Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Jul;127(4):190-7.
doi: 10.1590/s1516-31802009000400003.

Approach towards total knee arthroplasty in Brazil: cross-sectional study

Raul Frankllim de Carvalho Almeida  1 , Antônio Altenor Bessa de Queiroz, João Carlos Belloti, José Maria Bedran de Castro Filho, Moisés Cohen, Ricardo Dizioli Navarro
Affiliations

Approach towards total knee arthroplasty in Brazil: cross-sectional study

Raul Frankllim de Carvalho Almeida et al. Sao Paulo Med J. 2009 Jul.

Abstract
in English, Portuguese

Context and objective: Total knee arthroplasty (TKA) has evolved particularly since the 1970s, with improvements in implants and surgical instruments, and has thus become an effective intervention for treating knee arthrosis. Many studies have presented rates of satisfactory clinical and radiological results greater than 90%, from follow-ups of over ten years. Nevertheless, despite scientific evidence showing the efficacy of TKA, the approaches taken present controversies in certain respects. The objective of this study was to evaluate how the Brazilian orthopedists deal with TKA, with investigation of the main aspects of this procedure.

Design and setting: Cross-sectional survey conducted during the 39th Brazilian Congress of Orthopedics and Traumatology, in São Paulo, Brazil, in November 2007.

Methods: We applied a questionnaire to orthopedists registered at the congress. The questionnaire was randomly distributed and participation was voluntary; 858 completed questionnaires were included in the analysis.

Results: Most of the Brazilian orthopedists were members of SBOT and worked in the southeastern region. They used imported cemented implants through an anterior access route centered on the patella, with replacement of the joint surface of the patella and preservation of the posterior cruciate ligament. They did not have experience with simultaneous bilateral TKA. Postoperatively, they used antibiotics and suction drains for 48 hours. There was no consensus regarding prophylaxis for venous thromboembolism or the frequency of the main complications.

Conclusion: The majority of Brazilian orthopedists work in the southeastern region of the country and agree about the main aspects of the approaches towards TKA.

CONTEXTO E OBJETIVO:: A artroplastia total do joelho (ATJ) evoluiu sobremaneira desde os anos 70, com melhora dos implantes e do instrumental cirúrgico, tornando-se uma intervenção efetiva para o tratamento da artrose do joelho. Muitos estudos apresentam resultados clínicos e radiológicos satisfatórios superiores a 90% no acompanhamento acima de 10 anos. Apesar das evidências científicas sobre sua eficácia da ATJ, a sua abordagem apresenta controvérsias em alguns aspectos. O objetivo do estudo foi avaliar como o ortopedista brasileiro aborda a ATJ e os principais aspectos técnicos na realização deste procedimento.

TIPO DE ESTUDO E LOCAL:: Estudo transversal, realizado durante o 39o Congresso Brasileiro de Ortopedia e Traumatologia em São Paulo, Brasil, em novembro de 2007.

MÉTODOS:: Aplicamos um questionário aos ortopedistas inscritos no congresso. A distribuição foi aleatória com adesão voluntária. Foram incluídos 858 questionários para análise.

RESULTADOS:: A maioria dos Ortopedistas Brasileiros são membros da SBOT e atua na região sudeste. Usam o implante importado, cimentado, por via de acesso anterior centrada na patela, com substituição da superfície articular da patela e preservação do ligamento cruzado posterior e não tem experiência com a artroplastia total bilateral simultânea. No pós-operatório utilizam antibióticos e dreno de sucção por 48 horas. Não houve consenso quanto à profilaxia para tromboembolismo venoso e frequência das principais complicações.

CONCLUSÃO:: A maioria dos ortopedistas brasileiros trabalha na região sudeste e concorda quanto aos principais aspectos da abordagem da ATJ.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest: None

Figures

Graph 1.
Graph 1.. Training.
Graph 2.
Graph 2.. Number of orthopedists per region of Brazil.
Graph 3.
Graph 3.. Number of total knee arthroplasty (TKA) procedures performed per year.
Graph 4.
Graph 4.. Type of implant used, with regard to manufacture.
Graph 5.
Graph 5.. Type of cementation for implant.
Graph 6.
Graph 6.. Replacement of the joint surface of the patella.
Graph 7.
Graph 7.. Type of implant, with regard to preservation of the posterior cruciate ligament.
Graph 8.
Graph 8.. Simultaneous bilateral total knee arthroplasty.
Graph 9.
Graph 9.. Use of antibiotic prophylaxis.
Graph 10.
Graph 10.. Preference regarding surgical access route.
Graph 11.
Graph 11.. Use of suction drain after the operation.
Graph 12.
Graph 12.. Use of prophylaxis for venous thromboembolism.
Graph 13.
Graph 13.. Duration of prophylaxis for venous thromboembolism in weeks.
Graph 14.
Graph 14.. Main complications observed after the operation.
None
See this image and copyright information in PMC

References

    1. Bozic KJ, Kinder J, Meneghini RM, Zurakowski D, Rosenberg AG, Galante JO. Implant survivorship and complication rates after total knee arthroplasty with a third-generation cemented system: 5 to 8 years followup. Clin Orthop Relat Res. 2005;(430):117–124. - PubMed
    1. Rand JA, Ilstrup DM. Survivorship analysis of total knee arthroplasty. Cumulative rates of survival of 9200 total knee arthroplasties. J Bone Joint Surg Am. 1991;73(3):397–409. - PubMed
    1. Ranawat CS, Flynn WF, Jr, Saddler S, Hansraj KK, Maynard MJ. Long-term results of the total condylar knee arthroplasty. A 15-year survivorship study. Clin Orthop Relat Res. 1993;(286):94–102. - PubMed
    1. Ritter MA, Herbst SA, Keating EM, Faris PM, Meding JB. Long-term survival analysis of a posterior cruciate-retaining total condylar total knee arthroplasty. Clin Orthop Relat Res. 1994;(309):136–145. - PubMed
    1. Font-Rodriguez DE, Scuderi GR, Insall JN. Survivorship of cemented total knee arthroplasty. Clin Orthop Relat Res. 1997;(345):79–86. - PubMed

MeSH terms