Universidad del Desarrollo

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Editorial Commentary: Use of Platelet-Rich Plasma in Anterior Cruciate Ligament Reconstruction: Should We Abandon?
(2020)
DAVID HUMBERTO FIGUEROA POBLETE
Scopus© Citations 1 16
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Osteochondral Autologous Transplantation for Treating Patellar High-Grade Chondral Defects: A Systematic Review
(2019)
Rodrigo Donoso
;
DAVID HUMBERTO FIGUEROA POBLETE
;
Jaime Espinoza
;
Claudio Yañez
;
Jamil Saavedra
<jats:sec><jats:title>Background:</jats:title><jats:p>Patellar cartilage defects account for 34.6% of defects found during routine arthroscopy. These defects pose a challenge in orthopaedic surgery because they have been associated with worse outcomes after surgical repair compared with other chondral lesions within the knee.</jats:p></jats:sec><jats:sec><jats:title>Purpose:</jats:title><jats:p>To systematically review the literature for evidence on results of osteochondral autologous transplantation (OAT) for the management of isolated patellar cartilage high-grade defects (International Cartilage Repair Society [ICRS] grade 3-4).</jats:p></jats:sec><jats:sec><jats:title>Study Design:</jats:title><jats:p>Systematic review; Level of evidence, 4.</jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p>A systematic review of the literature was performed to find studies that addressed outcomes regarding OAT to treat patellar high-grade cartilage defects (ICRS grade 3-4). Studies addressing patient-reported outcomes, return to sports, or magnetic resonance imaging (MRI) at follow-up after isolated OAT procedures for patellar cartilage defects were included.</jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p>A total of 5 studies were included in this review. We were not able to perform a meta-analysis as no studies had available data. A total of 102 patients who received an isolated OAT for a patellar chondral defect were included in these 5 studies. All patients showed significant improvement at final follow-up based on the following patient-reported outcome scores: Lysholm, International Knee Documentation Committee, Kujala, Tegner, and 36-Item Short Form Health Survey. We found that 4 studies used MRI during the first postoperative year to assess osteochondral plug integration and positioning. The results demonstrated that most plugs were integrated and correctly positioned when evaluated at follow-up, conducted on average after 12 months. Whether patients were able to return to sports was queried in 2 of the included studies, revealing that patients could return to their previous level in most cases (Tegner score, 5-9 at 2 years after surgery).</jats:p></jats:sec><jats:sec><jats:title>Conclusion:</jats:title><jats:p>Results indicate that OAT is a safe and reliable technique to treat patellar high-grade osteochondral defects, allowing for significant improvement in patient-reported outcomes and return to sports.</jats:p></jats:sec>
Scopus© Citations 24 1
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Réplica a: Utilidad de la resonancia magnética en la evaluación del mal alineamiento patelar
(2014)
DAVID HUMBERTO FIGUEROA POBLETE
;
F. Novoa
;
P. Meleán
;
CALVO RODRIGUEZ, RAFAEL
;
A. Vaisman
52
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Total knee replacement in patients with osteoarthritis and concomitant inveterate patellar dislocation
(2019)
David Figueroa
;
Alan Garín
;
Francisco Figueroa
;
DAVID HUMBERTO FIGUEROA POBLETE
Scopus© Citations 7 1
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Presoaking of Hamstring Autografts in Vancomycin Decreases the Occurrence of Infection Following Primary Anterior Cruciate Ligament Reconstruction
(2019)
David Figueroa
;
Francisco Figueroa
;
CALVO RODRIGUEZ, RAFAEL
;
Mario Lopez
;
Ignacio Goñi
<jats:sec><jats:title>Background:</jats:title><jats:p> Postoperative septic arthritis is an uncommon but potentially devastating complication after anterior cruciate ligament (ACL) reconstruction. Our group started presoaking grafts with vancomycin to decrease this risk. </jats:p></jats:sec><jats:sec><jats:title>Purpose:</jats:title><jats:p> To compare the rate of septic arthritis in primary hamstring autograft ACL reconstruction with and without vancomycin-presoaked grafts. </jats:p></jats:sec><jats:sec><jats:title>Study Design:</jats:title><jats:p> Cohort study; Level of evidence, 3. </jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p> Consecutive periods were studied, inclusive of April 2013 through October 2015 (pre-vancomycin protocol) and November 2015 through May 2018 (vancomycin protocol). A total of 490 patients were included in the study: 230 in the pre-vancomycin protocol and 260 in the vancomycin protocol. All patients who underwent a primary hamstring autograft ACL reconstruction by 2 senior surgeons during the periods studied were included. The final outcome studied was occurrence of highly probable postoperative septic arthritis in both groups. Diagnosis of probable septic arthritis was made by clinical diagnosis as well as cytological analysis of joint aspiration (cell count >50,000/μL and >90% neutrophils). Statistical analysis was performed with the Fisher exact test. Significance was set at P < .05. </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> Four cases of probable postoperative septic arthritis were noted in the pre-vancomycin protocol (1.7%; 2 cases per surgeon), while no cases of septic arthritis were noted in the vancomycin protocol during the study period ( P < .05). Diagnosis was made at a mean 21.7 days (range, 16-25 days). Staphylococcus epidermidis was isolated in 2 cases, and in the other 2 cases, no organism was isolated. </jats:p></jats:sec><jats:sec><jats:title>Conclusion:</jats:title><jats:p> Presoaking of hamstring autografts in vancomycin for primary ACL reconstruction prevented the occurrence of postoperative septic arthritis during the study period as compared with no soaking of the grafts. </jats:p></jats:sec>
13Scopus© Citations 31

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