Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

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Introduction: Periprosthetic infection rates are sometimes underestimated, as many cases of presumed aseptic failure may be due to unrecognized infection. The objectives of the present study of aseptic revision THA were: (1) to estimate the prevalence of unexpected positive intraoperative cultures; (2) to determine if any of the patient’s comorbidities or risk factors were related to the presence of unexpected positive cultures; (3) to determine the implant survival during the follow-up of at least 12 months. Methods: A retrospective and observational study was carried out where, through electronic medical records, all revisions total hip arthroplasty (THA) from a single institution between 2014 and 2021 were identified. Results: Of the 49 revisions THA in 1 time, 9 patients (18.4%) had an unexpected positive culture. The isolated microorganisms were Staphylococcus aureus (3), Pseudomonas aeruginosa (1), Staphylococcus lugdunensis (1), Staphylococcus epidermidis (2), Staphylococcus haemolyticus (1), Streptococcus epidermidis (1). In addition, when we evaluated the comorbidities of the patients, none had statistical significance in favoring unexpected positive cultures in aseptic revisions. We found out that 2% of our sample with a follow-up period of 49 months developed reinfection. Conclusion: Our study showed a prevalence of unexpected positive cultures of 18.4%. None of the risk factors reported in the literature was associated with a higher risk of unexpected positive cultures in these aseptic check-ups, except for high ESR values. Our findings suggest that unexpected positive cultures in presumably aseptic reviews do not have significant consequences on implant survival, as found in the literature.

Objective: To evaluate the functional outcomes of three different conservative treatment protocols in patients with adhesive capsulitis of the shoulder. Materials and Methods: Reviews of medical records were carried out on patients treated at the institution for adhesive capsulitis in the period between January 2016 and January 2019. 3 different treatment protocols were compared. Group 1; Suprascapular nerve block (SSNB) with local anesthetic and corticosteroid, analgesics, and physiotherapy after pain reduction. Group 2: SSNB with local anesthetic without corticosteroids, analgesics, and physiotherapy, and group 3: analgesics and physiotherapy,without SSNB. The functional outcomes were determined with the ASES scale and the subjective results were assessed with the SSV. Results: A total of 46 patients treated for adhesive capsulitis were divided into 3 groups. Group 3 presented a higher mean number of physiotherapy sessions (30.31±21.07). Group 2 had the highest mean number of SSN blocks (3.27±1.22). The results of the functional scores were: group 1 (15 patients): mean ASES 84 and mean SSV 84; group 2 (15 patients): mean ASES 93.40 and mean SSV 91.67; group 3 (16 patients): mean ASES 79.4 and mean SSV 80.63. Conclusion: The various forms of conservative treatment for adhesive capsulitis achieve excellent outcomes. Analgesia through serial blocks of the suprascapular nerve with an anesthetic and corticosteroid achieved better functional and subjective outcomes and decreased the need to administer analgesics and physiotherapy sessions (group 1).Level of Evidence: IV

We present a case of a 72-year-old male patient who consulted pain in the left shoulder of 5 months of evolution, predominantly at night. He does not report a history of trauma. On physical examination, no tumors are palpated. Passive and active mobility is decreased with positive tests for rotator cuff. Preliminary images are presented.  

The images of intraosseous Lipoma and its differential diagnoses are described.

The use of allografts carries the risk of various complications. Among the most frequent is infection. An important risk factor for infection with the use of bone grafts is the transmission of germs through the graft itself. Our objectives are to determine if there is a relationship between possible contamination of the grafts from this bank and postoperative infections; demonstrate how the proper donor selection, procurement, and processing of the graft decrease the rate of contamination; and report other complications relatedto the quality of the graft. Materials and Methods: We selected patients who received structural bone grafts from our bank.All grafts were microbiologically studied. A review of the health records, anamnesis, physical examination, and radiographs was performed to evaluate infection and other complications. The ISOLS Osseointegration Scale was used to asses the consolidation of the grafts. Results: No graft contamination was detected. One case (7.7%) of infection by carbapenemase-producing Klebsiella pneumoniae (KPC) and 3 cases (23%) of nonunion were identified. Consolidation was good to excellent in 77% of cases, satisfactory in 8%, and poor in 15%. No other complications were found. Conclusion: There is a risk for infection transmission with structural allograft. Regulated donor selection criteria and control of bone bank procedures reduce the risk of infection due to graft contamination and other complications related to graft quality.

Calcaneal fractures account for 2-3.1% of all fractures1 ; among these, the least common are avulsions of the Achilles tendon, described by Dr. Bohler as “Beak fractures”2 . Descriptions in the literature are very scarce, the largest report being that of SangMyung et al. in 2012, where a summary of 764 cases of calcaneal fractures contained 20 avulsion fractures. The most common mechanisms of trauma are tripping, falling, or a direct knock3 . This report presents the clinical case of a 48-year-old patient who attended the Emergency Service of a second-level hospital after falling from a tree which resulted in being suspended by the lowerright limb. Radiographs revealed signs of a calcaneal avulsion fracture, which was surgically managed via osteosynthesis with excellent clinical outcomes in follow-up. Given the infrequency of this type of fracture, we considered it important to present this article