B. Seral Garcia

Coste-efectividad del proceso hallux valgus en cirugía mayor ambulatoria

INTRODUCTION The development of one-day surgery units has shown to be a better use of health resources without reducing quality. The objective of this study was to evaluate the effectiveness and quality criteria of ambulatory surgery program in the Hallux valgus process. MATERIAL AND METHODS A retrospective study was conducted on a sample of 753 patients who underwent a Hallux valgus process at our institution between 2002 and 2012 (292 in ambulatory surgery cohort and 461 in hospitalization group). The cost-process was evaluated using the Weighted Care Unitas a measuring unit. Secondary data were collected as regards discharge criteria and patient satisfaction. RESULTS A significant difference was found between Weighted Care Unit spending on in-patient surgery and out-patient surgery. Both samples were comparable and no differences were found between diagnosis and intervention. The admission rate after ambulatory surgery was 2.39%, and the substitution index increased to 56.04%. The ambulatory surgery program was given a satisfaction rating of 84.6 out of 100. CONCLUSIONS The results of our study indicate that it is possible to maximize the substitution index of the Hallux valgus process leading to a better use of resources and a high degree of patient satisfaction.

Simulación en 3D con elementos finitos de un modelo de prótesis de rodilla

El analisis mediante elementos finitos (AEF) viene aplicandose en la bibliografia al estudio biomecanico de las protesis de rodilla. Material y metodo En nuestro trabajo hemos realizado un modelo de articulacion de rodilla y otro de artroplastia de rodilla mediante AEF, estudiando el efecto de las cargas sobre ambos modelos en la fase de soporte unilateral a 0° y 15° de flexion. Se han comparado los desplazamientos, las tensiones en direccion vertical para el tejido oseo y las tensiones de Von Mises para los implantes protesicos. Resultados En extension los desplazamientos obtenidos con la rodilla anatomica son mayores que con artroplastia. En la rodilla con artroplastia se produce una mayor concentracion de tensiones a nivel de la cabeza femoral, mientras que en el modelo de rodilla anatomica la distribucion es mas uniforme. El componente tibial es el que mas trabaja, sobre todo en la zona del vastago pero tambien en la bandeja metalica. Conclusiones A pesar de las limitaciones del modelo, podemos afirmar que el AEF permite realizar un estudio biomecanico del comportamiento estructural de la articulacion de la rodilla y la rodilla con artroplastia.