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.
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.
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.
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.
Dr Ribas participated in the Virtual Seminar on Double Mobility organized in Argentina this April 22, 2020.
For more than a decade, with the appearance of the new high cross linked polyethylene (HXLPE), the double mobility system born in France in 1974 by Prof Gils Bousquet (a 22 to 28 mm femoral head articulated with a large diameter HXLPE head) has enormous popularity, since in addition to providing great stability (superior to all conventional systems), it provides excellent clinical-functional results and durability. In the beginning, the polyethylene which if used in the present case is not comparable to actuality.
Nowadays the system with the improved polyethylene (HXLPE) holds very precise indications, especially in situations with special risk of dislocation, reducing these practically to zero. For this reason, in 2009, the North American FDA approved on use with the already new HXLPE.
In said seminar Drs. Ricardo Munafó and Federico Manfrin, expert in Duomobility in Argentina make an update. Dr. Manfrin explains the hip unit protocol of the University Hospital Dexeus as a case of his own Ribas.
The Duomobility represents a valid alternative in different situations as the Ribas includes in its protocol.
During the ascent phase and the peak phase of the Covid 19 pandemic curve, the Hip Unit has only deferred those non-urgent interventions (also called “electives”) following the rules dictated by the Alarm State Decree.
The protocols have been followed in the entire group of Quirónsalud hospitals. With the proper protection regulations, both for patients and healthcare personnel, and in completely separate circuits for Covid – and + patients, we have managed to satisfactorily attend to hip emergencies and their corresponding interventions.
Consultations have been made in the form of a telephone and telematic visit, to minimize the presence of patients in hospital facilities. In the case that attendance has been compulsory, they have been carried out with due spatial and temporal separation.
These prevailing rules will be followed until further notice. However, the ICATME hip unit, in view of the de-escalation of the curve in Spain, will resume its activity in a very short time under extremely strict preoperative, intraoperative and extraoperative protocols.
From here we want to thank the Quirónsalud group and its network of professionals, and especially those with whom we work at the Dexeus University Hospital for making it possible.
Communicated as of March 16, 2020 in relation to the current situation of the Coronavirus and its effects on visits and surgeries of the Hip Unit of ICATME – Hospital Universitari Dexeus.
Starting today, Monday the 16th and after the urgent meetings held over the weekend with the health authorities of the Hospital and the management of ICATME, it has been decided, acting with the greatest responsibility, to take the following measures, which will be subject to modifications as they change. the situation in the coming days:
At ICATME the well-being of our patients has always been a priority. The activity is maintained in a controlled way to provide coverage to those who need it.
Dr. Manel Ribas
Dr. Carlomagno Cardenas-Nylander
Dr. Vittorio Bellotti
Dr. Emanuele Astarita
Dr. Luís Ramírez- Núñez
Dr. Gabriel Chacón
Dr. Anna Isart
Dr. Víctor Aguirre is appointed by the Mexican College of Orthopedics and Traumatology Medical Holder in the Chapter of Hip and Knee Surgery for the Biennium 2020 and 2021.
The tasks attributed to this appointment for the whole country are:
Our most sincere congratulations to Dr. Victor Aguirre, whose training stay in the hip subspecialty in our unit has left us with a deep imprint.
After his formative stay in the Hip Unit, Dr. Víctor Aguirre performs periacetabular osteotomy for the treatment of adult residual dysplasia according to the mini-invasive technique, which in his day, 14 years ago, Ribas learned from Professor Kjeld Søballe and that other doctors of the Unit (Dr Carlomagno Cárdenas) also perform.
As we have already announced through our Twitter account, the reviewers and the scientific editorial confirm their next publication in the Spanish journal of Orthopedics and Traumatology.
This is the description of the periacetabular Ganz mini-invasive technique by Søballe mini-approach (JBJS Am 2008) with the technical variants developed by the Hip Unit itself and its results in the medium term, in a significant number of cases ( 131), which today have exceeded five hundred. It is the greatest experience in this technique in all of southern Europe.
The first signatory, developer and lead author is Dr. Ramírez-Núñez, helped by Dr. Ribas, who is carrying out a line of work and publications on this subject, which will soon bear fruit. From here, our most sincere thanks to the fellows who, during these years, have made possible, with their collaboration, such a great database.
Remember also that Dr. Ribas learned periacetabular osteotomy from the hands of Dr. Robert Trousdale in 2003 during his stay at the Mayo Clinic with Dr. Oliver Marín of Madrid and Dr. Javier Camacho of Mexico City. He started it in September 2003 and in his mini-invasive variant in 2007, after his stay in Denmark with Professor Söballe (one year before its publication in the JBJS Am 2008).
Dr Ribas, for the third consecutive year, participates in the official congress of the Mexican Society of Hip Surgery in the company of famous world-famous surgeons such as Professor Reinhold Ganz, Professor Miguel Cabanela, Professor David Kendoff, Professor Mariano Fernández Fairén and the most recognized hip surgeons in the Central American country.
On this occasion there will even be an extra day of live surgery, in which Dr. Ribas will carry out jointly with expert surgeons from the country trained in the hip unit of Dexeus University Hospital, Dr. Victor Aguirre and Dr. Edwin a periacetabular osteotomy of Ganz but via mini-invasive, which will be commented live to the auditorium by Professor Reinhold Ganz himself.
This is the first time that Dr. Manuel Ribas has performed Ganz periacetabular osteotomy, in his minimally invasive variant approach, in the presence of its inventor, in 1988, the very and very honorable Professor Reinhold Ganz. As always, Dr. Ribas had recognition during his speech; not surprisingly, Dr Ribas translated this technique from German into Spanish in the “Operative Orthopädie und Traumatology” magazine by Springer (1990), published in Spanish by Doyma Publishing.
Dr Ribas always dedicated himself to the translation of articles and techniques published in said magazine during the following 13 years. That meant a great acquisition of knowledge in the specialty of Orthopedic Surgery and Traumatology. Currently this journal is indexed medline and Dr. Ribas already has published various techniques in the field of hip surgery.
During these days, you will also have the opportunity to give other master readings in the field of femoroacetabular shock surgery, pain surgery in the pubic-inguinal complex (of which it is a world reference, with techniques that bear the same name), of the ruptures of the gluteal tendons at the level of the greater trochanter (the so-called trochanteritis and even trochanteric bursitis), of the acetabular labrum transplant and finally, will also talk about the mini-invasive periacetabular osteotomy in athletes.
Last Monday, in the capital of Dubai Abi Dhabi, the advanced medical assistance plan for the citizens of that emirate state was presented to the Dubai Ministry of Health.
Two representatives of Icatme, Professor Enric Cáceres and Dr Ignacio Ginebreda, presented to the country’s authorities the program of comprehensive specialized assistance based on excellence, in which the Hip Unit will have, like the other Icatme units, a relevant role The Quirónsalud group manager, Don German Barraqueta, signed two MOUs (Memorandum for Organization and Understanding) with the health authorities of Dubai and Abu Dhabi.
This fact highlights the expansive nature of knowledge that exists in the world about the whole group, always linked to evidence-based medicine but also excellence.
Link to the news to the local Dubai press.