Revista Espanola de Cirugia Ortopedica y Traumatologia最新文献

{"title":"Clinical Outcomes of Closuring Technique in Total Hip Arthroplasty and Total Knee Arthroplasty: A Comparative Study of Staples technique vs Triclosan-coated Barbed Sutures.","authors":"Benkovich Vadim, Abialevich Artsiom, Benkovich Guy","doi":"10.1016/j.recot.2025.03.006","DOIUrl":"https://doi.org/10.1016/j.recot.2025.03.006","url":null,"abstract":"<p><strong>Background: </strong>The demand for total joint arthroplasty (TJA) continues to rise due to an aging population, increased life expectancy, and expanding surgical indications. Medicare projections estimate a 176% increase in total hip arthroplasty (THA) and a 139% increase in total knee arthroplasty (TKA) by 2040, reaching 659% and 469%, respectively, by 2060.</p><p><strong>Methods: </strong>From January 2014 to October 2024, our arthroplasty database was categorized into two groups by closure method: Group 1 (with staples), Group 2 (with barbed sutures). Data included demographics, BMI, comorbidities, wound complications, hospital stay, and readmissions.</p><p><strong>Results: </strong>This retrospective study of 3,110 hip and knee arthroplasty patients with osteoarthritis found no significant differences in age (P = 0.26) or sex distribution (P = 0.778) between groups, though the second group had a higher BMI (28.43 ± 4.43 vs. 29.15 ± 3.44; P < 0.001) and a more balanced operated limb distribution (P = 0.040). Comorbidities were lower in the second group for arterial hypertension (48.48% vs. 57.63%; P < 0.001), diabetes mellitus (20.8% vs. 26.21%; P = 0.0004), and hyperlipidemia (26.8% vs. 33.28%; P < 0.001), with no significant differences in ischemic heart disease (P = 0.668), atrial fibrillation (P = 0.725), or hypothyroidism (P = 0.827). Operative time was longer in the second group (82.7 ± 7.44 vs. 78.4 ± 13.62 minutes; P < 0.001), while hospital stay was marginally shorter (23.33 ± 4.53 vs. 23.3 ± 5.16 hours; P = 0.039). Postoperative complication rates, including bleeding, wound dehiscence, falls, stitch abscess, and readmission, showed no significant differences. There was no observed incidence of deep infections (PJI) in the study cohort at all.</p><p><strong>Conclusions: </strong>The study demonstrated that there were no statistically significant differences in the frequency of wound complications between the two wound closure methods in THA and TKA surgeries, indicating comparable surgical outcomes in terms of wound healing and complication rates.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744121","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":"Gender and diabetes mellitus do not influence the outcomes of patients with proximal humeral fractures treated with a reverse shoulder arthroplasty.","authors":"Francisco Antonio Miralles Muñoz, Emilio Sebastiá Forcada, Luis Albero Catalá","doi":"10.1016/j.recot.2025.03.008","DOIUrl":"https://doi.org/10.1016/j.recot.2025.03.008","url":null,"abstract":"<p><strong>Background and objective: </strong>Some studies have described that gender and the diabetes mellitus may impact the outcomes of reverse shoulder arthroplasty (RSA). The objective of this study was to compare the functional outcomes and survival of RSA based on the patient's gender and the presence or absence of diabetes mellitus as independent variables.</p><p><strong>Materials and methods: </strong>This retrospective study included all patients who underwent RSA for acute proximal humeral fracture with a minimum follow-up of 2 years. Two independent stratifications were conducted to assess the influence of female gender and diabetes on RSA outcomes. The primary outcome variable was the Constant score. Additionally, the quickDASH and UCLA functional scales were evaluated, as well as estimated survival using the Kaplan-Meier method.</p><p><strong>Results: </strong>The final sample comprised 131 patients. The final Constant scores were 47.0 in women and 51.8 in men (p=0.198), and 48.4 in diabetics and 45.3 in non-diabetics (p=0.347). There were also no significant differences in the secondary functional scales. The estimated 12-year survival rate was 94.4% in women and 94.7% in men (p=0.543); and 80.2% in diabetics and 97.8% in non-diabetics (p=0.141).</p><p><strong>Conclusions: </strong>In acute proximal humeral fractures treated with RSA, neither female gender nor the presence of diabetes had an impact on functional outcomes at 2 years postoperative follow-up.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744124","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":"IN VITRO ANALYSIS OF CARPAL KINEMATICS DURING VALIDATION OF A STABILIZED SCAPHOID HEMIARTHROPLASTY.","authors":"Patricia Gómez Barbero, Pau Rey Vidal, Daniel Montaner Alonso, José Luis Rodrigo Pérez","doi":"10.1016/j.recot.2025.03.009","DOIUrl":"https://doi.org/10.1016/j.recot.2025.03.009","url":null,"abstract":"<p><strong>Objective: </strong>Pseudoarthrosis and necrosis of the proximal pole of the scaphoid require complex treatment. If primary treatments fail, there are only techniques that sacrifice part of the mobility. We present the design and in vitro results of an anatomical partial prosthesis of the scaphoid bone.</p><p><strong>Material and method: </strong>The kinematics of the carpus are tested in vitro on 6 cadaveric forearms before and after prosthetic replacement, applying active loads on the main muscles. Pre- and post-intervention movements are recorded by Kinescan/IBV®, translating an angular value.</p><p><strong>Results: </strong>After prostheticization, a decrease in the movement of the capitate (-19.36º) and scaphoid (-15.46º) is recorded during flexion-extension, while that of the lunate increases (11.67º). With the radial-ulnar deviation, only the movement of the great muscle decreases (-11.78º), but that of the scaphoid (4.03º) and lunate (5.9º) increases. We find significant differences whenever there is a decrease in movement. In the \"throwing darts\" movement (DTM), the average movement decreases in flexion-extension (-18.44º) and in radial-ulnar deviation (-3.66º), without significant differences. While the descent of the scaphoid in flexion-extension and radio-ulnar deviation of the DTM will affect the kinematics (p<0.05). There is no involvement of the lunate in the DTM.Regarding the relative interosseous movement, significant differences are observed in the main axis of the F-E.</p><p><strong>Conclusions: </strong>The implantation of a stabilized partial scaphoid prosthesis does not significantly modify the movement pattern of a healthy wrist. Therefore, in the future it could be a viable alternative for the treatment of recalcitrant pathology of the carpal scaphoid.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744128","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":"Biomechanical Evaluation and Analysis of a Reused Telescopic Intramedullary Femoral Nail in a Child with Achondroplasia.","authors":"César M Posada, Roberto D'Amato, María Galán-Olleros, Carlos Miranda-Gorozarri, Ángel Palazón-Quevedo, Javier Alonso-Hernández","doi":"10.1016/j.recot.2025.03.005","DOIUrl":"https://doi.org/10.1016/j.recot.2025.03.005","url":null,"abstract":"<p><strong>Introduction: </strong>Telescopic intramedullary nails (CIMT) have represented a significant advancement in limb lengthening procedures. However, their elongation capacity is limited to 5 cm in the bones of patients with achondroplasia. Consequently, techniques involving CIMT reutilization have been developed. This reuse presents mechanical and safety challenges due to material fatigue and repetitive loading, which may compromise the structural integrity of the implant. This study evaluates the biomechanical performance and potential damage of a reused CIMT.</p><p><strong>Methods: </strong>An experimental analysis was conducted on a TIMN removed after two 5 cm lengthening procedures in a patient with achondroplasia. The nail was measured and assessed following non-destructive deconstruction, material analysis, 3D modeling through reverse engineering, and finite element analysis (FEM) to assess its behavior under different loading conditions.</p><p><strong>Results: </strong>Mechanical and chemical damage was identified, compromising the nail's integrity. The aged Ti6Al4V alloy was validated for its resistance to complex loads. The 3D modeling showed that the gear mechanism effectively converted rotational movement into translational motion. The FEM analysis revealed that the safety factor reached its critical limit at angles of 2.44° and 2.25°, suggesting that the nail was nearing its resistance limit. The stem and guide were identified as critical components.</p><p><strong>Conclusions: </strong>CIMT reutilization must be performed with caution due to potential material fatigue. This study provides a foundation for redesigning these implants to improve their capacity to withstand prolonged loading cycles. LEVEL OF EVIDENCE Level IV, Pre-clinical experimental study.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744117","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":"A PERIOPERATIVE OPTIMIZATION PROGRAM CAN IMPROVE RESULTS AND REDUCE HOSPITAL LENGTH OF STAY IN HIP AND KNEE ARTHROPLASTY: EXPERIENCE IN CHILE.","authors":"José Miguel Luarte, José Tomás Vizcaya, Diego Munita, Esteban Stocker, Romina Núñez, Juan Antonio Merino, Claudio Rojas","doi":"10.1016/j.recot.2025.03.002","DOIUrl":"https://doi.org/10.1016/j.recot.2025.03.002","url":null,"abstract":"<p><strong>Background and objective: </strong>Perioperative optimization programs have been shown to improve outcomes in total hip and knee arthroplasty; however, the evidence in Latin America is limited. Our objective is to evaluate the impact of implementing a multidisciplinary optimization program in prosthetic surgery at a Latin American center.</p><p><strong>Materials and methods: </strong>A retrospective cohort study evaluating elective hip and knee prosthesis surgeries between 2016 and 2023 at a private hospital. We compared pre-intervention (2016-2018) and post-intervention (2019-2023) groups following the implementation of a multidisciplinary perioperative optimization program in 2019. The impact of the program on hospital length of stay and 90-day readmission rates was assessed.</p><p><strong>Results: </strong>A total of 1,462 patients (1,636 surgeries) were included, with 429 surgeries in the pre-intervention group and 1,207 in the post-intervention group. Hospital length of stay decreased from 3.5 to 2.22 days (p<0.05). The 90-day readmission rate decreased from 2.56% to 2.24% (p=0.71), with a significant reduction in knee arthrofibrosis (from 0.9% to 0.2%, p<0.05). The optimization program was the main factor contributing to the reduction in hospital length of stay.</p><p><strong>Conclusions: </strong>The multidisciplinary perioperative program implemented significantly reduced hospital stay without increasing 90-day readmission rates.Furthermore, it equated outcomes between patients with public and private insurance.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671374","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":"TREATMENT OF DORSAL RADIOCARPAL FRACTURE-DISLOCATION: CLINICAL AND RADIOLOGICAL LONGTERM OUTCOMES.","authors":"Verónica Jiménez-Díaz, Lorena García-Lamas, Ismael Auñón-Martín, Víctor Rodríguez Vega, David Cecilia-López","doi":"10.1016/j.recot.2025.03.003","DOIUrl":"https://doi.org/10.1016/j.recot.2025.03.003","url":null,"abstract":"<p><p>Main: To describe our experience treating dorsal radiocarpal fracture-dislocations, regarding longterm clinical and radiological outcomes. Matherial and method: Retrospective chart review of 15 patients treated in our institution from 2007 to 2021. Inclusion criteria were patients over 16 years, treated at a third level hospital of Madrid and an average follow up of 56 months. Epidemiological data were collected from digital records. VAS, QuickDASH and Patient Rated Wrist Evaluation scales were employed for clinical results assessment. All radiological studies were reviewed for radiological results assessment. A descriptive statiscal analisys of all variables was developed. Results: Among 15 patients with a mean follow-up of 56 months; 12 males (80%) and 3 females (20%) with a mean age of 39.5 years. The left wrist was injured in most cases (66.7%). All patients were treated surgically; 4 of them (27%) were assisted by wrist arthroscopy. Mean VAS at final follow up was 2.6 with activity. Mean PRWE was 32 and mean QuickDASH was 28, which means satisfactory results. 80% patients developed wrist stiffness with most affected flexo-extension followed by prono-supination. 67% patients developed radiological signs of wrist osteoarthritis at the end of follow-up. Conclusions: In spite of a large number of clinical and radiological complications during follow-up, longterm functional results are good in this kind of wrist injuries.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670096","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":"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, J Hurtado-Avilés, M López-López, F Santonja-Medina, J Moya-Angeler","doi":"10.1016/j.recot.2025.03.001","DOIUrl":"10.1016/j.recot.2025.03.001","url":null,"abstract":"","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587562","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":"Success after surgical treatment of unstable hip prosthesis: 12 years of experience in a Third Level Hospital.","authors":"Alba Gabriela Casa Casa","doi":"10.1016/j.recot.2025.02.018","DOIUrl":"https://doi.org/10.1016/j.recot.2025.02.018","url":null,"abstract":"<p><strong>Objetives: </strong>Hip arthroplasty instability is one of the most worrisome complications and one of the main indications for revision surgery. We present a retrospective study evaluating the results of revision hip replacement surgery performed for instability.</p><p><strong>Material and methods: </strong>Observational, retrospective study from 1/12/2010 to 1/12/2022. Fifty-nine medical records of patients operated for hip dislocation were reviewed. Epidemiological variables and data such as type of dislocation based on Wera classification, cup position based on Lewinnek, type of implants, associated surgical techniques and the results in terms of recurrence of dislocation or reoperation were recorded.</p><p><strong>Results: </strong>59 patients: 33 women, 26 men, mean age 77.0 years. Mean follow-up 3.2 years (range 1.6-13.1). Based on Wera: had a single cause 37 cases, 2 causes 19 and 3 causes or more, 3 cases. In 61% of the cases in the series, malposition of the cup played an essential role in the dislocation (type I Wera). In the series, the Lewinnek zone could not be evaluated in 7 cases. For the remaining patients, 30% were within the Lewinnek zone. Only one patient in the series had a history of lumbar instrumentation. Implant used: double mobility (DM) in 17 cases (28.8%) and a constrained system in 38 cases (64.4%). Heads with adaptive cone were used in 2 cases (3%). In 4 cases (6%) a modified Whiteside type plasty was associated. Girdlestone was indicated in 2 cases (3%). Recurrence of dislocation 1 occasion: 18 cases (31%); 2 or more occasions 7 cases (12%). Re-operation 15 cases (25%) range (1-5), main reasons: instability, infection or peri-prosthetic fractures. Probability of success defined as no recurrence: at one year is 80.5%, and at two years is 70.6%, showing no differences between constrained or dual mobility implant.</p><p><strong>Comments and conclusions: </strong>Hip prosthesis dislocation is multifactorial in origin, although in most cases in the series the key factor was malposition of the acetabulum. Constrained and DM implants showed similar effectiveness. The results of this study emphasize the need for techniques that allow adequate positioning and orientation of the acetabular component to prevent, in a high percentage of cases, the need for this type of revision surgery.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568426","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] In memoriam of professor Antonio Herrera Rodríguez","authors":"J. Albareda Albareda","doi":"10.1016/j.recot.2024.12.005","DOIUrl":"10.1016/j.recot.2024.12.005","url":null,"abstract":"","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 2","pages":"Page T221"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143551950","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":"Parestesias en la cara lateral del antebrazo: una lesión nerviosa difícilmente reconocible","authors":"S. Parra Escorihuela,&nbsp;A.D. Ghinea,&nbsp;Á. Montero Sánchez,&nbsp;J. Orenga Orenga","doi":"10.1016/j.recot.2024.09.001","DOIUrl":"10.1016/j.recot.2024.09.001","url":null,"abstract":"<div><div>The lateral antebrachial cutaneous nerve (LACN) is the sensory branch of the musculocutaneous nerve and usually innervates the lateral aspect of the forearm. Isolated lesions are rare, of varied etiology and generally underdiagnosed. We present a retrospective descriptive study of electromyography performed at the General University Hospital of Castellón in the last 20 years with isolated NCAL lesion. We identified 11 cases (8 men and 3 women), average age 44 years (15-73 years). 73% were referred from traumatology. Only one patient was correctly guided in the application. 63.6% of cases noted hypoesthesia extending to the wrist and 18.2% to the thumb. The electromyographic study showed severe axonal involvement in 3 patients and moderate in 8. The symptoms were observed associated with surgery in 4 patients, manipulation of the elbow flexure in 4 cases and bicipital tendonitis in the rest. Four patients had a poor clinical outcome (3 with severe axonal involvement and 1 with moderate involvement). Isolated involvement of the NCAL is a rare and underdiagnosed alteration. It is important to suspect it in patients with hypoesthesia in the forearm, including the radial edge of the wrist or thumb, especially if it is associated with manipulations around the elbow flexure or bicipital tendonitis. Electromyography is useful in confirming the diagnosis, ruling out other differential diagnoses, and predicting prognosis. Knowing the location of this nerve during manipulations on the arm and placing patients in an appropriate posture during surgeries can help minimize cases.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 2","pages":"Pages 206-209"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297709","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}