Browsing by Author "Zilleruelo, Nicolás"
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Item Magnetic Resonance Imaging Evaluation of the Integration and Maturation of Semitendinosus-Gracilis Graft in Anterior Cruciate Ligament Reconstruction Using Autologous Platelet Concentrate(Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 26, No 10 (October), 2010: pp 1318-1325, 2010) Figueroa, David; Melean, Patricio; Calvo, Rafael; Vaisman, Alex; Zilleruelo, Nicolás; Figueroa, Francisco; Villalón, gnacioPurpose: To evaluate integration and maturation of semitendinosus-gracilis (STG) grafts in anterior cruciate ligament (ACL) reconstruction with magnetic resonance imaging (MRI) in patients who underwent ACL reconstruction with STG with and without autologous platelet concentrate (APC). Methods: A randomized single–blinded evaluator prospective study was performed in 2 consecutive series of patients who underwent reconstruction over a 14-month period: 30 with APC use (group A) and 20 as control subjects (group B). At 6 months, an MRI evaluation was performed, with observation of the graft’s maturation and presence or absence of synovial fluid at the tunnel-graft interface. To facilitate interpretation, a scoring scale was designed to evaluate graft integration and maturation. Results: Regarding the presence of synovial fluid at the bone-graft interface, the test was negative in 86.84% of patients in group A and 94.74% in group B. A disorganized autograft signal pattern was found in 2.63% in group A and 5.26% in group B. Signal intensity was considered hypointense in 63.16% in group A and 42.11% in group B, isointense in 34.21% in group A and 52.63% in group B, and hyperintense in 0% in both groups. The final mean score was 4.45 points in group A and 4.2 points in group B (P .05). Poor integration was found in 2.63% in group A and 5.26% in group B (P .214). Good integration was found in 97.37% in group A and 94.74% in group B (P .784). Conclusions: In our consecutive series of patients who underwent ACL reconstruction with STG grafts, 1 group with intraoperative APC use versus a control group, followed up by MRI at 6 months after reconstruction, we did not find any statistically significant benefit in the APC group in terms of integration assessment and graft maturation (ligamentization). Level of Evidence: Level III, case-control studyItem Osteochondral autografts in full thickness patella cartilage lesions(2011) Figueroa, David; Melean, Patricio; Calvo R., Rafael; Gili, Federico; Zilleruelo, Nicolás; Vaisman, AlexThe purpose of this study was to evaluate clinical, functional and imaging results of full thickness patella cartilage lesions treated with osteochondral autografts (OCA). We studied a consecutive case series of 10 patients. At follow-up, Lysholm and International Knee Documentation Committee (IKDC) scores were obtained. Magnetic resonance imaging (MRI) evaluation was performed at an average of 8 months post-op. The average cartilage lesion area was 1.2 cm(2). An average of 1.9 grafts was used per patient. The average Lysholm scores were: pre-op 73.8 +/- 8.36; post-op 95 +/- 4.47 points (p < 0.05). The average IKDC post-op score was 95 +/- 1.74 points. No postoperative complications were registered. In the MRI analysis we found that in all cases. OCA presented flush characteristics when compared with adjacent cartilage. The majority of cases presented no fissures in the graft-receptor interface (60%). In 80% we observed mild bone marrow edema around the graft. According to the International Cartilage Research Society (ICRS) cartilage lesions classification, all grafts were considered 1A; in the periphery cartilage was classified as 1A in 60%. We conclude that patellar OCA is a good alternative for the treatment of full thickness patellar cartilage lesions, offering good clinical, functional and imaging results at midterm follow-up. (C) 2010 Elsevier B.V. All rights reserved.