Browsing by Author "Liendo Verdugo, Rodrigo Javier"

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    A pilot multicenter randomized controlled trial comparing Bankart repair and remplissage with the Latarjet procedure in patients with subcritical bone loss (STABLE): study protocol
    (2022) Marinis Acle, Rodrigo Ignacio de; Khan, Moin; Bedi, Asheesh; Degen, Ryan; Warner, Jon; Bhandari, Mohit; Khan, Moin; Degen, Ryan; Bhandari, Mohit; Bedi, Asheesh; Warner, Jon; Madden, Kim; Barkhordari, Nazanin; Garrido Clua, Miriam; Wozny, Kelsey; Moro, Jaydeep; Denkers, Matthew; Ayeni, Olufemi R.; Litchfield, Robert; Bryant, Diane; Wanlin, Stacey; Firth, Andrew; Horst, Stephanie; Inch, Katelyn; Lapner, Peter; McIlquham, Katie; García Portabella, Montserrat; H. Núñez, Jorge; Batalla, Lledo; Massons, Josep; Henry, Patrick; Milner, Katrine; Ou, Yinmin; Kunz, Mónica; Álvares, Alicia; Moganathas, Saranjan; Chandrasegaram, Aarani; Oliogu, Etinosa; Balasuberamaniam, Phumeena; Gundi, Bárbara; Sivakumar, Nithila; Rashid, Khadija; Lewaniak, Stephanie; Fariha, Atqiya; Sri, Lavaneyaa; Alolabi, Bashar; Bolton, Carlee; Li, Xinning; Curry, Emily; Michlin, Dana; Bardana, Davide; Bicknell, Ryan; Liendo Verdugo, Rodrigo Javier; Vidal Olate, Catalina Victoria
    Introduction: Anterior dislocations, the most common type of shoulder dislocation, are often complicated by subsequent instability. With recurrent dislocations there often is attrition of the labrum and progressive loss of the anterior bony contour of the glenoid. Treatment options for this pathology involve either soft tissue repair or bony augmentation procedure. The optimal management remains unknown and current clinical practice is highly varied. Methods and analysis:The Shoulder instability Trial comparing Arthroscopic stabilization Benefits compared with Latarjet procedure Evaluation (STABLE) is an ongoing multi-centre, pilot randomized controlled trial of 82 patients who have been diagnosed with recurrent anterior shoulder instability and subcritical glenoid bone loss. Patients are randomized to either soft tissue repair (Bankart + Remplissage) or bony augmentation (Latarjet procedure). The primary outcome for this pilot is to assess trial feasibility and secondary outcomes include recurrent instability as well as functional outcomes up to two years post-operatively. Conclusions: This trial will help to identify the optimal treatment for patients with recurrent shoulder instability with a focus on determining which treatment option results in reduced risk of recurrent dislocation and improved patient outcomes. Findings from this trial will guide clinical practice and improve care for patients with shoulder instability. Ethics and dissemination: This study has ethics approval from the McMaster University/Hamilton Health Sciences Research Ethics Board (REB) (approval #4942). Successful completion will significantly impact the global management of patients with recurrent instability. This trial will develop a network of collaboration for future high-quality trials in shoulder instability.
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    Critical shoulder angle and failure of conservative treatment in patients with atraumatic full thickness rotator cuff tears
    (2022) Meissner-Haecker, Arturo; Contreras Marambio, Julio César; Valenzuela, Alfonso; Delgado, Byron; Taglioni, Angelinni; Marinis Acle, Rodrigo Ignacio de; Calvo, Claudio; Soza, Francisco; Liendo Verdugo, Rodrigo Javier; Pontificia Universidad Católica de Chile. Escuela de Medicina
    Atraumatic full thickness rotator cuff tears (AFTRCT) are common lesions whose incidence increases with age. Physical therapy is an effective conservative treatment in these patients with a reported success rate near 85% within 12 weeks of treatment. The critical shoulder angle (CSA) is a radiographic metric that relates the glenoid inclination with the lateral extension of the acromion in the coronal plane. A larger CSA has been associated with higher incidence of AFTRCT and a higher re-tear rate after surgical treatment. However, no study has yet described an association between a larger CSA and failure of conservatory treatment in ARCT. The main objective of this study is to determine whether there is an association between CSA and failure of physical therapy in patients with AFTRCT. Methods: We reviewed the imaging and clinical records of 48 patients (53 shoulders), 60% female, with a mean age of 63.2 years (95% CI ± 10.4 years); treated for AFTRCT who also underwent a true anteroposterior radiograph of the shoulder within a year of diagnosis of the tear. We recorded demographic (age, sex, type of work), clinical (comorbidities), and imaging data (CSA, size and location of the tear). We divided the patients into two groups according to success or failure of conservative treatment (indication for surgery), so 21 shoulders (39.6%) required surgery and were classified as failure of conservative treatment. Univariate and multivariate analysis was performed to detect predictors of failure of conservative treatment. Results: The median CSA was 35.5º with no differences between those with failure (median 35.5º, range 29º to 48.2º) and success of conservative treatment (median 35.45º, range 30.2º to 40.3º), p = 0.978. The multivariate analysis showed a younger age in patients with failure of conservative treatment (56.14 ± 9.2 vs 67.8 ± 8.4, p < 0.001) and that male gender was also associated with failure of conservative treatment (57% of men required surgery vs 28% of women, p = 0.035). Conclusions: It is still unclear if CSA does predict failure of conservative treatment. A lower age and male gender both could predicted failure of conservative treatment in AFTRCT. Further research is needed to better address this subject.
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    Efectividad de un programa de rehabilitación autoadministrado en el tratamiento del síndrome de hombro doloroso en atención primaria de salud : un estudio clínico aleatorizado, simple ciego
    (2018) Contreras, Julio; Liendo Verdugo, Rodrigo Javier; Díaz, Cristóbal; Díaz, María; Osorio, Matías; Guzmán, Ricardo; Soza Rex, José Francisco; Beltrán, Manuel; Palomo, Héctor; Córdova, Carlos
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    Increasing incidence of rotator cuff surgery : a nationwide registry study in Chile
    (2021) Vidal Olate, Catalina Victoria; Lira Salas, María Jesús; Marinis Acle, Rodrigo Ignacio de; Liendo Verdugo, Rodrigo Javier; Contreras, Julio J.
    Background: The rotator cuff surgery (RCS) incidence is rising rapidly in North America, Europe, Asia, and Australia. Despite this, multiple factors limit patients’ access to surgery. In Latin America, barriers to orthopedic surgery have been largely ignored. The purpose of this study was to calculate the rate of RCS in Chile between 2008 and 2018, investigating possible associated factors to access such as age, sex, and the health insurance. Methods: An ecological study was carried out with nationwide data obtained from the Database of Hospital Discharges of the Department of Statistics. All Chilean inhabitants aged 25 years or more were included. We used the ICD-10 codes M751, M754, and S460. The annual incidence rate of surgeries and the incidence rate for the period studied per 100,000 inhabitants were calculated. Data were analyzed stratified by age, sex, year of study, and the health insurance. Negative binomial regression was used to compare rates. Statistical analyzes were performed with Stata v.14 software. Results: 39,366 RCSs were performed, with a total rate for the period of 32.36 per 100,000 inhabitants. The annual rate of surgeries from 2008 to 2018 increased from 24.55 to 49.11 per 100,000/year. When adjusting for year, an annual increase in surgery rates of 8.19% (95% CI 6.7–9.6) and 101% growth between 2008 and 2018 (95% CI 90–109%, p < 0.001) was observed. When comparing the global rates according to the health insurance, the public system corresponds to 21.3 per 100,000 and the private system to 72 per 100,000, the latter being 3.4-times higher (95% CI 2.7–4.4; p < 0.001). Conclusion: RCS rates are increasing in Chile concordantly with previous reports of other western countries. The most important factor associated with RCS rate found was the patients’ health insurance, with higher rates observed for the private sector.
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    Increasing surgical rate of clavicle fractures and acromioclavicular dislocations in Chile: analysis over the last 15 years reveals disparities in access according to insurance type
    (Springer Nature, 2025) Vidal Olate, Catalina Victoria; Marinis Acle, Rodrigo Ignacio de; Liendo Verdugo, Rodrigo Javier; Silva Canales, Isadora Camila del Carmen; Lira Salas, María Jesús; Contreras Fernández, Julio José
    Background In recent years, an increase in surgeries to treat clavicle injuries has been reported. It has been hypothesized that the studies regarding the beneficial effect of surgery in patients with displaced clavicle fractures may have contributed to raise the surgical rates for injuries around the clavicle. To our knowledge, there is a lack of data from Latin American countries on surgical rates of clavicle-related surgeries. The aim of this study is to describe the rate of clavicle surgeries, including clavicle fracture and acromioclavicular dislocation, in the last 15 years and to analyze the possible effect of sex, age, and health insurance in those rates. Methods An observational cross-sectional study was carried out. Patients over 18 years old diagnosed with the following ICD-10 codes were selected: S420 "Clavicle fracture", S431 "Dislocation of the acromioclavicular joint", and S435 "Sprains and strains of the acromioclavicular joint". We collected information on the year of surgery, sex, age and type of insurance. The annual rate of surgeries and the rate for the period studied per 100,000 people were calculated. The rate was compared through negative binomial regression, reporting Incidence Rate Ratios (IRR) with 95% confidence interval (95% CI). Results During a 15 years period of observation, 24,570 surgeries were performed. For clavicle fractures an 8.0 × 100,000 surgical rate was observed, and a 4.7 × 100,000 rate was found for acromioclavicular dislocations. The surgical rate for clavicular injuries increased from 2.8 in 2005 to 19.1 in 2019. Rates were higher in men, and ages between 20 and 35 years. The surgical rate for clavicular injuries in the public system was 11.1 × 100,000 and 30.9 × 100,000 in the private system, which represents a difference of 2.8 times between those healthcare systems. Conclusion There has been a significant increase in clavicle and acromioclavicular dislocation surgeries in Chile, with disparities influenced by age, gender, and type of health insurance.
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    Proximal humerus variable angle locking plate for the treatment of periprosthetic humeral fractures in a patient with previous tendon transfers: A case report
    (2023) Marinis Acle, Rodrigo Ignacio de; López Le-beuffe, Cristóbal Ernesto; Regan, Christina; Guarin, Sergio; Valenzuela, Alfonso; Kameid, Gonzalo; Liendo Verdugo, Rodrigo Javier
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    Shoulder surgery in Chile: how far we have come and our future challenges
    (Elsevier Inc., 2025) Marinis Acle, Rodrigo Ignacio de; Vidal Olate, Catalina Victoria; Correa Rivas, Ignacio Andrés; Contreras Fernández, Julio José; Kuroiwa Rivero, Aron Rriky; Calvo Palma, Claudio; Liendo Verdugo, Rodrigo Javier; Cerda, Jaime; Soza Rex, José Francisco
    Shoulder surgery in Chile has seen a remarkable development in the last 2 decades. From a handful of overseas-trained pioneers, Chilean shoulder surgeons now have a growing and robust society with more than 150 members with 8 fellowship programs and around 10 new fellowship-trained shoulder surgeons graduating every year. Academic activity has been steadily improving in both quality and quantity, aspiring to reach the standards of Europe and North America. State-of-the-art clinical practice is the standard in larger cities with considerable access issues in more remote areas of the country. In the broader picture, the country has a mixed public-private insurance system with a health budget that accounts for 9% of the gross domestic product (GDP).27 Although private insurance is accessible to only approximately 18% of the population, the elevated out-of-pocket cost of health care is a growing issue, especially for elective surgery. In this narrative review, we provide an overview of the development of shoulder surgery in Chile. We will discuss our health care system, surgical rates, and waiting lists issues and address the challenges along with opportunities for future developments. By discussing our strengths, limitations, opportunities, and threats, we aim to provide the reader with useful insights into global health care issues around shoulder surgery and exemplify potential solutions and barriers.