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Search Results: 1 - 10 of 71094 matches for " Carlos Roberto Schwartsmann "
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Carta do leitor
Carlos Roberto Schwartsmann
Revista Brasileira de Ortopedia , 2008, DOI: 10.1590/s0102-36162008001100008
Abstract:
Avalia??o da fun??o hepática em pacientes submetidos à artroplastia total do quadril em uso de enoxaparina
Wink, Felipe Vitiello;Schwartsmann, Carlos Roberto;
Revista Brasileira de Ortopedia , 2010, DOI: 10.1590/S0102-36162010000200007
Abstract: objective: to evaluate hepatic changes due to the use of enoxaparin for prophylaxis of deep vein thrombosis in patients submitted to total hip arthroplasty. methods: thirty two patients submitted to elective total hip arthroplasty, using enoxaparin, were followed up for 65 days with serial doses of hepatic enzymes. results: laboratory changes were found in up to 75% of patients during the study, which normalized after suspension of the treatment. no clinical evidence of hepatic lesion was found. conclusion: increase in hepatic enzymes levels occurs in most patients using enoxaparin, but without clinical relevance, and normalizes after suspension of the treatment.
Paralisia nervosa na artroplastia total do quadril
Schwartsmann, Carlos Roberto;Yepez, Antony Kerbes;
Revista Brasileira de Ortopedia , 2008, DOI: 10.1590/S0102-36162008000100001
Abstract: nerve palsy after total hip replacement is a rare complication (0.17% to 1%). this review of the literature on this topic reviews 50 relevant papers on the issue. the purpose of the review is to analyze pathophysiology, prevalence, etiology, risk factors, prognosis, and prevention of this complication.
Total Knee Arthroplasty: Patellar Replacement’s Influence in Patient Quality of Life Postoperatively  [PDF]
Carlos Roberto Schwartsmann, Gabriel Severo da Silva, Ivan Fadanelli Simionato, Flávia Magalh?es Nunes, Henrique Lammerhirt, Jo?o Pedro Farina Brunelli, Leandro de Freitas Spinelli
Open Journal of Orthopedics (OJO) , 2017, DOI: 10.4236/ojo.2017.78024
Abstract: Objective: To study the influence of patellar resurfacing on quality of life under a standardised score. The chosen score was the Knee Society Score (KSS), which considers range of motion, pain, contractors, alignment and stability. Methods: Retrospective review of 60 patients submitted to total knee arthroplasty (TKA) was divided into two groups: with patellar resurfacing (PR) and without patellar resurfacing (NPR). We reviewed data from these patients containing the KSS, which are routinely used in our service. Data were analysed from 2013 to 2014, with a minimal patient follow-up of 18 months. Results: There were no unsatisfactory scores in our study. Total scores (KSS) were similar between the groups (mean KSS: PR = 88.36 ± 9.64; NPR = 84.26 ± 9.44 [p = 0.1]). While stratifying into groups (poor, fair, good, excellent), we found excellent results in 84.8% of PR versus 59.3% NPR (p = 0.056). These data did not reach statistical significance and can therefore be considered a coincidental result. Conclusion: Although these results did not show statistical significance (p = 0.056), patellar resurfacing patients tend to get more “excellent” results after 18 months of follow-up in quality of life when evaluated by KSS. Perhaps a larger amount of patients would suffice to acquire statistical significance in a future study.
Clinical, Laboratory and Echografic Evaluation of Patients with Deep Vein Thrombosis Following Total Knee Arthroplasty  [PDF]
Carlos Roberto Schwartsmann, Mario Arthur Rockenbach Binz, Marco Tonding Ferreira, Felipe Roth, Ivan Fadanelli Simionato, Leandro de Freitas Spinelli, Jo?o Pedro Farina Brunelli
Open Journal of Orthopedics (OJO) , 2019, DOI: 10.4236/ojo.2019.92003
Abstract: Introduction: Total knee arthroplasty, being a major surgery, carries a risk of post-operative deep vein thrombosis (DVT). The main objective of the present study was to elucidate the association of clinical, laboratory, and echographic findings with the occurrence of DVT. Patients and Methods: The present study was prospective and non-randomized, with restricted exclusion criteria. Forty patients were submitted to total knee arthroplasty due to osteoarthritis. Patients were clinically evaluated by laboratory tests, assessment of pain and calf circumference, and the presence of Homans’ sign. Echo Doppler was performed in each patient on postoperative day 7. The echographic evaluation divided the patients into two groups: positive (G1) and negative for thrombosis (G2). All patients received prophylactic heparin during the 7-day hospital admission. Results: Eleven patients complained of pain (analgesic medication was used during the entire admission). Leg circumference variation from the pre-operative period to post-operative day 7 was: G1, 1.70 ± 1.12 cm and G2, 0.68 ± 1.25 cm (p = 0.03). Homans’ sign was considered positive in 10 patients. Echographic evaluation was positive in 11 patients (27.5%). No cases of pulmonary embolism, infection, or death were observed. Conclusions: The incidence of DVT was 27.5%, with an increase in leg circumference being the main predictive factor (p = 0.03).


Estudo comparativo entre rivaroxaban e enoxaparina na profilaxia de tromboembolismo venoso profundo em pacientes submetidos à artroplastia total do quadril
Kanan, Pedro Silva;Schwartsmann, Carlos Roberto;Boschin, Leonardo Carbonera;Conrad, Samuel;Silva, Marcelo Faria;
Revista Brasileira de Ortopedia , 2008, DOI: 10.1590/S0102-36162008000800002
Abstract: objective: to compare the effectiveness and safety of rivaroxaban to those of enoxaparin for the prophylaxis of deep venous thrombosis (dvt) after total hip arthroplasty. methods: from september 2006 to april 2007, at the orthopedics and traumatology clinic of the hospital complex of the santa casa of porto alegre, state of rio grande do sul, a randomized, double-blind clinical trial was carried out in which 67 patients were selected (n = 67), all of them submitted to total hip arthroplasty (atq). of these patients, two were excluded for lack of adherence to the prophylaxis proposed after hospital release (n = 65). one of the groups was given subcutaneous 40 mg enoxaparin 6 hours to 8 hours before surgery, and after surgery a placebo pill was added, for once a day oral intake, during the first 32 to 36 days. the other group was given oral 10 mg rivaroxaban, once a day, during the first 32 to 36 post-operative days. in order to have the double-blind feature of the study, a subcutaneous placebo injection was given 6 hours to 8 hours before surgery and on the 32 to 36 days following surgery. the main outcome aimed at was the effectiveness in preventing dvt, which was evaluated by bilateral venography carried out between days 32 and 36 after surgery, or through documented symptoms of deep venous thrombosis or pulmonary thromboembolism (pte). the secondary outcome studied was administration safety, that was evaluated through major bleeding or liver toxicity. results: rivaroxaban and enoxaparin showed similar results (the differences were not statistically significant) when compared for the reduction of dvt incidence till the 36th post-operative day. there was no difference in blood loss and liver toxicity when the drugs were compared. conclusion: in patients submitted to total hip arthroplasty, rivaroxaban showed as effective and safe as enoxaparin to prevent deep venous thrombosis and pulmonary thromboembolism.
Tempo de radia??o emitida por fluoroscopia em cirurgias ortopédicas
La Salvia, Jo?o Caron;Moraes, Pablo Reis de;Ammar, Tiago Yossef;Schwartsmann, Carlos Roberto;
Revista Brasileira de Ortopedia , 2011, DOI: 10.1590/S0102-36162011000200003
Abstract: objective: to ascertain the mean length of radiation emission from fluoroscopic devices during several types of orthopedic surgery and which of these required greater use of radiation. methods: the times taken to perform sixteen different types of surgery (total of 80 procedures) were measured. at the end of each procedure, the length of time for which fluoroscopy was used directly from the image intensifier was ascertained. results: the mean time required for fluoroscopy per operation was 61 seconds. the procedures that demanded greatest mean duration of radiation use were bilateral proximal femoral epiphysiodesis (5.1 minutes) and femoral shaft osteosynthesis using a locked intramedullary nail (3.33 min). conclusion: the mean duration of fluoroscopy use in orthopedic operations was 61 seconds. the procedures using an intramedullary device were the ones that required greatest radiation emission.
Compara o dos volumes ocupados pelos diferentes dispositivos de fixa o interna para fraturas do colo femoral Comparison of volumes occupied by different internal fixation devices for femoral neck fractures
Daniel Lauxen Junior,Carlos Roberto Schwartsmann,Marcelo Faria Silva,Leandro de Freitas Spinelli
Revista Brasileira de Ortopedia , 2012,
Abstract: OBJETIVO: Medir o volume ocupado pelos dispositivos de fixa o interna mais difundidos para o tratamento das fraturas de colo femoral, usando como aproxima o os primeiros 30, 40 e 50mm de cada parafuso. O estudo visa observar qual desses implantes causa menor agress o óssea. MéTODOS: Foram avaliados cinco modelos de parafusos canulados e quatro modelos de parafusos deslizantes (DHS) encontrados no mercado nacional através de diferen a de volume por deslocamento de água. RESULTADOS: A fixa o com dois parafusos canulados apresentou volume significativamente menor do que com DHS nas inser es de 30, 40 e 50mm (p=0,01, 0,012 e 0,013, respectivamente), a fixa o com três parafusos n o apresentou significancia estatística (p=0,123, 0,08 e 0,381, respectivamente) e a fixa o com quatro parafusos canulados apresenta volumes maiores que o DHS (p=0,072, 0,161 e 0,033). CONCLUS ES: A fixa o da cabe a femoral com dois parafusos canulados ocupa menor volume quando comparada ao DHS com diferen a estatisticamente significativa. A maioria das outras combina es de parafusos n o atingiram significancia estatística, apesar de a fixa o com quatro parafusos canulados apresentar, em média, volumes maiores que o ocupado pelo DHS. OBJECTIVE: The objective of this paper is to measure the volume occupied by the most widely used internal fixation devices for treating femoral neck fractures, using the first 30, 40 and 50 mm of insertion of each screw as an approximation. The study aimed to observe which of these implants caused least bone aggression. METHODS: Five types of cannulated screws and four types of dy namic hip screws (DHS) available on the Brazilian market were evaluated in terms of volume differences through water displace ment. RESULTS: Fixation with two cannulated screws presented significantly less volume than shown by DHS, for insertions of 30, 40 and 50 mm (p=0.01, 0.012 and 0.013, respectively), fixa tion with three screws did not show any statistically significant difference (p= 0.123, 0.08 and 0.381, respectively) and fixa tion with four cannulated screws presented larger volumes than shown by DHS (p=0.072, 0.161 and 0.033). CONCLUSIONS: Fixa tion of the femoral neck with two cannulated screws occupied less volume than DHS, with a statistically significant difference. The majority of screw combinations did not reach statistical significance, although fixation with four cannulated screws pre sented larger volumes on average than those occupied by DHS.
Novas superfícies em artroplastia total do quadril New bearing surfaces in total hip replacement
Carlos Roberto Schwartsmann,Leonardo Carbonera Boschin,Ramiro Zilles Gon?alves,Anthony Kerbes Yépez
Revista Brasileira de Ortopedia , 2012, DOI: 10.1590/s0102-36162012000200002
Abstract: A artroplastia total do quadril tem sido indicada cada vez mais em pacientes mais jovens e ativos, além de haver uma natural e crescente demanda do procedimento em fun o do aumento da expectativa de vida dos pacientes. Os altos custos da cirurgia e as controvérsias da performance dos implantes fazem deste assunto objeto de constantes pesquisas na busca de novos materiais com melhores resistências ao desgaste e biocompatibilidade. O presente artigo abrange um estudo de revis o das novas superfícies em artroplastia total do quadril. Total hip arthroplasty is being increasingly indicated for younger and more active patients, in addition to a naturally growing demand for the procedure because of increasing life expectancy among patients. The high costs of this surgery and the controversies regarding implant performance have made this topic the subject of constant research, seeking new materials with better resistance to wear and better biocompatibility. The present article provides a review of new surfaces in total hip arthroplasty.
Avalia??o da apresenta??o de sinais e sintomas de impacto femoroacetabular após epifisiólise do fêmur proximal
Krüger, Fábio Peng;Britto, Paulo Sérgio Gérzon de;Machado Neto, Lauro;Schwartsmann, Carlos Roberto;
Revista Brasileira de Ortopedia , 2011, DOI: 10.1590/S0102-36162011000200011
Abstract: objectives: in this study, we sought to evaluate whether there is any relationship between the degree of epiphysiolysis of the proximal femur (epf) and the presence of femoroacetabular impingement (fai). hip range of motion (rom) was also analyzed in relation to fai, and the literature on this topic was reviewed. methods: nineteen cases of epf in fifteen patients who had been treated surgically by means of in situ epiphysiodesis with a cannulated screw were evaluated. the mean follow-up was 27 months. the degree of epf was analyzed using the epimetaphyseal and neck-epiphyseal angles on lateral-view radiographs, the radiographic signs of fai on anteroposterior-view radiographs, clinic symptoms and hip rom. results: it was found that the degree of epf (through the epimetaphyseal angle) presented a statistically significant inverse relationship with the presence of fai over the mean follow-up period of this study. in other words, the patients with symptoms of fai presented lesser degrees of slippage. this can be explained by the fact that the types of impingement that occurs in cases of epf (i.e. cam impaction or inclusion) depends on the degree of slippage, and these present different clinical forms and chronology. the rom did not present any relationship with fai. conclusion: there is a relationship between the degree of slippage and the presence of clinical-radiological fai after epf.
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