Revista Latinoamericana de Cirugía Ortopédica最新文献

Osteoarthritis (OA) is a disease of the whole joint that presents obvious signs at advanced stages preceded by a long asymptomatic period difficult to identify. Conventional X-ray is still the most common utilized method for diagnosis, however, it remains silent during most of the degenerative process and it presents late indirect signs of degeneration, such as joint space narrowing and osteophytes. Despite its cost, MR has demonstrated to be a really effective method to evaluate initial degenerative changes in OA. Quantitative MRI has been shown to be able to detect some of the initial changes at early stages of OA, however, this technique requires highly specialized technicians and an elevated cost. In addition, compositional MR is one of the most promising techniques for the visualization and quantification of pre-morphologic cartilage changes by analyzing the biomechanical properties that take place at the early onset of the disease. Likewise, synovial fluid analysis and the presence of certain biomarkers constitute an additional method for the evaluation of early degenerative changes in OA.

Purpose

In this study, we aimed to determine if there is any difference between the subjetive satisfaction and the residual tibial traslation outcomes, of the three most common reconstruction techniques; which are conventional trans-tibial technique, anatomic tunnel technique and all inside technique.

Material and methods

Observational, retrospective study of eigthteen patients who underwent ACL reconstruction between 2014 and 2015. Single-bundle reconstruction with an autologous or allograft was performed in all patients. Femoral tunnel was drilled by the conventional TT technique in 6 patients, Anatomic in 6 patients and all inside in 6. Functional evaluation was performed about 6 months postoperatively. Functional evaluation included the International Knee Documentation Committee Scoring Subjetive form (IKDC) and anteroposterior stability was assessed using a arthrometer in lachman test and anterior drawer test.

Results

The results of IKDC subjetive test and residual ligament laxity, demonstrated statistical diference between Transtibial (IKDC 70.52) vs all inside technique (IKDC 89.63) (P0.05).

Conclusion

The all inside preparation technique in the reconstruction of the ACL seems as effective as the conventional techniques in terms of subjetive satisfaction and stability in the midterm of follow up.

Level of evidence: IV.

3D printing allows translation of a virtual planning to tangible models. Domestic 3D printers in hospital facilitate obtaining autonomously («do it yourself») realistic reproductions at minimum cost.

Objective

To describe our methodology for clinical translation of domestic 3D printing in Orthopedic Surgery and Traumatology, define indications and specific applications according to clinical experience.

Materials and methods

A prospective observational analytical study of 63 patients treated in our service from 2014 in which domestic 3D printing is included in the care process. Variables such as degree of satisfaction perceived by patients, accuracy, time or exposure to ionizing radiation during surgery are analyzed.

Results

A workflow is defined to obtaining 3D printed model using freely available programs and domestic 3D printers, and variables included in the study improved.

Conclusions

Domestic 3D printing has numerous applications in Orthopedic Surgery and Traumatology. Clinical experience has allowed defining a workflow with satisfactory clinical results.

Objective

To analyze the injuries in 4, male and female, official championships CONMEBOL for determined the differences in location, diagnosis and severity of injuries among players of both sexes.

Material and methodology

Injuries recorded in competitions with 506 female players in 48 games, and 644 male players in 58 games. One hundred fifteen males and 151 females were injured of varying severity. We study the diagnosis, location, time, lowered sports and mechanism of injury.

Results

One third of the injuries occurred between minute 30 and 45 of the game. Most frequent injuries in women were in the head and face (22.5%), knee (15.9%), ankle (15.2%) and calf (11.2%). In men were in the thigh (25.2%), head and face (14.8%), calf (11.2%), foot (10.3%) and ankle (9.5%). Bruises, in both groups, was the most frequent diagnosis (65.5% women; 44% men), followed by muscle tears (12.1%), muscle strains (13%) and sprains (7.7%) in males and followed by concussions (14%) and sprains (8.6%) in females. A total of 70% of serious injuries were not sanctioned in men's soccer.

Conclusion

The bruises were the leading cause of injury followed, in women, by concussions and in men by thigh muscle injury. A third of the injuries occurred in the last quarter of the first half and most of the injuries were mild. In men's football are most common severe injuries.

Cartilage is a sensitive tissue prone to damage with the continuous practice of sports and ageing process, holding a low self repairing capacity. Degenerative joint diseases are among the most disabling and limiting in regards to life quality and daily activities. Biological therapies have become available to potentially treat osteoarthritis and focal chondral defects. However, there is still no efficient way to regenerate native hyaline cartilage. Stem cell therapy and bioengineering is a promising field which can transform the paradigms in orthopaedics. This review provides an overall view of the current state of biological therapies with stem and progenitor cells. We summarize cell therapy options with culture expanded cells and also four common sources of adult stem cells: bone marrow, adipose tissue, synovium and peripheral venous blood, along with clinical studies reporting their effectiveness. The purpose of this review is to summarize adult stem cells approaches for the treatment of focal chondral lesions and osteoarthritis.

Objective

Assessment the concentric isokinetic performance of the flexor and extensor muscles of the joints of the knees legs dominant and not dominant prior to the commencement of a new soccer season.

Material and methods

A total of 30 high-performance professional soccer players aged between 18 and 33 years, and 86% had the right leg as dominant (kick) and the remaining 14% left leg. All underwent isokinetic testing in angular velocity of 60°/s in the dynamometer using concentric muscle action.

Results

The following results were obtained: peak torque in angular velocity of 60°/s of the flexors of the dominant leg (DL) was higher than 3% to the non-dominant leg (NDL), but this difference was not significant. Unlike the torque pique the extensor muscles of the NDL was 9% higher (P = 0.06) than DL. The percentage of flexors/extensors ratio for peak torque NDL was abnormal and below 7% (P = 0.09) than DL.

Conclusion

These results indicate the need for prior assessment of the flexor and extensor muscles of the knee as a preventive conduct before starting the training program of high performance soccer players.