Physical and sports activity after hip arthroplasty

A artroplastia é utilizada para reconstrução da articulação do quadril, visando minimizar a dor e possibilitar o retorno às atividades de vida diária, esportivas e de lazer. O objetivo deste artigo é analisar na literatura as indicações e contraindicações referentes à prática de atividade física, esportiva e lazer após a artroplastia de quadril. Essa revisão aborda estudos publicados entre os anos de 1980 e 2009, obtidos por buscas em bancos de dados eletrônicos Medline, Scielo, Ovid, Infomaworld, Sciencedirect, Springerlink, Interscience, Sportdiscuss, Bireme, Informglobal, Opas, Ovid, Diseasedex, Eric, que totalizaram 39 artigos. Os artigos analisados apontam para a utilização de atividade física, esportiva e de lazer de baixo impacto. como a caminhada, natação, boliche, ciclismo, dentre outras. Outra indicação constatada na literatura é a utilização da atividade física e esportiva visando à manutenção do condicionamento físico, qualidade óssea e controle do peso corporal. Há ressalvas na literatura sobre a utilização de atividades de alto impacto, esporte com giro como o basquete e futebol ou com grande intensidade como tênis e a corrida, bem como os esportes de luta. As atividades físicas, esportivas e de lazer mais indicadas após uma atroplastia de quadril são as de baixo impacto como a hidroginástica, natação, caminhada, dentre outras. O início dessas atividades deve aguardar a liberação do médico, mas em média iniciam 60 dias após a cirurgia.Hip arthroplasty is used for reconstruction of the hip joint to reduce pain and to make the return to daily life, physical, sports and leisure activities possible. The objective of this article was to analyze in the literature the indications and counter-indications referring to practice of physical, sportive and leisure activities after hip arthroplasty. This revision approaches studies published between 1980 and 2009, obtained in searches in the Medline, Scielo, Ovid, Infomaworld, Sciencedirect, Springerlink, Interscience, Sportdiscuss, Bireme, Informglobal, Opas, Ovid, Diseasedex and Erics electronic databases with a total of 39 articles. The analyzed articles point to the use of physical, leisure and sports of low impact activities such as walking, swimming, bowling, cycling and others. Another indication evidenced in the literature is the use of physical and sportive activity aiming at the maintenance of physical fitness, bone quality and body weight control. The literature shows concerns with the use of activities of high impact or with great intensity like tennis and jogging, as well as fights

The Transcription Factor SOX18 Regulates the Expression of Matrix Metalloproteinase 7 and Guidance Molecules in Human Endothelial Cells

Mutations in the transcription factor SOX18 are responsible for specific cardiovascular defects in humans and mice. In order to gain insight into the molecular basis of its action, we identified target genes of SOX18 and analyzed one, MMP7, in detail.SOX18 was expressed in HUVEC using a recombinant adenoviral vector and the altered gene expression profile was analyzed using microarrays. Expression of several regulated candidate SOX18 target genes was verified by real-time PCR. Knock-down of SOX18 using RNA interference was then used to confirm the effect of the transcription factor on selected genes that included the guidance molecules ephrin B2 and semaphorin 3G. One gene, MMP7, was chosen for further analysis, including detailed promoter studies using reporter gene assays, electrophoretic mobility shift analysis and chromatin-immunoprecipitation, revealing that it responds directly to SOX18. Immunohistochemical analysis demonstrated the co-expression of SOX18 and MMP7 in blood vessels of human skin.The identification of MMP7 as a direct SOX18 target gene as well as other potential candidates including guidance molecules provides a molecular basis for the proposed function of this transcription factor in the regulation of vessel formation

Basic Science Considerations in Primary Total Hip Replacement Arthroplasty

Total Hip Replacement is one of the most common operations performed in the developed world today. An increasingly ageing population means that the numbers of people undergoing this operation is set to rise. There are a numerous number of prosthesis on the market and it is often difficult to choose between them. It is therefore necessary to have a good understanding of the basic scientific principles in Total Hip Replacement and the evidence base underpinning them. This paper reviews the relevant anatomical and biomechanical principles in THA. It goes on to elaborate on the structural properties of materials used in modern implants and looks at the evidence base for different types of fixation including cemented and uncemented components. Modern bearing surfaces are discussed in addition to the scientific basis of various surface engineering modifications in THA prostheses. The basic science considerations in component alignment and abductor tension are also discussed. A brief discussion on modular and custom designs of THR is also included. This article reviews basic science concepts and the rationale underpinning the use of the femoral and acetabular component in total hip replacement

Effect of total knee arthroplasty on recreational and sporting activity

BackgroundCommon concerns of patients undergoing total knee arthroplasty (TKA) are whether they can continue with certain recreational and sporting activities or even commence new ones after the procedure. The present study was designed to determine preoperative and postoperative activities, the numbers participating and the time to resume these activities.MethodsBetween 1 and 2 years after TKA, patients who had undergone 144 arthroplasties, were surveyed by postal questionnaire to ascertain how the arthroplasty had affected their recreational and sporting ability. Their preoperative and postoperative activity along with the time to resume was recorded. The Oxford knee score and estimate of physical activity was also collected.ResultsOut of the 144 TKA performed, 122 participated in sport and recreational activity preoperatively and 108 participated postoperatively. Patients stated that the surgery had a beneficial effect on their performance of sporting and recreational activities although the number of sporting events decreased. By multiplying individuals by the number of activities they participated in, there were 254 occurrences of sport and recreational activities preoperatively giving a mean for the group of 1.76 sports/patient. Postoperatively this had reduced to 204, giving a mean of 1.41. Three activities showed a significant change for individual patients from pre- to postoperation. Those which showed an increase were exercise walking, where 19 patients (13.2%) who did not walk before surgery took up walking afterwards (P ConclusionThe present study has shown that patients are adopting lower impact activities to participate in after TKA. The total number of patients performing a sport decreases postoperatively and the total amount of sport played decreases. These data will help to counsel patients