Revista Espanola de Cirugia Ortopedica y Traumatologia最新文献

{"title":"[Translated article] Use of “ice-cream cone” prosthesis in acetabular defects secondary to tumor resections","authors":"J. Teves,&nbsp;J. Perez-Abdala,&nbsp;N. Stramazzo,&nbsp;I. Albergo,&nbsp;G. Farfalli,&nbsp;M. Ayerza,&nbsp;L. Aponte-Tinao","doi":"10.1016/j.recot.2025.08.006","DOIUrl":"10.1016/j.recot.2025.08.006","url":null,"abstract":"<div><h3>Background and objectives</h3><div>The treatment of pelvic tumors, particularly in the periacetabular region (zone II of the Enneking and Dunham classification), represents a significant challenge for orthopedic oncologic surgeons due to the anatomical complexity and the need to preserve hip function. “Ice-cream cone” prostheses have emerged as a promising reconstructive option due to their versatility and potential to reduce infection rates, although evidence regarding their effectiveness remains limited.</div></div><div><h3>Materials and methods</h3><div>A retrospective cohort of patients with pelvic bone tumors treated with “ice-cream cone” prostheses between 2016 and 2023 at a single tertiary care center was analyzed. Patients with tumors affecting zone II and undergoing preservation of zone Ia were included. Surgical variables, complications, functionality, recurrence, and mortality were evaluated.</div></div><div><h3>Results</h3><div>Ten patients met the inclusion criteria. The median age was 50 years, with a mean follow-up of 26.4 months. Chondrosarcoma was the most common tumor (60%). All surgeries achieved negative oncologic margins. The median postoperative score on the Musculoskeletal Tumor Society (MSTS) scale was 22.5 points (range: 12–28). No local recurrence was observed, although one patient developed metastases and another died due to complications of chronic kidney disease.</div></div><div><h3>Conclusion</h3><div>The use of “ice-cream cone” prostheses for acetabular defects following oncologic resection appears to be a safe and effective technique in selected patients, offering good functional outcomes and high satisfaction, with complication rates comparable to other alternatives.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 6","pages":"Pages T605-T613"},"PeriodicalIF":0.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145374741","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] Complications in the surgical treatment of scoliosis in pediatric patients","authors":"F.J. Quiñonez,&nbsp;M.R. Latorre,&nbsp;P. Dardanelli,&nbsp;C. Halliburton,&nbsp;R. Maenza,&nbsp;M. Puigdevall,&nbsp;S.T. Bosio","doi":"10.1016/j.recot.2025.08.005","DOIUrl":"10.1016/j.recot.2025.08.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Scoliosis in pediatric patients encompasses a highly heterogeneous group and is one of the most common reasons for consultation, with a prevalence ranging between 1.5% and 3% of the pediatric population. The most common categories of pediatric scoliosis include idiopathic, neuromuscular, and congenital forms. Surgical correction of spinal deformities is a complex procedure, and although major complications are rare, it remains a crucial intervention. The main goal of surgical treatment is to prevent deformity progression while minimizing morbidity, maximizing postoperative function, and improving the patient's quality of life. This study aims to evaluate complication rates associated with surgical treatment of pediatric scoliosis and analyze the variables linked to increased complication rates over a 30-year period.</div></div><div><h3>Methods</h3><div>This study involved a retrospective review of prospectively collected data from a single institution's registry of patients who underwent surgical treatment for pediatric scoliosis over a 30-year period.</div></div><div><h3>Results</h3><div>Between 1991 and 2021, 779 patients underwent surgery. A total of 63 complications (8.08%) were recorded. Neuromuscular scoliosis had the highest complication rate, with 34 complications in 186 patients (18.28%), followed by congenital scoliosis with 6 complications in 57 patients (10.53%), and 23 complications in 536 patients with adolescent idiopathic scoliosis (4.29%). Infections were the most frequent complications at 4.49%. Neuromuscular scoliosis had the highest infection rate at 10.75%, followed by congenital scoliosis at 5.26%, and idiopathic scoliosis at 2.24%. Neurological deficit rates varied significantly according to the etiology of scoliosis (<em>p</em> <!-->&lt;<!--> <!-->.001), with the highest rate in neuromuscular cases (2.69%), followed by congenital cases (1.75%), and idiopathic scoliosis (0.93%). Neuromuscular and congenital scoliosis had the highest rates of clinical complications, at 3.76% and 1.75%, respectively, followed by idiopathic scoliosis (1.12%).</div></div><div><h3>Conclusion</h3><div>An overall complication rate of 8.09% was observed in our series following surgery for pediatric scoliosis. Although neuromuscular scoliosis presented the highest morbidity, relatively high complication rates were observed across all groups. This information can be valuable for preoperative counseling and surgical decision-making in the treatment of pediatric scoliosis.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 6","pages":"Pages T652-T658"},"PeriodicalIF":0.0,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145374459","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] A perioperative optimisation programme can improve results and reduce hospital length of stay in hip and knee arthroplasty: Experience in Chile","authors":"J.M. Luarte ,&nbsp;J.T. Vizcaya ,&nbsp;D. Munita ,&nbsp;E. Stocker ,&nbsp;R. Núñez ,&nbsp;J.A. Merino ,&nbsp;C. Rojas","doi":"10.1016/j.recot.2025.08.002","DOIUrl":"10.1016/j.recot.2025.08.002","url":null,"abstract":"<div><h3>Background and objective</h3><div>Perioperative optimisation programmes 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 optimisation programme in prosthetic surgery at a Latin American centre.</div></div><div><h3>Materials and methods</h3><div>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 optimisation programme in 2019. The impact of the programme on hospital length of stay and 90-day readmission rates was assessed.</div></div><div><h3>Results</h3><div>A total of 1462 patients (1636 surgeries) were included, with 429 surgeries in the pre-intervention group and 1207 in the post-intervention group. Hospital length of stay decreased from 3.5 to 2.22 days (<em>p</em> <!-->&lt;<!--> <!-->0.05). The 90-day readmission rate decreased from 2.56 to 2.24% (<em>p</em> <!-->=<!--> <!-->0.71), with a significant reduction in knee arthrofibrosis (from 0.9 to 0.2%, <em>p</em> <!-->&lt;<!--> <!-->0.05). The optimisation programme was the main factor contributing to the reduction in hospital length of stay.</div></div><div><h3>Conclusions</h3><div>The multidisciplinary perioperative programme implemented significantly reduced hospital stay without increasing 90-day readmission rates. Furthermore, it equated outcomes between patients with public and private insurance.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 6","pages":"Pages T614-T620"},"PeriodicalIF":0.0,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145374740","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":"[Artículo traducido] Minimización del sangrado y la transfusión en artroplastias bilaterales de cadera y rodilla en un solo tiempo: una revisión sistemática de las intervenciones actuales","authors":"R. Gonzalez-Pola ,&nbsp;R.O. Tafoya-Olivos ,&nbsp;L.A. Culebras-Almeida ,&nbsp;G. Zermeño-Garcia ,&nbsp;A. Herrera-Lozano","doi":"10.1016/j.recot.2025.07.015","DOIUrl":"10.1016/j.recot.2025.07.015","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate perioperative strategies for minimizing bleeding and transfusion needs in single-stage bilateral hip and knee arthroplasty. This systematic review identifies effective interventions and provides evidence-based recommendations and highlight areas for future research in optimizing bleeding management.</div></div><div><h3>Methods</h3><div>A systematic review of literature from January 2010 to October 2024 was conducted, focusing on randomized controlled trials, meta-analyses, and guidelines. Databases searched included PubMed/MEDLINE, Embase, Cochrane Library, and Web of Science. Interventions assessed included tranexamic acid (TXA), surgical techniques, regional anesthesia, controlled hypotension, preoperative anemia correction, tourniquet use, bone wax, and restrictive transfusion strategies. Study selection, data extraction, and quality assessment followed PRISMA and Newcastle-Ottawa Scale guidelines.</div></div><div><h3>Results</h3><div>From 325 included studies, TXA consistently demonstrated the most significant impact, reducing transfusion rates by 40-60%. Anterior total hip arthroplasty was associated with reduced blood loss. Regional anesthesia and controlled hypotension further minimized intraoperative bleeding. Preoperative anemia correction and restrictive transfusion thresholds also showed benefits. Tourniquet evidence was inconclusive. Limited evidence supported bone wax. GRADE assessment suggested high evidence quality for TXA and regional anesthesia, moderate for minimally invasive surgery, anemia correction, and restrictive transfusion, and low for bone wax.</div></div><div><h3>Conclusions</h3><div>Multimodal approach integrating TXA, regional anesthesia, minimally invasive surgery, anemia correction, and restrictive transfusion protocols effectively reduces bleeding and transfusion needs in bilateral arthroplasty. Incorporation into enhance recovery after surgery protocols is recommended. Future research should refine TXA dosing, clarify tourniquet use, and assess cost-effectiveness.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 5","pages":"Pages T532-T543"},"PeriodicalIF":0.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144890967","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] 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 ,&nbsp;J. Hurtado-Avilés ,&nbsp;M. López-López ,&nbsp;F. Santonja-Medina ,&nbsp;J. Moya-Angeler","doi":"10.1016/j.recot.2025.07.016","DOIUrl":"10.1016/j.recot.2025.07.016","url":null,"abstract":"","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 5","pages":"Pages T553-T554"},"PeriodicalIF":0.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144888777","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] Reconsidering preoperative transfusion testing in primary total hip and knee arthroplasty: Are they truly efficient?","authors":"J.H. Núñez ,&nbsp;M.J. Jimenez-Jimenez ,&nbsp;B. Escudero","doi":"10.1016/j.recot.2025.07.017","DOIUrl":"10.1016/j.recot.2025.07.017","url":null,"abstract":"","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 5","pages":"Pages T551-T552"},"PeriodicalIF":0.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144890999","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] Letter to the Editor about the article: “The configuration of the screws in the osteosynthesis of fractures of the femoral neck does not influence the functional or mechanical outcome”","authors":"D. González-Morgado ,&nbsp;J.V. Andrés-Peiró ,&nbsp;J. Tomàs-Hernández ,&nbsp;J. Selga-Marsà ,&nbsp;C.A. Piedra-Calle ,&nbsp;J. Teixidor-Serra","doi":"10.1016/j.recot.2025.07.004","DOIUrl":"10.1016/j.recot.2025.07.004","url":null,"abstract":"","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 6","pages":"Pages T670-T671"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145374463","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] Update on the treatment of acute infections in knee prostheses: Is it possible to retain the components? An in-depth look at the DAIR procedure","authors":"R. Calvo Rodriguez ,&nbsp;J. Isla Villanueva ,&nbsp;D. Edwards Silva ,&nbsp;H. Cifuentes Aedo","doi":"10.1016/j.recot.2025.07.008","DOIUrl":"10.1016/j.recot.2025.07.008","url":null,"abstract":"<div><h3>Introduction</h3><div>Periprosthetic knee infections are serious complications after knee arthroplasty, affecting 1–2% of patients with primary surgery and up to 20% of revisions. The DAIR strategy (debridement, antibiotics, and implant retention) has emerged as a treatment for acute infections, allowing component retention in certain cases, with a high success rate.</div></div><div><h3>Objectives</h3><div>This review discusses its application, success factors, techniques such as the “double DAIR” and postoperative management, highlighting the importance of correct patient selection and the combination of a thorough and meticulous surgical technique with appropriate antibiotic therapy to optimise results.</div></div><div><h3>Methods</h3><div>An exhaustive updated literature search was conducted regarding the use of DAIR in acute periprosthetic infections, highlighting the step-by-step procedure and some surgical tips that are helpful when performing it. Based on this, recommendations were made for physicians interested in the subject.</div></div><div><h3>Results</h3><div>A series of recommendations are made based on current literature, which are a useful guide when dealing with patients with acute infections in the context of knee prostheses, with a success rate greater than 70% in most cases where the patient is well selected.</div></div><div><h3>Conclusions</h3><div>DAIR is a useful and effective tool in the eradication and treatment of acute periprosthetic infections, with a good success rate. It is a cheap, technically simple and reproducible procedure, so as a group, we suggest it be adopted globally by orthopaedic surgeons.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 6","pages":"Pages T568-T578"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145374388","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] Effectiveness, safety and efficiency of next-day discharge versus a 3-day hospital stay after primary total hip arthroplasty","authors":"J.C. Ferragut Bria ,&nbsp;F.A. Miralles Muñoz ,&nbsp;F. Sendra Miralles ,&nbsp;E. Ruiz Piñana ,&nbsp;B. González Navarro ,&nbsp;M.F. Vizcaya Moreno","doi":"10.1016/j.recot.2025.07.007","DOIUrl":"10.1016/j.recot.2025.07.007","url":null,"abstract":"<div><h3>Background</h3><div>Some studies have proposed reducing unnecessary hospitalization days after total hip arthroplasty 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 total hip arthroplasty surgery (rapid discharge), comparing it with the standard 3-day postoperative stay.</div></div><div><h3>Material and methods</h3><div>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 score, patient satisfaction, and economic cost.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>Rapid discharge, the morning after surgery, is a safe, effective and efficient procedure for primary total hip arthroplasty in the majority of patients, with respect to a 3-day stay.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 6","pages":"Pages T597-T604"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145374392","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] Arthroscopic rotator cuff repair using a single or double row technique: A meta-analysis of randomized clinical trial","authors":"J.H. Núñez ,&nbsp;J.D. Montenegro ,&nbsp;M. Surroca ,&nbsp;B. Ocrospoma-Flores ,&nbsp;E. Guerra-Farfán ,&nbsp;G. Mendez-Sanchez ,&nbsp;A. Fraguas ,&nbsp;O. Gómez","doi":"10.1016/j.recot.2025.07.005","DOIUrl":"10.1016/j.recot.2025.07.005","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the double row technique versus the single row technique for arthroscopic rotator cuff repair, in order to assess whether there are clinical differences.</div></div><div><h3>Methods</h3><div>Systematic review of randomized clinical trials comparing the clinical results of the double-row technique versus the single-row technique in arthroscopic rotator cuff repair. Demographic, clinical, and surgical variables were analyzed, including functional scores, tendon healing rate, and re-tear rate.</div></div><div><h3>Results</h3><div>Thirteen randomized clinical trials were selected. 437 patients in the single row group (50.7%) and 424 patients in the double row group (49.3%) were analyzed. No significant differences were found between the two groups in terms of age (<em>P</em> = .84), sex (<em>P</em> <!-->=<!--> <!-->.23) and loss to follow-up (<em>P</em> <!-->=<!--> <!-->.52). Significant differences were found for the better results of the double row technique at the UCLA level (<em>P</em> <!-->=<!--> <!-->.01). No significant differences were found on the Constant-Murley scale (<em>P</em> <!-->=<!--> <!-->.87) or on the ASES scale (<em>P</em> <!-->=<!--> <!-->.56). Similarly, there was a higher healing rate (<em>P</em> <!-->=<!--> <!-->.006) and less risk of rotator cuff re-tears with the double row technique (<em>P</em> <!-->=<!--> <!-->.006).</div></div><div><h3>Conclusions</h3><div>In rotator cuff repair, the double row technique was found to be superior to the single row technique in terms of better UCLA score, better tendon healing rate, and lower re-tear rate. No clinically significant differences were found on the Constant-Murley scale or on the ASES scale.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 6","pages":"Pages T659-T669"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145374462","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}