Person: Marco Martínez, Fernando
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First Name
Fernando
Last Name
Marco Martínez
Affiliation
Universidad Complutense de Madrid
Faculty / Institute
Medicina
Department
Cirugía
Area
Traumatología y Ortopedia
Identifiers
4 results
Search Results
Now showing 1 - 4 of 4
Item Do the humeral radiographic changes at 5-year follow-up affect the clinical outcomes of press-fit humeral stems in primary reverse shoulder arthroplasties?(European Journal of Orthopaedic Surgery & Traumatology, 2024) García Fernández, Carlos; Lópiz Morales, María Yaiza; Garríguez Pérez, Daniel; Arvinius, Camilla; Ponz, Virginia; Echevarria, Marta; Garrido, Ana; Marco Martínez, FernandoIntroduction: The purposes of this study were to analyze and compare the functional outcomes and radiological changes around the press-fit humeral components in two contemporary medialized reverse total shoulder arthroplasty (RTSA) systems at a minimum of 5-year follow-up. Materials and methods: Between December 2003 and December 2015, 249 consecutive RTSAs were performed at our hospital. Of these, 68 primary uncemented RTSA met our inclusion criteria. The Constant-Murley score (CMS), the modified Constant score, a visual analog scale (VAS) and active shoulder range of motion (ROM) were measured pre- and postoperatively. Radiological assessment was performed by plain radiographs at a minimum of 5 years postoperatively. Results: At a mean follow-up of 80.2 months, there was no significant difference (p = .59) between the postoperative functional scores and range of motion of the two groups (Delta Xtend and Lima SMR). Radiological data of stress-shielding were observed in 38 patients (55.9%) being slightly more frequent in the Lima SMR group (21 patients) than in the Delta Xtend group (17 patients) (p = .62). Conclusions: Our study shows that the good functional results are similar between the two uncemented RTSA systems used and that they do not depend on the presence of radiological changes (stress-shielding) in the humeral stem at a minimum 5-year follow-up.Item Does fluoroscopy improve baseplate position compared to conventional technique in reverse shoulder arthroplasty? A preliminary study(Shoulder and Elbow, 2021) Galán Olleros, María; Lópiz Morales, María Yaiza; Ciller, Gabriel; Alcobía Díaz, Borja; García Fernández, Carlos; Marco Martínez, FernandoBackground: Accurate placement of glenoid component in reverse shoulder arthroplasty remains a challenge for surgeons of all levels of expertise; however, no studies have evaluated the utility of fluoroscopy as a surgical assistance method. Methods: Prospective comparative study of 33 patients undergoing primary reverse shoulder arthroplasty during a 12-month period. Fifteen patients had a baseplate placed using the conventional "free hand" technique (control group), and 18 patients using intraoperative fluoroscopy assistance group, in a case-control design. Postoperative glenoid position was evaluated on postoperative Computed Tomography (CT) scan. Results: The mean deviation of version and inclination for fluoroscopy assistance vs. control group was 1.75° (0.675-3.125) vs. 4.2° (1.975-10.45) (p = .015), and 3.85° (0-7.225) vs. 10.35° (4.35-18.75) (p = .009). The distance from the central peg midpoint to the inferior glenoid rim (fluoroscopy assistance 14.61 mm/control 4.75 mm, p = .581) and the surgical time (fluoroscopy assistance 1.93 ± 0.57/control 2.18 ± 0.44 h, p = .400) showed no differences, with an average radiation dose of 0.45 mGy and fluoroscopy time of 14 s. Conclusions: Accurate axial and coronal scapular plane positioning of glenoid component is improved with intraoperative fluoroscopy at the cost of a greater radiation dose and without differences in surgical time. Comparative studies are needed to determine whether their use in relation to more expensive surgical assistance systems result in similar effectiveness.L evel of evidence : Level III, therapeutic study.Item Reverse total shoulder arhroplasty for the treatment of failed xation in proximal humeral fractures(Injury, 2018) García Fernández, Carlos; Lópiz Morales, María Yaiza; Rizo, Belén; Serrano Mateo, Laura; Alcobía Díaz, Borja; Rodríguez González, Alberto; Marco Martínez, FernandoBackground: This study evaluates the clinical outcomes in patients with proximal humerus fractures (PHF) treated with reverse total shoulder arthroplasty (RTSA) as a revision procedure for failed fixation that have more than 5 years of follow-up. Materials and methods: This is a retrospective study of 270 RTSA. The inclusion criteria for this study consisted of patients initially treated with either open reduction and plate fixation (ORIF) or fixation using an intramedullary nail (IMN), who were managed with a single-stage revision to a RTSA, and had a minimum of 24 months clinical and radiological follow-up. Six patients with failed fixation of displaced PHF were revised with RTSA. One patient was excluded from the study because she died. Five shoulders were reviewed for the purpose of this study. The patients were evaluated using Constant score, relative Constant score and visual analogue scale for pain. Results: The mean follow-up was 89 months (65-108). The mean absolute Constant score improved from 31, 81 to 44, 2 and the relative Constant score improved from 31,81% to 67,2%. Mean VAS improved from 6, 8 to 2. One patient rated their outcome excellent, 1good, 1 satisfied and 2 poor. Conclusion: RTSA is an appropriate treatment as a revision surgery for failed fixation of PHF. Patients should be adequately warned that they will improve their function but may have complications following this salvage procedure.Item Injury to the axillary and suprascapular nerves in rotator cuff arthropathy and after reverse shoulder arthroplasty: a prospective electromyographic analysis(Journal of Shoulder and Elbow Surgery, 2018) Lópiz Morales, María Yaiza; Rodriguez González, Alberto; Martín Albarrán, Susana; Marcelo, Hector; García Fernández, Carlos; Marco Martínez, FernandoBackground: Neurologic pre- and postoperative injuries to the axillary and/or suprascapular nerve (SSN) have a higher incidence than expected and may lead to significantly decreased functional outcomes and increased risk of reverse shoulder arthroplasty (RSA) failure. Methods: Patients who underwent a RSA for rotator cuff tear arthropathy (RCTA) were included from December 2014 to December 2015. This study focused on the clinical (Constant score), radiographic, and pre- and postoperative electromyographic evaluations at 3 and 6 months. Results: Twenty patients met the inclusion criteria. One was lost to follow-up. Preoperatively, 15 patients showed changes on electromyography (9 SSN and 15 axillary nerve lesions); all of them were chronic and disuse injuries. The mean preoperative relative Constant score (rCS) of all included patients was 39 ± 9 (range, 19-64). At 3 months postsurgery, the prevalence of acute injuries for both nerves was 31.5%. At 6 months postsurgery, 2 axillary nerve injuries and 6 SSN injuries remain unchanged, and the rest improved or normalized. The mean postsurgery rCS of the entire cohort at 6-month follow-up was 78 ± 6.5. Mean postoperative rCS for acute postoperative nerve injury was 71 ± 3 for the axillary nerve and 64 ± 5 for SSN. Conclusions: Axillary and SSN injuries in RCTA have a much higher incidence than expected. Most of these axillary lesions are transient, with an almost complete recovery seen on electromyography at 6 months and with scarce functional impact. However, SSN lesions appear to behave differently, with poor functional results and having a lower potential for a complete recovery.