Letter to the Editor
Spontaneous tendon ruptures in chronic renal failure
Roturas tendinosas espontáneas en la insuficiencia renal crónica
José Ruiza,b, Antonio Ríosa,b,c,
, José Manuel Rodrígueza,b,c, Santiago Llorented
Corresponding author
a Departamento de Cirugía, Ginecología, Obstetricia y Pediatría, Universidad de Murcia, Murcia, Spain
b Servicio de Cirugía General y de Aparato Digestivo, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
c Instituto Murciano de Investigación Bio-Sanitaria Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
d Servicio de Nefrología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
Read
11897
Timeswas read the article
2630
Total PDF
9267
Total HTML
Share statistics
array:25 [ "pii" => "S2013251417300962" "issn" => "20132514" "doi" => "10.1016/j.nefroe.2016.10.011" "estado" => "S300" "fechaPublicacion" => "2017-05-01" "aid" => "298" "copyright" => "Sociedad Española de Nefrología" "copyrightAnyo" => "2016" "documento" => "simple-article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Nefrologia (English Version). 2017;37:341-3" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4315 "formatos" => array:3 [ "EPUB" => 321 "HTML" => 3305 "PDF" => 689 ] ] "Traduccion" => array:1 [ "es" => array:20 [ "pii" => "S0211699516301928" "issn" => "02116995" "doi" => "10.1016/j.nefro.2016.10.018" "estado" => "S300" "fechaPublicacion" => "2017-05-01" "aid" => "298" "copyright" => "Sociedad Española de Nefrología" "documento" => "simple-article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Nefrologia. 2017;37:341-3" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4787 "formatos" => array:3 [ "EPUB" => 351 "HTML" => 3637 "PDF" => 799 ] ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta al Director</span>" "titulo" => "Roturas tendinosas espontáneas en la insuficiencia renal crónica" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "341" "paginaFinal" => "343" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Spontaneous tendon ruptures in chronic renal failure" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "José Ruiz, Antonio Ríos, José Manuel Rodríguez, Santiago Llorente" "autores" => array:4 [ 0 => array:2 [ "nombre" => "José" "apellidos" => "Ruiz" ] 1 => array:2 [ "nombre" => "Antonio" "apellidos" => "Ríos" ] 2 => array:2 [ "nombre" => "José Manuel" "apellidos" => "Rodríguez" ] 3 => array:2 [ "nombre" => "Santiago" "apellidos" => "Llorente" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2013251417300962" "doi" => "10.1016/j.nefroe.2016.10.011" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251417300962?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0211699516301928?idApp=UINPBA000064" "url" => "/02116995/0000003700000003/v1_201706230110/S0211699516301928/v1_201706230110/es/main.assets" ] ] "itemSiguiente" => array:20 [ "pii" => "S2013251417301074" "issn" => "20132514" "doi" => "10.1016/j.nefroe.2017.05.010" "estado" => "S300" "fechaPublicacion" => "2017-05-01" "aid" => "299" "copyright" => "Sociedad Española de Nefrología" "documento" => "simple-article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Nefrologia (English Version). 2017;37:343-5" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 5439 "formatos" => array:3 [ "EPUB" => 553 "HTML" => 3980 "PDF" => 906 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Prevalence and risk of progression of chronic kidney disease in diabetics and hypertensive patients followed by primary care physicians" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "343" "paginaFinal" => "345" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Prevalencia y riesgo de progresión de enfermedad renal crónica en pacientes diabéticos e hipertensos seguidos en atención primaria en la Comunidad de Madrid" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Guadalupe Alemán-Vega, Isabel Gómez Cabañas, Laura Reques Sastre, Javier Rosado Martín, Elena Polentinos-Castro, Ricardo Rodríguez Barrientos" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Guadalupe" "apellidos" => "Alemán-Vega" ] 1 => array:2 [ "nombre" => "Isabel" "apellidos" => "Gómez Cabañas" ] 2 => array:2 [ "nombre" => "Laura" "apellidos" => "Reques Sastre" ] 3 => array:2 [ "nombre" => "Javier" "apellidos" => "Rosado Martín" ] 4 => array:2 [ "nombre" => "Elena" "apellidos" => "Polentinos-Castro" ] 5 => array:2 [ "nombre" => "Ricardo" "apellidos" => "Rodríguez Barrientos" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S021169951630193X" "doi" => "10.1016/j.nefro.2016.10.019" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S021169951630193X?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251417301074?idApp=UINPBA000064" "url" => "/20132514/0000003700000003/v1_201707070022/S2013251417301074/v1_201707070022/en/main.assets" ] "itemAnterior" => array:20 [ "pii" => "S2013251417300949" "issn" => "20132514" "doi" => "10.1016/j.nefroe.2017.05.005" "estado" => "S300" "fechaPublicacion" => "2017-05-01" "aid" => "297" "copyright" => "Sociedad Española de Nefrología" "documento" => "simple-article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Nefrologia (English Version). 2017;37:339-41" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 5097 "formatos" => array:3 [ "EPUB" => 305 "HTML" => 4132 "PDF" => 660 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Cortical necrosis: An uncommon cause of acute renal failure with a very poor outcome" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "339" "paginaFinal" => "341" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "La necrosis cortical: una causa infrecuente de fracaso renal agudo pero con un pésimo pronóstico" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 675 "Ancho" => 900 "Tamanyo" => 74483 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Doppler Ultrasound showing a 2–3<span class="elsevierStyleHsp" style=""></span>mm thick hypoecogenic halo diffuse and concentric marking the cortical; the rest including medullary pyramids an renal sinus is preserved.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Paola María Rodríguez, Enrique Morales, Ángel Sánchez, Mónica Milla, Miguel Angel Martínez, Manuel Praga" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Paola María" "apellidos" => "Rodríguez" ] 1 => array:2 [ "nombre" => "Enrique" "apellidos" => "Morales" ] 2 => array:2 [ "nombre" => "Ángel" "apellidos" => "Sánchez" ] 3 => array:2 [ "nombre" => "Mónica" "apellidos" => "Milla" ] 4 => array:2 [ "nombre" => "Miguel Angel" "apellidos" => "Martínez" ] 5 => array:2 [ "nombre" => "Manuel" "apellidos" => "Praga" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0211699516301916" "doi" => "10.1016/j.nefro.2016.10.017" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0211699516301916?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251417300949?idApp=UINPBA000064" "url" => "/20132514/0000003700000003/v1_201707070022/S2013251417300949/v1_201707070022/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Spontaneous tendon ruptures in chronic renal failure" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "341" "paginaFinal" => "343" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "José Ruiz, Antonio Ríos, José Manuel Rodríguez, Santiago Llorente" "autores" => array:4 [ 0 => array:3 [ "nombre" => "José" "apellidos" => "Ruiz" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 1 => array:4 [ "nombre" => "Antonio" "apellidos" => "Ríos" "email" => array:1 [ 0 => "arzrios@um.es" ] "referencia" => array:4 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 3 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 2 => array:3 [ "nombre" => "José Manuel" "apellidos" => "Rodríguez" "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "Santiago" "apellidos" => "Llorente" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Departamento de Cirugía, Ginecología, Obstetricia y Pediatría, Universidad de Murcia, Murcia, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Cirugía General y de Aparato Digestivo, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Instituto Murciano de Investigación Bio-Sanitaria Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Servicio de Nefrología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Roturas tendinosas espontáneas en la insuficiencia renal crónica" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Spontaneous rupture of tendons (STR) is not frequent. The pathogenesis is unclear but there are a number risk factors involved: secondary hyperparathyroidism (HPTH), diabetes mellitus, obesity, rheumatoid arthritis, gout, statins, steroids, fluorquinolones and the presence of B and/or C hepatitis virus. In patients with chronic renal failure (CKD) the most frequent cause of tendon rupture is secondary hyperparathyoridims, which is present in most of these patients.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1,2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">There is no consensus about the treatment. Thus the objective of this study is to analyze the clinical features, risk factors, treatment and clinical evolution of STR in CKD patients.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The study includes end stage renal disease patients on renal replacement therapy that had STR during the years 1994 to 2013. Patients had a complete clinical history and they had a least one-year of follow up. Patient with tendon rupture caused by trauma or those with of the lost follow up were excluded.</p><p id="par0020" class="elsevierStylePara elsevierViewall">There were six patients (0.23%) with STR. Mean age was 46.6<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>11.8 years, 4 were males (66.7%). Before the episode of STR all patients had been on hemodialysis for an average of 9.1<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>4.2 years. In 4 cases (66.7%) the STR affected the extremity of one body side and in 2 cases (33.3) they were bilateral.</p><p id="par0025" class="elsevierStylePara elsevierViewall">In six patients there was a rupture of the femoral quadriceps tendon and in 2 cases the patellar tendon was affected. All patients had SHPT and one patient (16.6%) also receive statins to treat hypercholesterolemia (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">All patients underwent urgent (within 5 days) surgical intervention to repair the tendon fracture. In five cases the tendon was detached with respect to the patella and it was reinserted using nonabsorbable suture through transosseous tunnels in the patella. In 3 cases there was a rupture of the tendon and it had to be repaired by end-to-end suture with a material that is not absorbable. Thereafter, the knee had to be immobilized for 8 weeks followed by a rehabilitation period of up to six months after surgery</p><p id="par0035" class="elsevierStylePara elsevierViewall">With respect to the SHPT, all patients had bone pain and one patient (16.6%) complained of pruritus that was refractory to treatment. Mean serum concentration of PTH was 968<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>308.2<span class="elsevierStyleHsp" style=""></span>pg/ml, the CaxP was 69.6<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>17.6 and the mean value of alkaline phosphatase was 518.3<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>334.4<span class="elsevierStyleHsp" style=""></span>UI/l. All patients underwent total parathyroidectomy after a mean period of 3.6<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.7 months.</p><p id="par0040" class="elsevierStylePara elsevierViewall">After 12.5<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>5 year of follow up there was no further evidence of STR or SHPT and 4 patients (66.7%) underwent renal transplantation (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">The feature of a CKD patient with STR is a relatively young patient on hemodialysis for more that 5 years that may be malnourished, with insufficient dose of dialysis, amyloidosis, chronic acidosis and also SHPT which is the most important pathogenic factor for STR.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1–5</span></a> The pathophysiology is not totally clear; it has been proposed that the increased subperiostial resorption together with elastosis of the connective tissue due to chronic acidosis may debilitate the ostetendinous junction favoring the STR.<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">6–8</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">STR affecting extensor knee required urgent or immediate surgery, it has to be done within the first few days after rupture, so fibrosis and retraction of tendon and muscle are avoided. Optimal results require immobilization and 4–6 months of rehabilitation.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">In addition to the treatment of STR, it is necessary to control risk factors to prevent new STR. Therefore SHPT should be treated, the use of calcimimetics have markedly reduced the need for parathyroidectomy. In patients with STR and persistent hyperparathyroidism, parathyroidectomy is reccomended.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">In conclusion, STR in CKD patients usually affect the knee extensor tendons; it is more frequent in young males with more than nine years in hemodialysis and the main predisposing factor is SHPT. Quick surgical treatment, rehabilitation and treatment of SHPT allows patient's recovery and prevents long term re-occurrence.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Ruiz J, Ríos A, Rodríguez JM, Llorente S. Roturas tendinosas espontáneas en la insuficiencia renal crónica. Nefrologia. 2017;37:341–343.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">R: right; M: male; HD: hemodialysis; SHPT: secondary hyperparathyroidism; L: left; CKD: chronic renal failure; F: female.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Case 1 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Case 2 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Case 3 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Case 4 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Case 5 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Case 6 \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Age \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">34 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">57 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">57 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">53 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">49 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Gender \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">F \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">M \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">F \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">F \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">M \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">M \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Etiology CKD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Chronic pyelonephritis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Unknown etiology \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Polycystic kidneys \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Unknown etiology \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Chronic pyelonephritis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Glomerulonephritis \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Dialysis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">HD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">HD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">HD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">HD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">HD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">HD \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Dialysis vintage (years) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Risk factors \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">SHPT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">SHPT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">SHPT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">SHPT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">SHPT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">SHPT, statins \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Type of rupture \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Partial \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Total \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Total \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Total \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Total \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Total \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Body side \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Unilateral \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Unilateral \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Unilateral \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Unilateral \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Bilateral \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Bilateral \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Tendons affected \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Quadriceps \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Quadriceps \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Rotuliano \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Quadriceps \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Quadriceps \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Quadriceps (L) and patellar (R) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">PTH (pg/ml) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">541 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1000 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1400 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">730 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1187 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">950 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Calcium (mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">11.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">12.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">12.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10.2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Phosphate (mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7.4 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">CaxP \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">73.08 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">73.16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">63.44 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">68.97 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">64 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">75.48 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Alkaline phosphatase (UI/l) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">360 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">679 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1000 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">115 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">713 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">243 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1454346.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Clinical features of spontaneous tendon rupture.</p>" ] ] 1 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Case 1 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Case 2 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Case 3 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Case 4 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Case 5 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Case 6 \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Follow up (year) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Renal transplant \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes, same year of STR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes, one year after STR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes, two years after STR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes, two years after STR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Graft rejection \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Chronic, after 7 years of transplantation. On hemodialysis until end of follow up \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Chronic, after 12 years of transplantation. On hemodialysis until end of follow up \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Death at the end of follow up? \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1454347.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Clinical follow up.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Spontaneous tendon ruptures in patients with end-stage renal disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "N. Basic-Jukic" 1 => "I. Juric" 2 => "S. Racki" 3 => "P. Kes" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1159/000201792" "Revista" => array:6 [ "tituloSerie" => "Kidney Blood Press Res" "fecha" => "2009" "volumen" => "32" "paginaInicial" => "32" "paginaFinal" => "36" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19212123" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0060" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Quadriceps tendon rupture in maintenance haemodialysis patients: results of surgical treatment and analysis of risk factors" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "L.M. Malta" 1 => "V.S. Gameiro" 2 => "E.A. Sampaio" 3 => "M.E. Gouveia" 4 => "J.R. Lugon" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.injury.2014.09.008" "Revista" => array:6 [ "tituloSerie" => "Injury" "fecha" => "2014" "volumen" => "45" "paginaInicial" => "1970" "paginaFinal" => "1973" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25441174" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0065" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Spontaneous tendon ruptures in patients on chronic dialysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "N. Jones" 1 => "C.M. Kjellstrand" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Kidney Dis" "fecha" => "1996" "volumen" => "28" "paginaInicial" => "861" "paginaFinal" => "866" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8957038" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0070" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Simultaneous bilateral quadriceps tendon rupture in renal patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M.K. Shah" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clin Nephrol" "fecha" => "2002" "volumen" => "58" "paginaInicial" => "118" "paginaFinal" => "121" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12227683" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0075" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Spontaneous major tendon ruptures in patients receiving long-term hemodialysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "E. Shiota" 1 => "K. Tsuchiya" 2 => "K. Yamaoka" 3 => "O. Kawano" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Clin Orthop Relat Res" "fecha" => "2002" "volumen" => "394" "paginaInicial" => "236" "paginaFinal" => "242" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0080" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Quadriceps tendon ruptures in uremia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R. Bhole" 1 => "J.C. Flynn" 2 => "T.C. Marbury" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Clin Orthop Relat Res" "fecha" => "1985" "volumen" => "195" "paginaInicial" => "200" "paginaFinal" => "206" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0085" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Spontaneous rupture of the quadriceps tendon in patients on maintenance hemodialysis – report of three cases with clinicopathological observations" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Ryuzaki" 1 => "K. Konishi" 2 => "A. Kasuga" 3 => "H. Kumagai" 4 => "H. Suzuki" 5 => "S. Abe" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clin Nephrol" "fecha" => "1989" "volumen" => "32" "paginaInicial" => "144" "paginaFinal" => "148" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2791366" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0090" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tears of major tendons in chronic acidosis with elastosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "K.J. Murphy" 1 => "I. McPhee" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Bone Joint Surg Am" "fecha" => "1965" "volumen" => "47" "paginaInicial" => "1253" "paginaFinal" => "1258" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14337786" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0095" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acute and old ruptures of the extensor apparatus of the knee in adults (excluding knee replacement)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "D. Saragaglia" 1 => "A. Pison" 2 => "B. Rubens-Duval" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.otsr.2012.12.002" "Revista" => array:7 [ "tituloSerie" => "Orthop Traumatol Surg Res" "fecha" => "2013" "volumen" => "99" "numero" => "1 Suppl" "paginaInicial" => "S67" "paginaFinal" => "S76" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23352566" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0100" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Recomendaciones de la Sociedad Española de Nefrología para el manejo de las alteraciones del metabolismo óseo-mineral en los pacientes con enfermedad renal crónica (S.E.N.-M.M.)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.V. Torregrosa" 1 => "J. Bover" 2 => "J. Cannata Andía" 3 => "V. Lorenzo" 4 => "A.L. de Francisco" 5 => "I. Martínez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3265/Nefrologia.pre2011.Jan.10816" "Revista" => array:7 [ "tituloSerie" => "Nefrología" "fecha" => "2011" "volumen" => "31" "numero" => "Suppl 1" "paginaInicial" => "3" "paginaFinal" => "32" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21468161" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/20132514/0000003700000003/v1_201707070022/S2013251417300962/v1_201707070022/en/main.assets" "Apartado" => array:4 [ "identificador" => "35436" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/20132514/0000003700000003/v1_201707070022/S2013251417300962/v1_201707070022/en/main.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251417300962?idApp=UINPBA000064" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 23 | 8 | 31 |
| 2024 October | 127 | 29 | 156 |
| 2024 September | 99 | 20 | 119 |
| 2024 August | 132 | 63 | 195 |
| 2024 July | 128 | 24 | 152 |
| 2024 June | 107 | 43 | 150 |
| 2024 May | 139 | 31 | 170 |
| 2024 April | 91 | 35 | 126 |
| 2024 March | 74 | 32 | 106 |
| 2024 February | 60 | 36 | 96 |
| 2024 January | 105 | 27 | 132 |
| 2023 December | 82 | 28 | 110 |
| 2023 November | 116 | 59 | 175 |
| 2023 October | 126 | 37 | 163 |
| 2023 September | 124 | 35 | 159 |
| 2023 August | 108 | 34 | 142 |
| 2023 July | 94 | 34 | 128 |
| 2023 June | 98 | 33 | 131 |
| 2023 May | 95 | 45 | 140 |
| 2023 April | 78 | 14 | 92 |
| 2023 March | 81 | 24 | 105 |
| 2023 February | 105 | 19 | 124 |
| 2023 January | 85 | 29 | 114 |
| 2022 December | 101 | 30 | 131 |
| 2022 November | 73 | 46 | 119 |
| 2022 October | 92 | 33 | 125 |
| 2022 September | 67 | 43 | 110 |
| 2022 August | 78 | 55 | 133 |
| 2022 July | 83 | 46 | 129 |
| 2022 June | 74 | 34 | 108 |
| 2022 May | 139 | 33 | 172 |
| 2022 April | 107 | 61 | 168 |
| 2022 March | 153 | 60 | 213 |
| 2022 February | 145 | 46 | 191 |
| 2022 January | 166 | 44 | 210 |
| 2021 December | 113 | 41 | 154 |
| 2021 November | 135 | 36 | 171 |
| 2021 October | 130 | 49 | 179 |
| 2021 September | 86 | 42 | 128 |
| 2021 August | 103 | 56 | 159 |
| 2021 July | 101 | 36 | 137 |
| 2021 June | 84 | 18 | 102 |
| 2021 May | 101 | 49 | 150 |
| 2021 April | 207 | 64 | 271 |
| 2021 March | 144 | 50 | 194 |
| 2021 February | 119 | 22 | 141 |
| 2021 January | 84 | 22 | 106 |
| 2020 December | 81 | 15 | 96 |
| 2020 November | 112 | 10 | 122 |
| 2020 October | 82 | 18 | 100 |
| 2020 September | 98 | 24 | 122 |
| 2020 August | 97 | 18 | 115 |
| 2020 July | 101 | 20 | 121 |
| 2020 June | 102 | 22 | 124 |
| 2020 May | 95 | 12 | 107 |
| 2020 April | 87 | 19 | 106 |
| 2020 March | 99 | 17 | 116 |
| 2020 February | 110 | 22 | 132 |
| 2020 January | 123 | 20 | 143 |
| 2019 December | 85 | 23 | 108 |
| 2019 November | 90 | 24 | 114 |
| 2019 October | 117 | 20 | 137 |
| 2019 September | 112 | 42 | 154 |
| 2019 August | 66 | 18 | 84 |
| 2019 July | 60 | 26 | 86 |
| 2019 June | 76 | 24 | 100 |
| 2019 May | 82 | 20 | 102 |
| 2019 April | 126 | 52 | 178 |
| 2019 March | 89 | 31 | 120 |
| 2019 February | 55 | 28 | 83 |
| 2019 January | 84 | 15 | 99 |
| 2018 December | 183 | 39 | 222 |
| 2018 November | 296 | 17 | 313 |
| 2018 October | 189 | 26 | 215 |
| 2018 September | 94 | 40 | 134 |
| 2018 August | 79 | 17 | 96 |
| 2018 July | 80 | 16 | 96 |
| 2018 June | 82 | 22 | 104 |
| 2018 May | 83 | 21 | 104 |
| 2018 April | 158 | 12 | 170 |
| 2018 March | 125 | 22 | 147 |
| 2018 February | 138 | 5 | 143 |
| 2018 January | 82 | 9 | 91 |
| 2017 December | 114 | 5 | 119 |
| 2017 November | 59 | 15 | 74 |
| 2017 October | 48 | 8 | 56 |
| 2017 September | 72 | 23 | 95 |
| 2017 August | 78 | 10 | 88 |
| 2017 July | 67 | 19 | 86 |
| 2017 June | 49 | 9 | 58 |
Show all
