Resultados clínicos de artroplastia total de cadera asistida por brazo robótico en España: estudio preliminar / Clinical results of total hip arthroplasty assisted by robotic arm in Spain: Preliminary study

Objetivos: Resultados clínicos, radiológicos y funcionales de la primera serie española de pacientes intervenidos de artroplastia total de cadera (ATC) asistida mediante brazo robótico Mako® (Stryker) del Hospital Clínico San Carlos (HCSC) de Madrid. Material y métodos: Estudio descriptivo prospectivo que analiza los primeros 25 pacientes intervenidos de ATC asistida por robot (ATCaR) en el HCSC, con un seguimiento mínimo de 4meses. Se evaluaron la demografía, los estudios de imagen (procesamiento Mako®, Rx y TAC), los parámetros clínicos, la funcionalidad (Harris modificada) y las complicaciones asociadas. Resultados: La edad media fue 67,2años (min 47, max 88), siendo el 56% varones. El 88% corresponden a coxartrosis primaria, el 4% postraumática, el 4% secundaria a NAV y el 4% secundaria a choque femoroacetabular. El tiempo medio de cirugía fue de 116,9minutos (min 92, max 150). La media de las cinco primeras intervenciones fue 122,6minutos, y la de las cinco últimas, de 108,2minutos. Como complicaciones intraoperatorias se cuantificaron 4 pérdidas de marcadores intraoperatorios. El tiempo de ingreso medio fue 4,4días (min 3, max 7), con una disminución de hemoglobina posquirúrgica media de 3,08±1,08g/dl, requiriendo transfusión en el 12% de los casos. Se registran tres complicaciones médicas durante el ingreso, destacando un síndrome confusional con caída y fractura periprotésica AG1 no desplazada. El análisis del posicionamiento de los implantes registrados con sistema Mako® fueron 40,55±1,53 grados de inclinación y 12,2±3,6 grados de anteversión acetabular. El estudio de imagen posquirúrgico realizado a los pacientes, en concordancia con Mako®, muestra valores de inclinación acetabular de 41,2±1,7 en Rx y versión acetabular de 16±4,6 en TAC. La discrepancia de longitud de cadera varía de valores preoperatorios de −3,91mm (DE: 3,9; min −12, max 3) a 1,29mm (DE: 1,96) tras la cirugía registrados con Mako...(AU)

Objectives: Clinical, radiological and functional results of the first Spanish series of patients undergoing total hip arthroplasty assisted by Mako® (Stryker) robotic arm at the Hospital Clínico San Carlos (HCSC) in Madrid. Material and methods: Prospective and descriptive study analyzing the first 25 patients who underwent robotic-assisted THA at the HCSC, with a minimum follow-up of 4months. Demographics, imaging studies (Mako® processing, Rx and CT), clinical parameters, functionality (modified Harris) and associated complications were evaluated. Results: Average age was 67.2years (min 47, max 88), being 56% male population sample. 88% involves primary coxarthrosis, 4% post-traumatic coxarthrosis, 4% secondary avascular necrosis and 4% secondary femoroacetabular impingement. Average surgery time was 116.9min (min 92, max 150). The average time of the first five surgeries was 122.6min, and, regarding the last five interventions, it was 108.2min. Found medical intraoperative complications were four intraoperative markers loss. Average admission time was 4.4days (min 3, max 7), with an average postoperative hemoglobin decrease of 3.08±1.08g/dL, requiring a transfusion in 12% of the cases. Three medical complications have been registered in the meantime of the admission, with a relevant case of a confusional syndrome and a fall, which resulted in a non-displaced AG1 periprosthetic fracture. The analysis of the positioning of registered implants with Mako® system shows 40.55±1.53 acetabular inclination degrees and 12.2±3.6 acetabular anteversion degrees. The postoperative image study carried out on patients, are consistent with Mako® s results, as it shows an acetabular inclination of 41.2±1.7 in Rx, as well as acetabular anteversion of 16±4.6 in CT. Hip length variance ranges depending on preoperative values of 3.91mm (SD: 3.9; min −12, max 3) to 1.29mm (SD: 1.96) after surgery registered with...(AU)

[Translated article] Clinical results of total hip arthroplasty assisted by robotic arm in Spain: Preliminary study / Resultados clínicos de la artroplastia total de cadera asistida por brazo robótico en España: estudio preliminar

Objetivos: Resultados clínicos, radiológicos y funcionales de la primera serie española de pacientes intervenidos de artroplastia total de cadera (ATC) asistida mediante brazo robótico Mako® (Stryker) del Hospital Clínico San Carlos (HCSC) de Madrid. Material y métodos: Estudio descriptivo prospectivo que analiza los primeros 25 pacientes intervenidos de ATC asistida por robot (ATCaR) en el HCSC, con un seguimiento mínimo de 4meses. Se evaluaron la demografía, los estudios de imagen (procesamiento Mako®, Rx y TAC), los parámetros clínicos, la funcionalidad (Harris modificada) y las complicaciones asociadas. Resultados: La edad media fue 67,2años (min 47, max 88), siendo el 56% varones. El 88% corresponden a coxartrosis primaria, el 4% postraumática, el 4% secundaria a NAV y el 4% secundaria a choque femoroacetabular. El tiempo medio de cirugía fue de 116,9minutos (min 92, max 150). La media de las cinco primeras intervenciones fue 122,6minutos, y la de las cinco últimas, de 108,2minutos. Como complicaciones intraoperatorias se cuantificaron 4 pérdidas de marcadores intraoperatorios. El tiempo de ingreso medio fue 4,4días (min 3, max 7), con una disminución de hemoglobina posquirúrgica media de 3,08±1,08g/dl, requiriendo transfusión en el 12% de los casos. Se registran tres complicaciones médicas durante el ingreso, destacando un síndrome confusional con caída y fractura periprotésica AG1 no desplazada. El análisis del posicionamiento de los implantes registrados con sistema Mako® fueron 40,55±1,53 grados de inclinación y 12,2±3,6 grados de anteversión acetabular. El estudio de imagen posquirúrgico realizado a los pacientes, en concordancia con Mako®, muestra valores de inclinación acetabular de 41,2±1,7 en Rx y versión acetabular de 16±4,6 en TAC. La discrepancia de longitud de cadera varía de valores preoperatorios de −3,91mm (DE: 3,9; min −12, max 3) a 1,29mm (DE: 1,96) tras la cirugía registrados con Mako...(AU)

Objectives: Clinical, radiological and functional results of the first Spanish series of patients undergoing total hip arthroplasty assisted by Mako® (Stryker) robotic arm at the Hospital Clínico San Carlos (HCSC) in Madrid. Material and methods: Prospective and descriptive study analyzing the first 25 patients who underwent robotic-assisted THA at the HCSC, with a minimum follow-up of 4months. Demographics, imaging studies (Mako® processing, Rx and CT), clinical parameters, functionality (modified Harris) and associated complications were evaluated. Results: Average age was 67.2years (min 47, max 88), being 56% male population sample. 88% involves primary coxarthrosis, 4% post-traumatic coxarthrosis, 4% secondary avascular necrosis and 4% secondary femoroacetabular impingement. Average surgery time was 116.9min (min 92, max 150). The average time of the first five surgeries was 122.6min, and, regarding the last five interventions, it was 108.2min. Found medical intraoperative complications were four intraoperative markers loss. Average admission time was 4.4days (min 3, max 7), with an average postoperative hemoglobin decrease of 3.08±1.08g/dL, requiring a transfusion in 12% of the cases. Three medical complications have been registered in the meantime of the admission, with a relevant case of a confusional syndrome and a fall, which resulted in a non-displaced AG1 periprosthetic fracture. The analysis of the positioning of registered implants with Mako® system shows 40.55±1.53 acetabular inclination degrees and 12.2±3.6 acetabular anteversion degrees. The postoperative image study carried out on patients, are consistent with Mako® s results, as it shows an acetabular inclination of 41.2±1.7 in Rx, as well as acetabular anteversion of 16±4.6 in CT. Hip length variance ranges depending on preoperative values of 3.91mm (SD: 3.9; min −12, max 3) to 1.29mm (SD: 1.96) after surgery registered with...(AU)

[Translated article] Validation of the Spanish version of the modified Harris score / Validación de la versión española de la escala de Harris modificada

Objetivos: Resultados clínicos, radiológicos y funcionales de la primera serie española de pacientes intervenidos de artroplastia total de cadera (ATC) asistida mediante brazo robótico Mako® (Stryker) del Hospital Clínico San Carlos (HCSC) de Madrid. Material y métodos: Estudio descriptivo prospectivo que analiza los primeros 25 pacientes intervenidos de ATC asistida por robot (ATCaR) en el HCSC, con un seguimiento mínimo de 4meses. Se evaluaron la demografía, los estudios de imagen (procesamiento Mako®, Rx y TAC), los parámetros clínicos, la funcionalidad (Harris modificada) y las complicaciones asociadas. Resultados: La edad media fue 67,2años (min 47, max 88), siendo el 56% varones. El 88% corresponden a coxartrosis primaria, el 4% postraumática, el 4% secundaria a NAV y el 4% secundaria a choque femoroacetabular. El tiempo medio de cirugía fue de 116,9minutos (min 92, max 150). La media de las cinco primeras intervenciones fue 122,6minutos, y la de las cinco últimas, de 108,2minutos. Como complicaciones intraoperatorias se cuantificaron 4 pérdidas de marcadores intraoperatorios. El tiempo de ingreso medio fue 4,4días (min 3, max 7), con una disminución de hemoglobina posquirúrgica media de 3,08±1,08g/dl, requiriendo transfusión en el 12% de los casos. Se registran tres complicaciones médicas durante el ingreso, destacando un síndrome confusional con caída y fractura periprotésica AG1 no desplazada. El análisis del posicionamiento de los implantes registrados con sistema Mako® fueron 40,55±1,53 grados de inclinación y 12,2±3,6 grados de anteversión acetabular. El estudio de imagen posquirúrgico realizado a los pacientes, en concordancia con Mako®, muestra valores de inclinación acetabular de 41,2±1,7 en Rx y versión acetabular de 16±4,6 en TAC. La discrepancia de longitud de cadera varía de valores preoperatorios de −3,91mm (DE: 3,9; min −12, max 3) a 1,29mm (DE: 1,96) tras la cirugía registrados con Mako...(AU)

Objectives: Clinical, radiological and functional results of the first Spanish series of patients undergoing total hip arthroplasty assisted by Mako® (Stryker) robotic arm at the Hospital Clínico San Carlos (HCSC) in Madrid. Material and methods: Prospective and descriptive study analyzing the first 25 patients who underwent robotic-assisted THA at the HCSC, with a minimum follow-up of 4months. Demographics, imaging studies (Mako® processing, Rx and CT), clinical parameters, functionality (modified Harris) and associated complications were evaluated. Results: Average age was 67.2years (min 47, max 88), being 56% male population sample. 88% involves primary coxarthrosis, 4% post-traumatic coxarthrosis, 4% secondary avascular necrosis and 4% secondary femoroacetabular impingement. Average surgery time was 116.9min (min 92, max 150). The average time of the first five surgeries was 122.6min, and, regarding the last five interventions, it was 108.2min. Found medical intraoperative complications were four intraoperative markers loss. Average admission time was 4.4days (min 3, max 7), with an average postoperative hemoglobin decrease of 3.08±1.08g/dL, requiring a transfusion in 12% of the cases. Three medical complications have been registered in the meantime of the admission, with a relevant case of a confusional syndrome and a fall, which resulted in a non-displaced AG1 periprosthetic fracture. The analysis of the positioning of registered implants with Mako® system shows 40.55±1.53 acetabular inclination degrees and 12.2±3.6 acetabular anteversion degrees. The postoperative image study carried out on patients, are consistent with Mako® s results, as it shows an acetabular inclination of 41.2±1.7 in Rx, as well as acetabular anteversion of 16±4.6 in CT. Hip length variance ranges depending on preoperative values of 3.91mm (SD: 3.9; min −12, max 3) to 1.29mm (SD: 1.96) after surgery registered with...(AU)

El papel de la cirugía mínimamente invasiva de columna en el tratamiento de las metástasis vertebrales: una revisión narrativa / The role of minimally invasive spine surgery in the treatment of vertebral metastasis: A narrative review

Introducción: Las metástasis vertebrales son un problema muy frecuente y asocian un deterioro importante de la calidad de vida en los pacientes oncológicos. El objetivo de esta revisión es determinar el encaje de las técnicas quirúrgicas mínimamente invasivas dentro del manejo de esta entidad. Métodos: Se realizó una revisión bibliográfica en las bases de datos Google Scholar, PubMed, Scopus y Cochrane. Se revisaron los artículos publicados en los últimos 10 años que fueran de una relevancia y calidad adecuadas. Resultados: Tras el cribado de los 2.184 trabajos identificados inicialmente en las distintas bases de datos, se incluyeron un total de 24 artículos en esta revisión. Conclusión: La cirugía mínimamente invasiva de columna es especialmente útil en pacientes oncológicos frágiles con metástasis vertebrales por la reducida comorbilidad que presentan las técnicas que se engloban en ella en comparación con la de la cirugía abierta convencional. Los avances en tecnología aplicada a la cirugía, como la navegación y la robótica, mejoran la precisión y reducen las complicaciones de esta técnica.(AU)

Background: Spinal metastases are a very common problem which dramatically affects the quality of life of cancer patients. The objective of this review is to address the issue of how minimally invasive surgery can play an important role in treating this pathology. Methods: A literature review was performed, searching in the Google Scholar, PubMed, Scopus and Cochrane databases. Relevant and quality papers published within the last 10 years were included in the review. Results: After screening the 2184 initially identified registers, a total of 24 articles were included for review. Conclusion: Minimally invasive spine surgery is specially convenient for fragile cancer patients with spinal metastases, because of its reduced comorbidity compared to conventional open surgery. Technological advances in surgery, such as navigation and robotics, improve accuracy and safety in this technique.(AU)

[Translated article] The role of minimally invasive spine surgery in the treatment of vertebral metastasis: A narrative review / El papel de la cirugía mínimamente invasiva de columna en el tratamiento de las metástasis vertebrales: una revisión narrativa

Introducción: Las metástasis vertebrales son un problema muy frecuente y asocian un deterioro importante de la calidad de vida en los pacientes oncológicos. El objetivo de esta revisión es determinar el encaje de las técnicas quirúrgicas mínimamente invasivas dentro del manejo de esta entidad. Métodos: Se realizó una revisión bibliográfica en las bases de datos Google Scholar, PubMed, Scopus y Cochrane. Se revisaron los artículos publicados en los últimos 10 años que fueran de una relevancia y calidad adecuadas. Resultados: Tras el cribado de los 2.184 trabajos identificados inicialmente en las distintas bases de datos, se incluyeron un total de 24 artículos en esta revisión. Conclusión: La cirugía mínimamente invasiva de columna es especialmente útil en pacientes oncológicos frágiles con metástasis vertebrales por la reducida comorbilidad que presentan las técnicas que se engloban en ella en comparación con la de la cirugía abierta convencional. Los avances en tecnología aplicada a la cirugía, como la navegación y la robótica, mejoran la precisión y reducen las complicaciones de esta técnica.(AU)

Background: Spinal metastases are a very common problem which dramatically affects the quality of life of cancer patients. The objective of this review is to address the issue of how minimally invasive surgery can play an important role in treating this pathology. Methods: A literature review was performed, searching in the Google Scholar, PubMed, Scopus and Cochrane databases. Relevant and quality papers published within the last 10 years were included in the review. Results: After screening the 2184 initially identified registers, a total of 24 articles were included for review. Conclusion: Minimally invasive spine surgery is specially convenient for fragile cancer patients with spinal metastases, because of its reduced comorbidity compared to conventional open surgery. Technological advances in surgery, such as navigation and robotics, improve accuracy and safety in this technique.(AU)

El papel de la cirugía mínimamente invasiva de columna en el tratamiento de las metástasis vertebrales (parte 1): una revisión clínica / The role of minimally invasive spine surgery in the treatment of vertebral metastasis (part 1): A clinical review

Las metástasis espinales representan una importante carga sobre la calidad de vida en los pacientes afectados por una enfermedad oncológica activa, debido a la alta incidencia de síndromes dolorosos, deformidad espinal y deterioro neurológico. La cirugía juega un papel determinante a la hora de mejorar la calidad de vida mediante el control del dolor, el restablecimiento de la función neurológica y el mantenimiento de la estabilidad espinal, además de contribuir a la respuesta de la terapia médica. La cirugía mínimamente invasiva (MIS) es una opción de tratamiento en determinados pacientes con alto riesgo quirúrgico, ya que tiene una baja tasa de complicaciones, de sangrado intraoperatorio, de estancia hospitalaria y ofrece resultados similares a la cirugía abierta. Presentamos en esta revisión el papel de la MIS en esta enfermedad, y algunos casos tratados en nuestro centro hospitalario.(AU)

Spinal metastases represent a significant burden on the quality of life in patients affected by active oncological disease due to the high incidence of pain syndromes, spinal deformity, and neurological impairment. Surgery plays a decisive role in improving quality of life by controlling pain, restoring neurological function and maintaining spinal stability, as well as contributing to the response to medical therapy. Minimally invasive surgery (MIS) is a treatment option in certain patients with high surgical risk since it has a low rate of complications, intraoperative bleeding, hospital stay, and offers similar results to open surgery. In this review, we present the role of MIS in this pathology and some cases treated in our hospital.(AU)

[Translated article] The role of minimally invasive spine surgery in the treatment of vertebral metastasis (Part 1): A clinical review / El papel de la cirugía mínimamente invasiva de columna en el tratamiento de las metástasis vertebrales (parte 1): una revisión clínica

Las metástasis espinales representan una importante carga sobre la calidad de vida en los pacientes afectados por una enfermedad oncológica activa, debido a la alta incidencia de síndromes dolorosos, deformidad espinal y deterioro neurológico. La cirugía juega un papel determinante a la hora de mejorar la calidad de vida mediante el control del dolor, el restablecimiento de la función neurológica y el mantenimiento de la estabilidad espinal, además de contribuir a la respuesta de la terapia médica. La cirugía mínimamente invasiva (MIS) es una opción de tratamiento en determinados pacientes con alto riesgo quirúrgico, ya que tiene una baja tasa de complicaciones, de sangrado intraoperatorio, de estancia hospitalaria y ofrece resultados similares a la cirugía abierta. Presentamos en esta revisión el papel de la MIS en esta enfermedad, y algunos casos tratados en nuestro centro hospitalario.(AU)

Spinal metastases represent a significant burden on the quality of life in patients affected by active oncological disease due to the high incidence of pain syndromes, spinal deformity, and neurological impairment. Surgery plays a decisive role in improving quality of life by controlling pain, restoring neurological function and maintaining spinal stability, as well as contributing to the response to medical therapy. Minimally invasive surgery (MIS) is a treatment option in certain patients with high surgical risk since it has a low rate of complications, intraoperative bleeding, hospital stay, and offers similar results to open surgery. In this review, we present the role of MIS in this pathology and some cases treated in our hospital.(AU)

[Translated article] Clinical results of total hip arthroplasty assisted by robotic arm in Spain: Preliminary study.

OBJECTIVES: Clinical, radiological and functional results of the first Spanish series of patients undergoing total hip arthroplasty assisted by Mako® (Stryker) robotic arm at the Hospital Clínico San Carlos (HCSC) in Madrid. MATERIAL AND METHODS: Prospective and descriptive study analyzing the first 25 patients who underwent robotic-assisted THA at the HCSC, with a minimum follow-up of 4 months. Demographics, imaging studies (Mako® processing, Rx and CT), clinical parameters, functionality (modified Harris) and associated complications were evaluated. RESULTS: Average age was 67.2 years (min 47, max 88), being 56% male population sample. 88% involves primary coxarthrosis, 4% post-traumatic coxarthrosis, 4% secondary avascular necrosis and 4% secondary femoroacetabular impingement. Average surgery time was 116.9min (min 92, max 150). The average time of the first five surgeries was 122.6min, and, regarding the last five interventions, it was 108.2min. Found medical intraoperative complications were four intraoperative markers loss. Average admission time was 4.4days (min 3, max 7), with an average postoperative haemoglobin decrease of 3.08±1.08g/dl, requiring a transfusion in 12% of the cases. Three medical complications have been registered in the meantime of the admission, with a relevant case of a confusional syndrome and a fall, which resulted in a non-displaced AG1 periprosthetic fracture. The analysis of the positioning of registered implants with Mako® system shows 40.55±1.53 acetabular inclination degrees and 12.2±3.6 acetabular anteversion degrees. The postoperative image study carried out on patients, are consistent with Mako® results, as it shows an acetabular inclination of 41.2±1.7 in Rx, as well as acetabular anteversion of 16±4.6 in CT. Hip length variance ranges depending on preoperative values of 3.91mm (SD: 3.9; min -12, max 3) to 1.29mm (SD: 1.96) after surgery registered with Mako®, with an increase of an average hip length of 5.64mm (SD: 3.35). Rx simple study results show a postoperative difference between both hips of 0.5±3.08mm, which is consistent with Mako® results. Native femoral offset was stable after surgery with a showing difference both pre and post operative of the intervened hip of 0.1mm (SD: 3.7), registered with Mako®. Preoperatory modified Harris punctuation was 41.6±13.3, improving to postoperative values of 74.6±9.7 after four months since the surgery. No complications were registered in immediate postoperative (4 months). CONCLUSIONS: Total hip arthroplasty robot-assisted achieves an adequate precision and repeatability of the implant positioning and the postoperative hip dysmetry without showing an increase of associated complications to the technique applied. Surgery time, complications and functional results in a short-time period are similar to conventional techniques applied to great series previously published.

[Translated article] The role of minimally invasive spine surgery in the treatment of vertebral metastasis: A narrative review.

BACKGROUND: Spinal metastases are a very common problem which dramatically affects the quality of life of cancer patients. The objective of this review is to address the issue of how minimally invasive surgery can play an important role in treating this pathology. METHODS: A literature review was performed, searching in the Google Scholar, PubMed, Scopus and Cochrane databases. Relevant and quality papers published within the last 10 years were included in the review. RESULTS: After screening the 2184 initially identified registers, a total of 24 articles were included for review. CONCLUSION: Minimally invasive spine surgery is specially convenient for fragile cancer patients with spinal metastases, because of its reduced comorbidity compared to conventional open surgery. Technological advances in surgery, such as navigation and robotics, improve accuracy and safety in this technique.

[Translated article] The role of minimally invasive spine surgery in the treatment of vertebral metastasis (Part 1): A clinical review.

Spinal metastases represent a significant burden on the quality of life in patients affected by active oncological disease due to the high incidence of pain syndromes, spinal deformity, and neurological impairment. Surgery plays a decisive role in improving quality of life by controlling pain, restoring neurological function and maintaining spinal stability, as well as contributing to the response to medical therapy. Minimally invasive surgery (MIS) is a treatment option in certain patients with high surgical risk since it has a low rate of complications, intraoperative bleeding, hospital stay, and offers similar results to open surgery. In this review, we present the role of MIS in this pathology and some cases treated in our hospital.

The role of minimally invasive spine surgery in the treatment of vertebral metastasis (part 1): A clinical review. / El papel de la cirugía mínimamente invasiva de columna en el tratamiento de las metástasis vertebrales (parte 1): una revisión clínica.

Spinal metastases represent a significant burden on the quality of life in patients affected by active oncological disease due to the high incidence of pain syndromes, spinal deformity, and neurological impairment. Surgery plays a decisive role in improving quality of life by controlling pain, restoring neurological function and maintaining spinal stability, as well as contributing to the response to medical therapy. Minimally invasive surgery (MIS) is a treatment option in certain patients with high surgical risk since it has a low rate of complications, intraoperative bleeding, hospital stay, and offers similar results to open surgery. In this review, we present the role of MIS in this pathology and some cases treated in our hospital.

Clinical results of total hip arthroplasty assisted by robotic arm in Spain: Preliminary study. / Resultados clínicos de artroplastia total de cadera asistida por brazo robótico en España: estudio preliminar.

OBJECTIVES: Clinical, radiological and functional results of the first Spanish series of patients undergoing total hip arthroplasty assisted by Mako® (Stryker) robotic arm at the Hospital Clínico San Carlos (HCSC) in Madrid. MATERIAL AND METHODS: Prospective and descriptive study analyzing the first 25 patients who underwent robotic-assisted THA at the HCSC, with a minimum follow-up of 4months. Demographics, imaging studies (Mako® processing, Rx and CT), clinical parameters, functionality (modified Harris) and associated complications were evaluated. RESULTS: Average age was 67.2years (min 47, max 88), being 56% male population sample. 88% involves primary coxarthrosis, 4% post-traumatic coxarthrosis, 4% secondary avascular necrosis and 4% secondary femoroacetabular impingement. Average surgery time was 116.9min (min 92, max 150). The average time of the first five surgeries was 122.6min, and, regarding the last five interventions, it was 108.2min. Found medical intraoperative complications were four intraoperative markers loss. Average admission time was 4.4days (min 3, max 7), with an average postoperative hemoglobin decrease of 3.08±1.08g/dL, requiring a transfusion in 12% of the cases. Three medical complications have been registered in the meantime of the admission, with a relevant case of a confusional syndrome and a fall, which resulted in a non-displaced AG1 periprosthetic fracture. The analysis of the positioning of registered implants with Mako® system shows 40.55±1.53 acetabular inclination degrees and 12.2±3.6 acetabular anteversion degrees. The postoperative image study carried out on patients, are consistent with Mako® s results, as it shows an acetabular inclination of 41.2±1.7 in Rx, as well as acetabular anteversion of 16±4.6 in CT. Hip length variance ranges depending on preoperative values of 3.91mm (SD: 3.9; min -12, max 3) to 1.29mm (SD: 1.96) after surgery registered with Mako®, with an increase of an average hip length of 5.64mm (SD: 3.35). Rx simple study results show a postoperative difference between both hips of 0.5±3.08mm, which is consistent with Mako® results. Native femoral offset was stable after surgery with a showing difference both pre and post operative of the intervened hip of 0.1mm (SD: 3.7), registered with Mako®. Preoperatory modified Harris punctuation was 41.6±13.3, improving to postoperative values of 74.6±9.7 after four months since the surgery. No complications were registered in immediate postoperative (4month). CONCLUSIONS: Total hip arthroplasty robot-assisted achieves an adequate precision and repeatability of the implant positioning and the postoperative hip dysmetry without showing an increase of associated complications to the technique applied. Surgery time, complications and functional results in a short-time period are similar to conventional techniques applied to great series previously published.

The role of minimally invasive spine surgery in the treatment of vertebral metastasis: A narrative review. / El papel de la cirugía mínimamente invasiva de columna en el tratamiento de las metástasis vertebrales: una revisión narrativa.

BACKGROUND: Spinal metastases are a very common problem which dramatically affects the quality of life of cancer patients. The objective of this review is to address the issue of how minimally invasive surgery can play an important role in treating this pathology. METHODS: A literature review was performed, searching in the Google Scholar, PubMed, Scopus and Cochrane databases. Relevant and quality papers published within the last 10 years were included in the review. RESULTS: After screening the 2184 initially identified registers, a total of 24 articles were included for review. CONCLUSION: Minimally invasive spine surgery is specially convenient for fragile cancer patients with spinal metastases, because of its reduced comorbidity compared to conventional open surgery. Technological advances in surgery, such as navigation and robotics, improve accuracy and safety in this technique.

[Impact of COVID-19 pandemic confinement on musculoskeletal pain and quality of life]. / Impacto del confinamiento por la pandemia COVID-19 en el dolor musculoesquelético y la calidad de vida.

INTRODUCTION: in March 2020, lockdown was established in Spain because of the COVID-19 pandemic. The aim of this study is to assess its impact on pain and quality of life in patients with musculoskeletal pain. MATERIAL AND METHODS: prospective study including 490 individuals grouped in: 140 people without pain, 140 people with musculoskeletal pain but without any related pathology diagnosed, 140 patients diagnosed for a musculoskeletal condition and 70 patients in surgical waiting list (SWL) for a musculoskeletal condition. Data regarding pain, physical activity and quality of life (EuroQol-5D) was collected at the beginning of lockdown and one year after (March 2021). RESULTS: mean age was 53 ± 17.5 years old (18-88) and 51.3% were women. Patients in SWL referred significantly more pain than the rest of groups (p < 0.001), with a score in the visual analogue scale of 6.3 ± 1.9. Groups 3 and 4 suffered a significant increase of their pain from 2020 to 2021 (p < 0.001), while decreasing in group 2 (p < 0.001). Analgesics intake grew from 2020 to 2021 (39.9% versus 44.3%, p = 0.007). 70.2% experienced a worsening of at least one dimension of EuroQol-5D over last year, with patients in SWL being the most affected (p < 0.001). CONCLUSION: lockdown has caused in patients with musculoskeletal conditions a greater aggravation of pain and deterioration of quality of life than in the general population, especially in patients in SWL, translating in an increase in analgesics intake.

INTRODUCCIÓN: en Marzo de 2020 se estableció el confinamiento en España debido a la pandemia por COVID-19. El objetivo de este estudio es determinar su impacto en el dolor y la calidad de vida de personas con dolor osteomuscular. MATERIAL Y MÉTODOS: estudio prospectivo que incluyó 490 personas agrupadas en: 140 personas sin dolor (grupo 1), 140 personas con dolor osteomuscular, pero sin patología diagnosticada (grupo 2), 140 pacientes con patología musculoesquelética (grupo 3) y 70 pacientes en lista de espera quirúrgica (LEQ) por patología musculoesquelética (grupo 4). Se recogieron datos sobre el dolor, la actividad física y la calidad de vida (EuroQol-5D) al inicio del confinamiento y un año después. RESULTADOS: la edad media fue de 53 ± 17.5 años (18-88) y 51.3% fueron mujeres. Las personas en LEQ refirieron un dolor significativamente mayor que el resto de grupos (p < 0.001) con una puntuación en la escala visual analógica del dolor de 6.3 ± 1.9. Los grupos 3 y 4 sufrieron un aumento significativo de su dolor desde 2020 hasta 2021 (p < 0.001), mientras que en el grupo 2 disminuyó (p < 0.001). El consumo de analgésicos creció de 2020 a 2021 (39.9% versus 44.3%, p = 0.007); 70.2% sufrió un empeoramiento en alguna de las dimensiones del EuroQol-5D, siendo el grupo en LEQ el más afectado (p < 0.001). CONCLUSIONES: el confinamiento ha producido en pacientes con patología musculoesquelética un empeoramiento del dolor y de calidad de vida mayor que en el resto de personas, especialmente en aquéllas en espera de cirugía, traduciéndose en un aumento del consumo de analgésicos.

Impacto del confinamiento por la pandemia COVID-19 en el dolor musculoesquelético y la calidad de vida / Impact of COVID-19 pandemic confinement on musculoskeletal pain and quality of life

Resumen: Introducción: En Marzo de 2020 se estableció el confinamiento en España debido a la pandemia por COVID-19. El objetivo de este estudio es determinar su impacto en el dolor y la calidad de vida de personas con dolor osteomuscular. Material y métodos: Estudio prospectivo que incluyó 490 personas agrupadas en: 140 personas sin dolor (grupo 1), 140 personas con dolor osteomuscular, pero sin patología diagnosticada (grupo 2), 140 pacientes con patología musculoesquelética (grupo 3) y 70 pacientes en lista de espera quirúrgica (LEQ) por patología musculoesquelética (grupo 4). Se recogieron datos sobre el dolor, la actividad física y la calidad de vida (EuroQol-5D) al inicio del confinamiento y un año después. Resultados: La edad media fue de 53 ± 17.5 años (18-88) y 51.3% fueron mujeres. Las personas en LEQ refirieron un dolor significativamente mayor que el resto de grupos (p < 0.001) con una puntuación en la escala visual analógica del dolor de 6.3 ± 1.9. Los grupos 3 y 4 sufrieron un aumento significativo de su dolor desde 2020 hasta 2021 (p < 0.001), mientras que en el grupo 2 disminuyó (p < 0.001). El consumo de analgésicos creció de 2020 a 2021 (39.9% versus 44.3%, p = 0.007); 70.2% sufrió un empeoramiento en alguna de las dimensiones del EuroQol-5D, siendo el grupo en LEQ el más afectado (p < 0.001). Conclusiones: El confinamiento ha producido en pacientes con patología musculoesquelética un empeoramiento del dolor y de calidad de vida mayor que en el resto de personas, especialmente en aquéllas en espera de cirugía, traduciéndose en un aumento del consumo de analgésicos.

Abstract: Introduction: In March 2020, lockdown was established in Spain because of the COVID-19 pandemic. The aim of this study is to assess its impact on pain and quality of life in patients with musculoskeletal pain. Material and methods: Prospective study including 490 individuals grouped in: 140 people without pain, 140 people with musculoskeletal pain but without any related pathology diagnosed, 140 patients diagnosed for a musculoskeletal condition and 70 patients in surgical waiting list (SWL) for a musculoskeletal condition. Data regarding pain, physical activity and quality of life (EuroQol-5D) was collected at the beginning of lockdown and one year after (March 2021). Results: Mean age was 53 ± 17.5 years old (18-88) and 51.3% were women. Patients in SWL referred significantly more pain than the rest of groups (p < 0.001), with a score in the visual analogue scale of 6.3 ± 1.9. Groups 3 and 4 suffered a significant increase of their pain from 2020 to 2021 (p < 0.001), while decreasing in group 2 (p < 0.001). Analgesics intake grew from 2020 to 2021 (39.9% versus 44.3%, p = 0.007). 70.2% experienced a worsening of at least one dimension of EuroQol-5D over last year, with patients in SWL being the most affected (p < 0.001). Conclusion: Lockdown has caused in patients with musculoskeletal conditions a greater aggravation of pain and deterioration of quality of life than in the general population, especially in patients in SWL, translating in an increase in analgesics intake.

Arteriovenograma de cemento óseo en artroplastia de cadera / Cement arteriovenogram after hip arthroplasty

Las altas presiones intramedulares que se alcanzan durante la cementación en la artroplastia de cadera pueden producir la extrusión de este cemento hacia los vasos nutricios femorales, generando una imagen radiográfica característica (arteriovenograma de cemento o cementograma). Presentamos una serie de 14 casos de pacientes intervenidos mediante artroplastia de cadera cementada en los que se observó un cementograma como hallazgo postoperatorio. Ninguno de estos pacientes sufrió complicaciones locales o sistémicas tras la cementación ni durante un seguimiento medio de 3 años. El cementograma es un hallazgo radiográfico postoperatorio que da cuenta de una buena presurización del cemento durante la cirugía y que no se asocia a complicaciones médicas ni a fracturas alrededor del implante femoral

Modern cement implantation techniques during hip arthroplasty rely on high intramedullary pressures which can result in cement extrusion towards femoral nutrient vessels, and thus, the occurrence of a particular image in postoperative radiographs (bone cement arterio-venogram). We report a case series of 14 patients in whom a bone cement arterio-venogram was observed after undergoing a cemented hip arthroplasty. No local or systemic complications developed after cementing nor during a mean follow-up of three years. Bone cement arterio-venogram is a radiologic sign that indicates a good cement pressurisation during surgery and is not associated to medical complications or periprosthetic femoral fractures

Cement arteriovenogram after hip arthroplasty. / Arteriovenograma de cemento óseo en artroplastia de cadera.

Modern cement implantation techniques during hip arthroplasty rely on high intramedullary pressures which can result in cement extrusion towards femoral nutrient vessels, and thus, the occurrence of a particular image in postoperative radiographs (bone cement arterio-venogram). We report a case series of 14 patients in whom a bone cement arterio-venogram was observed after undergoing a cemented hip arthroplasty. No local or systemic complications developed after cementing nor during a mean follow-up of three years. Bone cement arterio-venogram is a radiologic sign that indicates a good cement pressurisation during surgery and is not associated to medical complications or periprosthetic femoral fractures.

Fluidoterapia de mantenimiento administrada en un hospital terciario: estudio de prevalencia / Maintenance fluid therapy in a tertiary hospital: a prevalence study

Objetivos. Evaluar el tipo de «fluidos/sueros» de mantenimiento administrados en nuestro hospital, y comparar como se ajustan a las recomendaciones actuales, tanto en volumen como en composición. Material y métodos. Estudio observacional y transversal. Se registró el volumen y tipo de fluidoterapia de mantenimiento que se pautaba durante 24h a pacientes ingresados en diferentes servicios del hospital. Se excluyeron aquellos en los que la administración de líquidos estuviese condicionada por un exceso o déficit de líquidos y electrólitos. Resultados. Se recogieron los datos de 198 pacientes, de los cuales 74 (37,4%) fueron excluidos por no cumplir los criterios de inclusión. El volumen medio administrado fue de 2.500cc/día. La dosis media de glucosa fue de 36g cada 24h (DE: 31,4). La combinación más frecuente incluyó suero salino fisiológico (SSF) con glucosado 5% (64,4% de los casos). La cantidad media de sodio administrada en 24h fue de 173mEq (DE: 74,8) y la de cloro de 168mEq (DE: 75), lo que supone superávit de +87,4mEq y +85mEq, respectivamente. En relación con el potasio, magnesio y calcio, el déficit fue de -50mEq, -22mEq y -21mEq día, respectivamente. La administración de sustancias buffer fue excepcional, siendo las más frecuentemente utilizadas el bicarbonato (2,29%), acetato (1,29%), lactato (1,15%) y gluconato (1,10%). Conclusión. El SSF es la solución más frecuentemente utilizada. En contraste con el exceso de sodio y cloro habitualmente pautado, la cantidad de otros iones, como potasio, magnesio, sustancias buffer y aporte calórico, es muy deficitaria (AU)

Objective. To assess the types of maintenance fluids used in our hospital, comparing their volume and composition to the standards recommended by the guidelines. Material and methods. Observational, cross-sectional study. Volume and type of fluid therapy administered during 24h to patients admitted to various hospital departments were recorded. Patients receiving fluid therapy because of water-electrolyte imbalance were excluded. Results. Out of 198 patients registered, 74 (37.4%) were excluded because they did not meet the criteria for inclusion. Mean administered volume was 2,500cc/day. Mean daily glucose dose was 36g per 24h (SD: 31.4). The most frequent combination included normal saline solution (NSS) and glucose 5% (64.4%). Mean daily dose of sodium and chlorine was, respectively, 173mEq (SD: 74.8) and 168mEq (SD: 75), representing a surplus daily dose of +87.4mEq and +85mEq. Potassium, magnesium and calcium daily deficit was, respectively, -50mEq, -22mEq and -21mEq per day. Buffer administration was exceptional, bicarbonate (2.29%), acetate (1.29%), lactate (1.15%) and gluconate (1.10%) being the buffering agents most frequently used. Conclusion. NNS is the most frequently used solution. In contrast to excess doses of sodium and chlorine, there is a great deficit of other ions, buffering agents and caloric intake in the fluid therapy regimens that are usually prescribed (AU)

Maintenance fluid therapy in a tertiary hospital: A prevalence study. / Fluidoterapia de mantenimiento administrada en un hospital terciario: estudio de prevalencia.

OBJECTIVE: To assess the types of maintenance fluids used in our hospital, comparing their volume and composition to the standards recommended by the guidelines. MATERIAL AND METHODS: Observational, cross-sectional study. Volume and type of fluid therapy administered during 24h to patients admitted to various hospital departments were recorded. Patients receiving fluid therapy because of water-electrolyte imbalance were excluded. RESULTS: Out of 198 patients registered, 74 (37.4%) were excluded because they did not meet the criteria for inclusion. Mean administered volume was 2,500cc/day. Mean daily glucose dose was 36g per 24h (SD: 31.4). The most frequent combination included normal saline solution (NSS) and glucose 5% (64.4%). Mean daily dose of sodium and chlorine was, respectively, 173mEq (SD: 74.8) and 168mEq (SD: 75), representing a surplus daily dose of +87.4mEq and +85mEq. Potassium, magnesium and calcium daily deficit was, respectively, -50mEq, -22mEq and -21mEq per day. Buffer administration was exceptional, bicarbonate (2.29%), acetate (1.29%), lactate (1.15%) and gluconate (1.10%) being the buffering agents most frequently used. CONCLUSION: NNS is the most frequently used solution. In contrast to excess doses of sodium and chlorine, there is a great deficit of other ions, buffering agents and caloric intake in the fluid therapy regimens that are usually prescribed.