Browsing by Author "Orrego Luzoro, Mario Santiago"

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    An Isolated Transosseous Flexible Suture Frame in the Treatment of Patellar Tendon Rupture Provides Adequate Mechanical Resistance
    (2021) Besa Vial, Pablo José; Telias, Alberto; Orrego, Francisca; Guzmán-Venegas, Rodrigo; Cariola, Martín; Amenábar, Diego; Palma, Felipe H.; Irarrázaval Domínguez, Sebastián; Orrego Luzoro, Mario Santiago
    Introduction: Acute patellar tendon ruptures are frequently observed in patients with metabolic comorbidities, and the benchmark treatment is surgical repair. It is desirable not to harm an already fragile biologic environment with sutures and hardware. We aimed to compare the mechanical requirements of an isolated, flexible, high-strength nonabsorbable transosseous suture frame with that of the Krackow suture technique. Methods: A total of 12 cadaveric pieces were randomized into two groups: the isolated flexible frame group (n = 6) and the standard Krackow fixation group (n = 6). A traumatic rupture of the patellar tendon was performed, and a transosseous displacement sensor was installed on a validated biomechanical system. Gap formation was measured during 50 cycles of flexion and extension with traction on the quadriceps (250 N). Subsequently, specimens underwent progressive loading in a fixed flexion position until failure occurred. The data were analyzed using nonparametric statistical tools with a significance level of 5%. Results: The isolated frame group had a smaller gap formation (1.7 mm) than the Krackow group (3.4 mm; P = 0.01). No significant difference existed in the median failure end points of the two groups (676 and 530 N, respectively; P = 0.11). Discussion: Patellar tendon repair using an isolated, transosseous, flexible, suture frame outperformed using the traditional Krakow repair technique in gap formation. Further studies are needed to determine if this will result in better functional outcomes or fewer clinical failures. Level of evidence: Level IV, experimental case series.
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    Evaluation of the Chilean National Orthopaedic Examination Over 11 Years: Progress and Outcomes of National and International Examinees
    (LIPPINCOTT WILLIAMS & WILKINS, 2024) Lira Salas, María Jesús; Besa Vial, Pablo José; Irarrázaval Dominguez, Sebastián; Ruz Laurent, Cristian Andrés; Walbaum, Garcia Cristóbal; Montecinos, Carla; Amenabar, Diego; Orrego Luzoro, Mario Santiago
    Introduction: The National Orthopaedics Examination (EMNOT) was initially designed for Chilean orthopaedic program graduates and is now a crucial component of the revalidation process for international orthopaedic surgeons seeking practice in Chile. This study aims to describe participation and performance of EMNOT examinees based on their origin and to analyze the difficulty and discrimination indexes during its first 11 years of implementation. Methods: A retrospective assessment was conducted on all EMNOT results from 2009 to 2019. The study evaluated the participation and performance of examinees according to their origin and examined the difficulty and discrimination indexes of the examination.Results: A total of 975 examinees were evaluated, with 41.23% from national resident programs (National Medical Graduates) and 58.77% from international examinees (International Medical Graduates). The number of participating universities increased from 4 in 2009 to 17 in 2019. National Medical Graduates examinees achieved a mean score of 66.52 +/- 8.67 (0 to 100 points) while International Medical Graduates examinees scored 55.13 +/- 11.42 (P , 0.001). The difficulty and discrimination indexes remained adequate throughout this period. Discussion: Over the course of 11 years, the number of EMNOT examinees exhibited notable growth. The examination effectively differentiates between candidates based on their origin and maintains appropriate levels of difficulty and discrimination.
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    Medial opening wedge high tibial osteotomy: more than ten years of experience with Puddu plate technique supports its indication
    (2022) Orrego Luzoro, Mario Santiago; Besa Vial, Pablo José; Orrego, Francisca; Amenábar, Diego; Vega Mayer, Jorge Rafael; Irribarra Trivelli, Luis Alfonso; Espinosa, J.; Vial Irarrázabal, Raimundo; Phillips, V.; Irarrázaval Domínguez, Sebastián
    Purpose: To describe the short-term and long-term results of patients who underwent a medial opening wedge high tibial osteotomy (MOW-HTO) for unicompartmental medial knee joint osteoarthritis. Methods: A retrospective review was conducted of patients with MOW-HTO using a Puddu plate®, with more than ten year follow-up. The degree of correction, initial chondral damage, number of meniscal lesions, preoperative and 1-year postoperative functional scale scores (IKDC and Lysholm), and arthroplasty conversion rates at the ten year follow-up were registered. We assumed early indication when patients underwent the operation before they were 40 years old and delayed ≥ 40. Functional outcomes were analyzed by adjusting for pre-operative values. Fisher’s exact test was used to study the association between the arthroplasty conversion rates and the timing of indication. Results: Fifty-five patients were included, 37 of whom were male (67%). Twenty-nine patients had early indications for surgery (53%). All patients completed ten year follow-up. All patients improved IKDC (p < 0.01) and Lysholm (p < 0.01) scores compared to their presurgical scores at the one year post-operative evaluation. We had six minor complications, none requiring revision surgery. We had three conversions to arthroplasty, all in the late indication group, not statistically significant different. Linear regression showed that early indication was associated with a higher IKDC score when adjusting for the Outerbridge chondral damage score, the number of meniscal lesions, and sex (p < 0.01). Conclusion: All patients improved functional scores one year after surgery. Early indication (i.e., younger than 40 years of age) was independently associated with better functional outcomes than late indication at one year follow-up.
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    The distance between the fibular collateral ligament tunnel and the common peroneal nerve allows a posterolateral corner reconstruction without neurolysis
    (Institute for Ionics, 2023) Vial Irarrazabal, Raimundo; Orrego Luzoro, Mario Santiago; Espinosa Fuenzalida, Julio Andrés; Besa Vial, Pablo José; Irarrazaval Domínguez, Sebastián
    © 2023, The Author(s) under exclusive licence to SICOT aisbl.Purpose: The most popular knee posterolateral corner (PLC) reconstruction techniques describe that a common peroneal nerve (CPN) neurolysis must be done to safely address the posterolateral aspect of the knee. The purpose of this study was to measure the distance between the CPN and the fibular insertion of the FCL in different degrees of knee flexion in cadaveric specimens, to identify if tunnel drilling could be done anatomically and safely without a CPN neurolysis. Methods: Ex vivo experimental analytical study. Ten fresh frozen human knees were dissected leaving FCL and CPN in situ. Shortest distance from the centre of the FCL distal tunnel and CPN was measured (antero-posterior and proximal-distal wire-nerve distances) at 90°, 60°, 30°, and 0° of knee flexion. Measurements between different flexion angles were compared and correlation between knee flexion angle and distance was identified. Results: The mean distance between the FCL tunnel and the CPN at 90° were 21.15 ± 6.74 mm posteriorly (95% CI: 16.33–25.97) and 13.01 ± 3.55 mm distally (95% CI: 10.47–15.55). The minimum values were 9.8 mm posteriorly and 8.9 mm, respectively. These distances were smaller at 0° (p ≤ 0.017). At 90° of knee flexion, the mean distance from the fibular tip to the CPN distally was 23.46 ± 4.13 mm (20.51–26.41). Conclusion: Anatomic localization and orientation of fibular tunnels can be done safely while avoiding nerve neurolysis. Further studies should aim to in vivo measurements and results.
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    Tibial tubercle to trochlear groove and the roman arch method for tibial tubercle lateralisation are reliable and distinguish between subjects with and without major patellar instability
    (2024) Irarrázaval Domínguez, Sebastián; Besa Vial, Pablo José; Fernández, Tomás; Fernandez Schlein, Francisco Andrés; Aguirre Donoso, Rodrigo; Tuca De Diego, María Jesús; Lira Salas, María Jesús; Orrego Luzoro, Mario Santiago