Browsing by Author "Meissner-Haecker, Arturo"

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    An independent inter- and intraobserver agreement assessment of the AOSpine sacral fracture classification system
    (2021) Urrutia, Julio; Meissner-Haecker, Arturo; Astur, Nelson; Valencia, Manuel; Yurac, Ratko; Camino-Willhuber, Gaston; Valacco, Marcelo
    BACKGROUND CONTEXT: The AOSpine sacral classification scheme was recently described. It demonstrated substantial interobserver and excellent intraobserver agreement in the study describing it; however, an independent assessment has not been performed.
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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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    Inter- and intra-observer agreement using the new AOSpine sacral fracture classification, with a comparison between spine and pelvic trauma surgeons
    (2022) Meissner-Haecker, Arturo; Diaz-Ledezma, Claudio; Klaber, Ianiv; Zamora, Tomas; Valencia, Manuel; Camino-Willhuber, Gaston; Astur, Nelson; Yurac, Ratko; Valacco, Marcelo; Urrutia, Julio
    Background: Sacral fractures treatment frequently involves both spine and pelvic trauma surgeons; therefore, a consistent communication among surgical specialists is required. We independently assessed the new AOSpine sacral fracture classification's agreement from the perspective of spine and pelvic trauma surgeons. Methods: Complete computerized tomography (CT) scans of 80 patients with sacral fractures were selected and classified using the new AOSpine sacral classification system by six spine surgeons and three pelvic trauma surgeons. After four weeks, the 80 cases were presented and reassessed by the same raters in a new random sequence. The Kappa coefficient ( K) was used to measure the inter-and intra-observer agreement. Results: The inter-observer agreement considering the fracture severity types (A, B, or C) was substantial for spine surgeons ( K= 0.68 [0.63 - 0.72]) and pelvic trauma surgeons ( K= 0.74 (0.64 - 0.84). Regarding the subtypes, both groups achieved moderate agreement with K= 0.52 (0.49 - 0.54) for spine surgeons and K= 0.51 (0.45 - 0.57) for pelvic trauma surgeons. The intra-observer agreement considering the fracture types was substantial for spine surgeons ( K= 0.74 [0.63 - 0.75]) and almost perfect for pelvic trauma surgeons ( K= 0.84 [0.74 - 0.93]). Concerning the subtypes, both groups achieved substantial agreement with, K= 0.61 (0.56 - 0.67) for spine surgeons and K= 0.68 (0.62 - 0.74) for pelvic trauma surgeons. Conclusion: This classification allows an adequate communication for spine surgeons and pelvic trauma surgeons at the fracture severity type, but the agreement is only moderate at the subtype level. Future prospective studies are required to evaluate whether this classification allows for treatment recommendations and establishing prognosis in patients with sacral fractures. @ 2021 Elsevier Ltd. All rights reserved.
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    Mid and lower thoracic kyphosis changes during adulthood: the influence of age, sex and thoracic coronal curvature
    (2021) Urrutia Escobar, Julio Octavio; Besa Vial, Pablo José; Narvaez, Felipe; Meissner-Haecker, Arturo; Rios, Clemente; Piza, Cristobal