Dr Michell Ruiz

Dr Michell Ruiz
Cirugía de hombro y del Manguito rotador

miércoles, 30 de julio de 2014

Hombro y paciente deportista: manguito rotador


martes, 29 de julio de 2014

Ream and run for B2 glenoid - beach smashball at 13 weeks

http://shoulderarthritis.blogspot.mx/2014/07/ream-and-run-for-b2-glenoid-beach.html


Ream and run for B2 glenoid - beach smashball at 13 weeks

A man in his late 40s had a ream and run for the bad arthritic triad (BAT) which developed after a previous repair for anterior instability ( = capsulorrhaphy arthropathy). His preoperative films showed complete loss of the joint space and the arthritic triad: a biconcave glenoid, glenoid retroversion and posterior subluxation of the humeral head on the face of the glenoid.


Thirteen weeks ago, he had a ream and run with a 56 21 anteriorly eccentric head and a rotator interval plication.

His postoperative films show centering of the humeral head on the glenoid.


He recently send a video of his playing smashball on the beach 13 weeks after surgery - possibly a new way to rehabilitate a shoulder.


lunes, 28 de julio de 2014

Patologías del hombro


Propionibacterium in a primary arthroplasty after a Latarjet procdure, seeing what you look for





Monday, July 28, 2014

Propionibacterium in a primary arthroplasty after a Latarjet procdure, seeing what you look for

A man is his early twenties presented with pain and stiffness in the shoulder after two prior instability procedures, the last being a Latarjet in 2012.




He had a primary hemiarthroplasty with removal of the screw, the head of which was rubbing on his humeral head. Because of the global loss of cartilage seen on his preoperative films, we obtained cultures before administering antibiotics.

At surgery there was no obvious evidence of infection. The humeral head showed global loss of cartilage as shown here.
His postoperative films are shown here.


After surgery he was started on the 'yellow' antibiotic protocol. Range of motion exercises were started on day one and he had 150 degrees of motion on discharge two days later.

Five days after surgery, the cultures grew out coagulase negative staph in one specimen and Propionibacterium in three (capsule, humeral head #1 and humeral head #2). At that time a PICC line was plaeced and he was converted to the 'red' antibiotic protocol.

Comment: It would have been easy to miss this infection. Our index of suspicion was heightened by the generalized destruction of the joint surface in contrast to the local destruction that would be expected from contact of the humeral head with the screw.

http://shoulderarthritis.blogspot.mx/2014/07/propionibacterium-in-primary.html

sábado, 26 de julio de 2014

Una de manguitos, para que os ahoguéis. ‪#‎xtensal‬ ‪#‎anatomía‬ ‪#‎hombro‬


jueves, 24 de julio de 2014

Shoulder resurfacing hemiarthroplasty with caution in young patients


http://ote.healio.com/i/337565/75



martes, 22 de julio de 2014

What's the difference between a reverse total shoulder and a CTA prosthesis

http://shoulderarthritis.blogspot.mx/2011/10/whats-difference-between-reverse-total.html


Wednesday, October 26, 2011

What's the difference between a reverse total shoulder and a CTA prosthesis

This question is asked often. Here are the 'cliff notes'.
Both are used to help manage the combination of shoulder arthritis and rotator cuff deficiency or rotator cuff tear arthropathy.
A CTA prosthesis is a resurfacing of the upper humerus that requires an intact coracoacromial arch for stability and active elevation of over 90 degrees before surgery.


A reverse total shoulder is a constrained shoulder that fixes the fulcrum for the deltoid when the shoulder is unstable or has pseudoparalysis (it cannot be elevated away from the side).


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Netherlands Patient Gets 3D-Printed Shoulder Prosthesis

http://news.softpedia.com/news/Netherlands-Patient-Gets-3D-Printed-Shoulder-Prosthesis-450676.shtml



Reemplazo de Hombro y Prótesis Invertida en pacientes con dolor de hombro - Dr. Sanchez-Sotelo


Publicado el 26/3/2014
El Dr. Joaquín Sanchez-Sotelo, cirujano ortopedista de Mayo Clinic, nos habla sobre la evaluación, diagnóstico, procedimiento y tratamiento del Reemplazo de Hombro y Prótesis Invertida en Pacientes con Dolor de Hombro.

For more information, visit:http://www.mayoclinic.org/departments...




Tenogenic Induction of Human MSCs by Anisotropically Aligned Collagen Biotextiles

http://onlinelibrary.wiley.com/doi/10.1002/adfm.201400828/abstract

Tenogenic Induction of Human MSCs by Anisotropically Aligned Collagen Biotextiles


MSCs and Tendon Tissue Engineering

Research Assistant at CWRU
A novel biofabrication modality, electrophoretic compaction with macromolecular alignment, is utilized to make collagen threads that mimic the native tendon's structure and mechanical properties. A device with kinematic electrodes is designed to...

Keywords:

A novel biofabrication modality, electrophoretic compaction with macromolecular alignment, is utilized to make collagen threads that mimic the native tendon's structure and mechanical properties. A device with kinematic electrodes is designed to fabricate collagen threads in continuous length. For the first time, a 3D-biotextile is woven purely from collagen. Mechanical properties and load-displacement behavior of the biotextile mimic those of the native tendon while presenting a porosity of 80%. The open pore network facilitates cell seeding across the continuum of the bioscaffold. Mesenchymal stem cells (MSCs) seeded in the woven scaffold undergo tenogenic differentiation in the absence of growth factors and synthesize a matrix that is positive for tenomodulin, COMP and type I collagen. Up-regulation of tenomodulin, a tendon specific marker, is 11.6 ± 3.5 fold, COMP is up-regulated 16.7 ± 5.5 fold, and Col I is up-regulated 6.9 ± 2.7 fold greater on ELAC threads when compared to randomly oriented collagen gels. These results demonstrate that a bioscaffold woven using collagen threads with densely compacted and anisotropically aligned substrate texture stimulates tenogenesis topographically, rendering the electrochemically aligned collagen as a promising candidate for functional repair of tendons and ligaments.

Palabras clave: 
ingeniería de tejidos; alineación de celdas; anisotropía de rigidez del sustrato; células madre; diferenciación; andamios de colágeno tejidas 
Una nueva modalidad de biofabricación, compactación electroforética con la alineación macromolecular, se utiliza para hacer hebras de colágeno que imitan la estructura del tendón nativo y propiedades mecánicas. Un dispositivo con electrodos cinemáticos está diseñado para fabricar hebras de colágeno en longitud continua. Por primera vez, un-biotextile 3D se teje puramente a partir de colágeno. Las propiedades mecánicas y el comportamiento de carga-desplazamiento de la biotextile son similares a los del tendón nativo al tiempo que presenta una porosidad de 80%. La red de poros abiertos facilita la siembra de células en todo el continuo de la bioscaffold. Las células madre mesenquimales (MSCs) se sembraron en el andamio de tejido se someten a diferenciación tenogenic en ausencia de factores de crecimiento y sintetizar una matriz que es positivo para tenomodulin, COMP y colágeno de tipo I. Sobre regulación de tenomodulin, un marcador específico del tendón, es de 11,6 ± 3,5 veces, COMP es regulado hasta 16,7 ± 5,5 veces, y Col I es regulada hasta 6,9 ± 2,7 veces mayor en las roscas de ELAC en comparación con orientación al azar geles de colágeno. Estos resultados demuestran que un bioscaffold tejida con hilos de colágeno con textura sustrato densamente compactada y anisotrópicamente alineado estimula tenogenesis topográficamente, haciendo que el colágeno electroquímicamente alineado como un candidato prometedor para la reparación funcional de los tendones y los ligamentos....

    EDITOR’S CHOICE: Are We Overtreating Clavicular Fractures?

    http://orthobuzz.jbjs.org/2014/07/09/editors-choice-are-we-overtreating-clavicular-fractures/




    sábado, 19 de julio de 2014

    A reverse shoulder arthroplasty with increased offset for the treatment of cuff-deficient shoulders with glenohumeral arthritis

    http://www.bjj.boneandjoint.org.uk/content/96-B/7/936.abstract




    domingo, 13 de julio de 2014

    Planning a shoulder replacement surgery?






    Surgical Pearls and Pitfalls for Effective and Reproducible Arthroscopic Rotator Cuff Repair

    http://www.healio.com/orthopedics/journals/ortho/%7Bafb839f3-0d22-4a7d-bd33-28ded8aff944%7D/surgical-pearls-and-pitfalls-for-effective-and-reproducible-arthroscopic-rotator-cuff-repair



    Scapula Fracture and Os Acromiale After Reverse Total Shoulder Arthroplasty

    http://www.healio.com/orthopedics/journals/ortho/%7Bdb1e867d-fba1-406d-a59a-fe0087af7875%7D/scapula-fracture-and-os-acromiale-after-reverse-total-shoulder-arthroplasty#




    Patient to Receive First 3D Printed Shoulder Prosthesis in the Netherlands

    sábado, 12 de julio de 2014

    Discusión entre pares / 5 days old Shoulder dislocation reduced nd fixation done ....critics pls





    5 days old Shoulder dislocation reduced nd fixation done ....critics pls