Revista Espanola de Cirugia Ortopedica y Traumatologia最新文献

{"title":"Update on the treatment of acute infections in knee prostheses: Is it possible to retain the components? An in-depth look at the DAIR procedure.","authors":"R Calvo Rodriguez, J Isla Villanueva, D Edwards Silva, H Cifuentes Aedo","doi":"10.1016/j.recot.2024.12.001","DOIUrl":"10.1016/j.recot.2024.12.001","url":null,"abstract":"<p><strong>Introduction: </strong>Periprosthetic knee infections are serious complications after knee arthroplasty, affecting 1 to 2% of patients with primary surgery and up to 20% of revisions. The DAIR strategy (debridement, antibiotics, and implant retention) has emerged as a treatment for acute infections, allowing component retention in certain cases, with a high success rate.</p><p><strong>Objectives: </strong>This review discusses its application, success factors, techniques such as the «double DAIR» and postoperative management, highlighting the importance of correct patient selection and the combination of a thorough and meticulous surgical technique with appropriate antibiotic therapy to optimize results.</p><p><strong>Methods: </strong>An exhaustive updated literature search was conducted regarding the use of DAIR in acute periprosthetic infections, highlighting the step-by-step procedure and some surgical tips that are helpful when performing it. Based on this, recommendations were made for physicians interested in the subject.</p><p><strong>Results: </strong>A series of recommendations are made based on current literature, which are a useful guide when dealing with patients with acute infections in the context of knee prostheses, with a success rate greater than 70% in most cases where the patient is well selected.</p><p><strong>Conclusions: </strong>DAIR is a useful and effective tool in the eradication and treatment of acute periprosthetic infections, with a good success rate. It is a cheap, technically simple and reproducible procedure, so as a group, we suggest it be adopted globally by orthopedic surgeons.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792487","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] La lesión del hueso subcondral no influye en los resultados clínicos a 12 semanas en los pacientes tratados con plasma rico en plaquetas intraarticular por artrosis de rodilla: estudio retrospectivo.","authors":"Ricardo Escribano Rey","doi":"10.1016/j.recot.2024.11.020","DOIUrl":"https://doi.org/10.1016/j.recot.2024.11.020","url":null,"abstract":"<p><strong>Objective: </strong>To determine if subchondral bone damage can influence the clinical results of intraarticular platelet-rich-plasma (PRP) treatment in knee osteoarthritic patients.</p><p><strong>Material and methods: </strong>A retrospective review of patients treated with intraarticular PRP injections for knee osteoarthritis who previously underwent a Magnetic Resonance (MR) of the knee was performed. Visual Analogic Score (VAS) was assesed for pain, whereas WORMS MR score was adapted to assess the damage to the subchondral bone (WORMSsc score).</p><p><strong>Results: </strong>Sixty-one patients were treated with 3 weekly injections of PRP. Mean VAS reduction was 27.67 ± 13.13 points (P<.005). WORMS sc mean score was 32 ± 18.5 points. NO correlation between WORMSsc and VAS was found. A moderate correlation between WORMSsc score and Preoperative VAS was found (r=.43; P<.005).</p><p><strong>Conclusion: </strong>There is no correlation between the damage to the subchondral bone assesed by MR and pain relief at 12 weeks in patients treated with intraarticular platelet-rich plasma in patients with knee osteoarthritis. A greater damage to the subchondral bone could be associated with more pain.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773360","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] Paresthesias on the lateral face of the forearm: A nervous injury that is difficult to recognize.","authors":"S Parra Escorihuela, A D Ghinea, Á Montero Sánchez, J Orenga Orenga","doi":"10.1016/j.recot.2024.11.019","DOIUrl":"10.1016/j.recot.2024.11.019","url":null,"abstract":"<p><p>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 aetiology 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.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773364","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] Epidemiology of musculoskeletal tumours in a reference unit.","authors":"J L Huguet Carmona, C De la Calva Ceinos, P González Rojo, A Ortega Yago, M Angulo Sánchez, J V Amaya Valero, J Ferràs Tarragó, F Baixauli García","doi":"10.1016/j.recot.2024.11.021","DOIUrl":"10.1016/j.recot.2024.11.021","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to perform an epidemiological analysis of patients presented to the Musculoskeletal Tumors Committee of a reference hospital.</p><p><strong>Material and method: </strong>A retrospective analysis of patients with sarcomas treated in a reference Sarcoma Unit between 2009 and 2022 was carried out.</p><p><strong>Results: </strong>A total of 1978 patients were analysed, of which 1477 (74.67%) were diagnosed as sarcomas. They were divided into 446 (30.20%) bone tumours and 1.031 (69.80%) soft tissue tumours. The most common benign bone tumour was enchondroma (27.23%), giant cell tumour (59.21%) was the most common tumour of intermediate malignancy and the malignant one was osteosarcoma (24.78%). The most frequently observed benign soft tissue tumour was lipoma (50.74%), the atypical lipomatous tumour (53.25%) was the most frequent tumour of intermediate malignancy and the malignant one was sarcoma of uncertain differentiation (38.10%).</p><p><strong>Conclusion: </strong>Our study represents the first work on the epidemiology of sarcomas and other musculoskeletal tumours in our country, being very useful to adapt the resources destined for their diagnosis and treatment.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773368","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] Influencia de los factores socioeconómicos y psicológicos en los resultados del tratamiento quirúrgico de la artrosis trapecio-metacarpiana.","authors":"A M Martín-Fuentes, C Ojeda-Thies, M Campoy-Serón, C Ortega-Romero, L R Ramos-Pascua, D Cecilia López","doi":"10.1016/j.recot.2024.11.022","DOIUrl":"https://doi.org/10.1016/j.recot.2024.11.022","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate to what extent people with carpometacarpal thumb osteoarthritis that are socioeconomically disadvantaged and have psychological disorders report higher pain levels and worse patient-rated upper-extremity functionality after surgical treatment.</p><p><strong>Material and method: </strong>A single center, retrospective observational cohort study analysing 100 patients diagnosed with thumb carpometacarpal osteoarthritis between 2013 and 2019. Patients were divided into two groups (50/50), depending on whether they received surgical or conservative treatment. The socio-economic status (ESeC classification) and presence of psychological comorbidities were investigated. Functional outcomes were assessed using the Visual Analogue Scale (VAS), Q-DASH questionnaire and Kapandji score. Current mental disorders were evaluated using STAI, PHQ-9 and PCS screening scales.</p><p><strong>Results: </strong>Measures of functional hand scores (Q-DASH) were higher and had considerably less pain in surgically treated participants, although thumb mobility (Kapandji) was more restricted. They were also associated with higher scores on psychological assessment scales. Sixty-four per cent of the patients came from lower socio-economic classes and suffered from poorer scores on the mental health screening questionnaires. Of the patients manage surgically, 54% were diagnosed of dysthymic disorder and showed significantly worse patient-rated upper-extremity function (Q-DASH questionnaire, median [IR]:31,8 [20,5-54,6] than patients without psychological disorders (median [IR]: 13,6 [2,3-36,5]). No differences were found for patients with and without disthymic disorder managed nonoperatively.</p><p><strong>Conclusions: </strong>Patients with higher rates of depression, anxiety and pain catastrophising behaviour showed significantly worse outcomes after surgery for osteoarthritis of the first carpometacarpal joint. Lower socio-economic class significantly influences levels of depression and anxiety but did not affect functional outcome. Surgical treatment of carpometacarpal thumb osteoarthritis achieved better self-perceived hand function (QDASH, VAS, Kapandji) than conservative treatment.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773328","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":"Digital orthopaedic surgery: Benefits and challenges of extended reality and spatial computing.","authors":"R Pérez-Mañanes, J A Calvo-Haro","doi":"10.1016/j.recot.2024.11.018","DOIUrl":"10.1016/j.recot.2024.11.018","url":null,"abstract":"","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755510","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 and the cartilaginous growth plate.","authors":"M J Delgado-Martos, B Quintana-Villamandos, E Delgado-Baeza","doi":"10.1016/j.recot.2024.11.017","DOIUrl":"10.1016/j.recot.2024.11.017","url":null,"abstract":"<p><p>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 Elements of Normal Histology and Micrographic Technique, 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.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-26","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] New times, same objectives.","authors":"M Herrera-Pérez","doi":"10.1016/j.recot.2024.11.016","DOIUrl":"10.1016/j.recot.2024.11.016","url":null,"abstract":"","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693780","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":"Correspondence \"Exploring the potential of artificial intelligence in traumatology: Conversational answers to specific questions\".","authors":"H Daungsupawong, V Wiwanitkit","doi":"10.1016/j.recot.2024.11.010","DOIUrl":"10.1016/j.recot.2024.11.010","url":null,"abstract":"","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630267","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":"Does plate fixation improve the Latarjet procedure for anterior glenohumeral instability?","authors":"A Portes, F Santana, C Torrens","doi":"10.1016/j.recot.2024.11.015","DOIUrl":"10.1016/j.recot.2024.11.015","url":null,"abstract":"<p><p>The Latarjet technique is a procedure used to treat anterior glenohumeral instability with glenoid bone loss. Various fixation systems for the coracoid have been described in the literature. This study aims to compare the results in quality of life and complications between patients treated with plate and screws (GP) and those with screws only (GSP) for coracoid fixation.</p><p><strong>Material and methods: </strong>A retrospective study including patients with anterior glenohumeral instability and glenoid bone loss treated with Latarjet at the same center between October 2009 and February 2021. A total of 85 shoulders were analyzed, of which 64 completed at least one year of follow-up. Patients with previous surgical history in the same shoulder, bone loss <10%, ligamentous hyperlaxity (Beighton score >6), and previous infections were excluded. Complications were recorded, and the WOSI and Rowe tests were used to assess quality of life and return to sports activity.</p><p><strong>Results: </strong>Of the 64 patients, 35 were treated with a plate (GP) and 29 with screws (GSP). The mean age was 30±8.78years. Both groups were statistically comparable. No significant differences were found in the WOSI test (P=.140), the Rowe test (P=.380) or in complications (P=.692). A higher percentage of the GP group returned to sports activity (77.1% GP vs. 51.7% GSP, P=.039).</p><p><strong>Conclusions: </strong>No statistically differences were observed in quality of life, complications, or re-dislocations. However, the use of a plate showed a greater predisposition to return to sports activity (P=.039) in patients with anterior glenohumeral instability.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630282","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}