Histological study of atraumatic periprosthetic fractures: does atypical periprosthetic fracture exist?

Purpose: Is it possible a correlation between some periprosthetic femoral fractures and atypical fractures?

Case: We present a case of a 77-year-old woman with atypical periprosthetic femoral fracture. The patient had a history of long-term bisphosphonate use. We performed an open reduction, a synthesis of the fracture and a histological exam.

Underdiagnosis of osteoporotic vertebral fractures in patients with fragility fractures: retrospective analysis of over 300 patients.

Osteoporosis (OP) is a silent disease unless a fracture occurs; it is a major health problem, mainly due to fragility fractures, that occur at vertebral and peripheral sites. Vertebral fractures (VF) are probably the most common fragility fractures, but they go often unrecognized. The main clinical symptoms of VF are acute and chronic back pain, spinal deformity, reduced mobility and impaired quality of life.

Efficacy of a specific rehabilitation protocol in postural control of a young woman with multiple fragility vertebral fractures: a case report.

The fragility vertebral fractures have a considerable impact on an individual's health-related quality of life due to pain, limitations in activity, social participation, altered mood and balance impairment. Physiotherapy interventions may have an important role in improving quality of life, balance and reducing the fracture risk in people with osteoporotic vertebral fractures. In literature there are only a few studies that examine exercise interventions in osteoporotic populations with vertebral fracture and few studies that examine the effects on balance with instrumental measurements.

Algodystrophy: complex regional pain syndrome and incomplete forms.

The algodystrophy, also known as complex regional pain syndrome (CRPS), is a painful disease characterized by erythema, edema, functional impairment, sensory and vasomotor disturbance. The diagnosis of CRPS is based solely on clinical signs and symptoms, and for exclusion compared to other forms of chronic pain. There is not a specific diagnostic procedure; careful clinical evaluation and additional test should lead to an accurate diagnosis.

Giant Schwannoma of the Saphenous Nerve in The Distal Thigh: A Case Report.

Case: Schwannomas are benign nerve myelin sheath tumors that can occur anywhere in the peripheral nervous system. It is very rare for Schwannomas to become malignant, but surgery is still the principal treatment to eliminate symptoms and to correctly diagnosis the tumor. We report an interesting case of a schwannoma of the saphenous nerve at the distal third of the posteromedial thigh: the patient complained of muscle weakness at left lower limb and vague anteromedial knee pain, mimicking a meniscal tear.

Single-Use Instrumentation Technologies in Knee Arthroplasty: State of the Art.

The surgical site contamination and the resulting periprosthetic infections are an important cause of morbidity and socio-economic impact. In total knee arthroplasty, the single-use instrumentation is developed to simplify the surgical procedure, reduce the chance of instrument contamination, improve the operating room efficiency, and reduce overall costs (low cost of instrument washing and sterilization as well as personnel management). Surgical single-use instrumentations on the market are complete with all you need for the surgical procedure-cutting guides, conventional or PSI (patient-specific instrumentation), femoral cutting block, re-cutting block, trials components, alignment rods, inserts, and impactors.

Grafting of Expanded Mesenchymal Stem Cells without Associated Procedure in a Healed Case of Ulna Pseudarthrosis: A Case Report.

Background: The surgical management of pseudoarthrosis is often a challenge. The use of mesenchymal multipotent cells expanded and manipulated in the laboratory is an interesting treatment of pseudoarthrosis, because they can lead to differentiation into osteocytes and thus the formation of bone tissue.

Case Description: We present a case of a 47-years-old man with isolate ulna fracture, treated with plate and screws and evolved in non-union.

Total hip replacement in osteoarthritis: the role of bone metabolism and its complications.

Osteoarthritis is one of the most common joint disorder. For treatment of hip symptomatic osteoarthritis, when conservative medical therapy has failed, total hip arthroplasty (THA) is a successful orthopaedic procedures that reduces pain and improves function and quality of life. Incidence of osteoarthritis is constantly increasing with raising life expectancy.

Three-dimensional parametric mapping in quantitative micro-CT imaging of post-surgery femoral head-neck samples: preliminary results.

Osteoporosis and pathological increased occurrence of fractures are an important public health problem. They may affect patients' quality of life and even increase mortality of osteoporotic patients, and consequently represent a heavy economic burden for national healthcare systems. The adoption of simple and inexpensive methods for mass screening of population at risk may be the key for an effective prevention.

Stemless humeral component in reverse shoulder prosthesis in patient with Parkinson's disease: a case report.

Introduction: In patients with Parkinson's disease falling is very common and for this reason, the prosthetic surgical indication in shoulder is reserved for special cases. PD has been linked to several interrelated factors that may contribute to failure of shoulder arthroplasty.

Case Presentation: A 65-year-old woman with PD, severe pain, recurrent bursitis, swelling and functional limitation to all movements in left shoulder presented to our attention.

Treatment of Tendon Injuries of the Lower Limb with Growth Factors Associated with Autologous Fibrin Scaffold or Collagenous Scaffold.

Tendon injuries are an increasing problem in orthopedics as we are faced with a growing demand in sports and recreation and an aging population. Tendons have poor spontaneous regenerative capacity, and often, complete recovery after injury is not achieved. Once injured, tendons do not completely re-acquire the biological and biomechanical properties of normal tendons due to the formation of adhesions and scarring, and often these abnormalities in the arrangement and structure are risk factors for re-injury.

Up-to-date Review and Cases Report on Chondral Defects of Knee Treated by ACI Technique: Clinical-instrumental and Histological Results.

The limited regenerative potential of a full thickness defect of the knee joint cartilage has certainly conditioned the development of therapeutic strategies that take into account all the aspects of the healing process. The most common treatments to repair chondral and osteochondral lesions are bone marrow stimulation, osteochondral autograft transplantation, autologous matrix-induced chondrogenesis, and autologous chondrocyte implantation. We like to emphasize the difference between a chondral and an osteochondral lesion because the difference is sometimes lost in the literature.

The hip prosthesis in lateral femur fracture: current concepts and surgical technique.

The third proximal femur fractures are divided into medial and lateral ones. For medial fractures already exists unanimity of thought for the choice of treatment that involves the prosthetic replacement of the hip joint in patients over 60 without indications to the synthesis. Regarding the lateral femur fractures this unanimity does not exist yet even if the majority of surgeons practice treatment with osteosynthesis.

Hip replacement in femoral head osteonecrosis: current concepts.

Osteonecrosis of the femoral head is a destructive disease that usually affects young adults with high functional demands and can have devastating effects on hip joint. The treatment depends on extent and location of the necrosis lesion and on patient's factors, that suggest disease progression, collapse probability and also implants survival. Non-idiopathic osteonecrosis patients had the worst outcome.

The role of external fixation in the treatment of humeral shaft fractures: a retrospective case study review on 85 humeral fractures.

There is no consensus among surgeons on the treatment for humeral fractures: the best it is still a matter of some debate. The aim of our work was to demonstrate that external fixation may be considered a valid method not only in emergencies but also for the definitive treatment of such fractures. We perform a retrospective case study review on 85 humeral fractures, 62 shaft fractures, and 23 extrarticular distal third fractures treated with external fixation.

Cement extractor device in revision prosthesis of the humerus.

In revision arthroplasty the surgeon is often faced with the problem of removal of residual cement in the medullary canal. Conventional manual cement removal by hand or power-driven instruments can be time-consuming, can require osteotomy, and can be associated with complications such as cortical perforation, fracture, or bone loss. Ultrasonic devices offer an alternative method of cement removal, but the potential for thermal injury exists, in particular for the humerus and the radial nerve.

A case of bilateral stress fractures in an old woman: three years of pain.

In elderly patients frequent episodes of joint pain of lower limbs exacerbated by stress and resistant to treatment occur frequently. This paper reports a case of a long lasting bilateral atraumatic knee pain with a final diagnosis of bilateral stress fractures of proximal tibia in osteoporotic postmenopausal woman. The distinctive trait of this case is that the fracture has set in bilaterally and associated with an isthmic L4-L5 spondylolisthesis in a patient afflicted by a decline in mood.

Osteoporosis with vertebral fractures associated with pregnancy: two case reports.

Pregnancy and lactation-associated osteoporosis (PAO) is a rare condition characterized by the occurrence of fragility fractures, most commonly vertebral, in late pregnancy or the early postpartum period. The prevalence, etiology and pathogenesis of this osteoporosis are unknown, although there are several hypotheses attempting to explain the etiopathogenesis of pregnancy associated osteoporosis. In this paper we present two cases of young women who developed severe PAO with vertebral fractures: a 42-year-old woman with a family history of osteoporosis, and a 21-year-old woman affected with myasthenia gravis.

Study of the porcine dermal collagen repair patch in morpho-functional recovery of the rotator cuff after minimum follow-up of 2.5 years.

Tendon augmentation grafts have the potential to facilitate the repair of massive or otherwise unrepairable rotator cuff tears. In our clinic, between 2009 and 2013, 25 patients underwent surgery to treat massive symptomatic rotator cuff tears with porcine dermal collagen patch. This study is a clinical and instrumental assessment of 9 patients with the longest follow-up.

Disuse osteoporosis of the upper limb: assessment of thirty patients.

Osteoporosis is a multifactorial skeletal disorder characterized by the decrease of bone mass and the alteration of bone microarchitecture that leads to the increase of fracture risks. Traditionally, osteoporosis has been classified into primary and secondary osteoporosis. Primary osteoporosis refers to osteoporotic conditions which are not related to other chronic illnesses and is usually associated with aging and decreased gonadal function, such as decreased level of estrogen, whereas secondary osteoporosis is the type of osteoporosis caused by other health problems.

The second hip fracture in osteoporotic patients: not only an orthopaedic matter.

The second hip fracture indicates the fracture of the osteoporotic femoral neck which occurs in patients already operated on the opposite side. It is a growing problem, especially in Italy where the ageing rate of the population is one of the highest in the world. Only in recent years this issue has been discussed in the international literature about timing and the treatment methods as a consequence linked to the social costs, mortality, disability of this pathology.

Current medical treatment strategies concerning fracture healing.

The morbidity and socioeconomic costs associated with bone healing are considerable. A number of fractures are complicated by impaired healing. This is prevalent in certain risk groups such as elderly, osteoporotics, post-menopausal women, and in people with malnutrition.

Use of autologous human mesenchymal stromal cell/fibrin clot constructs in upper limb non-unions: long-term assessment.

Background: Tissue engineering appears to be an attractive alternative to the traditional approach in the treatment of fracture non-unions. Mesenchymal stromal cells (MSCs) are considered an appealing cell source for clinical intervention. However, ex vivo cell expansion and differentiation towards the osteogenic lineage, together with the design of a suitable scaffold have yet to be optimized.

Clinical and surgical approach of severe bone fragility fracture: clinical case of 4 fragility fracture in patient with heavy osteoporosis.

An accurate diagnosis of osteoporosis and a proper treatment are today recognized to be the most important facts for prevention and for a correct arrangement and treatment of fragility fractures. In the text the Authors describe a case of severe osteoporosis aggravated by 2 femur fractures and 2 periprosthetic fractures occurred in 2 months. In such cases the orthopaedic surgeon needs to formulate first a clinical osteoporotic pattern, than its treatment together with a surgery suitable choice, that has to take into consideration of the bone structural characteristics.

Comparison of 50 vertebral compression fractures treated with surgical (kyphoplasty) or non surgical approach.

The presence of a vertebral fracture increases the risk of a new fracture within a year by at least five times and the risk further increases in case of recurrent fractures (domino effect).The pain and fracture kyphosis can compromise respiratory function. Many patients sustain serious cardiovascular, musculoskeletal, metabolic, and immune complications related to immobility and bedrest.