Person:
Marco Martínez, Fernando

First Name

Fernando

Last Name

Marco Martínez

URI

https://hdl.handle.net/20.500.14352/79599

Affiliation

Universidad Complutense de Madrid

Faculty / Institute

Medicina

Department

Cirugía

Area

Traumatología y Ortopedia

Identifiers

Full item page

Search Results

Now showing 1 - 10 of 27

Impact of Heart Failure on In-Hospital Outcomes after Surgical Femoral Neck Fracture Treatment
(Journal of Clinical Medicine, 2021) Marco Martínez, Javier; Bernal Sobrino, José Luis; Fernández Pérez, Cristina; Elola Somoza, Francisco Javier; Azaña Gómez, Javier; García Klepizg, José Luis; Andrès, Emmanuel; Zapatero Gaviria, Antonio; Barba Martín, Raquel; Marco Martínez, Fernando; Canora Lebrato, Jesus; Lorenzo Villalba, Noel; Méndez Bailón, Manuel
Background: Femoral neck fracture (FNF) is a common condition with a rising incidence, partly due to aging of the population. It is recommended that FNF should be treated at the earliest opportunity, during daytime hours, including weekends. However, early surgery shortens the available time for preoperative medical examination. Cardiac evaluation is critical for good surgical outcomes as most of these patients are older and frail with other comorbid conditions, such as heart failure. The aim of this study was to determine the impact of heart failure on in-hospital outcomes after surgical femoral neck fracture treatment. Methods: We performed a retrospective study using the Spanish National Hospital Discharge Database, 2007–2015. We included patients older than 64 years treated for reduction and internal fixation of FNF. Demographic characteristics of patients, as well as administrative variables, related to patient’s diseases and procedures performed during the episode were evaluated. Results: A total of 234,159 episodes with FNF reduction and internal fixation were identified from Spanish National Health System hospitals during the study period; 986 (0.42%) episodes were excluded, resulting in a final study population of 233,173 episodes. Mean age was 83.7 (±7) years and 179,949 (77.2%) were women (p < 0.001). In the sample, 13,417 (5.8%) episodes had a main or secondary diagnosis of heart failure (HF) (p < 0.001). HF patients had a mean age of 86.1 (±6.3) years, significantly older than the rest (p < 0.001). All the major complications studied showed a higher incidence in patients with HF (p < 0.001). Unadjusted in-hospital mortality was 4.1%, which was significantly higher in patients with HF (18.2%) compared to those without HF (3.3%) (p < 0.001). The average length of stay (LOS) was 11.9 (±9.1) and was also significantly higher in the group with HF (16.5 ± 13.1 vs. 11.6 ± 8.7; p < 0.001). Conclusions: Patients with HF undergoing FNF surgery have longer length of stay and higher rates of both major complications and mortality than those without HF. Although their average length of stay has decreased in the last few years, their mortality rate has remained unchanged.
Project number: 240
Aprendizaje activo basado en la resolución de casos clínico-radiológicos de patología del aparato locomotor en enseñanza virtual
(2021) Crespo Rodríguez, Ana María; Archanco Olcese, Miguel; Cabrera Martín, Mª Nieves; Carreras Delgado, José Luis; Casado Herráez, Antonio; Corona Sánchez, Juan Antonio; Cuenca González, Concepción; Fernández Gutiérrez, Benjamín; Francés Borrego, Alberto; García Merino, Mikel; Gómez Peña, Sara; Lópiz Morales, María Yaiza; Marco Martínez, Fernando; Marquina Ospina, Gloria; Muñoz Hernando, Miriam; Nava Muñoz, Ángel
Las estrategias de enseñanza on-line basadas en Tecnologías de la Información y la Comunicación (TIC) se han utilizado con éxito para acercar la práctica clínica de Radiología a los estudiantes de Grado de Medicina durante el curso académico 2020-21. Los alumnos trabajaron por equipos con el método de Aprendizaje Basado en la Resolución de Problemas (ABRP). De esta manera, se aseguró la consecución de los objetivos formativos y se dio a conocer la forma de trabajo del médico radiólogo, el proceso de razonamiento diagnóstico, los sistemas de información de los hospitales y en particular del Picture Archiving and Communication System (PACS).
Subspine femoroacetabular impingement: retrospective study of a series of patients treated by hip arthroscopic resection
(Archives of Orthopaedic and Trauma Surgery, 2023) Francés Borrego, Alberto; Martínez García, Álvaro; Baño Barragán, Laura del; Rodríguez González, Alberto; Echevarría Marín, Marta; Marco Martínez, Fernando
Background: Femoroacetabular impingement syndrome (FAIS) is a common hip pathology that causes pain and functional limitation in young patients. subspine femoroacetabular impingement (SFAI) is an increasingly diagnosed extra-articular subtype that occurs from mechanical conflict of the anteroinferior iliac spine (AIIS) with the cervico-diaphyseal junction during hip flexion, which is poorly described in the literature. Questions/purposes: We aimed to describe the clinical, functional, and radiological results of the arthroscopic treatment of a group of patients with SFAI treated in our Hip Unit. Study design: Case series. Methods: We present a retrospective study of ten patients with SFAI treated between 2013 and 2020 with arthroscopic resection. Clinical results were assessed with scales such as visual analog scale (VAS); modified Harris Hip Score (mHHS), and Hip disability and Osteoarthritis Outcome Score (HOOS). Radiological results were assessed with radiological measurements, magnetic resonance imaging (MRI), and computed tomography (CT) reconstructions. Results: Six patients had a Type III AIIS and four of them had Type II. Two patients had previously been surgically treated for FAIS. The range of motion improved in flexion from 107 ± 11 degrees before surgery to 127.5 ± 6 degrees (p = 0.005). MHHS improved from 48.1 (38-75.3) before surgery to 83.1 (57-91) (p = 0.007) and HOOS improved from 65.2 (58-75) to 89 (68.1-100) (p = 0.007). VAS improved from 7.3 (5-9) pre-surgical to 2.5 (0-8) post-surgical (p = 0.005). We did not have significant complications except for an asymptomatic case of heterotopic ossification (Brooker I). Conclusion: Arthroscopic decompression of AIIS in SFAI patients is a safe procedure that provides satisfactory short-term functional results, improving clinical symptoms, function, sports performance, and range of motion in our study.
Shoulder problems after percutaneous antegrade intramedullary nailing in humeral diaphyseal fractures using contemporary straight third-generation nail
(J Shoulder Elbow Surg, 2023) Garriguez Pérez, Daniel; Roman Gómez, Julia; Scarano Pereira, Juan Pablo; Ponz Lueza, Virginia; García-Fernández, Carlos; Lópiz Morales, María Yaiza; Marco Martínez, Fernando
Background: Antegrade intramedullary nailing in humeral shaft fracture has been abandoned by certain orthopedic surgeons because of rotator cuff injury caused by first- and second-generation intramedullary nails (IMNs). However, only a few studies have specifically addressed the results of antegrade nailing for the treatment of humeral shaft fractures with a straight third-generation IMN; thus, complications need to be re-evaluated. We hypothesized that fixation of displaced humeral shaft fractures with a straight third-generation antegrade IMN with the percutaneous technique avoid shoulder problems (stiffness and pain) incurred by first- and second-generation IMNs. Methods: This was a retrospective, single-center, nonrandomized study of 110 patients with a displaced humeral shaft fracture between 2012 and 2019 treated surgically with a long third-generation straight IMN. Mean follow-up was 35.6 months (range, 15-44 months). Results: There were 73 women and 37 men with a mean age of 64.7 ± 19 years. All fractures were closed (37.3% 12A1, 13.6% 12B2, and 13.6% 12B3 AO/OTA classification). Mean Constant score was 82 ± 19, Mayo Elbow Performance Score 96 ± 11 and the mean EQ-5D visual analog scale score was 69.7 ± 21.5. Mean forward elevation 150° ± 40°, abduction 148° ± 45°, and external rotation 38° ± 15°. Symptoms associated with rotator cuff disease were present in 6.4%. Evidence of radiographic fracture healing was detected in all but 1 case. One postoperative nerve injury and 1 adhesive capsulitis were present. Overall, 6.3% underwent second surgeries (4.5% were minor surgeries like hardware removal). Conclusion: Percutaneous antegrade intramedullary nailing of humeral shaft fractures with a straight third-generation nail considerably reduced complications related to shoulder problems and achieved good functional results.
Suprascapular nerve injury after reverse total shoulder arthroplasty. Correlation with screw out of vault penetration and functional situation. Prospective study
(Journal of Shoulder and Elbow Surgery, 2023) Lópiz Morales, María Yaiza; Rodriguez Gonzalez, Alberto; Martín Albarrán, Susana; Moreu Gamazo, Manuel; Ponz, Virginia; García Fernandez, Carlos; Marco Martínez, Fernando
Introduction: Baseplate screws have been suggested as a possible cause of suprascapular neuropathy after reverse total shoulder arthroplasty (RTSA). This study aims to investigate the association between screw penetration out of the vault, electromyographic study and the clinical outcomes. Methods: 31 patients who underwent RTSA for cuff tear arthropathy were prospectively enrolled. They were followed up for a minimum of 24 months. All underwent computed tomography 6 months postoperatively in order to determine the extraosseous position of the screws (perforation of the second bone cortex and protrusion into the supra or infraspinatus fossa). Electrodiagnostic evaluation was performed preoperatively and postoperatively to stablish any relation between cortex perforation of the screw and SSN injury. Clinical outcomes pre and postoperatively (Constant score, ranges of motion, and VAS) of patients with and without documented injury were recorded. Results: 14 patients (45.2%) had abnormal preoperative SSN electrodiagnostic study (chronic or disuse injuries) and 6 patients (19.4%) abnormal postoperative study (acute injury. Of these last 6 patients: 2 cases appeared over the pre-existing lesion and 4 appeared over an intact preoperative nerve, all of them affecting the infraspinatus branch of the SSN. Perforation of the second cortex was detected for 60% of superior screws and 40% of posterior screws. The mean lengths of the superior and posterior screws were 30 and 18.2 mm, respectively. Patients with screw perforation of the second cortex were assessed as having a high risk of nerve injury (40% vs. 9.5%). Conclusions: Preoperative SSN injuries do not have a significant clinical impact and do not predispose to an acute postoperative SSN lesion. The Constant Score and VAS scale for patients with acute SSN injuries were not statistically different than those without SSN injury. Extraosseous position of the screw increases the probability of a SSN injury to 31%. This risk is higher with the posterior screw, which leads us to question whether it is really necessary to use it.
Project number: 272
Atlas de anatomía radiológica correlacionado con imágenes de anatomía seccional y disecciones anatómicas
(2017) Maranillo Alcaide, Eva; Vázquez Osorio, Teresa; Sañudo Tejero, José Ramón; Arrazola García, Juan Lorenzo; Marco Martínez, Fernando; Valderrama Canales, Francisco José; Rodríguez Vázquez, Jose Francisco; Viejo Tirado, Fermín; Scola Yurrita, Bartolomé; Ruiz Yuretschke, Fernando; Navarro Collín, Cristina
RNA sequencing of mesenchymal stem cells reveals a blocking of differentiation and immunomodulatory activities under inflammatory conditions in rheumatoid arthritis patients
(Arthritis Research & Therapy, 2019) Lamas, José Ramón; Fernández Gutiérrez, Benjamín; Mucientes, Arkaitz; Marco Martínez, Fernando; Lópiz Morales, María Yaiza; Jover Jover, Juan Ángel; Abasolo, Lydia; Rodríguez Rodríguez, Luis
Introduction: Mesenchymal stem cells (MSCs) have the ability to differentiate into different types of cells of the mesenchymal lineage, such as osteocytes, chondrocytes, and adipocytes. It is also known that under inflammatory stimuli or in the appropriate experimental conditions, they can also act as regulators of inflammation. Thus, in addition to their regenerating potential, their interest has been extended to their possible use in cell therapy strategies for treatment of immune disorders. Objective: To analyze, by RNA-seq analysis, the transcriptome profiling of allogenic MSCs under RA lymphocyte activation. Methods: We identified the differentially expressed genes in bone marrow mesenchymal stem cells after exposure to an inflammatory environment. The transcriptome profiling was evaluated by means of the precise measurement of transcripts provided by the RNA-Seq technology. Results: Our results evidenced the existence of blocking of both regenerative (differentiation) and immunomodulatory phenotypes under inflammatory conditions characterized by an upregulation of genes involved in immune processes and a simultaneous downregulation of genes mainly involved in regenerative or cell differentiation functions. Conclusions: We conclude that the two main functions of MSCs (immunomodulation and differentiation) are blocked, at least while the inflammation is being resolved. Inflammation, at least partially mediated by gamma-interferon, drives MSCs to a cellular distress adopting a defensive state. This knowledge could be of particular interest in cases where the damage to be repaired has an important immune-mediated component.
Adverse effects of xenogenic scaffolding in the context of a randomized double-blind placebo-controlled study for repairing full thickness rotator cuff tears
(Trials, 2019) Lamas, José Ramón; García Fernández, Carlos; Tornero Esteban, Pilar; Lópiz Morales, María Yaiza; Rodríguez Rodríguez, Luis; Ortega Medina, Luis; Fernández Gutiérrez, Benjamín; Marco Martínez, Fernando
Purpose: The purpose of the study was to compare the safety and efficacy of autologous mesenchymal stem cells (MSCs) embedded in a xenogenic scaffold for repairing the supraspinatus tendon. Methods: This was a randomized, double-blind and placebo-controlled trial evaluating patients with full-thickness rotator cuff tears (Eudra-CT, 2007-007630-19). Effectiveness was evaluated using the Constant score and a visual analogue pain scale (VAS). Constant score has four domains including pain (15 possible points), activities of daily living (20 possible points), mobility (40 possible points), and strength (25 possible points). Scores range from 0 points (most disability) to 100 points (least disability). The structural integrity of the repaired tendon was assessed by magnetic resonance imaging (MRI) according to Patte and Thomazeau classification criteria. The primary study end point was an improvement in the Constant score by 20 points at one year compared to initial assessment. Results: The trial was stopped due to adverse effects observed in both groups. Only thirteen patients were included and analyzed. The Constant questionnaire showed a significant improvement in the MSC treatment group compared with the preoperative data (p = 0.0073). Secondary outcome measures were similar in both groups. Conclusions: Our study showed preliminary inconclusive clinical outcomes in the patients treated with MSCs. Adverse events revealed the need for further approaches using scaffolds of a different nature or perhaps no scaffolds, in the context of small joints. Trial registration: Eudra-CT, 2007-007630-19. Registered on 30 January 2008. Level of evidence: A Level 1 of evidence treatment study.
Check-control of inflammation displayed by bone marrow mesenchymal stem cells in rheumatoid arthritis patients
(Immunotherapy, 2019) Lamas, José Ramón; Mucientes, Arkaitz; Lajas Petisco, Cristina De Jesús; Fernández Gutiérrez, Benjamín; Lópiz Morales, María Yaiza; Marco Martínez, Fernando; Jover Jover, Juan Ángel; Abasolo, Lydia; Rodríguez Rodríguez, Luis
Background: Mesenchymal stem cells (MSCs) are a promising treatment of different musculoskeletal diseases including osteoarthritis and rheumatoid arthritis (RA). Results from different approaches in this treatment have been not conclusive. Aim: To analyze factors related to interactions between peripheral blood mononuclear cells (PBMCs) and MSCs and the influence of cellular activation. Materials & methods: PBMCs from RA patients and healthy controls (HC) were obtained. MSCs from bone marrow (BM-MSCs) were obtained from six donors. CD4, CD25, CD69 and CD127 expression was measured by flow cytometry. Repeated measures analysis of variance (ANOVA) models were performed using activation, co-culture with BM-MSCs and time of culture (24 h, 72 h, 6 days) as within-subject variables. Results: PBMCs activated and co-cultured with BM-MSCs showed a lower proportion of CD25-positive and CD25high/CD127low-negative cells in both RA and HC. Additionally, a maintained expression of CD69 was also observed in RA and HC when PBMCs were activated and co-cultured with BM-MSCs. Conclusion: Both PBMC activation grade and RA disease activity influence the immunomodulatory effect of BM-MSCs on T-cell activation.
Third-generation intramedullary nailing for displaced proximal humeral fractures in the elderly: quality of life, clinical results, and complications
(Archives of Orthopaedic and Trauma Surgery, 2020) Lópiz Morales, María Yaiza; Garríguez Pérez, Daniel; Martínez Illán, Marina; García Fernández, Carlos; Marco Martínez, Fernando
Introduction: Antegrade insertion of third-generation intramedullary nail (IMN) has been shown to provide excellent results in young patients for treatment of displaced two-part surgical neck fracture. In elderly patients, osteoporosis makes internal fixation problematic and frequently contributes to failed fixation and poor clinical results. The purpose of this study was to report the health-related quality of life (HRQoL), functional results, and postoperative complications obtained with straight third-generation antegrade nailing of proximal humerus fractures (PHFs) in elderly patients. Methods: A retrospective review of 32 patients aged 80 y.o. or older presenting a two-part or three-part PHFs treated with a straight IMN with a minimum follow-up of 12 months. Results assessed included 1) radiographic measures 2) clinical data: Charlson Comorbidity Index (CCI), VAS, range of motion (ROM), Individual Relative Constant score (IRC), Simple Shoulder Test (SST) and 3) Health-related Quality of life (HRQoL) with the EQ-5D index/EQ-VAS. Results: Mean age was 82.1 (range 80-90) and mean follow-up was 45.6 months (range 16-53 months) with 91% of female patients and a mean CCI 4.6. 81% were two-part surgical neck fractures and 19% were three-part greater tuberosity fractures. The mean neck-shaft angle (NSA) at final follow-up was 132º ± 17.9º. 15.6% underwent hardware removal because of subacromial impingement and one patient (3%) was revised to RSA because of severe secondary fracture displacement. Mean IRC was 67,7 ± 30, the mean SST and VAS-Pain were 8.1 ± 3.1 and 3.2 ± 3.2, respectively, and the mean EQ-5D/EQ-VAS were 0.40 ± 0.33/64.2 ± 8.9. At last review, mean active forward flexion, abduction, and external rotation were 115º ± 35º, 100º ± 35º, and 20º ± 15º, respectively. Conclusion: Appropriate selection of fracture and proper operative technique with a third-generation nail result in good functional results and good HRQol with a low complication rate in elderly population. Elderly; Multiloc; Proximal humeral fracture; Proximal humeral nail; Quality of life.