Revista Espanola de Cirugia Ortopedica y Traumatologia最新文献

{"title":"[Translated article] Predictive factors of hospital and nursing facility admission in the fixation of low-energy ankle fractures","authors":"J.V. Andrés-Peiró ,&nbsp;M.M. Reverté-Vinaixa ,&nbsp;O. Pujol-Alarcón ,&nbsp;M. Altayó-Carulla ,&nbsp;S. Castellanos-Alonso ,&nbsp;J. Teixidor-Serra ,&nbsp;J. Tomàs-Hernández ,&nbsp;J. Selga-Marsà ,&nbsp;C.A. Piedra-Calle ,&nbsp;F. Blasco-Casado ,&nbsp;Y. García-Sánchez ,&nbsp;N. Joshi-Jubert ,&nbsp;J. Minguell-Monyart","doi":"10.1016/j.recot.2025.06.014","DOIUrl":"10.1016/j.recot.2025.06.014","url":null,"abstract":"<div><h3>Introduction</h3><div>Ankle fractures are increasingly common in frail patients, with hospitalisation being the principal cost driver, particularly for the elderly who often need referral to nursing facilities. This study aims to identify factors affecting resource utilisation per admission (hospital and nursing) in the fixation of low-energy ankle fractures.</div></div><div><h3>Materials and methods</h3><div>This retrospective cohort study examined patients undergoing fixation for low-energy ankle fractures. The primary outcome was the length of hospitalisation. Secondary outcomes included delays in fixation and the need for referral to a nursing institution. Multiple linear and logistic regression models were used to determine predictors related to patient demographics, injury characteristics, and treatment.</div></div><div><h3>Results</h3><div>We analysed 651 patients with a median age of 58<!--> <!-->years. The median hospitalisation duration was 9<!--> <!-->days, primarily before surgery. Extended hospitalisation was associated with antithrombotic treatment (<em>b</em> <!-->=<!--> <!-->4.08), fracture-dislocation (2.26), skin compromise (7.56), complications (9.90), and discharge to a nursing centre (5.56). Referral to a nursing facility occurred in 17.2%, associated with older age (OR<!--> <!-->=<!--> <!-->1.10) and an ASA score<!--> <!-->≥<!--> <!-->III (6.96).</div></div><div><h3>Conclusions</h3><div>Prolonged hospitalisation was mainly due to surgical delays and was related to fracture-dislocations, skin compromise, and complications. Older and comorbid patients were more likely to need nursing facilities, and delays in these facilities’ availability contributed to extended hospital stays.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 5","pages":"Pages T495-T503"},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144890996","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] Biomechanical study on cadaveric reconstruction with graft of the anterior talofibular and calcaneofibular ligaments","authors":"A. Abarquero-Diezhandino ,&nbsp;M.Á. Mellado-Romero ,&nbsp;M. Muñoz de la Espada-López ,&nbsp;R. Diaz-Suárez ,&nbsp;E. García-Jarabo ,&nbsp;A. Núñez-García ,&nbsp;E.J. Sánchez-Morata ,&nbsp;M.T. Vázquez-Osorio ,&nbsp;F. Guerra-Pinto ,&nbsp;J. Vilá-Rico","doi":"10.1016/j.recot.2025.06.008","DOIUrl":"10.1016/j.recot.2025.06.008","url":null,"abstract":"<div><h3>Background and aim</h3><div>Ankle sprains can lead to chronic lateral ankle instability (CLAI) in 10-50% of cases. While the anterior talofibular ligament (ATFL) is traditionally considered the primary structure affected, recent studies indicate a high incidence of combined injuries to the ATFL and the calcaneofibular ligament (CFL). Given the importance of the CFL, this study aims to evaluate the biomechanical efficacy of double tendon graft reconstruction of the ATFL and CFL in cases of CLAI.</div></div><div><h3>Materials and methods</h3><div>This biomechanical study on cadaveric ankles compares two techniques: anatomical reconstruction using a double graft for both the ATFL and CFL versus isolated anatomical reconstruction of the ATFL with a single graft. Stability was assessed using specific examination maneuvers (anterior drawer, forced varus, and pivot shift) with an arthrometer measuring angular displacement across three spatial planes (horizontal, coronal, and sagittal). Four models were analyzed: intact ankle, sectioning of the ATFL and CFL, double graft reconstruction of the ATFL and CFL, and single graft reconstruction of the ATFL.</div></div><div><h3>Results</h3><div>The results showed no significant differences between the double graft reconstruction and the intact ankle. Comparing the double graft with the single graft reconstruction revealed statistically significant differences, favoring the double graft for greater angular stability in the coronal plane during forced varus and external rotation maneuvers.</div></div><div><h3>Conclusions</h3><div>Double graft reconstruction of the ATFL and CFL provides greater angular stability compared to isolated ATFL reconstruction, demonstrating significant benefits in lateral and rotational stabilization of the ankle in CLAI cases.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 5","pages":"Pages T512-T522"},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144890998","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] Induced osteogenesis by chitosan (3-glycidoxypropyl)trimethoxysilane and silica-based biomaterial in rabbits","authors":"J. Orta-Chincoa ,&nbsp;M. Salido ,&nbsp;M. Piñero ,&nbsp;N. García ,&nbsp;P. Andrés-Cano","doi":"10.1016/j.recot.2025.06.012","DOIUrl":"10.1016/j.recot.2025.06.012","url":null,"abstract":"<div><h3>Introduction</h3><div>Synthetic biomaterials obtained through tissue engineering offer an alternative to the use of autologous and heterologous grafts for the repair of bone defects of various etiologies, although the ideal material for this purpose has not yet been developed. A gel based on chitosan (CS) (3-glycidoxypropyl)trimethoxysilane (GPTMS), and silica have shown efficacy in experimental studies from a biomechanical and in vitro osseointegration perspective.</div></div><div><h3>Objective</h3><div>To demonstrate that the hybrid aerogel based on CS-GPTMS-silica is effective and safe for treating bone defects in load-bearing bone in rabbits.</div></div><div><h3>Materials and methods</h3><div>A comparative experimental study was conducted on 12 adult New Zealand rabbits, involving osteotomy in both radii as case (osteotomy with biomaterial placement) and contralateral control (osteotomy with placement of the extracted bone), both fixed with plates and screws. After 10 weeks, the animals were euthanized, and the surgical area was subjected to histological analysis.</div></div><div><h3>Results</h3><div>For all subjects, wound healing was successful, and normal gait was observed within 24–48<!--> <!-->h. In <em>case limbs</em>, cortical closure of 95.9% was observed compared to 98% in <em>control limbs</em>. Residual biomaterial was observed in 5 subjects, with an average of 16% of the total analyzed area. Inflammatory cells were grouped (5–10%) in all <em>case samples</em>, with significant differences between case and control samples (<em>p</em> <!-->&lt;<!--> <!-->.05). An increase in the presence of bone precursor cells (5–10%) was observed in all <em>case samples</em> compared to <em>control samples</em>, with significant differences (<em>p</em> <!-->&lt;<!--> <!-->.05).</div></div><div><h3>Conclusions</h3><div>The aerogel based on chitosan CS-GPTMS, and silica is biocompatible and safe in rabbits, demonstrating minimal inflammatory reaction, good osteoblast adhesion, and a high resorption rate.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 5","pages":"Pages T469-T476"},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144891000","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] Superior capsular reconstruction of the shoulder with biceps autograft vs. Achilles allograft: A 2-year comparative study","authors":"D.J. Gómez,&nbsp;S. Ávila Posada,&nbsp;N. Gabotto,&nbsp;G.M. Viollaz,&nbsp;Á.J. Muratore,&nbsp;N.N. Altamirano,&nbsp;D. Moya","doi":"10.1016/j.recot.2025.06.006","DOIUrl":"10.1016/j.recot.2025.06.006","url":null,"abstract":"<div><h3>Purpose</h3><div>To retrospectively evaluate the clinical–functional outcomes, healing rates, complications, and surgical time in patients treated with superior capsular reconstruction (SCR) using long head of the biceps autograft (LHB) and Achilles allograft (AA).</div></div><div><h3>Materials and methods</h3><div>This retrospective study included 24 patients with irreparable rotator cuff tears of the supraspinatus and infraspinatus, treated with SCR. Two treatment groups were formed: one with 12 cases using AA and another with 12 cases using LHB. All patients were followed for a minimum of 2 years.</div></div><div><h3>Results</h3><div>The SSV was 73.7<!--> <!-->±<!--> <!-->25.3 vs. 86.0<!--> <!-->±<!--> <!-->8.7 (<em>p</em> <!-->=<!--> <!-->0.26), the Constant score was 76.8<!--> <!-->±<!--> <!-->20.1 vs. 83.7<!--> <!-->±<!--> <!-->4.6 (<em>p</em> <!-->=<!--> <!-->0.12), and the VAS was 1.6<!--> <!-->±<!--> <!-->2.3 vs. 1.7<!--> <!-->±<!--> <!-->0.5 (<em>p</em> <!-->=<!--> <!-->0.9) for the LHB and AA groups, respectively. Tendon healing was 66.7% in AA and 100% in LHB (<em>p</em> <!-->=<!--> <!-->0.001). Complications were 50% in AA and 0% in LHB. The average surgical time was 127.7<!--> <!-->±<!--> <!-->37.6<!--> <!-->min for AA and 84.3<!--> <!-->±<!--> <!-->14.3<!--> <!-->min for LHB (<em>p</em> <!-->=<!--> <!-->0.01).</div></div><div><h3>Conclusions</h3><div>SCR with LHB showed better results in terms of tendon healing, fewer complications, and reduced surgical time compared to the use of AA.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 5","pages":"Pages T484-T494"},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144890995","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] Use of artificial intelligence to predict complications in degenerative thoracolumbar spine surgery: A systematic review","authors":"G. Ricciardi ,&nbsp;J.I. Cirillo Totera ,&nbsp;R. Pons Belmonte ,&nbsp;L. Romero Valverde ,&nbsp;F. López Muñoz ,&nbsp;A. Manríquez Díaz","doi":"10.1016/j.recot.2025.06.015","DOIUrl":"10.1016/j.recot.2025.06.015","url":null,"abstract":"<div><h3>Objective</h3><div>We aim to conduct a systematic review of the literature to evaluate the effectiveness of artificial intelligence prediction models in predicting complications in adult patients undergoing surgery for degenerative thoracolumbar pathology compared with other commonly used prediction techniques.</div></div><div><h3>Methods</h3><div>A systematic literature review was conducted in Medline/Pubmed, Cochrane Library, and Lilacs/Portal de la BVS to identify machine learning models in predicting complications in patients undergoing surgery for degenerative thoracolumbar spine pathology between January 1, 2000, and May 1, 2023. The risk of bias was assessed using the PROBAST tool. Study characteristics and outcomes focusing on general or specific complications were recorded.</div></div><div><h3>Results</h3><div>A total of 2341 titles were identified (763 were duplicates). Screening was performed on 1578 titles, and 22 were selected for full-text reading, with 18 exclusions and 4 publications selected for the subsequent review. Additionally, 8 publications were included from other sources (Argentine Association of Orthopaedics and Traumatology Library; manual citation search). In 5 (41.6%) articles, the effectiveness of artificial intelligence predictive models was compared with conventional techniques. All were globally classified as having a very high risk of bias. Due to heterogeneity in samples, outcomes of interest, and algorithm evaluation metrics, a meta-analysis was not performed.</div></div><div><h3>Conclusion</h3><div>Although the available evidence is limited and carries a high risk of bias, the studies analysed suggest that these models may achieve promising performance in predicting complications, with area under the curve values mostly ranging from acceptable to excellent.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 5","pages":"Pages T446-T460"},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144891030","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] Treatment of dorsal radiocarpal fracture dislocation: Clinical and radiological long-term outcomes","authors":"V. Jiménez-Díaz ,&nbsp;L. García-Lamas ,&nbsp;I. Auñón-Martín ,&nbsp;V. Rodríguez-Vega ,&nbsp;D. Cecilia-López","doi":"10.1016/j.recot.2025.06.007","DOIUrl":"10.1016/j.recot.2025.06.007","url":null,"abstract":"<div><h3>Main</h3><div>To describe our experience treating dorsal radiocarpal fracture dislocations, regarding long-term clinical and radiological outcomes.</div></div><div><h3>Material and method</h3><div>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 (PRWE) scales were employed for clinical results assessment. All radiological studies were reviewed for radiological results assessment. A descriptive statistical analysis of all variables was developed.</div></div><div><h3>Results</h3><div>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. Eighty percent of patients developed wrist stiffness with most affected flexo-extension followed by prono-supination. Sixty-seven percent of patients developed radiological signs of wrist osteoarthritis at the end of follow-up.</div></div><div><h3>Conclusions</h3><div>In spite of a large number of clinical and radiological complications during follow-up, long-term functional results are good in this kind of wrist injuries.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 5","pages":"Pages T429-T438"},"PeriodicalIF":0.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144891028","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] Biomechanical evaluation and analysis of a reused telescopic intramedullary femoral nail in a child with achondroplasia","authors":"C.M. Posada ,&nbsp;R. D’Amato ,&nbsp;M. Galán-Olleros ,&nbsp;C. Miranda-Gorozarri ,&nbsp;Á. Palazón-Quevedo ,&nbsp;J. Alonso-Hernández","doi":"10.1016/j.recot.2025.06.009","DOIUrl":"10.1016/j.recot.2025.06.009","url":null,"abstract":"<div><h3>Introduction</h3><div>Telescopic intramedullary nails (TIMN) 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 TIMN 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 TIMN.</div></div><div><h3>Methods</h3><div>An experimental analysis was conducted on a femoral TIMN removed after two 5-cm lengthenings in a patient with achondroplasia. The nail was measured and examined following non-destructive deconstruction, material analysis, 3D reverse engineering modeling, and finite element analysis to assess its performance under various loading conditions.</div></div><div><h3>Results</h3><div>Mechanical and chemical damage compromising the integrity of the nail was identified. The aged Ti6Al4V alloy was validated for its resistance to complex loads. The 3D model showed that the gear mechanism effectively transformed rotational into translational motion. Finite element analysis revealed that the safety factor reached its critical threshold at 2.44̊ and 2.25̊, indicating the nail was near its mechanical limit. The rod and guide were identified as critical components.</div></div><div><h3>Conclusions</h3><div>TIMN reuse should be approached with caution due to potential material fatigue. This study provides a foundation for redesigning these implants to improve their ability to withstand prolonged loading cycles.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 5","pages":"Pages T523-T531"},"PeriodicalIF":0.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144890965","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] Evolution of the rapid recovery program to outpatient surgery in total hip arthroplasty","authors":"S.M. Miguela Alvarez,&nbsp;A. Bartra,&nbsp;M. Novellas,&nbsp;M. Surroca,&nbsp;F. Anglès","doi":"10.1016/j.recot.2025.06.011","DOIUrl":"10.1016/j.recot.2025.06.011","url":null,"abstract":"<div><h3>Introduction</h3><div>The implementation of enhanced recovery programs has transformed total hip arthroplasty (THA) surgery. Outpatient prosthetic surgery is a safe and beneficial technique. Few centers in our country perform outpatient total hip arthroplasty (OTHA). We present the preliminary results of our experience.</div></div><div><h3>Material and method</h3><div>This is a prospective observational study conducted in 2023 with a sample of 30 patients proposed for THA following an outpatient surgery protocol by the orthopedic surgery and traumatology service.</div></div><div><h3>Results</h3><div>In 2023, we performed 132 THAs in our center. Thirty patients, 27 men and 3 women with an average age of 55.7 years were included for an outpatient surgery circuit. Three patients did not meet the inclusion criteria identified by the Anesthesiology Department. Of the 27 patients included in the program, 25 were discharged on the same day. Two patients were admitted: one due to an intraoperative fracture and the other due to poor pain control and dizziness. No secondary complications related to the program were observed after discharge. All patients except one would recommend the outpatient protocol.</div></div><div><h3>Conclusions</h3><div>OTHA programs should evolve from rapid recovery programs. Their implementation depends on an experienced multidisciplinary team. In this study, inclusion criteria were defined, achieving high satisfaction without increased complications. Outpatient surgery is a good option, and the implementation of this circuit is a safe, effective, and a satisfactory practice for selected patients.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 5","pages":"Pages T504-T511"},"PeriodicalIF":0.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144890997","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] Musculoskeletal injuries treated following the flood in October 2024 in Valencia, Spain","authors":"J.F. Garrido Ferrer,&nbsp;J. Diranzo García,&nbsp;X. Bertó Martí,&nbsp;L. Marco Díaz,&nbsp;L. Hernández Ferrando","doi":"10.1016/j.recot.2025.06.002","DOIUrl":"10.1016/j.recot.2025.06.002","url":null,"abstract":"<div><h3>Introduction</h3><div>The aim of this study was to describe and analyze the musculoskeletal injuries treated at a tertiary hospital, resulting from the sudden flooding and landslides that occurred on October 29, 2024, in the province of Valencia, Spain.</div></div><div><h3>Materials and methods</h3><div>A retrospective, single-center study design was employed, documenting all patients who required hospital treatment from October 29, 2024, to November 30, 2024, inclusive. Data collected included the date of treatment, delay time until rescue and evacuation, demographic information, injury location and severity, records of surgeries performed and required hospitalization time.</div></div><div><h3>Results</h3><div>A total of 410 hospital admissions were recorded, all of which were through the emergency department. A slight male predominance was observed (55.5%), with an average age of 48 years (range 1–97). The mean time to treatment was 1.4 days from the trauma (range 1–12), although 47% of cases exceeded 48<!--> <!-->h. 60.1% of contusions presented with at least one associated fracture. A total of 84 wounds (20.5% of the sample) and musculoskeletal and ligament injuries (14.4%) were treated, along with joint dislocations (2.4%). The most common injury sites were the lower limbs (48.6%), followed by the upper limbs (36.7%). The majority of cases (90.5%) were managed with conservative treatment, with 9.5% requiring surgical revision. During this period, 53 hospital admissions (1.76 admissions/day) and 38 urgent surgeries were performed.</div></div><div><h3>Conclusion</h3><div>The flooding caused by the Valencia flood in October 2024 is considered one of the most severe environmental disasters in the history of Spain. Natural disasters affecting multiple victims demand effective and coordinated medical attention across all healthcare levels. Continuous learning for trauma specialists will provide the necessary tools for appropriate knowledge and management of such potentially severe injuries.</div><div><em>Level of evidence</em>: IV. Retrospective descriptive and analytical study. Case series.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 5","pages":"Pages T421-T428"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144889541","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] ¿Es útil la clasificación CPAK (Coronal Plane Alignment of the Knee) para planificar la cirugía individualizada de artroplastia total de rodilla en la población española? Un análisis crítico de la clasificación CPAK","authors":"O. Pujol ,&nbsp;P. Hinarejos ,&nbsp;A. Pons ,&nbsp;E. Famada ,&nbsp;A. Zumel ,&nbsp;J. Erquicia ,&nbsp;J. Leal-Blanquet","doi":"10.1016/j.recot.2025.06.003","DOIUrl":"10.1016/j.recot.2025.06.003","url":null,"abstract":"<div><h3>Introduction</h3><div>The CPAK classification aims to categorize knee phenotypes. The original study was based on Australian and Belgian population, but significant variation in CPAK distribution exists between different geographic areas. The primary objective is to evaluate knee phenotypes of osteoarthritic Spanish population based on the CPAK system. The secondary objective is to compare the Spanish CPAK distribution with that observed in the original study to analyse if proposing modifications is necessary when applying the classification to our population. Finally, we aim to critically analyse the utility of this classification to plan individualized TKA.</div></div><div><h3>Methods</h3><div>It is a cross-sectional observational study analysing radiological datasets from 121 patients with knee osteoarthritis treated with a Mako assisted TKA in three Spanish institutions. The preoperative lower limb CT-scan was used to measure the MPTA and LDFA of each patient. Then, the aHKA (MPTA<!--> <!-->−<!--> <!-->LDFA) and JLO (MPTA<!--> <!-->+<!--> <!-->LDFA) were calculated to categorize patients into the nine CPAK phenotypes.</div></div><div><h3>Results</h3><div>The commonest knee phenotypes of osteoarthritic Spanish population were the distal apex JLO CPAK types (74%: II [28%], I [23%] and III [23%]). No patient presented a proximal apex type (VII, VIII and IX). The 30% of the patients had a varus alignment and 26% a valgus. No relevant differences were found between the Spanish CPAK distribution and that observed in the original study.</div></div><div><h3>Conclusions</h3><div>No modifications to the CPAK classification should be necessary for the Spanish population. The CPAK classification can be useful to describe and categorize osteoarthritic patients. However, relevant limitations have been found to the classification, questioning its utility to plan and guide individualized TKA surgery.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 5","pages":"Pages T477-T483"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144890985","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}