Is Total Knee Arthroplasty Surgical Performance Enhanced Using Augmented Reality? A Single-Center Study on 76 Consecutive Patients.

Background: Augmented reality (AR) is a powerful multipurpose tool. With a dedicated visor, AR allows the visualization of a series of information and/or images superimposed on the user's field of vision. For this reason, it was recently introduced as a surgical assistant tool.

Biomechanical analysis of different levels of constraint in TKA during daily activities.

Background: Numerous total knee prosthetic implants are currently available on the orthopedic market, and this variety covers a set of different levels of constraint: among the various models available, a significant role is covered by mobile bearing cruciate-retaining design with an ultra-congruent insert, mobile bearing cruciate-retaining design, fixed-bearing posterior stabilized prosthesis and fixed-bearing constrained condylar knee. A biomechanical comparative study among them could therefore be helpful for the clinical decision-making process. This study aimed to compare the effect of these different levels of constraint in the knee biomechanics of a patient, in three different configurations representing the typical boundary conditions experienced by the knee joint during daily activities.

The effect of different insert design congruencies on the kinematics of a mobile bearing TKA: A cadaveric study.

Introduction: Total knee arthroplasty has proved to be a safe, effective and reproducible surgical treatment for patients with serious/advanced degenerative joint disease of the knee, but the optimal results after these implants can be achieved only if the joint kinematics and kinetics are carefully respected and not significantly altered after the replacement. In order to enhance the capability of matching the healthy configuration, therefore, different prosthesis models in terms of constraints and designs are available for the surgeons to choose among. As an example of this variety, mobile bearing models allow the surgeon to choose among different insert designs in terms of geometry and relative biomechanical approaches, with the relative performances depending on which one is adopted.

The use of mobile bearing TKA in valgus deformities - A clinical study.

Background: The number of patients presenting valgus deformities undergoing total knee arthroplasty (TKA) represents approximately 10% of the total number of TKAs performed: the presence of valgus deformity requires the implant to have proper alignment, stability and balance to achieve successful clinical outcomes, especially for knees with high coronal deformities, but these have proven to be difficult goals to achieve and therefore the use of constrained prostheses is often recommended for these cases. However, even though the use of unconstrained mobile bearing for severe knee deformities is rare, it has been shown to give successful outcomes and therefore the aim of this study is to evaluate whether this surgical technique can achieve satisfactory clinical results and correct alignment, as well as good patient satisfaction.

Methods: This study presents the results of 69 TKA performed with cemented mobile bearing implants by a single surgeon on knee affected by valgus deformities.

Bankart Repair With Subscapularis Augmentation in Athletes With Shoulder Hyperlaxity.

Purpose: The purpose of this study was to demonstrate that arthroscopic Bankart repair with associated arthroscopic subscapularis augmentation (ASA) could be a valid surgical option in the treatment of anterior shoulder instability, in collision and contact sports athletes, affected by shoulder hyperlaxity.

Methods: In total, 591 arthroscopic Bankart repairs plus ASA were performed in 6 shoulder centers from 2009 to 2017. Inclusion criteria were the following: collision and contact sports activities, recurrent anterior instability associated with hyperlaxity and glenoid bone loss (GBL) < 15%.

Experimental and clinical analysis of the use of asymmetric vs symmetric polyethylene inserts in a mobile bearing total knee arthroplasty.

Purpose: This study compared the effects of symmetric and asymmetric designs for mobile bearing polyethylene insert for total knee arthroplasty (TKA), both clinically and biomechanically through experimental cadaver tests.

Methods: 303 patients implanted with a mobile bearing TKA were retrospectively analyzed up to 2-year follow-up with relative scores. The same femoral and tibial components were used for all the patients; 151 patients received a Symmetric Design (SD) insert and 152 an Asymmetric Design (AD).

A simple technique to perform total knee replacement without violating the femoral canal: early clinical results on a cohort of 303 patients.

Background: It is becoming increasingly common to find patients candidate for total knee replacement with inaccessible femoral canal due to long femoral hip stems, osteo-synthetic hardware or diaphyseal mal-unions. To treat those patients avoiding complex and expensive procedures, we developed an innovative surgical technique based on a novel device called extra-medullary alignment system. We initially employed this technique in 18 cases with inaccessible femoral canal.

A novel surgical technique to perform total knee arthroplasty in patients with inaccessible femoral medullary canal.

Not seldom Surgeons have to deal with total knee cases where the femoral intramedullary canal is not accessible due to hardware still in place, long hip stems or diaphyseal mal-unions, so intra-medullary referenced instrumentations cannot be employed. We developed a novel instrument called EMAS (Extra Medullary Alignment System) able to help addressing those cases in a simple and reproducible way avoiding the use of more complex and expensive technologies. We present the results achieved using EMAS on 18 of those difficult cases with a maximum follow-up of 7 years as well as our experience using EMAS in our standard practice.

Asymmetric polyethylene inserts promote favorable kinematics and better clinical outcome compared to symmetric inserts in a mobile bearing total knee arthroplasty.

Purpose: This study aims at comparing the effects of symmetric and asymmetric designs for the polyethylene insert currently available and also for mobile bearing total knee arthroplasty (TKA). The investigation was performed both clinically and biomechanically through finite element analysis.

Methods: 303 patients, with a mobile bearing TKA, were analyzed retrospectively.

Manipulation and arthroscopy under general anesthesia and early rehabilitative treatment for frozen shoulders.

Objective: To evaluate the efficacy of manipulation followed by arthroscopic release of the glenohumeral joint in conjunction with an immediate and intensive rehabilitation program.

Design: Retrospective, descriptive study.

Setting: A free-standing, university-affiliated orthopedics and rehabilitation hospital.