Carlos Olivo - Academia.edu (original) (raw)
Papers by Carlos Olivo
Revue de Chirurgie Orthopédique et Traumatologique
Abstract Objective Firearm violence has a high economic impact, representing the third most expen... more Abstract Objective Firearm violence has a high economic impact, representing the third most expensive injury and associated with the fourth highest hospitalization cost. This study was performed to determine the clinical and epidemiological characteristics of patients with injuries due to firearm projectile during a period of increased violence related to organized crime in our country. Methods A retrospective study (2010–2017) was conducted to analyze the clinical data of patients admitted due to firearm projectile injury. Clinical and epidemiological characteristics of each patient were recorded, and patients were stratified by sex and age. Compared low-energy versus high-energy gunshot injuries, complications and treatment. Results A total of 1309 gunshot wounds in appendicular skeleton and spine fractures. The mean age of the patients was 29 ± 11.5 years. Upper extremities wounds in 358 cases, lower extremities wounds in 727 cases and 224 fractures in spine region. There were no significant differences between low-velocity and high-velocity projectiles in anatomic affected region, complications and treatment. Conclusions We concluded that firearm projectiles cause a variety of injuries both in soft and bone tissues and caused a major rate of complications in our patients even with low- or high-energy weapons. The majority of patients affected was the civilian population. Most patients with gunshot wounds were young males. We observed a low mortality rate in our patients. Level of evidence III; Retrospective cohort study.
International Orthopaedics, 2021
To evaluate the efficacy of arthrotomy, when compared with arthroscopy, in the treatment of adult... more To evaluate the efficacy of arthrotomy, when compared with arthroscopy, in the treatment of adults with septic arthritis of any joint. MEDLINE, EMBASE, and Scopus were searched to identify studies comparing arthrotomy and arthroscopy as therapeutic approaches in patients with septic arthritis of any joint. The main outcome was the re-infection rate. A meta-analysis was performed using the generic inverse variance method with random or fixed effects model depending on heterogeneity between studies. Heterogeneity was tested with the I2 statistic index. Twenty studies with 10,249 patients treated by arthrotomy or arthroscopy were evaluated. We observed a significant lower risk of re-infection (odds ratio [OR], 1.35 [95% CI, 1.16–1.58]; p = 0.0002) and complications (OR, 1.32 [95% CI, 1.12–1.55]; p = 0.001) rate as well as less hospital stay (mean difference [MD], 0.57 days [95% CI, 0.10–1.05]; p = 0.02) favouring arthroscopic intervention. The subanalysis indicated that patients with knee (OR, 1.50 [95% CI, 1.17–1.92]; p = 0.001) and shoulder (OR, 1.24 [95% CI, 1.00–1.53]; p = 0.04) septic arthritis intervened by arthrotomy had a higher risk of re-infection. A lower number of hospitalization days (MD, 0.89 days [95% CI, 0.31–1.47]; p = 0.003) and a lower risk for complications (OR, 1.26 [95% CI, 1.04–1.52]; p = 0.02) were observed in patients treated with arthroscopy after septic knee arthritis. Available evidence suggests that patients with septic arthritis of the knee and shoulder treated by arthroscopy have less risk of re-infection than those treated by arthrotomy. The quality of the body of evidence is still insufficient to reach reliable conclusions. CRD42020176044. Date registration: April 28, 2020.
Acta ortopedica mexicana, 2017
BACKGROUND The distal radius fracture represent until 15% of all bone injuries in adults. The key... more BACKGROUND The distal radius fracture represent until 15% of all bone injuries in adults. The key in the recovery of mobility and functional outcomes are rehabilitation. The intra-articular application of magnesium sulphate has been used for postoperative pain. The objective was to determinate the improvement in pain and functional outcome of patients with distal radius fracture using intra-articular magnesium sulphate. MATERIAL AND METHODS Patients with distal radius fracture treated with percutaneous pinning and cast immobilization was included and randomized into two groups. The group 1 was applied 1.0 ml of magnesium sulphate and 1.5 ml of injectable water; meanwhile the group 2, the water was replaced with 1 ml of bupivacaine (5 mg/ml). The intra-articular infiltration was applied at the end of immobilization. Pain, functionality and movement of the wrist was evaluated for two weeks. RESULTS Twenty patients, 8 male and twelve females, with a mean age of 53 years (± 17 SD) was e...
Objetivo. Evaluar las caracteristicas clinicas, biomecanicas y morfologicas de un ligamento prote... more Objetivo. Evaluar las caracteristicas clinicas, biomecanicas y morfologicas de un ligamento protesico a base de Kevlar® como injerto sintetico de ligamento cruzado anterior en un modelo animal de experimentacion en conejos. Metodos. Se analizaron 27 rodillas de conejos distribuidas aleatoriamente en tres grupos de estudio (control, excision del ligamento cruzado anterior y remplazo del ligamento cruzado anterior con una protesis de Kevlar®) en los cuales fueron analizados mediante pruebas clinicas, biomecanicas y morfologicas a las 6, 12 y 18 semanas post procedimiento. Resultados. El promedio de los desplazamientos en las pruebas mecanicas fue de 0.73 ± 0.06 mm, 1.58 ± 0.19 mm y 0.94 ± 0.20 mm para el grupo control, excision del LCA y remplazo del LCA con protesis sintetica respectivamente. Los resultados muestran una mejoria en la estabilidad de la rodilla con el uso de la protesis sintetica de Kevlar® en las pruebas biomecanicas (p 0.05) entre el grupo remplazo y el grupo control...
Archives of Physical Medicine and Rehabilitation, 2021
OBJECTIVE To evaluate the efficacy of botulinum toxin A (BTX-A) for the treatment of plantar fasc... more OBJECTIVE To evaluate the efficacy of botulinum toxin A (BTX-A) for the treatment of plantar fasciitis through a meta-analysis of randomized controlled trials (RCT) focusing on pain and functional outcomes since current literature has supported a potential benefit of BTX-A. DATA SOURCES The MEDLINE, EMBASE, Web of Science, and Scopus databases were searched until December 2020 for RCT reporting the effects of BTX-A injections on plantar fasciitis. The complementary literature search included Cochrane Central Register of Controlled Trials and, Clinicaltrials.gov, and greylit.org. STUDY SELECTION Only RCT assessing the effect of BTX-A injections on either pain, functional improvement, or plantar fascia thickness in patients with plantar fasciitis were included. Multiple researchers carried out the screening process of the 413 records. DATA EXTRACTION Data were extracted independently and in duplicate using a standardized data extraction format. Information was contrasted by a third observer. DATA SYNTHESIS BTX-A injections resulted in significant pain relief (MD, -2.07 [95% CI: -3.21, -0.93]; p = 0.0004; I2 = 97%) and functional improvement (SMD, 1.15 [95% CI: 0.39, 1.91]; p = 0.003; I2 = 87%). A subanalysis indicated that pain relief was sustained at 12 months while functional improvement remained significant after 0-6 months. The results were not affected by a single study after sensitivity analysis. The site of injection and the use or not of ultrasound-guided injections may account for potential sources of inter-study heterogeneity. CONCLUSION This meta-analysis suggests both a statistically significant and a clinically meaningful improvement on plantar fasciitis symptoms after BTX-A treatment.
Blood Coagulation & Fibrinolysis, 2021
To compare the effects of oral ε-aminocaproic acid (EACA) as a hemostatic agent versus the use of... more To compare the effects of oral ε-aminocaproic acid (EACA) as a hemostatic agent versus the use of oral tranexamic acid (TXA) administered in multiple doses pre and postsurgery in patients undergoing elective primary total hip arthroplasty (THA). We enrolled 102 patients that were randomly divided into two groups: received three oral doses of EACA (2000 mg per dose) or three oral doses of TXA (1300 mg per dose). The medication was given according to the following schedule: 2 h before surgery and 6 and 12 h after surgery. The variables analyzed to compare the effectiveness of the hemostatic agents were total blood loss, hidden blood loss, external blood loss, transfusion rate, intraoperative blood loss, decreases in hemoglobin and hematocrit values, surgical drainage output, visual analog scale, and surgical complications. There were no significant differences between any of the study variables for the group receiving oral TXA and the group receiving oral EACA (P > 0.05). Our study showed that the use of oral EACA was similar to its counterpart TXA regarding the evaluated parameters. TXA did not have superior blood conservation effects, safety profile, or differences in functional scales compared with EACA in THA. We consider the use of multiple oral doses of aminocaproic acid at the selected dose to be effective as a standard protocol to achieve less blood loss and a lower rate of transfusion and adverse events related to the medication in patients undergoing a THA.
Revista Medicina Universitaria, 2020
A simple elbow dislocation represents between 51% and 74% of all elbow dislocations. It is the se... more A simple elbow dislocation represents between 51% and 74% of all elbow dislocations. It is the second joint in dislocation frequency after the shoulder. Elbow dislocations are classified as simple (without a fracture) or complex (with a fracture); direction of cubitus displacement and radius in relation to the humerus is also important. Usually, the injury mechanism indicates the dislocation type. The radiographic evaluation (gold standard) is done with an anteroposterior and lateral of the elbow joint. Treatment is related to the dislocation classification. In a simple dislocation, the objectives are a concentric, closed, and stable reduction of the joint, to gain a range of movement early. Related complications are neurological or vascular injuries, compartmental syndrome, heterotopic ossification, chronic instability, and osteoarthritis.
Foot & Ankle International, 2020
Background: Plantar fasciitis is the most common cause of heel pain, and injection therapies are ... more Background: Plantar fasciitis is the most common cause of heel pain, and injection therapies are part of the treatment modalities. This study aimed to compare 2 intralesional injection therapies for plantar fasciitis: corticosteroid and botulinum toxin A, compared with a third control group using a local anesthetic. The clinical evolution, as well as changes in the thickness of the plantar fascia and ankle dorsiflexion, was evaluated. Methods: A randomized, controlled, double-blind trial design was used. Patients were divided into 3 groups: group 1, anesthetic only; group 2, corticosteroid; and group 3, botulinum toxin A (BoNT-A). We used an ultrasonographic evaluation to measure the plantar fascia thickness. The results were evaluated using the Maryland Foot Score and a 10-cm visual analog scale. Clinical scores were recorded at the beginning of the study, at 2 weeks, and at 1, 3, and 6 months. We evaluated 78 patients for study eligibility. The 3 intervention groups were homogeneo...
Cirugía y Cirujanos, 2020
Lesiones de ligamento cruzado anterior tratadas con autoinjerto de tendón de cuádriceps versus au... more Lesiones de ligamento cruzado anterior tratadas con autoinjerto de tendón de cuádriceps versus autoinjerto de isquiotibiales: estudio controlado aleatorizado
Foot and Ankle Surgery, 2019
This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Revista Medicina Universitaria, 2019
The advances generated in the field of orthopedics, specifically in the treatment of soft-tissue ... more The advances generated in the field of orthopedics, specifically in the treatment of soft-tissue injuries in the musculoskeletal system, have allowed a more favorable evolution and recovery in affected patients. The development and application of new biotechnologies, such as the use of platelet-rich plasma (PRP), have generated great interest in the area of regenerative medicine in the last decade. Being of biological origin, PRP has some advantages, one of the most important being its autologous origin, which prevents any adverse immune reaction in the patient. A disadvantage of PRP is the fact that its preparation requires obtaining a sample of blood from the patient. Furthermore, the processing of the sample usually takes between 30 and 45 min before it is ready for application. There is great inter-and intra-individual variation on platelet and leukocyte concentration obtained. As a result, efforts have been made to standardize the different formulations of PRP, using several classification scales. Multiple applications of this technology have been researched in the different areas of orthopedics; this review describes its use in some of the more frequent pathologies.
The Journal of Knee Surgery, 2019
Total primary knee replacement results in significant postoperative bleeding. There are reports t... more Total primary knee replacement results in significant postoperative bleeding. There are reports that 20 to 50% of the patients require a blood transfusion, which has been related to many complications, resulting in the search for strategies to reduce bleeding. The use of oral antifibrinolytics is becoming a low cost and safe way of achieving this goal. The hypothesis of this study was that the use of oral aminocaproic acid could provide similar results to the use of oral tranexamic acid (TXA). The purpose was to compare the effects of oral aminocaproic acid as a hemostatic agent versus the use of oral TXA administered in multiple doses pre and postsurgery in patients undergoing total primary knee replacement. We enrolled 92 patients that were randomly divided into two groups: received three doses of aminocaproic acid (2,000 mg per dose) or three doses of oral TXA (1,300 mg per dose). The drugs were administered according to the following schedule: 2 hours before surgery and 6 and 12...
International Journal of Morphology, 2019
RESUMEN: Evaluar de manera integral los parámetros morfométricos de la vértebra atlas (C1) en la ... more RESUMEN: Evaluar de manera integral los parámetros morfométricos de la vértebra atlas (C1) en la población mexicana de relevancia en la realización de procedimientos quirúrgicos de la unión craneocervical con el fin de proveer datos cuantitativos indispensables para su realización. Para este estudio se utilizaron un total de 576 vértebras C1 secas de población mexicana contemporánea. Se realizaron 11 mediciones respecto a la morfología de C1. Las mediciones se efectuaron bilateralmente utilizando un vernier digital milimétrico con una precisión de 0,01 milímetros y se aplicó un análisis estadístico. Un total de 576 vértebras atlas (C1), fueron medidas de manera bilateral, todas nuestras mediciones se reportaron en milímetros. El promedio del ancho de las masas lateral fue de 14,87 mm ± 1,38 mm. El promedio de la altura de las masas laterales fue de 4,05 mm ± 0,93 mm. El promedio del ancho del foramen transverso fue de 5,93 mm ± 0,98 mm. El promedio del largo del foramen transverso fue de 6,96 mm ± 0,98 mm. El promedio de la altura del foramen transverso fue de 5,76 mm ± 1,31 mm. El promedio del ancho del surco de la arteria vertebral fue de 18,87 mm ± 1,3 mm. El promedio de la distancia entre la línea media y el margen medial del surco de la arteria vertebral sobre la superficie anterior del arco posterior de C1 en su cara superior fue de 12,47 mm ± 3,14 mm. El promedio de la distancia entre la línea media y el margen medial del surco de la arteria vertebral sobre la superficie posterior del arco posterior de C1 en su cara superior fue de 18,75 mm ± 3,94 mm. El promedio de la distancia entre la línea media y el margen lateral del surco de la arteria vertebral sobre la superficie anterior del arco posterior de C1 en su cara superior fue de 19,7 mm ± 2,52 mm. El promedio de la distancia entre la línea media y el margen lateral del surco de la arteria vertebral sobre la superficie posterior del arco posterior de C1 en su cara superior fue de 29,52 mm ± 3,23. Nuestro estudio demuestra que las mediciones realizadas en nuestra población presentan diferencias significativas respecto a lo reportado actualmente en la literatura. Es necesario contar con un conocimiento de la morfología vertebral en nuestra población para disminuir la ventana de error al realizar procedimientos quirúrgicos que involucren este segmento.
International Orthopaedics, 2018
Purpose Osteoarthritis (OA) is one of the most common causes of disability and a prevalent chroni... more Purpose Osteoarthritis (OA) is one of the most common causes of disability and a prevalent chronic disease. The use of collagen is growing due to the satisfactory results in the treatment of OA. However, the possible beneficial effects of collagen for the treatment of OA are currently controversial. The aim of the present meta-analysis was to evaluate the effect of collagen-based supplements on OA symptoms. Methods PubMed-Medline, Scopus, and Google Scholar databases were searched for randomized placebo-controlled trials evaluating the effect of orally administered collagen on OA symptoms using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scale and/or the Visual Analog Scale (VAS). Meta-analysis was conducted using a randomeffects model and a generic inverse variance method. Heterogeneity was tested using the I 2 statistic index. Results Collagen treatment showed a significant reduction in the score of total WOMAC index (WMD − 8.00; 95% CI − 13.04, − 2.95; p = 0.002). After subgroup analysis of the WOMAC subscores, the collagen supplementation revealed a significant decrease in the stiffness subscore (WMD − 0.41; 95% CI − 0.74, − 0.08; p = 0.01), whereas the pain (WMD − 0.22; 95% CI − 1.58, 1.13; p = 0.75) and functional limitation (WMD − 0.62; 95% CI − 5.77, 4.52; p = 0.81) subscores did not have significant differences. Finally, a significant reduction was found in the VAS score after collagen administration (WMD − 16.57; 95% CI − 26.24, − 6.89; p < 0.001). Conclusion The results of this meta-analysis showed that collagen is effective in improving OA symptoms by the decrease of both total WOMAC index and VAS score.
The Journal of Foot and Ankle Surgery, 2019
Foot & ankle international, 2018
Brachymetatarsia is a rare foot deformity caused by the premature closure of the metatarsal physi... more Brachymetatarsia is a rare foot deformity caused by the premature closure of the metatarsal physis. It may result in functional as well as cosmetic alterations, which may require operative management. A prospective study examining outcomes of 48 cases of brachymetatarsia with gradual bone lengthening at a rate of 1 mm/d using an external fixator and metatarsophalangeal joint fixation was performed. The difference between the length before treatment and after external fixator removal was measured. The patients were assessed at 2, 4, 6, and 8 weeks postoperatively; at the end of the period of distraction; and 1 year after surgery. The total number of patients was 26, and surgery was performed in 48 metatarsals. The mean age was 17.0 ± 4.1 (range, 11-24) years, and all were female. The fourth metatarsal was the most frequently affected, representing 98% of the cases; the third metatarsal represented the other 2%. The average length gained was 18.6 ± 6.7 mm, and the average length gaine...
World Journal of Clinical Infectious Diseases, 2017
Journal of Applied Biomaterials & Functional Materials, 2017
Background The aim of this study was to evaluate the clinical, biomechanical and morphological ch... more Background The aim of this study was to evaluate the clinical, biomechanical and morphological characteristics of a Kevlar®-based prosthetic ligament as a synthetic graft of the anterior cruciate ligament (ACL) in an experimental animal model in rabbits. Methods A total of 27 knees of rabbits randomly divided into 3 groups (control, ACL excision and ACL replacement with a Kevlar® prosthesis) were analyzed using clinical, biomechanical and morphological tests at 6, 12 and 18 weeks postprocedure. Results The mean displacement in mechanical testing was 0.73 ± 0.06 mm, 1.58 ± 0.19 mm and 0.94 ± 0.20 mm for the control, ACL excision and ACL replacement with synthetic prosthesis groups, respectively. The results showed an improvement in the stability of the knee with the use of the Kevlar® synthetic prosthesis in the biomechanical testing (p<0.05) compared with rabbits that underwent ACL excision, in addition to displacements that were larger but comparable to that in the control group...
Acupuncture & Electro-Therapeutics Research, 2017
The objective of this study was to determine whether application of laser beam on acupuncture poi... more The objective of this study was to determine whether application of laser beam on acupuncture points has a positive effect on the rehabilitation of patients with a diagnosis of distal radius fracture (1.5 inches proximal to distal articular surface of the radius) when applied with active conventional physical therapy exercises. Patients with a distal radius fracture treated with closed reduction, percutaneous pinning, and a short cast for six weeks was included and were assigned to one of two study groups. The control group was given simulated laser acupuncture with the laser off, while the experimental group received laser beam on acupuncture points. A low power infrared 980 nm, 50 mW laser (Diller & Diller Laser Performance) electric energy, was used; each acupuncture point was irradiated for 30 seconds at 8,000 Hz at each therapy session. In both groups, treatment was applied to the following points: Ipsilateral- Yanggu (SI5), Yangchi (SJ4), Waiguan (SJ15), Yangxi (LI5), Daling (...
Archives of Orthopaedic and Trauma Surgery, 2017
Introduction Despite an adequate orthopedic treatment with functional bracing, some patients deve... more Introduction Despite an adequate orthopedic treatment with functional bracing, some patients develop a delayed union in humeral shaft fractures. The objective of the present study was to determine the bone consolidation time among patients with delayed union of diaphyseal humeral fractures who were managed with locking compression plate (LCP) fixation combined with an iliac crest autograft using platelet-rich plasma (PRP) as a co-adjuvant. Materials and methods This study was a controlled, randomized, experimental, longitudinal, comparative, prospective, blind clinical trial. Patients diagnosed with delayed union of a diaphyseal humeral fracture with at least 4 months of evolution were treated with an open reduction and LCP osteosynthesis combined with an iliac crest autograft. The experimental group also received PRP. The patients were assessed radiographically until 36 weeks of evolution. Results A total of 16 patients were included. Both groups had similar demographic characteristics. The patients treated with PRP had an earlier beginning of bone consolidation. Furthermore, these same patients exhibited bone consolidation at 19.9 weeks, on average, in contrast to 25.4 weeks in the control group. Conclusions The use of PRP promotes earlier bone consolidation in patients with delayed union of the humeral shaft.
Revue de Chirurgie Orthopédique et Traumatologique
Abstract Objective Firearm violence has a high economic impact, representing the third most expen... more Abstract Objective Firearm violence has a high economic impact, representing the third most expensive injury and associated with the fourth highest hospitalization cost. This study was performed to determine the clinical and epidemiological characteristics of patients with injuries due to firearm projectile during a period of increased violence related to organized crime in our country. Methods A retrospective study (2010–2017) was conducted to analyze the clinical data of patients admitted due to firearm projectile injury. Clinical and epidemiological characteristics of each patient were recorded, and patients were stratified by sex and age. Compared low-energy versus high-energy gunshot injuries, complications and treatment. Results A total of 1309 gunshot wounds in appendicular skeleton and spine fractures. The mean age of the patients was 29 ± 11.5 years. Upper extremities wounds in 358 cases, lower extremities wounds in 727 cases and 224 fractures in spine region. There were no significant differences between low-velocity and high-velocity projectiles in anatomic affected region, complications and treatment. Conclusions We concluded that firearm projectiles cause a variety of injuries both in soft and bone tissues and caused a major rate of complications in our patients even with low- or high-energy weapons. The majority of patients affected was the civilian population. Most patients with gunshot wounds were young males. We observed a low mortality rate in our patients. Level of evidence III; Retrospective cohort study.
International Orthopaedics, 2021
To evaluate the efficacy of arthrotomy, when compared with arthroscopy, in the treatment of adult... more To evaluate the efficacy of arthrotomy, when compared with arthroscopy, in the treatment of adults with septic arthritis of any joint. MEDLINE, EMBASE, and Scopus were searched to identify studies comparing arthrotomy and arthroscopy as therapeutic approaches in patients with septic arthritis of any joint. The main outcome was the re-infection rate. A meta-analysis was performed using the generic inverse variance method with random or fixed effects model depending on heterogeneity between studies. Heterogeneity was tested with the I2 statistic index. Twenty studies with 10,249 patients treated by arthrotomy or arthroscopy were evaluated. We observed a significant lower risk of re-infection (odds ratio [OR], 1.35 [95% CI, 1.16–1.58]; p = 0.0002) and complications (OR, 1.32 [95% CI, 1.12–1.55]; p = 0.001) rate as well as less hospital stay (mean difference [MD], 0.57 days [95% CI, 0.10–1.05]; p = 0.02) favouring arthroscopic intervention. The subanalysis indicated that patients with knee (OR, 1.50 [95% CI, 1.17–1.92]; p = 0.001) and shoulder (OR, 1.24 [95% CI, 1.00–1.53]; p = 0.04) septic arthritis intervened by arthrotomy had a higher risk of re-infection. A lower number of hospitalization days (MD, 0.89 days [95% CI, 0.31–1.47]; p = 0.003) and a lower risk for complications (OR, 1.26 [95% CI, 1.04–1.52]; p = 0.02) were observed in patients treated with arthroscopy after septic knee arthritis. Available evidence suggests that patients with septic arthritis of the knee and shoulder treated by arthroscopy have less risk of re-infection than those treated by arthrotomy. The quality of the body of evidence is still insufficient to reach reliable conclusions. CRD42020176044. Date registration: April 28, 2020.
Acta ortopedica mexicana, 2017
BACKGROUND The distal radius fracture represent until 15% of all bone injuries in adults. The key... more BACKGROUND The distal radius fracture represent until 15% of all bone injuries in adults. The key in the recovery of mobility and functional outcomes are rehabilitation. The intra-articular application of magnesium sulphate has been used for postoperative pain. The objective was to determinate the improvement in pain and functional outcome of patients with distal radius fracture using intra-articular magnesium sulphate. MATERIAL AND METHODS Patients with distal radius fracture treated with percutaneous pinning and cast immobilization was included and randomized into two groups. The group 1 was applied 1.0 ml of magnesium sulphate and 1.5 ml of injectable water; meanwhile the group 2, the water was replaced with 1 ml of bupivacaine (5 mg/ml). The intra-articular infiltration was applied at the end of immobilization. Pain, functionality and movement of the wrist was evaluated for two weeks. RESULTS Twenty patients, 8 male and twelve females, with a mean age of 53 years (± 17 SD) was e...
Objetivo. Evaluar las caracteristicas clinicas, biomecanicas y morfologicas de un ligamento prote... more Objetivo. Evaluar las caracteristicas clinicas, biomecanicas y morfologicas de un ligamento protesico a base de Kevlar® como injerto sintetico de ligamento cruzado anterior en un modelo animal de experimentacion en conejos. Metodos. Se analizaron 27 rodillas de conejos distribuidas aleatoriamente en tres grupos de estudio (control, excision del ligamento cruzado anterior y remplazo del ligamento cruzado anterior con una protesis de Kevlar®) en los cuales fueron analizados mediante pruebas clinicas, biomecanicas y morfologicas a las 6, 12 y 18 semanas post procedimiento. Resultados. El promedio de los desplazamientos en las pruebas mecanicas fue de 0.73 ± 0.06 mm, 1.58 ± 0.19 mm y 0.94 ± 0.20 mm para el grupo control, excision del LCA y remplazo del LCA con protesis sintetica respectivamente. Los resultados muestran una mejoria en la estabilidad de la rodilla con el uso de la protesis sintetica de Kevlar® en las pruebas biomecanicas (p 0.05) entre el grupo remplazo y el grupo control...
Archives of Physical Medicine and Rehabilitation, 2021
OBJECTIVE To evaluate the efficacy of botulinum toxin A (BTX-A) for the treatment of plantar fasc... more OBJECTIVE To evaluate the efficacy of botulinum toxin A (BTX-A) for the treatment of plantar fasciitis through a meta-analysis of randomized controlled trials (RCT) focusing on pain and functional outcomes since current literature has supported a potential benefit of BTX-A. DATA SOURCES The MEDLINE, EMBASE, Web of Science, and Scopus databases were searched until December 2020 for RCT reporting the effects of BTX-A injections on plantar fasciitis. The complementary literature search included Cochrane Central Register of Controlled Trials and, Clinicaltrials.gov, and greylit.org. STUDY SELECTION Only RCT assessing the effect of BTX-A injections on either pain, functional improvement, or plantar fascia thickness in patients with plantar fasciitis were included. Multiple researchers carried out the screening process of the 413 records. DATA EXTRACTION Data were extracted independently and in duplicate using a standardized data extraction format. Information was contrasted by a third observer. DATA SYNTHESIS BTX-A injections resulted in significant pain relief (MD, -2.07 [95% CI: -3.21, -0.93]; p = 0.0004; I2 = 97%) and functional improvement (SMD, 1.15 [95% CI: 0.39, 1.91]; p = 0.003; I2 = 87%). A subanalysis indicated that pain relief was sustained at 12 months while functional improvement remained significant after 0-6 months. The results were not affected by a single study after sensitivity analysis. The site of injection and the use or not of ultrasound-guided injections may account for potential sources of inter-study heterogeneity. CONCLUSION This meta-analysis suggests both a statistically significant and a clinically meaningful improvement on plantar fasciitis symptoms after BTX-A treatment.
Blood Coagulation & Fibrinolysis, 2021
To compare the effects of oral ε-aminocaproic acid (EACA) as a hemostatic agent versus the use of... more To compare the effects of oral ε-aminocaproic acid (EACA) as a hemostatic agent versus the use of oral tranexamic acid (TXA) administered in multiple doses pre and postsurgery in patients undergoing elective primary total hip arthroplasty (THA). We enrolled 102 patients that were randomly divided into two groups: received three oral doses of EACA (2000 mg per dose) or three oral doses of TXA (1300 mg per dose). The medication was given according to the following schedule: 2 h before surgery and 6 and 12 h after surgery. The variables analyzed to compare the effectiveness of the hemostatic agents were total blood loss, hidden blood loss, external blood loss, transfusion rate, intraoperative blood loss, decreases in hemoglobin and hematocrit values, surgical drainage output, visual analog scale, and surgical complications. There were no significant differences between any of the study variables for the group receiving oral TXA and the group receiving oral EACA (P > 0.05). Our study showed that the use of oral EACA was similar to its counterpart TXA regarding the evaluated parameters. TXA did not have superior blood conservation effects, safety profile, or differences in functional scales compared with EACA in THA. We consider the use of multiple oral doses of aminocaproic acid at the selected dose to be effective as a standard protocol to achieve less blood loss and a lower rate of transfusion and adverse events related to the medication in patients undergoing a THA.
Revista Medicina Universitaria, 2020
A simple elbow dislocation represents between 51% and 74% of all elbow dislocations. It is the se... more A simple elbow dislocation represents between 51% and 74% of all elbow dislocations. It is the second joint in dislocation frequency after the shoulder. Elbow dislocations are classified as simple (without a fracture) or complex (with a fracture); direction of cubitus displacement and radius in relation to the humerus is also important. Usually, the injury mechanism indicates the dislocation type. The radiographic evaluation (gold standard) is done with an anteroposterior and lateral of the elbow joint. Treatment is related to the dislocation classification. In a simple dislocation, the objectives are a concentric, closed, and stable reduction of the joint, to gain a range of movement early. Related complications are neurological or vascular injuries, compartmental syndrome, heterotopic ossification, chronic instability, and osteoarthritis.
Foot & Ankle International, 2020
Background: Plantar fasciitis is the most common cause of heel pain, and injection therapies are ... more Background: Plantar fasciitis is the most common cause of heel pain, and injection therapies are part of the treatment modalities. This study aimed to compare 2 intralesional injection therapies for plantar fasciitis: corticosteroid and botulinum toxin A, compared with a third control group using a local anesthetic. The clinical evolution, as well as changes in the thickness of the plantar fascia and ankle dorsiflexion, was evaluated. Methods: A randomized, controlled, double-blind trial design was used. Patients were divided into 3 groups: group 1, anesthetic only; group 2, corticosteroid; and group 3, botulinum toxin A (BoNT-A). We used an ultrasonographic evaluation to measure the plantar fascia thickness. The results were evaluated using the Maryland Foot Score and a 10-cm visual analog scale. Clinical scores were recorded at the beginning of the study, at 2 weeks, and at 1, 3, and 6 months. We evaluated 78 patients for study eligibility. The 3 intervention groups were homogeneo...
Cirugía y Cirujanos, 2020
Lesiones de ligamento cruzado anterior tratadas con autoinjerto de tendón de cuádriceps versus au... more Lesiones de ligamento cruzado anterior tratadas con autoinjerto de tendón de cuádriceps versus autoinjerto de isquiotibiales: estudio controlado aleatorizado
Foot and Ankle Surgery, 2019
This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Revista Medicina Universitaria, 2019
The advances generated in the field of orthopedics, specifically in the treatment of soft-tissue ... more The advances generated in the field of orthopedics, specifically in the treatment of soft-tissue injuries in the musculoskeletal system, have allowed a more favorable evolution and recovery in affected patients. The development and application of new biotechnologies, such as the use of platelet-rich plasma (PRP), have generated great interest in the area of regenerative medicine in the last decade. Being of biological origin, PRP has some advantages, one of the most important being its autologous origin, which prevents any adverse immune reaction in the patient. A disadvantage of PRP is the fact that its preparation requires obtaining a sample of blood from the patient. Furthermore, the processing of the sample usually takes between 30 and 45 min before it is ready for application. There is great inter-and intra-individual variation on platelet and leukocyte concentration obtained. As a result, efforts have been made to standardize the different formulations of PRP, using several classification scales. Multiple applications of this technology have been researched in the different areas of orthopedics; this review describes its use in some of the more frequent pathologies.
The Journal of Knee Surgery, 2019
Total primary knee replacement results in significant postoperative bleeding. There are reports t... more Total primary knee replacement results in significant postoperative bleeding. There are reports that 20 to 50% of the patients require a blood transfusion, which has been related to many complications, resulting in the search for strategies to reduce bleeding. The use of oral antifibrinolytics is becoming a low cost and safe way of achieving this goal. The hypothesis of this study was that the use of oral aminocaproic acid could provide similar results to the use of oral tranexamic acid (TXA). The purpose was to compare the effects of oral aminocaproic acid as a hemostatic agent versus the use of oral TXA administered in multiple doses pre and postsurgery in patients undergoing total primary knee replacement. We enrolled 92 patients that were randomly divided into two groups: received three doses of aminocaproic acid (2,000 mg per dose) or three doses of oral TXA (1,300 mg per dose). The drugs were administered according to the following schedule: 2 hours before surgery and 6 and 12...
International Journal of Morphology, 2019
RESUMEN: Evaluar de manera integral los parámetros morfométricos de la vértebra atlas (C1) en la ... more RESUMEN: Evaluar de manera integral los parámetros morfométricos de la vértebra atlas (C1) en la población mexicana de relevancia en la realización de procedimientos quirúrgicos de la unión craneocervical con el fin de proveer datos cuantitativos indispensables para su realización. Para este estudio se utilizaron un total de 576 vértebras C1 secas de población mexicana contemporánea. Se realizaron 11 mediciones respecto a la morfología de C1. Las mediciones se efectuaron bilateralmente utilizando un vernier digital milimétrico con una precisión de 0,01 milímetros y se aplicó un análisis estadístico. Un total de 576 vértebras atlas (C1), fueron medidas de manera bilateral, todas nuestras mediciones se reportaron en milímetros. El promedio del ancho de las masas lateral fue de 14,87 mm ± 1,38 mm. El promedio de la altura de las masas laterales fue de 4,05 mm ± 0,93 mm. El promedio del ancho del foramen transverso fue de 5,93 mm ± 0,98 mm. El promedio del largo del foramen transverso fue de 6,96 mm ± 0,98 mm. El promedio de la altura del foramen transverso fue de 5,76 mm ± 1,31 mm. El promedio del ancho del surco de la arteria vertebral fue de 18,87 mm ± 1,3 mm. El promedio de la distancia entre la línea media y el margen medial del surco de la arteria vertebral sobre la superficie anterior del arco posterior de C1 en su cara superior fue de 12,47 mm ± 3,14 mm. El promedio de la distancia entre la línea media y el margen medial del surco de la arteria vertebral sobre la superficie posterior del arco posterior de C1 en su cara superior fue de 18,75 mm ± 3,94 mm. El promedio de la distancia entre la línea media y el margen lateral del surco de la arteria vertebral sobre la superficie anterior del arco posterior de C1 en su cara superior fue de 19,7 mm ± 2,52 mm. El promedio de la distancia entre la línea media y el margen lateral del surco de la arteria vertebral sobre la superficie posterior del arco posterior de C1 en su cara superior fue de 29,52 mm ± 3,23. Nuestro estudio demuestra que las mediciones realizadas en nuestra población presentan diferencias significativas respecto a lo reportado actualmente en la literatura. Es necesario contar con un conocimiento de la morfología vertebral en nuestra población para disminuir la ventana de error al realizar procedimientos quirúrgicos que involucren este segmento.
International Orthopaedics, 2018
Purpose Osteoarthritis (OA) is one of the most common causes of disability and a prevalent chroni... more Purpose Osteoarthritis (OA) is one of the most common causes of disability and a prevalent chronic disease. The use of collagen is growing due to the satisfactory results in the treatment of OA. However, the possible beneficial effects of collagen for the treatment of OA are currently controversial. The aim of the present meta-analysis was to evaluate the effect of collagen-based supplements on OA symptoms. Methods PubMed-Medline, Scopus, and Google Scholar databases were searched for randomized placebo-controlled trials evaluating the effect of orally administered collagen on OA symptoms using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scale and/or the Visual Analog Scale (VAS). Meta-analysis was conducted using a randomeffects model and a generic inverse variance method. Heterogeneity was tested using the I 2 statistic index. Results Collagen treatment showed a significant reduction in the score of total WOMAC index (WMD − 8.00; 95% CI − 13.04, − 2.95; p = 0.002). After subgroup analysis of the WOMAC subscores, the collagen supplementation revealed a significant decrease in the stiffness subscore (WMD − 0.41; 95% CI − 0.74, − 0.08; p = 0.01), whereas the pain (WMD − 0.22; 95% CI − 1.58, 1.13; p = 0.75) and functional limitation (WMD − 0.62; 95% CI − 5.77, 4.52; p = 0.81) subscores did not have significant differences. Finally, a significant reduction was found in the VAS score after collagen administration (WMD − 16.57; 95% CI − 26.24, − 6.89; p < 0.001). Conclusion The results of this meta-analysis showed that collagen is effective in improving OA symptoms by the decrease of both total WOMAC index and VAS score.
The Journal of Foot and Ankle Surgery, 2019
Foot & ankle international, 2018
Brachymetatarsia is a rare foot deformity caused by the premature closure of the metatarsal physi... more Brachymetatarsia is a rare foot deformity caused by the premature closure of the metatarsal physis. It may result in functional as well as cosmetic alterations, which may require operative management. A prospective study examining outcomes of 48 cases of brachymetatarsia with gradual bone lengthening at a rate of 1 mm/d using an external fixator and metatarsophalangeal joint fixation was performed. The difference between the length before treatment and after external fixator removal was measured. The patients were assessed at 2, 4, 6, and 8 weeks postoperatively; at the end of the period of distraction; and 1 year after surgery. The total number of patients was 26, and surgery was performed in 48 metatarsals. The mean age was 17.0 ± 4.1 (range, 11-24) years, and all were female. The fourth metatarsal was the most frequently affected, representing 98% of the cases; the third metatarsal represented the other 2%. The average length gained was 18.6 ± 6.7 mm, and the average length gaine...
World Journal of Clinical Infectious Diseases, 2017
Journal of Applied Biomaterials & Functional Materials, 2017
Background The aim of this study was to evaluate the clinical, biomechanical and morphological ch... more Background The aim of this study was to evaluate the clinical, biomechanical and morphological characteristics of a Kevlar®-based prosthetic ligament as a synthetic graft of the anterior cruciate ligament (ACL) in an experimental animal model in rabbits. Methods A total of 27 knees of rabbits randomly divided into 3 groups (control, ACL excision and ACL replacement with a Kevlar® prosthesis) were analyzed using clinical, biomechanical and morphological tests at 6, 12 and 18 weeks postprocedure. Results The mean displacement in mechanical testing was 0.73 ± 0.06 mm, 1.58 ± 0.19 mm and 0.94 ± 0.20 mm for the control, ACL excision and ACL replacement with synthetic prosthesis groups, respectively. The results showed an improvement in the stability of the knee with the use of the Kevlar® synthetic prosthesis in the biomechanical testing (p<0.05) compared with rabbits that underwent ACL excision, in addition to displacements that were larger but comparable to that in the control group...
Acupuncture & Electro-Therapeutics Research, 2017
The objective of this study was to determine whether application of laser beam on acupuncture poi... more The objective of this study was to determine whether application of laser beam on acupuncture points has a positive effect on the rehabilitation of patients with a diagnosis of distal radius fracture (1.5 inches proximal to distal articular surface of the radius) when applied with active conventional physical therapy exercises. Patients with a distal radius fracture treated with closed reduction, percutaneous pinning, and a short cast for six weeks was included and were assigned to one of two study groups. The control group was given simulated laser acupuncture with the laser off, while the experimental group received laser beam on acupuncture points. A low power infrared 980 nm, 50 mW laser (Diller & Diller Laser Performance) electric energy, was used; each acupuncture point was irradiated for 30 seconds at 8,000 Hz at each therapy session. In both groups, treatment was applied to the following points: Ipsilateral- Yanggu (SI5), Yangchi (SJ4), Waiguan (SJ15), Yangxi (LI5), Daling (...
Archives of Orthopaedic and Trauma Surgery, 2017
Introduction Despite an adequate orthopedic treatment with functional bracing, some patients deve... more Introduction Despite an adequate orthopedic treatment with functional bracing, some patients develop a delayed union in humeral shaft fractures. The objective of the present study was to determine the bone consolidation time among patients with delayed union of diaphyseal humeral fractures who were managed with locking compression plate (LCP) fixation combined with an iliac crest autograft using platelet-rich plasma (PRP) as a co-adjuvant. Materials and methods This study was a controlled, randomized, experimental, longitudinal, comparative, prospective, blind clinical trial. Patients diagnosed with delayed union of a diaphyseal humeral fracture with at least 4 months of evolution were treated with an open reduction and LCP osteosynthesis combined with an iliac crest autograft. The experimental group also received PRP. The patients were assessed radiographically until 36 weeks of evolution. Results A total of 16 patients were included. Both groups had similar demographic characteristics. The patients treated with PRP had an earlier beginning of bone consolidation. Furthermore, these same patients exhibited bone consolidation at 19.9 weeks, on average, in contrast to 25.4 weeks in the control group. Conclusions The use of PRP promotes earlier bone consolidation in patients with delayed union of the humeral shaft.