Revista Espanola de Cirugia Ortopedica y Traumatologia最新文献

{"title":"[Translated article] Use of 3D printing for the manufacture of antibiotic carriers in the treatment of bone and joint infections","authors":"A. Ortega Yago ,&nbsp;C. Ezquer Garín ,&nbsp;P. Medina Bessó ,&nbsp;F. Baixauli García ,&nbsp;J. Ferràs Tarragó","doi":"10.1016/j.recot.2025.11.035","DOIUrl":"10.1016/j.recot.2025.11.035","url":null,"abstract":"<div><h3>Background</h3><div>Local antibiotic delivery is crucial in prosthetic infections due to the limited bone penetration of systemic treatments. With the rise of bacterial resistance, alternatives are being explored to utilize these antibiotics without compromising their properties. The aim of this study is to investigate the application of stereolithography in manufacturing customized objects that incorporate thermolabile antibiotics and analyze their biomechanical behavior.</div></div><div><h3>Materials and methods</h3><div>A stereolithography (SLA) 3D printer with biocompatible resin <em>Optoprint</em>® <em>Lumina</em> was used to create different models, incorporating various amounts of amoxicillin–clavulanic acid. Mechanical studies were conducted to evaluate the performance of the 3D-printed models before and after antibiotic release.</div></div><div><h3>Results</h3><div>Resin pieces without antibiotics demonstrated higher resistance, while adding the antibiotic reduced resistance by 18%, and after the elution of amoxicillin-clavulanic acid, the reduction reached 56% of their total strength. Comparatively, antibiotic-loaded cement pieces retained more than twice the resistance post-elution. The progressive loss of biomechanical strength correlated with the antibiotic release from the resin pieces.</div></div><div><h3>Conclusions</h3><div>The results of this study suggest that it is feasible to design pieces with variable structural characteristics using SLA (stereolithography) printing with biocompatible resin, combined with the incorporation of drugs, including thermolabile antibiotics.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 1","pages":"Pages T78-T83"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fractura meseta tibial externa (AO 41B3/Schatzker 2): análisis de factores clínico-radiológicos en los resultados funcionales y de calidad de vida a largo plazo tras tratamiento quirúrgico","authors":"P.I. Codesido Vilar ,&nbsp;P. Sucasas Hermida ,&nbsp;B. Calvete Vázquez ,&nbsp;C. Bonome Roel ,&nbsp;A. Montero Picallo ,&nbsp;M. Goday Etxebarria ,&nbsp;A. López González","doi":"10.1016/j.recot.2025.06.001","DOIUrl":"10.1016/j.recot.2025.06.001","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;The most common tibial plateau fractures are AO 41B3/Schatzker type&lt;!--&gt; &lt;!--&gt;2 (external unicondylar lesions with a vertical fracture line). The goal of treatment for these fractures is the satisfactory restoration of mechanical alignment, anatomic reduction of the articular surface, and stable fixation to allow early range of motion. The aim of our study is to determine the factors that most influence long-term functional and quality of life outcomes after surgical treatment by strictly selecting previously healthy patients facing an unexpected external tibial plateau fracture.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Material and method&lt;/h3&gt;&lt;div&gt;A retrospective study was conducted in our tertiary hospital after obtaining approval from the ethics committee. Data from patients with external tibial plateau fracture hospitalized between 2013 and 2018 with more than 3&lt;!--&gt; &lt;!--&gt;years of evolution were analyzed. All patients who met the strict inclusion criteria completed the KOOS, EQ-5-D profile and VAS questionnaires. In addition, they underwent a physical examination and radiological study using telemetry and computed tomography (CT). The clinical data collected from the patients were: age, sex, fracture side, implant use, graft use, days elapsed until surgery, years after surgery, ASA, range of motion in extension and flexion. The radiological data were: in the telemetry, the deviation in mm of the load axis with respect to the contralateral limb was analyzed, the MPTA of both limbs and the difference in degrees between them; in the CT, the maximum joint step was measured and the affected area was calculated in cm&lt;sup&gt;2&lt;/sup&gt; as well as the largest anteroposterior diameter and maximum width in mm (maximum anteroposterior and transverse diameters).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 27 patients were analysed, with a mean age of 53.3&lt;!--&gt; &lt;!--&gt;years and a mean evaluation time since the fracture of 4.8&lt;!--&gt; &lt;!--&gt;years. We found statistically significant correlations (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;.05) between: days until surgery and size of the area in cm&lt;sup&gt;2&lt;/sup&gt; (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;.042) and step in mm (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;.028), that is, the more days of delay, the greater the area and the greater the step; being a man presented a positive correlation with having a greater step (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;.025), greater area (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;.007) and greater slope (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;.039) compared to women. A statistically significant relationship was observed between the area of residual fracture and the values of KOOS symptoms (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;.015), KOOS function (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;.012), EQ-5D profile (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;.038) and VAS (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;.049); the greater the affected area, the worse the patient's condition. We also detected significant correlations between increased joint step and KOOS symptoms (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;=&lt;!--","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 1","pages":"Pages 28-35"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Translated article] Analysis of the results of anterior cruciate ligament reconstruction associated with high-resistance tape reinforcement (ultra-high molecular weight polyethylene braided material)","authors":"A.N. Toro-Ibarguen ,&nbsp;E. Sánchez Benito ,&nbsp;J.M. Cortés Villar","doi":"10.1016/j.recot.2025.11.004","DOIUrl":"10.1016/j.recot.2025.11.004","url":null,"abstract":"<div><h3>Background and objective</h3><div>The primary objective is to evaluate the clinical and functional outcomes of tape reinforcement in anterior cruciate ligament (ACL) reconstructions, recording complications, as well as the rate of reinterventions and graft failure.</div></div><div><h3>Materials and methods</h3><div>Retrospective analysis of ACL reconstructions with hamstring (HS) autograft that were reinforced with high-strength tape. We included patients in whom we obtained a graft of HS &lt;8<!--> <!-->mm or ≥8<!--> <!-->mm of poor quality. Age, sex, body mass index (BMI), and previous activity were recorded. Clinical and functional evaluation were made and postoperative range of motion (ROM), pain, and Lysholm functional scale were recorded. Complication rate, graft failure rate, and reintervention rate were analyzed.</div></div><div><h3>Results</h3><div>A total of 160 patients were included, with a mean age of 29.19 years. Of these, 98 were male and 62 female, with a mean BMI of 23.5. The mean follow-up period was 31.7 months. The average ROM was 137.2°, the mean pain level was 0.8, and the average Lysholm score was 95.1. The complication rate was 11%, with 5% requiring reoperation. The graft failure rate was 1.3%. A graft diameter &lt;8<!--> <!-->mm was associated with females with Fisher's exact test of <em>p</em> <!-->&lt;<!--> <!-->.0001. In the other parameters, no statistically significant differences were found between patients with grafts &lt;8<!--> <!-->mm and those with grafts ≥8<!--> <!-->mm.</div></div><div><h3>Conclusions</h3><div>This study demonstrates that tape reinforcement in ACL reconstruction is a safe procedure, offering excellent clinical and functional outcomes with low reinterventions and graft failure rates.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 1","pages":"Pages T20-T27"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Éxito tras el tratamiento quirúrgico de la prótesis de cadera inestable: 12 años de experiencia en un hospital de tercer nivel","authors":"A.G. Casa Casa ,&nbsp;J.I. Baltá Aymar ,&nbsp;A. Alías Petralanda ,&nbsp;L. Ramírez Núñez ,&nbsp;A. Serra Trullas ,&nbsp;J.A. Fernández-Valencia","doi":"10.1016/j.recot.2025.02.018","DOIUrl":"10.1016/j.recot.2025.02.018","url":null,"abstract":"<div><h3>Objectives</h3><div>Hip arthroplasty instability is one of the most worrisome complications and one of the main indications for revision surgery. We present a retrospective study evaluating the results of revision hip replacement surgery performed for instability.</div></div><div><h3>Material and methods</h3><div>Observational, retrospective study from 1/12/2010 to 1/12/2022. Fifty-nine medical records of patients operated for hip dislocation were reviewed. Epidemiological variables and data such as type of dislocation based on Wera classification, cup position based on Lewinnek, type of implants, associated surgical techniques and the results in terms of recurrence of dislocation or reoperation were recorded.</div></div><div><h3>Results</h3><div>Fifty-nine patients: 33 women, 26 men, mean age 77.0 years. Mean follow-up 3.2 years (range 1.6-13.1). Based on Wera: had a single cause 37 cases, 2 causes 19 and 3 causes or more, 3 cases. In 61% of the cases in the series, malposition of the cup played an essential role in the dislocation (type I Wera). In the series, the Lewinnek zone could not be evaluated in 7 cases. For the remaining patients, 30% were within the Lewinnek zone. Only one patient in the series had a history of lumbar instrumentation. Implant used: double mobility (DM) in 17 cases (28.8%) and a constrained system in 38 cases (64.4%). Heads with adaptive cone were used in 2 cases (3%). In 4 cases (6%) a modified Whiteside type plasty was associated. Girdlestone was indicated in 2 cases (3%). Recurrence of dislocation 1 occasion: 18 cases (31%); 2 or more occasions 7 cases (12%). Re-operation 15 cases (25%) range (1-5), main reasons: instability, infection or peri-prosthetic fractures. Probability of success defined as no recurrence: at one year is 80.5%, and at two years is 70.6%, showing no differences between constrained or dual mobility implant.</div></div><div><h3>Comments and conclusions</h3><div>Hip prosthesis dislocation is multifactorial in origin, although in most cases in the series the key factor was malposition of the acetabulum. Constrained and DM implants showed similar effectiveness. The results of this study emphasize the need for techniques that allow adequate positioning and orientation of the acetabular component to prevent, in a high percentage of cases, the need for this type of revision surgery.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 1","pages":"Pages 64-69"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Translated article] Complications in the surgical treatment of scoliosis in pediatric patients","authors":"F.J. Quiñonez,&nbsp;M.R. Latorre,&nbsp;P. Dardanelli,&nbsp;C. Halliburton,&nbsp;R. Maenza,&nbsp;M. Puigdevall,&nbsp;S.T. Bosio","doi":"10.1016/j.recot.2025.08.005","DOIUrl":"10.1016/j.recot.2025.08.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Scoliosis in pediatric patients encompasses a highly heterogeneous group and is one of the most common reasons for consultation, with a prevalence ranging between 1.5% and 3% of the pediatric population. The most common categories of pediatric scoliosis include idiopathic, neuromuscular, and congenital forms. Surgical correction of spinal deformities is a complex procedure, and although major complications are rare, it remains a crucial intervention. The main goal of surgical treatment is to prevent deformity progression while minimizing morbidity, maximizing postoperative function, and improving the patient's quality of life. This study aims to evaluate complication rates associated with surgical treatment of pediatric scoliosis and analyze the variables linked to increased complication rates over a 30-year period.</div></div><div><h3>Methods</h3><div>This study involved a retrospective review of prospectively collected data from a single institution's registry of patients who underwent surgical treatment for pediatric scoliosis over a 30-year period.</div></div><div><h3>Results</h3><div>Between 1991 and 2021, 779 patients underwent surgery. A total of 63 complications (8.08%) were recorded. Neuromuscular scoliosis had the highest complication rate, with 34 complications in 186 patients (18.28%), followed by congenital scoliosis with 6 complications in 57 patients (10.53%), and 23 complications in 536 patients with adolescent idiopathic scoliosis (4.29%). Infections were the most frequent complications at 4.49%. Neuromuscular scoliosis had the highest infection rate at 10.75%, followed by congenital scoliosis at 5.26%, and idiopathic scoliosis at 2.24%. Neurological deficit rates varied significantly according to the etiology of scoliosis (<em>p</em> <!-->&lt;<!--> <!-->.001), with the highest rate in neuromuscular cases (2.69%), followed by congenital cases (1.75%), and idiopathic scoliosis (0.93%). Neuromuscular and congenital scoliosis had the highest rates of clinical complications, at 3.76% and 1.75%, respectively, followed by idiopathic scoliosis (1.12%).</div></div><div><h3>Conclusion</h3><div>An overall complication rate of 8.09% was observed in our series following surgery for pediatric scoliosis. Although neuromuscular scoliosis presented the highest morbidity, relatively high complication rates were observed across all groups. This information can be valuable for preoperative counseling and surgical decision-making in the treatment of pediatric scoliosis.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 6","pages":"Pages T652-T658"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145374459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"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 ,&nbsp;J.V. Andrés-Peiró ,&nbsp;J. Tomàs-Hernández ,&nbsp;J. Selga-Marsà ,&nbsp;C.A. Piedra-Calle ,&nbsp;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":"2025-11-01","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}

{"title":"Validación transcultural de la escala risk assessment and prediction tool (RAPT) al español","authors":"A. Pérez-Perdomo,&nbsp;M. Rivero,&nbsp;M. Bassas,&nbsp;C. Bordanove,&nbsp;E. Ripoll-Romero","doi":"10.1016/j.recot.2024.11.024","DOIUrl":"10.1016/j.recot.2024.11.024","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 562-567"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828683","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":"Resultados clínicos y radiológicos del vástago SL-Plus con un seguimiento mínimo de 10 años: un estudio retrospectivo","authors":"L. Palacios-Díaz,&nbsp;R. Fernández-Fernández,&nbsp;A. Losa Sánchez,&nbsp;A. Cruz-Pardos","doi":"10.1016/j.recot.2024.10.014","DOIUrl":"10.1016/j.recot.2024.10.014","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: 5.9mm<!--> <!-->±<!--> <!-->6.7; B: 6.9mm<!--> <!-->±<!--> <!-->7.1 and C: 8.2mm<!--> <!-->±<!--> <!-->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 favorable and comparable to previous reports.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 6","pages":"Pages 555-561"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630280","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":"Clinical outcomes of closuring technique in total hip arthroplasty and total knee arthroplasty: A comparative study of staples technique vs triclosan-coated barbed sutures","authors":"V. Benkovich ,&nbsp;A. Abialevich ,&nbsp;G. Benkovich","doi":"10.1016/j.recot.2025.03.006","DOIUrl":"10.1016/j.recot.2025.03.006","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> <!-->=<!--> <!-->0.26) or sex distribution (<em>P</em> <!-->=<!--> <!-->0.778) between groups, though the second group had a higher BMI (28.43<!--> <!-->±<!--> <!-->4.43 vs. 29.15<!--> <!-->±<!--> <!-->3.44; <em>P</em> <!-->&lt;<!--> <!-->0.001) and a more balanced operated limb distribution (<em>P</em> <!-->=<!--> <!-->0.040). Comorbidities were lower in the second group for arterial hypertension (48.48% vs. 57.63%; <em>P</em> <!-->&lt;<!--> <!-->0.001), diabetes mellitus (20.8% vs. 26.21%; <em>P</em> <!-->=<!--> <!-->0.0004), and hyperlipidemia (26.8% vs. 33.28%; <em>P</em> <!-->&lt;<!--> <!-->0.001), with no significant differences in ischemic heart disease (<em>P</em> <!-->=<!--> <!-->0.668), atrial fibrillation (<em>P</em> <!-->=<!--> <!-->0.725), or hypothyroidism (<em>P</em> <!-->=<!--> <!-->0.827). Operative time was longer in the second group (82.7<!--> <!-->±<!--> <!-->7.44 vs. 78.4<!--> <!-->±<!--> <!-->13.62<!--> <!-->min; <em>P</em> <!-->&lt;<!--> <!-->0.001), while hospital stay was marginally shorter (23.33<!--> <!-->±<!--> <!-->4.53 vs. 23.3<!--> <!-->±<!--> <!-->5.16<!--> <!-->h; <em>P</em> <!-->=<!--> <!-->0.039). 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 621-626"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744121","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":"Efectividad, seguridad y eficiencia del alta al día siguiente frente a la estancia hospitalaria de 3 días tras la artroplastia total de cadera primaria","authors":"J.C. Ferragut Bria ,&nbsp;F.A. Miralles Muñoz ,&nbsp;F. Sendra Miralles ,&nbsp;E. Ruiz Piñana ,&nbsp;B. González Navarro ,&nbsp;M.F. Vizcaya Moreno","doi":"10.1016/j.recot.2025.02.020","DOIUrl":"10.1016/j.recot.2025.02.020","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 2 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 597-604"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530943","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}