Shoulder balloon spacer for massive irreparable rotator cuff tears results in significant improvements.

Purpose: The aim of the present study was to assess the effectiveness of balloon implantation in patients with irreparable supraspinatus tears alone or in combination with other rotator cuff (RC) tendon tears and the effect of several covariables, such as age, gender, status of the long head biceps, with or without tendon repair and regardless the number of tendon involved.

Methods: Patients enrolled from 'San Carlo' Hospital of Potenza (Italy, IT), from January 2012 to September 2014, underwent arthroscopic implantation of shoulder balloon by a single surgeon, and followed for 3 years. The American Shoulder and Elbow Surgeons (ASES) and Constant score (CS) were administered pre-, post-operatively at 12 months, and then annually.

Achilles Tendinopathy Pathogenesis and Management: A Narrative Review.

The Achilles tendon is the thickest and strongest tendon of the human body, and it is frequently injured during sports activity. The incidence of Achilles tendon pathologies has increased over recent decades, especially in the last few years, because of increased sports participation among the general population and due to the diffusion of competitive sports at a high level. Tendinopathies are common in athletes and in middle-aged overweight patients.

Rotational ankle instability: A current concept review.

Ankle sprains are extremely common. It is important to have a clear insight of the course of recovery after such injury to evaluate the effective strategies to guide management decisions, and understand the potential risk factors involved in the development of chronic problems and recurrent ankle sprains. When a prompt diagnosis is not formulated, ligament tears can remain untreated, and chronic ankle instability can result after acute lateral or medial ankle sprain.

Hand Flexor Tendon Repair: From Biology to Surgery and Rehabilitation.

Tendon biology and anatomy are crucial to manage hand flexor tendon injuries, not only for surgical treatment but also for rehabilitation; surgeon and physical therapist have to choose zone by zone the best way to manage and restore the normal function of hand flexor tendons.

Proximal Femoral Fractures in the Elderly: A Few Things to Know, and Some to Forget.

Hip fractures are a leading cause of hospitalisation in elderly patients, representing an increasing socioeconomic problem arising from demographic changes, considering the increased number of elderly people in our countries. Adequate peri-operative treatment is essential to decrease mortality rates and avoid complications. Modern management should involve a coordinated multidisciplinary approach, early surgery, pain treatment, balanced fluid therapy, and prevention of delirium, to improve patients' functional and clinical outcomes.

The use of long head biceps tendon autograft for massive rotator cuff tears: a PRISMA compliant systematic review.

Introduction: Rotator cuff tears (RCT) are a common cause of shoulder pain and disability, with massive RCT accounting for 10-40% of all rotator cuff tears.

Sources Of Data: A systematic search of PubMed and Scopus electronic databases was performed up to August 2022, and a total of 17 scientific articles were included in the present PRISMA compliant systematic review.

Areas Of Agreement: Understanding the geometric patterns in RCT is essential to achieve appropriate repositioning of the injured tendons in their anatomic location.

The double posteromedial portals endoscopy for posterior ankle impingement syndrome in athletes.

Background: Posterior ankle impingement syndrome (PAIS) may result from flexor hallucis longus tendinopathy, compression of the posterior process of the talus from the presence of an os trigonum, soft-tissue impingement, or a combination of these. Posterior extra-articular endoscopy performed with the patient supine through the double posteromedial portals, with excision of adhesions, excision of the posterior process of the talus or an os trigonum, and decompression of the tendon of the flexor hallucis longus (FHL), can be used in athletes with PAIS.

Methods: Thirty-four athletes with PAIS in whom conservative management had failed underwent posterior ankle endoscopy in the supine position using the double posteromedial portals.

Pregnancy and parturition after hip arthroplasty.

Background: The indications for total hip arthroplasty (THA) have become more widespread. Of the patients receiving a THA, some will be women with child-bearing potential. There has been little research into the effects of pregnancy and parturition on THA, and the effect of THA on pregnancy and parturition.

Mini-invasive bilateral transfacet screw fixation with reconstruction of the neural arch for lumbar stenosis: A two centre case series.

Background And Purpose: Lumbar stenosis and instability frequently coexist. Spinal canal decompression is often combined with fixation of the relevant vertebral segment and can be performed using different techniques and devices, including pedicle screws and interspinous devices and facet screws. The present study evaluates the clinical outcome of laminectomy and single-level fusion using a minimally invasive technique for rigid posterior spinal column fixation with two cross-linked lag screws.

Combined medial patellofemoral and medial patellotibial reconstruction for patellar instability: a PRISMA systematic review.

Background: The medial patellofemoral ligament (MPFL) works in association with the medial patellotibial ligament (MPTL) and the medial patellomeniscal ligament (MPML) to impart stability to the patellofemoral joint. The anatomy and biomechanical characteristics of the MPFL have been well described but little is known about the MPTL and MPML. Several reconstruction procedures of the MPFL with semitendinosus, gracilis, patellar and quadriceps tendons, allografts and synthetic grafts have been described.

Chronic Lateral Ankle Instability: Topical Review.

Chronic ankle instability can result from untreated or badly managed acute lateral ankle ligament injuries. Conservative management is the modality of choice for acute lateral ankle ligament injuries, and operative treatment is reserved for special cases. Failure after strict rehabilitation may be an indication for surgery.

Management of Achilles and patellar tendinopathy: what we know, what we can do.

Tendinopathies are challenging conditions frequent in athletes and in middle-aged overweight patients with no history of increased physical activity. The term "tendinopathy" refers to a clinical condition characterised by pain, swelling, and functional limitations of tendons and nearby structures, the effect of chronic failure of healing response. Tendinopathies give rise to significant morbidity, and, at present, only limited scientifically proven management modalities exist.

Combined medial patellofemoral and patellotibial reconstruction with soft tissue fixation in recurrent patellar dislocation.

Introduction: The medial patellofemoral and patellotibial ligaments (MPFL and MPTL) are the main passive restraints to lateral patellar translation. When nonoperative management of patellofemoral dislocations fails, surgical options can be considered to restore patellofemoral stability. Several reconstruction procedures of the MPFL with semitendinosus, gracilis, quadriceps tendon, and synthetic grafts have been described.

Impact of an orthogeriatrician on length of stay of elderly patient with hip fracture.

Unlabelled: Hip fracture patients are complex, and orthopaedic management is limited to the surgery phase. To provide better evaluation pre-operatively and an optimal level of post-operative care, an orthogeriatrician was introduced in the orthopaedic team. This ensured that time to surgery from admission consistently was below 48 h, decreasing hospitalization time after surgery and total length of stay.

Current pharmacological approaches to the treatment of tendinopathy.

Introduction: Tendinopathies are common in elite and recreational athletes: traditionally considered overuse injuries, they involve excessive tensile loading and subsequent breakdown of the loaded tendon. Many pharmacological treatments have been proposed for the management of tendinopathy, with no agreement regarding the overall best option available both for Achilles and patellar tendinopathy.

Areas Covered: The present article reports the best scientific evidence regarding the efficacy and safety of different pharmacological treatments in different types of tendinopathy, focusing on Achilles and patellar tendinopathy, the conditions on which more studies have been published.

Iliotibial band syndrome rehabilitation in female runners: a pilot randomized study.

Background: Iliotibial band syndrome (ITBS) carries marked morbidity in runners. Its management is not standardized and lacks evidence base. We evaluated the effectiveness of three different exercises programs in reducing ITBS symptoms.

An evidence based narrative review on treatment of diabetic foot osteomyelitis.

Objective: The diagnosis of diabetic food infection is usually clinical, and its severity is related to location and depth of the lesion, and the presence of necrosis or gangrene. Osteomyelitis of the foot and ankle can be extremely debilitating, and, in the preantibiotic era acute staphylococcal osteomyelitis carried a mortality rate of 50%. The microbiology of diabetic foot osteomyelitis (DFO) is usually polymicrobial.

Lower limb joint repair and replacement: an overview.

In the last few years, much has been published concerning total joint arthroplasty, and debates and discussions to new questions and points of view started many years ago. In this commentary, we report the latest evidence of best practice in the field of lower limb arthroplasty; this evidence is based on a literature search conducted by using PubMed and Scopus databases with a time limit of five years. We found novel evidence regarding cemented and not cemented implant, implant design, anticoagulant use, tourniquets, and other aspects of joints replacement surgery that we consider a common part of modern orthopedic practice.

O'nil Anteversa® mini-plate for stable hip fracture: first experience considerations and outcomes.

Hip fractures are associated with a 20% one-year mortality and a 50% loss of function. Over 700,000 deaths are estimated to occur annually worldwide following hip fractures. Concern exist regarding which is the best implant for extracapsular fractures fixation.

Surgery within 48 hours in hip fractures in elderly patients exerts a positive effect on post-operative hyponatremia.

This study investigated the prevalence of hyponatremia during the hospital stay, in a cohort of elderly patients with hip fractures who underwent surgery within 48 h from admission. Records data were retrieved from the database of the San Giovanni di Dio e Ruggi d'Aragona Hospital of Salerno, Italy. All elderly patients (≥65 years old) with a documented hip fracture that underwent surgery within 48 h from admission, between 2016 and 2018, were included and divided in 4 subgroups according to their sex and type of fracture.

Genetics in orthopaedic practice.

DNA holds genetic information in the nucleus of eukaryotic cells; and has three different functions: replication, storage of hereditary information, and regulation of cell division. Most studies described the association of single nucleotide polymorphism (SNP) to common orthopaedics diseases and the susceptibility to develop musculoskeletal injuries. Several mutations are associated with osteoporosis, musculoskeletal ailments and other musculoskeletal deformity and conditions.

Biological and chemical changes in fluoroquinolone-associated tendinopathies: a systematic review.

Introduction: The present systematic review investigates the biological and chemical mechanisms that affect the health and structure of tendons following the use of fluoroquinolones (FQs).

Sources Of Data: A total of 12 articles were included, organized, and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Areas Of Agreement: Five mechanisms were identified: arrest of proliferation through a decreased activity of cyclin B, CDK-1, CHK-1, and increased PK-1; decrease tenocytes migration through decreased phosphorylation of FAK; decrease type I collagen metabolism through increased MMP-2; chelate effect on ions that influence epigenetics and several enzymes; fluoroquinolones-induced ROS (radical oxygen species) production in mitochondria.