A decade of the Catalonian Arthroplasty Register (RACat): Variability, exhaustivity, and survival of prostheses between 2005 and 2014. / Una década del Registro de Artroplastias de Cataluña (RACat): exhaustividad, variabilidad y supervivencia de las prótesis entre 2005 y 2014.

BACKGROUND AND AIM: The Catalonian Arthroplasty Register (RACat) is a public health-based population register used to analyse and evaluate hip and knee replacements in Catalonia. The aim of this study is to present the outcomes after 10 years in operation (January 2005-December 2014). METHODOLOGY: Using the information from the RACat and the minimum basic data set at hospital discharge, an analysis was made of the quality and exhaustivity of the data, as well as a descriptive analysis of the patients, prostheses, and care process. Survival was also analysed by calculating the accumulated incidence of revisions (according to the cause of intervention in hip replacements and conservation or sacrifice of the posterior cruciate ligament in knee replacement). The relationship between revision risk and the fixation technique of the prosthesis is also analysed, using competitive risk models adjusted for gender, age, and comorbidities. RESULTS: The main reason for the primary hip and knee replacement surgery was arthrosis. The accumulated incidence of revisions at 10 years was 3.9% in hip replacements caused by arthrosis, and 2.3% in those caused by fracture. Conservation of the posterior cruciate ligament was achieved in 4.4% of knee replacements, with sacrifice in 5.1%. DISCUSSION: The RACat is consolidated as a tool for the evaluation of joint replacements, with great potential in the analysis of medium and long-term efficacy, the study of the variability in clinical practice, and post-marketing surveillance.

Aseptic necrosis of the sternal end of the clavicle Friedrich's disease.

A case of aseptic necrosis of the medial segment of the clavicle with X-ray images of fragmentation and few clinical symptoms is presented. This condition develops spontaneously and leads to early sternoclavicular osteoarthritis. The benign nature of the disease and the absence of treatment make it important to establish the correct diagnosis, differentiating it from other disorders in this area.

Intrathoracic migration of a Kirschner wire.

Migration of Kirschner wires, Rush pins, etc., is well known. Such migrations usually follow a retrograde path and the wires protrude near the entry point. Occasionally migration occurs in another direction. We describe a case in which the Kirschner wire migrated from the shoulder to the thorax. Several factors caused this migration. This complication must be avoided by bending the free end of the wire, removing the osteosynthesis material as soon as possible and following up the patient for a long period.

Immediate complications and associated lesions in fractures of the pelvis. A review of 447 cases.

The high incidence of pelvic fractures and the frequency of complications and associated lesions encouraged us to conduct a retrospective study with the purpose of evaluating the treatment of these patients. 447 fractures of the pelvis were reviewed. Of these, 84% were characterised by associated lesions either secondary to the fracture or involving other systems. Collaboration between the various disciplines involved is essential in order to guarantee the best possible treatment of these patients.