Sérgio Rocha Piedade

University of Campinas | UNICAMP · Orthopedic and Traumatology

Introduction The literature presents several scientifically validated and cross-culturally adapted questionnaires in the area of orthopedics and Sports Medicine scientifically validated and cross-culturally adapted. However, they are anatomically specific, and do not consider the specific needs of athletes. The “4-Domain PROM for Orthopedic and Spo...

Introduction The literature presents several scientifically validated and cross-culturally adapted questionnaires in the area of orthopedics and Sports Medicine scientifically validated and cross-culturally adapted. However, they are anatomically specific, and do not consider the specific needs of athletes. The “4-Domain PROM for Orthopedic and Spo...

Background: Surgical reconstruction of the posterior cruciate ligament (PCL) can be technically challenging given the proximity of the popliteal artery to the PCL tibial insertion. This "no-safe zone" makes some knee surgeons less confident and willing to perform this surgical procedure. Surgical technique: We present a PCL tibial inlay reconstr...

Anterior cruciate ligament (ACL) insufficiency can be disabling, given the physical and sports activity constraints that negatively impact the quality of life. Consequently, surgery is the main approach for most active patients. Nonetheless, ACL reconstruction cannot be successful without adequate pre- and postoperative rehabilitation. Since the 19...

Different surgical techniques have been proposed to reconstruct combined anterior cruciate (ACL) and lateral collateral ligaments (LCL). Although these surgical techniques are reliable and reproducible, the number of autologous grafts needed for the reconstruction could be a limiting factor, especially when patients present with multi-ligament knee...

Like any sport, running is affected by biological development, the body process of maturity and degeneration. Each phase of our lives, childhood, adolescence, and old age plays an essential role in this physiological development—lifetime effect. Therefore, to evaluate the development of sports skills, the sports physician must systematically assess...

Along time, the human body suffers from a gradual process of deterioration, manifested by biomechanical and physiological changes that impact the biological and metabolic systems. The literature has explored the biological process of aging in athletes’ performance and how sports practice and regular physical activity impact their quality of life. T...

Objective: By analyzing our cases of posterior cruciate ligament (PCL) tibial avulsion fracture, we noted that a U-shaped image was present in the anteroposterior plain radiographs view of the affected knee, even in cases where the profile view of the knee had been inconclusive as to tibial PCL avulsion fracture, a "hidden" fracture. Therefore, we...

Each sport has a specific physical demand, and, as a result, specific sports-related injuries may occur. In order to better investigate and establish an accurate diagnosis, the sports medicine physician has to initially assess sports trauma considering three key points: athlete’s history of trauma, physical examination, and radiological evaluation....

In all areas of Medicine, physicians must be aware of patients’ voice and opinions because patients’ observations about their treatment play an essential role in developing and refining a management plan. This chapter aims to discuss PROM in Sports Medicine, starting by its definition, contributions in Orthopedics, the lack of PROM in Sports Medici...

CrossFit, indoor cycling, and aerobic exercises are stimulating actions as they promote rewarding physical and mental well-being. However, even though the athletes and regular sports practitioners train sports movements exhaustively, anatomical and functional issues could play a role in the biomechanical effectiveness of these exercises. Moreover,...

Each martial art has a DNA that reflects how their methods of combat are organized, physical demands, and common injuries, mostly because of their dynamics: Judo with gripping, throwing, and being thrown, Karate with punching, kicking, and jumping, and Taekwondo with intense full-contact sparring and higher incidence of injuries during competition....

“When going downhill, the skier leans on his pole and closes his eyes. Then he goes straight and continues until he can no longer breathe. He then throws himself on the side in the snow and waits to catch his breath, then he launches straight on until he still loses his breath and throws himself in the snow, and so on to the bottom.” This chapter a...

Since Pheidippides’ times, the first Marathon runner in history, this running has become an attractive and inspiring activity to many runners around the world. A marathon is a type of endurance race that moves runners’ imagination because it defies athletes’ body limits; it also offers them a fantastic moment of joy and celebration for overcoming t...

Objective: To analyze the functional outcomes after arthroscopic treatment of femoroacetabular impingement (FAI). Methods: 194 patients (131 males and 63 females), with a mean age of 39 (15-68) years old for men and 43 (16-58) years old for women. The average follow-up was 17 months (2 to 71). 103 patients presented Cam-type FAI, 102 mixed and 2...

Objective: To correlate clinical and intraoperative findings with the postoperative evaluation of two-stage bicruciate knee ligament reconstruction. Methods: The study was conducted with 25 patients (20 men and 05 women) with mean age of 32.3 years, mean body mass index (BMI) of 26.2, and mean lesion duration of 18.3 months. The treatment consiste...

Introduction: Concussion is traumatic brain injury with associated tissue damage commonly produced by an indirect or direct head or facial trauma that can negatively impact an athletes' career and personal life. In this context, the importance on how to deal with a concussion has received attention from worldwide literature and has become a topic...

The validation of a 4-domain PROM tailored to orthopedic sports medicine was performed through item generation, item scaling, validity and reliability testing, statistical analysis, as well as item reduction. Conbrach's alpha was used to verify item homogeneity, i. e. their accuracy or consistency. This PROM showed acceptable statistical accuracy a...

This book offers a comprehensive and detailed overview of specific sports-related injuries and a valuable guide for decision-making to establish the best strategies to prevent and manage such injuries. As a thorough understanding of each sports modality plays a key role, both in injury prevention and management, a dedicated chapter is devoted to ea...

Introdução: A lesão ligamentar bicruciada do joelho não possui um protocolo cirúrgico bem estabelecido na literatura. Objetivo: Correlacionar os dados clínicos e os achados intra-operatórios com os dados da avaliação pós-operatória da escala de Lysholm, escore de atividade de Tegner e questionário SF-36 após reconstrução do ligamento bicruzado do j...

Importance The concept of patient-reported outcome measures (PROMs) has come to the forefront in the evaluation of the results of treatment for musculoskeletal ailments, reflecting the concerns of improving patient-centred care. However, athletes and physically active individuals have physical and psychological expectations and goals that differ fr...

PROMs in sports medicine could be a useful tool to analyze the results of several sports injuries in athletes and sports practitioners, regardless of the involved anatomical site (the shoulder, hip, knee, foot, and ankle). Moreover, the athletic population has singular expectations and objectives, differing from the general and sedentary population...

Since ancient times, sports practice is well-recognized as a health-promoting activity as it may act to improving our biological reserve. Sports practice is not an injury-free activity, and a clear example of that is sudden cardiac arrest, one of the most overwhelming events in sports practice, which could signal the first clinical presentation of...

Adulthood and old age involve huge biomechanical changes in the human body due to natural biological deterioration that takes place slowly and progressively during lifetime. In this context, the quality of life is directly related to how prepared we are to live longer because a price should be paid for it. Nevertheless, the speed of this process co...

Judo and Brazilian jiu-jitsu (BJJ) are popular martial arts, but, nowadays, mixed martial arts (MMA), a sport that joins all martial arts, has shown an exponential growth worldwide. Like all contact sports, injuries are frequent events. This chapter presents some aspects of these martial arts (judo, BJJ, wrestling, and MMA) as well as discusses the...

Musculoskeletal injuries occur as a result of forces that are applied to the body. The science of biomechanics tries to explain these forces and their momentum and puts musculoskeletal injuries in the context of physics. The present chapter explains basic biomechanical terms and principles of importance while dealing with sports-related injuries. T...

“Shin” (leg) pain, “shin splints,” and medial tibial stress syndrome, are general terms used to describe pain and lower leg discomfort. It could affect recreational and professional athletes indistinctly, mainly distance runners, athletes of endurance sports, dancers, and the military, confirming that higher physical demands (overload) are closely...

Facial injuries in sports present a broad epidemiological distribution, and their incidence and prevalence vary according to the nature of the sports modality, the mechanism of trauma, and dynamics of the sport, which classify them as higher- or lower-risk injury. A facial trauma may result in visual harm, respiratory impairment, and hearing dysfun...

This superbly illustrated book provides information of outstanding quality on the presentation and management of the entire range of sports injuries and conditions likely to be encountered by the sports medicine physician, as well as many other topics relating to sports activity, events, and outcomes. It is the product of close collaboration among...

Background: Graft elongation might be a major reason for increased anterior laxity after anterior cruciate ligament (ACL) reconstruction. This study analyzed the force relaxation values and their stabilization when single strands of the gracilis and semitendinosus tendons underwent cyclic and static tensioning at 2.5% strain level, and compared th...

Most of the increasing popularity of the all-inside meniscal repair is related to the possibility to perform a meniscal repair with no additional skin incision. Moreover, the all-inside techniques allow the possibility of placing sutures in the different meniscal tear patterns such as horizontal, vertical, oblique, or longitudinal. In this situatio...

The classification systems of meniscal tears strengthen the importance of the anatomical and biomechanical particularities of meniscus tissue, regarding the pattern and configuration of a meniscal tear. Each system of classification approaches a particular aspect of the meniscal structure according to its morphology, proximity to the blood supply,...

Objective: To evaluate the impact of morbid obesity on physical capacity, joint-related symptoms, and on the overall quality of life. Method: Cross-sectional study carried out at a university hospital, enrolling 39 individuals admitted to a bariatric surgery service. Physical capacity was assessed by Six-Minute Walk Test (SMWT) and the Borg rating...

Necrosis in burns has a major impact on dermal regeneration, functional, and esthetic results. Thus patient’s satisfaction and quality of life is determined by the timely regeneration process of all dermal layers. Pathophysiological changes after burn trauma lead to different perfusion patterns (“zones”). Inflammation has been described having a ke...

Posterior cruciate ligament (PCL) injuries are often associated with other ligament lesions. Multiligament reconstructions require an important quantity of grafts and often determine the need for cadaver allografts during the surgical repair procedures. Herein, the fundamentals of allografts that have been currently used for PCL reconstructions are...

Posterior cruciate ligament (PCL) injuries are often associated with other ligament lesions. Multiligament reconstructions require an important quantity of grafts and often determine the need for cadaver allografts during the surgical repair procedures. Herein, the fundamentals of allografts that have been currently used for PCL reconstructions are...

The turnout, primary gesture in classical ballet, refers the 180º of the feet. The lateral rotation provides the greatest amount of degrees necessary to perform the position perfectly. If performed improperly, it can generate problems, specialy in the knees, causing pain. The aim of this study was to evaluate the factors that influence the implemen...

To assess the functional balance of the knee after bicruciate reconstruction and its correlation with clinical score. 14 patients (11 men and three women), mean age 29.9±7.65 years, mean BMI 26.2±2.51 kg/m(2) underwent surgical reconstruction of the Posterior Cruciate Ligament (PCL) and Anterior Cruciate Ligament (ACL) in two stages, with a mean in...

Analyze in vitro the mechanical response of bovine calcaneus tendons subjected to static stretching in three different intervals (15, 30, 45 s). Six groups of bovine calcaneus tendons (n=10) were formed according to the static stretching protocol: three different intervals (15, 30, 45 s) and initial stretching percentage (2.5% and 3.5%). The contro...

Posterior cruciate ligament (PCL) injuries are often associated with other ligament lesions. Multiligament reconstructions require an important quantity of grafts and often determine the need for cadaver allografts during the surgical repair procedures. Herein, the fundamentals of allografts that have been currently used for PCL reconstructions are...

Purpose: Bone surgery around the knee joint could represent a more traumatic prior surgical procedure compared to soft tissue knee surgery and may predispose to differing postoperative total knee arthroplasty (TKA) outcomes. The objective of this study was to analyse the postoperative results as well as complications and failures in two groups of...

This technique of minimal invasive surgical (MIS) approach was developed in an anatomic study performed in 20 cadaveric knees. This MIS approach eliminates section or dissection of any posterior anatomical structures in the popliteal region including the medial gastrocnemius muscle (MGM) and popliteus muscle. Since 2002, the authors have been used...

Knee joint stability is determined by the ligament and capsular complex combined with intact osteocartilaginous structures. The ligaments are described as dense connective collagenous tissue bands that connect one bone to another. Their purpose is to support loads of tension, particularly on their long axis, allowing joint stability and guiding kne...

Isolated degeneration of the medial femorotibial compartment is a common pathologic process, being the source of important social costs due to disease-related disability and treatment expenses (1–3). Simultaneously aff ecting the cartilage, the menisci and, in later stages, the ligaments, it is currently viewed as an irreversible process. In that,...

Intraoperative fractures are a reported complication during the course of primary total knee replacement. Major ligament disruptions can also occur. Clinical data are lacking to tell how much these incidents affect implantation quality and outcome. A thorough knowledge of these occasional incidents helps proper decision making when confronted to su...

Introduction Nous avons, dans une série d’arthroplasties totales du genou postérostabilisées de première intention (PTG à glissement postérostabilisée avec un troisième condyle médian du laboratoire Tornier®), dénombré toutes les complications mécaniques survenues pendant la réalisation de l’arthroplastie et analysé la cause de leur survenue. Nous...

The purpose of this study was to evaluate cases of early aseptic failures presented during the first 5-year follow-up in a group of 981 primary total knee arthroplasty (primary TKA). Predisposing factors as well causes of failures and postoperative complications in different groups of aseptic failures were re-assessed and compared to a control grou...

OBJECTIVE: To analyze and to identify possible gait adaptations by individuals with objective patellofemoral instability when climbing up/down stairs. METHODS: A control group (group A) composed by nine women with mean age = 25 years (±1.87), height = 1.62 m (±0.05) and weight = 56.20 kg (±7.34), and; nine women with objective patellofemoral instab...

Objective: To analyze and to identify possible gait adaptations by individuals with objective patellofemoral instability when climbing up/down stairs. Methods: A control group (group A) composed by nine women with mean age = 25 years (+/- 1.87), height = 1.62 m (+/- 0.05) and weight = 56.20 kg (+/- 7.34), and; nine women with objective patellofemor...

According to literature, knee arthroscopy is a minimal invasive surgery performed for minor surgical trauma, reduced morbidity and shortens the hospitalization period. Therefore, this type of surgery before total knee arthroplasty (TKA) could be considered a minor procedure with minimum postoperative complication. A retrospective and cohort series...

The objective of this study was to investigate the influence of tibial tubercle osteotomy on postoperative outcome, intra- and postoperative complications, as well as postoperative clinical results and failures in primary total knee arthroplasty (TKA). In a continuous, consecutive series of 1474 primary TKA, we analysed 126 cases where a tibial tub...

Neste trabalho, 22 pacientes com fraturas ipslaterais do fêmur e da tíbia ("joelho flutuante") tratados cirurgicamente foram convocados para reavaliação. Com seguimento mínimo de 4 meses, 17 pacientes compareceram e foram reavaliados através de exame físico, radiológico, escala de Lysholm e o escore de Kärlstron. As fraturas foram classificadas qua...

Lesion of the anterior cruciate ligament (ACL) in the knee is a problem that affects animals as well as humans and may evolve with joint instability that is often symptomatic and incapacitating. The main option for ligament substitution is the autologous tendon graft. The graft undergoes tensioning during ACL reconstructive surgery to reestablish t...

Neste trabalho, 22 pacientes com fraturas ipslaterais do fêmur e da tíbia ("joelho flutuante") tratados cirurgicamente foram convocados para reavaliação. Com seguimento mínimo de 4 meses, 17 pacientes compareceram e foram reavaliados através de exame físico, radiológico, escala de Lysholm e o escore de Kärlstron. As fraturas foram classificadas qua...

Numerous surgical techniques have been described to treat episodic patellar dislocations (EPD). Some of them involve the soft tissues while others primarily address a bony correction. Tibial tubercle osteotomy is used to perform a distal realignment of the extensor apparatus. Four principal anatomical factors have been identified that increase the...

SUMMARY We assessed 21 patients (16 males and 5 females), with mean age of 27.6 years who underwent surgical treatment for PCL avulsion fracture. In 57% of the cases, injuries were secondary to motorcycle accidents and 19% resulted from car accidents. Injuries on knee's anterior surface were detected in 71% of the cases. The surgical procedure invo...

We assessed 21 patients (16 males and 5 females), with mean age of 27.6 years who underwent surgical treatment for PCL avulsion fracture. In 57% of the cases, injuries were secondary to motorcycle accidents and 19% resulted from car accidents. Injuries on knee.s anterior surface were detected in 72% of the cases. The surgical procedure involved pos...

During knee ligament reconstruction, the tendon graft is tensioned to prevent the occurrence of excessive graft elongation during the postoperative period. Tensioning may be achieved by applying a cyclic or static load to the graft during fixation. Although this procedure is part of the surgery, there is no consensus in international literature reg...

Este trabalho teve por finalidade analisar o comportamento de tendões calcâneo bovino submetidos a ensaios mecânicos cíclicos. Para cada corpo de prova foram aplicados três ensaios de dez ciclos de tração e três níveis de deformação: 2,5%, 3% e 4%. Ao término de cada ensaio o tendão era mantido em repouso por 300 s. A velocidade de carregamento ado...

RESUMO Este trabalho teve por finalidade analisar o comportamento de tendões calcâneo bovino submetidos a ensaios mecânicos cíclicos. Para cada corpo de prova foram aplicados três ensaios de dez ciclos de tração e três níveis de deformação: 2,5%, 3% e 4%. Ao término de cada ensaio o tendão era mantido em repouso por 300 s. A velocidade de carregame...

Surgical reconstruction of the knee posterior cruciate ligament (P.C.L.) still remains as a major therapeutic challenge. In this paper, we assessed 30 patients submitted to surgical reconstruction of the P.C.L. with a technique of tendinous graft fixation on tibial bed by direct approach ("INLAY"). Twentyeight male patients and 2 female patients, w...

Surgical reconstruction of the knee posterior cruciate ligament (P.C.L.) still remains as a major therapeutic challenge. In this paper, we assessed 30 patients submitted to surgical reconstruction of the P.C.L. with a technique of tendinous graft fixation on tibial bed by direct approach ("INLAY"). Twenty-eight male patients and 2 female patients,...

SUMMARY Surgical reconstruction of the knee posterior cruciate ligament (P.C.L.) still remains as a major therapeutic challenge. In this paper, we assessed 30 patients submitted to surgical reconstruction of the P.C.L. with a technique of tendinous graft fixation on tibial bed by direct approach ("INLAY"). Twenty- eight male patients and 2 female p...

Na cirurgia de reconstrução do ligamento cruzado anterior do joelho, os enxertos de tendões autólogos são a principal opção como substitutos ligamentares. Entretanto, uma das razões da falha da reconstrução ligamentar com tecidos moles é o estiramento ou elongamento do enxerto com o tempo. Neste trabalho, foram ensaiados oito tendões do músculo grá...

Na cirurgia de reconstrução do ligamento cruzado anterior do joelho, os enxertos de tendões autólogos são a principal opção como substitutos ligamentares. Entretanto, uma das razões da falha da reconstrução ligamentar com tecidos moles é o estiramento ou elongamento do enxerto com o tempo. Neste trabalho, foram ensaiados oito tendões do músculo grá...

O uso de tendões humanos, de forma isolada ou associada, em reconstruções ligamentares do joelho é uma prática usual. A utilização desses enxertos (tendão patelar, duplo semitendinoso associado ao duplo grácil) apresenta evolução pós-operatória diferente, quando analisados os parâmetros : perda mínima da extensão, deslocamento ântero-posterior (art...

O uso de tendões humanos, de forma isolada ou associada, em reconstruções ligamentares do joelho é uma prática usual. A utilização desses enxertos (tendão patelar, duplo semitendinoso associado ao duplo grácil) apresenta evolução pós-operatória diferente, quando analisados os parâmetros : perda mínima da extensão, deslocamento ântero-posterior (art...