From now on you can access the ICATME mobile application either in the Appstore or Play Store
From now on you can access the ICATME mobile application either in the Appstore or Play Store
The most important follow-up work in the world on surface prostheses for young people (with special characteristics and not implantable in all patients with a specific protocol) has been published.
This is a 22-year follow-up study of 11,382 surface prostheses in patients under 50 years of age. These prostheses have been implanted by 27 reference teams in the world from up to 13 different top-level countries, from the American, European and Oceanic continents.
In the present study it is shown that with an adequate indication, planning and technical execution, those patients (especially men with hip osteoarthritis) the durability of their implants exceeds 22 years in more than 90% of the cases. Women equal men in durability in prosthetics that can be implanted with the same sizes to most men’s head diameters.
The surface prosthesis is not implantable in all patients, this will depend on their intrinsic bone characteristics, their bone mineral density, their body mass index and the follow-up that the patient will perform. The vast majority of these are young patients involved both in high-demand physical-sports activities and in those professions that require physical effort.
The Icatme Hip Unit, Dexeus Grupo Quirón Salud University Hospital in Barcelona, is an accredited world reference center, both for surface prostheses as well as for minimally invasive surgery, whether for hip replacement or hip joint preservation surgery or either hip arthroscopy such as periacetabular, femoral, combined osteotomy and AAMOT.
You can consult the entire study by clicking here.
As published in the North American prosthetics journal “Journal of Arthroplasty”, randomized comparative studies on the anterior versus posterior approach in hip prosthesis implantation do not show any significant difference either in the first year or in the second after the implantation of the prosthesis. prosthesis. On the other hand, it does depend on the experience of the surgeon.
If we add to this that the superior approach, which is the mini-invasive advance of the posterior approach, does not cause tendinomuscular damage, the result is more immediate.
The superior approaches can be the Superpath and the DSA, both used by the hip unit for years as a reference center in minimally invasive surgery by all its members.
From the Hip Unit we recommend the following video, which shows the procedure of the Superpath technique. You can see the video by clicking here.
On September 11, Dr Ribas, head of the Dexeus Hip Unit, will participate as the main speaker in the webinar: “Primary prosthesis by superior approach with soft tissue protection”, together with doctors Marcelo Lizarraga, Víctor Valladares and Christian Valladares, all of them Peruvians. The Central Military Hospital of Peru is in charge of organizing the event.
The medical team of the Hip Unit of the Department of Orthopedic Surgery and Traumatology of the Hospital Universitari Dexeus (ICATME), led by Dr. Manel Ribas, has published in the latest issue of the Spanish Journal of Orthopedic Surgery and Traumatology (RECOT) the first large series in Southern Europe of cases of periacetabular osteotomy using a mini-invasive technique in the treatment of residual hip dysplasia.
This is a retrospective study of 131 patients who underwent this technique at the Dexeus University Hospital between 2007 and 2016. The study concludes that the periacetabular osteotomy using the mini-invasive approach allows to restore the coverage of the acetabulum, correcting dysplasia, improving capacity. functional and quality of life of the operated patients.
Residual hip dysplasia
“Residual hip dysplasia is a more common pathology than is believed. At the end of growth, the head of the femur, for different reasons, may not have been well covered by the acetabulum and hip instability and alteration of the hip occurs. a series of stabilizing structures that in the long run produce pain and loss of functional capacity, which leads to the need to implant a prosthesis “, explained Dr. Manel Ribas, head of the Hip Unit of the Hospital Universitari Dexeus.
In recent decades there have been various attempts to try to restore these hips but it was not until 1988 that Dr. Ganz from the University of Bern developed a technique capable of correcting this pathology. It is a periacetabular osteotomy that, through four cuts around the acetabulum, allows it to be rotated in a way that provides more coverage to the head of the femur and recovers the contact of the patient’s natural cartilage between the acetabulum and the femur, protecting the joint.
In 2003 Dr. Manel Ribas was the first Spanish surgeon to perform this technique. “However,” adds the surgeon, “with the aim of continuing to improve, in 2007 at the recently opened Hospital Universitari Dexeus we performed the first periacetabular osteotomy using a mini-invasive technique described by Dr. Soballe”.
“This new surgical approach consists of making a series of blind cuts, which are visualized with the help of a radiological team in the operating room, avoiding the muscle so that we achieve less bleeding, less surgical time, less post-operative pain, a rapid functional recovery and an aesthetic improvement over the previous technique “.
The study published by RECOT compiles the first 131 cases of mini-invasive periacetabular osteotomy performed by Dr. Ribas’ team at the Dexeus University Hospital and analyzes the medium and long-term results.
According to Dr. Luis Ramírez Nuñez, surgeon of the hip unit and first signatory of the study, “the patients treated with this technique achieved correct acetabular coverage with few complications and with a significant improvement in functional results.”
“Four years after undergoing the operation, 98% of the patients did not need to undergo any other procedure since the intervention had completely solved the dysplasia,” he adds.
Dr. Ribas affirms that “it is important to be able to diagnose and treat residual dysplasia since it is an underdiagnosed pathology that is extremely confusing with other hip pathologies such as acetabular shock injury and requires a differentiated treatment”.
The Hip Unit of the Dexeus University Hospital is a benchmark in the performance of this technique that is performed on a regular basis. Since Dr. Ribas’s first intervention in 2007, nearly 500 surgeries have been performed using this technique.
This news has been published on the Quirón Dexeus Hospital website. You can see it by pressing here.
As readers already know, Dr. Ribas’ grandfather was a prominent internist, specialist in pulmonary pathology and infectious diseases, who practiced in Barcelona in the late 19th and first half of the 20th century. He was the Head of the Hospital de la Santa Creu y Sant Pau, and had to face the cholera epidemic that broke out in Barcelona and the Spanish flu epidemic. Professor Ribas had as his assistant the one who later became a professor of medicine in Zaragoza and Madrid, and the Nobel Prize in Medicine: Professor Santiago Ramón y Cajal.
He wrote numerous books and reported works of enormous impact in the Europe of the time. He spoke perfectly German, having trained as an internist in Germany (perhaps someone is familiar).
Regarding epidemics, he publicly expressed an opinion that seems taken from the present, only 100 years ago:
“For an epidemic to be considered over, one or more of the following conditions must exist:
That more than half of the population is immunized.
That the germ loses virulence.
That there is an effective treatment to combat it.
Let there be a vaccine for the population.”
We believe that 100 years later his thinking is still very current.
The program of the “Primeiro Simpósio Internacional de Atualizaçao em cirugia do quadril”, held on May 1, 2019 in the Aula Magna of the Hospital de Santa Caterina de São Paulo, is now available in its entirety on the YouTube platform.
In the images we can see Dr Ribas with Dr Lage de São Paulo, famous hip surgeon around the world for his classification of acetabular labrum ruptures, and organizer of the contest.
We can also see Dr Ribas together with Dr Jorge Cruz de Melo, a recognized doctor in Portugal, also Porto FC staff.
Within a week we will celebrate 2 months from the restart of elective surgical activity with the greatest success: no reported case of Covid complication19 in our center.
The months at the top of the contagion curve, when confinement was normal and necessary, and we only intervened in those strictly urgent hip surgeries, are behind us.
When the contagion curve stabilized, always below 1, it was time to resume elective activity, that is, the vast majority of hip surgeries: surgery for femoroacetabular shock, dysplasia and osteoarthritis of the hip in its different presentations by mini-invasive techniques.
From the beginning of May we proceeded through the “Safe Hospital” protocol. Hospital Seguro is a protocol that includes a series of both physical and clinical-diagnostic measures whose objective is to protect all Covid patients, both negative and cured, from possible Covid positives, both in outpatients and in emergencies. operating room area, intensive care and hospitalization plants.
Thanks to the implementation of this protocol and the positive response not only from healthcare personnel but from all the patients cared for (at this time ICATME works at full capacity) we have been able to carry out our activity without any reports from Sars-cov- two.
As with other infectious agents, human beings must adapt to coexist in this new phase.
Thank you all that made this posible. Even so, adapting does not mean letting your guard down at any time and anywhere beyond the hospital environment.
Now, although already during the high curve of the pandemic in Spain, patients could move between Autonomous Communities to be treated in hospital centers with the corresponding document, with the lifting of the State of Alarm Decree, said movement between Autonomous Communities enters a new phase of normality, which never excludes 3 premises for their own good and that of others: distance, hands and mask
After the intervention of the Hip Unit in the recovery of Aritz Aduriz, football player of the Athletic Club de Bilbao, the team of the Hip Unit has participated in the documentary “Six Dreams”, soon on Amazon Prime.
In this second season of this Spanish-produced documentary series, iconic figures from our national soccer will be followed: Borja Iglesias (Betis), Aritz Aduriz (Athletic Bilbao) or Santi Cazorla (Villareal).
The Basque footballer from Athetic de Bilbao has successfully undergone surgery on his left hip at the Hospital Universitari Dexeus Quirónsalud, in Barcelona.
The operation, realized by Dr Ribas and his team, has been carried out with absolute normality and without any complications.
The official news of the club is echoed, you can access it by clicking here.
The Hip Unit, as well as all ICATME, have successfully started elective non-urgent surgical activity (for example: arthrosis surgery, femoroacetabular shock, hip dysplasia, …) since the beginning of May. of the SAFE HOSPITAL protocol that emerged from the adaptation of the protocols of the German Society of Orthopedic Surgery (DGOOC), International Hip Society (IHS), American Association of Hip and Knee Surgeons (AAHKS) and European Society of Arthroscopy of the knee and Sports (ESSKA), presenting its widely satisfactory results, protecting patients who have not suffered from COVID disease as well as those who were cured of asymptomatic positive COVID patients, by means of specific clinical and radiological examinations mandatory in the Dexeus University Hospital, Grupo Quirón Salud.
For the interest of readers, both healthcare and non-healthcare, an image is left that corresponds to the outline chart of the Safe Hospital protocol that is followed for the introduction of surgical patients according to the strictest safety standards.
On May 23 the Venezuelan Society of Orthopedic Surgery and Traumatology (SVCOT) organizes an international telematic Congress, with the assistance of specialists from both continents.
Dr Ribas and Cardenas present their achievements and their experience in the diagnosis and treatment of femoroacetabular shock (known in Central and South America as Femoroacetabular Impingement).
With more than 2,000 interventions carried out, the Hip Unit has emerged as one of the benchmarks in the treatment of this pathology, the first cause of pain in the athlete’s hip and the first mechanical cause of arthrosis in said joint.
In addition to exposing cases of femoroacetabular shock, clinical cases of other mechanical hip pathologies that need to be differentiated are presented. The most frequently confused with femoroacetabular shock is residual hip dysplasia. Both cause chondrolabral lesions to evolve freely, but the treatment of the cause is completely different: while femoroacetabular shock is treated with remodeling of the acetabular overlay and femoral hump, residual dysplasia is treated by redirecting the acetabulum to provide physiological coverage . This is obtained through periacetabular osteotomy, a technique of which this Unit is a reference center in Europe for its mini-invasive technique.
The Hip Unit has successfully returned to its usual activity. In a very satisfactory way, maintaining the “negative Covid circuit” protocol implemented by ICATME and Dexeus University Hospital, which isolates and protects patients who have not suffered from Covid-19 and those who have been cured.
The care activity of patients with pathologies of the locomotor system is resumed.
For more information follow the link clicking here.
REMEMBER TO GO TO YOUR APPOINTMENT:
1. You must wear the mask.
2. Try to be punctual, neither before nor after the indicated time.
3. Only the patient will be able to access the consultation, unless he is a dependent or a minor.
4. Respect the social distance of 2m.
After the stabilization of infections by COVID 19, the Quirón Dexeus University Hospital and consequently ICATME, we have gradually resumed our activity. To do this, we have restructured the physical space of our consultations and waiting rooms, with the aim of avoiding crowds and guaranteeing physical distance. In addition to the reforms of the workspace, the state of the professionals is monitored day by day.
For this new phase, ICATME has a Coronavirus prevention manual, of which we can highlight:
In these conditions, with an exhaustive preoperative procedure focused on the Coronavirus, with the measures established in the operating rooms and the measures adopted by ICATME in the doctor’s offices, we can offer a safe environment to carry out surgical interventions, and follow-up in our facilities in person. and by telemedicine, if applicable, to avoid avoidable displacement.
More information on the website of ICATME.
With a worldwide telematic audience of more than 500 medical specialists in hip arthroscopy, Dr Cárdenas places his emphasis on the surgical treatment of space conflicts around the hip, also treatable by arthroscopy.
Today Dr Cárdenas is considered one of the world’s greatest specialists in the field.
From the Hip Unit we want to thank Professor Kjeld Söballe (Aarhus -Denmark), brilliant hip and pelvic surgeon, former chairman of the scientific committee of the European Hip Society (EHS); he in 2006 (2 years before I published it in the American Journal JBJS Am 2008) taught me the mini-invasive technique. Our fortune is to have known him, his generosity, didactic commitment. We can never thank him as he deserves.
First of all thank you friend Kjeld.
He was the one who realized that Ganz periacetabular osteotomy could be done by a mini-invasive approach that does not compromise the muscles, produces less bleeding, much less postoperative pain, and a faster return to everyday activities, including sport.
Today there is an undetermined number of athletes with moderate dysplasia, with a ratio of 4 to 5 women to 1 man, although there are ethnic and genetic factors. Low-grade dysplasia is not always detected at birth or during the first year of life.
Mini-invasive periacetabular osteotomy requires a highly specialized and coordinated medical and nursing team. We can see in the image Dr. Luis Ramírez placing the screws while Dr. Ribas maintains the correct redirection of the acetabulum to give normal three-dimensional coverage of the femoral head by the acetabulum. In our experience, there is no limit or residual standard dysplasia that is the same as another. Treatment is individualized patient by patient under a detailed preoperative calculation. We recommend reading on Instagram – Linkedin or on Twitter of “Periacetabular osteotomy step by step” by Dr. Luis Ramírez.
As we have been able to read in media such as the Medical Writing or the German newsletter BR24, a study carried out by the University of Eindhoven (Netherlands) together with the Catholic University of Leuven (Belgium), shows that the virus particles that remain floating in the air when we are in motion, they require a greater distance between people.
The study’s recommendation is that we should maintain a distance of 4m when walking and more than 10m when running.
To read the full article on Medical Writing, you can click here.
If you want to see the BR24 article, you can access by clicking here.
Although the Hip Unit is aimed at young people and young adults with dysplasia, often not noticed during childhood, it occurred in the 2nd, 3rd and 4th decades of life. This work, published in the largest Spanish journal of Orthopedics and Traumatology, represents the first work published on this mini-invasive technique throughout Central Europe and Southern Europe.
To thank our colleague Dr. Luis José Ramírez, specialist and member of the Unit staff, and the fellows we have had in recent years who, with their dedication, have made this work of data collection, angle measurement and analysis possible. statistical.
We could have perfectly published this work in an international magazine, but we believe that we owe it to our country. Disseminate knowledge of this technique in our field. This is how fundamentally Spanish and Spanish-speaking medical colleagues can access such precious and uplifting information.
I thank Dr. Luis José Ramírez for his dedication to the subject, the subject of his Doctoral Thesis, under the baton of the Professor at the University of Barcelona Andreu Combalía and myself (Dr. Manuel Ribas) as his tutor.
New works will appear, already more specific in the line of his Doctoral Thesis, as well as in the field of dysplastic athletes. Recently in the American Journal of Sports Medicine it was reported that 21% of Scandinavian soccer players suffered from hip pain as a result of residual dysplasia, and 46% from borderline dysplasia. In these cases, individual assessment is essential to offer the most appropriate treatment: simple arthroscopic treatment, repair of chondrolabal lesions in borderline dysplasia, arthroscopic treatment associated with mini-invasive periacetabular osteotomy or just mini-invasive periacetabular osteotomy.
For now, the Dexeus University Hospital is the only one in the South of Europ, which has carried out, since 2007, periacetabular osteotomy using a mini-invasive technique.
You can consult the study by clicking here.
123 questions about the Coronavirus. Aimed at the entire public, it provides scientific clarifications for all readers interested in expanding, without effort, knowledge on the subject.
A slow reading is recommended and always from the beginning, looking for those questions that interest us all.
You can download the document by clicking here.