Cara, J.A. (José Antonio)
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- Banco de tejidos del sistema musculoesquelético. Aplicaciones clínicas(Universidad de Navarra, 1990) Cara, J.A. (José Antonio); Amillo, S. (Santiago); Valenti-Nin, J.R. (Juan Ramón)Desde Junio de 1987 hasta Junio de 1990 se han utilizado 310 aloinjertos del Banco de huesos y otros tejidos del sistema musculoesquelético del Departamento de Cirugía Ortopédica y Traumatología de la Clínica Universitaria de Navarra. De éstos, 219 se han utilizado en el Departamento correspondiendo a 142 aloinjertos de hueso esponjoso, 42 aloinjertos de hueso cortica], 24 a tendón rotuliano y 11 de fascia lata. Los otros 91 injertos se han remitido a otros centros hospitalarios de ámbito nacional. Se estudian retrospectivamente los pacientes que han sido sometidos a cirugía más aporte de aloinjerto. Se observan las diferencias entre los distintos tipos de aloinjerto y se compara con las técnicas convencionales. En las complicaciones sólo destaca el 10,52 % de infecciones por aloinjertos corticales en pacientes sometidos a tratamientos antineoplásicos y ninguna infección en los otros tipos de aloinjertos. Concluimos que el banco de huesos y otros tejidos del sistema musculoesquelético tiene una gran utilidad en diferentes técnicas quirúrgicas reconstructivas y de artrodesis que se utilizan con frecuencia en la cirugía ortopédica y traumatología, y es necesario disponer de un Banco para poder hacer y desarrollar la cirugía en esta especialidad médico-quirúrgica.
- Iliac allograft used for sternal reconstruction after resection of a chondrosarcoma(Springer Verlag, 1993) Cañadell, J.M. (J. M.); Cara, J.A. (José Antonio); Lacleriga, A. (Antonio)We report the case of a man, aged 48 years, with a primary chondrosarcoma of the sternum which was treated by radical resection and reconstruction with an iliac allograft and musculocutaneous flaps. No complications were seen at follow up after two years.
- La prótesis de resección de rodilla en la cirugía reconstructiva tumoral(Universidad de Navarra, 1991) Cañadell, J.M. (J. M.); Cara, J.A. (José Antonio); Amillo, S. (Santiago)From july 1983 to december 1990, 34 patients with aggressive or malignant bone tumors in the knee have been treated by radical resection and endoprosthesis replacement with or without allograft. The follow up was three years. We have a comparative study between allograft and plastic spacer. The functional character is better with endoprosthesis with non biologic material (75% excellent and good versus 66.6%). The complications were similar in both.
- Intercalary bone allografts 23 tumor cases followed for 3 years(Orthopaedica Scandinavica, 1994) Cañadell, J.M. (J. M.); Cara, J.A. (José Antonio); Lacleriga, A. (Antonio)From 1987 to 1991, 26 patients with malignant bone tumors (osteosarcoma, Ewing's sarcoma, chondrosarcoma and malignant fibrous histiocytoma) in the diaphysis or metaphysis of long bones have been treated by chemotherapy, radiotherapy and intercalary bone allograft replacement after resection. The mean follow-up was 3 years in 23 patients, 2 died from tumors, and 1 had an amputation because of local recurrence. Allograft incorporation in 11 metaphyseal anastomoses was excellent in all cases. In the 23 diaphyseal anastomoses there were 6 non-unions. Other complications were deep infection in 3 cases, leg length discrepancy in 2 and allograft fracture in 2. Function became satisfactory in 14 cases.
- External fixation in tumour pathology(Springer Verlag, 1998) Cañadell, J.M. (J. M.); Cara, J.A. (José Antonio); San-Julian, M. (Mikel); Forriol, F. (Francisco)An appraisal of the clinical records of patients with malignant bone tumours enabled us to identify 61 whom we have treated by external fixation. There were 38 males and 23 females with ages ranging from 4 to 58 years, the mean being 14 years. The average period of follow-up was 6 years (1-12 years). For the purpose of our analysis the patients were divided into three groups according to whether the fixator was fitted before, during or after tumour resection.
- Limb Salvage for Malignant Bone Tumors in Young Children(Lippincott, Williams & Wilkins, 2000) Cañadell, J.M. (J. M.); Cara, J.A. (José Antonio)From March 1984 to April 1991, the Orthopaedics Department of the Clínica Universitaria de Navarra treated 47 cases of malignant bone tumors in young children by limb-salvage surgery. Mean follow-up time was 4.4 years. The histologic diagnoses were osteosarcoma (33 cases) and Ewing's sarcoma (14 cases). All patients were treated following the Cancer Protocol of the Clínica Universitaria de Navarra. We used allograft reconstruction in 26 patients, autograft reconstruction in seven, and nonbiologic material in seven other patients. Thirty-six of these patients are alive currently; 11 have died. The overall survival rate was 76.6%. Three patients suffered local recurrences, and seven developed metastatic disease. The most significant complications were infection in four cases, and osteosynthesis anchorage detachment in eight cases. We believe that with recent medical, surgical, and rehabilitative advances, limb-salvage surgery has surpassed amputation as the primary treatment for malignant bone tumors in young children