Sep 13

Evaluación clínico-radiológica de la técnica de aloinjerto compactado y vástago cementado en cirugías de revisión de cadera / Clinical-radiological evaluation of the impaction allografting and cemented rod technique in revision knee surgery

Fuente
Este artículo es originalmente publicado en:
De:
Rev Esp Cir Ortop Traumatol. 2016 Mar-Apr;60(2):141-7. doi: 10.1016/j.recot.2015.09.001. Epub 2015 Dec 4.
[PubMed – in process]

 

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Copyright © 2015 SECOT. Published by Elsevier Espana. All rights reserved.
Resumen

Objetivo

Evaluar a largo plazo, el resultado clínico-radiológico, la supervivencia y las complicaciones intra y postoperatorias de pacientes intervenidos de cirugía de revisión de cadera mediante esta técnica.

Material y métodos

Estudio analítico observacional, prospectivo y no aleatorizado de 26 pacientes intervenidos de cirugía de revisión de cadera en nuestro hospital (1997-1998), a los que se les realizó un seguimiento clínico-radiológico y un análisis de la supervivencia del implante.

Resultados

Se observan diferencias estadísticamente significativas en los valores pre y postoperatorios de las escalas de Harris y de Merle D¿Aubigne. La supervivencia del implante teniendo en cuenta como punto final la cirugía de revisión fue del 84% a los 13 años. Hubo 9 complicaciones intraoperatorias (6 de ellas fueron fracturas) e influyeron de forma significativa en la estancia hospitalaria. El 70% de los pacientes no tuvo ninguna complicación postoperatoria. Ninguna de las variables analizadas influyó en el hundimiento radiográfico de los implantes.

Discusión

Diversas técnicas intentan solventar el déficit de stock óseo en las cirugías de revisión de cadera, pero solo una intenta recuperarlo, el injerto compactado.

Conclusiones

La técnica de Ling ofrece una mejoría clínica tanto en la escala de Merle D¿Aubigne como en la de Harris, a medio-largo plazo. La presentación de complicaciones intraoperatorias incrementa la estancia hospitalaria y los días necesarios para iniciar la sedestación. La técnica de Ling es una buena opción a tener en cuenta en pacientes jóvenes en los que es previsible que haya una nueva cirugía de revisión en el futuro.

Abstract

Objective

Long term clinical and radiological evaluation of results, survival, and peri- operative and post-operative complications of the patients who have been operated on for revision total hip arthroplasty using the impaction allografting and cemented rod technique.

Material and methods

An observational, analytical, prospective and non-random study was conducted on 26 patients who underwent revision total hip arthroplasty in our Hospital (1997-98). They were clinically and radiologically assessed, and a survival analysis of the implant was performed.

Results

Statistically significant differences were identified in the pre- and post-operative values, according to Harris and Merle D¿Aubigne scores. The femoral components survival was considered as an endpoint of the revision replacement, which was 84% at a mean of 13 years. There were 9 intraoperative complications (6 were fractures) and they significantly affected the length of hospital stay. No post-operative complications were observed in 70% of the patients. None of the analysed variables had any influence on the radiological subsidence of the femoral component.

Discussion

Several techniques aim to solve the bone stock deficiency in revision total hip arthroplasty, but only impaction grafting attempts to recover it.

Conclusions

The Ling’s technique shows an improvement over the Merle D¿Aubigne and Harris scores, in the medium-long term. The intraoperative complications are mainly an increase in the length of hospital stay and the number of days needed to be able to sit down. Ling’s technique is a good option to consider in young patients where it is foreseeable that there is a new revision surgery in the future.

Palabras clave
Cirugía de revisión, Cadera, Impaction grafting
Keywords
Total hip arthroplasty, Hip, Impaction bone grafting

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