Today we say goodbye to our visitors from Mexico: Dr. Roberto de la Garza and India: Dr. Deepak Chitragar. With them we have shared several months of very good moments. We wish them the best for the future.
We take this opportunity to welcome Dr. Pich-Aguilera, from Moises Broggi Hospital.
On October 16, 17, 18 and 19, almost all of the members of the Hip Unit have participated in this ISHA Congress contest, the only one in the world of hip preservation surgery (a specialty that treats injuries for reduce pain and improve hip functionality).
In this edition, in which doctors, hip surgeons, specialists in rehabilitation and sports medicine participate, the most up-to-date knowledge and techniques in the field of arthroscopy, osteotomies in young adults, treatment of injuries have been discussed of cartilage and acetabular labrum, accelerated and specific functional recovery, labrum transplants.
Important has been the contribution of the Unit with the themes:
From here, we want to send our most sincere congratulations from Drs. Oliver Marín and Luís Perez-Carro, indefatigable organizers of this event, who have made it possible for Madrid to successfully host a contest of this caliber.
The next edition will be in 2020 and will be held in Ottawa.
The publication of the first Labrum transplant in the history of medicine reaches 200 downloads of specialists in hip preservation surgery.
This transplant was performed by Dr Ribas and Dr Tey in 2007 and subsequently published by said authors in the Hip-International hip scientific journal.
Currently, the Hip Unit is the medical team in Europe with the largest number of donor Labrum transplants. And their excellent results have been published in various scientific journals.
Our most sincere congratulations to the athlete Jesús Angel García Bragado who, at his 50 years, has achieved his 12 + 1 participation in the 50 km world march held in Doha.
Congratulations for triple departure:
1 / Selfless dedication, example for all. (18 of the participants had not yet been born in their first World Cup).
2/12 + 1 worldwide.
3 / 8th place and direct classification for its 6th Olympiad, this time in Tokyo.
From the My Hip team, congratulations!
This Saturday, September 28, Dr. Ribas, together with Dr. Paolo Esopi and Dr. Sílvia, carry out, in the Dolo Hospital – Venice, a gluteus maximus transfer intervention.
What is a muscle transfer for? One of the causes of the instability of a hip prosthesis may be due to the lack of musculotendinous support of the pelvitrocating muscles and especially the middle and lower gluteus (see the update on the conference given by Dr. Ribas in the Society Hip Italian from last week in Bergamo). The absence of correctly functioning pelvitrocantereos is an invalidating situation for the patient, who is even forced to wander with one or two crutches.
This insufficiency can occur for different reasons. During the last decades, multiple techniques have been used and described to replace and / or strengthen the pelitrochanteric muscles of the hip, which go from tendon transplantation, muscle transposition with microsurgical techniques to the application of human or artificial collagen mesh-plates .
In the last two decades, the technique of transfer of the proximal third of the gluteus maximus muscle, with its prolongation of Fascia Lata acting as a tendon (fixed to the greater trochanter of the ugly) described by Professor Dr Leo Whiteside of the USA, has represented a solution biological that alleviates this pathology with clinical-functional results.
The hip unit has been doing this intervention in very specific cases for more than fifteen years.
His presence is required this year as a recognized pioneer in the treatment of lesions of the middle and minor gluteal tendons in his area of femoral insertion, often misnamed “Trochanteritis or trochanteric bursitis.” Today the Anglo-Saxon medical literature calls it Great Trochanter Pain Syndrome (GTPS).
For the reader here are the most important points of his Presentation:
1 / The Great Trochanter Pain Syndrome (painful trochanter syndrome – GTPS, which causes pain in the lateral side of the hip and functional limitation) occurs between 10 to 25% of the population at some time in life, mostly in middle-aged women, according to a review article by the newly appointed head of the hip preservation surgery unit at the Hospital for Special Surgery in New York, Professor Bryan Kelly.
2 / Among different mechanical and biological causes, the fall in the production of estrogens during menopause, which alter the quality of tensile strength of the tendons, especially in the shoulder and hip *, stands out.
2 / Other reviews show that between 40 and 68% of cases of GTPS are ruptures at the level of the insertion of the gluteus medius / minor.
3 / An inadequate treatment, depending on the degree of rupture, can put at risk the fatty degeneration of the muscle and its loss of function with the consequent lameness and functional limitation.
4 / Different degrees of injury are distinguished, according to the combined Thomas-Milwaukee classification, from which medical evidence emphasizes different treatments according to the stage.
5 / The hip unit was a pioneer in Europe in the treatment of middle and minor gluteal tears. In their study presented in 2018, at the European Hip Society in The Hague (EHS), the good clinical-functional results of the treatment of tears are demonstrated, according to the mini-invasive technique for this pathology launched in 2007, with and more than 12 years of experience through mini-invasive and arthroscopic technique.
6 / Dr Ribas explains the algorithm in the treatment of these injuries.
* Salini et al. “Prevalence of and risk factors for asymptomatic rotator cuff tears in postmenopausal women.” Menopause 2014 Mar; 21 (3): 275-80.
The insufficiencies of coverage of the femoral head, associated with deformities (as in this case of sequels of Perthes disease), can be combined by mini-invasive technique with femoral osteotomies using new fixation systems such as femoral plates of angular stability. This fixation is enormously stable and allows immediate mobilization and rehabilitation to the patient.
The interest in learning to perform the mini-invasive periacetabular osteotomy in super hip surgeons grows in Spain and Portugal.
The mini-invasive periacetabular osteotomy for the treatment of Residual Dysplasia of the young adult, its injuries and its multiple pathological associations, is starting a growing interest in the countries of Southern Europe, both in patients and specialists due to the excellent results obtained with said technique.
During this summer, Dr Manel Ribas and Dr Carlomagno Cardenas, specialists in this intervention, doctors specializing in this technique, have carried out demonstration interventions before young surgeons of great renown, recognition and projection, both in Madrid and in Porto.
On the other hand, the active participation of the hip unit in the world hip preservation congress (ISHA society), which will be held in Madrid from October 16 to 19, is ready.
On May 24, Dr. Manel Ribas was named Honorary Member of the Russian Hip Society, in the Russian city of Nizhny, Novgorod.
His entry reading, pronounced in English and translated into Russian, has been “Novel soft tissue-sparing mini-invasive techniques in primary total hip replacement” (new techniques of primary hip prosthesis with soft tissue protection).
It is widely known that the Hip Unit is a European reference center and precisely with the figure of Dr Cardenas-Nylander, as well as the Head of Teaching of the entire ICATME department. The Hip Unit provides courses in corpses, training and specialists from South and Central Europe, also from Russia, the USA and Japan.
The Superpath technique has shown, according to data from the Australian Registry, up to a reduction of 91% in taking analgesics to hospital discharge, as well as autonomy in daily life in 85% of cases at 2 weeks.
With the appointment of Dr Manuel Ribas as an honorary member of the Russian Hip Society, a member of the third generation of doctors from the Ribas family revisits Russia 130 years later. 130 years after a doctor of the family-Saga of the Doctors Ribas, the also prestigious professor Dr Manuel Ribas, specialist in Internal Medicine and Epidemiology and former president of the Academy of Medical Sciences of Catalonia and the Balearic Islands until his death, brother of the Pulmonologist Joan Ribas, (different populations of Catalonia take their name as a street or avenue, such as the well-known Avenida del Dr Manuel Ribas and Perdigó de Badalona for example.
Professor Manuel Ribas was the right hand of Dr Bartolomé Robert, who was the mayor of Barcelona. Manuel Ribas never yielded to his work in the service of patients and has in his file one, which he considered a “black stain”: having lost the oppositions in Madrid in a hand to hand with his colleague also Professor Ramón y Cajal.
What I would not know is that two generations later Antoni Ribas, today professor of Oncology at UCLA and president of the International Society of Oncology, discovered immunotherapy against melanoma.
In the circles of the Ribas family, by the way very united, with meetings and family meals, it is said that “if one day Ribas can be a Nobel Prize winner”, Antoni can surely be.
A detail of Professor Manuel Ribas (1888): not knowing German, he moved to make his stay of specialized training in Internal Medicine in Germany. It sounds familiar, right?
Dr. Manuel Ribas, hip surgeon, did his final year’s work in History of Medicine in a seemingly simple way:
“Medical Biography of Professor Manuel Ribas i Perdigó”, year 1981.
Leading European specialists in double hip mobility and mini-invasive approaches participate in this edition of the, under the auspices of the Stryker North American Multinational Company.
It discusses the role of double mobility in hip prosthesis, mini-invasive surgery by direct superior approach that preserves muscle tendons and joint capsule (DSA: Direct Superior Approach), the role of rapid recovery with this approach and what the new materials bring
The program was integrated by Dr Jorge Guadilla (Vitoria), Dr Manuel Ribas, Professor Jean Alain Epinette (Lille and current president of the EHS-European Hip Society) and Dr Jesús Mas (Alicante).
In the afternoon practical sessions (cadaver-Lab) of instruction in the technique were carried out to the specialists assembled, coming from Spain and Portugal.
The “Double mobility” is not a current concept, it was developed in France in the mid-seventies. Because of its intrinsic mechanism of rolling one sphere over another, the lowest rate of prosthetic dislocation is obtained (first cause of revision during the first 5 years according to data from the Australian Prosthetic Registry). In France, currently almost 50% of surgeons use this technique, but it was not until the end of the first decade of the twenty-first century that its use has increased with the appearance on the market of the new polyethylenes with high cross-linking.
Different reports have shown a perfect combination in hyperlaxed patients, with neuropathies, muscular deficit of the hip, in obesity, in patients with lumbosacral fixation where the pelvis remains in an invariable position, in the treatment of advanced dysplasia, in deankylosis, etc. . and in prosthetic replacement surgery
The minimally invasive DSA approach allows the implementation of a double mobility system. The hip unit of the University Hospital Dexeus has a protocol of the technique according to individualized pathology and after a meticulous preoperative planning.
The mini-invasive approaches with tendinomusculocapsular, anterior direct and supracapsular protection assisted by the Superpath (R) portal as DSA have been implemented for years in the Dexeus University Hospital, being a reference center where specialists and residents in the specialty of Orthopedic Surgery and Traumatology meet. official MIR training program.
Yesterday, May 13 was a very intense day, 9 hip surgeries in which visitors from Mexico, Portugal, Romania, Spain (Madrid) and Japan, accompanied Dr Cardenas, head of the teaching unit of ICATME, in his interventions of prosthetic surgery and preservation surgery.
The Hip Unit receives around 5o annual visitors who request to attend the interventions of the members of our team. Once again, the Hip Unit proves to be a benchmark in the sector.
Sponsored by Brazilian Hip Society (SBQ), Dr. Manel Ribas as head of the Hip Unit of the Dexeus University Hospital (Quirónsalud group) participates with the presentation of 9 lectures that deal with topics ranging from pathology, its prevention and hip treatment in the young and in the athlete, whether elite or amateur and occasional.
Specialists surgeons from different parts of Brazil, sports doctors and rehabilitators attended this meeting. The event, organized by the well-known Prof. Lafayette Lage of Sao Paulo, was attended by renowned and renowned specialists such as Professor Javier Pérez Torres from Bogotá, Jorge Cruz from Meló, Fernando Leal, Manuel Padín from Oporto, and other renowned specialists from both sides of the Atlantic.
The importance of early detection of mechanical pathology of the hip was highlighted, as well as the treatment of the effects-causing lesions, mini-invasive surgery and its effect on the rapid recovery of patients.
Special emphasis was placed on modern mini-invasive techniques used to protect the capsule and its structures, in patients of all ages with osteoarthritis. Said prevention results in an increase in stability and a faster recovery by reducing the sensation of pain since the pain receptors remain unchanged, as well as the mechanoreceptors, and faster functionality is obtained.
On April 25 and 26, the annual Congress of SETRADE (Spanish Society of Sports Traumatology) was held in Palma de Mallorca, where two of the most recognized and world-renowned Spanish hip specialists attended: Dr. Luís Pérez Carro of Santander and Dr. Manuel Ribas of Barcelona.
The conference has been presented with a new and interesting format, where the experts sit on the stage, a rapporteur updates current knowledge by way of summary -by the way, many congratulations to the rapporteurs of the different round tables – and then an interactive dialogue is established between the moderator and the assistants.
On this occasion, Dr. Manuel Ribas participated as an expert and moderator at the “Femoroactabular Shock”, “Residual Dysplasia” and “Peripheral Hip Syndromes” (deep gluteus, ischiofemoral, infratuberal and trochanteric) tables. In these days, the current limitations of hip arthroscopy in different areas and the importance of the periacetabular osteotomy in the case of labral lesion due to Residual Dysplasia (insufficiency of femoral head coverage) were highlighted.
The Dexeus University Hospital is a reference in all of Southern Europe in the treatment of Periacetabular Osteotomy by a mini-invasive technique.
Dr. Ribas will soon move, as representative of the European Hip Society (EHS) to the Russian city Nizhny Novgorof (the third in number of inhabitants) to participate in the annual congress of the Russian Hip Society.
Dr Oliver Marín, chief hip surgeon at Infanta Leonor Hospital in Madrid, participates in the 2019 Ukrainian Hip Congress.
On April 24-27, the International Conference “Advanced Treatment of Hip and Knee Pathology” was held in the Ukrainian town of Kharkiv.
The congress was organized by doctors Stanislav Bondarenko and Olga Pidgaiska of the Ukrainian society of orthopedic surgery and traumatology. The hip reconstructive surgery part was held on Thursday, April 25 with the massive presence of Ukrainian orthopedic surgeons and neighboring countries, reaching 350 participants.
The subject of hip surgery addressed issues related to prosthetic surgery, producing very interesting debates on the most controversial topics of hip surgery.
This congress was held in collaboration with the European Hip Society (EHS) and the European Federation of Orthopedic Surgery and Traumatology (EFORT). With more than 20 international speakers sent by these societies, it became a showcase of hip surgery update. The local assistants contributed their questions to the debate and took the opportunity to share cases with the European speakers.
The Spanish representation consisted of the doctors Eduardo García-Rey and Oliver Marín-Peña, being the representation of the most numerous European countries.
Our instrumentalists, Laura De Vazeilles and Vanessa Leal, of the Hip Unit of Icatme, present in the National Nursing Congress the portal-assisted mini-invasive technique for the implantation of hip prostheses.
Regarding other prosthetic implantation techniques, “Superpath” has a very different and specific instrumentation. The success of the mini-invasive technique is multidisciplinary. It is fundamental the participation of all and our team of angular pillar instrumentalists on which we rely and depend.
Thank you very much Laura and Vanessa for being as you are.
Drs Dimitri Kanellopoulos and Vadim Benkovich, from Greece and Israel attend the Hip Unit of the Dexeus University Institute, to train together with Dr Carlomagno Cardenas (specialized instructor, head of Teaching at Icatme) in the mini-invasive technique “Superpath” of implantation of hip prosthesis.
This technique, in which no muscle is disinserted and in which the acetabular component is implanted through an accessory portal, provides less bleeding and allows an early return to daily activities.
Comparative studies with other approaches performed both in North America and in Australia show great differences, both in intra and postoperative bleeding, as well as hospital stay, consumption of analgesia and resumption of daily activities.
The Superpath Technique: Supracapsular Portal Assisted Total Hip is a technique that allows to implant a hip prosthesis without any need to section tendons or dislocate the hip to implant a hip prosthesis, in addition, it keeps intact all the innervation and vascularization of the hip
This is the interval through which the hip is approached without affecting muscles or tendons of both the anterior and posterior part. Those above are only required to be gently and gently separated without cutting them
On November 30, the XXIII Round Table on the prevention and treatment of athlete injuries was held in the Agora Room in Sitges. As every year, the topics have been radiant today: “Myths and truths about sports nutrition”, “Treatment of residual dysplasia in the athlete” or “Chronic posttraumatic encephalopathy”.
Dr. Manel Ribas, before a large audience full of personalities of medicine and the world of sport, said: “The residual dysplasia is not exclusive of an evolutionary sequel of newborns, diagnosed and treated for congenital hip dislocation. Impact on the adolescent can produce an early closure (in its maturation phase) of acetabular triradiate growth cartilage.Accordingly, there is a lack of acetabular coverage of the femoral head “.
After the appearance of the periacetabular osteotomy (1988), different authors in Europeans and Americans have shown an excellent rate of return to sport, either in medium or high impact modalities.
In light of the news that some media have spread, we must inform our patients that no implant – hip prosthesis, of those that have been and are being implanted in our University Hospital, are subject to withdrawal or alert to the Spanish Agency and international monitoring and control agencies.
We wish to emphasize that all these implants are approved and comply with European regulations.
We hope to transmit to you in this way a message of total tranquility.
Dr Manuel Ribas
Unidad de Cadera
Hospital Universitari Quirón-Dexeus