Pub Date : 2025-08-09DOI: 10.1016/j.recot.2025.08.002
J.M. Luarte , J.T. Vizcaya , D. Munita , E. Stocker , R. Núñez , J.A. Merino , C. Rojas
Background and objective
Perioperative optimisation programmes have been shown to improve outcomes in total hip and knee arthroplasty; however, the evidence in Latin America is limited. Our objective is to evaluate the impact of implementing a multidisciplinary optimisation programme in prosthetic surgery at a Latin American centre.
Materials and methods
A retrospective cohort study evaluating elective hip and knee prosthesis surgeries between 2016 and 2023 at a private hospital. We compared pre-intervention (2016–2018) and post-intervention (2019–2023) groups following the implementation of a multidisciplinary perioperative optimisation programme in 2019. The impact of the programme on hospital length of stay and 90-day readmission rates was assessed.
Results
A total of 1462 patients (1636 surgeries) were included, with 429 surgeries in the pre-intervention group and 1207 in the post-intervention group. Hospital length of stay decreased from 3.5 to 2.22 days (p < 0.05). The 90-day readmission rate decreased from 2.56 to 2.24% (p = 0.71), with a significant reduction in knee arthrofibrosis (from 0.9 to 0.2%, p < 0.05). The optimisation programme was the main factor contributing to the reduction in hospital length of stay.
Conclusions
The multidisciplinary perioperative programme implemented significantly reduced hospital stay without increasing 90-day readmission rates. Furthermore, it equated outcomes between patients with public and private insurance.
{"title":"[Translated article] A perioperative optimisation programme can improve results and reduce hospital length of stay in hip and knee arthroplasty: Experience in Chile","authors":"J.M. Luarte , J.T. Vizcaya , D. Munita , E. Stocker , R. Núñez , J.A. Merino , C. Rojas","doi":"10.1016/j.recot.2025.08.002","DOIUrl":"10.1016/j.recot.2025.08.002","url":null,"abstract":"<div><h3>Background and objective</h3><div>Perioperative optimisation programmes have been shown to improve outcomes in total hip and knee arthroplasty; however, the evidence in Latin America is limited. Our objective is to evaluate the impact of implementing a multidisciplinary optimisation programme in prosthetic surgery at a Latin American centre.</div></div><div><h3>Materials and methods</h3><div>A retrospective cohort study evaluating elective hip and knee prosthesis surgeries between 2016 and 2023 at a private hospital. We compared pre-intervention (2016–2018) and post-intervention (2019–2023) groups following the implementation of a multidisciplinary perioperative optimisation programme in 2019. The impact of the programme on hospital length of stay and 90-day readmission rates was assessed.</div></div><div><h3>Results</h3><div>A total of 1462 patients (1636 surgeries) were included, with 429 surgeries in the pre-intervention group and 1207 in the post-intervention group. Hospital length of stay decreased from 3.5 to 2.22 days (<em>p</em> <!--><<!--> <!-->0.05). The 90-day readmission rate decreased from 2.56 to 2.24% (<em>p</em> <!-->=<!--> <!-->0.71), with a significant reduction in knee arthrofibrosis (from 0.9 to 0.2%, <em>p</em> <!--><<!--> <!-->0.05). The optimisation programme was the main factor contributing to the reduction in hospital length of stay.</div></div><div><h3>Conclusions</h3><div>The multidisciplinary perioperative programme implemented significantly reduced hospital stay without increasing 90-day readmission rates. Furthermore, it equated outcomes between patients with public and private insurance.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 6","pages":"Pages T614-T620"},"PeriodicalIF":0.0,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145374740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-14DOI: 10.1016/j.recot.2025.07.015
R. Gonzalez-Pola , R.O. Tafoya-Olivos , L.A. Culebras-Almeida , G. Zermeño-Garcia , A. Herrera-Lozano
Objectives
To evaluate perioperative strategies for minimizing bleeding and transfusion needs in single-stage bilateral hip and knee arthroplasty. This systematic review identifies effective interventions and provides evidence-based recommendations and highlight areas for future research in optimizing bleeding management.
Methods
A systematic review of literature from January 2010 to October 2024 was conducted, focusing on randomized controlled trials, meta-analyses, and guidelines. Databases searched included PubMed/MEDLINE, Embase, Cochrane Library, and Web of Science. Interventions assessed included tranexamic acid (TXA), surgical techniques, regional anesthesia, controlled hypotension, preoperative anemia correction, tourniquet use, bone wax, and restrictive transfusion strategies. Study selection, data extraction, and quality assessment followed PRISMA and Newcastle-Ottawa Scale guidelines.
Results
From 325 included studies, TXA consistently demonstrated the most significant impact, reducing transfusion rates by 40-60%. Anterior total hip arthroplasty was associated with reduced blood loss. Regional anesthesia and controlled hypotension further minimized intraoperative bleeding. Preoperative anemia correction and restrictive transfusion thresholds also showed benefits. Tourniquet evidence was inconclusive. Limited evidence supported bone wax. GRADE assessment suggested high evidence quality for TXA and regional anesthesia, moderate for minimally invasive surgery, anemia correction, and restrictive transfusion, and low for bone wax.
Conclusions
Multimodal approach integrating TXA, regional anesthesia, minimally invasive surgery, anemia correction, and restrictive transfusion protocols effectively reduces bleeding and transfusion needs in bilateral arthroplasty. Incorporation into enhance recovery after surgery protocols is recommended. Future research should refine TXA dosing, clarify tourniquet use, and assess cost-effectiveness.
目的探讨单期双侧髋关节和膝关节置换术中减少出血和输血需求的围手术期策略。本系统综述确定了有效的干预措施，提供了基于证据的建议，并强调了优化出血管理的未来研究领域。方法对2010年1月至2024年10月的文献进行系统回顾，主要包括随机对照试验、荟萃分析和指南。检索的数据库包括PubMed/MEDLINE、Embase、Cochrane Library和Web of Science。评估的干预措施包括氨甲环酸（TXA）、手术技术、区域麻醉、控制低血压、术前贫血矫正、止血带使用、骨蜡和限制性输血策略。研究选择、数据提取和质量评估遵循PRISMA和纽卡斯尔-渥太华量表指南。结果在325项纳入的研究中，TXA始终显示出最显著的影响，可将输血率降低40-60%。前路全髋关节置换术可减少失血量。区域麻醉和控制低血压进一步减少术中出血。术前贫血矫正和限制性输血阈值也显示出益处。止血带证据尚无定论。有限的证据支持骨蜡。GRADE评价表明，TXA和区域麻醉的证据质量高，微创手术、贫血矫正和限制性输血的证据质量中等，骨蜡的证据质量低。结论结合TXA、区域麻醉、微创手术、贫血矫正和限制性输血方案的多模式入路可有效减少双侧关节置换术的出血和输血需求。建议纳入增强术后恢复方案。未来的研究应完善TXA剂量，澄清止血带的使用，并评估成本效益。
{"title":"[Artículo traducido] Minimización del sangrado y la transfusión en artroplastias bilaterales de cadera y rodilla en un solo tiempo: una revisión sistemática de las intervenciones actuales","authors":"R. Gonzalez-Pola , R.O. Tafoya-Olivos , L.A. Culebras-Almeida , G. Zermeño-Garcia , A. Herrera-Lozano","doi":"10.1016/j.recot.2025.07.015","DOIUrl":"10.1016/j.recot.2025.07.015","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate perioperative strategies for minimizing bleeding and transfusion needs in single-stage bilateral hip and knee arthroplasty. This systematic review identifies effective interventions and provides evidence-based recommendations and highlight areas for future research in optimizing bleeding management.</div></div><div><h3>Methods</h3><div>A systematic review of literature from January 2010 to October 2024 was conducted, focusing on randomized controlled trials, meta-analyses, and guidelines. Databases searched included PubMed/MEDLINE, Embase, Cochrane Library, and Web of Science. Interventions assessed included tranexamic acid (TXA), surgical techniques, regional anesthesia, controlled hypotension, preoperative anemia correction, tourniquet use, bone wax, and restrictive transfusion strategies. Study selection, data extraction, and quality assessment followed PRISMA and Newcastle-Ottawa Scale guidelines.</div></div><div><h3>Results</h3><div>From 325 included studies, TXA consistently demonstrated the most significant impact, reducing transfusion rates by 40-60%. Anterior total hip arthroplasty was associated with reduced blood loss. Regional anesthesia and controlled hypotension further minimized intraoperative bleeding. Preoperative anemia correction and restrictive transfusion thresholds also showed benefits. Tourniquet evidence was inconclusive. Limited evidence supported bone wax. GRADE assessment suggested high evidence quality for TXA and regional anesthesia, moderate for minimally invasive surgery, anemia correction, and restrictive transfusion, and low for bone wax.</div></div><div><h3>Conclusions</h3><div>Multimodal approach integrating TXA, regional anesthesia, minimally invasive surgery, anemia correction, and restrictive transfusion protocols effectively reduces bleeding and transfusion needs in bilateral arthroplasty. Incorporation into enhance recovery after surgery protocols is recommended. Future research should refine TXA dosing, clarify tourniquet use, and assess cost-effectiveness.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 5","pages":"Pages T532-T543"},"PeriodicalIF":0.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144890967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-14DOI: 10.1016/j.recot.2025.07.016
V.J. León-Muñoz , J. Hurtado-Avilés , M. López-López , F. Santonja-Medina , J. Moya-Angeler
{"title":"[Translated article] Letter to the editor about the article: “Is the coronal plane alignment of the knee (CPAK) classification useful to plan individualized total knee arthroplasty surgery for the Spanish population? A critical analysis of the CPAK classification”","authors":"V.J. León-Muñoz , J. Hurtado-Avilés , M. López-López , F. Santonja-Medina , J. Moya-Angeler","doi":"10.1016/j.recot.2025.07.016","DOIUrl":"10.1016/j.recot.2025.07.016","url":null,"abstract":"","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 5","pages":"Pages T553-T554"},"PeriodicalIF":0.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144888777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-14DOI: 10.1016/j.recot.2025.07.017
J.H. Núñez , M.J. Jimenez-Jimenez , B. Escudero
{"title":"[Translated article] Reconsidering preoperative transfusion testing in primary total hip and knee arthroplasty: Are they truly efficient?","authors":"J.H. Núñez , M.J. Jimenez-Jimenez , B. Escudero","doi":"10.1016/j.recot.2025.07.017","DOIUrl":"10.1016/j.recot.2025.07.017","url":null,"abstract":"","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 5","pages":"Pages T551-T552"},"PeriodicalIF":0.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144890999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-09DOI: 10.1016/j.recot.2025.07.004
D. González-Morgado , J.V. Andrés-Peiró , J. Tomàs-Hernández , J. Selga-Marsà , C.A. Piedra-Calle , J. Teixidor-Serra
{"title":"[Translated article] Letter to the Editor about the article: “The configuration of the screws in the osteosynthesis of fractures of the femoral neck does not influence the functional or mechanical outcome”","authors":"D. González-Morgado , J.V. Andrés-Peiró , J. Tomàs-Hernández , J. Selga-Marsà , C.A. Piedra-Calle , J. Teixidor-Serra","doi":"10.1016/j.recot.2025.07.004","DOIUrl":"10.1016/j.recot.2025.07.004","url":null,"abstract":"","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 6","pages":"Pages T670-T671"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145374463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-09DOI: 10.1016/j.recot.2025.07.008
R. Calvo Rodriguez , J. Isla Villanueva , D. Edwards Silva , H. Cifuentes Aedo
Introduction
Periprosthetic knee infections are serious complications after knee arthroplasty, affecting 1–2% of patients with primary surgery and up to 20% of revisions. The DAIR strategy (debridement, antibiotics, and implant retention) has emerged as a treatment for acute infections, allowing component retention in certain cases, with a high success rate.
Objectives
This review discusses its application, success factors, techniques such as the “double DAIR” and postoperative management, highlighting the importance of correct patient selection and the combination of a thorough and meticulous surgical technique with appropriate antibiotic therapy to optimise results.
Methods
An exhaustive updated literature search was conducted regarding the use of DAIR in acute periprosthetic infections, highlighting the step-by-step procedure and some surgical tips that are helpful when performing it. Based on this, recommendations were made for physicians interested in the subject.
Results
A series of recommendations are made based on current literature, which are a useful guide when dealing with patients with acute infections in the context of knee prostheses, with a success rate greater than 70% in most cases where the patient is well selected.
Conclusions
DAIR is a useful and effective tool in the eradication and treatment of acute periprosthetic infections, with a good success rate. It is a cheap, technically simple and reproducible procedure, so as a group, we suggest it be adopted globally by orthopaedic surgeons.
{"title":"[Translated article] Update on the treatment of acute infections in knee prostheses: Is it possible to retain the components? An in-depth look at the DAIR procedure","authors":"R. Calvo Rodriguez , J. Isla Villanueva , D. Edwards Silva , H. Cifuentes Aedo","doi":"10.1016/j.recot.2025.07.008","DOIUrl":"10.1016/j.recot.2025.07.008","url":null,"abstract":"<div><h3>Introduction</h3><div>Periprosthetic knee infections are serious complications after knee arthroplasty, affecting 1–2% of patients with primary surgery and up to 20% of revisions. The DAIR strategy (debridement, antibiotics, and implant retention) has emerged as a treatment for acute infections, allowing component retention in certain cases, with a high success rate.</div></div><div><h3>Objectives</h3><div>This review discusses its application, success factors, techniques such as the “double DAIR” and postoperative management, highlighting the importance of correct patient selection and the combination of a thorough and meticulous surgical technique with appropriate antibiotic therapy to optimise results.</div></div><div><h3>Methods</h3><div>An exhaustive updated literature search was conducted regarding the use of DAIR in acute periprosthetic infections, highlighting the step-by-step procedure and some surgical tips that are helpful when performing it. Based on this, recommendations were made for physicians interested in the subject.</div></div><div><h3>Results</h3><div>A series of recommendations are made based on current literature, which are a useful guide when dealing with patients with acute infections in the context of knee prostheses, with a success rate greater than 70% in most cases where the patient is well selected.</div></div><div><h3>Conclusions</h3><div>DAIR is a useful and effective tool in the eradication and treatment of acute periprosthetic infections, with a good success rate. It is a cheap, technically simple and reproducible procedure, so as a group, we suggest it be adopted globally by orthopaedic surgeons.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 6","pages":"Pages T568-T578"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145374388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-09DOI: 10.1016/j.recot.2025.07.007
J.C. Ferragut Bria , F.A. Miralles Muñoz , F. Sendra Miralles , E. Ruiz Piñana , B. González Navarro , M.F. Vizcaya Moreno
Background
Some studies have proposed reducing unnecessary hospitalization days after total hip arthroplasty surgery to just a single overnight stay with discharge the morning after surgery. However, the available evidence on patient safety is of poor quality. The main objective was to analyze patient safety after discharge from the hospital the morning after total hip arthroplasty surgery (rapid discharge), comparing it with the standard 3-day postoperative stay.
Material and methods
A prospective, non-randomized comparative study was designed to compare two consecutive cohorts over time. The first cohort included patients with a postoperative stay of 3 days, while the second cohort had discharge the morning after surgery. The study evaluated the rate of complications and adverse events both postoperatively and after hospital discharge, as well as pain control using the visual analog scale, functional outcome using the Harris hip score, patient satisfaction, and economic cost.
Results
The rates of unexpected visits to the emergency room, early complications, readmissions, and reinterventions were similar in both groups, with no significant differences. The functional outcome was also similar in both groups, but the rapid discharge group experienced earlier recovery and significant financial savings.
Conclusion
Rapid discharge, the morning after surgery, is a safe, effective and efficient procedure for primary total hip arthroplasty in the majority of patients, with respect to a 3-day stay.
{"title":"[Translated article] Effectiveness, safety and efficiency of next-day discharge versus a 3-day hospital stay after primary total hip arthroplasty","authors":"J.C. Ferragut Bria , F.A. Miralles Muñoz , F. Sendra Miralles , E. Ruiz Piñana , B. González Navarro , M.F. Vizcaya Moreno","doi":"10.1016/j.recot.2025.07.007","DOIUrl":"10.1016/j.recot.2025.07.007","url":null,"abstract":"<div><h3>Background</h3><div>Some studies have proposed reducing unnecessary hospitalization days after total hip arthroplasty surgery to just a single overnight stay with discharge the morning after surgery. However, the available evidence on patient safety is of poor quality. The main objective was to analyze patient safety after discharge from the hospital the morning after total hip arthroplasty surgery (rapid discharge), comparing it with the standard 3-day postoperative stay.</div></div><div><h3>Material and methods</h3><div>A prospective, non-randomized comparative study was designed to compare two consecutive cohorts over time. The first cohort included patients with a postoperative stay of 3 days, while the second cohort had discharge the morning after surgery. The study evaluated the rate of complications and adverse events both postoperatively and after hospital discharge, as well as pain control using the visual analog scale, functional outcome using the Harris hip score, patient satisfaction, and economic cost.</div></div><div><h3>Results</h3><div>The rates of unexpected visits to the emergency room, early complications, readmissions, and reinterventions were similar in both groups, with no significant differences. The functional outcome was also similar in both groups, but the rapid discharge group experienced earlier recovery and significant financial savings.</div></div><div><h3>Conclusion</h3><div>Rapid discharge, the morning after surgery, is a safe, effective and efficient procedure for primary total hip arthroplasty in the majority of patients, with respect to a 3-day stay.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 6","pages":"Pages T597-T604"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145374392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-09DOI: 10.1016/j.recot.2025.07.005
J.H. Núñez , J.D. Montenegro , M. Surroca , B. Ocrospoma-Flores , E. Guerra-Farfán , G. Mendez-Sanchez , A. Fraguas , O. Gómez
Purpose
To compare the double row technique versus the single row technique for arthroscopic rotator cuff repair, in order to assess whether there are clinical differences.
Methods
Systematic review of randomized clinical trials comparing the clinical results of the double-row technique versus the single-row technique in arthroscopic rotator cuff repair. Demographic, clinical, and surgical variables were analyzed, including functional scores, tendon healing rate, and re-tear rate.
Results
Thirteen randomized clinical trials were selected. 437 patients in the single row group (50.7%) and 424 patients in the double row group (49.3%) were analyzed. No significant differences were found between the two groups in terms of age (P = .84), sex (P = .23) and loss to follow-up (P = .52). Significant differences were found for the better results of the double row technique at the UCLA level (P = .01). No significant differences were found on the Constant-Murley scale (P = .87) or on the ASES scale (P = .56). Similarly, there was a higher healing rate (P = .006) and less risk of rotator cuff re-tears with the double row technique (P = .006).
Conclusions
In rotator cuff repair, the double row technique was found to be superior to the single row technique in terms of better UCLA score, better tendon healing rate, and lower re-tear rate. No clinically significant differences were found on the Constant-Murley scale or on the ASES scale.
{"title":"[Translated article] Arthroscopic rotator cuff repair using a single or double row technique: A meta-analysis of randomized clinical trial","authors":"J.H. Núñez , J.D. Montenegro , M. Surroca , B. Ocrospoma-Flores , E. Guerra-Farfán , G. Mendez-Sanchez , A. Fraguas , O. Gómez","doi":"10.1016/j.recot.2025.07.005","DOIUrl":"10.1016/j.recot.2025.07.005","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the double row technique versus the single row technique for arthroscopic rotator cuff repair, in order to assess whether there are clinical differences.</div></div><div><h3>Methods</h3><div>Systematic review of randomized clinical trials comparing the clinical results of the double-row technique versus the single-row technique in arthroscopic rotator cuff repair. Demographic, clinical, and surgical variables were analyzed, including functional scores, tendon healing rate, and re-tear rate.</div></div><div><h3>Results</h3><div>Thirteen randomized clinical trials were selected. 437 patients in the single row group (50.7%) and 424 patients in the double row group (49.3%) were analyzed. No significant differences were found between the two groups in terms of age (<em>P</em> = .84), sex (<em>P</em> <!-->=<!--> <!-->.23) and loss to follow-up (<em>P</em> <!-->=<!--> <!-->.52). Significant differences were found for the better results of the double row technique at the UCLA level (<em>P</em> <!-->=<!--> <!-->.01). No significant differences were found on the Constant-Murley scale (<em>P</em> <!-->=<!--> <!-->.87) or on the ASES scale (<em>P</em> <!-->=<!--> <!-->.56). Similarly, there was a higher healing rate (<em>P</em> <!-->=<!--> <!-->.006) and less risk of rotator cuff re-tears with the double row technique (<em>P</em> <!-->=<!--> <!-->.006).</div></div><div><h3>Conclusions</h3><div>In rotator cuff repair, the double row technique was found to be superior to the single row technique in terms of better UCLA score, better tendon healing rate, and lower re-tear rate. No clinically significant differences were found on the Constant-Murley scale or on the ASES scale.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 6","pages":"Pages T659-T669"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145374462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-09DOI: 10.1016/j.recot.2025.07.013
P. Gómez Barbero , P. Rey Vidal , D. Montaner Alonso , J.L. Rodrigo Pérez
Objective
Pseudoarthrosis and necrosis of the proximal pole of the scaphoid require complex treatment. If primary treatments fail, there are only techniques that sacrifice part of the mobility. We present the design and in vitro results of an anatomical partial prosthesis of the scaphoid bone.
Material and method
The kinematics of the carpus are tested in vitro on six cadaveric forearms before and after prosthetic replacement, applying active loads on the main muscles. Pre- and post-intervention movements are recorded by Kinescan/IBV®, translating an angular value.
Results
After prostheticization, a decrease in the movement of the capitate (−19.36°) and scaphoid (−15.46°) is recorded during flexion–extension, while that of the lunate increases (11.67°). With the radial-ulnar deviation, only the movement of the great muscle decreases (−11.78°), but that of the scaphoid (4.03°) and lunate (5.9°) increases. We find significant differences whenever there is a decrease in movement. In the “throwing darts” movement (DTM), the average movement decreases in flexion–extension (−18.44°) and in radial-ulnar deviation (−3.66°), without significant differences. While the descent of the scaphoid in flexion–extension and radio-ulnar deviation of the DTM will affect the kinematics (p < .05). There is no involvement of the lunate in the DTM. Regarding the relative interosseous movement, significant differences are observed in the main axis of the F–E.
Conclusions
The implantation of a stabilized partial scaphoid prosthesis does not significantly modify the movement pattern of a healthy wrist. Therefore, in the future it could be a viable alternative for the treatment of recalcitrant pathology of the carpal scaphoid.
{"title":"[Translated article] In vitro analysis of carpal kinematics during validation of a stabilized scaphoid hemiarthroplasty","authors":"P. Gómez Barbero , P. Rey Vidal , D. Montaner Alonso , J.L. Rodrigo Pérez","doi":"10.1016/j.recot.2025.07.013","DOIUrl":"10.1016/j.recot.2025.07.013","url":null,"abstract":"<div><h3>Objective</h3><div>Pseudoarthrosis and necrosis of the proximal pole of the scaphoid require complex treatment. If primary treatments fail, there are only techniques that sacrifice part of the mobility. We present the design and <em>in vitro</em> results of an anatomical partial prosthesis of the scaphoid bone.</div></div><div><h3>Material and method</h3><div>The kinematics of the carpus are tested <em>in vitro</em> on six cadaveric forearms before and after prosthetic replacement, applying active loads on the main muscles. Pre- and post-intervention movements are recorded by Kinescan/IBV®, translating an angular value.</div></div><div><h3>Results</h3><div>After prostheticization, a decrease in the movement of the capitate (−19.36°) and scaphoid (−15.46°) is recorded during flexion–extension, while that of the lunate increases (11.67°). With the radial-ulnar deviation, only the movement of the great muscle decreases (−11.78°), but that of the scaphoid (4.03°) and lunate (5.9°) increases. We find significant differences whenever there is a decrease in movement. In the “throwing darts” movement (DTM), the average movement decreases in flexion–extension (−18.44°) and in radial-ulnar deviation (−3.66°), without significant differences. While the descent of the scaphoid in flexion–extension and radio-ulnar deviation of the DTM will affect the kinematics (<em>p</em> <!--><<!--> <!-->.05). There is no involvement of the lunate in the DTM. Regarding the relative interosseous movement, significant differences are observed in the main axis of the F–E.</div></div><div><h3>Conclusions</h3><div>The implantation of a stabilized partial scaphoid prosthesis does not significantly modify the movement pattern of a healthy wrist. Therefore, in the future it could be a viable alternative for the treatment of recalcitrant pathology of the carpal scaphoid.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 6","pages":"Pages T641-T651"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145374719","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 : 2025-07-09DOI: 10.1016/j.recot.2025.07.012
F.A. Miralles Muñoz, E. Sebastiá Forcada, L. Albero Catalá
Background and objective
Some studies have described that gender and the diabetes mellitus may impact the outcomes of reverse shoulder arthroplasty (RSA). The objective of this study was to compare the functional outcomes and survival of RSA based on the patient's gender and the presence or absence of diabetes mellitus as independent variables.
Materials and methods
This retrospective study included all patients who underwent RSA for acute proximal humeral fracture with a minimum follow-up of 2 years. Two independent stratifications were conducted to assess the influence of female gender and diabetes on RSA outcomes. The primary outcome variable was the Constant score. Additionally, the QuickDASH and UCLA functional scales were evaluated, as well as estimated survival using the Kaplan–Meier method.
Results
The final sample comprised 131 patients. The final Constant scores were 47.0 in women and 51.8 in men (p = .198), and 48.4 in diabetics and 45.3 in non-diabetics (p = .347). There were also no significant differences in the secondary functional scales. The estimated 12-year survival rate was 94.4% in women and 94.7% in men (p = .543), and 80.2% in diabetics and 97.8% in non-diabetics (p = .141).
Conclusions
In acute proximal humeral fractures treated with RSA, neither female gender nor the presence of diabetes had an impact on functional outcomes at 2 years postoperative follow-up.
{"title":"[Translated article] Gender and diabetes mellitus do not influence the outcomes of patients with proximal humeral fractures treated with a reverse shoulder arthroplasty","authors":"F.A. Miralles Muñoz, E. Sebastiá Forcada, L. Albero Catalá","doi":"10.1016/j.recot.2025.07.012","DOIUrl":"10.1016/j.recot.2025.07.012","url":null,"abstract":"<div><h3>Background and objective</h3><div>Some studies have described that gender and the diabetes mellitus may impact the outcomes of reverse shoulder arthroplasty (RSA). The objective of this study was to compare the functional outcomes and survival of RSA based on the patient's gender and the presence or absence of diabetes mellitus as independent variables.</div></div><div><h3>Materials and methods</h3><div>This retrospective study included all patients who underwent RSA for acute proximal humeral fracture with a minimum follow-up of 2 years. Two independent stratifications were conducted to assess the influence of female gender and diabetes on RSA outcomes. The primary outcome variable was the Constant score. Additionally, the QuickDASH and UCLA functional scales were evaluated, as well as estimated survival using the Kaplan–Meier method.</div></div><div><h3>Results</h3><div>The final sample comprised 131 patients. The final Constant scores were 47.0 in women and 51.8 in men (<em>p</em> <!-->=<!--> <!-->.198), and 48.4 in diabetics and 45.3 in non-diabetics (<em>p</em> <!-->=<!--> <!-->.347). There were also no significant differences in the secondary functional scales. The estimated 12-year survival rate was 94.4% in women and 94.7% in men (<em>p</em> <!-->=<!--> <!-->.543), and 80.2% in diabetics and 97.8% in non-diabetics (<em>p</em> <!-->=<!--> <!-->.141).</div></div><div><h3>Conclusions</h3><div>In acute proximal humeral fractures treated with RSA, neither female gender nor the presence of diabetes had an impact on functional outcomes at 2 years postoperative follow-up.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 6","pages":"Pages T633-T640"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145374465","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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