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.
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.
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.
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.
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.
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.
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.
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 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.
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.
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”.
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.