ABSTRACT
La luxación congénita de rodilla (LCR) es una patología muy poco frecuente cuyo diagnóstico se realiza al nacimiento por los hallazgos clínicos, confirmándose radiológicamente. Se ha relacionado con diversas etiologías, desde malas posiciones fetales intraútero hasta trastornos genéticos. El pronóstico dependerá del inicio precoz del tratamiento y de la asociación de otras anomalías congénitas. Presentamos 2 nuevos casos de LCR observados en nuestro hospital en el período de un mes, diagnosticados en los primeros momentos tras el nacimiento, ambos con buena evolución clínica
Congenital dislocation of the knee is a rare disease. The diagnosis is made at birth by clinical findings, and confirmed radiologically. It has been associated with various etiologies from intrauterine fetal malpositions to genetic disorders. The prognosis depends on early treatment and whether there are other congenital anomalies. We report two new cases of congenital dislocation of the knee, observed in our hospital during the period of a month, diagnosed immediately after birth, and both with a good clinical outcome
Subject(s)
Humans , Male , Female , Infant, Newborn , Knee Dislocation/congenital , Knee Dislocation/diagnosis , Knee Dislocation/metabolism , Orthopedic Procedures , Orthopedic Procedures/instrumentation , Knee Dislocation/complications , Knee Dislocation/prevention & control , Knee Dislocation/therapy , Calcium Sulfate , Orthopedic Procedures/methods , Orthopedic Procedures/rehabilitationABSTRACT
Congenital dislocation of the knee is a rare disease. The diagnosis is made at birth by clinical findings, and confirmed radiologically. It has been associated with various etiologies from intrauterine fetal malpositions to genetic disorders. The prognosis depends on early treatment and whether there are other congenital anomalies. We report two new cases of congenital dislocation of the knee, observed in our hospital during the period of a month, diagnosed immediately after birth, and both with a good clinical outcome.
Subject(s)
Knee Dislocation/congenital , Female , Humans , Infant, Newborn , Knee Dislocation/diagnosis , Knee Dislocation/therapy , MaleABSTRACT
Objetivo. Las causas más frecuentes de prótesis dolorosas son la movilización o aflojamiento aséptico, y la movilización séptica o infección. Una infección protésica siempre constituye un reto diagnóstico puesto que, salvo ante la presencia de fístula u otros signos de infección evidente, no existe ninguna prueba definitiva (sensibilidad y especificidad del 100 %) para el diagnóstico prequirúrgico. El objetivo de nuestro estudio fue intentar conseguir un protocolo diagnósticoeficaz y eficiente de movilización protésica.Material y método. Para ello se estudiaron 24 recambiosprotésicos de cadera prospectivamente mediante clínica, estudios de laboratorio, radiografía, tomografía por emisión de positrones con 2-18F-fluoro-2-desoxi-D-glucosa (18FDG-PET), cultivo de líquido articular y de biopsia y estudio histopatológico. Resultados. 11 de las 24 prótesis estaban infectadas. La sensibilidad y especificidad de la tomografía por emisión de positrones (PET) para detectar infección protésica fue del 63,6 y del 61,5 %, respectivamente. Conclusiones. La imagen 18FDG-PET no permite discernir, en nuestras manos, entre movilización séptica y aséptica protésica, por lo que en pacientes con sospecha de infección tiene un valor limitado como técnica de cribaje diagnóstico
Infection following hip arthroplasties can presenta diagnostic challenge. No test is 100 % sensitive and100 % specific; this prospective study was undertaken to evaluate the utility of FDG-PET imaging for diagnosing infected joint replacements. 24 hip joint replacements were studied prospectively and we have complete diagnoses with clinical signs and symptoms, laboratory test, radiography, joint aspiration, radionuclide imaging including FDG-PET, and histopathologicexamination. 11 of 24 prostheses were infected. The sensitivity and specificity of PET for detecting infection associated with prostheses were 64,3 % and 64,7 % respectively, in our hands. FDG imaging is not useful in patients with suspected prostheticinfection like a screening test
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Fluorine Radioisotopes , Hip Prosthesis/adverse effects , Prosthesis-Related Infections , Radiopharmaceuticals , Fluorodeoxyglucose F18 , Sensitivity and Specificity , Bacteriological Techniques , Prospective Studies , BiopsyABSTRACT
Infection following hip arthroplasties can present a diagnostic challenge. No test is 100 % sensitive and 100 % specific; this prospective study was undertaken to evaluate the utility of FDG-PET imaging for diagnosing infected joint replacements. 24 hip joint replacements were studied prospectively and we have complete diagnoses with clinical signs and symptoms, laboratory test, radiography, joint aspiration, radionuclide imaging including FDG-PET, and histopathologic examination. 11 of 24 prostheses were infected. The sensitivity and specificity of PET for detecting infection associated with prostheses were 64,3 % and 64,7 % respectively, in our hands. FDG imaging is not useful in patients with suspected prosthetic infection like a screening test.
Subject(s)
Fluorine Radioisotopes , Fluorodeoxyglucose F18 , Hip Prosthesis/adverse effects , Prosthesis-Related Infections/diagnostic imaging , Radiopharmaceuticals , Adult , Aged , Aged, 80 and over , Bacteriological Techniques , Biopsy , Female , Humans , Male , Middle Aged , Prospective Studies , Radionuclide Imaging , Sensitivity and SpecificityABSTRACT
Objetivo. La luxación habitual de rótula se trata de una patología en la que se produce una luxación de la misma cada vez que el paciente realiza una flexión de la rodilla, volviendo a su posición correcta en el surco intercondíleo con la rodilla en extensión. El tratamiento debe ir encaminado al recentraje rotuliano, y es importante realizarlo de forma precoz, para evitar daños irreparables producidos por las constantes luxaciones y choques de los cóndilos con el cartílago rotuliano. Cuando esta patología se produce en pacientes en los que el cartílago de crecimiento se encuentra todavía activo, la cirugía ósea no se puede llevar a cabo. El objeto del trabajo es valorar en este grupo de pacientes la cirugía de realineamiento rotuliano actuando exclusivamente sobre partes blandas. Material y método. Estudiamos la evolución de las rodillas de 11 pacientes (14 rodillas) afectos de luxación habitual de rótula antes de la madurez esquelética en los que se realizó realineamiento rotuliano mediante la técnica Krogius-Lecène. Resultados. El seguimiento medio de estos pacientes fue de 21,9 años, período tras el cual los resultados clínicos obtenidos fueron excelentes en 10 rodillas, buenos en tres y regulares en una. En ningún caso la rodilla volvió a sufrir episodios de luxación. Conclusión. La técnica de Krogius-Lecène para el tratamiento de la luxación habitual de rótula es un método que consigue buenos resultados a largo plazo en pacientes con el cartílago de crecimiento activo (AU)
Subject(s)
Female , Child, Preschool , Male , Child , Humans , Patella/surgery , Patella/injuries , Joint Dislocations/surgery , Orthopedic Procedures/methods , Treatment Outcome , Follow-Up StudiesABSTRACT
The transmission of disease or infection from the donor to the recipient is always a risk with the use of allografts. We carried out a research study on the behavioural pattern of implanted allografts, which were initially stored in perfect conditions (all cultures being negative) but later presented positive cultures at the implantation stage. Because there is no information available on how to deal with this type of situation, our aim was to set guidelines on the course of action which would be required in such a case. We conducted a retrospective study of 181 patients who underwent an ACL reconstruction using BPTB allografts. All previous bone and blood cultures and tests for hepatitis B and C, syphilis and HIV were negative. An allograft sample was taken for culture in the operating theatre just before its implantation. The results of the cultures were obtained 3-5 days after the operation. We had 24 allografts with positive culture (13.25%) after the implantation with no clinical infection in any of these patients. Positive cultures could be caused by undetected contamination while harvesting, storing or during manipulation before implantation. The lack of clinical signs of infection during the follow-up of our patients may indicate that no specific treatment-other than an antibiotic protocol-would be required when facing a case of positive culture of a graft piece after its implantation.
Subject(s)
Anterior Cruciate Ligament Injuries , Knee Injuries/surgery , Surgical Wound Infection/prevention & control , Tendons/microbiology , Adolescent , Adult , Antibiotic Prophylaxis , Female , Humans , Knee Injuries/microbiology , Male , Middle Aged , Plastic Surgery Procedures , Retrospective Studies , Rupture , Tendons/transplantation , Transplantation, HomologousABSTRACT
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