Person: Murillo González, Jorge Alfonso
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First Name
Jorge Alfonso
Last Name
Murillo González
Affiliation
Universidad Complutense de Madrid
Faculty / Institute
Medicina
Department
Anatomía y Embriología
Area
Anatomía y Embriología Humana
Identifiers
4 results
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Item Comparison of Coracoid Graft Position and Fixation in the Open Versus Arthroscopic Latarjet Techniques: A Cadaveric Study(The American Journal of Sports Medicine, 2020) Minuesa Asensio, Álvaro; García Esteo, Francisco; Mérida Velasco, José Ramón; Barrio Asensio, María Del Carmen; López Fernández, Pedro; Aramberri Gutiérrez, Mikel; Murillo González, Jorge AlfonsoBackground: Since the description of the arthroscopic Latarjet technique, discussion about the superiority of the open or arthroscopic procedure has arisen. The appropriate placement of the coracoid graft (CG) on the anterior glenoid neck is reported to be the most important step of the Latarjet procedure. Purpose: To verify if there are differences in the parameters that may affect the final position and fixation of CG obtained from the open and arthroscopic Latarjet techniques. Study Design: Controlled laboratory study. Methods: Twenty fresh-frozen human paired cadaveric shoulder specimens were randomly distributed in 2 surgery groups (open group [OG] and arthroscopic group [AG]) with 10 specimens in each. Two surgeons, each with experience performing open and arthroscopic Latarjet techniques, executed these procedures: one surgeon performed all open techniques, and the other performed all arthroscopic techniques, respectively. After surgery, a computerized tomography scan was performed. The surgical time, the position of each CG, a series of variables that might affect the CG fixation, and the level of the subscapularis muscle split were evaluated. Results: The mean surgical time was significantly longer in the AG (mean, 26 minutes for OG and 57 minutes for AG). Three intraoperative complications (30%) were identified in the AG, consisting of graft fractures. The CG was determined to be in an optimal cranial-caudal position in 90% of specimens of the OG and 44% of the AG (Fisher, P = .057). In both groups, the CG was placed in an optimal medial-lateral position in all specimens. In the OG, the degree of parallelism between the major axes of the glenoid surface and CG was significantly greater than in the AG (mean, 3.88 for OG and 15.18 for AG). No significant differences were observed in superior and inferior screw orientation between the groups. In the longitudinal and transverse directions, significant differences were found in the centering of the superior screw, being closer to the ideal point in the OG than in the AG. The location where the longitudinal subscapularis muscle split was performed was significantly higher in the AG. Conclusion: The open Latarjet technique required less surgical time; presented a lower number of intraoperative complications; and allowed more adequate placement of the CG, better centering of the screws, and a subscapularis muscle split closer to the ideal position. Clinical Relevance: The reported benefits of the arthroscopic Latarjet technique seem less clear if we take into account the added surgery time and complications.Item Endoscopic Lesser Trochanter Resection With Refixation of the Iliopsoas Tendon for Treatment of Ischiofemoral Impingement(Arthroscopy Techniques, 2018) Corrales, Rafael; Mediavilla, Iñaki; Margalet, Eric; Aramberri, Mikel; Murillo González, Jorge Alfonso; Matsuda, DeanIschiofemoral impingement is a source of hip pain derived from impingement between the lesser trochanter and the ischium. Lesser trochanter excision has been recommended for recalcitrant ischiofemoral impingement through either an anterior or posterior approach. However, neither of these approaches involves refixation of the iliopsoas tendon. We describe an endoscopic procedure involving anterior trochanter-plasty, minimizing the risk of sciatic complications, with refixation of the partially detached iliopsoas tendinous insertion, potentially minimizing compromise to hip flexion strength and anterior hip stability.Item Basic morphological characteristics of coracoid grafts obtained by open and arthroscopic Latarjet techniques: A comparative study(Orthopaedics & Traumatology: Surgery & Research, 2020) Minuesa Asensio, Álvaro José; García Esteo, Francisco; Mérida Velasco, José Ramón; Barrio Asensio, María Del Carmen; Cuadra Blanco, Crótida de la; Murillo González, Jorge AlfonsoBackground: A knowledge of the anthropometric characteristics of the coracoid graft (CG) that can be obtained by the open and arthroscopic Latarjet techniques may be beneficial in the preoperative planning and intraoperative decision making for coracoid osteotomy and transfer. We have not found any study that compared the morphology of the CG that can be obtained from open and arthroscopic Latarjet techniques. The purpose of this study was to verify if the basic anthropometric characteristics of CGs are equivalent. Hypothesis: We hypothesize that the basic anthropometric characteristics of the CGs are similar. Methods: Twenty fresh-frozen human paired cadaveric shoulder specimens that had been randomly distributed in two groups of 10 specimens each were used. Two surgeons, each with experience in performing the open and arthroscopic Latarjet technique, performed these procedures in each of the respective groups (OG, open group; AG, arthroscopic group). A CT scan was performed. Using the volume rendering technique, a metric analysis of the volume, area and length of the CG were performed, evaluated and statistically analysed. Results: There were no significant differences in length (p = 0.162) (mean length, 22.6 mm for OG and 23.6 mm for AG). There were significant differences in the volume (p = 0.031) and area (p = 0.007) of the CG, being lower in the OG (mean volume, 2.8 cm3 for OG and 3.6 cm3 for AG; mean area, 9.9 cm2 for OG and 12.8 cm2 for AG). No significant differences were observed by sex or laterality. Conclusion: The mean lengths of the CGs that were obtained by each technique are equivalent. However, the areas and volumes of the grafts are different, being lower in the open surgery. These differences have not been an impediment to perform the technique. Our results corroborates that consolidation is more related to the preparation and placement than to the anthropometric characteristics of the CG. No significant differences were observed by sex or laterality.Item A mini-incision carpal tunnel release technique to prevent pillar pain: A technical note(Acta Orthopaedica et Traumatologica Turcica, 2021) Morán Morán, Julio; Mérida Velasco, José Ramón; Bartolomé del Valle, Emilio; Murillo González, Jorge AlfonsoPillar pain represents one of the most common complications of classic open carpal tunnel release (CTR). This complication causes a sense of discomfort worse than the compression syndrome itself. We, herein, introduce a new treatment method for CTR through a mini-incision, which allows subcutaneously cutting the transverse carpal ligament (TCL) and releasing the median nerve without neurovascular complications. This mini-incision approach can allow the direct visualization and preservation of the thenar motor branch in those rare cases where it has an aberrant origin. For the past 10 years, we have consecutively performed this technique in the surgical treatment of 318 patients with the diagnosis of primary CTS, without developing any neurovascular and tendon injuries as well as pillar pain.