Jorge Gil-Albarova | University of Zaragoza (original) (raw)

Papers by Jorge Gil-Albarova

Joint Diseases and Related Surgery

Osteochondromas are neoplasm that belong to the family of cartilaginous histogenesis tumors and r... more Osteochondromas are neoplasm that belong to the family of cartilaginous histogenesis tumors and represent 90% of all forms of exostoses. As most osteochondromas are asymptomatic, underdiagnosis is frequent. Symptomatic forms usually manifest before the age of 20 years, and the most common symptoms are pain and the detection of a bony mass. Herein, we report four cases of spontaneous regression of solitary osteochondromas in the light of literature. We consider that orthopedic surgeons should take into account the possibility of spontaneous regression of these tumors, before recommending surgery. Symptoms are usually mild and we recommend following these patients with X-ray and physical examination annually.

Revista de la Asociación Argentina de Ortopedia y Traumatología

Introducción: Las fracturas aisladas del hueso grande son muy infrecuentes en los niños y se prod... more Introducción: Las fracturas aisladas del hueso grande son muy infrecuentes en los niños y se producen por traumatismos de alta energía. Pueden pasar desapercibidas en la valoración inicial y las radiografías solo permiten identificar las lesiones en huesos osificados, por lo que son necesarias pruebas complementarias, como la resonancia magnética, para descartar posibles lesiones del carpo asociadas, sobre todo en menores de 10 años. Se presenta el caso de una fractura aislada del hueso grande con aparición de quiste sinovial por causa traumática en un paciente pediátrico, tratado mediante inmovilización con yeso antebraquial durante cuatro semanas, con buena evolución. Conclusión: El manejo de estos casos depende de la gravedad de la lesión y, aunque por lo común evolucionan bien con un tratamiento conservador, su diagnóstico precoz permite elegir la mejor opción yevitar posibles complicaciones, como la falta de consolidación o la necrosis avascular.Nivel de Evidencia: IV

The clavicle is an infrequent location for primary tumors in general, and aneurysmal bone cyst (A... more The clavicle is an infrequent location for primary tumors in general, and aneurysmal bone cyst (ABC) of the clavicle is particularly rare. The challenge of the functional and esthetic result in the treatment of these lesions in the pediatric population is high when considering the reconstruction of critical bone defects. In this article, we present the case of a seven-year-old boy with an ABC in the middle third of the clavicle, treated by resection and reconstruction with free autograft of the fibula stabilized by using an intramedullary titanium nail. We offer a description of the used technique, considerations about treatment options in children, and a follow-up of more than two-and-a-half years.

INTRODUCCION Y OBJETIVOS El Nitinol (NiTi) es un material biocompatible, que ademas reune las cua... more INTRODUCCION Y OBJETIVOS El Nitinol (NiTi) es un material biocompatible, que ademas reune las cualidades de superelasticidad y memoria de forma. El objetivo de este trabajo es inducir remodelacion osea sobre el femur del conejo de Nueva Zelanda con clavos endomedulares de acero quirurgico y NiTi y comparar ambos materiales. MATERIAL Y METODOS Se utilizaron 25 conejos machos, albinos, de Nueva Zelanda de 2,5 meses de edad, esqueleticamente inmaduros, a los que se implanto un clavo endomedular femoral retrogrado a traves del surco intercondileo. Los animales se distribuyeron aleatoriamente en 5 grupos de 5 animales cada uno, implantando en cada grupo uno de los siguientes clavos: - Tubo de acero (AISI 316L) de 2,2 / 1,7 mm O (0,5 mm de espesor) - Tubo de NiTi de 2,178/1,68 mm O (0,498 mm de espesor) - Tubo de NiTi de 2,2/1,55 mm O (0,65 mm de espesor) - Clavo macizo de acero (AISI 316L) de 2,3 mm O - Clavo macizo de NiTi de 2,31 mm O El seguimiento fue de 4 meses, durante los cuales los animales fueron estabulados, permitiendo el libre movimiento y carga de la extremidad intervenida. Mensualmente se realizaron, bajo sedacion, radiografias en proyeccion lateral, estandarizara, de ambos femures. Durante este tiempo se realizo un seguimiento evolutivo del antecurvatum de los femures intervenidos respecto al femur contralateral, que sirvio de control. Las imagenes radiograficas digitalizadas se procesaron con la aplicacion UTHSCSA ImageTool 3.0, realizando un estudio estadistico de los resultados RESULTADOS Un animal murio en el primer mes del postoperatorio y otro sufrio una fractura del femur intervenido y fue desechado del estudio. Los femures intervenidos presentaron cambios estadisticamente significativos en el angulo cortical anterior y posterior durante los 4 meses del estudio, sobre todo en el primer mes, sin observarse modificaciones significativas en los femures control contralaterales. Estos cambios fueron significativamente superiores en el grupo del NiTi macizo, que tambien presento un mayor cambio en su angulacion, respecto al resto de implantes testados. No hubo influencia de otros parametros, como el peso inicial, el crecimiento en longitud del femur y el aumento ponderal del conejo, en la modificacion de los angulos corticales del femur de los conejos del estudio. CONCLUSIONES Nuestro estudio experimental demuestra que es posible la induccion de remodelacion osea del antecurvatum fisiologico en el femur del conejo de Nueva Zelanda esqueleticamente inmaduro mediante la implantacion endomedular de clavos de Niquel-Titanio (NiTi) rectos. Esta remodelacion osea se manifiesta en la modificacion estadisticamente significativa de los angulos de la cortical posterior y anterior del femur del conejo.

Revista de Ortopedia y Traumatología, 1992

Joint Diseases and Related Surgery, 2021

PLOS ONE, 2016

A comparative study between two stems (Linea Anatomic and Minihip) has been performed in order to... more A comparative study between two stems (Linea Anatomic and Minihip) has been performed in order to analyse the differences in their biomechanical behaviour, concerning stem micromotions and load transmission between stem and bone. From the corresponding finite element models, a parametric study was carried out to quantify ranges of micromotions taking into account: friction coefficient in the stem-bone interface, press-fit and two types of gait cycle. Micromotions were evaluated for each stem at six different levels along repeated gait cycles. An initial and marked stem subsidence at the beginning of the simulation was observed, followed by an asymptotic decrease due to friction forces. Once migration occurs, a repeated reversible cyclic micromotion is developed and stabilized as gait cycle times are simulated. The general motion pattern exhibited higher amplitude of micromotion for Minihip compared to Linea stem. The load transmission mechanism was analyzed, identifying the main internal forces. The results show higher local forces for Minihip stem up to 80% greater than for Linea stem. The differences of design between Minihip and Linea conditioned different distributions of load, influencing the posterior stress-shielding. Consequently, short stems require high bone stock and quality should, being indicated for young patients with high bone quality.

$Research paper thumbnail of A predictive mechanical model for evaluating vertebral fracture probability in lumbar spine under different osteoporotic drug therapies$

Computer Methods and Programs in Biomedicine, 2016

Highlights • Method for estimating the fracture risk in osteoporotic patients based on Damage and... more Highlights • Method for estimating the fracture risk in osteoporotic patients based on Damage and Fracture Mechanics and DXA measurements. • The method evaluates the evolution over time of the mechanical strength of bone from BMD, for different treatments. • Evolutionary algorithm and a finite element model of the lumbar spine allow the prediction of fracture probability. • The incorporation of clinical measurements and simulation results will be useful for an individualized treatment in patients. • The model predicts the evolution of vertebral fracture probability and the expected evolution under different therapies.

BioMed Research International, 2015

More than twenty years ago, hydroxyapatite (HA), calcium phosphate ceramics, was introduced as a ... more More than twenty years ago, hydroxyapatite (HA), calcium phosphate ceramics, was introduced as a coating for cementless hip prostheses. The choice of this ceramic is due to its composition being similar to organic apatite bone crystals. This ceramic is biocompatible, bioactive, and osteoconductive. These qualities facilitate the primary stability and osseointegration of implants. Our surgical experience includes the implantation of more than 4,000 cementless hydroxyapatite coated hip prostheses since 1990. The models implanted are coated with HA in the acetabulum and in the metaphyseal area of the stem. The results corresponding to survival and stability of implants were very satisfactory in the long-term. From our experience, HA-coated hip implants are a reliable alternative which can achieve long term survival, provided that certain requirements are met: good design selection, sound choice of bearing surfaces based on patient life expectancy, meticulous surgical technique, and ind...

Musculoskeletal surgery, 2013

The records of 4 children of under 14 years of age treated at our institution for traumatic stern... more The records of 4 children of under 14 years of age treated at our institution for traumatic sternoclavicular dislocation (SCJ) were reviewed. Closed reduction in posterior SCJ after computed tomography (CT) was successful as immediate procedure. For anterior SCJ instability, open reduction and SCJ reconstruction obtained satisfactory results. Conservative treatment of SCJ subluxation for asymptomatic children was sufficient. Radiographs in ''serendipity view'' were useful for confirming reduction and stability in children. No postoperative CT was needed for this purpose. Closed reduction in posterior SCJ dislocation and surgical treatment in anterior SCJ dislocation in young children can provide stability and a satisfactory return to a normal function, but with some limitation when intense or competitive shoulder motion is required during sport. Young children and parents should be aware about this possibility. Conservative treatment of SCJ subluxation for asymptomatic children is useful. Reflection is required regarding the correct imaging examination after treatment to check stable reduction in a SCJ injury.

$Research paper thumbnail of Prevalence of osteoporotic vertebral fracture in Spanish women over age 45$

Journal of Pediatric Surgery, 2011

Myositis ossificans circumscripta (MOC), with nonneoplastic heterotopic bone formation in soft ti... more Myositis ossificans circumscripta (MOC), with nonneoplastic heterotopic bone formation in soft tissue and skeletal muscle, is rare in children. Extraskeletal osteosarcoma is a very rare malignant mesenchymal neoplasm of soft tissues in children. At onset, it may be difficult to distinguish MOC from a musculoskeletal infection or neoplasm, particularly in the absence of trauma, and a biopsy is frequently required. However, differentiating MOC from malignant neoplasm is imperative. We describe the case of a 22-month-old girl who presented with a benign fibrous-myofibroblastic tumor mimicking MOC. However, extraskeletal osteosarcoma was also considered in the differential diagnosis due to the absence of attachment of the lesion to the skeleton. Pathologic findings after a previous needle biopsy and posterior marginal resection exclude both differential diagnoses. Close follow-up during 3 years postoperatively showed no signs of recurrence.

Journal of Pediatric Orthopaedics B, 2012

Osteomyelitis is an uncommon infection that is considered to be a childhood disease. Diagnosis is... more Osteomyelitis is an uncommon infection that is considered to be a childhood disease. Diagnosis is frequently delayed, as it is a very rare condition and also because of its variable presentation. After an accurate diagnosis and treatment, the outcome is favorable in children. We present one case without recent previous infection, antecedent trauma, or penetrating injury, illustrating the difficulties in diagnosis. Nontraumatic osteomyelitis of the patella should be regarded as a rare hematogenous infection. A high index of suspicion should be addressed for early recognition. Study design is level of evidence: level IV.

Injury, Jan 4, 2012

INTRODUCTION: The experience of the treatment of proximal humeral nonunions with the reverse tota... more INTRODUCTION: The experience of the treatment of proximal humeral nonunions with the reverse total shoulder arthroplasty is limited. We report our results. PATIENTS: Eighteen patients with proximal humeral atrophic nonunion were treated with the reverse total shoulder prosthesis. There were 12 women and 6 men, with a mean age of 78.8 years (range, 75-84 years). The mean follow-up after the reverse arthorplasty was 28months (range, 24-32months). Extensive proximal humeral bone loss that was found in six cases was treated adding a proximal humeral allograft. A long humeral stem was always used. RESULTS: The mean constant score increased from 26% preoperatively to 55% postoperatively (p<0.0001). The average anterior elevation increased from 35° to 90° (p<0.0001), abduction from 35° to 85°…

The records of 82 patients (129 feet) with resistant clubfoot deformity treated surgically by mea... more The records of 82 patients (129 feet) with resistant clubfoot deformity treated surgically by means of different releases were retrospectively reviewed. There are many treatment regimes for clubfoot. Some authors recommend manipulation with minimal multi-stage surgery, whereas others recommend neonatal corrective surgery. However, objective comparison of different treatment programs is not easy because different criteria are used to evaluate the results. Teratologic or neuromuscular clubfeet were not included in this revision. Between 1982 and 1998, 82 patients (27 girls, 55 boys) with 129 clubfeet underwent surgical treatment. All feet were initially treated with a serial long-leg cast for a minimum of four months. Mean age at the time of first surgery was 5.5 months (range 3.5 to 24). Minimum follow-up was two years. Primary posterior release was performed on 105 feet. Subsequent medial release was performed on 16 feet, posteromedial release on three, and a subtalar (Cincinnati) release on three. Primary isolated posteromedial release was performed on 14 feet, and two of these required a subsequent subtalar (Cincinnati) release. Primary isolated medial release was performed on seven feet. Primary isolated lateral release was performed on one foot and primary isolated subtalar (Cincinnati) release was performed on two feet. Subsequent derotative tibial osteotomy was performed in seven cases, wedge tarsectomy on four feet, triple arthrodesis on five, and calcaneocuboid fusion on one foot. Residual varus was present in seven feet. Calcaneal gait caused by overlengthening of the Achilles tendon occurred in one foot, and residual equinus in two feet. Residual valgus heel was observed in three feet. The surgeon must assess each foot and plan the surgery accordingly. A total release is not required for every foot.

Acta Biomaterialia, 2012

The main requirement of bone regenerative scaffolds is to enhance the chemical reactions leading ... more The main requirement of bone regenerative scaffolds is to enhance the chemical reactions leading to the formation of new bone while providing a proper surface for tissue in-growth as well as a suitable degradation rate. Calcium phosphate ceramics are conformed by different shaping methods. One requirement is to design implants and scaffolds with suitable shapes and sizes, but also with interconnected porosity to ensure bone oxygenation and angiogenesis. In this work we present the in vivo performance of hierarchically arranged glutaraldehyde crosslinked, gelatin-coated nanocrystalline hydroxyapatite (HABP) scaffolds (1-400 lm), with high potential as bone regenerators and excellent osteointegration perfor

World Journal of Orthopedics, 2012

Osteoporosis in men is a heterogeneous disease that has received little attention. However, one t... more Osteoporosis in men is a heterogeneous disease that has received little attention. However, one third of worldwide hip fractures occur in the male population. This problem is more prevalent in people over 70 years of age. The etiology can be idiopathic or secondary to hypogonadism, vitamin D deficiency and inadequate calcium intake, hormonal treatments for prostate cancer, use of toxic and every disease or drug use that alters bone metabolism. Risk factors such as a previous history of fragility fracture should be assessed for the diagnosis. However, risk factors in men are very heterogeneous. There are significant differences in the pharmacological treatment of osteoporosis between men and women fundamentally due to the level of evidence in published trials supporting each treatment. New treatments will offer new therapeutic prospects. The goal of this work is a revision of the present status knowledge about male osteoporosis.

$Research paper thumbnail of Factores del retardo de consolidación en fracturas de antebrazo pediátricas$

The aim of this study was to assess predictive factors for delayed healing in forearm paediatric ... more The aim of this study was to assess predictive factors for delayed healing in forearm paediatric fractures. This is a case-control study of all paediatric shaft fractures of forearm presenting delayed union in follow-up period of 12 months or more, from 2003 through 2009, treated in Miguel Servet University Hospital. Exclusion criteria were fracture-dislocations, infection, suboptimal osteosynthesis, greenstick, open, pathologic and associated radial head fractures, as well as patients without stablished period of follow up. Statistical assessment included bivariant and multivariant linear regression analysis. Results: During the study period 441 complete both-bone forearm fractures were treated: 14 of them (3.2%) were identified as suffering delayed union; and 63 controls fulfilling inclusion criteria were randomly selected. Bivariant analysis showed significant differences between "delayed union" and "control" groups in age, need of surgical treatment, open ver...

$Research paper thumbnail of Estudio del tratamiento de las fracturas supracondíleas de húmero en la infancia en el Hospital Universitario Miguel Servet de Zaragoza entre 1998 y 2008$

INTRODUCCION: En el campo de la ingenieria de tejidos, las ceramicas de fosfato calcico son ampli... more INTRODUCCION: En el campo de la ingenieria de tejidos, las ceramicas de fosfato calcico son ampliamente utilizadas como sustituto oseo debido a su semejanza estructural a la fase mineral del hueso, lo que hace que presenten una buena compatibilidad y capacidad de osteointegracion. El principal requisito que han de cumplir los andamios de ceramica es el ser capaces de favorecer la formacion de tejido oseo, asi como asegurar la creacion de una red vascular que permita la oxigenacion y nutricion del hueso recien formado. Para poder cumplir estos requisitos, los materiales disenados deben presentar una estructura porosa con porosidad interconectada. Por otra parte ha de existir un compromiso entre la tasa de degradacion del material fabricado y la velocidad de regeneracion del tejido recien formado. Las ceramicas fosfocalcicas se pueden conformar mediante distintos metodos de sintesis. OBJETIVO: Estudiar in vivo la regeneracion del tejido oseo en un defecto cavitario critico experimenta...