ABSTRACT Objective: The aim of this study is to compare micro-sutures commonly used in our midst. Methods: In this double-blind study, 30 Wistar rats were operated randomly divided into three groups matched according to the suture used (Nylon 10-0, 75micron, brands Microsuture(r), Polysuture(r) and Ethicon(r)). We analyzed the number of surgical nodes required, bleeding, surgical time and histological evaluation. Results: There was no significant difference between the amount of stitches of arterial suture per anastomosis. Surgical time was longer in Microsuture(r) group as compared to Polysuture(r) (p ≤ 0.05). Bleeding in Microsuture(r) group was higher when compared to the others (p <0.01). In the histological analysis, the Microsuture(r) group showed a greater tendency to develop fibrosis and aneurysm in surgical site than the others (p <0.01 and p≤0,05, respectively). Similarly, the Ethicon(r) group showed less tendency to myointimal proliferation than the rest. (p = 0.025). Conclusion: The results confirm the relevance of the choice of surgical thread as an independent determining factor for the success of the procedure, besides serving as a rational subsidy for a better cost-benefit analysis. Level of Evidence I, Experimental Study, Controlled Animal Study.

OBJETIVO: Avaliar os resultados a longo prazo de setenta pacientes submetidos à artrodese do quadril pela técnica original descrita por Davis. MÉTODOS: Realizamos um estudo clínico retrospectivo com 70 pacientes, operados entre 1982 e 1995. A presença de sintomas sobre a coluna lombar, joelho ipsilateral e quadril contralateral foi aferida assim como o sucesso da consolidação da artrodese, o posicionamento da mesma e a eventual indicação para conversão à artroplastia total do quadril. RESULTADOS: O tempo médio de seguimento foi 21,6 anos. Uma consolidação satisfatória foi constatada em 48 pacientes (85,7%). A dor lombar foi presente em 11 pacientes (19,6%) e osteoartrite dolorosa do joelho em quatro pacientes (7,1%). Discussão: Dois trabalhos com seguimento superior ao nosso estudo ( 35 e 38 anos) apresentaram repercussões sobre a coluna lombar mais prevalentes (57% e 62%), assim como dor no joelho homolateral (45% e 57%) e indicação para conversão em artroplastia total do quadril (17% e 28%). CONCLUSÃO: Concluímos que a artrodese do quadril pela técnica de Davis apresenta resultados satisfatórios até o vigésimo ano, porém a presença de dor lombar é mais frequente com o passar dos anos e a dor no joelho homolateral sugere associação com a posição inicial em abdução do quadril artrodesado. Nivel de Evidência III, estudo clinico.

OBJECTIVE: To evaluate the long-term results of seventy patients who underwent hip arthrodesis using the original technique described by Davis. METHODS: We carried out a retrospective study involving seventy patients submitted to hip arthrodesis between 1982 and 1995. The presence of symptoms involving the lumbar spine, ipsilateral knee, and contralateral hip was noted, as well as the success of the arthrodesis fusion, its positioning, and the need for conversion surgery to total hip replacement. RESULTS: The mean follow-up time was 21.6 years. A satisfactory hip fusion was found in 48 patients (85.7%). Lumbar spine pain was reported by 11 patients (19.6%) and ipsilateral knee osteoarthritis was found in four patients (7.1%). Discussion: Two works, with a longer follow-up time (35 and 38 years) present more prevalent symptoms involving the lumbar spine (57% and 62% ) and ipsilateral knee joint (45% and 57%), and higher conversion surgery rates (17% e 28%). CONCLUSION: hip arthrodesis by the Davis technique presents satisfactory results until the 20th year after surgery, however lumbar spine disease seems to become more prevalent over the years, and the pain in the homolateral knee suggests an association with the initial position in abduction of the hip submitted to arthrodesis. Level of Evidence: Level III clinical study.

OBJETIVO: Avaliar a ocorrência de luxação nas artroplastias totais do quadril não cimentadas, comparando-se os acessos posterior e lateral direto. Métodos: Estudo retrospectivo comparativo com 232 pacientes submetidos à artroplastia total do quadril não cimentada, por diagnóstico de osteoartrose primária e secundária, sendo 105 submetidos ao acesso posterior e 127 ao acesso lateral. O modelo protético utilizado foi único, assim como o protocolo de reabilitação e cuidados pós-operatórios. Foram verificados ocorrência de luxação, posicionamento acetabular e componentes utilizados. RESULTADOS: Ocorreu um caso isolado de luxação no grupo do acesso lateral direto (0,8%) contra 0% no grupo de pacientes submetidos ao acesso posterior, sem diferença significativa (p = 1). A luxação ocorreu em uma paciente de 47 anos de idade, que foi tratada com redução incruenta sem recidiva da luxação após três anos e um mês de seguimento. O tempo de seguimento dos dois grupos variou entre seis e 42 meses, com média de 23,7 meses. CONCLUSÃO: Os autores concluem que a prevalência de luxação nas artroplastias totais do quadril é similar nos dois acessos estudados e que medidas educativas, técnica cirúrgica adequada e utilização de próteses com offsets maiores podem diminuir o risco dessa complicação.

OBJECTIVES: Our primary aim was to evaluate the occurrence of dislocation of non-cemented total hip arthroplasty, when using the posterior and the direct lateral approaches. METHODS: We performed a comparative retrospective study with 232 patients submitted to non-cemented total hip arthroplasty, due to the diagnosis of primary or secondary osteoarthritis. The posterior approach was used in 105 patients while direct lateral approach was used in 127 patients. There was only one prosthesis model and the same rehabilitation program and post-operative care was used for all patients. We checked the occurrence of dislocation, the acetabular positioning and also the size of the components. RESULTS: There was only one case of dislocation, treated with closed reduction successfully. This was a 47 year-old female, submitted to direct lateral approach. The mean follow-up time for both groups was 23.7 months, ranging from six to 42 months. Conclusion: The authors conclude that the prevalence of total hip arthroplasty dislocation is similar for both approaches, and educational measures besides the use of a higher femoral offset seem to reduce the risk of this complication.