Post-operative lumbar pain is related to alterations in the sagittal and spinopelvic parameters. A lumbar fusion that fails to maintain, or that worsens the physiological lordosis alters the sagittal balance. Objective: To analyze spinopelvic variation in different surgical positions. Methods: A prospective, analytical and comparative study of spinograms, lumbosacral radiographs in the surgical position over a 4-pole quadratus lumborum, and lumbosacral radiographs with quadratus lumborum and support in the knees. A sample of 129 patients, of both sexes, aged between 18 and 60 years, and presenting with lower back pain. Lumbar Lordosis (LL), Pelvic Tilt (PT), Pelvic Incidence (PI) and Sacral Slope (SS) were measured. Results: PI was the most stable parameter. With quadratus lumborum, a slight increase in PT, a decrease in SS and a significant reduction in LL were found. With quadratus lumborum and support in the knees, a decrease in PT and a slight increase in SS were found, while the LL value remained similar to that of the spinogram. Conclusion: The intraoperative position with hip flexion of between 40° and 45° over quadratus lumborum reduced LL to 10.52° in men and 16.21° in women, increased PT, and decreased SS. The intraoperative position with hip flexion of between 0° and 10° showed the same values as the reference spinogram. Level of Evidence II; Prospective comparative study.

Introduction:Indications in the treatment of rotator cuff lesions are widely discussed and not standardized. The aim of this study is to evaluate the variability among Argentinean orthopedic surgeons regarding the indications of treatment in different rotator cuff lesions.Methods:A questionnaire was designed based on the study carried out by Dunn et al. (JBJS Am 2005). Its aim was to gather the opinion of Argentine orthopedic surgeons on decision making concerning different rotator cuff lesions. Surgeons were divided into general orthopedic surgeons or shoulder specialists according to the number of shoulders treated surgically in the last year. The questionnaire has two sections: four hypothetical clinical cases and 11 questions about factors that could influence treatment selection.Results:Out of 556 questionnaires sent, 162 were completed, 117 by orthopedic surgeons and 45 by shoulder specialists. The specialists reported mostly arthroscopic repairs (57%), orthopedic surgeons reported repairing these lesions mainly by mini open or open technique (48% and 21% respectively). The highest agreement between both groups was evidenced in case number 1 (traumatic partial injuries in young patients (70% in favor of rotator cuff repair)). There was also agreement in the contraindication of the use of corticosteroids before surgery (p = 0.74), and in the repair of rotator cuff as a factor to prevent osteoarthritis (p = 0.27). Rotator cuff repair failure rate was considered to be 20%, not evidencing differences between groups.Conclusions:This study evidences the variation in indications between Argentinean surgeons in the treatment of rotator cuff lesions. The variability in the management of these patients, makes it difficult to establish protocols of treatment, or consensus guidelines to help standardize treatments for these injuries

Introduction: Indications in the operative and nonoperative treatment of rotator cuff tears are widely discussed and not standardized. The aim of this study is to evaluate the variability among Argentinean orthopedic surgeons regarding the indications of treatment for different rotator cuff injuries. Materials and Methods: A questionnaire was developed based on the study carried out by Dunn et al. Our aim was to gather the opinions of Argentinean orthopedic surgeons on decision-making concerning thetreatment of different rotator cuff lesions. The questionnaire was sent to 2 groups: general orthopedic surgeons and shoulder specialist surgeons, included according to the number of shoulders treated surgically and non-surgically in 2017. The questionnaire has two sections: 4 hypothetical clinical cases and 11 questions on factors that could influence treatment selection. Results: Out of 556 questionnaires sent, 162 were completed, 117 by general orthopedic surgeons and 45 by shoulder specialists. The specialists reported mostly arthroscopic repairs (60%), general orthopedic surgeons reported repairing these injuries mainly by mini-open or by standard open technique (49% and 22% respectively). The failure rate was considered to be 20%, not evidencing differences between professionals (P=0.42). There was also agreement in the contraindication of the use of corticosteroids before surgery(P=0.74). Conclusion: This study evidences significant variability in the management of these patients (for which we selected potentially controversial injuries), making it difficult to establish protocols or consensus guidelines to help standardize treatments for these injuries. Level of evidence: IIb