Revista Espanola de Cirugia Ortopedica y Traumatologia最新文献

{"title":"Is one year follow-up sufficient to assess functional outcomes after rotator cuff repair?","authors":"I. Pasqualini,&nbsp;N. Lucero Viviani,&nbsp;O. Turan,&nbsp;I. Domenech,&nbsp;E.T. Hurley,&nbsp;C. Larrague,&nbsp;I. Tanoira,&nbsp;M. Ranalletta,&nbsp;L. Rossi","doi":"10.1016/j.recot.2026.01.004","DOIUrl":"10.1016/j.recot.2026.01.004","url":null,"abstract":"<div><h3>Background</h3><div>Arthroscopic rotator cuff repair (ARCR) traditionally requires a 2-year follow-up to report results. However, most of the recovery occurs within the first year. The aim of this study was to determine if there are clinically significant changes in patient-reported outcome measures (PROMs) and clinically significant outcomes (CSOs) between the first and second postoperative years.</div></div><div><h3>Methods</h3><div>Retrospective analysis of 140 patients. Four scales (ASES, VAS, PSQI, and SANE) were evaluated preoperatively and at 1 and 2 years postoperatively. Clinical relevance was measured using the minimal clinically important difference (MCID). Linear regression was used to identify factors associated with changes in outcomes.</div></div><div><h3>Results</h3><div>Improvements were observed in all scores; however, although statistically significant, these changes were minimal and lacked clinical relevance as they did not reach the minimal clinically important difference (MCID). Clinically significant outcome (CSO) rates remained stable, except for the SANE score. Factors such as diabetes, subscapularis tears, and tear size were associated with score changes during the second year.</div></div><div><h3>Conclusion</h3><div>Although there are slight statistical improvements in function, pain, and sleep quality between the first and second years, these are not clinically significant. A one-year follow-up is sufficient to evaluate functional outcomes after ARCR in the majority of patients.</div><div>Level of evidence IV</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 5","pages":"Pages 361-365"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784527","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] RECOT looks to the future: Internationalisation, excellence and scientific impact","authors":"M. Herrera-Pérez","doi":"10.1016/j.recot.2026.07.013","DOIUrl":"10.1016/j.recot.2026.07.013","url":null,"abstract":"","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 5","pages":"Pages T353-T354"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621849","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":"Patient satisfaction after radiological recurrence hallux valgus","authors":"Y. Hernanz-González,&nbsp;J.C. Martínez-Ávila,&nbsp;E. Sánchez-Morata,&nbsp;J. Vilá-Rico","doi":"10.1016/j.recot.2026.01.002","DOIUrl":"10.1016/j.recot.2026.01.002","url":null,"abstract":"<div><h3>Background and study aims</h3><div>Recurrence of the deformity is the most common complication following hallux valgus (HV) surgery correction.</div><div>The factors influencing patient satisfaction after HV surgery are currently widely debated.</div><div>The aims of this study was to investigate the association of the radiological recurrence of the HV deformity after distal chevron metatarsal osteotomy (DCMO) and the patient satisfaction.</div></div><div><h3>Materials and methods</h3><div>One hundred twenty patients (134 feet) with symptomatic moderate or severe HV deformity who underwent distal chevron metatarsal osteotomy (DCMO) at our institution between 2014 and 2019 were included in the present study. Each patient was evaluated preoperatively, postoperatively and at final follow-up by means of radiographs lateral and dorsoplantar views. The hallux valgus angle (HVA) was analyzed to define radiologic recurrence. Radiologic HV recurrence was defined by a final HVA equal or greater than 20°. Data were collected retrospectively.</div><div>The patient satisfaction after surgery was evaluated the last consultation by the PASS (patient acceptable symptom state).</div></div><div><h3>Results</h3><div>The mean follow-up time was 23.65 months (range 6–69.4). The recurrence rate was 76.1%.</div><div>All patients completed the PASS question at the last consultation. Of them, 105/134 (78.36%) patients considered their current state satisfactory and only 29/134 (21.64%) unsatisfactory.</div></div><div><h3>Conclusions</h3><div>In our cohort, we found no association between radiological recurrence of the HV deformity and patient satisfaction at final follow-up.</div><div>Patient satisfaction after HV surgery seems to be a complex concept and not explained completely by adequate deformity correction.</div></div><div><h3>Level of evidence</h3><div>Level IV.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 5","pages":"Pages 355-360"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784623","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":"RECOT hacia el futuro: internacionalización, excelencia e impacto científico","authors":"M. Herrera-Pérez","doi":"10.1016/j.recot.2026.07.012","DOIUrl":"10.1016/j.recot.2026.07.012","url":null,"abstract":"","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 5","pages":"Pages 353-354"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621790","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":"Cambios hemodinámicos transitorios asociados a la liberación del manguito neumático en la artroplastia total de rodilla: un estudio multicéntrico retrospectivo","authors":"W.F. Martínez,&nbsp;A. Jaime,&nbsp;G. Grecco,&nbsp;E.J. Bochatey,&nbsp;F.A. Lopreite","doi":"10.1016/j.recot.2026.02.002","DOIUrl":"10.1016/j.recot.2026.02.002","url":null,"abstract":"<div><h3>Background</h3><div>The release of a pneumatic tourniquet during total knee arthroplasty (TKA) causes an abrupt increase in blood flow to the lower limb, which may result in transient hemodynamic instability. The aim of this study was to quantify the magnitude and duration of these changes in a real-world clinical setting.</div></div><div><h3>Methods</h3><div>A multicenter retrospective observational study was conducted including 149 patients undergoing primary TKA under pneumatic tourniquet ischemia. Systolic (SBP), diastolic (DBP), and mean arterial pressure (MAP), heart rate (HR), respiratory rate (RR), and oxygen saturation (SpO₂) were recorded at three time points: baseline (pre-release), 3<!--> <!-->minutes (T3), and 6<!--> <!-->minutes (T6) after tourniquet release. Statistical analysis was performed using repeated-measures ANOVA or the Friedman test, according to data distribution, with p<!--> <!-->&lt;<!--> <!-->0.05 considered statistically significant.</div></div><div><h3>Results</h3><div>Following tourniquet release, a significant immediate decrease in SBP and DBP was observed (p<!--> <!-->&lt;<!--> <!-->0.001), with mean reductions of 19.8% and 21.2%, respectively, at T3. HR showed a mild but significant increase (p<!--> <!-->=<!--> <!-->0.012). SpO₂ decreased slightly (p<!--> <!-->=<!--> <!-->0.034) without clinical relevance. Transient arrhythmias were recorded in 8.7% of patients. At 6<!--> <!-->minutes post-release, all parameters returned to baseline values.</div></div><div><h3>Conclusion</h3><div>Tourniquet release during TKA is associated with transient hemodynamic changes and early recovery. These findings support the need for reinforced monitoring in patients classified as ASA III and/or with ischemia times longer than 85<!--> <!-->minutes, and provide a rationale for future prospective studies incorporating advanced hemodynamic monitoring.</div></div><div><h3>Level of evidence</h3><div>Level III, retrospective study.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 5","pages":"Pages 402-409"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784574","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":"Infección relacionada con la fractura en fracturas diafisarias cerradas de fémur tratadas con fijación externa y posterior fijación interna en un hospital de referencia: estudio de tipo corte transversal","authors":"M.F. Ochoa Ariza,&nbsp;J. Calderón Gamba,&nbsp;D.F. Rincón Cardozo","doi":"10.1016/j.recot.2026.01.005","DOIUrl":"10.1016/j.recot.2026.01.005","url":null,"abstract":"<div><h3>Introduction</h3><div>The definitive management of fractures is not completely unhazardous, with fracture-related infection (FRI) being one of the complications. The main objective of this study was to determine the prevalence of FRI in patients with closed femur fractures treated with initial external fixation followed by definitive fixation at a reference hospital.</div></div><div><h3>Materials and methods</h3><div>A cross-sectional observational study was conducted over a seven-year period. Patients aged 18 to 65 years with closed diaphyseal femoral fractures were included. FRI was defined according to the international consensus of Metsemakers et al. Demographic, clinical, and microbiological variables were analyzed using descriptive statistics with STATA v16.0.</div></div><div><h3>Results</h3><div>A total of 32 patients were evaluated, with a mean age of 33.9 years; 81.3% were male. Traffic accidents accounted for 87.5% of the cases, most frequently involving motorcycles (84.3%). The most common AO classification was 32B (53.1%). Conversion to internal fixation was performed between 4 and 21 days after the trauma. The prevalence of FRI was 12.5%, appearance of infection signs in the femur was between 3 and 16 days, and the predominant bacterial isolate was gram-negative bacteria.</div></div><div><h3>Conclusions</h3><div>The prevalence of early infection was higher than that reported in other settings, with a predominance of Gram-negative bacteria. Studies with larger sample sizes are needed to identify risk factors and to guide region-specific prevention strategies.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 5","pages":"Pages 366-372"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784482","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":"Effect of central sensitization on outcomes after hallux valgus surgery.","authors":"J M Rodríguez Sánchez, M Calderón García, N Prados Olleta","doi":"10.1016/j.recot.2026.07.011","DOIUrl":"10.1016/j.recot.2026.07.011","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":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148383040","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] Healthcare impact of increased use of direct oral anticoagulants in patients with hip fractures: A retrospective study.","authors":"J Sanz-Romera, L Bellido, I Miranda, M J Sangüesa-Nebot","doi":"10.1016/j.recot.2026.07.005","DOIUrl":"10.1016/j.recot.2026.07.005","url":null,"abstract":"<p><strong>Introduction and aim: </strong>Hip fractures are a major cause of hospital admissions in orthopaedic trauma, predominantly affecting elderly patients. The frequent use of anticoagulants in this population significantly impacts perioperative management. The aim was to analyse anticoagulant use in the general population and in patients with hip fractures, evaluating changes in prescription patterns and their clinical impact.</p><p><strong>Material and methods: </strong>A retrospective, analytical, and observational cohort study was conducted, including 435 patients who underwent surgical treatment for hip fractures in 2018 and 2023. The type of anticoagulation was recorded, and variables such as surgical delay (SD), hospital length of stay, and mortality were analysed and compared.</p><p><strong>Results: </strong>The use of direct oral anticoagulants (DOACs) increased significantly, with apixaban (+400%) and edoxaban (+20%), while that of acenocoumarol decreased by 33.33% (p=0.001). SD was longer in DOAC users (77±32h) than in those on acenocoumarol (55±27h) and non-anticoagulated patients (41±38h; p<0.005). Hospital stays were also longer with DOACs (8.96±4 days) vs non-anticoagulated patients (7.63±4 days; p=0.021). Worse survival rates were found in hip fracture patients anticoagulated with acenocoumarol compared with those receiving DOACs and non-anticoagulated patients.</p><p><strong>Conclusion: </strong>The analysis of anticoagulant use from 2018 to 2023 revealed a significant shift in prescription patterns, both in the general population and in patients with hip fractures. DOAC use was associated with increased SD and longer hospital stays in patients with proximal femoral fractures. The use of acenocoumarol is associated with an increase in mortality in patients who have undergone hip fracture surgery compared to users of DOACs.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148383043","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] Functional assessment in patients with metacarpal fractures treated with plates vs intramedullary screws: A scoping review.","authors":"K Quelal, E Jiménez, D J Gil Contreras, J F Castañeda","doi":"10.1016/j.recot.2026.07.003","DOIUrl":"10.1016/j.recot.2026.07.003","url":null,"abstract":"<p><strong>Introduction: </strong>Metacarpal fractures have an incidence of 8.4 per 10,000 people/year, representing 18-44% of hand fractures, and are more common in men. Various techniques have been described, such as fixation with Kirschner wires, locking plates, and intramedullary screws. The purpose of this review is to compare the functional outcomes reported in the literature.</p><p><strong>Materials and methods: </strong>A scoping review (PRISMA) was conducted, based on the PICO question: \"What are the functional outcomes in patients with metacarpal fractures fixed with plates versus intramedullary screws?\".</p><p><strong>Results: </strong>Five retrospective studies, one prospective study, two systematic literature reviews, and one meta-analysis were analysed.</p><p><strong>Discussion: </strong>Kirschner wire fixation is inexpensive and readily available, requires prolonged postoperative immobilisation, and is associated with a high rate of infection. The plate and screws provide the most stable fixation, require extensive soft tissue dissection, and are associated with stiffness, extensor adhesions, and infection. Screw fixation maintains reduction and prevents rotational instability, allowing for early mobilisation. Joint damage does not exceed 8% of the articular surface. A total of 1873 patients were included (295 women and 1578 men), with a mean age of 32years. The fifth metacarpal was the most frequently fractured, and the most common fracture locations were the neck (44.66%), the shaft (38.55%), and the head (10.68%). Regarding functionality, Barrera-Ochoa, DelPrete, and Fatima reported lower QuickDASH scores for intramedullary screw fixation compared to plate fixation (8.62 vs. 4.55). Grip strength was also superior with screws (90.3% for plates, 104.4% for screws). Esteban-Feliu and Barrera report an earlier return to activity, shorter surgical time, less pain, and a lower rate of implant removal procedures in the intramedullary screw group.</p><p><strong>Conclusion: </strong>The authors conclude that intramedullary screw fixation is a safe, effective, and minimally invasive technique with satisfactory clinical results and minimal complications, offering significant functional advantages over plate fixation.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148383076","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] Pre-transfusion testing in cervical spine surgery: Are we overprepared?","authors":"A Taberner, J D Montenegro, K Zelada, B Escudero, D Bosch, J H Núñez","doi":"10.1016/j.recot.2026.07.008","DOIUrl":"10.1016/j.recot.2026.07.008","url":null,"abstract":"<p><strong>Objective: </strong>Previous studies have shown that routine pre-transfusion testing is unnecessary for most patients undergoing cervical spine surgery, except for those with preoperative haemoglobin (Hb) levels below 12g/dL. However, the applicability of this recommendation in patients undergoing anterior cervical arthrodesis (ACA) remains uncertain. This study aimed to evaluate the necessity of pre-transfusion testing in this specific patient subgroup.</p><p><strong>Material and methods: </strong>A prospective study was conducted including patients undergoing ACA for degenerative conditions between 2014 and 2023 at our centre. Bivariate analyses were performed to identify predictive factors for transfusion based on preoperative Hb (< or ≥12g/dL). The crossmatch-to-transfusion ratio (C/T), likelihood of transfusion (%T), and transfusion index (TI) were also assessed.</p><p><strong>Results: </strong>A total of 318 patients were analysed, of whom only 2 (0.6%) required a transfusion. Patients with Hb<12g/dL had an OR of 25.33 (95% CI: 1.49-429.799; p=0.02) for transfusion. Significant differences were observed between the Hb<12g/dL and ≥12g/dL groups regarding age (p=0.002), ASA score (p<0.001), and transfusion rate (p=0.001). In patients with Hb<12g/dL, the C/T ratio was 13.0, %T was 7.69%, and TI was 0.08, indicating suboptimal levels. Although the TI differed between groups (0.08 vs. 1), the difference was not statistically significant (p=0.14).</p><p><strong>Conclusions: </strong>Routine blood reservation and pre-transfusion testing could be limited in patients undergoing ACA, particularly in those with haemoglobin levels above 12g/dL. These findings support the optimisation of preoperative protocols by eliminating routine pre-transfusion testing in this surgical subgroup.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148382986","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}