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1.
Unfallchirurg ; 123(Suppl 1): 25-28, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31960086

RESUMO

A small portion of patients suffer from severe knee pain following previous knee surgery or a trauma. Awareness among traumatologists regarding a neuropathic origin of this persistent knee pain is poor. Ongoing pain close to the knee may be caused by damage of the infrapatellar nerve (IN). This branch of the saphenous nerve is purely sensory and is at risk for iatrogenic damage due to its superficial medial course. Once recognized using simple tests during physical examination, a variety of treatment modalities may be proposed. However, a standard treatment algorithm was hitherto absent. This study includes 15 patients having IN damage who were offered a step-up regimen including lidocaine injections, pulsed radiofrequency (PRF) or neurectomy. Success (>50% drop in numeric rating scale pain score) was attained in 11 (73% success rate, 9 month median follow-up). The aim of this contribution is to increase knowledge regarding this illusive entity and to discuss the efficacy of our treatment protocol.


Assuntos
Articulação do Joelho , Dor , Denervação , Humanos , Medição da Dor , Resultado do Tratamento
2.
Cancer Immunol Immunother ; 69(2): 307-314, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31912230

RESUMO

Sensory nerves sensitive to capsaicin are afferent nerve fibers which contain TRPV1 channels. Activation of these channels induces release of neuropeptides which regulate local blood flow and immune response. Inactivation of sensory neurons either with high-dose capsaicin treatment or local ablation of vagal sensory nerve activity markedly increases metastasis of breast carcinoma formed by 4T1 derivative cells. These cancer cells also induce an extensive systemic inflammatory response. Further findings have documented that lack of local sensory neuromediators alters phenotype of cancer cells within primary tumor leading to overgrowth of metastatic subsets. This might be due to decreases in local and systemic immune response to growing tumor. Specifically, Substance P, one of the most abundant sensory neuropeptides, enhances anti-tumoral immune response evoked by radiotherapy under in vivo conditions. These findings further suggest that activation of TRPV1 channels on sensory neurons may induce an anti-tumoral immune response. We are testing this hypothesis. Our initial results as reported here demonstrate anti-inflammatory consequences of low-dose systemic capsaicin treatment. In conclusion, sensory nerve fibers sensitive to capsaicin have important roles in defense against metastatic breast carcinoma; hence, controlled activation of these neural pathways might be effective in cancer therapy. Specifically, activation of sensory fibers of left vagus nerve using a perineuronal stimulation may inhibit metastasis of breast carcinoma. Likewise, pharmacological modulators of TRPV1 channels may induce anti-tumoral immune response. Exact players of this newly explored defense system are, however, only partly validated, and further studies are required.


Assuntos
Neoplasias da Mama/etiologia , Neoplasias da Mama/metabolismo , Neuroimunomodulação , Células Receptoras Sensoriais/metabolismo , Canais de Cátion TRPV/metabolismo , Animais , Neoplasias da Mama/patologia , Neoplasias da Mama/terapia , Denervação , Modelos Animais de Doenças , Feminino , Humanos , Camundongos , Metástase Neoplásica , Fenótipo , Radioterapia
5.
Adv Clin Exp Med ; 28(11): 1525-1530, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31693316

RESUMO

BACKGROUND: With emerging new therapeutic concepts including renal denervation (RDN), there is a renewed interest in resistant hypertension (ResH). Among patients suspected of having ResH, a definitive diagnosis needs to be established. OBJECTIVES: This study presents observations from a standardized single-center screening program for RDN candidates, including medical therapy modification and reassessment. MATERIAL AND METHODS: All patients referred to our center for RDN underwent a standardized screening protocol. Candidates were recruited from among patients receiving no less than 3 antihypertensive drugs, including diuretics with office blood pressure (BP) >140/90 mm Hg. The assessment included 2 measurements of BP and ambulatory BP monitoring (ABPM). If needed, pharmacotherapy was intensified and the diagnosis of ResH was reconfirmed after 6 weeks. If ResH was persistent, patients were hospitalized with repeated ABPM on day 4. Further, renal CT-angio was performed and a multidisciplinary team discussed the patients' suitability for RDN. RESULTS: A total of 87 patients with a ResH diagnosis were referred for RDN. Mean office BP was 159/92 (±7.0/6.5) mm Hg and mean ABPM was 154/90 (±9.0/4.8) mm Hg. The initial medication included angiotensin convertase inhibitors (ACE-I, 78%), angiotensin receptor blockers (12%), ß-blockers (85%), calcium channel blockers (36%), and diuretics (93%). During the 18 months of the RDN program, 5 patients underwent RDN and 2 further had ineligible renal anatomy. A new diagnosis of secondary hypertension was made in 21 patients. However, in 59 patients, BP control was achieved after optimization of medical therapy, with a mean ABPM of 124/74 mm Hg. The final treatment included ACE-I (100%), ß-blockers (92%), indapamide (94%), amlodipine (72%), and spironolactone (61%). Medication in most of these patients (88%) included single-pill triple combination (52.5%) or double combination (35.6%). CONCLUSIONS: Patients with elevated BP screened for RDN require a rigorous diagnostic workup. Up to 2/3 of patients can be managed with strict pharmacotherapy compliance and pharmaceutical intensification, including single-pill combinations and improved drug compliance. Hasty use of RDN may be a result of poor drug optimization and/or compliance. It does remain a viable treatment option in thoroughly vetted ResH patients.


Assuntos
Denervação , Hipertensão/cirurgia , Farmacovigilância , Artéria Renal/cirurgia , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea , Monitorização Ambulatorial da Pressão Arterial , Humanos , Hipertensão/tratamento farmacológico , Rim/inervação , Rim/cirurgia , Artéria Renal/inervação , Simpatectomia , Resultado do Tratamento
6.
Unfallchirurg ; 122(11): 860-863, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31712851

RESUMO

A small portion of patients suffer from severe knee pain following previous knee surgery or a trauma. Awareness among traumatologists regarding a neuropathic origin of this persistent knee pain is poor. Ongoing pain close to the knee may be caused by damage of the infrapatellar nerve (IN). This branch of the saphenous nerve is purely sensory and is at risk for iatrogenic damage due to its superficial medial course. Once recognized using simple tests during physical examination, a variety of treatment modalities may be proposed. However, a standard treatment algorithm was hitherto absent. This study includes 15 patients having IN damage who were offered a step-up regimen including lidocaine injections, pulsed radiofrequency (PRF) or neurectomy. Success (>50% drop in numeric rating scale pain score) was attained in 11 (73% success rate, 9 month median follow-up). The aim of this contribution is to increase knowledge regarding this illusive entity and to discuss the efficacy of our treatment protocol.


Assuntos
Nervo Femoral/lesões , Dor/etiologia , Traumatismos dos Nervos Periféricos/terapia , Denervação , Humanos , Perna (Membro)/inervação , Dor/diagnóstico , Manejo da Dor , Medição da Dor , Traumatismos dos Nervos Periféricos/etiologia , Resultado do Tratamento
7.
Urology ; 134: 237-242, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31539508

RESUMO

OBJECTIVE: To determine if targeted and modulated radiofrequency ablation (RFA) of the urinary bladder using our novel ablation device (Denerblate) reduces bladder nerve density, potentially leading to a novel strategy for the management of overactive bladder. METHODS: Fifteen pigs were divided into 4 groups: control (n = 3), 1-week (n = 4), 4-week (n = 4) and 12-week (n = 4) survival times. Denerblate was deployed on the trigone area of the bladder. Three 240-second cycles of modulated RFA were applied with 30 seconds between cycles. At the end of each survival term, urinary bladders were harvested for histopathologic evaluation. Nerve count and density were manually calculated. RESULTS: All procedures were successfully completed, and all animals survived to the desired time points. Mean nerve density (nerves/mm2) was highest in the control and 1-week survival group compared to the 4-week and 12-week groups, both of which demonstrated significant diminishment. Nerve density in the bladder neck at control, 1 week, 4 weeks, and 12 weeks were 1.8, 1.35, 0.87, and 0.12, respectively (P <.001). Nerve density in the bladder trigone area at control, 1 week, 4 weeks, and 12 weeks were 1.5, 0.98, 0.65, and 0.112, respectively (P <.001). Epithelial heat injury was observed in 14.3% at 1 week, 10.7% at 4 weeks, but completely resolved by 12 weeks. CONCLUSION: In the porcine model, modulated RFA delivered by our novel device reduced nerve density in the bladder neck and trigone by 88.6% and 88.9% at 12 weeks without evidence of lasting epithelial injury.


Assuntos
Denervação/instrumentação , Ablação por Radiofrequência/instrumentação , Bexiga Urinária/inervação , Animais , Modelos Animais , Suínos , Bexiga Urinária Hiperativa/cirurgia
8.
Acta Cir Bras ; 34(7): e201900705, 2019 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-31531527

RESUMO

PURPOSE: The denervation of the intestine with benzalkonium chloride (BAC) reduces mortality and improves weight gain in rats with short bowel syndrome (SBS). Nevertheless, translating these promising findings from bench to bedside is not feasible because BAC promotes peritonitis and irreversible denervation which may be followed by an uncontrolled dilatation of the viscera. The use of botulinum toxin (BT) instead of BAC to achieve the denervation of the remaining small intestine in SBS could be an interesting option because it leads to a mild and transient denervation of the intestine. METHODS: Here we evaluated the effects of the ileal denervation with BT in rats with SBS by verifying the body weight variation and intestinal morphological parameters. Four groups with 6 animals each were submitted to enterectomy with an ileal injection of saline (group E) or BT (group EBT). Control groups were submitted to simulated surgery with an ileal injection of BT (group BT) or saline (group C - control). RESULTS: We observed that the treatment of the remaining ileum with BT completely reversed the weight loss associated to extensive small bowel resection. CONCLUSION: This may provide a new promising approach to the surgical treatment of SBS.


Assuntos
Toxinas Botulínicas/farmacologia , Denervação/métodos , Íleo/inervação , Síndrome do Intestino Curto/cirurgia , Animais , Compostos de Benzalcônio/farmacologia , Peso Corporal/efeitos dos fármacos , Modelos Animais de Doenças , Íleo/patologia , Jejuno/inervação , Debilidade Muscular/patologia , Ratos , Ratos Wistar , Síndrome do Intestino Curto/patologia
10.
Mayo Clin Proc ; 94(9): 1665-1667, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31402055
11.
Invest Ophthalmol Vis Sci ; 60(10): 3538-3546, 2019 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-31415077

RESUMO

Purpose: To determine if trigeminal innervations of the corneal epithelium maintains its integrity and homeostasis through controlling the nicotinamide adenine dinucleotide (NAD) content of this tissue. Methods: Corneal denervation of C57BL/6 mice was induced by squeezing the nerve bundles that derive from the trigeminal ganglion and was confirmed by whole-mount corneal nerve staining and the sensation test. The apoptosis of the corneal epithelium was examined by TUNEL assay and annexin V/propidium iodide staining. NAD biosynthesis-related enzymes were analyzed by quantitative PCR, immunofluorescence staining, and Western blotting. FK866, an inhibitor of nicotinamide phosphoribosyltransferase (NAMPT), exogenous nicotinamide mononucleotide (NMN), and NAD+ were used to evaluate the effect of NAD+ on the apoptosis of cultured corneal epithelial cells and epithelial detachment in denervated mice. Protein expression that related to apoptosis and phosphorylation were analyzed by Western blotting. Results: The denervated mice showed spontaneous corneal epithelial detachment and cell apoptosis accompanied with impaired epithelial NAD+ contents due to low levels of NAMPT. Similarly, inhibition of NAMPT recapitulated epithelial detachment as in denervated mice and induced apoptosis in cultured corneal epithelial cells. The replenishment of NMN or NAD+ partially slowed down corneal nerve fiber degeneration, reduced the epithelial defect in denervated mice, and improved apoptosis induction in FK866-treated cells by restoring the activation levels of SIRT1, AKT, and CREB. Conclusions: Corneal denervation lowered epithelial NAD+ contents through reducing the expression of NAMPT and caused cell apoptosis and epithelial defects, suggesting that corneal innervations contribute to epithelial homeostasis by regulating NAD+ biosynthesis.


Assuntos
Apoptose , Córnea/inervação , Denervação , Epitélio Anterior/patologia , NAD/metabolismo , Nervo Trigêmeo/fisiologia , Animais , Anexina A5/metabolismo , Western Blotting , Proteína de Ligação a CREB/metabolismo , Córnea/metabolismo , Doenças da Córnea/diagnóstico , Doenças da Córnea/metabolismo , Epitélio Anterior/metabolismo , Técnica Indireta de Fluorescência para Anticorpo , Marcação In Situ das Extremidades Cortadas , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Proteínas Proto-Oncogênicas c-akt/metabolismo , Proteínas Proto-Oncogênicas c-bcl-2/metabolismo , Reação em Cadeia da Polimerase em Tempo Real , Sirtuína 1/metabolismo , Doenças do Nervo Trigêmeo/diagnóstico , Doenças do Nervo Trigêmeo/metabolismo , Proteína X Associada a bcl-2/metabolismo
12.
Hypertension ; 74(3): 493-494, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31327273

Assuntos
Rim , Animais , Denervação , Cães
13.
Kidney Blood Press Res ; 44(4): 628-642, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31291627

RESUMO

BACKGROUND/AIMS: Catheter-based renal denervation (RDN) has emerged as an innovative interventional approach for reducing blood pressure (BP), suppressing ventricular substrate remodeling, and attenuating heart failure, which suggests that it might reduce kidney fibrosis in a canine model of high-fat diet-induced hypertension. This study thus sought to assess whether RDN could reduce kidney fibrosis and halt the progression of renal impairment in a canine model of high-fat diet-induced hypertension. METHODS: Thirty-two beagles were randomized into either the normal control group (normal diet, n = 10) or the hypertension group (high-fat diet, n = 22). After successful establishment of the model, the hypertension model group was randomized to either the RDN group (n = 9) or the sham-surgery group (n = 8). Renal artery angiography, BP, heart rate (HR), and blood and urine biochemistry results were assessed at 1, 3, and 6 months after surgery. Canines were sacrificed at 6 months after surgery. The extent of kidney interstitial fibrosis, transforming growth factor-beta 1, alpha-smooth muscle actin, connective tissue growth factor, and E-cadherin protein were measured. RESULTS: The group fed a high-fat diet had significantly (p ˂ 0.05) increased body weight, BP, and HR and higher levels of urine albumin, serum noradrenaline (NE), and angiotensin II (AngII) than the control group. The sham-surgery group and RDN group also had higher levels than the control group (p ˂ 0.05). Compared with the sham-surgery group, the RDN group had lower BP, urine albumin, serum NE, and AngII and less fibrotic tissue (all p ˂ 0.05). CONCLUSION: RDN reduced BP, slowed progression of albuminuria, and suppressed renal remodeling in a canine model of high-fat diet-induced hypertension.


Assuntos
Denervação/métodos , Dieta Hiperlipídica/efeitos adversos , Fibrose/prevenção & controle , Hipertensão/etiologia , Nefropatias/patologia , Rim/cirurgia , Albuminúria , Animais , Pressão Sanguínea , Cães , Frequência Cardíaca , Rim/patologia , Nefropatias/cirurgia
14.
Nat Neurosci ; 22(8): 1289-1305, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31285612

RESUMO

The effects of autonomic innervation of tumors on tumor growth remain unclear. Here we developed a series of genetic techniques to manipulate autonomic innervation in a tumor- and fiber-type-specific manner in mice with human breast cancer xenografts and in rats with chemically induced breast tumors. Breast cancer growth and progression were accelerated following stimulation of sympathetic nerves in tumors, but were reduced following stimulation of parasympathetic nerves. Tumor-specific sympathetic denervation suppressed tumor growth and downregulated the expression of immune checkpoint molecules (programed death-1 (PD-1), programed death ligand-1 (PD-L1), and FOXP3) to a greater extent than with pharmacological α- or ß-adrenergic receptor blockers. Genetically induced simulation of parasympathetic innervation of tumors decreased PD-1 and PD-L1 expression. In humans, a retrospective analysis of breast cancer specimens from 29 patients revealed that increased sympathetic and decreased parasympathetic nerve density in tumors were associated with poor clinical outcomes and correlated with higher expression of immune checkpoint molecules. These findings suggest that autonomic innervation of tumors regulates breast cancer progression.


Assuntos
Fibras Autônomas Pré-Ganglionares/patologia , Neoplasias da Mama/patologia , Antagonistas Adrenérgicos/farmacologia , Animais , Antígeno B7-H1/genética , Denervação , Progressão da Doença , Feminino , Fatores de Transcrição Forkhead/genética , Xenoenxertos , Humanos , Camundongos , Camundongos Endogâmicos BALB C , Transplante de Neoplasias , Sistema Nervoso Parassimpático/patologia , Receptor de Morte Celular Programada 1/genética , Ratos , Estudos Retrospectivos , Estresse Psicológico/psicologia , Sistema Nervoso Simpático/patologia
15.
Medicine (Baltimore) ; 98(26): e16230, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31261580

RESUMO

BACKGROUND: Effective treatment of low back pain (LBP) originating in the lumbar and sacroiliac joints is difficult to achieve. The objective of the current study was to compare the clinical effectiveness of radiofrequency (RF) neurotomy versus conservative nonsurgical approaches for the management of chronic lumbar and sacroiliac joint pain. METHODS: The PICOS framework was adhered to (P [population]: patients with a history of chronic function-limiting lumbar and sacroiliac joint pain lasting at least 6 months; I [intervention]: RF neurotomy; C [comparator]: other nonsurgical treatments; O [outcomes]: the Oswestry Disability Index (ODI), measurement for pain, and a quality of life (QoL) questionnaire; S [study design]: meta-analysis). Two trained investigators systematically searched Medline, Cochrane, EMBASE, and ISI Web of Knowledge databases for relevant studies published in English through March 2019. RESULTS: Patients treated with RF neurotomy (n = 528) had significantly greater improvement in ODI scores, pain scores and QoL measured by EQ-5D compared with controls (n = 457); however, significant heterogeneity was observed when data were pooled from eligible studies. In subgroup analyses, patients who received RF neurotomy had a significantly greater improvement in ODI scores compared with those with sham treatment. Patients treated with RF achieved significantly greater improvement in pain scores compared with controls who received sham treatment or medical treatment. In a subgroup analysis of pain in the sacroiliac joint and in lumbar facet joints, the RF neurotomy group achieved a significantly greater improvement in ODI score and pain scores compared with the control group. The ODI score and pain score were improved after 2 months of follow up in the analyses stratified by follow-up duration. CONCLUSIONS: Use of RF neurotomy as an intervention for chronic lumbar and sacroiliac joint pain led to improved function; however, larger, more directly comparable studies are needed to confirm this study's findings.


Assuntos
Artralgia/terapia , Dor Crônica/terapia , Tratamento Conservador , Denervação , Dor Lombar/terapia , Articulação Sacroilíaca , Humanos , Resultado do Tratamento
16.
Einstein (Sao Paulo) ; 17(3): eAO4489, 2019 Jun 27.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31271607

RESUMO

OBJECTIVE: To analyze the anatomical variations of the innervation of the flexor digitorum superficialis muscle and to determine if the branch of the median nerve that supply this muscle is connected to the branches to the extensor carpi radialis brevis and the pronator teres muscles, without tension, and how close to the target-muscles the transfer can be performed. METHODS: Fifty limbs of 25 cadavers were dissected to collect data on the anatomical variations of the branches to the flexor digitorum superficialis muscle. RESULTS: This muscle received innervation from the median nerve in the 50 limbs. In 22 it received one branch, and in 28 more than one. The proximal branch was identified in 22 limbs, and in 12 limbs it shared branches with other muscles. The distal branch was present in all, and originated from the median nerve as an isolated branch, or a common trunk with the anterior interosseous nerve in 3 limbs, and from a common trunk with the flexor carpi radialis muscle and anterior interosseous nerve in another. It originated distally to the anterior interosseous nerve at 38, in 5 on the same level, and in 3 proximal to the anterior interosseous nerve. In four limbs, innervation came from the anterior interosseous nerve, as well as from the median nerve. Accessory branches of the median nerve for the distal portion of the flexor digitorum superficialis muscle were present in eight limbs. CONCLUSION: In 28 limbs with two or more branches, one of them could be connected to the branches to the extensor carpi radialis brevis and pronator teres muscles without tension, even during the pronation and supination movements of the forearm and flexion-extension of the elbow.


Assuntos
Denervação/métodos , Dedos/inervação , Antebraço/inervação , Nervo Mediano/anatomia & histologia , Músculo Esquelético/inervação , Punho/inervação , Adulto , Cadáver , Dissecação , Dedos/cirurgia , Humanos , Masculino , Nervo Mediano/cirurgia , Músculo Esquelético/cirurgia , Tendões
17.
Cardiovasc Intervent Radiol ; 42(9): 1363-1365, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31187230

RESUMO

The sacroiliac joint is the culprit in 15-30% of patients with chronic lumbar back pain. Ablation of the posterior sensory nerves supplying the joint is an established treatment option before arthrodesis. We report the successful application of MR-HIFU in a patient with therapy-refractory pain using the Sonalleve MR-HIFU system. The outpatient procedure was performed under spinal anaesthesia and analgosedation. The ramus dorsalis of L5 as well as the lateral branches of the ramus dorsalis S1-S3 was targeted, and tissue peak temperature per sonication was controlled using MR-thermometry. There were no post-interventional complications. Clinical improvement began 4 days post-intervention with complete resolution of the pain after 1 month.


Assuntos
Ablação por Ultrassom Focalizado de Alta Intensidade/métodos , Dor Lombar/cirurgia , Imagem por Ressonância Magnética Intervencionista/métodos , Articulação Sacroilíaca/cirurgia , Idoso , Denervação/métodos , Feminino , Humanos , Articulação Sacroilíaca/inervação
19.
Plast Reconstr Surg ; 144(1): 48e-57e, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31246816

RESUMO

BACKGROUND: The purpose of this study was to assess the efficacy of biodegradable, electrospun poly(ε-caprolactone) nanofiber nerve conduits in improving nerve regeneration. METHODS: The authors used a rat forelimb chronic denervation model to assess the effects of poly(ε-caprolactone) conduits on improving nerve regeneration and upper extremity function. Three groups of rats were examined: (1) negative-control animals (n = 5), which underwent 8 weeks of median nerve chronic denervation injury followed by repair with no conduit; (2) experimental animals (n = 5), which underwent 8 weeks of median nerve chronic denervation followed by repair and poly(ε-caprolactone) nerve conduit wrapping of the nerve coaptation site; and (3) positive-control animals (n = 5), which were naive controls. All animals underwent compound muscle action potential and functional testing. At 14 weeks after repair, the median nerve and flexor muscles were harvested for histologic analysis. RESULTS: Histomorphometric analysis of regenerating median nerves demonstrated augmented axonal regeneration in experimental versus negative control animals (total axon count, 1769 ± 672 versus 1072 ± 123.80; p = 0.0468). With regard to functional recovery, experimental and negative-control animals (1.67 ± 0.04 versus 0.97 ± 0.39; p = 0.036) had regained 34.9 percent and 25.4 percent, respectively, of baseline hand grip strength at 14 weeks after repair. Lastly, less collagen deposition at the nerve coaptation site of experimental animals was found when compared to control animals (p < 0.05). CONCLUSION: Biodegradable, poly(ε-caprolactone) nanofiber nerve conduits can improve nerve regeneration and subsequent physiologic extremity function in the setting of delayed nerve repair by decreasing the scar burden at nerve coaptation sites.


Assuntos
Neuropatia Mediana/cirurgia , Nanofibras/uso terapêutico , Regeneração Nervosa/fisiologia , Poliésteres/uso terapêutico , Animais , Doença Crônica , Denervação , Modelos Animais de Doenças , Masculino , Neuropatia Mediana/patologia , Ratos , Recuperação de Função Fisiológica
20.
Zhongguo Gu Shang ; 32(5): 407-411, 2019 May 25.
Artigo em Chinês | MEDLINE | ID: mdl-31248233

RESUMO

OBJECTIVE: To explore the clinical effect of knee denervation combined with micro-fracture under arthroscope in the treatment of patellofemoral arthritis. METHODS: From May 2015 to May 2018, 60 patients with knee joint degenerative patellofemoral arthritis were treated, including 28 males and 32 females, aged from 24 to 56(40.5±3.35) years old. Among them, 30 cases underwent arthroscopic debridement alone(control group), 30 cases underwent arthroscopic debridement, peripatellar denervation combined with cartilage cone and patellofemoral articular surface microfracture treatment (treatment group). VAS, Lysholm and Kujala scores were used to evaluate the therapeutic effect. RESULTS: No complications such as wound infection, vascular nerve injury and deep venous thrombosis occurred in all patients. The patients were followed up for 7 to 36 months with an average of 12.5 months. The VAS scores of the two groups were improved 4 weeks after operation, and the improvement of the treatment group was significantly better than that of the control group, the difference was statistically significant (P<0.05). Lysholm and Kujala scores were compared at the last follow-up of the two groups, the improvement of the treatment group was significantly better than that of the control group. CONCLUSIONS: The treatment of patellofemoral arthritis with patellar denervation combined with microfracture can better relieve pain and improve knee function.


Assuntos
Fraturas de Estresse , Articulação Patelofemoral , Adulto , Idoso , Artrite , Denervação , Feminino , Fêmur , Humanos , Articulação do Joelho , Masculino , Patela , Resultado do Tratamento , Adulto Jovem
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