RESUMO Objetivo: Estudo comparativo entre tratamento com corticóide e aspirado de medula óssea concentrado (BMAC) para o tratamento de tendinopatias glúteas. Métodos: O ensaio clínico randomizado selecionou pacientes diagnosticados com tendinopatia glútea e os dividiu em dois grupos: (G1) aspirado de medula óssea concentrada e (G2) injeção de corticosteróide. Resultados: Foram selecionados 48 pacientes, dos quais 40 foram monitorados por 6 meses, com melhora nos escores nos dois grupos. Os pacientes que foram submetidos ao tratamento com BMAC tiveram uma melhora estatisticamente significativa nos escores de EVA e nos escores de Lequesne em comparação ao tratamento padrão. Houve uma melhora na avaliação da qualidade de vida em ambos os grupos, sem diferença estatisticamente significativa. Conclusão: O aspirado de medula óssea concentrada surge como uma alternativa ao tratamento padrão da tendinopatia glútea, provando ser uma técnica segura e com resultados promissores quando combinada à terapia comportamental de equipe multidisciplinar. Nível de Evidência II, O ensaio clínico randomizado.

ABSTRACT Objective: To compare bone marrow aspirate concentrate (BMAC) with the standard treatment for gluteal tendinopathies. Methods: 48 patients diagnosed with gluteal tendinopathy at a university hospital were selected by a randomized clinical trial and divided into two groups: (G1) bone marrow aspirate concentrate and (G2) corticosteroid injections. Results: 40 of the 48 selected patients were monitored for six months and both groups showed better scores. Visual analog scale (VAS) scores and Lequesne index were statistically significant higher in patients submitted to BMAC treatment when compared to standard treatment. Both groups improved their quality of life, without statistically significant difference. Conclusion: BMAC constitutes an alternative to gluteal tendinopathy standard treatment, proving to be a safe technique with promising results when combined with multidisciplinary team behavioral therapy. Level of Evidence II, Randomized Clinical Trial.

ABSTRACT To evaluate the efficacy of viscosupplementation in patients with osteoarthritis of the ankle. A systematic review to evaluate the evidence in the literature on the use of viscosupplementation for osteoarthritis of the ankle. For this review, we considered blind randomized prospective studies involving the use of viscosupplementation for osteoarthritis of the ankle. A total of 1,961 articles were identified in various databases. After examining each of the articles, five articles were included in this review. Treatment with intraarticular hyaluronic acid is a safe treatment modality that significantly improves functional scores of patients, with no evidence of superiority in relation to other conservative treatments. Further clinical trials with larger numbers of patients are needed so that we can recommend its use and address unanswered questions . Systematic Review of Randomized Clinical Trials.

Objective: To assess the reproducibility of Tronzo and AO/ASIF classifications for transtrochanteric fractures, in order to determine the most appropriate classification for clinical application, and to evaluate the influence of the level of experience of the observers in the agreement between evaluations.Methods: We selected 30 radiographic images of transtrochanteric fractures of the femur, which were presented to two groups of observers, one formed by expert physicians and the other by resident physicians.Results: When evaluated together, Tronzo classification obtained a Kappa value of 0.44. The same classification assessed by the expert group obtained a value of 0.46, while the group of residents' value was 0.44. Evaluating the AO/ASIF classification of the complete pool analysis the value found was 0.42. For the same classification, analyzed by the expert group, obtained a value of 0.41, and by the group of residents, the Kappa value achieved was 0.42. However, when analyzed in its simplified form, the AO/ASIF classification obtained Kappa values of 0.70 (pooled analysis), 0.68 (experts) and 0.72 (residents), considered concurrent.Conclusion: The AO/ASIF simplified classification showed substantial reproducibility and is, therefore, recommended as the most suitable for clinical application. The level of experience of the observers did not influence significantly the agreement between evaluations. Level of Evidence III, Diagnostic Study - Investigating a Diagnostic Test.