Acta ortopedica mexicana最新文献

{"title":"[Irreductable lateral subatalar fracture-dislocation by entrapment of the posterior tibial neurovascular bundle: case report].","authors":"E Guillén-Botaya, I Polo-Pérez, C Blasco-Molla, F Forriol-Brocal, A Silvestre-Muñoz","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>subtalar dislocations, typical of high-energy trauma, are classified as medial, lateral, anterior or posterior depending on the deviation of the foot in relation to the talus. Lateral dislocation accounts for 17% of the total and has a worse prognosis. Immediate reduction is required to reduce the risk of sequelae, the incidence of which is around 90%.</p><p><strong>Objective: </strong>a case of lateral subtalar dislocation is presented; a review of the literature on its diagnosis, treatment and prognosis is carried out.</p><p><strong>Clinical case: </strong>a 46-year-old woman fell from a height of 3 meters, with severe deformity in the hindfoot. There was good distal vascular coloration, but no pulse or posterior tibial sensitivity could be identified. In addition, she had a medial sulcocutaneous fold under the head of the talus. Plain radiograph and CT revealed lateral subtalar dislocation, with fracture of the sustentaculum tali, and a \"fleck sign\" in the posterior region of the distal fibula. Suspecting soft tissue incarceration, a medial approach was performed, observing interposition of the posterior tibial neurovascular bundle. After joint reduction, the sustentaculum tali and the \"fleck sign\" were osteosynthesized. In addition, a complete section of the long lateral peroneal tendon was identified, which was tenodesed to the short peroneal tendon. Finally, an external fixator was placed. After eight weeks, the fixator was removed and weight bearing was authorized; after six months, mobility was complete and hypoesthesia persisted only in the plantar pad.</p><p><strong>Conclusions: </strong>lateral subtalar dislocation is an uncommon entity with a poor prognosis. Adequate interpretation through a thorough examination and pre-reduction CT of the bone and soft tissue lesions minimizes future sequelae.</p>","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"39 4","pages":"242-248"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031544","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":"[Why are we revising our primary knee arthroplasties? An evaluation of the causes for revision of primary knee arthroplasties over a five-year period (2018-2022)].","authors":"J Sánchez-Del Saz, B Alcobía-Díaz, M B Rizo-de Álvaro, R García-Crespo","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>the progressive increase in the volume of primary knee arthroplasty surgery is leading in parallel to an increase in revision surgeries, and this trend is expected to continue in the coming decades.</p><p><strong>Material and methods: </strong>a retrospective observational study with 203 interventions in 201 patients with knee arthroplasty revision surgery at our center between 2018-2022, including the variables age, sex, body mass index, primary implant, time until revision surgery, mechanical alignment of the primary implant, cause of revision, revision implant, and need for secondary revision.</p><p><strong>Results: </strong>the average age of the patients was 73.8 years (70% were women). The average time from primary surgery to revision was 58.7 months. The main cause of revision was aseptic loosening (37.9%). Eighty-three (34.9%) patients required an early revision (on average, in 12.7 months), with instability being the main cause in this subgroup (36.1%). Twenty-four (11.8%) patients required an additional revision, also mainly due to instability (33.3%), with a younger average age (66.9 years). The most common surgical approach was complete replacement (70%).</p><p><strong>Conclusions: </strong>knee arthroplasty revision surgery in our environment is determined by different patterns depending on the chronology. Joint stability is the main determinant of revision in the first two years, while aseptic loosening seems to predominate in the long term, with infection in the background. Revision of primary knee arthroplasty remains to be a surgical challenge, as 11.8% of patients required an additional revision surgery, especially in younger patients.</p>","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"39 4","pages":"204-211"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031519","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":"[Acta Ortopédica Mexicana... Tradition and history].","authors":"G García-Pinto","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"39 4","pages":"195-196"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031551","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":"[Surgical management of patellofemoral dislocation using an autologous quadriceps tendon graft for medial patellofemoral ligament reconstruction. Clinical and functional outcomes in a retrospective cohort of pediatric patients].","authors":"J I Pérez-Abdala, D Semeschenko, C Halliburton, S Bosio, M Puigdevall","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>medial patellofemoral ligament (MPFL) reconstruction using an autologous quadriceps tendon graft to treat patellofemoral dislocation in the pediatric population is a surgical alternative that may offer advantages compared to other types of grafts. We assessed clinical and functional outcomes, rate of return to sport, and complications in a cohort of pediatric patients.</p><p><strong>Material and methods: </strong>retrospective and descriptive cohort study. Pediatric patients with recurrent patellofemoral dislocation treated with MPFL reconstruction using an autologous quadriceps tendon graft, with or without an additional procedure, were included. A minimum follow-up of two years was required. Patients with congenital patellofemoral dislocation, previous surgeries, connective tissue disorders, and medial patellar dislocation were excluded. We measured the Kujala functional score, its minimally clinically important difference (MCID), and the Tegner activity scale. The difference between preoperative and postoperative Kujala and Tegner scores was analyzed using the Wilcoxon signed-rank test.</p><p><strong>Results: </strong>we selected nine patients (12 knees) with a mean age of 16.5 years. The median preoperative Kujala score was 56 with an interquartile range (IQR) of 51-65, and 99 (IQR 95100) postoperatively. A MCID and a statistically significant difference were achieved (p < 0.01). The median preoperative Tegner score was 6 (IQR 68.5) and 5.5 (IQR 47) postoperatively, with this difference being statistically significant (p = 0.02). The average time to return to sports was 6.5 months. Four complications were found.</p><p><strong>Conclusions: </strong>MPFL reconstruction using autologous quadriceps tendon graft in pediatric patients is a reliable option with good clinical and functional outcomes.</p>","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"39 4","pages":"220-230"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031508","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":"Teres major rupture: case report in a jiu-jitsu athlete.","authors":"D Drummond, L C Lopes-Ferreira-Júnior, L H Paiva-D'Elia, L R De Oliveira-Revite, M L Duarte","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The rupture of the teres major muscle is a well-known condition in sports activities like baseball, hockey, and tennis. There is no real consensus in the literature regarding treatment, with approaches varying between functional and surgical methods. While functional treatment appears to be a viable option, there is a lack of evidence indicating significant improvement in medial rotation strength after aforementioned treatment. We report a 30-year-old male with pain below the right armpit for the past 10 days, attributed to jiu-jitsu training which revealed a complete tear of the musculotendinous junction of the teres major and a partial insertional tear (approximately 75% of thickness) of the supraspinatus and infraspinatus tendons, along with atrophy in the musculotendinous transition of the pectoralis major. The patient was treated with analgesic medication, accompanied by physiotherapeutic treatment included electrothermophototherapy, laser/LED therapy, manual therapy, and a structured exercise regimen over 14 weeks, gradually reintroducing sport-specific training.</p>","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"39 4","pages":"231-235"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031587","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":"Tuberculosis tenosynovitis in the wrist: a case report.","authors":"R Penagos, R De Los Reyes, M Cortés-Molano, S Sarzosa-Varona, C E Rivera-Molano, M A Cortés-Molano, S Urueña-Barrios","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Articular tuberculosis is a rare condition, with extrapulmonary presentations most commonly appearing in joints such as the hip or knee. It is usually associated with conditions like immunosuppression or a history of pulmonary tuberculosis. Diagnosis involves imaging or pathology, and treatment typically involves surgical intervention along with medication. Here is the case of a 25-year-old male from Barranquilla, Colombia. He lacks classical risk factors for pulmonary tuberculosis but has a history of open reduction of a traumatic fracture in his right distal radius four years ago. He presented with persistent pain, joint swelling, and limited movement, leading to removal of the osteosynthesis material. Despite this, the pain persisted, prompting further investigation with X-ray and MRI of the wrist. These imaging studies revealed findings compatible with tuberculosis. Based on these results, the medical team opted for a surgical procedure. An oncological resection of the synovium was performed, and the material that was removed was used for histological studies to confirm suspicions of extrapulmonary tuberculosis. Following these procedures, the patient underwent physical therapy and began tuberculosis medication, resulting in significant improvement of his symptoms.</p>","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"39 4","pages":"236-241"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031550","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":"[Utility of robotic-assisted total knee arthroplasty in patients with an occupied femoral canal].","authors":"V M Ilizaliturri-Sánchez, I F Rodríguez-Rodríguez, C García-Ramos","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>the presence of implants that occupy the femoral canal is frequent in patients undergoing ipsilateral total knee replacement (TKR). The use of electronic alignment and robotic assistance make intramedullary alignment unnecessary and could be adequate in situations with an occupied femoral canal (OFC).</p><p><strong>Material and methods: </strong>we present a prospective cohort of 25 patients who underwent robotic alignment TKR and had prior ipsilateral surgery in the femur that resulted in occupied femoral canal.</p><p><strong>Results: </strong>we had 21 female, four male patients, with an average age of 62 years. There were 14 left knees, and 11 right knees. Twenty-two patients had a hip arthroplasty and three had femur osteosynthesis. Alignment prior to surgery was 16 valgus knees (average 11°, 3-22°) and nine varus knees (average 9.5°, 0.5-18.5°). TKR alignment was five neutral (0° as measured with the robot), 11 valgus 1.3° (range 0.5-3.5°) and 8 varus 1.5° (range 0.5- 2.5°). The average preoperative WOMAC scores was 43 points, postoperative 14 points.</p><p><strong>Conclusions: </strong>we present a cohort of patients with moderate to severe varus and valgus knee deformities with an occupied femoral canal that were electronic alignment during robot-assisted (RA) TKR without the use of an intramedullary alignment (IMA) rod. We conclude electronic alignment of TKR can be performed successfully in patients with occupied femoral canal.</p>","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"39 4","pages":"197-203"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031533","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":"Repair of rotator cuff injuries using transosseous tunnels. Introduction to the technique, devices and other relevant points.","authors":"M Ruiz-Suárez, B Stanford-Sanders, M Solís-Olguín","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Rotator cuff injuries are common and procedures of repair have evolved from open techniques to minimally invasive and arthroscopic ones. Despite these advances, the biomechanics, biology, and value of transosseous repairs remain superior, leading to the development of innovative devices that enable the utilization of this technique without the use of anchors, improving both the efficiency and safety of the procedure. This article reviews the latest advances in transosseous rotator cuff repair, highlighting its biomechanical advantages, as well as the factors that enhance recovery and offer more consistent long-term outcomes. In addition, the surgical technique developed by Dr. Brett Sanders is analyzed. This technique eliminates or reduces the use of anchors with a specialized reusable device, depending on the clinical scenario and surgeon discretion. Besides, not only presents biomechanical benefits but also offers economic and clinical advantages, especially in developing countries where access to advanced treatments may be limited. Comparative studies between transosseous and transosseous-equivalent techniques have demonstrated a significant reduction in postoperative pain and statistically equivalent or superior long-term clinical outcomes with the arthroscopic transosseous tunnel technique (ATOT), reinforcing its viability as a superior option for value-based care. Finally, a detailed economic analysis is presented, showing significant cost savings in surgical procedures which could greatly benefit public healthcare systems in Latin America, highlighting advanced suture management that would enhance rotator cuff repair.</p>","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"39 4","pages":"252-260"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031527","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":"[Innovation in complex hip arthroplasty (Perthes sequel and developmental dysplasia of the hip): use of 3D models in surgical planning and simulation. Functional and radiographic results. Pilot study].","authors":"D Godoy-Monzón, E Fernández Sainz-Rozas, J M Pascual-Espinosa, J Jiménez-Baquero","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>anatomical deformities such as developmental dysplasia of the hip (DDH) and Perthes disease represent a challenge for reconstruction. The use of 3D-printed models can be helpful for assessing the deformity, bone mass, implant size, and orientation.</p><p><strong>Objectives: </strong>to prospectively evaluate the outcomes of 3D simulation in primary total hip arthroplasty.</p><p><strong>Material and methods: </strong>between January 2019 and March 2020, 22 patients received a trabecular titanium cup and a neck preserving stem after preoperative planning with 3D plastic models and surgery simulation. Inclusion criteria: sequelae of Perthes, hip dysplasia type I and II Crowe classification. Exclusion criteria: fractures, previous infection, remaining metal implants. Demographic data, surgery time, blood loss, and complications were recorded. Preoperative and postoperative Harris Hip Score (HHS) and subjective satisfaction using the Roles and Maudsley scale were evaluated, along with radiographic findings and Moore's criteria for osteointegration.</p><p><strong>Results: </strong>the average patient age was 35 years (range: 18-57), with 15 women and seven men. The 3D modeling process, from CT scan acquisition to final model production, took an average of 3.4 hours, and the surgery simulation lasted an average of 32 minutes. In all cases, the acetabular cup size was correct, with only one discrepancy in the femoral stem size. The average follow-up was 40.7 months. The average HHS increased from 37.5 ± 5.8 preoperatively to 90.0 ± 2.3 at the final follow-up. The average surgery time was 71 minutes, and the average blood loss was 260 ml. Complications included one case of temporary paresthesia (resolved by 50 days postoperatively), one superficial infection, and one deep infection. All components were stable at the final follow-up.</p><p><strong>Conclusions: </strong>3D simulation allowed for accurate implant placement with significant improvement in both functional and subjective scores.</p>","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"39 4","pages":"212-219"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031530","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":"Fracture of the medial tubercle of the posterior process of the talus in a futsal player. A rare fracture successfully treated conservatively.","authors":"D D Coelho-Marra, G Miura, E Kenzo-Arie, M L Duarte","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Talus is the second largest bone in the posterior region of the foot and participates in the talocrural (ankle), subtalar, and talonavicular joints. Talar fractures account for only one percent of all feet and ankle fractures, being the fracture of the medial tubercle of the posterior process of the talus an uncommon injury, caused by the rupture of the posterior talotibial ligament after dorsiflexion and traumatic pronation. Such fractures may not be radiographically evident, as described in this rare case of fracture of the medial tubercle of the posterior process of the talus with a satisfactory outcome without the need for surgical treatment.</p>","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"39 4","pages":"249-251"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031565","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}