Navegando por Autor "Gontijo, Thiago de Carvalho"

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Perfil dos pacientes submetidos a revisão de artroplastia de quadril com reconstrução utilizando enxerto de banco de osso realizadas em um serviço de referência
(Faculdade Ciências Médicas de Minas Gerais, 2020-12-21) Gontijo, Thiago de Carvalho; Leopoldino, Amanda Aparecida Oliveira; Polese, Janaine Cunha
Background: The revision of total hip arthroplasty (RATQ) using a bone graft from a musculoskeletal tissue bank is a large, highly complex surgical procedure, with high costs, in a relatively restricted number of patients. Aims: To determine the epidemiological profile of patients undergoing RATQ, with bone graft from a tissue bank at a reference service. Material and methods: Observational cross-sectional study with the analyses of the medical records of patients undergoing the procedure from 2013 to 2019. As collections were made in medical records by two trained teachers, they were evaluated in an inter-examiner reliability analysis to ensure the reproducibility and safety of the collections. The initial data were collected from the sample by random selection of medical records and analyzed from the calculation of the Kappa index, for dichotomous variables, and by the Intraclass Correlation Coefficient for quantitative variables, which showed satisfactory reliability indexes. 36 variables were collected, such as quantitative data such as age, time between primary total arthroplasty (THA) and the review with use of bone allograft, previous surgeries, number of comorbidities and medications, length of stay in intensive care and hospital stay, blood transfusion, time from the first assessment to surgery and number of postoperative complications. In addition to variables such as sex, place of residence, presentation of the graft, previous complications, comorbidities, presence of contralateral THA, smoking, alcoholism, among others. In the treatment of the final data, descriptive statistics were used, in addition to the percentage to treat the variables in terms of frequency. Pearson's correlation coefficient was used to verify the correlations between the selected quantitative variables and the t test for comparison between groups. Results: 67 hips were analyzed, 53% men, with a mean age of 63.2 years, with 52.2% coming from the metropolitan region. More than half (53.7%) were hypertensive and only 10.4% were diabetic, with an average number of comorbidities of 1.16. Thirty-two patients (47.8%) had no history of RATQ. Loosening of the implants was the most common cause of surgery 89.6%. The average THA time and the revision evaluated were 178.4 months. They used ground graft in 66.7%. When comparing, those with the use of structured graft, in relation to the impacted ground graft, had a higher number of previous surgeries (p = 0.01) and a longer time elapsed between THA (p = 0.03). Conclusion: A sample of younger elderly patients was found, with few comorbidities, possibly with access to treatment facilitated by living in the metropolitan region. The time between the first prosthesis, and the number of procedures on the hip, showed a statistically positive difference in the group using structured grafts, generally used in larger bone defects, compared to the group using the crushed and impacted bone graft.