Lesões do cabo longo do bíceps: tenotomia versus tenodese

ResumoAs lesões da cabeça longa do tendão bicipital (CLB) são comuns na prática clínica e podem ter causas degenerativas, inflamatórias, instabilidades (subluxação ou luxação) ou traumáticas. Geralmente, elas estão associadas a outras doenças do ombro, principalmente a lesões do manguito rotador. Atualmente, existem controvérsias quanto às indicações dos tratamentos cirúrgicos e à escolha da melhor técnica para cada caso, devido à possibilidade de deformidade estética, perda da força muscular e dor residual.O objetivo deste estudo foi identificar as indicações do tratamento cirúrgico, a melhor técnica cirúrgica e as vantagens e desvantagens de cada técnica descritas na literatura médica ortopédica no tratamento das lesões da CLB.Foi realizada revisão da literatura médica ortopédica disponível na base de dados da Biblioteca Regional de Medicina (BIREME), Medline, PubMed, Cochrane Library e Google Scholar, incluindo artigos publicados no período de 1991 a 2015.AbstractDisorders of the long head of biceps tendon are common in clinical practice. Their causes could be degenerative, inflammatory, instability (subluxation or luxation) or traumatic. They are generally associated to other diseases of the shoulder, mainly rotator cuff injuries. Currently, there is controversy in the literature regarding the indications for surgical treatment and the choice of the best technique for each case, due to the possibility of esthetic deformity, loss of muscle strength, and residual pain.The objective of this study was to identify the indications for surgical treatment, the best surgical technique, and the advantages and disadvantages of each technique described in the orthopedic literature for the treatment of long head of biceps tendon injuries.A revision of the orthopedic medical literature on the following databases: Biblioteca Regional de Medicina (BIREME), Medline, PubMed, Cochrane Library and Google Scholar, comprising articles published in the period from 1991 to 2015

In vivo evaluation of porous hydrogel pins to fill osteochondral defects in rabbits

ABSTRACT OBJECTIVE: This experimental study aimed to evaluate the biological performance of poly (l-co-D, l-lactic acid)-co-trimetilene carbonate/poly (vinyl alcohol) (PLDLA-co TMC/PVA), hydrogel scaffolds, as an implant in the filling (and not in the repair) of osteochondral defects in New Zealand rabbits, assessing the influence of the material in tissue protection in vivo. METHODS: Twelve rabbits were divided into groups of nine and 16 weeks. In each animal, an osteochondral defect was created in both medial femoral condyles. In one knee, a hydrogel scaffold was implanted (pin group) and in the other, the defect was maintained (control group). A histological analysis of the material was performed after euthanasia. RESULTS: The condyles of the pin group showed no inflammatory reaction and were surrounded by a fibrous capsule. The control group presented higher bone growth in the areas of the defect, but with disorganized articular cartilage, evident fibrosis, bone exposure, atrophy, and proliferation of synovial membrane. CONCLUSION: The hydrogel pins are promising in filling osteochondral defects, generally do not cause inflammatory reactions, and are not effective in the repair of osteochondral defects