Trabecular Metal Augments for the Management of Paprosky Type III Defects Without Pelvic Discontinuity: Average 11-Year Follow-Up in Cases With Previously Reported 4-Year Clinical Results.

Background: This retrospective case series aimed to assess the clinical and radiographic outcomes of revision total hip arthroplasty with trabecular metal (TM) augments associated with cementless TM acetabular components for the management of Paprosky type IIIA and IIIB defects without pelvic discontinuity.

Methods: There were 83 hips (82 patients) enrolled. There were 53 patients who completed the clinical and radiological follow-up (64% of the total) who had a mean follow-up of 11 years (range, 7 to 16.

The Trochlear Bisector as a New Landmark for Kinematic Alignment in Total Knee Arthroplasty: A Radiographic Study.

: In recent years, there has been considerable interest in prosthetic alignment techniques for total knee arthroplasty (TKA), particularly in the so-called kinematic alignment, which aims to restore the knee's native alignment. However, implementing this technique requires specialized instruments and procedural steps that can be laborious. This study introduces the bisector of the trochlear groove as a reliable landmark for performing the distal femoral cut while maintaining parallelism with the native femoral joint line.

A new classification to characterize and predict treatment of acetabular bone defects.

Background: The increasing amount of revision surgeries in total hip arthroplasty (THA) represents a burden for orthopedic surgeons given the complexity and unpredictability of this kind of surgery. The aim of the current study was to develop a new radiographic classification of acetabular bone defects stratify the severity of the lesion and to suggest the surgical strategy to address it.

Methods: Radiographs of 151 consecutive patients who underwent acetabular revision surgery in our institution were collected to develop a new classification that groups the acetabular bone defects in three zones (A, B and C).

Femoral bone defect classifications in revision total hip arthroplasty: a comprehensive review and proposal of a new algorithm of management.

The number of primary total hip arthroplasties (THAs) and revisions is expected to steadily grow in the future. The femoral revision surgery can be technically demanding whether severe bone defects need to be addressed. The femoral revision aims to obtain a proper primary stability of the stem with a more proximal fixation as possible.

All-Polyethylene Versus Metal-Backed Tibial Components in Total Knee Arthroplasty: A Meta-Analysis of Randomized Controlled Trials.

Background: In the literature, there is no evidence suggesting the superiority in clinical performance between all-polyethylene (AP) and metal-backed (MB) tibial implants in total knee arthroplasty. The aim of this study was to systematically review the literature to collect only high-quality studies investigating the differences in terms of clinical and radiostereometric analysis (RSA) outcomes of AP compared to MB implants.

Methods: Only randomized controlled trials (RCTs) reporting either clinical or RSA outcomes have been included.

AI-based hip prosthesis failure prediction through evolutional radiological indices.

Introduction: This study aimed to develop artificial intelligence models for predicting hip implant failure from radiological features. Analyzing the evolution of the periprosthetic bone and implant's position throughout the entire follow-up period has shown the potential to be more relevant in outcome prediction than simply considering the latest radiographic images. Thus, we investigated an AI-based model employing a small set of evolutional parameters derived from conventional radiological features to predict hip prosthesis failure.

An in vitro model for osteoarthritis using long-cultured inflammatory human macrophages repeatedly stimulated with TLR agonists.

Osteoarthritis (OA) is characterized by an abundance of inflammatory M1-like macrophages damaging local tissues. The search for new potential drugs for OA suffers from the lack of appropriate methods of long-lasting inflammation. Here we developed and characterized an in vitro protocol of long-lasting culture of primary human monocyte-derived macrophages differentiated with a combination of M-CSF+GM-CSF that optimally supported long-cultured macrophages (LC-Mϕs) for up to 15 days, unlike their single use.

Clinical and radiological outcomes of an uncemented metaphyseal short stem at minimum 10 years of follow-up: a prospective observational study.

Purpose: There is growing interest around short stems as they provide a less invasive approach for total hip arthroplasty preserving bone stock for a possible revision surgery if required. The main purpose of this work was to assess the long-term performance of an uncemented metaphyseal short stem in terms of survival rate and in addition its clinical and radiological outcomes.

Materials And Methods: From January to December 2010, we prospectively enrolled all consecutive patients undergoing primary total hip arthroplasty with an uncemented metaphyseal short stem in our institution with a minimum follow-up of 10 years.

Sub-optimal femoral fit in total knee arthroplasty, a systematic review of human femoral data vs off-the-shelf contemporary femoral components.

Purpose: The purpose of the current study is to investigate the inadequacy of fit between the human distal femur and the knee implants offerings and describe the available strategies to overcome this issue.

Methods: A systematic research of the literature was performed to identify studies reporting morphologic measures of the distal femur. Studies were excluded if they included unhealthy knees or the morphological analysis did not report the two key dimensions to identify the patient's unique anatomy: AP length and mediolateral (ML) width.

Sport Activity and Clinical Outcomes after Hip Arthroscopy with Acetabular Microfractures at a Minimum 2-Year Follow-Up: A Matched-Pair Controlled Study.

: Acetabular microfractures for cartilage lesions have been shown to be a safe procedure able to improve patient reported outcomes (PROs). Nevertheless, the return to sport activity rate represents a crucial outcome to be investigated in these young athletic patients. : Patients undergoing acetabular microfracture for full chondral acetabular lesions were compared to a 1:1 matched-pair by age and gender control group undergoing hip arthroscopy without microfractures.

Automatic Identification of Failure in Hip Replacement: An Artificial Intelligence Approach.

Background: Total hip arthroplasty (THA) follow-up is conventionally conducted with serial X-ray imaging in order to ensure the early identification of implant failure. The purpose of this study is to develop an automated radiographic failure detection system. Methods: 630 patients with THA were included in the study, two thirds of which needed total or partial revision for prosthetic loosening.

Large variation in timing of follow-up visits after hip replacement: a review of the literature.

The study investigated the existing guidelines on the quality and frequency of the follow-up visits after total hip replacement surgery and assessed the level of evidence of these recommendations. The review process was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Additional works were retrieved by direct investigation of the available guidelines of the most important orthopedic societies and regulatory agencies.

A single step, centrifuge-free method to harvest bone marrow highly concentrated in mesenchymal stem cells: results of a pilot trial.

Purpose: The aims of the present study were: (1) to characterize the bone-marrow aspirate (BMA) obtained with a centrifuge-free process, employing a dedicated aspiration device; (2) to test the in vitro efficacy of BMA in a model of cartilage inflammation; and (3) to report the preliminary clinical results in a small cohort of patients affected by knee OA.

Methods: Ten patients (4 M, 6 W; mean age: 51.9 ± 9.

Drug Delivery Systems for the Treatment of Knee Osteoarthritis: A Systematic Review of In Vivo Studies.

Many efforts have been made in the field of nanotechnology to improve the local and sustained release of drugs, which may be helpful to overcome the present limitations in the treatment of knee OA. Nano-/microparticles and/or hydrogels can be now engineered to improve the administration and intra-articular delivery of specific drugs, targeting molecular pathways and pathogenic mechanisms involved in OA progression and remission. In order to summarize the current state of this field, a systematic review of the literature was performed and 45 relevant studies were identified involving both animal models and humans.

Injections in the osteoarthritic knee: a review of current treatment options.

Knee osteoarthritis is a degenerative condition characterized by progressive cartilage degradation, subchondral damage, and bone remodelling. Among the approaches implemented to achieve symptomatic and functional improvements, injection treatments have gained increasing attention due to the possibility of intra-articular delivery with reduced side effects compared to systemic therapies.In addition to well-established treatment options such as hyaluronic acid (HA), cortico-steroids (CS) and oxygen-ozone therapy, many other promising products have been employed in the last decades such as polydeoxyribonucleotide (PDRN) and biologic agents such as platelet-rich plasma (PRP) and mesenchymal stem cells (MSCs).

Therapeutic Manipulation of Macrophages Using Nanotechnological Approaches for the Treatment of Osteoarthritis.

Osteoarthritis (OA) is the most common joint pathology causing severe pain and disability. Macrophages play a central role in the pathogenesis of OA. In the joint microenvironment, macrophages with an M1-like pro-inflammatory phenotype induce chronic inflammation and joint destruction, and they have been correlated with the development and progression of the disease, while the M2-like anti-inflammatory macrophages support the recovery of the disease, promoting tissue repair and the resolution of inflammation.