Browsing by Author "Liendo, Rodrigo"

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    Glenoid size and Orientation in the Chilean Population
    (2020) Contreras, Julio; Liendo, Rodrigo; Beltran, Manuel; Soza, Francisco
    Glenoid morphology is a key factor in determining the success of shoulder surgery. The purpose of this experimental study was to precisely determine the anatomical size and orientation of the glenoid in the Chilean population. 122 CT scans from asymptomatic Chilean patients were obtained. The mean age was 43.8 years (SD 12.3; range, 17-53 years) with 63 female and 59 male patients. For each of the scapulae, were obtained the glenoid version and inclination, maximum glenoid width and height, superior glenoid width, glenoid surface area, glenoid vault depth, and maximum scapular width. The glenoid size showed an average width of 26 +/- 2.7 mm, a height of 40.3 +/- 3.5 mm and a vault depth of 26.5 +/- 3.7 mm. There were significant differences between men and women. The glenoid orientation showed an average of -13.9 +/- 4.8 degrees of retroversion and a superior inclination of 11.1 +/- 4.7 degrees. Significant differences between men and women were seen only for version. We conclude, that in this Chilean sample the morphological parameters of the glenoid correspond to the published literature, however, some characteristics in this cohort must be further confirmed using other methods.
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    Intra-articular treatment with corticosteroids increases apoptosis in human rotator cuff tears
    (2019) Pablo Ramirez, Juan; Bonati-Richardson, Francesca; Pia Garcia, Maria; Hidalgo, Christian; Stoore, Caroll; Liendo, Rodrigo; Soza, Francisco; Landerer, Eduardo; Paredes, Rodolfo
    Purpose: The aim of this study is to evaluate in vivo the level of apoptosis in human rotator cuff tears and the relationship it might have with tendon degeneration. Methods: Rotator cuff biopsies from 19 male and female patients, ages between 38 and 68 years, with and without previous corticosteroid infiltrations were collected via arthroscopy. Biopsies from seven patients with healthy rotator cuffs were used as a control group. An in situ terminal deoxynucleotidyl transferase dUTP nick end labeling assay was performed to detect the level of apoptosis, which was expressed as a percentage of apoptotic cells (PAC). Results: PAC in patients with corticosteroid infiltrations was 76.97 +/- 16.99 in all tendon rupture zones, in non-infiltrated patients was 35.89 +/- 22.96, whereas in control patients was 14.48 +/- 8.15. Likewise, the tendency of PAC reveals that apoptosis in control and non-infiltrated groups was different and dispersed in all tear zones; while in corticosteroid treated patients, the tendency was similar in all rupture sites. Conclusions: This investigation leads us to conclude that the administration of corticosteroid is associated with a higher amount of apoptosis at the insertion site of the rotator cuff (rupture edge).
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    Intraoperative immediate strength recovery following lacertus fibrosus release in patients with proximal median nerve compression at the elbow
    (2023) Azocar, Camila; Corvalan, Gonzalo; Orellana, Pablo; Cobb, Peter; Liendo, Rodrigo; Roman, Javier
    PurposeIn the literature, we find that patients with lacertus syndrome (LS), proximal median nerve compression at the elbow, present subjective improvement of thumb, and index flexion strength after lacertus fibrosus (LF) release. The aim of this study is to objectively evaluate the immediate change in intraoperative flexion strength after LF release.MethodWe retrospectively reviewed prospectively collected data of a cohort of 24 patients with a double crush syndrome of the median nerve with no response to conservative treatment. All patients had surgery with LF and carpal tunnel release (CTR) under wide-awake local anaesthesia and no tourniquet (WALANT) and were evaluated intraoperatively with a dynamometer immediately before and after LF release. Flexor digitorum profundus of the second finger (FDP2) and Flexor pollicis longus (FPL) were tested in peak strength to failure. The primary outcome was the percentage of change in strength before and after the release in both assessed muscles. CTR was done after evaluating the change in flexor strength.ResultsA percentage of 79.2 women with an average age of 43.3 years. The average strength of FDP2 before LF release was 15.5 pounds (lbs.) (7.0 kg) (SD, 7.2 lbs (3.3 kg)) and 27.1 lbs. (12.2 kg) (SD, 7.1 lbs. (3.2 kg)) after LF release, which corresponds to a 96% (SD, 70%) change in strength (p=0.000). For FPL, the average pre-release strength was 17.7 lbs. (8.0kg) (SD, 4.8 lbs. (2.2 kg)) and 27.4 lbs. (12.4 kg) (SD, 5.2 lbs. (2.4 kg)) post-release, this corresponded to a 65% (SD, 38%) change in strength (p=0.000).ConclusionsPeak strength to failure in FDP2 and FPL has an immediate significant recovery after LF surgical release in patients with Lacertus syndrome.Level of evidence: IV, retrospective study.
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    Straight antegrade humeral nailing and risk of iatrogenic injury of supraspinatus tendon footprint: An MRI study
    (2023) Contreras, Julio J.; Meissner, Arturo; Valenzuela, Alfonso; Liendo, Rodrigo; de Marinis, Rodrigo; Calvo, Claudio; Soza, Francisco
    Background: Straight antegrade humeral nailing (SAHN) is associated with excellent clinical results in proximal humerus fractures. The optimal entry point is the top of the humeral head. However, the anatomy is variable, and the entry point can affect supraspinatus tendon footprint (SSP-F) or fracture reduction. The aim of this study was to analyze the relationship between the SSP-F and SAHN entry point by analyzing magnetic resonance imaging (MRI) studies of the humerus.Methods: In total 58 MRI studies of entire humerus were reviewed. The mean age was 51.6 +/- 12.4 years, with 40 female patients. The distance between the SSP-F and the SAHN insertion point (critical distance: CD), the width of the footprint, and the neck-shaft angle (NSA) were measured. Univariate and multivariate analysis were performed.Results: The mean CD was 7.51 mm +/- 2.81 (0-12.9 mm) with 51.7% of proximal humerus "critical type" (CD <8 mm). The CD was found to be lower in females, with no difference found with varying age (62.5% "critical type"). CD correlated with NSA (linear regression). "Critical type" correlated with female gender and NSA (logistic regression).Discussion: More than half of the humerus are "critical types" as to SAHN and may, therefore, be at risk for procedure-related complications.
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    The Reliability of Acromioclavicular Joint Dislocation Classification Systems: A Comparison Between the Rockwood and Kraus Classifications
    (2023) Velasquez Garcia, Ausberto; Liendo, Rodrigo; Ekdahl, Max; Calvo, Cristobal; Vidal, Catalina
    Background:The Rockwood system for the classification of acute acromioclavicular (AC) joint dislocations has been associated with a lack of reliability. A novel system has been proposed (Kraus classification) that is based on dynamic posterior translation of these injuries. Purpose:To assess the interobserver and intraobserver reliability of the Rockwood and Kraus classification systems and also to examine the impact of surgeon experience on the assessments. Study Design:Cohort study (diagnosis); Level of evidence, 3. Methods:Included were 45 patients with acute AC joint injuries who underwent a radiographic examination using standard bilateral AP and modified Alexander views. For interobserver reliability, 6 shoulder surgeons (expert group) and 6 orthopaedic residents (novice group) reviewed the radiographs to classify injuries according to the Rockwood and Kraus classifications; for each categorization, the participants chose between nonoperative management and surgical treatment. The evaluation was repeated 6 weeks later to determine intraobserver reliability. Kappa (kappa) coefficients and their 95% CIs were used to compare interobserver and intraobserver reliability for each classification system according to assessor experience. Statistical differences were considered significant when the upper and lower boundaries of the 95% CI did not overlap. Results:The overall interobserver agreement for diagnosis (both novice and expert groups) was moderate (kappa = 0.52 [95% CI, 0.51-0.54]) for the Rockwood classification and substantial (kappa = 0.62 [95% CI, 0.53-0.65]) for the Kraus classification; however, no significant differences were observed between the kappa values. The overall interobserver agreement for treatment selection was substantial when using both the Rockwood (kappa = 0.78 [95% CI, 0.72-0.81]) and Kraus (kappa = 0.77 [95% CI, 0.66-0.87]) classifications. The overall intraobserver agreement for diagnosis was substantial using both the Rockwood (kappa = 0.65 [95% CI, 0.61-0.67]) and Kraus (kappa = 0.73 [95% CI, 0.69-0.75]) classifications. There were no significant differences between the novice and expert groups on any of the evaluations. Conclusion:The Kraus system was slightly more reliable than the Rockwood system for classifying AC joint injuries both between assessor groups and overall. The level of surgeon experience had no impact on the evaluations.