Early appearance of radiolucent lines around total knee arthroplasty in rheumatoid arthritis patients. How does it impact the aseptic failure rate and functional outcomes at 13 years of follow-up? / [Artículo traducido] Aparición temprana de líneas radiolúcidas alrededor de la artroplastia total de rodilla en pacientes con artritis reumatoide. ¿Cuál es su impacto en la tasa de fracaso aséptico y los resultados funcionales a los 13 años de seguimiento?

INTRODUCTION: Aseptic total knee arthroplasty (TKA) failure has been associated with radiolucent lines. This study aimed to determine the impact of the early appearance of radiolucent lines (linear images of 1, 2, or > 2mm at the cement-bone interface) around the TKA on prosthetic survival and functional outcomes in rheumatoid arthritis (RA) patients during a 2-20 years follow-up. METHODS: We retrospectively analyzed a consecutive series of RA patients treated with TKA between 2000 and 2011. We comparatively analyzed patients with and without radiolucent lines around implants. Clinical outcomes were assessed with the knee society score (KSS) collected before surgery, at years 2, 5, and 10, and at the last postoperative follow-up. The knee society roentgenographic evaluation system was used to analyze the impact of radiolucent lines around the implants at 1, 2, 5, and more than ten years of follow-up. The reoperation and prosthetic survival rates were calculated at the end of the follow-up. RESULTS: The study series included 72 TKAs with a median follow-up of 13.2 years (range: 4.0-21.0), of which 16 (22.2%) had radiolucent lines. We did not observe aseptic failure, and prosthetic survival at the end of the study was 94.4% (n=68). The KSS improved significantly (p<0.001) between preoperative values at 2, 5, and 10 years and the end of follow-up, with no differences between patients with and without radiolucent lines. CONCLUSIONS: Our study demonstrates that the early appearance of radiolucent lines around a TKA in RA patients does not significantly impact prosthetic survival or long-term functional outcomes at 13 years of follow-up.

La artroplastia total de rodilla en pacientes con enfermedad de Parkinson es efectiva. Evaluación funcional y análisis de complicaciones / Total knee arthroplasty is effective in patients with Parkinson's disease. Functional assessment and analysis of complications

Introducción: Gracias a las mejoras en el tratamiento médico de la enfermedad de Parkinson (EP), la esperanza de vida de estos pacientes ha aumentado. Los resultados generales después de la artroplastia total de rodilla (ATR) son controvertidos. Nuestro objetivo es analizar una serie de pacientes con EP, evaluando su estado clínico, resultados funcionales, complicaciones y tasas de supervivencia después de la ATR. Métodos: Se estudiaron retrospectivamente 31 pacientes con EP operados entre 2014-2020. La edad media fue de 71 años (DE±5,8). Había 16 pacientes mujeres. El seguimiento medio fue de 68,2 meses (DE±36). Se utilizó el Knee Scoring System (KSS) y la escala visual analógica (EVA) para la evaluación funcional. Se utilizó la escala modificada de Hoehn y Yahr para evaluar la gravedad de la EP. Se registraron todas las complicaciones y se realizaron curvas de supervivencia. Resultados: La evaluación media postoperatoria del KSS tuvo un aumento de 40 puntos (35 [DE±15] vs. 75 [DE±15] [p<0,001]). La media de EVA postoperatoria disminuyó 5 puntos (8 [DE±2] vs. 3 [DE±2] [p<0,001]). Trece pacientes informaron estar muy satisfechos, 13 estaban satisfechos y solo 5 estaban poco satisfechos. Siete pacientes sufrieron complicaciones quirúrgicas y 4 tuvieron inestabilidad rotuliana recurrente. Con una media de 68,2 meses de seguimiento, la tasa de supervivencia global fue del 93,5%. Al considerar el rescate rotuliano secundario como punto final, la tasa de supervivencia fue del 80,6%. Conclusiones: En este estudio, la ATR se asoció con muy buenos resultados funcionales en pacientes con EP. A una media de 68,2 meses de seguimiento, la ATR tuvo una buena supervivencia a corto plazo, siendo la inestabilidad rotuliana recurrente la complicación más frecuente. Aunque estos hallazgos confirman la efectividad de la ATR en esta población, se necesita una evaluación clínica exhaustiva y un enfoque multidisciplinario para disminuir la probabilidad de complicaciones.(AU)

Introduction: Thanks to improvements in the medical treatment of Parkinson's disease (PD), the life expectancy of these patients has increased, but the overall outcome after total knee arthroplasty (TKA) is controversial. We aim to analyse a series of patients with PD, evaluating their clinical status, functional results, complications and survival rates after TKA. Methods: We retrospectively studied 31 patients with PD operated between 2014-2020. The mean age was 71 years (SD±5.8). There were 16 female patients. The mean follow-up was 68.2 months (SD±36). We used the Knee Scoring System (KSS) and the Visual Analog Scale (VAS) for the functional evaluation. The Modified Hoehn and Yahr Scale was used to assess the severity of PD. All complications were recorded, and survival curves were performed. Results: The mean postoperative KSS evaluation had an increase of 40 points [35 (SD±15) vs 75 (SD±15) (P<.001)]. The mean postoperative VAS decreased 5 points [8 (SD±2) vs 3 (SD±2) (P<.001)]. Thirteen patients reported being very satisfied, 13 were satisfied, and only 5 were poorly satisfied. Seven patients suffered surgical complications, and 4 patients had recurrent patellar instability. At a mean 68.2 months follow-up, the overall survival rate was 93.5%. When considering the secondary patellar resurfacing as the endpoint, the survival rate was 80.6%. Conclusions: In this study, TKA was associated with excellent functional outcomes in patients with PD. At a mean 68.2 months follow-up, TKA had excellent survivorship in the short term, with recurrent patellar instability as the most common complication. Even though these findings confirm the effectiveness of TKA in this population, a thorough clinical evaluation and multidisciplinary approach are needed to decrease the likelihood of complications.(AU)

[Translated article] Total knee arthroplasty is effective in patients with Parkinson's disease. Functional assessment and analysis of complications / La artroplastia total de rodilla en pacientes con enfermedad de Parkinson es efectiva. Evaluación funcional y análisis de complicaciones

Introducción: Gracias a las mejoras en el tratamiento médico de la enfermedad de Parkinson (EP), la esperanza de vida de estos pacientes ha aumentado. Los resultados generales después de la artroplastia total de rodilla (ATR) son controvertidos. Nuestro objetivo es analizar una serie de pacientes con EP, evaluando su estado clínico, resultados funcionales, complicaciones y tasas de supervivencia después de la ATR. Métodos: Se estudiaron retrospectivamente 31 pacientes con EP operados entre 2014-2020. La edad media fue de 71 años (DE±5,8). Había 16 pacientes mujeres. El seguimiento medio fue de 68,2 meses (DE±36). Se utilizó el Knee Scoring System (KSS) y la escala visual analógica (EVA) para la evaluación funcional. Se utilizó la escala modificada de Hoehn y Yahr para evaluar la gravedad de la EP. Se registraron todas las complicaciones y se realizaron curvas de supervivencia. Resultados: La evaluación media postoperatoria del KSS tuvo un aumento de 40 puntos (35 [DE±15] vs. 75 [DE±15] [p<0,001]). La media de EVA postoperatoria disminuyó 5 puntos (8 [DE±2] vs. 3 [DE±2] [p<0,001]). Trece pacientes informaron estar muy satisfechos, 13 estaban satisfechos y solo 5 estaban poco satisfechos. Siete pacientes sufrieron complicaciones quirúrgicas y 4 tuvieron inestabilidad rotuliana recurrente. Con una media de 68,2 meses de seguimiento, la tasa de supervivencia global fue del 93,5%. Al considerar el rescate rotuliano secundario como punto final, la tasa de supervivencia fue del 80,6%. Conclusiones: En este estudio, la ATR se asoció con muy buenos resultados funcionales en pacientes con EP. A una media de 68,2 meses de seguimiento, la ATR tuvo una buena supervivencia a corto plazo, siendo la inestabilidad rotuliana recurrente la complicación más frecuente. Aunque estos hallazgos confirman la efectividad de la ATR en esta población, se necesita una evaluación clínica exhaustiva y un enfoque multidisciplinario para disminuir la probabilidad de complicaciones.(AU)

Introduction: Thanks to improvements in the medical treatment of Parkinson's disease (PD), the life expectancy of these patients has increased, but the overall outcome after total knee arthroplasty (TKA) is controversial. We aim to analyse a series of patients with PD, evaluating their clinical status, functional results, complications and survival rates after TKA. Methods: We retrospectively studied 31 patients with PD operated between 2014-2020. The mean age was 71 years (SD±5.8). There were 16 female patients. The mean follow-up was 68.2 months (SD±36). We used the Knee Scoring System (KSS) and the Visual Analog Scale (VAS) for the functional evaluation. The Modified Hoehn and Yahr Scale was used to assess the severity of PD. All complications were recorded, and survival curves were performed. Results: The mean postoperative KSS evaluation had an increase of 40 points [35 (SD±15) vs 75 (SD±15) (P<.001)]. The mean postoperative VAS decreased 5 points [8 (SD±2) vs 3 (SD±2) (P<.001)]. Thirteen patients reported being very satisfied, 13 were satisfied, and only 5 were poorly satisfied. Seven patients suffered surgical complications, and 4 patients had recurrent patellar instability. At a mean 68.2 months follow-up, the overall survival rate was 93.5%. When considering the secondary patellar resurfacing as the endpoint, the survival rate was 80.6%. Conclusions: In this study, TKA was associated with excellent functional outcomes in patients with PD. At a mean 68.2 months follow-up, TKA had excellent survivorship in the short term, with recurrent patellar instability as the most common complication. Even though these findings confirm the effectiveness of TKA in this population, a thorough clinical evaluation and multidisciplinary approach are needed to decrease the likelihood of complications.(AU)

Early appearance of radiolucent lines around total knee arthroplasty in rheumatoid arthritis patients. How does it impact the aseptic failure rate and functional outcomes at 13 years of follow-up?

INTRODUCTION: Aseptic total knee arthroplasty (TKA) failure has been associated with radiolucent lines. This study aimed to determine the impact of the early appearance of radiolucent lines (linear images of 1, 2, or >2mm at the cement-bone interface) around the TKA on prosthetic survival and functional outcomes in rheumatoid arthritis (RA) patients during a 2-20 years follow-up. METHODS: We retrospectively analyzed a consecutive series of RA patients treated with TKA between 2000 and 2011. We comparatively analyzed patients with and without radiolucent lines around implants. Clinical outcomes were assessed with the knee society score (KSS) collected before surgery, at years 2, 5, and 10, and at the last postoperative follow-up. The knee society roentgenographic evaluation system was used to analyze the impact of radiolucent lines around the implants at 1, 2, 5, and more than ten years of follow-up. The reoperation and prosthetic survival rates were calculated at the end of the follow-up. RESULTS: The study series included 72 TKAs with a median follow-up of 13.2 years (range: 4.0-21.0), of which 16 (22.2%) had radiolucent lines. We did not observe aseptic failure, and prosthetic survival at the end of the study was 94.4% (n=68). The KSS improved significantly (p<0.001) between preoperative values at 2, 5, and 10 years and the end of follow-up, with no differences between patients with and without radiolucent lines. CONCLUSIONS: Our study demonstrates that the early appearance of radiolucent lines around a TKA in RA patients does not significantly impact prosthetic survival or long-term functional outcomes at 13 years of follow-up.

[Translated article] Total knee arthroplasty is effective in patients with Parkinson's disease. Functional assessment and analysis of complications.

INTRODUCTION: Thanks to improvements in the medical treatment of Parkinson's disease (PD), the life expectancy of these patients has increased, but the overall outcome after total knee arthroplasty (TKA) is controversial. We aim to analyse a series of patients with PD, evaluating their clinical status, functional results, complications and survival rates after TKA. METHODS: We retrospectively studied 31 patients with PD operated between 2014 and 2020. The mean age was 71 years (SD±5.8). There were 16 female patients. The mean follow-up was 68.2 months (SD±36). We used the knee scoring system (KSS) and the visual analogue scale (VAS) for the functional evaluation. The modified Hoehn and Yahr scale was used to assess the severity of PD. All complications were recorded, and survival curves were performed. RESULTS: The mean postoperative KSS evaluation had an increase of 40 points [35 (SD±15) vs 75 (SD±15) (p<.001)]. The mean postoperative VAS decreased 5 points [8 (SD±2) vs 3 (SD±2) (p<.001)]. Thirteen patients reported being very satisfied, 13 were satisfied, and only 5 were poorly satisfied. Seven patients suffered surgical complications, and 4 patients had recurrent patellar instability. At a mean 68.2 months follow-up, the overall survival rate was 93.5%. When considering the secondary patellar resurfacing as the endpoint, the survival rate was 80.6%. CONCLUSIONS: In this study, TKA was associated with excellent functional outcomes in patients with PD. At a mean 68.2 months follow-up, TKA had excellent survivorship in the short term, with recurrent patellar instability as the most common complication. Even though these findings confirm the effectiveness of TKA in this population, a thorough clinical evaluation and multidisciplinary approach are needed to decrease the likelihood of complications.

Screws versus plate with screws for osteosynthesis of the posterior malleolus: a systematic review and meta-analysis / Tornillos frente a placa con tornillos para la osteosíntesis del maléolo posterior: una revisión sistemática y meta-análisis

Abstract: Introduction: fractures involving the posterior malleolus (PM) of the ankle can have significant functional and clinical implications if not properly treated. The optimal treatment approach for these fractures remains uncertain. This review aims to compare the use of cannulated screws versus plate with screw fixation in terms of their impact on the development of postoperative ankle osteoarthritis and functional outcomes in patients with PM fractures. Material and methods: a comprehensive search was conducted in PubMed, EMBASE, and Cochrane Library databases to identify studies directly comparing cannulated screws versus plate with screw fixation for PM fractures and their association with the development of postoperative osteoarthritis and functional outcomes. The quality of the included studies was assessed using appropriate assessment tools. The data on osteoarthritis development and functional outcomes were extracted and analyzed. Results: a total of 691 articles were screened, and several studies were included for analysis. The findings revealed no statistically significant difference in the development of postoperative ankle osteoarthritis between the cannulated screws and plate with screw fixation groups. Similarly, there was no significant difference in functional outcomes between the two treatment approaches. Conclusion: based on the available evidence, there is no significant difference in the development of postoperative ankle osteoarthritis or functional outcomes between cannulated screws and plate with screw fixation for PM fractures. However, further research is needed to strengthen these findings and provide more conclusive evidence.

Resumen. Introducción: las fracturas que involucran el maléolo posterior (MP) del tobillo pueden tener importantes implicaciones funcionales y clínicas si no se tratan adecuadamente. El enfoque de tratamiento óptimo para estas fracturas sigue siendo incierto. El objetivo de esta revisión es comparar el uso de tornillos canulados versus placa con fijación de tornillos en cuanto a su impacto en el desarrollo de la osteoartrosis de tobillo postoperatoria y los resultados funcionales en pacientes con fracturas del MP. Material y métodos: se realizó una búsqueda exhaustiva en las bases de datos de PubMed, EMBASE y Cochrane Library para identificar estudios que compararan directamente tornillos canulados versus placa con fijación de tornillos para fracturas de MP y su asociación con el desarrollo de osteoartrosis postoperatoria y los resultados funcionales. La calidad de los estudios incluidos se evaluó utilizando herramientas de evaluación adecuadas. Los datos sobre el desarrollo de osteoartrosis y los resultados funcionales se extrajeron y analizaron. Resultados: se revisaron un total de 691 artículos y se incluyeron varios estudios para su análisis. Los hallazgos revelaron que no hay una diferencia estadísticamente significativa en el desarrollo de osteoartrosis de tobillo postoperatoria entre los grupos de tornillos canulados y placa con fijación de tornillos. Del mismo modo, no hubo una diferencia significativa en los resultados funcionales entre los dos enfoques de tratamiento. Conclusión: según la evidencia disponible, no hay una diferencia significativa en el desarrollo de osteoartrosis de tobillo postoperatoria o en los resultados funcionales entre los tornillos canulados y la placa con fijación de tornillos para las fracturas del MP. Sin embargo, se necesita más investigación para fortalecer estos hallazgos y proporcionar evidencia más concluyente.

Total knee arthroplasty is effective in patients with Parkinson's disease. Functional assessment and analysis of complications. / La artroplastia total de rodilla en pacientes con enfermedad de Parkinson es efectiva. Evaluación funcional y análisis de complicaciones.

INTRODUCTION: Thanks to improvements in the medical treatment of Parkinson's disease (PD), the life expectancy of these patients has increased, but the overall outcome after total knee arthroplasty (TKA) is controversial. We aim to analyse a series of patients with PD, evaluating their clinical status, functional results, complications and survival rates after TKA. METHODS: We retrospectively studied 31 patients with PD operated between 2014-2020. The mean age was 71 years (SD±5.8). There were 16 female patients. The mean follow-up was 68.2 months (SD±36). We used the Knee Scoring System (KSS) and the Visual Analog Scale (VAS) for the functional evaluation. The Modified Hoehn and Yahr Scale was used to assess the severity of PD. All complications were recorded, and survival curves were performed. RESULTS: The mean postoperative KSS evaluation had an increase of 40 points [35 (SD±15) vs 75 (SD±15) (P<.001)]. The mean postoperative VAS decreased 5 points [8 (SD±2) vs 3 (SD±2) (P<.001)]. Thirteen patients reported being very satisfied, 13 were satisfied, and only 5 were poorly satisfied. Seven patients suffered surgical complications, and 4 patients had recurrent patellar instability. At a mean 68.2 months follow-up, the overall survival rate was 93.5%. When considering the secondary patellar resurfacing as the endpoint, the survival rate was 80.6%. CONCLUSIONS: In this study, TKA was associated with excellent functional outcomes in patients with PD. At a mean 68.2 months follow-up, TKA had excellent survivorship in the short term, with recurrent patellar instability as the most common complication. Even though these findings confirm the effectiveness of TKA in this population, a thorough clinical evaluation and multidisciplinary approach are needed to decrease the likelihood of complications.

Percutaneous achilles tendon repair with absorbable suture: Outcomes and complications / Reparación percutánea del tendón de Aquiles con sutura reabsorbible: resultados y complicaciones

Objective: The purpose of this study is to evaluate the clinical outcomes and complications of percutaneous achilles tendon repair with absorbable sutures. Material and methods: A prospective cohort study including patients treated for an achilles tendon rupture from January 2016 to March 2019 was conducted. Inclusion criteria: ≥18 years of age, non-insertional (2–8cm proximal to insertion) achilles tendon ruptures. Open or partial ruptures were excluded. The diagnosis was based on clinical criteria and confirmed by ultrasonography in all patients. Epidemiological data, rupture and healing risk factors, previous diagnosis of tendinopathy, pre-rupture sport activity, job information, mechanism of rupture and the time in days between lesion and surgery were collected. Patients were assessed using visual analogue scale (VAS) at the 1, 3, 6 and 12-month follow-up. The achilles tendon rupture score (ATRS) were assessed at the 6 and 12 month follow-up. Ultrasound was performed at the 6-month follow-up. The re-rupture rate and postoperative complications were also collected. Conclusions: In our experience, percutaneous achilles tendon repair with absorbable sutures in patients with an acute achilles tendon rupture has shown good functional results but with a high incidence of complications. Although most complications were transitory sural nerve symptoms, this complication would be avoided in patients treated conservatively. For this reason, conservative treatment associated with an early weightbearing rehabilitation protocol should be considered a viable option for patients with achilles tendon ruptures, mainly in cooperative young patients.(AU)

Objetivo: El propósito de este estudio es evaluar los resultados clínicos y las complicaciones de la reparación percutánea del tendón de Aquiles con suturas reabsorbibles. Material y métodos: Se realizó un estudio de cohorte prospectivo que incluye pacientes tratados por una rotura del tendón de Aquiles desde enero de 2016 hasta marzo de 2019. Criterios de inclusión: ≥18años de edad, roturas del tendón de Aquiles no insercionales (de 2 a 8cm proximales a la inserción). Se excluyeron roturas abiertas o parciales. El diagnóstico se basó en criterios clínicos y se confirmó mediante ecografía en todos los pacientes. Se recogieron datos epidemiológicos, factores de riesgo de rotura y cicatrización, diagnóstico previo de tendinopatía, actividad deportiva previa a la rotura, información laboral, mecanismo de rotura y tiempo en días entre la lesión y la cirugía. Los pacientes fueron evaluados utilizando la escala analógica visual (VAS) en el seguimiento de 1, 3, 6 y 12meses. La puntuación de rotura del tendón de Aquiles (ATRS) se evaluó a los 6 y 12meses de seguimiento. La ecografía se realizó a los 6meses de seguimiento. También se recogieron la tasa de re-ruptura y las complicaciones postoperatorias. Conclusiones: En nuestra experiencia, la reparación percutánea del tendón de Aquiles con suturas reabsorbibles en pacientes con rotura aguda del tendón de Aquiles ha mostrado buenos resultados funcionales pero con una alta incidencia de complicaciones. Aunque la mayoría de las complicaciones fueron síntomas transitorios del nervio sural, esta complicación se evitaría en pacientes tratados de forma conservadora. Por esta razón, el tratamiento conservador asociado a un protocolo de rehabilitación con carga temprana debe considerarse una opción viable para pacientes con roturas del tendón de Aquiles, principalmente en pacientes jóvenes colaboradores.(AU)

Reparación percutánea del tendón de Aquiles con sutura reabsorbible: resultados y complicaciones / Percutaneous Achilles tendon repair with absorbable suture: Outcomes and complications

Objective: The purpose of this study is to evaluate the clinical outcomes and complications of percutaneous achilles tendon repair with absorbable sutures. Material and methods: A prospective cohort study including patients treated for an achilles tendon rupture from January 2016 to March 2019 was conducted. Inclusion criteria: ≥18 years of age, non-insertional (2–8cm proximal to insertion) achilles tendon ruptures. Open or partial ruptures were excluded. The diagnosis was based on clinical criteria and confirmed by ultrasonography in all patients. Epidemiological data, rupture and healing risk factors, previous diagnosis of tendinopathy, pre-rupture sport activity, job information, mechanism of rupture and the time in days between lesion and surgery were collected. Patients were assessed using visual analogue scale (VAS) at the 1, 3, 6 and 12-month follow-up. The achilles tendon rupture score (ATRS) were assessed at the 6 and 12 month follow-up. Ultrasound was performed at the 6-month follow-up. The re-rupture rate and postoperative complications were also collected. Conclusions: In our experience, percutaneous achilles tendon repair with absorbable sutures in patients with an acute achilles tendon rupture has shown good functional results but with a high incidence of complications. Although most complications were transitory sural nerve symptoms, this complication would be avoided in patients treated conservatively. For this reason, conservative treatment associated with an early weightbearing rehabilitation protocol should be considered a viable option for patients with achilles tendon ruptures, mainly in cooperative young patients.(AU)

Objetivo: El propósito de este estudio es evaluar los resultados clínicos y las complicaciones de la reparación percutánea del tendón de Aquiles con suturas reabsorbibles. Material y métodos: Se realizó un estudio de cohorte prospectivo que incluye pacientes tratados por una rotura del tendón de Aquiles desde enero de 2016 hasta marzo de 2019. Criterios de inclusión: ≥18años de edad, roturas del tendón de Aquiles no insercionales (de 2 a 8cm proximales a la inserción). Se excluyeron roturas abiertas o parciales. El diagnóstico se basó en criterios clínicos y se confirmó mediante ecografía en todos los pacientes. Se recogieron datos epidemiológicos, factores de riesgo de rotura y cicatrización, diagnóstico previo de tendinopatía, actividad deportiva previa a la rotura, información laboral, mecanismo de rotura y tiempo en días entre la lesión y la cirugía. Los pacientes fueron evaluados utilizando la escala analógica visual (VAS) en el seguimiento de 1, 3, 6 y 12meses. La puntuación de rotura del tendón de Aquiles (ATRS) se evaluó a los 6 y 12meses de seguimiento. La ecografía se realizó a los 6meses de seguimiento. También se recogieron la tasa de re-ruptura y las complicaciones postoperatorias. Conclusiones: En nuestra experiencia, la reparación percutánea del tendón de Aquiles con suturas reabsorbibles en pacientes con rotura aguda del tendón de Aquiles ha mostrado buenos resultados funcionales pero con una alta incidencia de complicaciones. Aunque la mayoría de las complicaciones fueron síntomas transitorios del nervio sural, esta complicación se evitaría en pacientes tratados de forma conservadora. Por esta razón, el tratamiento conservador asociado a un protocolo de rehabilitación con carga temprana debe considerarse una opción viable para pacientes con roturas del tendón de Aquiles, principalmente en pacientes jóvenes colaboradores.(AU)

Percutaneous Achilles tendon repair with absorbable suture: Outcomes and complications / Reparación percutánea del tendón de Aquiles con sutura reabsorbible: resultados y complicaciones

Background and objective: The purpose of this study is to evaluate the clinical outcomes and complications of percutaneous Achilles tendon repair with absorbable sutures. Material and methods: Prospective cohort study including 52 patients treated for Achilles tendon ruptures (January 2016 to March 2019). Inclusion criteria: ≥18 years of age, non-insertional Achilles tendon ruptures. Diagnosis based on clinical criteria, confirmed by ultrasonography. Assessment using Visual Analogue Scale (VAS), Achilles Tendon Rupture Score (ATRS) and ultrasound. Re-rupture rate and postoperative complications were collected. Results: VAS scoring (SD) at 1, 3, 6 and 12 months follow-up (FU) were 2.63 (0.83), 1.79 (1.25), 0.69 (1.09) and 0.08 (0.39), respectively. Mean (SD) ATRS score was 92.45 points at 6 months (6.27) and 94.04 points at 12 months FU (4.59). Three re-ruptures (5.77%) occurred with a mean time between surgery and re-rupture of 108.75 days (SD 28.4), all of them within 4-month FU. No ruptures at the time to return to sports activity. Thirteen complications (25%) (3 re-ruptures, 1 superficial wound infection and 9 transitory sural nerve injuries). Conclusions: Percutaneous Achilles tendon repair with absorbable sutures in patients with acute Achilles tendon ruptures has shown good functional results but with a high incidence of complications. Although most complications were transitory sural nerve symptoms, these would be avoided with conservative treatment. Conservative treatment associated with an early weight-bearing rehabilitation protocol should be considered a viable option for patients with Achilles tendon ruptures, specially in cooperative young patients.(AU)

Antecedentes y objetivo: El propósito es evaluar los resultados clínicos y complicaciones de la reparación percutánea del tendón de Aquiles con suturas reabsorbibles. Material y métodos: Estudio de cohorte prospectivo incluyendo 52 pacientes tratados por rotura del tendón de Aquiles (enero 2016-marzo 2019). Criterios de inclusión: ≥18 años de edad, roturas no insercionales del tendón de Aquiles. Diagnóstico clínico y confirmado por ecografía. Evaluación mediante Escala Analógica Visual (EVA), puntuación de rotura del tendón de Aquiles (ATRS) y ecografía. Recopilación de tasas de re-rotura y complicaciones postoperatorias. Resultados: Puntuación EVA (DE) al mes, 3, 6 y 12 meses de seguimiento: 2,63 (0,83), 1,79 (1,25), 0,69 (1,09) y 0,08 (0,39). Media (DE) de la puntuación ATRS: 92,45 puntos a los 6 meses (6,27) y 94,04 puntos a los 12 meses (4,59). 3 re-roturas (5,77%) con tiempo medio entre cirugía y re-rotura de 108,75 días (DE 28,4), todas durante los 4 meses de seguimiento. No roturas a la reincorporación a la actividad deportiva. 13 complicaciones (25%) (3 re-roturas, 1 infección de herida superficial y 9 lesiones transitorias del nervio sural). Conclusiones: La reparación percutánea del tendón de Aquiles con suturas reabsorbibles en pacientes con rotura aguda del tendón de Aquiles muestra buenos resultados funcionales; con alta incidencia de complicaciones. La mayoría de complicaciones fueron síntomas transitorios del nervio sural, que se evitarían en pacientes tratados conservadoramente. Asociado a un protocolo temprano de rehabilitación con carga, debe considerarse una opción, especialmente en pacientes jóvenes cooperadores.(AU)

[Artículo traducido] Reparación percutánea del tendón de Aquiles con sutura reabsorbible: resultados y complicaciones / Percutaneous Achilles tendon repair with absorbable suture: Outcomes and complications

Antecedentes y objetivo: El propósito es evaluar los resultados clínicos y complicaciones de la reparación percutánea del tendón de Aquiles con suturas reabsorbibles. Material y métodos: Estudio de cohorte prospectivo incluyendo 52 pacientes tratados por rotura del tendón de Aquiles (enero 2016-marzo 2019). Criterios de inclusión: ≥18 años de edad, roturas no insercionales del tendón de Aquiles. Diagnóstico clínico y confirmado por ecografía. Evaluación mediante Escala Analógica Visual (EVA), puntuación de rotura del tendón de Aquiles (ATRS) y ecografía. Recopilación de tasas de re-rotura y complicaciones postoperatorias. Resultados: Puntuación EVA (DE) al mes, 3, 6 y 12 meses de seguimiento: 2,63 (0,83), 1,79 (1,25), 0,69 (1,09) y 0,08 (0,39). Media (DE) de la puntuación ATRS: 92,45 puntos a los 6 meses (6,27) y 94,04 puntos a los 12 meses (4,59). 3 re-roturas (5,77%) con tiempo medio entre cirugía y re-rotura de 108,75 días (DE 28,4), todas durante los 4 meses de seguimiento. No roturas a la reincorporación a la actividad deportiva. 13 complicaciones (25%) (3 re-roturas, 1 infección de herida superficial y 9 lesiones transitorias del nervio sural). Conclusiones: La reparación percutánea del tendón de Aquiles con suturas reabsorbibles en pacientes con rotura aguda del tendón de Aquiles muestra buenos resultados funcionales; con alta incidencia de complicaciones. La mayoría de complicaciones fueron síntomas transitorios del nervio sural, que se evitarían en pacientes tratados conservadoramente. Asociado a un protocolo temprano de rehabilitación con carga, debe considerarse una opción, especialmente en pacientes jóvenes cooperadores.(AU)

Background and objective: The purpose of this study is to evaluate the clinical outcomes and complications of percutaneous Achilles tendon repair with absorbable sutures. Material and methods: Prospective cohort study including 52 patients treated for Achilles tendon ruptures (January 2016 to March 2019). Inclusion criteria: ≥18 years of age, non-insertional Achilles tendon ruptures. Diagnosis based on clinical criteria, confirmed by ultrasonography. Assessment using Visual Analogue Scale (VAS), Achilles Tendon Rupture Score (ATRS) and ultrasound. Re-rupture rate and postoperative complications were collected. Results: VAS scoring (SD) at 1, 3, 6 and 12 months follow-up (FU) were 2.63 (0.83), 1.79 (1.25), 0.69 (1.09) and 0.08 (0.39), respectively. Mean (SD) ATRS score was 92.45 points at 6 months (6.27) and 94.04 points at 12 months FU (4.59). Three re-ruptures (5.77%) occurred with a mean time between surgery and re-rupture of 108.75 days (SD 28.4), all of them within 4-month FU. No ruptures at the time to return to sports activity. Thirteen complications (25%) (3 re-ruptures, 1 superficial wound infection and 9 transitory sural nerve injuries). Conclusions: Percutaneous Achilles tendon repair with absorbable sutures in patients with acute Achilles tendon ruptures has shown good functional results but with a high incidence of complications. Although most complications were transitory sural nerve symptoms, these would be avoided with conservative treatment. Conservative treatment associated with an early weight-bearing rehabilitation protocol should be considered a viable option for patients with Achilles tendon ruptures, specially in cooperative young patients.(AU)

Percutaneous Achilles tendon repair with absorbable suture: Outcomes and complications.

BACKGROUND AND OBJECTIVE: The purpose of this study is to evaluate the clinical outcomes and complications of percutaneous Achilles tendon repair with absorbable sutures. MATERIAL AND METHODS: Prospective cohort study including 52 patients treated for Achilles tendon ruptures (January 2016 to March 2019). INCLUSION CRITERIA: ≥18 years of age, non-insertional Achilles tendon ruptures. Diagnosis based on clinical criteria, confirmed by ultrasonography. Assessment using Visual Analogue Scale (VAS), Achilles Tendon Rupture Score (ATRS) and ultrasound. Re-rupture rate and postoperative complications were collected. RESULTS: VAS scoring (SD) at 1, 3, 6 and 12 months follow-up (FU) were 2.63 (0.83), 1.79 (1.25), 0.69 (1.09) and 0.08 (0.39), respectively. Mean (SD) ATRS score was 92.45 points at 6 months (6.27) and 94.04 points at 12 months FU (4.59). Three re-ruptures (5.77%) occurred with a mean time between surgery and re-rupture of 108.75 days (SD 28.4), all of them within 4-month FU. No ruptures at the time to return to sports activity. Thirteen complications (25%) (3 re-ruptures, 1 superficial wound infection and 9 transitory sural nerve injuries). CONCLUSIONS: Percutaneous Achilles tendon repair with absorbable sutures in patients with acute Achilles tendon ruptures has shown good functional results but with a high incidence of complications. Although most complications were transitory sural nerve symptoms, these would be avoided with conservative treatment. Conservative treatment associated with an early weight-bearing rehabilitation protocol should be considered a viable option for patients with Achilles tendon ruptures, specially in cooperative young patients.

Percutaneous achilles tendon repair with absorbable suture: Outcomes and complications. / Reparación percutánea del tendón de Aquiles con sutura reabsorbible: resultados y complicaciones.

OBJECTIVE: The purpose of this study is to evaluate the clinical outcomes and complications of percutaneous achilles tendon repair with absorbable sutures. MATERIAL AND METHODS: A prospective cohort study including patients treated for an achilles tendon rupture from January 2016 to March 2019 was conducted. INCLUSION CRITERIA: ≥18 years of age, non-insertional (2-8cm proximal to insertion) achilles tendon ruptures. Open or partial ruptures were excluded. The diagnosis was based on clinical criteria and confirmed by ultrasonography in all patients. Epidemiological data, rupture and healing risk factors, previous diagnosis of tendinopathy, pre-rupture sport activity, job information, mechanism of rupture and the time in days between lesion and surgery were collected. Patients were assessed using visual analogue scale at the 1, 3, 6 and 12-month follow-up. The achilles tendon rupture score were assessed at the 6 and 12 month follow-up. Ultrasound was performed at the 6-month follow-up. The re-rupture rate and postoperative complications were also collected. CONCLUSIONS: In our experience, percutaneous achilles tendon repair with absorbable sutures in patients with an acute achilles tendon rupture has shown good functional results but with a high incidence of complications. Although most complications were transitory sural nerve symptoms, this complication would be avoided in patients treated conservatively. For this reason, conservative treatment associated with an early weightbearing rehabilitation protocol should be considered a viable option for patients with achilles tendon ruptures, mainly in cooperative young patients.

Percutaneous Achilles tendon repair with absorbable suture: Outcomes and complications. / [Artículo traducido] Reparación percutánea del tendón de Aquiles con sutura reabsorbible: resultados y complicaciones.

BACKGROUND AND OBJECTIVE: The purpose of this study is to evaluate the clinical outcomes and complications of percutaneous Achilles tendon repair with absorbable sutures. MATERIAL AND METHODS: Prospective cohort study including 52 patients treated for Achilles tendon ruptures (January 2016 to March 2019). INCLUSION CRITERIA: ≥18 years of age, non-insertional Achilles tendon ruptures. Diagnosis based on clinical criteria, confirmed by ultrasonography. Assessment using Visual Analogue Scale (VAS), Achilles Tendon Rupture Score (ATRS) and ultrasound. Re-rupture rate and postoperative complications were collected. RESULTS: VAS scoring (SD) at 1, 3, 6 and 12 months follow-up (FU) were 2.63 (0.83), 1.79 (1.25), 0.69 (1.09) and 0.08 (0.39), respectively. Mean (SD) ATRS score was 92.45 points at 6 months (6.27) and 94.04 points at 12 months FU (4.59). Three re-ruptures (5.77%) occurred with a mean time between surgery and re-rupture of 108.75 days (SD 28.4), all of them within 4-month FU. No ruptures at the time to return to sports activity. Thirteen complications (25%) (3 re-ruptures, 1 superficial wound infection and 9 transitory sural nerve injuries). CONCLUSIONS: Percutaneous Achilles tendon repair with absorbable sutures in patients with acute Achilles tendon ruptures has shown good functional results but with a high incidence of complications. Although most complications were transitory sural nerve symptoms, these would be avoided with conservative treatment. Conservative treatment associated with an early weight-bearing rehabilitation protocol should be considered a viable option for patients with Achilles tendon ruptures, specially in cooperative young patients.

Percutaneous achilles tendon repair with absorbable suture: Outcomes and complications.

OBJECTIVE: The purpose of this study is to evaluate the clinical outcomes and complications of percutaneous achilles tendon repair with absorbable sutures. MATERIAL AND METHODS: A prospective cohort study including patients treated for an achilles tendon rupture from January 2016 to March 2019 was conducted. INCLUSION CRITERIA: ≥18 years of age, non-insertional (2-8cm proximal to insertion) achilles tendon ruptures. Open or partial ruptures were excluded. The diagnosis was based on clinical criteria and confirmed by ultrasonography in all patients. Epidemiological data, rupture and healing risk factors, previous diagnosis of tendinopathy, pre-rupture sport activity, job information, mechanism of rupture and the time in days between lesion and surgery were collected. Patients were assessed using visual analogue scale (VAS) at the 1, 3, 6 and 12-month follow-up. The achilles tendon rupture score (ATRS) were assessed at the 6 and 12 month follow-up. Ultrasound was performed at the 6-month follow-up. The re-rupture rate and postoperative complications were also collected. CONCLUSIONS: In our experience, percutaneous achilles tendon repair with absorbable sutures in patients with an acute achilles tendon rupture has shown good functional results but with a high incidence of complications. Although most complications were transitory sural nerve symptoms, this complication would be avoided in patients treated conservatively. For this reason, conservative treatment associated with an early weightbearing rehabilitation protocol should be considered a viable option for patients with achilles tendon ruptures, mainly in cooperative young patients.

Ensayo clínico comparando el uso de tornillos y del sistema TighRope® Knotless en el tratamiento de las lesiones agudas de la sindesmosis / A randomized clinical trial comparing screws and the TighRope® Knotless system in the treatment of acute injuries of syndesmosis

Antecedentes y objetivo: Clásicamente el tratamiento de las lesiones agudas de la sindesmosis se ha realizado mediante tornillos. Hace unos años aparecieron implantes más flexibles que han evolucionado hasta el moderno TighRope® Knotless. El objetivo del presente estudio es comparar los resultados de ambos implantes. Material y métodos: Desde abril de 2019 hasta septiembre de 2020 reclutamos 68 pacientes diagnosticados de lesión aguda de la sindesmosis que fueron aleatorizados para tratamiento quirúrgico con tornillo o con TighRope® Knotless. Realizamos control posquirúrgico con tomografía axial computarizada, y a los 3, 6 y 12 meses se recogieron datos del rango articular, valores de escalas funcionales y se realizaron estudios de radiología simple. Resultados: Los pacientes tratados con tornillos no presentaban diferencias estadísticamente significativas en la escala AOFAS frente al grupo tratado con TighRope® Knotless a los 3 meses (83,1 vs. 81,80; p=1,03), ni a los 6 meses (88,27 vs. 88; p=0,26) ni a los 12 meses (93,03 vs. 92,10; p=0,93). Igualmente recogimos resultados similares en la escala de Olerud-Molander a los 3 meses (65 vs. 61,50; p=3,5), 6 meses (82,33 vs. 80,67; p=1,67) y 12 meses (92,67 vs. 90; p=2,67). Tampoco hubo diferencias en la tasa de malreducción posquirúrgica (ningún caso en ambos grupos), pérdida de reducción (3 en el grupo tratado con tornillo frente a 4 del grupo del TighRope® Knotless, p=0,54) o complicaciones (p=1). Conclusiones: El tratamiento de las lesiones agudas de la sindesmosis con tornillos o con TighRope® Knotless es similar tanto en resultados clínicos como radiológicos.(AU)

Background and aim: Classically acute syndesmosis injuries have been treated using screws. A few years ago more flexible implants appeared evolving to current TighRope® Knotless. The primary aim of this study is to compare clinical and radiographic outcome of both implants. Material and methods: From April 2019 to September 2020 68 patients diagnosed with acute syndesmosis injury were randomized to use screws or TighRope® Knotless. Syndesmosis reduction was assessed using bilateral CT potsoperatively. Outcomes were clinically and radiologically assessed at three, six, and twelve months after surgery. Results: No significant differences were identified in the AOFAS Scale between groups at three months (83.1 vs. 81.80; P=1.03), nor at six (88.27 vs. 88; P=.26) or at twelve (93.03 vs. 92.10; P=,93). There were also no differences in Olerud-Molander scale at three (65 vs. 61.50; P=3.5), six (82.33 vs. 80.67; P=1.67) and twelve months (92.67 vs. 90; P=2.67). Likewise, there were no differences in rate of postoperative malreduction (no cases in both groups), loss of reduction (three cases in screw group vs. four in TighRope® Knotless group, P=.54) or complications (P=1). Conclusions: Treatment of acute syndesmosis injuries with screws or the TighRope® Knotless implant is similar in both clinical and radiological results.(AU)

[Translated article] A randomised clinical trial comparing screws and the TighRope® Knotless system in the treatment of acute injuries of syndesmosis / Ensayo clínico comparando el uso de tornillos y del sistema TighRope® Knotless en el tratamiento de las lesiones agudas de la sindesmosis

Antecedentes y objetivo: Clásicamente el tratamiento de las lesiones agudas de la sindesmosis se ha realizado mediante tornillos. Hace unos años aparecieron implantes más flexibles que han evolucionado hasta el moderno TighRope® Knotless. El objetivo del presente estudio es comparar los resultados de ambos implantes. Material y métodos: Desde abril de 2019 hasta septiembre de 2020 reclutamos 68 pacientes diagnosticados de lesión aguda de la sindesmosis que fueron aleatorizados para tratamiento quirúrgico con tornillo o con TighRope® Knotless. Realizamos control posquirúrgico con tomografía axial computarizada, y a los 3, 6 y 12 meses se recogieron datos del rango articular, valores de escalas funcionales y se realizaron estudios de radiología simple. Resultados: Los pacientes tratados con tornillos no presentaban diferencias estadísticamente significativas en la escala AOFAS frente al grupo tratado con TighRope® Knotless a los 3 meses (83,1 vs. 81,80; p=1,03), ni a los 6 meses (88,27 vs. 88; p=0,26) ni a los 12 meses (93,03 vs. 92,10; p=0,93). Igualmente recogimos resultados similares en la escala de Olerud-Molander a los 3 meses (65 vs. 61,50; p=3,5), 6 meses (82,33 vs. 80,67; p=1,67) y 12 meses (92,67 vs. 90; p=2,67). Tampoco hubo diferencias en la tasa de malreducción posquirúrgica (ningún caso en ambos grupos), pérdida de reducción (3 en el grupo tratado con tornillo frente a 4 del grupo del TighRope® Knotless, p=0,54) o complicaciones (p=1). Conclusiones: El tratamiento de las lesiones agudas de la sindesmosis con tornillos o con TighRope® Knotless es similar tanto en resultados clínicos como radiológicos.(AU)

Background and aim: Classically acute syndesmosis injuries have been treated using screws. A few years ago more flexible implants appeared evolving to current TighRope® Knotless. The primary aim of this study is to compare clinical and radiographic outcome of both implants. Material and methods: From April 2019 to September 2020 68 patients diagnosed with acute syndesmosis injury were randomized to use screws or TighRope® Knotless. Syndesmosis reduction was assessed using bilateral CT potsoperatively. Outcomes were clinically and radiologically assessed at three, six, and twelve months after surgery. Results: No significant differences were identified in the AOFAS Scale between groups at three months (83.1 vs. 81.80; P=1.03), nor at six (88.27 vs. 88; P=.26) or at twelve (93.03 vs. 92.10; P=,93). There were also no differences in Olerud-Molander scale at three (65 vs. 61.50; P=3.5), six (82.33 vs. 80.67; P=1.67) and twelve months (92.67 vs. 90; P=2.67). Likewise, there were no differences in rate of postoperative malreduction (no cases in both groups), loss of reduction (three cases in screw group vs. four in TighRope® Knotless group, P=.54) or complications (P=1). Conclusions: Treatment of acute syndesmosis injuries with screws or the TighRope® Knotless implant is similar in both clinical and radiological results.(AU)

[Translated article] A randomised clinical trial comparing screws and the TighRope® Knotless system in the treatment of acute injuries of syndesmosis.

BACKGROUND AND AIM: Classically acute syndesmosis injuries have been treated using screws. A few years ago more flexible implants appeared evolving to current TighRope® Knotless. The primary aim of this study is to compare clinical and radiographic outcome of both implants. MATERIAL AND METHODS: From April 2019 to September 2020 68 patients diagnosed with acute syndesmosis injury were randomised to use screws or TighRope® Knotless. Syndesmosis reduction was assessed using bilateral CT potsoperatively. Outcomes were clinically and radiologically assessed at three, six, and twelve months after surgery. RESULTS: No significant differences were identified in the AOFAS Scale between groups at three months (83.1 vs. 81.80; P=1.03), nor at six (88.27 vs. 88; P=.26) or at twelve (93.03 vs. 92.10; P=.93). There were also no differences in Olerud-Molander scale at three (65 vs. 61.50; P=3.5), six (82.33 vs. 80.67; P=1.67) and twelve months (92.67 vs. 90; P=2.67). Likewise, there were no differences in rate of postoperative malreduction (no cases in both groups), loss of reduction (three cases in screw group vs. four in TighRope® Knotless group, P=.54) or complications (P=1). CONCLUSIONS: Treatment of acute syndesmosis injuries with screws or the TighRope® Knotless implant is similar in both clinical and radiological results.

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.

Influencia de la obesidad en los resultados del tratamiento quirúrgico de la estenosis lumbar degenerativa / Obesity Influence on the Surgical Treatment Results of Degenerative Lumbar Stenosis

Introducción: La estenosis lumbar degenerativa altera la calidad de vida y disminuye la capacidad funcional en adultos mayores. La obesidad representa un problema de la salud mundial actual. Objetivo: Detallar los efectos de la obesidad sobre el riesgo quirúrgico, los índices de complicaciones posoperatorias y los resultados funcionales en pacientes adultos mayores sometidos a cirugía electiva por estenosis lumbar degenerativa. Métodos: Estudio prospectivo-descriptivo, con pacientes adultos mayores intervenidos quirúrgicamente por diagnóstico de estenosis lumbar degenerativa y valorados un año después. Resultados: 55 pacientes, 23 obesos, 32 no obesos; relación de sexos 1,5:1 masculino-femenino, mayor cantidad de espacios intervenidos, tiempo quirúrgico y pérdida de sangre en obesos. Los obesos presentaron un mayor número de complicaciones postquirúrgicas y resultados funcionales menos buenos. Conclusiones: La obesidad constituye un mayor riesgo quirúrgico, que, aunque la diferencia en los resultados clínicos no sea muy importante, provoca intervenciones más prolongadas y mayor incidencia de complicaciones quirúrgicas(AU)

Introduction: Degenerative lumbar stenosis alters quality of life and decreases functional capacity in older adults. Obesity represents a current global health problem. Objective: To detail the effects of obesity on surgical risk, postoperative complication rates, and functional outcomes in older patients undergoing elective surgery for degenerative lumbar stenosis. Methods: Prospective-descriptive study with elderly patients who underwent surgery for a diagnosis of degenerative lumbar stenosis, who were evaluated one year later. Results: Fifty-five patients, 23 obese, 32 non-obese; sex ratio 1.5:1 male-female, higher number of intervened spaces, surgical time and blood loss in obese subjects. The obese patients showed higher number of post-surgical complications and less good functional results. Conclusions: Obesity constitutes a higher surgical risk, even when the difference in clinical results is not very important, it causes longer interventions and higher incidence of surgical complications(AU)