6 research outputs found
Últimas tendencias en cirugía protésica de rodilla
En los últimos años hemos asistido a una importante evolución en los diseños protésicos de la
artroplastia total de rodilla. Todos ellos tienen como finalidad mejorar los satisfactorios resultados de este procedimiento.
La búsqueda del par de fricción ideal en este implante ha dado como resultado las mejoras en el
proceso de fabricación del inserto e incluso la incorporación de nuevos materiales empleados con éxito en otras
articulaciones, pero cuyos beneficios en la rodilla todavía requieren de experiencia. Los objetivos quirúrgicos
de precisión y reproductibilidad de resultados ha dado lugar a la incorporación de la robótica en este proceso.
Asimismo, la necesidad de restablecer la cinemática articular ha supuesto la evolución a diseños que preservan
el pivot central de la rodilla o cuya constricción es variable entre los dos compartimentos. No obstante, debemos
ser cautos a la hora de evaluar los beneficios derivados de estas supuestas mejoras.We have attended to an amazing development in total knee replacement designs for the last years.
Everyone grows with the idea of improving the good outcomes of this procedure. The search an ideal friction
torque has assumed a better manufacturing of the insert and even the usage of new materials with great success
in other joints, but whose profits in the knee must be tested. Accuracy and outcomes reproducibility led to add
robotic to this procedure. Likewise the need to recreate joint kinematics provoked the evolution to designs with
preservation of cruciate ligaments or with different constriction in each compartment. However, we must be careful
when analysing benefits of these improvements
El presente de la cirugía artroscópica. ¿Dónde está el límite?
La cirugía artroscópica ha supuesto un importante avance en las técnicas terapéuticas y diagnósti
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cas dentro del campo de la cirugía ortopédica, convirtiéndose en estas dos últimas décadas en uno de los grandes
pilares de la cirugía mínimamente invasiva de grandes y pequeñas articulaciones, permitiendo la realización
de técnicas quirúrgicas que hace unos años hubiese sido impensable. El objetivo de este trabajo es analizar las
indicaciones y técnicas quirúrgicas artroscópicas que actualmente realizamos en nuestro equipo basándonos en
niveles de evidencia científica y una valoración del futuro de la cirugía artroscópica.Arthroscopic surgery has involved a great advance in diagnostic and therapeutic techniques within
orthopedic surgery field. For twenty years now, it has become as one of the great pillars of minimally invasive
surgery of large and small joints, allowing the realization of surgical techniques that a few years ago would be
unthinkable. Aim of this study is to analyze currently indications and arthroscopic surgical techniques performed
in our work team based on levels of scientific evidence and the assessment of arthroscopic surgery in the future
Tratamiento artroscópico de las roturas masivas del manguito rotador
La reparación artroscópica de las roturas masivas del manguito rotador (RMMR) es un procedimiento
técnicamente exigente, que requiere de una indicación correcta, una buena técnica artroscópica y un
adecuado tratamiento rehabilitador. El estudio clínico del paciente y las características de la lesión del manguito
son fundamentales para establecer el plan estratégico y terapéutico, que debe incluir desde el tratamiento no
quirúrgico hasta la reparación artroscópica, transferencias tendinosas artroscópicas, espaciadores subacromiales
o artroplastias de hombro. La reparación artroscópica se establece en pacientes con roturas masivas reparables
y sin degeneración grasa del manguito, las transferencias tendinosas se indican en pacientes jóvenes con importantes
exigencias funcionales que presentan roturas masivas irreparables y los espaciadores subacromiales y las
artroplastias de hombro para roturas irreparables en pacientes con baja demanda funcionalThe arthroscopic repair of a massive rotator cuff tear, is a technically demanding procedure. It
requires correct indications, good arthroscopic skills and a proper rehabilitation program. The clinical study of
the patient and the instances of the rotator cuff injury, are fundamental to determine a correct therapeutic strategy.
This strategy should consider every option from non-surgical to arthroscopic repair, tendon transfers, subacromial
spreaders or shoulder arthroplasties. The arthroscopic repair is the standard treatment in patients with
massive repairable tears and with no fatty degeneration of the affected muscle. Meanwhile, the tendon transfers
are indicated in young patients with highly functional demands that comprehend irreparable massive tears. The
spreaders or subacromial balloons and the shoulder prosthesis are performed in irreparable tears in low functional
demand patients
Recommended from our members
Dietary α‐Linolenic Acid, Marine ω‐3 Fatty Acids, and Mortality in a Population With High Fish Consumption: Findings From the PREvención con DIeta MEDiterránea (PREDIMED) Study
Background: Epidemiological evidence suggests a cardioprotective role of α‐linolenic acid (ALA), a plant‐derived ω‐3 fatty acid. It is unclear whether ALA is beneficial in a background of high marine ω‐3 fatty acids (long‐chain n‐3 polyunsaturated fatty acids) intake. In persons at high cardiovascular risk from Spain, a country in which fish consumption is customarily high, we investigated whether meeting the International Society for the Study of Fatty Acids and Lipids recommendation for dietary ALA (0.7% of total energy) at baseline was related to all‐cause and cardiovascular disease mortality. We also examined the effect of meeting the society's recommendation for long‐chain n‐3 polyunsaturated fatty acids (≥500 mg/day). Methods and Results: We longitudinally evaluated 7202 participants in the PREvención con DIeta MEDiterránea (PREDIMED) trial. Multivariable‐adjusted Cox regression models were fitted to estimate hazard ratios. ALA intake correlated to walnut consumption (r=0.94). During a 5.9‐y follow‐up, 431 deaths occurred (104 cardiovascular disease, 55 coronary heart disease, 32 sudden cardiac death, 25 stroke). The hazard ratios for meeting ALA recommendation (n=1615, 22.4%) were 0.72 (95% CI 0.56–0.92) for all‐cause mortality and 0.95 (95% CI 0.58–1.57) for fatal cardiovascular disease. The hazard ratios for meeting the recommendation for long‐chain n‐3 polyunsaturated fatty acids (n=5452, 75.7%) were 0.84 (95% CI 0.67–1.05) for all‐cause mortality, 0.61 (95% CI 0.39–0.96) for fatal cardiovascular disease, 0.54 (95% CI 0.29–0.99) for fatal coronary heart disease, and 0.49 (95% CI 0.22–1.01) for sudden cardiac death. The highest reduction in all‐cause mortality occurred in participants meeting both recommendations (hazard ratio 0.63 [95% CI 0.45–0.87]). Conclusions: In participants without prior cardiovascular disease and high fish consumption, dietary ALA, supplied mainly by walnuts and olive oil, relates inversely to all‐cause mortality, whereas protection from cardiac mortality is limited to fish‐derived long‐chain n‐3 polyunsaturated fatty acids. Clinical Trial Registration URL: http://www.Controlled-trials.com/. Unique identifier: ISRCTN35739639
Arthroscopic resection of volar wrist ganglion: surgical technique description and a prospective series of 39 patients
Dietary α-linolenic acid, marine ω-3 fatty acids, and mortality in a population with high fish consumption: Findings from the PREvención con DIeta MEDiterránea (PREDIMED) Study
12 Páginas.-- 6 Tablas.-- 1 FiguraBackground-Epidemiological evidence suggests a cardioprotective role of α-linolenic acid (ALA), a plant-derived ω-3 fatty acid. It is unclear whether ALA is beneficial in a background of high marine ω-3 fatty acids (long-chain n-3 polyunsaturated fatty acids) intake. In persons at high cardiovascular risk from Spain, a country in which fish consumption is customarily high, we investigated whether meeting the International Society for the Study of Fatty Acids and Lipids recommendation for dietary ALA (0.7% of total energy) at baseline was related to all-cause and cardiovascular disease mortality. We also examined the effect of meeting the society's recommendation for long-chain n-3 polyunsaturated fatty acids (≥500 mg/day). Methods and Results-We longitudinally evaluated 7202 participants in the PREvención con DIeta MEDiterránea (PREDIMED) trial. Multivariable-adjusted Cox regressionmodels were fitted to estimate hazard ratios. ALA intake correlated towalnut consumption (r=0.94). During a 5.9-y follow-up, 431 deaths occurred (104 cardiovascular disease, 55 coronary heart disease, 32 sudden cardiac death, 25 stroke). The hazard ratios formeeting ALArecommendation (n=1615, 22.4%) were 0.72 (95% CI 0.56-0.92) for all-causemortality and 0.95 (95% CI 0.58-1.57) for fatal cardiovascular disease. The hazard ratios formeeting the recommendation for long-chain n-3 polyunsaturated fatty acids (n=5452, 75.7%) were 0.84 (95% CI 0.67-1.05) for all-causemortality, 0.61 (95% CI 0.39-0.96) for fatal cardiovascular disease, 0.54 (95% CI 0.29-0.99) for fatal coronary heart disease, and 0.49 (95% CI 0.22-1.01) for sudden cardiac death. The highest reduction in all-cause mortality occurred in participants meeting both recommendations (hazard ratio 0.63 [95% CI 0.45-0.87]). Conclusions-In participants without prior cardiovascular disease and high fish consumption, dietary ALA, supplied mainly by walnuts and olive oil, relates inversely to all-cause mortality, whereas protection from cardiac mortality is limited to fish-derived long-chain n-3 polyunsaturated fatty acids.This study was funded in part by Instituto de Salud Carlos III (ISCIII) (Spanish Ministry of Economy) through grants RTIC G03/140, RTIC RD 06/0045, Centro Nacional de Investigaciones Cardiovasculares CNIC 06/2007, ISCIII FIS PS09/01292, the Spanish Ministry of Science and Innovation (MICINN) AGL2010‐22319‐C03‐02 and AGL2009‐13906‐C02‐02, and an unrestricted grant from the California Walnut Commission. Sala‐Vila holds a Miguel Servet I fellowship from the Ministry of Economy and Competitiveness through the ISCIII