Person: Figueroa, Francisco
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Figueroa
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Francisco
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Publication Cross-cultural adaptation and validation of the KOOS, JR questionnaire for assessing knee osteoarthritis in Spanish-speaking patients(2023) Guiloff, Rodrigo; IƱiguez, Magaly; Prado, TomĆ”s; Figueroa, Francisco; OlavarrĆa, NicolĆ”s; Carrasco, Eduardo; Ergas, Enrique; Salgado, MartĆn; 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 āGuidelines for the Process ofCross-Cultural Adaptation of Self-Report Measuresā. 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 (Cronbachās Ī±), reproducibility (mixed-effect model coefficient [MEMC]) and construct validity (Spearmanās correlation; p = 0.05) were assessed.Results Forty-one patients (mean age: 65.6 Ā± 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 Cronbachās Ī± for the S-KOOS, JR was 0.927 and its MEMC was 0.852 (CI 95% 0.636ā1.078).The Spearmanās correlation between the S-KOOS, JR and the S-OKS was 0.711 (CI 0.345ā0.608; p < 0.001) and 0.870 (CI0.444ā0.651; 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 Age influences the efficacy of osteochondral autograft transfer: Promising results for patients under 40(2024) Figueroa, Francisco; Figueroa, David; Calvo, Rafael; Stocker, Esteban; Itriago, Minerva; NuƱez, MarilauraBackground: Previous research using osteochondral autograft transfer (OAT) has shown poorer outcomes with increasing patient age. The aim of this article is to evaluate a cohort of patients that received an OAT and to correlate their clinical results with their age at procedure. Methods: Patients that underwent an OAT to treat an osteochondral (OC) lesion with a minimum 24-month follow-up were included. Patients were categorized into two groups based on their age at procedure (<40 years and ā„40 years). Postoperatively, each patient completed the Knee injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee (IKDC), and Lysholm scales. Results: 51 patients were included (35<40 years, 16ā„40 years). Mean follow-up was 4.2 years (2-7). For patients<40 years, IKDC averaged 80.8 (SD 15.9) versus 71.2 (SD 19.4) in ā„40 years (p=0.03). For patients <40 years, Lysholm averaged 85.9 (SD 10.8) versus 77.0 (SD 21.6) in ā„40 years (p=0.02). For patients<40 years, KOOS averaged 78.3 (SD 11.8) versus 68.9 (SD 18.5) in ā„40 years (p=0.01). There was a 100% sensibility in identifying all the patients with a poor IKDC and Lysholm from 34 years old (AUC 0.76 and 0.8). Conclusions: OAT has better outcomes in patients younger than 40 years compared to patients older than 40 years. Based on the prognostic capacity of age, the ideal candidate for an OAT is a patient younger than 34 years old.Publication Diagnosis of knee cartilage injuriesāan international Delphi consensus statement(2024) Aman, Zachary; Champagne, Allen; Hurley, Eoghan; Danilkowicz, Richard; Ciccotti, Michael; Hirschmann, Michael; Figueroa, Francisco; Jones, Kristofer; Murray, Iain; Shannon, Fintan; Jazrawi, Laith; International Knee Cartilage Injury Delphi Consensus Study GroupIntroduction Articular cartilage injuries of the knee are a complex and challenging clinical pathology. Objectives The purpose of this study was to establish consensus statements via a Delphi process on the diagnosis of knee cartilage injuries. Methods A consensus process on knee cartilage injuries utilizing a modified Delphi technique was conducted. Seventy-nine surgeons across 17 countries participated in these consensus statements. Eleven questions were generated on the diagnosis of knee cartilage injuries, with 3 rounds of questionnaires and final voting occurring. Consensus was defined as achieving 80% to 89% agreement, whereas strong consensus was defined as 90% to 99% agreement, and unanimous consensus was defined as 100% agreement with a proposed statement. Results Of the 11 total questions and consensus statements regarding the diagnosis of knee cartilage injuries developed from 3 rounds of voting, 0 achieved unanimous consensus, 8 achieved strong consensus, and 3 achieved consensus. Conclusions The majority of the statements regarding diagnosis achieved strong consensus, which related to aspects of the physical exam and history, imaging and documentation, and assessment of concomitant injury or bony malalignment that aid in surgical decision-making. The statements that did not achieve strong consensus were determining when a lesion is symptomatic, documentation of imaging, and when a diagnostic arthroscopy is indicated.Publication 4 Domain Sports PROM en espaƱol: adaptaciĆ³n transcultural en la poblaciĆ³n chilena y anĆ”lisis de confiabilidad(2024) Figueroa, David; Guiloff, Rodrigo; Figueroa, Francisco; Stocker, Esteban; Rocha, SergioAntecedentes y objetivo: Las medidas de resultado reportadas por el paciente (PROM) son herramientas de interĆ©s creciente en la poblaciĆ³n deportiva. El propĆ³sito de este estudio fue realizar la adaptaciĆ³n transcultural y anĆ”lisis de confiabilidad del 4-Domain Sports Patient-Reported Outcome Measure (4DSP) al espaƱol. MĆ©todos: Se ejecutĆ³ un protocolo de adaptaciĆ³n transcultural en seis etapas para obtener la versiĆ³n en espaƱol del 4DSP (S-4DSP). Posteriormente, se aplicĆ³ el cuestionario a una poblaciĆ³n de 108 deportistas posoperados de reconstrucciĆ³n de ligamento cruzado anterior (RLCA). Se aplicĆ³ nuevamente el cuestionario luego de 30 dĆas. Se evaluĆ³ la aceptabilidad, efecto piso y techo, consistencia interna (alfa de Cronbach) y reproducibilidad (correlaciĆ³n intraclase). Resultados: La S-4DSP fue respondida completamente por 108 participantes (edad media 34 Ā± 10,75, 26% mujeres) alcanzando una aceptabilidad de 100%. No se detectĆ³ efecto piso. El anĆ”lisis estadĆstico entregĆ³ un alfa de Cronbach global para el cuestionario de 0,65, y desagregado por dominios de 0,88, 0,72, 0,27, 0,68 para el primer, segundo, tercer y cuarto dominio, respectivamente. El estudio de correlaciĆ³n intraclase alcanzĆ³ un mĆ”ximo de 0,94 y un mĆnimo de 0,48 en la primera y quinta preguntas, respectivamente. ConclusiĆ³n:El S-4DSP es una herramienta confiable y Ćŗtil para evaluar deportistas de habla hispana posterior a una RLCA. Abstract Background: Patient-Reported Outcome Measures (PROMs) are tools of increasing interest in the sports population. The purpose of this study was to perform the cross-cultural adaptation and reliability analysis of the 4 Domain Sports Patient-Reported Outcome Measure (4 DSP) into Spanish. Methods: A six-stage cross-cultural adaptation protocol was executed to obtain the Spanish version of the 4 DSP (S-4DSP). Subsequently, the questionnaire was administered to a population of 108 postoperative athletes with ACL (Anterior Cruciate Ligament) injuries. The questionnaire was administered again after 30 days. Acceptability, floor and ceiling effects, internal consistency (Cronbach's alpha), and reproducibility (Intraclass Correlation) were evaluated. Results: The S-4DSP was fully completed by 108 participants (mean age 34 Ā± 10.75, 26% women), achieving 100% acceptability. No floor effect was detected. The statistical analysis yielded a global Cronbach's alpha for the questionnaire of 0.65, and domain-specific alphas of 0.88, 0.72, 0.27, and 0.68 for the first, second, third, and fourth domains, respectively. The Intraclass Correlation test reached a maximum of 0.94 and a minimum of 0.48 for the first and fifth questions, respectively. Conclusions: The S-4DSP is a reliable and useful tool for evaluating Spanish-speaking athletes after ACL reconstruction.Publication Specific considerations in female patients with patellar instability: current concepts(Figueroa F, Guiloff R, Bolton S, Figueroa D, Tapasvi S, Stocker E. Specific considerations in female patients with patellar instability: current concepts. J ISAKOS. 2024 Jun;9(3):457-463. doi: 10.1016/j.jisako.2024.03.014, 2024) Figueroa, Francisco; Guiloff, Rodrigo; Bolton, Sarah; Figueroa, David; Tapasvi, Sachin; Stocker, EstebanPrior literature suggests that patellofemoral instability (PFI) is significantly more prevalent in women than in men. This higher prevalence is commonly attributed to anatomical differences between sexes, particularly with patellofemoral alignment. These differences encompass a higher rate of trochlear dysplasia (TD), patella alta, an increased Q angle, and soft tissue imbalances. In recent years, worse outcomes have been reported in female patients after patellofemoral stabilization surgery using medial patellofemoral ligament reconstruction (MPFLr) alone or in combination with a tibial tubercle osteotomy (TTO), for this reason an "Ć la carte" plan (addressing the individuals anatomical risk factors) could be more appropriate for female patients.Publication Return to sports in female athletes after anterior cruciate ligament reconstruction: A systematic review and metanalysis(2024) Figueroa, David; Figueroa, MarĆa; Figueroa, FranciscoImportance: Return to sport (RTS) is considered an indicator of successful recovery after anterior cruciate ligament reconstruction (ACLR). In recent years, there has been major interest in documenting RTS following anterior cruciate ligament (ACL) injury. Despite women being at increased risk for ACL injuries and a global increase in women's participation in sports, research has not adequately focused on female athletes. Objective: The purpose of this study is to conduct a systematic review and meta-analysis evaluating the RTS rate in female athletes after ACLR. We hypothesize that most of the female athletes can RTS. Evidence review: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Electronic databases (PubMed, Embase, and Epistemonikos) were searched for articles reporting RTS rates and contextual data in female athletes. The following search terms were used: "anterior cruciate ligament reconstruction" OR "ACL reconstruction" AND "female" OR "women" AND "return to sports" OR "return to play" to retrieve all relevant articles published between 2003 and 2023. A quality assessment of the included studies was conducted. Findings: Fifteen articles were included, reporting on 1456 female athletes participating in pivoting sports. The included studies comprised 9 cohorts, 1 case-control study, 2 case series, 2 descriptive epidemiology studies, and 1 observational study. Eight out of fifteen studies focused solely on elite-level athletes. The participants had a mean age of 23.13 years. Soccer was the most prevalent sport among the participants, accounting for 49.7% of all athletes included. All 15 studies reported an RTS rate, yielding a meta-proportion of 69% [95% CI, 58-80%] for RTS. Nine articles reported the average time to RTS, which was 10.8 months [95% CI, 8.7-12.8 months]. Conclusions: This systematic review demonstrates that a majority of female athletes (69 ā%) can RTS participation at an average of 10.8 months, however, the available information is insufficient, and quantitative data and reasons for not returning to play are lacking. Future studies should establish return-to-play criteria in this population and determine reasons for not returning to play. Level of evidence: III.