[Surgical treatment of distal biceps tendon ruptures with bone anchors using a single anterior approach]. / Tratamiento quirúrgico de las roturas del tendón distal del bíceps con anclajes óseos por abordaje anterior único.

PURPOSE: To evaluate the clinical results of reinsertion of the distal biceps tendon with anterior bone anchors. MATERIAL AND METHODS: A retrospective study was conducted on 79 patients who underwent reinsertion of the distal biceps tendon with anterior bone anchors. The mean age was 46 years (range, 32-64). Two anchors were used in 57% of cases, and one anchor in 43%. The same postoperative protocol was performed in all patients. Functional assessment was made using a Motor evoked potentials (MEPS) functional scale. The mean of follow-up time was 20 months (range, 12 -28 months). RESULTS: The final mean of MEPS score was 95.2 points (SD 6.8). Almost all (94%) patients had excellent and good results, and 6% a bad result. No differences were observed when comparing functional outcome among patients in whom one anchor was used (96 points) with those in whom two anchors were used (95 points), p=0.5. The mean time off work was 14 weeks (range, 5-56) and 100% of patients were able to return to work. The incidence of complications was 13%. The most frequent was neuropraxia of the lateral antebrachial cutaneous nerve. CONCLUSION: The anatomic re-attachment of the distal biceps tendon with bone anchors using a single anterior approach is a safe technique that offers excellent and good functional results in the medium term.

[Knee arthrodesis in rescue surgery: a study of 18 cases]. / Artrodesis de rodilla en cirugía de rescate: estudio de 18 casos.

BACKGROUND: The aim of the study is evaluate the functional outcome, complications and general health in patients undergoing knee arthrodesis. PATIENTS AND METHODS: Eighteen patients undergoing knee arthrodesis due to contraindication of primary or revision of a total knee arthroplasty (TKA). Anatomical arthrodesis was performed if there was a good contact of the two bone surfaces, whereas if it was not possible to achieve adequate femoral-tibial contact, artificial arthrodesis was performed. Function was assessed using the WOMAC score, and the health status using the SF-36. RESULTS: Four patients were diagnosed with anatomical non-union arthrodesis and required a secondary surgical procedure to achieve fusion. Patients with artificial fusion did not have any secondary procedure. Patients less than 65 years-old and the patients with anatomical fusion had a better outcome in the physical role and body pain area using the SF-36 score. WOMAC index outcomes were similar in all patients, regardless of age and fusion type. CONCLUSIONS: Anatomical and artificial arthrodesis of the knee achieved pain relief, acceptable function of the limb and an adequate quality of life, with the best results in patients less than 65 years-old.

Tratamiento quirúrgico de las roturas del tendón distal del bíceps con anclajes óseos por abordaje anterior único / Surgical treatment of distal biceps tendon ruptures with bone anchors using a single anterior approach

Objetivo. Valorar los resultados clínicos de la reinserción del tendón distal del bíceps con anclajes óseos por vía anterior. Material y métodos. Estudio retrospectivo de 79 pacientes en los que se realizó la reinserción del tendón distal del bíceps con anclajes metálicos óseos por vía anterior. El promedio de edad fue de 46 años (rango, 32-64). En el 57% de los casos se utilizaron dos anclajes y en el 43% un anclaje. Todos los pacientes realizaron el mismo protocolo postoperatorio. Se hizo una valoración funcional con la escala funcional MEPS. El promedio de tiempo de seguimiento fue de 20 meses (rango: 12-28). Resultados. La puntuación final media de la escala MEPS fue de 95,2 pts (DE 6,8). El 94% de los pacientes tuvieron resultado excelente y bueno y en el 6% el resultado fue aceptable y pobre. No se observaron diferencias al comparar el resultado funcional entre los pacientes en los que se utilizó un anclaje (96 puntos) con aquellos en los que se utilizaron dos anclajes (95 puntos), p = 0,5. El tiempo promedio de baja laboral fue de 14 semanas (rango, 5-56) pudiendo reincorporarse a su trabajo el 100% de los pacientes. La incidencia de complicaciones fue del 13%, siendo la más frecuente la neuroapraxia del nervio cutáneo antebraquial lateral. Conclusiones. La reinserción anatómica del tendón distal del bíceps con anclajes óseos por vía anterior única es una técnica segura que ofrece resultados funcionales excelentes y buenos a mediano plazo (AU)

Purpose. To evaluate the clinical results of reinsertion of the distal biceps tendon with anterior bone anchors. Material and methods. A retrospective study was conducted on 79 patients who underwent reinsertion of the distal biceps tendon with anterior bone anchors. The mean age was 46 years (range, 32-64). Two anchors were used in 57% of cases, and one anchor in 43%. The same postoperative protocol was performed in all patients. Functional assessment was made using a Motor evoked potentials (MEPS) functional scale. The mean of follow-up time was 20 months (range, 12 -28 months). Results. The final mean of MEPS score was 95.2 points (SD 6.8). Almost all (94%) patients had excellent and good results, and 6% a bad result. No differences were observed when comparing functional outcome among patients in whom one anchor was used (96 points) with those in whom two anchors were used (95 points), p = 0.5. The mean time off work was 14 weeks (range, 5-56) and 100% of patients were able to return to work. The incidence of complications was 13%. The most frequent was neuropraxia of the lateral antebrachial cutaneous nerve. Conclusion. The anatomic re-attachment of the distal biceps tendon with bone anchors using a single anterior approach is a safe technique that offers excellent and good functional results in the medium term (AU)

Artrodesis de rodilla en cirugía de rescate: estudio de 18 casos / Knee arthrodesis in rescue surgery: a study of 18 cases

Objetivo. Evaluar el resultado funcional, la incidencia de complicaciones y el estado general de salud de los pacientes con artrodesis de rodilla. Pacientes y métodos. Estudio retrospectivo de 18 pacientes con artrodesis de rodilla, en los que debido al fallo irreparable del aparato extensor, problemas de cobertura cutánea o afectación severa de la superficie ósea no estaba indicada una prótesis total de rodilla. Se realizó una artrodesis anatómica si había un buen contacto de las 2 superficies óseas. Si no era posible un contacto adecuado femorotibial se realizó una artrodesis artificial. Al final del seguimiento se hizo una valoración funcional con el cuestionario WOMAC y del estado general de salud con el SF-36. Resultados. De los 13 pacientes con artrodesis anatómica de rodilla consiguieron la fusión primaria 9 (69,2%) y 4 (30,7%) presentaron seudoartrosis los cuales necesitaron un procedimiento quirúrgico secundario para conseguir la fusión. Ninguno de los pacientes con artrodesis artificial precisó otro procedimiento. Los pacientes con artrodesis anatómica y los menores de 65 años obtuvieron la puntuación más alta en la esfera de rol físico, vitalidad y dolor corporal del SF-36. Los resultados del cuestionario WOMAC fueron parecidos en todos los pacientes independientemente de la edad y del tipo de artrodesis. Conclusiones. La artrodesis de rodilla es una opción en cirugía de rescate, logrando con ambos métodos de artrodesis (artificial y anatómica) el alivio del dolor, una correcta función de la extremidad y una calidad de vida aceptable, consiguiendo los mejores resultados en los pacientes menores de 65 y en aquellos con artrodesis anatómica (AU)

Background. The aim of the study is evaluate the functional outcome, complications and general health in patients undergoing knee arthrodesis. Patients and methods. Eighteen patients undergoing knee arthrodesis due to contraindication of primary or revision of a total knee arthroplasty (TKA). Anatomical arthrodesis was performed if there was a good contact of the two bone surfaces, whereas if it was not possible to achieve adequate femoral-tibial contact, artificial arthrodesis was performed. Function was assessed using the WOMAC score, and the health status using the SF-36. Results. Four patients were diagnosed with anatomical non-union arthrodesis and required a secondary surgical procedure to achieve fusion. Patients with artificial fusion did not have any secondary procedure. Patients less than 65 years-old and the patients with anatomical fusion had a better outcome in the physical role and body pain area using the SF-36 score. WOMAC index outcomes were similar in all patients, regardless of age and fusion type. Conclusions. Anatomical and artificial arthrodesis of the knee achieved pain relief, acceptable function of the limb and an adequate quality of life, with the best results in patients less than 65 years-old (AU)