Agustin Guala | Universidad Nacional del Litoral (original) (raw)

Papers by Agustin Guala

Revista De La Asociacion Argentina De Ortopedia Y Traumatologia, Sep 1, 2009

ABSTRACT Background: Some authors have found a reduced subcoracoid space associated to the subsca... more ABSTRACT Background: Some authors have found a reduced subcoracoid space associated to the subscapularis tendon rupture but the cause of this association is unknown. The goal of the study is to analyze the subcoracoid space behavior in relation to the superior migration of the humeral head in a cadaveric model. Methods: Ten non-pathologic, homolateral (dry bone) humeri and scapulas were used for this study. The humeri were fixed to the scapulas in neutral position with a dynamic external fixator, allowing only the superior migration of the humeral head in the glenoid. The subcoracoid spaces were measured with a caliper in neutral humerus position, 6 mm of superior migration, and full migration.Results: In the neutral position, the subacromial space mean measurement was 12 mm (range: 10-14mm) while the subcoracoid space mean size was 12 mm (range: 10 to 13 mm), with 6 mm superior migration of the humeral head, the subcoracoid space mean measurement was 7 mm (range: 5 to 8 mm). In the full humeral head superior migration, contacting the acromion, the subcoracoid space was reduced to a mean of 5 mm (range: 4 to 6 mm). Conclusions: Complete superior migration of the humeral head causes 58 percent reduction of the subcoracoid space.

Rev. Asoc. Argent. …, 2005

Donndorff, Agustin; Halliburton, Carolina; Yacuzzi, Carlos; Nuñez, Leandro; Bongiovanni, Santiago... more Donndorff, Agustin; Halliburton, Carolina; Yacuzzi, Carlos; Nuñez, Leandro; Bongiovanni, Santiago; Farfalli, German; Guala, Agustin; Astoul Bonorino, Juan; Pascual Garrido, Cecilia; Lopez Ovenza, Juan Manuel; Rial, Pedro; Piccirilli, Giacomo; Paredes, Marco; Santini ...

Rev Asoc Argent Ortop Traumatol, Mar 1, 2006

Rev Asoc Argent Ortop Traumatol

Base de dados : LILACS. Pesquisa : 413289 [Identificador único]. Referências encontradas : 1 [ref... more Base de dados : LILACS. Pesquisa : 413289 [Identificador único]. Referências encontradas : 1 [refinar]. Mostrando: 1 .. 1 no formato [Detalhado]. página 1 de 1, 1 / 1, LILACS, seleciona. para imprimir. Fotocópia. experimental, Documentos relacionados. Id: 413289. ...

Clinical Orthopaedics and Related Research®, 2009

Thromboembolic complications after shoulder arthroscopy are rare and their cause has not been wel... more Thromboembolic complications after shoulder arthroscopy are rare and their cause has not been well determined. Heritable thrombophilia has been studied in relation to numerous clinical conditions, and it has been associated with thromboembolic complications after some orthopaedic surgeries, especially after total hip or knee arthroplasty. We report three patients who had deep vein thrombosis develop after shoulder arthroscopy. All three tested positive for heritable thrombophilia, a condition undetected until this complication occurred. This report highlights the possibility that unrecognized coagulation disorders might seriously influence the clinical outcome of minimally invasive surgery. We suggest heritable thrombophilia is a possible risk factor for or etiology of deep vein thrombosis after shoulder arthroscopy.

Hip International the Journal of Clinical and Experimental Research on Hip Pathology and Therapy, 2010

The addition of antibiotic to cement is a frequent practice in aseptic revision hip surgery There... more The addition of antibiotic to cement is a frequent practice in aseptic revision hip surgery There is concern about adding vancomycin to cement due to potential effects on mechanical properties and prolonged elution of subtherapeutic levels antibiotic. Bone allografts can store and provide high levels of vancomycin to surrounding tissues. We analyzed the incidence of infection after one-stage aseptic revision hip reconstruction utilizing acetabular and/or femoral vancomycin-impregnated impacted bone allograft and a THA fixed with cement containing no antibiotic. We hypothesized that the infection rate may be similar to that reported in the literature following traditional impaction grafting using antibiotic loaded cement. Seventy five consecutive patients (80 hips) with a preoperative Merle D'Aubigné and Postel functional score averaging 4.8 points were followed up for a mean of 36 months (range 24 - 59 months). The incidence of infection was 1.25% (CI 95%=96.26-100%). A deep infection (thought to be haematognous in origin) occurred in 1 patient 2 years after the index surgery. The average postoperative Merle D´Aubigne score was 16.2 points. The last radiographic evaluation demonstrated a less than 5 mm acetabular migration and a less than 5 mm femoral subsidence in all cases. Vancomycin-supplemented allografts restored bone stock and provided sound fixation with a low incidence of infection. This incidence of deep sepsis is similar to that reported with antibiotic-loaded PMMA but without the reported mechanical and pharmacological disadvantages.

Hip international : the journal of clinical and experimental research on hip pathology and therapy

The addition of antibiotic to cement is a frequent practice in aseptic revision hip surgery There... more The addition of antibiotic to cement is a frequent practice in aseptic revision hip surgery There is concern about adding vancomycin to cement due to potential effects on mechanical properties and prolonged elution of subtherapeutic levels antibiotic. Bone allografts can store and provide high levels of vancomycin to surrounding tissues. We analyzed the incidence of infection after one-stage aseptic revision hip reconstruction utilizing acetabular and/or femoral vancomycin-impregnated impacted bone allograft and a THA fixed with cement containing no antibiotic. We hypothesized that the infection rate may be similar to that reported in the literature following traditional impaction grafting using antibiotic loaded cement. Seventy five consecutive patients (80 hips) with a preoperative Merle D'Aubigné and Postel functional score averaging 4.8 points were followed up for a mean of 36 months (range 24 - 59 months). The incidence of infection was 1.25% (CI 95%=96.26-100%). A deep inf...

International Orthopaedics, 2008

When the proximal femur is absent due to a failed femoral stem in total hip arthroplasty, impacte... more When the proximal femur is absent due to a failed femoral stem in total hip arthroplasty, impacted bone grafts contained within circumferential meshes could be an alternative reconstructive method. The purpose of this study was to analyse the initial resistance to axial and rotational forces in a fresh frozen bovine model with complete loss of the proximal femur reconstructed with a circumferential metal mesh, impacted bone allografts and a long cemented stem. Four bovine femurs with a complete proximal bone defect were reconstructed with a circumferential mesh, impacted bone grafts and a cemented stem. The results were compared with four intact femurs using the same implant. Under axial load, subsidence was observed at an average of 617 kg in the experimental group, and a cortical fracture occured at 1335 kg in the control group. Under rotational load, experimental femurs failed at an average of 79 kg and the control femurs fractured at 260 kg. This model provided 50% of the resistance to axial load and 30% of the resistance to rotational load compared to an intact femur, which is enough to resist physiological load. This stability encourages the use of circumferential meshes, impacted bone allografts and cemented stems in revision hip surgery with massive bone loss.

Revista De La Asociacion Argentina De Ortopedia Y Traumatologia, Mar 1, 2011

... Increased frequency of genetic thrombophilia in women with complications of pregnancy. N Engl... more ... Increased frequency of genetic thrombophilia in women with complications of pregnancy. N Engl J Med. 1999;340:9-13. 28. Levine JS, Branch DW, Rauch J. The antiphospholipid syndrome. N Engl J Med. 2002;346:752-63. 29. ...

Clinical Orthopaedics and Related Research, 2007

We present the case of a 60-year-old man who had metastasis of a nodular squamous cell carcinoma ... more We present the case of a 60-year-old man who had metastasis of a nodular squamous cell carcinoma from a laryngeal carcinoma that mimicked an infected sinus in a 4-month postoperative revision total hip arthroplasty scar. A diagnosis was made at the time of frozen section. The patient died 3 months after tumor resection as a result of multiorgan failure. Nodular squamous cell carcinoma metastasis in a total hip arthroplasty scar is extremely uncommon. However, this association must be considered in a patient with a known tumor after revision surgery. In such patients, we recommend obtaining an intraoperative frozen section to avoid misdiagnosis in cases of infected sinuses associated with implants.

Clinical Orthopaedics and Related Research, 2009

Revista De La Asociacion Argentina De Ortopedia Y Traumatologia, Sep 1, 2009

ABSTRACT Background: Some authors have found a reduced subcoracoid space associated to the subsca... more ABSTRACT Background: Some authors have found a reduced subcoracoid space associated to the subscapularis tendon rupture but the cause of this association is unknown. The goal of the study is to analyze the subcoracoid space behavior in relation to the superior migration of the humeral head in a cadaveric model. Methods: Ten non-pathologic, homolateral (dry bone) humeri and scapulas were used for this study. The humeri were fixed to the scapulas in neutral position with a dynamic external fixator, allowing only the superior migration of the humeral head in the glenoid. The subcoracoid spaces were measured with a caliper in neutral humerus position, 6 mm of superior migration, and full migration.Results: In the neutral position, the subacromial space mean measurement was 12 mm (range: 10-14mm) while the subcoracoid space mean size was 12 mm (range: 10 to 13 mm), with 6 mm superior migration of the humeral head, the subcoracoid space mean measurement was 7 mm (range: 5 to 8 mm). In the full humeral head superior migration, contacting the acromion, the subcoracoid space was reduced to a mean of 5 mm (range: 4 to 6 mm). Conclusions: Complete superior migration of the humeral head causes 58 percent reduction of the subcoracoid space.

Rev. Asoc. Argent. …, 2005

Donndorff, Agustin; Halliburton, Carolina; Yacuzzi, Carlos; Nuñez, Leandro; Bongiovanni, Santiago... more Donndorff, Agustin; Halliburton, Carolina; Yacuzzi, Carlos; Nuñez, Leandro; Bongiovanni, Santiago; Farfalli, German; Guala, Agustin; Astoul Bonorino, Juan; Pascual Garrido, Cecilia; Lopez Ovenza, Juan Manuel; Rial, Pedro; Piccirilli, Giacomo; Paredes, Marco; Santini ...

Rev Asoc Argent Ortop Traumatol, Mar 1, 2006

Rev Asoc Argent Ortop Traumatol

Base de dados : LILACS. Pesquisa : 413289 [Identificador único]. Referências encontradas : 1 [ref... more Base de dados : LILACS. Pesquisa : 413289 [Identificador único]. Referências encontradas : 1 [refinar]. Mostrando: 1 .. 1 no formato [Detalhado]. página 1 de 1, 1 / 1, LILACS, seleciona. para imprimir. Fotocópia. experimental, Documentos relacionados. Id: 413289. ...

Clinical Orthopaedics and Related Research®, 2009

Thromboembolic complications after shoulder arthroscopy are rare and their cause has not been wel... more Thromboembolic complications after shoulder arthroscopy are rare and their cause has not been well determined. Heritable thrombophilia has been studied in relation to numerous clinical conditions, and it has been associated with thromboembolic complications after some orthopaedic surgeries, especially after total hip or knee arthroplasty. We report three patients who had deep vein thrombosis develop after shoulder arthroscopy. All three tested positive for heritable thrombophilia, a condition undetected until this complication occurred. This report highlights the possibility that unrecognized coagulation disorders might seriously influence the clinical outcome of minimally invasive surgery. We suggest heritable thrombophilia is a possible risk factor for or etiology of deep vein thrombosis after shoulder arthroscopy.

Hip International the Journal of Clinical and Experimental Research on Hip Pathology and Therapy, 2010

The addition of antibiotic to cement is a frequent practice in aseptic revision hip surgery There... more The addition of antibiotic to cement is a frequent practice in aseptic revision hip surgery There is concern about adding vancomycin to cement due to potential effects on mechanical properties and prolonged elution of subtherapeutic levels antibiotic. Bone allografts can store and provide high levels of vancomycin to surrounding tissues. We analyzed the incidence of infection after one-stage aseptic revision hip reconstruction utilizing acetabular and/or femoral vancomycin-impregnated impacted bone allograft and a THA fixed with cement containing no antibiotic. We hypothesized that the infection rate may be similar to that reported in the literature following traditional impaction grafting using antibiotic loaded cement. Seventy five consecutive patients (80 hips) with a preoperative Merle D'Aubigné and Postel functional score averaging 4.8 points were followed up for a mean of 36 months (range 24 - 59 months). The incidence of infection was 1.25% (CI 95%=96.26-100%). A deep infection (thought to be haematognous in origin) occurred in 1 patient 2 years after the index surgery. The average postoperative Merle D´Aubigne score was 16.2 points. The last radiographic evaluation demonstrated a less than 5 mm acetabular migration and a less than 5 mm femoral subsidence in all cases. Vancomycin-supplemented allografts restored bone stock and provided sound fixation with a low incidence of infection. This incidence of deep sepsis is similar to that reported with antibiotic-loaded PMMA but without the reported mechanical and pharmacological disadvantages.

Hip international : the journal of clinical and experimental research on hip pathology and therapy

The addition of antibiotic to cement is a frequent practice in aseptic revision hip surgery There... more The addition of antibiotic to cement is a frequent practice in aseptic revision hip surgery There is concern about adding vancomycin to cement due to potential effects on mechanical properties and prolonged elution of subtherapeutic levels antibiotic. Bone allografts can store and provide high levels of vancomycin to surrounding tissues. We analyzed the incidence of infection after one-stage aseptic revision hip reconstruction utilizing acetabular and/or femoral vancomycin-impregnated impacted bone allograft and a THA fixed with cement containing no antibiotic. We hypothesized that the infection rate may be similar to that reported in the literature following traditional impaction grafting using antibiotic loaded cement. Seventy five consecutive patients (80 hips) with a preoperative Merle D'Aubigné and Postel functional score averaging 4.8 points were followed up for a mean of 36 months (range 24 - 59 months). The incidence of infection was 1.25% (CI 95%=96.26-100%). A deep inf...

International Orthopaedics, 2008

When the proximal femur is absent due to a failed femoral stem in total hip arthroplasty, impacte... more When the proximal femur is absent due to a failed femoral stem in total hip arthroplasty, impacted bone grafts contained within circumferential meshes could be an alternative reconstructive method. The purpose of this study was to analyse the initial resistance to axial and rotational forces in a fresh frozen bovine model with complete loss of the proximal femur reconstructed with a circumferential metal mesh, impacted bone allografts and a long cemented stem. Four bovine femurs with a complete proximal bone defect were reconstructed with a circumferential mesh, impacted bone grafts and a cemented stem. The results were compared with four intact femurs using the same implant. Under axial load, subsidence was observed at an average of 617 kg in the experimental group, and a cortical fracture occured at 1335 kg in the control group. Under rotational load, experimental femurs failed at an average of 79 kg and the control femurs fractured at 260 kg. This model provided 50% of the resistance to axial load and 30% of the resistance to rotational load compared to an intact femur, which is enough to resist physiological load. This stability encourages the use of circumferential meshes, impacted bone allografts and cemented stems in revision hip surgery with massive bone loss.

Revista De La Asociacion Argentina De Ortopedia Y Traumatologia, Mar 1, 2011

... Increased frequency of genetic thrombophilia in women with complications of pregnancy. N Engl... more ... Increased frequency of genetic thrombophilia in women with complications of pregnancy. N Engl J Med. 1999;340:9-13. 28. Levine JS, Branch DW, Rauch J. The antiphospholipid syndrome. N Engl J Med. 2002;346:752-63. 29. ...

Clinical Orthopaedics and Related Research, 2007

We present the case of a 60-year-old man who had metastasis of a nodular squamous cell carcinoma ... more We present the case of a 60-year-old man who had metastasis of a nodular squamous cell carcinoma from a laryngeal carcinoma that mimicked an infected sinus in a 4-month postoperative revision total hip arthroplasty scar. A diagnosis was made at the time of frozen section. The patient died 3 months after tumor resection as a result of multiorgan failure. Nodular squamous cell carcinoma metastasis in a total hip arthroplasty scar is extremely uncommon. However, this association must be considered in a patient with a known tumor after revision surgery. In such patients, we recommend obtaining an intraoperative frozen section to avoid misdiagnosis in cases of infected sinuses associated with implants.

Clinical Orthopaedics and Related Research, 2009