Revista Espanola de Cirugia Ortopedica y Traumatologia最新文献

{"title":"[Translated article] Clinical and radiological outcomes of the SL-Plus stem with a minimum 10-year follow-up: A retrospective study","authors":"L. Palacios-Díaz,&nbsp;R. Fernández-Fernández,&nbsp;A. Losa Sánchez,&nbsp;A. Cruz-Pardos","doi":"10.1016/j.recot.2025.07.002","DOIUrl":"10.1016/j.recot.2025.07.002","url":null,"abstract":"<div><h3>Purpose</h3><div>The SL-Plus cementless stem was introduced in 1993 as an evolution of the Alloclassic® stem with some modifications. The aim of this study was to analyse if these modifications have any influence in clinical and radiological outcomes at minimum 10-year follow-up.</div></div><div><h3>Methods</h3><div>Sixty-eight consecutive implants (64 patients) were retrospective evaluated. The mean duration of clinical and radiographic follow-up was 12.2 years. There were 41 female and 23 male patients with a median age of 73.5 years. All complications and reinterventions were collected. Functional outcomes were assessed using the modified Harris Hip Score (mHHS). Radiographs were evaluated immediately after the operation, after a minimum 2-year follow-up and by the end of follow-up (time A, B and C, respectively).</div></div><div><h3>Results</h3><div>Two stems were revised, one due to periprosthetic fracture and one due to aseptic loosening with a cumulative probability of not having a stem revision for any reason of 97.2% at 12.2 years. Mean mHHS was 76.7 points at the latest follow-up. Significant differences were found in distal migration (time A: 5.9<!--> <!-->mm<!--> <!-->±<!--> <!-->6.7; B: 6.9<!--> <!-->mm<!--> <!-->±<!--> <!-->7.1 and C: 8.2<!--> <!-->mm<!--> <!-->±<!--> <!-->6.3; <em>P</em> <!-->=<!--> <!-->.000) and varus angulation (time A: 0.0°<!--> <!-->±<!--> <!-->2; B: 0.0°<!--> <!-->±<!--> <!-->2 and C: 1.0°<!--> <!-->±<!--> <!-->3; <em>P</em> <!-->&lt;<!--> <!-->.001), although these stems showed radiographic signs of osseointegration. Thirty-three hips (48.5%) showed any radiolucent line around the stem, most of them located the proximal femur (Gruen 1 and 7). Multivariate regression analysis showed lower mHHS scores in older patients (<em>P</em> <!-->=<!--> <!-->.004) and female (<em>P</em> <!-->=<!--> <!-->.00).</div></div><div><h3>Conclusions</h3><div>The modifications of the SL-Plus stem influence the long-term outcome of the implant regarding radiological results, particularly in progressive varus angulation and distal migration. However, our study has not been able to demonstrate any clinical repercussions: functional scores and survival free of all cause revision were favourable and comparable to previous reports.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 6","pages":"Pages T555-T561"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145374682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Translated article] Short-term evaluation of minimally invasive Chevron–Akin osteotomy versus conventional Chevron: Patient-reported outcomes","authors":"S. Carlucci ,&nbsp;M. Iguaran-Jimenez ,&nbsp;J.I. Zaourak ,&nbsp;E.G. Pace ,&nbsp;J.J. Drago ,&nbsp;D.J. Yearson","doi":"10.1016/j.recot.2025.07.014","DOIUrl":"10.1016/j.recot.2025.07.014","url":null,"abstract":"<div><h3>Objective</h3><div>The choice of surgical technique for treating hallux valgus remains debated. Previous studies show favorable outcomes for both open and percutaneous techniques but do not conclude on their superiority. This study compares the functional outcomes of two groups of patients undergoing the minimally invasive Chevron–Akin (MICA) technique and the conventional technique, in short- and mid-term follow-up, using patient-reported outcome scores.</div></div><div><h3>Materials and methods</h3><div>A prospective study was conducted on patients with moderate hallux valgus, divided into two groups: conventional Chevron–Akin osteotomy and MICA with fixation using three screws. Pre- and postoperative records were evaluated at 4 weeks, 6 months, and 12 months using the Manchester-Oxford Foot Questionnaire (MOxFQ), the AOFAS scale, and the visual analog scale (VAS). Complications were recorded. Subjective aspects such as surgical technique recommendation and time to return to normal footwear were also assessed.</div></div><div><h3>Results</h3><div>Thirty patients were included in each group. Significant improvements were observed in functional scales post-surgery, but no differences were found between techniques. All patients recommended the surgery performed and returned to wearing normal footwear between the third and fourth postoperative weeks.</div></div><div><h3>Conclusions</h3><div>Both techniques show similar short- and mid-term outcomes and are effective in treating moderate hallux valgus. The choice of technique should depend on the surgeon's skills and experience.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 6","pages":"Pages T627-T632"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145374390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Translated article] Transcultural validation of the risk assessment and predictor tool (RAPT) to Spanish","authors":"A. Pérez-Perdomo,&nbsp;M. Rivero,&nbsp;M. Bassas,&nbsp;C. Bordanove,&nbsp;E. Ripoll-Romero","doi":"10.1016/j.recot.2025.07.006","DOIUrl":"10.1016/j.recot.2025.07.006","url":null,"abstract":"<div><h3>Objective</h3><div>Translation and validation of the risk assessment and prediction tool (RAPT) into Spanish to assess the discharge needs of patients after total hip arthroplasty.</div></div><div><h3>Methodology</h3><div>The original RAPT instrument was translated into Spanish following the guidelines of Sousa and Rojjanasrirat, 2011. To carry out the cross-cultural adaptation of the instrument to Spanish, the translation method of Guillermin et al., 1993 was used.</div></div><div><h3>Results</h3><div>One hundred and thirty-four patients were included. The mean age was 71.6 years. Of the patients analyzed in the study, the tool detected that 57.8% required home rehabilitation, 28.9% would be discharged home and 13.3% would require an assessment from the social worker to go to a social health center. The content validity index (CVI) for the entire scale was 0.91. Cronbach's alpha was 0.84.</div></div><div><h3>Conclusions</h3><div>The RAPT tool has been shown to be highly effective in assessing patients’ needs upon discharge. According to the results of the study, 94.2% of the needs identified by the tool coincided with the real needs of the patients. This suggests that the tool may be an efective tool for planning post-discharge care.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 6","pages":"Pages T562-T567"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145374679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Translated article] How does multidisciplinary collaboration with an internal medicine physician influence mortality in hip fracture patients?","authors":"L. Cano-Obando ,&nbsp;J.M. Gómez-Palomo ,&nbsp;A. Galán-Romero ,&nbsp;C. González-García ,&nbsp;P. Zamora-Navas","doi":"10.1016/j.recot.2025.07.009","DOIUrl":"10.1016/j.recot.2025.07.009","url":null,"abstract":"<div><h3>Introduction</h3><div>The increase in life expectancy and the ageing population have led to a higher incidence of hip fractures, especially in women over 60 years old. This study analyzes the influence of a multidisciplinary team with the collaboration of a specialist in internal medicine (IM) with the trauma department on mortality, perioperative complications and hospital stay in patients with hip fractures.</div></div><div><h3>Material and methods</h3><div>An analytical observational study of historical cohorts was conducted in patients over 65 years admitted for hip fracture and treated with arthroplasty or intramedullary nailing. Two cohorts were established: one before and one after the IM assignment. Patients with metabolic bone diseases different from osteoporosis and those who were operated in other centres were excluded. The minimum follow-up was 12 months.</div></div><div><h3>Results</h3><div>A total of 190 patients (50 men, 140 women) were included, with a mean age of 82.0 years and a BMI of 27.5. Mortality, which was the main objective of our study, during the first 12 months was higher in the non-IM (27.1 vs. 13.5%; <em>p</em> <!-->=<!--> <!-->.035). In addition, we included systemic complications and hospital stay as secondary objectives. Systemic complications were also higher in the non-IM cohort (43.2 vs. 27.1%; <em>p</em> <!-->=<!--> <!-->.031). Overall hospital stay was shorter in the IM cohort (7.3 vs. 9.9 days; <em>p</em> <!-->=<!--> <!-->.001). “Preoperative stays shorter than 72<!--> <!-->h were more frequent in the IM group (53.0 vs. 33.2%; <em>p</em> <!-->=<!--> <!-->.009).</div></div><div><h3>Conclusions</h3><div>Multidisciplinary collaboration with a specialist in internal medicine significantly reduces first-year mortality, systemic complications, and hospital stay in hip fracture patients, allowing earlier interventions and hospital discharge.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 6","pages":"Pages T579-T586"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145374391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Artículo traducido] Resultados clínicos de la técnica de cierre en artroplastia total de cadera y artroplastia total de rodilla: un estudio comparativo de la técnica de grapas frente a suturas barbadas recubiertas con triclosán","authors":"V. Benkovich ,&nbsp;A. Abialevich ,&nbsp;G. Benkovich","doi":"10.1016/j.recot.2025.07.010","DOIUrl":"10.1016/j.recot.2025.07.010","url":null,"abstract":"<div><h3>Background</h3><div>The demand for total joint arthroplasty (TJA) continues to rise due to an aging population, increased life expectancy, and expanding surgical indications. Medicare projections estimate a 176% increase in total hip arthroplasty (THA) and a 139% increase in total knee arthroplasty (TKA) by 2040, reaching 659% and 469%, respectively, by 2060.</div></div><div><h3>Methods</h3><div>From January 2014 to October 2024, our arthroplasty database was categorized into two groups by closure method: Group 1 (with staples), Group 2 (with barbed sutures). Data included demographics, BMI, comorbidities, wound complications, hospital stay, and readmissions.</div></div><div><h3>Results</h3><div>This retrospective study of 3110 hip and knee arthroplasty patients with osteoarthritis found no significant differences in age (<em>P</em>=.26) or sex distribution (<em>P</em>=.778) between groups, though the second group had a higher BMI (28.43<!--> <!-->±<!--> <!-->4.43 vs. 29.15<!--> <!-->±<!--> <!-->3.44; <em>P</em>&lt;.001) and a more balanced operated limb distribution (<em>P</em>=.040). Comorbidities were lower in the second group for arterial hypertension (48.48 vs. 57.63%; <em>P</em>&lt;.001), diabetes mellitus (20.8 vs. 26.21%; <em>P</em>=.0004), and hyperlipidemia (26.8 vs. 33.28%; <em>P</em>&lt;.001), with no significant differences in ischemic heart disease (<em>P</em> <!-->=<!--> <!-->0.668), atrial fibrillation (<em>P</em>=.725), or hypothyroidism (<em>P</em>=.827). Operative time was longer in the second group (82.7<!--> <!-->±<!--> <!-->7.44 vs. 78.4<!--> <!-->±<!--> <!-->13.62<!--> <!-->min; <em>P</em>&lt;.001), while hospital stay was marginally shorter (23.33<!--> <!-->±<!--> <!-->4.53 vs. 23.3<!--> <!-->±<!--> <!-->5.16<!--> <!-->h; <em>P</em>=.039). Postoperative complication rates, including bleeding, wound dehiscence, falls, stitch abscess, and readmission, showed no significant differences. There was no observed incidence of deep infections (PJI) in the study cohort at all.</div></div><div><h3>Conclusions</h3><div>The study demonstrated that there were no statistically significant differences in the frequency of wound complications between the two wound closure methods in THA and TKA surgeries, indicating comparable surgical outcomes in terms of wound healing and complication rates.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 6","pages":"Pages T621-T626"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145374718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Translated article] What is the validity of a curve of recent publications in PubMed as an argument that we are facing a current topic?","authors":"M. Fa-Binefa ,&nbsp;S. López-Hervás","doi":"10.1016/j.recot.2025.07.003","DOIUrl":"10.1016/j.recot.2025.07.003","url":null,"abstract":"","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 6","pages":"Pages T672-T673"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145374464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Translated article] Utility of postoperative drainage in total hip arthroplasty. A systematic review","authors":"C. Moreno-Benet ,&nbsp;P. Castells-Ayuso ,&nbsp;I. Miranda ,&nbsp;F.J. Miranda","doi":"10.1016/j.recot.2025.07.011","DOIUrl":"10.1016/j.recot.2025.07.011","url":null,"abstract":"<div><h3>Aim and hypothesis</h3><div>To investigate the advantages associated with the use of drainage in primary total hip arthroplasty (THA) versus not using drainage and to determine if drainage can be systematically discontinued. The starting hypothesis was that eliminating the use of drainage systematically in THA does not significantly increase the risk of postoperative complications.</div></div><div><h3>Materials and methods</h3><div>A systematic review was carried out following the PRISMA guidelines in the PubMed and Cochrane Library databases. The search was conducted on February 15, 2024, by entering the terms (“suction drainage”) AND (“total hip arthroplasty”). The Joanna Briggs Institute quality assessment tool was used to assess the quality of the included studies.</div></div><div><h3>Results</h3><div>Sixteen clinical trials comparing the use of drainage with no drainage in THA were included. No differences were observed in terms of infection rate or haematoma. Some authors find that the use of drainage increases the percentage of patients requiring transfusion and the length of hospitalisation. Of 16 studies, 13 recommend not to use drainage routinely in THA.</div></div><div><h3>Conclusions</h3><div>The use of drainage in THA has no advantage over no drainage. The results of the clinical trials reviewed suggest that drainage should not be used routinely in THA.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 6","pages":"Pages T587-T596"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145374389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complicaciones de la administración intraósea de vancomicina en artroplastia total de cadera","authors":"W.F. Martínez ,&nbsp;L. Camacho Terceros ,&nbsp;F. Garbini ,&nbsp;E.J. Bochatey ,&nbsp;F.A. Lopreite","doi":"10.1016/j.recot.2024.08.002","DOIUrl":"10.1016/j.recot.2024.08.002","url":null,"abstract":"<div><h3>Introduction</h3><div>The incidence of periprosthetic joint infection (PJI) in hip surgeries has significantly decreased thanks to intravenous (IV) antibiotic prophylaxis. However, in patients colonized with methicillin-resistant <em>Staphylococcus aureus</em> (MRSA) or those at risk of colonization, it is necessary to include vancomycin in the prophylaxis. Intraosseous administration of vancomycin could enhance its effectiveness in total hip arthroplasty (THA).</div></div><div><h3>Materials and methods</h3><div>A retrospective study was conducted between March and December 2023 involving 53 patients scheduled for primary THA with colonization risk factors. The median age of the patients was 67 years (range 61 to 75), and all received treatment with intraosseous vancomycin (500<!--> <!-->mg). Detailed records and documentation of complications during hospitalization and the first three months post-surgery were maintained. As a secondary outcome measure, the incidence of PJI was explored.</div></div><div><h3>Results</h3><div>We administered 500<!--> <!-->mg of intraosseous vancomycin, injected into the greater trochanter, along with standard IV prophylaxis. The incidence of complications was 1.64%. The PJI rate at 90 days was 0%.</div></div><div><h3>Conclusions</h3><div>Intraosseous administration of low-dose vancomycin in THA for patients at risk of MRSA colonization, combined with standard IV prophylaxis, was shown to be safe and did not present significant adverse effects. Furthermore, this strategy eliminates the logistical challenges associated with timely vancomycin administration.</div><div>Level of evidence IV: Case Series.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 4","pages":"Pages 340-346"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"La aumentación con tenodesis extraarticular de la reconstrucción del ligamento cruzado anterior asociado a la técnica «all-inside» no modifica la vuelta al deporte en jugadores de baloncesto federados: estudio de cohortes comparativo","authors":"E. García-Albó ,&nbsp;J. Nomdedéu Sancho ,&nbsp;M. Gispert Estadella ,&nbsp;R. Sevil Mayayo ,&nbsp;J.V. Andrés-Peiró ,&nbsp;J. Pijoan Bueno ,&nbsp;M.M. Reverté-Vinaixa ,&nbsp;J. Minguell-Monyart","doi":"10.1016/j.recot.2024.07.019","DOIUrl":"10.1016/j.recot.2024.07.019","url":null,"abstract":"<div><h3>Introduction</h3><div>Return to play rates after anterior cruciate ligament (ACL) reconstruction range between 50-98% depending on sport professionality, without being modified by the addition of an extra-articular augmentation (EA). The objective of the study is to describe the rate of return to play in our cohort. The hypothesis is that the addition of EA increases that rate.</div></div><div><h3>Material and methods</h3><div>A retrospective, descriptive and analytical study of a 130 basketball players cohort between 18 and 45 years old, whom underwent ACL reconstruction between the years 2018 and 2022, with a minimum follow-up of 18 months. Data was collected by reviewing medical records. IKDC score was registered after one year from surgery. All patients operated from 2020 received an extra-articular tenodesis.</div></div><div><h3>Results</h3><div>Of all patients, 72.31% returned to training, 70.77% returned to competition and 46.15% returned to the same level of performance prior to injury. The EA group (46.15%) did not increase the rate of return to competition (<em>P</em>=.552) nor to the same level of performance (<em>P</em>=.664). The mean IKDC. score was 86.83 (SD 14.85), and was not higher in the EA group (<em>P</em>=.418). However, its value was higher in the players who returned to training, competition and level of performance (<em>P</em>&lt;.05). EA did not delay the return to play in any group (<em>P</em>=.282).</div></div><div><h3>Conclusion</h3><div>To sum up, the EA does not modify the return to sport rate. Higher IKDC values predict a greater return to sport rate. in all groups. Prospective studies with larger sample size and longer follow-up time are required.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 4","pages":"Pages 330-339"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ramón y Cajal y la placa de crecimiento cartilaginosa","authors":"M.J. Delgado-Martos ,&nbsp;B. Quintana-Villamandos ,&nbsp;E. Delgado-Baeza","doi":"10.1016/j.recot.2024.11.017","DOIUrl":"10.1016/j.recot.2024.11.017","url":null,"abstract":"<div><div>Santiago Ramón y Cajal (1852-1934), a distinguished histologist and Nobel Laureate in Physiology or Medicine in 1906, is considered the father of Neuroscience. However, his legacy also extended to the study of various tissues, including hyaline cartilage, an area in which he was a pioneer. Throughout his work <em>Elements of Normal Histology and Micrographic Technique</em>, Cajal developed fundamental concepts that, when reviewed in light of molecular biology, resonate with current ideas about cellular communication and macromolecular interactions. In particular, his observations on hyaline cartilage, such as stellate chondrocytes, were largely overlooked in the scientific literature until today. In this paper, four hypotheses based on his discoveries are proposed: the architecture of chondrocyte columns, the role of the perichondrium in endochondral ossification, cartilage nutrition, and the role of the Golgi apparatus in the resting zone. Nearly a century later, research on hyaline cartilage continues to confirm Cajal's pioneering ideas.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 4","pages":"Pages 402-410"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751945","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}