Pub Date : 2026-03-01Epub Date: 2025-08-05DOI: 10.1016/j.recot.2025.07.024
L. Palacios-Díaz , A. González-García , P. Sanchez-Urgelles , J.J. Pozo-Kreilinger , M.T. Carrascal , A. Bustos , B. Diez Sánchez , S. Antuña , R. Barco
Purpose
Experimental post-traumatic arthrofibrosis studies have been conducted using mostly rabbit models. However, there is great interest in developing and validating models in smaller animals, which would allow for more cost-effective research. The aim is to validate a model in rats recently described by Owen et al.
Materials and methods
Twenty 14-weeks old Sprague Dawley female rats were used in the study: 10 rats were used to assess biomechanical contracture, as passive extension angle at different torques (PEA-2, PEA-4, PEA-8) and at capsule disruption, and 10 rats to assess histological fibrosis (area and thickness of posterior capsule). Left knee acted as control. Index surgery was performed on the right knee (operated knee) as described by Owen at al.: intra-articular injury, disruption of posterior capsule, and immobilization with a percutaneous suture in flexion. After a 4-week immobilization period, the suture was removed, followed by another 4-week remobilization period and euthanasia.
Results
Operated knees showed lower PEA-4 (−40.6°; P = .011), PEA-8 (−45.6°; P = .044) and PEA at capsule disruption (−66.5°; P = .043) than the control knees. Mean PEA-2, PEA-4 and PEA-8 from our sample were similar to those reported by Owen et al. Operated knees showed a larger posterior capsule area (1.82 mm2; P = .033) and thickness (.31 mm; P = .043) than the control knees.
Conclusions
The post-traumatic arthrofibrosis model described by Owen et al. has the capacity to induce biomechanical contracture and histological fibrosis. Our biomechanical results are comparable to those of Owen, supporting the model's reproducibility.
{"title":"Reproducibilidad y validez biomecánica e histológica de un nuevo modelo de artrofibrosis postraumática en ratas","authors":"L. Palacios-Díaz , A. González-García , P. Sanchez-Urgelles , J.J. Pozo-Kreilinger , M.T. Carrascal , A. Bustos , B. Diez Sánchez , S. Antuña , R. Barco","doi":"10.1016/j.recot.2025.07.024","DOIUrl":"10.1016/j.recot.2025.07.024","url":null,"abstract":"<div><h3>Purpose</h3><div>Experimental post-traumatic arthrofibrosis studies have been conducted using mostly rabbit models. However, there is great interest in developing and validating models in smaller animals, which would allow for more cost-effective research. The aim is to validate a model in rats recently described by Owen et al.</div></div><div><h3>Materials and methods</h3><div>Twenty 14-weeks old Sprague Dawley female rats were used in the study: 10 rats were used to assess biomechanical contracture, as passive extension angle at different torques (PEA-2, PEA-4, PEA-8) and at capsule disruption, and 10 rats to assess histological fibrosis (area and thickness of posterior capsule). Left knee acted as control. Index surgery was performed on the right knee (operated knee) as described by Owen at al.: intra-articular injury, disruption of posterior capsule, and immobilization with a percutaneous suture in flexion. After a 4-week immobilization period, the suture was removed, followed by another 4-week remobilization period and euthanasia.</div></div><div><h3>Results</h3><div>Operated knees showed lower PEA-4 (−40.6°; <em>P</em> <!-->=<!--> <!-->.011), PEA-8 (−45.6°; <em>P</em> <!-->=<!--> <!-->.044) and PEA at capsule disruption (−66.5°; <em>P</em> <!-->=<!--> <!-->.043) than the control knees. Mean PEA-2, PEA-4 and PEA-8 from our sample were similar to those reported by Owen et al. Operated knees showed a larger posterior capsule area (1.82<!--> <!-->mm<sup>2</sup>; <em>P</em> <!-->=<!--> <!-->.033) and thickness (.31<!--> <!-->mm; <em>P</em> <!-->=<!--> <!-->.043) than the control knees.</div></div><div><h3>Conclusions</h3><div>The post-traumatic arthrofibrosis model described by Owen et al. has the capacity to induce biomechanical contracture and histological fibrosis. Our biomechanical results are comparable to those of Owen, supporting the model's reproducibility.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 2","pages":"Pages 161-172"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388089","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}
Pub Date : 2026-03-01Epub Date: 2025-08-05DOI: 10.1016/j.recot.2025.07.019
A. Villalobos-Otayza , C. Arias-Calderon , N. Castrejon-Arias
Introduction
The COVID-19 pandemic led to the suspension of football leagues worldwide, resulting in changes to tournament formats and player performance. While European leagues have reported injury characteristics during this period, similar analyses are lacking in South America. This study aimed to compare injury incidence, burden, and patterns between a regular season (2023) and the pandemic-affected season (2020) in Peruvian professional football.
Methods
A total of 266 and 360 official matches were analyzed from the 2020 and 2023 seasons, respectively. Injury data were collected through video analysis of official broadcasts, sports media publications, and official statements from club medical departments. Injury severity was classified based on days lost until return to full competition. Injury burden was defined as total days lost per 1000 hours of exposure. Injury incidence rates (injuries per 1000 hours) and injury characteristics (type, anatomical location, mechanism, and severity) were compared between seasons.
Results
The 2020 season included 19 teams, 521 registered players, and 28 matches per team. In 2023, 20 teams and 532 players participated, with each team playing 37 matches. No significant difference was found in match injury incidence between seasons. However, injury burden in 2020 was 1.23 times higher (95% CI, P<.01) compared to 2023, with a median difference of 6 days lost per injury (U = 77, P<.001). Contact injuries significantly decreased in the 2020 season (RR 0.58, 95% CI, P<.05).
Conclusions
Although injury incidence remained similar, the 2020 pandemic season showed higher injury burden and fewer contact injuries, highlighting the need for adaptive strategies to protect athlete health during unexpected interruptions.
{"title":"Incidencia, carga y patrones de lesión del fútbol peruano: un análisis retrospectivo entre la temporada regular 2023 y la temporada 2020 durante la pandemia COVID-19","authors":"A. Villalobos-Otayza , C. Arias-Calderon , N. Castrejon-Arias","doi":"10.1016/j.recot.2025.07.019","DOIUrl":"10.1016/j.recot.2025.07.019","url":null,"abstract":"<div><h3>Introduction</h3><div>The COVID-19 pandemic led to the suspension of football leagues worldwide, resulting in changes to tournament formats and player performance. While European leagues have reported injury characteristics during this period, similar analyses are lacking in South America. This study aimed to compare injury incidence, burden, and patterns between a regular season (2023) and the pandemic-affected season (2020) in Peruvian professional football.</div></div><div><h3>Methods</h3><div>A total of 266 and 360 official matches were analyzed from the 2020 and 2023 seasons, respectively. Injury data were collected through video analysis of official broadcasts, sports media publications, and official statements from club medical departments. Injury severity was classified based on days lost until return to full competition. Injury burden was defined as total days lost per 1000<!--> <!-->hours of exposure. Injury incidence rates (injuries per 1000<!--> <!-->hours) and injury characteristics (type, anatomical location, mechanism, and severity) were compared between seasons.</div></div><div><h3>Results</h3><div>The 2020 season included 19 teams, 521 registered players, and 28 matches per team. In 2023, 20 teams and 532 players participated, with each team playing 37 matches. No significant difference was found in match injury incidence between seasons. However, injury burden in 2020 was 1.23 times higher (95% CI, <em>P</em><.01) compared to 2023, with a median difference of 6 days lost per injury (U<!--> <!-->=<!--> <!-->77, <em>P</em><.001). Contact injuries significantly decreased in the 2020 season (RR 0.58, 95% CI, <em>P</em><.05).</div></div><div><h3>Conclusions</h3><div>Although injury incidence remained similar, the 2020 pandemic season showed higher injury burden and fewer contact injuries, highlighting the need for adaptive strategies to protect athlete health during unexpected interruptions.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 2","pages":"Pages 98-104"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388373","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}
Pub Date : 2026-03-01Epub Date: 2025-11-26DOI: 10.1016/j.recot.2025.11.030
G. Slullitel , M. Fa-Binefa , P. Martínez de Albornoz , A. Oller Boix , N. Dopazo González , A. Fernández Cebrián , M. Monteagudo
Introduction
Talo-calcaneal coalition (TCC), presents a significant challenge in adult patients, often associated with pes planus and pes cavus. The aim of this study was to assess the effect of Medial Displacement Calcaneal Osteotomy (MDCO) on TTC.
Materials and methods
This study retrospectively analyzed 11 adult patients diagnosed with rigid flat feet caused by TCC, who underwent MDCO without coalition resection. Clinical and radiographic outcomes were assessed using questionnaires (ADL-FAAM, VAS and Likert scale) and imaging (Talar-first Metatarsal angle, Talo-calcaneal angle, both in AP and lateral views, and Talo-navicular Coverage) preoperatively and at one-year follow-up. Postoperative complications, infections or subsequent surgical procedures were also registered during follow up.
Results
One year postoperatively, the mean improvement in ADL-FAAM was –49 (SD 15.73), VAS was –6.7 (SD 1.21) and Likert scale –2.6 (SD 0.46). Radiographic analysis post-surgery revealed minimal changes, emphasizing that the substantial clinical benefits were primarily due to the correction of malalignment. A significant correlation was found between talo-calcaneal angles and talo-navicular coverage with postoperative FAAM scores (p = 0.011, p = 0.047), and talo-calcaneal angles with Likert scores (p = 0.05, p = 0.008). Patients with more severe preoperative valgus deformities experienced increased improvement.
Conclusion
MDCO without coalition resection offers a treatment alternative for adults with TCC-induced flatfoot.
Level of evidence
Level IV, retrospective case series.
距骨-跟骨联合（TCC）在成人患者中提出了重大挑战，通常与平足和足弓足有关。本研究的目的是评估内侧移位跟骨截骨术（MDCO）对TTC的影响。材料和方法本研究回顾性分析了11例确诊为TCC所致刚性扁平足的成年患者，这些患者接受了MDCO而没有联合切除术。术前和随访1年，采用问卷调查（ADL-FAAM、VAS和Likert量表）和影像学（距骨-第一跖骨角、距骨-跟骨角，包括正位和侧位，以及距骨-舟骨覆盖范围）评估临床和影像学结果。术后并发症、感染或后续手术也在随访中记录。结果术后1年，ADL-FAAM平均改善程度为-49 (SD 15.73)， VAS评分为-6.7 (SD 1.21)，李克特评分为-2.6 （SD 0.46）。术后放射学分析显示微小的变化，强调临床获益主要是由于矫正了不对准。距跟角和距舟骨覆盖度与术后FAAM评分有显著相关性（p = 0.011, p = 0.047），距跟角与Likert评分有显著相关性（p = 0.05, p = 0.008）。术前外翻畸形更严重的患者改善程度更高。结论mdco不联合切除是治疗成人tcc所致扁平足的一种选择。证据级别：IV级，回顾性病例系列。
{"title":"[Artículo traducido] Osteotomía medializadora de calcáneo aislada para el tratamiento de pie plano del adulto con coalición talocalcánea: ¿es la alineación el principal problema?","authors":"G. Slullitel , M. Fa-Binefa , P. Martínez de Albornoz , A. Oller Boix , N. Dopazo González , A. Fernández Cebrián , M. Monteagudo","doi":"10.1016/j.recot.2025.11.030","DOIUrl":"10.1016/j.recot.2025.11.030","url":null,"abstract":"<div><h3>Introduction</h3><div>Talo-calcaneal coalition (TCC), presents a significant challenge in adult patients, often associated with pes planus and pes cavus. The aim of this study was to assess the effect of Medial Displacement Calcaneal Osteotomy (MDCO) on TTC.</div></div><div><h3>Materials and methods</h3><div>This study retrospectively analyzed 11 adult patients diagnosed with rigid flat feet caused by TCC, who underwent MDCO without coalition resection. Clinical and radiographic outcomes were assessed using questionnaires (ADL-FAAM, VAS and Likert scale) and imaging (Talar-first Metatarsal angle, Talo-calcaneal angle, both in AP and lateral views, and Talo-navicular Coverage) preoperatively and at one-year follow-up. Postoperative complications, infections or subsequent surgical procedures were also registered during follow up.</div></div><div><h3>Results</h3><div>One year postoperatively, the mean improvement in ADL-FAAM was –49 (SD 15.73), VAS was –6.7 (SD 1.21) and Likert scale –2.6 (SD 0.46). Radiographic analysis post-surgery revealed minimal changes, emphasizing that the substantial clinical benefits were primarily due to the correction of malalignment. A significant correlation was found between talo-calcaneal angles and talo-navicular coverage with postoperative FAAM scores (<em>p</em> <!-->=<!--> <!-->0.011, <em>p</em> <!-->=<!--> <!-->0.047), and talo-calcaneal angles with Likert scores (<em>p</em> <!-->=<!--> <!-->0.05, <em>p</em> <!-->=<!--> <!-->0.008). Patients with more severe preoperative valgus deformities experienced increased improvement.</div></div><div><h3>Conclusion</h3><div>MDCO without coalition resection offers a treatment alternative for adults with TCC-induced flatfoot.</div></div><div><h3>Level of evidence</h3><div>Level IV, retrospective case series.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 2","pages":"Pages T91-T97"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388372","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}
Pub Date : 2026-03-01Epub Date: 2025-08-06DOI: 10.1016/j.recot.2025.07.023
D. Torres-Perez , E.R. Gil Monzó , N. Saez Mas , D. Martínez López , C. Martínez , J. Morales Rodríguez , A. Amaya Franco , S. López López , J.L. Rodrigo Pérez
Objectives
To provide information regarding the safety and effectiveness of soft tissue suturing as a fixation method for the Akin osteotomy (AO).
Materials and methods
We present a retrospective study involving 42 patients with hallux valgus who underwent a first metatarsal (MTT) procedure, all of whom additionally received an AO. The fixation method consisted of soft tissue suturing, supplemented with a cohesive bandage. We recorded the time to bone healing in all patients, as well as the length of the proximal phalanx of the hallux (P1) preoperatively, and at 1, 3, and 6 months postoperatively.
Results
In our series, 100% of AO fixed using soft tissue suturing achieved bone consolidation within an average of 4.5 months (SD: 0.3). No statistically significant differences were found (p > 0.5) between the P1 length measured at one month postoperatively (2.56 mm; SD: 0.04) and at the final radiographic evaluation (2.57 mm; SD: 0.04). Similarly, there were no significant differences between the postoperative distal articular set angle (DASA) (2.20; SD: 1.05) and the value at 6 months post-surgery (2.36; SD: 1.34).
Conclusions
Fixation of the AO using soft tissue suturing represents a simple, safe, reproducible, effective, and low-cost technique for maintaining the desired initial correction, while also avoiding complications associated with conventional osteosynthesis systems. To the best of our knowledge, this is the first reported series evaluating the efficacy of this type of fixation as a method of osteosynthesis for the AO.
目的探讨软组织缝合作为Akin截骨术固定方法的安全性和有效性。材料和方法我们提出了一项回顾性研究，涉及42例接受第一跖骨（MTT）手术的拇外翻患者，所有患者都接受了AO。固定方法为软组织缝合，辅以粘连绷带。我们记录了所有患者术前、术后1、3、6个月的骨愈合时间，以及拇近端指骨长度（P1）。结果在我们的研究中，100%的AO采用软组织缝合固定，平均在4.5个月内实现骨巩固（SD: 0.3）。术后1个月测得的P1长度（2.56 mm, SD: 0.04）与最终x线评估时测得的P1长度（2.57 mm, SD: 0.04）差异无统计学意义（p > 0.5）。同样，术后远端关节固定角（DASA） （2.20, SD: 1.05）与术后6个月值（2.36,SD: 1.34）无显著差异。结论使用软组织缝合固定AO是一种简单、安全、可重复性、有效和低成本的技术，可维持所需的初始矫正，同时也避免了传统骨合成系统相关的并发症。据我们所知，这是第一个评估这种固定作为AO固定方法疗效的系列报道。
{"title":"La fijación mediante sutura de partes blandas para la osteotomía de Akin en la patología del antepié. ¿Podemos abandonar la fijación con osteosíntesis?","authors":"D. Torres-Perez , E.R. Gil Monzó , N. Saez Mas , D. Martínez López , C. Martínez , J. Morales Rodríguez , A. Amaya Franco , S. López López , J.L. Rodrigo Pérez","doi":"10.1016/j.recot.2025.07.023","DOIUrl":"10.1016/j.recot.2025.07.023","url":null,"abstract":"<div><h3>Objectives</h3><div>To provide information regarding the safety and effectiveness of soft tissue suturing as a fixation method for the Akin osteotomy (AO).</div></div><div><h3>Materials and methods</h3><div>We present a retrospective study involving 42 patients with hallux valgus who underwent a first metatarsal (MTT) procedure, all of whom additionally received an AO. The fixation method consisted of soft tissue suturing, supplemented with a cohesive bandage. We recorded the time to bone healing in all patients, as well as the length of the proximal phalanx of the hallux (P1) preoperatively, and at 1, 3, and 6 months postoperatively.</div></div><div><h3>Results</h3><div>In our series, 100% of AO fixed using soft tissue suturing achieved bone consolidation within an average of 4.5 months (SD: 0.3). No statistically significant differences were found (p<!--> <!-->><!--> <!-->0.5) between the P1 length measured at one month postoperatively (2.56<!--> <!-->mm; SD: 0.04) and at the final radiographic evaluation (2.57<!--> <!-->mm; SD: 0.04). Similarly, there were no significant differences between the postoperative distal articular set angle (DASA) (2.20; SD: 1.05) and the value at 6 months post-surgery (2.36; SD: 1.34).</div></div><div><h3>Conclusions</h3><div>Fixation of the AO using soft tissue suturing represents a simple, safe, reproducible, effective, and low-cost technique for maintaining the desired initial correction, while also avoiding complications associated with conventional osteosynthesis systems. To the best of our knowledge, this is the first reported series evaluating the efficacy of this type of fixation as a method of osteosynthesis for the AO.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 2","pages":"Pages 111-116"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147387998","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}
Pub Date : 2026-03-01Epub Date: 2025-11-18DOI: 10.1016/j.recot.2025.11.024
D. Torres-Perez , E.R. Gil Monzó , N. Saez Mas , D. Martínez López , C. Martínez , J. Morales Rodríguez , A. Amaya Franco , S. López López , J.L. Rodrigo Pérez
Objectives
To provide information regarding the safety and effectiveness of soft tissue suturing as a fixation method for the Akin osteotomy (AO).
Materials and methods
We present a retrospective study involving 42 patients with hallux valgus who underwent a first metatarsal (MTT) procedure, all of whom additionally received an AO. The fixation method consisted of soft tissue suturing, supplemented with a cohesive bandage. We recorded the time to bone healing in all patients, as well as the length of the proximal phalanx of the hallux (P1) preoperatively, and at 1, 3, and 6 months postoperatively.
Results
In our series, 100% of AO fixed using soft tissue suturing achieved bone consolidation within an average of 4.5 months (SD: 0.3). No statistically significant differences were found (p > 0.5) between the P1 length measured at one month postoperatively (2.56 mm; SD: 0.04) and at the final radiographic evaluation (2.57 mm; SD: 0.04). Similarly, there were no significant differences between the postoperative distal articular set angle (DASA) (2.20; SD: 1.05) and the value at 6 months post-surgery (2.36; SD: 1.34).
Conclusions
Fixation of the AO using soft tissue suturing represents a simple, safe, reproducible, effective, and low-cost technique for maintaining the desired initial correction, while also avoiding complications associated with conventional osteosynthesis systems. To the best of our knowledge, this is the first reported series evaluating the efficacy of this type of fixation as a method of osteosynthesis for the AO.
目的探讨软组织缝合作为Akin截骨术固定方法的安全性和有效性。材料和方法我们提出了一项回顾性研究，涉及42例接受第一跖骨（MTT）手术的拇外翻患者，所有患者都接受了AO。固定方法为软组织缝合，辅以粘连绷带。我们记录了所有患者术前、术后1、3、6个月的骨愈合时间，以及拇近端指骨长度（P1）。结果在我们的研究中，100%的AO采用软组织缝合固定，平均在4.5个月内实现骨巩固（SD: 0.3）。术后1个月测得的P1长度（2.56 mm, SD: 0.04）与最终x线评估时测得的P1长度（2.57 mm, SD: 0.04）差异无统计学意义（p > 0.5）。同样，术后远端关节固定角（DASA） （2.20, SD: 1.05）与术后6个月值（2.36,SD: 1.34）无显著差异。结论使用软组织缝合固定AO是一种简单、安全、可重复性、有效和低成本的技术，可维持所需的初始矫正，同时也避免了传统骨合成系统相关的并发症。据我们所知，这是第一个评估这种固定作为AO固定方法疗效的系列报道。
{"title":"[Translated article] Soft tissue fixation using sutures for the Akin osteotomy in forefoot pathology: Can we abandon fixation with osteosynthesis?","authors":"D. Torres-Perez , E.R. Gil Monzó , N. Saez Mas , D. Martínez López , C. Martínez , J. Morales Rodríguez , A. Amaya Franco , S. López López , J.L. Rodrigo Pérez","doi":"10.1016/j.recot.2025.11.024","DOIUrl":"10.1016/j.recot.2025.11.024","url":null,"abstract":"<div><h3>Objectives</h3><div>To provide information regarding the safety and effectiveness of soft tissue suturing as a fixation method for the Akin osteotomy (AO).</div></div><div><h3>Materials and methods</h3><div>We present a retrospective study involving 42 patients with hallux valgus who underwent a first metatarsal (MTT) procedure, all of whom additionally received an AO. The fixation method consisted of soft tissue suturing, supplemented with a cohesive bandage. We recorded the time to bone healing in all patients, as well as the length of the proximal phalanx of the hallux (P1) preoperatively, and at 1, 3, and 6 months postoperatively.</div></div><div><h3>Results</h3><div>In our series, 100% of AO fixed using soft tissue suturing achieved bone consolidation within an average of 4.5 months (SD: 0.3). No statistically significant differences were found (<em>p</em> <!-->><!--> <!-->0.5) between the P1 length measured at one month postoperatively (2.56<!--> <!-->mm; SD: 0.04) and at the final radiographic evaluation (2.57<!--> <!-->mm; SD: 0.04). Similarly, there were no significant differences between the postoperative distal articular set angle (DASA) (2.20; SD: 1.05) and the value at 6 months post-surgery (2.36; SD: 1.34).</div></div><div><h3>Conclusions</h3><div>Fixation of the AO using soft tissue suturing represents a simple, safe, reproducible, effective, and low-cost technique for maintaining the desired initial correction, while also avoiding complications associated with conventional osteosynthesis systems. To the best of our knowledge, this is the first reported series evaluating the efficacy of this type of fixation as a method of osteosynthesis for the AO.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 2","pages":"Pages T111-T116"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147387999","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}
Pub Date : 2026-03-01Epub Date: 2025-08-18DOI: 10.1016/j.recot.2025.08.004
C. Castillejo , M. Zapatero , J.M. Bogallo , F. Lorente , C. Ortiz , J. Romero , F. Rivas-Ruiz , M.L. Bertrand
Objective
To compare the diagnostic and classification accuracy of tibial plateau fractures on simple radiographs among three groups: knee surgeons, resident physicians, and artificial intelligence (ChatGPT-4).
Methods
An observational, descriptive, cross-sectional study with a control group was conducted on a prospective cohort of patients treated for tibial plateau fractures between 2020 and 2024. Anteroposterior radiographs were blindly evaluated by three groups—three knee surgeons, three resident physicians., and ChatGPT-4—with fractures classified according to the Schatzker system. The reference standard was computed tomography (CT). The interobserver agreement was assessed using the Kappa statistic for fracture detection and the Ciccetti weighted Kappa for fracture classification, with a 95% confidence interval. A significance level of p < 0.01 was established.
Results
A total of 387 radiographs were included, of which 129 showed tibial plateau fractures (classified according to Schatzker as follows: 7 type I, 28 type II, 5 type III, 16 type IV, 21 type V, and 52 type VI) and 258 were without fracture. The AI demonstrated the highest accuracy in fracture detection, achieving an absolute agreement of 99.5% and a Kappa of 0.98 (95% CI: 0.97–1.00, p < 0.001), compared to 97% (K = 0.93, 95% CI: 0.91–0.95, p < 0.001) for knee surgeons and 93% (K = 0.848, 95% CI: 0.81–0.88, p < 0.001) for residents. In terms of interobserver variability for fracture diagnosis, the AI showed greater consistency than the human evaluators; however, for fracture classification, knee surgeons achieved a higher weighted Kappa (0.616, 95% CI: 0.554–0.679, p < 0.001) compared to the AI (0.612, 95% CI: 0.502–0.722, p < 0.001) and residents (0.572, 95% CI: 0.510–0.635, p < 0.001).
Conclusions
Artificial intelligence demonstrated notable accuracy in the detection of tibial plateau fractures, outperforming both residents and attending physicians in this specific task. However, in the classification of fractures using the Schatzker system, attending physicians achieved higher accuracy. These findings suggest that AI may serve as a valuable support tool in the diagnostic process, particularly in its early stages, complementing—but not replacing—the clinical judgment and experience of healthcare professionals.
Level of evidence: level III. Diagnostic. Cross-sectional descriptive study with control group.
目的比较膝关节外科医生、住院医师和人工智能（ChatGPT-4）三组单纯x线片对胫骨平台骨折的诊断和分类准确率。方法对2020年至2024年间接受胫骨平台骨折治疗的患者进行一项观察性、描述性、横断面研究，并以对照组为对照。三位膝关节外科医生和三位住院医师对前后位x线片进行了盲目评价。chatgpt -4，根据Schatzker系统对裂缝进行分类。参照标准为计算机断层扫描（CT）。采用Kappa统计量进行裂缝检测，Ciccetti加权Kappa进行裂缝分类，可信区间为95%。p <； 0.01的显著性水平。结果共纳入387张x线片，其中显示胫骨平台骨折129张（按照Schatzker分类：I型7张，II型28张，III型5张，IV型16张，V型21张，VI型52张），无骨折258张。人工智能在骨折检测方面显示出最高的准确性，达到99.5%的绝对一致性和0.98的Kappa (95% CI: 0.97-1.00, p < 0.001)，而膝关节外科医生为97% (K = 0.93, 95% CI: 0.91-0.95, p < 0.001)，住院医生为93% （K = 0.848, 95% CI: 0.81-0.88, p < 0.001）。在骨折诊断的观察者间变异性方面，人工智能比人类评估者表现出更大的一致性；然而，对于骨折分类，膝关节外科医生的加权Kappa评分（0.616,95% CI: 0.554-0.679, p < 0.001）高于人工智能（0.612,95% CI: 0.502-0.722, p < 0.001）和住院医生（0.572,95% CI: 0.510-0.635, p < 0.001）。结论人工智能在胫骨平台骨折的检测中具有显著的准确性，在这项特定任务中优于住院医生和主治医生。然而，在使用Schatzker系统进行骨折分类时，主治医生的准确率更高。这些发现表明，在诊断过程中，尤其是在早期阶段，人工智能可以作为一种有价值的辅助工具，补充而不是取代医疗保健专业人员的临床判断和经验。证据等级：三级。诊断。与对照组的横断面描述性研究。
{"title":"Fiabilidad de la inteligencia artificial (ChatGPT) en el diagnóstico y clasificación de las fracturas de meseta tibial","authors":"C. Castillejo , M. Zapatero , J.M. Bogallo , F. Lorente , C. Ortiz , J. Romero , F. Rivas-Ruiz , M.L. Bertrand","doi":"10.1016/j.recot.2025.08.004","DOIUrl":"10.1016/j.recot.2025.08.004","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the diagnostic and classification accuracy of tibial plateau fractures on simple radiographs among three groups: knee surgeons, resident physicians, and artificial intelligence (ChatGPT-4).</div></div><div><h3>Methods</h3><div>An observational, descriptive, cross-sectional study with a control group was conducted on a prospective cohort of patients treated for tibial plateau fractures between 2020 and 2024. Anteroposterior radiographs were blindly evaluated by three groups—three knee surgeons, three resident physicians., and ChatGPT-4—with fractures classified according to the Schatzker system. The reference standard was computed tomography (CT). The interobserver agreement was assessed using the Kappa statistic for fracture detection and the Ciccetti weighted Kappa for fracture classification, with a 95% confidence interval. A significance level of p<!--> <!--><<!--> <!-->0.01 was established.</div></div><div><h3>Results</h3><div>A total of 387 radiographs were included, of which 129 showed tibial plateau fractures (classified according to Schatzker as follows: 7 type I, 28 type II, 5 type III, 16 type IV, 21 type V, and 52 type VI) and 258 were without fracture. The AI demonstrated the highest accuracy in fracture detection, achieving an absolute agreement of 99.5% and a Kappa of 0.98 (95% CI: 0.97–1.00, p<!--> <!--><<!--> <!-->0.001), compared to 97% (K<!--> <!-->=<!--> <!-->0.93, 95% CI: 0.91–0.95, p<!--> <!--><<!--> <!-->0.001) for knee surgeons and 93% (K<!--> <!-->=<!--> <!-->0.848, 95% CI: 0.81–0.88, p<!--> <!--><<!--> <!-->0.001) for residents. In terms of interobserver variability for fracture diagnosis, the AI showed greater consistency than the human evaluators; however, for fracture classification, knee surgeons achieved a higher weighted Kappa (0.616, 95% CI: 0.554–0.679, p<!--> <!--><<!--> <!-->0.001) compared to the AI (0.612, 95% CI: 0.502–0.722, p<!--> <!--><<!--> <!-->0.001) and residents (0.572, 95% CI: 0.510–0.635, p<!--> <!--><<!--> <!-->0.001).</div></div><div><h3>Conclusions</h3><div>Artificial intelligence demonstrated notable accuracy in the detection of tibial plateau fractures, outperforming both residents and attending physicians in this specific task. However, in the classification of fractures using the Schatzker system, attending physicians achieved higher accuracy. These findings suggest that AI may serve as a valuable support tool in the diagnostic process, particularly in its early stages, complementing—but not replacing—the clinical judgment and experience of healthcare professionals.</div><div>Level of evidence: level III. Diagnostic. Cross-sectional descriptive study with control group.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 2","pages":"Pages 129-135"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388365","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}
Pub Date : 2026-03-01Epub Date: 2025-06-03DOI: 10.1016/j.recot.2025.05.007
A.D. Sánchez González , J. Prados Moreno , H.M. Pérez Díaz
Introduction/objectives
This article highlights the importance of historical knowledge in current medical training and practice, particularly in specialties such as Traumatology and Orthopedic Surgery. It criticizes the increasing technologization of medicine and its growing disconnection from the humanities. The study argues that the historical study of diseases —especially so-called “crippling” diseases, like poliomyelitis and musculoskeletal tuberculosis— provides a deeper understanding of current clinical processes, enhances medical empathy, and promotes a more comprehensive and critical education.
Methods
A historiographic study was conducted on 138 medical records from the San Juan de Dios Sanatorium in Seville, spanning the years 1943 to 1950. Thirty-two cases related to poliomyelitis and musculoskeletal tuberculosis were analyzed in depth, 9 of which underwent surgical intervention. Two cases involving subtalar arthrorisis were highlighted as examples to reinterpret past treatments using current orthopedic knowledge.
Results
Patients with poliomyelitis treated in the past underwent aggressive surgical procedures that, although well-intentioned, often resulted in severe deforming sequelae. Many of these patients now present with osteoarthritis, chronic pain, or deformities. Techniques such as rib arch grafting (Grice's technique) were precursors to modern methods like the calcaneal stop screw. While some procedures had long-term functional success (over 90% positive outcomes), many failed to consider the emotional and psychosocial impact on the patient.
Conclusions
This study demonstrates that understanding the historical context of disease is essential for providing more humane, effective, and empathetic care. It advocates for the integration of the History of Medicine into the curricula of medical specialties, to avoid simplistic judgments of past practices and to recognize that medical treatments are also cultural products of their time. Historical training allows physicians to develop critical, humanistic thinking and a respectful approach to the patient's experience.
本文强调了历史知识在当前医学培训和实践中的重要性，特别是在创伤学和骨科等专业。它批评了医学的日益技术化及其与人文学科的日益脱节。该研究认为，对疾病的历史研究——特别是所谓的“致残”疾病，如脊髓灰质炎和肌肉骨骼结核——提供了对当前临床过程的更深入理解，增强了医学同理心，并促进了更全面和批判性的教育。方法对1943 ~ 1950年塞维利亚San Juan de Dios疗养院的138份医疗记录进行史学研究。对32例脊髓灰质炎合并肌肉骨骼结核患者进行了深入分析，其中9例接受了手术干预。两个病例涉及距下关节炎突出作为例子，以重新解释过去的治疗使用当前的骨科知识。结果脊髓灰质炎患者过去接受了积极的手术治疗，尽管初衷是好的，但往往导致严重的畸形后遗症。这些患者中有许多现在表现为骨关节炎、慢性疼痛或畸形。肋骨弓移植（Grice的技术）等技术是跟骨止动螺钉等现代方法的先驱。虽然一些手术有长期的功能成功（超过90%的积极结果），但许多手术没有考虑到对患者的情感和心理社会影响。本研究表明，了解疾病的历史背景对于提供更人道、更有效和更有同情心的护理至关重要。它提倡将医学史纳入医学专业课程，以避免对过去做法的简单化判断，并认识到医疗也是其时代的文化产物。历史训练允许医生发展批判性的，人性化的思维和尊重病人的经验。
{"title":"Traumatología histórica: la importancia del conocimiento histórico de las enfermedades en la práctica clínica actual. El ejemplo de las «enfermedades lisiantes»","authors":"A.D. Sánchez González , J. Prados Moreno , H.M. Pérez Díaz","doi":"10.1016/j.recot.2025.05.007","DOIUrl":"10.1016/j.recot.2025.05.007","url":null,"abstract":"<div><h3>Introduction/objectives</h3><div>This article highlights the importance of historical knowledge in current medical training and practice, particularly in specialties such as Traumatology and Orthopedic Surgery. It criticizes the increasing technologization of medicine and its growing disconnection from the humanities. The study argues that the historical study of diseases —especially so-called “crippling” diseases, like poliomyelitis and musculoskeletal tuberculosis— provides a deeper understanding of current clinical processes, enhances medical empathy, and promotes a more comprehensive and critical education.</div></div><div><h3>Methods</h3><div>A historiographic study was conducted on 138 medical records from the San Juan de Dios Sanatorium in Seville, spanning the years 1943 to 1950. Thirty-two cases related to poliomyelitis and musculoskeletal tuberculosis were analyzed in depth, 9 of which underwent surgical intervention. Two cases involving subtalar arthrorisis were highlighted as examples to reinterpret past treatments using current orthopedic knowledge.</div></div><div><h3>Results</h3><div>Patients with poliomyelitis treated in the past underwent aggressive surgical procedures that, although well-intentioned, often resulted in severe deforming sequelae. Many of these patients now present with osteoarthritis, chronic pain, or deformities. Techniques such as rib arch grafting (Grice's technique) were precursors to modern methods like the calcaneal stop screw. While some procedures had long-term functional success (over 90% positive outcomes), many failed to consider the emotional and psychosocial impact on the patient.</div></div><div><h3>Conclusions</h3><div>This study demonstrates that understanding the historical context of disease is essential for providing more humane, effective, and empathetic care. It advocates for the integration of the History of Medicine into the curricula of medical specialties, to avoid simplistic judgments of past practices and to recognize that medical treatments are also cultural products of their time. Historical training allows physicians to develop critical, humanistic thinking and a respectful approach to the patient's experience.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 2","pages":"Pages 148-153"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388091","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}
Pub Date : 2026-03-01Epub Date: 2025-11-19DOI: 10.1016/j.recot.2025.11.025
A.D. Sánchez González , J. Prados Moreno , H.M. Pérez Díaz
Introduction/Objectives
This article highlights the importance of historical knowledge in current medical training and practice, particularly in specialties such as Traumatology and Orthopedic Surgery. It criticises the increasing technologization of medicine and its growing disconnection from the humanities. The study argues that the historical study of diseases—especially so-called “crippling” diseases, like poliomyelitis and musculoskeletal tuberculosis—provides a deeper understanding of current clinical processes, enhances medical empathy, and promotes a more comprehensive and critical education.
Methods
A historiographic study was conducted on 138 medical records from the San Juan de Dios Sanatorium in Seville, spanning the years 1943–1950. Thirty-two cases related to poliomyelitis and musculoskeletal tuberculosis were analysed in depth, 9 of which underwent surgical intervention. Two cases involving subtalar arthrorisis were highlighted as examples to reinterpret past treatments using current orthopaedic knowledge.
Results
Patients with poliomyelitis treated in the past underwent aggressive surgical procedures that, although well-intentioned, often resulted in severe deforming sequelae. Many of these patients now present with osteoarthritis, chronic pain, or deformities. Techniques such as rib arch grafting (Grice's technique) were precursors to modern methods like the calcaneal stop screw. While some procedures had long-term functional success (over 90% positive outcomes), many failed to consider the emotional and psychosocial impact on the patient.
Conclusions
This study demonstrates that understanding the historical context of disease is essential for providing more humane, effective, and empathetic care. It advocates for the integration of the History of Medicine into the curricula of medical specialties, to avoid simplistic judgments of past practices and to recognise that medical treatments are also cultural products of their time. Historical training allows physicians to develop critical, humanistic thinking and a respectful approach to the patient's experience.
本文强调了历史知识在当前医学培训和实践中的重要性，特别是在创伤学和骨科等专业。它批评了医学日益增长的技术化及其与人文学科的日益脱节。该研究认为，对疾病的历史研究——尤其是所谓的“致残”疾病，如脊髓灰质炎和肌肉骨骼结核——提供了对当前临床过程的更深入理解，增强了医学同理心，促进了更全面和批判性的教育。方法对1943 ~ 1950年塞维利亚San Juan de Dios疗养院的138份病历进行史学研究。对32例脊髓灰质炎合并肌肉骨骼结核患者进行了深入分析，其中9例接受了手术干预。两个病例涉及距下关节炎突出作为例子，以重新解释过去的治疗使用当前的骨科知识。结果脊髓灰质炎患者过去接受了积极的手术治疗，尽管初衷是好的，但往往导致严重的畸形后遗症。这些患者中有许多现在表现为骨关节炎、慢性疼痛或畸形。肋骨弓移植（Grice的技术）等技术是跟骨止动螺钉等现代方法的先驱。虽然一些手术有长期的功能成功（超过90%的积极结果），但许多手术没有考虑到对患者的情感和心理社会影响。本研究表明，了解疾病的历史背景对于提供更人道、更有效和更有同情心的护理至关重要。它提倡将医学史纳入医学专业的课程，以避免对过去的做法进行简单化的判断，并认识到医学治疗也是其时代的文化产物。历史训练允许医生发展批判性的，人性化的思维和尊重病人的经验。
{"title":"[Translated article] Historical traumatology: The importance of historical knowledge of diseases in current clinical practice—The example of “crippling diseases”","authors":"A.D. Sánchez González , J. Prados Moreno , H.M. Pérez Díaz","doi":"10.1016/j.recot.2025.11.025","DOIUrl":"10.1016/j.recot.2025.11.025","url":null,"abstract":"<div><h3>Introduction/Objectives</h3><div>This article highlights the importance of historical knowledge in current medical training and practice, particularly in specialties such as Traumatology and Orthopedic Surgery. It criticises the increasing technologization of medicine and its growing disconnection from the humanities. The study argues that the historical study of diseases—especially so-called “crippling” diseases, like poliomyelitis and musculoskeletal tuberculosis—provides a deeper understanding of current clinical processes, enhances medical empathy, and promotes a more comprehensive and critical education.</div></div><div><h3>Methods</h3><div>A historiographic study was conducted on 138 medical records from the San Juan de Dios Sanatorium in Seville, spanning the years 1943–1950. Thirty-two cases related to poliomyelitis and musculoskeletal tuberculosis were analysed in depth, 9 of which underwent surgical intervention. Two cases involving subtalar arthrorisis were highlighted as examples to reinterpret past treatments using current orthopaedic knowledge.</div></div><div><h3>Results</h3><div>Patients with poliomyelitis treated in the past underwent aggressive surgical procedures that, although well-intentioned, often resulted in severe deforming sequelae. Many of these patients now present with osteoarthritis, chronic pain, or deformities. Techniques such as rib arch grafting (Grice's technique) were precursors to modern methods like the calcaneal stop screw. While some procedures had long-term functional success (over 90% positive outcomes), many failed to consider the emotional and psychosocial impact on the patient.</div></div><div><h3>Conclusions</h3><div>This study demonstrates that understanding the historical context of disease is essential for providing more humane, effective, and empathetic care. It advocates for the integration of the History of Medicine into the curricula of medical specialties, to avoid simplistic judgments of past practices and to recognise that medical treatments are also cultural products of their time. Historical training allows physicians to develop critical, humanistic thinking and a respectful approach to the patient's experience.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 2","pages":"Pages T148-T153"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388114","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}
Pub Date : 2026-03-01Epub Date: 2025-08-06DOI: 10.1016/j.recot.2025.07.022
M. Ballester , G. Lúcar , L. Bello
Objective
To describe the application of the WALANT (Wide-Awake Local Anesthesia No Tourniquet) technique in hallux valgus surgery, highlighting its advantages in terms of patient comfort and surgical safety.
Methods
A descriptive study detailing the steps for administering WALANT anesthesia during hallux valgus correction. Patient selection, local anesthetic preparation, injection technique, and surgical approach were documented. The case of a 65-year-old woman with severe hallux valgus undergoing surgery with the WALANT technique is presented.
Results
The patient tolerated the procedure well without requiring sedation or experiencing significant pain. Despite the absence of a tourniquet, the surgery was performed with adequate visibility and hemostatic control. Early mobilization was achieved, and the patient reported a high level of satisfaction. At the 2-week follow-up, wound healing progressed favorably and alignment was satisfactory, with no complications observed.
Conclusion
WALANT appears to be a safe and effective alternative for hallux valgus surgery, minimizing the risks associated with general or regional anesthesia while improving the overall patient experience. This report outlines the anesthetic protocol routinely used in our practice, which may serve as a foundation for standardizing its application in forefoot procedures. Further comparative and prospective studies are warranted to assess its clinical and functional outcomes over the medium and long term.
Level of clinical evidence
This is a level 4 evidence study as it focuses on the description of a surgical technique based on clinical experience.
{"title":"Use of WALANT in hallux valgus correction: Anesthetic protocol and technical considerations","authors":"M. Ballester , G. Lúcar , L. Bello","doi":"10.1016/j.recot.2025.07.022","DOIUrl":"10.1016/j.recot.2025.07.022","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the application of the WALANT (Wide-Awake Local Anesthesia No Tourniquet) technique in hallux valgus surgery, highlighting its advantages in terms of patient comfort and surgical safety.</div></div><div><h3>Methods</h3><div>A descriptive study detailing the steps for administering WALANT anesthesia during hallux valgus correction. Patient selection, local anesthetic preparation, injection technique, and surgical approach were documented. The case of a 65-year-old woman with severe hallux valgus undergoing surgery with the WALANT technique is presented.</div></div><div><h3>Results</h3><div>The patient tolerated the procedure well without requiring sedation or experiencing significant pain. Despite the absence of a tourniquet, the surgery was performed with adequate visibility and hemostatic control. Early mobilization was achieved, and the patient reported a high level of satisfaction. At the 2-week follow-up, wound healing progressed favorably and alignment was satisfactory, with no complications observed.</div></div><div><h3>Conclusion</h3><div>WALANT appears to be a safe and effective alternative for hallux valgus surgery, minimizing the risks associated with general or regional anesthesia while improving the overall patient experience. This report outlines the anesthetic protocol routinely used in our practice, which may serve as a foundation for standardizing its application in forefoot procedures. Further comparative and prospective studies are warranted to assess its clinical and functional outcomes over the medium and long term.</div></div><div><h3>Level of clinical evidence</h3><div>This is a level 4 evidence study as it focuses on the description of a surgical technique based on clinical experience.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 2","pages":"Pages 142-147"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388118","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}
Pub Date : 2026-03-01Epub Date: 2025-11-17DOI: 10.1016/j.recot.2025.11.021
L. Palacios-Díaz , A. González-García , P. Sanchez-Urgelles , J.J. Pozo-Kreilinger , M.T. Carrascal , A. Bustos , B. Diez Sánchez , S. Antuña , R. Barco
Purpose
Experimental post-traumatic arthrofibrosis studies have been conducted using mostly rabbit models. However, there is great interest in developing and validating models in smaller animals, which would allow for more cost-effective research. The aim is to validate a model in rats recently described by Owen et al.
Materials and methods
Twenty 14-weeks old Sprague-Dawley female rats were used in the study: 10 rats were used to assess biomechanical contracture, as passive extension angle at different torques (PEA-2, PEA-4, PEA-8) and at capsule disruption, and 10 rats to assess histological fibrosis (area and thickness of posterior capsule). Left knee acted as control. Index surgery was performed on the right knee (operated knee) as described by Owen at al.: intra-articular injury, disruption of posterior capsule, and immobilization with a percutaneous suture in flexion. After a 4-week immobilization period, the suture was removed, followed by another 4-week remobilization period and euthanasia.
Results
Operated knees showed lower PEA-4 (−40.6°; p = .011), PEA-8 (−45.6°; p = .044) and PEA at capsule disruption (−66.5°; p = .043) than the control knees. Mean PEA-2, PEA-4 and PEA-8 from our sample were similar to those reported by Owen et al. Operated knees showed a larger posterior capsule area (1.82 mm2; p = .033) and thickness (.31 mm; p = .043) than the control knees.
Conclusions
The post-traumatic arthrofibrosis model described by Owen et al. has the capacity to induce biomechanical contracture and histological fibrosis. Our biomechanical results are comparable to those of Owen, supporting the model's reproducibility.
{"title":"[Translated article] Biomechanical and histological reproducibility and validity of a new post-traumatic model of arthrofibrosis in rats","authors":"L. Palacios-Díaz , A. González-García , P. Sanchez-Urgelles , J.J. Pozo-Kreilinger , M.T. Carrascal , A. Bustos , B. Diez Sánchez , S. Antuña , R. Barco","doi":"10.1016/j.recot.2025.11.021","DOIUrl":"10.1016/j.recot.2025.11.021","url":null,"abstract":"<div><h3>Purpose</h3><div>Experimental post-traumatic arthrofibrosis studies have been conducted using mostly rabbit models. However, there is great interest in developing and validating models in smaller animals, which would allow for more cost-effective research. The aim is to validate a model in rats recently described by Owen et al.</div></div><div><h3>Materials and methods</h3><div>Twenty 14-weeks old Sprague-Dawley female rats were used in the study: 10 rats were used to assess biomechanical contracture, as passive extension angle at different torques (PEA-2, PEA-4, PEA-8) and at capsule disruption, and 10 rats to assess histological fibrosis (area and thickness of posterior capsule). Left knee acted as control. Index surgery was performed on the right knee (operated knee) as described by Owen at al.: intra-articular injury, disruption of posterior capsule, and immobilization with a percutaneous suture in flexion. After a 4-week immobilization period, the suture was removed, followed by another 4-week remobilization period and euthanasia.</div></div><div><h3>Results</h3><div>Operated knees showed lower PEA-4 (−40.6°; <em>p</em> <!-->=<!--> <!-->.011), PEA-8 (−45.6°; <em>p</em> <!-->=<!--> <!-->.044) and PEA at capsule disruption (−66.5°; <em>p</em> <!-->=<!--> <!-->.043) than the control knees. Mean PEA-2, PEA-4 and PEA-8 from our sample were similar to those reported by Owen et al. Operated knees showed a larger posterior capsule area (1.82<!--> <!-->mm<sup>2</sup>; <em>p</em> <!-->=<!--> <!-->.033) and thickness (.31<!--> <!-->mm; <em>p</em> <!-->=<!--> <!-->.043) than the control knees.</div></div><div><h3>Conclusions</h3><div>The post-traumatic arthrofibrosis model described by Owen et al. has the capacity to induce biomechanical contracture and histological fibrosis. Our biomechanical results are comparable to those of Owen, supporting the model's reproducibility.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 2","pages":"Pages T161-T172"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388193","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}
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