One-stage complete eradication and revision hip due to pseudotumor in metal-on-metal hip arthroplasty.

Background: The correct management and treatment of pseudotumors due to metal-on-metal (MOM) hip arthroplasty are still debated. The purpose of this study is to analyze the surgical treatment and the clinical and radiographic 3-year outcomes of MOM arthroplasty revisions due to pseudotumor treated with a strategy of excision and revision.

Methods: Consecutive, retrospective series of 21 patients (8 males/13 females) with pseudotumor due to MOM hip arthroplasty was surgically treated at a single tertiary center.

Titanium modular stems in total hip arthroplasty due to developmental dysplasia: a registry comparison with single-taper implants.

Introduction: The routine use of proximal femoral modularity was discouraged in total hip arthroplasties (THAs). However, titanium dual-taper (DT) implants may provide some advantages over single-taper (ST) stems in cases of complex deformity. A registry study comparing ST and DT stems in dysplasia was designed, aiming to assess: (1) survival rates at long-term; (2) reasons for revision; (3) the profile of failed implants.

Revisions for Periprosthetic Hip Infections Do Not Fail More Than Revisions for Aseptic Loosening, but Mortality is Higher.

Background: The influence of the reasons for revision on the outcomes of revision hip arthroplasties is controversial and poorly described. A registry study was designed to compare the revision hips performed for periprosthetic hip infection (PHI) to the revision hips performed for aseptic loosening. The aims of this study were the long-term assessment and comparison of survival rates, reasons for rerevisions, and mortality rates between these two cohorts.

Metal on metal hip arthroplasty surveillance at a tertiary centre: design, patients' adherence, and cost analysis.

Purpose: Metal-on-metal (MOM) bearings may carry higher than expected revision rates and serious complications: an appropriate surveillance may be advocated. Aims of this paper were to (1) present the biennial experience of MOM surveillance in a tertiary centre, (2) describe the patients' adherence to monitoring, and (3) analyze the costs of the surveillance METHODS: The design of MOM surveillance was developed according to the guidelines of the Italian Society of Orthopaedics and Traumatology. The adherence to every follow-up was expressed as raw numbers and percentages.

Mid-term outcomes of a partial 2-stage approach in late chronic periprosthetic hip infections.

Introduction: Late chronic periprosthetic infections (LCPIs) are worrisome complications of primary hip arthroplasties. The gold standard procedure is the 2-stage revision. 1-stage exchange is gaining popularity in order to reduce the invasivity of the former technique.

Arthroscopic tendon release for iliopsoas impingement after primary total hip arthroplasty: a retrospective, consecutive series.

Introduction: Aim of this study was to describe the clinical outcomes of 16 patients with iliopsoas (IP) impingement after primary total hip arthroplasty (THA), treated with an arthroscopic tendon release.

Methods: 16 patients (11 females/5 males), with a mean age of 57.8 ± 11.

Cementless Total Hip Arthroplasty in Crowe III and IV Dysplasia: High Hip Center and Modular Necks.

Background: Total hip arthroplasty (THA) in severe developmental dysplasia of the hip (DDH) is a challenging procedure. The most used techniques involve anatomic cup positioning, augmentation femoral osteotomy. However, anatomic cup positioning is not always feasible in severe DDH and osteotomy nonunion may ensue.

Short Stems Versus Conventional Stems in Cementless Total Hip Arthroplasty: A Long-Term Registry Study.

Background: Short stems in total hip arthroplasty (THA) have recently gained increasing popularity, allowing mini-invasive exposures and bone-sparing approaches. However, long-term studies and recommendations for the routine use are not available. The aim of this report was to compare the survival rates and the reasons for revision of short stems versus conventional stems in cementless THAs, in a registry-based population.

Double-Incision Approach and Early Rehabilitation in a Complicated Bicondylar Tibial Plateau Fracture: A Case Report.

Objective: The main goal of this case was to report the treatment of bicondylar fractures of the tibial plateau and the restoration of the metaphyseo-diaphyseal dissociation.

Clinical Presentation And Intervention: A 54-year-old male who was cycling had a road accident that caused a closed fracture of the right tibial plateau and proximal fibula diagnosed by X-rays. The patient underwent surgery and was immobilized with a long-leg splint for 4 weeks.

3rd generation alumina-on-alumina in modular hip prosthesis: 13 to 18 years follow-up results.

Introduction: Ceramic-on-ceramic (CoC) couplings are alternative bearings surfaces that have been reported to reduce osteolysis, wear debris and aseptic loosening compared to the use of polyethylene. Early experiences with ceramics had poor results, but they have led to many improvements in the manufacture and design of subsequent implants.

Methods: We analysed medical files of 300 CoC total hip arthroplasty (THA) with a modular neck performed during period 1995-2000 by a single surgeon for a minimum follow-up of 13 years, evaluating clinical and radiological outcome.

Periprosthetic femoral fractures: treatments and outcomes. An analysis of 47 cases.

We evaluated the treatment and outcome of 47 cases of periprosthetic femoral fracture presenting to our unit over a nine-year period. The average follow-up period was 48 months 
(range 24-114). Surgical treatment involved stem revision in 29 hips, open reduction and internal fixation in 11 hips and conservative treatment in seven hips.

Coronary plaque quantification and composition in asymptomatic patients with type II diabetes mellitus.

Objective: The aim of this study was to characterize the extent and morphology of coronary lesions in asymptomatic patients with type II diabetes mellitus.

Methods: We enrolled 102 asymptomatic patients with type II diabetes mellitus and 97 patients without diabetes as controls. All individuals had no history of ischemic heart disease.

Solitary eosinophilic granuloma of the adult lumbar spine.

Introduction: Eosinophilic granuloma (EG) is a benign bone tumor that rarely occurs in adults. It is usually found occurring in flat and long bones, but spine is often affected too. EG is of unknown aetiology, and the course of the disease is unpredictable.

Gorham-Stout disease: the experience of the Rizzoli Institute and review of the literature.

Gorham-Stout disease (also known as "disappearing bone disease") was first described by Jackson in 1838, but was properly defined by Gorham and Stout in a series of 24 patients in 1954-1955. It is a rare disease of unknown etiology (about 200 cases reported in the literature) characterized by spontaneous progressive resorption of bone without malignant proliferation of vascular structures. The diagnosis is one of exclusion and it is based on combined histological, radiological, and clinical features.

Clinically significant thromboembolic disease in orthopedic oncology: an analysis of 986 patients treated with low-molecular-weight heparin.

Background And Objectives: Thromboembolic risk in orthopedic oncology is high due to several factors. The aim of this study was to assess clinically significant thromboembolic disease in 986 patients operated on with a prosthetic reconstruction of the lower limbs after the resection of bone tumors and prophylactically treated with low-molecular-weight heparin (LMWH).

Methods: Between 1983 and 2006, 986 patients had uncemented megaprostheses after a resection of the lower limbs for bone tumors.

The role of surgery and adjuvants to survival in Pagetic osteosarcoma.

Background: Osteosarcoma is a rare complication of Paget's disease with a very poor prognosis. Treatment is controversial: the older age of the patients affected by Paget's disease may limit the use of chemotherapy and axial involvement may limit the practicality of surgery.

Questions/purposes: The purposes of this study are (1) to report the survival in patients treated for osteosarcoma in Paget's disease; (2) to identify correlations between type of treatment and survival comparing our data with those in the literature; (3) to determine if the extent of Paget's disease and risk of malignant transformation are associated; (4) to assess if prognosis is related with site; and (5) to identify the variations of histologic subtypes of these osteosarcomas.

Surgical margins and local control in resection of sacral chordomas.

Background: The treatment of choice in sacral chordoma is surgical resection, although the risk of local recurrence and metastasis remains high. The quality of surgical margins obtained at initial surgery is the primary factor to improve survival reducing the risk of local recurrence, but proximal sacral resections are associated with substantial perioperative morbidity.

Questions/purposes: We considered survivorship related to local recurrence in terms of surgical margins, level of resection, and previous surgery.

Unusual radiographic appearance of adamantinoma.

Adamantinoma is a rare tumor with an indolent course that occurs most commonly in the tibia. It is locally aggressive, and local recurrences are described after resection. Pain is the most common symptom.

Secondary aneurysmal bone cyst in fibrous dysplasia of the proximal femur.

Fibrous dysplasia of bone is a congenital skeletal disorder characterized by proliferation of spindle cells inside an intramedullary collagenous stroma and by formation of metaplastic bone. An aneurysmal bone cyst is a lesion of unknown etiology. Macroscopically it appears like a blood-filled cavity that expands the affected bone.