Computer-assisted versus intramedullary and extramedullary alignment system in total knee replacement: Long term follow-up.

Introduction: The aim of this work is to compare in a retrospective study, the radiological results of three series of different total knee replacements performed using Orthopilot computer-based alignment system (Group A, 31 patients), a totally intramedullary alignment system (Group B, 34 patients) and a totally extramedullary alignment system (Group C, 32 patients).

Materials And Methods: At a medium follow-up of 15 years, all patients underwent call interview for clinical update. Of the 115 patients initially enrolled in the study, only 97 were available for radiological assessment.

Computer-assisted surgery in total knee replacement: advantages, surgical procedure and review of the literature.

Introduction: Total knee replacement (TKR) is one of the most frequent orthopaedic procedures performed every year. At the same time 20% of patients who underwent TKR are not satisfied with the outcome. The reasons are unknown; we think that a mechanical alignment beyond 3° of varus-valgus can represent the most important cause of failure of TKR and consequently patient dissatisfaction.

Bi-unicompartmental versus total knee arthroplasty: long term results.

The purpose is to demonstrate that Bi-Unicom- partmental knee arthroplasty (Bi-Uni) can produce equivalent long-term outcomes to total knee arthroplasty (TKA) in patients with bicompartmental knee osteoarthritis involving both the medial and lateral tibio-femoral compartments. A total of 37 patients with bicompartmental tibio- femoral osteoarthritis of the knee treated between January 1999 and March 2005 underwent either Bi-Uni or TKA. Nineteen patients who underwent simultaneous implantation of 2 unicompartmental knee arthroplasties (UKA) were matched and compared with 18 patients who had undergone a computer assisted TKA.

Periosteal osteoblastoma of the distal fibula with atypical radiological features: a case report.

We reported the case of a 22 year-old boy who suffered a periosteal osteoblastoma of the distal fibula. The radiographic features of our case did not correlate with the majority of periosteal osteoblastomas of the long bones reported in the literature and were identical to a periosteal aneurysmal bone cyst. Periosteal osteoblastoma is a very rare tumor with a wide range of clinical and radiological features, showing in 15% of cases association with secondary aneurysmal bone cyst.

Femoral press-fit fixation versus interference screw fixation in anterior cruciate ligament reconstruction with bone-patellar tendon-bone autograft: 20-year follow-up.

Introduction: The aim of this paper is to present our experience with femoral press-fit fixation in anterior cruciate ligament reconstruction using bone-patellar tendon-bone autograft.

Methods: The patient population was randomly placed in two groups: group A (58 patients), who underwent femoral screw fixation; group B (62 patients), who underwent femoral press-fit fixation.

Results: At last follow-up 9.

Bicompartmental (uni plus patellofemoral) versus total knee arthroplasty: a match-paired study.

Background: Osteoarthritis (OA) of the knee, whether primary or post-traumatic, does not always involve all three compartments (tibiofemoral medial and lateral and the patellofemoral ones). Bicompartmental knee arthroplasty (BKA) was proposed as a good alternative to total knee arthroplasty when two of the three knee compartments were affected.

Materials And Methods: We performed a retrospective comparative study collecting all BKAs performed between March 2010 and January 2016.

Intramuscular oxygen-ozone therapy in the treatment of low back pain.

Background And Aim Of The Work: Intramuscular paravertebral injections of ozone are minimally invasive, safe and efficacy in reducing pain and disability. The aim of this paper is to present the early results of paravertebral lumbar ozone injections in the treatment of low back pain.

Methods: Between February 2011 and December 2015, a total of 109 patients underwent intramuscular paravertebral lumbar injections of ozone due to low back pain.

Mazabraud syndrome associated with McCune-Albright syndrome: a case report and review of the literature.

Mazabraud syndrome is a very rare benign disorder characterized by the association of monostotic or polyostotic fibrous dysplasia and one or multiple intramuscular myxomas. McCune -Albright syndrome is a rare benign disorder characterized by the association of polyostotic fibrous dysplasia, cafè-au-lait skin pigmentations and endocrine dysfunction, such as precocious puberty, diabetes mellitus, goiter and breast fibroadenomatosis. The association of Mazabraud syndrome and McCune-Albright in the same patient is an anecdotal event.

Patient-specific modeling of the trochlear morphologic anomalies by means of hyperbolic paraboloids.

Diagnostic and therapeutic purposes are issuing pressing demands to improve the evaluation of the dysplasia condition of the femoral trochlea. The traditional clinical assessment of the dysplasia, based on Dejour classification, recognized 4 increasing (A, B, C, D) levels of severity. It has been extensively questioned in the literature that this classification methodology can be defective suggesting that quantitative measures can ensure more reliable criteria for the dysplasia severity assessment.

Navigated "small implants" in knee reconstruction.

Purpose: At the beginning of this century, unprecedented interest in the concept of using less invasive approaches for the treatment of knee degenerative diseases was ignited. Initial interest in this approach was about navigated and non-navigated knee reconstruction using small implants and conventional total knee arthroplasty.

Methods: To this end, a review of the published literature relating to less invasive compartmental arthroplasty of the knee using computer-based alignment techniques and on soft tissue-dedicated small implants is presented.

Synovial chondrosarcoma.

Background: Synovial chondrosarcoma (SCH) is a very rare tumor arising in the intra-articular cavity. In the majority of literature reports it is described as a malignant transformation of a pre-existing synovial chondromatosis (SC). We reported a systematic review of primary and secondary SCH described in the literature with the aim to recollect data from different case-reports and case-series, trying to summarize general aspects of this very rare disease.

Patellofemoral joint replacement, an evolving concept.

Isolated patellofemoral arthritis is a rare disease, whose management is challenging and controversial. Patellofemoral joint replacement can be an effective treatment for this condition. The very concept of a patellofemoral implant has evolved throughout the years, resulting in more anatomic designs and reproducible surgical techniques.

A flat all-polyethylene tibial component in medial unicompartmental knee arthroplasty: a long-term study.

Purpose: The aim of this study is to present the clinical and radiological results of a cemented unicompartmental knee arthroplasty (UKA) using a flat all-polyethylene tibial component at long-term follow-up, in a homogeneous group of patients with medial femoro-tibial knee arthritis.

Methods: The study group included 53 knees in 51 patients who were treated between January 1998 and November 1999 using a flat all-polyethylene tibial component. The same surgical technique was used for all patients.

Automating the design of resection guides specific to patient anatomy in knee replacement surgery by enhanced 3D curvature and surface modeling of distal femur shape models.

Personalized resection guides (PRG) have been recently proposed in the domain of knee replacement, demonstrating clinical outcome similar or even superior to both manual and navigated interventions. Among the mandatory pre-surgical steps for PRG prototyping, the measurement of clinical landmarks (CL) on the bony surfaces is recognized as a key issue due to lack of standardized methodologies, operator-dependent variability and time expenditure. In this paper, we focus on the reliability and repeatability of an anterior-posterior axis, also known as Whiteside line (WL), of the distal femur proposing automatic surface processing and modeling methods aimed at overcoming some of the major concerns related to the manual identification of such CL on 2D images and 3D models.

Computer-assisted unicompartmental knee arthroplasty using dedicated software versus a conventional technique.

Purpose: The aim of this study was to retrospectively compare the results of two matched-paired groups of patients who had undergone a medial unicompartmental knee arthroplasty (UKA) performed using either a conventional or a non-image-guided navigation technique specifically designed for unicompartmental prosthesis implantation.

Methods: Thirty-one patients with isolated medial-compartment knee arthritis who underwent an isolated navigated UKA were included in the study (group A) and matched with patients who had undergone a conventional medial UKA (group B). The same inclusion criteria were used for both groups.

Spontaneous patella fracture associated with anterior tibial tubercle pseudarthrosis in a revised knee replacement following knee arthrodesis.

Background: Conversion of a knee arthrodesis to a Total Knee Arthroplasty is an uncommon procedure. Revision Total Knee Arthroplasty in this setting presents the surgeon with a number of challenges including the management of the extensor mechanism and patella.

Case Presentation: We describe a unique case of a 69 years old Caucasian man who underwent a revision Total Knee Arthroplasty using a tibial tubercle osteotomy after a previous conversion of a knee arthrodesis without patella resurfacing.

Computer-assisted total knee arthroplasty after prior femoral fracture without hardware removal.

This study presents a consecutive series of patients who underwent total knee arthroplasty (TKA) after prior distal femoral fracture without hardware removal. The purpose of this study was to determine the effectiveness of computer-assisted TKA in patients with posttraumatic arthritis, specifically those with retained hardware after prior distal femoral fracture. The study group included a consecutive series of 16 patients who had developed posttraumatic knee arthritis after a distal femoral fracture with retention of hardware (group A).

Is computer-assisted total knee replacement for beginners or experts? Prospective study among three groups of patients treated by surgeons with different levels of experience.

Background: Computer-assisted total knee replacement (TKR) has been shown to improve radiographic alignment and therefore the clinical outcome. Outliers with greater than 3° of varus or valgus malalignment in TKR can suffer higher failure rates. The aim of this study was to determine the impact of experience with both computer navigation and knee replacement surgery on the frequency of errors in intraoperative bone cuts and implant alignment, as well as the actual learning curve.

Post traumatic knee arthritis: navigated total knee replacement without hardware removal.

Background: The Authors present the results of a series of navigated total knee replacements (TKR) without hardware removal in patients with post-traumatic arthritis following femoral fractures. The purpose of the paper was to determine the effectiveness of computer-assisted TKR in these patients compared to routine primary implants.

Methods: Sixteen patients with post-traumatic knee arthritis following a distal femoral fracture and retained hardware were included in the study (group I).

An uncommon cause of cemented unicompartmental knee arthroplasty failure: fracture of metallic components.

Purpose: Despite good overall clinical results, unicompartmental knee replacements (UKR) are not without their problems and failures have been reported. The most common causes of UKR failure are component loosening, poor patient selection, poor surgical technique, polyethylene wear and progression of arthritis in other compartments. The purpose of this study is to present a series of atraumatic fractures of metallic components in a UKR treated in a single orthopaedic centre.

Mean-shifted surface curvature algorithm for automatic bone shape segmentation in orthopedic surgery planning: a sensitivity analysis.

The results of recent studies concerning statistical bone atlases and automated shape analysis are promising with a view to widening the use of surface models in orthopedic clinical practice, both in pre-operative planning and in the intra-operative stages. In this domain, automatic shape analysis is strongly advocated because it offers the opportunity to detect morphological and clinical landmarks with superior repeatability in comparison to human operators. Surface curvatures have been proposed extensively for segmentation and labeling of image and surface regions based on their appearance and shape.

Advanced computational framework for the automatic analysis of the acetabular morphology from the pelvic bone surface for hip arthroplasty applications.

2D- and 3D-based innovative methods for surgical planning and simulation systems in orthopedic surgery have emerged enabling the interactive or semi-automatic identification of the clinical landmarks (CL) on the patient individual virtual bone anatomy. They enable the determination of the optimal implant sizes and positioning according to the computed CL, the visualization of the virtual bone resections and the simulation of the overall intervention prior to surgery. The virtual palpation of CL, highly dependent upon the examiner's expertise, was proved to be time consuming and to suffer from considerable inter-observer variability.

Determination of the Whiteside line on femur surface models by fitting high-order polynomial functions to cross-section profiles of the intercondylar fossa.

Innovative methods for morphological and functional analysis of bones have become a primary objective in the development of planning systems for total knee replacement (TKR). These methods involve the interactive identification of clinical landmarks (reference points, distances, angles, and functional axes of movement) and the determination of the optimal implant size and positioning. Among the functional axes used to estimate the correct alignment of the femoral component, the Whiteside line, namely, the anterior-posterior (AP) direction, is one of the most common.