Revista Espanola de Cirugia Ortopedica y Traumatologia最新文献

{"title":"[Translated article] Clinical and radiological outcomes when using standard versus retentive polyethylene humeral cups in Delta III reverse shoulder arthroplasty.","authors":"Manuel Zafra Gómez, Pilar Uceda Carrascosa, Luis E Gracia Delgado, Sergio González Andreu, Pilar Font Ugalde","doi":"10.1016/j.recot.2026.10.012","DOIUrl":"https://doi.org/10.1016/j.recot.2026.10.012","url":null,"abstract":"<p><strong>Background: </strong>The most common postoperative complication relating to reverse total shoulder arthroplasty (RTSA) is instability. The risk factors for luxation include a lack of the subscapularis tendon or inadequate soft tissue tension, the prosthetic design, the bone deficiency, the obesity, and mechanical factors such as bone impingement and implant position.. To prevent this luxation, we can insert a retentive polyethylene humeral cup, The purpose of this study was to evaluate the clinical outcomes, the incidence of luxation and scapular notching between standard versus retentive polyethylene humeral cups in Delta III RTSA.</p><p><strong>Materials and methods: </strong>51 patients with rotator cuff insufficiency and osteoarthritis who underwent primary Delta III PIH using a standard and retentive polyethylene humeral cup were retrospectively reviewed between September 2018 and December 2023. The main indication for placing the retentive polyethylene was the complete and irreparable chronic rupture of the subscapularis tendon with impossibility of reinsertion and with muscle atrophy. The average follow-up was 42,4 months (41,6 and 44,3 months respectively) Results. 51 patients were reviewed: 35 with standard humeral cups and 16 with retentive polyethylene humeral cups. We found no prosthesis luxation in either of the two study groups and there were no differences in forward flexion, abduction or internal rotation between the two groups at the end of the follow-up. There was a lower mean for external rotation in the retentive polyethylene humeral cup group (average,36.3 ± 11,6 vs 28,7 ±10,9) but it was not statistically significant. There was no statistical difference in the postoperative Constant score at the end of the follow-up. The incidence of scapular notching was 62.8 % and 62.5 % for the standard and retentive polyethylene humeral cups, respectively.</p><p><strong>Conclusion: </strong>The Delta III rTSA using either a standard or retentive polyethylene humeral cups provide functional improvement and pain relief. There were no differences between the two groups in clinical mobility, forward flexion, abduction, internal rotation, external rotation, incidence of luxation and scapular notching Level of evidence: Level III; Retrospective Cohort Comparison; Treatment Study.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229026","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 the diagnosis of a musculoskeletal sarcoma and its treatment outcomes on patients' mood, anxiety, quality life and coping strategies.","authors":"Paula Casas Ramos, Elena Ramos García, Elena Vacas Sánchez, Cristina Martín-Arriscado Arroba, Gabriel Rubio Valladolid, Luis Rafael Ramos Pascua","doi":"10.1016/j.recot.2026.10.015","DOIUrl":"https://doi.org/10.1016/j.recot.2026.10.015","url":null,"abstract":"<p><p>Background/objectives Cancer negatively impacts the physical, psychological, social, and spiritual dimensions of individuals. In musculoskeletal sarcomas, medical care prioritizes somatic aspects. The primary objective was to assess the impact of a musculoskeletal sarcoma diagnosis on anxiety, depression, and health-related quality of life (HRQoL). Secondary objectives included analyzing the one-year evolution of these variables and the predominant coping profile. Methods A prospective multicenter study with a concurrent control group (116 cases with musculoskeletal sarcomas and 67 controls with benign tumors) was conducted. The HADS and GAD-7 scales were administered to assess depression and anxiety, the QLQ-C30 to evaluate HRQoL, and the CERQ to assess coping strategies, with reassessment in the cases group one year after diagnosis. Outcomes were compared between groups, along with their evolution and the influence of epidemiological, demographic, sociolabor, oncological, functional (MSTS), and health-related variables. Results At diagnosis, cases showed higher prevalence of anxiety (64.7% vs. 40.3%; p = 0.005) and poorer HRQoL (62.1 ± 21.0 vs. 69.4 ± 22.8; p = 0.019) than controls, with no differences in depression. Anxiety and depression were associated with tumor stage (p = 0.01), increasing in advanced stages. In the cases group, anxiety significantly decreased after one year (β = -1.51; 95% CI: -2.38 to -0.63; p = 0.001). Oncological and functional outcomes were negatively associated with emotional evolution and QoL. An adaptive coping style predominated in 71% of patients. Conclusions Most patients with musculoskeletal sarcomas develop adaptive coping styles. However, emotional disturbances and their association with oncological and functional outcomes justify comprehensive interventions that include psychological care.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229011","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] Carta al director con relación al artículo: «ChatGPT frente a un examen teórico de Cirugía Ortopédica y Traumatología: valor clínico y educativo».","authors":"Fernando Canillas Del Rey, Marta Canillas Arias","doi":"10.1016/j.recot.2026.10.011","DOIUrl":"https://doi.org/10.1016/j.recot.2026.10.011","url":null,"abstract":"","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228977","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] One foot in myth, the other in science: beliefs and realities on the impact of climate on foot and ankle surgery.","authors":"Cristóbal Suárez Rueda, María Herrera Abián, Ana González Jiménez, Irene Portellano Pascual, José Luis Sopesén Veramendi","doi":"10.1016/j.recot.2026.10.007","DOIUrl":"https://doi.org/10.1016/j.recot.2026.10.007","url":null,"abstract":"<p><p>Introduction Beliefs about the influence of climate on wound healing in foot and ankle surgery are common among patients and healthcare professionals. This study assesses the prevalence of this belief and contrasts these perceptions with clinical data. Material and methods Observational retrospective cohort study, complemented by a cross-sectional perception survey. The survey collected 527 responses from physicians, nursing staff, and the general population. The surgical cohort included 488 patients operated on in Madrid between 2019 and 2025. The number of nursing wound care visits within three months post-surgery was used as an indirect variable for complications. Chi-square (χ²), ANOVA, and linear regressions were applied to the main variable, which was log-transformed. Results 70.4% of respondents believed summer increases complications, 21.3% pointed to winter, and 68.3% to humidity/rain. Nursing staff showed a higher degree of belief in these associations. No significant differences were found in the number of wound care visits between seasons (p = 0.071). Although regressions showed a statistically significant association with temperature (p = 0.014 and p = 0.036), the low determination coefficient (R² = 0.0124) indicated clinical irrelevance. No association was found with precipitation or day of the year. Discussion This study demonstrates a marked contrast between social and professional perception and clinical evidence. Despite the widespread belief that climate influences wound healing, the data do not support this in foot and ankle surgery.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229024","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] Coronal and rotational femoral anatomy in a Spanish cohort: Anatomical description and surgical implications for total knee arthroplasty.","authors":"Oriol Pujol, Pedro Hinarejos, Albert Pons, Ernest Famada, Angela Zumel, Matías Novillo, Juan Erquicia, Joan Leal-Blanquet","doi":"10.1016/j.recot.2026.10.003","DOIUrl":"https://doi.org/10.1016/j.recot.2026.10.003","url":null,"abstract":"<p><p>Purpose The primary objective is to analyse the distribution of three femoral anatomical parameters in a Spanish osteoarthritic population using CT-based measurements: (1) anatomical-mechanical axis (AA-MA), (2) posterior condylar-transepicondylar axis (PCA-TEA) and (3) lateral distal femoral angle (LDFA). The secondary objective is to assess the surgical relevance of these findings in TKA. Methods It is a multicentric cross-sectional observational study. Preoperative CT-scans of 318 patients from a Spanish cohort were analysed to determine AA-MA, PCA-TEA and LDFA. Then, femoral implant positioning was simulated as 5° of valgus from the AA and 3° of external rotation from the PCA. For each patient, this simulated positioning was compared to the theoretical mechanical alignment target. Finally, the native femoral JLO (LDFA) of each patient was compared to the mechanical alignment target (90°). Results Mean AA-MA relationship was 6.0° ± 0.9°, mean PCA-TEA angle was 3.1° ± 1.8° and mean native LDFA was 87.3° ± 2.9°. Positioning the femoral component systematically at 5° of valgus from the AA and 3° of external rotation from the PCA would result in 74.7% of implants being placed in varus and 46.1% in internal rotation from the TEA. Moreover, mechanically alignment would produce a more varus femoral JLO than the native LDFA in 78.1% of patients. Conclusions There is considerable variability in femoral anatomy within the osteoarthritic Spanish population. The 6.7% of patients had AA-MA values outside the 5-7° range. The 41.8% of patients showed PCA-TEA angles smaller than 2° or greater than 4°. The 30.6% of LDFA were outside the 85-90° interval. Simulating a femoral component positioned using only AA and PCA references was associated with deviations from the intended mechanical alignment, most commonly resulting in varus deviation and internal rotation from the TEA.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228982","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] Accuracy of the Akmese sign as a diagnostic method for posterior root tears of the medial meniscus in Peruvian healthcare facilities.","authors":"Stefany M Paucar-Vergara, Joseph S Urdanivia-Martos, Carlos J Toro-Huamanchumo","doi":"10.1016/j.recot.2026.10.010","DOIUrl":"https://doi.org/10.1016/j.recot.2026.10.010","url":null,"abstract":"<p><p>Background Medial meniscus injuries are the most prevalent knee injuries, frequently causing pain, instability, and orthopaedic surgeries. Although several clinical tests are used for meniscal pathology, most were developed for general meniscal lesions rather than specifically for medial meniscus posterior root tears (MMPRT). Evidence on root-specific physical examination signs remains limited. Recently, the Akmese manoeuvre has been introduced as a non-invasive diagnostic tool, assessing pain or tenderness during physical examination. This study aimed to determine the accuracy of the Akmese sign for the clinical diagnosis of MMPRT. Methods This prospective cohort diagnostic study included patients aged 18-55 years scheduled for arthroscopic surgery following a clinical diagnosis of medial meniscus injury between January 2022 and July 2023. Diagnostic performance metrics, including sensitivity, specificity, positive and negative predictive values (PPV, NPV), and likelihood ratios (LR+, LR-), were calculated, using arthroscopy as the reference standard. The interobserver reliability of the Akmese manoeuvre was assessed using the kappa coefficient. Results A total of 201 individuals met the eligibility criteria, with a mean age of 38.4 ± 9.8 years. The Akmese sign was positive in 26 patients, and MMPRT was confirmed by arthroscopy in 28 patients. The Akmese sign demonstrated a sensitivity of 85.7%, specificity of 98.8%, PPV of 92.3%, NPV of 97.7%, LR+ of 74.1, and a LR- of 0.15. Conclusion In this selected surgical population, the Akmese manoeuvre showed promising diagnostic performance and very good interobserver reliability for identifying MMPRT. The sign may be useful as an adjunctive clinical tool to support preoperative suspicion, targeted MRI review, and surgical planning, but it should not be considered a replacement for MRI or arthroscopic assessment.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229040","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] Outcomes of metastasectomy in patients with solitary bone metastases: Experience from a cancer center in Bogotá, Colombia.","authors":"Gabriel Andrés Narváez Rodríguez, Andrea Juliana Hernández Caicedo, Juan Fernando Chaustre Flórez, Camilo Soto-Montoya, Andrea Franco-Betancur, Luis Carlos Gómez Mier","doi":"10.1016/j.recot.2026.10.004","DOIUrl":"https://doi.org/10.1016/j.recot.2026.10.004","url":null,"abstract":"<p><p>Introduction Solitary bone metastases represent a major clinical challenge. Surgical metastasectomy remains a valid option in selected patients. This study evaluated the oncologic and functional outcomes following metastasectomy in a cancer referral centre in Bogotá, Colombia. Methods A retrospective observational study including patients with solitary bone metastases who underwent metastasectomy between January 2004 and March 2024. Demographic, clinical, and surgical data were collected. Postoperative functionality was assessed using the MSTS score. Local recurrence, disease progression, and survival were analysed with a minimum follow-up of 12 months. Kaplan-Meier and log-rank tests were used when appropriate. Results Thirty patients (73.3% female) were included, with a mean age of 60.4 ± 10.9 years. The most common primary tumors were renal (26.7%) and breast (16.7%). The predominant surgical technique was endoprosthetic reconstruction (50%). Postoperative complications occurred in 40% (12/30), mainly infections (41%). Among 13 patients with recorded functionality, the moderate MSTS category was most common (53.8%), with no significant associations found with the evaluated clinical or surgical variables (all p > 0.05). During follow-up, 19 patients (63%) developed metastatic progression, 2 (6.7%) developed local recurrence, and 11 (36.6%) remained progression-free. The overall survival rate at 12 months was 65%, with a median follow-up of 12 months (IQR: 12-36). Conclusion Metastasectomy in patients with solitary bone metastases appears to be a feasible and safe approach, associated with favorable functional outcomes and low rates of local recurrence in this cohort. Its role should be considered within a multidisciplinary context in carefully selected patients.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229048","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] Comparative analysis between intramedullary screw fixation and plate osteosynthesis in midshaft clavicle fractures: surgical efficiency and functional outcomes in contact athletes.","authors":"G A Tafoya-Arreguin, R D Esqueda-Godoy, S Magallon-Jaimes, J J Martinez-Ruiz, C O Sepulveda-Cadena","doi":"10.1016/j.recot.2026.10.008","DOIUrl":"https://doi.org/10.1016/j.recot.2026.10.008","url":null,"abstract":"<p><strong>Background: </strong> Plate fixation is the current gold standard for displaced midshaft clavicle fractures, despite concerns regarding surgical morbidity and implant prominence. The purpose of this study was to compare the clinical, radiographic, and surgical outcomes of an intramedullary screw system versus conventional plate fixation.</p><p><strong>Methods: </strong> A comparative cohort study was performed on 72 patients (36 treated with the Screw system and 36 with plate fixation). Surgical variables (time and blood loss), radiographic consolidation (at 4, 8, and 12 weeks), and functional outcomes (DASH and Constant-Murley scores) were analyzed. Statistical significance was set at p < .05.</p><p><strong>Results: </strong> The Screw group demonstrated a significantly shorter operative time (27.69+/- 9.39 vs. 105.47 +/- 55.18 minutes; p<.001) and minimal blood loss (10 vs. 228.33 ml; p<.001). Functional recovery was significantly faster in the DualTrack group, with an earlier return to physical activity (6.64 vs. 21.69 weeks; p<.001) and superior Constant scores (98.64 vs. 94.81; p = .0006). Radiographically, the screw group showed significantly lower fracture line visibility at 8 and 12 weeks compared to the plate group (p<.05). Complication rates were lower for the screw group (8.3%) than for the plate group (25.0%), although this did not reach statistical significance (p=.11).</p><p><strong>Conclusion: </strong> The intramedullary system is a highly effective alternative for clavicle fractures, providing superior surgical efficiency, faster functional recovery, and improved biological healing compared to conventional plate fixation. It should be considered a primary treatment option, particularly for patients seeking a rapid return to activity and minimally invasive surgery.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228980","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] Prevention of hip fractures in the elderly: A public health problem. I. Basic science.","authors":"E Guerado, J M Gómez-Palomo, D González-Quevedo, J R Cano, J M Sánchez-Siles, I Tamimi","doi":"10.1016/j.recot.2026.09.003","DOIUrl":"10.1016/j.recot.2026.09.003","url":null,"abstract":"<p><p>Hip fractures in the elderly constitute a severe public health problem. Its primary cause is a fall due to sarcopenia, sensory impairments, polypharmacy, or architectural barriers, among other factors. Prevention is based on correcting these factors, engaging in regular physical exercise, and maintaining adequate nutrition throughout life to acquire efficient muscle mass that declines as little as possible during old age and achieve peak bone mass, although bone mass will gradually decrease with age. This paper, in two parts (I. Basic science and II. Interventions), analyzes prevention, with particular attention to sarcopenia, bone fragility, and socioeconomic status.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149065213","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":"Investigación colaborativa en Cirugía Ortopédica y Traumatología (COT): experiencia, oportunidades y problemas.","authors":"Enrique Gómez Barrena","doi":"10.1016/j.recot.2026.09.002","DOIUrl":"https://doi.org/10.1016/j.recot.2026.09.002","url":null,"abstract":"","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002299","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}