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Resumen: Introducción: En cirugía protésica de cadera (prótesis total de cadera, PTC), el correcto cierre de la herida quirúrgica supone un elemento importante del proceso, que tiene como objetivo la rápida curación de las partes blandas, así como minimizar el riesgo de complicaciones.El objetivo del presente estudio es determinar si la utilización de una sutura barbada bidireccional (Quill®) disminuye el tiempo de cierre tras PTC, en el plano fascial y subcutáneo, al ser comparado con la sutura discontinua convencional de poliglactina 910. La hipótesis es que no hay diferencia en tiempo de cierre al comparar ambas suturas. Material y método: Se trata de un estudio prospectivo aleatorizado, simple, ciego, que compara un primer grupo de estudio con uso de sutura barbada continua bidireccional (Quill®; Ethicon-Johnson & Johnson, Miami, Florida, EUA) (Gr. Q) y un segundo grupo control (Gr. V) en quien se emplea sutura discontinua tipo poliglactina 91 (Vicryl® Ethicon-Johnson & Johnson, Miami, Florida, EUA). Sutura realizada en dos planos (fascial y subcutáneo) simultánea por dos cirujanos. Antecedente de cirugías previas en la misma cadera, cirugías de revisión, grandes deformidades y alergias a componentes de la sutura fueron criterios de exclusión del estudio.Las variables a estudio fueron: 1) tiempo de cierre de fascia, subcutáneo y global; 2) infección de herida quirúrgica; y 3) dehiscencia de la herida.0. Resultados: Se incluyeron 82 pacientes (39 Gr. Q, 43 Gr. V). El tiempo de cierre global fue menor en Gr. Q (5 min 59 seg) respecto Gr. V(7,01 min), (p

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Background: Plantar fasciitis is a common cause of foot pain. If conservative treatment fails, there is no consensus as to the best surgical management for recalcitrant plantar fasciitis (RPF). The aim of this study was to compare the results obtained from proximal medial gastrocnemius release (PMGR) with those obtained from open plantar fasciotomy (OPF) in terms of pain, satisfaction, health-related quality of life, and American Orthopaedic Foot & Ankle Society (AOFAS) score. Methods: This is a prospective randomized trial conducted between 2012 and 2016. Patients with RPF for at least 9 months were included. Diagnosis was clinically made. The exclusion criteria were neuropathic heel pain; a history of previous foot fracture, surgery, or deformity; rheumatoid arthritis; or the need for long-term analgesic administration. After ruling out other conditions with magnetic resonance or ultrasound imaging, patients were randomized to be operated on with OPF or PMGR independently of the Silfverskjold test. Follow-up was carried out for up to 1 year. The AOFAS, visual analog scale (VAS) for pain, SF-36, and Likert scale for satisfaction were used to evaluate the results obtained. The analysis was done with 21 patients in the OPF group and 15 in the PMGR group. The demographic data (age, sex, body mass index, duration of symptoms, and positivity to the Silfverskjold test) of the groups were comparable. Results: No differences were found in terms of the AOFAS (P =.24), VAS (P =.14), or any item of the SF-36. Satisfaction was very good in 85.8% of the PMGR group and 89.5% of the OPF group (P =.27). Faster recovery was observed in the PMGR group. Conclusion: OPF and PMGR provided good results for patients with RPF. Neither was superior to the other relative to pain, AOFAS score, satisfaction, or the SF-36. We recommend PMGR as the first option in RPF surgical management in order to avoid potential biomechanical complications related to OPF. Level of Evidence: Level I, therapeutic randomized controlled trial. [ABSTRACT FROM AUTHOR]

Background: Postoperative shoes are commonly used after forefoot surgery. This study's aim was to demonstrate that reducing rigid-soled shoe time to 3 weeks neither compromises functional outcomes nor does it produce complications., Methods: Prospective cohort study: 6 weeks versus 3 weeks of rigid postoperative shoe (100 and 96 patients respectively), after forefoot surgery with stable osteotomies. Manchester-Oxford Foot Questionnaire (MOXFQ) and pain Visual Analog Scale (VAS) were studied preoperative and one year postoperative. Radiological angles were also assessed after removing the rigid shoe and at 6 months., Results: The MOXFQ index and pain VAS depicted similar results in each group (group A: 29.8 and 25.7; group B: 32.7 and 23.7) with no differences between them (p = .43 Vs. p = .58). Moreover, no differences were reported in their differential angles (HV differential-angle p = .44, IM differential-angle p = .18) or in their complication rate., Conclusion: In forefoot surgery with stable osteotomies, shortening the postoperative shoe time to 3 weeks, neither impairs clinical results nor the initial correction angle., Competing Interests: Declarations of Competing Interest none., (Copyright © 2023 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.)

Bidirectional barbed sutures (BBSs) have recently been investigated in total knee arthroplasty (TKA). The contrasting results from the scarce literature suggest that BBSs are safe, save time and money, and give results comparable to traditional sutures. The purpose of the study is to test the real effect of BBSs on closure time in TKA and assess the functional results as well as the complications related to them. It was a randomized controlled trial. Eighty-five patients undergoing primary TKA were assigned to receive traditional closure with Vicryl (V-group) or with BBSs (Q-group). The exclusion criteria were significant coronal deformity, flexion contracture, or the need for stem and/or augmentation. The closure time for the capsule and that for the subcutaneous layer were registered separately. Intraoperative incidences were recorded. The follow-up was up to 1 month, during which the range of motion (ROM), superficial or deep infection, and wound dehiscence were assessed. There was a significant reduction in the capsule layer (27 seconds; p  = 0.02) and global time closure (51 seconds; p  = 0.01) in the Q-group. No differences were found in the subcutaneous layer (24 seconds; p  = 0.055). There were more intraoperative suture breakages in the Q-group, mainly in the subcutaneous layer ( p  < 0.001). No differences in terms of dehiscence, infection, and ROM were observed at the 1-month follow-up. BBSs allow for slightly faster wound closure than Vicryl during a TKA. However, the differences observed have minimal clinical repercussions. Moreover, no differences in the infection rate (deep or superficial), dehiscence, or ROM were found., Competing Interests: None declared., (Thieme. All rights reserved.)