bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of oral zinc and steroids on long COVID hyposmia and hypogeusia
Authors: Chiang Yi-Fang , Jiang Rong-San 
Published: November 2024

Objective: We studied the prognosis of olfactory and gustatory dysfunctions in patients with long COVID (Coronavirus Disease 2019) after treatment with oral zinc and steroids. Methods: We measured olfactory and gustatory functions of long COVID patients at their first visits, and after 2–4 months of treatment with oral zinc and steroids using the traditional Chinese version of the University of Pennsylvania Smell Identification Test and the Waterless Empirical Taste Test. We also assessed by phone the recovery of olfactory and gustatory functions at a mean of about 10 months of follow-up. Results: Among our 71 long COVID patients, 34 complained of loss of smell and taste. Their objective test results showed 88.2% hyposmic, 23.5% hypogeusic at the first visit. After treatment, 77.8% of the patients were hyposmic, and 16.7% were hypogeusic. After a mean follow-up of 10.35 months, 91.2% of the patients reported improvement in their olfactory function. Among the 36 patients who had complained only of smell loss, the objective test results showed 75% hyposmic at their first visit. After treatment, 71.4% of the patients were hyposmic. After a mean of 10.42 months of follow-up, 77.8% of the patients reported improvement in their olfactory function. Only one patient complained of taste loss. Conclusions: We found that olfactory dysfunction in most long COVID patients persisted for more than 10 months.
Anatomic posterolateral corner reconstruction with autografts provides superior stability compared to non-anatomic reconstruction in the setting of combined grade 3 posterolateral corner injury and single bundle posterior cruciate ligament reconstruction
Authors: Franciozi CES , Mameri ES , Schumacher FC , Credidio MV , Luzo MVM , Kubota MS 
Published: November 2024

Objectives To compare anatomic versus non-anatomic-posterolateral-corner (PLC) reconstructions with autografts for grade 3 posterolateral corner knee lesions combined with single bundle posterior cruciate ligament (PCL) reconstruction. Methods An outcome comparative study of chronic PCL lesions submitted to single bundle PCL reconstruction combined with a grade 3 PLC injury from Hughston and Fanelli classifications treated either by anatomic or non-anatomic PLC-reconstruction with autografts with at least 24 months of follow-up. Outcomes: Lysholm, IKDC, Tegner, side-to-side-difference (SSD) from posterior and varus stress radiographs, IKDC objective scores for posterior drawer, varus stress, dial test and recurvatum. Student’s t- and two-proportion Z-test were used. Power for sample size was 88.2%. Results Thirty-nine patients were evaluated: 18 in the Anatomic-PLC-group and 21 in the Non-anatomic-PLC-group. Mean follow-up: 28.3 months (range 24 to 59 months). Preoperatively, no significant differences were observed between the two groups in terms of age; time from injury until surgery; Lysholm; subjective IKDC; posterior, varus, external rotation or recurvatum laxity; stress radiographs; incidence of associated ligament and meniscus injuries. Postoperatively, no significant differences were observed for Lysholm (p=0.189), subjective IKDC (p=0.261), Tegner (p=0.385), mean improvement in Lysholm and IKDC scores (p=0.144, p=0.354, respectively), posterior tibial translation on stress radiographs [postoperative SSD (p=0.205) and percentage of patients with unacceptable (≥8mm) asymmetry (p=0.912)]; and complications. Significant differences favoring Anatomic-PLC-group were observed for Posterior-Drawer-Test (0.83±0.51 vs 1.1±0.43,p=0.046); Varus-Stress-Gapping at 30o (0.5±0.78 vs 1.14±0.85, p=0.01); Tibial-External-Rotation both 30o (33.3% vs 80.9%, p=0.002) and 90o (16.6% vs 47.6%, p=0.041); Asymmetrical-Recurvatum (5.5% vs 47.6%, p=0.00362); SSD-Lateral-Gapping-Varus-Stress-Radiographs (1.8±2.1 vs 3.35±2.28, p=0.028). Failure (presence of any of the following: Posterior Drawer ≥ 2+, Varus Stress ≥ 2+, SSD ≥ 8mm on Posterior-Radiograph or ≥ 4mm on Varus-Stress-Radiograph): 5% Anatomic versus 19% Non-anatomic, no statistical difference, p=0.103. Conclusion Anatomic posterolateral corner reconstruction with autografts provided superior stability compared to non-anatomic reconstruction in the setting of combined grade 3 posterolateral corner injuries and single bundle posterior cruciate ligament reconstruction.
Lateral hinge fracture does not compromise postoperative alignment of valgus open wedge high tibial osteotomy
Authors: Cruz PG , Paula RE , Mozella AP , Albuquerque RSP , Cordeiro A , Couto A 
Published: November 2024

Objectives Verify whether the previously planned correction with osteotomy was achieved and, in cases with hinge fracture, whether the accuracy of the correction was affected. In addition, identify the fracture characteristics responsible for inaccurate repair, including the type of fracture and the location of the hinge Methods Retrospective evaluation of patients who underwent tibial osteotomy with medial opening wedge and fixation with locking plate. The sample size was based on other similar studies available in the literature. After applying the exclusion and inclusion criteria, data from 47 participants were used. The research participants underwent the same surgical procedure, divided into two groups: patients without lateral cortical fracture and patients with fractures. Patients with fractures were compared to patients without fractures in terms of the statistical difference in the axis of correction of lower limb alignment. Results In the preoperative period, the following measurements were evaluated: Tibiofemoral Angle, Tibial Slope, mPtA (Medial Proximal Tibial Angle), Joint Obliquity (JLCA). In the immediate postoperative period: Tibiofemoral angle, tibial slope, mPtA, joint obliquity. In the late postoperative period: Tibiofemoral Angle, Tibial Slope, mPtA, Joint Obliquity, MAD (Mechanical Axis Deviation) and correction achieved between groups. There was no statistical difference between the groups in the preoperative, immediate postoperative and late postoperative periods. Conclusion No statistical differences were found between the group with and without lateral cortical fracture. We conclude that lateral cortical fracture does not cause loss of alignment correction as long as a rigid fixation method is used.
Measure of risk of fall in severe knee osteoarthritis patients using Techbalance device
Authors: Ooka NHM , Pessoa ALC , Runco GM , Matta MRS , Oliveira LP 
Published: November 2024

Objectives Knee Osteoarthritis prevalence increase is due to rise of life expectancy and ageing of the population. Ageing also affects gait and balance leading to increase of fall risk. To track this risk, newer and portable devices using accelerometers and gyroscopes are used in monitoring falls, because postural stability and balance compromise increase risk of falls (RF). The combination of accelerometer and gyroscope in portable devices are defined as Inertial Mobility Unity (IMU). Our study aims to assess RF using an IMU (Techbalance®) in patients with knee osteoarthritis. Methods Cross-sectional study in 133 eldery patients with knee osteoarthritis. The sample is divided in 2 groups, Group 1: no previous fall in the last year, Group 2: history of fall in the last year. Techbalance assessment of RF generates two scores: TechFragilidade is a clinical evaluation of frailty of the patient. TechEscore consists in 14 tasks to evaluate balance and posture assisted by a smartphone-like device IMU positioned on the girdle of the patient (center of mass). The RF assessment using the Techbalance was compared to both low-risk and high-risk of falls and the statistics analysis were performed with Chi-square, Mann-Whitney, and Spearman tests. Results Mean age was 65 (± 6,3) years. TechEscore and TechFragilidade scores correlate positively to risk of fall ( p<0.05 e <0.01, respectively) and negatively with SF12 physical ( p<0.05). TechFragilidade score (r = 0,313, p < 0,01) has a higher correlation to risk of fall than TechEscore score (r = 0,247, p < 0,01) ( z = 2,004; p < 0,023). Conclusion Our study showed that Techbalance was able to correlate RF in knee osteoarthritis patients combining frailty assessment and balance and postural evaluation using an IMU.
Pressure center behavior and plantar pressure distribution in patients undergoing total knee atropasty surgery
Authors: Filho UCS , Teixeira EM , Araujo HRS , Assis BR , Jacob TC , Azevedo FGS 
Published: November 2024

Objectives The study aimed to analyze the center of pressure behavior in individuals undergoing total knee arthroplasty (TKA), using a plantar pressure platform as an assessment tool. Methods Seventeen participants, with an average age of 71.23 years, diagnosed with knee osteoarthritis and undergoing TKA for the first time, were included. Inclusion criteria required participants to have no neurological dysfunctions, prior use of lower limb prostheses, or deformities on the plantar surfaces. The experimental protocol involved data collection on center of pressure behavior, arch index, and pain using the Visual Analog Scale, both with eyes open and closed. Results Revealed significant differences in anteroposterior center of pressure behavior (COPAP) and center of pressure area between moments with eyes open and closed. There were statistically significant variations in COPAP, indicating an influence of visual condition on postural stability. Other variables, such as arch index, average displacement speed, and percentage of pressure on the feet, did not show significant differences. Conclusion The visual condition, especially the difference between eyes open and closed, impacts the center of pressure behavior in patients undergoing TKA. The decrease in the center of pressure area with closed eyes suggests an adaptive response of the neuromuscular system to visual deprivation. This study emphasizes the importance of considering visual factors in the assessment of balance in pre-TKA patients, providing valuable insights for physiotherapeutic interventions and preoperative guidance.
Quality of Life in Women After Total Knee Arthroplasty With Valgus Deformity
Authors: Zorzi AR , Bento AF , Almeida LV , Campos GC , Piedade SR 
Published: November 2024

Objectives While traditional indicators focus on implant survivor, the assessment of quality of life encompasses broader dimensions, such as the experience of pain, mobility, the ability to perform daily activities, and mental well-being. Given the anatomical, psychological, and cultural differences found in females, and the rarity of valgus deformity, which comprises only 10% of total knee arthroplasty cases, there is a significant gap in available data, highlighting the importance of research directed towards this specific group of patients. Methods This observational study involved 20 participants with valgus deformity who underwent total knee arthroplasty at an university hospital. The study was previously approved by the Research Ethics Committee (CAAE: 58487222.5.0000.5404). The assessment of function, quality of life and pain was carried out using the WOMAC, EuroQol-5D 3L, Kujala and Visual Analogue Scale for pain (VASpain) questionnaires. Results The participants, all female, had an average age of 68.3 years ∓ 9.4SD, with an average weight of 78.6 kg ∓ 13.5SD, average height of 1.57 m ∓ 0.07SD and Average BMI of 24.7 ∓ 4.4 SD. Post-surgical follow-up time was on average 79.6 months ∓ 37.3SD, with 73.9% of cases on the right knee and 26.1% on the left side. The average pain VAS was 2.9 points. The Kujala scale presented an average of 66.9 points. WOMAC presented an average of 15.6 points ∓ 12.2 SD, with a minimum of 3.1 and a maximum of 61.5. EuroQol 5D 3L demonstrated good quality of life, with at least 61 points in 80% of all cases. Conclusion In conclusion, most participants experienced mild to moderate post-surgery pain, but the intervention substantially improved quality of life, enabling daily activities resumption.
Genicular block in total knee arthroplasty: a randomized clinical study
Authors: Lima PHR , Paganini GB , Oliveira AD , De Almeida GDB , De Moura CP , De Oliveira SG 
Published: November 2024

Objectives Our randomized clinical study aims to assess genicular nerve block performed intraoperatively compared to a control group without regional block, concerning pain and functional parameters. Methods The randomized clinical trial involved 28 patients with primary gonarthrosis scheduled for total knee arthroplasty due to disease progression and failure of conservative treatment.Patients were randomly assigned to two groups: control (Group C) and the proposed intervention (Group I).At the end of the surgical procedure, Group I received levobupivacaine infusion, while Group C received saline solution, targeting the medial-superior, lateral-superior, and medial-inferior genicular nerves.Parameters such as pain, muscle strength, joint effusion, orthostatic capacity, and ambulation were evaluated before and after surgery. Patients also recorded daily pain levels for five days post-procedure, as well as tramadol consumption.Statistical analysis was performed to compare the effects between the groups, adopting a p-value < 0.05 as the significance level. Results For the characterization of the cohort based on age and BMI variables, tests indicate no evidence that the studied groups have different profiles.In comparing variables such as Visual Analogue Scale, Muscle Strength, Joint Effusion, and Ambulation/Orthostasis between preoperative and postoperative day 1 evaluations, only one characteristic shows a significant difference. In the Muscle Strength variable, Group I exhibits a greater reduction (p=0.016).Throughout the study's follow-up period, none of the patients experienced any complications related to the surgical procedure. Conclusion The genicular nerve block performed intraoperatively during total knee arthroplasty surgeries, when done in isolation, proved ineffective in reducing postoperative pain and did not result in any benefit for early return to ambulation.The authors believe that further studies on the matter are necessary, with a larger number of patients, in order to better describe the outcomes of the intervention.
Surgical Treatment Of Chronic Patellar Tendon Rupture Using A Two-Stage Technique With Patellar Transosseous Traction: A Case Series
Authors: Faria JLR , Neto RVR , Pavao DM , Titonelli VE , Maia PAV , Albuquerque RSP 
Published: November 2024

Objectives This study aims to describe the clinical results of a novel surgical technique used in patients with chronic patellar tendon rupture, high patella, and non-reducible quadriceps shortening. Methods A cross-sectional study design was utilized, involving 5 patients treated with the described surgical technique. These patients were reassessed at 10, 24, and 48 weeks post-surgery. The techniques included staged surgery using patellar transosseous traction in the first stage and a modified Kelikian technique in the second stage. Results The study reported satisfactory functional and pain-related outcomes (Lysholm and IKDC scales), reduction in patellar height, and restoration of the full active range of motion in the affected knee. Conclusion The two-stage surgical technique for chronic patellar tendon rupture, incorporating patellar transosseous traction and a modified Kelikian technique, is simple, reproducible, and yields satisfactory clinical results.
Validation Of Risk Stratification Protocol For Total Knee Arthroplasty
Authors: FB Loures , GM Queiroz , DL Rosa , GM Runco , LP Oliveira , VS Gameiro 
Published: November 2024

Objectives The main objective of the study was to validate the protocol for performing TKA without admission to the ICU in the postoperative period. The secondary objective was to evaluate the transfusion rate blood flow for the same specific group of patients after surgery. Methods After approval of the study by the Institution’s Research Ethics Committee,270 cases of TKA performed between January 2020 and December 2021. All patients undergoing TKA in the period had followed the screening protocol defined by orthopedists, anesthetists and clinicians, after reviewing the literature. The seven criteria used were: age up to 75 years, body mass index up to 35 kg/m2, ASA score classification I or II (American Society of Anesthesiology), non-smoker, no previous history of ischemic disease (coronary or cerebral), creatinine clearance greater than 60mL/min, hemoglobin greater than 12g/dL, osteoarthritis with deformity treatable with a primary prosthesis. Results 270 patients who underwent TKA between January 2020 and December 2021 were included in the study, following the pre-defined screening protocol. The sample consisted of 182 female and 88 male patients. The average age was 65.5, ranging between 39 and 75 years. Only one patient required ICU surveillance after the surgical procedure, due to hemodynamic instability, giving the screening protocol a positive predictive value of 99.6%. Although there was a significant decrease in serum levels, no patient presented hemodynamic symptoms or clinical indication for blood transfusion. Conclusion The proposed screening protocol demonstrated that, following the criteria established, TKA can be performed without the need for ICU reservation, without typing preoperative blood supply and/or reserve of blood products, without compromising patient safety. The rational use of health resources allows the coverage of a greater number of patients, increasing the effectiveness of the system.
Clinical Outcomes of Combined Reconstruction of the Medial Patellofemoral Ligament (MPFL) and Medial Quadriceps Tendon-Femoral Ligament (MQTFL) at a Minimum Follow-up of 2 Years
Authors: EF Temponi , Carvalho LH , LFM Soares , MBJ Goncalves , FS Pimenta , Fávero RC 
Published: November 2024

Objectives: To report patient-reported outcome measures (PROMs) following isolated combined MPFL and MQTFL reconstruction in cases of patellar instability at a minimum follow-up of 2 years and to assess potential complications. Methods: A retrospective analysis of prospectively collected data was performed on consecutive skeletally mature patients who underwent isolated combined MPFL and MQTFL reconstruction between January 1, 2020, and May 31, 2022. Data were collected on physical examination, return to sport, and occurrence of complications. Patients completed Kujala and International Knee Documentation Committee (IKDC) Scores (PROMs) pre-operatively and at final follow-up. Results: A total of 82 patients underwent combined MPFL and MQTFL reconstruction, with 7 patients (8%) lost to follow-up. The mean follow-up time was 3.2 ± 0.7 years (range, 2.2 to 5.8). The mean pre-operative Kujala knee function score was 62 points (range, 39-76), which increased to 86 points (range, 86-93) at final follow-up (P = 0.00004). The mean pre-operative IKDC score was 42.5 (range, 39.1-44.8) points, increasing to 73 points (range, 70.1-75.9) at final follow-up (P = 0.00894). No instances of post-operative patellar fracture, infection, hematoma, or instability were reported. Minor complications were observed in 13.33% (10/75) of cases. Conclusion: In this series, combined MPFL and MQTFL reconstruction resulted in patellar stability, significant improvements in clinical and functional outcomes, and no major complications.
Selective embolization of genicular arteries after total knee arthroplasty with persistent synovitis and pain
Authors: MARCIA UCHOA DE REZENDE; , VALLE LEONARDO GUEDES MOREIRA , DE ASSIS ANDRE MOREIRA , GALASTRI FRANCISCO LEONARDO , AFFONSO BRENO BOUERI , NASSER FELIPE 
Published: November 2024

Objectives To document the effects of embolization of branches of genicular arteries in patients with pain and synovitis after total knee arthroplasty due to osteoarthritis (OA) Methods Prospective case series of eight patients (nine knees) with persistent pain, effusion, stiffness, and synovitis after knee arthroplasty submitted to transcatheter arterial embolization since August 2021. Clinical outcomes were evaluated at baseline, one and two years with EQ5D, WOMAC (0-96) and KOOS. All patients had their knees aspirated at the operating room to ascertain lack of infection. Results Abnormal neovessels were identified in all cases. One patient remained with cutaneous color changes even after two years of the procedure in both knees. No tissue necrosis, dermal ulcers, or peripheral ulcers. Three patients required to do the procedure more than once (twice in two and thrice in one). EQ5D improved from an average of 0.9063±0.05 to 0,9562±0.04 (one year), and 0.9828±0.02 at 2 years. WOMAC pain improved from 1.83±2 to 1.33±1(one year ) and 0 at 2 years (only three patients, i.e., four knees performed the procedure only once and reached de 2-year follow-up mark). Stiffness improved from 1±1.5 to 0.5±1.2(one year) and 0 (2-year). Baseline WOMAC function was 9.5±6.2 improving to 3.1±2.3 (one year) and 1.75±0.96 at two years. WOMAC total (0-96) WOMAC total reduced from average of 12.3 to ±7.4 to 4.7±2.9(one year) and 1.75±0.96 (two years). KOOS general improved from 75.8±11.3 to 84±4.3 at one year and to 88±3.4 at two years. All patients improved in all parameters continuously. Conclusion Embolization of branches of genicular arteries in patients with persistent pain, stiffness, effusion, and synovitis, after total knee arthroplasty, due to OA, may provide long lasting improvements in pain, function, and quality of life.
Stress fracture in athletes after reconstruction of the anterior cruciate ligament of the knee – case reports and literature review
Authors: DE SOUZA PINTO MAIKON FELICETTI , DE PAIVA LUCIANO ALEXANDRE , DE ARAUJO MATHEUS AGUIAR , ALEIXO BRUNA ANDRADE , LUDERS VICTOR CANDIOTTO , PIETROBOM LEONARDO CAÇADOR 
Published: November 2024

Objectives We purpose to report two cases of stress fractures in amateur athletes after anterior cruciate ligament reconstruction (ACLR) and review literature data. Methods Case Presentation: The first case involved a 30-year-old male, who underwent ACLR with hamstring autograft. Post-surgery, he recovered well and returned to sports after 9 months. However, he later experienced pain, swelling, and reduced joint motion, revealing a low-risk, grade III stress fracture in the postero-medial region of the proximal tibia. The second case featured a 34-year-old male with ACL injury, successfully treated with ACLR using hamstring autograft. Despite a smooth recovery, he developed pain and swelling, uncovering a low-risk, grade III stress fracture in the postero-medial proximal tibia during follow-up examinations. Results Two rare stress fracture cases in the tibial plateau post-ACLR are reported in amateur athletes. Following initial recovery, both experienced pain, swelling, and reduced knee motion. MRI revealed low-risk stress fractures in the postero-medial proximal tibia (grade III). Management involved a two-phase protocol: pain control, activity modification, and physiotherapy (1); gradual return to sports with predisposing factor correction (2). The paper discusses the rarity of such fractures in healthy athletes, emphasizing tibial tunnel positioning and biomechanical factors. Genetic susceptibility to stress fractures is considered. Evaluation of acutely painful knees post-ACLR should include stress fracture assessment, emphasizing early MRI diagnosis and established management principles. Conclusion In conclusion, stress fractures in the proximal tibia following ACLR are infrequent, especially in athletic individuals, highlighting the need for continued research into contributing biomechanical factors, optimal tunnel positioning, and genetic influences. Management protocols involve early detection through MRI and a phased approach to rehabilitation, emphasizing the significance of individualized patient care.