Shoulder injury related to vaccine administration following SARS-CoV-2 inoculation: Case series and review of literature.

Introduction: Shoulder Injuries Related to Vaccine Administration (SIRVA), describes those cases of shoulder severe post-inoculation complications, including pain and prolonged disability. Most of the reported cases have been secondary to influenza vaccination. This study retrospectively describes a series of 18 patients following SARS-CoV-2 inoculation and compares the findings with those previously reported for other vaccines. Materials and methods: Inclusion criteria was onset of symptoms within 48 h after injection, symptoms duration of at least seven days, and restricted range of motion in absence of symptoms prior to vaccination. Average age was 59.4 years old (38-76), and 72.2% were women. Results: In many cases (58%) the initial diagnosis was not clear, which lead to incorrect treatment. The most common pathological finding was subacromial-subdeltoid bursitis (66.6%). All patients who received depot corticosteroids followed by a gentle rehabilitation program showed strong clinical improvement but did not completely resolve the symptoms at 7.2 months average final follow-up. Surgical intervention was necessary in one of the patients due to the persistence of symptoms despite conservative treatment. Conclusions: Shoulder injury related to vaccine administration is rare, but when present, its torpid evolution makes it difficult to treat. We have found in our case series a similar pattern to that already described for other vaccines. A high index of suspicion helps to pick up the condition promptly and early treatment can bring satisfactory outcome.

¿Somos los cirujanos argentinos de hombro y codo los peor tratados de Iberoamérica? Comparación de los honorarios y el nivel de satisfacción entre los miembros de la Asociación Argentina de Cirugía de Hombro y Codo, y los colegas de Iberoamérica / Are Argentine shoulder and elbow surgeons the worst treated in Ibero-America? Comparison of fees and level of satisfaction between members of the Argentine Association of Shoulder and Elbow Surgery and colleagues from Ibero-America

Un nivel de satisfacción laboral adecuado de los miembros del equipo de salud es esencial para garantizar una buena prestación de servicios, generar compromiso personal, estimular el deseo de actualización y fomentar la retención dentro del sistema. No hemos encontrado ninguna publicación que aborde específicamente este tema en el ámbito de la Ortopedia y Traumatología en nuestro medio. El objetivo de este estudio es conocer cómo perciben los especialistas que pertenecen a la Asociación Argentina de Cirugía de Hombro y Codo sus condiciones de trabajo, cuál es su remuneración y su grado de satisfacción y compararlos con equivalentes de otros países iberoamericanos. Los resultados de la encuesta mostraron niveles promedio de satisfacción bajos en los profesionales argentinos encuestados. Existen diferencias estadísticamente significativas con profesionales de otros países de Iberoamérica tanto en lo relativo a la remuneración como en los índices de bienestar. Si no se producen profundos cambios en el sistema de atención, la remuneración y las condiciones de trabajo, tarde o temprano aparecerán consecuencias que afectarán no solo a los profesionales, sino también a los pacientes y al sistema en general. Nivel de Evidencia: IV

An adequate level of job satisfaction of the members of a health team is essential to guarantee the quality of the services provided, generate personal commitment, stimulate the desire to update, and promote retention within the system. We have not found any publication that specifically addresses this issue in the field of Orthopedics and Traumatology in our setting. The objective of this study is to know how the specialists who belong to the Argentine Association of Shoulder and Elbow Surgery perceive their work-ing conditions, what their remuneration is and their degree of satisfaction, and to compare them with equivalents from other Ibero-American countries. The results of the survey showed low average levels of satisfaction in the Argentine professionals surveyed. There are statistically significant differences with professionals from other Ibero-American countries both in terms of remuneration and wellbeing indices. If there are no profound changes in the healthcare system, the remuneration and the working conditions, sooner or later consequences will appear that will affect not only professionals but also patients and the system in general. Level of Evidence: IV

Tratamiento de la inestabilidad femoropatelar objetiva / Treatment of objective patellofemoral instability

Introducción: El objetivo de este estudio es presentar los diferentes procedimientos quirúrgicos en el tratamiento de las inestabilidades femoropatelares objetivas, como la osteotomía de la tuberosidad tibial anterior y la trocleoplastia femoral. Materiales y Métodos: Se analizó el Índice de Caton-Deschamps para evaluar la altura rotuliana, la distancia desde la tuberosidad tibial anterior hasta la tróclea femoral en la tomografía computarizada, en el plano axial, y los morfotipos troclear y rotuliano. Se incluyeron 11 pacientes (11 rodillas) tratados por inestabilidad femoropatelar objetiva y documentada. Resultados: Los resultados fueron satisfactorios tanto con la transferencia de la tuberosidad tibial anterior como con la trocleoplastia. En ambos procedimientos, se realizó una reconstrucción del ligamento femoropatelar medial. La recurrencia de la inestabilidad es muy rara después de estos procedimientos y es más probable que sea secundaria a anomalías asociadas no diagnosticadas. Conclusión: Se requiere una planificación preoperatoria precisa para determinar la altura rotuliana, la ubicación de la tuberosidad tibial anterior, y los morfotipos troclear y rotuliano para lograr resultados satisfactorios. De todas formas y, como cualquier procedimiento quirúrgico, tanto las osteotomías de la tuberosidad tibial anterior, como la trocleoplastia pueden causar complicaciones.

Introduction: The aim of this study is to show the different surgical procedures for treating the objective patellar instability, including the different tibial tubercle osteotomies and the sulcus deepening trochleoplasty. Methods: This study analyzed the Caton-Deschamps index used for assessment of patellar height, the distance from the tibial tubercle to the troclear groove on CT scan in the axial view, and the different trochlear and patellar morphotypes. We included 11 knees (11 patients) treated due to an objective and documented patellofemoral instability. Results: We obtained good results with both the transfer of the tibial tuberosity and the trochleoplasty. A reconstruction of the medial patellofemoral ligament was performed in both procedures.Recurrence of instability is very rare after these procedures and this is more likely to result from missed associated abnormalities. Conclusion: Accurate preoperative planning of the patellar height and determining the location of the tibial tubercle and the trochlear and patellar morphotypes for satisfactory results are required. How ever, as with any surgical procedure, both tibial tubercle osteotomy and the sulcus deepening trochleoplasty are susceptible of complications.