Acta Ortopedica Brasileira最新文献

{"title":"PRECONDITIONING OF PORCINE FLEXOR TENDONS FOR APPLICATION IN RECONSTRUCTION OF HAND FLEXOR TENDONS.","authors":"Raquel Bernardelli Iamaguchi, Cesar Augusto Martins Pereira, Gustavo Bispo Dos Santos, Flavio Elias Santiago do Nascimento, Heitor Pereira Vale da Costa, Rames Mattar","doi":"10.1590/1413-785220253306e295649","DOIUrl":"10.1590/1413-785220253306e295649","url":null,"abstract":"<p><strong>Objective: </strong>In chronic hand flexor tendon reconstruction with tendon grafts, the challenge is to obtain the best resistance and tension of the suture that allows early active mobility. This experimental study of tension relaxation aims to investigate whether prior preconditioning of the tendon graft could assist to identify the ideal tendon graft tension in these reconstructions.</p><p><strong>Methods: </strong>The porcine flexor tendons were subjected to the tension relaxation test, with three test cycles each with up to 50 N of tension and relaxation for 300 seconds. Measured: maximum force (N), maximum tension (Mpa) and maximum deformation.</p><p><strong>Results: </strong>After the peak tension of 50 N, the following was observed: maximum deformation, with an average tendon elongation of 2.3 mm; average residual tendon elongation of 0.6 mm; demonstrating the viscoelastic spring characteristic of porcine tendons.</p><p><strong>Conclusion: </strong>We recommend performing intraoperative preconditioning of the tendon graft with loads close to active grip strength (50 N to 70 N). If it is impossible to perform preconditioning, the suture can be placed 17 degrees of flexion of the proximal interphalangeal joint above the cascade flexion of fingers, compensating for tendon elongation under a load of 50 N. <b><i>Level of Evidence III; Experimental</i></b> .</p>","PeriodicalId":55563,"journal":{"name":"Acta Ortopedica Brasileira","volume":"33 6","pages":"e295649"},"PeriodicalIF":0.6,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12599819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145497248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HAS THE AHLBÄCK CLASSIFICATION BEEN ACCURATELY DESCRIBED AND CITED?","authors":"Julio Cesar Gali, Igor Silva de Novais, Leonardo Altieri Carletti, Pedro Rinaldi Alves Cruz, Edie Benedito Caetano","doi":"10.1590/1413-785220253306e296115","DOIUrl":"10.1590/1413-785220253306e296115","url":null,"abstract":"<p><p>The classification of knee osteoarthritis allows assessment of disease severity and may be useful in guiding treatment decisions. One of the most widely used systems for this purpose is the Ahlbäck classification. This study aimed to compare the original description of the Ahlbäck classification with how it has been reported and cited by other authors in subsequent publications. We conducted a search in the PubMed, Embase, and Cochrane databases for articles containing exclusively the terms \"knee\", \"osteoarthritis\", \"osteoarthrosis\", and \"Ahlbäck classification\". After applying the inclusion and exclusion criteria, 64 articles remained. These articles were analyzed in two aspects: the description of the Ahlbäck classification (categorized as correct, partially correct, or incorrect) and the accuracy of the reference citation (correctly or incorrectly cited). Only 10 articles (15.6%) correctly described the Ahlbäck classification and cited the original source properly. In contrast, 37 publications (58.4%) contained errors both in the description of the classification and the citation. Conversely, 37 publications (58.4%) contained errors both in the description of the classification and in the bibliographic reference. The proportion of articles that accurately described and cited the Ahlbäck classification was markedly low, comprising only 15.6% of those included in this systematic review. <b><i>Level of Evidence III; Systematic Review</i></b> .</p>","PeriodicalId":55563,"journal":{"name":"Acta Ortopedica Brasileira","volume":"33 6","pages":"e296115"},"PeriodicalIF":0.6,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12599822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145497178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EFFECTS OF CALCIUM SUPPLEMENTATION ON THE RISK OF FRACTURE IN OLDER ADULTS.","authors":"Jianlei Li","doi":"10.1590/1413-785220253306e284103","DOIUrl":"10.1590/1413-785220253306e284103","url":null,"abstract":"<p><p>To explore the effect of calcium supplementation on the risk of fractures at various sites in older adults based on randomized controlled trials (RCTs). PubMed, Embase, and the Cochrane Library were systematically searched for eligible RCTs from their inception until May 2023. The included trials investigated the effect of calcium supplementation on the risk of fracture in individuals aged 50 years or above, regardless of the use or nonuse of vitamin D. The primary and secondary outcome measures were total, vertebral, nonvertebral, and hip fractures. Twenty-three RCTs involving 70,837 individuals were enrolled. Calcium supplementation demonstrated a significant reduction in the risk of total (RR: 0.93; 95% CI: 0.88-0.99; P=0.019) and nonvertebral (RR: 0.93; 95% CI: 0.87-0.99; P=0.023) fractures. No significant differences were observed in vertebral (RR: 0.87; 95% CI: 0.75-1.01; P=0.074) and hip (RR: 0.90; 95% CI: 0.73-1.12; P=0.355) fractures between calcium and placebo or no treatment. Calcium dose influenced total fracture risk (P=0.008), while history of fracture (P=0.044), calcium dose (P=0.041), and follow-up duration (P=0.031) affected nonvertebral fracture risk. Follow-up duration impacted hip fracture risk (P=0.001). Calcium supplementation can significantly affect the risk of fracture, particularly nonvertebral fractures, in older adults. <b><i>Level of Evidence I; Therapeutic Studies - Investigating the Results of Treatment</i>.</b></p>","PeriodicalId":55563,"journal":{"name":"Acta Ortopedica Brasileira","volume":"33 6","pages":"e284103"},"PeriodicalIF":0.6,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12599811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145497131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RISK FACTORS, PREVENTION, AND TREATMENT OF INFECTIONS RELATED TO TOTAL HIP ARTHROPLASTY: SYNTHESIS OF CLINICAL EVIDENCE.","authors":"Tiago Afonso Silva Abati, Marco Antonio Bononi, Rafael Costa Lima, Israel Scholtz Veiga","doi":"10.1590/1413-785220253306e290069","DOIUrl":"10.1590/1413-785220253306e290069","url":null,"abstract":"<p><p>Total hip arthroplasty (THA) is a complex surgery and is indicated for the treatment of degenerative diseases such as osteoarthritis, rheumatoid arthritis and osteonecrosis, as well as femoral neck fractures. This procedure aims to restore mobility, relieve pain and improve patients' quality of life. However, infections, especially periprosthetic joint infection (PJI), are serious complications that can compromise the success of the surgery. To identify risk factors, as well as methods of preventing and treating infections in THA. An integrative literature review was carried out, selecting clinical trials published in the last 10 years that addressed the proposed topic, using the following search strategy in the PUBMED database: hip[title] AND arthroplasty[title] AND infec*[title]. The analysis involved reading and discussing 12 articles, which addressed different aspects of infection prevention and management in THA. Although some interventions, such as collagen sponges with gentamicin and triclosan-coated sutures, have not significantly reduced the incidence of infections, others, such as closed incisional negative pressure therapy (ciNPWT) and washing with diluted betadine, have shown promise in certain contexts. Diagnostic accuracy, especially for coagulase-negative staphylococci, still presents challenges, highlighting the need for advances in diagnostic and therapeutic methods. Thus, despite advances, the prevention and management of infections in THA still require improvement, and interventions must be carefully evaluated to ensure the effectiveness and safety of the procedure. <b><i>Level of Evidence IV; Evidence from Descriptive (non-experimental) or Qualitative Studies</i></b> .</p>","PeriodicalId":55563,"journal":{"name":"Acta Ortopedica Brasileira","volume":"33 6","pages":"e290069"},"PeriodicalIF":0.6,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12599808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145497313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ASSESSMENT OF ISOMETRIC AND ISOKINETIC ANKLE STRENGTH MEASURES: A PILOT STUDY.","authors":"Carolina Lins, Andreza Ribeiro Batista DE Oliveira, Marina Squarizi Simões Chagas, Felippe Ribeiro, Alberto Cliquet, Rodrigo Gonçalves Pagnano","doi":"10.1590/1413-785220253302e288925","DOIUrl":"10.1590/1413-785220253302e288925","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate isometric and isokinetic ankle strength in of dorsiflexion (DF), plantar flexion (PF), inversion (INV), and eversion (EVE) in healthy individuals.</p><p><strong>Methods: </strong>A cross-sectional study was conducted with individuals aged 18 to 60 years, of both sexes. The Lafayette® isometric manual dynamometer was used to evaluate isometric strength, the Humac Norm® isokinetic dynamometer to evaluate isokinetic strength, and the IPAQ questionnaire (International Physical Activity Questionnaire) for the level of physical activity. Statistical analysis compared sex, dominance, and physical activity level with isometric and isokinetic strengths using the Spearman coefficient and the Mann-Whitney test.</p><p><strong>Results: </strong>There was a difference between genders for dominant and non-dominant limbs in isokinetic strength and not in isometric strength. There was a difference between isokinetic strength variables and physical activity levels. The isokinetic strength of dominant PF (p=0.0153), non-dominant (p=0.0287), and non-dominant INV (p=0.0183) demonstrated that very active individuals have a higher torque peak than irregularly active and sedentary individuals.</p><p><strong>Conclusion: </strong>The results demonstrated greater isokinetic strength in men than in women and active individuals compared to sedentary ones. However, it was not possible to establish an association between isometric and isokinetic ankle measurements. Level of Evidence IV, Cross-Sectional Study.</p>","PeriodicalId":55563,"journal":{"name":"Acta Ortopedica Brasileira","volume":"33 spe2","pages":"e288925"},"PeriodicalIF":0.6,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12517553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"REINFORCEMENT WITH THE LONG HEAD OF THE BICEPS TENDON IN LARGE AND MASSIVE REPAIRABLE ROTATOR CUFF TEARS: A PROSPECTIVE CASE SERIES.","authors":"Gustavo DE Mello Ribeiro Pinto, Cristiano Nabuco Dantas, Marcelo Costa DE Oliveira Campos, Jorge Henrique Assunção, Mauro Emilio Conforto Gracitelli, Eduardo Angeli Malavolta","doi":"10.1590/1413-785220253302e288796","DOIUrl":"10.1590/1413-785220253302e288796","url":null,"abstract":"<p><strong>Introduction: </strong>The treatment of large and massive rotator cuff tears remains challenging. This study evaluates the efficacy and safety of reinforcement with the long head of the biceps tendon (LHBT) in patients with large and massive repairable rotator cuff tears.</p><p><strong>Methods: </strong>This is a prospective case series involving 25 patients who underwent open repair of large and massive rotator cuff tears with LHBT reinforcement. All patients were operated by the same surgeon and followed up for one year.</p><p><strong>Results: </strong>Pain scores (VAS: 6.6 ± 2.30 vs. 2.68 ± 2.73; p<0.001) and function scores (ASES: 36.86 ± 19.27 vs. 73.96 ± 23.73; p<0.001; UCLA: 13.04 ± 3.83 vs. 26.04 ± 7.39; p<0.001) improved significantly postoperatively compared to preoperatively. The biceps healing rate was 84%, while the rotator cuff retear rate was 60%. No complications related to the biceps or surgical site infections were documented.</p><p><strong>Conclusion: </strong>Reinforcement with the long head of the biceps tendon in the repair of large and massive rotator cuff tears shows satisfactory clinical outcomes and a low complication rate. Level of Evidence: IV, Case Series.</p>","PeriodicalId":55563,"journal":{"name":"Acta Ortopedica Brasileira","volume":"33 spe2","pages":"e288796"},"PeriodicalIF":0.6,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12517554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SPONTANEOUS RUPTURE OF BAKER'S CYST - CASE SERIES.","authors":"Gilberto Luis Camanho, Riccardo Gomes Gobbi, Márcia Uchôa DE Rezende, Guilherme Pereira Ocampos","doi":"10.1590/1413-785220253302e290230","DOIUrl":"10.1590/1413-785220253302e290230","url":null,"abstract":"<p><strong>Objective: </strong>The presence of popliteal cysts is common, although often unkown to the patient. When spontaneous rupture occurs, the clinical presentation is typically dramatic, frequently prompting the patient to seek emergency care. Eventually the condition can be mistaken for other pathologies, more commonly deep vein thrombosis, leading to inappropriate treatment. The objective of this study is to describe a case series of spontaneous Baker's cyst ruptures, with a 2-year follow-up.</p><p><strong>Methods: </strong>Sixteen consecutive patients with symptomatic ruptured popliteal cyst were treated acutely with anti-inflammatory measures and physical therapy.</p><p><strong>Results: </strong>All patients had a good resolution of their cases with conservative treatment over an average period of one week, and there was no recurrence of cyst rupture.</p><p><strong>Conclusion: </strong>Spontaneous rupture of Baker's cyst in adult patients can be very symptomatic and disabling; however, once diagnosed, it responds well to conservative treatment and rarely recurs. Level of Evidence IV; Case Series.</p>","PeriodicalId":55563,"journal":{"name":"Acta Ortopedica Brasileira","volume":"33 spe2","pages":"e290230"},"PeriodicalIF":0.6,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12517548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PROFILE AND LEARNING CURVE OF BRAZILIAN SURGEONS REGARDING SHOULDER ARTHROSCOPY.","authors":"Guilherme Vieira Lima, Paulo Santoro Belangero, Renato Aroca Zan, Rafael Fuchs Lazarini, Bernardo Barcellos Terra, Marcelo Carvalho Krause Goncalves, Maria Isabel Pozzi Guerra, Lucas Braga Jacques Gonçalves, Marcio Diego Castro Teixeira, Sandro DA Silva Reginaldo, Luis Alfredo Gomez-Vieira","doi":"10.1590/1413-785220253302e288584","DOIUrl":"10.1590/1413-785220253302e288584","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study is to investigate the number of surgeries necessary for an orthopedic surgeon specialized in shoulder surgery to become proficient in performing arthroscopy. This is an original article with level V evidence.</p><p><strong>Methods: </strong>A cross-sectional study was designed to examine the perspectives of surgeons at various stages of their careers, using an online questionnaire.</p><p><strong>Results: </strong>A total of 251 participants responded. The most prevalent training period was more than 15 years of experience. The proficient level was the most prevalent. In evaluating the number of arthroscopies by proficiency level, all agreed that for the specialist level, a total of over 500 arthroscopies is necessary. Most respondents judged 31 to 50 arthroscopies as necessary to perform safely. According to the methodologies, the best-rated were acting as the lead surgeon and training on cadavers.</p><p><strong>Conclusion: </strong>The study showed that 31 to 50 cases are necessary to perform shoulder arthroscopy safely, and over 500 cases to reach the specialist level. Participation as the lead surgeon and training on cadavers were rated as very important in specialist training. Evidence Level V; Expert Opinion.</p>","PeriodicalId":55563,"journal":{"name":"Acta Ortopedica Brasileira","volume":"33 spe2","pages":"e288584"},"PeriodicalIF":0.6,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12517551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"APPLICATION OF ANTERIOR MINI-INCISION VERTEBROPLASTY IN CERVICAL METASTASES.","authors":"Guan Shi, Hao Chen, P U Jia, L I Bao, Fei Feng","doi":"10.1590/1413-785220253302e288709","DOIUrl":"10.1590/1413-785220253302e288709","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the efficacy and safety of anterior cervical mini-incision vertebroplasty in the treatment of vertebral metastases.</p><p><strong>Methods: </strong>From July 2009 to March 2013, seven cases of vertebral metastases were treated by using vertebroplasty through an anterior cervical paratracheal mini-incision guided by C-arm X-ray in Beijing friendship hospital, Capital medical university. Among them, three were male and four were female, aged 51 to 74 years with an average age of 61.7 years. Preoperative and postoperative Visual Analog Scale (VAS) scores and analgesic medication usage were evaluated, and postoperative pain relief was assessed using the World Health Organization (WHO) criteria.</p><p><strong>Results: </strong>All seven surgeries were successful without any occurrences of complications such as nerve or vascular injury, pulmonary embolism, or hematoma. The average cement injection volume was 1.8ml, and postoperative X-rays and CT scans indicated satisfactory cement filling, with two cases showing paravertebral cement leakage, but without clinical symptoms. One week postoperatively, the VAS score decreased from a preoperative average of 8.86 to 2.14, with complete pain relief in three cases, leading to the cessation of analgesic drugs, and partial pain relief in four cases, resulting in a reduction or downgrade of analgesic medications. Follow-ups ranged from 3 to 28 months, with one patient dying at 3 months postoperatively, one at 4 months, two at 6 months, one at 8 months, and one at 17 months, while one patient survived 28 months postoperatively. Postoperatively, all patients showed no worsening of local pain symptoms, and the surgical efficacy remained stable.</p><p><strong>Conclusion: </strong>Anterior cervical mini-incision vertebroplasty is a precise and effective method for pain relief in the treatment of vertebral metastases, providing a safe approach that reduces the risk of damaging critical cervical tissues during the puncture procedure and postoperative hematoma formation. Level of Evidence lll; Retrospective Study.</p>","PeriodicalId":55563,"journal":{"name":"Acta Ortopedica Brasileira","volume":"33 spe2","pages":"e288709"},"PeriodicalIF":0.6,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12517557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"OUTCOMES OF EARLY SURGICAL REPAIR OF THE KNEE EXTENSOR MECHANISM INJURY, COMPARING THE QUADRICEPS AND PATELLAR TENDON INJURIES: A PROSPECTIVE OBSERVATIONAL STUDY.","authors":"Vinícius Antônio Santos Aragão, João Victor Lacerda Belfort, Flavio DE Fava Sanches, Renan José Rigonato, Maria Adelaide DE Miranda Gonçalves, Marcos DE Camargo Leonhardt, Jorge Dos Santos Silva, Kodi Edson Kojima","doi":"10.1590/1413-785220253302e290211","DOIUrl":"10.1590/1413-785220253302e290211","url":null,"abstract":"<p><strong>Objectives: </strong>this study aimed to compare the radiographic, functional and isokinetic results of the early repair of quadriceps tendon rupture (QTR) and patellar tendon rupture (PTR).</p><p><strong>Methods: </strong>We conducted a prospective observational study at a level one urban university trauma center from January 2022 to March 2023. The study included patients aged 18 years and older who underwent surgery within three weeks of injury and had at least one year of follow-up. The evaluation used the patellar indices (Insall-Salvati, Blackburn Peel and Caton Deschamps), functional (Lysholm and PCS-12) and isokinetic assessment.</p><p><strong>Results: </strong>the study involved 20 patients, predominantly male, with a slight predominance of left-sided injuries. The mean age was 39.4 years. Surgical outcomes showed no significant radiographic differences post-repair. Functionally, the PTR group exhibited better recovery compared to the QTR group, particularly in returning to sports and work. Isokinetic testing revealed a substantial reduction in strength on the injured side compared to the uninjured side across both groups.</p><p><strong>Conclusion: </strong>early surgical intervention leads to favorable radiographic and functional outcomes. The PTR group showed better functional recovery, especially in return to work and sports. No significant differences were found in isokinetic strength recovery between the QTR and PTR groups. Level of Evidence III; Prospective Observational Study.</p>","PeriodicalId":55563,"journal":{"name":"Acta Ortopedica Brasileira","volume":"33 spe2","pages":"e290211"},"PeriodicalIF":0.6,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12517552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}