andrade R, Correia AL, Nunes J, Xará-Leite F, Calvo E, Espregueira-Mendes J, Sevivas N. Is Bony Morphology and Morphometry Associated With Degenerative Full-Thickness Rotator Cuff Tears? A Systematic Review and Meta-analysis. Arthroscopy 2019; 35:3304-3315.e2. [PMID: 31785763 DOI: 10.1016/j.arthro.2019.07.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [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: 02/20/2019] [Revised: 06/28/2019] [Accepted: 07/03/2019] [Indexed: 02/02/2023]
Abstract
PURPOSE To scope the scientific literature and analyze the influence of bony risk factors for degenerative full-thickness primary rotator cuff tear. METHODS A systematic review of databases PubMed, Scopus, EMBASE, and Cochrane Library was performed up to June 30, 2018. Meta-analysis was performed with mean difference (MD) or risk ratio for degenerative full-thickness rotator cuff injury, and when there were ≥3 studies for the considered potential risk factor. Methodologic quality was assessed using the Newcastle-Ottawa scale. RESULTS We analyzed 34 studies comprising 5,916 shoulders (3,369 shoulders with rotator cuff tear and 2,546 controls) and identified 19 potential risk factors for degenerative full-thickness rotator cuff tears. There was moderate evidence that a higher critical shoulder angle (MD = 4.41, 95% confidence interval [CI] 3.43 to 5.39), higher acromion index (MD = 0.06, 95% CI 0.04 to 0.09), and lower lateral acromion angles (MD = -7.11, 95% CI -8.32 to -5.90) were associated with degenerative full-thickness rotator cuff tears compared with controls. Moderate evidence showed that a type III acromion significantly increases the risk for full-thickness degenerative rotator cuff tear (risk ratio = 2.26, 95% CI 1.38 to 3.70). CONCLUSION There is moderate evidence that larger critical shoulder angle, higher acromion index, lower lateral acromion angles, and a type III acromion are significantly associated with degenerative full-thickness rotator cuff tears. Other potential risk factors identified showed insufficient evidence. LEVEL OF EVIDENCE Level IV, systematic review of level II to IV studies.
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Affiliation(s)
- Renato Andrade
- Clínica do Dragão, Espregueira-Mendes Sports Centre, FIFA Medical Centre of Excellence, Porto, Portugal; Faculty of Sports, University of Porto, Porto, Portugal; Orthopaedics Department, Centro Hospitalar do Porto, Porto, Portugal
| | - Ana Lucinda Correia
- School of Medicine, Life and Health Sciences Research Institute/3B's - PT Government Associate Laboratory, University of Minho, Campus de Gualtar, Braga, Portugal
| | - Joni Nunes
- Orthopaedics Department, Hospital de Braga, Braga, Portugal
| | | | - Emilio Calvo
- Fundacion Jimenez Diaz, Universidad Autonoma de Madrid, Madrid, Spain
| | - João Espregueira-Mendes
- Clínica do Dragão, Espregueira-Mendes Sports Centre, FIFA Medical Centre of Excellence, Porto, Portugal; Dom Henrique Research Centre, Porto, Portugal; School of Medicine, Life and Health Sciences Research Institute/3B's - PT Government Associate Laboratory, University of Minho, Campus de Gualtar, Braga, Portugal.
| | - Nuno Sevivas
- Clínica do Dragão, Espregueira-Mendes Sports Centre, FIFA Medical Centre of Excellence, Porto, Portugal; Dom Henrique Research Centre, Porto, Portugal; School of Medicine, Life and Health Sciences Research Institute/3B's - PT Government Associate Laboratory, University of Minho, Campus de Gualtar, Braga, Portugal; Trofa Saúde Hospital Sr Bonfim - Trofa Saúde Group, Touguinhó, Portugal
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Andrade R, Rebelo-Marques A, Bastos R, Zaffagnini S, Seil R, Ayeni OR, Espregueira-Mendes J. Author Reply to "Regarding 'Identification of Normal and Injured Anterolateral Ligaments of the Knee: A Systematic Review of Magnetic Resonance Imaging Studies'". Arthroscopy 2019; 35:2258-2260. [PMID: 31395157 DOI: 10.1016/j.arthro.2019.05.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 05/31/2019] [Indexed: 02/02/2023]
Affiliation(s)
- Renato Andrade
- Clínica do Dragão, Espregueira-Mendes Sports Centre, FIFA Medical Centre of Excellence; Dom Henrique Research Centre; Faculty of Sports, University of Porto, Porto, Portugal
| | - Alexandre Rebelo-Marques
- Clínica do Dragão, Espregueira-Mendes Sports Centre, FIFA Medical Centre of Excellence; Dom Henrique Research Centre, Porto, Portugal; Faculty of Medicine, University of Coimbra; Instituto de Investigação Clínica e Biomédica de Coimbra, Coimbra, Portugal
| | - Ricardo Bastos
- Clínica do Dragão, Espregueira-Mendes Sports Centre, FIFA Medical Centre of Excellence; Dom Henrique Research Centre, Porto, Portugal; Fluminense Federal University, Niteroi, Rio de Janeiro, Brazil
| | - Stefano Zaffagnini
- Rizzoli Orthopaedic Institute, University of Bologna; 2nd Orthopaedic and Traumatology Clinic, Rizzoli Orthopaedic Institute, Bologna, Italy
| | - Romain Seil
- Département de l'Appareil Locomoteur, Centre Hospitalier de Luxemburg; Sports Medicine Research Laboratory, Luxembourg Institute of Health, Luxembourg, Luxembourg
| | - Olufemi R Ayeni
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - João Espregueira-Mendes
- School of Medicine, University of Minho, Braga, Portugal; Clínica do Dragão, Espregueira-Mendes Sports Centre, FIFA Medical Centre of Excellence; Dom Henrique Research Centre, Porto, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
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