[Translated article] Efficacy of platelet-rich plasma in rotator cuff repair: Systematic review and meta-analysis.

OBJECTIVE: To analyse the efficacy and safety after the application of platelet-rich-plasma (PRP) as an adjuvant in arthroscopic rotator cuff repairs. MATERIAL AND METHODS: A bibliographic search of the literature of prospective studies with level of evidence one or two was carried out from January 2004 to December 2021, including studies that compare the functional and re-tear results after arthroscopic cuff repair rotator with or without PRP. RESULTS: A total of 281 articles were identified, of which 14 met the inclusion criteria. The overall re-rupture rate was 24%. In the PRP group, a decrease in the re-rupture rate and better functional results were demonstrated, although these differences were not significant. CONCLUSIONS: Adjuvant treatment with PRP has shown promising results, although there is not yet enough evidence to provide a clear advantage for routine use in clinical practice.

Efficacy of platelet-rich plasma in rotator cuff repair: systematic review and meta-analysis. / Eficacia del plasma rico en plaquetas en la reparación del manguito rotador: revisión sistemática y metaanálisis.

OBJECTIVE: To analyze the efficacy and safety after the application of platelet-rich-plasma (PRP) as an adjuvant in arthroscopic rotator cuff repairs. MATERIAL AND METHODS: A bibliographic search of the literature of prospective studies with level of evidence one or two was carried out from January 2004 to December 2021, including studies that compare the functional and re-tear results after arthroscopic cuff repair rotator with or without PRP. RESULTS: A total of 281 articles were identified, of which 14 met the inclusion criteria. The overall re-rupture rate was 24%. In the PRP group, a decrease in the re-rupture rate and better functional results were demonstrated, although these differences were not significant. CONCLUSIONS: Adjuvant treatment with PRP has shown promising results, although there is not yet enough evidence to provide a clear advantage for routine use in clinical practice.

Sonographic Measurement of the Patellar Tendon Should Predict Autograft Bone Patellar Tendon Bone (BPTB) Size: Comparison of Anatomical and Clinical Findings.

The use of BPTB autograft is frequently used in ACL reconstruction, however, the risk of potential failure in patients with an anatomically unfavorable patellar tendon may predispose to reconstruction failure. Anatomical study of the extensor apparatus of the knee can provide knowledge about the best option obtain the graft and perform a better preoperative planning. Musculoskeletal ultrasound is a simple, reproducible, affordable technique that could be valid for patellar tendon evaluation. The objective of this study is to evaluate the reproducibility of the patellar tendon measurements by ultrasound and compare them with anatomical measurements, both in cadaver and patients undergoing ACLR. The study consists of two phases; first anatomical study in cadaver. The ultrasound measurement was performed by determining the length, width and thickness of the patellar tendon, both by ultrasound and anatomical dissection. The second phase is a cohort of 42 patients pending surgical ACLR. Previous ultrasound and intraoperative measurements were obtained. Regarding the anatomical study, statistical analysis did not show any differences comparing the measurements in length (p = ns) and thickness (p = ns) of the patellar tendon, although differences were obtained when comparing the results obtained for the width of the tendon after the ultrasound and anatomical measurement (p < 0.001). Same results were obtained in second phase of the study. The reproducibility of ultrasound measurements of the PT is comparable to intraoperatively measurements (without width measurement). These findings can be useful for preoperative planning in the reconstruction of ACL with BPTB Graft and to assess technical modifications prior to surgery.

Assessing long-term return to play after hip arthroscopy in football players evaluating risk factors for good prognosis.

PURPOSE: Groin pain is the third most common disease in football players and has often been associated with hip pathology such as femoroacetabular impingement and labral lesions. Hip arthroscopy offers possibilities of function restoration via minimally invasive procedures. The aim of this study is to evaluate professional football player's injuries and their return to play after hip arthroscopy for FAI and labral injuries. METHODS: Patients that underwent hip arthroscopy between 2009 and 2014 were selected retrospectively. From this population, only professional soccer players competing at national level were included (Tegner 10). Arthroscopic surgery was proposed in patients with persistent pain. All patients were assessed for VAS score preoperatively and at 3, 6, 12 and 24 months post-op. HOS (sport and DLA) and mHHS tests were performed at the same time periods. RESULTS: All patients were men with a mean age of 26.5 ± 7.1 years old. Preoperative VAS (7.4 ± 1.3), HOS ADL (67.7 ± 5.5), HOS sport (37.6 ± 18.7) and mHHS (72.5 ± 8.8) showed improved scores during long-term follow-up. Time to return to play was 10.8 months (SD ± 4.3), with range between 4 and 20 months. Mean follow-up was 45.4 ± 15.6 months (range from 26 to 72 months). No differences were observed between non-active and active patients at final follow-up with respect to chondral lesions, but significant differences were observed with reference to management of the labrum (p = 0.031), where a higher rate of labrectomies existed among inactive patients and a higher rate of suture among active patients. CONCLUSIONS: Hip arthroscopy is a safe procedure with very good return to play results, but for optimized return to football one should consider patient age at the time of surgery, the condition of the labrum and low scores on the Harris Hip Score (mHHS) and HOS (sport version) as predictive factors for poor prognosis. Level of evidence IV.

Hip arthroscopy complications regarding surgery and early postoperative care: retrospective study and review of literature.

PURPOSE: The purpose is to describe the rate of complications in a series of hip arthroscopies performed at our center, as well as perform a systematic review of the current literature in order to compare our outcomes. METHODS: Two hundred and fifty-eight patients affected of femoroacetabular impingement and treated with hip arthroscopy have been studied. All minor and major complications were studied during the first postsurgery year. Furthermore, a systematic review was performed comparing major and minor complications with our series. Two attending orthopedic surgeons selected the different studies with the same inclusion and exclusion criteria, remaining with 48 studies that have been reviewed and included in the present study. RESULTS: Mean age was 36.6 years old (SD 17.45), and the ratio men:women was 137:121. The mean complication rate observed was 14.34% (37/258) of global complications. Only three patients showed major complications: femoral neck fracture, septic arthritis and avascular necrosis of the femoral head. Any of these patients had permanent side effects. CONCLUSIONS: Hip arthroscopy has a low rate of major complications, but a higher number of minor complications that could be avoided with certain preventive measures.

Wastewater treatment and biodiesel production by Scenedesmus obliquus in a two-stage cultivation process.

The microalga Scenedesmus obliquus was cultured in two cultivation stages: (1) in batch with real wastewater; (2) maintaining the stationary phase with different conditions of CO2, light and salinity according to a factorial design in order to improve the lipid content. The presence of the three factors increased lipid content from 35.8% to 49% at the end of the second stage; CO2 presence presented the highest direct effect increasing lipid content followed by light presence and salt presence. The ω-3 fatty acids content increased with CO2 and light presence acting in isolation, nevertheless, when both factors acted together the interaction effect was negative. The ω-3 eicosapentaenoic acid content of the oil from S. obliquus slightly exceeded the 1% maximum to be used as biodiesel source (EU normative). Therefore, it is suggested the blend with other oils or the selective extraction of the ω-3 fatty acids from S. obliquus oil.

Influence of light presence and biomass concentration on nutrient kinetic removal from urban wastewater by Scenedesmus obliquus.

This work was aimed at studying the effect of light-darkness and high-low biomass concentrations in the feasibility of removing nitrogen and phosphorus from urban treated wastewater by the microalga Scenedesmus obliquus. Laboratory experiments were conducted in batch, where microalgae were cultured under different initial biomass concentrations (150 and 1500mgSSl(-1)) and light conditions (dark or illuminated). Nutrient uptake was more dependent on internal nutrient content of the biomass than on light presence or biomass concentration. When a maximum nitrogen or phosphorus content in the biomass was reached (around 8% and 2%, respectively), the removal of that nutrient was almost stopped. Biomass concentration affected more than light presence on the nutrient removal rate, increasing significantly with its increase. Light was only required to remove nutrients when the maximum nutrient storage capacity of the cells was reached and further growth was therefore needed. Residence times to maintain a stable biomass concentration, avoiding the washout of the reactor, were much higher than those needed to remove the nutrients from the wastewater. This ability to remove nutrients in the absence of light could lead to new configurations of reactors aimed to wastewater treatment.

Photobiotreatment model (PhBT): a kinetic model for microalgae biomass growth and nutrient removal in wastewater.

This article proposes a kinetic model for wastewater photobiotreatment with microalgae (the PhBT model). The PhBT model for nutrient uptake, coupled with the Verhulst growth model, is a simple and useful tool to describe batch experiments of nutrient removal by microalgae. The model has been validated with experiments of Chlorella vulgaris (C. vulgaris) grown in wastewater and different synthetic media. The model provided information about nitrogen and phosphorus limitation and their luxury uptake during the test. Productivity observed in synthetic medium (0.17 g SS L(-1) d(-1)) was similar to that obtained in nutrient enriched wastewater (0.15 g SS L(-1) d(-1)). Biomass productivity of this alga in wastewater and the efficient nutrient removal suggested that C. vulgaris could be cultured in wastewater for biomass production while nutrients are reduced from this stream.

Performance of a flat panel reactor in the continuous culture of microalgae in urban wastewater: prediction from a batch experiment.

A laboratory-scale flat panel photobioreactor was operated for the continuous growth of Scenedesmus obliquus and consequent removal of nutrients in wastewater. This study develops a simple model by which biomass values in continuous operation can be predicted from kinetic growth parameters obtained from a shorter batch experiment. Based on this study, biomass concentrations and productivities in continuous operation can be successfully predicted as a function of the specific hydraulic retention time (HRT) assumed. Considerable biomass production and nutrient uptake from wastewater were achieved in the experiment. Optimum operating conditions for the reactor depend on the particular objective: the maximization of biomass production and carbon dioxide biofixation involves a HRT of 2 µ(-1) (specific growth rate), whereas efficient nutrient removal involves a HRT as close as possible to µ(-1) (as long as discharges comply fully with the parameters set); alternatively biomass intended for biodiesel or biogas production would involve a HRT > 2 µ(-1).

Fracaso de la cirugía del LCA / Failure of anterior cruciate ligament surgery

El objetivo es clasificar y describir la etiología multifactorial para considerar como fallo la cirugía del ligamento cruzado anterior (LCA), ayudar a prevenirlo y a resolverlo, centrándonos sobre todo en aquellas etiologías que obligan al recambio del LCA por inestabilidad recurrente, sin olvidarnos de las que afectan a la función o son motivo de dolor persistente. A menudo se puede identificar una causa primaria o secundaria del fracaso de una cirugía de LCA e incluso con el plan más meticuloso, podemos encontrar hallazgos no anticipados durante la intervención por lo que nuestro protocolo debe ser lo suficientemente flexible para acomodarse al desarrollo de la cirugía. Es crucial aconsejar al paciente preoperatoriamente y limitar sus expectativas acerca de los resultados sobre la cirugía dada la complejidad de este procedimiento. Con una planificación preoperatoria apropiada, intensa atención a los detalles y ajuste apropiado de las expectativas del paciente, la cirugía de revisión del LCA puede suponer un beneficioso y satisfactorio resultado para el paciente (AU)

The present study classifies and describes the multifactorial causes of anterior cruciate ligament (ACL) surgery failure, with a view to preventing and resolving such situations. The study particularly focuses on those causes that require ACL replacement due to recurrent instability, without neglecting those that affect function or produce persistent pain. It is often possible to identify a primary or secondary cause of ACL surgery failure, and even the most meticulous planning can give rise to unexpected findings during the intervention. The adopted protocol therefore should be sufficiently flexible to adapt to the course of surgery. Preoperative patient counseling is essential, limiting his or her expectations as to the results of surgery, in view of the complexity of this kind of procedure. With adequate preoperative planning, close attention to details, and appropriate definition of the patient expectations ACL revision surgery may offer beneficial and satisfactory results for the patient (AU)