Revista Espanola de Cirugia Ortopedica y Traumatologia最新文献

{"title":"[Artículo traducido] Minimización del sangrado y la transfusión en artroplastias bilaterales de cadera y rodilla en un solo tiempo: una revisión sistemática de las intervenciones actuales","authors":"R. Gonzalez-Pola ,&nbsp;R.O. Tafoya-Olivos ,&nbsp;L.A. Culebras-Almeida ,&nbsp;G. Zermeño-Garcia ,&nbsp;A. Herrera-Lozano","doi":"10.1016/j.recot.2025.07.015","DOIUrl":"10.1016/j.recot.2025.07.015","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate perioperative strategies for minimizing bleeding and transfusion needs in single-stage bilateral hip and knee arthroplasty. This systematic review identifies effective interventions and provides evidence-based recommendations and highlight areas for future research in optimizing bleeding management.</div></div><div><h3>Methods</h3><div>A systematic review of literature from January 2010 to October 2024 was conducted, focusing on randomized controlled trials, meta-analyses, and guidelines. Databases searched included PubMed/MEDLINE, Embase, Cochrane Library, and Web of Science. Interventions assessed included tranexamic acid (TXA), surgical techniques, regional anesthesia, controlled hypotension, preoperative anemia correction, tourniquet use, bone wax, and restrictive transfusion strategies. Study selection, data extraction, and quality assessment followed PRISMA and Newcastle-Ottawa Scale guidelines.</div></div><div><h3>Results</h3><div>From 325 included studies, TXA consistently demonstrated the most significant impact, reducing transfusion rates by 40-60%. Anterior total hip arthroplasty was associated with reduced blood loss. Regional anesthesia and controlled hypotension further minimized intraoperative bleeding. Preoperative anemia correction and restrictive transfusion thresholds also showed benefits. Tourniquet evidence was inconclusive. Limited evidence supported bone wax. GRADE assessment suggested high evidence quality for TXA and regional anesthesia, moderate for minimally invasive surgery, anemia correction, and restrictive transfusion, and low for bone wax.</div></div><div><h3>Conclusions</h3><div>Multimodal approach integrating TXA, regional anesthesia, minimally invasive surgery, anemia correction, and restrictive transfusion protocols effectively reduces bleeding and transfusion needs in bilateral arthroplasty. Incorporation into enhance recovery after surgery protocols is recommended. Future research should refine TXA dosing, clarify tourniquet use, and assess cost-effectiveness.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 5","pages":"Pages T532-T543"},"PeriodicalIF":0.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144890967","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":"[Translated article] Letter to the editor about the article: “Is the coronal plane alignment of the knee (CPAK) classification useful to plan individualized total knee arthroplasty surgery for the Spanish population? A critical analysis of the CPAK classification”","authors":"V.J. León-Muñoz ,&nbsp;J. Hurtado-Avilés ,&nbsp;M. López-López ,&nbsp;F. Santonja-Medina ,&nbsp;J. Moya-Angeler","doi":"10.1016/j.recot.2025.07.016","DOIUrl":"10.1016/j.recot.2025.07.016","url":null,"abstract":"","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 5","pages":"Pages T553-T554"},"PeriodicalIF":0.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144888777","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":"[Translated article] Reconsidering preoperative transfusion testing in primary total hip and knee arthroplasty: Are they truly efficient?","authors":"J.H. Núñez ,&nbsp;M.J. Jimenez-Jimenez ,&nbsp;B. Escudero","doi":"10.1016/j.recot.2025.07.017","DOIUrl":"10.1016/j.recot.2025.07.017","url":null,"abstract":"","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 5","pages":"Pages T551-T552"},"PeriodicalIF":0.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144890999","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":"Complicaciones de la administración intraósea de vancomicina en artroplastia total de cadera","authors":"W.F. Martínez ,&nbsp;L. Camacho Terceros ,&nbsp;F. Garbini ,&nbsp;E.J. Bochatey ,&nbsp;F.A. Lopreite","doi":"10.1016/j.recot.2024.08.002","DOIUrl":"10.1016/j.recot.2024.08.002","url":null,"abstract":"<div><h3>Introduction</h3><div>The incidence of periprosthetic joint infection (PJI) in hip surgeries has significantly decreased thanks to intravenous (IV) antibiotic prophylaxis. However, in patients colonized with methicillin-resistant <em>Staphylococcus aureus</em> (MRSA) or those at risk of colonization, it is necessary to include vancomycin in the prophylaxis. Intraosseous administration of vancomycin could enhance its effectiveness in total hip arthroplasty (THA).</div></div><div><h3>Materials and methods</h3><div>A retrospective study was conducted between March and December 2023 involving 53 patients scheduled for primary THA with colonization risk factors. The median age of the patients was 67 years (range 61 to 75), and all received treatment with intraosseous vancomycin (500<!--> <!-->mg). Detailed records and documentation of complications during hospitalization and the first three months post-surgery were maintained. As a secondary outcome measure, the incidence of PJI was explored.</div></div><div><h3>Results</h3><div>We administered 500<!--> <!-->mg of intraosseous vancomycin, injected into the greater trochanter, along with standard IV prophylaxis. The incidence of complications was 1.64%. The PJI rate at 90 days was 0%.</div></div><div><h3>Conclusions</h3><div>Intraosseous administration of low-dose vancomycin in THA for patients at risk of MRSA colonization, combined with standard IV prophylaxis, was shown to be safe and did not present significant adverse effects. Furthermore, this strategy eliminates the logistical challenges associated with timely vancomycin administration.</div><div>Level of evidence IV: Case Series.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 4","pages":"Pages 340-346"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914247","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 aumentación con tenodesis extraarticular de la reconstrucción del ligamento cruzado anterior asociado a la técnica «all-inside» no modifica la vuelta al deporte en jugadores de baloncesto federados: estudio de cohortes comparativo","authors":"E. García-Albó ,&nbsp;J. Nomdedéu Sancho ,&nbsp;M. Gispert Estadella ,&nbsp;R. Sevil Mayayo ,&nbsp;J.V. Andrés-Peiró ,&nbsp;J. Pijoan Bueno ,&nbsp;M.M. Reverté-Vinaixa ,&nbsp;J. Minguell-Monyart","doi":"10.1016/j.recot.2024.07.019","DOIUrl":"10.1016/j.recot.2024.07.019","url":null,"abstract":"<div><h3>Introduction</h3><div>Return to play rates after anterior cruciate ligament (ACL) reconstruction range between 50-98% depending on sport professionality, without being modified by the addition of an extra-articular augmentation (EA). The objective of the study is to describe the rate of return to play in our cohort. The hypothesis is that the addition of EA increases that rate.</div></div><div><h3>Material and methods</h3><div>A retrospective, descriptive and analytical study of a 130 basketball players cohort between 18 and 45 years old, whom underwent ACL reconstruction between the years 2018 and 2022, with a minimum follow-up of 18 months. Data was collected by reviewing medical records. IKDC score was registered after one year from surgery. All patients operated from 2020 received an extra-articular tenodesis.</div></div><div><h3>Results</h3><div>Of all patients, 72.31% returned to training, 70.77% returned to competition and 46.15% returned to the same level of performance prior to injury. The EA group (46.15%) did not increase the rate of return to competition (<em>P</em>=.552) nor to the same level of performance (<em>P</em>=.664). The mean IKDC. score was 86.83 (SD 14.85), and was not higher in the EA group (<em>P</em>=.418). However, its value was higher in the players who returned to training, competition and level of performance (<em>P</em>&lt;.05). EA did not delay the return to play in any group (<em>P</em>=.282).</div></div><div><h3>Conclusion</h3><div>To sum up, the EA does not modify the return to sport rate. Higher IKDC values predict a greater return to sport rate. in all groups. Prospective studies with larger sample size and longer follow-up time are required.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 4","pages":"Pages 330-339"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876254","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":"Ramón y Cajal y la placa de crecimiento cartilaginosa","authors":"M.J. Delgado-Martos ,&nbsp;B. Quintana-Villamandos ,&nbsp;E. Delgado-Baeza","doi":"10.1016/j.recot.2024.11.017","DOIUrl":"10.1016/j.recot.2024.11.017","url":null,"abstract":"<div><div>Santiago Ramón y Cajal (1852-1934), a distinguished histologist and Nobel Laureate in Physiology or Medicine in 1906, is considered the father of Neuroscience. However, his legacy also extended to the study of various tissues, including hyaline cartilage, an area in which he was a pioneer. Throughout his work <em>Elements of Normal Histology and Micrographic Technique</em>, Cajal developed fundamental concepts that, when reviewed in light of molecular biology, resonate with current ideas about cellular communication and macromolecular interactions. In particular, his observations on hyaline cartilage, such as stellate chondrocytes, were largely overlooked in the scientific literature until today. In this paper, four hypotheses based on his discoveries are proposed: the architecture of chondrocyte columns, the role of the perichondrium in endochondral ossification, cartilage nutrition, and the role of the Golgi apparatus in the resting zone. Nearly a century later, research on hyaline cartilage continues to confirm Cajal's pioneering ideas.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 4","pages":"Pages 402-410"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751945","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":"[Translated article] Complications of intraosseous administration of vancomycin in total hip arthroplasty","authors":"W.F. Martínez ,&nbsp;L. Camacho Terceros ,&nbsp;F. Garbini ,&nbsp;E.J. Bochatey ,&nbsp;F.A. Lopreite","doi":"10.1016/j.recot.2025.04.004","DOIUrl":"10.1016/j.recot.2025.04.004","url":null,"abstract":"<div><h3>Introduction</h3><div>The incidence of periprosthetic joint infection (PJI) in hip surgeries has significantly decreased thanks to intravenous (IV) antibiotic prophylaxis. However, in patients colonised with methicillin-resistant <em>Staphylococcus aureus</em> (MRSA) or those at risk of colonisation, it is necessary to include vancomycin in the prophylaxis. Intraosseous administration of vancomycin could enhance its effectiveness in total hip arthroplasty (THA).</div></div><div><h3>Materials and methods</h3><div>A retrospective study was conducted between March and December 2023 involving 53 patients scheduled for primary THA with colonisation risk factors. The median age of the patients was 67 years (range 61–75), and all received treatment with intraosseous vancomycin (500<!--> <!-->mg). Detailed records and documentation of complications during hospitalisation and the first three months post-surgery were maintained. As a secondary outcome measure, the incidence of PJI was explored.</div></div><div><h3>Results</h3><div>We administered 500<!--> <!-->mg of intraosseous vancomycin, injected into the greater trochanter, along with standard IV prophylaxis. The incidence of complications was 1.64%. The PJI rate at 90 days was 0%.</div></div><div><h3>Conclusions</h3><div>Intraosseous administration of low-dose vancomycin in THA for patients at risk of MRSA colonisation, combined with standard IV prophylaxis, was shown to be safe and did not present significant adverse effects. Furthermore, this strategy eliminates the logistical challenges associated with timely vancomycin administration.</div><div>Level of evidence IV: Case series.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 4","pages":"Pages T340-T346"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549833","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":"[Translated article] Surgical treatment of non-displaced subcapital hip fracture: Femoral Neck System vs. cannulated screws. Comparative study","authors":"P. Lalueza-Andreu ,&nbsp;Á. Martínez-García ,&nbsp;P. Checa-Betegón ,&nbsp;J. García-Coiradas ,&nbsp;J.A. Valle-Cruz ,&nbsp;F. Marco-Martínez","doi":"10.1016/j.recot.2025.04.007","DOIUrl":"10.1016/j.recot.2025.04.007","url":null,"abstract":"<div><h3>Objective</h3><div>The objective of this study is to compare the outcomes of using the Femoral Neck System (FNS) (DePuy Synthes®) versus the use of cannulated screws (CS) in the surgical treatment of non-displaced subcapital hip fractures.</div></div><div><h3>Materials and methods</h3><div>A retrospective cohort study was conducted on non-displaced subcapital hip fractures treated with CS or FNS between 2020 and 2023, with a minimum follow-up of one year. A total of 28 patients were included, 14 treated with CS and 14 with FNS. Demographic, radiological, clinical, and functional variables were analyzed.</div></div><div><h3>Results</h3><div>In the CS group, 64% were male, with a mean age of 66.5 years (SD 14.9) and an average follow-up of 22 months (range, 12-36 months). In the FNS group, 57% were male, with a median age of 60.8 years (SD 13.78) and an average follow-up of 16 months (range, 12-24 months).</div><div>Regarding functional outcomes, no significant differences were found between FNS and CS in the Harris scale: 94.21 ± 11.55 for FNS and 96.50 ± 6.9 for CS (p = 0.618).</div><div>The total postoperative complications (FNS/CS) were 7.1% versus 43%, and implant failure with conversion to total hip replacement was 0% versus 43%, both significantly higher in the CS group (p = 0.047; p = 0.016, respectively). The FNS also presented a lower rate of avascular necrosis (0% versus 11.1%, p = 0.391) and nonunion (0% versus 20%, p = 0.163), although these differences did not reach statistical significance.</div></div><div><h3>Conclusions</h3><div>Although both treatment methods, cannulated screws and the FNS, showed similar short-term functional outcomes in the management of undisplaced subcapital femoral fractures, the FNS demonstrated a significantly lower rate of complications and reoperations. These results suggest that the FNS could be considered a safer and more effective option compared to cannulated screws.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 4","pages":"Pages T365-T371"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549836","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":"Is endoscopic decompression for Morton's neuroma a safe technique?","authors":"L. López-Capdevila ,&nbsp;M. Ballester ,&nbsp;G. Lucar ,&nbsp;T. Mota-Gomes ,&nbsp;M. Fa-Binefa ,&nbsp;S. López-Hervás","doi":"10.1016/j.recot.2024.10.005","DOIUrl":"10.1016/j.recot.2024.10.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Morton's neuroma is predominantly attributed to chronic nerve entrapment within third space adjacent metatarsals, the deep transverse metatarsal ligament (DTML), and the plantar skin. While conservative treatments are of election, failures require alternative interventions such as ultrasound-guided injections and various surgical procedures, including minimally invasive neurectomy and DTML release. This study aimed to anatomically assess the risks associated with the endoscopic dorsal surgical decompression of Morton's neuroma.</div></div><div><h3>Materials and methods</h3><div>Twenty feet from ten fresh-frozen cadaveric specimens underwent a dorsal percutaneous approach for endoscopic access. Surgical procedures were monitored by three foot and ankle surgeons. Post-surgical anatomical dissections were conducted to evaluate potential risks to surrounding structures.</div></div><div><h3>Results</h3><div>The endoscopic technique successfully sectioned the DMTL in all specimens (100%) without iatrogenic injury of tendons, nerves, or arteries, while lumbricals may be at risk.</div></div><div><h3>Conclusion</h3><div>Endoscopic dorsal decompression of Morton's neuroma presents as an accessible minimally invasive surgical option with low risk of collateral associated injuries.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 4","pages":"Pages 380-384"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477019","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":"[Translated article] Impact of lower limb lengthening with telescopic nails on functionality and quality of life in patients with achondroplasia","authors":"M. Galán-Olleros,&nbsp;J. Alonso-Hernández,&nbsp;C. Miranda-Gorozarri,&nbsp;J. García-Fernández,&nbsp;R.M. Egea-Gámez,&nbsp;Á. Palazón-Quevedo","doi":"10.1016/j.recot.2025.04.012","DOIUrl":"10.1016/j.recot.2025.04.012","url":null,"abstract":"<div><h3>Introduction</h3><div>The short stature characteristic of patients with achondroplasia can negatively affect health-related quality of life (HRQoL). Lower limb lengthening reusing telescopic intramedullary nails (TIMNs) offers an alternative to external fixators, with the potential to enhance functionality, self-esteem, and HRQoL, while reducing complication risks, which this study aims to evaluate.</div></div><div><h3>Materials and methods</h3><div>This retrospective study included nine patients with achondroplasia who underwent parallel transverse lengthening of femurs and/or tibias reusing a TIMN between 2015 and 2022. Functionality (Lower Extremity Functional Scale, LEFS), self-esteem (Rosenberg Self-Esteem Scale), and HRQoL (Short Form-12, SF-12, and EuroQol VAS) were assessed preoperatively and at least two years post-surgery. Complications (Clavien–Dindo–Sink classification) and patient satisfaction were also recorded.</div></div><div><h3>Results</h3><div>The median age was 13.5 years (IQR: 12.5–17.1), with a significant height increase of +19.9<!--> <!-->cm (<em>p</em> <!-->&lt;<!--> <!-->0.05). Improvements were significant in functionality (LEFS, +4.6 points; <em>p</em> <!-->&lt;<!--> <!-->0.05), self-esteem (Rosenberg, +3.7 points; <em>p</em> <!-->&lt;<!--> <!-->0.05), and HRQoL (SF-12 physical, +8.9 points; <em>p</em> <!-->&lt;<!--> <!-->0.05; EQ-VAS, +20 points; <em>p</em> <!-->&lt;<!--> <!-->0.05). A total of 22 complications were reported in 32 treated bones, most classified as grade 2 or 3B, with no significant correlation to outcomes in functionality, HRQoL, or self-esteem outcomes (<em>p</em> <!-->&gt;<!--> <!-->0.05).</div></div><div><h3>Conclusions</h3><div>Lower limb lengthening reusing TIMNs appears to improve functionality, HRQoL, and self-esteem in patients with achondroplasia compared to their preoperative status. High patient satisfaction and manageable complications were observed, with no negative impact on outcomes, laying the groundwork for future studies.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 4","pages":"Pages T412-T420"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549848","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}