Browsing by Author "Besomi, Javier"
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Item Bernese periacetabular osteotomy for hip dysplasia. A modification to original technique and South American perspective(2014) Lara, Joaquín; Tobar, Carlos; Besomi, JavierAbstract Bernese periacetabular osteotomy has become a secure and reproducible technique for treatment of hip dysplasia. It allows an adequate reorientation of the acetabulum and coverage of the femoral head improving biomechanical conditions of the hip joint. We present a review of literatura and a modification of original technique that includes a small-er incision and preservation of the abductor muscles and rectus femoris tendon insertion.Publication Current status of the diagnosis of developmental dysplasia of the hips in the 21st Century(2023) Pérez, Lizbet; Besomi, Javier; Fuentealba, IsabelInspired by an article on developmental dysplasia of the hips (DDH) from the mid-20th century, we present an updated examination of the epidemiology, etiology, risk factors, and natural history of this condition. We provide a concise overview of essential concepts and definitions crucial for an accurate diagnostic approach. We assess the current significance of imaging in the diagnostic process, with a particular focus on AP pelvic radiography the prevailing imaging modality employed in our country for diagnosis. We elucidate our own method, termed HI-RADS, for analyzing and reporting AP pelvic X-rays in the context of universal screening at three months. Furthermore, we discuss various ultrasound techniques for diagnosis and advocate for their combined static and dynamic utilization. We emphasize the critical need for early detection to prevent potential complications, a practice adopted by several countries; however, achieving a consensus on its implementation remains an ongoing challenge. Inspirados en un artículo sobre displasia del desarrollo de las caderas (DDC) escrito a mediados del siglo XX, presentamos un análisis actualizado de la epidemiología, etiología, factores de riesgo e historia natural de esta enfermedad. Recapitulamos los conceptos y definiciones fundamentales necesarios para abordar un diagnóstico adecuado. Examinamos el papel de las imágenes en el diagnóstico, destacando la Radiografía de pelvis AP (anteroposterior), la modalidad más empleada en nuestro país para este propósito. Describimos el método que hemos desarrollado, denominado HI-RADS, para analizar e informar las Radiografías de pelvis AP en el contexto de la pesquisa universal a los tres meses. Abordamos las diversas técnicas ecográficas disponibles para el diagnóstico, recomendando la utilización combinada de enfoques estáticos y dinámicos. Enfatizamos la importancia de una detección temprana para prevenir secuelas, práctica que se lleva a cabo en varios países, aunque aún existe falta de consenso en cuanto a su implementación.Item Effect of Warmed Irrigation Solution on Core Body Temperature During Hip Arthroscopy for Femoroacetabular Impingement(Elsevier, 2014) Parodi, Dante; Valderrama, Juanjosé; Tobar, Carlos; Besomi, Javier; López, Jaime; Lara, Joaquín; Ilic, JuanPURPOSE: To determine the effect of warming arthroscopic irrigation solution on core body temperature during hip arthroscopic surgery in patients with femoroacetabular impingement. METHODS: An analytical, prospective, observational study was performed in a cohort of 166 consecutive patients. All patients underwent hip arthroscopy for treatment of femoroacetabular impingement. Two groups were studied: patients operated on with arthroscopic irrigation solution warmed up to 32°C ± 2°C (89.6°F ± 3.6°F) and a control group comprising patients operated on with irrigation solution used at room temperature. Relevant information was collected regarding the patients (age, sex, body mass index, and blood pressure) and the procedure (volume and temperature of saline solution, pressure of fluid pump, surgery time, and room temperature). Corresponding statistical analysis was performed with STATA 11.0 (StataCorp, College Station, TX), by use of descriptive statistics, parametric and nonparametric tests, and a generalized estimating equation model for repeated measurements. RESULTS: Both groups were comparable in terms of age, sex, systolic and diastolic blood pressure, body mass index, volume of irrigation solution used, and room temperature. The mean age of the cohort was 33 years (range, 14 to 60 years); mean body mass index, 23.7 kg/m(2) (range, 17.2 to 34 kg/m(2)); mean volume of irrigation solution, 26 L (range, 12 to 39 L); mean systolic blood pressure, 97 mm Hg; mean diastolic blood pressure, 51 mm Hg; and mean surgical time, 110 minutes. A decrease in core body temperature by 0.5°C (0.9°F) or greater occurred during the course of surgery in 66% of patients in the control group versus 28% in the warmed-solution group (P < .001). At least 1 core body temperature measurement of less than 36°C (96.8°F) was recorded in 48% of patients in the control group versus 14% in the warmed-solution group (P < .001). The trend toward a decrease in core body temperature was 4 times greater in the control group than in the warmed-solution group (P < .001). CONCLUSIONS: Use of arthroscopic irrigation solution warmed up to 32°C (89.6°F) reduces the risk of a decrease in core body temperature during hip arthroscopy in patients with femoroacetabular impingement. LEVEL OF EVIDENCE: Level II, analytical, prospective, comparative study in a cohort of consecutive patients.