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Language Revista española de cirugía osteoarticular, 2020, vol. 55, no. 283
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- Inestabilidad de la articulación tibioperonea proximal como causa de dolor en artroplastia total de rodillaprimaria.(2020) Rodríguez, J.R.; Mifsut Miedes, DamianThe isolated instability of the proximal tibiofibular joint (PTFJ) as a cause of pain in a prosthetic knee is a very rare clinical entity, to date we have only found one reference in the bibliography of ATPP instability associated with total knee arthroplasty. We review the bibliography on the different forms of instability and their etiology, as well as the possibilities of conservative and surgical treatment. We present the case of a patient with anterolateral instability PTFJ associated with a primary postero-stabilized (PS) TKA with a mobile tibial polyethylene.
- Infección protésica de cadera : recambio en dos tiempos en una serie de 50 casos(2020) Sánchez Losilla, C.; Diranzo García, J.; Estrems Díaz, V.; Jara García, F.; Brú Pomer, Antonio; Hernández Ferrando, L.Chronic infection in hip replacement is an important complication with a complex treatment, that is solved by adequate antibiotic therapy together with single-stage exchange or two-stage exchange. We present a descriptiveand retrospective study of a series of 50 consecutive patients operated on in our center with a diagnosis of chronic infection of the hip prosthesis between 2007 and 2018 with a two-stage exchange.At a mean follow-up of 52 months, the overall implant survival was 89%, with a 91% infection cure rate. The most frequent microorganism isolated was Staphylococcus epidermidis. The mean score achieved on the HHS was 82,4 points and 1.67 points on the visual analogue scale. We obtained better functional results (p=0,021) in those patients who had a preformed antibiotic-loaded spacer in the first surgical stage.As complications, we recorded four cases of prosthetic reinfection (8,7%), three cases of dislocation (6,5%), and one case of postsurgical hematoma (4,6%).No case of neurovascular injury or component loosening was recorded.According to the showed results, we consider that two-stage revision procedure, although it is a demanding surgery, is an effective method for the treatment of periprosthetic hip infection, with high implant survival and erradication of the infection.
- Valoración funcional en pacientes intervenidos medianteplastia de LCA con semitendinoso-recto interno y sistema Togglelock.(2020) Descalzo Pérez, P; Mifsut Miedes, Damian; Rodríguez, J.R.; López Sánchez, A.; Silvestre Muñoz, AntonioIntroducción: Una de las lesiones más frecuente de la rodilla y que está en aumento, sobre todo en el ámbito deportivo es la lesión del ligamento cruzado anterior. La reconstrucción quirúrgica es fundamental para recuperar la biomecánica de la rodilla, proporcionar una correcta estabilidad y funcionamiento libre de dolor, así como evitar cambios degenerativos tempranos. El objetivo del presente estudio fue valorar la recuperación funcional de los pacientes sometidos a una reconstrucción del ligamento cruzado anterior mediante ligamentoplastia con tendón semitendinoso-recto interno y sistema Toggelock. Material y métodos: Se diseñó un estudio retrospectivo descriptivo observacional, en el que se incluyeron a 29 pacientes a los cuales se les realizó una ligamentoplastia con semitendinoso-recto interno y sistema Togglelock en nuestro Centro, durante los años 2017-2018. Se estudiaron variables obtenidas de la historia clínica y la escala de Lysholm para la valoración del paciente. Resultados: En total, se obtuvo una muestra de 29 pacientes, 26 hombres y 3 mujeres con una media de edad de 31,13 años (rango 19-53). La rodilla más frecuentemente lesionada fue la derecha en 17 pacientes de 29, presentando lesiones asociadas el 65%. Una paciente había sufrido una fractura tibial intervenida con un clavo endomedular que alteró los resultados finales. La puntuación postquirúrgica de la escala de valoración subjetiva de Lysholm fue de 86. La movilidad de la rodilla intervenida presentó una reducción mínima de flexión de 6º en comparación con la rodilla no operada estadísticamente significativa. Conclusión: Los resultados obtenidos tras la reconstrucción del LCA con dicha técnica, utilizando la plastia del semitendinoso-recto interno y sistema Togglelock fueron buenos-excelentes, con un alto grado de satisfacción en los pacientes, escasas complicaciones y con resultados funcionales notables.
- Osteítis por radiación y fracturas por insuficiencia pélvica en paciente con adenocarcinoma de próstata tratado con radioterapia. Aspectos clínicos y radiográficos de la enfermedad.(2020) Fernández Gabarda, Rafael; Ballesta Moratalla, M.; Sangüesa Nebot, María JoséOsteítis por radiación es un término anatomopatológico acuñado por primera vez por Ewing en 1926 y hace referencia a una respuesta inflamatoria inducida por la radiación en los vasos sanguíneos, el tejido nervioso y las células óseas que pueden conducir a fracturas del hueso trabecular y cortical. La fractura por insuficiencia pélvica es una fractura de stress sobre un hueso debilitado, visto en pacientes que tienen ciertos factores de riesgo como osteoporosis, enfermedades del tejido conectivo, uso de corticoides y sobre todo en pacientes que han sido tratados con radioterapia pélvica por tumores rectales, anales, urogenitales y de próstata. Presentamos el caso clínico de un paciente de 73 años, con fracturas por insuficiencia pélvica tratado cuatro años antes de adenocarcinoma de próstata mediante radioterapia y hormonoterapia. Se discuten aspectos clínicos y radiográficos diagnósticos.
- Estudio de las lesiones en el judo(2020) Orenga, S.; Hurtado Oliver, V.; Picazo Gabaldón, Benito R.; Gracia Ochoa, M.; Escribano Zacarés, S; Capó Soliveres, Irina; Villanueva Dolcet, C.Judo is a martial art whose origins come from jujutsu, created in 1882 by the master Jigoro Kano, who proposed a method that was based on techniques that could be applied in real combat, as well as practiced with the partner without risk of injury .The objective of the present study is to assess the prevalence, type and distribution of the injuries suffered. Check whether sex or sports performance influences the appearance of injuries, determine which technique intervenes more frequently, assess whether they occur mostly in training or competition, and analyze how they act.This is a descriptive crosssectional observational study, in which four clubs were asked to participate, in which they had to answer an anonymous survey.Regarding the results, a total of 652 injuries were registered, in 63 men and 38 women. The most commonly injured body regions were the upper limbs 254 (38.95 %%). Contusions and sprains were the most frequent injuries and the most frequently associated technique was Seoi Nage. The number of injuries was higher during the competition if we take into account time. Most of the injuries (74.1%) were of slight characteristics, with a sports rest of less than a week and only 38.95% forced the judoka to interrupt the sport.After the study carried out, we can conclude that the results obtained are comparable to the bibliography, confirming the stated objectives
- Estudio de la valoración del dolor articular y del grado de satisfacción,tras infiltración con plasma rico en fibrina en pacientes con artrosis de rodilla.(2020) Rodrigo Pérez, José Luis; García Álvarez, J; Puig Conca, A.; Jordá Llona, Mónica; Novoa, C.The definition of platelet rich plasma (PRP) is still controversial, though it can be described in general terms as ?a volumeof autologous plasma that contains a higher platelet concentration than the physiological basal concentration?. A retrospective observational analytical study was carried out in our hospital in order to assess the results and satisfaction of patients that had undergone PRF injection in knee. Between January and December of 2017, 80 gonoarthrosis patients treated with PRF injection were selected by the Orthopaedic Surgery and Rehabilitation Department, all of whom attended several medical appointments to check their recovery. Those cases that did not follow an appropriate clinical follow-up were dismissed from the study.Pain before treatment was assessed by the Numeric Rating Scale, with a mean of 8.48. A statistically significant decrease was observed after treatment (p<0.001), with a 4.87 mean and a 5.00 post-injection median. Regarding walking perimeter, most patients walked a median of 30 minutes and 55.3 minute mean, and their walking autonomy increased after treatment, doubling the median to 60 minutes, with an average of 93.15 minutes of pain-free walking. This 37.8 minute increase in the walking ability impliesa statistically significant improvement (p<0.001). A significant decrease in analgesics intake after treatment was also observed, being 81.3% patients who needed analgesia prior to treatment (n=61), and just 49.3% (n=37) after the procedure.Consequently,there is a significative improvement of pain, walking perimeter and absolute intake of analgesics that cannot be explained by any variable prior to PRF injection.
