Acta ortopedica mexicana最新文献_第6页

Silent surface osteosarcoma treated following the hemi-capanna technique. A case report. 采用半卡帕纳技术治疗的沉默表面骨肉瘤。病例报告。

Acta ortopedica mexicana Pub Date : 2024-09-01

S Donadeu-Sánchez, E Manrique-Gamo, R C García-Maroto, L Alarcón, J L Cebrián-Parra

{"title":"Silent surface osteosarcoma treated following the hemi-capanna technique. A case report.","authors":"S Donadeu-Sánchez, E Manrique-Gamo, R C García-Maroto, L Alarcón, J L Cebrián-Parra","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: surface sarcomas are a rare entity that need correct diagnosis to differentiate parosteal (cPOS), periosteal and the high grade surface osteosarcomas (HGSO). HGSO has malignant behavior similarities with osteosarcomas and wide resection is the key to a successful treatment.1 The Capanna and Hemi-Capanna reconstruction techniques have being developed in order to avoid amputation after an oncological resection, allowing structural support from an allograft and biological advantages from a vascularised autograft.Case presentation: 46 years old male presenting with knee pain and 4 × 3 cm soft tissue tumor on the right tibial surface diagnosed of High Grade Surface Osteosarcoma (HGSO). Was treated by oncological resection followed by reconstruction with allograft and ipsilateral fibula autograft following the \"Hemi-Capanna\" technique and pedicled medial gastrocnemius flap.Conclusion: sufficient evidence supports the use of the Capanna technique in major musculoskeletal reconstructions. The new \"Hemi-Capanna\" technique has less evidence but proves to be an easier surgical technique with good functional results and little complications.","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"38 5","pages":"340-344"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142718140","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}

引用次数: 0

[Minimizing risk: evaluation of the relationship between femoral stem loosening and the risk of presenting with peri-prosthetic hip fracture]. [风险最小化：评估股骨干松动与假体周围髋部骨折风险之间的关系]。

Acta ortopedica mexicana Pub Date : 2024-09-01

J Flores-Gallardo, C Sánchez-Pérez, J Vaquero

{"title":"[Minimizing risk: evaluation of the relationship between femoral stem loosening and the risk of presenting with peri-prosthetic hip fracture].","authors":"J Flores-Gallardo, C Sánchez-Pérez, J Vaquero","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: evaluation of predictors of periprosthetic fracture in loosened femoral stems.Material and methods: retrospective case-control study comparing aseptic loosened stems in two groups: cases: patients who experienced periprosthetic femoral fracture before replacement could be performed (n = 9). Controls: experienced prosthetic replacement without fracture (n = 19).Results: pain intensity (VAS) was the most important aspect (p = 0.01), predominating in the controls. The simple radiological parameters did not show statistically significant findings predictive of peri-prosthetic fracture (number of Gruen zones, sum of them in mm, stress shielding, pedestal, polyethylene wear, stem subsidence). The role of complementary tests (CT and scintigraphy) for the definitive diagnosis of loosening was relevant, but not significant. The type of implant showed no differences. Overall implant survival was higher in cases than in controls (p = 0.016). This difference continues when comparing each loosened stem until fracture or replacement (p = 0.024).Conclusion: the main factor protecting against fracture is the replacement of a stem with clinical and radiological diagnosis of loosening. Adequate follow-up of the patient plays a determining role in this, especially when considering the greater intensity of pain in the controls, which used to guide surgeons to perform replacements before the fracture occurred. This is reinforced if we take into account that up to one third of the cases did not have regular check-ups, and therefore did not have the opportunity for replacement prior to the fracture. The role of complementary tests (CT and scintigraphy) is also very important, taking into account the low diagnostic yield obtained from simple X-rays.","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"38 5","pages":"291-297"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142718077","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}

引用次数: 0

[The importance of research training for the orthopedic surgeon]. [研究培训对骨科医生的重要性]。

Acta ortopedica mexicana Pub Date : 2024-09-01

A Torres-Gómez

引用次数: 0

Comparative outcomes of PFN vs PFNA2 nailing for osteoporotic unstable intertrochanteric fractures in the elderly. PFN 与 PFNA2 钉治疗老年人骨质疏松性不稳定转子间骨折的疗效比较。

Acta ortopedica mexicana Pub Date : 2024-09-01

A Dahuja, K Khatri, R Kaur, K Bansal, S Singh

{"title":"Comparative outcomes of PFN vs PFNA2 nailing for osteoporotic unstable intertrochanteric fractures in the elderly.","authors":"A Dahuja, K Khatri, R Kaur, K Bansal, S Singh","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: fixation of unstable intertrochanteric fractures presents a significant challenge, especially in the context of osteoporosis. Intramedullary implants have been established as superior to plate constructs. Our aim is to compare the complications and clinical outcomes of the Proximal Femur Nail (PFN) and Proximal Femur Nail Antirotation-2 (PFNA2) in managing unstable intertrochanteric fractures.Material and methods: a total of 212 patients meeting inclusion and exclusion criteria underwent fixation of trochanteric fractures using either a standard PFN (n = 110) or PFNA2 (n = 102). Their intraoperative and postoperative clinical and radiographic data were evaluated along with the quality of fixation. Data analysis was performed using the student's t-test, 2 test, and Mann-Whitney U test.Results: PFNA2 demonstrated more favorable outcomes compared to PFN in terms of a better intraoperative profile, functional outcomes (PFNA2: PFN = 82:75), and fewer implant-related complications. Significant issues in the PFN group included screw back-out, guidewire breakage, and proximal protrusion of the nail tip. In contrast, locking mechanism failure and lateral screw prominence were significant problems in the PFNA2 group.Conclusion: PFNA2 is the preferred implant for managing osteoporotic unstable intertrochanteric fractures, given the bone's weak inherent tendency to secure the implant.","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"38 5","pages":"298-306"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142718082","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}

引用次数: 0

[Conversions from failed unicompartmental prostheses to total knee replacement]. [从失败的单腔假体转为全膝关节置换术]。

Acta ortopedica mexicana Pub Date : 2024-09-01

R Olivetto

{"title":"[Conversions from failed unicompartmental prostheses to total knee replacement].","authors":"R Olivetto","doi":"","DOIUrl":"","url":null,"abstract":"The evolution and challenges of unicompartmental knee prostheses (UNIS) are addressed, highlighting their use since the 1970s as an alternative to osteotomies. Over the years, these prostheses have gained popularity, although they initially faced criticism due to higher revision rates compared to total knee arthroplasties (TKA). Multicenter studies, such as that of Heck et al., revealed an increase in failures associated with body mass index and female sex. Despite this, recent reviews, such as that of Vasso et al., have shown a positive evolution in the results of UNIS, although with a higher percentage of revisions than TKA. The importance of adequate patient selection, meticulous surgical technique, and avoidance of overcorrection for surgical success is also emphasized. It is mentioned that external UNIS, although representing a small percentage of total prosthetic knees, have shown favorable results in terms of long-term survival. In addition, technical aspects such as minimal bone resection and polyethylene wear, which are crucial for the performance of prostheses, are discussed. In conclusion, the need for further research and improvement of techniques to optimize the results of unicompartmental arthroplasties is highlighted.","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"38 5","pages":"307-320"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142718071","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}

引用次数: 0

[Total knee replacement in patients under 60 years with high functional demand: functional outcomes and return to sports after an average 2-year follow-up]. [60岁以下高功能需求患者的全膝关节置换术：平均2年随访后的功能结果和运动恢复情况]。

Acta ortopedica mexicana Pub Date : 2024-07-01

M F Garbini, E Bochatey, C Ramirez-Sampedro, F Tillet, W Martinez, F Lopreite

{"title":"[Total knee replacement in patients under 60 years with high functional demand: functional outcomes and return to sports after an average 2-year follow-up].","authors":"M F Garbini, E Bochatey, C Ramirez-Sampedro, F Tillet, W Martinez, F Lopreite","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: a common concern in presurgical medical appointment of total knee replacement medical appointment is return to exercise. The purpose of this study was to analyze functional results and return to sport in patients under 60 years of age after this surgery.Material and methods: we retrospectively analyzed 41 total knee replacements in 36 athletic patients (average age: 53 years [46-60]). Average follow-up of two years (6 months-5 years). Diagnoses: 37 osteoarthritis, three sequelae of Rheumatoid Arthritis, 1 extra-articular deformity. Functional and radiographic outcomes assessed using modified Knee Society and High Activity Arthroplasty Scores.Results: average improvement from 31.95 to 91.61 in KSS and average from 7.95 to 13.73 in HAAS. Return to sport in 3.5 months average (range 2-6 months). Three patients did not return to sport.Conclusions: we consider that delaying surgery in these patients will cause progression in their osteoarthritis pathology and cessation of their sports activities. This makes the surgical technique difficult in addition to reducing the patient's physical performance. Analyzing the survival rate of implants in young patients, more than 80% is reported in a 25-year follow-up.","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"38 4","pages":"234-238"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142121496","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}

引用次数: 0

[Avascular necrosis of the femoral head after COVID-19: clinical presentation and management. Clinical-functional outcomes of decompression and supplementation with bone marrow cell aspirate]. [COVID-19后股骨头血管性坏死：临床表现与处理。减压和补充骨髓细胞抽吸的临床功能结果]。

Acta ortopedica mexicana Pub Date : 2024-07-01

D Godoy-Monzón, A Cid-Casteulani, S Svarzchtein, S Sasaki, J M Pascual-Espinosa

{"title":"[Avascular necrosis of the femoral head after COVID-19: clinical presentation and management. Clinical-functional outcomes of decompression and supplementation with bone marrow cell aspirate].","authors":"D Godoy-Monzón, A Cid-Casteulani, S Svarzchtein, S Sasaki, J M Pascual-Espinosa","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: the pandemic of COVID-19 has led to clinical complications such as avascular necrosis of the femoral head (AVNFH) associated with the use of corticosteroids. The aim of the study is to report the functional and radiographic results of 13 patients with post-COVID-19 ANFH after decompression using Forage and bone marrow aspirate concentrate (BMAC).Material and methods: single-center, prospective, uncontrolled clinical study. From April 2020 to September 2021, 13 patients (21 hips) with post-COVID-19 ANFH were treated. All received corticosteroids during infection (average daily dose: 480 mg). Clinical, radiographic and magnetic resonance imaging evaluations were performed; the Ficat classification was applied for the classification of AVNFH. The surgical technique used was decompression with Forage and ACMO.Results: the mean age was 47 years, with a follow-up of 30.4 months. Symptoms appeared with a mean of 4.2 months after COVID-19 infection. Harris score improved from 41.2 ± 5.2 to 86.6 ± 3.4. Radiographic evaluation showed that 14.3% of the sample experienced femoral head collapse and underwent total hip arthroplasty.Conclusions: post-COVID-19 ANFH is a clinical entity with rapid progression and different degrees of severity. Decompression with Forage and ACMO seems a promising initial treatment, however, the variable response and the probability of collapse emphasize the importance of long-term follow-up and identification of patients who may require additional interventions.","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"38 4","pages":"208-213"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142121487","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}

引用次数: 0

[Radiographic measurements of acetabular component orientation with Widmer´s method in total hip arthroplasty. Descriptive case series]. [在全髋关节置换术中使用 Widmer's 方法对髋臼组件方向进行射线测量。描述性病例系列]。

Acta ortopedica mexicana Pub Date : 2024-07-01

E Macías-González, J C Pérez-Alavez, H Contreras-Blancas, L E Guadalupe-Rojas

{"title":"[Radiographic measurements of acetabular component orientation with Widmer´s method in total hip arthroplasty. Descriptive case series].","authors":"E Macías-González, J C Pérez-Alavez, H Contreras-Blancas, L E Guadalupe-Rojas","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: total hip arthroplasty (THA) is one of the most performed surgeries worldwide, with high satisfaction rates. The orientation of the acetabular component has a direct impact on the risk of dislocation, recently with the support of robotic surgery the margin of error in implant placement has decreased; however, the conventional technique even without fluoroscopic support continues to have satisfactory results within the safety zone.Material and methods: retrospective, cross-sectional, descriptive case series of patients treated with THA at Hospital General Xoco between 2022 and 2024. Degrees of anteversion and inclination were measured with Widmer's method on postoperative radiographs.Results: the radiographs of 113 patients were studied, 80 female and 33 male, with a mean age of 63.2 ± 13.01 years (95% CI: 60.6-65.4), a mean inclination of 42.2° ± 8.1° (95% CI: 40.7-43.2) and anteversion of 14.3° ± 8.5° (95% CI: 12.5-15.4); 76% of the population was within Lewinnek safe zone; by etiology: osteoarthrosis 74%, sequelae of dysplasia 68% and intracapsular fracture 82%; difference between the values of the affected side: left 65%, right 83%, of 3.9° and 4.7°/6.4o and 9° in relation to the overall values of the population.Conclusion: in our population undergoing THA, without the use of robotic technique or support of imaging studies, anteversion and inclination figures were recorded within the Lewinnek safety parameters with a conventional method.","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"38 4","pages":"226-233"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142121492","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}

引用次数: 0

[Systematic evaluation of the painful hip]. [髋关节疼痛的系统评估]。

Acta ortopedica mexicana Pub Date : 2024-07-01

V H Aguirre-Rodríguez, J P Pinal-Covarrubio

{"title":"[Systematic evaluation of the painful hip].","authors":"V H Aguirre-Rodríguez, J P Pinal-Covarrubio","doi":"","DOIUrl":"","url":null,"abstract":"The painful hip has been a topic of study that has evolved from the beginning of the last century to the present. The clinical approach is complex, and requires a systematization process associated with good questioning, clinical maneuvers with their corresponding interpretation, and complementary imaging studies. The understanding of hip pathology, especially in young adults, is highly simplified and sometimes underdiagnosed, therefore, not treated in a timely manner. The prevalence of painful hip is more common in males (49 to 55%) than in females (25 to 28%), and the causes may vary according to demographic characteristics and the history of each patient. Bryan Kelly, made a topographic and anatomical description of the approach to the painful hip according to the theory or system of the layers: I. Osteochondral layer; II. Inert layer; III. Contractile layer; and IV. Neuro-mechanical layer. This system helps us understand the anatomical site of pain and its clinicopathological correlation. The semiological approach to hip pain is the fundamental pillar for differential diagnosis. We can divide it according to its topography into anterior, lateral and posterior, as well as according to its chronology and characteristics. The physical examination should be carried out systematically, starting from a generalized inspection of gait and posture to the evaluation of specific signs for alterations in each layer, which evoke pain with specific postures and ranges of mobility, or weakness and alterations in the arc of mobility of the joint. Image evaluation is initially recommended with radiographic projections that evaluate different planes, both coronal, sagittal and axial, complemented with panoramic views, and eventually dynamic sagittal ones if necessary. Requesting specific studies such as tomography to evaluate bone structure and reserve, or simple MRI when there is suspicion of soft tissue affection, or failing that, arthroresonance for joint pathology, will depend on the clinical symptoms and radiographic findings.","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"38 4","pages":"246-256"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142121494","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}

引用次数: 0

Efficacy of periarticular local infiltrative anaesthesia (modified Ranawat cocktail regimen) for postoperative pain control and reducing morbidity in total knee arthroplasty: a tertiary centre retrospective study. 全膝关节置换术中关节周围局部浸润麻醉（改良拉纳瓦特鸡尾酒疗法）控制术后疼痛和降低发病率的效果：一项三级中心回顾性研究。

Acta ortopedica mexicana Pub Date : 2024-07-01

H Kaur, A Dahuja, R Kaur, K Khatri, K Bansal, R S Garg

{"title":"Efficacy of periarticular local infiltrative anaesthesia (modified Ranawat cocktail regimen) for postoperative pain control and reducing morbidity in total knee arthroplasty: a tertiary centre retrospective study.","authors":"H Kaur, A Dahuja, R Kaur, K Khatri, K Bansal, R S Garg","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: surgical pain is managed with multi-modal anesthesia in total knee arthroplasty (TKA). It is dubious whether including local infiltrative anaesthesia (LIA) before wound closure provides adequate pain control and decreases morbidity.Material and methods: this was a retrospective conducted to assess postoperative pain control, morbidity index, and opioid consumption in 116 patients who underwent TKA and were divided into two groups based on LIA (Modified Ranawat Regimen) or normal saline infiltration in the wound.Results: the mean NRS score was significantly lower in LIA group (3.2) as compared to the control group (3.9) in the first 24 hours. Functional milestones were relatively achieved earlier in LIA group but the values were not significant. Tramadol consumption was remarkably higher in the control group as compared to LIA group on day 1 and 2. As per the morbidity index the mean score on day one was 16.18 and 23.40 which decreased to 6.37 and 9.21 by day three in LIA and control group respectively indicating morbidity has decreased but more so in LIA group.Conclusion: our study concludes that use of modified cocktail regimen in the knee effectively decreased morbidity with excellent to good results, declining NRS score, minimal rescue analgesia requirement, early ambulation with better safety.","PeriodicalId":101296,"journal":{"name":"Acta ortopedica mexicana","volume":"38 4","pages":"239-245"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142121497","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}

引用次数: 0