CALVO RODRIGUEZ, RAFAEL
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CALVO RODRIGUEZ, RAFAEL
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rcalvo@udd.cl
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20733524800

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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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Lower Limb Symmetry: Comparison of Muscular Power Between Dominant and Nondominant Legs in Healthy Young Adults Associated With Single-Leg-Dominant Sports

2017 , Alex Vaisman , Rodrigo Guiloff , Juan Rojas , DELGADO BECERRA, OROZIMBA IRIS , David Figueroa , CALVO RODRIGUEZ, RAFAEL

Background:Achieving a symmetrical power performance (difference <15%) between lower limbs is generally recommended during sports rehabilitation. However, athletes in single-leg-dominant sports, such as professional soccer players, could develop significant asymmetry between their dominant and nondominant legs, such that symmetry does not act as a viable comparison.Purpose:To (1) compare maximal muscular power between the dominant and nondominant legs in healthy young adults, (2) evaluate the effect of a single-leg-dominant sport activity performed at the professional level, and (3) propose a parameter of normality for maximal power difference in the lower limbs of this young adult population.Study Design:Controlled laboratory study.Methods:A total of 78 healthy, male, young adults were divided into 2 groups according to sport activity level. Group 1 consisted of 51 nonathletes (mean ± SD age, 20.8 ± 1.5 years; weight, 71.9 ± 10.5 kg) who participated in less than 8 hours a week of recreational physical activity with nonspecific training; group 2 consisted of 27 single-leg-dominant professional soccer players (age, 18.4 ± 0.6 years; weight, 70.1 ± 7.5 kg) who specifically trained and competed at their particular activity 8 hours or more a week. For assessment of maximal leg power, both groups completed the single-leg squat jump test. Dominance was determined when participants completed 2 of 3 specific tests with the same extremity. Statistical analysis included the Student t test.Results:No statistical difference was found for maximal power between dominant and nondominant legs for nonathletes ( t = –1.01, P = .316) or single-leg-dominant professional soccer players ( t = –1.10, P = .281). A majority (95%) of participants studied showed a power difference of less than 15% between their lower extremities.Conclusion:Among young healthy adults, symmetrical power performance is expected between lower extremities independent of the existence of dominance and difference in sport activity level. A less than 15% difference in power seems to be a proper parameter to define symmetrical power performance assessed by vertical single-leg jump tests.

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Septic arthritis in ACL reconstruction surgery with hamstring autografts. Eleven years of experience

2014 , CALVO RODRIGUEZ, RAFAEL , David Figueroa , Zoy Anastasiadis , Alex Vaisman , Arturo Olid , Federico Gili , Juan José Valderrama , Paulina De La Fuente

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Anterior cruciate ligament regeneration using mesenchymal stem cells and collagen type I scaffold in a rabbit model

2014 , David Figueroa , Maximiliano Espinosa , CALVO RODRIGUEZ, RAFAEL , Maximiliano Scheu , Alex Vaisman , Marcela Gallegos , CONGET MOLINA, PAULETTE ANDREA

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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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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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Clinical and arthrometric outcomes of an anatomic outside-in single-bundle anterior cruciate ligament reconstruction using a retrodrill

2016 , David Figueroa , CALVO RODRIGUEZ, RAFAEL , Francisco Figueroa , Daniel Paccot , Guillermo Izquierdo , Nelson Morales , DAVID HUMBERTO FIGUEROA POBLETE

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Patellar tendinopathy: Diagnosis and treatment

2016 , David Figueroa , Francisco Figueroa , CALVO RODRIGUEZ, RAFAEL , DAVID HUMBERTO FIGUEROA POBLETE

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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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Assessment of Cell Viability of Fresh Osteochondral Allografts in N-Acetylcysteine-Enriched Medium

2020 , CALVO RODRIGUEZ, RAFAEL , Maximiliano Espinosa , David Figueroa , Luz María Pozo , CONGET MOLINA, PAULETTE ANDREA

Objective The purpose of this study was to evaluate the effect of N-acetylcysteine (NAC)-enriched storage medium on fresh osteochondral viability at 4°C. Our hypothesis was that the cell viability of chondrocytes obtained from human osteochondral tissue and stored at 4°C significantly improves in the presence of NAC. Design Controlled laboratory study. For this study, 8 samples of femoral condyle osteochondral tissue were obtained from patients undergoing total knee replacement. The samples were stored at either 4°C in phosphate-buffered saline (PBS) or at 3 different concentrations of NAC (NAC 1, 2, and 5 mM). Cell viability was analyzed at time 0 and 4 weeks by flow cytometry. The results of cell viability (median) were analyzed statistically using analysis of variance and Tukey’s post hoc test. P values <0.05 were considered statistically significant. Results The viability at time 0 was 95.5% ± 3.7%. At 4 weeks, the cell viability was 56.8% ± 20.1% in the control group (PBS), 83.8% ± 11.9% in the group stored with NAC 1 mM, 73.4% ± 13.6% in the group stored with NAC 2 mM, and 66.4% ± 27.7% in the group stored with NAC 5 mM. A statistically significant difference from the baseline viability (time 0) was observed in the PBS control group ( P = 0.0018) but not in the other groups. A statistically significant difference was observed in the NAC 1 mM group compared with the PBS group ( P = 0.0255). Conclusion The use of NAC at 1 mM concentration improves cell viability after 4 weeks of storage in chondrocytes obtained from human osteochondral tissue.

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