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espanolIntroduccion En nuestro medio es cada vez mas necesario realizar una actividad basada en evidencia cientifica y el campo de la cirugia protesica deberian regirse por los mismos principios. Los registros nacionales de artroplastias permiten evaluar los resultados de esta practica. El objetivo de nuestro trabajo es analizar la evidencia cientifica que respalda los modelos de artroplastia total de rodilla implantados en los hospitales publicos catalanes sobre la base del Registro de Artroplastias de Cataluna (RACat). Material y metodos Se realizo una revision de la literatura de las protesis de rodilla (conserva cruzado posterior, estabilizada posterior, constrenida y rotacional) registradas en el RACat entre 2005 y 2013 en las siguientes bases de datos: Orthopaedic Data Evaluation Panel, PubMed, TripDatabase y Google Academico. Se excluyeron aquellas protesis implantadas en numero inferior a 10 unidades (1.358 protesis correspondientes a 62 modelos). Resultados De las 43.305 protesis implantadas, se analizaron 41.947 (96,86%), correspondientes a 74 modelos diferentes. En 13 modelos (n = 4.715) (11,24%) no se encontraron evidencias clinicas que respaldasen su uso. En los 36 modelos restantes (n = 13.609) (32,45%) predominaban los estudios de nivel iv, con una baja evidencia. Conclusiones Existe un numero significativo de protesis implantadas (11,24%) en las cuales no se ha encontrado evidencia cientifica. Cabe destacar el numero de modelos, 36 de un total de 110, con implantacion inferior a 10 unidades. La implantacion de un registro de artroplastias se ha revelado como una herramienta extremadamente util que permite analizar y extraer conclusiones que permitan mejorar la eficiencia de esta tecnica quirurgica. EnglishIntroduction In our environment, it is increasingly necessary to perform an activity based on scientific evidence and the field of prosthetic surgery should be governed by the same principles. The national arthroplasty registries allow us to obtain a large amount of data in order to evaluate this technique. The aim of our study is to analyse the scientific evidence that supports the primary total knee arthroplasties implanted in Catalonian public hospitals, based on the Arthoplasty Registry of Catalonia (RACat) Material and methods A review of the literature was carried out on knee prostheses (cruciate retaining, posterior stabilized, constricted and rotational) recorded in RACat between the period 2005-2013 in the following databases: Orthopedic Data Evaluation Panel, PubMed, TripDatabase and Google Scholar. The prostheses implanted in fewer than 10 units (1,358 prostheses corresponding to 62 models) were excluded. Results 41,947 prostheses (96.86%) were analysed out of 43,305 implanted, corresponding to 74 different models. In 13 models (n = 4,715) (11.24%) no clinical evidence to support their use was found. In the remaining 36 models (n = 13,609) (32.45%), level iv studies were the most predominant evidence. Conclusions There was a significant number of implanted prostheses (11.24%) for which no clinical evidence was found. The number of models should be noted, 36 out of 110, with fewer than 10 units implanted. The use of arthroplasty registries has proved an extremely useful tool that allows us to analyse and draw conclusions in order to improve the efficiency of this surgical technique. |
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