Renato Andrade

Clínica Espregueira - FIFA Medical Centre of Excellence · Research

Background Mosaicplasty has been associated with good short- to long-term results. Nevertheless, the osteochondral harvesting is restricted to the donor-site area available and it may lead to significant donor-site morbidity. PurposeProvide an overview of donor-site morbidity associated with harvesting of osteochondral plugs from the knee joint in...

Objectives: To summarise recommendations and appraise the quality of international clinical practice guidelines (CPGs) for rehabilitation after ACL reconstruction. Design: Systematic review of CPGs (PROSPERO number: CRD42017020407). Data sources: Pubmed, EMBASE, Cochrane, SPORTDiscus, PEDro and grey literature databases were searched up to 30...

Background The acute: chronic workload ratio (ACWR) is an index of the acute workload relative to the cumulative chronic workloads. The monitoring of physical workloads using the ACWR has emerged and been hypothesized as a useful tool for coaches and athletes to optimize performance while aiming to reduce the risk of potentially preventable load-dr...

Poor reporting of medical and healthcare systematic reviews is a problem from which the sports and exercise medicine, musculoskeletal rehabilitation, and sports science fields are not immune. Transparent, accurate and comprehensive systematic review reporting helps researchers replicate methods, readers understand what was done and why, and clinici...

Western democracies' voting practices have altered recently, most notably with candidates now taking center stage at the expense of the institutions. These events are the result of a phenomenon called the personalisation of politics. The present review aims to synthesize evidence regarding the impact of voters' evaluation of candidates' traits on p...

Background Magnetic resonance imaging (MRI) has shown limited diagnostic accuracy for multiple ligament knee injuries (MLKIs), especially posterolateral corner (PLC) injuries. Hypothesis The diagnostic accuracy of MRI for MLKIs will only be moderate for some knee structures. Patient-related factors and injury patterns could modify the diagnostic a...

Background: Hamstrings injuries are common in sports and the reinjury risk is high. Despite the extensive literature on hamstrings injuries, the effectiveness of the different conservative (i.e., non-surgical) interventions (i.e., modalities and doses) for the rehabilitation of athletes with acute hamstrings injuries is unclear. Objective: We aime...

Objective To investigate the effects and mechanotransduction pathways of therapeutic ultrasound on chondrocytes. Method PubMed, EMBASE and Web of Science databases were searched up to 19th September 2021 to identify in vitro studies exploring ultrasound to stimulate chondrocytes for OA treatment. Study characteristics, ultrasound parameters, in vi...

The impact of mental illness on the sport performance of athletes is increasingly recognized by the clinic and scientific community. The demand of elite sport influences the mental health of this population and increases the risk of mental illness. This article aims to briefly discuss the most relevant points about mental illness in athletes, as we...

Purpose: The purpose of this study was to analyze the diagnostic accuracy of magnetic resonance imaging (MRI) to detect and grade the severity of patellofemoral (PF) cartilage injuries. Methods: A systematic review was conducted on PubMed, EMBASE and Cochrane Library databases (up to July 1st 2022) to search for studies that reported the diagnos...

Background: The purpose of this systematic review is to analyze the methodologies, utilized stimulation parameters, and the main cellular outcomes obtained by in vitro studies that apply a light source on tenocyte cultures. Methods: The PubMed, Scopus, and Web of Science databases were searched up to December 9, 2019 for in vitro studies that used...

Globally, better health care access and social conditions ensured a significant increase in the life expectancy of the population. There is, however, a clear increase in the incidence of age-related diseases which, besides affecting the social and economic sustainability of countries and regions around the globe, leads to a decrease in the individu...

Background Total ankle arthroplasty was developed as an alternative option to ankle arthrodesis in patients with end-stage ankle osteoarthritis. Multiple trials have assessed the outcomes of ankle arthroplasty, but complication risk or relative effectiveness is not systematized in literature. Aim Review complications of new designs of total ankle...

Posterolateral corner knee injuries are currently recognized as an important component of articular instability, occurring more frequently in the context of multiligamentar lesions of the knee. Knowledge of the anatomy and biomechanics is key, and the diagnosis arises from the clinical history and patient examination and should be complemented with...

Background Mechanical-based therapies are not yet recommended to manage osteoarthritis (OA). This systematic review and meta-analysis aim to assess the effects of passive mechanical-based therapies (isolated or combined with other therapies) on patients with knee OA compared to placebo, other isolated or combined interventions. Methods Pubmed, Coc...

Background: Community-based pulmonary rehabilitation (PR) programs can be offered to patients with COPD, but the literature on its effects is still not well summarized. Our purpose was to investigate the health-, physical-, and respiratory-related effects of community-based PR in individuals with COPD as compared to control groups. Methods: The...

Osgood-Schlatter disease is a traction apophysitis of the anterior tibial tuberosity. It is a selflimiting disease, with resolution in up to 90% of patients with conservative treatment. Its etiology is unknown despite clinical observation of the role of mechanical stress on the knee extensor apparatus in exacerbating symptoms. It occurs more common...

Background Hamstrings injuries are a major concern in football (soccer), affecting both recreational players and professional athletes. Although being a recognized issue within the football community, its incidence has been increasing over the last years and still poses a challenge to all practitioners involved. Study objectives and rationale The...

Articular cartilage lesions are a common pathology of the knee joint. A careful evaluation of cartilage and osteochondral lesions is essential in order to choose the most suitable treatment. This becomes more relevant in young patients, with a good overall cartilage situation. The physical examination must be done by the orthopedic surgeon that sho...

Joint laxity should be distinguished from instability and its objective assessment is a determinant of safety and effectiveness clinical management of anterior cruciate ligament (ACL) tear and other often injured structures through injury mechanisms as knee sprains. Clinical evaluation is mandatory for all clinicians but requires the addition of me...

Numerous advances continue to be made and have contributed to the improvement of the diagnosis and treatment of patellofemoral (PF) disorders. These include technological advances in instrumented laxity, 3D and dynamic CT imaging and computational modeling, devices for implantation, and developments in the field of orthobiologics. The Porto Patello...

The patellofemoral joint is complex and includes an interplay of static and dynamic anatomic structures. Patellofemoral disorders can range from traumatic injuries, instability or those leading to patellofemoral pain syndrome. Patellofemoral pain syndrome is one of the most common diagnoses in patients complaining from anterior knee pain. The cause...

Lateral epicondylalgia, also popularly and formerly known as tennis elbow, is the most prevalent elbow pathology in adult population, including professional and recreational athletes, especially in handgrip activities. Due to its predominant incidence, the understanding of its etiopathogenesis and therapeutic approaches have been recently more wide...

Background: Lateralized reverse shoulder arthroplasty (RSA) has emerged as an attempt to improve on some of the drawbacks of conventional RSA, such as glenoid notching and decrease in ROM. Although this new design is being used in clinical practice, the evidence is mostly limited to case series and has not been systematically reviewed. Questions/...

Our goal was to assess the type and frequency of injuries associated with torn anterior cruciate ligament (ACL) in the pediatric population, as well as to compare patterns of associated injuries between children/adolescents and adults. We included all children and adolescents undergoing ACL reconstruction at our institution between 2013-2019. We an...

Background Recent evidence suggests that athletes may not be prepared to return to sport at 6 months following an anterior cruciate ligament (ACL) reconstruction. Objective Identify knee isokinetic neuromuscular deficits at 6 months after ACL reconstruction and assess if deficits impact on the rate of new knee injuries and level of activity. Desi...

Biomaterials have long been explored in regenerative medicine strategies for the repair or replacement of damaged organs and tissues, due to their biocompatibility, versatile physicochemical properties and tuneable mechanical cues capable of matching those of native tissues. However, poor adhesion under wet conditions (such as those found in tissue...

A tendinopatia rotuliana e uma causa comum de dor na região anterior do joelho, podendo levar a incapacidade funcional e a quebra significativa no desempenho do atleta. O diagnóstico é clínico e consiste num quadro de dor e edema localizados no polo inferior da rótula com agravamento associado ao exercício. O tratamento inicialmente conservador, co...

Subtalar instability remains a topic of debate, and its precise cause is still unknown. The mechanism of injury and clinical symptoms of ankle and subtalar instabilities largely overlap, resulting in many cases of isolated or combined subtalar instability that are often misdiagnosed. Neglecting the subtalar instability may lead to failure of conser...

Complete access to the posterior medial compartment of the knee may represent a technical challenge during arthroscopy in patients with a tight tibiofemoral joint space. Medial collateral release reduces direct iatrogenic cartilage damage in the medial compartment of the knee through manipulation with instruments. We recommend performing medial col...

Flexibility is the ability to move through full joint range of motion (ROM), while stretching is an intervention to improve flexibility and achieve other goals (e.g., post-exercise relaxation) (ACSM, 2021). Stretching has been promoted as mandatory in exercise programs (Behm, 2019; American Heart Association, 2020; ACSM, 2021), although this is cha...

We performed a systematic review with meta-analysis of randomized controlled trials (RCTs) to assess the effects of strength training (ST) as compared to alternative multimodal or unimodal exercise programs on the number of falls in older adults (≥60 years). Ten databases were con-sulted (CINAHL, Cochrane Library, EBSCO, EMBASE, PEDro, PubMed, Scie...

A instabilidade objetiva da rótula é uma das patologias mais frequentes do joelho. O tratamento depende da avaliação completa e minuciosa das características intrínsecas e funcionalidade do joelho. O tratamento conservador tem uma taxa de reincidência não menosprezável. O tratamento cirúrgico pode consistir maioritariamente na reconstrução do ligam...

Purpose: To compare a physically active lifestyle or structured exercise program to physically inactive lifestyle or control groups on telomere length (TL). Method: We searched PubMed, EMBASE, Cochrane Library, and Open Gray databases up to March 31, 2020. We calculated standardized mean differences (SMD) with 95% confidence intervals (CI) of TL...

Background There have been conflicting results about the theoretical advantages of anatomic double-bundle anterior cruciate ligament (ACL) reconstruction. Purpose To evaluate the clinical and functional outcomes comparing anatomic single- versus double-bundle techniques, anatomic versus nonanatomic techniques, and transportal versus outside-in tun...

The effects and usefulness of active and passive static stretching have raised heated debates. Over the years, the pendulum has swung from a glorified vision to their vilification. As most of the times, the truth often lies somewhere in-between. But even if there was no controversy surrounding the effects of static and passive stretching (which the...

Anterior shoulder dislocation, as the most common dislocation in humans, is a condition affecting both professional and recreational athletes, particularly in overhead and contact sports. Despite its high incidence, several questions remain within the scientific debate, with many questions still to be clarified, such as: which type and duration of...

Despite extensive research on ankle instability a consensual and clear objective definition for pathological mechanical lateral ankle instability is yet to be determined. This systematic review aimed to summarize current available arthrometric devices, measuring methods and lateral ankle laxity outcomes in patients with chronic ankle instability th...

Objective To analyze the effects of light therapy (LT) on cartilage repair for knee osteoarthritis (OA) treatment. Design The PubMed, Embase, Scopus, and Web of Science databases were searched up to August 31, 2020 to identify in vitro and in vivo studies that analyzed the effects of LT on knee cartilage for OA treatment. The study and sample char...

The purpose of this systematic review is to report the characteristics and methods utilized in human lower limb or knee joint only biomechanical models to provide state-of-the-art knowledge on the topic. This review was conducted according to the preferred reporting items for systematic reviews and meta-analyses guidelines. PubMed, Scopus and Web o...

Objectives Menstrual symptoms are commonly cited barriers to physical activity in women. Delay or avoidance of menstruation through hormonal contraceptives may mitigate those barriers. Our purpose is to identify the uterine bleeding patterns of Portuguese athletes, their contraceptive choices and the impact of contraceptive methods in sports perfor...

Ankle sprains are common and often develop into chronic ankle instability. Ankle laxity is usually assessed by manual testing followed by magnetic resonance imaging to confirm the diagnosis. Manual testing however provides a subjective measure and is limited to the assessor sensibility. Current available technologies incorporate arthrometers to obj...

Background: Falls are the leading causes of (non)fatal injuries in older adults. Recent research has developed interventions that aim to improve balance in older adults using virtual reality (VR). Purpose: We aimed to investigate the validity, reliability, safety, feasibility, and efficacy of head mounted display (HMD) systems for assessing and tra...

IntroductionThe cement-in-cement technique for revision hip arthroplasty has many potential advantages and has recently gained widespread interest but still lacks evidence to support it. Our aim was to examine the surgical and patient-reported outcomes after cement-in-cement revision hip arthroplasty.Materials and methodsA systematic review was con...

In the second part we addressed the basic concepts of imaging evaluation of groin pain, the main imaging findings and the current challenges in imaging diagnosis of this pathology. In this third part we describe the many imaging modalities that can be used to support the diagnosis of groin pain. Na segunda parte abordámos os conceitos básicos de av...

Purpose: Despite the evidence on the role of gravity stress test to access the instability of other ankle injuries, there is limited literature regarding gravity stress on the lateral ankle ligament's insufficiency. The objective of our study was to objectively measure the tibiotalar angular movement under gravity stress after progressive sectioni...

The diagnosis of groin pain centered on the early detection of injuries is essential to allow an early implementation of therapeutic and prophylactic strategies. In this second part (part 2), we address the basic concepts of imaging evaluation of groin pain, the main imaging findings and the current challenges in imaging diagnosis of this pathology...

Purpose: To systematically analyse post-operative outcomes following enhanced microfracture procedures in focal cartilage injuries of the knee. Methods: Database searches were conducted in PubMed, EMBASE and Cochrane Library databases up to 30 November 2018, for clinical studies in humans that assessed surgical outcomes of enhanced microfracture...

Background Arterial vascularization is intimately related to the peroneal tendon ruptures. Our purpose is to describe the vascular anatomy of peroneal tendons and assess differences in the vascularization patterns between peroneus brevis tendon (PBT) and peroneus longus tendon (PLT). Methods Anatomical study of 22 cadaveric lower extremities. We e...

Trochanteric bursitis is a common condition that frequently comes across the Orthopedic Surgeon. Although, most of the times, it has a benign course, subsiding with conservative treatment ranging from physical therapy to injections, sometimes it can become disabling.

The purpose of this systematic review is to analyze characteristics and methodologies utilized in bioheat transfer models of human skin to provide state-of-the-art knowledge on the topic. This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. PubMed, EMBASE and Web of Science databa...

Worldwide, 25% of adults and 75% adolescents do not match the global recommendations for physical activity set by World Health Organization (WHO). Sports and, particularly, team sports may change the reality of physical inactivity and contribute to primary prevention and control of noncommunicable diseases (NCDs). These were responsible for 40.5 mi...

Objective Investigate the patellar force-displacement profile (ligament stiffness) of patellofemoral disorders. Methods Fifty-two knees from 34 consecutive patients (mean 31.6 years and 53% male) were analysed including 24 knees with patellofemoral pain (PFP), 19 with potential patellofemoral instability (PPI) and 9 with objective patellofemoral i...

Purpose This study aimed to systematically analyze the postoperative clinical, functional, and imaging outcomes, complications, reoperations, and failures following patellofemoral cartilage restoration surgery. Methods This review was conducted according to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISM...

Purpose To determine the clinical outcomes of arthroscopic superior capsular reconstruction (ASCR) using either fascia lata autograft or human dermal allograft for irreparable rotator cuff tears (IRCTs). Methods A systematic review was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines by...

Purpose The purpose of this study was to investigate if the calcaneofibular ligament (CFL) presents morphologic variants and measure the morphometrics of the ligament and its footprints Methods An anatomical study of 47 fresh-frozen below-the-knee ankle specimens was performed. Lateral ankle structures were dissected to expose the CFL. Overdissect...

Purpose To compare the clinical and laboratory outcomes of intra-articular injections of culture-expanded bone-derived mesenchymal stem cells (MSCs) with or without platelet-rich plasma (PRP) to intra-articular corticosteroid injections for the treatment of knee osteoarthritis (OA). Methods Forty-seven patients with radiographic and symptomatic kn...

Purpose To objectively compare side-to-side patellar position and mobility in patients with idiopathic unilateral anterior knee pain (AKP) using a stress-testing device concomitantly with magnetic resonance imaging. It is hypothesized that the painful knees present greater patellar mobility than the contralateral non-painful knees. Methods From a...