BIBLIOTECA

ARTÍCULOS MÉDICOS

BIBLIOTECA

ARTÍCULOS MÉDICOS

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    “Shoe Shop” Lacing Technique: A New Biceps-Augmented Knotless Suture for Arthroscopic Rotator Cuff Repair

    Advancements in rotator cuff tear repair have led to innovative techniques for complex cases. In this article, we introduce the “shoe shop” lacing technique, a knotless, side-to-side, and tendon-to-bone suture method augmented with the long head of the biceps tendon (LHBT) for anterior margin–deficient massive rotator cuff tears. This approach offers simplicity, durability, and potential advantages in biomechanics. The LHBT integration and knotless sutures make it a promising solution for challenging tear patterns. This technique provides an attractive option for arthroscopic repair, improving outcomes in cases where anterior cable reinforcement is essential.

    Abordaje del adulto mayor con fractura vertebral por fragilidad ósea

    La osteoporosis es una enfermedad metabólica y sistémica caracterizada por alteraciones a nivel del tejido óseo con pérdida de densidad mineral ósea, cambios en la microarquitectura, mineralización y remodelado que determinan una mayor fragilidad del hueso y riesgo de fractura. Las caídas en el adulto mayor son un factor de riesgo estrechamente relacionado con las fracturas por fragilidad y numerosos estudios demuestran esta relación. Las fracturas vertebrales son causa de morbimortalidad importante. En el adulto mayor, el abordaje de la fractura vertebral osteoporótica implica una evaluación integral del paciente, ya que es tanto causa como consecuencia de múltiples síndromes geriátricos. Esta fractura, en su fase aguda y posteriormente, puede suponer la desestabilización de otros órganos y sistemas del anciano, complicaciones médicas a distintos niveles, deterioro funcional, dependencia e incluso necesidad de institucionalización. Es, por tanto, importante una valoración múltiple del paciente con fractura vertebral, abordando no solo los antecedentes y factores de riesgo de osteoporosis, sino también aquellos factores condicionantes de caídas, además de una valoración geriátrica integral y de las complicaciones íntimamente asociadas a la misma.

    Una revisión sistemática de la literatura: el uso de vainas metafisarias en cirugía de revisión de artroplastia de rodilla

    Revisión sistemática siguiendo las recomendaciones PRISMA sobre el uso de vainas metafisarias para cirugía de revisión de artroplastia de rodilla. Se incluyeron estudios prospectivos y retrospectivos publicados en los últimos 10 años que analizasen la supervivencia del implante, el resultado clínico y funcional con un seguimiento mínimo de 2 años.

    Is A One-Week X-Ray Follow-Up Necessary For Acute Proximal Humeral Fractures Treated Conservatively? A Prospective Multicenter Randomized Study

    Esta comunicación de unos compañeros de Cataluña sobre la necesidad de control radiográfico a la semana de las fracturas de húmero proximal, premio EFORT 2024.

    Intra-articular injection of mesenchymal stem cells for clinical outcomes and cartilage repair in osteoarthritis of the knee: a meta-analysis of randomized controlled trials

    Mesenchymal stem cells (MSCs) have gained popularity for articular cartilage repair. However, efficacy of intra-articular MSCs in osteoarthritis remains unclear. In the setting of a meta-analysis of randomized controlled trials (RCTs), we aimed to investigate the efficacy of intra-articular MSCs on clinical outcomes and cartilage repair in patients with knee osteoarthritis.

    Outcomes of the “Calcaneo-stop” procedure for treating symptomatic flexible flatfoot in children: A systematic review and meta-analysis of 2394 feet

    This study evaluates the efficacy of the calcaneo-stop (C-Stop) procedure’s effectiveness in treating symptomatic flexible flatfoot (FFF) in children.

    Circumferential Cross-Stitch Suture for Longitudinal Lateral Meniscal Tear Around the Popliteal Tendon Hiatus Region

    Lateral meniscal repair of the popliteal hiatus is technically demanding. The inside-out technique requires an additional incision and carries the risk of posterolateral soft tissue damage to the knee joint. In addition, the presence of the popliteal tendon limits the route of the suture thread. Within the current trend of the all-inside suture technique, meniscal suture-based all-inside repair demonstrates biomechanical advantages over anchor-based all-inside repair. We introduce a meniscal suture-based all-inside meniscal repair technique for longitudinal lateral meniscal tears.

    ALARGAMIENTO PROXIMAL DEL GASTROCNEMIO MEDIAL. MODA O EVIDENCIA CIENTÍFICA (MONOGRAFÍA SEMCPT)

    Es bien conocido por todos nosotros que en los últimos años se ha desarrollado un interés creciente por las repercusiones que el acortamiento del sistema aquíleo-calcáneo-plantar (SACP) puede tener en su correcto funcionamiento durante la marcha, así como la posibilidad de generar patologías en el pie y el tobillo, o incluso en otras localizaciones a distancia. El acortamiento de cualquier componente del sistema gastrocnemio-sóleo-aquíleo-calcáneo-plantar puede generar un incremento de la tensión que aumente las solicitaciones mecánicas en el tendón de Aquiles, la fascia plantar y/o el antepié, contribuyendo al desarrollo de múltiples patologías tales como las metatarsalgias estáticas, fascitis plantar, hallux limitus/rigidus, tendinopatía aquílea o pie plano valgo, entre otras.  En nuestra práctica clínica diaria, son cada vez más frecuentes los casos en los que asociamos el gesto quirúrgico del alargamiento proximal del gastrocnemio medial (APGM) para complementar el procedimiento específico utilizado para resolver cada patología.

    Tendinopatía rotuliana: una guía práctica de consenso para la elección del mejor tratamiento

    La tendinopatía rotuliana cursa como un cuadro de dolor anterior de rodilla localizado fundamentalmente en el polo inferior de la patela. La causa principal de esta condición degenerativa son los movimientos repetitivos que generan una carga excesiva del tendón, particularmente durante los deportes que impliquen cambios rápidos de dirección, saltos y carreras, como voleibol, baloncesto o fútbol. Representa hasta un 30-45% de las lesiones que sufren los atletas involucrados en deportes de salto, con tiempos de inactividad que pueden alcanzar los 6 meses. Aunque se acepta que el manejo conservador debe suponer la primera línea de tratamiento, existen diferentes alternativas dentro de este, con mecanismos de acción y duración heterogéneos, así como efectividad y niveles de evidencia variables. Asimismo, es difícil encontrar protocolos de tratamiento que sirvan de guía para el manejo de esta patología durante la práctica clínica. Cuando fracasa el tratamiento conservador, se ha descrito la cirugía tanto abierta como artroscópica para el tratamiento de esta patología, con técnicas variables y resultados consistentes. El objetivo de este trabajo es realizar una revisión narrativa para exponer las alternativas de tratamiento más habituales, su mecanismo de acción, así como detallar el nivel de evidencia disponible para su aplicación y, finalmente, emitir un grado de recomendación para cada uno de ellos. Se pone de manifiesto que la terapia física basada en un programa de ejercicios supervisados ha de suponer la base del tratamiento; no obstante, cuando esta fracasa, parece indicado proporcionar al paciente una técnica invasiva orientada a favorecer los mecanismos de reparación tendinosos, reservando la cirugía para aquellos casos recalcitrantes, puesto que se carece de estudios comparativos de calidad que permitan universalizar su uso.

    In the Treatment of Lateral Epicondylitis by Percutaneous Perforation, Injectables Have No Added Value

    No single injection therapy has been proven to be superior in the treatment of lateral epicondylitis. In most studies, the injection technique is not standardized, which makes it challenging to compare outcomes.

    Clinical Faceoff: Strategies for Management of Suspected Scaphoid Fractures

    In the United Kingdom, guidelines issued by the National Institute for Health and Clinical Research (NICE) suggest the routine use of MRI when a scaphoid fracture is suspected based on interview, examination findings, and normal scaphoid-specific radiographs [5]. This clinical scenario is often referred to as a “suspected scaphoid fracture” [16]. An alternative strategy for managing suspected scaphoid fractures is based on the management of other fractures that predictably heal (such as metacarpal fractures and isolated nondisplaced or minimally displaced radial head fractures) and is premised on the idea that if a fracture is likely to heal without serious sequelae, then overtreatment represents a risk as great as undertreatment. The alternative pathway for the care of patients who present to emergency departments with a history, signs, and symptoms potentially consistent with scaphoid fracture involves providing patients with information about the expected course of recovery and specific instructions about how to seek more care if desired.

    The effects of length and width of the stem on proximal humerus stress shielding in uncemented primary reverse total shoulder arthroplasty

    To preserve humeral bone during RTSA, stems have been made shorter and cement avoided whenever possible. However, with the increased use of uncemented RTSA, a phenomenon comparable to the stress shielding of the hip has been described for the proximal humerus. The aim of this study was to investigate the influence of stem length and width on proximal humeral bone resorption after primary uncemented RTSA.

    The ‘Holy Grail’ of shoulder dislocations: a systematic review on traumatic bilateral luxatio erecta; is it in reality a once-in-a-lifetime experience for an orthopaedic surgeon?

    Even though shoulder dislocation is thought to be the most common dislocation treated in the Emergency Department, inferior ones, known as Luxatio Erecta, comprise only 0.5% of them. Taking into consideration the rareness of unilateral Luxatio Erecta, bilateral cases should be even fewer. The purpose of this paper is to identify the reported number of cases of Traumatic Bilateral Luxatio Erecta in the literature over the last 100 years and to summarize the mechanism of injury, the initial management, and the complications of these patients.

    Is restoration of vertebral body height after vertebral body fractures and minimally-invasive dorsal stabilization with polyaxial pedicle screws just an illusion?

    Thoracolumbar spine fractures often require surgical treatment as they are associated with spinal instability. Optimal operative techniques and treatment are discussed controversially. Aim of our prospective cohort study was to investigate the sagittal alignment after reduction, the secondary loss of reduction and the subjective outcome as well as the causal correlation of these parameters after minimally invasive stabilization of thoracic and lumbar fractures with polyaxial pedicle screws.

    Validity of leg length measurement in the supine and standing position compared with pelvic survey X-ray after total hip arthroplasty

    The correct adjustment of leg length is a major goal in the implantation of total hip replacements (THRs). Differences in leg length can lead to functional impairment and patient dissatisfaction. By determining leg length at an early stage, before the patient is discharged from hospital, compensatory measures such as the production of special insoles or orthopaedic footwear can be initiated promptly if there is a difference in leg length. Due to shortening of the period of time spent in hospital, the traditional measurement of leg length in a standing position may be increasingly subject to error. A protective posture immediately after surgery or the presence of a twisted pelvis, for example, due to scoliotic spinal misalignments, falsifies the measurement result in the standing position. Here, the measurement of leg length in the supine position may prove to be accurate immediately postoperatively, regardless of potential sources of error, and is to be compared with measurement in the standing position versus radiological measurement on the AP pelvic survey.

    Chopart dislocations: a review of diagnosis, treatment and outcomes

    Chopart injuries can be allocated into 4 broad groups, ligamentous injury with or without dislocation and fracture with or without dislocation, which must occur at the talonavicular joint (TNJ) and/or calcaneocuboid joint (CCJ). Chopart dislocations are comprised of pure-dislocations and fracture-dislocations. We aim to review the literature, to enable evidence-based recommendations.

    Complications associated using the reamer–irrigator –aspirator (RIA) system: a systematic review and meta-analysis

    Complications associated with the application of the Reamer–irrigator–Aspirator (RIA) system are described in the literature. However, to date a systematic review and meta-analysis to assess prevalence of complications associated with the use of the RIA system have not been conducted.

    Complications following surgical treatment of posterior malleolar fractures: an analysis of 300 cases

    The treatment of ankle fractures and fracture-dislocations involving the posterior malleolus (PM) has undergone considerable changes over the past decade. The aim of our study was to identify risk factors related to the occurrence of complications in surgically treated ankle fractures with PM involvement.

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