Revista Espanola de Cirugia Ortopedica y Traumatologia最新文献

{"title":"A PERIOPERATIVE OPTIMIZATION PROGRAM CAN IMPROVE RESULTS AND REDUCE HOSPITAL LENGTH OF STAY IN HIP AND KNEE ARTHROPLASTY: EXPERIENCE IN CHILE.","authors":"José Miguel Luarte, José Tomás Vizcaya, Diego Munita, Esteban Stocker, Romina Núñez, Juan Antonio Merino, Claudio Rojas","doi":"10.1016/j.recot.2025.03.002","DOIUrl":"https://doi.org/10.1016/j.recot.2025.03.002","url":null,"abstract":"<p><strong>Background and objective: </strong>Perioperative optimization programs have been shown to improve outcomes in total hip and knee arthroplasty; however, the evidence in Latin America is limited. Our objective is to evaluate the impact of implementing a multidisciplinary optimization program in prosthetic surgery at a Latin American center.</p><p><strong>Materials and methods: </strong>A retrospective cohort study evaluating elective hip and knee prosthesis surgeries between 2016 and 2023 at a private hospital. We compared pre-intervention (2016-2018) and post-intervention (2019-2023) groups following the implementation of a multidisciplinary perioperative optimization program in 2019. The impact of the program on hospital length of stay and 90-day readmission rates was assessed.</p><p><strong>Results: </strong>A total of 1,462 patients (1,636 surgeries) were included, with 429 surgeries in the pre-intervention group and 1,207 in the post-intervention group. Hospital length of stay decreased from 3.5 to 2.22 days (p<0.05). The 90-day readmission rate decreased from 2.56% to 2.24% (p=0.71), with a significant reduction in knee arthrofibrosis (from 0.9% to 0.2%, p<0.05). The optimization program was the main factor contributing to the reduction in hospital length of stay.</p><p><strong>Conclusions: </strong>The multidisciplinary perioperative program implemented significantly reduced hospital stay without increasing 90-day readmission rates.Furthermore, it equated outcomes between patients with public and private insurance.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671374","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":"TREATMENT OF DORSAL RADIOCARPAL FRACTURE-DISLOCATION: CLINICAL AND RADIOLOGICAL LONGTERM OUTCOMES.","authors":"Verónica Jiménez-Díaz, Lorena García-Lamas, Ismael Auñón-Martín, Víctor Rodríguez Vega, David Cecilia-López","doi":"10.1016/j.recot.2025.03.003","DOIUrl":"https://doi.org/10.1016/j.recot.2025.03.003","url":null,"abstract":"<p><p>Main: To describe our experience treating dorsal radiocarpal fracture-dislocations, regarding longterm clinical and radiological outcomes. Matherial and method: 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 scales were employed for clinical results assessment. All radiological studies were reviewed for radiological results assessment. A descriptive statiscal analisys of all variables was developed. Results: 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. 80% patients developed wrist stiffness with most affected flexo-extension followed by prono-supination. 67% patients developed radiological signs of wrist osteoarthritis at the end of follow-up. Conclusions: In spite of a large number of clinical and radiological complications during follow-up, longterm functional results are good in this kind of wrist injuries.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670096","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":"Letter to the editor about the article: «Is the coronal plane alignment of the knee (CPAK) classification useful to plan individualized total knee arthroplasty surgery for the Spanish population? A critical analysis of the CPAK classification».","authors":"V J León-Muñoz, J Hurtado-Avilés, M López-López, F Santonja-Medina, J Moya-Angeler","doi":"10.1016/j.recot.2025.03.001","DOIUrl":"10.1016/j.recot.2025.03.001","url":null,"abstract":"","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587562","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":"Success after surgical treatment of unstable hip prosthesis: 12 years of experience in a Third Level Hospital.","authors":"Alba Gabriela Casa Casa","doi":"10.1016/j.recot.2025.02.018","DOIUrl":"https://doi.org/10.1016/j.recot.2025.02.018","url":null,"abstract":"<p><strong>Objetives: </strong>Hip arthroplasty instability is one of the most worrisome complications and one of the main indications for revision surgery. We present a retrospective study evaluating the results of revision hip replacement surgery performed for instability.</p><p><strong>Material and methods: </strong>Observational, retrospective study from 1/12/2010 to 1/12/2022. Fifty-nine medical records of patients operated for hip dislocation were reviewed. Epidemiological variables and data such as type of dislocation based on Wera classification, cup position based on Lewinnek, type of implants, associated surgical techniques and the results in terms of recurrence of dislocation or reoperation were recorded.</p><p><strong>Results: </strong>59 patients: 33 women, 26 men, mean age 77.0 years. Mean follow-up 3.2 years (range 1.6-13.1). Based on Wera: had a single cause 37 cases, 2 causes 19 and 3 causes or more, 3 cases. In 61% of the cases in the series, malposition of the cup played an essential role in the dislocation (type I Wera). In the series, the Lewinnek zone could not be evaluated in 7 cases. For the remaining patients, 30% were within the Lewinnek zone. Only one patient in the series had a history of lumbar instrumentation. Implant used: double mobility (DM) in 17 cases (28.8%) and a constrained system in 38 cases (64.4%). Heads with adaptive cone were used in 2 cases (3%). In 4 cases (6%) a modified Whiteside type plasty was associated. Girdlestone was indicated in 2 cases (3%). Recurrence of dislocation 1 occasion: 18 cases (31%); 2 or more occasions 7 cases (12%). Re-operation 15 cases (25%) range (1-5), main reasons: instability, infection or peri-prosthetic fractures. Probability of success defined as no recurrence: at one year is 80.5%, and at two years is 70.6%, showing no differences between constrained or dual mobility implant.</p><p><strong>Comments and conclusions: </strong>Hip prosthesis dislocation is multifactorial in origin, although in most cases in the series the key factor was malposition of the acetabulum. Constrained and DM implants showed similar effectiveness. The results of this study emphasize the need for techniques that allow adequate positioning and orientation of the acetabular component to prevent, in a high percentage of cases, the need for this type of revision surgery.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568426","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":"Parestesias en la cara lateral del antebrazo: una lesión nerviosa difícilmente reconocible","authors":"S. Parra Escorihuela,&nbsp;A.D. Ghinea,&nbsp;Á. Montero Sánchez,&nbsp;J. Orenga Orenga","doi":"10.1016/j.recot.2024.09.001","DOIUrl":"10.1016/j.recot.2024.09.001","url":null,"abstract":"<div><div>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 etiology 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.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 2","pages":"Pages 206-209"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Artículo traducido] Artroplastia semiconstreñida en gonartrosis con insuficiencia de ligamentos colaterales: resultados clínicos y funcionales","authors":"A. Garrido-Hidalgo ,&nbsp;R. García Crespo ,&nbsp;B. Rizo de Álvaro ,&nbsp;B. Alcobía-Díaz ,&nbsp;G. Aparicio ,&nbsp;F. Marco","doi":"10.1016/j.recot.2024.12.007","DOIUrl":"10.1016/j.recot.2024.12.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Achieving stability in total knee arthroplasty (TKA) is crucial for long-term implant survival. In cases of severe deformity or ligament laxity, constrained implants may be required. Traditionally, increasing constraint involved intramedullary stems. However, there are intermediary alternatives, including employing a constrained polyethylene insert without stems, thereby avoiding complications related to them. The study aims to evaluate our experience with a non-modular constrained (NMC) implant in primary TKA.</div></div><div><h3>Material and methods</h3><div>We conducted a retrospective review of the clinical and radiographic outcomes of 108 non-stemmed primary TKAs performed at our institution between 2013 and 2021 in patients with at least 10° deformity or 10<!--> <!-->mm ligament laxity. Data included demographics, preoperative and postoperative deformities, clinical outcomes and revision rates.</div></div><div><h3>Results</h3><div>A total of 103 patients (108 knees) with a mean age of 74 were followed up for a minimum of 2<!--> <!-->years. The mean postoperative range of motion was 105°/0°. The median Oxford Knee Score, Knee Society Score and Knee Society Function Score were 43.5, 92 and 90, respectively. 17 knees had varus deformity (mean tibiofemoral angle of 2.7°), and 87 knees had excessive valgus deformity (mean tibiofemoral angle of 15.1°). The remaining 4 knees had a neutral alignment. The mean postoperative tibiofemoral angle was 6.8°. The overall revision rate was 6.5% (7 patients): 3 deep periprosthetic infections, 2 patellar dislocations, 1 stiffness and 1 aseptic loosening.</div></div><div><h3>Conclusion</h3><div>Our experience demonstrates favorable mid-term outcomes with the NMC implant, providing a safe alternative to stemmed implants in primary TKA, particularly in cases of severe deformity or ligament laxity.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 2","pages":"Pages T135-T141"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Translated article] In memoriam of professor Antonio Herrera Rodríguez","authors":"J. Albareda Albareda","doi":"10.1016/j.recot.2024.12.005","DOIUrl":"10.1016/j.recot.2024.12.005","url":null,"abstract":"","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 2","pages":"Page T221"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143551950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of semi-constrained total knee arthroplasty in gonarthrosis with collateral ligament insufficiency: Clinical and functional outcomes","authors":"A. Garrido-Hidalgo ,&nbsp;R. García Crespo ,&nbsp;B. Rizo de Álvaro ,&nbsp;B. Alcobía-Díaz ,&nbsp;G. Aparicio ,&nbsp;F. Marco","doi":"10.1016/j.recot.2024.04.003","DOIUrl":"10.1016/j.recot.2024.04.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Achieving stability in total knee arthroplasty (TKA) is crucial for long-term implant survival. In cases of severe deformity or ligament laxity, constrained implants may be required. Traditionally, increasing constraint involved intramedullary stems. However, there are intermediary alternatives, including employing a constrained polyethylene insert without stems, thereby avoiding complications related to them. The study aims to evaluate our experience with a non-modular constrained (NMC) implant in primary TKA.</div></div><div><h3>Material and methods</h3><div>We conducted a retrospective review of the clinical and radiographic outcomes of 108 non-stemmed primary TKAs performed at our institution between 2013 and 2021 in patients with at least 10° deformity or 10<!--> <!-->mm ligament laxity. Data included demographics, preoperative and postoperative deformities, clinical outcomes and revision rates.</div></div><div><h3>Results</h3><div>A total of 103 patients (108 knees) with a mean age of 74 were followed up for a minimum of 2 years. The mean postoperative range of motion was 105°/0°. The median Oxford Knee Score, Knee Society Score and Knee Society Function Score were 43.5, 92 and 90, respectively. 17 knees had varus deformity (mean tibiofemoral angle of 2.7°), and 87 knees had excessive valgus deformity (mean tibiofemoral angle of 15.1°). The remaining 4 knees had a neutral alignment. The mean postoperative tibiofemoral angle was 6.8°. The overall revision rate was 6.5% (7 patients): 3 deep periprosthetic infections, 2 patellar dislocations, 1 stiffness and 1 aseptic loosening.</div></div><div><h3>Conclusion</h3><div>Our experience demonstrates favorable mid-term outcomes with the NMC implant, providing a safe alternative to stemmed implants in primary TKA, particularly in cases of severe deformity or ligament laxity.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 2","pages":"Pages 135-141"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140761322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Técnica quirúrgica del manejo de las fracturas de calcáneo a través de un abordaje del seno del tarso","authors":"J. Mingo-Robinet,&nbsp;L. González-García,&nbsp;C. González-Alonso","doi":"10.1016/j.recot.2024.02.003","DOIUrl":"10.1016/j.recot.2024.02.003","url":null,"abstract":"<div><div>Calcaneal articular fractures are fractures classically associated with a high rate of complications and poor outcomes. Osteosynthesis of the calcaneus through a sinus tarsi approach has shown results equal to or superior to those of the extended approach, having become the new gold standard.</div><div>The objective of this article is to detail step by step the surgical technique of osteosynthesis of intra-articular fractures of the calcaneus through a sinus tarsi approach, from the selection of the fracture, positioning of the patient, layout of the operating room and the fluoroscope, the entire surgical process until postoperative treatment.</div><div>The surgical technique described below is described in 6 steps.<ul><li><span>1.</span><span><div>Layout of the operating room. Patient and Fluoroscope Positioning</div></span></li><li><span>2.</span><span><div>Reduction of the posterior tuberosity (correct height and varus)</div></span></li><li><span>3.</span><span><div>Sinus tarsi approach.</div></span></li><li><span>4.</span><span><div>Reduction of the articular surface and correct visualization. Arthroscopy</div></span></li><li><span>5.</span><span><div>Fixation of the articular surface</div></span></li><li><span>6.</span><span><div>Fixation of the posterior tuberosity</div></span></li></ul></div><div>Anatomical reduction of complex calcaneal fractures through an Sinus Tarsi Approach requires an understanding of the fracture and its associated deformities. Following the described sequence step by step will help to achieve a better reduction in order to achieve better functional results.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 2","pages":"Pages 110-123"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139973937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Translated article] AVIP project (Prosthetic Virtual Friend): Study of clinical–functional outcomes and satisfaction with a mobile application in the perioperative management and follow-up of hip arthroplasty","authors":"J. Diranzo-García,&nbsp;V. Estrems-Díaz,&nbsp;J.F. Garrido-Ferrer,&nbsp;L. Castillo-Ruipérez,&nbsp;V.M. Zarzuela-Sánchez,&nbsp;L. Hernández-Ferrando","doi":"10.1016/j.recot.2024.12.006","DOIUrl":"10.1016/j.recot.2024.12.006","url":null,"abstract":"<div><h3>Objective</h3><div>To analyse the clinical, quality of life, and healthcare quality outcomes obtained in a series of patients undergoing total hip arthroplasty (THA), who were empowered and monitored using the AVIP application. These results will be compared with a control group followed through a standard protocol.</div></div><div><h3>Material and method</h3><div>Randomised clinical trial with parallel groups involving patients with an indication for THA. Clinical variables were measured and compared using the WOMAC and mHHS, pain assessed by the VAS, quality of life with the SF-12 test. Walking capabilities were analysed using the Functional Gait Assessment Scale, along with satisfaction levels assessed through the SUCE questionnaire, and perceived anxiety levels related to the process.</div></div><div><h3>Results</h3><div>A total of 68 patients were evaluated, with 31 patients in the AVIP group and 33 in the Control group completing the follow-up. Both groups demonstrated improvement in clinical outcomes based on the WOMAC and mHHS hip tests, a reduction in perceived pain, and an enhancement in quality of life according to the SF-12 test. Patients in the AVIP study group exhibited non-inferiority in clinical outcomes and satisfaction compared to the control group, as well as lower anxiety levels and improved walking capabilities after the first month of follow-up. Notably, 82.25% of the follow-up visits for this group were conducted remotely.</div></div><div><h3>Conclusion</h3><div>The implementation of a mHealth application like AVIP can be safely offered to selected patients undergoing hip arthroplasty, enabling effective monitoring and providing continuous information and training.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 2","pages":"Pages T124-T134"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}