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Exploração da hipótese de criação e implementação de um registo de reconstruções do ligamento cruzado anterior do joelho em Portugal
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Resumo(s)
Com o aumento do número de doentes submetidos a cirurgia de reconstrução do ligamento cruzado
anterior (LCA) do joelho, torna-se fundamental desenvolver ferramentas que possibilitem o seu estudo e
otimização. É neste contexto que surgem os registos de reconstruções do LCA. Este trabalho pretende
explorar a hipótese de criação e implementação de um registo de reconstruções do LCA em Portugal,
compreendendo o levantamento do estado da arte dos registos do LCA, a exploração do Registo
Português de Artroplastias (RPA) e a auscultação da opinião dos médicos ortopedistas quanto à temática
em estudo. Para o efeito, procedeu-se a uma pesquisa sistemática com recurso ao Google, Medline (via
Pubmed) e Cohcrane Library, e ao desenvolvimento de um inquérito em formato online através da
plataforma de formulários da Google, com posterior análise estatística dos dados recorrendo aos
softwares Microsoft Excel e SPSS. Apurou-se que os registos do LCA encontrados assemelham-se bastante
entre si, sobretudo no que diz respeito à natureza dos dados recolhidos e às metodologias de recolha,
organização e divulgação dos mesmos. Caracterizam-se pela recolha de dados do pré/intra/pósoperatório
através do preenchimento de formulários estandardizados, em papel ou digital, procurando
envolver tanto o cirurgião como o doente, divulgando posteriormente os seus dados através de relatórios
anuais. Apurou-se que o RPA foi criado e implementado após um processo complexo e moroso,
envolvendo um vasto leque de entidades e respetivos apoios ou pareceres favoráveis. A sua organização
está dependente de diversas comissões e tanto o seu modus operandi como a divulgação dos conteúdos
assemelham-se bastante ao observado para os registos do LCA. Porém, desde 2013/2014 que o RPA não
reporta a sua atividade. O inquérito realizado revelou que a maioria dos ortopedistas inquiridos considera
exequível e de uma importância elevada a criação e implementação de um registo do LCA em Portugal,
mostrando-se disposta a colaborar caso o projeto se concretize. No entanto, alguns inquiridos apontam
as questões burocráticas, o baixo sucesso verificado com o RPA e uma provável fraca adesão global como
motivos para não colaboração ou exequibilidade do projeto. Portanto, conclui-se que criar e implementar
um registo do LCA em Portugal constitui uma tarefa difícil, mas exequível e desafiante. Seria necessário
desenvolver formulários estandardizados para a recolha de dados, preferencialmente em formato digital,
desenvolver um website e uma organização competente, reunir parceiros, apoios e financiamento, sendo
também benéfico realizar um balanço formal da experiência portuguesa com um projeto semelhante, o
RPA.
With the increase in the number of patients undergoing surgery to reconstruct the anterior cruciate ligament (ACL) of the knee, it is essential to develop tools that enable its study and optimization. It is in this context that the ACL reconstruction registries arise. The purpose of this work is to explore the hypothesis of creating and implementing a registry of ACL reconstructions in Portugal, comprising the survey of the state of the art of the ACL registries, the exploration of the Portuguese Register of Arthroplasties (PRA) and the hearing of the opinion of orthopedists regarding the topic under study. For this purpose, a systematic search was carried out using Google, Medline (via Pubmed) and Cohcrane Library, and the development of a survey in online format through the Google forms platform, with subsequent statistical analysis of the data using the Microsoft Excel and SPSS software.It was verified that the ACL registries identified are quite similar to each other, especially with regard to the nature of the data collected and the methodologies for collecting, organizing and disseminating them. They are characterized by the collection of pre/intra/post-operative data by filling in standardized forms, on paper or digital, seeking to involve both the surgeon and the patient, with subsequent dissemination of the data by annual reports. It was verified that the PRA was created and implemented after a complex and lengthy process, involving a wide range of entities and their respective support or favorable opinions. Its organization is dependent on several committees and both its modus operandi and the dissemination of contents are very similar to that observed for ACL records. However, since 2013/2014, the PRA does not report its activity. The survey carried out revealed that the majority of surveyed orthopedists consider that the creation and implementation of an ACL registry in Portugal is feasible and of high importance, showing their willingness to collaborate if the project comes to fruition. However, some respondents pointed to bureaucratic issues, the low success seen with the PRA and a likely poor global uptake as reasons for non-collaboration or project feasibility. Therefore, it is concluded that creating and implementing an ACL registry in Portugal is a difficult, but feasible and challenging task. It would be necessary to develop standardized forms for data collection, preferably in digital format, to develop a website and a competent organization, to bring together partners, support and funding, and it would also be beneficial to carry out a formal assessment of the Portuguese experience with a similar project, the PRA.
With the increase in the number of patients undergoing surgery to reconstruct the anterior cruciate ligament (ACL) of the knee, it is essential to develop tools that enable its study and optimization. It is in this context that the ACL reconstruction registries arise. The purpose of this work is to explore the hypothesis of creating and implementing a registry of ACL reconstructions in Portugal, comprising the survey of the state of the art of the ACL registries, the exploration of the Portuguese Register of Arthroplasties (PRA) and the hearing of the opinion of orthopedists regarding the topic under study. For this purpose, a systematic search was carried out using Google, Medline (via Pubmed) and Cohcrane Library, and the development of a survey in online format through the Google forms platform, with subsequent statistical analysis of the data using the Microsoft Excel and SPSS software.It was verified that the ACL registries identified are quite similar to each other, especially with regard to the nature of the data collected and the methodologies for collecting, organizing and disseminating them. They are characterized by the collection of pre/intra/post-operative data by filling in standardized forms, on paper or digital, seeking to involve both the surgeon and the patient, with subsequent dissemination of the data by annual reports. It was verified that the PRA was created and implemented after a complex and lengthy process, involving a wide range of entities and their respective support or favorable opinions. Its organization is dependent on several committees and both its modus operandi and the dissemination of contents are very similar to that observed for ACL records. However, since 2013/2014, the PRA does not report its activity. The survey carried out revealed that the majority of surveyed orthopedists consider that the creation and implementation of an ACL registry in Portugal is feasible and of high importance, showing their willingness to collaborate if the project comes to fruition. However, some respondents pointed to bureaucratic issues, the low success seen with the PRA and a likely poor global uptake as reasons for non-collaboration or project feasibility. Therefore, it is concluded that creating and implementing an ACL registry in Portugal is a difficult, but feasible and challenging task. It would be necessary to develop standardized forms for data collection, preferably in digital format, to develop a website and a competent organization, to bring together partners, support and funding, and it would also be beneficial to carry out a formal assessment of the Portuguese experience with a similar project, the PRA.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2021
Palavras-chave
Ligamento cruzado anterior Reconstrução do ligamento cruzado anterior Registo Registo de reconstruções do ligamento cruzado anterior Ortopedia