Health-related quality of life in patients with anterior cruciate ligament insufficiency undergoing arthroscopic reconstruction: a practice-based Italian normative group in comorbid-free patients.

Background: Health-related quality of life (HRQoL) in anterior cruciate ligament (ACL) insufficiency has not been assessed in comorbid-free patients to date. An observational study was therefore conducted on a practice-based sample to test the hypothesis that SF-36 scoring in patients with chronic ACL insufficiency differs from the age- and gender-matched Italian norm.

Materials And Methods: Chronically ACL-insufficient patients with or without meniscal and/or focal chondral lesions were enrolled in the study.

Resurfacing versus nonresurfacing the patella in total knee arthroplasty: a critical appraisal of the available evidence.

A systematic literature search for evidences comparing treatment effect and harm of resurfacing versus nonresurfacing the patella in total knee arthroplasty was conducted and yielded five meta-analysis (MA), one systematic review (SR) and six randomized controlled trials not included in previous MAs/SR. The evidence suggests that patellar resurfacing would reduce the risk of anterior knee pain, as well as the risk of patella-related reoperation. Furthermore, patients not undergoing patella resurfacing would experience more knee pain during stair climbing and be less satisfied with surgery.

C-reactive protein changes in the uncomplicated course of arthroscopic anterior cruciate ligament reconstruction.

The diagnosis of septic arthritis following arthroscopic anterior cruciate ligament (ACL) reconstruction is often elusive and can only be confirmed by joint aspiration, although arthrocentesis carries a risk for superinfection. C-reactive protein (CRP) may prove a useful laboratory test to substantiate clinical suspicion. The present study investigated the post-operative variations of CRP in 58 patients (age range 15-52, median age 25) undergoing ACL reconstruction with either bone-patellar tendon-bone (BPTB) or hamstring tendon (HT) who did not develop infection at 6 months follow-up.

Comorbidity-related quality of life in anterior cruciate ligament insufficiency: a cross-sectional study involving 282 candidates for arthroscopic reconstruction.

Background And Purpose: Comorbidity-adjusted health-related quality of life (HRQoL) in anterior cruciate ligament insufficiency (ACLI) has not been assessed to date. A cross-sectional study was conducted to test the hypothesis that HRQoL in ACLI is comorbidity-related and differs from the Italian norm.

Methods: 282 chronically ACL-insufficient candidates for arthroscopic reconstruction with or without meniscal and/or focal chondral lesions were studied.

Subcutaneous emphysema and pneumomediastinum following shoulder arthroscopy with brachial plexus block: a case report and review of the literature.

A number of complications are associated with shoulder arthroscopic surgery. However rare, respiratory complications such as pneumomediastinum and related tension pneumothorax as well as spontaneous pneumothorax in patients undergoing shoulder arthroscopy by endotracheal intubation have been reported in the literature. Although the exact pathogenetic mechanisms remain undetermined, surgery-related factors as well as associated respiratory comorbidity have been hypothesized to intervene in the onset of respiratory complications.

Arthroscopic all-inside suture of symptomatic Baker's cysts: a technical option for surgical treatment in adults.

Synovial fluid caused by repeated effusions may replete the gastrocnemius-semimembranosus bursa (GSB) communicating with the knee joint. Fluid trapped inside the GSB through an alleged unidirectional valve-like mechanism forms a so-called Baker's cyst. Since a significant association of Baker's cysts with knee joint disorders has been reported, treatment should primarily address articular lesions causing recurrent effusions.

Single-bundle versus double-bundle arthroscopic reconstruction of the anterior cruciate ligament: what does the available evidence suggest?

The introduction of the double-bundle technique as a surgical option for primary anterior cruciate ligament (ACL) surgery stems from the hypothesis that replicating the double-bundle anatomy of the native ACL improves knee kinematics by supplying better rotational control. We performed a systematic review of the literature comparing double-bundle with standard single-bundle reconstruction methods. One RCT and three quasi-RCTs with a one-to two-year follow-up were included in this review.

A view from above: a modified Patel's medial midpatellar portal for anterior cruciate ligament arthroscopic surgery.

The use of flexible positions based on the surgeon's need to address specific pathology has been advocated in arthroscopic surgery. In this report we reappraise the midpatellar portals popularized by Patel and present a technique modification of the medial midpatellar portal (mMPP) focusing on its use in anterior cruciate ligament primary and revision arthroscopic surgery. The modified mMPP is established under arthroscopic control from a high anterolateral portal.

Biomechanics of the conservative treatment in idiopathic scoliotic curves in surgical "grey-area".

The biomechanical behaviour of the spine significantly varies in relation to the age of the spine. Particularly, the elastic behaviour of the intervertebral discs has been proved to change during the spine growth, which changes the disc reaction to externally imparted forces. The biomechanical analysis of the G modulus of torsion rigidity of the intervertebral disc shows that the G values progressively increase through growth, which favours the progression of early scoliotic curves.

Study of vertebral morphology in Scheuermann's kyphosis before and after treatment.

Variation of vertebral morphology in Scheuermann's Kyphosis before and after orthopedic treatment is usually measured by the entity of the curve, using Cobb's method, and by vertebral wedging. But the lack of correlation between these parameters and the clinical evolution of the deformity, lead to the possibility of other alterations that can explain part of the kyphosis deformities before and after the treatment. In this group of alterations the inclination of anterior and posterior walls, that express the trapezoid deformity of vertebras, seem to be more reliable indicators of curve response to ortopedic treatment.

Biomechanical factors affecting progression of structural scoliotic curves of the spine.

The development of the spine is affected by both biological and mechanical factors. As the geometry of the motion segment changes throughout growth, so does the mechanical behaviour of the spine owing to changing vectors acting on a variable geometry system. The biomechanical analysis of the growing spine enables the assessment of the role played by biological and mechanical factors in the pathogenesis of progressive scoliosis to be assessed and its comparison with factors acting on an adult scoliotic spine.

Surgery of osteoarticular tuberculosis.

Because of the increasing incidence of tuberculosis consequent on the increasing number of patients with drug-related or HIV-induced immunosuppression, the problems of the invasive or noninvasive treatment of osteoarticular tuberculosis have come up again. While the approach aimed at the elimination of infectious foci with an adequate combination of medical therapy with a conservative treatment or surgery is still valid, the advanced technology of osteosynthesis systems and prosthetic replacement for spinal, hip and knee involvement respectively, with suitable indications, affords new solutions of surgical technique. The objective is to achieve surgical procedures that preserve at best the physiology of locomotor apparatus.

Intraneural cyst of the peroneal nerve.

A 15-year-old girl was referred to us because of foot drop. The motor deficit was characterized by a peculiar fluctuating course related to sporting activity: improvement of symptoms during no-sport periods and worsening during sport training. Neurophysiological examination revealed marked global impairment of muscles innervated by the peroneal nerve.

Immunohistochemical investigation on type III and VI collagen organization in human intervertebral discs in the neonatal period.

Nine L5-S1 discs from cadavers following death at ages ranging from 28 weeks of gestation to 1 month after birth were analysed immunohistochemically to investigate type III and VI collagen organization in neonatal discs. The annulus fibrosus stained poorly with the anti-type III antibody. The transition zone and the nucleus pulposus showed a fibrillary framework.

[The role of computed tomography and magnetic resonance in assessing degenerative arthropathy of the lumbar articular facets].

Degenerative arthropathy of the lumbar facet joints remains a debated issue relative to both its etiopathogenesis and its clinical significance. The authors studied 9 autoptic specimens by means of CT and MRI: the diagnostic value of the two methods was assessed taking the histopathologic findings of the relative specimens as the gold standard. The following signs of degenerative arthropathy were investigated in each specimen: cartilaginous wears, hypertrophy of the articular processes, osteophytosis, subchondral sclerosis and geodes and capsular and ligamentous calcifications.