Objective: To retrospectively survey the most frequent complications from medial opening wedge high-tibial osteotomy. This procedure is becoming increasingly important in treating knee arthrosis, as one of the options for young and active patients. Despite satisfactory results and its benefits, it is not a complication-free procedure. Methods: All cases of medial opening wedge high-tibial osteotomy above the tibial tubercle with fixation using a Puddu plate that were performed at the Celso Pierro Hospital and Maternity Hospital, Pontifical Catholic University of Campinas (PUC-Campinas) and the Wilson Mello Institute, Campinas, between October 1, 1987, and October 30, 2008, were evaluated retrospectively. Patients with less than 12 months of follow-up or incomplete medical files, and those who underwent bilateral osteotomy, were excluded. Results: Out of the 67 cases evaluated, 55 were males and 12 were females, with a mean age of 49.5 years. The mean wedge size was 10.15 mm and the most common complications were moderate to severe pain (13.04%), stiffness (6.52%), material breakage (4.4%), intraoperative fracture of the lateral cortical bone (4.4%) and infection (4.4%). It was observed that patients with delayed consolidation of the osteotomy had a greater chance of presenting complications (p < 0.05). Conclusion: Complications from medial wedge osteotomy are more frequent when associated with delayed consolidation.
Background: Anterior knee pain is a frequent condition after anterior cruciate ligament reconstruction (ACLR), but its origin remains uncertain. Studies have suggested that donor site morbidity in autologous bone–patellar tendon–bone reconstructions may contribute to patellofemoral pain, but this does not explain why hamstring tendon reconstructions may also present with anterior pain. Purpose: To evaluate the prevalence of anterior knee pain after ACLR and its predisposing factors. Study Design: Case-control study; Level of evidence, 3. Methods: We evaluated the records of all patients who underwent ACLR between 2000 and 2016 at a private facility. The prevalence of anterior knee pain after surgery was assessed, and possible risk factors (graft type, patient sex, surgical technique, range of motion) were evaluated. Results: The records of 438 patients (mean age, 30 years) who underwent ACLR were analyzed. Anterior knee pain was found in 6.2% of the patients. We found an increased prevalence of anterior knee pain with patellar tendon graft, with an odds ratio of 3.4 ( P = .011). Patients who experienced extension deficit in the postoperative period had an odds ratio of 5.3 of having anterior pain ( P < .001). Anterior knee pain was not correlated with patient sex or surgical technique. Conclusion: The chance of having anterior knee pain after ACLR was higher when patellar tendon autograft was used compared with hamstring tendon graft, as well as in patients who experienced extension deficit in the postoperative period.
Implantación de una historia clínica informatizada: encuesta sobre el grado de utilización y satisfacción en un hospital terciario Implantation of a computerised clinical history: survey on the degree of utilisation and satisfaction in a tertiary hospital RESUMENFundamento. Evaluar en un hospital terciario, el grado de utilización de una historia clínica informatizada (HCI), las opiniones de los profesionales sobre sus ventajas e inconvenientes y su nivel de satisfacción con la misma. Material y métodos.Encuesta enviada por correo a todos los médicos del Hospital Virgen del Camino en Pamplona.Resultados. De los 445 médicos del centro, contestaron la encuesta 174 (39%). De éstos, el 79% consideran que la HCI es mejor que la historia clínica tradicional, el 61% la utilizan para consultar e introducir datos de manera habitual y el 55% están muy de acuerdo con que la HCI ofrece ventajas para el paciente. Los principales problemas detectados son la posible pérdi-da de confidencialidad, y la falta de tiempo, de dotación informática y de mayor formación, para el manejo del programa. El 90% de los encuestados opina que se debe continuar con su implantación y sólo el 6% dice estar poco satisfecho con la aplicación.Conclusión. Existe una extendida utilización de la HCI entre los médicos del Hospital Virgen del Camino y su opinión sobre el programa puede considerarse globalmente favorable. Se deben desarrollar medidas para subsanar los problemas detectados mediante este estudio.Palabras clave. Historia clínica informatizada. Encuesta. Hospitales. Satisfacción. ABSTRACTBackground. To assess the utilization of an electronic medical record (EMR), the degree of satisfaction with this tool, as well as to detect problems in its utilization, in a tertiary hospital in Spain.
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