Pub Date : 2026-01-01DOI: 10.1016/j.recot.2025.06.013
P. González-Herranz, N. Penelas-Abelleira, M.L. Rodríguez-Rodríguez, M. Goday-Etxebarria
Introduction
Early diagnosis of DDH, ultrasonography and treatment with Pavlik arnais have provided an improvent of the results. However, always appear children more than 3 months until 24 months-old with late diagnosis or failure with Pavlik treatment requiring closed reduction and spica cast treament as standard management.
Material and method
The authors reviewed retrospectively DDH cases treated all patients treated with spica cast in human position during 3 months. The minimum follow-up was 5 years. It was considered good result when DDH reduced, remained stable, concentric, without AVN and not required surgery for sequels. All demographics, clinical and radiological parameters were statiscally analyzed.
Results
Of a total 152 hips were treated, 24 (15.8%) required surgery. In 6 cases (4%) was observed AVN. According IHDI/Tönnis displacement severity, types I and II were success treated in 98,9% and types III/IV in 64%. As bad prognosis factors were identified Ortolani test (+), alfa angle minor than 44°, acetabular index higher than 44° or IHDI/Tönnis types III/IV and factors for a good prognosis types I/II and the early recovery of the acetabular index more than 10° after 5 months of treatment. The age and early treatment of the patients was only important for the hips type III/IV (64 hips), the mean age of patients treated successfully was 5,1 months (64%), comparing with 8,8 months of the surgery group (36%). The incidence of AVN was 4% (6 cases) and in all cases the nucleus of ossification was not present in the x-ray pre-treatment. We cannot find relationship between AVN with previous skin traction, adductor tenotomy or severity of displacement.
Conclusions
Conservative management of DDH with spica cast provide excellent results in almost all cases in types I and II hips (98,9%) and in 64% of Types III /IV. An improvement of the Acetabular Index more than 10°, 5 months after the treatment is the best prognosis factor for a good result.
{"title":"Normalización precoz del índice acetabular como factor de buen pronóstico en la ddc tratada mediante reducción cerrada e inmovilización con yeso pelvipédico","authors":"P. González-Herranz, N. Penelas-Abelleira, M.L. Rodríguez-Rodríguez, M. Goday-Etxebarria","doi":"10.1016/j.recot.2025.06.013","DOIUrl":"10.1016/j.recot.2025.06.013","url":null,"abstract":"<div><h3>Introduction</h3><div>Early diagnosis of DDH, ultrasonography and treatment with Pavlik arnais have provided an improvent of the results. However, always appear children more than 3 months until 24 months-old with late diagnosis or failure with Pavlik treatment requiring closed reduction and spica cast treament as standard management.</div></div><div><h3>Material and method</h3><div>The authors reviewed retrospectively DDH cases treated all patients treated with spica cast in human position during 3 months. The minimum follow-up was 5 years. It was considered good result when DDH reduced, remained stable, concentric, without AVN and not required surgery for sequels. All demographics, clinical and radiological parameters were statiscally analyzed.</div></div><div><h3>Results</h3><div>Of a total 152 hips were treated, 24 (15.8%) required surgery. In 6 cases (4%) was observed AVN. According IHDI/Tönnis displacement severity, types I and II were success treated in 98,9% and types III/IV in 64%. As bad prognosis factors were identified Ortolani test (+), alfa angle minor than 44°, acetabular index higher than 44° or IHDI/Tönnis types III/IV and factors for a good prognosis types I/II and the early recovery of the acetabular index more than 10° after 5 months of treatment. The age and early treatment of the patients was only important for the hips type III/IV (64 hips), the mean age of patients treated successfully was 5,1 months (64%), comparing with 8,8 months of the surgery group (36%). The incidence of AVN was 4% (6 cases) and in all cases the nucleus of ossification was not present in the x-ray pre-treatment. We cannot find relationship between AVN with previous skin traction, adductor tenotomy or severity of displacement.</div></div><div><h3>Conclusions</h3><div>Conservative management of DDH with spica cast provide excellent results in almost all cases in types I and II hips (98,9%) and in 64% of Types III /IV. An improvement of the Acetabular Index more than 10°, 5 months after the treatment is the best prognosis factor for a good result.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 1","pages":"Pages 36-42"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963214","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 : 2026-01-01DOI: 10.1016/j.recot.2025.04.001
A. Gargantilla Vázquez , M.J. Pérez Úbeda
A natural disaster is a phenomenon causing significant human, material, economic, and environmental losses, exceeding the capacity of the affected community or country to respond with its own resources. These events progress through phases: hyperacute, acute, subacute, chronic, and rehabilitation/recovery. Orthopedic surgeons play a vital role in each phase, from initial rescue to long-term rehabilitation.
In the acute phase, their responsibilities include triaging and managing injuries such as fractures (commonly in the lower limbs), wound infections, and crush injuries. Effective treatment is crucial to minimizing morbidity and mortality. Coordination between emergency medical teams (EMTs) and local authorities is essential for an efficient response, while poor organization can hinder relief efforts.
Orthopedic surgeons must adapt to limited resources, respect cultural contexts, and address socio-economic realities. Their role is increasingly critical due to the rising frequency of natural disasters linked to climate change, emphasizing the need for preparation and collaboration.
{"title":"The role of the orthopaedic surgeon in natural disasters","authors":"A. Gargantilla Vázquez , M.J. Pérez Úbeda","doi":"10.1016/j.recot.2025.04.001","DOIUrl":"10.1016/j.recot.2025.04.001","url":null,"abstract":"<div><div>A natural disaster is a phenomenon causing significant human, material, economic, and environmental losses, exceeding the capacity of the affected community or country to respond with its own resources. These events progress through phases: hyperacute, acute, subacute, chronic, and rehabilitation/recovery. Orthopedic surgeons play a vital role in each phase, from initial rescue to long-term rehabilitation.</div><div>In the acute phase, their responsibilities include triaging and managing injuries such as fractures (commonly in the lower limbs), wound infections, and crush injuries. Effective treatment is crucial to minimizing morbidity and mortality. Coordination between emergency medical teams (EMTs) and local authorities is essential for an efficient response, while poor organization can hinder relief efforts.</div><div>Orthopedic surgeons must adapt to limited resources, respect cultural contexts, and address socio-economic realities. Their role is increasingly critical due to the rising frequency of natural disasters linked to climate change, emphasizing the need for preparation and collaboration.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 1","pages":"Pages 59-63"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963171","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 : 2026-01-01DOI: 10.1016/j.recot.2024.01.002
M. Fa-Binefa, M. Valera Pertegás, A. Peiró Ibañez, L. Trullols Tarragó, P. Machado Granados, I. Gracia Alegría
Managing chronic periprosthetic infections in patients who have undergone limb-salvage surgery following a malignant bone tumor with megaprosthesis often involves a two-stage revision surgery with the use of a cement-spacer. This paper show details the preparation of a self-made intramedullary metal-stabilized mega-cement spacer for patients needing a two-stage revision surgery due to infection after oncologic bone tumor resection and limb-salvage surgery with megaprosthesis and present two clinical cases treated with this technique. The report provides a practical surgical technique to create a cement hip mega-spacer using readily available tools in most orthopedic surgical settings.
{"title":"How to create by your own a customized hip cement mega-spacer for a hip megaprosthesis two-stage revision surgery after oncologic limb-salvage surgery – Surgical technique and case report","authors":"M. Fa-Binefa, M. Valera Pertegás, A. Peiró Ibañez, L. Trullols Tarragó, P. Machado Granados, I. Gracia Alegría","doi":"10.1016/j.recot.2024.01.002","DOIUrl":"10.1016/j.recot.2024.01.002","url":null,"abstract":"<div><div>Managing chronic periprosthetic infections in patients who have undergone limb-salvage surgery following a malignant bone tumor with megaprosthesis often involves a two-stage revision surgery with the use of a cement-spacer. This paper show details the preparation of a self-made intramedullary metal-stabilized mega-cement spacer for patients needing a two-stage revision surgery due to infection after oncologic bone tumor resection and limb-salvage surgery with megaprosthesis and present two clinical cases treated with this technique. The report provides a practical surgical technique to create a cement hip mega-spacer using readily available tools in most orthopedic surgical settings.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 1","pages":"Pages 84-87"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139418301","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 : 2026-01-01DOI: 10.1016/j.recot.2025.11.007
M. Galán-Olleros, S. Martínez-Álvarez, I. Martínez-Caballero
{"title":"[Translated article] Reduction is not necessary in overriding metaphyseal distal radius fractures in prepubertal children","authors":"M. Galán-Olleros, S. Martínez-Álvarez, I. Martínez-Caballero","doi":"10.1016/j.recot.2025.11.007","DOIUrl":"10.1016/j.recot.2025.11.007","url":null,"abstract":"","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 1","pages":"Pages T88-T90"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963123","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 : 2026-01-01DOI: 10.1016/j.recot.2025.06.001
P.I. Codesido Vilar , P. Sucasas Hermida , B. Calvete Vázquez , C. Bonome Roel , A. Montero Picallo , M. Goday Etxebarria , A. López González
<div><h3>Introduction</h3><div>The most common tibial plateau fractures are AO 41B3/Schatzker type<!--> <!-->2 (external unicondylar lesions with a vertical fracture line). The goal of treatment for these fractures is the satisfactory restoration of mechanical alignment, anatomic reduction of the articular surface, and stable fixation to allow early range of motion. The aim of our study is to determine the factors that most influence long-term functional and quality of life outcomes after surgical treatment by strictly selecting previously healthy patients facing an unexpected external tibial plateau fracture.</div></div><div><h3>Material and method</h3><div>A retrospective study was conducted in our tertiary hospital after obtaining approval from the ethics committee. Data from patients with external tibial plateau fracture hospitalized between 2013 and 2018 with more than 3<!--> <!-->years of evolution were analyzed. All patients who met the strict inclusion criteria completed the KOOS, EQ-5-D profile and VAS questionnaires. In addition, they underwent a physical examination and radiological study using telemetry and computed tomography (CT). The clinical data collected from the patients were: age, sex, fracture side, implant use, graft use, days elapsed until surgery, years after surgery, ASA, range of motion in extension and flexion. The radiological data were: in the telemetry, the deviation in mm of the load axis with respect to the contralateral limb was analyzed, the MPTA of both limbs and the difference in degrees between them; in the CT, the maximum joint step was measured and the affected area was calculated in cm<sup>2</sup> as well as the largest anteroposterior diameter and maximum width in mm (maximum anteroposterior and transverse diameters).</div></div><div><h3>Results</h3><div>A total of 27 patients were analysed, with a mean age of 53.3<!--> <!-->years and a mean evaluation time since the fracture of 4.8<!--> <!-->years. We found statistically significant correlations (<em>P</em> <!--><<!--> <!-->.05) between: days until surgery and size of the area in cm<sup>2</sup> (<em>P</em> <!-->=<!--> <!-->.042) and step in mm (<em>P</em> <!-->=<!--> <!-->.028), that is, the more days of delay, the greater the area and the greater the step; being a man presented a positive correlation with having a greater step (<em>P</em> <!-->=<!--> <!-->.025), greater area (<em>P</em> <!-->=<!--> <!-->.007) and greater slope (<em>P</em> <!-->=<!--> <!-->.039) compared to women. A statistically significant relationship was observed between the area of residual fracture and the values of KOOS symptoms (<em>P</em> <!-->=<!--> <!-->.015), KOOS function (<em>P</em> <!-->=<!--> <!-->.012), EQ-5D profile (<em>P</em> <!-->=<!--> <!-->.038) and VAS (<em>P</em> <!-->=<!--> <!-->.049); the greater the affected area, the worse the patient's condition. We also detected significant correlations between increased joint step and KOOS symptoms (<em>P</em> <!-->=<!--
{"title":"Fractura meseta tibial externa (AO 41B3/Schatzker 2): análisis de factores clínico-radiológicos en los resultados funcionales y de calidad de vida a largo plazo tras tratamiento quirúrgico","authors":"P.I. Codesido Vilar , P. Sucasas Hermida , B. Calvete Vázquez , C. Bonome Roel , A. Montero Picallo , M. Goday Etxebarria , A. López González","doi":"10.1016/j.recot.2025.06.001","DOIUrl":"10.1016/j.recot.2025.06.001","url":null,"abstract":"<div><h3>Introduction</h3><div>The most common tibial plateau fractures are AO 41B3/Schatzker type<!--> <!-->2 (external unicondylar lesions with a vertical fracture line). The goal of treatment for these fractures is the satisfactory restoration of mechanical alignment, anatomic reduction of the articular surface, and stable fixation to allow early range of motion. The aim of our study is to determine the factors that most influence long-term functional and quality of life outcomes after surgical treatment by strictly selecting previously healthy patients facing an unexpected external tibial plateau fracture.</div></div><div><h3>Material and method</h3><div>A retrospective study was conducted in our tertiary hospital after obtaining approval from the ethics committee. Data from patients with external tibial plateau fracture hospitalized between 2013 and 2018 with more than 3<!--> <!-->years of evolution were analyzed. All patients who met the strict inclusion criteria completed the KOOS, EQ-5-D profile and VAS questionnaires. In addition, they underwent a physical examination and radiological study using telemetry and computed tomography (CT). The clinical data collected from the patients were: age, sex, fracture side, implant use, graft use, days elapsed until surgery, years after surgery, ASA, range of motion in extension and flexion. The radiological data were: in the telemetry, the deviation in mm of the load axis with respect to the contralateral limb was analyzed, the MPTA of both limbs and the difference in degrees between them; in the CT, the maximum joint step was measured and the affected area was calculated in cm<sup>2</sup> as well as the largest anteroposterior diameter and maximum width in mm (maximum anteroposterior and transverse diameters).</div></div><div><h3>Results</h3><div>A total of 27 patients were analysed, with a mean age of 53.3<!--> <!-->years and a mean evaluation time since the fracture of 4.8<!--> <!-->years. We found statistically significant correlations (<em>P</em> <!--><<!--> <!-->.05) between: days until surgery and size of the area in cm<sup>2</sup> (<em>P</em> <!-->=<!--> <!-->.042) and step in mm (<em>P</em> <!-->=<!--> <!-->.028), that is, the more days of delay, the greater the area and the greater the step; being a man presented a positive correlation with having a greater step (<em>P</em> <!-->=<!--> <!-->.025), greater area (<em>P</em> <!-->=<!--> <!-->.007) and greater slope (<em>P</em> <!-->=<!--> <!-->.039) compared to women. A statistically significant relationship was observed between the area of residual fracture and the values of KOOS symptoms (<em>P</em> <!-->=<!--> <!-->.015), KOOS function (<em>P</em> <!-->=<!--> <!-->.012), EQ-5D profile (<em>P</em> <!-->=<!--> <!-->.038) and VAS (<em>P</em> <!-->=<!--> <!-->.049); the greater the affected area, the worse the patient's condition. We also detected significant correlations between increased joint step and KOOS symptoms (<em>P</em> <!-->=<!--","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 1","pages":"Pages 28-35"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963207","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 : 2026-01-01DOI: 10.1016/j.recot.2025.11.035
A. Ortega Yago , C. Ezquer Garín , P. Medina Bessó , F. Baixauli García , J. Ferràs Tarragó
Background
Local antibiotic delivery is crucial in prosthetic infections due to the limited bone penetration of systemic treatments. With the rise of bacterial resistance, alternatives are being explored to utilize these antibiotics without compromising their properties. The aim of this study is to investigate the application of stereolithography in manufacturing customized objects that incorporate thermolabile antibiotics and analyze their biomechanical behavior.
Materials and methods
A stereolithography (SLA) 3D printer with biocompatible resin Optoprint® Lumina was used to create different models, incorporating various amounts of amoxicillin–clavulanic acid. Mechanical studies were conducted to evaluate the performance of the 3D-printed models before and after antibiotic release.
Results
Resin pieces without antibiotics demonstrated higher resistance, while adding the antibiotic reduced resistance by 18%, and after the elution of amoxicillin-clavulanic acid, the reduction reached 56% of their total strength. Comparatively, antibiotic-loaded cement pieces retained more than twice the resistance post-elution. The progressive loss of biomechanical strength correlated with the antibiotic release from the resin pieces.
Conclusions
The results of this study suggest that it is feasible to design pieces with variable structural characteristics using SLA (stereolithography) printing with biocompatible resin, combined with the incorporation of drugs, including thermolabile antibiotics.
{"title":"[Translated article] Use of 3D printing for the manufacture of antibiotic carriers in the treatment of bone and joint infections","authors":"A. Ortega Yago , C. Ezquer Garín , P. Medina Bessó , F. Baixauli García , J. Ferràs Tarragó","doi":"10.1016/j.recot.2025.11.035","DOIUrl":"10.1016/j.recot.2025.11.035","url":null,"abstract":"<div><h3>Background</h3><div>Local antibiotic delivery is crucial in prosthetic infections due to the limited bone penetration of systemic treatments. With the rise of bacterial resistance, alternatives are being explored to utilize these antibiotics without compromising their properties. The aim of this study is to investigate the application of stereolithography in manufacturing customized objects that incorporate thermolabile antibiotics and analyze their biomechanical behavior.</div></div><div><h3>Materials and methods</h3><div>A stereolithography (SLA) 3D printer with biocompatible resin <em>Optoprint</em>® <em>Lumina</em> was used to create different models, incorporating various amounts of amoxicillin–clavulanic acid. Mechanical studies were conducted to evaluate the performance of the 3D-printed models before and after antibiotic release.</div></div><div><h3>Results</h3><div>Resin pieces without antibiotics demonstrated higher resistance, while adding the antibiotic reduced resistance by 18%, and after the elution of amoxicillin-clavulanic acid, the reduction reached 56% of their total strength. Comparatively, antibiotic-loaded cement pieces retained more than twice the resistance post-elution. The progressive loss of biomechanical strength correlated with the antibiotic release from the resin pieces.</div></div><div><h3>Conclusions</h3><div>The results of this study suggest that it is feasible to design pieces with variable structural characteristics using SLA (stereolithography) printing with biocompatible resin, combined with the incorporation of drugs, including thermolabile antibiotics.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 1","pages":"Pages T78-T83"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963213","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 : 2026-01-01DOI: 10.1016/j.recot.2025.11.004
A.N. Toro-Ibarguen , E. Sánchez Benito , J.M. Cortés Villar
Background and objective
The primary objective is to evaluate the clinical and functional outcomes of tape reinforcement in anterior cruciate ligament (ACL) reconstructions, recording complications, as well as the rate of reinterventions and graft failure.
Materials and methods
Retrospective analysis of ACL reconstructions with hamstring (HS) autograft that were reinforced with high-strength tape. We included patients in whom we obtained a graft of HS <8 mm or ≥8 mm of poor quality. Age, sex, body mass index (BMI), and previous activity were recorded. Clinical and functional evaluation were made and postoperative range of motion (ROM), pain, and Lysholm functional scale were recorded. Complication rate, graft failure rate, and reintervention rate were analyzed.
Results
A total of 160 patients were included, with a mean age of 29.19 years. Of these, 98 were male and 62 female, with a mean BMI of 23.5. The mean follow-up period was 31.7 months. The average ROM was 137.2°, the mean pain level was 0.8, and the average Lysholm score was 95.1. The complication rate was 11%, with 5% requiring reoperation. The graft failure rate was 1.3%. A graft diameter <8 mm was associated with females with Fisher's exact test of p < .0001. In the other parameters, no statistically significant differences were found between patients with grafts <8 mm and those with grafts ≥8 mm.
Conclusions
This study demonstrates that tape reinforcement in ACL reconstruction is a safe procedure, offering excellent clinical and functional outcomes with low reinterventions and graft failure rates.
{"title":"[Translated article] Analysis of the results of anterior cruciate ligament reconstruction associated with high-resistance tape reinforcement (ultra-high molecular weight polyethylene braided material)","authors":"A.N. Toro-Ibarguen , E. Sánchez Benito , J.M. Cortés Villar","doi":"10.1016/j.recot.2025.11.004","DOIUrl":"10.1016/j.recot.2025.11.004","url":null,"abstract":"<div><h3>Background and objective</h3><div>The primary objective is to evaluate the clinical and functional outcomes of tape reinforcement in anterior cruciate ligament (ACL) reconstructions, recording complications, as well as the rate of reinterventions and graft failure.</div></div><div><h3>Materials and methods</h3><div>Retrospective analysis of ACL reconstructions with hamstring (HS) autograft that were reinforced with high-strength tape. We included patients in whom we obtained a graft of HS <8<!--> <!-->mm or ≥8<!--> <!-->mm of poor quality. Age, sex, body mass index (BMI), and previous activity were recorded. Clinical and functional evaluation were made and postoperative range of motion (ROM), pain, and Lysholm functional scale were recorded. Complication rate, graft failure rate, and reintervention rate were analyzed.</div></div><div><h3>Results</h3><div>A total of 160 patients were included, with a mean age of 29.19 years. Of these, 98 were male and 62 female, with a mean BMI of 23.5. The mean follow-up period was 31.7 months. The average ROM was 137.2°, the mean pain level was 0.8, and the average Lysholm score was 95.1. The complication rate was 11%, with 5% requiring reoperation. The graft failure rate was 1.3%. A graft diameter <8<!--> <!-->mm was associated with females with Fisher's exact test of <em>p</em> <!--><<!--> <!-->.0001. In the other parameters, no statistically significant differences were found between patients with grafts <8<!--> <!-->mm and those with grafts ≥8<!--> <!-->mm.</div></div><div><h3>Conclusions</h3><div>This study demonstrates that tape reinforcement in ACL reconstruction is a safe procedure, offering excellent clinical and functional outcomes with low reinterventions and graft failure rates.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 1","pages":"Pages T20-T27"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963182","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 : 2026-01-01DOI: 10.1016/j.recot.2025.02.018
A.G. Casa Casa , J.I. Baltá Aymar , A. Alías Petralanda , L. Ramírez Núñez , A. Serra Trullas , J.A. Fernández-Valencia
Objectives
Hip arthroplasty instability is one of the most worrisome complications and one of the main indications for revision surgery. We present a retrospective study evaluating the results of revision hip replacement surgery performed for instability.
Material and methods
Observational, retrospective study from 1/12/2010 to 1/12/2022. Fifty-nine medical records of patients operated for hip dislocation were reviewed. Epidemiological variables and data such as type of dislocation based on Wera classification, cup position based on Lewinnek, type of implants, associated surgical techniques and the results in terms of recurrence of dislocation or reoperation were recorded.
Results
Fifty-nine patients: 33 women, 26 men, mean age 77.0 years. Mean follow-up 3.2 years (range 1.6-13.1). Based on Wera: had a single cause 37 cases, 2 causes 19 and 3 causes or more, 3 cases. In 61% of the cases in the series, malposition of the cup played an essential role in the dislocation (type I Wera). In the series, the Lewinnek zone could not be evaluated in 7 cases. For the remaining patients, 30% were within the Lewinnek zone. Only one patient in the series had a history of lumbar instrumentation. Implant used: double mobility (DM) in 17 cases (28.8%) and a constrained system in 38 cases (64.4%). Heads with adaptive cone were used in 2 cases (3%). In 4 cases (6%) a modified Whiteside type plasty was associated. Girdlestone was indicated in 2 cases (3%). Recurrence of dislocation 1 occasion: 18 cases (31%); 2 or more occasions 7 cases (12%). Re-operation 15 cases (25%) range (1-5), main reasons: instability, infection or peri-prosthetic fractures. Probability of success defined as no recurrence: at one year is 80.5%, and at two years is 70.6%, showing no differences between constrained or dual mobility implant.
Comments and conclusions
Hip prosthesis dislocation is multifactorial in origin, although in most cases in the series the key factor was malposition of the acetabulum. Constrained and DM implants showed similar effectiveness. The results of this study emphasize the need for techniques that allow adequate positioning and orientation of the acetabular component to prevent, in a high percentage of cases, the need for this type of revision surgery.
{"title":"Éxito tras el tratamiento quirúrgico de la prótesis de cadera inestable: 12 años de experiencia en un hospital de tercer nivel","authors":"A.G. Casa Casa , J.I. Baltá Aymar , A. Alías Petralanda , L. Ramírez Núñez , A. Serra Trullas , J.A. Fernández-Valencia","doi":"10.1016/j.recot.2025.02.018","DOIUrl":"10.1016/j.recot.2025.02.018","url":null,"abstract":"<div><h3>Objectives</h3><div>Hip arthroplasty instability is one of the most worrisome complications and one of the main indications for revision surgery. We present a retrospective study evaluating the results of revision hip replacement surgery performed for instability.</div></div><div><h3>Material and methods</h3><div>Observational, retrospective study from 1/12/2010 to 1/12/2022. Fifty-nine medical records of patients operated for hip dislocation were reviewed. Epidemiological variables and data such as type of dislocation based on Wera classification, cup position based on Lewinnek, type of implants, associated surgical techniques and the results in terms of recurrence of dislocation or reoperation were recorded.</div></div><div><h3>Results</h3><div>Fifty-nine patients: 33 women, 26 men, mean age 77.0 years. Mean follow-up 3.2 years (range 1.6-13.1). Based on Wera: had a single cause 37 cases, 2 causes 19 and 3 causes or more, 3 cases. In 61% of the cases in the series, malposition of the cup played an essential role in the dislocation (type I Wera). In the series, the Lewinnek zone could not be evaluated in 7 cases. For the remaining patients, 30% were within the Lewinnek zone. Only one patient in the series had a history of lumbar instrumentation. Implant used: double mobility (DM) in 17 cases (28.8%) and a constrained system in 38 cases (64.4%). Heads with adaptive cone were used in 2 cases (3%). In 4 cases (6%) a modified Whiteside type plasty was associated. Girdlestone was indicated in 2 cases (3%). Recurrence of dislocation 1 occasion: 18 cases (31%); 2 or more occasions 7 cases (12%). Re-operation 15 cases (25%) range (1-5), main reasons: instability, infection or peri-prosthetic fractures. Probability of success defined as no recurrence: at one year is 80.5%, and at two years is 70.6%, showing no differences between constrained or dual mobility implant.</div></div><div><h3>Comments and conclusions</h3><div>Hip prosthesis dislocation is multifactorial in origin, although in most cases in the series the key factor was malposition of the acetabulum. Constrained and DM implants showed similar effectiveness. The results of this study emphasize the need for techniques that allow adequate positioning and orientation of the acetabular component to prevent, in a high percentage of cases, the need for this type of revision surgery.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 1","pages":"Pages 64-69"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568426","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 : 2025-08-22DOI: 10.1016/j.recot.2025.08.006
J. Teves, J. Perez-Abdala, N. Stramazzo, I. Albergo, G. Farfalli, M. Ayerza, L. Aponte-Tinao
Background and objectives
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.
Materials and methods
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.
Results
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.
Conclusion
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.
{"title":"[Translated article] Use of “ice-cream cone” prosthesis in acetabular defects secondary to tumor resections","authors":"J. Teves, J. Perez-Abdala, N. Stramazzo, I. Albergo, G. Farfalli, M. Ayerza, 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}
Pub Date : 2025-08-21DOI: 10.1016/j.recot.2025.08.005
F.J. Quiñonez, M.R. Latorre, P. Dardanelli, C. Halliburton, R. Maenza, M. Puigdevall, S.T. Bosio
Introduction
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.
Methods
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.
Results
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 (p < .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%).
Conclusion
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.
{"title":"[Translated article] Complications in the surgical treatment of scoliosis in pediatric patients","authors":"F.J. Quiñonez, M.R. Latorre, P. Dardanelli, C. Halliburton, R. Maenza, M. Puigdevall, 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> <!--><<!--> <!-->.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}
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