Encuesta de Percepción en Capacidad Instalada para la Formación de Médicos Residentes en Ortopedia (Traumatología) y Necesidades de la Atención en Patología Musculoesquelética Aguda y Crónica en México. Primera Parte / Installed Capacity Perception Survey for the Training of Resident's Program in Orthopedics and Care Needs in Acute and Chronic Musculoskeletal Pathology in Mexico

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Abstract: Introduction: It is essential that orthopaedic resident physicians be highly proficient in all aspects, considering the balance between supply, demand, need and context. Fundamental to identify the capacity and quality installed for their training in Mexico. Material and methods: Observational Study, transverse, non-probabilistic sampling-conglomerates, in two phases. The instrument has 8 domains, 57 variables and 4,867 items. 60 graduate professors of 20 states, 50 hospital sites, 22 university programs. Results: 1,038 years of experience (collective intelligence), 17 years of experience/teacher (01 to 50 years). Identified: acute pathology 30 (2 to 90%), chronic pathology 30 (5 to 96%), patients ˂ 15 years, 10 (3 to 30%), patients between 15 and 65 years, 47 (2 to 78%), patients ˃ 65 years, 20 (2 to 60%), number of beds/seat 20 (2 to 510), number of clinics 3 (1 to 48), number of surgical procedures/headquarters per year at the national level, was 960 (50 to 24,650). The national average per resident doctor is 362 surgeries/year with 1,450 surgical times/year. Conclusions: The needs and resources for the training of physicians specializing in orthopedics/traumatology are highly heterogeneous, so it should be adapted to the epidemiological needs of the region of influence, in an area of epidemiological transition. 62.2% expressed not having or have bad academic and scientific infrastructure at its headquarters, more than 50% without rotation overseas and ˃ 90% without regular scientific production.

Claudicación, resultados funcionales y calidad de vida en artroplastía total de cadera primaria con abordaje anterolateral mínimamente invasivo / Claudication, functional outcomes and quality of life in primary Total hip arthroplasty with minimally invasive anterolateral approach

Resumen: Introducción: La coxartrosis tiene incidencia de 88 casos por 100,000 personas/año y prevalencia sintomática de 16% para hombres y 6% para mujeres en edades de 65-74 años e incrementa con la edad. Representa una enfermedad de salud pública que va en aumento, la mujer es quien presenta padecimiento más grave. La ATC (artroplastía total de cadera) se ha convertido en el procedimiento más exitoso para mejorar la calidad de vida de pacientes con coxartrosis. Objetivo: Determinar la claudicación, calidad de vida y resultados funcionales de la ATC mediante abordaje mínimo invasivo en pacientes con coxartrosis primaria. Material y métodos: Estudio longitudinal y prospectivo en pacientes con coxartrosis primaria unilateral postoperados de ATC primaria con técnica mínimamente invasiva en el período comprendido de Marzo de 2015 a Febrero de 2016, se analizó a cada paciente con somatometría, calidad de vida (WOMAC), funcionalidad en pacientes con coxartrosis (HHS) y funcionalidad en pacientes con cirugía de cadera (OHS) de manera prequirúrgica y postquirúrgica con seguimiento a un año. Resultados: Se incluyeron 21 pacientes, 17 femeninos y cuatro masculinos que corresponde a 80.95 y 19.05%, respectivamente, edad promedio de 59.95 años (DE = 9.64), con resultados funcionales excelentes a un año, según escalas de HHS y OHS, calidad de vida alta en 100% de los casos según WOMAC, con índice de claudicación bajo de 4.76%. Discusión: El abordaje mínimo invasivo es una técnica quirúrgica reproducible con resultados funcionales excelentes, índice de claudicación baja y alta calidad de vida en pacientes postoperados de ATC primaria durante el primer año de seguimiento.

Abstract: Introduction: The coxarthrosis has incidence of 88 cases per 100,000 people/year and symptomatic prevalence of 16% men and 6% women aged 65-74 years and increases with age. It is a growing public health disease. Total hip arthroplasty (THA) has become the most successful procedure to increase the quality of life of patients with coxarthrosis. Our objective was to determine the claudication, quality of life and functional results of THA through minimal invasive approach in patients with primary coxarthrosis. Material and methods: Prospective longitudinal study in patients with unilateral primary coxarthrosis postop of THA with minimally invasive approach from March 2015-February 2016, each patient was analyzed with quality of Life instrument (WOMAC), Functional test for coxarthrosis (HHS) and functional test in patients with hip surgery (OHS) with follow-up of one year. Results: We included 21 patients, 17 female and 4 males corresponding to 80.95% and 19.05% respectively, average age of 59.95 years (ED = 9.64), with excellent functional results to one year according to HHS and OHS, quality of life high in 100% of cases according to WOMAC, with claudication rate of 4.76%. Discussion: The minimal invasive approach is a reproducible surgical technique, with excellent functional results, low claudication rate and high quality of life in postoperative patients of primary ATC at only one year of follow-up.