Efeitos do ácido zoledrônico sobre o processo de remodelação óssea em ratas ooforectomizadas: estudo clínico, densitométrico, biomecânico e microtomográfico

Com o objetivo de se investigar as repercussões clínicas, densitométricas, biomecânicas e microtomográficas do ácido zoledrônico sobre o tecido ósseo de ratas osteoporóticas, após menopausa induzida por ooforectomia bilateral, foram estudadas, prospectivamente, 80 ratas da linhagem Wistar (Rattus novergicus albinus), adultas e virgens. Com trinta dias de vida, os animais foram aleatorizados, pelo método de sorteio de envelopes opacos e lacrados, em dois grupos, segundo o tipo de procedimento cirúrgico a que seriam, imediatamente, submetidos: grupo O (ooforectomia bilateral) (n=40) e grupo S (cirurgia sham) (n=40). No 30º dia de pós-operatório, os animais foram novamente sorteados e divididos em quatro subgrupos, de acordo com a administração, intraperitoneal, de 0,1mg/kg de ácido zoledrônico ou água destilada, totalizando os quatro grupos de estudo: grupo OAZ (ooforectomizado com ácido zoledrônico) (n=20), grupo OAD (ooforectomizado com água destilada) (n=20), grupo SAZ (cirurgia sham com ácido zoledrônico) (n=20) e grupo SAD (cirurgia sham com água destilada) (n=20). Todos os animais foram mensalmente pesados ao longo do experimento. A eutanásia ocorreu com dose letal de pentobarbital sódico 3% (80 mg/kg), intraperitonealmente, em dois momentos, após a administração das substâncias: nove meses (Momento 1) e 12 meses (Momento 2). Para a análise do peso, foi considerada a sua curva evolutiva ao longo de todo o experimento. Os fêmures direitos foram utilizados para o estudo biomecânico, analisando-se as variáveis: carga máxima (N), limite de elasticidade (N) e coeficiente de rigidez (N/mm). Os fêmures esquerdos foram utilizados para o estudo densitométrico (mmAl) e para o estudo microtomográfico...The objective of this study was to prospectively investigate the clinical, densitometric, biomechanical and microtomographyc effects of zoledronic acid in the femurs of 80 female Wistar rats (Rattus norvegicus albinus), with osteoporosis due to bilateral oophorectomy. With the age of thirty days, the animals were randomized into two groups, according to the surgical procedures: bilateral oophorectomy (group O) (n=40) and sham surgery (group S) (n=40). On the 30th postoperative day, the subjects were randomly divided into four groups, according to the intraperitoneal administration of 0.1 mg/kg of zoledronic acid or distilled water: group OAZ (ovariectomized group with zoledronic acid) (n=20), group OAD (ovariectomized group with distilled water) (n=20), group SAZ (sham group with zoledronic acid) (n=20) and group SAD (sham group with distilled water) (n=20). All animals were monthly weighted. The animals were euthanized with a lethal intraperitoneal dose of sodium pentobarbital 3% (80 mg/kg) after a follow up period of nine months (n=40) and 12 months (n=40). For the analysis of weight, it was considered the weight curve throughout the experiment. The right femurs were used for biomechanical tests, analyzing the maximum load (N), the yield point (N) and stiffness coefficient (N/mm). The left femurs were used for both, densitometric (mmAl) and microtomographyc tests, getting the bone volume (mm3), the trabecular number (mm-3), the trabecular diameter (mm) and intertrabecular separation (mm). The statistical analysis was performed through the analysis of variances and complemented with the multiple averages comparison tests, for a 2 x 2 x 2 factorial project (two substances, two types of surgical procedures and two periods of euthanasia). It was used an entirely casual model... (Complete abstract click electronic access below

O Zoledronato no tratamento da osteoporose umeral em ratas: estudo prospectivo e randomizado

OBJETIVO: Investigar as repercussões clínicas, biomecânicas e histomorfométricas do zoledronato no tratamento da osteoporose umeral em ratas osteoporóticas. MÉTODOS: Analisou-se, prospectivamente, 40 ratas (Rattus novergicus albinus). Com 60 dias de vida, foram aleatorizadas em dois grupos de acordo com o procedimento cirúrgico: ooforectomia bilateral (O) (n=20) e pseudo-cirurgia (P) (n=20). Após trinta dias, os animais foram novamente randomizados, de acordo com a administração de 0,1mg/kg de zoledronato (AZ) ou água destilada (AD): OAZ (n=10), OAD (n=10), PAZ (n=10) e PAD (n=10). Após doze meses, os animais foram eutanasiados e seus úmeros retirados. Clinicamente considerou-se o peso dos animais; biomecanicamente foram realizados ensaios compressivos e histomorfometricamente foi determinada a área trabecular óssea. RESULTADOS: Os grupos O tiveram um aumento de peso maior que os grupos P (p=0,005). Os grupos com zoledronato suportaram maior carga máxima que os grupos com água destilada (p=0,02). Nos grupos com zoledronato verificou-se o aumento da área trabecular óssea quando comparados aos grupos com água destilada (p=0,001). Houve correlação positiva entre a área trabecular e a carga máxima (p=0,04; r=0,95). CONCLUSÃO: O zoledronato não influiu no peso dos animais. Os resultados mostraram o aumento da resistência óssea umeral e da área trabecular óssea.OBJECTIVE: To evaluate the clinical, biomechanical and histomorphometric effects of zoledronate in the humerus of ovariectomized rats. METHODS: Forty female rats (Rattus norvegicus albinus) were prospectively evaluated. Within 60 days, animals were randomized into two groups: ovariectomy (O) (n=20) or sham surgery (P) (n=20). Within 90 days, groups O and P were subdivided into four groups, according to the administration of zoledronate (AZ) or deionized water (AD): OAZ (n=10), OAD (n=10), PAZ (n=10) and PAD (n=10). Within 15 months, animals were sacrificed. Body weight was used for clinical study, axial compression tests for the biomechanical study and cancellous bone area for the histomorphometric study. RESULTS: Ovariectomized groups had greater body weight gain than the sham groups (p=0.005). Zoledronate groups had greater body weight gain compared to the deionized water groups (p=0.68). Maximum load support was greater in the groups treated with zoledronate (p=0.02). An increase in cancellous bone area was noted in the groups treated with zoledronate (p=0.001). A positive correlation was shown in the evaluation of cancellous area and maximum load (p=0.04; r=0.95). CONCLUSIONS: Zoledronate had no effect on animals' body weight. Groups treated with zoledronate had increased maximum load support and cancellous bone area

Effects of zoledronic acid on ooforectomized rats' tibiae: a prospective and randomized study

OBJETIVO: Investigar as repercussões clínicas, biomecânicas e histomorfométricas do ácido zoledrônico em tíbias de ratas osteoporóticas, após ooforectomia bilateral. MÉTODOS: Foram estudadas, prospectivamente, 40 ratas da linhagem Wistar (Rattus novergicus albinus). Com 60 dias de vida, os animais foram aleatorizados em dois grupos de acordo com o procedimento cirúrgico: ooforectomia bilateral (O) (n=20) e pseudo-cirurgia (sham) (P) (n=20). Após 30 dias, os animais foram divididos em quatro subgrupos, de acordo com a administração de 0,1mg/kg de ácido zoledrônico (AZ) ou água destilada (AD): OAZ (n=10), OAD (n=10), PAZ (n=10) e PAD (n=10). Após 12 meses, os animais foram eutanasiados e suas tíbias analisadas. No estudo clínico foi considerado o peso dos animais; no estudo biomecânico foram realizados ensaios compressivos e na análise histomorfométrica foi determinada a área trabecular óssea. RESULTADOS: Os grupos O tiveram aumento de peso significativamente maior que os grupos P (p=0,005). Os grupos OAZ e PAZ tiveram aumento, não significativo, de peso quando comparados aos grupos OAD (p=0,47) e PAD (p=0,68). Os grupos com ácido zoledrônico e com água destilada suportaram carga máxima, semelhante (p=0,2), no momento em que ocorreu fratura. Nos grupos com ácido zoledrônico verificou-se o aumento não significante da área trabecular óssea quando comparados aos grupos com água destilada (p=0,21). Houve correlação positiva entre a área trabecular e a carga máxima (p=0,04; r=0,95). CONCLUSÃO: O ácido zoledrônico não influiu significativamente no peso dos animais. Os resultados mostraram aumento, não significante, tanto da resistência óssea diafisária tibial, como da área trabecular óssea.OBJECTIVE: To investigate clinical, biomechanic and histomorphometric effects of zoledronic acid on osteoporotic rats'tibiae after bilateral ooforectomy. METHODS: 40 female Wistar (Rattus novergicus albinus) rats were prospectively studied. on the 60th day of life, the animals were randomized into two groups according to the surgical procedure: bilateral ooforectomy (O) (n=20) and sham surgery (sham) (P) (n=20). After 30 days, the animals were divided into four groups, according to the administration of zoledronic acid (ZA) 0.1mg/kg or distilled water (DW): OZA (n=10), ODW (n=10), PZA (n=10) and PDW (n=10). After 12 months, the animals were sacrificed, and had their tibiae assessed. In the clinical study, animals'weight was considered; in the biomechanical study, compressive assays were applied and, in the histomorphometric analysis, the bone trabecular area was determined. RESULTS: O groups showed a significantly greater weight gain than P groups (p=0.005). Groups OZA and PZA showed an insignificant weight gain when compared to ODW (p=0.47) and PDW (p=0.68). The groups receiving zoledronic acid and distilled water were able to bear maximum load, similar (p=0.2), at the moment of fracture. In the groups receiving zoledronic acid, an insignificant increase of the bone trabecular area was found when compared to the groups receiving distilled water (p=0.21). There was a positive correlation between trabecular area and maximum load (p=0.04; r=0.95). CONCLUSION: Zoledronic acid did not significantly influence animals' weight. The results showed an insignificant increase both of the tibial shaft bone resistance and the bone trabecular area

Effects of platelet-rich plasma on lateral epicondylitis of the elbow: prospective randomized controlled trial

ABSTRACT OBJECTIVE: To evaluate the effects of platelet-rich plasma (PRP) infiltration in patients with lateral epicondylitis of the elbow, through analysis of the Disabilities of the Arm, Shoulder and Hand (DASH) and Patient-Rated Tennis Elbow Evaluation (PRTEE) questionnaires. METHODS: Sixty patients with lateral epicondylitis of the elbow were prospectively randomized and evaluated after receiving infiltration of three milliliters of PRP, or 0.5% neocaine, or dexamethasone. For the scoring process, the patients were asked to fill out the DASH and PRTEE questionnaires on three occasions: on the day of infiltration and 90 and 180 days afterwards. RESULTS: Around 81.7% of the patients who underwent the treatment presented some improvement of the symptoms. The statistical tests showed that there was evidence that the cure rate was unrelated to the substance applied (p = 0.62). There was also intersection between the confidence intervals of each group, thus demonstrating that the proportions of patients whose symptoms improved were similar in all the groups. CONCLUSION: At a significance level of 5%, there was no evidence that one treatment was more effective than another, when assessed using the DASH and PRTEE questionnaires

The effects of ethyl-2-cyanoacrylate and butyl-2-cyanoacrylate in the process of bone healing in rats. A controlled experimental study

ABSTRACT Objective: Synthetic adhesives are used by various medical specialties, especially in surgery; however, studies reporting their use in orthopedic practice are scarce. The aim of this study was to compare the results in using ethyl-2-cyanoacrylate or butyl-2-cyanoacrylate in the treatment of fractures in rats. Methods: This was an experimental prospective controlled study in 90 rats, with humerus, femur, and tibia fractures, treated with ethyl-2-cyanoacrylate (SB group; n = 45) or butyl-2-cyanoacrylate (HA group; n = 45). Biomechanical and histomorphometric analyses were performed at three different moments (60, 120, and 180 days); besides a clinical study performed weekly by measurement of the animals body mass. Results: No differences were observed regarding body mass (p = 0.07). In both groups, there were no significant differences regarding maximum load (p = 0.6), yield point strength (p = 0.6), and stiffness coefficient (p = 0.4) of the femurs. The same was observed in tibias for maximum load (p = 0.4), yield point strength (p = 0.7), and stiffness coefficient (p = 0.6). The humerus from both groups had similar bone callus area (p = 0.66). In both groups, there were no statistical differences related to inflammatory cells (p = 0.4), osteoblasts (p = 0.2), and osteoclasts (p = 0.2). Conclusion: Ethyl-2-cyanoacrylate was more effective than butyl-2-cyanoacrylate in the treatment of fractures in rats

Results from surgical treatment of Morel-Lavallée lesions: prospective cohort study

OBJECTIVE: To present the results from early diagnosis and delayed surgical treatment of a cohort of patients who were diagnosed with Morel-Lavallée lesions.METHODS: Between January 2006 and December 2013, we performed delayed surgical debridement on Morel-Lavallée lesions, after delimitation of the local tissue necrosis, followed by closure through second intention and/or use of grafts/flaps.RESULTS: All the patients evolved with complete closure of the lesion after the delayed debridement, granulation of the operative wound and primary suturing or construction of pedunculated flaps. Three patients (50%) evolved with deep infectious processes due to the successive operative procedures.CONCLUSION: Whatever the treatment methods used are, they should be performed in a radical manner. If not, the patient will be at risk of evolution to septicemia and death

Detecting Early Biomechanical Effects of Zoledronic Acid on Femurs of Osteoporotic Female Rats

Aim. To investigate the biomechanical effects of zoledronic acid (ZA) on femurs of female osteoporotic rats after follow-up periods of 9 and 12 months. Methods. Eighty female Wistar rats were prospectively assessed. At 60 days of age, the animals were randomly divided into two groups: bilateral oophorectomy (O) (n=40) and sham surgery (S) (n=40). At 90 days of age, groups O and S were randomly subdivided into four groups, according to whether 0.1 mg/kg of ZA or distilled water (DW) was intraperitoneally administered: OZA (n=20), ODW (n=20), SZA (n=20), and SDW (n=20). The animals were sacrificed at 9 and 12 months after the administration of the substances, and then their right femurs were removed and analyzed biomechanically. Axial compression tests that focused on determining the maximum load (N), yield point (N), and stiffness coefficient (N/mm) of the proximal femur were performed in the biomechanical study. Results. ZA significantly increased the maximum load and yield point, reducing the stiffness coefficient concerning the oophorectomy status and follow-up period. Conclusion. Zoledronic acid, at a dose of 0.1 mg/kg, significantly increased the maximum loads and yield points and reduced the stiffness coefficients in the femurs of female rats with osteoporosis caused by bilateral oophorectomy