Revista de Ortopedia y Traumatología最新文献

{"title":"Luxación recidivante de prótesis total de cadera","authors":"A. Murcia ,&nbsp;L.M. Azorín ,&nbsp;A. Blanco ,&nbsp;H. Ferrer ,&nbsp;X. Gallart ,&nbsp;E. García-Cimbrelo ,&nbsp;S. Suso","doi":"10.1016/S0482-5985(06)75308-1","DOIUrl":"10.1016/S0482-5985(06)75308-1","url":null,"abstract":"<div><p>Más del 50% de los casos de caderas inestables se pueden resolver mediante la reducción cerrada de la luxación. Un intento sistemático para entender la causa de la inestabilidad, normalmente suele conducir a un tratamiento eficaz del problema cuando hace falta cirugía. Los componentes constreñidos o de retención han mejorado las posibilidades de resolver los problemas difíciles de inestabilidad, pero los efectos negativos potenciales de estos componentes deben tenerse también en cuenta. Los implantes tripolares, cuyos resultados clínicos en la literatura son muy alentadores, ocupan un lugar de elección en el arsenal terapéutico de la inestabilidad protética.</p></div><div><p>Over 50% of unstable hip cases can be solved by carrying out a closed reduction of the dislocation. A systematic attempt to understand the cause of the instability, normally results in an efficient treatment of the condition in cases where surgery is required. Constrained – also known as retentive – components have enhanced the possibilities of addressing difficult instability problems, although the potential negative effects of these implants also need to be considered. Tripolar implants, whose clinical results are very encouraging according to the literature, should occupy a prominent place among the therapeutic options available for prosthetic instability.</p></div>","PeriodicalId":101102,"journal":{"name":"Revista de Ortopedia y Traumatología","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0482-5985(06)75308-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56216502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Equilibrio sagital y su aplicación en patologías de columna vertebral","authors":"J.M. Vital,&nbsp;A. García Suárez,&nbsp;J.C. Sauri Barraza,&nbsp;C. Soderlund,&nbsp;N. Gangnet,&nbsp;O. Gille","doi":"10.1016/S0482-5985(06)75307-X","DOIUrl":"https://doi.org/10.1016/S0482-5985(06)75307-X","url":null,"abstract":"<div><p>Para evaluar el equilibrio sagital es necesario valorar la forma y posición de la pelvis, así como la posición de las rodillas. Si analizamos tres condiciones de la columna, la cifosis degenerativa, la espondilolistesis y la cifosis lumbosacra posquirúrgica, es posible determinar lo siguiente: en la cifosis degenerativa hay una asociación de lesión osteoarticular y de lesión muscular secundaria; en la espondilolistesis, la incidencia pélvica aumenta en los casos de lisis; y es más importante valorar el ángulo de cifosis lumbosacra que el deslizamiento. La corrección de la cifosis lumbosacra permite una corrección del desequilibrio anterior de la columna. Las osteotomías transpediculares son un buen procedimiento para corregir los desequilibrios anteriores fijos. Es necesario usar un programa de informática especial para realizar los cálculos preoperatorios con el fin de corregir la deformidad.</p></div><div><p>To evaluate sagittal balance, it is necessary to assess the form and position of the pelvis and the position of the knees. If we analyze three spine conditions, namely degenerative kyphosis, spondylolisthesis, and postoperative lumbosacral kyphosis, it is possible to determine the following: in degenerative kyphosis there is an association of osteoarticular lesions and secondary muscular lesions; in spondylolisthesis, PI increases in cases where there is lysis; and the lumbosacral kyphosis angle is more important to assess than the slippage. The correction of lumbosacral kyphosis allows correction of the anterior imbalance of the spine. Transpedicular osteotomies are a good procedure to correct fixed anterior imbalances. It is necessary to use a special computer program for preoperative calculations to correct the deformity.</p></div>","PeriodicalId":101102,"journal":{"name":"Revista de Ortopedia y Traumatología","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0482-5985(06)75307-X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136818114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"","authors":"","doi":"10.1016/S0482-5985(06)75310-X","DOIUrl":"https://doi.org/10.1016/S0482-5985(06)75310-X","url":null,"abstract":"","PeriodicalId":101102,"journal":{"name":"Revista de Ortopedia y Traumatología","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0482-5985(06)75310-X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136818116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"La luxación posterior del hombro","authors":"L. Gubern Salisachs","doi":"10.1016/S0482-5985(06)75299-3","DOIUrl":"10.1016/S0482-5985(06)75299-3","url":null,"abstract":"","PeriodicalId":101102,"journal":{"name":"Revista de Ortopedia y Traumatología","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0482-5985(06)75299-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56216455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efectividad de la cirugía mínimamente invasiva de incisión única postero-lateral en artroplastia total de cadera","authors":"J.J. Panisello-Sebastiá,&nbsp;V. Canales-Cortés,&nbsp;L. Herrero-Barcos,&nbsp;A. Herrera-Rodríguez,&nbsp;J. Mateo-Agudo,&nbsp;A.A. Martínez-Martín","doi":"10.1016/S0482-5985(06)75303-2","DOIUrl":"10.1016/S0482-5985(06)75303-2","url":null,"abstract":"<div><h3>Objetivo</h3><p>Determinar la efectividad de la cirugía mínimamente invasiva (CMI) en prótesis de cadera, como factor aislado, en los resultados clínicos y radiológicos obtenidos en un hospital de nuestro entorno.</p></div><div><h3>Material y método</h3><p>Estudio prospectivo, controlado, con dos grupos de 40 pacientes. Un grupo intervenido mediante CMI por vía postero-lateral de incisión única, y otro mediante abordaje postero-externo clásico. Se realizó seguimiento clínico y radiológico durante el primer año postoperatorio.</p></div><div><h3>Resultados</h3><p>A lo largo del primer año postoperatorio, únicamente se apreciaron diferencias significativas a favor de la CMI en el sangrado per-operatorio y las necesidades transfusionales. La evolución clínica, radiológica, estancia hospitalaria, incidencia de complicaciones y satisfacción del paciente fueron semejante entre grupos.</p></div><div><h3>Conclusiones</h3><p>La introducción de técnicas CMI en artroplastia de cadera aporta, por sí misma, menor cuantía de pérdida hemática. La mejora de los resultados clínicos asociada a esta técnica pasa por incluir cambios en el manejo analgésico, anestésico y rehabilitador.</p></div><div><h3>Aim</h3><p>To determine the effectiveness, by means of clinical and X-ray studies, of minimally invasive surgery (MIS) for total hip replacement performed as an isolated procedure in a Spanish hospital.</p></div><div><h3>Materials and methods</h3><p>This was a prospective, controlled study that comprised two groups of 40 patients. One group underwent MIS through a single postero-lateral incision and the other by means of a classical postero-external approach. Patients were followed up clinically and radiographically during the first postoperative year.</p></div><div><h3>Results</h3><p>During the first postoperative year the only significant differences in favor of MIS were a lower amount of perioperative bleeding and the less need of transfusions. The evolution, determined both clinically and by X-rays, days in hospital, incidence of complications and patient satisfaction were similar in both groups.</p></div><div><h3>Conclusions</h3><p>The use of MIS techniques in hip replacement causes less blood loss. The improvement in clinical results associated with this technique depends on changes in analgesia, anesthesia and rehabilitation.</p></div>","PeriodicalId":101102,"journal":{"name":"Revista de Ortopedia y Traumatología","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0482-5985(06)75303-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80036653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Remodelado óseo periprotésico con un vástago femoral anatómico no cementado. Estudio densitométrico longitudinal a tres años","authors":"J.J. Panisello Sebastiá,&nbsp;L. Herrero Barcos,&nbsp;V. Canales Cortés,&nbsp;A. Herrera Rodríguez,&nbsp;Á. Martínez Martín,&nbsp;J. Cuenca Espíerrez","doi":"10.1016/S0482-5985(06)75302-0","DOIUrl":"https://doi.org/10.1016/S0482-5985(06)75302-0","url":null,"abstract":"<div><h3>Objetivo</h3><p>Estudio prospectivo, controlado, diseñado para determinar el remodelado periprotésico de un vástago femoral anatómico, no cementado y de anclaje metafisario, mediante densitometrías de la masa ósea femoral en los primeros tres años de evolución.</p></div><div><h3>Material y método</h3><p>En 69 pacientes se efectuó el seguimiento densitométrico de la cadera intervenida y de la contralateral, sana, utilizada como control. Las densitometrías se realizaron en el preoperatorio, a los 12 y 36 meses en ambas caderas, con un estudio adicional de la cadera intervenida a los 6 meses.</p></div><div><h3>Resultados</h3><p>La densidad mineral ósea mostró, a los 3 años, un incremento en las zonas 2 y 6, de 7,05 y 5,92%. Las zonas 1 y 7 mostraban un descenso de 8,26 y 16,81% por atrofia proximal. Las diferencias en peso, edad y posición del implante no causaron diferencias en el patrón de remodelado. Únicamente el sexo de los pacientes influyó de forma significativa.</p></div><div><h3>Conclusiones</h3><p>El vástago femoral anatómico consigue un anclaje eficiente a nivel metafisario, con transmisión de cargas que minimizan la pérdida ósea a ese nivel y determinan un estímulo a largo plazo que permite la conservación ósea en zonas más distales.</p></div><div><h3>Aim</h3><p>To carry out a prospective, controlled study designed to determine the periprosthetic remodeling of an anatomic, non-cemented, femoral stem anchored in the bone metaphysis, using femoral bone mass densitometry studies during the first three years of evolution.</p></div><div><h3>Materials and methods</h3><p>A densitometric followup was carried out in 69 patients who had one operated hip and a healthy contralateral hip that was used as a control. The densitometries were performed on both hips, preoperatively, at 12 and at 36 months. An additional densitometry of the operated hip was done at 6 months.</p></div><div><h3>Results</h3><p>At 3 years bone mineral density had increased in zones 2 (7.05%) and 6 (5.92%), and had decreased in zones 1 (8.26%) and 7 (16.81%) due to proximal atrophy. No differences in the remodeling pattern were seen due to differences in weight, age or position of the implant. Only patient gender had a significant influence.</p></div><div><h3>Conclusions</h3><p>The anatomic femoral stem achieves efficient fixation in the bone metaphysis, and a load transmission pattern that minimizes bone loss at this level and causes a long-term stimulus that allows bone preservation in more distal areas.</p></div>","PeriodicalId":101102,"journal":{"name":"Revista de Ortopedia y Traumatología","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0482-5985(06)75302-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136817982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disociación del polietileno de una copa acetabular no cementada. Aportación de 11 casos","authors":"A. López-Sastre-Núñez,&nbsp;R. Mencía-Barrio,&nbsp;J.A. Alonso-Barrio,&nbsp;J.J. González-Fernández","doi":"10.1016/S0482-5985(06)75304-4","DOIUrl":"10.1016/S0482-5985(06)75304-4","url":null,"abstract":"<div><h3>Objetivo</h3><p>Se estudian los casos de disociación del núcleo de polietileno de la copa metálica no cementada Cerafit^® (Ceraver-Osteal, Roisy, Francia).</p></div><div><h3>Material y método</h3><p>Once casos de disociación polietilenocopa metálica, de los cuales en cinco se reconoció un antecedente traumático y en los otros seis una clínica insidiosa.</p></div><div><h3>Resultados</h3><p>Cuando la clínica se presentó de forma aguda se apreció una luxación del núcleo del polietileno con rotura del mecanismo de anclaje. Mientras que los pacientes con clínica insidiosa presentaron diferentes grados de usura del polietileno y abrasión de la copa metálica con metalosis. En todos los casos se recambiaron el cótilo y el vástago femoral.</p></div><div><h3>Conclusión</h3><p>La disociación del núcleo de polietileno de la copa metálica es una complicación de la artroplastia total de cadera relativamente rara. Si no se reconoce a tiempo, las consecuencias pueden ser catastróficas.</p></div><div><h3>Aim</h3><p>To study cases in which there has been disassociation of the polyethylene insert from the Cerafit^® (Ceraver-Osteal, Roisy, France) non-cemented metallic acetabular shell.</p></div><div><h3>Materials and methods</h3><p>Eleven cases were seen of disassociation of the polyethylene liner from the metallic acetabular shell. In five cases there was trauma and the other six had an insidious clinical evolution.</p></div><div><h3>Results</h3><p>In the cases with acute onset there was dislocation of the polyethylene liner and rupture of the fixation mechanism. In the cases with an insidious clinical evolution, there were different degrees of wear of the polyethylene with abrasion of the metallic acetabular shell and metallosis.</p><p>All cases underwent revision with replacement of the acetabular cup and the femoral stem.</p></div><div><h3>Conclusion</h3><p>Disassociation of the polyethylene liner from the metallic acetabular shell is a relatively rare complication in total hip replacement. But if it is not recognized in time the consequences can be catastrophic.</p></div>","PeriodicalId":101102,"journal":{"name":"Revista de Ortopedia y Traumatología","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0482-5985(06)75304-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56216470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Necrológica del Profesor Don Claudio Hernández Meyer","authors":"Antonio Herrera Rodríguez (Prof)","doi":"10.1016/S0482-5985(06)75309-3","DOIUrl":"10.1016/S0482-5985(06)75309-3","url":null,"abstract":"","PeriodicalId":101102,"journal":{"name":"Revista de Ortopedia y Traumatología","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0482-5985(06)75309-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92970286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comentario","authors":"F. Gómez-Castresana","doi":"10.1016/S0482-5985(06)75300-7","DOIUrl":"https://doi.org/10.1016/S0482-5985(06)75300-7","url":null,"abstract":"","PeriodicalId":101102,"journal":{"name":"Revista de Ortopedia y Traumatología","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0482-5985(06)75300-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136817992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"La evolución de los abordajes en la artroplastia total de rodilla hacia técnicas menos invasivas","authors":"R. Llopis Miró","doi":"10.1016/S0482-5985(06)75298-1","DOIUrl":"https://doi.org/10.1016/S0482-5985(06)75298-1","url":null,"abstract":"","PeriodicalId":101102,"journal":{"name":"Revista de Ortopedia y Traumatología","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0482-5985(06)75298-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136817993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}