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    Scopus© Citations 17  1
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    The double posteromedial portals endoscopy for posterior ankle impingement syndrome in athletes
    (2022)
    Nicola Maffulli
    ;
    Rocco Aicale
    ;
    Filippo Migliorini
    ;
    WAGNER, EMILIO  
    ;
    Amol Saxena
    <jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>Posterior ankle impingement syndrome (PAIS) may result from flexor hallucis longus tendinopathy, compression of the posterior process of the talus from the presence of an os trigonum, soft-tissue impingement, or a combination of these. Posterior extra-articular endoscopy performed with the patient supine through the double posteromedial portals, with excision of adhesions, excision of the posterior process of the talus or an os trigonum, and decompression of the tendon of the flexor hallucis longus (FHL), can be used in athletes with PAIS.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>Thirty-four athletes with PAIS in whom conservative management had failed underwent posterior ankle endoscopy in the supine position using the double posteromedial portals. The patients were assessed pre- and postoperatively using the American Orthopaedic Foot and Ankle Society hindfoot scale score, the Tegner scale, and the simple visual analogue scale. Time of surgery, return to sports, patient satisfaction, and complications were recorded and analysed. The average length of postoperative follow-up was 26.7 ± 12.6 (range 24 to 72) months.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>The mean Tegner activity scale score improved to 9 ± 0.2 postoperatively (<jats:italic>p</jats:italic> &lt; 0.05), while the mean American Orthopaedic Foot and Ankle Society scale score improved to 96 ± 5.1 (range 87 to 100) postoperatively, with 29 of 34 patients (85.3%) achieving a perfect score of 100 (<jats:italic>p</jats:italic> &lt; 0.05). The mean time to return to sports was 8.7 ± 0.7 (range 8 to 10) weeks. The complication rate was low, with no superficial wound infections or venous thromboembolism events; only two patients (5.9%) reported pain and tenderness by 3 months after the index procedure.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusion</jats:title> <jats:p>Posterior ankle endoscopy for the resection of a posterior process of the talus or an os trigonum and decompression of the tendon of FHL is safe and allows excellent outcomes with low morbidity in athletes with PAIS.</jats:p> </jats:sec>
    Scopus© Citations 4  1
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    Functional and radiologic results of the crimson duvet procedure in rotator cuff treatment: a randomized controlled clinical trial
    (2022)
    Felipe Toro
    ;
    Fernando Pinochet
    ;
    Francisco Ruiz
    ;
    Claudio Moraga
    ;
    Rene Pozo
      31Scopus© Citations 23
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    Scopus© Citations 5  1
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    High-Grade Patellar Chondral Defects: Promising Results From Management With Osteochondral Autografts
    (2020)
    FIGUEROA POBLETE, DAVID HUMBERTO  
    ;
    CALVO RODRIGUEZ, RAFAEL  
    ;
    Rodrigo Donoso
    ;
    Jaime Espinoza
    ;
    Alex Vaisman  
    <jats:sec><jats:title>Background:</jats:title><jats:p>Patellar chondral defects represent up to 34.6% of defects found during routine arthroscopy. Surgical management has evolved during the past 20 years in an effort to develop techniques to replace hyaline cartilage. Currently, the only technique that achieves this is osteochondral autologous transfer (OAT). Although good and excellent results have often been reported at midterm and long-term follow-up for femoral lesions, little is known about isolated patellar defects.</jats:p></jats:sec><jats:sec><jats:title>Purpose:</jats:title><jats:p>To assess clinical and imaging results of patients treated with OAT for high-grade patellar defects.</jats:p></jats:sec><jats:sec><jats:title>Study Design:</jats:title><jats:p>Case series; Level of evidence, 4.</jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p>This was a retrospective study on all patients who received OAT for high-grade symptomatic patellar chondral defects between 2010 and 2018 at our institution. The study included patients younger than 40 years of age with anterior knee pain and a grade 4 International Cartilage Repair Society patellar chondral defect between 1 and 2.5 cm<jats:sup>2</jats:sup>. Patients with surgery in other knee compartments, concomitant anterior cruciate ligament ruptures, infection, rheumatoid arthritis, and degenerative lesions were excluded. Six months postoperatively, all patients underwent magnetic resonance imaging (MRI) to allow assessment of graft integrity via the MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) score to evaluate morphologic features and integration. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Kujala scores were used to assess functional outcomes at final follow-up.</jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p>A total of 26 patients who received a patellar OAT were included. Most patients were male (88.4%), and the mean ± SD age was 28.5 ± 9.7 years. Patellar chondral defects had a median size of 180 mm<jats:sup>2</jats:sup>(range, 64-250 mm<jats:sup>2</jats:sup>), and patients received a median of 1 autograft (range, 1-3). Functional outcomes assessed at a minimum of 1 year after surgery showed a mean Kujala score of 90.42 ± 6.7 and a mean WOMAC score of 95 ± 3.6. MRI revealed a median MOCART score of 75 points (range, 20-90 points).</jats:p></jats:sec><jats:sec><jats:title>Conclusion:</jats:title><jats:p>To our knowledge, this is the largest series to date regarding isolated patellar OAT. At midterm follow-up, most patients reported good and excellent results regarding symptoms and activity levels. Most autografts showed good osseous integration and excellent filling of the chondral surface, as evidenced on MRI. OAT is a good alternative to treat high-grade patellar chondral defects, especially among young patients.</jats:p></jats:sec>
    Scopus© Citations 11  1
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    Arthroscopy-Assisted Latissimus Dorsi Transfer for Irreparable Subscapularis Tears
    (2021)
    Felipe Reinares
    ;
    Andres Calvo
    ;
    José T. Reyes
    ;
    José L. Moreno
    ;
    Daniel Paccot
      13Scopus© Citations 3
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    Tibial tubercle avulsion fractures in children
    (2020)
    Pia Franz
    ;
    Eva Luderowski
    ;
    María Tuca  
    Scopus© Citations 24  2
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    Hip arthroscopy and osteoarthritis: Where are the limits and indications?
    (2015)
    Claudio Mella
    ;
    Ignacio E. Villalón
    ;
    Álvaro Núñez
    ;
    Daniel Paccot
    ;
    Claudio Díaz-Ledezma
      13Scopus© Citations 24