Browsing by Author "Vieira da Silva, M"
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- Benefits of radial distortion correction in arthroscopic surgery: a first experimental study on a knee modelPublication . Duarte, RM; Ferre, NV; Oliveira, AM; Fonseca, FP; Vieira da Silva, M; Correia-Pinto, JBACKGROUND: Lens probes used in arthroscopy typically have a small diameter and wide field-of-view. This introduces strong radial distortion (RD) into the image, ultimately affecting the surgeon's hand-eye coordination. This study evaluates potential benefits of using distortion-free images in arthroscopic surgery. METHODS: Distortion-free images were obtained using RDFixer™ software (Perceive3D, SA) to remove RD in the input video stream. Twelve orthopedic residents performed an arthroscopic task (loose body removal) in a dry-knee model using video with and without distortion. Residents were questioned about image quality, and surgical performance was rated using an adapted Global Rating Scale. RESULTS: A statistically significant improvement of all parameters was observed with distortion-free images. Residents perceived distortion-free images as providing a wider field-of-view and a better notion of relative depth and distance. CONCLUSION: RD correction improved the surgical performance of residents, potentially decreasing their learning curve. Future work will study whether the benefits are observable in experienced surgeons.
- Giant knee “ganglion”—a case reportPublication . Ferreira, NV; Carriço, FL; Pereira, B; Duarte, R; Maia, R; Sevivas, N; Fidalgo, R; Vieira da Silva, M
- Metacarpal solitary osteochondroma—case report of a rare conditionPublication . Duarte, RM; Ferreira, NV; Silva, LM; Rodrigues, LF; Ribeiro, JM; Vieira da Silva, M
- Neuropatia compressiva do nervo supraescapularPublication . Vieira-Ferreira, N; Sevivas, N; Vieira da Silva, MIntrodução: a neuropatia compressiva do nervo supraescapular foi descrita pela primeira vez em 1952 mas só recentemente tem sido mais compreendida e diagnosticada. A sua etiologia nem sempre é clara e o seu diagnóstico ainda não está bem estabelecido. O tratamento é controverso, especialmente a opção pela libertação artroscópica. Esta técnica tem sido cada vez mais utilizada mas, apesar dos bons resultados relatados, não encontramos na literatura qualquer análise sistematizada dos resultados clínicos desta técnica. Pretendeu-se com este trabalho efetuar uma revisão teórica do tema e uma análise detalhada dos resultados do tratamento artroscópico, procurando as indicações mais apropriadas para esta técnica. Material e Métodos: pesquisa efetuada em 6 bases de dados disponíveis na Internet utilizando as expressões: “suprascapular nerve”, “arthroscopic”, “release” e “decompression”. Efetuada revisão sistemática da literatura encontrada e uma síntese narrativa. Síntese de dados e conclusão. A neuropatia compressiva do nervo supraescapular é atualmente uma entidade nosológica bem estabelecida e cada vez melhor compreendida. Integra o diagnóstico diferencial da patologia da cintura escapular, sobretudo em doentes jovens, atletas ou no contexto de roturas da coifa. O tratamento cirúrgico está indicado na falência do tratamento conservador sendo a libertação artroscópica do nervo uma técnica em expansão. Está indicada em doentes com omalgia posterior, diminuição da força do supraespinhoso e infraespinhoso ou apenas do infraespinhoso, com ou sem alterações electromiográficas. O resultado das pequenas series publicadas até ao momento é encorajador pois parece proporcionar resultados clínicos positivos consistentes, constituindo um tratamento válido para a neuropatia compressiva do nervo supraescapular
- Osteochondral transplantation using autografts from the upper tibio-fibular joint for the treatment of knee cartilage lesionsPublication . Espregueira-Mendes, J; Pereira, H; Sevivas, N; Varanda, P; Vieira da Silva, M; Monteiro, A; Oliveira, JM; Reis, RLPURPOSE: Treatment of large cartilage lesions of the knee in weight-bearing areas is still a controversy and challenging topic. Autologous osteochondral mosaicplasty has proven to be a valid option for treatment but donor site morbidity with most frequently used autografts remains a source of concern. This study aims to assess clinical results and safety profile of autologous osteochondral graft from the upper tibio-fibular joint applied to reconstruct symptomatic osteochondral lesions of the knee. METHODS: Thirty-one patients (22 men and 9 women) with grade 4 cartilage lesions in the knee were operated by mosaicplasty technique using autologous osteochondral graft from the upper tibio-fibular joint, between 1998 and 2006. Clinical assessment included visual analog scale (VAS) for pain and Lysholm score. All patients were evaluated by MRI pre- and post-operatively regarding joint congruency as good, fair (inferior to 1 mm incongruence), and poor (incongruence higher than 1 mm registered in any frame). Donor zone status was evaluated according to specific protocol considering upper tibio-fibular joint instability, pain, neurological complications, lateral collateral ligament insufficiency, or ankle complaints. RESULTS: Mean age at surgery was 30.1 years (SD 12.2). In respect to lesion sites, 22 were located in weight-bearing area of medial femoral condyle, 7 in lateral femoral condyle, 1 in trochlea, and 1 in patella. Mean follow-up was 110.1 months (SD 23.2). Mean area of lesion was 3.3 cm2 (SD 1.7), and a variable number of cylinders were used, mean 2.5 (SD 1.3). Mean VAS score improved from 47.1 (SD 10.1) to 20.0 (SD 11.5); p = 0.00. Similarly, mean Lysholm score increased from 45.7 (SD 4.5) to 85.3 (SD 7.0); p = 0.00. The level of patient satisfaction was evaluated, and 28 patients declared to be satisfied/very satisfied and would do surgery again, while 3 declared as unsatisfied with the procedure and would not submit to surgery again. These three patients had lower clinical scores and kept complaints related to the original problem but unrelated to donor zone. MRI score significantly improved at 18-24 months comparing with pre-operative (p = 0.004). No radiographic or clinical complications related to donor zone with implication in activity were registered. CONCLUSIONS: This work corroborates that mosaicplasty technique using autologous osteochondral graft from the upper tibio-fibular joint is effective to treat osteochondral defects in the knee joint. No relevant complications related to donor zone were registered.
- Técnica Transfisária Parcial para Plastia do Ligamento Cruzado Anterior em Idade PediátricaPublication . Vieira da Silva, M; Duarte, RMWith more and more children participating in competitive sports at younger and younger ages, we have seen an increase in the incidence and diagnosis of intrasubstance ruptures of the anterior cruciate ligament. As in adults, the instability of the ligaments predisposes children to a potential risk of meniscos and chondral injuries with consequent early degenerative alterations. The timely treatment of these injuries is crucial and the surgical technique depends directly on the patient’s physiological age. The authors present a clinical case of the complete rupture of the anterior cruciate ligament in a skeletally immature child, surgically treated by a partial transphyseal technique, with an excellent functional result.