Dr. Joffre Pérez Pereira / Cirujano Ortopedista. Valencia, Venezuela. Tel.+58 412 656 9400
Evaluar con criterio.
Operar solo cuando aporta beneficios reales.
Cadera · Rodilla · Pelvis · Fracturas complejas.
Más de 25 años de experiencia. Manejo basado en evidencia, con decisiones tomadas con calma y junto a la familia.
Evaluar con criterio.
Operar solo cuando aporta beneficios reales.
Cadera · Rodilla · Pelvis · Fracturas complejas.
Dr. Joffre Pérez Pereira
Cirujano ortopedista con trayectoria en trauma y reconstrucción.
Dr. Joffre Pérez Pereira
Cirujano ortopedista con trayectoria en trauma y reconstrucción.
Especialista en cadera, rodilla, pelvis y fracturas complejas
Especialista en:
cadera, rodilla, pelvis y fracturas complejas
Más de dos décadas de práctica clínica y académica, con énfasis en evaluación precisa y cirugía de abordaje reducido solo cuando ofrece beneficios reales.
Más de dos décadas de práctica clínica y académica, con énfasis en evaluación precisa y cirugía de abordaje reducido solo cuando ofrece beneficios reales.
Cada decisión se toma con calma y junto a la familia.
Cada decisión se toma con calma y junto a la familia.
Principios de atención
Principios de atención
Criterio
Criterio sustentado en evidencia, técnicas actuales y práctica acumulada.
Criterio sustentado en evidencia, técnicas actuales y práctica acumulada.
Claridad
Comunicación clínica precisa, con información clara y suficiente para tomar decisiones
Comunicación clínica precisa, con información clara y suficiente para tomar decisiones
Orientación
Indicación quirúrgica estricta, basada en criterios objetivos y evidencia actualizada.
Indicación quirúrgica estricta, basada en criterios objetivos y evidencia actualizada.
Ética
Seguimiento estructurado y manejo de expectativas basado en escenarios clínicos reales.
Seguimiento estructurado y manejo de expectativas basado en escenarios clínicos reales.
Criterio
Criterio sustentado en evidencia, técnicas actuales y práctica acumulada.
Claridad
Comunicación clínica precisa, con información clara y suficiente para tomar decisiones
Orientación
Indicación quirúrgica estricta, basada en criterios objetivos y evidencia actualizada.
Ética
Seguimiento estructurado y manejo de expectativas basado en escenarios clínicos reales.
Enfoque escalonado
Un proceso claro para tomar decisiones seguras
Enfoque escalonado
Un proceso claro para tomar decisiones seguras
Opciones de tratamiento según tu diagnóstico
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Evaluación clínica completa / Tratamiento conservador
Evaluación clínica completa / Tratamiento conservador
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Prótesis y reemplazos articulares / Solo si es la indicación correcta
Prótesis y reemplazos articulares / Solo si es la indicación correcta
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Cirugía mínimamente invasiva / Manejo basado en evidencia
Cirugía mínimamente invasiva / Manejo basado en evidencia
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Rehabilitación y seguimiento a lo largo de todo el proceso.
Rehabilitación y seguimiento a lo largo de todo el proceso.
“El dolor no es parte normal del envejecimiento. Siempre hay algo que se puede hacer.”
El dolor no es parte normal del envejecimiento. Siempre hay algo que se puede hacer.
¿A quién ayuda?
¿A quién ayuda?
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57.194 20.646 57.067 C 20.646 56.943 19.342 54.35 18.832 53.461 C 18.627 53.102 17.71 51.509 16.796 49.92 C 15.88 48.331 15.073 46.874 15 46.68 C 14.863 46.313 15.298 45.448 15.62 45.448 C 15.718 45.448 16.347 45.197 17.016 44.889 C 17.687 44.581 18.27 44.33 18.311 44.33 C 18.353 44.33 18.917 44.089 19.563 43.793 C 20.21 43.497 21.661 42.864 22.786 42.385 C 23.912 41.907 25.012 41.427 25.23 41.32 C 26.002 40.938 27.029 42.18 26.685 43.079 C 26.633 43.212 25.983 43.624 25.241 43.991 L 23.889 44.66 L 22.727 47.803 C 22.088 49.531 21.451 51.297 21.313 51.727 L 21.061 52.51 L 22.815 55.71 C 23.781 57.471 25.033 59.7 25.6 60.664 C 26.862 62.811 27.596 64.422 27.899 65.713 C 28.092 66.538 28.207 66.71 28.622 66.802 C 28.893 66.862 29.868 67.108 30.789 67.348 C 34.95 68.433 37.986 68.926 40.513 68.926 C 42.805 68.926 43.629 68.812 46.051 68.157 C 47.631 67.731 47.549 67.843 47.802 65.73 C 48.192 62.451 49.137 59.496 51.875 52.995 C 52.743 50.931 53.608 49.205 53.89 48.971 C 54.289 48.639 55.074 48.716 55.485 49.126 C 55.831 49.474 55.86 49.823 55.947 54.693 C 56.053 60.629 56.185 61.42 57.272 62.629 C 57.652 63.051 59.135 64.38 60.568 65.583 C 62.002 66.785 63.509 68.061 63.918 68.42 L 64.662 69.071 L 65.314 68.3 C 65.673 67.876 66.204 67.309 66.496 67.039 Z M 20.319 47.829 C 20.691 46.781 20.967 45.894 20.93 45.857 C 20.821 45.747 18.048 47.019 18.044 47.18 C 18.039 47.394 19.402 49.734 19.532 49.734 C 19.592 49.734 19.946 48.877 20.319 47.829 Z M 46.888 40.734 C 47.35 40.518 48.302 39.921 49.005 39.409 C 50.417 38.378 50.444 38.473 48.563 37.901 C 48.001 37.729 46.828 37.247 45.958 36.827 C 43.8 35.788 41.704 33.713 40.645 31.566 C 39.965 30.19 39.868 30.078 39.375 30.113 C 39.081 30.135 38.801 30.192 38.752 30.241 C 38.703 30.29 38.88 31.188 39.143 32.237 C 40.007 35.674 41.655 38.374 44.101 40.359 C 45.406 41.419 45.427 41.422 46.888 40.734 Z M 56.008 35.908 C 61.05 34.72 64.17 29.706 65.608 20.483 C 66.02 17.841 65.896 13.883 65.34 11.87 C 64.703 9.575 63.746 7.919 62.057 6.202 C 60.474 4.591 59.336 3.894 57.014 3.115 C 55.882 2.736 55.386 2.686 52.844 2.698 C 50.184 2.71 49.844 2.751 48.47 3.231 C 46.864 3.793 44.841 4.79 44.841 5.022 C 44.841 5.1 45.283 5.414 45.824 5.719 C 49.067 7.552 49.66 10.673 47.639 15.262 C 46.132 18.682 45.15 19.962 43.841 20.208 C 42.837 20.397 42.586 20.268 41.833 19.175 C 41.446 18.611 40.948 18.004 40.73 17.824 C 40.297 17.468 39.245 17.392 38.71 17.679 C 37.856 18.137 37.425 20.763 38.015 21.906 C 38.403 22.656 39.291 23.398 39.986 23.55 C 40.752 23.719 40.863 23.909 41.189 25.637 C 42.313 31.564 45.847 35.31 51.083 36.121 C 52.324 36.313 54.734 36.208 56.008 35.908 Z M 56.921 31.02 C 55.356 29.523 53.515 29.404 51.499 30.666 C 50.297 31.419 49.308 31.179 49.308 30.134 C 49.308 29.729 49.505 29.468 50.192 28.96 C 51.781 27.787 54.103 27.421 56.13 28.024 C 58.311 28.672 59.821 30.611 58.881 31.553 C 58.397 32.038 57.823 31.882 56.921 31.02 Z M 60.829 24.187 C 59.943 23.236 60.191 21.962 61.358 21.473 C 62.01 21.199 62.102 21.203 62.707 21.528 C 63.583 21.999 63.935 22.745 63.631 23.481 C 63.078 24.818 61.733 25.156 60.829 24.187 Z M 52.27 22.849 C 50.941 21.827 51.554 19.734 53.183 19.734 C 54.709 19.734 55.411 21.324 54.41 22.514 C 54.031 22.966 53.783 23.087 53.246 23.082 C 52.872 23.079 52.432 22.975 52.27 22.849 Z M 62.429 19.657 C 60.812 18.774 60.346 18.227 60.543 17.442 C 60.741 16.651 61.402 16.611 62.659 17.314 C 64.451 18.315 64.942 18.756 64.942 19.36 C 64.942 19.829 64.39 20.493 64.017 20.474 C 63.963 20.472 63.248 20.104 62.429 19.657 Z M 52.286 18.004 C 51.72 17.807 51.628 17.688 51.578 17.091 C 51.505 16.21 51.815 16.035 53.833 15.819 C 54.672 15.73 55.621 15.601 55.942 15.533 C 56.86 15.34 57.641 16.319 57.166 17.067 C 56.965 17.382 56.081 17.694 54.891 17.87 C 54.329 17.953 53.659 18.068 53.403 18.126 C 53.147 18.183 52.645 18.129 52.286 18.004 Z M 44.054 17.079 C 44.268 16.813 45.597 13.564 46.037 12.227 C 46.83 9.819 45.856 8.098 43.439 7.636 C 42.315 7.42 42.235 7.497 41.027 9.952 C 40.245 11.539 39.345 14.578 39.555 14.918 C 39.608 15.005 39.878 15.078 40.153 15.079 C 40.949 15.086 42.122 15.714 42.89 16.545 C 43.661 17.379 43.771 17.429 44.054 17.079 Z M 7.99 94.872 C 7.392 94.684 7.245 94.204 7.244 92.415 L 7.242 90.635 L 5.244 90.219 C 1.43 89.427 0.87 89.272 0.498 88.899 C -0.266 88.134 0.095 87.738 3.803 85.275 C 5.693 84.021 7.24 82.928 7.242 82.845 C 7.244 82.763 6.764 82.483 6.175 82.226 C 2.654 80.682 0.424 79.608 0.226 79.363 C -0.111 78.946 -0.062 77.97 0.312 77.647 C 0.605 77.394 4.525 75.886 6.099 75.419 C 6.655 75.255 6.694 75.202 6.46 74.922 C 3.389 71.246 3.084 70.769 3.377 70.124 C 3.612 69.608 4.394 69.293 4.94 69.495 C 5.389 69.661 9.021 74.002 9.558 75.014 C 10.073 75.985 9.743 76.476 8.176 77.071 C 6.734 77.618 5.876 77.942 5.058 78.248 C 4.726 78.373 4.453 78.527 4.453 78.592 C 4.453 78.658 5.899 79.423 7.664 80.294 C 10.821 81.85 10.876 81.887 10.936 82.514 C 11.007 83.268 10.922 83.346 7.524 85.579 C 6.258 86.413 5.07 87.195 4.884 87.317 C 4.382 87.65 4.78 87.842 6.763 88.221 C 8.787 88.607 9.068 88.734 9.218 89.336 C 9.282 89.589 9.394 89.796 9.468 89.796 C 9.543 89.796 10.339 88.663 11.238 87.278 C 12.398 85.493 13.002 84.729 13.318 84.65 C 13.918 84.499 14.69 85.022 14.69 85.58 C 14.69 85.958 13.488 87.959 10.196 93.057 C 9.141 94.69 8.664 95.082 7.99 94.872 Z" fill="rgb(0, 0, 0)" height="119.92094953897275px" id="mdaTRGAn9" transform="translate(6.92 0)" width="79.06678107323351px"/></svg>)
Personas mayores con dolor articular
Atención calmada, explicada paso a paso, siempre con participación de la familia.
Pacientes complejos o con cirugías previas
Análisis de imagenología, revisión del caso y decisión clara entre manejo del dolor, rehabilitación o cirugía correctiva.
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Deportistas jóvenes y adultos con exigencias fisicas
Lesiones de carga, movimientos repetitivos o dolores que no mejoran tras fisioterapia.
Adultos activos con lesiones recurrentes
Dolor que avanza con el tiempo, rigidez al levantarse, dificultad para subir o bajar escaleras o caminar.
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Hijos que buscan soluciones para sus padres
Acceso rápido, explicaciones precisas y un proceso clínico lógico: evaluación → tratamiento conservador → cirugía si está indicada → rehabilitación dirigida.
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85.818 10.708 84.604 11.198 C 79.936 13.08 76.397 13.775 71.544 13.764 C 67.282 13.753 63.738 13.21 58.94 11.832 C 58.136 11.601 56.995 11.276 56.403 11.109 C 55.329 10.806 53.959 10.337 52.6 9.809 C 52.205 9.656 51.72 9.476 51.523 9.411 C 51.326 9.345 50.616 9.086 49.944 8.836 C 49.273 8.587 48.563 8.328 48.366 8.263 C 48.168 8.196 47.652 8.004 47.218 7.834 C 45.761 7.265 39.408 5.135 38.248 4.826 C 30.643 2.806 25.873 2.36 19.375 3.06 C 15.667 3.459 13.069 4.039 9.544 5.255 C 6.736 6.224 6.573 6.289 4.502 7.244 L 2.655 8.097 L 2.61 16.619 C 2.585 21.305 2.599 25.14 2.641 25.14 C 2.683 25.14 3.575 24.728 4.623 24.225 C 5.672 23.721 7.24 23.039 8.109 22.71 C 8.977 22.379 10.01 21.988 10.405 21.838 C 12.03 21.224 16.034 20.324 18.729 19.967 C 20.55 19.726 25.713 19.724 27.699 19.963 C 32.452 20.536 38.535 22.046 43.917 23.988 C 44.824 24.316 46.116 24.774 46.787 25.008 C 47.458 25.241 48.621 25.652 49.37 25.921 C 50.945 26.487 57.288 28.545 58.771 28.973 C 62.01 29.906 66.185 30.665 69.104 30.853 C 70.921 30.969 71.429 30.962 74.414 30.78 Z" fill="rgb(0, 0, 0)" height="81.62210555483028px" id="uYe0OU1y1" transform="translate(0 0.003)" width="92.8648815474143px"/></g></svg>)
Venezolanos en el exterior que regresan para operarse
Agenda organizada, evaluación precisa y planificación para retorno seguro al país donde viven.
Personas mayores con dolor articular
Atención calmada, explicada paso a paso, siempre con participación de la familia.
Deportistas jóvenes y adultos con exigencias fisicas
Lesiones de carga, movimientos repetitivos o dolores que no mejoran tras fisioterapia.
Hijos que buscan soluciones para sus padres
Acceso rápido, explicaciones precisas y un proceso clínico lógico: evaluación → tratamiento conservador → cirugía si está indicada → rehabilitación dirigida.
Pacientes complejos o con cirugías previas
Análisis de imagenología, revisión del caso y decisión clara entre manejo del dolor, rehabilitación o cirugía correctiva.
Adultos activos con lesiones recurrentes
Dolor que avanza con el tiempo, rigidez al levantarse, dificultad para subir o bajar escaleras o caminar.
Venezolanos en el exterior que regresan para operarse
Agenda organizada, evaluación precisa y planificación para retorno seguro al país donde viven.
Personas mayores con dolor articular
Atención calmada, explicada paso a paso, siempre con participación de la familia.
Pacientes complejos o con cirugías previas
Análisis de imagenología, revisión del caso y decisión clara entre manejo del dolor, rehabilitación o cirugía correctiva.
Deportistas jóvenes y adultos con exigencias fisicas
Lesiones de carga, movimientos repetitivos o dolores que no mejoran tras fisioterapia.
Adultos activos con lesiones recurrentes
Dolor que avanza con el tiempo, rigidez al levantarse, dificultad para subir o bajar escaleras o caminar.
Hijos que buscan soluciones para sus padres
Acceso rápido, explicaciones precisas y un proceso clínico lógico: evaluación → tratamiento conservador → cirugía si está indicada → rehabilitación dirigida.
Venezolanos en el exterior que regresan para operarse
Agenda organizada, evaluación precisa y planificación para retorno seguro al país donde viven.
Participación continua en congresos, sociedades y publicaciones científicas.
Participación continua en congresos, sociedades y publicaciones científicas.
Docencia y actividad académica
Miembro y conferencista en sociedades y congresos internacionales
Miembro y conferencista en sociedades y congresos internacionales
• Faculty AO Trauma.
• Faculty AO Trauma.
• Faculty AO Trauma.
• Conferencista en SVCOT, TraumaUnit y congresos internacionales.
• Conferencista en SVCOT, TraumaUnit y congresos internacionales.
• Conferencista en SVCOT, TraumaUnit y congresos internacionales.
• Publicaciones en Injury (Elsevier).
• Publicaciones en Injury (Elsevier).
• Publicaciones en Injury (Elsevier).
• Participación continua en cursos y simposios de trauma y reconstrucción.
• Participación continua en cursos y simposios de trauma y reconstrucción.
• Participación continua en cursos y simposios de trauma y reconstrucción.
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37.19 31.35 37.048 31.589 36.534 C 31.755 36.179 31.89 35.872 31.89 35.85 C 31.89 35.829 32.042 35.489 32.229 35.094 C 32.414 34.702 32.595 34.307 32.772 33.911 C 33.072 33.229 33.082 33.217 33.375 33.191 C 33.673 33.165 33.749 33.231 33.897 33.64 C 33.952 33.79 34.024 33.981 34.057 34.066 C 34.091 34.151 34.177 34.395 34.248 34.608 C 34.32 34.821 34.409 35.065 34.446 35.15 C 34.482 35.235 34.589 35.531 34.684 35.808 C 34.778 36.084 34.916 36.485 34.99 36.698 C 35.092 36.993 35.181 37.111 35.367 37.196 C 35.514 37.264 35.602 37.357 35.588 37.429 C 35.569 37.529 35.401 37.553 34.616 37.571 C 33.797 37.59 33.661 37.576 33.619 37.466 C 33.562 37.317 33.712 37.204 33.97 37.202 C 34.144 37.201 34.152 37.181 34.102 36.872 C 34.073 36.691 34.016 36.51 33.976 36.47 C 33.936 36.429 33.903 36.334 33.903 36.257 C 33.903 36.132 33.823 36.117 33.142 36.117 C 32.298 36.117 32.393 36.06 32.092 36.748 C 31.925 37.128 31.935 37.201 32.151 37.201 C 32.358 37.201 32.549 37.383 32.473 37.507 C 32.418 37.596 31.021 37.622 30.935 37.536 Z M 33.67 35.54 C 33.67 35.495 33.378 34.685 33.258 34.398 C 33.173 34.193 33.165 34.201 32.932 34.764 C 32.801 35.081 32.67 35.364 32.64 35.393 C 32.504 35.529 32.628 35.575 33.129 35.575 C 33.427 35.575 33.67 35.56 33.67 35.54 Z M 35.889 37.536 C 35.762 37.409 35.861 37.281 36.128 37.232 C 36.288 37.203 36.444 37.14 36.475 37.093 C 36.543 36.991 36.552 34.064 36.485 33.814 C 36.452 33.687 36.381 33.64 36.225 33.64 C 35.945 33.64 35.78 33.454 35.915 33.292 C 35.995 33.196 36.277 33.176 37.547 33.176 C 39.314 33.176 39.265 33.155 39.234 33.911 C 39.214 34.405 39.161 34.517 38.963 34.48 C 38.863 34.461 38.795 34.35 38.745 34.122 C 38.664 33.759 38.662 33.758 37.908 33.683 L 37.463 33.639 L 37.463 35.188 L 37.758 35.188 C 38.12 35.188 38.299 35.066 38.38 34.763 C 38.422 34.607 38.491 34.53 38.591 34.53 C 38.728 34.53 38.742 34.599 38.76 35.343 C 38.771 35.791 38.748 36.205 38.71 36.264 C 38.612 36.415 38.392 36.311 38.392 36.115 C 38.392 35.769 38.255 35.653 37.847 35.653 L 37.463 35.653 L 37.463 36.384 C 37.463 36.785 37.489 37.128 37.521 37.144 C 37.553 37.16 37.879 37.158 38.245 37.141 L 38.911 37.108 L 39.097 36.71 C 39.328 36.213 39.505 36.183 39.538 36.635 C 39.551 36.813 39.523 37.101 39.477 37.273 L 39.392 37.588 L 37.666 37.588 C 36.718 37.588 35.918 37.565 35.889 37.536 Z M 40.197 37.464 C 40.141 37.319 40.293 37.204 40.542 37.202 C 40.818 37.2 40.87 36.921 40.86 35.474 C 40.848 33.841 40.822 33.687 40.545 33.655 C 40.3 33.627 40.137 33.456 40.2 33.293 C 40.237 33.197 40.427 33.176 41.273 33.176 C 43.551 33.176 44.513 33.652 44.796 34.918 C 44.956 35.636 44.59 36.632 44.001 37.082 C 43.443 37.507 43.057 37.588 41.584 37.588 C 40.427 37.588 40.238 37.571 40.197 37.464 Z M 42.959 37.023 C 43.455 36.793 43.888 36.012 43.888 35.347 C 43.888 34.371 43.078 33.64 41.997 33.64 L 41.717 33.64 L 41.738 35.362 L 41.759 37.083 L 41.991 37.133 C 42.272 37.193 42.696 37.144 42.959 37.023 Z M 45.397 37.51 C 45.318 37.382 45.426 37.287 45.75 37.2 L 46.058 37.117 L 46.037 35.398 L 46.016 33.679 L 45.771 33.655 C 45.454 33.624 45.3 33.456 45.438 33.29 C 45.518 33.193 45.716 33.176 46.55 33.193 L 47.564 33.215 L 47.564 33.408 C 47.564 33.566 47.521 33.606 47.332 33.628 C 47.205 33.643 47.074 33.695 47.043 33.744 C 47.012 33.794 46.986 34.548 46.986 35.421 C 46.986 36.294 47.012 37.048 47.043 37.097 C 47.074 37.146 47.205 37.199 47.332 37.213 C 47.504 37.233 47.571 37.285 47.589 37.414 C 47.614 37.587 47.61 37.588 46.529 37.588 C 45.89 37.588 45.425 37.556 45.397 37.51 Z M 64.878 37.414 C 64.897 37.281 64.961 37.234 65.154 37.215 C 65.351 37.196 65.418 37.146 65.464 36.983 C 65.54 36.712 65.537 34.304 65.46 33.935 C 65.408 33.686 65.37 33.647 65.152 33.626 C 64.944 33.606 64.903 33.57 64.903 33.408 L 64.903 33.215 L 66.102 33.217 C 66.863 33.218 67.429 33.257 67.649 33.322 C 68.119 33.46 68.502 33.87 68.502 34.235 C 68.502 34.636 68.228 35.066 67.834 35.282 C 67.504 35.463 67.499 35.473 67.634 35.619 C 67.79 35.787 68.38 36.557 68.618 36.901 C 68.703 37.025 68.877 37.154 69.005 37.187 C 69.16 37.229 69.246 37.305 69.262 37.418 C 69.286 37.581 69.261 37.588 68.665 37.588 L 68.043 37.588 L 67.718 37.104 C 67.341 36.543 66.633 35.626 66.548 35.589 C 66.407 35.526 66.51 35.354 66.741 35.267 C 67.377 35.028 67.573 34.813 67.573 34.354 C 67.573 34.005 67.101 33.64 66.648 33.64 L 66.409 33.64 L 66.43 35.401 L 66.451 37.162 L 66.658 37.186 C 66.89 37.213 67.071 37.385 66.994 37.507 C 66.964 37.557 66.542 37.588 65.899 37.588 C 64.859 37.588 64.853 37.587 64.878 37.414 Z M 74.36 37.538 C 74.234 37.412 74.328 37.289 74.597 37.226 L 74.888 37.157 L 74.926 36.347 C 74.983 35.165 74.924 33.711 74.82 33.68 C 74.772 33.665 74.637 33.632 74.52 33.607 C 74.282 33.555 74.223 33.302 74.429 33.223 C 74.497 33.197 75.227 33.176 76.053 33.176 C 77.781 33.176 77.666 33.116 77.62 33.992 C 77.599 34.4 77.577 34.456 77.426 34.478 C 77.291 34.496 77.244 34.454 77.207 34.284 C 77.103 33.797 77.036 33.718 76.728 33.717 C 76.533 33.714 76.338 33.697 76.145 33.668 L 75.855 33.62 L 75.855 35.188 L 76.184 35.187 C 76.597 35.186 76.662 35.142 76.779 34.782 C 76.845 34.578 76.918 34.492 77.025 34.492 C 77.167 34.492 77.175 34.543 77.154 35.401 C 77.136 36.149 77.112 36.311 77.016 36.311 C 76.95 36.311 76.853 36.174 76.789 35.988 C 76.678 35.67 76.671 35.665 76.266 35.64 L 75.855 35.614 L 75.855 37.22 L 76.097 37.172 C 76.23 37.145 76.56 37.123 76.83 37.123 L 77.322 37.123 L 77.519 36.692 C 77.663 36.378 77.752 36.268 77.85 36.288 C 77.955 36.308 77.981 36.389 77.974 36.661 C 77.968 36.851 77.932 37.129 77.893 37.278 L 77.823 37.549 L 76.118 37.57 C 75.18 37.581 74.389 37.567 74.36 37.538 Z M 28.495 30.147 C 27.464 29.976 26.852 29.393 26.666 28.405 C 26.562 27.852 26.648 27.235 26.895 26.758 C 27.098 26.365 27.73 25.867 28.183 25.745 C 28.625 25.624 29.743 25.616 30.149 25.73 L 30.381 25.795 L 30.403 26.467 C 30.424 27.095 30.415 27.138 30.27 27.138 C 30.096 27.138 29.956 26.928 29.953 26.66 C 29.949 26.387 29.783 26.224 29.427 26.144 C 28.84 26.012 28.165 26.259 27.895 26.704 C 27.531 27.305 27.465 28.012 27.709 28.688 C 27.992 29.47 28.568 29.791 29.454 29.658 C 29.857 29.598 30.045 29.428 30.188 28.994 C 30.265 28.761 30.33 28.686 30.458 28.686 C 30.55 28.686 30.643 28.703 30.663 28.724 C 30.721 28.782 30.523 29.853 30.439 29.937 C 30.365 30.01 29.254 30.236 29.026 30.223 C 28.962 30.219 28.723 30.185 28.495 30.147 Z M 52.209 30.106 C 51.518 29.958 51.066 29.639 50.748 29.075 C 50.527 28.681 50.509 28.597 50.518 27.952 C 50.526 27.375 50.56 27.188 50.72 26.867 C 51.191 25.927 52.184 25.497 53.492 25.666 C 53.807 25.707 54.11 25.741 54.163 25.743 C 54.233 25.745 54.26 25.937 54.26 26.442 C 54.26 27.075 54.246 27.138 54.113 27.138 C 53.966 27.138 53.795 26.805 53.795 26.517 C 53.795 26.323 53.634 26.219 53.213 26.14 C 52.542 26.014 51.908 26.325 51.651 26.906 C 51.424 27.418 51.373 27.827 51.476 28.32 C 51.585 28.844 51.788 29.205 52.121 29.467 C 52.562 29.813 53.792 29.719 53.92 29.329 C 54.079 28.849 54.199 28.678 54.362 28.701 C 54.544 28.727 54.547 28.755 54.448 29.513 C 54.388 29.976 54.314 30.025 53.486 30.155 C 52.876 30.25 52.883 30.25 52.209 30.106 Z M 85.956 30.119 C 85.374 29.989 85.093 29.846 84.78 29.522 C 84.391 29.119 84.215 28.617 84.215 27.912 C 84.215 27.2 84.37 26.768 84.796 26.297 C 85.601 25.405 87.541 25.407 88.359 26.301 C 88.754 26.731 88.937 27.236 88.935 27.897 C 88.933 28.87 88.526 29.586 87.773 29.942 C 87.552 30.046 86.615 30.25 86.459 30.228 C 86.438 30.225 86.211 30.176 85.956 30.119 Z M 86.932 29.682 C 87.287 29.564 87.579 29.278 87.785 28.849 C 87.994 28.414 88.017 27.418 87.829 26.983 C 87.287 25.731 85.815 25.773 85.297 27.057 C 85.166 27.381 85.159 28.578 85.287 28.706 C 85.336 28.755 85.376 28.853 85.376 28.923 C 85.376 29.086 85.823 29.528 86.12 29.659 C 86.407 29.786 86.605 29.791 86.932 29.682 Z M 9.233 30.065 C 9.189 30.009 9.107 29.824 9.05 29.654 C 8.993 29.484 8.919 29.312 8.886 29.271 C 8.852 29.231 8.824 29.134 8.824 29.057 C 8.824 28.98 8.792 28.856 8.753 28.783 C 8.713 28.708 8.587 28.404 8.471 28.106 C 8.356 27.808 8.188 27.407 8.098 27.216 L 7.934 26.867 L 7.913 28.173 C 7.899 29.01 7.921 29.514 7.973 29.578 C 8.019 29.632 8.178 29.7 8.329 29.728 C 8.529 29.765 8.595 29.814 8.576 29.91 C 8.554 30.025 8.433 30.041 7.623 30.041 C 6.85 30.041 6.695 30.022 6.695 29.925 C 6.695 29.861 6.815 29.771 6.96 29.723 C 7.107 29.676 7.25 29.572 7.279 29.491 C 7.309 29.41 7.349 28.639 7.367 27.777 L 7.402 26.209 L 7.145 26.116 C 6.984 26.058 6.889 25.972 6.889 25.885 C 6.889 25.76 6.969 25.745 7.665 25.745 C 8.526 25.745 8.421 25.683 8.679 26.345 C 8.716 26.441 8.778 26.598 8.817 26.693 C 8.855 26.789 8.981 27.112 9.097 27.409 C 9.212 27.707 9.334 28.021 9.367 28.106 C 9.4 28.191 9.471 28.376 9.524 28.516 C 9.577 28.657 9.646 28.744 9.677 28.71 C 9.707 28.676 9.88 28.265 10.06 27.796 C 10.24 27.328 10.433 26.841 10.487 26.713 C 10.541 26.585 10.631 26.359 10.685 26.21 C 10.854 25.751 10.867 25.745 11.742 25.745 C 12.47 25.745 12.548 25.759 12.525 25.881 C 12.509 25.963 12.386 26.044 12.21 26.088 L 11.92 26.159 L 11.92 27.89 C 11.92 29.206 11.943 29.627 12.017 29.65 C 12.119 29.679 12.222 29.704 12.326 29.726 C 12.472 29.758 12.539 29.822 12.539 29.927 C 12.539 30.072 12.484 30.08 11.453 30.08 C 10.529 30.08 10.36 30.062 10.319 29.956 C 10.264 29.812 10.415 29.696 10.659 29.694 C 10.945 29.692 10.992 29.466 10.985 28.131 C 10.982 27.436 10.962 26.92 10.94 26.984 C 10.898 27.111 10.647 27.736 10.489 28.106 C 10.398 28.325 10.307 28.544 10.218 28.764 C 9.71 30.022 9.66 30.115 9.473 30.142 C 9.385 30.154 9.278 30.119 9.233 30.065 Z M 40.19 30.106 C 40.137 30.084 39.982 29.904 39.847 29.705 C 39.713 29.507 39.582 29.327 39.556 29.306 C 39.531 29.284 39.32 29.006 39.087 28.686 C 38.853 28.367 38.588 28.019 38.496 27.912 C 38.282 27.66 38.069 27.406 37.857 27.151 L 37.386 26.583 L 37.387 28.003 C 37.388 28.783 37.418 29.469 37.454 29.526 C 37.491 29.584 37.639 29.655 37.782 29.684 C 37.972 29.723 38.05 29.784 38.068 29.908 C 38.093 30.077 38.079 30.08 37.154 30.08 C 36.223 30.08 36.215 30.078 36.239 29.906 C 36.256 29.787 36.325 29.723 36.457 29.705 C 36.563 29.691 36.682 29.65 36.72 29.613 C 36.778 29.557 36.926 26.301 36.873 26.222 C 36.863 26.207 36.722 26.15 36.56 26.093 C 36.396 26.038 36.263 25.945 36.263 25.888 C 36.263 25.809 36.457 25.779 37.076 25.766 L 37.889 25.747 L 38.368 26.385 C 38.744 26.882 39.125 27.376 39.511 27.866 L 40.176 28.709 L 40.155 27.443 L 40.134 26.176 L 39.824 26.089 C 39.65 26.04 39.514 25.954 39.514 25.893 C 39.514 25.807 39.702 25.779 40.415 25.762 C 41.173 25.744 41.322 25.76 41.361 25.861 C 41.405 25.976 41.361 26.004 40.888 26.171 C 40.814 26.197 40.792 26.66 40.792 28.133 L 40.792 30.062 L 40.617 30.109 C 40.418 30.162 40.329 30.161 40.19 30.106 Z M 72.879 29.985 C 72.814 29.89 72.759 29.778 72.759 29.736 C 72.759 29.665 72.459 28.81 72.296 28.416 C 72.26 28.331 72.177 28.114 72.11 27.935 C 72.026 27.714 71.936 27.494 71.839 27.277 C 71.757 27.095 71.672 26.893 71.65 26.829 C 71.628 26.765 71.608 27.365 71.604 28.163 L 71.598 29.613 L 71.95 29.702 C 72.206 29.766 72.296 29.824 72.278 29.916 C 72.244 30.094 70.479 30.147 70.412 29.972 C 70.358 29.832 70.492 29.716 70.747 29.681 C 70.935 29.655 70.941 29.634 70.99 28.841 C 71.017 28.394 71.052 27.612 71.067 27.104 L 71.095 26.179 L 70.843 26.106 C 70.676 26.057 70.592 25.985 70.592 25.889 C 70.592 25.758 70.664 25.745 71.368 25.745 C 72.141 25.745 72.143 25.746 72.23 25.958 C 72.453 26.505 72.516 26.667 72.679 27.1 C 72.775 27.355 72.9 27.669 72.956 27.796 C 73.011 27.924 73.103 28.177 73.159 28.357 C 73.285 28.763 73.393 28.775 73.526 28.396 C 73.583 28.236 73.68 27.984 73.743 27.835 C 73.88 27.513 73.898 27.47 74.28 26.501 L 74.578 25.747 L 75.416 25.746 C 76.159 25.746 76.251 25.76 76.228 25.875 C 76.215 25.947 76.106 26.032 75.986 26.064 C 75.543 26.182 75.546 26.172 75.546 27.913 C 75.546 29.649 75.548 29.658 75.971 29.705 C 76.143 29.725 76.21 29.777 76.228 29.906 C 76.253 30.08 76.251 30.08 75.125 30.08 C 74.065 30.08 73.998 30.071 73.998 29.932 C 73.998 29.826 74.071 29.767 74.249 29.729 C 74.692 29.634 74.694 29.629 74.692 28.232 C 74.691 27.083 74.679 26.97 74.585 27.178 C 74.333 27.734 74.23 27.978 74.23 28.022 C 74.23 28.048 74.156 28.234 74.067 28.436 C 73.99 28.609 73.915 28.783 73.843 28.958 C 73.532 29.736 73.427 29.978 73.36 30.061 C 73.239 30.211 73.012 30.175 72.879 29.985 Z M 0 29.921 C 0 29.813 0.077 29.736 0.241 29.678 C 0.44 29.609 0.533 29.484 0.783 28.949 C 0.948 28.593 1.084 28.285 1.084 28.265 C 1.084 28.244 1.174 28.025 1.285 27.779 C 1.396 27.533 1.515 27.262 1.55 27.177 C 1.584 27.092 1.699 26.831 1.803 26.597 C 1.976 26.211 2.144 25.822 2.319 25.397 C 2.439 25.108 2.793 24.314 2.889 24.12 C 2.959 23.977 3.056 23.921 3.253 23.906 C 3.401 23.895 3.557 23.912 3.602 23.945 C 3.645 23.977 3.827 24.439 4.004 24.971 C 4.457 26.324 5.233 28.573 5.277 28.656 C 5.297 28.694 5.361 28.882 5.418 29.073 C 5.551 29.514 5.608 29.588 5.866 29.653 C 6.102 29.712 6.196 29.824 6.138 29.976 C 6.107 30.057 5.838 30.08 4.945 30.08 L 3.793 30.08 L 3.793 29.887 C 3.793 29.722 3.837 29.688 4.109 29.644 C 4.283 29.616 4.445 29.544 4.468 29.483 C 4.523 29.339 4.365 28.795 4.076 28.125 L 3.95 27.835 L 2.952 27.835 C 2.245 27.835 1.932 27.863 1.88 27.932 C 1.777 28.063 1.238 29.376 1.238 29.493 C 1.238 29.544 1.387 29.618 1.567 29.659 C 1.822 29.715 1.902 29.771 1.921 29.906 C 1.945 30.078 1.938 30.08 0.973 30.08 C 0.044 30.08 0 30.073 0 29.921 Z M 3.793 27.205 C 3.793 27.121 3.304 25.636 3.172 25.319 C 3.137 25.235 3.093 25.113 3.076 25.048 C 3.059 24.985 2.966 25.142 2.871 25.397 C 2.776 25.653 2.644 25.983 2.579 26.132 C 2.518 26.273 2.459 26.415 2.403 26.558 C 2.37 26.643 2.287 26.843 2.218 27.003 L 2.092 27.293 L 2.943 27.293 C 3.525 27.293 3.793 27.266 3.793 27.205 Z M 13.623 29.93 C 13.623 29.816 13.704 29.754 13.934 29.693 L 14.245 29.609 L 14.224 27.89 L 14.203 26.171 L 13.913 26.099 C 13.709 26.049 13.623 25.985 13.623 25.885 C 13.623 25.75 13.714 25.743 15.268 25.763 L 16.913 25.784 L 16.913 26.364 C 16.913 26.931 16.908 26.945 16.72 26.945 C 16.561 26.945 16.521 26.9 16.484 26.671 C 16.413 26.234 16.374 26.21 15.747 26.21 L 15.171 26.21 L 15.171 27.603 L 15.593 27.603 C 16.013 27.603 16.016 27.602 16.066 27.335 C 16.12 27.044 16.277 26.863 16.406 26.943 C 16.455 26.973 16.487 27.348 16.487 27.884 C 16.487 28.757 16.483 28.774 16.318 28.75 C 16.197 28.732 16.127 28.647 16.078 28.455 C 15.992 28.12 15.916 28.07 15.5 28.068 L 15.171 28.067 L 15.171 29.615 L 15.848 29.614 C 16.221 29.613 16.561 29.587 16.603 29.556 C 16.682 29.498 16.824 29.223 16.903 28.977 C 16.93 28.893 17.025 28.841 17.15 28.841 C 17.342 28.841 17.352 28.859 17.313 29.132 C 17.283 29.332 17.247 29.532 17.206 29.731 L 17.142 30.041 L 15.383 30.062 C 13.673 30.082 13.623 30.078 13.623 29.929 Z M 18.377 29.993 C 18.313 29.889 18.543 29.693 18.731 29.693 C 19.017 29.693 19.041 29.549 19.041 27.868 L 19.041 26.228 L 18.828 26.149 C 18.711 26.105 18.551 26.049 18.473 26.023 C 18.218 25.94 18.387 25.785 18.776 25.745 C 18.986 25.724 19.651 25.724 20.254 25.746 C 21.337 25.784 21.354 25.788 21.643 26.023 C 22.172 26.449 22.159 27.15 21.615 27.598 C 21.457 27.729 21.286 27.835 21.234 27.835 C 21.071 27.835 21.052 27.964 21.191 28.128 C 21.264 28.215 21.464 28.469 21.634 28.691 C 22.179 29.402 22.363 29.594 22.601 29.693 C 22.743 29.751 22.834 29.846 22.834 29.934 C 22.834 30.065 22.769 30.08 22.227 30.08 L 21.622 30.08 L 21.329 29.656 C 21.169 29.423 20.815 28.947 20.543 28.599 C 20.034 27.947 19.951 27.758 20.177 27.758 C 20.716 27.758 21.247 27.146 21.09 26.706 C 20.991 26.428 20.702 26.233 20.299 26.17 L 19.97 26.119 L 19.97 29.609 L 20.283 29.703 C 20.498 29.768 20.588 29.835 20.572 29.919 C 20.552 30.022 20.382 30.045 19.491 30.063 C 18.742 30.078 18.417 30.057 18.377 29.993 Z M 23.545 29.906 C 23.562 29.782 23.635 29.721 23.801 29.693 C 23.982 29.662 24.043 29.602 24.082 29.421 C 24.149 29.108 24.162 27.198 24.101 26.615 C 24.053 26.156 24.046 26.145 23.791 26.097 C 23.599 26.061 23.531 26.008 23.531 25.895 C 23.531 25.747 23.578 25.742 24.595 25.763 C 25.449 25.779 25.659 25.805 25.659 25.893 C 25.659 25.953 25.54 26.043 25.394 26.092 C 25.249 26.14 25.103 26.248 25.071 26.33 C 25.001 26.509 24.983 29.191 25.05 29.441 C 25.082 29.561 25.189 29.639 25.397 29.695 C 25.617 29.754 25.698 29.817 25.698 29.928 C 25.698 30.072 25.639 30.08 24.609 30.08 C 23.525 30.08 23.52 30.079 23.545 29.906 Z M 31.147 29.99 C 31.099 29.912 31.302 29.681 31.487 29.602 C 31.521 29.588 31.639 29.385 31.752 29.151 C 32.049 28.53 32.432 27.682 32.432 27.643 C 32.432 27.603 33.079 26.184 33.227 25.9 C 33.339 25.683 33.758 25.593 33.942 25.746 C 34.001 25.795 34.123 26.067 34.213 26.351 C 34.304 26.635 34.408 26.938 34.444 27.022 C 34.48 27.107 34.602 27.438 34.714 27.758 C 34.827 28.077 34.951 28.399 34.991 28.473 C 35.031 28.547 35.064 28.66 35.064 28.725 C 35.064 28.79 35.096 28.904 35.134 28.978 C 35.174 29.052 35.249 29.229 35.303 29.372 C 35.366 29.543 35.475 29.659 35.618 29.709 C 35.756 29.757 35.838 29.841 35.838 29.933 C 35.838 30.07 35.769 30.08 34.831 30.08 C 33.881 30.08 33.825 30.071 33.825 29.927 C 33.825 29.82 33.901 29.754 34.077 29.708 C 34.291 29.651 34.327 29.607 34.319 29.415 C 34.313 29.291 34.254 29.059 34.187 28.899 L 34.065 28.609 L 32.614 28.609 L 32.407 29.058 C 32.293 29.304 32.2 29.545 32.2 29.591 C 32.2 29.638 32.322 29.699 32.471 29.726 C 32.671 29.764 32.742 29.817 32.742 29.928 C 32.742 30.069 32.684 30.08 31.972 30.08 C 31.471 30.08 31.183 30.048 31.147 29.99 Z M 33.878 27.97 C 33.857 27.917 33.759 27.621 33.66 27.313 C 33.561 27.004 33.451 26.76 33.415 26.772 C 33.34 26.797 32.896 27.82 32.896 27.969 C 32.896 28.039 33.044 28.067 33.406 28.067 C 33.782 28.067 33.906 28.042 33.878 27.97 Z M 43.965 29.921 C 43.965 29.813 44.042 29.736 44.205 29.679 C 44.399 29.611 44.494 29.488 44.708 29.024 C 44.853 28.711 44.971 28.439 44.971 28.421 C 44.971 28.403 45.093 28.125 45.242 27.802 C 45.391 27.479 45.513 27.201 45.513 27.182 C 45.513 27.164 45.614 26.929 45.738 26.66 C 45.887 26.331 46.032 26.001 46.171 25.668 C 46.424 25.057 46.805 24.201 46.896 24.042 C 46.932 23.977 47.096 23.916 47.271 23.903 C 47.622 23.876 47.593 23.832 47.953 24.932 C 48.063 25.273 48.186 25.622 48.224 25.706 C 48.263 25.792 48.419 26.245 48.572 26.713 C 48.724 27.181 48.88 27.634 48.916 27.719 C 48.954 27.804 49.099 28.221 49.239 28.645 C 49.504 29.448 49.664 29.693 49.925 29.693 C 50.039 29.693 50.08 29.745 50.08 29.886 L 50.08 30.08 L 48.955 30.08 C 48.005 30.08 47.823 30.061 47.784 29.959 C 47.722 29.797 47.842 29.688 48.157 29.621 C 48.401 29.57 48.414 29.549 48.398 29.27 C 48.378 28.96 48.104 28.099 47.971 27.932 C 47.916 27.863 47.601 27.835 46.892 27.835 L 45.892 27.835 L 45.696 28.28 C 45.596 28.507 45.495 28.732 45.392 28.957 C 45.332 29.086 45.275 29.275 45.263 29.378 C 45.245 29.537 45.286 29.578 45.526 29.636 C 45.803 29.704 45.946 29.866 45.857 30.01 C 45.833 30.048 45.398 30.08 44.889 30.08 C 44.009 30.08 43.965 30.072 43.965 29.921 Z M 47.442 26.19 C 47.238 25.584 47.048 25.087 47.019 25.087 C 46.99 25.087 46.899 25.261 46.818 25.474 C 46.666 25.871 46.648 25.916 46.376 26.53 C 46.288 26.728 46.194 26.98 46.166 27.091 L 46.115 27.293 L 47.811 27.293 Z M 55.008 29.97 C 54.964 29.855 55.059 29.749 55.273 29.673 C 55.393 29.631 55.448 29.534 55.81 28.725 C 56.065 28.155 56.414 27.385 56.617 26.945 C 56.736 26.687 56.853 26.429 56.969 26.171 C 57.164 25.734 57.233 25.671 57.518 25.669 C 57.733 25.668 57.927 25.841 57.995 26.093 C 58.047 26.288 58.504 27.588 58.594 27.796 C 58.63 27.881 58.718 28.125 58.79 28.338 C 58.862 28.551 58.949 28.795 58.984 28.88 C 59.019 28.965 59.091 29.162 59.143 29.317 C 59.209 29.512 59.318 29.636 59.495 29.721 C 59.671 29.804 59.738 29.881 59.707 29.962 C 59.669 30.059 59.487 30.08 58.663 30.08 C 57.723 30.08 57.665 30.071 57.665 29.928 C 57.665 29.817 57.746 29.754 57.967 29.695 C 58.296 29.606 58.294 29.626 58.072 28.88 L 58.003 28.648 L 57.231 28.626 L 56.459 28.604 L 56.322 28.936 C 56.247 29.118 56.152 29.329 56.11 29.405 C 56.01 29.589 56.066 29.663 56.348 29.72 C 56.516 29.753 56.582 29.81 56.582 29.923 C 56.582 30.07 56.533 30.08 55.816 30.08 C 55.224 30.08 55.04 30.055 55.008 29.97 Z M 57.743 28.011 C 57.743 27.981 57.649 27.686 57.535 27.356 C 57.37 26.882 57.306 26.774 57.225 26.841 C 57.17 26.887 57.124 26.956 57.124 26.994 C 57.124 27.031 57.037 27.242 56.93 27.463 C 56.648 28.048 56.657 28.067 57.24 28.067 C 57.517 28.067 57.743 28.042 57.743 28.011 Z M 60.338 30.006 C 60.26 29.88 60.42 29.719 60.674 29.668 L 60.893 29.624 L 60.936 28.787 C 60.959 28.328 60.956 27.554 60.928 27.068 L 60.878 26.184 L 60.607 26.093 C 60.458 26.043 60.336 25.953 60.336 25.893 C 60.336 25.803 60.603 25.784 61.884 25.785 L 63.432 25.786 L 63.819 26.008 C 64.614 26.462 64.942 26.969 64.94 27.738 C 64.938 28.744 64.46 29.474 63.509 29.924 C 63.205 30.068 60.421 30.141 60.338 30.006 Z M 63.102 29.489 C 63.632 29.216 63.946 28.597 63.953 27.815 C 63.956 27.37 63.923 27.237 63.732 26.925 C 63.449 26.46 62.998 26.222 62.348 26.192 L 61.884 26.171 L 61.863 27.794 C 61.851 28.688 61.859 29.462 61.88 29.517 C 61.936 29.664 62.803 29.644 63.102 29.489 Z M 65.793 29.928 C 65.793 29.817 65.864 29.764 66.064 29.726 C 66.271 29.688 66.35 29.627 66.393 29.471 C 66.463 29.218 66.462 26.63 66.391 26.362 C 66.356 26.228 66.26 26.142 66.085 26.091 C 65.944 26.049 65.821 25.956 65.807 25.881 C 65.783 25.755 65.903 25.745 67.451 25.745 L 69.121 25.745 L 69.121 26.364 C 69.121 26.971 69.117 26.984 68.93 26.984 C 68.739 26.984 68.739 26.987 68.717 27.854 L 68.695 28.725 L 68.502 28.725 C 68.344 28.725 68.304 28.683 68.284 28.493 C 68.252 28.187 68.08 28.067 67.674 28.067 L 67.341 28.067 L 67.341 29.615 L 68.025 29.615 C 68.776 29.615 68.848 29.578 69.04 29.093 C 69.114 28.905 69.188 28.841 69.328 28.841 C 69.512 28.841 69.515 28.85 69.463 29.325 C 69.375 30.137 69.52 30.08 67.531 30.08 C 65.857 30.08 65.793 30.074 65.793 29.928 Z M 68.257 27.332 C 68.289 27.05 68.413 26.886 68.553 26.939 C 68.68 26.988 68.697 26.584 68.576 26.359 C 68.509 26.232 68.411 26.21 67.918 26.21 L 67.341 26.21 L 67.341 27.611 L 67.786 27.588 C 68.217 27.565 68.232 27.557 68.257 27.332 Z M 77.945 29.925 C 77.945 29.823 77.996 29.77 78.096 29.77 C 78.179 29.77 78.336 29.73 78.445 29.681 C 78.634 29.594 78.642 29.565 78.642 28.907 C 78.642 28.229 78.639 28.22 78.293 27.68 C 78.102 27.381 77.945 27.103 77.945 27.06 C 77.945 27.018 77.919 26.983 77.887 26.982 C 77.855 26.981 77.729 26.811 77.606 26.604 C 77.47 26.375 77.281 26.18 77.122 26.104 C 76.979 26.036 76.861 25.927 76.861 25.862 C 76.861 25.764 77.024 25.745 77.906 25.745 C 78.9 25.745 78.951 25.753 78.951 25.9 C 78.951 26.001 78.9 26.055 78.803 26.055 C 78.607 26.055 78.409 26.133 78.409 26.212 C 78.409 26.3 79.277 27.68 79.332 27.68 C 79.39 27.68 80.267 26.306 80.267 26.216 C 80.267 26.178 80.163 26.111 80.035 26.066 C 79.907 26.022 79.803 25.931 79.803 25.865 C 79.803 25.692 81.311 25.686 81.378 25.859 C 81.407 25.934 81.337 26.014 81.174 26.092 C 80.994 26.177 80.726 26.509 80.209 27.283 C 79.503 28.342 79.493 28.363 79.493 28.826 C 79.493 29.442 79.587 29.676 79.858 29.736 C 80.232 29.818 80.265 29.839 80.219 29.961 C 80.181 30.06 79.99 30.08 79.059 30.08 C 77.996 30.08 77.945 30.072 77.945 29.925 Z M 89.802 29.906 C 89.819 29.782 89.887 29.725 90.034 29.708 C 90.423 29.662 90.447 29.561 90.435 27.949 C 90.429 27.132 90.4 26.388 90.372 26.298 C 90.34 26.2 90.221 26.108 90.073 26.07 C 89.937 26.035 89.816 25.947 89.801 25.875 C 89.778 25.752 89.903 25.744 91.388 25.763 L 93 25.784 L 93 26.364 C 93 26.898 92.987 26.947 92.834 26.968 C 92.695 26.988 92.655 26.934 92.577 26.61 L 92.485 26.227 L 91.969 26.191 C 91.685 26.171 91.426 26.17 91.394 26.187 C 91.362 26.205 91.336 26.531 91.336 26.911 L 91.336 27.603 L 91.713 27.603 C 92.112 27.603 92.114 27.6 92.294 27.042 C 92.318 26.967 92.39 26.907 92.456 26.907 C 92.556 26.907 92.574 27.053 92.574 27.836 C 92.574 28.692 92.563 28.764 92.429 28.764 C 92.328 28.764 92.269 28.689 92.235 28.52 C 92.162 28.157 92.051 28.067 91.675 28.067 L 91.336 28.067 L 91.336 28.787 C 91.336 29.564 91.39 29.692 91.719 29.694 C 91.988 29.696 92.143 29.806 92.085 29.956 C 92.045 30.062 91.872 30.08 90.907 30.08 C 89.779 30.08 89.777 30.08 89.802 29.906 Z M 41.101 18.856 C 40.011 18.767 39.2 18.573 38.199 18.159 C 37.858 18.018 37.487 17.839 37.374 17.761 C 37.261 17.682 37.147 17.618 37.12 17.618 C 37.073 17.618 36.453 17.23 36.38 17.154 C 36.358 17.132 36.202 17.01 36.031 16.883 C 35.111 16.197 34.079 14.935 33.497 13.786 C 32.82 12.447 32.587 11.517 32.532 9.934 C 32.482 8.528 32.584 7.679 32.857 7.207 C 33.234 6.556 34.564 5.473 35.607 4.966 C 35.925 4.811 36.247 4.651 36.32 4.61 C 36.395 4.57 36.508 4.537 36.573 4.537 C 36.638 4.537 36.751 4.504 36.826 4.464 C 36.989 4.376 37.905 4.176 38.414 4.117 C 38.924 4.059 38.964 4.205 38.571 4.676 C 37.761 5.644 37.15 6.846 36.832 8.097 C 36.704 8.603 36.534 9.824 36.538 10.219 C 36.542 10.658 36.716 11.937 36.828 12.354 C 37.602 15.23 39.645 17.49 42.378 18.493 C 42.549 18.556 42.699 18.663 42.713 18.732 C 42.733 18.831 42.67 18.857 42.403 18.857 C 42.219 18.858 41.999 18.87 41.914 18.884 C 41.829 18.898 41.463 18.886 41.101 18.856 Z M 55.73 18.703 C 54.714 18.616 53.877 18.443 52.886 18.115 L 52.479 17.981 L 52.479 13.361 L 52.9 13.361 C 53.154 13.361 53.346 13.399 53.382 13.457 C 53.416 13.51 53.468 13.781 53.498 14.057 C 53.585 14.861 53.697 15.498 53.805 15.814 C 54.017 16.431 54.498 16.975 55.034 17.206 C 55.563 17.433 55.733 17.478 56.458 17.581 C 57.459 17.724 57.999 17.724 58.616 17.58 C 59.779 17.31 60.514 16.761 60.994 15.799 C 61.765 14.257 61.556 12.811 60.427 11.867 C 59.801 11.344 58.602 10.663 57.414 10.156 C 57.254 10.088 56.993 9.977 56.833 9.909 C 56.066 9.582 54.804 8.906 54.492 8.653 C 54.041 8.288 54.038 8.286 53.652 7.795 C 53.314 7.365 53.167 7.078 52.974 6.472 C 52.842 6.058 52.817 4.308 52.94 4.079 C 52.985 3.996 53.021 3.863 53.021 3.783 C 53.021 3.567 53.396 2.842 53.711 2.447 C 54.28 1.736 54.786 1.332 55.576 0.96 C 56.611 0.472 57.198 0.359 58.672 0.362 C 60.179 0.365 62.315 0.672 62.478 0.91 C 62.518 0.968 62.532 1.273 62.507 1.588 C 62.484 1.903 62.464 2.782 62.464 3.542 L 62.464 4.924 L 62.047 4.924 C 61.569 4.924 61.56 4.912 61.45 4.188 C 61.307 3.246 61.247 2.945 61.155 2.718 C 61.028 2.403 60.627 1.998 60.297 1.854 L 59.871 1.667 C 59.412 1.465 58.016 1.381 57.472 1.522 C 56.907 1.67 56.656 1.826 56.145 2.352 C 55.538 2.978 55.223 3.872 55.282 4.8 C 55.329 5.524 55.542 5.97 56.114 6.539 C 56.522 6.944 57.28 7.384 58.439 7.887 C 58.588 7.951 59.021 8.15 59.4 8.329 C 59.779 8.506 60.163 8.685 60.252 8.724 C 60.341 8.763 60.623 8.916 60.878 9.063 C 61.133 9.212 61.394 9.357 61.458 9.386 C 61.684 9.491 62.429 10.096 62.697 10.391 C 63.571 11.357 63.86 12.071 63.855 13.253 C 63.849 14.681 63.338 15.885 62.285 16.951 C 61.452 17.794 60.711 18.205 59.339 18.585 C 58.8 18.735 56.844 18.799 55.73 18.703 Z M 0.512 18.348 C 0.447 18.179 0.454 17.753 0.524 17.649 C 0.555 17.601 0.807 17.538 1.084 17.508 C 1.361 17.477 1.668 17.4 1.769 17.335 C 1.914 17.241 2.709 15.753 2.709 15.574 C 2.709 15.535 2.783 15.365 3.281 14.268 C 3.392 14.022 3.483 13.806 3.483 13.786 C 3.483 13.768 3.588 13.523 3.715 13.244 C 3.843 12.966 3.948 12.722 3.948 12.703 C 3.948 12.684 4.039 12.467 4.15 12.221 C 4.639 11.142 4.722 10.955 4.722 10.923 C 4.722 10.904 4.809 10.698 4.915 10.465 C 5.022 10.233 5.109 10.024 5.109 10.001 C 5.109 9.978 5.213 9.73 5.341 9.452 C 5.468 9.173 5.573 8.931 5.573 8.914 C 5.573 8.897 5.695 8.619 5.844 8.296 C 5.993 7.974 6.115 7.693 6.115 7.673 C 6.115 7.653 6.202 7.445 6.308 7.209 L 6.695 6.354 C 6.802 6.118 6.889 5.911 6.889 5.891 C 6.889 5.872 6.994 5.628 7.121 5.349 C 7.249 5.071 7.353 4.827 7.353 4.808 C 7.353 4.789 7.436 4.589 7.538 4.365 C 7.751 3.895 7.959 3.423 8.164 2.95 C 8.219 2.822 8.355 2.517 8.467 2.271 C 8.578 2.025 8.669 1.807 8.669 1.786 C 8.669 1.765 8.737 1.601 8.819 1.421 C 8.912 1.216 9.001 1.01 9.086 0.802 C 9.158 0.623 9.256 0.51 9.342 0.507 C 10.24 0.472 10.743 0.479 10.848 0.527 C 10.925 0.563 11.071 0.899 11.219 1.381 C 11.354 1.818 11.495 2.246 11.532 2.331 C 11.571 2.416 11.728 2.851 11.882 3.298 C 12.313 4.548 12.319 4.566 12.387 4.73 C 12.422 4.815 12.508 5.077 12.578 5.311 C 12.648 5.545 12.736 5.807 12.773 5.891 C 12.811 5.976 12.932 6.325 13.042 6.665 C 13.153 7.006 13.276 7.345 13.317 7.419 C 13.357 7.493 13.391 7.607 13.391 7.671 C 13.391 7.737 13.423 7.85 13.463 7.924 C 13.503 7.998 13.713 8.598 13.931 9.258 C 14.149 9.918 14.361 10.518 14.401 10.593 C 14.441 10.667 14.474 10.78 14.474 10.845 C 14.474 10.91 14.508 11.024 14.55 11.098 C 14.626 11.232 15.461 13.649 15.533 13.941 C 15.554 14.026 15.602 14.166 15.639 14.251 C 15.675 14.336 15.797 14.684 15.908 15.025 C 16.019 15.366 16.139 15.714 16.176 15.799 C 16.212 15.884 16.336 16.215 16.45 16.534 C 16.671 17.152 16.927 17.463 17.213 17.463 C 17.495 17.463 17.88 16.935 18.212 16.093 C 18.306 15.859 18.404 15.626 18.505 15.396 C 18.596 15.192 18.699 14.955 18.735 14.87 C 18.901 14.482 19.068 14.095 19.237 13.709 C 19.293 13.581 19.412 13.312 19.5 13.109 C 19.588 12.907 19.73 12.587 19.815 12.397 C 19.901 12.208 19.97 12.035 19.97 12.013 C 19.97 11.99 20.075 11.743 20.202 11.464 C 20.33 11.185 20.434 10.942 20.434 10.923 C 20.434 10.904 20.521 10.696 20.628 10.46 L 21.015 9.605 C 21.121 9.369 21.208 9.16 21.208 9.14 C 21.208 9.12 21.331 8.84 21.479 8.518 C 21.628 8.195 21.75 7.918 21.75 7.9 C 21.75 7.883 21.855 7.641 21.983 7.362 C 22.11 7.083 22.215 6.839 22.215 6.821 C 22.215 6.801 22.305 6.585 22.416 6.339 C 22.527 6.092 22.647 5.822 22.683 5.736 C 22.718 5.652 22.831 5.39 22.932 5.156 C 23.07 4.834 23.207 4.512 23.34 4.188 C 23.463 3.891 23.625 3.532 23.702 3.392 C 23.778 3.253 23.84 3.108 23.84 3.07 C 23.84 3.031 23.962 2.736 24.111 2.413 C 24.26 2.091 24.382 1.81 24.382 1.791 C 24.382 1.758 24.666 1.112 24.868 0.686 C 24.946 0.521 24.994 0.512 25.813 0.512 L 26.676 0.512 L 26.852 1.112 C 26.948 1.442 27.057 1.782 27.092 1.866 C 27.127 1.951 27.215 2.195 27.287 2.408 C 27.358 2.621 27.446 2.865 27.482 2.95 C 27.566 3.151 28.121 4.765 28.413 5.659 C 28.538 6.042 28.675 6.416 28.717 6.49 C 28.759 6.564 28.794 6.678 28.794 6.743 C 28.794 6.808 28.827 6.922 28.868 6.995 C 28.909 7.069 29.155 7.774 29.414 8.562 C 29.674 9.35 29.918 10.064 29.956 10.148 C 29.994 10.234 30.117 10.582 30.227 10.922 C 30.339 11.263 30.461 11.612 30.499 11.696 C 30.537 11.782 30.625 12.043 30.695 12.277 C 30.764 12.511 30.85 12.773 30.886 12.857 C 30.923 12.943 31.079 13.396 31.234 13.864 C 31.388 14.332 31.547 14.776 31.587 14.85 C 31.626 14.924 31.658 15.047 31.658 15.124 C 31.658 15.202 31.686 15.298 31.72 15.339 C 31.753 15.379 31.844 15.603 31.92 15.838 C 32.194 16.681 32.486 17.282 32.655 17.35 C 32.724 17.378 33.059 17.442 33.399 17.491 L 34.019 17.581 L 34.043 17.96 C 34.059 18.21 34.033 18.36 33.965 18.403 C 33.91 18.438 32.413 18.467 30.641 18.468 C 27.084 18.47 27.322 18.504 27.325 17.979 C 27.326 17.629 27.392 17.568 27.826 17.511 C 28.712 17.394 29.189 17.274 29.315 17.134 C 29.466 16.967 29.488 16.292 29.352 15.938 C 29.307 15.819 29.179 15.426 29.068 15.063 C 28.957 14.702 28.837 14.336 28.802 14.251 C 28.767 14.166 28.678 13.905 28.604 13.67 C 28.486 13.294 28.349 12.904 28.081 12.18 L 28.001 11.967 L 21.525 11.967 L 21.415 12.219 C 21.336 12.397 21.258 12.575 21.179 12.753 C 21.11 12.909 21.054 13.056 21.054 13.081 C 21.054 13.105 20.949 13.353 20.821 13.632 C 20.694 13.91 20.589 14.155 20.589 14.173 C 20.589 14.193 20.499 14.409 20.388 14.655 C 20.277 14.901 20.159 15.172 20.125 15.257 C 20.092 15.342 19.978 15.622 19.872 15.879 C 19.63 16.466 19.547 16.941 19.652 17.138 C 19.742 17.306 19.951 17.366 20.899 17.492 L 21.557 17.579 L 21.557 18.431 L 16.689 18.45 C 13.158 18.465 11.793 18.447 11.716 18.383 C 11.606 18.292 11.581 18.007 11.658 17.721 C 11.694 17.586 11.78 17.543 12.102 17.504 C 13.991 17.271 14.017 17.21 13.266 14.831 C 13.07 14.214 12.891 13.657 12.867 13.593 C 12.843 13.529 12.711 13.146 12.575 12.741 L 12.328 12.006 L 5.745 11.966 L 5.696 12.162 C 5.669 12.27 5.563 12.541 5.461 12.764 C 5.359 12.988 5.205 13.348 5.119 13.566 C 5.021 13.812 4.919 14.056 4.814 14.299 C 4.702 14.552 4.595 14.807 4.491 15.063 C 4.402 15.283 4.311 15.503 4.219 15.721 C 3.857 16.566 3.773 17.058 3.967 17.211 C 4.106 17.32 4.436 17.397 5.186 17.494 L 5.844 17.579 L 5.844 18.431 L 3.201 18.451 C 0.842 18.469 0.554 18.458 0.512 18.348 Z M 11.843 10.444 C 11.843 10.382 11.692 9.902 11.604 9.684 C 11.569 9.599 11.448 9.233 11.335 8.871 C 11.221 8.51 11.098 8.144 11.063 8.058 C 11.026 7.974 10.872 7.521 10.719 7.052 C 10.567 6.584 10.412 6.131 10.375 6.046 C 10.338 5.961 10.215 5.613 10.101 5.272 C 9.867 4.57 9.546 3.67 9.418 3.361 L 9.332 3.152 L 9.196 3.438 C 9.122 3.596 9.06 3.751 9.059 3.783 C 9.057 3.815 8.991 3.989 8.911 4.17 C 8.831 4.35 8.549 5.038 8.285 5.698 C 7.687 7.192 7.705 7.148 7.552 7.496 C 7.466 7.694 7.387 7.894 7.315 8.097 C 7.247 8.287 7.174 8.475 7.094 8.66 C 6.966 8.953 6.734 9.52 6.509 10.09 L 6.35 10.497 L 9.096 10.497 C 10.607 10.497 11.843 10.473 11.843 10.444 Z M 27.507 10.284 C 27.422 9.931 26.703 7.759 26.623 7.615 C 26.583 7.541 26.549 7.416 26.549 7.337 C 26.549 7.258 26.53 7.175 26.506 7.151 C 26.466 7.111 25.581 4.606 25.486 4.266 C 25.463 4.181 25.42 4.076 25.391 4.034 C 25.362 3.991 25.292 3.807 25.233 3.623 C 25.176 3.44 25.106 3.276 25.077 3.259 C 25.028 3.228 24.899 3.496 24.539 4.382 C 24.45 4.601 24.36 4.821 24.268 5.04 C 24.215 5.168 24.075 5.516 23.958 5.814 C 23.841 6.112 23.696 6.468 23.635 6.606 C 23.556 6.791 23.482 6.979 23.414 7.168 C 23.342 7.371 23.263 7.572 23.177 7.77 C 23.112 7.918 23.048 8.065 22.983 8.213 C 22.769 8.709 22.137 10.357 22.137 10.42 C 22.137 10.469 23.122 10.497 24.848 10.497 L 27.559 10.497 Z M 43.888 18.375 C 42.151 17.869 41.01 17.217 39.897 16.097 C 39.583 15.781 39.265 15.419 39.191 15.293 C 39.117 15.167 39.028 15.063 38.994 15.063 C 38.961 15.063 38.934 14.992 38.934 14.904 C 38.934 14.752 38.96 14.748 39.495 14.808 C 39.803 14.842 40.561 14.869 41.179 14.867 C 42.397 14.865 43.134 14.737 44.081 14.369 C 44.695 14.129 44.959 14.009 45.138 13.887 C 45.251 13.81 45.364 13.748 45.389 13.748 C 45.459 13.748 46.5 12.994 46.814 12.717 C 47.246 12.334 47.587 11.966 47.937 11.503 C 48.115 11.269 48.278 11.06 48.299 11.039 C 48.362 10.976 48.517 10.711 48.661 10.419 C 48.734 10.271 48.817 10.131 48.845 10.11 C 48.872 10.088 48.958 9.897 49.036 9.684 C 49.114 9.471 49.2 9.262 49.228 9.22 C 49.256 9.177 49.323 8.985 49.378 8.794 C 49.433 8.603 49.508 8.358 49.543 8.252 C 49.775 7.559 49.846 5.965 49.695 4.858 C 49.646 4.502 49.62 4.196 49.638 4.179 C 49.807 4.01 50.369 4.87 50.81 5.969 C 50.903 6.201 50.996 6.433 51.091 6.665 C 51.168 6.851 51.353 7.711 51.468 8.416 C 51.573 9.068 51.574 10.083 51.468 10.686 C 51.321 11.528 51.139 12.314 51.073 12.389 C 51.038 12.43 51.009 12.526 51.009 12.603 C 51.009 12.68 50.975 12.804 50.936 12.878 C 50.895 12.952 50.753 13.249 50.62 13.538 C 50.033 14.817 48.903 16.171 47.673 17.072 C 47.157 17.451 46.054 18.057 45.552 18.239 C 45.467 18.27 45.3 18.334 45.181 18.382 C 44.92 18.487 44.261 18.483 43.888 18.375 Z M 48.092 9.4 C 48.046 9.343 47.983 9.21 47.952 9.103 C 47.666 8.131 46.811 6.774 45.9 5.852 C 45.332 5.276 44.509 4.614 44.362 4.614 C 44.321 4.614 44.276 4.584 44.262 4.547 C 44.247 4.511 43.905 4.324 43.501 4.132 C 41.524 3.195 39.502 2.969 37.579 3.47 C 36.188 3.833 34.684 4.587 33.869 5.329 C 33.69 5.491 33.516 5.507 33.516 5.361 C 33.516 5.143 34.244 3.92 34.672 3.418 C 36.289 1.527 38.25 0.418 40.637 0.047 C 41.224 -0.044 43.386 0.006 43.81 0.12 C 44.002 0.172 44.298 0.25 44.468 0.294 C 45.839 0.645 47.311 1.451 48.203 2.338 C 48.542 2.676 48.687 2.878 48.687 3.016 C 48.687 3.123 48.722 3.233 48.764 3.259 C 48.806 3.286 48.841 3.395 48.841 3.501 C 48.841 3.608 48.873 3.754 48.911 3.826 C 48.949 3.897 49.021 4.347 49.072 4.824 C 49.163 5.69 49.092 7.058 48.927 7.606 C 48.473 9.117 48.249 9.597 48.092 9.4 Z" fill="rgb(0, 0, 0)" height="37.73707545342606px" id="Kw5voOSOe" transform="translate(0 0.13)" width="93.00000061120926px"/></svg>)
Preguntas Frecuentes
¿Cuándo puedo manejar?
Generalmente entre 2 y 6 semanas, dependiendo del tipo de cirugía, el lado operado y tu control del dolor.
Lo importante es poder frenar con seguridad y no depender de analgésicos fuertes. Cada caso se evalúa individualmente.
Generalmente entre 2 y 6 semanas, dependiendo del tipo de cirugía, el lado operado y tu control del dolor.
Lo importante es poder frenar con seguridad y no depender de analgésicos fuertes. Cada caso se evalúa individualmente.
¿Qué dolor es “normal” después de una cirugía?
Molestias moderadas, sensación de tirantez y rigidez son comunes en las primeras semanas.
Dolor que va mejorando día a día es esperado.
Dolor que aumenta, se vuelve profundo o viene con fiebre sí requiere valoración.
Molestias moderadas, sensación de tirantez y rigidez son comunes en las primeras semanas.
Dolor que va mejorando día a día es esperado.
Dolor que aumenta, se vuelve profundo o viene con fiebre sí requiere valoración.
¿Puedo tener relaciones sexuales después de la cirugía?
Sí, pero el momento varía según el tipo de cirugía y la estabilidad de la articulación.
En la mayoría de los casos, es seguro después de 3 a 6 semanas, siempre evitando posiciones que generen dolor.
Lo principal es comodidad y movilidad sin riesgo.
Sí, pero el momento varía según el tipo de cirugía y la estabilidad de la articulación.
En la mayoría de los casos, es seguro después de 3 a 6 semanas, siempre evitando posiciones que generen dolor.
Lo principal es comodidad y movilidad sin riesgo.
¿Cuándo puedo volver al trabajo?
Depende de la actividad:
– Trabajo de oficina: 2 a 4 semanas.
– Trabajo físico: 6 a 12 semanas.
Lo importante es la recuperación funcional y la movilidad segura, no solo el calendario.
Depende de la actividad:
– Trabajo de oficina: 2 a 4 semanas.
– Trabajo físico: 6 a 12 semanas.
Lo importante es la recuperación funcional y la movilidad segura, no solo el calendario.
¿Qué señales indican una complicación?
Fiebre, dolor que aumenta, herida roja o caliente, secreción, dificultad para mover la extremidad, o pérdida súbita de fuerza.
Estos síntomas requieren revisión inmediata.
Fiebre, dolor que aumenta, herida roja o caliente, secreción, dificultad para mover la extremidad, o pérdida súbita de fuerza.
Estos síntomas requieren revisión inmediata.
¿Por qué se producen tantas caídas en las personas mayores?
Las caídas ocurren por una combinación de factores propios del paciente y del entorno.
Entre los factores intrínsecos están la disminución del equilibrio, la fuerza muscular, la memoria y el uso de medicamentos que alteran el sueño o afectan el oído y el equilibrio.
Entre los factores extrínsecos destacan la iluminación deficiente, obstáculos en el hogar, superficies resbalosas y falta de apoyos.
En mayores de 75 años, y especialmente si hay problemas de movilidad o medicamentos para dormir, el riesgo aumenta significativamente.
Las caídas ocurren por una combinación de factores propios del paciente y del entorno.
Entre los factores intrínsecos están la disminución del equilibrio, la fuerza muscular, la memoria y el uso de medicamentos que alteran el sueño o afectan el oído y el equilibrio.
Entre los factores extrínsecos destacan la iluminación deficiente, obstáculos en el hogar, superficies resbalosas y falta de apoyos.
En mayores de 75 años, y especialmente si hay problemas de movilidad o medicamentos para dormir, el riesgo aumenta significativamente.
¿Cuándo puedo volver a caminar sin dolor?
El rango es amplio: de 2 a 12 semanas según el diagnóstico y la cirugía.
Lo clave es que el dolor vaya disminuyendo progresivamente.
Si no ocurre, se reevalúa con imagenología y examen físico.
El rango es amplio: de 2 a 12 semanas según el diagnóstico y la cirugía.
Lo clave es que el dolor vaya disminuyendo progresivamente.
Si no ocurre, se reevalúa con imagenología y examen físico.
Ejemplos que ilustran el enfoque y la toma de decisiones.
Ejemplos que ilustran el enfoque y la toma de decisiones.
Casos clínicos
*Casos reales presentados con consentimiento informado y con fines educativos.
*Casos reales presentados con consentimiento informado y con fines educativos.
Antes
Después
Mujer, 71 años
Diagnóstico: Fractura de cuello de fémur derecho, previamente tratada con prótesis parcial, complicada con dolor persistente y protrusión acetabular.
Enfoque
La paciente presentaba dolor continuo desde hacía un año tras una cirugía previa realizada por otro equipo. Se realizó una evaluación clínica completa, revisión de estudios de imagen y análisis del estado funcional para identificar la causa del dolor y las opciones reales de tratamiento.
Decisión clínica
Se indicó cirugía de revisión para retirar la prótesis parcial mal posicionada y colocar una prótesis de revisión de cadera, corrigiendo el problema estructural que generaba el dolor.
Objetivo
Aliviar el dolor, mejorar la movilidad y recuperar calidad de vida sin procedimientos innecesarios adicionales.
Antes
Después
Mujer, 72 años
Diagnóstico: Fractura trocantérica y subtrocantérica del fémur derecho tras caída de su propia altura.
Enfoque
Tras la evaluación clínica e imagenológica, se determinó que la fractura requería estabilización quirúrgica para permitir una movilización segura y reducir complicaciones asociadas al reposo prolongado.
Decisión clínica
Se realizó cirugía para reducir y fijar la fractura mediante clavo proximal de fémur, utilizando una técnica estable y adecuada al tipo de lesión.
Objetivo
Restablecer la estabilidad del fémur, permitir la rehabilitación temprana y recuperar la independencia funcional de forma segura.
Antes
Después
Hombre, 48 años
Diagnóstico: Lesión pélvica compleja con apertura de la sínfisis del pubis, compromiso de la articulación sacroilíaca derecha y fractura de clavícula izquierda tras accidente de tránsito.
Enfoque
Se realizó una evaluación integral del trauma, priorizando la estabilidad pélvica y la planificación quirúrgica precisa para evitar secuelas funcionales a largo plazo.
Decisión clínica
Se indicó cirugía para reducir y fijar la sínfisis del pubis con placa de reconstrucción, fijación sacroilíaca con tornillo y estabilización de la clavícula con placa anatómica.
Objetivo
Recuperar estabilidad, función y movilidad, permitiendo una rehabilitación progresiva sin cirugías adicionales innecesarias.
Antes
Después
Mujer, 71 años
Diagnóstico: Fractura de cuello de fémur derecho, previamente tratada con prótesis parcial, complicada con dolor persistente y protrusión acetabular.
Enfoque
La paciente presentaba dolor continuo desde hacía un año tras una cirugía previa realizada por otro equipo. Se realizó una evaluación clínica completa, revisión de estudios de imagen y análisis del estado funcional para identificar la causa del dolor y las opciones reales de tratamiento.
Decisión clínica
Se indicó cirugía de revisión para retirar la prótesis parcial mal posicionada y colocar una prótesis de revisión de cadera, corrigiendo el problema estructural que generaba el dolor.
Objetivo
Aliviar el dolor, mejorar la movilidad y recuperar calidad de vida sin procedimientos innecesarios adicionales.
Antes
Después
Mujer, 72 años
Diagnóstico: Fractura trocantérica y subtrocantérica del fémur derecho tras caída de su propia altura.
Enfoque
Tras la evaluación clínica e imagenológica, se determinó que la fractura requería estabilización quirúrgica para permitir una movilización segura y reducir complicaciones asociadas al reposo prolongado.
Decisión clínica
Se realizó cirugía para reducir y fijar la fractura mediante clavo proximal de fémur, utilizando una técnica estable y adecuada al tipo de lesión.
Objetivo
Restablecer la estabilidad del fémur, permitir la rehabilitación temprana y recuperar la independencia funcional de forma segura.
Antes
Después
Hombre, 48 años
Diagnóstico: Lesión pélvica compleja con apertura de la sínfisis del pubis, compromiso de la articulación sacroilíaca derecha y fractura de clavícula izquierda tras accidente de tránsito.
Enfoque
Se realizó una evaluación integral del trauma, priorizando la estabilidad pélvica y la planificación quirúrgica precisa para evitar secuelas funcionales a largo plazo.
Decisión clínica
Se indicó cirugía para reducir y fijar la sínfisis del pubis con placa de reconstrucción, fijación sacroilíaca con tornillo y estabilización de la clavícula con placa anatómica.
Objetivo
Recuperar estabilidad, función y movilidad, permitiendo una rehabilitación progresiva sin cirugías adicionales innecesarias.
Dr. Joffre Pérez Pereira
Dr. Joffre Pérez Pereira
Centro Médico Torre ¨D¨
Mezz. 001-A. Calle Rondon c/c 5 de Julio. Valencia. Venezuela.
👉 Al lado de la Clinica ¨La Guerra Méndez¨
Mezz. 001-A. Calle Rondon c/c 5 de Julio. Valencia. Venezuela.
👉 Al lado de la Clinica ¨La Guerra Méndez¨
CENTRO MÉDICO TORRE ¨D¨
CENTRO MÉDICO TORRE ¨D¨
Mezz. 001-A. Calle Rondon c/c 5 de Julio. Valencia. Venezuela. 👉 Al lado de la Clinica ¨La Guerra Méndez¨
Citas/WhatsApp: +58 412 656 9400
Citas/WhatsApp: +58 412 656 9400
