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
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.
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.
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.
Dr Ribas participates in the Webinar, promoted by the German Society DGOOC for German speaking countries. In this virtual congress the operation of the Hip Unit during the pandemic in its different phases was explained.
A protocol for restarting habitual surgical activity was also discussed based on those proposed by the same DGOOC, AAHKS, IHS, ESSKA (scientific societies of the specialty in Europe and North America).
In a few days, confirmation of publication of different works in indexed scientific journals by the Hip Unit has been received:
The Press Association of the newspaper La Razón, one of the largest circulation in Spain, has awarded the head of the Hip unit of the Dexeus University Hospital in the section of hip traumatology among applicants from different parts of Spain.
In his speech Ribas thanked the members of his team and orthopedics and traumatology service of Icatme. Dr. Charlemagne Cardenas member of the Unit, Dr. Eugenio Jimeno, medical director of Icatme and Dr. David Campos member of Icatme accompanied Ribas at the event, held at the prestigious Westin Palace in Madrid.
This recognition coincides with the third consecutive year in which Icatme is in first place as the best orthopedic surgery and traumatology service in Spain according to the IEH (Hospital Excellence Index, prepared through a vote by the Spanish doctors of the different hospitals in the country).
You will find the news of the award by clicking here.
Dr Cardenas has been the international guest in Moscow, at the Moscow Hip Conference, where he has performed two live surgeries, conferences and a hip physical examination workshop at the V.M. State Clinical Hospital. Buyanova
All this in front of 200 hip surgeons from all over Russia.
Once again, the Icatme Hip Unit participates in a scientific event of great impact. The most innovative strategies in the prosthetic exchange are analyzed in this congress and in it prominent figures, both European and from the other side of the ocean, participate.
The fact that Dr Ribas participates in this congress is not accidental. In the early 1990s, Dr Ribas was trained in replacements of infected hip and knee prostheses in the world-famous Endoklinik in Hamburg with Drs. Steinbrink, Roig, Engelbrecht and Dr Lars Frommelt. The latter is considered today the largest microbiologist of the musculoskeletal system in the world.
Upon his return to Spain, 10 years before his last long training stay at the Mayo Clinic, Ribas shared the cases of septic replacement with Frommelt and studied their antibiotic application strategies in acrylic cements.
Today, with the new technical advances, the scientific community meets biannually in Philadelphia to establish a framework of consensus on these therapies (“Philadelphia Consensus”). Spain was behind the US and the United Kingdom the country with the largest number of delegates, just ahead of Germany.
The Spanish Society of Orthopedic Surgery and Traumatology (SECOT) through its website and in App has been the first to translate the Philadelphia Consensus from English to Spanish. The Spanish Society of Infectious Diseases and Clinical Microbiology has also established a Consensus Document.
In the months of October and November, Dr. Vittorio Bellotti was able to participate, through the European Hip Society, in the daily work in these orthopedic centers of excellence in hip surgery.
He has been able to be in hip prosthetic implantation interventions through another mini-invasive approach, another surgical school, periacetabular osteotomy for hip dysplasia, precisely in the place where the latter was born.
Gone are the end of the eighties, when Dr. Ribas visited Dr Ganz in the same hospital overnight in the round trip on the train TALGO Barcelona – Bern.
As of the end of 2003, Dr. Ribas began performing said osteotomy for the treatment of dysplasia, only that in 2006 he modified the approach to perform it by the mini-invasive method, nowadays only available to few centers in the world.
Between November 6th and 9th, Professor Dr. Flavio Peirano, a renowned Argentine hip and knee surgeon, head of the Churruca Hospital of the Federal Police of Buenos Aires, visits the Hip Unit, ICATME, Dexeus University Hospital – Quirónsalud Group.
Dr. Flavio carries out a stay of medical training exchange, with the aim of bringing to Buenos Aires the Superpath technique of implanting hip prostheses with musculoskeletal protection. The Superpath technique (Supracapsular Percutaneous Portal Assisted Total Hip) for the implantation of hip prostheses with protection of muscles, tendons and capsule was introduced in Spain by Drs Cardenas and Ribas back in 2015 after their training and accreditation in San Diego – CA through the SOV program.
From here, other leading specialists in our country such as Dr. Raúl Torres, Jesús Mas, Juan Rivera or Boris García have also developed and expanded the technique.
During the ISHA 2019 Congress, held in the city of Madrid, Dr Ribas, head of the Hip Unit made a presentation in which he related his experience in the miniopen treatment of tendon ruptures of medium and minor gluteus.
The painful syndrome of the greater trochanter (GTPS) is an underestimated pathology of a huge prevalence in the general population, between 10 and 25% of the population suffers from this syndrome.
Between 48 and 60% of patients diagnosed with GTPS have medium or smaller gluteal tears that can degenerate into muscle fat tissue irreversibly if the tears are not treated properly.
Yesterday Dr. Roberto de la Garza (Resident Physician of the ISSSTE Regional Monterrey Hospital) began his rotation, he will perform a 2-month rotation in the hip unit.
Teaching of the mini-invasive technique for the treatment of femoroacetabular shock of the hip, in the German Course of Continuous Training for hip surgeons that has been held in the city of Essen.
Under the title of “Modern mini-invasive hip techniques”, both the mini-invasive technique for the treatment of femoroacetabular shock, by Prof Marco Ezechieli, as well as the previous approach of Madera and the Superpath technique for the implantation of Total hip prostheses, well-known techniques of which the Hip Unit of the Dexeus University Hospital (Quirónsalud group) was already a pioneer in its day. We are very happy with the advances and dissemination of these techniques, in addition to the mini-invasive periacetabular osteotomy for Residual Dysplasia such as hip arthroscopy, which make our work the daily work.
Soon German doctors will begin their superspecialized training in our center.
Professor Marco Ezechieli, a well-known expert hip surgeon, did part of his superspecialized training at the Hip Unit of Dexeus University Hospital.
On this occasion, the XXI Congress of the Spanish Society of Hip Surgery was held in the city of Elche, Valencian Country and was able to count on the presence of Dr Ribas, chief member of the Hip Unit.
Dr. Ribas, 15 years after the publication of his article “Current evidence in the treatment of femoroacetabular shock” in the Spanish Journal of Orthopedic Surgery and Traumatology of the article, has made a presentation on the evidences of this pathology.
In his presentation, Dr. Ribas pointed out, point by point, all those evidences that today doctors and patients should know. The most outstanding, with the highest level of evidence, is that it has been shown that the surgical treatment of femoroacetabular shock presents better clinical-functional results than the best non-surgical treatment and simply rehabilitation.
Different randomized, multicenter, comparative studies (level of evidence 1) have been carried out that corroborate this. These studies have been published even in high-impact scientific journals such as “The Lancet.
The seventh edition of the joint congress between AEA (Spanish Arthroscopy Association) and SEROD (Spanish Knee Society) took place on May 22, 23 and 24 at the Exhibition Center of the city of Santander.
Dr Cardenas, as the only representative of the Hip Unit, participated with the paper: “Pathogenesis and clinical diagnosis of the peritrochanteric space”, where we talked about the so-called “hip bursitis or trochanteritis”.