Evidencia limitada de que la presencia de un hematoma en los huesos solo afecta el resultado clínico del ligamento cruzado anterior reconstruido quirúrgicamente: una revisión sistemática

http://jointsolutions-ortotraumadeportiva.blogsyte.com/index.php/2018/10/05/evidencia-limitada-de-que-la-presencia-de-un-hematoma-en-los-huesos-solo-afecta-el-resultado-clinico-del-ligamento-cruzado-anterior-reconstruido-quirurgicamente-una-revision-sistematica/

https://jisakos.bmj.com/content/2/4/186.2?hootPostID=83a1d7a26e4dc8b24ba7a6e3635b2fac


La lesión del ligamento cruzado anterior (LCA) puede ser una lesión devastadora que, sin cirugía, puede conducir a una inestabilidad crónica. Aunque la reconstrucción quirúrgica recrea la restricción estabilizadora de la LCA nativa, puede seguir el dolor postoperatorio y la artrosis posterior.

Aunque la lesión osteocondral se identifica con frecuencia después de la lesión de la LCA, la presencia de un hematoma en los huesos por sí sola no parece afectar significativamente el resultado clínico de las LCA reconstruidas quirúrgicamente. Sin embargo, factores como la lesión del cartílago articular y la alteración de la carga articular pueden ser variables importantes para futuras investigaciones.



Title
Limited evidence that the presence of a bone bruise alone affects the clinical outcome of surgically reconstructed anterior cruciate ligaments: a systematic review
Published in
JISAKOS, July 2017
DOI 10.1136/jisakos-2016-000117
Pubmed ID
28845301
Authors
Brian E Walczak, Cody Lukes, Ned Amendola, Warren R Dunn

Copyright information: © International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (unless otherwise stated in the text of the article) 2017. All rights reserved.

Online: ISSN 2059-7762Print: ISSN 2059-7754
Copyright © American Federation for Medical Research
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Componentes glenoideos sin cemento versus componentes cementados en la artroplastia total de hombro convencional: análisis del Registro Nacional de Reemplazo de Articulaciones de la Asociación Australiana de Ortopedia.

http://www.mihombroycodo.com.mx/academia/componentes-glenoideos-sin-cemento-versus-componentes-cementados-en-la-artroplastia-total-de-hombro-convencional-analisis-del-registro-nacional-de-reemplazo-de-articulaciones-de-la-asociacion-austral/

El aflojamiento glenoideo es un modo común de falla después de la artroplastia total de hombro (TSA). Se han introducido nuevos componentes glenoideos sin cemento para promover la fijación biológica con el objetivo de disminuir el aflojamiento glenoideo. Se dispone de datos limitados que comparan las tasas de revisión entre la fijación glenoidea cementada y no cementada en TSA. El objetivo del estudio fue comparar las tasas de revisión de los componentes glenoideos de diseño cementado y sin cemento utilizados en la TSA convencional realizada para el diagnóstico de osteoartritis. El objetivo secundario fue comparar varias subclases de componentes glenoideos.

Los componentes glenoideos sin cemento en la TSA convencional tuvieron una tasa de revisión significativamente más alta que los componentes glenoideos cementados. Las tasas de aflojamiento entre los componentes glenoideos cementados y no cementados fueron similares. El diseño y la fijación de los glenoides son consideraciones importantes al seleccionar una prótesis para TSA.

       

https://www.ncbi.nlm.nih.gov/pubmed/29752154

https://www.jshoulderelbow.org/article/S1058-2746(18)30226-X/fulltext

J Shoulder Elbow Surg. 2018 Oct;27(10):1859-1865. doi: 10.1016/j.jse.2018.03.017. Epub 2018 May 8.

Cementless versus cemented glenoid components in conventional total shoulder joint arthroplasty: analysis from the Australian Orthopaedic Association National Joint Replacement Registry.

Page RS¹, Pai V², Eng K², Bain G³, Graves S⁴, Lorimer M⁵.

Copyright © 2018 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Lesiones de ligamento cruzado anterior

http://www.clinicadeartroscopia.com.mx/academia/lesiones-de-ligamento-cruzado-anterior/


En los últimos 15 años, hemos visto que el número de reconstrucciones de LCA ha aumentado en más del 70% en los menores de 25 años. Y si observamos a atletas jóvenes, les va peor a las mujeres son más sensibles
Observando solo el reciente informe de lesiones de mujeres de la AFL en los últimos 2 años, las atletas femeninas tuvieron una tasa de lesiones de ACL promedio de 5 por 1000 jugadores por hora. En comparación, en 2017, los atletas masculinos de AFL sufren lesiones de ACL a una tasa de 0.7 por 1000 jugadores por hora.
Estoy seguro de que el mundo no es tan diferente a lo que está debajo. Lo preocupante es que el 50% de todas las lesiones de ACL son PREVENIBLES.🤔🤔😷😷😷 lo dudo muchoh!!

Los pacientes prefieren las clínicas virtuales de fracturas , los resultados son comparables, y los costes se reducen.

http://ortopediaytraumatologia.sytes.net/index.php/2018/09/27/los-pacientes-prefieren-las-clinicas-virtuales-de-fracturas-los-resultados-son-comparables-y-los-costes-se-reducen/
La Edinburgh Truma Triage Clinic (TTC) agiliza la atención ambulatoria a través de la clasificación “virtual” dirigida por consultores y el alta directa de fracturas menores del Departamento de Emergencias. Comparamos los resultados de los pacientes para las fracturas simples de la cabeza radial, el metacarpiano y el quinto metatarsiano antes y después de la implementación del TTC.

El manejo de las fracturas menores a través del TTC de Edimburgo produce resultados clínicos comparables con el sistema anterior de consulta presencial de rutina. La carga de trabajo ambulatorio para estas lesiones se redujo en un 88%.

https://www.ncbi.nlm.nih.gov/pubmed/29954208

https://online.boneandjoint.org.uk/doi/abs/10.1302/0301-620X.100B7.BJJ-2017-1388.R2

Bone Joint J. 2018 Jul;100-B(7):959-965. doi: 10.1302/0301-620X.100B7.BJJ-2017-1388.R2.

Discharged but not dissatisfied: outcomes and satisfaction of patients discharged from the Edinburgh Trauma Triage Clinic.

Mackenzie SP1, Carter TH1, Jefferies JG2, Wilby JBJ1, Hall P3, Duckworth AD1, Keating JF1, White TO1.

 

PMID: 29954208 DOI: 10.1302/0301-620X.100B7.BJJ-2017-1388.R2

 

© 2018 The British Editorial Society of Bone & Joint Surgery. Registered charity no: 209299.

http://myemail.constantcontact.com/Dolor-cr-nico-postoperatorio---Chronic-postsurgical-pain.html?soid=1101929420180&aid=j-GcFJbX0PM

http://myemail.constantcontact.com/Dolor-cr-nico-postoperatorio---Chronic-postsurgical-pain.html?soid=1101929420180&aid=j-GcFJbX0PM

Analgesia regional, ERAS, cirugía de tórax / Regional analgesia, ERAS protocols, thoracic surgery

Septiembre  10, 2018. No. 3182

Viaje Culinario en Chiapas El papel de las técnicas de anestesia local en los protocolos ERAS para cirugía torácica. The role of local anaesthetic techniques in ERAS protocols for thoracic surgery. Crumley S1, Schraag S1. Author information J Thorac Dis. 2018 Mar;10(3):1998-2004. doi: 10.21037/jtd.2018.02.48. Abstract The use of enhanced recovery after surgery (ERAS), as in other surgical specialties, is an emerging concept in cardio-thoracic surgery but there is still a lack of effective protocols to reduce the burden of surgery on the patient, shorten the period of postoperative recovery, and reduce the likelihood of chronic pain developing. The use of local anaesthetic (LA) techniques, such as thoracic epidural analgesia (TEA) and paravertebral blocks (PVB), as an adjunct to anaesthesia are considered key components, though there is little data for direct comparison of the techniques. This review aims to evaluate the role of LA techniques in a thoracic ERAS program through evidence from literature and considering aspects of clinical practice. We discuss how ERAS is adapting and evolving with the increasing use of video-assisted thoracoscopic surgery (VATS) is thoracic surgery. It also examines the advantages of multimodal, opioid-sparing analgesia in the post-operative period to minimise the inflammatory response and improve functional recovery. LA techniques within ERAS protocols have the potential to hasten recovery when managed appropriately and to their full potential. KEYWORDS: Enhanced recovery; epidural anaesthesia; local anaesthetics (LA); paravertebral block (PVB) PDF Aumento de las vías de recuperación en cirugía torácica del grupo italiano VATS: protocolos de analgesia perioperatoria. Enhanced recovery pathways in thoracic surgery from Italian VATS Group: perioperative analgesia protocols. Piccioni F1, Segat M2, Falini S2, Umari M2, Putina O3, Cavaliere L4, Ragazzi R5, Massullo D6, Taurchini M7, Del Naja C7, Droghetti A8. Author information J Thorac Dis. 2018 Mar;10(Suppl 4):S555-S563. doi: 10.21037/jtd.2017.12.86. Abstract Video-assisted thoracoscopic surgery (VATS) is a minimally invasive technique that allows a faster recovery after thoracic surgery. Although enhanced recovery after surgery (ERAS) principles seem reasonably applicable to thoracic surgery, there is little literature on the application of such a strategy in this context. In regard to pain management, ERAS pathways promote the adoption of a multimodal strategy, tailored to the patients. This approach is based on combining systemic and loco-regional analgesia to favour opioid-sparing strategies. Thoracic paravertebral block is considered the first-line loco-regional technique for VATS. Other techniques include intercostal nerve block and serratus anterior plane block. Nonsteroidal anti-inflammatory drugs and paracetamol are essential part of the multimodal treatment of pain. Also, adjuvant drugs can be useful as opioid-sparing agents. Nevertheless, the treatment of postoperative pain must take into account opioid agents too, if necessary. All above is useful for careful planning and execution of a multimodal analgesic treatment to enhance the recovery of patients. This article summarizes the most recent evidences from literature and authors' experiences on perioperative multimodalanalgesia principles for implementing an ERAS program after VATS lobectomy. KEYWORDS: Regional analgesia; pain management; video-assisted thoracoscopic surgery (VATS) PDF Los beneficios de la recuperación mejorada después de los programas de cirugía y su aplicación en la cirugía cardiotorácica. The Benefits of Enhanced Recovery After Surgery Programs and Their Application in Cardiothoracic Surgery. Brown JK1, Singh K1, Dumitru R1, Chan E1, Kim MP1. Author information Methodist Debakey Cardiovasc J. 2018 Apr-Jun;14(2):77-88. doi: 10.14797/mdcj-14-2-77. Abstract The perioperative care of the surgical patient is undergoing a paradigm shift. Enhanced Recovery After Surgery (ERAS) programs are becoming the standard of care and best practice in many surgical specialties throughout the world. ERAS is a multimodal, multidisciplinary, evidence-based approach to care of the surgical patient that aims to optimize perioperative management and outcomes. Implementation, however, has been slow because it challenges traditional surgical doctrine. The key elements of ERAS Pathways strive to reduce the response to surgical stress, decrease insulin resistance, and maintain anabolic homeostasis to help the patient return to baseline function more quickly. Data suggest that these pathways have produced not only improvements in clinical outcome and quality of care but also significant cost savings. Large trials reveal an increase in 5-year survival and a decrease in immediate complication rates when strict compliance is maintained with all pathway components. Years of success using ERAS in colorectal surgery have helped to establish a body of evidence through a number of randomized controlled trials that encourage application of these pathways in other surgical specialties. KEYWORDS: ERAS; cardiothoracic surgery; enhanced recovery after surgery; length of stay; lung resection; multimodal analgesia; transcatheter aortic valve replacement PDF  Inscripciones Abiertas Información / Information Curso de Alta Especialidad en Medicina del Dolor y Paliativa 2019 Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Ciudad de México Convocatoria / Announcement  Congresos Médicos por Especialidades en todo Mundo Medical Congresses by Specialties around the World Información / Information Safe Anaesthesia Worldwide Delivering safe anaesthesia to the world's poorest people Informes / Information

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org

Libro sobre Cardiomiopatias / Book on Cardiomyopathies

Septiembre  11, 2018. No. 3183

Viaje Culinario en Chiapas Cardiomiopatías. Tipos y manejos Cardiomyopathies Types and Treatments Edited by Kaan Kırali Sakarya University, Turkey Cardiomyopathies are the most featured cardiac pathologies in the twenty-first century, that threaten public health and burden healthcare budgets. This book is composed of the main topics on pathophysiology, general forms and specific types of cardiomyopathies and it also introduces new research in the field. Specific forms with or without genetic inheritance are discussed separately to attract the readers' attention on these topics. Well-known medical follow-up strategies occur ineffective at the end-stage heart failure, however, new surgical approaches can be an alternative for these patients to get a chance at the last crossroad and to improve their life quality and survival and also to gain or prolong time until possible heart transplantation. Libro / Book / Livre Cardiomiopatías y anestesia Cardiomyopathies and anaesthesia. Juneja R1, Nambiar PM1. Author information Indian J Anaesth. 2017 Sep;61(9):728-735. doi: 10.4103/ija.IJA_385_17. Abstract Cardiomyopathy is considered as a heart muscle disease of multiple aetiologies, unlike other cardiac diseases related to a definitive pathophysiology. With more and more research and with the advent of genetic analysis pin pointing the disease causing mutations, causative factors have been defined and classifications and definitions have changed over time. Patients with these conditions present to anaesthesiologists in elective and emergency situations, placement of automated internal cardioverter defibrillator (AICD) devices or biventricular pacing but may also be diagnosed at anaesthetic pre-assessment. We describe cardiomyopathies such as dilated cardiomyopathy, hypertrophic cardiomyopathy, post-partum cardiomyopathy and Takotsubo cardiomyopathy in brief and their anaesthetic management. KEYWORDS: Anaesthesiologist; cardiomyopathy; hypertrophic cardiomyopathy PDF Anestesia en pacientes con cardiomiopatía dilatada para cirugía no cardiaca Anesthetic management of patients with dilated cardiomyopathy for noncardiac surgery. Chen CQ1, Wang X, Zhang J, Zhu SM. Author information Eur Rev Med Pharmacol Sci. 2017 Feb;21(3):627-634.Abstract Anesthetic management of patients with dilated cardiomyopathy (DCM) is a challenge to the anesthesiologist, due to poor left systolic function, ventricular enlargement, risk of malignant arrhythmias and sudden cardiac death. Therefore, preoperative assessment and appropriate anesthetic management are important in patients with DCM. This review describes the preoperative evaluation and anesthesiaconsiderations of patients with DCM undergoing non-cardiac surgery. Patient pathophysiology and clinical status, such as ventricular function, degree of myocardial fibrosis, resting heart rate and high-sensitivity C-reactive protein can affect survival rates. Advanced monitoring devices, such as transesophageal echocardiography and cardiac resynchronization therapy can be used to assess ventricular function and myocardial fibrosis. Thoracic epidural blockade can improve ventricular function. In summary, the optimal anesthetic management of patients with dilated cardiomyopathy requires good preoperative assessment, close perioperative monitoring, suitable anesthetic, optimization fluid management, and stable hemodynamic status. PDF Inscripciones Abiertas Información / Information Curso de Alta Especialidad en Medicina del Dolor y Paliativa 2019 Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Ciudad de México Convocatoria / Announcement  Congresos Médicos por Especialidades en todo Mundo Medical Congresses by Specialties around the World Información / Information Safe Anaesthesia Worldwide Delivering safe anaesthesia to the world's poorest people Informes / Information

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org