Revista Espanola de Cirugia Ortopedica y Traumatologia最新文献

{"title":"Exploratory study of the efficacy and safety of treatment with high-low molecular weight hybrid hyaluronic acid in patients with plantar fasciitis: One-year follow-up.","authors":"Á Fernández Reinales, D Poggio Cano, R García Elvira","doi":"10.1016/j.recot.2026.03.022","DOIUrl":"10.1016/j.recot.2026.03.022","url":null,"abstract":"<p><strong>Introduction: </strong>Plantar fasciitis (PF) is a common musculoskeletal injury that can occur in adults of all ages and activity levels. This condition accounts for more than 1 million medical visits annually in the United States alone. Despite its name, PF is considered a degenerative condition rather than a primary inflammatory disorder. It is characterized by pain in the medial part of the heel that worsens with weight-bearing activity and prolonged standing. Treatment for PF can be conservative, including stretching complemented by formal physical therapy, NSAIDs, and orthotics. If symptoms have not improved after these options, the use of injectable treatments should be considered. If symptoms persist for more than 6 months, surgical release could be considered as a last resort. Different studies have demonstrated the efficacy and safety of high molecular weight hyaluronic acid (HA) injections in the treatment of patients with PF.</p><p><strong>Objetives: </strong>The objective of the study was to evaluate the efficacy and safety of treatment with hybrid high-low molecular weight hyaluronic acid (HA) in patients diagnosed with plantar fasciitis through retrospective analysis of medical records.</p><p><strong>Materials and methods: </strong>Patient functionality was assessed using the Spanish-validated Manchester-Oxford Foot and Ankle Questionnaire (MOXFQ), and pain level was measured with the Verbal Numeric Rating Scale (VNRS), both before the procedure and after 12 months of post-treatment follow-up, in 10 patients diagnosed with PF who were administered hybrid high-low molecular weight HA (Sinovial HL® 1ml) through ultrasound-guided injection into the plantar fascia. In all cases, the thickness of the plantar fascia was evaluated by ultrasound before the procedure and at 12 months.</p><p><strong>Results: </strong>A significant reduction in pain assessed by the VNRS was observed when comparing baseline data to values at 12 months post-procedure (P<.001). In all cases, patients reported total absence of pain 12 months after the HA injection. Likewise, a statistically significant reduction in MOXFQ scores was observed between baseline values and those obtained at the 12-month follow-up. The mean scores decreased from 57.2±4.3 points at baseline to 2.5±2.8 points at 12 months, with a median difference of -55 points (IQR: -58.2 to -50.8; P=.002). Regarding the evaluation of ultrasound changes in plantar fascia thickness, the analysis revealed a statistically significant reduction at 12 months after the procedure compared to baseline measurements (median difference: -2.25mm, IQR: -2.85 to -1.95; P=.002). The body mass index (BMI) was 27.8%, and the predominant gender was male (70%) compared to female (30%). The baseline characteristics of the patients and the results of the tests performed are shown in table 1.</p><p><strong>Conclusions: </strong>Ultrasound-guided infiltration with hyaluronic acid hybrid high-low molecular weight in","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784308","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":"Effect Of Central Sensitization On Outcomes After Hallux Valgus Surgery.","authors":"Juan Manuel Rodríguez Sánchez, Marta Calderón García, Nicolás Prados Olleta","doi":"10.1016/j.recot.2026.03.021","DOIUrl":"https://doi.org/10.1016/j.recot.2026.03.021","url":null,"abstract":"<p><strong>Introduction: </strong>Central sensitization (CS) is a pain amplification mechanism associated with poorer surgical outcomes. Its influence on Hallux Valgus (HV) surgery remains unclear. This study evaluates whether CS is associated with worse outcomes following Chevron and Akin osteotomies.</p><p><strong>Methods: </strong>Retrospective cohort study including 76 operated patients, divided according to their Central Sensitization Inventory (CSI) score (≥40 vs <40). Functionality (AOFAS), pre-/postoperative pain (VAS), satisfaction (VAS), quality of life (EQ-5D-5L), and treatment response were analyzed.</p><p><strong>Results: </strong>Patients with CS showed worse functionality and quality of life, greater pain, and lower satisfaction (p<0.001). The most affected dimensions were pain, mobility, and daily activities (p<0.001). Both groups improved, particularly the non-CS group (p=0.001).</p><p><strong>Conclusion: </strong>CS is associated with poorer functional outcomes and may serve as a negative prognostic factor. Surgical intervention improves pain even in patients with CS.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784268","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":"Management of surgical management of beak-type avulsion fractures of the posterior calcaneal tuberosity: a systematic narrative review.","authors":"J Olucha Puchol, L Díaz Aviñó, F Forriol Brocal","doi":"10.1016/j.recot.2026.03.012","DOIUrl":"https://doi.org/10.1016/j.recot.2026.03.012","url":null,"abstract":"<p><strong>Introduction: </strong>Beak-type avulsion fractures of the posterior calcaneal tuberosity have a high risk of skin complications due to Achilles tendon traction and limited soft tissue coverage. The objective was to synthesize evidence on their surgical management, comparing open and percutaneous approaches, focusing on skin complications and prognostic factors.</p><p><strong>Material and methods: </strong>Systematic review following PRISMA 2020. Search in PubMed/MEDLINE and ScienceDirect (2000-2024). Clinical studies describing open reduction with internal fixation (ORIF) or closed reduction with percutaneous fixation (CRIF) were included. Narrative synthesis was performed due to methodological heterogeneity.</p><p><strong>Results: </strong>Fourteen observational studies (268 patients) were included. Comparative series consistently showed a trend toward lower skin complication rates with CRIF compared to ORIF. Time to surgery (<48hours) and fragment displacement (>2cm) were identified as relevant prognostic factors.</p><p><strong>Conclusion: </strong>In selected fractures with moderate displacement, percutaneous fixation represents a reasonable option to minimize skin complications. Open fixation remains necessary for significantly displaced or comminuted injuries.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784471","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] Soft tissue infections during a climate emergency: Impact of the October 2024 cut-off low (DANA) event in Valencia.","authors":"A Amaya Franco, L Pelegrín Dura, D Torres-Perez, J Tecles Peydró, D Martínez López, J Antonio Blas Dobón, J Luis Rodrigo Pérez","doi":"10.1016/j.recot.2026.03.019","DOIUrl":"https://doi.org/10.1016/j.recot.2026.03.019","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;The objective of this study is to provide an epidemiological description of soft tissue infections caused by traumatic injuries treated at a tertiary hospital in Valencia during the floods resulting from the cut-off low (depresión aislada en niveles altos [DANA]) that occurred in October 2024. The study also addresses the therapeutic approach and associated complications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;We conducted a retrospective, single-centre, descriptive study evaluating musculoskeletal soft tissue infections in patients with an emergency department diagnosis of \"DANA-related injury\" who required hospitalisation in the Department of Orthopedic Surgery and Traumatology of a tertiary care hospital. The study period extended from October 30th to November 14th, 2024. A total of 41 admissions (14%) were recorded out of the 289 patients treated in the trauma emergency department for wounds and closed fractures. Patients who were admitted with fractures only, without associated wounds, were excluded, resulting in a final sample of 31 patients. All patients underwent emergency surgical intervention, including wound debridement in the operating room, with intraoperative collection of multiple samples sent to the Microbiology Department for etiological identification of micro organisms, as well as analysis of their antibiotic susceptibility and resistance patterns. Until antibiogram results were available, all patients received empirical broad-spectrum intravenous antibiotic therapy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of the 41 admitted patients, 10 were excluded due to the absence of open wounds (closed fractures), resulting in a final cohort of 31 patients with soft tissue injuries, 10 of whom (32%) also presented with long bone fractures. Among the 31 patients, 21 were male (67%) and 10 female, with a mean age of 54.7 years. The most frequent anatomical location of the wounds was the lower extremities. The most commonly isolated microorganisms in culture were Aeromonas hydrophila (7 cases), Escherichia coli (7 cases), and Klebsiella pneumoniae (5 cases), with 56.5% of cases presenting polymicrobial infections.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Soft tissue infections secondary to traumatic injuries sustained during the flooding caused by the October 2024 DANA event posed a significant clinical challenge to Orthopedic and Trauma Surgery Services. Flood-related soft tissue infections are characterised by a high prevalence of polymicrobial infections, frequently involving Gram-negative and multidrug-resistant pathogens. These findings underscore the need for early diagnosis and the initiation of broad-spectrum antimicrobial therapy to reduce the risk of complications and the need for multiple surgical interventions. This study highlights the importance of prompt, multidisciplinary, and protocol-driven responses to extreme weather events that carry a high risk of serious infections in contaminated environmen","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784555","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 of long-term outcomes of highly porous titanium acetabular cups in primary total hip arthroplasty.","authors":"R Fernández-Fernández, L-R Merino-Rueda, P Diaz-Freire, A Cruz-Pardos","doi":"10.1016/j.recot.2026.03.018","DOIUrl":"https://doi.org/10.1016/j.recot.2026.03.018","url":null,"abstract":"<p><strong>Objective: </strong>An observational, ambispective study comparing the long-term clinical and radiological outcomes of two surface coatings (Porocoat® and Gription®) in Pinnacle® acetabular cups used for primary total hip arthroplasty.</p><p><strong>Materials and methods: </strong>A total of 50 consecutively implanted cups between January 2012 and July 2013 were analyzed, categorized into Group A (n=25 Pinnacle®-Porocoat® cups) and Group B (n=25 Pinnacle®-Gription® cups). Clinical and radiological outcomes of both groups, including the need for surgical revision and time to revision, were compared over long-term follow-up, during the decade following the index procedure.</p><p><strong>Results: </strong>The study population had a median age of 70 [61-73] years and was predominantly male (64%, n=32). Preoperative BMI and functional evaluation were similar for both coating types. Revision-free survival was 96% in Group A and 92% in Group B (p=.591). Both groups showed significant and comparable clinical improvement, with no cases of aseptic loosening. Only two Pinnacle®-Gription® cups presented with non-progressive radiolucent lines.</p><p><strong>Conclusions: </strong>Both Porocoat® and Gription® demonstrated stable fixation and favorable long-term clinical and radiological outcomes, with no significant differences observed during follow-up after primary total hip arthroplasty.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784467","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] Short- and mid-term efficacy of extracorporeal shock wave therapy versus corticosteroid injections in the treatment of trigger finger: A non-randomized prospective comparative study.","authors":"A H Suárez Cabañas, M Ramírez Sánchez, A Álvarez Jiménez, M Santana Bañolas, J M González Martín, J M García Castellano","doi":"10.1016/j.recot.2026.03.020","DOIUrl":"https://doi.org/10.1016/j.recot.2026.03.020","url":null,"abstract":"<p><strong>Background and objective: </strong>Trigger finger is a common condition managed through various conservative approaches. This study aimed to compare the short- and mid-term efficacy of radial extracorporeal shock wave therapy (rESWT) versus corticosteroid injection (INF) in patients with moderate trigger finger.</p><p><strong>Material and methods: </strong>A non-randomized prospective comparative study was conducted with 42 patients diagnosed with Quinnell grade II-III trigger finger, assigned to treatment groups (rESWT vs. INF) by sequential sampling. The following outcomes were assessed at baseline, 6 weeks, and 6 months: pain (VAS), functionality (QuickDASH and Roles & Maudsley), stiffness/severity (Quinnell), and grip strength (hand dynamometry). The primary variable was main pain improvement at 6 months. Statistical analysis included nonparametric tests (Wilcoxon, Mann-Whitney U), chi-square/Fisher tests for qualitative variables, and paired regression for temporal changes (α=0.05).</p><p><strong>Results: </strong>Both groups showed significant improvements in all evaluated parameters. At short-term follow-up (6 weeks), INF achieved a faster pain reduction, whereas at mid-term (6 months), rESWT demonstrated sustained benefits in pain, stiffness, and functionality, with a higher proportion of \"excellent-good\" outcomes on the Roles & Maudsley scale (p<.05). Grip strength increased similarly in both groups. No major adverse events were reported.</p><p><strong>Conclusions: </strong>rESWT and INF are both effective treatments for trigger finger. INF may be preferred for rapid pain relief, while rESWT provides longer-lasting benefits and represents a useful non-invasive alternative for patients with contraindications to corticosteroids.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784590","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] Mid- to long-term radiological and functional outcomes after calcaneoplasty with Achilles tendon reinsertion for insertional tendinopathy.","authors":"C López-Hernández, M González-Alonso, R Vázquez-Crespo, J Zhang-Chen, S Tejero","doi":"10.1016/j.recot.2026.03.006","DOIUrl":"https://doi.org/10.1016/j.recot.2026.03.006","url":null,"abstract":"<p><strong>Background: </strong>Insertional Achilles tendinopathy (IAT) significantly impairs function and quality of life, particularly in young athletes. When conservative treatment fails, surgical options include Zadek osteotomy and calcaneoplasty with tendon reinsertion. Although certain preoperative radiological parameters, such as calcaneal inclination and tuberosity length, may influence functional outcomes, comprehensive studies analyzing their impact on calcaneoplasty results remain limited.</p><p><strong>Objectives: </strong>To evaluate the mid- and long-term effectiveness of calcaneoplasty with Achilles tendon reinsertion in patients with refractory IAT and to assess the relationship between preoperative radiological parameters (calcaneal inclination) and postoperative functional outcomes.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 38 patients who underwent calcaneoplasty with reinsertion between 2011 and 2024. Mean follow-up was 22 months (IQR: 71) with a median age of 55 years (IQR: 10). Preoperative radiological parameters (Ruch, Fowler-Phillips, CLA, BRINK angles, among others) and functional scales (VAS, AOFAS, EFAS, VISA-A, Tegner) were assessed before and after surgery.</p><p><strong>Results: </strong>Significant postoperative improvement was observed across all functional scales (p<.001, Wilcoxon signed-rank test). Mean VAS pain scores decreased from 8.75±1.27 to 1.71±2.02, while AOFAS scores increased from 38.36±14.55 to 88.82±11.95. EFAS and VISA-A scores improved by 16.46 and 45.59 points, respectively. Tegner scores showed an increase of 50.48 points in athletic capacity. Two complications (5.26%) were reported: one suture granuloma and one case of lateral plantar nerve neuralgia, both successfully managed conservatively. No significant correlation was found between calcaneal inclination or tuberosity length and postoperative functional outcomes. Strengths of the study include a comprehensive functional assessment and consistent follow-up, while limitations include the retrospective design and use of two reinsertion techniques (single- and double-row), with no significant differences in outcomes.</p><p><strong>Conclusion: </strong>Calcaneoplasty with Achilles tendon reinsertion is effective for refractory insertional Achilles tendinopathy, providing sustained mid- and long-term benefits. Preoperative radiological parameters were not significantly associated with postoperative functional outcomes.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784601","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] Diabetes mellitus as a risk factor for infection after posterior lumbar arthrodesis: multivariate analysis of 356 cases.","authors":"J H Núñez, J Diego Montenegro, B Escudero-Cisneros, I Omiste, D Bosch García, C García Cardona","doi":"10.1016/j.recot.2026.03.008","DOIUrl":"https://doi.org/10.1016/j.recot.2026.03.008","url":null,"abstract":"<p><strong>Introduction: </strong>Lumbar spinal fusion is a widely used technique in the treatment of conditions such as lumbar stenosis and degenerative spondylolisthesis. However, acute postoperative infection remains a significant complication. The aim of this study was to identify risk factors associated with a higher incidence of acute infection following posterior lumbar fusion for degenerative pathology.</p><p><strong>Material and methods: </strong>We conducted an observational, retrospective, and analytical study at a single hospital center. Patients over 18 years of age who underwent instrumented lumbar fusion for lumbar stenosis or degenerative spondylolisthesis between 2017 and 2022 were included. Demographic, clinical, and surgical variables were analyzed. A bivariate analysis was followed by a multivariate logistic regression model to identify independent risk factors for acute postoperative infection.</p><p><strong>Results: </strong>A total of 356 patients was analyzed, with a mean age of 60.4 years; 55.6% were male. The overall incidence of acute postoperative infection was 5.9% (21 cases). Bivariate analysis revealed significant associations with infection for diabetes mellitus (P = .010), hypertension (P = .042), chronic corticosteroid use (P = .001), and surgical duration > 3 hours (P = .028). In the multivariate model, only diabetes mellitus remained a significant independent risk factor (OR: 3.36; 95% CI: 1.22-9.31; P = .019).</p><p><strong>Conclusions: </strong>Diabetes mellitus was identified as the main independent risk factor for acute postoperative infection. This finding highlights the importance of a thorough preoperative assessment of surgical risk in diabetic patients and the need to provide them with adequate information during the informed consent process.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784456","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] Tibial slope in ACL reconstruction: When should it be corrected?","authors":"T Pineda, D H Dejour","doi":"10.1016/j.recot.2026.03.016","DOIUrl":"https://doi.org/10.1016/j.recot.2026.03.016","url":null,"abstract":"<p><p>The tibial slope has been identified as a key anatomical factor influencing anteroposterior knee stability. Increased slope values have been linked to greater anterior tibial translation, higher stress on the anterior cruciate ligament and an elevated risk of graft failure following reconstruction. This review aims to examine the current evidence and ongoing controversies regarding the clinical relevance of tibial slope, measurement methods, and surgical correction indications.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784606","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] Mortality following periprosthetic and peri-implant femoral fractures: Comparative analysis according to previous implant type.","authors":"P Ulldemolins, D Mayorga Naranjo, G Mariscal Ruiz-Rico, M Bovea Marco, T Ros Ample","doi":"10.1016/j.recot.2026.03.009","DOIUrl":"https://doi.org/10.1016/j.recot.2026.03.009","url":null,"abstract":"<p><strong>Introduction: </strong>Periprosthetic and peri-implant femoral fractures (PPF) include periprosthetic hip fractures (periPC), periprosthetic knee fractures (periPR), as well as peri-implant fractures associated with an osteosynthesis nail (periCL). Although risk factors for PPF are widely studied, there is scarce evidence on differential risk factors for each subtype. The objective of this study is to compare 30-day and 1-year mortality rates among the three PPF subtypes and identify differential risk factors between them.</p><p><strong>Methodology: </strong>A retrospective cohort study conducted in a tertiary hospital, including 100 patients with PPF between 2019 and 2022, with a minimum follow-up of one year. Demographic, clinical, and surgical data were collected, along with 30-day and 1-year mortality and changes in ambulation capacity. Statistical analysis included intergroup comparison tests and stratified mortality analysis.</p><p><strong>Results: </strong>There were 49 periprosthetic hip fractures, 29 knee fractures, and 22 femoral nail-related fractures. Overall mortality was 12% at 30 days and 28% at one year, with no differences between subtypes. Mortality was associated with ASA>III, CCI>5, systemic complications, intraoperative transfusions, and deterioration of ambulation capacity (p<.05). Stratified analysis identified significant differential associations in periPC (age, CCI>5, ASA>III, systemic complications, postoperative ambulatory status) and periPR (ASA, surgical time, systemic and local complications, ambulatory status), with no significant factors in periCL.</p><p><strong>Conclusions: </strong>Elevated ASA index, CCI, and systemic complications are risk factors in all three types of PPF. Surgical time and local complications were associated with worse outcomes in the periPR group. Novel findings include the need for blood transfusions and deterioration of ambulatory status as modifiable risk factors associated with higher mortality.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784642","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}