Research Output

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Intraarticular Administration of Dexamethasone after Mesenchymal Stem Cells Implantation Does Not Improve Significantly the Treatment of Preestablished Full-Thickness Chondral Defect in a Rabbit Model

2013 , Maximiliano Espinosa , Alex Vaisman , Nicolas Nazal , FIGUEROA POBLETE, DAVID HUMBERTO , Marcela Gallegos , CONGET MOLINA, PAULETTE ANDREA

Objective: The aim of this study was to evaluate the contribution to hyaline cartilage regeneration of dexamethasone intraarticular administration after autologous mesenchymal stem cells (MSCs) implantation into a preestablished knee full-thickness chondral defect. Design: Full-thickness chondral defects of 4.5 × 4.5 mm2 were surgically made in both medial femoral condyles of adult male New Zealand rabbits. Two weeks later, autologous ex vivo expanded bone marrow–derived MSCs were embedded in hyaluronic acid and implanted into the chondral defects. Immediately and every week after the intervention, dexamethasone 0.25 mg/kg was intraarticularly administered (MSC/dexa-treated group). Six weeks after MSC transplantation, the animals were euthanized and condyles were characterized molecularly according to aggrecan, collagen type II, and collagen type I gene expression (quantitative reverse transcriptase-polymerase chain reaction) and histologically (hematoxylin–eosin staining). Data of MSC/dexa-treated condyles were compared with untreated, dexa-treated, MSC-treated, or normal unlesioned condyles. Results: The ratio between collagen type II expression versus collagen type I expression in MSC/dexa-treated condyles was higher than one, even though the group mean value was not statistically different from that of untreated defects. Histological changes were observed between MSC/dexa-treated and untreated defects mainly in surface regularity and in hyaline matrix abundance. However, International Cartilage Repair Society score analysis did not support robust differences between those groups. Conclusion: Intraarticular administration of dexamethasone after autologous MSC implantation into a preestablished full-thickness chondral defect does not contribute significantly to the regeneration of a tissue with molecular and histological characteristics identical to hyaline cartilage.

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Magnetic Resonance Imaging Evaluation of the Integration and Maturation of Semitendinosus-Gracilis Graft in Anterior Cruciate Ligament Reconstruction Using Autologous Platelet Concentrate

2010 , FIGUEROA POBLETE, DAVID HUMBERTO , Patricio Melean , CALVO RODRIGUEZ, RAFAEL , Alex Vaisman , Nicolás Zilleruelo , FIGUEROA BERRIOS, FRANCISCO JAVIER , Ignacio Villalón

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Platelet-Rich Plasma Use in Anterior Cruciate Ligament Surgery: Systematic Review of the Literature

2015 , FIGUEROA POBLETE, DAVID HUMBERTO , FIGUEROA BERRIOS, FRANCISCO JAVIER , CALVO RODRIGUEZ, RAFAEL , Alex Vaisman , Ximena Ahumada , Sergio Arellano

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Clinical outcomes after arthroscopic treatment of knee osteoarthritis

2013 , FIGUEROA POBLETE, DAVID HUMBERTO , CALVO RODRIGUEZ, RAFAEL , Ignacio E. Villalón , Patricio Meleán , Felipe Novoa , Alex Vaisman

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Aloinjertos óseos y la función del banco de huesos

2011 , CALVO RODRIGUEZ, RAFAEL , FIGUEROA POBLETE, DAVID HUMBERTO , Claudio Díaz-Ledezma , Alex Vaisman , FIGUEROA BERRIOS, FRANCISCO JAVIER

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Osteochondral autografts in full thickness patella cartilage lesions

2011 , FIGUEROA POBLETE, DAVID HUMBERTO , Patricio Meleán , CALVO RODRIGUEZ, RAFAEL , Federico Gili , Nicolas Zilleruelo , Alex Vaisman

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Early Postoperative Results in Robotic-Arm-Assisted Total Knee Replacement versus Conventional Technique: First Latin American Experience

2023 , David Figueroa , Rodrigo Guiloff , Tomas Prado , Loreto Figureoa , Juan Jose Sotomayor , Alberto Alarcon , Francisco Figueroa , Alex Vaisman , Rafael Calvo

AbstractEarly results with robotic-arm-assisted total knee arthroplasty (TKA) are encouraging; nevertheless, literature might be unrepresentative, as it comes mostly from American, European, and Asian countries. There is limited experience and no comparative clinical reports in Latin America, a region of mainly low- and middle-income countries with limited access to these promising technologies. This study aims to compare the early postoperative results of the first Latin American experience with robotic-arm-assisted TKA versus conventional TKA. A cohort study was performed, including 181 consecutive patients (195 knees) with advanced symptomatic knee osteoarthritis (OA) undergoing primary TKA between March 2016 and October 2019. The cohort included 111 consecutive patients (123 knees) undergoing conventional TKA, followed by 70 consecutive patients (72 knees) undergoing robotic-arm-assisted TKA. The same surgical team (surgeon 1 and surgeon 2) performed all procedures. Patients with previous osteotomy, posttraumatic OA, and revision components were not considered. The same anesthetic and rehabilitation protocol was followed. The investigated clinical outcomes (for the first 60 postoperative days) were: surgical tourniquet time, time to home discharge, time to ambulation, postoperative daily pain (Visual Analog Scale), opioid use, range of motion, blood loss, complications, and postoperative mechanical axis. The early clinical postoperative results of this first Latin American comparative experience of robotic-arm-assisted TKA versus conventional technique showed lower opioids requirements and faster functional recovery of ambulation in those patients operated with the robotic system; nevertheless, surgical times were higher, without differences in total postoperative complications and other clinical outcomes.

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Meniscus allograft transplantation: indications, techniques and outcomes

2019 , FIGUEROA BERRIOS, FRANCISCO JAVIER , FIGUEROA POBLETE, DAVID HUMBERTO , CALVO RODRIGUEZ, RAFAEL , Alex Vaisman , João Espregueira-Mendes

New indications for meniscal allograft transplantation (MAT) are being added, but the general expert opinion is that it is still a procedure reserved for symptomatic meniscal loss. Lateral MAT has better clinical outcomes and less failure risk compared to medial MAT. Ideal conditions (low-grade chondral lesions) make MAT a more survivable and successful procedure. Meniscal extrusion after MAT is common and does not seem to alter results. Midterm survivorship of a MAT is reported to be 85–90%, while long-term survivorship decreases to 50–70% depending on chondral status and concomitant procedures. Even if the procedure is a success, there are high possibilities of not being able to resume sports activities. Cite this article: EFORT Open Rev 2019;4:115-120. DOI: 10.1302/2058-5241.4.180052

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Vancomycin presoaking of hamstring autografts to prevent infection in anterior cruciate ligament reconstruction: a narrative review

2021 , FIGUEROA BERRIOS, FRANCISCO JAVIER , Alex Vaisman , CALVO RODRIGUEZ, RAFAEL , David Figueroa , João Espregueira-Mendes

Hamstring autograft use has been linked to an increased risk of infection after anterior cruciate (ACL) reconstruction compared to other grafts. The absolute reason for this remains unclear, with contamination after harvesting and preparation of the graft being the most accepted hypothesis. Using the rationale that a contaminated graft could be the main factor in postoperative septic arthritis and in an effort to maximize the antibiotic efficacy of the graft, the Vancomycin presoaking technique was developed. It has shown success in decreasing the infection rate in ACL reconstruction. In recent years, an important number of research articles using this protocol have appeared, but the technique is still not widely implemented. Recent literature shows that Vancomycin presoaking of the graft has shown a successful decrease in the infection rate after hamstring autograft ACL reconstruction. It has also shown efficacy decreasing the infection rate in other types of grafts (patellar tendon, quadriceps tendon, allograft) and also in patients with concomitant ligament procedures or open surgeries. Despite the positive effects of Vancomycin presoaking reducing the infection rate after ACL reconstruction, the lack of prospective randomized control trials and the heterogeneity of the different studies mean it is not feasible to recommend Vancomycin presoaking of the graft universally for every ACL reconstruction patient. Cite this article: EFORT Open Rev 2021;6:211-216. DOI: 10.1302/2058-5241.6.200059

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Knee Chondral Lesions: Incidence and Correlation Between Arthroscopic and Magnetic Resonance Findings

2007 , FIGUEROA POBLETE, DAVID HUMBERTO , CALVO RODRIGUEZ, RAFAEL , Alex Vaisman , Miguel A. Carrasco , Claudio Moraga , DELGADO BECERRA, OROZIMBA IRIS