Browsing by Author "Guiloff, Rodrigo"
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Item Comparison of Muscular Power Between Dominant and Nondominant Legs in Healthy Young Adults Associated With Single-Leg-Dominant Sports(2017) Vaisman, Alex; Guiloff, Rodrigo; Rojas, Juan; Delgado, Iris; Figueroa, David; Calvo, RafaelBackground: 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 ears; 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 ¼ –1.01, P ¼ .316) or single-leg-dominant professional soccer players (t ¼ –1.10, P ¼ .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.Publication Cross-cultural adaptation and validation of the KOOS, JR questionnaire for assessing knee osteoarthritis in Spanish-speaking patients(2023) Guiloff, Rodrigo; Iñiguez, Magaly; Prado, Tomás; Figueroa, Francisco; Olavarría, Nicolás; Carrasco, Eduardo; Ergas, Enrique; Salgado, Martín; Lyman, StephenPurpose The present study aims to translate, adapt and validate a Spanish version of the Knee Injury and OsteoarthritisOutcome Score, Joint Replacement (KOOS, JR), including a reliability and validity analysis in patients with knee osteoar-thritis (OA).Methods This study conducted a prospective validation study following the six stages of the “Guidelines for the Process ofCross-Cultural Adaptation of Self-Report Measures”. Psychometric testing was conducted in patients with knee osteoarthritis.Subjects answered the Spanish KOOS, JR (S-KOOS, JR) and a validated Spanish Oxford Knee Score (S-OKS). Retest wasconducted at 10 days. Acceptability, floor and ceiling effect, internal consistency (Cronbach’s α), reproducibility (mixed-effect model coefficient [MEMC]) and construct validity (Spearman’s correlation; p = 0.05) were assessed.Results Forty-one patients (mean age: 65.6 ± 5.39; 48.8% female) participated in the study. All patients (100%) answeredboth scores during the first assessment and 38 (92.7%) during the second assessment. All patient-reported outcomes measureswere answered completely (100%). The S-KOOS, JR resulted in 100% acceptability when answered. There were no ceilingor floor effects detected. The Cronbach’s α for the S-KOOS, JR was 0.927 and its MEMC was 0.852 (CI 95% 0.636–1.078).The Spearman’s correlation between the S-KOOS, JR and the S-OKS was 0.711 (CI 0.345–0.608; p < 0.001) and 0.870 (CI0.444–0.651; p < 0.001) for the first and second assessments, respectively.Conclusion The S-KOOS, JR has very high internal consistency and reproducibility, with a high correlation with the S-OKS;it is a reliable and valid instrument for characterising Spanish-speaking patients suffering from knee OA.Level of evidence IV.Publication Knee Iliotibial Band Z-Plasty Lengthening and Bursectomy Technique(2022) Vaisman, Alex; Guiloff, Rodrigo; Andreani, DomingoMultiple surgical techniques have been described to treat refractory iliotibial band syndrome. However, there is lacking evidence demonstrating superiority of one technique over the other and limited audiovisual resources. Most surgical procedures aim to release the iliotibial band; nevertheless, few focus on reducing concomitant inflammation. The present article illustrates a Z-plasty lengthening technique associated with local bursectomy for treating iliotibial band syndrome refractory to conservative treatment.Item Ligament Lesions: Biologics(2022) Figueroa, David; Guiloff, Rodrigo; Figueroa, FranciscoIn terms of the latest clinical evidence, the use of PRP for ligament injuries remains controversial. There is insufficient evidence to recommend the use of PRP in ACL-R for improving graft maturation and donor site morbidity or improving functional outcomes. The use of PRP injections for the treatment of partial ACL injuries, MCL injuries, and ankle sprains cannot be recommended. Finally, there is no reported clinical evidence of the use of PRP in other knee ligament injuries such as posterior cruciate ligament, lateral collateral ligament, and posterolateral cornerItem Navigation in anterior cruciate ligament reconstruction: State of the art(2023) Figueroa, Francisco; Figueroa, David; Guiloff, Rodrigo; Putnis, Sven; Fritsch, Brett; Itriago, MinervaComputer navigation (CN) for anterior cruciate ligament (ACL) surgery has been used mainly for two purposes: to enhance the accuracy of tunnel position and to evaluate the kinematics of the ACL reconstruction (ACLR) and the stability achieved bydifferent surgical techniques.Many studies have shownthatnavigationmay improve the accuracy of anatomical tunnel orientation and position during ACL reconstructive surgery compared with normal arthroscopic tunnel placement, especially regarding the femoral side. At the same time, it has become the gold-standardmethod for intraoperative knee kinematic assessment, as it permits a quantitative multidirectional knee joint laxity evaluation. CN in ACL surgery has been associated with diverse problems. First, in most optic systems additional skin incisions and drill holes in the femoral bone are required for fixation of a reference frame to the femur. Second, additional radiation exposure and extra medical cost to the patient for preoperative planning are usually needed. Third, CN, due to additional steps, has more opportunities for error during preoperative planning, intraoperative registration, and operation. Fourth, soft tissues, including the skin and subcutaneous tissues, are usually not considered during the preoperative planning, which can be a problem for kinematic and stability assessment. Many studies have concluded that ACLR using a CN system is more expensive than conventional surgery, it adds extra time to the surgery and it is not mitigated by better clinical outcomes. This, combined with costs and invasiveness, has limited the use of CN to research-related cases. Future technology should prioritize less invasive intra-operative surgical navigationPublication Over 50% of self-reported burnout among Latin American orthopaedic surgeons: A cross-sectional survey on prevalence and risk factors(2023) Vaisman, Alex; Guiloff, Rodrigo; Contreras, Martín; Casas, Juan; Calvo, Rafael; Figueroa, DavidObjective: Assess the prevalence of self-reported burnout and identify risk and protective factors based on demographic and life quality aspects, among Latin American orthopaedic surgeons. Methods: This study employed a cross-sectional analytical design. An original design survey was developed using multiple-choice and Likert-scale questions to gather self-reported burnout, demographic, work-related, social, personal, and mood-related data. The survey was electronically distributed to the Chilean Orthopaedic Surgery Society and the Latin American Society of Arthroscopy, Knee Surgery, and Sports Medicine members. Statistical analysis included Chi-square and Fisher's exact tests to determine associations between self-reported burnout and other variables. Subsequently, a multivariate logistic regression was carried out to identify key risk and protective factors (p < 0.05). Results: The survey's response rate was 20 % (n = 358) out of the 1779 invitations that were sent. The most representative age range was 41-60 years (50 %) and 94 % were men. Of those surveyed, 50 % reported a burnout episode more than once per year, 60 % depersonalization when treating patients at least yearly, 13 % anhedonia, 11 % a depressive mood more than half of the month or almost every day, and 61 % weariness at the end of a working day. Burnout was statistically associated with age under 40 years old (p = 0.012), fewer years as a specialist (p = 0.037), fear of lawsuits (p < 0.001), a non-healthy diet (p = 0.003), non-doing recreational activities (p = 0.004), depersonalization when treating their patients (p < 0.001), weariness (p < 0.001), anhedonia (p < 0.001), depressive mood (p < 0.001), and career dissatisfaction (p < 0.001). The logistic regression demonstrated that fear of lawsuits (p < 0.001), weariness at the end of a workday (p = 0.016), and anhedonia (p = 0.019) were those variables with stronger direct associations with self-reported burnout. A healthy diet was the strongest protective variable (p < 0.001). Conclusion: Over 50 % of the Latin American orthopaedic surgeons who participated in the survey reported experiencing burnout episodes more than once a year, along with depersonalization when treating their patients at least once a year. Additionally, nearly 10 % of respondents experienced weekly depressive symptoms. Among the noteworthy risk factors for self-reported burnout were fear of lawsuits, weariness at the end of the workday, and anhedonia. Conversely, maintaining a healthy diet emerged as the most potent protective factorItem Posterolateral corner knee injuries: a narrative review(2021) Figueroa, Francisco; Figueroa, David; Putnis, Sven; Guiloff, Rodrigo; Caro, Patricio; Espregueira-Mendes, João; Clinica Alemana-Universidad del Desarrollo, Santiago, ChileLimited knowledge of the anatomy and biomechanics of the posterolateral corner (PLC) of the knee, coupled with poor patient outcomes with non-operative management, resulted in the PLC often being labelled as the ‘dark side’ of the knee. In the last two decades, extensive research has resulted in a better understanding of the anatomy and function of the PLC, and has led to the development of anatomic reconstructions that have resulted in improved patient outcomes. Despite considerable attention in the clinical orthopaedic literature (nearly 400 articles published in the last decade), a standardized algorithm for the diagnosis and treatment of the PLC is still lacking, and much controversy remains. Considering the literature review, there is not a reconstruction technique that clearly prevails over the others. As anatomic, biomechanical, and clinical knowledge of PLC injuries continues to progress, finding the balance between re-creating native anatomy and safely performing PLC reconstruction provides a big challenge. Treatment decisions should be made on a case-by-case basis.