FIGUEROA BERRIOS, FRANCISCO JAVIER
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FIGUEROA BERRIOS, FRANCISCO JAVIER
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ffigeroa@udd.cl
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36096587900

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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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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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Trends in Total Knee Arthroplasty in a Developing Region: A Survey of Latin American Orthopaedic Surgeons

2020 , David Limo Figueroa , FIGUEROA BERRIOS, FRANCISCO JAVIER , CALVO RODRIGUEZ, RAFAEL , Alex Vaisman , Figueroa, María , Sven Putnis

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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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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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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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Five-Strand Hamstring Autograft Versus Quadruple Hamstring Autograft With Graft Diameters 8.0 Millimeters or More in Anterior Cruciate Ligament Reconstruction: Clinical Outcomes With a Minimum 2-Year Follow-Up

2017 , CALVO RODRIGUEZ, RAFAEL , David Figueroa , Alex Vaisman , Francisco Figueroa , Andrés Schmidt-Hebbel , Nelson Morales , Guillermo Izquierdo

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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 the Graft Appears to Prevent Infection After Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis

2021 , FIGUEROA BERRIOS, FRANCISCO JAVIER , FIGUEROA POBLETE, DAVID HUMBERTO , CALVO RODRIGUEZ, RAFAEL , Alex Vaisman , Marilaura Nuñez , Sven Putnis

Background: Vancomycin presoaking of the graft has been shown to decrease infection rates in some case series of anterior cruciate ligament (ACL) reconstruction. Purpose: We sought to substantiate the efficacy of vancomycin presoaked grafts for the prevention of infection after ACL reconstruction. Methods: We performed a systematic review of Medline and OVID to assess the incidence of postoperative infection in studies comparing patients undergoing ACL reconstruction with the use of vancomycin presoaked ACL grafts and a control group of patients undergoing ACL reconstruction without the use of presoaked grafts. The efficacy of vancomycin presoaking was calculated using the Agresti-Coull confidence interval. Relative risk (RR) was calculated for every study and the total sample. Results: The 11 studies that met inclusion criteria comprised 24,298 patients. In patients with vancomycin presoaking of the graft, 1 infection was reported in 8764 cases (0.01% rate). In the studies with control groups that did not have vancomycin presoaked grafts, there were 125 infections in 15,534 ACL reconstructions (0.8% rate). The efficacy of vancomycin presoaking in preventing infection after ACL reconstruction was 99.9% (0.999%–1.000% CI). The overall RR obtained was 0.07 (0.03–0.16 CI). All included studies were retrospective cohort studies (level III). Conclusions: Vancomycin presoaking of the graft has been shown to decrease infection rates after ACL reconstruction in studies of low evidence level. This suggests the need for prospective randomized controlled trials addressing this issue so that recommendations on the routine use of vancomycin presoaking of ACL grafts can be made with confidence.

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Graft choice in combined anterior cruciate ligament and medial collateral ligament reconstruction

2020 , FIGUEROA BERRIOS, FRANCISCO JAVIER , David Figueroa , CALVO RODRIGUEZ, RAFAEL , Alex Vaisman , João Espregueira-Mendes

There is a concern regarding which grafts should be used in combined anterior cruciate ligament (ACL) and medial collateral ligament (MCL) reconstructions, with a paucity of recommendations focused on this specific topic. Expert opinions suggest the use of allograft-only reconstructions to limit donor-site morbidity or using at least one allograft and one autograft. When a hamstring tendon autograft is harvested, techniques that maintain both the integrity of the sartorius fascia and the gracilis are recommended because of the role that the ST-G-S (semitendinosus-gracilis-sartorius) complex plays in valgus stability in the setting of an MCL-deficient knee. Cite this article: EFORT Open Rev 2020;5:221-225. DOI: 10.1302/2058-5241.5.190049

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