Resultados clínicos de artroplastia total de cadera asistida por brazo robótico en España: estudio preliminar / Clinical results of total hip arthroplasty assisted by robotic arm in Spain: Preliminary study

Objetivos: Resultados clínicos, radiológicos y funcionales de la primera serie española de pacientes intervenidos de artroplastia total de cadera (ATC) asistida mediante brazo robótico Mako® (Stryker) del Hospital Clínico San Carlos (HCSC) de Madrid. Material y métodos: Estudio descriptivo prospectivo que analiza los primeros 25 pacientes intervenidos de ATC asistida por robot (ATCaR) en el HCSC, con un seguimiento mínimo de 4meses. Se evaluaron la demografía, los estudios de imagen (procesamiento Mako®, Rx y TAC), los parámetros clínicos, la funcionalidad (Harris modificada) y las complicaciones asociadas. Resultados: La edad media fue 67,2años (min 47, max 88), siendo el 56% varones. El 88% corresponden a coxartrosis primaria, el 4% postraumática, el 4% secundaria a NAV y el 4% secundaria a choque femoroacetabular. El tiempo medio de cirugía fue de 116,9minutos (min 92, max 150). La media de las cinco primeras intervenciones fue 122,6minutos, y la de las cinco últimas, de 108,2minutos. Como complicaciones intraoperatorias se cuantificaron 4 pérdidas de marcadores intraoperatorios. El tiempo de ingreso medio fue 4,4días (min 3, max 7), con una disminución de hemoglobina posquirúrgica media de 3,08±1,08g/dl, requiriendo transfusión en el 12% de los casos. Se registran tres complicaciones médicas durante el ingreso, destacando un síndrome confusional con caída y fractura periprotésica AG1 no desplazada. El análisis del posicionamiento de los implantes registrados con sistema Mako® fueron 40,55±1,53 grados de inclinación y 12,2±3,6 grados de anteversión acetabular. El estudio de imagen posquirúrgico realizado a los pacientes, en concordancia con Mako®, muestra valores de inclinación acetabular de 41,2±1,7 en Rx y versión acetabular de 16±4,6 en TAC. La discrepancia de longitud de cadera varía de valores preoperatorios de −3,91mm (DE: 3,9; min −12, max 3) a 1,29mm (DE: 1,96) tras la cirugía registrados con Mako...(AU)

Objectives: Clinical, radiological and functional results of the first Spanish series of patients undergoing total hip arthroplasty assisted by Mako® (Stryker) robotic arm at the Hospital Clínico San Carlos (HCSC) in Madrid. Material and methods: Prospective and descriptive study analyzing the first 25 patients who underwent robotic-assisted THA at the HCSC, with a minimum follow-up of 4months. Demographics, imaging studies (Mako® processing, Rx and CT), clinical parameters, functionality (modified Harris) and associated complications were evaluated. Results: Average age was 67.2years (min 47, max 88), being 56% male population sample. 88% involves primary coxarthrosis, 4% post-traumatic coxarthrosis, 4% secondary avascular necrosis and 4% secondary femoroacetabular impingement. Average surgery time was 116.9min (min 92, max 150). The average time of the first five surgeries was 122.6min, and, regarding the last five interventions, it was 108.2min. Found medical intraoperative complications were four intraoperative markers loss. Average admission time was 4.4days (min 3, max 7), with an average postoperative hemoglobin decrease of 3.08±1.08g/dL, requiring a transfusion in 12% of the cases. Three medical complications have been registered in the meantime of the admission, with a relevant case of a confusional syndrome and a fall, which resulted in a non-displaced AG1 periprosthetic fracture. The analysis of the positioning of registered implants with Mako® system shows 40.55±1.53 acetabular inclination degrees and 12.2±3.6 acetabular anteversion degrees. The postoperative image study carried out on patients, are consistent with Mako® s results, as it shows an acetabular inclination of 41.2±1.7 in Rx, as well as acetabular anteversion of 16±4.6 in CT. Hip length variance ranges depending on preoperative values of 3.91mm (SD: 3.9; min −12, max 3) to 1.29mm (SD: 1.96) after surgery registered with...(AU)

[Translated article] Clinical results of total hip arthroplasty assisted by robotic arm in Spain: Preliminary study / Resultados clínicos de la artroplastia total de cadera asistida por brazo robótico en España: estudio preliminar

Objetivos: Resultados clínicos, radiológicos y funcionales de la primera serie española de pacientes intervenidos de artroplastia total de cadera (ATC) asistida mediante brazo robótico Mako® (Stryker) del Hospital Clínico San Carlos (HCSC) de Madrid. Material y métodos: Estudio descriptivo prospectivo que analiza los primeros 25 pacientes intervenidos de ATC asistida por robot (ATCaR) en el HCSC, con un seguimiento mínimo de 4meses. Se evaluaron la demografía, los estudios de imagen (procesamiento Mako®, Rx y TAC), los parámetros clínicos, la funcionalidad (Harris modificada) y las complicaciones asociadas. Resultados: La edad media fue 67,2años (min 47, max 88), siendo el 56% varones. El 88% corresponden a coxartrosis primaria, el 4% postraumática, el 4% secundaria a NAV y el 4% secundaria a choque femoroacetabular. El tiempo medio de cirugía fue de 116,9minutos (min 92, max 150). La media de las cinco primeras intervenciones fue 122,6minutos, y la de las cinco últimas, de 108,2minutos. Como complicaciones intraoperatorias se cuantificaron 4 pérdidas de marcadores intraoperatorios. El tiempo de ingreso medio fue 4,4días (min 3, max 7), con una disminución de hemoglobina posquirúrgica media de 3,08±1,08g/dl, requiriendo transfusión en el 12% de los casos. Se registran tres complicaciones médicas durante el ingreso, destacando un síndrome confusional con caída y fractura periprotésica AG1 no desplazada. El análisis del posicionamiento de los implantes registrados con sistema Mako® fueron 40,55±1,53 grados de inclinación y 12,2±3,6 grados de anteversión acetabular. El estudio de imagen posquirúrgico realizado a los pacientes, en concordancia con Mako®, muestra valores de inclinación acetabular de 41,2±1,7 en Rx y versión acetabular de 16±4,6 en TAC. La discrepancia de longitud de cadera varía de valores preoperatorios de −3,91mm (DE: 3,9; min −12, max 3) a 1,29mm (DE: 1,96) tras la cirugía registrados con Mako...(AU)

Objectives: Clinical, radiological and functional results of the first Spanish series of patients undergoing total hip arthroplasty assisted by Mako® (Stryker) robotic arm at the Hospital Clínico San Carlos (HCSC) in Madrid. Material and methods: Prospective and descriptive study analyzing the first 25 patients who underwent robotic-assisted THA at the HCSC, with a minimum follow-up of 4months. Demographics, imaging studies (Mako® processing, Rx and CT), clinical parameters, functionality (modified Harris) and associated complications were evaluated. Results: Average age was 67.2years (min 47, max 88), being 56% male population sample. 88% involves primary coxarthrosis, 4% post-traumatic coxarthrosis, 4% secondary avascular necrosis and 4% secondary femoroacetabular impingement. Average surgery time was 116.9min (min 92, max 150). The average time of the first five surgeries was 122.6min, and, regarding the last five interventions, it was 108.2min. Found medical intraoperative complications were four intraoperative markers loss. Average admission time was 4.4days (min 3, max 7), with an average postoperative hemoglobin decrease of 3.08±1.08g/dL, requiring a transfusion in 12% of the cases. Three medical complications have been registered in the meantime of the admission, with a relevant case of a confusional syndrome and a fall, which resulted in a non-displaced AG1 periprosthetic fracture. The analysis of the positioning of registered implants with Mako® system shows 40.55±1.53 acetabular inclination degrees and 12.2±3.6 acetabular anteversion degrees. The postoperative image study carried out on patients, are consistent with Mako® s results, as it shows an acetabular inclination of 41.2±1.7 in Rx, as well as acetabular anteversion of 16±4.6 in CT. Hip length variance ranges depending on preoperative values of 3.91mm (SD: 3.9; min −12, max 3) to 1.29mm (SD: 1.96) after surgery registered with...(AU)

[Translated article] Validation of the Spanish version of the modified Harris score / Validación de la versión española de la escala de Harris modificada

Objetivos: Resultados clínicos, radiológicos y funcionales de la primera serie española de pacientes intervenidos de artroplastia total de cadera (ATC) asistida mediante brazo robótico Mako® (Stryker) del Hospital Clínico San Carlos (HCSC) de Madrid. Material y métodos: Estudio descriptivo prospectivo que analiza los primeros 25 pacientes intervenidos de ATC asistida por robot (ATCaR) en el HCSC, con un seguimiento mínimo de 4meses. Se evaluaron la demografía, los estudios de imagen (procesamiento Mako®, Rx y TAC), los parámetros clínicos, la funcionalidad (Harris modificada) y las complicaciones asociadas. Resultados: La edad media fue 67,2años (min 47, max 88), siendo el 56% varones. El 88% corresponden a coxartrosis primaria, el 4% postraumática, el 4% secundaria a NAV y el 4% secundaria a choque femoroacetabular. El tiempo medio de cirugía fue de 116,9minutos (min 92, max 150). La media de las cinco primeras intervenciones fue 122,6minutos, y la de las cinco últimas, de 108,2minutos. Como complicaciones intraoperatorias se cuantificaron 4 pérdidas de marcadores intraoperatorios. El tiempo de ingreso medio fue 4,4días (min 3, max 7), con una disminución de hemoglobina posquirúrgica media de 3,08±1,08g/dl, requiriendo transfusión en el 12% de los casos. Se registran tres complicaciones médicas durante el ingreso, destacando un síndrome confusional con caída y fractura periprotésica AG1 no desplazada. El análisis del posicionamiento de los implantes registrados con sistema Mako® fueron 40,55±1,53 grados de inclinación y 12,2±3,6 grados de anteversión acetabular. El estudio de imagen posquirúrgico realizado a los pacientes, en concordancia con Mako®, muestra valores de inclinación acetabular de 41,2±1,7 en Rx y versión acetabular de 16±4,6 en TAC. La discrepancia de longitud de cadera varía de valores preoperatorios de −3,91mm (DE: 3,9; min −12, max 3) a 1,29mm (DE: 1,96) tras la cirugía registrados con Mako...(AU)

Objectives: Clinical, radiological and functional results of the first Spanish series of patients undergoing total hip arthroplasty assisted by Mako® (Stryker) robotic arm at the Hospital Clínico San Carlos (HCSC) in Madrid. Material and methods: Prospective and descriptive study analyzing the first 25 patients who underwent robotic-assisted THA at the HCSC, with a minimum follow-up of 4months. Demographics, imaging studies (Mako® processing, Rx and CT), clinical parameters, functionality (modified Harris) and associated complications were evaluated. Results: Average age was 67.2years (min 47, max 88), being 56% male population sample. 88% involves primary coxarthrosis, 4% post-traumatic coxarthrosis, 4% secondary avascular necrosis and 4% secondary femoroacetabular impingement. Average surgery time was 116.9min (min 92, max 150). The average time of the first five surgeries was 122.6min, and, regarding the last five interventions, it was 108.2min. Found medical intraoperative complications were four intraoperative markers loss. Average admission time was 4.4days (min 3, max 7), with an average postoperative hemoglobin decrease of 3.08±1.08g/dL, requiring a transfusion in 12% of the cases. Three medical complications have been registered in the meantime of the admission, with a relevant case of a confusional syndrome and a fall, which resulted in a non-displaced AG1 periprosthetic fracture. The analysis of the positioning of registered implants with Mako® system shows 40.55±1.53 acetabular inclination degrees and 12.2±3.6 acetabular anteversion degrees. The postoperative image study carried out on patients, are consistent with Mako® s results, as it shows an acetabular inclination of 41.2±1.7 in Rx, as well as acetabular anteversion of 16±4.6 in CT. Hip length variance ranges depending on preoperative values of 3.91mm (SD: 3.9; min −12, max 3) to 1.29mm (SD: 1.96) after surgery registered with...(AU)

[Translated article] Clinical results of total hip arthroplasty assisted by robotic arm in Spain: Preliminary study.

OBJECTIVES: Clinical, radiological and functional results of the first Spanish series of patients undergoing total hip arthroplasty assisted by Mako® (Stryker) robotic arm at the Hospital Clínico San Carlos (HCSC) in Madrid. MATERIAL AND METHODS: Prospective and descriptive study analyzing the first 25 patients who underwent robotic-assisted THA at the HCSC, with a minimum follow-up of 4 months. Demographics, imaging studies (Mako® processing, Rx and CT), clinical parameters, functionality (modified Harris) and associated complications were evaluated. RESULTS: Average age was 67.2 years (min 47, max 88), being 56% male population sample. 88% involves primary coxarthrosis, 4% post-traumatic coxarthrosis, 4% secondary avascular necrosis and 4% secondary femoroacetabular impingement. Average surgery time was 116.9min (min 92, max 150). The average time of the first five surgeries was 122.6min, and, regarding the last five interventions, it was 108.2min. Found medical intraoperative complications were four intraoperative markers loss. Average admission time was 4.4days (min 3, max 7), with an average postoperative haemoglobin decrease of 3.08±1.08g/dl, requiring a transfusion in 12% of the cases. Three medical complications have been registered in the meantime of the admission, with a relevant case of a confusional syndrome and a fall, which resulted in a non-displaced AG1 periprosthetic fracture. The analysis of the positioning of registered implants with Mako® system shows 40.55±1.53 acetabular inclination degrees and 12.2±3.6 acetabular anteversion degrees. The postoperative image study carried out on patients, are consistent with Mako® results, as it shows an acetabular inclination of 41.2±1.7 in Rx, as well as acetabular anteversion of 16±4.6 in CT. Hip length variance ranges depending on preoperative values of 3.91mm (SD: 3.9; min -12, max 3) to 1.29mm (SD: 1.96) after surgery registered with Mako®, with an increase of an average hip length of 5.64mm (SD: 3.35). Rx simple study results show a postoperative difference between both hips of 0.5±3.08mm, which is consistent with Mako® results. Native femoral offset was stable after surgery with a showing difference both pre and post operative of the intervened hip of 0.1mm (SD: 3.7), registered with Mako®. Preoperatory modified Harris punctuation was 41.6±13.3, improving to postoperative values of 74.6±9.7 after four months since the surgery. No complications were registered in immediate postoperative (4 months). CONCLUSIONS: Total hip arthroplasty robot-assisted achieves an adequate precision and repeatability of the implant positioning and the postoperative hip dysmetry without showing an increase of associated complications to the technique applied. Surgery time, complications and functional results in a short-time period are similar to conventional techniques applied to great series previously published.

Clinical results of total hip arthroplasty assisted by robotic arm in Spain: Preliminary study. / Resultados clínicos de artroplastia total de cadera asistida por brazo robótico en España: estudio preliminar.

OBJECTIVES: Clinical, radiological and functional results of the first Spanish series of patients undergoing total hip arthroplasty assisted by Mako® (Stryker) robotic arm at the Hospital Clínico San Carlos (HCSC) in Madrid. MATERIAL AND METHODS: Prospective and descriptive study analyzing the first 25 patients who underwent robotic-assisted THA at the HCSC, with a minimum follow-up of 4months. Demographics, imaging studies (Mako® processing, Rx and CT), clinical parameters, functionality (modified Harris) and associated complications were evaluated. RESULTS: Average age was 67.2years (min 47, max 88), being 56% male population sample. 88% involves primary coxarthrosis, 4% post-traumatic coxarthrosis, 4% secondary avascular necrosis and 4% secondary femoroacetabular impingement. Average surgery time was 116.9min (min 92, max 150). The average time of the first five surgeries was 122.6min, and, regarding the last five interventions, it was 108.2min. Found medical intraoperative complications were four intraoperative markers loss. Average admission time was 4.4days (min 3, max 7), with an average postoperative hemoglobin decrease of 3.08±1.08g/dL, requiring a transfusion in 12% of the cases. Three medical complications have been registered in the meantime of the admission, with a relevant case of a confusional syndrome and a fall, which resulted in a non-displaced AG1 periprosthetic fracture. The analysis of the positioning of registered implants with Mako® system shows 40.55±1.53 acetabular inclination degrees and 12.2±3.6 acetabular anteversion degrees. The postoperative image study carried out on patients, are consistent with Mako® s results, as it shows an acetabular inclination of 41.2±1.7 in Rx, as well as acetabular anteversion of 16±4.6 in CT. Hip length variance ranges depending on preoperative values of 3.91mm (SD: 3.9; min -12, max 3) to 1.29mm (SD: 1.96) after surgery registered with Mako®, with an increase of an average hip length of 5.64mm (SD: 3.35). Rx simple study results show a postoperative difference between both hips of 0.5±3.08mm, which is consistent with Mako® results. Native femoral offset was stable after surgery with a showing difference both pre and post operative of the intervened hip of 0.1mm (SD: 3.7), registered with Mako®. Preoperatory modified Harris punctuation was 41.6±13.3, improving to postoperative values of 74.6±9.7 after four months since the surgery. No complications were registered in immediate postoperative (4month). CONCLUSIONS: Total hip arthroplasty robot-assisted achieves an adequate precision and repeatability of the implant positioning and the postoperative hip dysmetry without showing an increase of associated complications to the technique applied. Surgery time, complications and functional results in a short-time period are similar to conventional techniques applied to great series previously published.

[Impact of COVID-19 pandemic confinement on musculoskeletal pain and quality of life]. / Impacto del confinamiento por la pandemia COVID-19 en el dolor musculoesquelético y la calidad de vida.

INTRODUCTION: in March 2020, lockdown was established in Spain because of the COVID-19 pandemic. The aim of this study is to assess its impact on pain and quality of life in patients with musculoskeletal pain. MATERIAL AND METHODS: prospective study including 490 individuals grouped in: 140 people without pain, 140 people with musculoskeletal pain but without any related pathology diagnosed, 140 patients diagnosed for a musculoskeletal condition and 70 patients in surgical waiting list (SWL) for a musculoskeletal condition. Data regarding pain, physical activity and quality of life (EuroQol-5D) was collected at the beginning of lockdown and one year after (March 2021). RESULTS: mean age was 53 ± 17.5 years old (18-88) and 51.3% were women. Patients in SWL referred significantly more pain than the rest of groups (p < 0.001), with a score in the visual analogue scale of 6.3 ± 1.9. Groups 3 and 4 suffered a significant increase of their pain from 2020 to 2021 (p < 0.001), while decreasing in group 2 (p < 0.001). Analgesics intake grew from 2020 to 2021 (39.9% versus 44.3%, p = 0.007). 70.2% experienced a worsening of at least one dimension of EuroQol-5D over last year, with patients in SWL being the most affected (p < 0.001). CONCLUSION: lockdown has caused in patients with musculoskeletal conditions a greater aggravation of pain and deterioration of quality of life than in the general population, especially in patients in SWL, translating in an increase in analgesics intake.

INTRODUCCIÓN: en Marzo de 2020 se estableció el confinamiento en España debido a la pandemia por COVID-19. El objetivo de este estudio es determinar su impacto en el dolor y la calidad de vida de personas con dolor osteomuscular. MATERIAL Y MÉTODOS: estudio prospectivo que incluyó 490 personas agrupadas en: 140 personas sin dolor (grupo 1), 140 personas con dolor osteomuscular, pero sin patología diagnosticada (grupo 2), 140 pacientes con patología musculoesquelética (grupo 3) y 70 pacientes en lista de espera quirúrgica (LEQ) por patología musculoesquelética (grupo 4). Se recogieron datos sobre el dolor, la actividad física y la calidad de vida (EuroQol-5D) al inicio del confinamiento y un año después. RESULTADOS: la edad media fue de 53 ± 17.5 años (18-88) y 51.3% fueron mujeres. Las personas en LEQ refirieron un dolor significativamente mayor que el resto de grupos (p < 0.001) con una puntuación en la escala visual analógica del dolor de 6.3 ± 1.9. Los grupos 3 y 4 sufrieron un aumento significativo de su dolor desde 2020 hasta 2021 (p < 0.001), mientras que en el grupo 2 disminuyó (p < 0.001). El consumo de analgésicos creció de 2020 a 2021 (39.9% versus 44.3%, p = 0.007); 70.2% sufrió un empeoramiento en alguna de las dimensiones del EuroQol-5D, siendo el grupo en LEQ el más afectado (p < 0.001). CONCLUSIONES: el confinamiento ha producido en pacientes con patología musculoesquelética un empeoramiento del dolor y de calidad de vida mayor que en el resto de personas, especialmente en aquéllas en espera de cirugía, traduciéndose en un aumento del consumo de analgésicos.

Evaluación funcional y calidad de vida en megaprótesis implantadas por tumores musculoesqueléticos en miembro inferior / Functional evaluation and quality of life in megaprostheses implanted by musculoskeletal tumors in the lower limb

Resumen: Introducción: La resección amplia es el tratamiento quirúrgico de elección en los tumores malignos musculoesqueléticos, que con frecuencia asientan en la pelvis y en los miembros inferiores. La reconstrucción mediante megaprótesis se ha impuesto en los últimos años como primera opción en la cirugía de preservación de la extremidad. Material y métodos: Estudio retrospectivo descriptivo serie de casos, incluye 30 pacientes intervenidos entre 2011 y 2019 de tumores musculoesqueléticos de pelvis y miembro inferior. En todos ellos valoramos la tasa de complicaciones y los resultados funcionales mediante el índice MSTS (Musculoskeletal Tumor Society). Resultados: Se realizó un seguimiento de 40.8 meses (12-101.7). En nueve pacientes (30%) se realizaron resecciones y reconstrucciones pélvicas, a 11 pacientes (36.7%) se les implantaron megaprótesis de cadera por afectación femoral, en tres de los pacientes (10%) se realizó resección del fémur completo y en siete pacientes (23.3%) reconstrucción protésica de la rodilla. El resultado funcional medio de la escala MSTS fue de 72.5% (rango: 40-95%) y la tasa de complicaciones de 56.7% (17 pacientes), siendo la recurrencia tumoral (29%) la principal complicación. Conclusión: La reconstrucción mediante megaprótesis ofrece buenos resultados funcionales a los pacientes dentro de la cirugía de resección radical, permitiendo realizar una vida relativamente normal.

Abstract: Introduction: Radical resection is the surgical treatment of choice in musculoskeletal malignancies, which often settle in the pelvis and lower limbs. Megaprothesis reconstruction has been imposed in recent years as the gold standard in limb preservation surgery. Material and methods: Descriptive retrospective study series of cases, including 30 patients operated between 2011 and 2019 of musculoskeletal pelvic and lower limb tumors at our institution that underwent limb-sparing reconstruction with the megaprosthesis. Functional results according to the MSTS (Musculoskeletal Tumor Society) index and complication rate were analyzed. Results: The average follow-up was 40.8 months (12-101.7). Nine patients (30%) underwent pelvic resections and reconstructions, 11 patients (36.7%) underwent hip reconstruction with megaprothesis due to femoral involvement, in three patients (10%) complete femur resection was performed, and seven patients (23.3%) underwent prosthetic reconstruction of the knee. The mean MSTS score was 72.5% (range: 40-95%), and the complication rate was 56.7% (17 patients), being de tumoral recurrence (29%) the main complication. Conclusion: Tumor megaprothesis give satisfying functional results, allowing the patients to realize a relatively normal life after a lower limb-sparing surgery.

Impacto del confinamiento por la pandemia COVID-19 en el dolor musculoesquelético y la calidad de vida / Impact of COVID-19 pandemic confinement on musculoskeletal pain and quality of life

Resumen: Introducción: En Marzo de 2020 se estableció el confinamiento en España debido a la pandemia por COVID-19. El objetivo de este estudio es determinar su impacto en el dolor y la calidad de vida de personas con dolor osteomuscular. Material y métodos: Estudio prospectivo que incluyó 490 personas agrupadas en: 140 personas sin dolor (grupo 1), 140 personas con dolor osteomuscular, pero sin patología diagnosticada (grupo 2), 140 pacientes con patología musculoesquelética (grupo 3) y 70 pacientes en lista de espera quirúrgica (LEQ) por patología musculoesquelética (grupo 4). Se recogieron datos sobre el dolor, la actividad física y la calidad de vida (EuroQol-5D) al inicio del confinamiento y un año después. Resultados: La edad media fue de 53 ± 17.5 años (18-88) y 51.3% fueron mujeres. Las personas en LEQ refirieron un dolor significativamente mayor que el resto de grupos (p < 0.001) con una puntuación en la escala visual analógica del dolor de 6.3 ± 1.9. Los grupos 3 y 4 sufrieron un aumento significativo de su dolor desde 2020 hasta 2021 (p < 0.001), mientras que en el grupo 2 disminuyó (p < 0.001). El consumo de analgésicos creció de 2020 a 2021 (39.9% versus 44.3%, p = 0.007); 70.2% sufrió un empeoramiento en alguna de las dimensiones del EuroQol-5D, siendo el grupo en LEQ el más afectado (p < 0.001). Conclusiones: El confinamiento ha producido en pacientes con patología musculoesquelética un empeoramiento del dolor y de calidad de vida mayor que en el resto de personas, especialmente en aquéllas en espera de cirugía, traduciéndose en un aumento del consumo de analgésicos.

Abstract: Introduction: In March 2020, lockdown was established in Spain because of the COVID-19 pandemic. The aim of this study is to assess its impact on pain and quality of life in patients with musculoskeletal pain. Material and methods: Prospective study including 490 individuals grouped in: 140 people without pain, 140 people with musculoskeletal pain but without any related pathology diagnosed, 140 patients diagnosed for a musculoskeletal condition and 70 patients in surgical waiting list (SWL) for a musculoskeletal condition. Data regarding pain, physical activity and quality of life (EuroQol-5D) was collected at the beginning of lockdown and one year after (March 2021). Results: Mean age was 53 ± 17.5 years old (18-88) and 51.3% were women. Patients in SWL referred significantly more pain than the rest of groups (p < 0.001), with a score in the visual analogue scale of 6.3 ± 1.9. Groups 3 and 4 suffered a significant increase of their pain from 2020 to 2021 (p < 0.001), while decreasing in group 2 (p < 0.001). Analgesics intake grew from 2020 to 2021 (39.9% versus 44.3%, p = 0.007). 70.2% experienced a worsening of at least one dimension of EuroQol-5D over last year, with patients in SWL being the most affected (p < 0.001). Conclusion: Lockdown has caused in patients with musculoskeletal conditions a greater aggravation of pain and deterioration of quality of life than in the general population, especially in patients in SWL, translating in an increase in analgesics intake.

[Functional evaluation and quality of life in megaprostheses implanted by musculoskeletal tumors in the lower limb]. / Evaluación funcional y calidad de vida en megaprótesis implantadas por tumores musculoesqueléticos en miembro inferior.

INTRODUCTION: radical resection is the surgical treatment of choice in musculoskeletal malignancies, which often settle in the pelvis and lower limbs. Megaprothesis reconstruction has been imposed in recent years as the gold standard in limb preservation surgery. MATERIAL AND METHODS: descriptive retrospective study series of cases, including 30 patients operated between 2011 and 2019 of musculoskeletal pelvic and lower limb tumors at our institution that underwent limb-sparing reconstruction with the megaprosthesis. Functional results according to the MSTS (Musculoskeletal Tumor Society) index and complication rate were analyzed. RESULTS: the average follow-up was 40.8 months (12-101.7). Nine patients (30%) underwent pelvic resections and reconstructions, 11 patients (36.7%) underwent hip reconstruction with megaprothesis due to femoral involvement, in three patients (10%) complete femur resection was performed, and seven patients (23.3%) underwent prosthetic reconstruction of the knee. The mean MSTS score was 72.5% (range: 40-95%), and the complication rate was 56.7% (17 patients), being de tumoral recurrence (29%) the main complication. CONCLUSION: tumor megaprothesis give satisfying functional results, allowing the patients to realize a relatively normal life after a lower limb-sparing surgery.

INTRODUCCIÓN: la resección amplia es el tratamiento quirúrgico de elección en los tumores malignos musculoesqueléticos, que con frecuencia asientan en la pelvis y en los miembros inferiores. La reconstrucción mediante megaprótesis se ha impuesto en los últimos años como primera opción en la cirugía de preservación de la extremidad. MATERIAL Y MÉTODOS: estudio retrospectivo descriptivo serie de casos, incluye 30 pacientes intervenidos entre 2011 y 2019 de tumores musculoesqueléticos de pelvis y miembro inferior. En todos ellos valoramos la tasa de complicaciones y los resultados funcionales mediante el índice MSTS (Musculoskeletal Tumor Society). RESULTADOS: se realizó un seguimiento de 40.8 meses (12-101.7). En nueve pacientes (30%) se realizaron resecciones y reconstrucciones pélvicas, a 11 pacientes (36.7%) se les implantaron megaprótesis de cadera por afectación femoral, en tres de los pacientes (10%) se realizó resección del fémur completo y en siete pacientes (23.3%) reconstrucción protésica de la rodilla. El resultado funcional medio de la escala MSTS fue de 72.5% (rango: 40-95%) y la tasa de complicaciones de 56.7% (17 pacientes), siendo la recurrencia tumoral (29%) la principal complicación. CONCLUSIÓN: la reconstrucción mediante megaprótesis ofrece buenos resultados funcionales a los pacientes dentro de la cirugía de resección radical, permitiendo realizar una vida relativamente normal.