Lesiones del labrum acetabular. Etiología, lesiones artroscópicas e indicaciones de tratamiento

En la última década se ha experimentado un notable incremento en el número de cirugías artroscópicas de cadera realizadas en nuestros hospitales. Las lesiones de labrum acetabular son probablemente la principal causa por la que un cirujano ortopédico realiza una artroscopia de cadera. El objetivo del siguiente artículo es revisar las diferentes lesiones del labrum que podemos encontrarnos en la práctica diaria y atendiendo a los cambios anatomopatológicos que se han producido. Esto nos va a permitir entender de manera global cuál es el problema fundamental al que nos enfrentamos cuando tratamos a pacientes con dolor inguinal y lesiones del labrum acetabular, y así poder elegir la mejor estrategia terapéutica. Se describen de forma superficial las diferentes opciones terapéuticas, sin profundizar en ellas, puesto que no es el objetivo de la presente revisiónDuring the last decade, an increasing rate in the number of hip arthroscopies has been experienced in our hospitals. Acetabular labrum injuries are likely the main cause by which an orthopedic surgeon perform a hip arthroscopy. The objective of the following paper is to review the different labral injuries we can find in our daily practice and indentify the its anatomopathological changes. This is going to let us know, in a global way, which is the main problem we are facing when we are treating patients with groin pain and acetabular labral injuries, and then we can choose the best treatment option. Different treatment options are superficialy described, becaus it’s not the objective of this revie

Síndrome doloroso del trocánter mayor.Resultados a corto plazo con el tratamiento artroscópico

Objetivo : Evaluar los resultados clínicos de la cirugía artroscópica de cadera en el tratamiento del síndrome doloroso del trocánter mayor tras fracaso del tratamiento conservador. Material y Método : Estudio prospectivo de 15 pacientes tratados mediante cirugía artroscópica de cadera por síndrome doloroso del trocánter mayor. Para valoracion clínica se utilizó la escala modificada de Harris. Resultados : La edad media de los pacien - tes fue de 53,2 años. Se detectó rotura del glúteo medio en el 73,3% de los casos. El seguimiento medio de los pacientes fue de 16,3 meses. La puntuación media de la escala modificada de Harris pasó de 55,4 puntos preope - ratoriamente a 83,8 puntos al final del seguimiento. Discusión : La artroscopia de cadera ha permitido la mejoría clínica de los pacientes con síndrome doloroso del trocánter mayor que no responde al tratamiento conservador. Un mayor seguimiento de los pacientes es preciso para confirmar la estabilidad de los resultados obtenidosObjective: Evaluate the outcomes of hip arthroscopy as a treatment for greater throcanter pain syndrome after conservative treatment failed. Material and methods: Prospective study with 15 patients under - going hip arthroscopy for greater trochanter pain syndrome. Modified Harris Hip Score scale was used for clini - cal assessment. Results: The mean age of patients was 53.2 years. Gluteus medium tears was detected in 73.3%. The average follow-up was 16.3 months. The mean modified Harris Hip score increased from 55.4 points preop to 83.8 points postoperative. Discusion: Hip arthroscopy resulted in improvement in hip functional outcome in patients with greater trochanter pain syndrome after conservative treatment failed. Further follow-up is essential to confirm the stability of the clinical outcome

Epidemiología descriptiva de una cohorte con choque femoroacetabular y tratamiento con cirugía artroscópica de cadera

The purpose of the study was to report the clinical epidemiology for patients with symptomatic femoroacetabular impingement undergoing hip arthroscopy. A total of 112 patients were enrolled. In this cohort, femoroacetabular impingement occurred predominantly in young patients, with normal BMI, more male than female, high level of sports activity, duration of symptoms prior to surgery time longer than 12 months, with a pattern of cam type, labrum and acetabular rim injury in arthroscopic procedure

Effect of viral storm in patients admitted to intensive care units with severe COVID-19 in Spain: a multicentre, prospective, cohort study

Background: The contribution of the virus to the pathogenesis of severe COVID-19 is still unclear. We aimed to evaluate associations between viral RNA load in plasma and host response, complications, and deaths in critically ill patients with COVID-19. Methods: We did a prospective cohort study across 23 hospitals in Spain. We included patients aged 18 years or older with laboratory-confirmed SARS-CoV-2 infection who were admitted to an intensive care unit between March 16, 2020, and Feb 27, 2021. RNA of the SARS-CoV-2 nucleocapsid region 1 (N1) was quantified in plasma samples collected from patients in the first 48 h following admission, using digital PCR. Patients were grouped on the basis of N1 quantity: VIR-N1-Zero ([removed]2747 N1 copies per mL). The primary outcome was all-cause death within 90 days after admission. We evaluated odds ratios (ORs) for the primary outcome between groups using a logistic regression analysis. Findings: 1068 patients met the inclusion criteria, of whom 117 had insufficient plasma samples and 115 had key information missing. 836 patients were included in the analysis, of whom 403 (48%) were in the VIR-N1-Low group, 283 (34%) were in the VIR-N1-Storm group, and 150 (18%) were in the VIR-N1-Zero group. Overall, patients in the VIR-N1-Storm group had the most severe disease: 266 (94%) of 283 patients received invasive mechanical ventilation (IMV), 116 (41%) developed acute kidney injury, 180 (65%) had secondary infections, and 148 (52%) died within 90 days. Patients in the VIR-N1-Zero group had the least severe disease: 81 (54%) of 150 received IMV, 34 (23%) developed acute kidney injury, 47 (32%) had secondary infections, and 26 (17%) died within 90 days (OR for death 0·30, 95% CI 0·16–0·55; p<0·0001, compared with the VIR-N1-Storm group). 106 (26%) of 403 patients in the VIR-N1-Low group died within 90 days (OR for death 0·39, 95% CI 0·26–0·57; p[removed]11 página