Mariscal, G. (Gonzalo)
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- 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.
- Validation of the concavity-convexity quotient as a new method to measure the magnitude of scoliosis.(Wolters Kluwer, 2020) Figueira, P. (Paulo); Barrios, C. (Carlos); Nuñez, J.H. (Jorge H.); Montiel-Terrón, V. (Verónica); López, M.A. (Miguel A.); Malo, A. (Ana); Mariscal, G. (Gonzalo); Domenech-Fernández, P. (Pedro); Castro, M. (Miguel)Objectives: We propose a novel and simple method to determine the magnitude of the curve in scoliosis and its correlation with the Cobb angle. Methods: Using multiple rounds of nominal group technique and an established consensus‑building methodology, a multidisciplinary research group identified a simple method to value the curve deformity based on the vertebral pedicles. Measurements: A mathematical study was performed to determine the relationship between the Cobb angle and the concavity–convexity quotient (CCQ). To evaluate the clinical correlation between the Cobb angle and CCQ, spine surgeons measured 48 curves (before and after follow‑up) of congenital scoliosis. Results: This quotient reflects the ratio between the distance from the upper end of the most inclined upper vertebra to the lower end of the most inclined lower vertebra on the concave side (A‑distance) and the corresponding distance on the convex side of the curve (B‑distance). The existing mathematical relationship is based on changing the explicit coordinates to polar coordinates. Finally, the clinical correlation between the Cobb angle and CCQ was statistically significant (r = −0.688; P < 0.001 in first measure and r = −0.789; P < 0.001 in the second measure). Conclusions: Our study provides Level III evidence that CCQ represents a promising alternative or a complementary method to the traditional Cobb angle due to its simple and reliable ability to measure the magnitude of the curve.