Revista Brasileira de Ortopedia最新文献

{"title":"[Comparison of Capsular Closure and Capsulectomy in Primary Total Hip Arthroplasty Using the Direct Anterior Approach].","authors":"Bruno Dutra Roos, Milton Valdomiro Roos, Ezequiel Moreno Ungaretti Lima, Mauricio Domingos Betto, Juan Victor Guzman Gonzales, Henrique Emanuelli Della Méa","doi":"10.1055/s-0046-1818620","DOIUrl":"10.1055/s-0046-1818620","url":null,"abstract":"<p><strong>Objective: </strong>To compare the clinical, radiographic, and complication outcomes of patients undergoing capsular repair or resection during total hip arthroplasty (THA) using the anterior approach.</p><p><strong>Methods: </strong>The present prospective cohort study included 232 patients submitted to THA at a tertiary hospital, who were divided according to exposure. One group of subjects underwent THA with capsular preservation and closure, and the other underwent THA with capsular resection (capsulectomy). Clinical assessment included the Harris Hip Score (HHS), evaluation of hip range of motion, and identification of symptoms indicative of iliopsoas tendinitis. Additionally, a radiological assessment determined the presence of heterotopic ossification, and we evaluated any postoperative complications.</p><p><strong>Results: </strong>There was no statistically significant difference in HHS and hip range of motion. No patient from the capsular closure group presented complications. In the capsulectomy group, 7 (5.20%) subjects presented with heterotopic ossification, including 1 case classified as Brooker grade 3, besides 3 (2.25%) cases of iliopsoas tendinitis and 1 (0.75%) case of prosthesis dislocation.</p><p><strong>Conclusion: </strong>Capsular closure in THA using the direct anterior approach resulted in a lower incidence of iliopsoas tendinitis, heterotopic ossification, and complications, such as prosthesis dislocation, compared with the capsulectomy group.</p>","PeriodicalId":21536,"journal":{"name":"Revista Brasileira de Ortopedia","volume":"61 1","pages":"s00461818620"},"PeriodicalIF":0.5,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Results of Latissimus Dorsi Transfer Associated with the Use of Autologous Fascia Lata Tendon Graft in Irreparable Posterosuperior Rotator Cuff Injuries].","authors":"Ricardo Makoto Okamoto, Guilherme do Val Sella, Luciana Andrade da Silva, Thomas Yogo Mendonça Alves, Alberto Naoki Miyazaki","doi":"10.1055/s-0046-1819620","DOIUrl":"10.1055/s-0046-1819620","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the functional outcomes of latissimus dorsi transfer reinforced with an autologous fascia lata graft harvested from the thigh contralateral to the injury to treat irreparable posterosuperior rotator cuff tears (IPSRCTs). The secondary objective was to assess complications related to graft harvesting.</p><p><strong>Methods: </strong>The present retrospective functional evaluation involved 17 patients (8 men and 9 women), with a mean age of 62.6 (54-73) years and a mean postoperative follow-up period of 21.2 (12-45) months. We compared pre- and postoperative University of California, Los Angeles (UCLA) scores and range of motion (ROM), assessed donor-site hip abduction strength and recorded potential associated complications. The determination of correlations between variables used Pearson's coefficient, with <i>p</i> ≤ 0.05 considered statistically significant.</p><p><strong>Results: </strong>The mean postoperative UCLA score was 27.9 (14-33) points, representing an improvement of 16.7 points compared to the preoperative mean. Range of motion improved significantly ( <i>p</i>  < 0.05), with the following final values: elevation, 27.9°; lateral rotation (LR), 133°; medial rotation (MR) at T9, all with <i>p</i>  < 0.05. No patient presented signs of infection at the graft harvest site; two subjects reported pain in the surgical wound, and one developed a small incisional hernia.</p><p><strong>Conclusion: </strong>This technique was effective in treating IPSRCTs, achieving a 70.6% satisfactory outcome based on the UCLA score and showing significant improvement in ROM. The use of an autologous graft represents a viable option with low complication rates, both at the shoulder and hip.</p>","PeriodicalId":21536,"journal":{"name":"Revista Brasileira de Ortopedia","volume":"61 1","pages":"s00461819620"},"PeriodicalIF":0.5,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Cross-sectional Evaluation of the Mechanical Axis and Other Angular Parameters of the Lower Limbs in Male Professional Soccer Players].","authors":"Jean Klay Santos Machado, Eurineto Gomes do Nascimento, Erik Silva de Menezes","doi":"10.1055/s-0046-1818619","DOIUrl":"10.1055/s-0046-1818619","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the mechanical axis and angular parameters of the lower limbs in professional soccer players, relating them to age, limb dominance, and field position.</p><p><strong>Methods: </strong>The present cross-sectional study included 102 male athletes from a Brazilian professional soccer team. Full-length radiographs in the orthostatic position were analyzed using the PeekMed (Peek Health, S.A.) software to measure the condylar efficiency (CE), the medial mechanical proximal tibial angle (mMPTA), the mechanical lateral distal femoral angle (mLDFA), and the mechanical tibiofemoral angle (mTFA). The results were analyzed using descriptive statistics, analysis of variance (ANOVA), multivariate analysis of variance (MANOVA), Pearson's/Spearman's correlations, and multiple regression.</p><p><strong>Results: </strong>The mean age of the participants was of 26.9 years. The valgus pattern was the most prevalent (68.6%), with bilateral valgus in 47.0% of the sample. A negative correlation was found between age and bilateral CE (ρ = -0.42 on the right side; and -0.39 on the left side; p < 0.05), and defenders and left-footed players presented greater condylar asymmetry (ΔCE). The MANOVA indicated a significant association between field position and angular parameters ( <i>p</i>  = 0.0016), with no global effect of dominance ( <i>p</i>  = 0.243). Midfielders and fullbacks showed a higher prevalence of valgus (of up to 80%), while defenders and goalkeepers commonly presented with neutral alignment. There were significant bilateral differences in CE, mMPTA, and mTFA.</p><p><strong>Conclusion: </strong>Age and field position influenced lower-limb alignment in professional soccer players, with more pronounced asymmetries in defenders and left-footed athletes. Individualized monitoring of the mechanical axis may help prevent injuries and optimize performance.</p>","PeriodicalId":21536,"journal":{"name":"Revista Brasileira de Ortopedia","volume":"61 1","pages":"s00461818619"},"PeriodicalIF":0.5,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protocol for a Randomized Clinical Trial to Assess the Effects of Extra-Articular Strengthening in Anterior Cruciate Ligament Reconstruction on the Clinical and Functional Condition of High-Performance Athletes.","authors":"Thiago Lemos, Conrado T Laett, José P G Aramburu Filho, Geraldo R Motta Filho, João M Guimarães, José Leonardo R Faria","doi":"10.1055/s-0046-1818612","DOIUrl":"10.1055/s-0046-1818612","url":null,"abstract":"<p><strong>Objective: </strong>To describe a randomized clinical trial designed to evaluate the impact of three extra-articular reinforcement techniques combined with anterior cruciate ligament reconstruction (ACLR) on postoperative muscle function, activity levels, and return-to-sport in high-performance athletes. The primary hypothesis is that these techniques will differentially influence joint stability and recovery trajectories.</p><p><strong>Methods: </strong>A prospective, quasirandomized, single-blind trial intending to enroll 220 athletes, between 18 and 45-years-old, with isolated ACL injuries. Participants will be allocated via block randomization to one of three procedures: lateral extra-articular tenodesis (LET), involving fixation of a iliotibial band strip near the anterolateral ligament (ALL) at 30° knee flexion for rotational stability; single-bundle ALL reconstruction (ALL-S), using a gracilis graft between the femoral epicondyle and Gerdy's tubercle; and double-bundle ALL (ALL-D), employing two graft limbs in a double tibial tunnel located between Gerdy's tubercle and the fibular head, with a single femoral fixation at the anatomical position of the ALL. Assessments will occur preoperatively and at 3, 6, 9, 12, and 24-months postsurgery, including joint laxity, quadriceps morphology, functional performance, and knee isokinetic strength. Furthermore, self-reported outcomes, such as the International Knee Documentation Committee's (IKDC), 36-Item Short Form Health Survey (SF-36), and Tegner scale, will also be collected. Linear mixed-effects models will analyze outcomes, adjusting for meniscal repair status.</p><p><strong>Results: </strong>Upon completion, this study is expected to identify the most effective extra-articular technique for restoring knee stability and function, potentially guiding surgical decision-making. Our findings may optimize rehabilitation protocols and reduce reinjury rates in athletes.</p><p><strong>Conclusion: </strong>This protocol describes a comprehensive clinical trial that addresses important gaps in current knowledge regarding optimal surgical approaches for ACLR in athletes.</p>","PeriodicalId":21536,"journal":{"name":"Revista Brasileira de Ortopedia","volume":"61 1","pages":"s00461818612"},"PeriodicalIF":0.5,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Results of Latissimus Dorsi Transfer Associated with the Use of Autologous Fascia Lata Tendon Graft in Irreparable Posterosuperior Rotator Cuff Injuries.","authors":"Ricardo Makoto Okamoto, Guilherme do Val Sella, Luciana Andrade da Silva, Thomas Yogo Mendonça Alves, Alberto Naoki Miyazaki","doi":"10.1055/s-0046-1819619","DOIUrl":"10.1055/s-0046-1819619","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the functional outcomes of latissimus dorsi transfer reinforced with an autologous fascia lata graft harvested from the thigh contralateral to the injury to treat irreparable posterosuperior rotator cuff tears (IPSRCTs). The secondary objective was to assess complications related to graft harvesting.</p><p><strong>Methods: </strong>The present retrospective functional evaluation involved 17 patients (8 men and 9 women), with a mean age of 62.6 (54-73) years and a mean postoperative follow-up period of 21.2 (12-45) months. We compared pre- and postoperative University of California, Los Angeles (UCLA) scores and range of motion (ROM), assessed donor-site hip abduction strength and recorded potential associated complications. The determination of correlations between variables used Pearson's coefficient, with <i>p</i> ≤ 0.05 considered statistically significant.</p><p><strong>Results: </strong>The mean postoperative UCLA score was 27.9 (14-33) points, representing an improvement of 16.7 points compared to the preoperative mean. Range of motion improved significantly ( <i>p</i>  < 0.05), with the following final values: elevation, 27.9°; lateral rotation (LR), 133°; medial rotation (MR) at T9, all with <i>p</i>  < 0.05. No patient presented signs of infection at the graft harvest site; two subjects reported pain in the surgical wound, and one developed a small incisional hernia.</p><p><strong>Conclusion: </strong>This technique was effective in treating IPSRCTs, achieving a 70.6% satisfactory outcome based on the UCLA score and showing significant improvement in ROM. The use of an autologous graft represents a viable option with low complication rates, both at the shoulder and hip.</p>","PeriodicalId":21536,"journal":{"name":"Revista Brasileira de Ortopedia","volume":"61 1","pages":"s00461819619"},"PeriodicalIF":0.5,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Viscosupplementation with High Molecular Weight Hyaluronic Acid for Hip Osteoarthritis: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials].","authors":"Tales Pasqualotto, Eric Pasqualotto, Leonardo Salvatore Migliardi, Laura Lunelli, Letícia Oliveira Lunelli, Renan Vinicius Romano Martinelli","doi":"10.1055/s-0046-1819580","DOIUrl":"10.1055/s-0046-1819580","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy and safety of high molecular weight hyaluronic acid (HMWHA) versus other therapies for hip osteoarthritis (OA) management.</p><p><strong>Methods: </strong>The present systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Randomized controlled trials (RCTs) comparing HMWHA versus other therapies (corticosteroids, platelet-rich plasma, saline, or low molecular weight hyaluronic acid) for hip OA treatment were included. Mean differences (MDs) or standardized mean differences (SMDs) were calculated for continuous outcomes with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Four RCTs were included, involving 823 patients with hip OA, of whom 408 (49.5%) were treated with HMWHA. The mean age of the patients was 60.1 (±10.21) years. No significant differences were observed between groups for pain (SMD -0.30 points; 95% CI -1.60 to 0.99), Lequesne index (MD 1.30 points; 95% CI -8.83 to 11.44), WOMAC total (MD -9.26 points; 95% CI -51.33 to 32.56), WOMAC stiffness (MD -0.93 points; 95% CI -12.30 to 10.45), WOMAC physical function (MD -0.15 points; 95% CI -7.24 to 7.60), and patient global self-assessment (MD -1.95 points; 95% CI -27.49 to 23.59).</p><p><strong>Conclusion: </strong>No significant differences were observed between HMWHA and other treatments regarding pain relief and functional recovery in patients with hip OA. However, further high-quality RCTs are needed to evaluate the HMWHA in the treatment of hip OA.</p>","PeriodicalId":21536,"journal":{"name":"Revista Brasileira de Ortopedia","volume":"61 1","pages":"s00461819580"},"PeriodicalIF":0.5,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-sectional Evaluation of the Mechanical Axis and Other Angular Parameters of the Lower Limbs in Male Professional Soccer Players.","authors":"Jean Klay Santos Machado, Eurineto Gomes do Nascimento, Erik Silva de Menezes","doi":"10.1055/s-0046-1818613","DOIUrl":"10.1055/s-0046-1818613","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the mechanical axis and angular parameters of the lower limbs in professional soccer players, relating them to age, limb dominance, and field position.</p><p><strong>Methods: </strong>The present cross-sectional study included 102 male athletes from a Brazilian professional soccer team. Full-length radiographs in the orthostatic position were analyzed using the PeekMed (Peek Health, S.A.) software to measure the condylar efficiency (CE), the medial mechanical proximal tibial angle (mMPTA), the mechanical lateral distal femoral angle (mLDFA), and the mechanical tibiofemoral angle (mTFA). The results were analyzed using descriptive statistics, analysis of variance (ANOVA), multivariate analysis of variance (MANOVA), Pearson's/Spearman's correlations, and multiple regression.</p><p><strong>Results: </strong>The mean age of the participants was of 26.9 years. The valgus pattern was the most prevalent (68.6%), with bilateral valgus in 47.0% of the sample. A negative correlation was found between age and bilateral CE (ρ = -0.42 on the right side; and -0.39 on the left side; <i>p</i>  < 0.05), and defenders and left-footed players presented greater condylar asymmetry (ΔCE). The MANOVA indicated a significant association between field position and angular parameters ( <i>p</i>  = 0.0016), with no global effect of dominance ( <i>p</i>  = 0.243). Midfielders and fullbacks showed a higher prevalence of valgus (of up to 80%), while defenders and goalkeepers commonly presented with neutral alignment. There were significant bilateral differences in CE, mMPTA, and mTFA.</p><p><strong>Conclusion: </strong>Age and field position influenced lower-limb alignment in professional soccer players, with more pronounced asymmetries in defenders and left-footed athletes. Individualized monitoring of the mechanical axis may help prevent injuries and optimize performance.</p>","PeriodicalId":21536,"journal":{"name":"Revista Brasileira de Ortopedia","volume":"61 1","pages":"s00461818613"},"PeriodicalIF":0.5,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Viscosupplementation with High Molecular Weight Hyaluronic Acid for Hip Osteoarthritis: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Tales Pasqualotto, Eric Pasqualotto, Leonardo Salvatore Migliardi, Laura Lunelli, Letícia Oliveira Lunelli, Renan Vinicius Romano Martinelli","doi":"10.1055/s-0046-1819579","DOIUrl":"10.1055/s-0046-1819579","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy and safety of high molecular weight hyaluronic acid (HMWHA) versus other therapies for hip osteoarthritis (OA) management.</p><p><strong>Methods: </strong>The present systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Randomized controlled trials (RCTs) comparing HMWHA versus other therapies (corticosteroids, platelet-rich plasma, saline, or low molecular weight hyaluronic acid) for hip OA treatment were included. Mean differences (MDs) or standardized mean differences (SMDs) were calculated for continuous outcomes with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Four RCTs were included, involving 823 patients with hip OA, of whom 408 (49.5%) were treated with HMWHA. The mean age of the patients was 60.1 (±10.21) years. No significant differences were observed between groups for pain (SMD -0.30 points; 95% CI -1.60 to 0.99), Lequesne index (MD 1.30 points; 95% CI -8.83 to 11.44), WOMAC total (MD -9.26 points; 95% CI -51.33 to 32.56), WOMAC stiffness (MD -0.93 points; 95% CI -12.30 to 10.45), WOMAC physical function (MD -0.15 points; 95% CI -7.24 to 7.60), and patient global self-assessment (MD -1.95 points; 95% CI -27.49 to 23.59).</p><p><strong>Conclusion: </strong>No significant differences were observed between HMWHA and other treatments regarding pain relief and functional recovery in patients with hip OA. However, further high-quality RCTs are needed to evaluate the HMWHA in the treatment of hip OA.</p>","PeriodicalId":21536,"journal":{"name":"Revista Brasileira de Ortopedia","volume":"61 1","pages":"s00461819579"},"PeriodicalIF":0.5,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Capsular Closure and Capsulectomy in Primary Total Hip Arthroplasty Using the Direct Anterior Approach.","authors":"Bruno Dutra Roos, Milton Valdomiro Roos, Ezequiel Moreno Ungaretti Lima, Mauricio Domingos Betto, Juan Victor Guzman Gonzales, Henrique Emanuelli Della Méa","doi":"10.1055/s-0046-1818602","DOIUrl":"10.1055/s-0046-1818602","url":null,"abstract":"<p><strong>Objective: </strong>To compare the clinical, radiographic, and complication outcomes of patients undergoing capsular repair or resection during total hip arthroplasty (THA) using the anterior approach.</p><p><strong>Methods: </strong>The present prospective cohort study included 232 patients submitted to THA at a tertiary hospital, who were divided according to exposure. One group of subjects underwent THA with capsular preservation and closure, and the other underwent THA with capsular resection (capsulectomy). Clinical assessment included the Harris Hip Score (HHS), evaluation of hip range of motion, and identification of symptoms indicative of iliopsoas tendinitis. Additionally, a radiological assessment determined the presence of heterotopic ossification, and we evaluated any postoperative complications.</p><p><strong>Results: </strong>There was no statistically significant difference in HHS and hip range of motion. No patient from the capsular closure group presented complications. In the capsulectomy group, 7 (5.20%) subjects presented with heterotopic ossification, including 1 case classified as Brooker grade 3, besides 3 (2.25%) cases of iliopsoas tendinitis and 1 (0.75%) case of prosthesis dislocation.</p><p><strong>Conclusion: </strong>Capsular closure in THA using the direct anterior approach resulted in a lower incidence of iliopsoas tendinitis, heterotopic ossification, and complications, such as prosthesis dislocation, compared with the capsulectomy group.</p>","PeriodicalId":21536,"journal":{"name":"Revista Brasileira de Ortopedia","volume":"61 1","pages":"s00461818602"},"PeriodicalIF":0.5,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Protocol for a Randomized Clinical Trial to Assess the Effects of Extra-Articular Strengthening in Anterior Cruciate Ligament Reconstruction on the Clinical and Functional Condition of High-Performance Athletes].","authors":"Thiago Lemos, Conrado T Laett, José P G Aramburu Filho, Geraldo R Motta Filho, João M Guimarães, José Leonardo R Faria","doi":"10.1055/s-0046-1822751","DOIUrl":"10.1055/s-0046-1822751","url":null,"abstract":"<p><strong>Objective: </strong>To describe a randomized clinical trial designed to evaluate the impact of three extra-articular reinforcement techniques combined with anterior cruciate ligament reconstruction (ACLR) on postoperative muscle function, activity levels, and return-to-sport in high-performance athletes. The primary hypothesis is that these techniques will differentially influence joint stability and recovery trajectories.</p><p><strong>Methods: </strong>A prospective, quasirandomized, single-blind trial intending to enroll 220 athletes, between 18 and 45-years-old, with isolated ACL injuries. Participants will be allocated via block randomization to one of three procedures: lateral extra-articular tenodesis (LET), involving fixation of a iliotibial band strip near the anterolateral ligament (ALL) insertion at 30° knee flexion for rotational stability; single-bundle ALL reconstruction (ALL-S), using a gracilis graft between the fibula head and Gerdy's tubercle; and double-bundle ALL (ALL-D), employing two graft limbs in a double tibial tunnel between Gerdy's tubercle and the fibular head, with a single femoral fixation in the anatomical position of the ALL. Assessments will occur preoperatively and at 3, 6, 9, 12, and 24-months postsurgery, including joint laxity, quadriceps morphology, functional performance, and knee isokinetic strength. Furthermore, self-reported outcomes, such as the International Knee Documentation Committee's (IKDC), 36-Item Short Form Health Survey (SF-36), and Tegner scale, will also be collected. Linear mixed-effects models will analyze outcomes, adjusting for meniscal repair status.</p><p><strong>Results: </strong>Upon completion, this study is expected to identify the most effective extra-articular technique for restoring knee stability and function, potentially guiding surgical decision-making. Our findings may optimize rehabilitation protocols and reduce reinjury rates in athletes.</p><p><strong>Conclusion: </strong>This protocol describes a comprehensive clinical trial that addresses important gaps in current knowledge regarding optimal surgical approaches for ACLR in athletes.</p>","PeriodicalId":21536,"journal":{"name":"Revista Brasileira de Ortopedia","volume":"61 1","pages":"s00461818613"},"PeriodicalIF":0.5,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}