Valenti, J.R. (Juan Ramón)

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    The use of a cementless tapered stem in young patients affected of secondary hip arthritis
    (OMICS International, 2014) Cruz-Morande, S. (Sebastián); Llombart-Blanco, R. (Rafael); Valenti, J.R. (Juan Ramón)
    Introduction: The Wagner cone stem was designed for uncemented hip arthroplasty in difficult proximal femoral conditions or femoral deformities. The most common indications for the use of this stem are secondary hip arthritis due to developmental hip dysplasia, septic arthritis or congenital malformations. We present a case series of patients that underwent hip arthroplasty with the use of a Wagner cone stem. Materials and methods: A retrospective chart review of 17 patients (15 women and 2 men) was performed with a mean age of 39 (25-62). Clinical evaluation was rated with the Merlé D´Aubigné score. Radiographic evaluation consisted in antero posterior and axial views of the hip. One patient was operated bilaterally, with a total of 18 hips operated, and mean follow up of 8 years (5-12). Results: Diagnosis of secondary arthritis was: developmental hip dysplasia in 12 patients, septic arthritis sequelae in 3 patients and other causes of hip arthritis in 3 patients. Average Merlé-D´Aubigné score was 9,9 (8-13) preoperatively and 16,10 (13-18) at last follow-up. One patient presented crural nerve paresia after surgery, which was recovered completely and one stem was reviewed due to aseptic loosening. Discussion: The Wagner cone stem has successfully resolved cases with abnormalities in the proximal femur in patients with secondary hip arthritis. Although this procedure is not exempt of complications, it has shown good stability which translates into good results in the medium to long term.
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    Evaluation of driving skills after anterior cruciate ligament reconstruction with hamstring autograft
    (Elsevier, 2018) Valenti, A. (Andrés); Payo-Ollero, J. (Jesús); Pérez-Mozas, M. (Maria); Lamo-de-Espinosa-Vázquez-de-Sola, J.M. (José María); Valenti, J.R. (Juan Ramón)
    Background: There are no well-established guidelines for safe driving after injury or surgical treatment. The purpose of this study was to assess the aptitude to regain driving skills and brake reaction abilities after anterior cruciate ligament (ACL) surgery. Methods: This study compared the driving abilities and skills at four to six weeks after surgery of 31 patients who underwent ACL reconstruction with hamstring autograft with 31 healthy volunteers. Multiple variables, including pedestrian impact, car crash, red traffic light violations, visual reaction time, and other driving abilities were measured with a validated driving simulator. Results: There was no statistically significant between-group difference with respect to skill, driving ability, and brake reaction times (P N 0.05). The differences between right and left knees were also not statistically significant (P N 0.05). However, patients with a right ACL reconstruction had a higher number of collisions with fixed objects (2.82 vs. 1.84, P = 0.239) and pedestrian impacts (0.23 vs. 0.00 P = 0.221), and had slower brake reaction times (585.69 vs. 456.02 ms, P = 0.069). The Tegner score was similar in each group (7.19 in ACL reconstruction group vs. 6.8 in control group, P = 0.092) and the Lysholm score improved as compared with the presurgical measurement (53.48 vs. 89.61, P b 0.001). Conclusions: Anterior cruciate ligament surgery with hamstring autograft did not result in a decrease in driving performance and safety at four to six weeks after surgery with respect to skill, ability to drive, and brake response time.