Midterm outcomes of patellofemoral arthroplasty / Resultados a medio plazo de la artroplastia femoropatelar

Background: The purpose of this study is the evaluation of the patellofemoral arthroplasty (PFA) survival and clinical and radiological outcomes in our institution. Methods: A retrospective evaluation of our institution patellofemoral arthroplasty cases from 2006 to 2018 was performed; the n sample after applying exclusion and inclusion criteria was 21. All patients excepting one were female with a median age of 63 (20–78). A Kaplan–Meier survival analysis at ten years was calculated. Informed consent was obtained from all patients prior being included in the study. Results: The total revision rate was 6 out of 21 patients (28.57%). The progression of the osteoarthritis in the tibiofemoral compartment was the main cause (50% of revision surgeries). The degree of satisfaction with the PFA was high, with a mean Kujala score of 70.09 and a mean OKS of 35.45 points. The VAS score improved significantly (p<0.001) from a preoperative mean of 8.07 to a postoperative mean of 3.45, with an average improvement of 5 (2–8). Survival at 10 years, with revision for any reason as the endpoint, was 73.5%. A significant positive correlation between BMI and the WOMAC pain (r=0.72, p<0.01) and between BMI and the post-operative VAS (r=0.67, p<0.01) was observed. Conclusions: The results of the case series under consideration suggest that PFA could be a possibility in the joint preservation surgery on the isolated patellofemoral osteoarthritis. BMI >30 seems to be a negative predictor factor in relationship with the postoperative satisfaction, increasing the pain proportionally to this index and requiring more replacement surgery than patients with BMI <30. Meanwhile the radiologic parameters of the implant are not correlated with the clinical or functional outcomes.(AU)

Antecedentes: El propósito de este estudio es la evaluación de la supervivencia de la prótesis femoropatelar y los resultados clínicos y radiológicos en nuestro centro. Métodos: En el presente estudio se realiza una evaluación retrospectiva de los casos de prótesis femoropatelar en nuestro centro entre los años 2006 y 2018. El tamaño muestral, tras aplicar los criterios de inclusión y de exclusión, fue de 21 pacientes. Todos los pacientes excepto uno fueron mujeres, con una media de edad de 63 años (rango 20-78). Se calculó una gráfica de Kaplan-Meier de supervivencia en los primeros 10 años. El consentimiento informado de todos los pacientes fue obtenido previamente a la inclusión en este estudio. Resultados: La tasa de recambio a prótesis total fue 6 de 21 pacientes (28,57%). La progresión de la osteoartrosis en el compartimento tibiofemoral fue la causa principal (50% de las cirugías de revisión). El grado de satisfacción con la PFA fue alto, con una media en la escala de Kujala de 70,09 y una media de OKS de 35,45 puntos. La EVA mejoró significativamente (p<0,001), de una media preoperatoria de 8,07 a una media postoperatoria de 3,45, siendo la media de mejoría de 5 puntos (2 a 8 puntos). La supervivencia a los 10 años, con rescate de la prótesis debido a cualquier causa, fue del 73,5%. Se observó una correlación positiva ente el IMC y la escala WOMAC (r=0,72, p>0,01) y entre el IMC y la EVA postoperatoria (r=0,67 y p<0,01). Conclusiones: Los resultados de esta serie de casos mostraron que la prótesis femoropatelar puede ser una alternativa de tratamiento como cirugía de preservación de la osteoartritis femoropatelar aislada. El IMC>30 parece ser un factor predictor negativo en relación con la satisfacción postoperatoria, incrementando el dolor con una correlación positiva con este índice y requiriendo mayor cirugía de reemplazo que los pacientes con IMC<30. Por otra parte, los parámetros radiológicos relacionados con el implante no están...(AU)

[Artículo traducido] Resultados a medio plazo de la artroplastia femoropatelar / Midterm outcomes of patellofemoral arthroplasty

Background: The purpose of this study is the evaluation of the patellofemoral arthroplasty (PFA) survival and clinical and radiological outcomes in our institution. Methods: A retrospective evaluation of our institution patellofemoral arthroplasty cases from 2006 to 2018 was performed; the n sample after applying exclusion and inclusion criteria was 21. All patients excepting one were female with a median age of 63 (20–78). A Kaplan–Meier survival analysis at ten years was calculated. Informed consent was obtained from all patients prior being included in the study. Results: The total revision rate was 6 out of 21 patients (28.57%). The progression of the osteoarthritis in the tibiofemoral compartment was the main cause (50% of revision surgeries). The degree of satisfaction with the PFA was high, with a mean Kujala score of 70.09 and a mean OKS of 35.45 points. The VAS score improved significantly (p<0.001) from a preoperative mean of 8.07 to a postoperative mean of 3.45, with an average improvement of 5 (2–8). Survival at 10 years, with revision for any reason as the endpoint, was 73.5%. A significant positive correlation between BMI and the WOMAC pain (r=0.72, p<0.01) and between BMI and the post-operative VAS (r=0.67, p<0.01) was observed. Conclusions: The results of the case series under consideration suggest that PFA could be a possibility in the joint preservation surgery on the isolated patellofemoral osteoarthritis. BMI >30 seems to be a negative predictor factor in relationship with the postoperative satisfaction, increasing the pain proportionally to this index and requiring more replacement surgery than patients with BMI <30. Meanwhile the radiologic parameters of the implant are not correlated with the clinical or functional outcomes.(AU)

Antecedentes: El propósito de este estudio es la evaluación de la supervivencia de la prótesis femoropatelar y los resultados clínicos y radiológicos en nuestro centro. Métodos: En el presente estudio se realiza una evaluación retrospectiva de los casos de prótesis femoropatelar en nuestro centro entre los años 2006 y 2018. El tamaño muestral, tras aplicar los criterios de inclusión y de exclusión, fue de 21 pacientes. Todos los pacientes excepto uno fueron mujeres, con una media de edad de 63 años (rango 20-78). Se calculó una gráfica de Kaplan-Meier de supervivencia en los primeros 10 años. El consentimiento informado de todos los pacientes fue obtenido previamente a la inclusión en este estudio. Resultados: La tasa de recambio a prótesis total fue 6 de 21 pacientes (28,57%). La progresión de la osteoartrosis en el compartimento tibiofemoral fue la causa principal (50% de las cirugías de revisión). El grado de satisfacción con la PFA fue alto, con una media en la escala de Kujala de 70,09 y una media de OKS de 35,45 puntos. La EVA mejoró significativamente (p<0,001), de una media preoperatoria de 8,07 a una media postoperatoria de 3,45, siendo la media de mejoría de 5 puntos (2 a 8 puntos). La supervivencia a los 10 años, con rescate de la prótesis debido a cualquier causa, fue del 73,5%. Se observó una correlación positiva ente el IMC y la escala WOMAC (r=0,72, p>0,01) y entre el IMC y la EVA postoperatoria (r=0,67 y p<0,01). Conclusiones: Los resultados de esta serie de casos mostraron que la prótesis femoropatelar puede ser una alternativa de tratamiento como cirugía de preservación de la osteoartritis femoropatelar aislada. El IMC>30 parece ser un factor predictor negativo en relación con la satisfacción postoperatoria, incrementando el dolor con una correlación positiva con este índice y requiriendo mayor cirugía de reemplazo que los pacientes con IMC<30. Por otra parte, los parámetros radiológicos relacionados con el implante no están...(AU)

Midterm outcomes of patellofemoral arthroplasty. / [Artículo traducido] Resultados a medio plazo de la artroplastia femoropatelar.

BACKGROUND: The purpose of this study is the evaluation of the patellofemoral arthroplasty (PFA) survival and clinical and radiological outcomes in our institution. METHODS: A retrospective evaluation of our institution patellofemoral arthroplasty cases from 2006 to 2018 was performed; the n sample after applying exclusion and inclusion criteria was 21. All patients excepting one were female with a median age of 63 (20-78). A Kaplan-Meier survival analysis at ten years was calculated. Informed consent was obtained from all patients prior being included in the study. RESULTS: The total revision rate was 6 out of 21 patients (28.57%). The progression of the osteoarthritis in the tibiofemoral compartment was the main cause (50% of revision surgeries). The degree of satisfaction with the PFA was high, with a mean Kujala score of 70.09 and a mean OKS of 35.45 points. The VAS score improved significantly (P<.001) from a preoperative mean of 8.07 to a postoperative mean of 3.45, with an average improvement of 5 (2-8). Survival at 10 years, with revision for any reason as the endpoint, was 73.5%. A significant positive correlation between BMI and the WOMAC pain (r=.72, P<.01) and between BMI and the post-operative VAS (r=.67, P<.01) was observed. CONCLUSIONS: The results of the case series under consideration suggest that PFA could be a possibility in the joint preservation surgery on the isolated patellofemoral osteoarthritis. BMI >30 seems to be a negative predictor factor in relationship with the postoperative satisfaction, increasing the pain proportionally to this index and requiring more replacement surgery than patients with BMI <30. Meanwhile the radiologic parameters of the implant are not correlated with the clinical or functional outcomes.

Midterm outcomes of patellofemoral arthroplasty.

BACKGROUND: The purpose of this study is the evaluation of the patellofemoral arthroplasty (PFA) survival and clinical and radiological outcomes in our institution. METHODS: A retrospective evaluation of our institution patellofemoral arthroplasty cases from 2006 to 2018 was performed; the n sample after applying exclusion and inclusion criteria was 21. All patients excepting one were female with a median age of 63 (20-78). A Kaplan-Meier survival analysis at ten years was calculated. Informed consent was obtained from all patients prior being included in the study. RESULTS: The total revision rate was 6 out of 21 patients (28.57%). The progression of the osteoarthritis in the tibiofemoral compartment was the main cause (50% of revision surgeries). The degree of satisfaction with the PFA was high, with a mean Kujala score of 70.09 and a mean OKS of 35.45 points. The VAS score improved significantly (p<0.001) from a preoperative mean of 8.07 to a postoperative mean of 3.45, with an average improvement of 5 (2-8). Survival at 10 years, with revision for any reason as the endpoint, was 73.5%. A significant positive correlation between BMI and the WOMAC pain (r=0.72, p<0.01) and between BMI and the post-operative VAS (r=0.67, p<0.01) was observed. CONCLUSIONS: The results of the case series under consideration suggest that PFA could be a possibility in the joint preservation surgery on the isolated patellofemoral osteoarthritis. BMI >30 seems to be a negative predictor factor in relationship with the postoperative satisfaction, increasing the pain proportionally to this index and requiring more replacement surgery than patients with BMI <30. Meanwhile the radiologic parameters of the implant are not correlated with the clinical or functional outcomes.

Mid-term outcomes of mobile-bearing lateral unicompartmental knee arthroplasty.

BACKGROUND: This research was undertaken to evaluate Oxford Domed Lateral unicompartmental knee replacement (UKR) survival and clinical and radiological outcomes. The study also considered the influence of body mass index (BMI) on results and proposed contralateral healthy knee anatomic femorotibial angle (AFTA) as a predictor of postoperative knee alignment. METHODS: A retrospective evaluation of 41 primary Oxford Domed Lateral UKR performed in 41 patients in the same institution was undertaken on a patient group comprising of 10 men and 31 women with a mean age of 63 years (range: 38-81 years). A minimum follow-up of two years was required. RESULTS: The total revision rate was one out of 41 patients (2.4%), with a mean follow-up of 49 months (range: 25-84 months). One patient presented with a traumatic medial dislocation of the bearing after 15 months (resulting in an overall dislocation rate of 2.4%). The visual analogue scale (VAS) and the Oxford knee score (OKS) demonstrated significant postoperative improvement (P < 0.001). Survival at five years, with revision for any reason as the endpoint, was 97.5%. No significant correlation was observed between BMI and postoperative flexion angle, radiologically measured parameters, or pre- and postoperative VAS and OKS. Significant correlation was found (r = 0.77, P < 0.001) between postoperative and contralateral healthy knee anatomic femorotibial angles. CONCLUSIONS: The Oxford Domed Lateral UKR presents a low dislocation rate and excellent mid-term clinical and functional results. Contralateral healthy knee AFTA appears to be a predictor of postoperative knee alignment.

Mid-term results in total hip arthroplasty with the basic noncemented hip prosthesis.

The Basic (IQL-Biomet, Valencia, Spain) hip prosthesis was used in 430 implant procedures, of which 417 had mean follow-up of 6 years. Radiographic follow-up was performed at 1, 3, 6, and 12 months postoperatively, and annually thereafter. The average Harris hip score improved from 35.7 preoperatively to 90.9 postoperatively. Clinical results after 2 years of follow-up showed 6% thigh pain, which decreased to 2% at 6 years. Radiographic evaluation demonstrated 22 cases of calcar resorption, 14% of which had distal pedestal formation. Heterotopic ossification was noted radiographically in 36%. These mid-term results obtained with the Basic prosthesis are similar to the findings of other series and warrant its use.

[Abdomino-pelvic actinomycosis associated with an intrauterine device. Apropos of a case]. / Actinomicosis abdomino-pélvica asociada al dispositivo intrauterino. A propósito de un caso.

PIP: Although over 300 cases of pelvic actinomycosis have been published, it was not until 1973 that the 1st case of pelvic actinomycosis associated with the new generation of IUDs was described. Data is provided in this article on the causative agent, laboratory procedures, surgical excision, and pathological studies in 1 case of abdominal-pelvic actinomycosis, and the findings are compared to other reports in the English and Spanish literature. A multipara of 25 years with fever, metrorrhagia, and painful tumoration began to suffer dysmenorrhea in June 1980 but attributed the symptoms to the Copper 250 Multiload IUD she had used since July 1979. A laparotomy in December 1980 disclosed the infection, and pathological tests confirmed the diagnosis. The exact incidence of the association of actinomycosis and the IUD is not known, but the microorganism, Actinomyces-Israeli, is more common in wearers of IUDs than in other women. The diagnosis of actinomycosis is confirmed through microbiological study and histological identification. Treatment since 1945 has consisted of large doses of penicillin over long periods of time, but the use of other antibiotics including tetracycline and erythromycin has been introduced. The abscess or abscesses should be excised and the IUD removed in cases where a relationship is suspected.^ieng