Revista Espanola de Cirugia Ortopedica y Traumatologia最新文献

{"title":"Synovial fluid Lipocalin-2 as a biomarker for chronic prosthetic joint infection: Prospective validation in hip and knee revision arthroplasty","authors":"A. Alías ,&nbsp;J.A. Fernández-Valencia ,&nbsp;J.C. Martínez-Pastor ,&nbsp;M. Sabater-Martos ,&nbsp;E. Tornero ,&nbsp;A. Vergara ,&nbsp;A. Combalia ,&nbsp;L. Morata ,&nbsp;A. Soriano ,&nbsp;E. Muñoz-Mahamud","doi":"10.1016/j.recot.2025.09.004","DOIUrl":"10.1016/j.recot.2025.09.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Diagnosing prosthetic joint infection (PJI) remains challenging, as no single test can definitively confirm or rule out infection. Current diagnostic criteria rely on a combination of clinical, laboratory, and microbiological data. Lipocalin-2 (LCN2) has emerged as a potential biomarker for PJI, particularly in acute cases. However, its diagnostic role in chronic PJI and aseptic failures is not well established. This study aimed to evaluate the diagnostic performance of synovial LCN2 in chronic PJI.</div></div><div><h3>Material and methods</h3><div>We conducted a prospective study of patients undergoing revision total hip or knee arthroplasty between April 2022 and April 2023. Cases were initially classified preoperatively as aseptic or septic according to the European Bone and Joint Infection Society (EBJIS) criteria, based on the tests available before surgery. After surgery, the EBJIS criteria were reapplied to establish the final diagnosis. Synovial LCN2 levels were compared between groups, and diagnostic performance was assessed using receiver operating characteristic (ROC) curve analysis.</div></div><div><h3>Results</h3><div>Of 125 patients undergoing revision surgery, 110 were included in the final analysis after excluding those with insufficient synovial fluid for LCN2 quantification. The median age was 75.0 years (IQR 68.0–81.0), and 65 patients (59.1%) were female. Based on preoperative evaluation, 90 cases (81.8%) were classified as aseptic failures and 20 (18.2%) as chronic PJI. However, according to the EBJIS criteria, 77 cases (70.0%) were ultimately diagnosed as aseptic and 33 (30.0%) as PJI. An LCN2 threshold of 266<!--> <!-->ng/mL was identified as the optimal cut-off for diagnosing PJI, showing a significant association with both the preoperative diagnosis of infection (<em>p</em> <!-->=<!--> <!-->0.012) and the definitive postoperative diagnosis (<em>p</em> <!-->=<!--> <!-->0.001). Elevated LCN2 levels were also significantly associated with increased serum C-reactive protein (CRP) levels (<em>p</em> <!-->=<!--> <!-->0.02). There were 13 cases with discordant diagnoses: initially considered aseptic but ultimately confirmed as septic. Among these, 9 cases (69.2%) exhibited elevated LCN2 levels.</div></div><div><h3>Conclusion</h3><div>Synovial fluid LCN2 is a promising biomarker for the diagnosis of chronic PJI, especially in cases initially misclassified as aseptic. Its strong association with the final diagnosis of infection highlights its potential to enhance diagnostic accuracy. Further prospective studies are needed to confirm these findings and support the incorporation of LCN2 into routine clinical practice.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 3","pages":"Pages 200-208"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784289","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] It's possible to know tibial torsion in a X ray of the limbs?","authors":"P. González-Herranz,&nbsp;N. Penelas-Abelleira","doi":"10.1016/j.recot.2026.02.014","DOIUrl":"10.1016/j.recot.2026.02.014","url":null,"abstract":"<div><h3>Introduction</h3><div>Rotational deformities are a common reason for consultation and are usually assessed clinically using the Staheli Rotational Profile and/or torsional CT. The authors present a new method, using a simple AP X-ray of the lower limbs to measure tibial torsion, comparing this method with two other common methods: the thigh-foot angle and CT.</div></div><div><h3>Material and method</h3><div>The radiological measurement is based on the constant relationship between the epiphyseal and metaphyseal centers of the tibia and fibula, independent of the degree of rotation. If we express this relationship as the sum of the radii of the tibial and fibular epiphyses, we can see that as tibial torsion increases, the distance between the epiphyseal centers decreases when we observe the ankle in an AP projection. Expressing this as the trigonometric function Cosine of Alpha<!--> <!-->=<!--> <!-->Adjacent Leg/Hypotenuse, we obtain values between 0 and 1 and applying the inverse function to the Cosine of Alpha, Arc Cosine of Alpha, we can determine how many degrees of rotation α value &lt;1 corresponds to. This measurement is performed on an AP TeleRx of the MMII with the patellas in front and is compared with the thigh-foot angle and the condyle-malleolar angles measured tibio-malleolar by CT.</div></div><div><h3>Results</h3><div>The medical records of 70 patients (39 women/31 men) were reviewed, comprising 140 limbs. Clinical measurements, CT scans, and Arc Cosine Alpha measurements were recorded on plain radiographs of the lower limbs (MMII). The mean patient age was 12.5 years (<em>r</em>: 10–16). The mean thigh-foot angle was 23° (<em>r</em>: −15°–55°). According to the CT scan, the mean condyle-malleolar angle measured by the radiologist was 44.3° (<em>r</em>: 13°–72°), and that measured by the surgeon was 38.6° (<em>r</em>: 11°–66°). The mean tibial torsion on the lower limbs radiograph according to Arc Cosine Alpha was 40.4° (<em>r</em>: 0°–68°).The interobserver variability between the CT measurements of the radiologist and surgeon for the condylo-malleolar angle was 6° (ICC 0.8). The variation between the CT measurements and the radiological measurement was 4° (ICC 0.65). Comparisons of the clinical measurement (thigh-foot angle) with the CT and radiological measurements were inaccurate and highly variable.</div></div><div><h3>Conclusions</h3><div>A simple X-ray of the limbs allows tibial torsion measurement. The results are very similar to the values condylar-maleolar angle obtained by CT. It is a way to minimize exposure to ionizing radiations, mainly in children. It is a quick tool to evaluate external rotation in pre or post-surgical treatment.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 3","pages":"Pages T183-T189"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784620","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":"Análisis radiográfico para la elección de tornillos endomedulares en fijación de fracturas de metacarpianos en población colombiana","authors":"J.R. Gaviria García ,&nbsp;S.J. Gómez ,&nbsp;J.A. Londoño ,&nbsp;C.J. Romero Barreto ,&nbsp;J.H. Donado Gómez ,&nbsp;M.S. Rivera","doi":"10.1016/j.recot.2025.11.013","DOIUrl":"10.1016/j.recot.2025.11.013","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the variability in normal anatomical parameters of the second to fifth metacarpals according to age and sex, and to compare the results with the dimensions of the intramedullary screws available in Colombia for the fixation of metacarpal fractures.</div></div><div><h3>Methodology</h3><div>This was an observational, descriptive, retrospective study. Normal PA and oblique radiographs were taken from 188 patients. The variables age, sex, length, isthmus diameter, isthmus distance, head width, dorsal lateral entry distance, and bicortical isthmus diameter were measured from the second to fifth metacarpals. The results will be presented stratified by age and sex as follows: 18–44 years, 45–64 years, and ≥65 years, and compared with the screws available for intramedullary fixation of the metacarpals.</div></div><div><h3>Results</h3><div>In total, images were studied from 188 patients with a mean age of 52.5 years. The index metacarpal was the longest on average, measuring 64.71<!--> <!-->mm. The mean distance from the metacarpal head to the isthmus was greatest in the index finger (38.21<!--> <!-->mm), followed by the middle finger (37.18<!--> <!-->mm). A wide range of isthmus diameters was found, with a minimum of 0.1<!--> <!-->mm in a ring finger and a maximum of 6.4<!--> <!-->mm in a middle finger. The proportion of the dorsal entry point distance in the oblique projection ranged from 0.29 to 0.33 of the total head width. Only one manufacturer's screws came in lengths between 20<!--> <!-->mm and 70<!--> <!-->mm and diameters between 1.8<!--> <!-->mm and 3.0<!--> <!-->mm; the remaining manufacturers produced screws less than 40<!--> <!-->mm in length.</div></div><div><h3>Conclusions</h3><div>This study represents the first investigation to analyze the anatomical characteristics of the metacarpals in the Colombian population and compare them with the intramedullary screws available in the country. It seeks to provide surgeons with guidance for surgical planning in the context of fracture fixation with intramedullary screws.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 3","pages":"Pages 233-239"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784154","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":"ChatGPT frente a un examen teórico de Cirugía Ortopédica y Traumatología: valor clínico y educativo","authors":"O. Pujol ,&nbsp;M. Guzmán ,&nbsp;C. Álvaro ,&nbsp;J. Leal ,&nbsp;J. Minguell ,&nbsp;N. Joshi","doi":"10.1016/j.recot.2025.10.001","DOIUrl":"10.1016/j.recot.2025.10.001","url":null,"abstract":"<div><h3>Introduction</h3><div>ChatGPT, a generative artificial intelligence (AI) chatbot, represents a potential tool to support diagnosis, decision-making, and education in Orthopaedic Surgery and Traumatology (OST). The primary aim of this study was to evaluate the ability of ChatGPT-4o to answer questions from a theoretical exam designed for OST residents. The secondary aim was to compare the chatbot's score and response patterns with those of residents, stratified by years of training.</div></div><div><h3>Methods</h3><div>This was a retrospective observational study. A theoretical OST exam administered in 2024 to residents at a Spanish tertiary hospital was analyzed. The exam comprised 48 multiple-choice questions (10 including images) across different subspecialties. The responses of ChatGPT-4o and the residents were recorded to compare accuracy rates. In addition, the ability to correctly answer questions was analyzed according to topic and association with images.</div></div><div><h3>Results</h3><div>ChatGPT-4o correctly answered 34 out of 48 questions (71%). Its accuracy rate was higher than the average of OST residents (67%), achieving a score comparable to fifth-year residents (70%). However, its performance was notably lower in image-based clinical or radiological questions (30% accuracy).</div></div><div><h3>Conclusion</h3><div>ChatGPT-4o is capable of answering questions from a theoretical OST examination, achieving a score higher than the average of OST residents and comparable to that of the most experienced residents (fifth-year). However, the error rate was 29.2%, with a notably lower accuracy in questions involving images and those requiring complex clinical reasoning. The use of this AI model cannot replace the expertise and reasoning of medical professionals.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 3","pages":"Pages 214-218"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784542","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":"[Artículo traducido] Lipocalina-2 en líquido sinovial como biomarcador de infección protésica articular crónica: validación prospectiva en revisiones de artroplastia de cadera y rodilla","authors":"A. Alías ,&nbsp;J.A. Fernández-Valencia ,&nbsp;J.C. Martínez-Pastor ,&nbsp;M. Sabater-Martos ,&nbsp;E. Tornero ,&nbsp;A. Vergara ,&nbsp;A. Combalia ,&nbsp;L. Morata ,&nbsp;A. Soriano ,&nbsp;E. Muñoz-Mahamud","doi":"10.1016/j.recot.2026.02.007","DOIUrl":"10.1016/j.recot.2026.02.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Diagnosing prosthetic joint infection (PJI) remains challenging, as no single test can definitively confirm or rule out infection. Current diagnostic criteria rely on a combination of clinical, laboratory, and microbiological data. Lipocalin-2 (LCN2) has emerged as a potential biomarker for PJI, particularly in acute cases. However, its diagnostic role in chronic PJI and aseptic failures is not well established. This study aimed to evaluate the diagnostic performance of synovial LCN2 in chronic PJI.</div></div><div><h3>Material and methods</h3><div>We conducted a prospective study of patients undergoing revision total hip or knee arthroplasty between April 2022 and April 2023. Cases were initially classified preoperatively as aseptic or septic according to the European Bone and Joint Infection Society (EBJIS) criteria, based on the tests available before surgery. After surgery, the EBJIS criteria were reapplied to establish the final diagnosis. Synovial LCN2 levels were compared between groups, and diagnostic performance was assessed using receiver operating characteristic (ROC) curve analysis.</div></div><div><h3>Results</h3><div>Of 125 patients undergoing revision surgery, 110 were included in the final analysis after excluding those with insufficient synovial fluid for LCN2 quantification. The median age was 75.0 years (IQR 68.0–81.0), and 65 patients (59.1%) were female. Based on preoperative evaluation, 90 cases (81.8%) were classified as aseptic failures and 20 (18.2%) as chronic PJI. However, according to the EBJIS criteria, 77 cases (70.0%) were ultimately diagnosed as aseptic and 33 (30.0%) as PJI. An LCN2 threshold of 266<!--> <!-->ng/mL was identified as the optimal cut-off for diagnosing PJI, showing a significant association with both the preoperative diagnosis of infection (<em>p</em> <!-->=<!--> <!-->0.012) and the definitive postoperative diagnosis (<em>p</em> <!-->=<!--> <!-->0.001). Elevated LCN2 levels were also significantly associated with increased serum C-reactive protein (CRP) levels (<em>p</em> <!-->=<!--> <!-->0.02). There were 13 cases with discordant diagnoses: initially considered aseptic but ultimately confirmed as septic. Among these, 9 cases (69.2%) exhibited elevated LCN2 levels.</div></div><div><h3>Conclusion</h3><div>Synovial fluid LCN2 is a promising biomarker for the diagnosis of chronic PJI, especially in cases initially misclassified as aseptic. Its strong association with the final diagnosis of infection highlights its potential to enhance diagnostic accuracy. Further prospective studies are needed to confirm these findings and support the incorporation of LCN2 into routine clinical practice.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 3","pages":"Pages T200-T208"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784553","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] Radiographic analysis for the selection of intramedullary screws for fixation of metacarpal fractures in the Colombian population","authors":"J.R. Gaviria García ,&nbsp;S.J. Gómez ,&nbsp;J.A. Londoño ,&nbsp;C.J. Romero Barreto ,&nbsp;J.H. Donado Gómez ,&nbsp;M.S. Rivera","doi":"10.1016/j.recot.2026.02.015","DOIUrl":"10.1016/j.recot.2026.02.015","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the variability in normal anatomical parameters of the second to fifth metacarpals according to age and sex, and to compare the results with the dimensions of the intramedullary screws available in Colombia for the fixation of metacarpal fractures.</div></div><div><h3>Methodology</h3><div>This was an observational, descriptive, retrospective study. Normal PA and oblique radiographs were taken from 188 patients. The variables age, sex, length, isthmus diameter, isthmus distance, head width, dorsal lateral entry distance, and bicortical isthmus diameter were measured from the second to fifth metacarpals. The results will be presented stratified by age and sex as follows: 18–44 years, 45–64 years, and ≥65 years, and compared with the screws available for intramedullary fixation of the metacarpals.</div></div><div><h3>Results</h3><div>In total, images were studied from 188 patients with a mean age of 52.5 years. The index metacarpal was the longest on average, measuring 64.71<!--> <!-->mm. The mean distance from the metacarpal head to the isthmus was greatest in the index finger (38.21<!--> <!-->mm), followed by the middle finger (37.18<!--> <!-->mm). A wide range of isthmus diameters was found, with a minimum of 0.1<!--> <!-->mm in a ring finger and a maximum of 6.4<!--> <!-->mm in a middle finger. The proportion of the dorsal entry point distance in the oblique projection ranged from 0.29 to 0.33 of the total head width. Only one manufacturer's screws came in lengths between 20<!--> <!-->mm and 70<!--> <!-->mm and diameters between 1.8<!--> <!-->mm and 3.0<!--> <!-->mm; the remaining manufacturers produced screws less than 40<!--> <!-->mm in length.</div></div><div><h3>Conclusions</h3><div>This study represents the first investigation to analyse the anatomical characteristics of the metacarpals in the Colombian population and compare them with the intramedullary screws available in the country. It seeks to provide surgeons with guidance for surgical planning in the context of fracture fixation with intramedullary screws.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 3","pages":"Pages T233-T239"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784576","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] Survival of tantalum-coated stems in primary hip arthroplasty during long term follow-up: A retrospective study","authors":"I. SanJosé-Pardo,&nbsp;M. Baruque-Astruga,&nbsp;C.A. Mora-Simón,&nbsp;J.D. Pérez-López,&nbsp;J. Mingo-Robinet,&nbsp;A. Alonso-Recio,&nbsp;M. González-Rodríguez","doi":"10.1016/j.recot.2026.02.012","DOIUrl":"10.1016/j.recot.2026.02.012","url":null,"abstract":"<div><h3>Background and objective</h3><div>Porous tantalum offers excellent osteointegration and bone growth over the implant, in addition to a physiological load transfer with reduced bone resorption. However, there is limited literature on the survival of tantalum-coated femoral stems. The objective of this study is to evaluate the outcomes in terms of survival of a tantalum-coated stem in the context of primary total hip arthroplasty (THA).</div></div><div><h3>Materials and methods</h3><div>A retrospective study was conducted on all patients who underwent primary THA between 2006 and 2009 at a single center, where a tantalum-coated femoral stem Trabecular Metal™ Taper (TMT) was implanted. The radiological evaluation included the positioning of the stem, radiolucent lines, osteolysis, and subsidence of the femoral stem. A Kaplan–Meier survival analysis was performed to calculate implant survival, considering revision of the femoral stem as well as revision for any reason as the endpoint.</div></div><div><h3>Results</h3><div>A total of 28 stems (14.2%) showed radiolucent lines during follow-up. However, no cases of subsidence greater than 3<!--> <!-->mm were identified. During a medium follow-up of 12.7 years, a total of 8 patients (4.1%) required revision surgery. The survival rate of the stems was 99.0% at 15 years follow-up. Implant survival for any reason was 96.0% at 15 years follow-up.</div></div><div><h3>Conclusions</h3><div>This study suggests that tantalum-coated stems offer excellent medium- to long-term survival in primary THA for aseptic loosening, with low rates of stem-specific revisions as well as revisions for any cause.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 3","pages":"Pages T190-T199"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784558","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] Effectiveness comparison of pediatric tibial spine fractures fixation techniques. A systematic review","authors":"C. Velandia-Amaya ,&nbsp;E. Vergara-Amador","doi":"10.1016/j.recot.2026.02.016","DOIUrl":"10.1016/j.recot.2026.02.016","url":null,"abstract":"<div><div>Tibial spine fractures are uncommon injuries, with a peak incidence between 8 and 14 years of age. Meyers and McKeever types II to IV are often managed surgically using a variety of techniques and fixation devices, depending on the fracture characteristics and the surgeon's expertise. The aim of this review is to analyze current evidence regarding functional outcomes across different surgical techniques. A systematic review was conducted using MeSH, Emtree, DeCS, Free Terms, and Boolean Operators across three databases. Data on trauma characteristics, patient demographics, and main outcomes for each fixation device were extracted and subjected to a descriptive analysis. From 88 records, 14 studies were included based on the eligibility criteria. Additionally, 2 studies were manually added from the references of included papers. The rate of arthrofibrosis was 15.9% for open surgery and 21% for arthroscopy-assisted techniques. A total of 6 different fixation methods were identified, with arthrofibrosis, residual laxity, nonunion, and range of motion limitations all reported in less than 10% of cases. Functional outcomes for all fixation methods were rated as good to excellent according to the Lysholm score. The main outcomes across different fixation devices are favorable and do not show significant differences. However, non-absorbable fixation methods were associated with a higher rate of reintervention. Larger, more robust epidemiological studies are needed to definitively recommend one fixation method over another.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 3","pages":"Pages T240-T247"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784506","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":"[Artículo traducido] El uso de fijación estática y dinámica con clavo intramedular para fracturas no conminutas de la diáfisis femoral no presenta diferencias estadísticamente significativas en las tasas de no unión","authors":"J. Laso ,&nbsp;T. Pineda ,&nbsp;P. Innocenti ,&nbsp;R. Olivieri ,&nbsp;N. Franulic ,&nbsp;D. Valiente ,&nbsp;C. Rojas ,&nbsp;N. Gaggero","doi":"10.1016/j.recot.2026.02.008","DOIUrl":"10.1016/j.recot.2026.02.008","url":null,"abstract":"<div><h3>Objectives</h3><div>The objective of our study was to evaluate whether static or dynamic fixation mode in non-comminuted femoral shaft fractures treated with intramedullary nail (IMN) exhibits differences in terms of nonunion. We hypothesize that there is no difference between both groups.</div></div><div><h3>Methods</h3><div><em>Design</em>: Retrospective. <em>Setting</em>: Level 1 trauma center. <em>Patient selection criteria</em>: Patients treated for femoral shaft fractures with IMN. Exclusion criteria included age under 18 years old, polytrauma patients, open fractures, periprosthetic fractures, pathologic fractures, associated lower extremity fractures, fractures involving joint extension, bilateral femoral fractures, or comminuted fractures. <em>Outcome measures and comparisons</em>: The primary outcome was the nonunion rate, defined as either a lack of progression in the radiographic femoral RUST score between two consecutive intervals starting at 6 months or a RUST score of less than 9 points at 12 months. The secondary outcome consists of nonunion rate analysis between groups based on Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) classification subgroups.</div></div><div><h3>Results</h3><div>In total 75 patients with the same number of fractures were included with a mean age of 33.5 years (SD 13.11). Thirty-seven (49.3%) patients received statically locked fixation and 38 (50.7%) patients received dynamically locked fixation. The overall nonunion rate was 9.3%, with no significant differences between groups (<em>p</em> <!-->=<!--> <!-->0.219). Union rates across the AO/OTA classification groups showed statistically significant differences (<em>p</em> <!-->=<!--> <!-->0.036). However, no differences were observed for the AO/OTA-A (<em>p</em> <!-->=<!--> <!-->0.423) and AO/OTA-B (<em>p</em> <!-->=<!--> <!-->0.221) groups when subgroup analysis by locking mode was performed. Good interobserver (ICC<!--> <!-->=<!--> <!-->0.832; 95% CI<!--> <!-->=<!--> <!-->0.66–0.92) and intraobserver (ICC<!--> <!-->=<!--> <!-->0.881; 95% CI<!--> <!-->=<!--> <!-->0.79–0.93) reliability of femoral RUST score was found.</div></div><div><h3>Conclusion</h3><div>No significant differences were found in overall nonunion rates between static and dynamic locking IMN fixation in non-comminuted femoral shaft fractures. Similarly, no differences were observed in fixation type when analyzing the AO/OTA-A or -B subgroups separately.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 3","pages":"Pages T209-T213"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784613","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":"Supervivencia de vástagos recubiertos de tantalio en la artroplastia primaria de cadera durante un seguimiento a largo plazo: un estudio retrospectivo","authors":"I. SanJosé-Pardo,&nbsp;M. Baruque-Astruga,&nbsp;C.A. Mora-Simón,&nbsp;J.D. Pérez-López,&nbsp;J. Mingo-Robinet,&nbsp;A. Alonso-Recio,&nbsp;M. González-Rodríguez","doi":"10.1016/j.recot.2025.09.003","DOIUrl":"10.1016/j.recot.2025.09.003","url":null,"abstract":"<div><h3>Background and objective</h3><div>Porous tantalum offers excellent osteointegration and bone growth over the implant, in addition to a physiological load transfer with reduced bone resorption. However, there is limited literature on the survival of tantalum-coated femoral stems.</div><div>The objective of this study is to evaluate the outcomes in terms of survival of a tantalum-coated stem in the context of primary total hip arthroplasty (THA).</div></div><div><h3>Materials and methods</h3><div>A retrospective study was conducted on all patients who underwent primary THA between 2006 and 2009 at a single center, where a tantalum-coated femoral stem Trabecular Metal™ Taper (TMT) was implanted.</div><div>The radiological evaluation included the positioning of the stem, radiolucent lines, osteolysis, and subsidence of the femoral stem. A Kaplan-Meier survival analysis was performed to calculate implant survival, considering revision of the femoral stem as well as revision for any reason as the endpoint.</div></div><div><h3>Results</h3><div>A total of 28 stems (14.2%) showed radiolucent lines during follow-up. However, no cases of subsidence greater than 3<!--> <!-->mm were identified.</div><div>During a medium follow-up of 12.7 years, a total of 8 patients (4.1%) required revision surgery. The survival rate of the stems was 99.0% at 15 years follow-up. Implant survival for any reason was 96.0% at 15 years follow-up.</div></div><div><h3>Conclusions</h3><div>This study suggests that tantalum-coated stems offer excellent medium- to long-term survival in primary THA for aseptic loosening, with low rates of stem-specific revisions as well as revisions for any cause.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 3","pages":"Pages 190-199"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784184","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}