[Use of metaphyseal stems «Proxima¼ DePuy: our experience to more than five years]. / Utilización de los vástagos metafisarios «Próxima¼ DePuy: nuestra experiencia a más de cinco años.

The total hip arthroplasty with short stems to preserve bone is a good choice in young patients that expected future revision surgery, it is also a good choice when we use approaches for minimal invasive surgeries. In this study, we have evaluated, clinically and radiologically, our experience in total hip arthroplasty with the use of short stems and metaphyseal anchorage. In total we have involved 23 patients with a mean age of 50.2 years (range 45 to 69 y/o) at the time of surgery. The median follow-up was greater than five years. There was a slight Varus femoral stem in three cases, one of them in severe varus. The latter presented continuous pain in the lateral aspect of the thigh that increased with time, with a diaphyseal reaction and an increase in radiolucencies around the stem that required revision surgery 12 months postoperative. A longer follow-up is required to analyze the results and confirm the durability of the observed clinical findings. Patients were evaluated radiological and clinically using the scale of Merle dAubigné (MD).

La artroplastía total de cadera con los vástagos cortos encaminada a preservar el hueso es una buena opción en pacientes jóvenes a quienes se les prevé futuras cirugías de revisión. También es una buena elección cuando se utilizan cirugías con abordajes miniinvasivos. En este estudio clínico y radiológico hemos evaluado nuestra experiencia en el uso de artroplastía total de cadera con vástagos cortos de anclaje metafisario tipo DePuy Próxima. En total se han intervenido 23 pacientes con una edad media de 50.2 años (rango de 45 a 69 años) en el momento de la cirugía. El seguimiento medio fue de más de cinco años. Hubo un ligero varo del tallo femoral en tres casos, uno de ellos en varo severo. Este último caso presentó dolor continuo en las caras laterales del muslo que aumentó con el tiempo junto con una reacción diafisaria y un aumento en el tallo que requirió cirugía de revisión a los 12 meses postoperatorios. Se requiere un seguimiento más prolongado para analizar los resultados y confirmar la durabilidad de los resultados clínicos observados. Los pacientes fueron evaluados radiológica y clínicamente utilizando el baremo de Merle dAubigné (MD).

[Anterolateral approach for minimally invasive hip surgery]. / El abordaje anterolateral en la cirugía miniinvasiva de la cadera.

INTRODUCTION: The approach for total hip arthroplasty (THA) using a mini-incision has been used progressively to decrease morbidity, achieve prompt patient recovery without an increased risk and shorten the hospital stay. However, the advantages and probable complications of these approaches are not clear. The objective of this paper is to compare the preliminary perioperative results of two groups of patients undergoing THA, one using the standard approach and the second one with a mini-incision. MATERIAL AND METHODS: 170 patients underwent surgery; they were divided into two groups. In group I (GI) patients an anterolateral mini-incision was performed, and in group II (GII) patients a standard Watson-Jones incision was used. Mean incision length was 8 cm in GI and 20 cm in GII. RESULTS: No statistically significant differences were found between both groups in the clinical and radiographic results and in the complications; however, a significant difference was found in the need for transfusions, wound size and hospital stay. CONCLUSIONS: This study showed that primary THA with a mini-incision was a safe procedure that reduced the operative time without increasing the complications.

[Hematogenous pubic osteoarthritis]. / Osteoartritis pubiana hematógena.

Pubic osteoarthritis is a little known pathological entity with a very controversial etiology. We present four cases of public osteoarthritis in which the infectious etiology was hematogeneous. The causal germs were: Staphilococcus aureus, Pseudomona aeruginosa, Mycobacterium tuberculosis and Brucella melitensis. In the first three cases, a surgical approach was used, allowing us to establish the etiological diagnosis of the process and to perform the local debridement. In the case of brucellar etiology, an isolated medical treatment was applied, according to the therapeutical guidelines recommended for brucellar bone infections. We have not observed recurrence of the septic process in any of the four cases, with a follow-up period ranging from one to three years.