Claudio Mella

University of Desarrollo, CiudadSantiago, Santiago, Chile

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Publications (10)14.7 Total impact

  • Arthroscopy The Journal of Arthroscopic and Related Surgery 12/2013; 29(12):e188. · 3.10 Impact Factor
  • Arthroscopy The Journal of Arthroscopic and Related Surgery 12/2013; 29(12):e191–e192. · 3.10 Impact Factor
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    ABSTRACT: To determine the incidence of and factors that contribute to the development of hypothermia during hip arthroscopic surgery. An analytic observational study was carried out in a cohort of 73 consecutive patients. All patients underwent hip arthroscopy for the treatment of femoroacetabular impingement. The patients' core temperature (esophageal) was measured throughout the surgery. Relevant information was collected on the patients (age, gender, body mass index, blood pressure) and on the procedure (volume and temperature of saline solution, pressure of fluid pump, surgery time, room temperature). The corresponding statistical analysis was performed with Stata 10.0 (StataCorp, College Station, TX), by use of a repeated-measures generalized estimating equations model. The patients' mean age was 33 years, and there were 39 female and 34 male patients. The mean body mass index was 23.9; systolic blood pressure, 97.5 mm Hg; and diastolic blood pressure, 52.2 mm Hg. The incidence of hypothermia below 35°C (95°F) was 2.7%. The multivariate statistical analysis of the results showed a direct relation between hypothermia and surgery time of more than 120 minutes (P < .001). There was an inverse relation between core body temperature and surgery time (P < .001), with a drop of 0.19°C/h (32.342°F/h). Of the patients, 68.22% had a decrease in temperature of more than 0.5°C (32.9°F) until the end of surgery. There was also a direct relation between core body temperature and saline solution temperature (P < .001), body mass index (P < .01), and diastolic blood pressure (P < .03). The incidence of hypothermia below 35°C (95°F) in patients who underwent hip arthroscopy for the treatment of femoroacetabular impingement is 2.7%. The factors that contribute toward the development of hypothermia during hip arthroscopic surgery are prolonged surgery time, low body mass index, low blood pressure during the procedure, and low temperature of the arthroscopic irrigation fluid.
    Arthroscopy The Journal of Arthroscopic and Related Surgery 02/2012; 28(7):924-8. · 3.10 Impact Factor
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    ABSTRACT: Zusammenfassung In der Folge von Luxationen oder Frakturen des Hüftgelenks können intraartikuläre Verletzungen auftreten, die mittels Hüftarthroskopie behandelt werden können. Wichtige Indikationen sind die Entfernung freier Gelenkkörper und die Therapie von Labrum- und Gelenkknorpelverletzungen. Zusätzlich besteht die Möglichkeit arthroskopisch vorbestehende Gelenkdeformitäten, wie z. B. das femoroazetabuläre Impingement (FAI), zu therapieren. Auch eine arthroskopieassistierte Frakturrefixierung ist im Einzelfall möglich. Vorgestellt werden 2 klinische Fälle mit intraartikulären Verletzungen nach traumatischer Hüftluxation. Der erste Fall beschreibt einen Patienten mit einer anterioren Labrumverletzung und freien Gelenkkörpern nach einer geschlossenen Hüftreposition einer dorsalen Hüftluxation. Der zweite Fall zeigt eine vordere Labrumläsion bei einem vorbestehenden FAI des Hüftgelenks. Bei beiden Patienten erfolgte die Teilresektion der verletzten Anteile des Labrums. Zusätzlich wurden die freien Gelenkkörper entfernt und eine femorale Osteoplastik durchgeführt. Die Hüftgelenkarthroskopie ist eine effektive chirurgische Therapie zur Behandlung intraartikulärer Verletzungen. Sie ermöglicht die gleichzeitige Therapie vorbestehender Gelenkdeformationen wie z. B. eines FAI.
    Der Unfallchirurg 01/2012; · 0.64 Impact Factor
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    ABSTRACT: Introduction The complete resection of the femoral bump is essential in the treatment of cam-type femoroacetabular impingement (FAI). The lesion of the retinacular vessels is possible during the resection of the most lateral portion of the femoral bump. The purpose of this study is the measurement of the distance between the femoral bump resection and the entry point of the retinacular vessels into the femoral head. Methods During a one-year period (October 2007-2008) we performed a CTscan with 3-D reconstruction in 60 patients with Cam-type FAI (34 males, 26 females, mean age 36, 5 years) before and after arthroscopic resection of the femoral bump. We identified the foraminas, corresponding to the entry point of the retinacular vessels into the femoral head. During the arthroscopy the retinacular vessels were identified prior to the bump resection. One year after hip-arthroscopy a clinical evaluation was realized to exclude avascular necrosis (AVN) of the femoral head. Results The mean distance between the most anterior foramina to the lateral limit of the femoral bump was 6.1 mm (1.1mm-17 mm). In the clinical evaluation 1 year after arthroscopy no patient presented with clinical signs suggesting AVN of the femoral head. Conclusion A CTscan with 3-D reconstruction helps to identify the lateral limit of the femoral bump and the entry point of the retinacular vessels into the femoral head. Because the lateral limit of the femoral bump extends close to the retinacular vessels, we recommend arthroscopic visualization of these vessels prior to the resection of the lateral portion of the femoral bump.
    Arthroscopy The Journal of Arthroscopic and Related Surgery 10/2011; 27(5):e52–e53. · 3.10 Impact Factor
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    ABSTRACT: Intra-articular injuries are common after dislocation and fracture of the hip joint and can be addressed using hip arthroscopy. The most common indications for this procedure are loose bodies, labral tears and chondral defects. In addition, preexisting femoroacetabular impingement can be addressed at the time of surgery. Arthroscopically guided fracture reduction and fixation has been described. We present two case reports of intra-articular lesions after traumatic hip dislocation. The first is a case of a man with an anterior labral tear and loose bodies after closed hip reduction. The second case is a man with a large anterior labral tear with preexisting femoroacetabular impingement. Both of them were treated by arthroscopic debridement of the unstable labrum. In addition loose bodies were removed in the first patient and a femoral osteoplasty was performed in the second patient. Hip arthroscopy has proven to be a safe and effective surgical technique for treating specific post-traumatic lesions and preexisting femoroacetabular impingement. The current case reports provide an overview of the indication for hip arthroscopy following traumatic injuries to the hip.
    Der Unfallchirurg 05/2011; 115(3):273-8. · 0.64 Impact Factor
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    ABSTRACT: IntroductionAbnormal hip anatomy of untreated Slipped Capital Femoral Epiphysis (SCFE), a prototype of cam impingement deformity, is a cause of early hip degeneration.
    Precambrian Research - PRECAMBRIAN RES. 01/2011; 55(2):110-115.
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    ABSTRACT: IntroductionAbnormal hip anatomy of untreated Slipped Capital Femoral Epiphysis (SCFE), a prototype of cam impingement deformity, is a cause of early hip degeneration.
    Revista Espanola de Cirugia Ortopedica y Traumatologia 01/2011; 55(2):110-115.
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    ABSTRACT: We present the clinical case of an 18-year-old woman who complained of acute hip pain. MRI showed an intra-articular tumor 4 cm in size with osteolysis (18 mm) on the distal region of the femoral head-neck junction. Focal pigmented villonodular synovitis infiltrating the bone was diagnosed. A complete resection of the tumor including the osteolytic area was done by an arthroscopic procedure. There was no sign of relapse after 8 months of follow-up, with no pain and complete function of the hip. Arthroscopic treatment has the advantage of minimal surgical trauma and good mid-term results for treating a focal lesion in selected cases.
    Der Orthopäde 03/2010; 39(5):512-5. · 0.51 Impact Factor
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    ABSTRACT: Der Fall einer 18-jährigen Patientin mit einem ausgedehnten intraartikulären Tumor des rechten Hüftgelenks und einer sekundärer Osteolyse am Schenkelhals wird dargestellt. Magnetresonanztomographie (MRT) und Biopsie ergaben die Diagnose einer fokalen villonodulären Synovitis. Durch die Hüftarthroskopie konnte der Tumor komplett entfernt und die Osteolyse mit einem exzellenten klinischen Ergebnis vollständig ausgeräumt werden. Die Hüftarthroskopie hat den Vorteil des geringeren Operationstraumas und des sehr guten frühfunktionellen Ergebnisses. Auch ausgedehnte intraartikuläre Tumore können im Einzelfall vollständig durch Hüftarthroskopie behandelt werden. We present the clinical case of an 18-year-old woman who complained of acute hip pain. MRI showed an intra-articular tumor 4cm in size with osteolysis (18 mm) on the distal region of the femoral head-neck junction. Focal pigmented villonodular synovitis infiltrating the bone was diagnosed. A complete resection of the tumor including the osteolytic area was done by an arthroscopic procedure. There was no sign of relapse after 8 months of follow-up, with no pain and complete function of the hip. Arthroscopic treatment has the advantage of minimal surgical trauma and good mid-term results for treating a focal lesion in selected cases. SchlüsselwörterHüftarthroskopie-Villonoduläre Synovitis-Tumor-Osteolyse-Hüftgelenk KeywordsFocal pigmented-Villonodular synovitis-Hip arthroscopy-Tumor-Osteolysis hipjoint
    Der Orthopäde 01/2010; 39(5):512-515. · 0.51 Impact Factor