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Article: JUXTACORTICAL OSTEOSARCOMA: CLINICAL EVOLUTION AND DEDIFFERENTIATION RELATED FACTORS.

Viola, Dan Carai Maia / Rocha, Allan Silva / Crisostomo, Bernardo Lopes / Garcia, Jairo Greco / Petrilli, Marcelo DE Toledo / Korukian, Marcos

Acta ortopedica brasileira

2022 Volume 30, Issue 5, Page(s) e257493

Abstract: Objective: Evaluate risk factors related to clinical evolution and dedifferentiation of parosteal (juxtacortical) osteosarcoma to high-grade osteosarcoma.: Methods: Retrospective cohort study performed over a period of 25 years, using data from ... ...

Abstract	Objective: Evaluate risk factors related to clinical evolution and dedifferentiation of parosteal (juxtacortical) osteosarcoma to high-grade osteosarcoma. Methods: Retrospective cohort study performed over a period of 25 years, using data from medical records of patients diagnosed with parosteal osteosarcoma. The data were submitted to statistical analysis by Fisher's exact test and Student's t-test. Results: Of the 326 patients treated for osteosarcoma, we identified 17 patients diagnosed with parosteal osteosarcoma. Of these, 4 (23.5%) were not actually diagnosed with parosteal osteosarcoma and 4 did not have the minimum data required for analysis, being excluded from the study. Of the 9 patients studied, we observed that 3 (33.3%) evolved with tumor dedifferentiation to high-grade osteosarcoma. Moreover, 2 (66.7%) had local recurrence and 2 (66.7%) metastases. Conclusion: Age, sex, and the tumor size were not directly related to the dedifferentiation from parosteal osteosarcoma to high-grade osteosarcoma. The most aggressive clinical evolution - presence of local recurrences and metastasis - in parosteal osteosarcoma occurred in tumors with dedifferentiation, however, we cannot associate each other as cause and effect, but as related factors.
Language	English
Publishing date	2022-11-11
Publishing country	Brazil
Document type	Journal Article
ZDB-ID	2105206-2
ISSN	1809-4406 ; 1413-7852
ISSN (online)	1809-4406
ISSN	1413-7852
DOI	10.1590/1413-785220223005e257493
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: EPIDEMIOLOGICAL PROFILE AND EVOLUTION IN MUSCULOSKELETAL TUMORS AT THE LEVEL OF THE ELBOW.

Mazzolin, Vinicius DE Abreu / Kalluf, Julia Rocha / Ogata, Fiama Kuroda / Oliveira, Nathalia Sundin Palmeira DE / Garcia, Jairo Greco / Petrilli, Marcelo DE Toledo / Korukian, Marcos / Viola, Dan Carai Maia

Acta ortopedica brasileira

2023 Volume 31, Issue 1, Page(s) e261309

Abstract: Objective: To present the epidemiological profile of bone and soft tissue tumors that affect the elbow region treated at an oncology referral center in Brazil.: Methods: Retrospective observational case series study to evaluate the results of elbow ... ...

Abstract	Objective: To present the epidemiological profile of bone and soft tissue tumors that affect the elbow region treated at an oncology referral center in Brazil. Methods: Retrospective observational case series study to evaluate the results of elbow cancer undergoing clinical and/or surgical treatment with the first visit from 1990 to 2020. The dependent variables were benign bone tumor, malignant bone tumor, benign soft tissue tumor, malignant soft tissue tumor. Independent variables were sex, age; presence of symptoms (pain/increase in local volume/fracture); diagnosis; treatment and recurrence. Results: In total, 37 patients were included, 51.35% of whom were female, with a mean age at diagnosis of 33.5 years. Soft tissue neoplasms correspond to 51% of cases against 49% of bone tumors. Among the symptoms, the general prevalence of pain was 56.75%, the general increase in local volume occurred in 54.04% of the patients and the presence of fractures in 13.43%. Surgical treatment occurred in 75.67% of cases and recurrence in 16.21% of cases. Conclusion: The tumors that affect the elbow in our series correspond mostly to benign tumors, involving bone or soft tissues, with a higher occurrence in young adult patients.
Language	English
Publishing date	2023-02-20
Publishing country	Brazil
Document type	Journal Article
ZDB-ID	2105206-2
ISSN	1809-4406 ; 1413-7852
ISSN (online)	1809-4406
ISSN	1413-7852
DOI	10.1590/1413-785220233101e261309
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Risk Factors Related to Poor Outcomes in the Treatment of Non-conventional Periprosthetic Infection.

Viola, Dan Carai Maia / Rodrigues Neto, Henrique Ribeiro / Garcia, Jairo Greco / Petrilli, Marcelo de Toledo / Carlesse, Fabianne Altruda de Moraes Costa / Jesus-Garcia Filho, Reynaldo

Revista brasileira de ortopedia

2021 Volume 56, Issue 5, Page(s) 615–620

Abstract: ... ...

Abstract	Objectives
Language	English
Publishing date	2021-10-28
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2411301-3
ISSN	1982-4378 ; 0102-3616
ISSN (online)	1982-4378
ISSN	0102-3616
DOI	10.1055/s-0041-1731354
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Biopsy Path Contamination in Primary Bone Sarcomas.

Garcia, Jairo Greco / Marques, Dayane Screpante / Viola, Dan Carai Maia / Petrilli, Marcelo de Toledo / Alves, Maria Teresa de Seixas / Jesus-Garcia Filho, Reynaldo

Revista brasileira de ortopedia

2019 Volume 54, Issue 1, Page(s) 33–36

Abstract: Objective: To determine the incidence of contamination of the biopsy pathway in patients with primary bone sarcomas, as well as the clinical characteristics that influenced this outcome.: Materials and methods: The anatomopathological reports of the ... ...

Abstract	Objective: To determine the incidence of contamination of the biopsy pathway in patients with primary bone sarcomas, as well as the clinical characteristics that influenced this outcome. Materials and methods: The anatomopathological reports of the patients who were treated by the Orthopedic Oncology Sector of the Orthopedic and Traumatology Department of this institution were retrospectively evaluated. Results: Of the 148 patients included for evaluation in the present study, only 1 presented contamination by neoplastic cells in his biopsy pathway. Conclusion: The bone biopsy procedure in patients with primary bone sarcomas presents great safety regarding pathway contamination when performed in specialized centers that treat this type of pathology.
Language	English
Publishing date	2019-03-01
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2411301-3
ISSN	1982-4378 ; 0102-3616
ISSN (online)	1982-4378
ISSN	0102-3616
DOI	10.1016/j.rbo.2017.09.006
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Fatores de risco relacionados a má evolução no tratamento da infecção periprótese não convencional

Viola, Dan Carai Maia / Rodrigues Neto, Henrique Ribeiro / Garcia, Jairo Greco / Petrilli, Marcelo de Toledo / Carlesse, Fabianne Altruda de Moraes Costa / Jesus-Garcia Filho, Reynaldo

Revista Brasileira de Ortopedia

2021 Volume 56, Issue 05, Page(s) 615–620

Abstract: Objetivos: O objetivo do estudo é identificar os principais fatores de risco relacionados a má evolução do tratamento da infecção periprótese.: Métodos: Foram avaliados de forma retrospectiva os prontuários de 109 pacientes submetidos a cirurgias de ... ...

Abstract	Objetivos: O objetivo do estudo é identificar os principais fatores de risco relacionados a má evolução do tratamento da infecção periprótese. Métodos: Foram avaliados de forma retrospectiva os prontuários de 109 pacientes submetidos a cirurgias de endoprótese não convencional (primárias e revisões), no período de 01 de janeiro de 2007 a 31 de dezembro de 2018. Destes, 15 pacientes diagnosticadas com infecção periprótese foram elegíveis para a participação no estudo. As variáveis sexo, idade do diagnóstico, osso acometido, duração da cirurgia, contagem de leucócitos no pré-operatório, infecção do trato urinário no 1° ano pós-operatório e tempo decorrido entre a colocação da endoprótese e o diagnóstico da infecção foram relacionadas aos desfechos utilizando o Teste Exato de Fisher (variáveis bicategóricas) e o Teste Anova (variáveis tricategóricas). A média de tempo entre diagnóstico e desfecho foram comparadas pelo método de t-student. Resultados: Os fatores de risco avaliados não demostraram correlação estatisticamente significante com os desfechos. Os dados demonstram haver tendência de diferença entre a média de tempo do aparecimento do processo infeccioso e o desfecho final do paciente. Devido a amostra limitada, acreditamos que estudos com coortes maiores possam comprovar essa tendência. Conclusão: Identificamos que o tempo entre a cirurgia de colocação da endoprótese e o aparecimento dos sintomas de infecção tende a ter relação com o desfecho e a evolução do paciente no tratamento da infecção periprótese. Os demais fatores associados, apesar de aparentemente relacionados, também não se mostraram estatisticamente relacionados a má evolução no tratamento. ; Objectives: To identify the main risk factors related to poor outcomes after the treatment for periprosthetic infection. Materials and Methods: Medical records from 109 patients who underwent non-conventional endoprosthesis surgeries (primary and revision procedures) from January 1, 2007, to December 31, 2018, were retrospectively evaluated. In total, 15 patients diagnosed with periprosthetic infection were eligible to participate in the study. Variables including gender, age at diagnosis, affected bone, surgery duration, white blood cell (WBC) count before endoprosthesis placement, urinary tract infection during the first postoperative year, and time elapsed from endoprosthesis placement to infection diagnosis were related to outcomes using the Fisher exact test (for the bicategorical variables) or analysis of variance (ANOVA, for the tricategorical variables). The mean times from diagnosis to final outcome were compared using the Student t -test. Results: These risk factors did not show a statistically significant correlation with the outcomes. The data revealed a trend towards a difference between the mean time for the onset of infection and the final outcome. Due to the limited sample, we believe that studies with larger cohorts can prove this trend. Conclusion: We identified that the time from endoprosthesis placement to the onset of the symptoms of infection tends to be related to the outcome and evolution of the patient evolution during the treatment for periprosthetic infection. Although apparently correlated, other associated factors were not statistically linked to poor treatment outcomes.
Keywords	próteses e implantes ; sarcoma ; infecções ; osteossarcoma ; amputação ; desbridamento ; prosthesis and implants ; sarcoma ; infections ; osteosarcoma ; amputation ; debridement
Language	Portuguese
Publishing date	2021-10-01
Publisher	Thieme Revinter Publicações Ltda.
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	2411301-3
ISSN	1982-4378 ; 0102-3616 ; 1982-4378
ISSN (online)	1982-4378
ISSN	0102-3616 ; 1982-4378
DOI	10.1055/s-0041-1731354
Database	Thieme publisher's database

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Article: Contaminação do trajeto de biópsia em sarcomas primários ósseos

Garcia, Jairo Greco / Marques, Dayane Screpante / Viola, Dan Carai Maia / Petrilli, Marcelo de Toledo / Alves, Maria Teresa de Seixas / Jesus-Garcia Filho, Reynaldo

Revista Brasileira de Ortopedia

2019 Volume 54, Issue 01, Page(s) 33–36

Abstract: Determinar a incidência da contaminação do trajeto de biópsia nos pacientes com sarcomas primários ósseos, bem como as características clínicas que influenciaram neste desfecho. Foram avaliados retrospectivamente os laudos anatomopatológicos de pacientes ...

Abstract	Determinar a incidência da contaminação do trajeto de biópsia nos pacientes com sarcomas primários ósseos, bem como as características clínicas que influenciaram neste desfecho. Foram avaliados retrospectivamente os laudos anatomopatológicos de pacientes tratados pelo Serviço de Oncologia Ortopédica do Departamento de Ortopedia e Traumatologia dessa instituição. Dentre os 148 pacientes incluídos no presente estudo, apenas um apresentou contaminação por células neoplásicas em seu trajeto de biópsia. O procedimento de biópsia óssea em pacientes com sarcomas primários ósseos apresenta grande segurança no quesito contaminação quando feito em centros especializados no tratamento dessas patologias. To determine the incidence of contamination of the biopsy pathway in patients with primary bone sarcomas, as well as the clinical characteristics that influenced this outcome. The anatomopathological reports of the patients who were treated by the Orthopedic Oncology Sector of the Orthopedic and Traumatology Department of this institution were retrospectively evaluated. Of the 148 patients included for evaluation in the present study, only 1 presented contamination by neoplastic cells in his biopsy pathway. The bone biopsy procedure in patients with primary bone sarcomas presents great safety regarding pathway contamination when performed in specialized centers that treat this type of pathology.
Keywords	sarcoma de Ewing ; osteossarcoma ; biópsia ; Ewing sarcoma ; osteosarcoma ; biopsy
Language	Portuguese
Publishing date	2019-02-01
Publisher	Sociedade Brasileira de Ortopedia e Traumatologia. Published by Thieme Revnter Publicações Ltda
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	2411301-3
ISSN	1982-4378 ; 0102-3616 ; 1982-4378
ISSN (online)	1982-4378
ISSN	0102-3616 ; 1982-4378
DOI	10.1016/j.rbo.2017.09.006
Database	Thieme publisher's database

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Article: Is PET-CT an accurate method for the differential diagnosis between chondroma and chondrosarcoma?

Jesus-Garcia, Reynaldo / Osawa, Akemi / Filippi, Renee Zon / Viola, Dan Carai Maia / Korukian, Marcos / de Carvalho Campos Neto, Guilherme / Wagner, Jairo

SpringerPlus

2016 Volume 5, Page(s) 236

Abstract: The differential diagnosis between chondroma and intraosseous chondrosarcoma is based on imaging and clinical exams, but only a biopsy can confirm diagnosis. The aim of this study was to evaluate the value of PET-CT in differentially diagnosing chondroma ...

Abstract	The differential diagnosis between chondroma and intraosseous chondrosarcoma is based on imaging and clinical exams, but only a biopsy can confirm diagnosis. The aim of this study was to evaluate the value of PET-CT in differentially diagnosing chondroma and chondrosarcoma. From October 2009 to May 2015, 36 patients with cartilaginous bone lesions in the extremities, 12 (33.3 %) men and 24 (66.6 %) women, were prospectively included in the study. Patients ranged in age from 21 to 68 years, with a mean age of 44 years. Lesions were located in the long bones: in the proximal humerus in 26 (72.2 %) patients, in the femoral shaft in 1 (2.7 %), in the distal femur in 7 (19.4 %), and in the proximal tibia in 2 (5.5 %). The SUVmax value of 2.0 was used to separate between patients submitted to surgery and patients submitted to observation. Among the 36 patients studied, 17 (47.2 %) had SUVmax ≤ 2.0, and they were diagnosed as chondroma and they were treated conservatively. Follow-up ranged from 14 to 76 months, averaging 38 months. Nineteen (52.7 %) patients with SUVmax >2.0 were diagnosed as chondrosarcoma and underwent surgery. The area of the curve, calculated considering the SUV variable as numeric, is estimated in 0.966, with a 95 % confidence interval from 0.906 to 1.000. To evaluate the sensitivity, specificity and positive/negative predictive values, it was built a 2 × 2 table. Significance was set at p < 0.05. According the criteria of maximum sensitivity and specificity, the cut point suggested to SUVmax was 2.2. If we consider this point, it is possible to identify 19 of 36 positive cases to chondroma (52.8 %), it means, all chondrosarcomas of the series. We concluded that PET-CT can be used as an objective and quantitative method of differentiating between chondromas and chondrosarcomas located within the long bones. It represents a complementary examination to standard imaging (X-ray, scintigraphy, CT and MRI) and pathological exams. The SUVmax between 2.0 and 2.2 would be a range area between chondroma and chondrosarcoma and this range can be of value, among others exams, in decide the best treatment for patients with cartilaginous lesions in long bones. Level of evidence Level I-diagnostic study-prospectively investigating a diagnostic test using a universally applied "gold" standard.
Language	English
Publishing date	2016-02-29
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2661116-8
ISSN	2193-1801
ISSN	2193-1801
DOI	10.1186/s40064-016-1782-8
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Postural assessment of patients with non-conventional knee endoprosthesis.

Nakaya, Luciana / Tsai, Liliana Yu / Jesus-Garcia Filho, Reynaldo / Petrilli, Marcelo de Toledo / Viola, Dan Carai Maia / Petrilli, Antonio Sérgio

Acta ortopedica brasileira

2014 Volume 22, Issue 5, Page(s) 245–249

Abstract: Objective: To investigate the correlation between the sagittal and frontal alignment and possible postural asymmetries found in patients submitted to total knee stent placement for osteosarcoma.: Methods: TWENTY TWO INDIVIDUALS WERE DIVIDED INTO TWO ... ...

Abstract	Objective: To investigate the correlation between the sagittal and frontal alignment and possible postural asymmetries found in patients submitted to total knee stent placement for osteosarcoma. Methods: TWENTY TWO INDIVIDUALS WERE DIVIDED INTO TWO GROUPS ACCORDING TO TUMOR LOCATION: femur group (13 patients) and tibia group (nine patients), who were evaluated through postural analysis software (SAPO). Results: No statistically significant difference was found between groups, supporting previous result showing that both groups present the same postural asymmetries. Conclusion: We conclude that both groups have the same postural imbalances, especially the knee of the affected limb that presents hyperextension and center of gravity shifted anteriorly and laterally to the non-affected limb, indicating changes in weight bearing and influencing the gait pattern and balance. Level of Evidence II, Prospective Comparative Study.
Language	English
Publishing date	2014-06-10
Publishing country	Brazil
Document type	Journal Article
ZDB-ID	2105206-2
ISSN	1809-4406 ; 1413-7852
ISSN (online)	1809-4406
ISSN	1413-7852
DOI	10.1590/1413-78522014220500826
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Article ; Online: Spine surgery cost reduction at a specialized treatment center.

Viola, Dan Carai Maia / Lenza, Mario / Almeida, Suze Luize Ferraz de / Santos, Oscar Fernando Pavão dos / Cendoroglo Neto, Miguel / Lottenberg, Claudio Luiz / Ferretti, Mario

Einstein (Sao Paulo, Brazil)

2013 Volume 11, Issue 1, Page(s) 102–107

Abstract: Objective: To compare the estimated cost of treatment of spinal disorders to those of this treatment in a specialized center.: Methods: An evaluation of average treatment costs of 399 patients referred by a Health Insurance Company for evaluation and ...

Abstract	Objective: To compare the estimated cost of treatment of spinal disorders to those of this treatment in a specialized center. Methods: An evaluation of average treatment costs of 399 patients referred by a Health Insurance Company for evaluation and treatment at the Spine Treatment Reference Center of Hospital Israelita Albert Einstein. All patients presented with an indication for surgical treatment before being referred for assessment. Of the total number of patients referred, only 54 underwent surgical treatment and 112 received a conservative treatment with motor physical therapy and acupuncture. The costs of both treatments were calculated based on a previously agreed table of values for reimbursement for each phase of treatment. Results: Patients treated non-surgically had an average treatment cost of US$ 1,650.00, while patients treated surgically had an average cost of US$ 18,520.00. The total estimated cost of the cohort of patients treated was US$ 1,184,810.00, which represents a 158.5% decrease relative to the total cost projected for these same patients if the initial type of treatment indicated were performed. Conclusion: Treatment carried out within a center specialized in treating spine pathologies has global costs lower than those regularly observed.
MeSH term(s)	Brazil ; Cost Savings ; Cost-Benefit Analysis/economics ; Female ; Health Care Costs ; Hospitals, Special/economics ; Humans ; Male ; Spinal Diseases/economics ; Spinal Diseases/surgery ; Treatment Outcome
Language	Portuguese
Publishing date	2013-03-27
Publishing country	Brazil
Document type	Journal Article
ZDB-ID	2418293-X
ISSN	2317-6385 ; 1679-4508
ISSN (online)	2317-6385
ISSN	1679-4508
DOI	10.1590/s1679-45082013000100018
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Platelet-rich plasma for long bone healing.

Lenza, Mário / Ferraz, Silvia de Barros / Viola, Dan Carai Maia / Santos, Oscar Fernando Pavão dos / Cendoroglo Neto, Miguel / Ferretti, Mario

Einstein (Sao Paulo, Brazil)

2013 Volume 11, Issue 1, Page(s) 122–127

Abstract: Objective: To evaluate effectiveness of the use of platelet-rich plasma as coadjuvant for union of long bones.: Methods: The search strategy included the Cochrane Library (via Central) and MEDLINE (via PubMed). There were no limits as to language or ... ...

Abstract	Objective: To evaluate effectiveness of the use of platelet-rich plasma as coadjuvant for union of long bones. Methods: The search strategy included the Cochrane Library (via Central) and MEDLINE (via PubMed). There were no limits as to language or publication media. The latest search strategy was conducted in December 2011. It included randomized clinical trials that evaluated the use of platelet-rich plasma as coadjuvant medication to accelerate union of long bones (acute fractures, pseudoarthrosis and bone defects). The outcomes of interest for this review include bone regeneration, adverse events, costs, pain, and quality of life. The authors selected eligible studies, evaluated the methodological quality, and extracted the data. It was not possible to perform quantitative analysis of the grouped studies (meta-analyses). Results: Two randomized prospective clinical trials were included, with a total of 148 participants. One of them compared recombinant human morphogenic bone protein-7 versus platelet-rich plasma for the treatment of pseudoarthrosis; the other evaluated the effects of three coadjuvant treatments for union of valgising tibial osteotomies (platelet-rich plasma, platelet-rich plasma plus bone marrow stromal cells, and no coadjuvant treatment). Both had low statistical power and moderate to high risk of bias. Conclusion: There was no conclusive evidence that sustained the use of platelet-rich plasma as a coadjuvant to aid bone regeneration of fractures, pseudoarthrosis, or bone defects.
MeSH term(s)	Bone Regeneration/physiology ; Fracture Healing/physiology ; Humans ; Platelet-Rich Plasma ; Pseudarthrosis/therapy ; Treatment Outcome
Language	Portuguese
Publishing date	2013-03-27
Publishing country	Brazil
Document type	Journal Article ; Review
ZDB-ID	2418293-X
ISSN	2317-6385 ; 1679-4508
ISSN (online)	2317-6385
ISSN	1679-4508
DOI	10.1590/s1679-45082013000100023
Database	MEDical Literature Analysis and Retrieval System OnLINE

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