Browsing by Author "Soza, Francisco"

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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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    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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    Innovative perfused cadaveric model for complete mesocolic excision
    (2024) Jarry Trujillo, Cristian Ignacio; Vela Ulloa, Javier Ignacio; Varas Cohen, Julian Emanue; Soza, Francisco; Corvetto Aqueveque, Marcia Antoniao; Heriot, Alexander; Warrier, Satish; Larach Kattan, José Tomas
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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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    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.