Outcomes of modular stem for the treatment of periprosthetic femoral fracture: a systematic review of the literature.

Background: Periprosthetic femoral fractures (PFFs) are a frequent complication after total hip arthroplasty (THA). Both modular and non-modular tapered fluted titanium (TFT) stems could be used in total hip revisions (THRs). Nevertheless, the most appropriate femoral stem type is still under debate.

Trabecular titanium cups in hip revision surgery: a systematic review of the literature.

Background: Hip revision surgery in extensive acetabular bone defects represents a complex challenge for hip surgeons. The primary goal is to obtain a stable acetabular component and restore the hip biomechanics. Through the years, different prosthetic implants have been developed to perform acetabular revision depending on bone loss location and extension.

PCL retained is safe in medial pivot TKA-a prospective randomized trial.

Purpose: Medial pivot (MP) designs resemble native knee kinematics and restore the "natural" kinematics of a knee after total knee arthroplasty (TKA). However, whether to preserve or resect the posterior cruciate ligament (PCL) is still under debate. We inquired whether sacrificing the PCL would improve range of motion, functional outcomes, and limb alignment compared to preserving the PCL in TKA using medial pivot implants (MP-TKA).

Two-stage revision in periprosthetic joint infection of the hip using a new intraoperatively molded articulating spacer design.

Purpose: The treatment of periprosthetic joint infection (PJI) after total hip arthroplasty (THA) is still under debate. Two-stage exchange arthroplasty is the most common surgical procedure performed. This study analyzed a new functional articulating hip spacer called "Spaceflex" regarding the mechanical-related complications, the recurrent/persistent infection during the interval period, the overall infection-free survivorship after reimplantation, the overall complication/reoperation after reimplantation and the evaluation of patient-reported outcome measures (PROMs) at three intervals of time: before the first stage, during the interval period, and at the final follow-up after reimplantation.

How to Manage Metallosis: A Retrospective Cohort Analysis after Revision Hip Surgery.

Background: Adverse local tissue reactions to metal debris are due to a metal-on-metal bearing complication caused by micromotions at modular interfaces that induce corrosion of the protective oxide layer. This process could lead to wear, fretting, and abrasion with the release of metal ions locally and systemically, which may cause adverse local reactions in nearby tissues. The aim of this study is to describe a series of patients with painful local adverse tissue reactions secondary to corrosion at the modular neck-body interface, to document the clinical presentation, diagnostic workup, and surgical findings of our research, and to search for a possible correlation between metallosis and infection.

Predictive Value of the C-Reactive Protein to Albumin Ratio in 30-Day Mortality after Hip Fracture in Elderly Population: A Retrospective Observational Cohort Study.

Background: C-reactive protein (CRP) to Albumin ratio (CAR) has been used in multiple clinical settings to predict early mortality. However, there is a lack of evidence on the predictive role of CAR in 30-day mortality after a hip fracture. The purpose of this study was to establish a potential association between CAR and 30-day mortality and to assess if the CAR Receiving Operating Characteristics curve (ROC) can be a reliable predictor of early mortality.

Extended trochanteric osteotomy is a safe procedure in two-stage hip revision: a systematic review of the literature.

Background: Extended trochanteric osteotomy (ETO) has proved to be an effective technique in complicated stem removal in femoral aseptic loosening or periprosthetic fracture. Debate remains about its safety in periprosthetic joint infection (PJI). The primary aim of this study is to analyze the ETO reinfection and union rate in two-stage hip revision.

Improving technical and non-technical skills of emergency medicine residents through a program based on high-fidelity simulation.

We evaluated the effectiveness of a training program with high-fidelity simulation (HFS) to improve technical (TS) and non-technical skills (NTS) of residents in Emergency Medicine. We conducted a 2-year training program for the management of a critical patient based on HFS (6 sessions for every year, four teams who performed 4 scenarios per session). At the beginning of the training program, all participants received a presentation of Crisis Resource Management (CRM) principles.

Mid-term survivorship and clinical outcomes of the medial stabilized systems in primary total knee arthroplasty: A systematic review.

Introduction: Medial Pivot Total Knee Arthroplasty was introduced in clinical practice in 1990s to reproduce the in vivo-natural knee kinematics. This design is characterized by an asymmetric constraint profile, with aa highly congruent medial compartment, and a less congruent lateral compartment. Short-term outcomes of the medial pivot systems in primary knee arthroplasty have been widely reported in the current literature, however, only few studies have described results beyond 5-year follow-up.

Plasma PCSK9 levels and sepsis severity: an early assessment in the emergency department.

The aim of the study is to evaluate the prognostic value of early PCSK9 levels in non-intubated septic patients admitted to the emergency department. This report utilized a portion of the data collected in a prospective study, with the aim of identifying reliable biomarkers for an early sepsis diagnosis. In the period November 2011-December 2016, we enrolled 268 patients, admitted to our High-Dependency Unit from the emergency department with a diagnosis of sepsis.

Does the medial pivot knee improve the clinical and radiographic outcome of total knee arthroplasty? A single centre study on two hundred and ninety seven patients.

Purpose: Total knee arthroplasty (TKA) is a cost-effective surgery with a survival rate higher than 90% after 15 years. Nevertheless, patients are unsatisfied in more than 15% of cases. Medial pivot (MP) prosthetic designs were introduced in late 90's with the aim to reproduce natural knee kinematics.

Prognostic value of serial lactate levels in septic patients with and without shock.

To analyze the prognostic value of lactate levels for day-7 and in-hospital mortality, in septic patients with and without shock. In the period November 2011-December 2016, we enrolled 268 patients, admitted to our High-Dependency Unit with a diagnosis of sepsis. Lactate dosage was performed at ED-HDU admission (T0), after 2 h (T2), 6 h (T6) and 24 h (T24); lactate clearance was calculated at T2 and T6 [T2: ((LAC T0-LAC T2/LAC T0)*100)]; T6: [(LAC T0-LAC T6/LAC T0)*100].

SOFA Score prognostic performance among patients admitted to High-Dependency Units.

Background: The aim of this study was to assess prognostic stratification in patients admitted in two Italian Emergency-Department High-Dependency Units (ED-HDU).

Methods: From June 2014, to July 2016, we recorded all patients admitted in the ED-HDU of the Careggi University Hospital and the Vittorio Emanuele University Hospital in a standardized database. Charlson Index and SOFA Score were calculated to evaluate comorbidity burden and severity of organ dysfunction.

Trabecular Titanium acetabular cups in hip revision surgery: mid-term clinical and radiological outcomes.

Introduction:: Severe acetabular bone loss during revision hip arthroplasty can be restored with different surgical techniques. Best results have been observed using porous tantalum cementless cups. Trabecular Titanium (TT) cups were designed to reproduce the structure, mechanical and biological characteristics of trabecular bone.

Prognostic value of sepsis-induced coagulation abnormalities: an early assessment in the emergency department.

To evaluate if the assessment of coagulation abnormalities at ED admission could improve prognostic assessment of septic patients. This report utilizes a portion of the data collected in a prospective study, with the aim to identify reliable biomarkers for an early sepsis diagnosis. In the period November 2011-December 2016, we enrolled 268 patients, admitted to our High-Dependency Unit with a diagnosis severe sepsis/septic shock.

Mechanical and elution properties of G3 Low Viscosity bone cement loaded up to three antibiotics.

Objective: Periprosthetic Joint Infection (PjI) is considered one of the most difficult complication to manage after total knee or hip arthroplasty, with a mean incidence of 1%. Antibiotic loaded bone cement is used as prophylaxis during primary arthroplasty and as local therapy during two-stage revision. The aim of this study is to evaluate the mechanical and elution properties of G3 Low Viscosity Bone Cement (G-21 San Possidonio, Modena, Italy) loaded with different doses of up to three antibiotics (12 specimens).

High values of pelvic incidence: A possible risk factor for zigoapophyseal facet arthrosis in young.

In humans the acquisition of the bipedalism caused different structural changes to achieve the new functional demands. In particular, several changes have occurred in the spine and pelvis. In recent years the sagittal morphology of the spine and pelvis has become one of the most focused topics in spine research.

Mini-open approach for femoroacetabular impingement: 10 years experience and evolved indications.

Introduction: Femoroacetabular impingement (FAI) has been proposed as a possible cause of early osteoarthritis of the hip. The treatment of this condition and its related lesions can be performed by 3 methods: surgical dislocation of the hip; pure arthroscopic; and anterior mini-open technique with or without arthroscopic assistance.

Methods: We describe the anterior mini-open technique and report our experience over the last decade in the treatment of FAI and different associated pathologies of the hip.

Arthroscopic assisted mini-open approach of the hip: Early multicentric experience.

Background: Surgical treatment of femoroacetabular impingement is becoming accepted worldwide, owing to improvements in clinical results and quality of life. In addition to treatment by surgical dislocation or arthroscopy, arthroscopic assisted mini-open approach was postulated to treat this pathology.

Objective: The aim of this study was to analyze early results of the first consecutive 72 cases of femoroacetabular impingement treated using the arthroscopic assisted mini-open approach in two different centers by two surgeons trained by a senior surgeon experienced in the technique.