Papers by Idemar Monteiro da Palma
Journal of orthopaedic research, May 10, 2024
Revista Brasileira De Ortopedia, Sep 1, 2013
Open Journal of Orthopedics, 2020
Background: Tibial polyethylene wear is related late failure in total knee arthroplasty. The cruc... more Background: Tibial polyethylene wear is related late failure in total knee arthroplasty. The cruciate substitute design depending on the cam-post mechanism to secure the knee cinematics after a posterior stabilized total knee arthroplasty (PS-TKA). A post fracture can occur after damage failure of the post. Aim: Report a case of post refracture after a PS-TKA and review the lecture about post wear in PS-TKA. Case presentation: A 63 woman with a primary TKA had a diagnosis of polyethylene post fracture. The polyethylene exchange wasn't enough and revisions of all components were necessary. Conclusion: In patient with previous well function, subtle swelling and giving away sings after PS-TKA, a post fracture must be excluded.
The Journal of Arthroplasty
Revista Brasileira De Ortopedia, 2001
European Journal of Orthopaedic Surgery & Traumatology, 2015
Objective The present study aimed to evaluate whether patient education level interferes in the p... more Objective The present study aimed to evaluate whether patient education level interferes in the percentage of pain relief or increase using visual analogue scale (VAS) and subjective pain perception. Patients and methods Ninety-five patients presenting acute shoulder pain due to enthesitis were evaluated. They were asked to quantify the pain using VAS before steroid articular infiltration. One week later, patients reevaluated the pain using VAS and orally stated the percentage of perceived pain increase or relief. The information gathered was then compared among three patient educational levels (elementary, high school, and university). Results Percentages of improvement stated orally and utilizing VAS presented no statistically significant differences among the three educational status levels (p = 0.804). Conclusion Patient educational status caused no impact in the results of acute pain self-assessment with VAS and oral evaluation.
Revista Brasileira de Ortopedia
Resumo Objetivo O manejo da perda óssea representa um grande desafio em cirurgias de revisão de a... more Resumo Objetivo O manejo da perda óssea representa um grande desafio em cirurgias de revisão de artroplastia do joelho (rATJ) e em artroplastias totais do joelho (ATJ) primárias complexas. O objetivo do presente estudo foi avaliar os resultados em médio prazo (seguimento mínimo de 5 anos) das reconstruções de joelho nas quais cones de metal trabecular (MT) de tântalo foram utilizados para tratamento de defeitos ósseos tipos 2 e 3, de acordo com a classificação proposta pela Anderson Orthopaedic Research Institute (AORI). Métodos Feita análise retrospectiva dos prontuários dos pacientes operados entre julho de 2008 e novembro de 2014, coletando-se os seguintes dados: idade, gênero, lateralidade, índice de massa corporal, etiologia da artrose, comorbidade, classificação AORI da falha óssea, causa da revisão da artroplastia total do joelho, reinternações, reoperações, complicações peri- e pós-operatórias, ocorrência de osteointegração radiográfica e manutenção da função de suporte do M...
Revista Brasileira de Ortopedia, 2013
Artroplastia total do joelho Canal de drenagem Próteses e implantes r e s u m o Objetivo: Compara... more Artroplastia total do joelho Canal de drenagem Próteses e implantes r e s u m o Objetivo: Comparar os resultados laboratoriais da abertura do dreno seis e 12 horas após a cirurgia de artroplastia total do joelho. Métodos: Estudo prospectivo e randomizado em 88 pacientes tratados com artroplastia total do joelho com implante em dois grupos: um com abertura do dreno seis horas (n = 45) após a cirurgia e outro, 12 horas (n = 43) após a cirurgia. Resultados: Existe uma queda significativa nas três variáveis laboratoriais (hemoglobina, hemácias e hematócrito) entre o pré e o pósoperatório na amostra total e nos grupos de tempo de abertura do dreno às seis e 12 horas. O grupo com tempo de abertura após 12 horas apresentou volume do dreno significativamente menor do que o grupo com tempo de abertura após 6 horas (p = 0,0003). Contudo, não foi verificada diferença significativa no delta absoluto das variáveis laboratoriais entre os dois grupos. Conclusão: A abertura do dreno em seis e 12 horas não demonstrou diferença significativa dos valores laboratoriais. Porém, o volume de sangue drenado foi maior com abertura do dreno após seis horas.
Revista Brasileira de Ortopedia, 2011
Total knee arthroplasty is a high-complexity procedure that is constantly evolving. It is basical... more Total knee arthroplasty is a high-complexity procedure that is constantly evolving. It is basically indicated for patients with a diagnosis of knee osteoarthrosis or rheumatic diseases. Implants with more modern designs are made to resemble the anatomy of normal knees as much as possible. They are inserted using instruments that are increasingly precise, with less aggression to soft tissues, thus making surgical indications ever more wide-ranging. The good results obtained from total knee arthroplasty (TKA) have been well documented in the literature, both with regard to pain relief and with regard to maintenance of these results over long-term follow-up (1-6). There are several complications inherent to this type of surgical procedure. Fractures in implants are a rare occurrence and are mostly seen in the literature in the form of case reports. The aim of this study was to present two cases of fracture of the tibial component using the same model and type of prosthesis.
Revista Brasileira de Ortopedia, 2009
Declaramos inexistência de conflito de interesses neste artigo ArTIGO dE ATUALIzAçãO
Revista Brasileira de Ortopedia, 2013
Objective: Identify the etiology and incidence, as well to assess functional outcomes of patients... more Objective: Identify the etiology and incidence, as well to assess functional outcomes of patients, undergoing lower limb amputation after failure or complication of total knee arthroplasty. These patients were treated at the Center for Knee Surgery at the National Institute of Traumatology and Orthopedics (INTO), during the period of January 2001 to December 2010. Methods: The patients were interviewed and their charts were retrospectively analyzed to evaluate their functional outcome. Results: The incidence of amputation due to failure or complication of total knee arthroplasty was 0.41% in 2409 cases. Recurrent deep infection was the cause of amputation in 81% of cases, being Staphylococcus aureus and Pseudomonas aeruginosa the most frequent germs. Vascular complications and periprosthetic fracture associated to metaphyseal bone loss were also causes of amputation. In our study, 44% of amputees patients were using orthesis and 62.5% have had the ability to walk. Conclusion: Incidence of 0.41%, being the main cause recurrent infection. The functional outcome is limited, and the fitting achieved in 44% of patients and only 62.5% are ambulatory.
International Journal of Family & Community Medicine, 2019
Knee arthrodesis, above the knee amputation and resection arthroplasty is salvage procedures for ... more Knee arthrodesis, above the knee amputation and resection arthroplasty is salvage procedures for patients with refractory infection after Total Knee Arthroplasty (TKA). The aim of this study was to review the literature of patients submitted to knee resection arthroplasty after septic failure of a TKA. This literature review identified three case series with more than two years of follow-up. After the resection arthroplasty, in a global analysis of the three studies, the rate of infection control reached 96% and with 56% of patients showing satisfaction. However, only 14% of them were able to walk without assistance.
Rev Bras Ortop, May 1, 1994
Revista Brasileira de Ortopedia (English Edition), 2016
Objective: To define the anthropometric profile of the knee in a Brazilian population with gonart... more Objective: To define the anthropometric profile of the knee in a Brazilian population with gonarthrosis using intraoperative measurements; and to evaluate the compatibility of three implants available for total knee arthroplasty. Methods: Morphometric data were collected prospectively from 117 subjects with gonarthrosis. Six dimensions in the distal femur and two in the proximal tibia were documented in 118 knees while performing total arthroplasty. These data were compared with the dimensions of three implants available for total knee arthroplasty. Results: The statistical analysis showed that more than a quarter of the patients presented an unsatisfactory relationship between the knee and prosthesis. Conclusion: The implants evaluated need to be adjusted to better fit Brazilian patients.
Revista Brasileira De Ortopedia, 2009
Revista Brasileira de Ortopedia (English Edition), 2015
Avulsion fractures of the posterior cruciate ligament in unusual locations are rare injuries. We ... more Avulsion fractures of the posterior cruciate ligament in unusual locations are rare injuries. We report the first case in the literature of an avulsion fracture of the posterior cruciate ligament associated with distal injury to the patellar ligament. The aim of this study was to present a novel case, the therapy used and the clinical follow-up.
Revista Brasileira de Ortopedia, 2015
ABSTRACT
Revista Brasileira de Ortopedia (English Edition), 2015
Objective: To analyze and describe the distance from the popliteal artery to three specific areas... more Objective: To analyze and describe the distance from the popliteal artery to three specific areas of the proximal region of the tibia, with the knee extended, by means of magnetic resonance. Methods: Images of 100 knees of patients who underwent magnetic resonance examinations were analyzed. The location of the popliteal artery was measured in three different areas of the posterior proximal region of the tibia. The first measurement was made at the level of the knee joint (tibial plateau). The second was 9 mm distally to the tibial plateau. The third was at the level of the anterior tuberosity of the tibia (ATT). Results: The distances between the popliteal artery and the tibial plateau and ATT region were significantly greater in males than in females. The distances between the popliteal artery and the regions 9 mm distally to the tibial plateau and the ATT were significantly greater in the age group over 36 years than in the group ≤36 years. Conclusion: Knowledge of the anatomical position of the popliteal artery, as demonstrated through magnetic resonance studies, is of great relevance in planning surgical procedures that involve the knee joint. In this manner, devastating iatrogenic injuries can be avoided, particularly in regions that are proximal to the tibial plateau and in young patients.
Revista Brasileira de Ortopedia, 2015
Revista Brasileira de Ortopedia (English Edition), 2013
Objective: to compare the laboratorial results of opening suction drainage 6 hours and 12 hours a... more Objective: to compare the laboratorial results of opening suction drainage 6 hours and 12 hours after total knee arthroplasty surgery. Methods: prospective and randomized study in 88 patients undergoing with total knee arthroplasty in two groups: in one group the opening suction drainage was performed 6 hours (n = 45) after the surgery and in the other 12 hours (n = 43) after the surgery. Results: the outcome was a significant fall in the three laboratorial variables (hemoglobin, red blood cells and hematocrit) between the pre and post-operative in the total sample and in the six and 12 hour opening suction drainage groups. In the group with opening suction drainage after 12 hours, the drainage volume was significantly lower than in the group with opening suction drainage after 6 hours (p = 0.0003). However, no significant difference was observed in the absolute delta of the laboratorial variables between the two groups. Concluasion: the opening suction drainage in six and 12 hours did not show significant difference from the laboratorial values although the volume of the blood drained was higher in the opening suction drainage in six hours.
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Papers by Idemar Monteiro da Palma