Pub Date : 2025-07-01DOI: 10.1016/j.recot.2025.04.004
W.F. Martínez , L. Camacho Terceros , F. Garbini , E.J. Bochatey , F.A. Lopreite
Introduction
The incidence of periprosthetic joint infection (PJI) in hip surgeries has significantly decreased thanks to intravenous (IV) antibiotic prophylaxis. However, in patients colonised with methicillin-resistant Staphylococcus aureus (MRSA) or those at risk of colonisation, it is necessary to include vancomycin in the prophylaxis. Intraosseous administration of vancomycin could enhance its effectiveness in total hip arthroplasty (THA).
Materials and methods
A retrospective study was conducted between March and December 2023 involving 53 patients scheduled for primary THA with colonisation risk factors. The median age of the patients was 67 years (range 61–75), and all received treatment with intraosseous vancomycin (500 mg). Detailed records and documentation of complications during hospitalisation and the first three months post-surgery were maintained. As a secondary outcome measure, the incidence of PJI was explored.
Results
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%.
Conclusions
Intraosseous administration of low-dose vancomycin in THA for patients at risk of MRSA colonisation, 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.
{"title":"[Translated article] Complications of intraosseous administration of vancomycin in total hip arthroplasty","authors":"W.F. Martínez , L. Camacho Terceros , F. Garbini , E.J. Bochatey , F.A. Lopreite","doi":"10.1016/j.recot.2025.04.004","DOIUrl":"10.1016/j.recot.2025.04.004","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 colonised with methicillin-resistant <em>Staphylococcus aureus</em> (MRSA) or those at risk of colonisation, 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 colonisation risk factors. The median age of the patients was 67 years (range 61–75), and all received treatment with intraosseous vancomycin (500<!--> <!-->mg). Detailed records and documentation of complications during hospitalisation 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 colonisation, 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 T340-T346"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549833","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 : 2025-07-01DOI: 10.1016/j.recot.2025.04.007
P. Lalueza-Andreu , Á. Martínez-García , P. Checa-Betegón , J. García-Coiradas , J.A. Valle-Cruz , F. Marco-Martínez
Objective
The objective of this study is to compare the outcomes of using the Femoral Neck System (FNS) (DePuy Synthes®) versus the use of cannulated screws (CS) in the surgical treatment of non-displaced subcapital hip fractures.
Materials and methods
A retrospective cohort study was conducted on non-displaced subcapital hip fractures treated with CS or FNS between 2020 and 2023, with a minimum follow-up of one year. A total of 28 patients were included, 14 treated with CS and 14 with FNS. Demographic, radiological, clinical, and functional variables were analyzed.
Results
In the CS group, 64% were male, with a mean age of 66.5 years (SD 14.9) and an average follow-up of 22 months (range, 12-36 months). In the FNS group, 57% were male, with a median age of 60.8 years (SD 13.78) and an average follow-up of 16 months (range, 12-24 months).
Regarding functional outcomes, no significant differences were found between FNS and CS in the Harris scale: 94.21 ± 11.55 for FNS and 96.50 ± 6.9 for CS (p = 0.618).
The total postoperative complications (FNS/CS) were 7.1% versus 43%, and implant failure with conversion to total hip replacement was 0% versus 43%, both significantly higher in the CS group (p = 0.047; p = 0.016, respectively). The FNS also presented a lower rate of avascular necrosis (0% versus 11.1%, p = 0.391) and nonunion (0% versus 20%, p = 0.163), although these differences did not reach statistical significance.
Conclusions
Although both treatment methods, cannulated screws and the FNS, showed similar short-term functional outcomes in the management of undisplaced subcapital femoral fractures, the FNS demonstrated a significantly lower rate of complications and reoperations. These results suggest that the FNS could be considered a safer and more effective option compared to cannulated screws.
{"title":"[Translated article] Surgical treatment of non-displaced subcapital hip fracture: Femoral Neck System vs. cannulated screws. Comparative study","authors":"P. Lalueza-Andreu , Á. Martínez-García , P. Checa-Betegón , J. García-Coiradas , J.A. Valle-Cruz , F. Marco-Martínez","doi":"10.1016/j.recot.2025.04.007","DOIUrl":"10.1016/j.recot.2025.04.007","url":null,"abstract":"<div><h3>Objective</h3><div>The objective of this study is to compare the outcomes of using the Femoral Neck System (FNS) (DePuy Synthes®) versus the use of cannulated screws (CS) in the surgical treatment of non-displaced subcapital hip fractures.</div></div><div><h3>Materials and methods</h3><div>A retrospective cohort study was conducted on non-displaced subcapital hip fractures treated with CS or FNS between 2020 and 2023, with a minimum follow-up of one year. A total of 28 patients were included, 14 treated with CS and 14 with FNS. Demographic, radiological, clinical, and functional variables were analyzed.</div></div><div><h3>Results</h3><div>In the CS group, 64% were male, with a mean age of 66.5 years (SD 14.9) and an average follow-up of 22 months (range, 12-36 months). In the FNS group, 57% were male, with a median age of 60.8 years (SD 13.78) and an average follow-up of 16 months (range, 12-24 months).</div><div>Regarding functional outcomes, no significant differences were found between FNS and CS in the Harris scale: 94.21 ± 11.55 for FNS and 96.50 ± 6.9 for CS (p = 0.618).</div><div>The total postoperative complications (FNS/CS) were 7.1% versus 43%, and implant failure with conversion to total hip replacement was 0% versus 43%, both significantly higher in the CS group (p = 0.047; p = 0.016, respectively). The FNS also presented a lower rate of avascular necrosis (0% versus 11.1%, p = 0.391) and nonunion (0% versus 20%, p = 0.163), although these differences did not reach statistical significance.</div></div><div><h3>Conclusions</h3><div>Although both treatment methods, cannulated screws and the FNS, showed similar short-term functional outcomes in the management of undisplaced subcapital femoral fractures, the FNS demonstrated a significantly lower rate of complications and reoperations. These results suggest that the FNS could be considered a safer and more effective option compared to cannulated screws.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 4","pages":"Pages T365-T371"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549836","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 : 2025-07-01DOI: 10.1016/j.recot.2024.10.005
L. López-Capdevila , M. Ballester , G. Lucar , T. Mota-Gomes , M. Fa-Binefa , S. López-Hervás
Introduction
Morton's neuroma is predominantly attributed to chronic nerve entrapment within third space adjacent metatarsals, the deep transverse metatarsal ligament (DTML), and the plantar skin. While conservative treatments are of election, failures require alternative interventions such as ultrasound-guided injections and various surgical procedures, including minimally invasive neurectomy and DTML release. This study aimed to anatomically assess the risks associated with the endoscopic dorsal surgical decompression of Morton's neuroma.
Materials and methods
Twenty feet from ten fresh-frozen cadaveric specimens underwent a dorsal percutaneous approach for endoscopic access. Surgical procedures were monitored by three foot and ankle surgeons. Post-surgical anatomical dissections were conducted to evaluate potential risks to surrounding structures.
Results
The endoscopic technique successfully sectioned the DMTL in all specimens (100%) without iatrogenic injury of tendons, nerves, or arteries, while lumbricals may be at risk.
Conclusion
Endoscopic dorsal decompression of Morton's neuroma presents as an accessible minimally invasive surgical option with low risk of collateral associated injuries.
{"title":"Is endoscopic decompression for Morton's neuroma a safe technique?","authors":"L. López-Capdevila , M. Ballester , G. Lucar , T. Mota-Gomes , M. Fa-Binefa , S. López-Hervás","doi":"10.1016/j.recot.2024.10.005","DOIUrl":"10.1016/j.recot.2024.10.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Morton's neuroma is predominantly attributed to chronic nerve entrapment within third space adjacent metatarsals, the deep transverse metatarsal ligament (DTML), and the plantar skin. While conservative treatments are of election, failures require alternative interventions such as ultrasound-guided injections and various surgical procedures, including minimally invasive neurectomy and DTML release. This study aimed to anatomically assess the risks associated with the endoscopic dorsal surgical decompression of Morton's neuroma.</div></div><div><h3>Materials and methods</h3><div>Twenty feet from ten fresh-frozen cadaveric specimens underwent a dorsal percutaneous approach for endoscopic access. Surgical procedures were monitored by three foot and ankle surgeons. Post-surgical anatomical dissections were conducted to evaluate potential risks to surrounding structures.</div></div><div><h3>Results</h3><div>The endoscopic technique successfully sectioned the DMTL in all specimens (100%) without iatrogenic injury of tendons, nerves, or arteries, while lumbricals may be at risk.</div></div><div><h3>Conclusion</h3><div>Endoscopic dorsal decompression of Morton's neuroma presents as an accessible minimally invasive surgical option with low risk of collateral associated injuries.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 4","pages":"Pages 380-384"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477019","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 : 2025-07-01DOI: 10.1016/j.recot.2025.04.012
M. Galán-Olleros, J. Alonso-Hernández, C. Miranda-Gorozarri, J. García-Fernández, R.M. Egea-Gámez, Á. Palazón-Quevedo
Introduction
The short stature characteristic of patients with achondroplasia can negatively affect health-related quality of life (HRQoL). Lower limb lengthening reusing telescopic intramedullary nails (TIMNs) offers an alternative to external fixators, with the potential to enhance functionality, self-esteem, and HRQoL, while reducing complication risks, which this study aims to evaluate.
Materials and methods
This retrospective study included nine patients with achondroplasia who underwent parallel transverse lengthening of femurs and/or tibias reusing a TIMN between 2015 and 2022. Functionality (Lower Extremity Functional Scale, LEFS), self-esteem (Rosenberg Self-Esteem Scale), and HRQoL (Short Form-12, SF-12, and EuroQol VAS) were assessed preoperatively and at least two years post-surgery. Complications (Clavien–Dindo–Sink classification) and patient satisfaction were also recorded.
Results
The median age was 13.5 years (IQR: 12.5–17.1), with a significant height increase of +19.9 cm (p < 0.05). Improvements were significant in functionality (LEFS, +4.6 points; p < 0.05), self-esteem (Rosenberg, +3.7 points; p < 0.05), and HRQoL (SF-12 physical, +8.9 points; p < 0.05; EQ-VAS, +20 points; p < 0.05). A total of 22 complications were reported in 32 treated bones, most classified as grade 2 or 3B, with no significant correlation to outcomes in functionality, HRQoL, or self-esteem outcomes (p > 0.05).
Conclusions
Lower limb lengthening reusing TIMNs appears to improve functionality, HRQoL, and self-esteem in patients with achondroplasia compared to their preoperative status. High patient satisfaction and manageable complications were observed, with no negative impact on outcomes, laying the groundwork for future studies.
{"title":"[Translated article] Impact of lower limb lengthening with telescopic nails on functionality and quality of life in patients with achondroplasia","authors":"M. Galán-Olleros, J. Alonso-Hernández, C. Miranda-Gorozarri, J. García-Fernández, R.M. Egea-Gámez, Á. Palazón-Quevedo","doi":"10.1016/j.recot.2025.04.012","DOIUrl":"10.1016/j.recot.2025.04.012","url":null,"abstract":"<div><h3>Introduction</h3><div>The short stature characteristic of patients with achondroplasia can negatively affect health-related quality of life (HRQoL). Lower limb lengthening reusing telescopic intramedullary nails (TIMNs) offers an alternative to external fixators, with the potential to enhance functionality, self-esteem, and HRQoL, while reducing complication risks, which this study aims to evaluate.</div></div><div><h3>Materials and methods</h3><div>This retrospective study included nine patients with achondroplasia who underwent parallel transverse lengthening of femurs and/or tibias reusing a TIMN between 2015 and 2022. Functionality (Lower Extremity Functional Scale, LEFS), self-esteem (Rosenberg Self-Esteem Scale), and HRQoL (Short Form-12, SF-12, and EuroQol VAS) were assessed preoperatively and at least two years post-surgery. Complications (Clavien–Dindo–Sink classification) and patient satisfaction were also recorded.</div></div><div><h3>Results</h3><div>The median age was 13.5 years (IQR: 12.5–17.1), with a significant height increase of +19.9<!--> <!-->cm (<em>p</em> <!--><<!--> <!-->0.05). Improvements were significant in functionality (LEFS, +4.6 points; <em>p</em> <!--><<!--> <!-->0.05), self-esteem (Rosenberg, +3.7 points; <em>p</em> <!--><<!--> <!-->0.05), and HRQoL (SF-12 physical, +8.9 points; <em>p</em> <!--><<!--> <!-->0.05; EQ-VAS, +20 points; <em>p</em> <!--><<!--> <!-->0.05). A total of 22 complications were reported in 32 treated bones, most classified as grade 2 or 3B, with no significant correlation to outcomes in functionality, HRQoL, or self-esteem outcomes (<em>p</em> <!-->><!--> <!-->0.05).</div></div><div><h3>Conclusions</h3><div>Lower limb lengthening reusing TIMNs appears to improve functionality, HRQoL, and self-esteem in patients with achondroplasia compared to their preoperative status. High patient satisfaction and manageable complications were observed, with no negative impact on outcomes, laying the groundwork for future studies.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 4","pages":"Pages T412-T420"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549848","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 : 2025-07-01DOI: 10.1016/j.recot.2024.09.003
J.J. Lopez Martínez , J.M. Rodríguez-Roiz , C. Salcedo Cánovas , J.P. García Paños , S. Toledo García
Background
Given the boom in sports in school age, its intensity and the increase in sports in females, we are experiencing a boom in sports injuries characteristic of “adults” in growing patients, the anterior cruciate ligament being an injury with possible serious consequences.
Methods
To show the surgical technique “without bone tunnels” by Micheli–Kocher in anterior cruciate ligament reconstruction in growing patients based on our results in 20 patients.
Results
Since 2017 we have performed the technique “without bone tunnels” by Micheli–Kocher in 30 patients, 20 of whom have been followed up for more than 2 years. In our study, we have observed a return to previous sports activity in more than 90% of the patients, with only one patient undergoing reoperation due to a new rupture of the plasty. The results on the IKDC scales show an improvement in mean score from 42 points preoperatively to 84 postoperatively and on the Lysholm scale from 48 preoperatively to 94 postoperatively.
Conclusions
The technique “without bone tunnels” by Micheli–Kocher is a technique indicated in patients under 12 years of age and Tanner stage 2 or less. It is a technique of moderate complexity with excellent results in recovery from previous sports activity and knee stability.
{"title":"Technique “without bone tunnels” (Micheli–Kocher) in anterior cruciate ligament reconstruction in growing patients. Surgical details and our experience with 19 cases","authors":"J.J. Lopez Martínez , J.M. Rodríguez-Roiz , C. Salcedo Cánovas , J.P. García Paños , S. Toledo García","doi":"10.1016/j.recot.2024.09.003","DOIUrl":"10.1016/j.recot.2024.09.003","url":null,"abstract":"<div><h3>Background</h3><div>Given the boom in sports in school age, its intensity and the increase in sports in females, we are experiencing a boom in sports injuries characteristic of “adults” in growing patients, the anterior cruciate ligament being an injury with possible serious consequences.</div></div><div><h3>Methods</h3><div>To show the surgical technique “without bone tunnels” by Micheli–Kocher in anterior cruciate ligament reconstruction in growing patients based on our results in 20 patients.</div></div><div><h3>Results</h3><div>Since 2017 we have performed the technique “without bone tunnels” by Micheli–Kocher in 30 patients, 20 of whom have been followed up for more than 2 years. In our study, we have observed a return to previous sports activity in more than 90% of the patients, with only one patient undergoing reoperation due to a new rupture of the plasty. The results on the IKDC scales show an improvement in mean score from 42 points preoperatively to 84 postoperatively and on the Lysholm scale from 48 preoperatively to 94 postoperatively.</div></div><div><h3>Conclusions</h3><div>The technique “without bone tunnels” by Micheli–Kocher is a technique indicated in patients under 12 years of age and Tanner stage 2 or less. It is a technique of moderate complexity with excellent results in recovery from previous sports activity and knee stability.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 4","pages":"Pages 347-354"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297710","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 : 2025-07-01DOI: 10.1016/j.recot.2025.04.015
E. García-Albó , J. Nomdedéu Sancho , M. Gispert Estadella , R. Sevil Mayayo , J.V. Andrés-Peiró , J. Pijoan Bueno , M.M. Reverté-Vinaixa , J. Minguell-Monyart
Introduction
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.
Material and methods
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.
Results
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 (P = .552) nor to the same level of performance (P = .664). The mean IKDC. score was 86.83 (SD 14.85), and was not higher in the EA group (P = .418). However, its value was higher in the players who returned to training, competition and level of performance(P < .05). EA did not delay the return to play in any group (P = .282).
Conclusion
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.
{"title":"[Translated article] Lateral extra-articular tenodesis in association to all-inside anterior cruciate ligament reconstruction does not modify return to play in basketball players: A comparative cohort study","authors":"E. García-Albó , J. Nomdedéu Sancho , M. Gispert Estadella , R. Sevil Mayayo , J.V. Andrés-Peiró , J. Pijoan Bueno , M.M. Reverté-Vinaixa , J. Minguell-Monyart","doi":"10.1016/j.recot.2025.04.015","DOIUrl":"10.1016/j.recot.2025.04.015","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> <!--><<!--> <!-->.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 T330-T339"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549789","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 : 2025-07-01DOI: 10.1016/j.recot.2025.04.002
A. Combalia , P. Hernigou , L. López-Duran Stern , M. Scarlat
{"title":"Madrid acoge el 45.° Congreso Mundial de Ortopedia y Traumatología SICOT","authors":"A. Combalia , P. Hernigou , L. López-Duran Stern , M. Scarlat","doi":"10.1016/j.recot.2025.04.002","DOIUrl":"10.1016/j.recot.2025.04.002","url":null,"abstract":"","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 4","pages":"Pages 319-322"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549999","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 : 2025-07-01DOI: 10.1016/j.recot.2024.09.008
P. Lalueza-Andreu , Á. Martínez-García , P. Checa-Betegón , J. García-Coiradas , J.A. Valle-Cruz , F. Marco-Martínez
Objective
The objective of this study is to compare the outcomes of using the Femoral Neck System (FNS) (DePuy Synthes®) versus the use of cannulated screws (CS) in the surgical treatment of non-displaced subcapital hip fractures.
Materials and methods
A retrospective cohort study was conducted on non-displaced subcapital hip fractures treated with CS or FNS between 2020 and 2023, with a minimum follow-up of one year. A total of 28 patients were included, 14 treated with CS and 14 with FNS. Demographic, radiological, clinical, and functional variables were analyzed.
Results
In the CS group, 64% were male, with a mean age of 66.5 years (SD 14.9) and an average follow-up of 22 months (range, 12-36 months). In the FNS group, 57% were male, with a median age of 60.8 years (SD 13.78) and an average follow-up of 16 months (range, 12-24 months).
Regarding functional outcomes, no significant differences were found between FNS and CS in the Harris scale: 94.21 ± 11.55 for FNS and 96.50 ± 6.9 for CS (p = 0.618).
The total postoperative complications (FNS/CS) were 7.1% versus 43%, and implant failure with conversion to total hip replacement was 0% versus 43%, both significantly higher in the CS group (p = 0.047; p = 0.016, respectively). The FNS also presented a lower rate of avascular necrosis (0% versus 11.1%, p = 0.391) and nonunion (0% versus 20%, p = 0.163), although these differences did not reach statistical significance.
Conclusions
Although both treatment methods, cannulated screws and the FNS, showed similar short-term functional outcomes in the management of undisplaced subcapital femoral fractures, the FNS demonstrated a significantly lower rate of complications and reoperations. These results suggest that the FNS could be considered a safer and more effective option compared to cannulated screws.
{"title":"Tratamiento quirúrgico de fractura subcapital de cadera no desplazada: Femoral Neck System vs. tornillos canulados. Estudio comparativo","authors":"P. Lalueza-Andreu , Á. Martínez-García , P. Checa-Betegón , J. García-Coiradas , J.A. Valle-Cruz , F. Marco-Martínez","doi":"10.1016/j.recot.2024.09.008","DOIUrl":"10.1016/j.recot.2024.09.008","url":null,"abstract":"<div><h3>Objective</h3><div>The objective of this study is to compare the outcomes of using the Femoral Neck System (FNS) (DePuy Synthes®) versus the use of cannulated screws (CS) in the surgical treatment of non-displaced subcapital hip fractures.</div></div><div><h3>Materials and methods</h3><div>A retrospective cohort study was conducted on non-displaced subcapital hip fractures treated with CS or FNS between 2020 and 2023, with a minimum follow-up of one year. A total of 28 patients were included, 14 treated with CS and 14 with FNS. Demographic, radiological, clinical, and functional variables were analyzed.</div></div><div><h3>Results</h3><div>In the CS group, 64% were male, with a mean age of 66.5 years (SD 14.9) and an average follow-up of 22 months (range, 12-36 months). In the FNS group, 57% were male, with a median age of 60.8 years (SD 13.78) and an average follow-up of 16 months (range, 12-24 months).</div><div>Regarding functional outcomes, no significant differences were found between FNS and CS in the Harris scale: 94.21<!--> <!-->±<!--> <!-->11.55 for FNS and 96.50<!--> <!-->±<!--> <!-->6.9 for CS (p<!--> <!-->=<!--> <!-->0.618).</div><div>The total postoperative complications (FNS/CS) were 7.1% versus 43%, and implant failure with conversion to total hip replacement was 0% versus 43%, both significantly higher in the CS group (p<!--> <!-->=<!--> <!-->0.047; p<!--> <!-->=<!--> <!-->0.016, respectively). The FNS also presented a lower rate of avascular necrosis (0% versus 11.1%, p<!--> <!-->=<!--> <!-->0.391) and nonunion (0% versus 20%, p<!--> <!-->=<!--> <!-->0.163), although these differences did not reach statistical significance.</div></div><div><h3>Conclusions</h3><div>Although both treatment methods, cannulated screws and the FNS, showed similar short-term functional outcomes in the management of undisplaced subcapital femoral fractures, the FNS demonstrated a significantly lower rate of complications and reoperations. These results suggest that the FNS could be considered a safer and more effective option compared to cannulated screws.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 4","pages":"Pages 365-371"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373083","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 : 2025-07-01DOI: 10.1016/j.recot.2024.07.018
J. Teves, F. Holc, A. García-Mansilla, S. Vildoza, R. Brandariz, L. Carbó, J. Costantini
Background and objectives
It has been shown that total knee replacement improves functional capacity and physical activity; however, the influence of age remains unclear. The objective is evaluate the pre and postoperative physical activity measured with the Knee Society Score (KSS) score and the Tegner score.
Materials and methods
A retrospective cohort analysis was conducted on patients who underwent total knee replacement (TKR) between January 2016 and December 2019 at our institution. Demographic variables (age, sex, and body mass index), activities of daily living, age-adjusted Charlson Comorbidity Index, American Society of Anesthesiologists score, the Knee Society Score (KSS) in its clinical (KSSc) and functional (KSSf) subscales, the Tegner functional scale, activity variables from the 2011 KSS version, and pain assessment using the visual analog scale were collected. Differences in these variables were analyzed between two age groups: group A (between 65 and 79 years old) and group B (80 years or older).
Results
A total of 450 patients were evaluated (group A = 245, group B = 167). Group A showed a Tegner improvement of 1.19 (95% CI: 1.06-1.31), whereas group B averaged 0.61 (95% CI: 0.43-0.80) (P<.001). Age >80 was an independent risk factor for less Tegner improvement. In KSSc, group A improved by 43 points (95% CI: 40.82-46.14), while group B showed a greater increase of 53 points (95% CI: 49.74-57.80). Adjusted for confounders, those >80 showed significantly higher KSSc improvement (12.8 points). For KSSf, group A improved by 33.91 points (95% CI: 31.07-36.75), and group B by 15.57 points (95% CI: 11.78-19.35). Adjusted for confounders, patients >80 had less improvement than those < 80 (19 points).
Conclusions
Patients who underwent TKR experienced improvements in physical and functional activity parameters. While these improvements were seen in the entire population, they were most notable in patients younger than 80 years.
背景和目的：有研究表明，全膝关节置换术可提高功能能力和体力活动；但年龄的影响仍不明确。本研究旨在通过膝关节社会评分（KSS）和 Tegner 评分来评估术前和术后的体力活动：我院对 2016 年 1 月至 2019 年 12 月间接受全膝关节置换术（TKR）的患者进行了回顾性队列分析。收集了人口统计学变量（年龄、性别和体重指数）、日常生活活动、年龄调整后的夏尔森合并症指数、美国麻醉医师协会评分、膝关节社会评分（KSS）的临床（KSSc）和功能（KSSf）分量表、Tegner功能量表、2011版KSS的活动变量以及使用视觉模拟量表进行的疼痛评估。分析了两个年龄组在这些变量上的差异：结果：共有 450 名患者接受了评估（A 组 245 人，B 组 167 人）。A 组的 Tegner 改善率为 1.19（95% CI 1.06/1.31），而 B 组平均为 0.61（95% CI 0.43/0.80）（P80 是 Tegner 改善率较低的独立风险因素）。在 KSSc 方面，A 组提高了 43 分（95% CI 40.82/46.14），而 B 组提高了 53 分（95% CI 49.74/57.80）。经混杂因素调整后，年龄大于 80 岁者的 KSSc 改善幅度明显更高（12.8 分）。就 KSSf 而言，A 组提高了 33.91 分（95% CI 31.07/36.75），B 组提高了 15.57 分（95% CI 11.78/19.35）。在对混杂因素进行调整后，大于 80 岁的患者比结论中的患者改善得更少：接受 TKR 的患者在体能和功能活动参数方面都有所改善。虽然这些改善在整个人群中都能看到，但在 80 岁以下的患者中最为明显。
{"title":"¿Los pacientes octogenarios sometidos a reemplazo total de rodilla regresan a la actividad física?","authors":"J. Teves, F. Holc, A. García-Mansilla, S. Vildoza, R. Brandariz, L. Carbó, J. Costantini","doi":"10.1016/j.recot.2024.07.018","DOIUrl":"10.1016/j.recot.2024.07.018","url":null,"abstract":"<div><h3>Background and objectives</h3><div>It has been shown that total knee replacement improves functional capacity and physical activity; however, the influence of age remains unclear. The objective is evaluate the pre and postoperative physical activity measured with the Knee Society Score (KSS) score and the Tegner score.</div></div><div><h3>Materials and methods</h3><div>A retrospective cohort analysis was conducted on patients who underwent total knee replacement (TKR) between January 2016 and December 2019 at our institution. Demographic variables (age, sex, and body mass index), activities of daily living, age-adjusted Charlson Comorbidity Index, American Society of Anesthesiologists score, the Knee Society Score (KSS) in its clinical (KSSc) and functional (KSSf) subscales, the Tegner functional scale, activity variables from the 2011 KSS version, and pain assessment using the visual analog scale were collected. Differences in these variables were analyzed between two age groups: group A (between 65 and 79 years old) and group B (80 years or older).</div></div><div><h3>Results</h3><div>A total of 450 patients were evaluated (group A<!--> <!-->=<!--> <!-->245, group B<!--> <!-->=<!--> <!-->167). Group A showed a Tegner improvement of 1.19 (95% CI: 1.06-1.31), whereas group B averaged 0.61 (95% CI: 0.43-0.80) (<em>P</em><.001). Age >80 was an independent risk factor for less Tegner improvement. In KSSc, group A improved by 43 points (95% CI: 40.82-46.14), while group B showed a greater increase of 53 points (95% CI: 49.74-57.80). Adjusted for confounders, those<!--> <!-->>80 showed significantly higher KSSc improvement (12.8 points). For KSSf, group A improved by 33.91 points (95% CI: 31.07-36.75), and group B by 15.57 points (95% CI: 11.78-19.35). Adjusted for confounders, patients >80 had less improvement than those <<!--> <!-->80 (19 points).</div></div><div><h3>Conclusions</h3><div>Patients who underwent TKR experienced improvements in physical and functional activity parameters. While these improvements were seen in the entire population, they were most notable in patients younger than 80 years.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 4","pages":"Pages 323-329"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879626","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 : 2025-07-01DOI: 10.1016/j.recot.2024.10.009
J.M. Bogallo , C. Castillejo , A. Ramirez , J.R. Cano , F. Rivas-Ruiz , E. Guerado
Objective
This study aimed to analyze factors of comorbidity in older patients with acetabular fracture to know the role of disease in the treatment of this population.
Methods
Design: retrospective cohort study.
Setting
Single Level 2 Trauma Center.
Patient selection criteria
A prospective database of acetabular fractures in patients over 55 years between January 2011 and January 2021 was studied. The exclusion criteria were age, pathological fracture, associated pelvic or hip fracture, follow-up of less than one year, and not having a computed tomography.
Outcome measures and comparisons
Patients were categorised as low (0–2), intermediate (3–4) or high (≥5) risk according to the age-adjusted Charlson comorbidity index (ACCI). The primary outcomes were risk of complications, number of complications and mortality at one year according to the ACCI scale. The difference between the pre-fracture Clinical Frailty Scale (CFS) and the one-year follow-up was also analysed. Descriptive and multivariable regression analyses were performed and ROC curves were constructed.
Results
A total of 119 patients with acetabular fracture were collected. Ninety-eight out of those met inclusion criteria for our study. In regard to ACCI groups, 22% were low-risk, 26% were intermediate-risk, and 52% were high-risk. Statistically significant differences were found according to age, sex, mechanism of injury, treatment type, surgical treatment type, Clinical Frailty Scale (CFS) score, readmissions, complications, and mortality. ROC curves showed an association between ACCI and CFS in terms of complications and mortality, with the exception of unadjusted Charlson comorbidity index. On the multivariable regression analysis, associations were found between ACCI and presence of complications (OR 1.37, 95% CI 1.06–1.77, p = 0.015) and mortality (OR 1.32, 95% CI 1.04–1.67, p = 0.025) and between CFS and complications (OR 2.01, 95% CI 1.30–3.11, p = 0.001) and mortality (OR 1.59, 95% CI 1.08–2.35, p = 0.019). No statistical correlation was established between ASA and complications or mortality.
Conclusion
Presurgical ACCI and CFS scales may serve as a risk assessment method in treatment decision-making for patients with acetabular fracture. An association is observed between patients with a pre-fracture ACCI score ≥5 (high-risk) and a pre-fracture CFS score >4 (mild frailty) and mortality and complications at one year.
{"title":"The age-adjusted Charlson comorbidity index in acetabular fracture in geriatric acetabular fractures","authors":"J.M. Bogallo , C. Castillejo , A. Ramirez , J.R. Cano , F. Rivas-Ruiz , E. Guerado","doi":"10.1016/j.recot.2024.10.009","DOIUrl":"10.1016/j.recot.2024.10.009","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to analyze factors of comorbidity in older patients with acetabular fracture to know the role of disease in the treatment of this population.</div></div><div><h3>Methods</h3><div><em>Design</em>: retrospective cohort study.</div></div><div><h3>Setting</h3><div>Single Level 2 Trauma Center.</div></div><div><h3>Patient selection criteria</h3><div>A prospective database of acetabular fractures in patients over 55 years between January 2011 and January 2021 was studied. The exclusion criteria were age, pathological fracture, associated pelvic or hip fracture, follow-up of less than one year, and not having a computed tomography.</div></div><div><h3>Outcome measures and comparisons</h3><div>Patients were categorised as low (0–2), intermediate (3–4) or high (≥5) risk according to the age-adjusted Charlson comorbidity index (ACCI). The primary outcomes were risk of complications, number of complications and mortality at one year according to the ACCI scale. The difference between the pre-fracture Clinical Frailty Scale (CFS) and the one-year follow-up was also analysed. Descriptive and multivariable regression analyses were performed and ROC curves were constructed.</div></div><div><h3>Results</h3><div>A total of 119 patients with acetabular fracture were collected. Ninety-eight out of those met inclusion criteria for our study. In regard to ACCI groups, 22% were low-risk, 26% were intermediate-risk, and 52% were high-risk. Statistically significant differences were found according to age, sex, mechanism of injury, treatment type, surgical treatment type, Clinical Frailty Scale (CFS) score, readmissions, complications, and mortality. ROC curves showed an association between ACCI and CFS in terms of complications and mortality, with the exception of unadjusted Charlson comorbidity index. On the multivariable regression analysis, associations were found between ACCI and presence of complications (OR 1.37, 95% CI 1.06–1.77, <em>p</em> <!-->=<!--> <!-->0.015) and mortality (OR 1.32, 95% CI 1.04–1.67, <em>p</em> <!-->=<!--> <!-->0.025) and between CFS and complications (OR 2.01, 95% CI 1.30–3.11, <em>p</em> <!-->=<!--> <!-->0.001) and mortality (OR 1.59, 95% CI 1.08–2.35, <em>p</em> <!-->=<!--> <!-->0.019). No statistical correlation was established between ASA and complications or mortality.</div></div><div><h3>Conclusion</h3><div>Presurgical ACCI and CFS scales may serve as a risk assessment method in treatment decision-making for patients with acetabular fracture. An association is observed between patients with a pre-fracture ACCI score ≥5 (high-risk) and a pre-fracture CFS score >4 (mild frailty) and mortality and complications at one year.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 4","pages":"Pages 392-401"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509918","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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