Browsing by Author "Poblete, Eduardo"

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    Return to sports and recreational activities after patellofemoral arthroplasty: A systematic review
    (2025) Arteaga, José; Poblete, Eduardo; Martin, Fernando; Domecq, Gabriel; Figueroa, David
    Importance: Patellofemoral arthroplasty (PFA) is an established treatment for isolated patellofemoral osteoarthritis. However, evidence regarding postoperative activity levels and return to sport (RTS) remains limited. Objective: The objective of this study was to evaluate RTS and recreational activity rates following PFA, identify factors influencing these outcomes, and report associated complications. Evidence review: A systematic search was conducted in June 2024 across PubMed, EMBASE, ScienceDirect, and Scopus databases, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Search terms included variations of “patellofemoral arthroplasty,” “physical activity,” and “return to sport.” Studies were included if they reported RTS outcomes following PFA. Studies lacking RTS data or isolated PFA results were excluded. From 492 records, 7 studies met the inclusion criteria. Findings: Seven studies (2 prospective and 5 retrospective) comprising 265 patients (281 knees; 64.6% women; mean age: 48.9 years) were included, with a mean follow-up of up to 5.3 years. RTS definitions varied, with reported rates ranging from 64.7% to 91%. Low-impact sports were more commonly resumed, and 58.6% of patients returned to sport within six months. Among those who returned, 74.8% reached or exceeded their preoperative activity level. Postoperative pain improved (visual analog scale scores decreased from 6.3 to 2.7), although up to 38.6% of patients reported pain limiting activity. Conversion to total knee arthroplasty occurred in 6.3% to 13% of cases, and reoperation rates ranged from 10.4% to 25%. Limitations included inconsistent RTS definitions, heterogeneous outcome reporting, and use of non-standardized questionnaires. Conclusions: RTS and recreational activity after PFA can be resumed by most patients, especially low-impact activities. Pain management should be actively addressed. High-quality studies with standardized RTS definitions are needed to evaluate the long-term impact of activity on implant survival. Relevance: RTS after PFA is safe and achievable. A personalized approach is essential to optimize RTS and manage patient expectations. Evidence level: III.
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    Viscosuplementación con ácido hialurónico en gonartrosis: seguimiento clínico a 9,8 años
    (2025) Figueroa, María; Figueroa, Francisco; Poblete, Eduardo; Montes, Vicente; Cañas, Martín; Marré, Andrea; Figueroa, David
    Introducción La eficacia de la viscosuplementación con ácido hialurónico (VAH) en el manejo conservador de la gonartrosis es controvertida. Una serie de casos publicada por nuestro equipo demostró que permitiría una sobrevida libre de artroplastia total de rodilla (ATR) mayor al 80% a 3,6 años. Objetivo Evaluar los resultados funcionales y la sobrevida libre de prótesis de una cohorte de pacientes con gonartrosis de moderada a severa, manejados con VAH, incorporando el efecto de reinfiltraciones. Materiales y Métodos Conducimos un estudio retrospectivo con pacientes con edad ≥ 60 años con gonartrosis de moderada a severa, ≥ 1 infiltración con AH de alto peso molecular y seguimiento mínimo de 8 años. Se analizaron datos demográficos, clínicos y la necesidad de ATR, y se realizaron pruebas estadísticas de Kaplan-Meier y el Test Exacto de Fisher (p < 0,05). Resultados La muestra estuvo compuesta de 85 pacientes (100 rodillas) con edad promedio de 72 años y seguimiento medio de 9,8 ± 0,42 (rango: 8,7–10,50) años. Hubo una tasa de 77% de rodillas infiltradas libres de prótesis, y 52% tuvieron ≥ 2 infiltraciones. La reinyección se asoció significativamente a mayor sobrevida libre de ATR (p = 0,005). Los puntajes medios en la escala Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) para dolor, rigidez y capacidad funcional fueron de 7,1, 2,5 y 20,7, respectivamente. Un total de 19 pacientes (22,4%) requirieron ATR a 4,5 ± 3,1 años de la primera infiltración. No se observaron diferencias en términos de sexo (p = 0,49) ni de edad (p = 0,46) de los pacientes que requirieron ATR. Conclusión La VAH mostró efectividad sostenida a largo plazo en pacientes ≥ 60 años con gonartrosis de moderada a severa. La reinyección se asoció a mejores resultados y los puntajes WOMAC confirmaron los beneficios funcionales. La VAH es una alternativa conservadora eficaz. Nivel de Evidencia: IV. Introduction The efficacy of hyaluronic acid (HA) viscosupplementation (HAVS) in knee osteoarthritis (KOA) remains controversial. A series of cases published by our team demonstrated a total knee arthroplasty (TKA)-free survival rate greater than 80% at a 3.6-year follow-up. Objective To evaluate the functional results and prosthesis-free survival rate in a patient cohort with moderate and severe KOA, treated with HAVS, considering the role of reinjections. Materials and Methods We conducted a retrospective study with patients aged ≥ 60 years with moderate and severe KOA, ≥ 1 HA injection and a minimum 8-year follow-up. Demographic and clinical data as well as TKA requirements were analyzed. Kaplan-Meier survival analysis and the Fisher’s exact test were conducted (p less than 0.05). Results The sample was composed of 85 patients (100 knees) with a mean age of 72 years and a mean follow-up of 9.8 ± 0.42 years; 77% of the injected knees remained TKA-free, from which 52% underwent ≥ 2 injections. Reinjections were associated with higher prosthesis-free survival rate (p = 0.005). According to the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scale, the mean scores for pain, stiffness, and physical function were of 7.1, 2.5, and 20.7 respectively. In total, 19 patients (22.4%) required TKA 4.5 ± 3.1 years after the first injection. No differences were observed regarding sex (p = 0.49) or age (p = 0.46) in patients requiring TKA. Conclusion The HAVS procedure showed sustained long-term effectiveness in patients aged ≥ 60 years with moderate and severe KOA. The reinjections were associated with better outcomes, and the WOMAC scores confirmed the functional benefits, supporting HAVS as an effective conservative option. Level of evidence: IV.

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