Lamo-Espinosa, J.M. (J. M.)

Filtering

Settings

Author search.filters.isAuthorOfPublication.75feb837-6d53-41fe-808d-4b70661db44e

Search Results

Now showing 1 - 9 of 9
  • Thumbnail Image
    Efficacy and safety of arthroscopy in femoroacetabular impingement syndrome: a systematic review and meta-analysis of randomized clinical trials
    (2023) Gómez-Álvarez, J. (Jorge); San-Julian, M. (Mikel); Mariscal, G. (Gonzalo); Lamo-Espinosa, J.M. (J. M.)
    This study aimed to compare the efficacy and safety of arthroscopy with physiotherapy or joint lavage in patients with femoroacetabular impingement (FAI). A meta-analysis using PubMed, Embase, Scopus, and the Cochrane Collaboration Library databases was performed in September 2022. We included studies focusing on patients with FAI who underwent arthroscopic surgery versus those who underwent physiotherapy or arthroscopic lavage. The outcomes were functional scores (iHOT-33 and HOS ADL) and adverse events. Randomized clinical trials were included in the study. The risk of bias in each study was assessed according to Cochrane guidelines for clinical trials. The data were combined using Review Manager version 5.4. (PROSPERO CRD42022375273). Six RCTs were included, from a pool of 839 patients (407 females). The iHOT-33 and HOS ADL scales showed significant differences at 12 months in favor of the arthroscopy group (MD, 10.65; 95% CI 6.54-4.76) and (MD, 8.09; 95% CI 3.11-13.07). MCID was not achieved through arthroscopy in functional variables. The rates of osteoarthritis (OR, 6.18; 95% CI 1.06-36.00) and numbness (OR, 73.73; 95% CI 10.00-43.92) were significantly higher in the arthroscopy group. Arthroscopic surgery showed statistical superiority over the control group without exceeding the MCID in most studies; however, the results might have been influenced by secondary variables. Finally, arthroscopic surgery results in a high rate of conversion to osteoarthritis.
  • Thumbnail Image
    Nonreferral of possible soft tissue sarcomas in adults: a dangerous omission in policy
    (Hindawi, 2009) Patiño-García, A. (Ana); Martinez-Monge, R. (Rafael); Martin-Algarra, S. (Salvador); Duart-Clemente, J. (Julio); Abellan, J.F. (Juan F.); San-Julian, M. (Mikel); Lamo-Espinosa, J.M. (J. M.)
    Introduction. The aim of this study is to compare outcomes in three groups of STS patients treated in our specialist centre: patients referred immediately after an inadequate initial treatment, patients referred after a local recurrence, and patients referred directly, prior to any treatment. Patients and methods. We reviewed all our nonmetastatic extremity-STS patients with a minimum follow-up of 2 years. We compared three patient groups: those referred directly to our centre (group A), those referred after an inadequate initial excision (group B), and patients with local recurrence (group C). Results. The study included 174 patients. Disease-free survival was 73%, 76%, and 28% in groups A, B, and C, respectively (P < .001). Depth, size, and histologic grade influenced the outcome in groups A and B, but not in C. Conclusion. Initial wide surgical treatment is the main factor that determines local control, being even more important than the known intrinsic prognostic factors of tumour size, depth, and histologic grade. The influence on outcome of initial wide local excision (WLE), which is made possible by referral to a specialist centre, is paramount.
  • Thumbnail Image
    Intra-articular injection of two different doses of autologous bone marrow mesenchymal stem cells versus hyaluronic acid in the treatment of knee osteoarthritis: long-term follow up of a multicenter randomized controlled clinical trial (phase I/II)
    (BMC, 2018) Cañizo, C. (C.) del; Granero-Moltó, F. (Froilán); Bondia, J.M. (J. M.); Aquerreta, D. (Dámaso); López-Elío, S. (Silvia); Villarón, E. (Eva); Mora, G. (Gonzalo); Andreu, E.J. (Enrique José); Blanco, J.F. (J. F.); Valentí-Nin, J.R. (Juan Ramón); Prosper-Cardoso, F. (Felipe); Nuñez-Cordoba, J.M. (Jorge M.); Lamo-Espinosa, J.M. (J. M.); Sanchez-Guijo, F.M. (Fermín M.); Valentí-Azcárate, A. (Andrés)
    Background: Mesenchymal stromal cells (MSCs) are a promising option to treat knee osteoarthritis (OA). Their safety and usefulness have been reported in several short-term clinical trials but less information is available on the longterm efects of MSC in patients with osteoarthritis. We have evaluated patients included in our previous randomized clinical trial (CMM-ART, NCT02123368) to determine their long-term clinical efect. Materials: A phase I/II multicenter randomized clinical trial with active control was conducted between 2012 and 2014. Thirty patients diagnosed with knee OA were randomly assigned to Control group, intraarticularly administered hyaluronic acid alone, or to two treatment groups, hyaluronic acid together with 10×106 or 100×106 cultured autol‑ ogous bone marrow-derived MSCs (BM-MSCs), and followed up for 12 months. After a follow up of 4 years adverse efects and clinical evolution, assessed using VAS and WOMAC scorings are reported. Results: No adverse efects were reported after BM-MSCs administration or during the follow-up. BM-MSCs-adminis‑ tered patients improved according to VAS, median value (IQR) for Control, Low-dose and High-dose groups changed from 5 (3, 7), 7 (5, 8) and 6 (4, 8) to 7 (6, 7), 2 (2, 5) and 3 (3, 4), respectively at the end of follow up (Low-dose vs Control group, p=0.01; High-dose vs Control group, p=0.004). Patients receiving BM-MSCs also improved clinically accord‑ ing to WOMAC. Control group showed an increase median value of 4 points (−11;10) while Low-dose and Highdose groups exhibited values of −18 (−28;−9) and −10 (−21;−3) points, respectively (Low-dose vs Control group p=0.043). No clinical diferences between the BM-MSCs receiving groups were found. Conclusions: Single intraarticular injection of in vitro expanded autologous BM-MSCs is a safe and feasible proce‑ dure that results in long-term clinical and functional improvement of knee OA.
  • Thumbnail Image
    Dose volume histogram constraints in patients with soft tissue sarcomas of the extremities and the superficial trunk treated with surgery and perioperative HDR brachytherapy
    (Elsevier, 2022) Gimeno, M. (Marta); Martinez-Monge, R. (Rafael); Kovács, G. (Gyorgy); Gómez-Álvarez, J. (Jorge); Ramos, L.I. (Luis Isaac); San-Julian, M. (Mikel); Tagliaferri, L. (Luca); Cambeiro, M. (Mauricio); Martin, S. (Santiago); Strnad, V. (Vratislav); Lamo-Espinosa, J.M. (J. M.)
    Background: Wound healing complications (WHC), osteoradionecrosis (ORN), and nerve damage (ND) are common adverse effects in adult patients with soft tissue sarcomas of the extremities and the superficial trunk treated with surgery and perioperative high dose rate brachytherapy (PHDRB) alone or combined with external beam radiotherapy (EBRT). Rationale: Analysis of the treatment factors contributing to these complications can potentially minimize their occurrence and severity. Patients: A total of 169 patients enrolled in two parallel prospective studies were included in this analysis. Previously Unirradiated cases (Group 1; n = 139) were treated with surgical resection, 16–24 Gy of PHDRB and 45 Gy of EBRT. Adjuvant chemotherapy was given to selected patients with high-grade tumors. Previously irradiated cases (Group 2; n = 30) were treated with surgical resection and 32– 40 Gy of PHDRB without further EBRT. Methods: Patient factors, tumor factors, surgical factors, PHDRB factors and EBRT factors were analyzed using Cox univariate and multivariate analysis. Results: In Previously Unirradiated cases, WHC, ORN and ND occurred in 38.8%, 5.0% and 19.4%. Multivariate analysis indicated that WHC increased with CTV size (p = 0.02) and CTV2cm3 Physical dose (p = 0.02). ORN increased with Bone2cm3 EQD2 67 Gy (p = 0.01) and ND was more frequent in patients with TV100 DVH-based dose (tissue volume encompassed by the 100% isodose) 84 Gy (p < 0.01). In Previously Irradiated cases, WHC, ORN and ND occurred in 63.3%, 3.3% and 23.3%. Multivariate analysis showed that WHC was more frequent in patients with Skin2cm3 Lifetime EQD2 84 Gy (p = 0.01) and ND was more frequent after CTVD90 Physical Doses 40 Gy (p < 0.01). Conclusions: WHC in Previously Unirradiated patients can be minimized by using a more conservative CTV definition together with a meticulous implant technique and planning aimed to minimize hyperdose CTV2cm3 areas. In Previously Irradiated patients WHC may be mimimized considering Lifetime EQD2 Skin2cm3 doses. ORN can be reduced by using the Bone2cm3 EQD2 constraint. ND occurs more frequently in patients with large tumors receiving high treated volume doses, but no specific constraints can be recommended due to the lack of peripheral nerve definition during brachytherapy planning.
  • Thumbnail Image
    Anisotropic cryostructured collagen scaffolds for efficient delivery of RhBMP–2 and enhanced bone regeneration
    (MDPI AG, 2019) Ewald, A. (Andrea); Andreu-Arzuaga, I. (Ion); Granero-Moltó, F. (Froilán); Groll, J. (Jürgen); Flandes-Iparraguirre, M. (María); Elizalde, R. (Reyes); Ripalda-Cemboráin, P. (Purificación); Stuckensen, K. (Kai); Lopez, T. (Tania); Pons-de-Villanueva, J. (Juan); Muiños-López, E. (Emma); Nickel, J. (Joachim); Iglesias, E. (Elena); Prosper-Cardoso, F. (Felipe); Lamo-Espinosa, J.M. (J. M.); Abizanda-Sarasa, G. (Gloria); Gbureck, U. (Uwe)
    In the treatment of bone non-unions, an alternative to bone autografts is the use of bone morphogenetic proteins (BMPs), e.g., BMP–2, BMP–7, with powerful osteoinductive and osteogenic properties. In clinical settings, these osteogenic factors are applied using absorbable collagen sponges for local controlled delivery. Major side effects of this strategy are derived from the supraphysiological doses of BMPs needed, which may induce ectopic bone formation, chronic inflammation, and excessive bone resorption. In order to increase the efficiency of the delivered BMPs, we designed cryostructured collagen scaffolds functionalized with hydroxyapatite, mimicking the structure of cortical bone (aligned porosity, anisotropic) or trabecular bone (random distributed porosity, isotropic). We hypothesize that an anisotropic structure would enhance the osteoconductive properties of the scaffolds by increasing the regenerative performance of the provided rhBMP–2. In vitro, both scaffolds presented similar mechanical properties, rhBMP–2 retention and delivery capacity, as well as scaffold degradation time. In vivo, anisotropic scaffolds demonstrated better bone regeneration capabilities in a rat femoral critical-size defect model by increasing the defect bridging. In conclusion, anisotropic cryostructured collagen scaffolds improve bone regeneration by increasing the efficiency of rhBMP–2 mediated bone healing.
  • Thumbnail Image
    Phase II multicenter randomized controlled clinical trial on the efficacy of intra-articular injection of autologous bone marrow mesenchymal stem cells with platelet rich plasma for the treatment of knee osteoarthritis
    (Springer Nature, 2020) Granero-Moltó, F. (Froilán); Dámaso-Aquerreta, J. (Jesús); Pompei-Fernández, O. (Orlando); Mora, G. (Gonzalo); Moreno, V. (V.); Andreu, E.J. (Enrique José); Blanco, J.F. (J. F.); Sánchez, M. (Mikel); Vitoria-Sola, M. (María); Cañizo, M.C. (María del Consuelo) del; Valentí-Nin, J.R. (Juan Ramón); Crespo-Cullel, Í. (Íñigo); Prosper-Cardoso, F. (Felipe); Delgado-San-Vicente, D. (Diego); Nuñez-Cordoba, J.M. (Jorge M.); Lamo-Espinosa, J.M. (J. M.); Sanchez-Guijo, F.M. (Fermín M.); Valentí-Azcárate, A. (Andrés)
    Background: Mesenchymal stromal cells are a safe and promising option to treat knee osteoarthritis as previously demonstrated in different clinical trials. However, their efficacy, optimal dose and addition of adjuvants must be determined. Here, we evaluated the clinical effects of a dose of 100 × 106 bone marrow mesenchymal stromal cells (BM-MSCs) in combination with Platelet Rich Plasma (PRGF®) as adjuvant in a randomized clinical trial. Methods: A phase II, multicenter, randomized clinical trial with active control was conducted. Sixty patients diagnosed with knee OA were randomly assigned to 3 weekly doses of PRGF® or intraarticular administration of 100 × 106 cultured autologous BM-MSCs plus PRGF®. Patients were followed up for 12 months, and pain and function were assessed using VAS and WOMAC and by measuring the knee range of motion range. X-ray and magnetic resonance imaging analyses were performed to analyze joint damage. Results: No adverse effects were reported after BM-MSC administration or during follow-up. According to VAS, the mean value (SD) for PRGF® and BM-MSC with PRGF® went from 5 (1.8) to 4.5 (2.2) (p = 0.389) and from 5.3 (1.9) to 3.5 (2.5) (p = 0.01), respectively at 12 months. In WOMAC, the mean (SD) baseline and 12-month overall WOMAC scores in patients treated with PRGF® was 31.9 (16.2) and 22.3 (15.8) respectively (p = 0.002) while that for patients treated with BM-MSC plus PRGF® was 33.4 (18.7) and 23.0 (16.6) (p = 0.053). Although statistical significances between groups have been not detected, only patients being treated with BM-MSC plus PRGF® could be considered as a OA treatment responders following OARSI criteria. X-ray and MRI (WORMS protocol) revealed no changes in knee joint space width or joint damage. Conclusions: Treatment with BM-MSC associated with PRGF® was shown to be a viable therapeutic option for osteoarthritis of the knee, with clinical improvement at the end of follow-up. Further phase III clinical trials would be necessary to confirm the efficacy. Trial registration Clinical Trials.gov identifier NCT02365142. Nº EudraCT: 2011-006036-23.
  • Thumbnail Image
  • Thumbnail Image
    Inyección intraarticular de células madre mesenquimales autólogas derivadas de médula ósea en el tratamiento de la artrosis de rodilla: Ensayo clínico multicéntrico aleatorizado (Fase I/II)
    (2018-06-20) Lamo-Espinosa, J.M. (J. M.); Granero-Moltó, F. (Froilán); Valenti-Nin, J.R. (Juan Ramón)
    El objetivo principal de este ensayo clínico es determinar la seguridad y viabilidad del tratamiento de la artrosis de rodilla mediante la administración intraarticular de BM-MSCs autólogas junto con ácido hialurónico (AH). Como objetivo secundario queremos determinar la eficacia terapéutica del tratamiento intraarticular con BM-MSCs autólogas en combinación con AH en pacientes con artrosis de rodilla, mediante la utilización de dos dosis celulares diferentes y comparándolo con el tratamiento aislado de AH. La determinación de la eficacia se realizará utilizando como variables principales del estudio: 1) Escalas clínicas de dolor y funcionalidad. 2) Valoración radiológica utilizando radiología simple y resonancia magnética. Las técnicas y escalas se detallan en la metodología del ensayo.
  • Thumbnail Image
    Inferior lateral genicular artery injury during anterior cruciate ligament reconstruction surgery
    (Hindawi Publishing Corporation, 2012) Lamo-Espinosa, J.M. (J. M.)
    We report a case of inferior lateral genicular artery (ILG) injury during anterior cruciate ligament (ACL) reconstruction surgery with lateral partial meniscectomy. This is a rare arthroscopy complication. A review of the literature has been made with the aim to define the anatomy of ILG across the lateral articular line and the risk of lesion during knee arthroscopy. We propose embolization as a good treatment option for this type of injuries