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Article ; Online: Letter to the Editor on "Who is Still Receiving Blood Transfusions After Primary and Revision Total Joint Arthroplasty?"

Nuñez, Jorge H / Mateu Vicent, David / Anglès, Francesc

2023 Volume 38, Issue 2, Page(s) e1

MeSH term(s)	Humans ; Arthroplasty ; Arthroplasty, Replacement, Knee ; Blood Transfusion
Language	English
Publishing date	2023-01-03
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	632770-9
ISSN	1532-8406 ; 0883-5403
ISSN (online)	1532-8406
ISSN	0883-5403
DOI	10.1016/j.arth.2022.10.005
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Article ; Online: Letter to the Editor on "Hypoalbuminemia increases complications in elderly patients operated for hip fracture".

Nuñez, Jorge H / Montenegro, Juan Diego / Fraguas, Antoni

Aging clinical and experimental research

2023 Volume 35, Issue 12, Page(s) 3239–3240

MeSH term(s)	Humans ; Aged ; Hypoalbuminemia/complications ; Hip Fractures/surgery ; Hip Fractures/complications ; Postoperative Complications/etiology ; Risk Factors
Language	English
Publishing date	2023-07-18
Publishing country	Germany
Document type	Letter
ZDB-ID	2104785-6
ISSN	1720-8319 ; 1594-0667
ISSN (online)	1720-8319
ISSN	1594-0667
DOI	10.1007/s40520-023-02502-y
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Article ; Online: Letter to the Editor on "The Albumin to Globulin Ratio Performs Well for Diagnosing Periprosthetic Joint Infection: A Single-Center Retrospective Study".

Surroca, Maria / Massons, Miriam / Nuñez, Jorge H

The Journal of arthroplasty

2023 Volume 39, Issue 2, Page(s) e10–e11

MeSH term(s)	Humans ; Prosthesis-Related Infections/diagnosis ; Retrospective Studies ; Albumins
Chemical Substances	Albumins
Language	English
Publishing date	2023-12-12
Publishing country	United States
Document type	Letter
ZDB-ID	632770-9
ISSN	1532-8406 ; 0883-5403
ISSN (online)	1532-8406
ISSN	0883-5403
DOI	10.1016/j.arth.2023.10.039
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Article ; Online: Response to Letter to the Editor on "Hypoalbuminemia Predicts Failure of Two-Stage Exchange for Chronic Periprosthetic Joint Infection of the Hip and Knee".

Nuñez, Jorge H / Guerra-Farfán, Ernesto / Citak, Mustafa

The Journal of arthroplasty

2023 Volume 38, Issue 9, Page(s) e32–e33

MeSH term(s)	Humans ; Hypoalbuminemia ; Prosthesis-Related Infections/etiology ; Prosthesis-Related Infections/surgery ; Knee Joint/surgery ; Arthroplasty, Replacement, Hip
Language	English
Publishing date	2023-08-13
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	632770-9
ISSN	1532-8406 ; 0883-5403
ISSN (online)	1532-8406
ISSN	0883-5403
DOI	10.1016/j.arth.2023.04.017
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Article ; Online: Hypoalbuminemia increases the risk of failure following one-stage septic revision for periprosthetic joint infection.

Traverso, Giacomo / Núñez, Jorge H / Gehrke, Thorsten / Citak, Mustafa

Archives of orthopaedic and trauma surgery

2023 Volume 143, Issue 9, Page(s) 5641–5648

Abstract: Purpose: Malnutrition is a potentially modifiable risk factor of periprosthetic joint infection (PJI). The purpose of this study was to analyze the role of nutritional status as a risk factor for failure after one- stage revision hip or knee ... ...

Abstract	Purpose: Malnutrition is a potentially modifiable risk factor of periprosthetic joint infection (PJI). The purpose of this study was to analyze the role of nutritional status as a risk factor for failure after one- stage revision hip or knee arthroplasty for PJI. Methods: Retrospective, single-center, case-control study. Patients with PJI according to the 2018 International Consensus Meeting criteria were evaluated. Minimum follow-up was 4 years. Total lymphocyte count (TLC), albumin values, hemoglobin, C-reactive protein, white blood cell (WBC) count and glucose levels were analyzed. An analysis was also made of the index of malnutrition. Malnutrition was defined as serum albumin < 3.5 g/dL and TLC < 1500/mm Results: No significant differences were found between increased failure rates after a one-stage revision hip or knee arthroplasty for PJI and TLC, hemoglobin level, WBC count, glucose levels, or malnutrition. Albumin and C-reactive protein values were found to have a positive and significant relationship with failure (p < 0.05). Multivariate logistic regression identified only hypoalbuminemia (serum albumin < 3.5 g/dL) (OR 5.64, 95% CI 1.26-25.18, p = 0.023) as a significant independent risk factor for failure. The receiver operating characteristic (ROC) curve for the model yielded an area under the curve of 0.67. Conclusion: TLC, hemoglobin; WBC count; glucose levels; and malnutrition, understood as the combination of albumin and TLC, were not found to be statically significant risk factors for failure after single-stage revision for PJI. However, albumin < 3.5 g/dL, alone was a statically significant risk factor for failure after single-stage revision for PJI. As hypoalbuminemia seems to influence the failure rate, it is advisable to measure albumin levels in preoperative workups.
MeSH term(s)	Humans ; Retrospective Studies ; Case-Control Studies ; C-Reactive Protein/analysis ; Prosthesis-Related Infections/etiology ; Prosthesis-Related Infections/surgery ; Prosthesis-Related Infections/diagnosis ; Hypoalbuminemia/complications ; Hypoalbuminemia/surgery ; Malnutrition/complications ; Malnutrition/surgery ; Arthritis, Infectious/surgery ; Serum Albumin/analysis ; Glucose ; Arthroplasty, Replacement, Hip/adverse effects ; Reoperation/adverse effects
Chemical Substances	C-Reactive Protein (9007-41-4) ; Serum Albumin ; Glucose (IY9XDZ35W2)
Language	English
Publishing date	2023-04-18
Publishing country	Germany
Document type	Journal Article
ZDB-ID	80407-1
ISSN	1434-3916 ; 0003-9330 ; 0344-8444
ISSN (online)	1434-3916
ISSN	0003-9330 ; 0344-8444
DOI	10.1007/s00402-023-04885-z
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Article ; Online: Letter to the Editor on "In the Era of Tranexamic Acid, Are Type and Screens for Primary Total Joint Arthroplasty Obsolete?"

Nuñez, Jorge H / Angles, Francesc / Minguell-Monyart, Joan

The Journal of arthroplasty

2021 Volume 36, Issue 5, Page(s) e36–e37

MeSH term(s)	Antifibrinolytic Agents ; Arthroplasty ; Humans ; Tranexamic Acid
Chemical Substances	Antifibrinolytic Agents ; Tranexamic Acid (6T84R30KC1)
Language	English
Publishing date	2021-04-30
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	632770-9
ISSN	1532-8406 ; 0883-5403
ISSN (online)	1532-8406
ISSN	0883-5403
DOI	10.1016/j.arth.2021.01.061
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Article ; Online: Routine pretransfusion testing before primary total hip or knee arthroplasty are an expensive and wasteful routine. Systematic review and meta-analysis.

Nuñez, Jorge H / Colomina, Jordi / Angles, Francesc / Pallisó, Francesc / Acosta, Héctor F / Mateu, David / Novellas, Marga

Archives of orthopaedic and trauma surgery

2024 Volume 144, Issue 4, Page(s) 1585–1595

Abstract: Background: The excessive routine ordering of pretransfusion tests (blood typing, screening, and cross-matching) for surgical cases incurs significant unnecessary costs and places an undue burden on transfusion services. This study aims to ... ...

Abstract	Background: The excessive routine ordering of pretransfusion tests (blood typing, screening, and cross-matching) for surgical cases incurs significant unnecessary costs and places an undue burden on transfusion services. This study aims to systematically review the literature regarding the necessity of routine pretransfusion tests before total hip arthroplasty (THA) or total knee arthroplasty (TKA) and summarize their outcomes. Study methods: A systematic review and meta-analysis were performed. The study's characteristics, the prevalence of over-ordering pretransfusion tests, transfusion rates, and potential cost savings to the healthcare system were analyzed. Results: The study included 17,667 patients. Pooled results revealed a 96.3% over-ordering pretransfusion test rate (95% CI: 0.92-1.00; p < 0.001) among patients undergoing primary THA or TKA. The pooled prevalence of hospital transfusion rate was 3.6%. Notably, there were statistically significant differences in preoperative hemoglobin (Hb) levels between patients not requiring transfusion (Hb = 13.9 g/dl; 95% CI 12.59-15.20; p < 0.001) and those needing transfusion (Hb = 11.9 g/dl; 95% CI 10.69-13.01; p < 0.001) (p = 0.03). The per-patient total cost savings ranged from 28.63 to 191.27 dollars. Discussion: Our study suggests that routine pre-transfusion testing for all patients undergoing primary THA or TKA may be unnecessary. We propose limiting pretransfusion test orders to patients with preoperative hemoglobin levels below 12 g/dl in unilateral primary TKA or THA. This targeted approach can result in significant cost savings for healthcare systems and transfusion services by reducing the over-ordering of pretransfusion tests in these surgical procedures.
MeSH term(s)	Humans ; Arthroplasty, Replacement, Knee ; Blood Transfusion ; Arthroplasty, Replacement, Hip ; Length of Stay ; Hemoglobins ; Retrospective Studies
Chemical Substances	Hemoglobins
Language	English
Publishing date	2024-02-28
Publishing country	Germany
Document type	Meta-Analysis ; Systematic Review ; Journal Article
ZDB-ID	80407-1
ISSN	1434-3916 ; 0003-9330 ; 0344-8444
ISSN (online)	1434-3916
ISSN	0003-9330 ; 0344-8444
DOI	10.1007/s00402-024-05243-3
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Article ; Online: Annealing effects on the magnetic and magnetotransport properties of iron oxide nanoparticles self-assemblies.

Fabris, Fernando / Lima, Enio / Nuñez, Jorge Martín / Troiani, Horacio E / Aguirre, Myriam H / Leborán, Victor / Rivadulla, Francisco / Winkler, Elin L

Nanotechnology

2023 Volume 34, Issue 45

Abstract: In magnetic tunnel junctions based on iron oxide nanoparticles the disorder and the oxidation state of the surface spin as well as the nanoparticles functionalization play a crucial role in the magnetotransport properties. In this work, we report a ... ...

Abstract	In magnetic tunnel junctions based on iron oxide nanoparticles the disorder and the oxidation state of the surface spin as well as the nanoparticles functionalization play a crucial role in the magnetotransport properties. In this work, we report a systematic study of the effects of vacuum annealing on the structural, magnetic and transport properties of self-assembled ∼10 nm Fe
Language	English
Publishing date	2023-08-21
Publishing country	England
Document type	Journal Article
ZDB-ID	1362365-5
ISSN	1361-6528 ; 0957-4484
ISSN (online)	1361-6528
ISSN	0957-4484
DOI	10.1088/1361-6528/aced0e
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Article ; Online: High reoperation and mortality rate after distal femoral replacement for periprosthetic knee fracture in the elderly.

Pujol, Oriol / Joshi-Jubert, Nayana / Nuñez, Jorge H / Pijoan, Joan / Castellet, Enric / Minguell, Joan

European journal of orthopaedic surgery & traumatology : orthopedie traumatologie

2022 Volume 33, Issue 4, Page(s) 911–918

Abstract: Purpose: To analyze the outcomes of elderly patients with periprosthetic fractures around the knee operated on with a distal femur replacement (DFR).: Methods: We performed a retrospective case series study of eleven elderly patients who underwent ... ...

Abstract	Purpose: To analyze the outcomes of elderly patients with periprosthetic fractures around the knee operated on with a distal femur replacement (DFR). Methods: We performed a retrospective case series study of eleven elderly patients who underwent DFR due to a periprosthetic fracture. Mean follow-up was 30.1 months (SD 28.1). Demographic, clinical and radiological data were reviewed. A descriptive analysis and a study of survival were conducted. Then, a comparative analysis between the patients who needed reoperation and did not need reoperation, and the patients who died and the patients who were alive during the follow-up was performed. Results: Mean age was 77.1 years (SD 13.9). Reoperation rate was 36%, being infection the most common complication (27%). The risk of reoperation increased with a longer time between fracture and surgery. The 36.4% of patients died during the follow-up. Older age, need of blood transfusion and need of early reoperation were related to a higher risk of mortality. Conclusion: DFR could be a valuable option for knee periprosthetic fractures in elderly patients. However, surgeons should be aware of the high reoperation and mortality rate.
MeSH term(s)	Humans ; Aged ; Periprosthetic Fractures/etiology ; Reoperation/adverse effects ; Femoral Fractures/surgery ; Arthroplasty, Replacement, Knee/adverse effects ; Knee Fractures ; Retrospective Studies ; Femur/surgery ; Fracture Fixation, Internal/adverse effects
Language	English
Publishing date	2022-02-19
Publishing country	France
Document type	Journal Article
ZDB-ID	1231084-0
ISSN	1432-1068 ; 1633-8065 ; 0948-4817 ; 0940-3264
ISSN (online)	1432-1068
ISSN	1633-8065 ; 0948-4817 ; 0940-3264
DOI	10.1007/s00590-022-03225-y
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Article ; Online: Pectoralis-major-pedicled bone window for revision of a shoulder arthroplasty.

Garcia-Portabella, Montserrat / Nuñez, Jorge H / Batalla, Lledó / Montserrat, Eric / Minguell, Joan / Massons, Josep

European journal of orthopaedic surgery & traumatology : orthopedie traumatologie

2022 Volume 33, Issue 4, Page(s) 1275–1281

Abstract: Purpose: The aim of this study is to review our experience with the pectoralis-major-pedicled bone window for the revision of shoulder arthroplasty.: Methods: This study used the retrospective case series of six patients who underwent a pectoralis- ... ...

Abstract	Purpose: The aim of this study is to review our experience with the pectoralis-major-pedicled bone window for the revision of shoulder arthroplasty. Methods: This study used the retrospective case series of six patients who underwent a pectoralis-major-pedicled bone window for revision of shoulder arthroplasty, with a minimum follow-up of 2 years. Demographic, clinical, and radiological data were analyzed. Results: The mean age of the included patients was 72.6 years old (standard deviation (SD) 4.7), and 83.3% were women (5/1). The mean follow-up was 36.6 months (range 25-48 months). Five patients had a shoulder hemiarthroplasty and one patient a reverse shoulder arthroplasty. The indications for revision were pain in five patients and recurrent dislocation in one patient. No intraoperative complications were found. One patient developed a wound infection that required debridement and a two-stage revision. Despite complications, 2 years after surgery, the range of motions and functional scores were improved from preoperative levels. The difference between preoperative and postoperative VAS pain scores was 7.1 points (p < 0.001). The difference between preoperative and postoperative CSS and ASES questionnaires were 32 and 31.6 points, respectively (p < 0.001). At the final follow-up, all radiographs showed bone union of the osteotomy, good fixation of all components, without evidence of prosthetic loosening or migration. Conclusions: Revision of a shoulder arthroplasty using a pectoralis-major-pedicled bone window can be an effective treatment that can yield pain relief; however, improvements in motion and function were difficult to achieve.
MeSH term(s)	Humans ; Female ; Aged ; Male ; Arthroplasty, Replacement, Shoulder ; Shoulder Joint/surgery ; Retrospective Studies ; Treatment Outcome ; Pain, Postoperative ; Range of Motion, Articular ; Reoperation ; Shoulder Prosthesis
Language	English
Publishing date	2022-05-24
Publishing country	France
Document type	Journal Article
ZDB-ID	1231084-0
ISSN	1432-1068 ; 1633-8065 ; 0948-4817 ; 0940-3264
ISSN (online)	1432-1068
ISSN	1633-8065 ; 0948-4817 ; 0940-3264
DOI	10.1007/s00590-022-03292-1
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