[Translated article] Efficacy of platelet-rich plasma in rotator cuff repair: Systematic review and meta-analysis.

OBJECTIVE: To analyse the efficacy and safety after the application of platelet-rich-plasma (PRP) as an adjuvant in arthroscopic rotator cuff repairs. MATERIAL AND METHODS: A bibliographic search of the literature of prospective studies with level of evidence one or two was carried out from January 2004 to December 2021, including studies that compare the functional and re-tear results after arthroscopic cuff repair rotator with or without PRP. RESULTS: A total of 281 articles were identified, of which 14 met the inclusion criteria. The overall re-rupture rate was 24%. In the PRP group, a decrease in the re-rupture rate and better functional results were demonstrated, although these differences were not significant. CONCLUSIONS: Adjuvant treatment with PRP has shown promising results, although there is not yet enough evidence to provide a clear advantage for routine use in clinical practice.

Efficacy of platelet-rich plasma in rotator cuff repair: systematic review and meta-analysis. / Eficacia del plasma rico en plaquetas en la reparación del manguito rotador: revisión sistemática y metaanálisis.

OBJECTIVE: To analyze the efficacy and safety after the application of platelet-rich-plasma (PRP) as an adjuvant in arthroscopic rotator cuff repairs. MATERIAL AND METHODS: A bibliographic search of the literature of prospective studies with level of evidence one or two was carried out from January 2004 to December 2021, including studies that compare the functional and re-tear results after arthroscopic cuff repair rotator with or without PRP. RESULTS: A total of 281 articles were identified, of which 14 met the inclusion criteria. The overall re-rupture rate was 24%. In the PRP group, a decrease in the re-rupture rate and better functional results were demonstrated, although these differences were not significant. CONCLUSIONS: Adjuvant treatment with PRP has shown promising results, although there is not yet enough evidence to provide a clear advantage for routine use in clinical practice.

Implantes de titanio trabecular en cirugía de revisión acetabular compleja / Trabecular titanium implants in complex acetabular revision surgery

Introducción: La cirugía de revisión acetabular supone un reto quirúrgico sobre todo cuando aparecen los defectos óseos complejos, pues dificultan la fijación primaria y osteointegración de los implantes, lo que condiciona la aparición de complicaciones. Los cotilos de titanio trabecular intentan solventar estos problemas. Objetivos: Valorar los resultados clínico-radiológicos, la supervivencia de los implantes y aparición de complicaciones a medio plazo en cirugía de revisión acetabular en una serie de 37 recambios acetabulares con defectos óseos tipo IIIA y IIIB de Paprosky en los que se utilizó un implante de revisión tipo Cup-Cage de titanio trabecular. Material y método: Realizamos un estudio observacional, descriptivo y retrospectivo de 37 casos con defectos acetabulares complejos (20 tipo IIIA y 17 tipo IIIB, cinco de ellos con discontinuidad pélvica) en los que se realizó recambio del componente acetabular por implantes de titanio trabecular entre los años 2011 y 2019. Analizamos resultados clínicos (dolor y funcionalidad) y parámetros radiológicos (restauración del centro de rotación de la cadera y la movilización de los implantes), así como la aparición de complicaciones. Resultados: El seguimiento medio fue de 61 meses. Obtuvimos una mejoría en la mediana de 8 puntos en la escala de funcionalidad de Merlé D’Aubigné-Postel y de 6 puntos en la escala EVA de dolor percibido por el paciente. Registramos dos casos de aflojamiento acetabular, un caso de inestabilidad y tres infecciones de herida quirúrgica sin afectar al implante. Conclusiones: La utilización de implantes tipo Cup-Cage de titanio trabecular podría constituir una opción válida en cirugía de revisión acetabular con defectos acetabulares complejos, presentando buenos resultados clínico-radiológicos y en cuanto a complicaciones y supervivencia de los implantes, debido a su buena fijación primaria y osteointegración.(AU)

Introduction: Acetabular revision surgery is a surgical challenge, especially when complex bone defects appear. This makes primary fixation and osseointegration of the implants difficult, which conditions the appearance of complications. Trabecular titanium implants attempt to solve these problems. Objectives: To evaluate our clinical-radiological results, the survival of the implants and the appearance of mid-term complications in acetabular revision surgery in a series of 37 acetabular replacements with Paprosky type IIIA and IIIB bone defects in which a trabecular titanium Cup-Cage revision implant was used. Material and method: We conducted an observational, descriptive and retrospective study of 37 cases with complex acetabular defects (20 type IIIA and 17 type IIIB, five of them with pelvic discontinuity) in which the acetabular component was replaced by trabecular titanium cups between 2011 and 2019. We analyzed clinical results (pain and functionality) and radiological parameters (restoration of the hip rotation centre and the mobilization of the implants), as well as the appearance of complications. Results: The mean follow-up was 61 months. We obtained a median improvement of 8 points on the Merlé D’Aubigné-Postel functionality scale and 6 points on the VAS scale of pain perceived by the patient. We recorded two cases of acetabular loosening, one case of dislocation and three surgical wound infections without affecting the implant. Conclusions: The use of trabecular titanium Cup-Cage implants could be a valid option in acetabular revision surgery with complex acetabular defects, presenting good clinical and radiological results and in terms of complications and survival of the implants, mainly due to their good primary fixation and subsequent osseointegration.(AU)

[Translated article] Trabecular titanium implants in complex acetabular revision surgery / Implantes de titanio trabecular en cirugía de revisión acetabular compleja

Introducción: La cirugía de revisión acetabular supone un reto quirúrgico sobre todo cuando aparecen los defectos óseos complejos, pues dificultan la fijación primaria y osteointegración de los implantes, lo que condiciona la aparición de complicaciones. Los cotilos de titanio trabecular intentan solventar estos problemas. Objetivos: Valorar los resultados clínico-radiológicos, la supervivencia de los implantes y aparición de complicaciones a medio plazo en cirugía de revisión acetabular en una serie de 37 recambios acetabulares con defectos óseos tipo IIIA y IIIB de Paprosky en los que se utilizó un implante de revisión tipo Cup-Cage de titanio trabecular. Material y método: Realizamos un estudio observacional, descriptivo y retrospectivo de 37 casos con defectos acetabulares complejos (20 tipo IIIA y 17 tipo IIIB, cinco de ellos con discontinuidad pélvica) en los que se realizó recambio del componente acetabular por implantes de titanio trabecular entre los años 2011 y 2019. Analizamos resultados clínicos (dolor y funcionalidad) y parámetros radiológicos (restauración del centro de rotación de la cadera y la movilización de los implantes), así como la aparición de complicaciones. Resultados: El seguimiento medio fue de 61 meses. Obtuvimos una mejoría en la mediana de 8 puntos en la escala de funcionalidad de Merlé D’Aubigné-Postel y de 6 puntos en la escala EVA de dolor percibido por el paciente. Registramos dos casos de aflojamiento acetabular, un caso de inestabilidad y tres infecciones de herida quirúrgica sin afectar al implante. Conclusiones: La utilización de implantes tipo Cup-Cage de titanio trabecular podría constituir una opción válida en cirugía de revisión acetabular con defectos acetabulares complejos, presentando buenos resultados clínico-radiológicos y en cuanto a complicaciones y supervivencia de los implantes, debido a su buena fijación primaria y osteointegración.(AU)

Introduction: Acetabular revision surgery is a surgical challenge, especially when complex bone defects appear. This makes primary fixation and osseointegration of the implants difficult, which conditions the appearance of complications. Trabecular titanium implants attempt to solve these problems. Objectives: To evaluate our clinical-radiological results, the survival of the implants and the appearance of mid-term complications in acetabular revision surgery in a series of 37 acetabular replacements with Paprosky type IIIA and IIIB bone defects in which a trabecular titanium Cup-Cage revision implant was used. Material and method: We conducted an observational, descriptive and retrospective study of 37 cases with complex acetabular defects (20 type IIIA and 17 type IIIB, five of them with pelvic discontinuity) in which the acetabular component was replaced by trabecular titanium cups between 2011 and 2019. We analyzed clinical results (pain and functionality) and radiological parameters (restoration of the hip rotation centre and the mobilization of the implants), as well as the appearance of complications. Results: The mean follow-up was 61 months. We obtained a median improvement of 8 points on the Merlé D’Aubigné-Postel functionality scale and 6 points on the VAS scale of pain perceived by the patient. We recorded two cases of acetabular loosening, one case of dislocation and three surgical wound infections without affecting the implant. Conclusions: The use of trabecular titanium Cup-Cage implants could be a valid option in acetabular revision surgery with complex acetabular defects, presenting good clinical and radiological results and in terms of complications and survival of the implants, mainly due to their good primary fixation and subsequent osseointegration.(AU)

[Translated article] Trabecular titanium implants in complex acetabular revision surgery.

INTRODUCTION: Acetabular revision surgery is a surgical challenge, especially when complex bone defects appear. This makes primary fixation and osseointegration of the implants difficult, which conditions the appearance of complications. Trabecular titanium implants attempt to solve these problems. OBJECTIVES: To evaluate our clinical-radiological results, the survival of the implants and the appearance of mid-term complications in acetabular revision surgery in a series of 37 acetabular replacements with Paprosky type IIIA and IIIB bone defects in which a trabecular titanium Cup-Cage revision implant was used. MATERIAL AND METHOD: We conducted an observational, descriptive and retrospective study of 37 cases with complex acetabular defects (20 type IIIA and 17 type IIIB, five of them with pelvic discontinuity) in which the acetabular component was replaced by trabecular titanium cups between 2011 and 2019. We analysed clinical results (pain and functionality) and radiological parameters (restoration of the hip rotation centre and the mobilisation of the implants), as well as the appearance of complications. RESULTS: The mean follow-up was 61 months. We obtained a median improvement of 8 points on the Merlé D'Aubigné-Postel functionality scale and 6 points on the VAS scale of pain perceived by the patient. We recorded two cases of acetabular loosening, one case of dislocation and three surgical wound infections without affecting the implant. CONCLUSIONS: The use of trabecular titanium Cup-Cage implants could be a valid option in acetabular revision surgery with complex acetabular defects, presenting good clinical and radiological results and in terms of complications and survival of the implants, mainly due to their good primary fixation and subsequent osseointegration.

Trabecular titanium implants in complex acetabular revision surgery. / Implantes de titanio trabecular en cirugía de revisión acetabular compleja.

INTRODUCTION: Acetabular revision surgery is a surgical challenge, especially when complex bone defects appear. This makes primary fixation and osseointegration of the implants difficult, which conditions the appearance of complications. Trabecular titanium implants attempt to solve these problems. OBJECTIVES: To evaluate our clinical-radiological results, the survival of the implants and the appearance of mid-term complications in acetabular revision surgery in a series of 37 acetabular replacements with Paprosky type IIIA and IIIB bone defects in which a trabecular titanium Cup-Cage revision implant was used. MATERIAL AND METHOD: We conducted an observational, descriptive and retrospective study of 37 cases with complex acetabular defects (20 type IIIA and 17 type IIIB, five of them with pelvic discontinuity) in which the acetabular component was replaced by trabecular titanium cups between 2011 and 2019. We analyzed clinical results (pain and functionality) and radiological parameters (restoration of the hip rotation centre and the mobilization of the implants), as well as the appearance of complications. RESULTS: The mean follow-up was 61 months. We obtained a median improvement of 8 points on the Merlé D'Aubigné-Postel functionality scale and 6 points on the VAS scale of pain perceived by the patient. We recorded two cases of acetabular loosening, one case of dislocation and three surgical wound infections without affecting the implant. CONCLUSIONS: The use of trabecular titanium Cup-Cage implants could be a valid option in acetabular revision surgery with complex acetabular defects, presenting good clinical and radiological results and in terms of complications and survival of the implants, mainly due to their good primary fixation and subsequent osseointegration.