Inestabilidad tras artroplastia total de rodilla: los límites de la constricción / Instability after total knee replacement: the limits to constraint

Introducción. La inestabilidad es una de las causas fundamentales de los fracasos asépticos de las prótesis de rodilla.Revisión de conceptos. En este artículo realizamos una actualización de la prevalencia, etiopatogenia, diagnóstico, formas clínicas, prevención y tratamiento de la inestabilidad protésica de rodilla.Conclusión. La elección del implante apropiado y la aplicación de técnicas y principios quirúrgicos correctos nos ayudarán a reducir la inestabilidad protésica de rodilla

Introduction. Instability is one of the most significant causes of aseptic failure in knee replacement surgery.Concept review. In this article, we provide an update on theprevalence, etiopathogenesis, diagnosis, clinical presentations,prevention and treatment of prosthetic knee instability.Conclusion. Appropriate implant choice and the application of sound surgical techniques and principles will help lower the incidence of prosthetic knee instability

Inestabilidad tras artroplastia total de rodilla: los límites de la constricción / Instability after total knee replacement: the limits to constraint

Introducción. La inestabilidad es una de las causas fundamentales de los fracasos asépticos de las prótesis de rodilla.Revisión de conceptos. En este artículo realizamos una actualización de la prevalencia, etiopatogenia, diagnóstico, formas clínicas, prevención y tratamiento de la inestabilidad protésica de rodilla.Conclusión. La elección del implante apropiado y la aplicación de técnicas y principios quirúrgicos correctos nos ayudarán a reducir la inestabilidad protésica de rodilla

Introduction. Instability is one of the most significant causes of aseptic failure in knee replacement surgery.Concept review. In this article, we provide an update on the prevalence, etiopathogenesis, diagnosis, clinical presentations, prevention and treatment of prosthetic knee instability.Conclusion. Appropriate implant choice and the application of sound surgical techniques and principles will help lower the incidence of prosthetic knee instability

Pulsed electromagnetic fields induce peripheral nerve regeneration and endplate enzymatic changes.

An experimental study was carried out in rats with the purpose of demonstrating the capacity of pulsed electromagnetic fields (PEMFs) to stimulate regeneration of the peripheral nervous system (PNS). Wistar and Brown Norway (BN) rats were used. Direct sciatic nerve anastomoses were performed after section or allograft interposition. Treatment groups then received 4 weeks of PEMFs. Control groups received no stimulation. The evaluation of the results was carried out by quantitative morphometric analysis, demonstrating a statistically significant increase in regeneration indices (P < 0.05) in the stimulated groups (9000 +/- 5000 and 4000 +/- 6000) compared to the non-stimulated groups (2000 +/- 4000 and 700 +/- 200). An increase of NAD specific isocitrate dehydrogenase (IDH) activity was found along with an increase in the activity of acetyl cholinesterase at the motor plate. The present study might lead to the search for new alternatives in the stimulation of axonal regenerative processes in the PNS and other possible clinical applications.

[Drug therapy of complex regional painful syndrome of the limbs as the cause of neuropathic pain]. / Tratamiento farmacológico del síndrome doloroso regional complejo de las extremidades como causa de dolor neuropático.

The term complex regional painful syndrome of the limbs seeks to clarify previous entities known as sympathicoreflex dystrophia and causalgia. Its diagnosis continues to be difficult despite the International Association for the Study of the Pain efforts for distinguish both entities. The predominant symptom is characteristically the neuropathic pain whose response to the current analgesic drugs is generally poor. Glucocorticoids are among the most frequent used drugs in the treatment of this syndrome; their effectiveness is, however, not entirely demonstrated and they give rise to important side effects that impede their use in patients with other concomitant conditions. Opioids are difficult to manage because of their side effects which require a strict control by the physician. The use of tricyclic antidepressants because of its analgesic effect is also associated to severe side effects that can be potentially lethal in patients with cardiopathy. In the heterogeneous group of anticonvulsant drugs gabapentin is regarded the treatment of choice because it seems to provide a high improvement of the quality of life in these patients besides a good safety profile.