Pub Date : 2025-03-01DOI: 10.1016/j.recot.2023.09.005
O. Abad Vélaz, I. Carbonel Bueno
Introduction
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.
Objectives
To analyze the efficacy and safety of rivaroxaban versus enoxaparin for thromboprophylaxis in different orthopedic surgeries.
Material and Methods
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 clinical relevant bleeding) was realized.
Results
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; P=.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; P<.0001; I2 = 0%; P=.49). The risk of bleeding was not significantly higher with rivaroxaban (RR: 1.20; 95% CI: 0.97-1.49; P=.09).
Conclusions
Rivaroxaban should be considerate such as a more effective alternative for thromboprophylaxis in orthopedic surgery.
{"title":"Rivaroxaban frente a enoxaparina como tromboprofilaxis en cirugía ortopédica y traumatología: un metaanálisis","authors":"O. Abad Vélaz, I. Carbonel Bueno","doi":"10.1016/j.recot.2023.09.005","DOIUrl":"10.1016/j.recot.2023.09.005","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 clinical 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><.0001; <em>I</em><sup>2</sup> <!-->=<!--> <!-->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 210-220"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41169060","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}
Pub Date : 2025-03-01DOI: 10.1016/j.recot.2024.02.004
J. Albareda Albareda
{"title":"Necrológica del profesor Antonio Herrera Rodríguez","authors":"J. Albareda Albareda","doi":"10.1016/j.recot.2024.02.004","DOIUrl":"10.1016/j.recot.2024.02.004","url":null,"abstract":"","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 2","pages":"Page 221"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140763068","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}
Pub Date : 2025-03-01DOI: 10.1016/j.recot.2024.11.020
R. Escribano Rey
Objective
To determine if subchondral bone damage can influence the clinical results of intraarticular platelet-rich-plasma (PRP) treatment in knee osteoarthritic patients.
Material and methods
A retrospective review of patients treated with intraarticular PRP injections for knee osteoarthritis who previously underwent a magnetic resonance (MR) of the knee was performed. Visual Analogic Score (VAS) was assessed for pain, whereas WORMS MR score was adapted to assess the damage to the subchondral bone (WORMSsc score).
Results
Sixty-one patients were treated with 3 weekly injections of PRP. Mean VAS reduction was 27.67 ± 13.13 points (p < .005). WORMS sc mean score was 32 ± 18.5 points. No correlation between WORMSsc and VAS was found. A moderate correlation between WORMSsc score and preoperative VAS was found (r = .43; p < .005).
Conclusion
There is no correlation between the damage to the subchondral bone assessed by MR and pain relief at 12 weeks in patients treated with intraarticular platelet-rich plasma in patients with knee osteoarthritis. A greater damage to the subchondral bone could be associated with more pain.
{"title":"[Translated article] Subchondral bone damage has no influence in 12-week clinical outcome in patients with knee osteoarthritis treated with intraarticular platelet-rich plasma: A retrospective study","authors":"R. Escribano Rey","doi":"10.1016/j.recot.2024.11.020","DOIUrl":"10.1016/j.recot.2024.11.020","url":null,"abstract":"<div><h3>Objective</h3><div>To determine if subchondral bone damage can influence the clinical results of intraarticular platelet-rich-plasma (PRP) treatment in knee osteoarthritic patients.</div></div><div><h3>Material and methods</h3><div>A retrospective review of patients treated with intraarticular PRP injections for knee osteoarthritis who previously underwent a magnetic resonance (MR) of the knee was performed. Visual Analogic Score (VAS) was assessed for pain, whereas WORMS MR score was adapted to assess the damage to the subchondral bone (WORMSsc score).</div></div><div><h3>Results</h3><div>Sixty-one patients were treated with 3 weekly injections of PRP. Mean VAS reduction was 27.67<!--> <!-->±<!--> <!-->13.13 points (<em>p</em> <!--><<!--> <!-->.005). WORMS sc mean score was 32<!--> <!-->±<!--> <!-->18.5 points. No correlation between WORMSsc and VAS was found. A moderate correlation between WORMSsc score and preoperative VAS was found (<em>r</em> <!-->=<!--> <!-->.43; <em>p</em> <!--><<!--> <!-->.005).</div></div><div><h3>Conclusion</h3><div>There is no correlation between the damage to the subchondral bone assessed by MR and pain relief at 12 weeks in patients treated with intraarticular platelet-rich plasma in patients with knee osteoarthritis. A greater damage to the subchondral bone could be associated with more pain.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 2","pages":"Pages T183-T189"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773360","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}
Pub Date : 2025-03-01DOI: 10.1016/j.recot.2024.12.010
J.C. Perdomo-Lizarraga , A. Combalia , J.A. Fernández-Valencia , A. Alías , J. Aponcio , L. Morata , A. Soriano , E. Muñoz-Mahamud
Introduction
Staphylococcus aureus stands as the predominant etiological agent in postoperative acute prosthetic joint infections (PJI), contributing to 35–50% of reported cases. This study aimed to evaluate the efficacy of dual prophylaxis incorporating cefuroxime and teicoplanin, in combination with nasal decolonization utilizing 70% alcohol, and oral and body lavage with chlorhexidine.
Material and methods
We conducted a retrospective review of electronic health records regarding primary and revision arthroplasties conducted at our institution from 2020 to 2021. Relevant variables linked to prosthetic joint infections (PJI) were documented until the latest follow-up.
Results
A total of 539 operations (447 primary arthroplasties and 92 revision arthroplasties) were performed on 519 patients. There were 11 cases of postoperative acute PJI, resulting in infection rates of 1.6% for primary arthroplasties and 4.3% for revision surgeries. Infections were more prevalent in male patients, individuals with an ASA classification > II, and those undergoing longer operations (>90 min). S. aureus was not isolated in any of the cases.
Conclusion
The prophylactic measures implemented in our institution have exhibited a high efficacy in preventing postoperative acute PJI caused by S. aureus.
{"title":"[Artículo traducido] Profilaxis efectiva para la erradicación de infecciones por Staphylococcus aureus en cirugía protésica de cadera primaria y de revisión electiva","authors":"J.C. Perdomo-Lizarraga , A. Combalia , J.A. Fernández-Valencia , A. Alías , J. Aponcio , L. Morata , A. Soriano , E. Muñoz-Mahamud","doi":"10.1016/j.recot.2024.12.010","DOIUrl":"10.1016/j.recot.2024.12.010","url":null,"abstract":"<div><h3>Introduction</h3><div><em>Staphylococcus aureus</em> stands as the predominant etiological agent in postoperative acute prosthetic joint infections (PJI), contributing to 35–50% of reported cases. This study aimed to evaluate the efficacy of dual prophylaxis incorporating cefuroxime and teicoplanin, in combination with nasal decolonization utilizing 70% alcohol, and oral and body lavage with chlorhexidine.</div></div><div><h3>Material and methods</h3><div>We conducted a retrospective review of electronic health records regarding primary and revision arthroplasties conducted at our institution from 2020 to 2021. Relevant variables linked to prosthetic joint infections (PJI) were documented until the latest follow-up.</div></div><div><h3>Results</h3><div>A total of 539 operations (447 primary arthroplasties and 92 revision arthroplasties) were performed on 519 patients. There were 11 cases of postoperative acute PJI, resulting in infection rates of 1.6% for primary arthroplasties and 4.3% for revision surgeries. Infections were more prevalent in male patients, individuals with an ASA classification<!--> <!-->><!--> <!-->II, and those undergoing longer operations (>90<!--> <!-->min). <em>S. aureus</em> was not isolated in any of the cases.</div></div><div><h3>Conclusion</h3><div>The prophylactic measures implemented in our institution have exhibited a high efficacy in preventing postoperative acute PJI caused by <em>S. aureus</em>.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 2","pages":"Pages T177-T182"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802663","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}
Pub Date : 2025-03-01DOI: 10.1016/j.recot.2024.12.004
J. Mingo-Robinet, L. González-García, C. González-Alonso
Calcaneal articular fractures are fractures classically associated with a high rate of complications and poor outcomes. Osteosynthesis of the calcaneus through a sinus tarsi approach has shown results equal to or superior to those of the extended approach, having become the new gold standard.
The objective of this article is to detail step by step the surgical technique of osteosynthesis of intra-articular fractures of the calcaneus through a sinus tarsi approach, from the selection of the fracture, positioning of the patient, layout of the operating room and the fluoroscope, the entire surgical process until postoperative treatment.
The surgical technique described below is described in 6 steps.
1.
Layout of the operating room. Patient and fluoroscope positioning.
2.
Reduction of the posterior tuberosity (correct height and varus).
3.
Sinus tarsi approach.
4.
Reduction of the articular surface and correct visualisation. Arthroscopy.
5.
Fixation of the articular surface.
6.
Fixation of the posterior tuberosity.
Anatomical reduction of complex calcaneal fractures through an sinus tarsi approach requires an understanding of the fracture and its associated deformities. Following the described sequence step by step will help to achieve a better reduction in order to achieve better functional results.
{"title":"[Translated article] Treatment of displaced intra-articular calcaneal fractures using a sinus tarsi approach. Surgical technique","authors":"J. Mingo-Robinet, L. González-García, C. González-Alonso","doi":"10.1016/j.recot.2024.12.004","DOIUrl":"10.1016/j.recot.2024.12.004","url":null,"abstract":"<div><div>Calcaneal articular fractures are fractures classically associated with a high rate of complications and poor outcomes. Osteosynthesis of the calcaneus through a sinus tarsi approach has shown results equal to or superior to those of the extended approach, having become the new gold standard.</div><div>The objective of this article is to detail step by step the surgical technique of osteosynthesis of intra-articular fractures of the calcaneus through a sinus tarsi approach, from the selection of the fracture, positioning of the patient, layout of the operating room and the fluoroscope, the entire surgical process until postoperative treatment.</div><div>The surgical technique described below is described in 6 steps.<ul><li><span>1.</span><span><div>Layout of the operating room. Patient and fluoroscope positioning.</div></span></li><li><span>2.</span><span><div>Reduction of the posterior tuberosity (correct height and varus).</div></span></li><li><span>3.</span><span><div>Sinus tarsi approach.</div></span></li><li><span>4.</span><span><div>Reduction of the articular surface and correct visualisation. Arthroscopy.</div></span></li><li><span>5.</span><span><div>Fixation of the articular surface.</div></span></li><li><span>6.</span><span><div>Fixation of the posterior tuberosity.</div></span></li></ul></div><div>Anatomical reduction of complex calcaneal fractures through an sinus tarsi approach requires an understanding of the fracture and its associated deformities. Following the described sequence step by step will help to achieve a better reduction in order to achieve better functional results.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 2","pages":"Pages T110-T123"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802665","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}
Pub Date : 2025-03-01DOI: 10.1016/j.recot.2024.09.002
Ricardo Escribano Rey
Objective
To determine if subchondral bone damage can influence the clinical results of intraarticular platelet-rich-plasma (PRP) treatment in knee osteoarthritic patients.
Material and methods
A retrospective review of patients treated with intraarticular PRP injections for knee osteoarthritis who previously underwent a Magnetic Resonance (MR) of the knee was performed. Visual Analogic Score (VAS) was assesed for pain, whereas WORMS MR score was adapted to assess the damage to the subchondral bone (WORMSsc score).
Results
Sixty-one patients were treated with 3 weekly injections of PRP. Mean VAS reduction was 27.67 ± 13.13 points (P<.005). WORMS sc mean score was 32 ± 18.5 points. NO correlation between WORMSsc and VAS was found. A moderate correlation between WORMSsc score and Preoperative VAS was found (r=.43; P<.005).
Conclusion
There is no correlation between the damage to the subchondral bone assesed by MR and pain relief at 12 weeks in patients treated with intraarticular platelet-rich plasma in patients with knee osteoarthritis. A greater damage to the subchondral bone could be associated with more pain.
{"title":"La lesión del hueso subcondral no influye en los resultados clínicos a 12 semanas en los pacientes tratados con plasma rico en plaquetas intraarticular por artrosis de rodilla: estudio retrospectivo","authors":"Ricardo Escribano Rey","doi":"10.1016/j.recot.2024.09.002","DOIUrl":"10.1016/j.recot.2024.09.002","url":null,"abstract":"<div><h3>Objective</h3><div>To determine if subchondral bone damage can influence the clinical results of intraarticular platelet-rich-plasma (PRP) treatment in knee osteoarthritic patients.</div></div><div><h3>Material and methods</h3><div>A retrospective review of patients treated with intraarticular PRP injections for knee osteoarthritis who previously underwent a Magnetic Resonance (MR) of the knee was performed. Visual Analogic Score (VAS) was assesed for pain, whereas WORMS MR score was adapted to assess the damage to the subchondral bone (WORMSsc score).</div></div><div><h3>Results</h3><div>Sixty-one patients were treated with 3 weekly injections of PRP. Mean VAS reduction was 27.67<!--> <!-->±<!--> <!-->13.13 points (<em>P</em><.005). WORMS sc mean score was 32<!--> <!-->±<!--> <!-->18.5 points. NO correlation between WORMSsc and VAS was found. A moderate correlation between WORMSsc score and Preoperative VAS was found (r=.43; <em>P</em><.005).</div></div><div><h3>Conclusion</h3><div>There is no correlation between the damage to the subchondral bone assesed by MR and pain relief at 12 weeks in patients treated with intraarticular platelet-rich plasma in patients with knee osteoarthritis. A greater damage to the subchondral bone could be associated with more pain.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 2","pages":"Pages 183-189"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297708","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}
Pub Date : 2025-03-01DOI: 10.1016/j.recot.2024.11.019
S. Parra Escorihuela, A.D. Ghinea, Á. Montero Sánchez, J. Orenga Orenga
The lateral antebrachial cutaneous nerve (LACN) is the sensory branch of the musculocutaneous nerve and usually innervates the lateral aspect of the forearm. Isolated lesions are rare, of varied aetiology and generally underdiagnosed. We present a retrospective descriptive study of electromyography performed at the General University Hospital of Castellón in the last 20 years with isolated NCAL lesion. We identified 11 cases (8 men and 3 women), average age 44 years (15–73 years). 73% were referred from traumatology. Only one patient was correctly guided in the application. 63.6% of cases noted hypoesthesia extending to the wrist and 18.2% to the thumb. The electromyographic study showed severe axonal involvement in 3 patients and moderate in 8. The symptoms were observed associated with surgery in 4 patients, manipulation of the elbow flexure in 4 cases and bicipital tendonitis in the rest. Four patients had a poor clinical outcome (3 with severe axonal involvement and 1 with moderate involvement). Isolated involvement of the NCAL is a rare and underdiagnosed alteration. It is important to suspect it in patients with hypoesthesia in the forearm, including the radial edge of the wrist or thumb, especially if it is associated with manipulations around the elbow flexure or bicipital tendonitis. Electromyography is useful in confirming the diagnosis, ruling out other differential diagnoses, and predicting prognosis. Knowing the location of this nerve during manipulations on the arm and placing patients in an appropriate posture during surgeries can help minimize cases.
{"title":"[Translated article] Paresthesias on the lateral face of the forearm: A nervous injury that is difficult to recognize","authors":"S. Parra Escorihuela, A.D. Ghinea, Á. Montero Sánchez, J. Orenga Orenga","doi":"10.1016/j.recot.2024.11.019","DOIUrl":"10.1016/j.recot.2024.11.019","url":null,"abstract":"<div><div>The lateral antebrachial cutaneous nerve (LACN) is the sensory branch of the musculocutaneous nerve and usually innervates the lateral aspect of the forearm. Isolated lesions are rare, of varied aetiology and generally underdiagnosed. We present a retrospective descriptive study of electromyography performed at the General University Hospital of Castellón in the last 20 years with isolated NCAL lesion. We identified 11 cases (8 men and 3 women), average age 44 years (15–73 years). 73% were referred from traumatology. Only one patient was correctly guided in the application. 63.6% of cases noted hypoesthesia extending to the wrist and 18.2% to the thumb. The electromyographic study showed severe axonal involvement in 3 patients and moderate in 8. The symptoms were observed associated with surgery in 4 patients, manipulation of the elbow flexure in 4 cases and bicipital tendonitis in the rest. Four patients had a poor clinical outcome (3 with severe axonal involvement and 1 with moderate involvement). Isolated involvement of the NCAL is a rare and underdiagnosed alteration. It is important to suspect it in patients with hypoesthesia in the forearm, including the radial edge of the wrist or thumb, especially if it is associated with manipulations around the elbow flexure or bicipital tendonitis. Electromyography is useful in confirming the diagnosis, ruling out other differential diagnoses, and predicting prognosis. Knowing the location of this nerve during manipulations on the arm and placing patients in an appropriate posture during surgeries can help minimize cases.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 2","pages":"Pages T206-T209"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773364","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}
Pub Date : 2025-03-01DOI: 10.1016/j.recot.2024.05.001
P. Checa-Betegón , Á. Ramos-Fernández , G. Ciller-González , M. Vallejo-Carrasco , J. García-Coiradas , J. Valle-Cruz
Introduction and objectives
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.
Materials and methods
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.
Results
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%).
Conclusions
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.
{"title":"Nailing intertrochanteric fractures in geriatric population: Do we know it all?","authors":"P. Checa-Betegón , Á. Ramos-Fernández , G. Ciller-González , M. Vallejo-Carrasco , J. García-Coiradas , J. Valle-Cruz","doi":"10.1016/j.recot.2024.05.001","DOIUrl":"10.1016/j.recot.2024.05.001","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 190-198"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960108","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}
Pub Date : 2025-03-01DOI: 10.1016/j.recot.2024.03.003
J. Diranzo-García, V. Estrems-Díaz, J.F. Garrido-Ferrer, L. Castillo-Ruipérez, V.M. Zarzuela-Sánchez, L. Hernández-Ferrando
Objective
To analyze the clinical, quality of life, and healthcare quality outcomes obtained in a series of patients undergoing total hip arthroplasty (THA), who were empowered and monitored using the AVIP application. These results will be compared with a control group followed through a standard protocol.
Material and method
Randomized clinical trial with parallel groups involving patients with an indication for THA. Clinical variables were measured and compared using the WOMAC and mHHS, pain assessed by the VAS, quality of life with the SF-12 test. Walking capabilities were analyzed using the Functional Gait Assessment Scale, along with satisfaction levels assessed through the SUCE questionnaire, and perceived anxiety levels related to the process.
Results
A total of 68 patients were evaluated, with 31 patients in the AVIP group and 33 in the Control group completing the follow-up. Both groups demonstrated improvement in clinical outcomes based on the WOMAC and mHHS hip tests, a reduction in perceived pain, and an enhancement in quality of life according to the SF-12 test. Patients in the AVIP study group exhibited non-inferiority in clinical outcomes and satisfaction compared to the control group, as well as lower anxiety levels and improved walking capabilities after the first month of follow-up. Notably, 82.25% of the follow-up visits for this group were conducted remotely.
Conclusion
The implementation of a mHealth application like AVIP can be safely offered to selected patients undergoing hip arthroplasty, enabling effective monitoring and providing continuous information and training.
{"title":"Proyecto AVIP (Amigo VIrtual Protésico): estudio de resultados clínico-funcionales y de satisfacción con una aplicación móvil en el manejo perioperatorio y seguimiento de implantes protésicos de cadera","authors":"J. Diranzo-García, V. Estrems-Díaz, J.F. Garrido-Ferrer, L. Castillo-Ruipérez, V.M. Zarzuela-Sánchez, L. Hernández-Ferrando","doi":"10.1016/j.recot.2024.03.003","DOIUrl":"10.1016/j.recot.2024.03.003","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze the clinical, quality of life, and healthcare quality outcomes obtained in a series of patients undergoing total hip arthroplasty (THA), who were empowered and monitored using the AVIP application. These results will be compared with a control group followed through a standard protocol.</div></div><div><h3>Material and method</h3><div>Randomized clinical trial with parallel groups involving patients with an indication for THA. Clinical variables were measured and compared using the WOMAC and mHHS, pain assessed by the VAS, quality of life with the SF-12 test. Walking capabilities were analyzed using the Functional Gait Assessment Scale, along with satisfaction levels assessed through the SUCE questionnaire, and perceived anxiety levels related to the process.</div></div><div><h3>Results</h3><div>A total of 68 patients were evaluated, with 31 patients in the AVIP group and 33 in the Control group completing the follow-up. Both groups demonstrated improvement in clinical outcomes based on the WOMAC and mHHS hip tests, a reduction in perceived pain, and an enhancement in quality of life according to the SF-12 test. Patients in the AVIP study group exhibited non-inferiority in clinical outcomes and satisfaction compared to the control group, as well as lower anxiety levels and improved walking capabilities after the first month of follow-up. Notably, 82.25% of the follow-up visits for this group were conducted remotely.</div></div><div><h3>Conclusion</h3><div>The implementation of a mHealth application like AVIP can be safely offered to selected patients undergoing hip arthroplasty, enabling effective monitoring and providing continuous information and training.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 2","pages":"Pages 124-134"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140177018","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}
Pub Date : 2025-03-01DOI: 10.1016/j.recot.2024.07.012
J.L. Huguet-Carmona , C. De la Calva-Ceinos , P. González-Rojo , A. Ortega-Yago , M. Angulo-Sánchez , J.V. Amaya Valero , J. Ferràs-Tarragó , F. Baixauli-García
Objective
The objective of this study was to perform an epidemiological analysis of patients presented to the Musculoskeletal Tumors Committee of a reference hospital.
Material and method
A retrospective analysis of patients with sarcomas treated in a reference Sarcoma Unit between 2009 and 2022 was carried out.
Results
A total of 1978 patients were analyzed, of which 1477 (74.67%) were diagnosed as sarcomas. They were divided into 446 (30.20%) bone tumors and 1.031 (69.80%) soft tissue tumors. The most common benign bone tumor was enchondroma (27.23%), giant cell tumor (59.21%) was the most common tumor of intermediate malignancy and the malignant one was osteosarcoma (24.78%). The most frequently observed benign soft tissue tumor was lipoma (50.74%), the atypical lipomatous tumor (53.25%) was the most frequent tumor of intermediate malignancy and the malignant one was sarcoma of uncertain differentiation (38.10%).
Conclusion
Our study represents the first work on the epidemiology of sarcomas and other musculoskeletal tumors in our country, being very useful to adapt the resources destined for their diagnosis and treatment.
{"title":"Epidemiología de los tumores musculoesqueléticos en una unidad de referencia","authors":"J.L. Huguet-Carmona , C. De la Calva-Ceinos , P. González-Rojo , A. Ortega-Yago , M. Angulo-Sánchez , J.V. Amaya Valero , J. Ferràs-Tarragó , F. Baixauli-García","doi":"10.1016/j.recot.2024.07.012","DOIUrl":"10.1016/j.recot.2024.07.012","url":null,"abstract":"<div><h3>Objective</h3><div>The objective of this study was to perform an epidemiological analysis of patients presented to the Musculoskeletal Tumors Committee of a reference hospital.</div></div><div><h3>Material and method</h3><div>A retrospective analysis of patients with sarcomas treated in a reference Sarcoma Unit between 2009 and 2022 was carried out.</div></div><div><h3>Results</h3><div>A total of 1978 patients were analyzed, of which 1477 (74.67%) were diagnosed as sarcomas. They were divided into 446 (30.20%) bone tumors and 1.031 (69.80%) soft tissue tumors. The most common benign bone tumor was enchondroma (27.23%), giant cell tumor (59.21%) was the most common tumor of intermediate malignancy and the malignant one was osteosarcoma (24.78%). The most frequently observed benign soft tissue tumor was lipoma (50.74%), the atypical lipomatous tumor (53.25%) was the most frequent tumor of intermediate malignancy and the malignant one was sarcoma of uncertain differentiation (38.10%).</div></div><div><h3>Conclusion</h3><div>Our study represents the first work on the epidemiology of sarcomas and other musculoskeletal tumors in our country, being very useful to adapt the resources destined for their diagnosis and treatment.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 2","pages":"Pages 158-166"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724666","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}
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