Browsing by Author "Meleán, Patricio"

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    Clinical outcomes after arthroscopic treatment of knee osteoarthritis
    (Elsevier, 2014) Figueroa, David; Calvo, Rafael; Villalón, Ignacio; Meleán, Patricio; Novoa, Felipe; Vaisman, Alex
    PURPOSE: The aim of this study was to describe the clinical outcomes of patients with knee osteoarthritis (OA) treated with arthroscopic surgery, documenting the associated injuries and defining the type of treatment selected for OA patients with different symptoms. HYPOTHESIS: Knee arthroscopy is effective for treating patients with symptomatic OA and mechanical symptoms. METHODS: This was a prospective, consecutive series of 100 patients with a clinical and radiological diagnosis of OA who were treated with knee arthroscopy. The average follow-up time was 35.9months (25-71), and the average age was 60.1years (50-83). INCLUSION CRITERIA: >50years of age, a clinical imaging diagnosis of knee OA with an Ahlbäck I-III classification. EXCLUSION CRITERIA: <50years of age, Ahlbäck IV, pathologic lower limb mechanical axis and inflammatory joint diseases. The IKDC and Lysholm scores were assessed before and after surgery. RESULTS: The preoperative average scores were as follows: Lysholm, 56.9±13.5 points (22-71); IKDC, 59.4±21.7 points (45-80). The postoperative average scores were as follows: Lysholm, 86.9 points (22-87); IKDC, 79.5 points (45-100). Regarding the Lysholm scores, 76% were good and excellent results and 24% were moderate (p=0.045). The associated injuries included 48% of chondral and 36% of unstable meniscal injuries. Good or excellent results were observed in 76% of the meniscal injury cases according to the Lysholm scores, while only 84.6% of the cases with unstable chondral lesions had good or excellent results (p=0.035). CONCLUSION: Most patients with knee OA associated with unstable cartilage or meniscal injuries reported good-to-excellent symptomatic results at the short- and mid-term follow-ups. LEVEL OF EVIDENCE: III.
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    Effect of tendon tensioning: An in vitro study in porcine extensor tendons
    (2010) Figueroa, David; Calvo, Rafael; Vaisman, Alex; Meleán, Patricio; Figueroa, Francisco
    Graft tensioning is a controversial issue in anterior cruciate ligament reconstruction (ACLR) that has not achieved consensus between peers. The purpose of this study is to determine if after tensioning tendón length and resistance to maximal load changes. We performed an in vitro study with 50 porcine extensors tendons. The first group (P= 25) was tensioned with 80 N (19.97 lb) for 10 min, using an ACL graft preparation board. The second group (C= 25) was used as control and was not tensioned. The average initial (groups P and C) and post tensioning tendon length (group C) were measured; the average initial and post tensioning tendon diameter were measured as well. All samples were fixated in a tube–clamp system connected to a tension sensor. The samples were stressed with continuous and progressive tensión until ultimate failure at maximum load (UFML) occurs. The initial mean length was: P before tensioning= 13.4 mm± 1.4 mm (range 10.5–16.5); P after tensioning= 13.8 mm± 1.4 mm (range 11.5–16.5); C= 13 mm± 1.35 mm (p= 0.005). The mean diameter was: P= 5.6 mm (4.5–6); C= 5.5 mm (range 4.5–6) (p> 0.05). The UFML was: P= 189.7 N (114–336); C= 229.9 N (143–365) (p= 0.029). Tendon tensioning with 80 N for 10 min produced 3% average elongation. These could be beneficial in ACLR since tendon tensioning decreases elongation of the graft after fixation. Regardless, tendón tensioning is not innocuous since it diminishes their resistance when continuously stressed until complete failure occurs
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    Ruptura del manguito rotador: Correlación de hallazgos ultrasonográficos y artroscópicos
    (2011) Toro Saelzer, Felipe; Meleán, Patricio; Moraga Huerta, C; González Foretic, F
    Objetivo: Analizar los hallazgos ultrasonográficos (US) de hombro preoperatorios en pacientes con diagnóstico de lesión del manguito rotador (MR), correlacionándolos con los hallazgos artroscópicos. Métodos: Análisis retrospectivo de una serie consecutiva de pacientes con diagnóstico de patología del MR, en los que se solicitó una US y fueron operados (artroscopía de hombro). Los hallazgos US/artroscópicos fueron correlacionados con pruebas de Fisher y c2 . Resultados: Fueron 53 pacientes en donde identificamos concordancia US/ artroscopía en 22/34 casos para rupturas totales (64.7%) y 7/19 casos para las rupturas parciales (36.8%) (p = 0.048). La concordancia global (totales y parciales) fue de 29/53 pacientes (54.7%). De los 24 pacientes sin correlación, 11 (45.8%) presentaron informes ecográficos de tendinitis; 75% de los casos de este grupo presentaron roturas parciales del supraespinoso durante la artroscopía (p = 0.006). Conclusión: La US presenta una adecuada correlación en el diagnóstico de RT del MR confirmada por artroscopía, siendo significativamente menor para las RP. Cuando enfrentamos una lesión diagnosticada con ecografía como tendinitis, la mayoría de los casos presentaron una RP durante la artroscopía.

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