Asociación entre el uso de la pistola de lavado pulsátil con la penetración del cemento óseo en reemplazos articulares de rodilla del servicio de ortopedia y traumatología en la clínica Foscal y Foscal Internacional
Por medio de este proyecto de investigación se busca definir las medidas de penetración e intrusión del cemento óseo al hueso trabecular a nivel de la tibia proximal en los pacientes que se les realice reemplazo articular. Determinando esta medida se evaluarían los factores asociados que podrían inf...
- Autores:
-
Molina Gómez, Rafael Andrés
- Tipo de recurso:
- Fecha de publicación:
- 2022
- Institución:
- Universidad Autónoma de Bucaramanga - UNAB
- Repositorio:
- Repositorio UNAB
- Idioma:
- spa
- OAI Identifier:
- oai:repository.unab.edu.co:20.500.12749/19049
- Acceso en línea:
- http://hdl.handle.net/20.500.12749/19049
- Palabra clave:
- Medical sciences
Health sciences
Orthopedics
Traumatology
Health services
Pulsating wash gun
Use
Emergency medicine
Arthroplasty
Knee prosthesis
Ciencias médicas
Ortopedia
Traumatología
Medicina de urgencias
Artroplastia
Prótesis de rodilla
Ciencias de la salud
Servicios de salud
Pistola de lavado pulsátil
Uso
- Rights
- License
- http://creativecommons.org/licenses/by-nc-nd/2.5/co/
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| dc.title.spa.fl_str_mv |
Asociación entre el uso de la pistola de lavado pulsátil con la penetración del cemento óseo en reemplazos articulares de rodilla del servicio de ortopedia y traumatología en la clínica Foscal y Foscal Internacional |
| dc.title.translated.spa.fl_str_mv |
Association between the use of the pulsatile lavage gun with the penetration of bone cement in knee joint replacements of the orthopedics and traumatology service at the Foscal clinic and Foscal Internacional |
| title |
Asociación entre el uso de la pistola de lavado pulsátil con la penetración del cemento óseo en reemplazos articulares de rodilla del servicio de ortopedia y traumatología en la clínica Foscal y Foscal Internacional |
| spellingShingle |
Asociación entre el uso de la pistola de lavado pulsátil con la penetración del cemento óseo en reemplazos articulares de rodilla del servicio de ortopedia y traumatología en la clínica Foscal y Foscal Internacional Medical sciences Health sciences Orthopedics Traumatology Health services Pulsating wash gun Use Emergency medicine Arthroplasty Knee prosthesis Ciencias médicas Ortopedia Traumatología Medicina de urgencias Artroplastia Prótesis de rodilla Ciencias de la salud Servicios de salud Pistola de lavado pulsátil Uso |
| title_short |
Asociación entre el uso de la pistola de lavado pulsátil con la penetración del cemento óseo en reemplazos articulares de rodilla del servicio de ortopedia y traumatología en la clínica Foscal y Foscal Internacional |
| title_full |
Asociación entre el uso de la pistola de lavado pulsátil con la penetración del cemento óseo en reemplazos articulares de rodilla del servicio de ortopedia y traumatología en la clínica Foscal y Foscal Internacional |
| title_fullStr |
Asociación entre el uso de la pistola de lavado pulsátil con la penetración del cemento óseo en reemplazos articulares de rodilla del servicio de ortopedia y traumatología en la clínica Foscal y Foscal Internacional |
| title_full_unstemmed |
Asociación entre el uso de la pistola de lavado pulsátil con la penetración del cemento óseo en reemplazos articulares de rodilla del servicio de ortopedia y traumatología en la clínica Foscal y Foscal Internacional |
| title_sort |
Asociación entre el uso de la pistola de lavado pulsátil con la penetración del cemento óseo en reemplazos articulares de rodilla del servicio de ortopedia y traumatología en la clínica Foscal y Foscal Internacional |
| dc.creator.fl_str_mv |
Molina Gómez, Rafael Andrés |
| dc.contributor.advisor.none.fl_str_mv |
Reyes González, Adriana Lucila Martínez Villalba Rodríguez, Diego |
| dc.contributor.author.none.fl_str_mv |
Molina Gómez, Rafael Andrés |
| dc.contributor.cvlac.spa.fl_str_mv |
Reyes González, Adriana Lucila [0000126469] |
| dc.contributor.orcid.spa.fl_str_mv |
Reyes González, Adriana Lucila [0000-0002-9852-9345] |
| dc.contributor.apolounab.spa.fl_str_mv |
Martínez Villalba Rodríguez, Diego [rodriguez-diego-martinez-villalba] |
| dc.subject.keywords.spa.fl_str_mv |
Medical sciences Health sciences Orthopedics Traumatology Health services Pulsating wash gun Use Emergency medicine Arthroplasty Knee prosthesis |
| topic |
Medical sciences Health sciences Orthopedics Traumatology Health services Pulsating wash gun Use Emergency medicine Arthroplasty Knee prosthesis Ciencias médicas Ortopedia Traumatología Medicina de urgencias Artroplastia Prótesis de rodilla Ciencias de la salud Servicios de salud Pistola de lavado pulsátil Uso |
| dc.subject.lemb.spa.fl_str_mv |
Ciencias médicas Ortopedia Traumatología Medicina de urgencias Artroplastia Prótesis de rodilla |
| dc.subject.proposal.spa.fl_str_mv |
Ciencias de la salud Servicios de salud Pistola de lavado pulsátil Uso |
| description |
Por medio de este proyecto de investigación se busca definir las medidas de penetración e intrusión del cemento óseo al hueso trabecular a nivel de la tibia proximal en los pacientes que se les realice reemplazo articular. Determinando esta medida se evaluarían los factores asociados que podrían influir en la diferencia de medidas. Si se evidencian situaciones que alteren la intrusión del cemento, se buscaría mejorar este para prevenir complicaciones mecánicas de los componentes protésicos. Disminuyendo las complicaciones en los pacientes, se disminuiría la tasa de revisiones protésicas y el costo total de los pacientes para las aseguradoras. Por medio de las radiografías de los postoperatorios de los reemplazos articulares de rodillas, se mediría la intrusión del cemento en el hueso trabecular, tanto para la tibia proximal y fémur distal. Analizando las medidas se evaluaría el impacto del lavado previo de la cementación por medio del uso de pistola de irrigación pulsátil, comparado con el lavado por medio de jeringa/irrigación por gravedad. La diferencia de intrusión ósea se espera que sea mayor en los pacientes lavados con pistolas de irrigación a presión pulsátil comparados con los otros métodos de lavado; teniendo un mayor índice de penetración en el hueso trabecular, los componentes protésicos se adhieren mejor con menores tasas de aflojamiento asociado. Se medirá el manto de cemento óseo en las radiografías de control postoperatorio de los pacientes, en milímetros. Si se encuentra este resultado en los pacientes evaluados; se podría determinar la necesidad y pertinencia para el uso y autorización de este tipo de pistolas para todos los procedimientos de reemplazo articular en rodilla. Actualmente se conocen las técnicas de cementación y mezclado durante la intervención en el reemplazo articular; Las pistolas de irrigación pulsátil también se utilizan en otras situaciones como método para lavado de heridas y fracturas expuestas, demostrando sus beneficios locales con el barrido macroscópico de la contaminación; la mayor contraparte evidente con el uso de la pistola de lavado pulsátil, que en ocasiones obstaculiza su uso, es el alto costo del propio instrumento; para nuestro proyecto los efectos y resultados del lavado con pistola queremos con el uso de este en el lavado y medición de intrusión ósea con la colocación de las prótesis y el manto correspondiente de cemento. Conociendo los resultados en nuestra institución y grupo de pacientes,se establecería la pertinencia y necesidad de uso de la pistola de irrigación pulsátil para favorecer la intrusión del cemento en el hueso, para así evitar y disminuir la tasa de aflojamiento aséptico en los reemplazos articulares de rodilla. Correlacionando estos factores se pueden prevenir mayores costos en el manejo del aflojamiento y consecuentes revisiones de prótesis primarias. Ya que no se cuentan con registros o estudios locales – nacionales en la literatura actual que determinen la penetración del cemento óseo en los reemplazos articulares, el proyecto con sus resultados aportarían cambios y ajustes que determinarán una mejor sobrevida para las prótesis con la consecuente estabilización de los componentes protésicos por la interdigitación del cemento, y disminución de la tasa de aflojamiento que es una de las causas principales para revisión de artroplastias primarias de rodilla. |
| publishDate |
2022 |
| dc.date.issued.none.fl_str_mv |
2022 |
| dc.date.accessioned.none.fl_str_mv |
2023-02-20T14:13:30Z |
| dc.date.available.none.fl_str_mv |
2023-02-20T14:13:30Z |
| dc.type.eng.fl_str_mv |
Thesis |
| dc.type.driver.spa.fl_str_mv |
info:eu-repo/semantics/masterThesis |
| dc.type.local.spa.fl_str_mv |
Tesis |
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info:eu-repo/semantics/acceptedVersion |
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http://purl.org/redcol/resource_type/TM |
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acceptedVersion |
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http://hdl.handle.net/20.500.12749/19049 |
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instname:Universidad Autónoma de Bucaramanga - UNAB |
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reponame:Repositorio Institucional UNAB |
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repourl:https://repository.unab.edu.co |
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instname:Universidad Autónoma de Bucaramanga - UNAB reponame:Repositorio Institucional UNAB repourl:https://repository.unab.edu.co |
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Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Jt Surg - Ser A. 2007;89(4):780– 5. Hampton CB, Berliner ZP, Nguyen JT, Mendez L, Smith SS, Joseph AD, et al. Aseptic Loosening at the Tibia in Total Knee Arthroplasty: A Function of Cement Mantle Quality? J Arthroplasty. 2020;35(6):S190–6. z SM, Gawel HA, Patel JD. History and systematic review of wear and osteolysis outcomes for first-generation highly crosslinked polyethylene. Clin Orthop Relat Res. Versión 1.0 , 01/07/2022 43 2011;469(8):2262–77 Ko DO, Lee S, Kim KT, Lee J Il, Kim JW, Yi SM. Cement mantle thickness at the bone cement interface in total knee arthroplasty: Comparison of ps150 rp and lps-flex knee implants. Knee Surg Relat Res. 2017;29(2):115–21. Knappe K, Stadler C, Innmann MM, Schonhoff M, Gotterbarm T, Renkawitz T, et al. Does additive pressurized carbon dioxide lavage improve cement penetration and bond strength in cemented arthroplasty? J Clin Med. 2021;10(22). Knappe K, Bitsch RG, Schonhoff M, Walker T, Renkawitz T, Jaeger S. Pulsatile lavage systems with high impact pressure and high flow produce cleaner cancellous bone prior to cementation in cemented arthroplasty. J Clin Med. 2022;11(1). Glowalla C, Ertl M, Lenze U, Lazic I, Burgkart R, Lang JJ, et al. Pulsatile Lavage During Cementation of Total Knee Arthroplasty - Is Fixation Impaired? A Cadaver Study. In Vivo (Brooklyn). 2022;36(2):672–7. Verburg H, Van Zeeland Koobs L, Niesten DD, Pilot P, Mathijssen N. Reliability of two different measuring techniques with computer tomography for penetration and distribution of cement in the proximal tibia after total knee arthroplasty. BMC Musculoskelet Disord. 2020;21(1):1–8. Lutz MJ, Halliday BR. Survey of current cementing techniques in total knee replacement. ANZ J Surg. 2002;72(6):437–9. Waanders D, Janssen D, Mann KA, Verdonschot N. The mechanical effects of different levels of cement penetration at the cement-bone interface. J Biomech [Internet]. 2010;43(6):1167–75. Available from: http://dx.doi.org/10.1016/j.jbiomech.2009.11.033 Kizilkurt T, Bayram S, Ekinci M, Ayik Ö, Ergin ÖN, Öztürk İ. Comparing the effect of tourniquet and tranexamic acid on the tibial cement mantle thickness in total knee arthroplasty. Eur J Orthop Surg Traumatol. 2022;32(2):263–8. |
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Reyes González, Adriana Lucila8378e5e2-3556-40ca-a7fa-4a1a56314986Martínez Villalba Rodríguez, Diego6f915485-6890-4ef9-adc1-39ce0675e040Molina Gómez, Rafael Andrésd4ecf24e-68e6-4901-b92c-b61102db8637Reyes González, Adriana Lucila [0000126469]Reyes González, Adriana Lucila [0000-0002-9852-9345]Martínez Villalba Rodríguez, Diego [rodriguez-diego-martinez-villalba]Floridablanca (Santander, Colombia)20222023-02-20T14:13:30Z2023-02-20T14:13:30Z2022http://hdl.handle.net/20.500.12749/19049instname:Universidad Autónoma de Bucaramanga - UNABreponame:Repositorio Institucional UNABrepourl:https://repository.unab.edu.coPor medio de este proyecto de investigación se busca definir las medidas de penetración e intrusión del cemento óseo al hueso trabecular a nivel de la tibia proximal en los pacientes que se les realice reemplazo articular. Determinando esta medida se evaluarían los factores asociados que podrían influir en la diferencia de medidas. Si se evidencian situaciones que alteren la intrusión del cemento, se buscaría mejorar este para prevenir complicaciones mecánicas de los componentes protésicos. Disminuyendo las complicaciones en los pacientes, se disminuiría la tasa de revisiones protésicas y el costo total de los pacientes para las aseguradoras. Por medio de las radiografías de los postoperatorios de los reemplazos articulares de rodillas, se mediría la intrusión del cemento en el hueso trabecular, tanto para la tibia proximal y fémur distal. Analizando las medidas se evaluaría el impacto del lavado previo de la cementación por medio del uso de pistola de irrigación pulsátil, comparado con el lavado por medio de jeringa/irrigación por gravedad. La diferencia de intrusión ósea se espera que sea mayor en los pacientes lavados con pistolas de irrigación a presión pulsátil comparados con los otros métodos de lavado; teniendo un mayor índice de penetración en el hueso trabecular, los componentes protésicos se adhieren mejor con menores tasas de aflojamiento asociado. Se medirá el manto de cemento óseo en las radiografías de control postoperatorio de los pacientes, en milímetros. Si se encuentra este resultado en los pacientes evaluados; se podría determinar la necesidad y pertinencia para el uso y autorización de este tipo de pistolas para todos los procedimientos de reemplazo articular en rodilla. Actualmente se conocen las técnicas de cementación y mezclado durante la intervención en el reemplazo articular; Las pistolas de irrigación pulsátil también se utilizan en otras situaciones como método para lavado de heridas y fracturas expuestas, demostrando sus beneficios locales con el barrido macroscópico de la contaminación; la mayor contraparte evidente con el uso de la pistola de lavado pulsátil, que en ocasiones obstaculiza su uso, es el alto costo del propio instrumento; para nuestro proyecto los efectos y resultados del lavado con pistola queremos con el uso de este en el lavado y medición de intrusión ósea con la colocación de las prótesis y el manto correspondiente de cemento. Conociendo los resultados en nuestra institución y grupo de pacientes,se establecería la pertinencia y necesidad de uso de la pistola de irrigación pulsátil para favorecer la intrusión del cemento en el hueso, para así evitar y disminuir la tasa de aflojamiento aséptico en los reemplazos articulares de rodilla. Correlacionando estos factores se pueden prevenir mayores costos en el manejo del aflojamiento y consecuentes revisiones de prótesis primarias. Ya que no se cuentan con registros o estudios locales – nacionales en la literatura actual que determinen la penetración del cemento óseo en los reemplazos articulares, el proyecto con sus resultados aportarían cambios y ajustes que determinarán una mejor sobrevida para las prótesis con la consecuente estabilización de los componentes protésicos por la interdigitación del cemento, y disminución de la tasa de aflojamiento que es una de las causas principales para revisión de artroplastias primarias de rodilla.Resumen del proyecto ...........................................................................................................pág.4 1. Justificación…………………………………………………………………………………………………………………..pág.6 2. Marco teórico………………………………………………………………………………………………………………..pág.8 2.1 Gonartrosis………………………………………………………………………………………………………………….pág.8 2.1.1 Fisiopatología……………………………………………………………………………………………………………pág.9 2.1.2 Prevalencia……………………………………………………………………………………………………………….pág.9 2.1.3 Causas y factores de riesgo………………………………………………………………………………………pág.9 2.1.4 Sintomatología…………………………………………………………………………………………………………pág.10 2.1.5 Diagnóstico y clasificación………………………………………………………………………………………..pág.10 2.1.6 Opciones de tratamiento………………………………………………………………………………………….pág.11 2.1.7 Opciones de tratamiento quirúrgico…………………………………………………………………………pág.12 2.1.7.1 Reemplazo total de rodilla…………………………………………………………………………………….pág.13 2.1.7.1.1 Técnicas y principios…………………………………………………………………………………………..pág.14 2.1.7.1.2 Cementación………………………………………………………………………………………………………pág.14 2.1.7.1.3 Penetración del cemento……………………………………………………………………………………pág.15 2.1.7.1.4 Complicaciones…………………………………………………………………………………………………..pág.16 3. Estado del arte………………………………………………………………………………………………………………pág.17 4. Objetivos……………………………………………………………………………………………………………………….pág.21 4.1 Objetivo General…………………………………………………………………………………………………………pág.21 4.2 Objetivos Específicos…………………………………………………………………………………………………..pág.21 5. Metodología………………………………………………………………………………………………………………… pág.22 5.1 Tipo de estudio…………………………………………………………………………………………………………... pág.22 5.2 Población……………………………………………………………………………………………………………………. pág.22 5.3 Criterios de inclusión………………………………………………………………………………………………….. pág.22 5.4 Criterios de exclusión…………………………………………………………………………………………………. pág.22 5.5 Cálculo de tamaño de muestra…………………………………………………………………………………… pág.22 5.6 Muestreo……………………………………………………………………………………………………………………. pág.23 5.7 Recolección de la información……………………………………………………………………………………. pág.23 Versión 1.0 , 01/07/2022 3 5.8 Variables…...................................................................................................................... pág.23 5.9 Plan de análisis de datos…………………………………………………………………………………………… pág.27 5.10 Consideraciones éticas………………………………............................................................... pág.27 6. Resultados esperados………………………………………………………………………………………………… pág.28 6.1 Relacionados con la generación de nuevo conocimiento………….................................. pág.28 6.2 Conducentes al fortalecimiento de la capacidad científica institucional……….............. pág.28 6.3 Dirigidos a la apropiación social del conocimiento…………………………………………………… pág.28 7. Impactos esperados…………………………………………………………………………………………………… pág.29 8. Resultados ………………………………………………………………………………………………………………… pág.30 8.1 Datos demográficos y análisis descriptivo de variables…………………………………………… pág.30 8.2 Análisis Bivariado……………………………………………………………………………………………………. pág.31 9. Discusión………………………………………………………………………………………………………………….. pág.34 10. Conclusiones…………………………………………………………………………………………………………… pág.36 11. Referencias bibliográficas………………………………………………………………………………………… pág.37 12. Anexos………………………………………………………………………………………………………………………. pág.44 12.1 Cronograma de actividades……………………………………………………………………………………… pág.45 12.2 Presupuesto…………………………………………………………………………………………………………….. pág.45EspecializaciónThrough this research project, it is sought to define the measures of penetration and intrusion bone cement to the trabecular bone at the level of the proximal tibia in patients who undergo joint replacement. Determining this measure, the associated factors that could influence the difference in measurements. If there are situations that alter the intrusion of the cement, it would seek to improve it to prevent mechanical complications of prosthetic components. decreasing the complications in patients, the rate of prosthetic revisions and the total cost of patients for insurers. Through the postoperative radiographs of knee joint replacements, it is possible to would measure the intrusion of the cement into the trabecular bone, both for the proximal tibia and distal femur. Analyzing the measures, the impact of the previous washing of the cementation would be evaluated by means of the use of pulsatile irrigation gun, compared with lavage via syringe/spray irrigation gravity. The difference in bone intrusion is expected to be greater in patients lavaged with guns. pulsatile pressure irrigation compared to the other lavage methods; having a higher rate penetration into trabecular bone, prosthetic components adhere better with minor associated loosening rates. The bone cement mantle will be measured in the control radiographs postoperative period of patients, in millimeters. If this result is found in patients evaluated; the need and relevance for the use and authorization of this type could be determined of guns for all knee joint replacement procedures. Cementing and mixing techniques are currently known during the intervention in the joint replacement; Pulsatile irrigation guns are also used in other situations such as method for washing wounds and exposed fractures, demonstrating its local benefits with the macroscopic sweep of contamination; the most obvious counterpart to the use of the pistol of pulsatile lavage, which sometimes hinders its use, is the high cost of the instrument itself; for our project the effects and results of washing with a gun we want with the use of this in the washing and measurement of bone intrusion with the placement of the prostheses and the corresponding mantle of cement. Knowing the results in our institution and group of patients, the relevance would be established. and the need to use the pulsatile irrigation gun to favor the intrusion of the cement into the bone, in order to avoid and reduce the rate of aseptic loosening in joint replacements of knee. By correlating these factors, higher costs can be prevented in the management of the loosening and consequent revisions of primary prostheses. Since there are no records or local-national studies in the current literature that determine the penetration of bone cement in joint replacements, the project with its The results would contribute changes and adjustments that will determine a better survival for the prostheses. with the consequent stabilization of the prosthetic components by the interdigitation of the cement, and decrease in the loosening rate, which is one of the main causes for revision of primary knee arthroplasties.application/pdfspahttp://creativecommons.org/licenses/by-nc-nd/2.5/co/Abierto (Texto Completo)Atribución-NoComercial-SinDerivadas 2.5 Colombiahttp://purl.org/coar/access_right/c_abf2Asociación entre el uso de la pistola de lavado pulsátil con la penetración del cemento óseo en reemplazos articulares de rodilla del servicio de ortopedia y traumatología en la clínica Foscal y Foscal InternacionalAssociation between the use of the pulsatile lavage gun with the penetration of bone cement in knee joint replacements of the orthopedics and traumatology service at the Foscal clinic and Foscal InternacionalThesisinfo:eu-repo/semantics/masterThesisTesisinfo:eu-repo/semantics/acceptedVersionhttp://purl.org/redcol/resource_type/TMEspecialista en Ortopedia y TraumatologíaUniversidad Autónoma de Bucaramanga UNABFacultad Ciencias de la SaludEspecialización en Ortopedia y TraumatologíaMedical sciencesHealth sciencesOrthopedicsTraumatologyHealth servicesPulsating wash gunUseEmergency medicineArthroplastyKnee prosthesisCiencias médicasOrtopediaTraumatologíaMedicina de urgenciasArtroplastiaPrótesis de rodillaCiencias de la saludServicios de saludPistola de lavado pulsátilUsoJORDAN JM, HELMICK CG, RENNER JB, LUTA G, DRAGOMIR AD, WOODARD J, et al. 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