Revista Espanola de Cirugia Ortopedica y Traumatologia最新文献

{"title":"Ensayo clínico aleatorizado sobre la utilidad de la impresión 3 D en las fracturas intraarticulares de radio distal","authors":"P.Á. Sebastián Giraldo ,&nbsp;M. Elvira Soler ,&nbsp;A. Fernández Kang ,&nbsp;F. Martínez Martínez ,&nbsp;A. García López","doi":"10.1016/j.recot.2023.05.011","DOIUrl":"10.1016/j.recot.2023.05.011","url":null,"abstract":"<div><h3>Objectives</h3><div>We evaluated the utility of 3<!--> <!-->D printing technology for preoperative planning in the treatment of intra-articular fractures of the distal radius in relation to the improvement of surgical technique, radiological and clinical results.</div></div><div><h3>Material and methods</h3><div>A total of 30 patients with 2<!--> <!-->B and C fractures of the AO classification were operated on by a single surgeon with a volar plate, randomly divided into two groups, 15 of them with conventional planning (Rx and CT) and 15 adding a 3<!--> <!-->D model of the fracture and the previous simulation of the intervention. Simulation time, surgical time in minutes, radioscopy time in minutes, loss of material expressed in lost screws were recorded. Clinical evaluation based PRWE questionnaire and full radiographic analysis was done for all patients with a mean follow-up of 6 months by an independent, blinded observed.</div></div><div><h3>Results</h3><div>No statistically significant differences were observed in the PRWE questionnaire (<em>p</em> <!-->=<!--> <!-->0.22), nor were we observed differences in the radiological values, except in relation to the articular step (<em>p</em> <!-->=<!--> <!-->0.028), which represents statistical significance, but in both groups the median was of 0.0 (0.0–0.0). We also did not see statistically significant differences in surgical times (<em>p</em> <!-->=<!--> <!-->0.745), radioscopy (<em>p</em> <!-->=<!--> <!-->0.819) or in the loss of synthesis material (<em>p</em> <!-->=<!--> <!-->0.779).</div></div><div><h3>Conclusions</h3><div>3<!--> <!-->D printing has not improved the parameters studied in relation to routinely operated patients.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 2","pages":"Pages 199-205"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10052946","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] Enclavado de fracturas intertrocantéricas en población geriátrica: ¿lo sabemos todo?","authors":"P. Checa-Betegón ,&nbsp;Á. Ramos-Fernández ,&nbsp;G. Ciller-González ,&nbsp;M. Vallejo-Carrasco ,&nbsp;J. García-Coiradas ,&nbsp;J. Valle-Cruz","doi":"10.1016/j.recot.2025.01.003","DOIUrl":"10.1016/j.recot.2025.01.003","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Pertrochanteric fractures constitute an important part of the daily activity of the orthopedic surgeon. The aim of this study was to carry out an analysis of pre-, intra- and post-operative radiographic parameters and to analyze the results of stable and unstable intertrochanteric fractures treated with short nails with dynamic distal locking.</div></div><div><h3>Materials and methods</h3><div>Retrospective study in our center, between the years 2017-2021 of patients over 65<!--> <!-->years of age with pertrochanteric fracture. We included 272 patients treated with Gamma3 Nail (Stryker®) with dynamic distal locking. As variables, we recorded: age, medical comorbidities, fracture pattern according to AO/OTA, osteopenia according to Singh's classification, pre-operative (such as diaphyseal extension), intra-operative (such as tip-to-the-apex or medial cortical support) and post-operative radiographic parameters (such as time to consolidation or loss of reduction), pre- and post-operative Barthel, quality of life and complications and reinterventions, such as non-union or cut-out.</div></div><div><h3>Results</h3><div>The mean age was 83.28<!--> <!-->years (65-102). Two hundred four cases were women (75%). The average follow-up was 18.2<!--> <!-->months (12-24). The distribution according to AO/OTA classification was 85.7% 31.A1; 12.5% 31.A2; 1.9% 31.A3. Radiographic consolidation was obtained in 97.4% of cases. Tip to apex distance was less than 25<!--> <!-->mm in 95.6% of cases. Medial cortical support was positive or neutral in 88.6% of cases. Sixty cases (22.1%) of screw back-out were recorded. Eight reinterventions (2.9%) were performed, corresponding to three cut-outs (1.1%), three non-unions (1.1%), one avascular necrosis (0.4%) and one secondary hip osteoarthritis (0.4%).</div></div><div><h3>Conclusions</h3><div>Short nail with dynamic distal locking offers good clinical, radiological and functional results in all types of AO/OTA patterns, without increasing the complication rate, as long as there is an appropriate tip-to-the-apex distance and good medial cortical support.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 2","pages":"Pages T190-T198"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081365","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] Digital orthopaedic surgery: Benefits and challenges of extended reality and spatial computing","authors":"R. Pérez-Mañanes ,&nbsp;J.A. Calvo-Haro","doi":"10.1016/j.recot.2025.01.004","DOIUrl":"10.1016/j.recot.2025.01.004","url":null,"abstract":"","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 2","pages":"Pages T107-T109"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081432","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] Rivaroxaban versus enoxaparin for thromboprophylaxis in orthopedic surgery: A meta-analysis","authors":"O. Abad Vélaz,&nbsp;I. Carbonel Bueno","doi":"10.1016/j.recot.2025.01.005","DOIUrl":"10.1016/j.recot.2025.01.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Venous thromboembolism is highly associated with orthopedic surgery, so thromboprophylaxis is an important consideration for orthopedic surgeons. The new oral anticoagulants have clear advantages for clinical practice.</div></div><div><h3>Objectives</h3><div>To analyze the efficacy and safety of rivaroxaban versus enoxaparin for thromboprophylaxis in different orthopedic surgeries.</div></div><div><h3>Material and methods</h3><div>Systematic electronic search of clinical trials was carried out. Data extraction of efficacy outcomes (deep venous thrombosis, pulmonary embolism and death) and safety outcomes (major bleeding and clinically relevant bleeding) was realized.</div></div><div><h3>Results</h3><div>Six randomized and controlled clinical trials were included in this meta-analysis. Compared with enoxaparin the risk of venous thromboembolism was lower with rivaroxaban both in different orthopedic surgeries (RR: 0.51; 95% CI: 0.36–0.73; <em>p</em> <!-->=<!--> <!-->.0002). This result was even better and more homogeneous in the analysis of symptomatic deep venous thrombosis outcome (RR: 0.43; 95% CI: 0.28–0.65; <em>p</em> <!-->&lt;<!--> <!-->.0001; <em>I</em>² <!-->=<!--> <!-->0%; <em>p</em> <!-->=<!--> <!-->.49). The risk of bleeding was not significantly higher with rivaroxaban (RR: 1.20; 95% CI: 0.97–1.49; <em>p</em> <!-->=<!--> <!-->.09).</div></div><div><h3>Conclusions</h3><div>Rivaroxaban should be considerate such as a more effective alternative for thromboprophylaxis in orthopedic surgery.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 2","pages":"Pages T210-T220"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081434","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":"La importancia de la presencia online y buenas prácticas en redes sociales para el Cirujano Ortopédico","authors":"M. Vázquez Gómez ,&nbsp;M. Galipienso Eri ,&nbsp;J. Dellonder Frigolé ,&nbsp;A. Hernández Martínez","doi":"10.1016/j.recot.2023.09.010","DOIUrl":"10.1016/j.recot.2023.09.010","url":null,"abstract":"","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 2","pages":"Pages 222-223"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71427665","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":"Eficacia de nuevos viscosuplementos activos en el comportamiento de un modelo experimental de osteoartritis","authors":"R.E. Pérez Expósito ,&nbsp;M.A. Ortega Núñez ,&nbsp;M.J. Buján Varela ,&nbsp;R.M. Vega Rodríguez ,&nbsp;A.I. Ortíz Chércoles ,&nbsp;B.J. De La Torre Escuredo","doi":"10.1016/j.recot.2024.04.006","DOIUrl":"10.1016/j.recot.2024.04.006","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate with an animal model of osteoarthritis (New Zealand rabbits) the effectiveness of treatment with active viscosupplements (hyaluronic acid loaded with nanoparticles (NPs) that encapsulate anti-inflammatory compounds or drugs.</div></div><div><h3>Material and methods</h3><div>Experimental study composed of 5 groups of rabbits in which section of the anterior cruciate ligament and resection of the internal meniscus were performed to trigger degenerative changes and use it as a model of osteoarthritis. The groups were divided into osteoarthrosis without treatment (I), treatment with commercial hyaluronic acid (HA) (II), treatment with HA with empty nanoparticles (III), treatment with HA with nanoparticles encapsulating dexamethasone (IV) and treatment with HA with nanoparticles that encapsulate curcumin (V). In groups II to V, the infiltration of the corresponding compound was carried out spaced one week apart.</div><div>Macroscopic histological analysis was performed using a scale based on the Outerbridge classification for osteoarthritis.</div></div><div><h3>Results</h3><div>We observed that this osteoarthritis model is reproducible and degenerative changes similar to those found in humans are observed.</div><div>The groups that were infiltrated with hyaluronic acid with curcumin-loaded nanoparticles (V), followed by the dexamethasone group (IV) presented macroscopically less fibrillation, exposure of subchondral bone and sclerosis (better score on the scale) than the control groups (I) (osteoarthritis without treatment), group (II) treated with commercial hyaluronic acid and hyaluronic acid with nanoparticles without drug (III).</div></div><div><h3>Conclusions</h3><div>The use of active viscosupplements could have an additional effect to conventional hyaluronic acid treatment due to its antioxidant and anti-inflammatory effect. The most promising group was hyaluronic acid with nanoparticles that encapsulate curcumin and the second group was the one that encapsulates dexamethasone.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 2","pages":"Pages 150-157"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140763783","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":"Plaster cast removal simulation model for resident training.","authors":"F Moller-Macherone, M Lobos-Urbina, I Cañete-Campos, C Vidal-Olate, F Hodgson-Ovalle, P Murati-Carrasco, M A Ibañez-León, M J Figueroa-Gatica","doi":"10.1016/j.recot.2025.02.021","DOIUrl":"10.1016/j.recot.2025.02.021","url":null,"abstract":"<p><strong>Purpose: </strong>Complications from cast removal are infrequent but can cause permanent skin sequelae. Formal training in cast removal is limited during residency. This study aimed to develop a plaster cast removal simulation model for resident training.</p><p><strong>Methods: </strong>Quasiexperimental study. A pediatric forearm phantom with temperature sensors was designed to simulate forearm cast removal. Six first-year orthopedic residents with no prior cast removal experience and two experts were evaluated. The residents underwent an initial evaluation, followed by an instruction session, and a final evaluation. Performance was assessed using a specific ratings scale (SRS), the Objective Structured Assessment of Technical Skills (OSATS) guideline, procedure time, and temperature measurement. Median scores with ranges were reported, and pre- and posttraining performances were compared using the Wilcoxon test. Experts scores were compared with resident scores using the Mann-Whitney test. The statistical significance was set at p<0.05.</p><p><strong>Results: </strong>Significant improvements in OSATS [(pre 22 points (range: 20-24); posttraining 25 (range: 25-28) (p=0.03)] and SRS [pre 8.5 points (range: 7-9); post 10 points (range: 8-10) (p=0.02)] were observed. No differences were found in temperature (p=0.50) and procedure time (p=0.09). When comparing residents' post-training scores with those of experts, no significant differences were found in OSATS (p=0.16), SRS (p=0.11), temperature measurement (p=0.50), or procedure time (p=0.09).</p><p><strong>Conclusions: </strong>The plaster cast removal simulation model proved to be an effective training tool for residents, enabling them to achieve expert-level competency. Significant improvements were observed in OSATS and SRS scores post-training, highlighting the positive impact of the intervention on this skill.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537857","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":"Effectiveness, safety and efficiency of next-day discharge versus a 3-day hospital stay after primary total hip arthroplasty.","authors":"Juan Carlos Ferragut Bria, Francisco Antonio Miralles Muñoz, Fernando Sendra Miralles, Enrique Ruiz Piñana, Blanca González Navarro, María Flores Vizcaya Moreno","doi":"10.1016/j.recot.2025.02.020","DOIUrl":"https://doi.org/10.1016/j.recot.2025.02.020","url":null,"abstract":"<p><strong>Background: </strong>Some studies have proposed reducing unnecessary hospitalization days after total hip arthroplasty (THA) surgery to just a single overnight stay with discharge the morning after surgery. However, the available evidence on patient safety is of poor quality. The main objective was to analyze patient safety after discharge from the hospital the morning after THA surgery (rapid discharge), comparing it with the standard 3-day postoperative stay.</p><p><strong>Material and methods: </strong>A prospective, non-randomized comparative study was designed to compare two consecutive cohorts over time. The first cohort included patients with a postoperative stay of 3 days, while the second cohort had discharge the morning after surgery. The study evaluated the rate of complications and adverse events both postoperatively and after hospital discharge, as well as pain control using the visual analog scale, functional outcome using the Harris hip scale, patient satisfaction, and economic cost.</p><p><strong>Results: </strong>The rates of unexpected visits to the emergency room, early complications, readmissions, and reinterventions were similar in both groups, with no significant differences. The functional outcome was also similar in both groups, but the rapid discharge group experienced earlier recovery and significant financial savings.</p><p><strong>Conclusion: </strong>Rapid discharge, the morning after surgery, is a safe, effective and efficient procedure for primary THA in the majority of patients, with respect to a 3-day stay.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530943","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":"Utility of postoperative drainage in total hip arthroplasty. A systematic review.","authors":"C Moreno-Benet, P Castells-Ayuso, I Miranda, F J Miranda","doi":"10.1016/j.recot.2025.02.019","DOIUrl":"10.1016/j.recot.2025.02.019","url":null,"abstract":"<p><strong>Aim and hypothesis: </strong>To investigate the advantages associated with the use of drainage in primary total hip arthroplasty (THA) versus not using drainage and to determine if drainage can be systematically discontinued. The starting hypothesis was that eliminating the use of drainage systematically in THA does not significantly increase the risk of postoperative complications.</p><p><strong>Materials and methods: </strong>A systematic review was carried out following the PRISMA guidelines in the PubMed and Cochrane Library databases. The search was conducted on February 15, 2024, by entering the terms (\"suction drainage\") AND (\"total hip arthroplasty\"). The Joanna Briggs Institute quality assessment tool was used to assess the quality of the included studies.</p><p><strong>Results: </strong>Sixteen clinical trials comparing the use of drainage with no drainage in THA were included. No differences were observed in terms of infection rate or haematoma. Some authors find that the use of drainage increases the percentage of patients requiring transfusion and the length of hospitalisation. Of 16 studies, 13 recommend not to use drainage routinely in THA.</p><p><strong>Conclusions: </strong>The use of drainage in THA has no advantage over no drainage. The results of the clinical trials reviewed suggest that drainage should not be used routinely in THA.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531048","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":"Use of Artificial Intelligence to Predict Complications in Degenerative Thoracolumbar Spine Surgery: A Systematic Review.","authors":"Ricciardi Guillermo, Cirillo Totera Juan Ignacio, Pons Belmonte Rodrigo, Romero Valverde Lyanne, Lopez Muñoz Felipe, Manriquez Díaz Alan","doi":"10.1016/j.recot.2025.02.007","DOIUrl":"https://doi.org/10.1016/j.recot.2025.02.007","url":null,"abstract":"<p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>A total of 2,341 titles were identified (763 were duplicates). Screening was performed on 1,578 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 Orthopedics 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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469507","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}