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Copyright of Revista Nutrición Clínica y Dietética Hospitalaria is the property of Sociedad Espanola de Dietetica y Ciencias de la Alimentacion and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

En el presente estudio investigamos la prevalencia, características y rasgos clínicos del síndrome benigno de hipermovilidad articular en 575 sujetos sanos. El diagnóstico se estableció empleando los criterios diagnósticos de Carter y Wilkinsoncon la modificación de Beighton.Encontramos una prevalencia global del síndrome benigno de hipermovilidad articular del 17.21% en nuestra población, la cual fue mayor en las mujeres (21.65%) que en los varones (11.87%); además la prevalencia disminuyó significativamente con la edad. La única asociación importante y estadísticamente significativa (p< 0,05) que encontramos fue entre el síndrome benigno de hipermovilidad articular y la presencia de cambios artrósicos. Los criterios diagnósticos más sensibles fueron la oposición pasiva del pulgar al borde interno del antebrazo y la hiperextensión del codo mayor de 10 grados, mientras que los criterios mas específicos fueron: hiperextensión pasiva de las rodillas mayor de 10 grados y extensión de la muñeca y articulaciones metacarpofalángicas de manera que los dedos queden paralelos al antebrazo.

Objective: To determine the prevalence and related factors of diagnosed osteoarthrosis (DO) and undiagnosed osteoarthrosis (UO) in the general Spanish adult population. Setting: Cross-sectional study with data from the Spanish National Health Survey 2017. Participants: N = 23,089 adults. Three groups of people were defined: DO, UO, and no osteoarthrosis (NO). Main measurements: Sociodemographic information, lifestyle (tobacco, alcohol, physical activity, body mass index) and health factors (intensity of pain, pain drug consumption, mental health, self-perceived health status, pain involvement in daily living) were collected. Descriptive and bivariate analyses were performed, and a multinomial logistic regression model for the factors associated with each group. Results: The prevalence of DO was 22.4% (95%CI = 21.8;22.9) and 0.9% (95%CI = 0.8;1) of UO. With respect to NO, risk factors for DO and UO included higher pain levels and pain drug consumption. Better self-perceived health status was inversely related with both. More pain involvement in daily living was associated with increased risk of DO, but reduced risk of UO. Conclusions: The prevalence of DO and UO was similar to that reported in Europe, but slightly higher than in low/middle-income countries. It was more prevalent in females, older people, people with worse perceived health status and worse mental health. Higher pain levels and pain drug consumption were risk factors for DO and UO. Better self-perceived health status was protective. Pain involvement in daily living was a risk factor for DO, but protective for UO. Different public health strategies should be considered in view of this. Resumen: Objetivo: Determinar la prevalencia y factores asociados a la artrosis diagnosticada (DO) y no diagnosticada (UO) en la población general adulta española. Emplazamiento: Estudio transversal con datos de la Encuesta Nacional de Salud en España 2017. Participantes: n = 23.089 adultos. Tres grupos definidos: DO, UO y sin artrosis (NO). Mediciones principales: Datos sociodemográficos, estilo de vida (tabaco, alcohol, actividad física, índice de masa corporal [IMC]) y salud (intensidad del dolor, consumo de analgésicos, salud mental, estado de salud autopercibido, impacto del dolor en la vida diaria). Se realizaron análisis descriptivos, bivariados y un modelo de regresión logística multinomial para los factores asociados a cada grupo. Resultados: La prevalencia de DO fue 22,4% (intervalo de confianza [IC] 95% = 21,8;22,9) y UO, 0,9% (IC 95% = 0,8;1). Los factores de riesgo para DO y UO incluyeron mayores niveles de dolor y consumo de analgésicos. El mejor estado de salud autopercibido se relacionó inversamente con ambos. El mayor impacto del dolor en la vida diaria se asoció con un mayor riesgo de DO, pero menor riesgo de UO. Conclusiones: La prevalencia de DO y UO fue similar a la europea, pero ligeramente superior a países de bajo/medio nivel de ingresos, más prevalente en mujeres, personas mayores, con peor estado de salud autopercibido y peor salud mental. Los mayores niveles de dolor y consumo de analgésicos fueron factores de riesgo para DO y UO. El mejor estado de salud fue protector. El impacto del dolor en la vida diaria fue un factor de riesgo para DO, pero protector para UO. Se deben considerar diferentes estrategias de salud pública en vista de estos resultados.

Introduction: pain in the pubic symphysis, even if studied in athletes, still sets out diagnostic and therapeutic challenges in other patient groups. Within this context, refractory osteorthritis of the pubic symphysis presents itself as an issue lacking clear therapeutic consensus. Material and methods: two women over 65 years old and presenting osteoarthritis of the pubic symphysis were evaluated. Following unsuccessful conventional therapies, arthrodesis via subpubic plate, wire suture and autologous graft from the iliac crest was performed. Results: after a one-year of following, both patients experienced clinical and radiographic improvement. Bone arthrodesis was achieved without significant complications, proving to be a viable surgical option. Conclusion: this study supports the medium and long-term efficacy of arthrodesis of the pubic symphysis in refractory cases of osteoarthrisis. Therefore, the technique can be considered a surgical option in the management of said condition. [ABSTRACT FROM AUTHOR]

Introduction: The fat of the synovial joints can be used to maintain the joint structure. Our objective is to analyse the evolution of joint degeneration in knees with and without adipose pack. Material and methodology: In six sheep, the anterior cruciate ligament was sectioned in both knees, to cause osteoarthritis. In one group the fat pack was preserved and in another group it was completely removed. We performed a histological and molecular biology study analyzing the expression, in the synovial membrane, subchondral bone, cartilage, fat, meniscus, and synovial fluid, of RUNX2, PTHrP, cathepsin-K, and MCP1. Results: We did not find morphological differences. We found increased expression of RUNX2 in synovial membrane, PTHrP and Cathepsin K in synovial fluid in the group without fat, and increased expression of RUNX2 in the meniscus and MCP1 in synovial fluid in the group with fat. Conclusion: Infrapatellar fat participates in the inflammatory process that accompanies osteoarthritis, since Hoffa fat pad resection alters pro-inflammatory markers, while the model with intact fat increases the pro-inflammatory marker MCP1 in synovial fluid. Resumen: Introducción: La grasa de las articulaciones sinoviales puede servir para el mantenimiento de la estructura articular. Nuestro objetivo es analizar la evolución de la degeneración articular en rodillas con y sin paquete adiposo. Material y metodología: En 6 ovejas se efectuó la sección del ligamento cruzado anterior en ambas rodillas, para provocar una artrosis. En un grupo se preservó el paquete adiposo y en otro grupo se extirpó completamente. Realizamos un estudio histológico y de biología molecular analizando la expresión —en la membrana sinovial, el hueso subcondral, el cartílago, la grasa, el menisco y el líquido sinovial— de RUNX2, PTHrP, catepsina-K y MCP1. Resultados: No encontramos diferencias morfológicas. Se detectó aumento de la expresión de RUNX2 en la membrana sinovial, PTHrP y catepsina-K en el líquido sinovial en el grupo sin grasa y aumento de la expresión RUNX2 en el menisco y MCP1 en el líquido sinovial en el grupo con grasa. Conclusión: La grasa infrapatelar participa en el proceso inflamatorio que acompaña en la artrosis, pues la resección de la grasa de Hoffa altera los marcadores proinflamatorios, mientras que el modelo con la grasa intacta incrementa el marcador proinflamatorio MCP1 en el líquido sinovial.

Pseudoseptic arthritis is a rare complication of hyaluronic acid injections that often is difficult to differentiate from septic arthritis. Patients present acute pain, swelling and joint effusion normally around 24 h after the second or third infiltration. We describe a female patient with seropositive rheumatoid arthritis and flare-ups of knee arthritis with pseudoseptic features in the past, who develops pseudoseptic arthritis of the knee following her first injection of hyaluronic acid. [ABSTRACT FROM AUTHOR]

Introducción Las prótesis trapeciometacarpianas son implantadas desde hace más de 50 años. Entre sus complicaciones, destacan la posibilidad de osteolisis, aflojamiento o luxación. Con el fin de disminuir el riesgo de luxación, se desarrollaron las prótesis trapeciometacarpianas de doble movilidad.

La patología de hombro es una de las causas más comunes de atención en salas de Ortopedia, y puede deberse a múltiples entidades, como inestabilidad, lesiones del manguito rotador, artrosis, capsulitis adhesiva, que pueden provocar un sinnúmero de signos o síntomas, y requerirán un manejo integral. Uno de los pilares fundamentales en el manejo de la patología de hombro es la fisioterapia. El avance tecnológico ha permitido la incorporación de dispositivos que nos ayudan a mejorar el proceso de fisioterapia. En este estudio, compartimos nuestra experiencia con el uso del Shoulder Pacemaker®, un dispositivo diseñado para mejorar el balance muscular en pacientes con patología de hombro.

Las denominadas patologías artrósicas engloban un conjunto de procesos crónicos, inflamatorios y degenerativos, muy frecuentes en poblaciones contemporáneas, para las cuales han sido propuestas como desencadenantes la edad, el sexo, la predisposición genética, los traumas, la obesidad, y las actividades laborales/deportivas. El objetivo de nuestro trabajo fue establecer la prevalencia de la artrosis vertebral anterior (AVA) en una población urbana contemporánea y su relación con la edad y el sexo de los individuos. Se analizaron 95 esqueletos (45 masculinos, 50 femeninos), pertenecientes a la Colección Lambre (La Plata, Argentina). Para el diagnóstico de la patología se relevaron: a) labiación, b) generación de tejido óseo, c) porosidad en las superficies articulares, d) osteofitos verticales mayores a 2 mm y e) eburnación. Los resultados mostraron un 84,21% de individuos afectados sin diferencias entre sexos. Un 60% presentó AVA en la zona cervical, 76,8% en el área torácica, y 74,7% en la zona lumbar. En menores de 50 años fue afectado un 53,85%, porcentaje significativamente menor a los hallados en los rangos 51-70 y mayores de 70 (93,02% y 100% respectivamente). Con el envejecimiento, la severidad de las lesiones aumenta de manera significativa. Estos resultados confirman la alta prevalencia de la patología en nuestra población, la baja implicancia del sexo como factor desencadenante y la relación directa entre la afección y el proceso de envejecimiento.

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Medicina (Buenos Aires) is the property of Medicina (Buenos Aires) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista del Museo de Antropología is the property of Museo de Antropologia - IDACOR and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Dilemas Contemporáneos: Educación, Política y Valores is the property of Dilemas Contemporaneos: Educacion, Politica y Valores and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: alkaptonuria is a very rare metabolic disease with autosomal recessive inheritance due to HGA oxidase deficiency. Classically described and diagnosed in the third to fourth decade of life, affecting both men and women; Its diagnostic impression is clinical based on the blue/black coloration of the conjunctivae, however it is confirmed by the specific analysis of the enzyme in the urine, to date there is no cure and its treatment is palliative and symptomatic. Material and methods: descriptive, observational, case series study, the primary objective of which is to describe the progression of the disease and its involvement in the musculoskeletal system. Results: two clinical cases are presented in women and men in which the broad clinic is illustrated, its progressive advance and the different alterations that it can generate in the musculoskeletal system. Conclusions: alkaptonuria is a rare disease which leads to a severe secondary arthropathy, currently without a specific management which is based on treating the symptoms, in its final stages joint replacements are a management option with satisfactory results for the relief of pain. [ABSTRACT FROM AUTHOR]

Osteoarthritis is a joint disease affecting 7 million people in Spain, which causes pain and affects patients' mobility and autonomy, as well as the psychological wear and tear it entails. Of these 7 million, more than 2 million suffer from osteoarthritis and cardiovascular pathology. At OAFI (Osteoarthritis Foundation International) we believe that it is essential to promote pharmacological treatments that do not generate a vascular risk and to promote self-management strategies to avoid unhealthy weight as well as daily physical activity; to improve patients' health conditions and quality of life. Recent epidemiological studies have shown that the use of chondroitin sulfate and glucosamine reduces the risk of stroke and cardiovascular accidents, such as ischemic stroke and acute myocardial infarction. Therefore, we believe these drugs should be considered the first therapeutic choice for treating osteoarthritis, due to their efficacy, safety and relevant cardiovascular and cerebrovascular benefits, which positively impact this significant and inexplicably neglected patient population in medicine and scientific research. [ABSTRACT FROM AUTHOR]

Objective: To determine if subchondral bone damage can influence the clinical results of intraarticular platelet-rich-plasma (PRP) treatment in knee osteoarthritic patients., Material and Methods: A retrospective review of patients treated with intraarticular PRP injections for knee osteoarthritis who previously underwent a Magnetic Resonance (MR) of the knee was performed. Visual Analogic Score (VAS) was assesed for pain, whereas WORMS MR score was adapted to assess the damage to the subchondral bone (WORMSsc score)., Results: Sixty-one patients were treated with 3 weekly injections of PRP. Mean VAS reduction was 27.67 ± 13.13 points (P<.005). WORMS sc mean score was 32 ± 18.5 points. NO correlation between WORMSsc and VAS was found. A moderate correlation between WORMSsc score and Preoperative VAS was found (r=.43; P<.005)., Conclusion: There is no correlation between the damage to the subchondral bone assesed by MR and pain relief at 12 weeks in patients treated with intraarticular platelet-rich plasma in patients with knee osteoarthritis. A greater damage to the subchondral bone could be associated with more pain., (Copyright © 2024 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objetivo: Describir la técnica quirúrgica, las indicaciones y los resultados iniciales de la osteotomía periacetabular bernesa para tratar la displasia del desarrollo de la cadera. Materiales y Métodos: Entre mayo de 2011 y mayo de 2020, se realizaron 44 osteotomías periacetabulares bernesas en 44 pacientes (35 mujeres, edad promedio 30 años [rango 23-38]). Todos tenían diagnóstico de displasia de cadera sintomática. El ángulo centro-borde promedio fue de 17° (rango 9°-20°) y el índice acetabular promedio, de 18° (rango 15°-20°). En 22 casos, se evaluaron y repararon los hallazgos intrarticulares por artroscopia en el mismo acto quirúrgico. Se evaluaron la corrección obtenida, la consolidación de la osteotomía y los resultados funcionales al final del seguimiento. Resultados: En 22 pacientes, se detectó hipertrofia y rotura del labrum acetabular asociadas a displasia de cadera. Diez pacientes tenían quistes paralabrales. El ángulo centro-borde promedio posoperatorio fue de 32° (rango 27°-35°) y el índice acetabular, de 6° (rango 4°-9°). El tiempo quirúrgico para la osteotomía periacetabular bernesa fue de 130 min, cuando se sumó un procedimiento artroscópico, el tiempo fue de 148 minutos. Conclusiones: La osteotomía periacetabular bernesa es técnicamente demandante, pero logra resultados predecibles en pacientes con integridad del cartílago articular y deformidades corregibles. La artroscopia antes de la osteotomía permite evaluar las condiciones del cartílago, diagnosticar y tratar lesiones intrarticulares asociadas con esta enfermedad y decidir si es necesaria la corrección del déficit de cobertura.

Hallux rigidus is the degenerative pathology of the metatarsophalangeal joint of the hallux. This pathology causes pain and decreased movement. There are multiple surgical treatments for this pathology, all with their respective indications. We present the case of a 54-year-old patient diagnosed with hallux rigidus who had only the lateral aspect of the metatarsal head affected. This patient was treated with a novel surgical procedure, performing an interposition hemiarthroplasty using the hallucis brevis extender associated with a cheilectomy and exostectomy. The patient had a favorable clinical evolution with improvement evidenced by clinical scales, with resolution of the symptoms and without complications. Interposition hemiarthroplasty using the extensor hallucis brevis is a successful joint and movement preservation treatment for hallux rigidus in young patients with lateral unicompartmental involvement of the metatarsal head, in whom it is important to preserve movement. [ABSTRACT FROM AUTHOR]

Introduction: Chondroitin sulfate was proposed as a more appropriate strategy for osteoarthritis long-term management than conventional treatment (nonsteroidal anti-inflammatory drugs and acetaminophen). However, its efficacy has been widely discussed and its public financing by the Spanish National Health System has been questioned. The aim of this paper was review on the clinical and economic aspects of chondroitin sulfate in osteoarthritis treatment. Method: A bibliographic search of recent literature was carried out until March 9th, 2022. The databases used were MEDLINE and Scopus. Results: According to the set of clinical studies identified in the search, chondroitin sulfate was effective in reducing cartilage volume loss, its clinical effects were estimated by objective (magnetic resonance or specific biomarkers) and subjective (visual analog pain scale or Lequesne index) outcome measures. In the set of studies reviewed, chondroitin sulfate proved to be an acceptable therapeutic option in clinical terms. Regarding economic aspects, only one study was identified, according to which, the prescription of chondroitin sulfate implies a lower cost per patient compared to non-steroidal anti-inflammatory drugs. Conclusion: From the clinical and economic points of view, the findings of this brief review justify the presence of chondroitin sulfate in osteoarthritis guidelines. [ABSTRACT FROM AUTHOR]

Resumen Introducción: El empleo de los condroprotectores se presentó como una estrategia mejor encaminada al tratamiento de la artrosis por su efecto modulador y mayor seguridad. Sin embargo, su empleo es discutido y serán retirados de la financiación por el Sistema Nacional de salud (SNS). El objetivo fue revisar y comparar los condroprotectores en términos de eficacia (sobre dolor, función y estrechamiento articular), seguridad y rentabilidad en el manejo de la artrosis. Metodología: Se ha realizado una búsqueda bibliográfica de la literatura. Las bases de datos utilizadas fueron Medline y Scopus. Se revisó guía médica de la ESCEO (European Society for Clinical and Economic Aspects of Osteoarthritis), estudio epidemiológico de la Sociedad Española de Reumatología y fichas técnicas de medicamentos de la Agencia Española del Medicamento. Resultados: Se identificaron un total de 152 artículos con los algoritmos de búsqueda utilizados y los criterios de inclusión/exclusión aplicados. Después de leer títulos y resúmenes, 79 fueron excluidos porque no adecuarse a la calidad metodológica requerida o tratar otras aplicaciones diferentes a la artrosis. Tras la lectura íntegra del resto de artículos, se seleccionaron 36 artículos que se adaptaban al objetivo de este trabajo. Conclusiones: Los ensayos clínicos que evaluaron la diacereína y el condroitín sulfato tuvieron diseños muy variables que podrían justificar la variabilidad de los resultados obtenidos. Con la desfinanciación de estos fármacos por el SNS, el ahorro esperado podría revertirse por el empleo de recursos sanitarios más costosos en el futuro dado el enfoque a corto plazo de las terapias permanentes.

Osteoarthritis is the first cause of chronic pain in the European population with a great socioeconomic impact both in direct and indirect costs, being one of the most prevalent causes of disability in our environment. For this reason, it must be considered as a public health problem with its own entity, and efforts to improve diagnosis, treatment and prevention must be a priority. The therapeutic approach to this pathology must be multimodal, promoting non-pharmacological measures associated with pharmacological treatments, as well as intra-articular therapies such as viscosupplementation or new regenerative techniques, improving the quality of life and functionality of patients with joint degeneration. Knowledge of the pathophysiological mechanisms of osteoarthritis is facilitating new therapeutic possibilities with the aim of obtaining more personalized therapies due to the great clinical variability. [ABSTRACT FROM AUTHOR]

El reemplazo total de rodilla (RTR) es un procedimiento quirúrgico, indicado en pacientes que presentan osteoartrosis severa (grado III - IV) de la articulación. Se han desarrollado diversas técnicas de analgesia para disminuir el dolor en el RTR. Objetivo: Evaluar la eficacia del bloqueo capsular versus bloqueo por infiltración entre la arteria poplítea y la cápsula de la rodilla (IPACK) en el manejo del dolor en pacientes tratados con RTR. Materiales y métodos: Se realizó un estudio observacional, analítico, de cohorte prospectivo, durante 10 meses, en 20 pacientes con artrosis severa de rodilla, corroborada por estudio de imágenes. A 10 pacientes se les aplicó el bloqueo IPACK guiado bajo ecografía con levobupivacaína y a los otros 10 pacientes se les aplicó el IPACK con la mezcla de Ranawat luego del cementado de la prótesis durante el acto quirúrgico. En un segundo tiempo, a las 24 y 48 horas del postoperatorio se aplicó un instrumento de evaluación para determinar la funcionalidad de la rodilla considerando los grados de flexión y el nivel de analgesia mediante la escala visual análoga del dolor (EVA). Resultados: No se presentaron diferencias significativas entre ambas técnicas anestésicas, sin embargo los grados de flexión con el bloqueo capsular fueron más altos con respecto al bloqueo IPACK así mismo que con la escala visual análoga del dolor. Conclusión: Los dos bloqueos resultan ser eficientes para el manejo del dolor postoperatorio en pacientes con reemplazo articular de rodilla.

Induction of osteoarthritis (OA) following diabetes is characterized by a sever inflammation of the joints that can lead to disability. The cartilage content of proteoglycans can substantially be reduced, following the induction of diabetes mellitus associated with inflammation as well as knee joint injury, and the antidiabetic drug metformin combined with the antiinflammatory agent resveratrol can prevent these deleterious effects. Therefore, insulin-independent diabetes, type 2 diabetes mellitus (T2DM) was induced in Albino rats by streptozotocin (STZ) injection (50 mg/kg) after being fed on a high carbohydrate and fat diets for 2 weeks. The protective group of rats which also received a single injection of STZ was treated daily with metformin (Met; 200 mg/kg) and resveratrol (Res; 30 mg/kg) for 12 weeks. Harvested knee joint tissues were prepared for basic histology stain and for proteoglycans staining using light microscopy. Histology images showed in diabetic rats (T2DM) OA development as demonstrated by profound injury to the knee joint and severe decrease of articular cartilage proteoglycans content, which were substantialy protected by Met+Res. Met+Res also significantly (p< 0.0001) decreased diabetes induced glycemia, dyslipidemia, and the inflammatory biomarkers, tumor necrosis factor-alpha (TNF-a), interleukin-6 (IL-6), and high sensitivity C-reactive protein (hs-CRP). In addition, there was a significant correlation between OA and glycemia, dyslipidemia, and inflammation. Collectively, we demonstrate an association between knee joint damage and biomarkers of glycemia, dyslipidemia, and inflammation in diabetes-induced OA, with metformin plus resveratrol providing protective effects. [ABSTRACT FROM AUTHOR]

Copyright of Avances en Odontoestomatologia is the property of Ediciones Avances SL and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Sesión del 10 de Junio de 1938.

Objetivo: El objetivo del estudio es evaluar si la desprescripción de medicamentos considerados de bajo valor intrínseco como los condroprotectores o SYSADOA, conlleva un empeoramiento sintomático de la artrosis, incrementándose el consumo de analgésicos. Material y métodos: Siguiendo la práctica clínica habitual se retiró el tratamiento con SYSADOA a pacientes de un Centro de Atención Primaria (población asignada: 34.382 habitantes, 17% mayores de 65 años) en base a la evidencia científica publicada y a la recomendación de la administración sanitaria de reducir los tratamientos con medicamentos de bajo valor intrínseco. Mediante un estudio observacional post-intervención se analizaron diferencias de consumo de analgésicos y AINEs entre un periodo anterior a la retirada y el mismo periodo post-retirada. Resultados: Se analizaron 354 pacientes (68,4% mujeres, media de edad 66,2 años). No se encontraron diferencias estadísticamente significativas en el consumo de analgesia total en el periodo de 6 meses post-retirada (media de 3,97 envases) comparado con el periodo de 6 meses previo (media de 4,04 envases). Al estratificar por código ATC, edad y género, únicamente se encontraron diferencias en el consumo de otros analgésicos y antipiréticos teniendo en cuenta el sexo. Conclusión: Se concluye que, considerar con el paciente la desprescripción de SYSADOA a criterio del médico, es seguro y no conlleva un aumento del consumo de analgésicos (otros analgésicos y antipiréticos, AINE, opioides menores, opioides mayores) sugiriendo que no implica un empeoramiento de la enfermedad artrósica. La desprescripción de SYSADOA, además, puede contribuir a reducir la polimedicación sin alterar la situación clínica y evitar posibles riesgos de efectos adversos o interacciones potenciales.

Objective: To determine if subchondral bone damage can influence the clinical results of intraarticular platelet-rich-plasma (PRP) treatment in knee osteoarthritic patients., Material and Methods: A retrospective review of patients treated with intraarticular PRP injections for knee osteoarthritis who previously underwent a Magnetic Resonance (MR) of the knee was performed. Visual Analogic Score (VAS) was assesed for pain, whereas WORMS MR score was adapted to assess the damage to the subchondral bone (WORMSsc score)., Results: Sixty-one patients were treated with 3 weekly injections of PRP. Mean VAS reduction was 27.67±13.13 points (P<.005). WORMS sc mean score was 32±18.5 points. NO correlation between WORMSsc and VAS was found. A moderate correlation between WORMSsc score and Preoperative VAS was found (r=.43; P<.005)., Conclusion: There is no correlation between the damage to the subchondral bone assesed by MR and pain relief at 12 weeks in patients treated with intraarticular platelet-rich plasma in patients with knee osteoarthritis. A greater damage to the subchondral bone could be associated with more pain., (Copyright © 2024 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: To determine the prevalence and related factors of diagnosed osteoarthrosis (DO) and undiagnosed osteoarthrosis (UO) in the general Spanish adult population., Setting: Cross-sectional study with data from the Spanish National Health Survey 2017., Participants: N=23,089 adults. Three groups of people were defined: DO, UO, and no osteoarthrosis (NO)., Main Measurements: Sociodemographic information, lifestyle (tobacco, alcohol, physical activity, body mass index) and health factors (intensity of pain, pain drug consumption, mental health, self-perceived health status, pain involvement in daily living) were collected. Descriptive and bivariate analyses were performed, and a multinomial logistic regression model for the factors associated with each group., Results: The prevalence of DO was 22.4% (95%CI=21.8;22.9) and 0.9% (95%CI=0.8;1) of UO. With respect to NO, risk factors for DO and UO included higher pain levels and pain drug consumption. Better self-perceived health status was inversely related with both. More pain involvement in daily living was associated with increased risk of DO, but reduced risk of UO., Conclusions: The prevalence of DO and UO was similar to that reported in Europe, but slightly higher than in low/middle-income countries. It was more prevalent in females, older people, people with worse perceived health status and worse mental health. Higher pain levels and pain drug consumption were risk factors for DO and UO. Better self-perceived health status was protective. Pain involvement in daily living was a risk factor for DO, but protective for UO. Different public health strategies should be considered in view of this., (Copyright © 2024 The Authors. Publicado por Elsevier España S.L.U. All rights reserved.)

Introduction: Closing wedge high tibial osteotomy (CW-HTO) is a surgical option for active patients with medial knee pain and mild-moderate osteoarthritis with varus limb deformity. Despite its good reported results, this technique has been losing popularity. The aim of this study was to analyse the survival rate, clinical functional outcomes and radiological results of CW-HTO., Methods: It is a retrospective case series study. Seventy patients with primary knee osteoarthritis, operated on between 2010 and 2020 in a single Spanish tertiary hospital using the CW-HTO technique and with a minimum follow-up of 2 years were analysed., Results: Survival rate was 87,6% and 75,5% after a follow-up of 5 and 10 years respectively. Functional outcomes were good-to-excellent (KSS 77.7/100 and OKS 35.6/48) and good pain control (VAS 3.9/10) and high satisfaction (7.2/10) were achieved. Limb varus malalignment was significantly corrected (mean postoperative HKA angle 177,6° and MPTA 90,7°). However, 30% of patients presented hypocorrection, which was associated with inferior survival, functionality and satisfaction., Conclusion: CW-HTO technique can be useful for patients with knee osteoarthritis and varus limb. It allows to correct varus malalignment while achieving good-to-excellent functional outcomes, good pain control, high patient satisfaction and acceptable medium-long term survival rate. However, it is associated with a non-negligible risk of hypocorrection or medial hinge disruption., (Copyright © 2023 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.)

La Sociedad Española de Reumatología elaboró en el año 2000 el estudio EPISER2000 para conocer la prevalencia de la artrosis y otras enfermedades reumáticas en España. Los cambios sociodemográficos y en los hábitos de vida ocurridos en los últimos años en España justifican actualizar los datos de las enfermedades reumáticas (EPISER2016). Estimar la prevalencia de artrosis sintomática de columna cervical, columna lumbar, cadera, rodilla y mano, en población adulta en España. Estudio transversal de base poblacional. Se realizó un muestreo aleatorizado polietápico estratificado y por conglomerados. Los participantes fueron contactados por teléfono para cumplimentar un cuestionario de cribado de artrosis. El reumatólogo confirmaba o descartaba el diagnóstico. Se utilizaron los criterios-clínicos-ACR para diagnosticar artrosis de manos y los criterios clínico-radiológicos-ACR para diagnosticar la artrosis de rodilla y cadera. La prevalencia de artrosis en España en una o más de las localizaciones estudiadas fue de 29,35%. La prevalencia de artrosis-cervical fue del 10,10% y de artrosis-lumbar del 15,52%. Ambas son más frecuentes en mujeres y a mayor edad, así como en personas con niveles de estudios bajos y obesidad. La prevalencia de artrosis de cadera fue del 5,13% y la de artrosis de rodilla del 13,83%; estas se asocian con el sexo femenino, sobrepeso y obesidad, menor frecuencia en nivel de estudios alto y con la edad. La prevalencia de la artrosis de mano fue del 7,73%. Es más frecuente en mujeres, obesas, con bajo nivel de estudios y mayor edad. El estudio EPISER2016 es el primero que analiza la prevalencia de artrosis sintomática en 5 localizaciones (columna cervical, lumbar, rodilla, cadera y manos) en España. La artrosis de la columna lumbar es la más prevalente. The Spanish Society of Rheumatology carried out the EPISER2000 study in 2000 to determine the prevalence of osteoarthritis and other rheumatic diseases in the Spanish population. Recent sociodemographic changes and lifestyle habits in Spain justified updating the epidemiological data on osteoarthritis and other rheumatic diseases (EPISER2016-study). To estimate the prevalence of symptomatic osteoarthritis of the cervical spine, lumbar spine, hip, knee and hand in the adult population in Spain. Cross-sectional population-based study. A multistage and stratified random cluster sampling was carried out. The participants were contacted by telephone to complete an osteoarthritis screening questionnaire. A rheumatologist confirmed or discarded the diagnosis. The ACR-clinical-criteria were used to diagnose hand-osteoarthritis and the ACR-clinical-radiological criteria to diagnose knee- and hip-osteoarthritis. To estimate the prevalence and its 95% confidence interval, weights were calculated according to the probability of selection in each of the sampling stages. The prevalence of osteoarthritis in Spain in one or more of the locations studied was 29.35%. The prevalence of cervical-osteoarthritis was 10.10% and of lumbar-osteoarthritis 15.52%. Both are more frequent in women and at older ages, as well as in people with low levels of education and obesity. The prevalence of hip-osteoarthritis was 5.13%, that of knee-osteoarthritis 13.83%, these are associated with female sex, overweight and obesity. The prevalence of hand osteoarthritis was 7.73%. It is more frequent in women, who are obese, with a low educational level and who are older. The EPISER2016 study is the first to analyse the prevalence of symptomatic osteoarthritis in 5 locations (cervical, lumbar, knee, hip and hands) in Spain. Lumbar spine osteoarthritis is the most prevalent. [ABSTRACT FROM AUTHOR]

Introduction: The use of chondroprotectives was presented as a better strategy aimed at the treatment of osteoarthritis due to its attributed chondromodulatory effect and greater safety. However, their use is disputed. The aim of the present work was to review and compare the chondroprotectives in terms of efficacy (on pain, function and joint narrowing), safety and economic profitability in the management of osteoarthritis. Methodology: A bibliographic search of the literature published has been carried out. The databases used were Medline and Scopus. The medical guide of the ESCEO (European Society for Clinical and Economic Aspects of Osteoathritis), the epidemiological study of the Spanish Society of Rheumatology and the technical sheets of medicines of the Spanish Agency of Medicines were reviewed. Results: A total of 152 articles were identified with the search algorithms used and the inclusion/exclusion criteria applied. After having read titles and abstracts, 79 were excluded because they did not conform to the required methodological quality or to treat other applications other than osteoarthritis. After reading the rest of the articles in their entirety, 36 articles were finally selected that were adapted to the objective of this work. Conclusions: The clinical trials that evaluated diacerein and chondroitin sulfate had highly variable designs that could justify the variability of the results obtained. With the underfunding of these drugs by the SNS, the expected savings could be reversed by the use of more expensive healthcare resources in the future given the short-term focus of permanent therapies. [ABSTRACT FROM AUTHOR]

A significant number of young active adults are affected by focal chondral lesions. These lesions, if left untreated, will progress to osteoarthritis (OA). OA is one of the main debilitating musculoskeletal diseases and leads to a high economic and social burden. Despite surgical cartilage repair for focal chondral lesions, which improve patient-reported outcomes at short- and mid-term, there is a risk of early OA progression. Biological treatments (i.e., stem-cell therapy, bioengineering) have made great progress in the last years. Tissue engineering is an evolving field for articular cartilage repair which could potentially be used for the treatment of focal chondral lesions, promoting regeneration and preventing joint surface degeneration. Stem cells and hydrogels may provide a functional, dynamic and biologically equivalent tissue that promotes tissue regeneration while being gradually degraded and replaced. The standard approach to tissue engineering consists in delivering cells within a hydrogel or a three-dimensional printed biomaterial scaffold into the chondral lesion to induce regeneration. This review focuses on the current and future use of hydrogels and tissue scaffold bioprinting for the treatment of focal chondral lesions, and provides preliminary data from two pilot animal studies.

Introducción: La artrosis (OA) es una enfermedad musculoesquelética degenerativa que afecta aproximadamente al 13% de la población occidental. A día de hoy no existe un tratamiento eficaz que evite el progreso de la misma o facilite la regeneración del cartílago articular. La conexina43 (Cx43) es una proteína transmembrana que se encuentra en niveles elevados en el cartílago y en la membrana sinovial de pacientes con OA. Esta proteína forma canales que permiten el intercambio de moléculas e iones entre dos células en contacto o entre la célula y su entorno, denominados uniones comunicantes (UCs) y hemicanales, respectivamente. En este estudio se investigó la función de la Cx43 y de las UCs en la degradación del cartílago articular de pacientes con OA. Material y métodos: Se han aislado condrocitos primarios del cartílago de donantes OA y sanos. Se evaluaron los niveles proteicos mediante Western blot, inmunofluorescencia y citometría de flujo. La expresión génica se ha evaluado mediante RT-qPCR, mientras que la comunicación celular se estudió mediante el ensayo scrape loading/dye transfer. La senescencia celular se evaluó midiendo la actividad de la β-galactosidasa mediante citometría celular o microscopía. Resultados: Los resultados obtenidos indican que la sobreactividad de la Cx43 y de la comunicación intercelular a través de UCs detectadas en OA están implicadas con el progreso de la enfermedad al activar procesos de desdiferenciación celular hacia un estado inmaduro y senescencia celular. Utilizando condrocitos en cultivo aislados del cartílago de donantes con OA hemos demostrado que el incremento de la Cx43 activa factores implicados en la transición epitelio-mesénquima (TEM), como el factor de transcripción Twist-1. El incremento en el número de células desdiferenciadas y con altos índices de proliferación celular desencadena en senescencia celular vía p53/p16INK4a, activando el fenotipo secretor asociado a senescencia (SASP, del inglés Senescence-Associated Secretory Phenotype) que incluye la síntesis y liberación de factores inflamatorios como la interleuquina 6 (IL-6). La disminución de los niveles de la Cx43 utilizando pequeñas moléculas como la oleuropeína o técnicas de edición genética como CRISPR/Cas9 revirtió el proceso dando lugar a re-diferenciación celular, mejorando el fenotipo celular con incremento en proteínas implicadas en formación del tejido y diminuyendo la síntesis de MMPs y del componente inflamatorio y senescencia. Conclusiones: La disminución de la Cx43 en condrocitos artrósicos restaura regeneración tisular, por activación de re-diferenciación celular y disminución de senescencia. Estos resultados corroboran el uso de la Cx43 como una diana terapéutica eficaz para restaurar regeneración del cartílago en pacientes con OA y evitar la progresión de la enfermedad.

Osteoarthritis (OA) is an inflammatory disease that damages the joints and affects millions of people worldwide. The potential inhibitory effects of the antidiabetic drug metformin combined with captopril, the angiotensin-converting enzyme inhibitor, on diabetes-induced damage to the knee joint articular cartilage associated with the inhibition of glycemia, dyslipidemia, and inflammation has not been investigated before. Therefore, we induced diabetes in rats using high carbohydrate and fat diets and a single injection of streptozotocin (50 mg/kg). The protective group of rats was pre-treated with combined daily doses of metformin (Met; 200 mg/kg body weight) and captopril (Cap; 150 mg/kg body weight) for 14 days before diabetic induction and continued on metformin and resveratrol until the end of the experiment at week 12. Harvested tissues obtained from knee joints were prepared for basic histology staining with haematoxylin and eosin (H&E) and examined under light microscopy. Representative H&E images showed that OA was developed in the diabetic rats as demonstrated by a profound damage to the knee joints such as irregular eroded and a sharp decrease in the thickness of the articular cartilage surface and abnormal remodeling of the subchondral bone that were substantially ameliorated by Met+Cap. Met+Cap also significantly (p< 0.05) reduced blood levels of glucose, glycated hemoglobin (HbA1c), dyslipidemia, and the inflammatory biomarkers, high sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and tumour necrosis factor-alpha (TNF-a) induced by diabetes. In addition, a significant (p£ 0.0014) correlation between the articular cartilage thickness and the blood levels of glucose, HbA1c, triglyceride (TG), low density lipoprotein-cholesterol (LDL-C), high density lipoproteincholesterol (HDL-C), and hs-CRP were observed. Thus, we demonstrate that Met+Cap effectively protect the knee joint against injuries induced secondary to diabetes in rats, possibly due to the inhibition of glycemia, dyslipidemia, and biomarkers of inflammation. [ABSTRACT FROM AUTHOR]

Objective: The objective of this work was to develop a passive exoskeleton prototype for the relief of knee-load employing ischiatic body weight support. Methods and materials: A functional prototype was developed and tested with three volunteers to analyze its potential effectiveness and effects on gait kinematics. The performance of the prototype was assessed using motion capture and pressure mapping systems, and a testing bench for the study of ischiatic body weight. Results and discussion: The results of the tests indicate that the prototype allows reducing the load supported by the knees and does not have a significant effect on the kinematics of the hip and knee joints. The process allowed the designers to identify possibilities of improvement mainly on reducing the restrictions imposed by the prototype to the motion of the ankles, especially on the midstance of the support phase. Conclusions: The passive exoskeleton prototype developed for ischiatic body weight support allows setting different percentages of knee-load relief. The prototype does not have a significant effect on the kinematics of the hip and knee joints. Nevertheless, improvements must be performed to reduce the restrictions to the motion of the ankles. [ABSTRACT FROM AUTHOR]

Introduction: Background: physical activity is a health-related behavior that is associated with increased well-being in people living with musculoskeletal disease. Objective: we assessed the association of different health and lifestyle factors with physical activity in the Spanish population living with musculoskeletal disease. Method: we used data from the 2014 European Health Survey for Spain. The population was classified according to their musculoskeletal disease (including osteoarthritis, back pain, osteoporosis, or several of these diseases) diagnostic status. The survey collected data on habitual physical activity and other health-related behaviors (diet, alcohol and tobacco consumption, among others) and other health indicators (self-perceived health status, perceived pain, mental health, physical limitations, among others). We used multivariate logistic regression models to analyze the relationship between the different variables studied in the population living with musculoskeletal disease. Results: physical activity is associated with daily fruit and vegetable intake, regardless of age and sex, and with daily fish consumption in women aged 45 years and older. Tobacco smoking is higher in inactive women and men, while weekly consumption of alcohol is associated with more physical activity (except in women aged 15-44 years). Conclusions: physical activity is a behavior associated with a better health status and healthier lifestyle in the Spanish population living with musculoskeletal disease. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Cirugía Ortopédica y Traumatologia (English Edition) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Española de Cirugía Ortopédica y Traumatologia (English Edition) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Española de Cirugía Ortopédica y Traumatologia (English Edition) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objetivo: Describir la situación funcional y la autopercepción de salud de los pacientes con osteoartritis (OA) en atención primaria, comprobando su relación con el nivel de actividad física y las características sociodemográficas. Diseño: Estudio de prevalencia y asociación cruzada. Emplazamiento: Consultas de medicina de familia. Participantes: Pacientes adultos diagnosticados en su historia clínica de OA de cualquier localización articular. De un total de 487, participaron 346 (71,0%). Mediciones principales: Capacidad funcional (escala WOMAC), nivel de autopercepción de salud (cuestionario EuroQoL-5D), nivel de actividad física (cuestionario IPAQ), número de articulaciones afectadas, nivel de dolor (EVA) y características sociodemográficas. Resultados: En la escala WOMAC se obtuvo una puntuación media de 30,2 (DE: 20,8; IC 95%: 28,0-32,4), correspondiendo a dolor, rigidez y capacidad funcional puntuaciones de 6,5 (DE: 4,8), 1,9 (DE: 2,0) y 21,7 (DE: 15,7), respectivamente. La puntuación presentó una tendencia lineal (p

Introduction: The fat of the synovial joints can be used to maintain the joint structure. Our objective is to analyze the evolution of joint degeneration in knees with and without adipose pack., Material and Methodology: In six sheep, the anterior cruciate ligament was sectioned in both knees, to cause osteoarthritis. In one group the fat pack was preserved and in another group it was completely removed. We performed a histological and molecular biology study analyzing the expression, in the synovial membrane, subchondral bone, cartilage, fat, meniscus, and synovial fluid, of RUNX2, PTHrP, cathepsin-K, and MCP1., Results: We did not find morphological differences. We found increased expression of RUNX2 in synovial membrane, PTHrP and Cathepsin K in synovial fluid in the group without fat, and increased expression of RUNX2 in the meniscus and MCP1 in synovial fluid in the group with fat., Conclusion: Infrapatellar fat participates in the inflammatory process that accompanies osteoarthritis, since Hoffa fat pad resection alters pro-inflammatory markers, while the model with intact fat increases the pro-inflammatory marker MCP1 in synovial fluid., (Copyright © 2023 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction and Objectives: Subtalar dislocations are a rare entity (<1%) in traumatic foot injuries. There is a loss of anatomical relationship between the talus, calcaneus and scaphoid. There are only small-published series., Material and Methods: We present a series of patients (N=13) with subtalar dislocations in which a descriptive analysis of the main epidemiological, clinical and radiological variables was carried out, from which an urgent treatment algorithm is proposed. Cases with fractures of the neck of the talus, body of the calcaneus, or isolated Chopart fracture-dislocations were excluded., Results: The median age was 48.5 years with a predominance of males (69.23%). Five patients suffered falls or sprained ankles and the other eight suffered high-energy mechanisms. The medial dislocations (nine) predominated over the lateral ones (four). In addition, four patients presented open dislocations, two of them type IIIC that required amputation. CT scans were requested in 76.93% of patients and 10 presented associated bone lesions of the foot. Open reduction surgery was performed in all open lesions and in one case in which closed reduction failed. Five patients required a delta-type external fixator. Subchondral articular sclerosis was observed in 77.77% of cases; although only one required subtalar arthrodesis., Conclusions: Subtalar dislocations are a traumatic emergency that require early reduction and subsequent immobilisation. Transarticular temporary external fixation is a good immobilisation option in open dislocations. They are serious lesions with a high probability of early osteoarthritis., (Copyright © 2023 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: The fat of the synovial joints can be used to maintain the joint structure. Our objective is to analyse the evolution of joint degeneration in knees with and without adipose pack., Material and Methodology: In six sheep, the anterior cruciate ligament was sectioned in both knees, to cause osteoarthritis. In one group the fat pack was preserved and in another group it was completely removed. We performed a histological and molecular biology study analyzing the expression, in the synovial membrane, subchondral bone, cartilage, fat, meniscus, and synovial fluid, of RUNX2, PTHrP, cathepsin-K, and MCP1., Results: We did not find morphological differences. We found increased expression of RUNX2 in synovial membrane, PTHrP and Cathepsin K in synovial fluid in the group without fat, and increased expression of RUNX2 in the meniscus and MCP1 in synovial fluid in the group with fat., Conclusion: Infrapatellar fat participates in the inflammatory process that accompanies osteoarthritis, since Hoffa fat pad resection alters pro-inflammatory markers, while the model with intact fat increases the pro-inflammatory marker MCP1 in synovial fluid., (Copyright © 2023 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction and Objectives: Subtalar dislocations are a rare entity (<1%) in traumatic foot injuries. There is a loss of anatomical relationship between the talus, calcaneus and scaphoid. There are only small-published series., Material and Methods: We present a series of patients (N=13) with subtalar dislocations in which a descriptive analysis of the main epidemiological, clinical and radiological variables was carried out, from which an urgent treatment algorithm is proposed. Cases with fractures of the neck of the talus, body of the calcaneus, or isolated Chopart fracture-dislocations were excluded., Results: The median age was 48.5 years with a predominance of males (69.23%). Five patients suffered falls or sprained ankles and the other eight suffered high-energy mechanisms. The medial dislocations (nine) predominated over the lateral ones (four). In addition, four patients presented open dislocations, two of them type IIIC that required amputation. CT scans were requested in 76.93% of patients and 10 presented associated bone lesions of the foot. Open reduction surgery was performed in all open lesions and in one case in which closed reduction failed. Five patients required a delta-type external fixator. Subchondral articular sclerosis was observed in 77.77% of cases; although only one required subtalar arthrodesis., Conclusions: Subtalar dislocations are a traumatic emergency that require early reduction and subsequent immobilization. Transarticular temporary external fixation is a good immobilization option in open dislocations. They are serious lesions with a high probability of early osteoarthritis., (Copyright © 2023 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.)