Browsing by Author "Espinoza, Gonzalo"
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Item Anterior cruciate ligament reconstruction in patients over 50 years of age(Elsevier, 2014) Figueroa, David; Figueroa, Francisco; Calvo, Rafael; Vaisman, Alex; Espinoza, Gonzalo; Gili, FedericoPURPOSE: To describe the clinical outcomes of patients over 50 years of age with following anterior cruciate ligament (ACL)reconstruction for acute rupture. METHODS: A prospective series of patients over the age of 50 years with a diagnosis of ACL rupture who underwent ACL reconstruction was examined. Lysholm and International Knee Documenting Committee (IKDC) subjective scores were assessed preoperatively and at the final follow-up. All associated injuries were documented, and complications were reported. The patients' satisfaction and return to sports were documented. The statistical analyses were preformed with Student's t-tests for independent samples. RESULTS: Fifty patients with a mean age of 52.12 years (50-64) and a mean follow-up period of 53.17 months (36-68) exhibited a mean postoperative Lysholm score of 93.7 (60-100) and IKDC score of 90.96 (57.5-100). Associated injuries occurred in 90% (45) of the patients and included the following: 76% (38) meniscal tears and 36% (18) osteochondral lesions. Complications occurred in 6% (3) of the patients and included the following: 4% (2) ACL re-ruptures and 2% (1) infections. Among all patients, 88% (44) returned to pre-injury sports levels, and 96% (48) were satisfied. CONCLUSIONS: For patients above the age of 50 years, ACL reconstruction appears to be a safe procedure with good to excellent results that are comparable to those for younger patients, and the possibility for returning to pre-injury sports levels for these patients is high.Publication Bacterial Analysis of Hamstring Autograft With Vancomycin Presoaking in Primary Anterior Cruciate Ligament Reconstruction Shows High Incidence of Colonization Without Early Clinical Infection(2025) Scheu, Maximiliano; Bosselin, Raimundo; Araos, Rafael; Ugalde, Juan; Tuca, María Jesús; Espinoza, GonzaloPurpose: To determine the incidence of autograft bacterial colonization (BC) in anterior cruciate ligament reconstruction (ACLR) and to identify any bacteria type at the genus level. Methods: This prospective descriptive study included patients aged 18 years or older undergoing ACLR with hamstring autograft. Thirty-one patients (21 male and 10 female patients), with a mean age of 32.2 years, were included, with a mean follow-up period of 150 days (range, 90-208 days). Three samples were taken from every surgical procedure: a sample from the graft at the time it was obtained, a sample from the graft after tibial fixation, and a sample from the saline solution receptacle on the instrument table (control). All grafts underwent vancomycin presoaking. Bacterial composition was determined by next-generation sequencing of the 16S ribosomal RNA coding gene. Descriptive statistics were used to summarize data. The Fisher exact test was used to compare group samples (with P<.05 considered significant). Results: BC was detected in 11 of 31 patients (35.4%). BC was found in the first sample (sample from the graft at the time it was obtained) in 1 patient and in the third sample (control) in another. All 11 patients showed BC in the second sample (sample from the graft after tibial fixation), with statistical significance (P=.003). In these samples with BC, 47 types of gram-negative bacteria (GNB)were identified, averaging 6.8 bacteria per sample, with 3.97% relative abundance per bacterium. Pseudomonas was present in 5 of 11 samples, with 6.76% relative abundance. Additionally, 33 types of gram-positive bacteria (GPB) were found, averaging 6 bacteria per sample, with 9.62% relative abundance per bacterium; Streptococcus was present in 8 of 11 samples, with 26.23% relative abundance. All colonized samples exhibited both GPB and GNB. Conclusions: Bacterial contamination during ACLR is frequent, with the presence of both GNB and GPB. Although such colonization was common, no early clinical infections were noted in our patient cohort. Level of Evidence: Level III, prospective descriptive study.Item No association between positive intraoperative allograft cultures and infection rates after reconstructive knee ligament surgery(2018) Schmidt-Hebbel, Andres; Gomez, Carlos; Aviles, Carolina; Herbst, Elmar; Scheu, Maximiliano; Ferrer, Gonzalo; Espinoza, GonzaloBackground: Several reports of severe infections associated with allograft tissue in knee reconstructivesurgery have led many surgeons to consider routine intraoperative culture of allograft tissue before implantation. Thus, the purpose of this study was to determine the prevalence of positive soft tissue allograft cultures in reconstructive knee surgery, and evaluate its association with surgical site infection. Methods: Retrospective study of 202 patients who underwent knee reconstructive ligament surgeries, including revisions, between January 2013 and July 2017. Intraoperative culture results were obtained and the report of a surgical site infection during follow-up was recorded. Patients without cultures were excluded. A priori power analysis was performed. The association between positive culture results and development of surgical site infection was evaluated usingFisher's Exact test (P b 0.05). Results: A total of 300 allografts were implanted in 202 patients. Mean average follow-up was 32.9 ± 12.5 (range 13 to 57.9) months. Sixteen patients had positive intraoperative allograft cultures (7.9%). The most frequently isolated organism was Bacillus species (six cultures); none of these patients presented with clinical signs of infection. Nine patients developed surgical site infections and were treated with oral antibiotics, and one patient developed septic arthritis that required surgical debridement of the implanted graft; all of these patients had a negative soft tissue allograft culture. No significant association was found between a positive culture and surgical site infection (P= 0.43). Conclusion: There was no apparent association between positive intraoperative irradiated soft tissue allograft cultures and surgical site infection in reconstructive knee surgery.