Comparable outcomes between cruciate-substituting and posterior-stabilized inserts in robotic total knee arthroplasty under the functional alignment principles.

Purpose: Functional alignment (FA) has emerged as a personalized strategy in total knee arthroplasty (TKA) to optimize outcomes by accounting for patient-specific anatomical and soft tissue characteristics. Limited evidence exists on how polyethylene insert type, specifically cruciate-substituting (CS) versus posterior-stabilized (PS), impacts clinical outcomes and complications in this context.

Methods: This retrospective comparative study included 329 patients who underwent robotic-assisted TKA with FA principles with a minimum 2-year follow-up.

Functional knee positioning in patients with valgus deformity undergoing image-based robotic total knee arthroplasty: Surgical technique.

Background: Functional knee positioning (FKP) represents an innovative personalized approach for total knee arthroplasty (TKA) that reconstructs a three-dimensional alignment based on the optimal balance of soft tissue and bony structures, but it has mostly been described for varus knee deformity.

Surgical Technique: Valgus deformities present specific challenges due to altered bone remodeling and soft tissue imbalances. Using robotic assistance, FKP enables precise intraoperative assessment and correction of compartmental gaps, accommodating each individual's unique anatomy and laxities.

Stress shielding influences shoulder function after reverse shoulder arthroplasty using a short stem at minimum 2 years follow-up and can be predicted using a preoperative planning software: A retrospective cohort study.

Background: The aim of the study was to assess if 3D CT-scan-based planification of distal filling ratio (DFR) is accurate when compared to postoperative DFR calculated on plain X-rays. A secondary aim was to investigate if an association between clinical outcomes and the degree of stress shielding (SS) exists.

Methods: Fifty patients with short-stem reverse shoulder arthroplasties, preoperative CT scans, and a minimum 24-month radiographic follow-up were included in the study.

Cartilage thickness can be accurately measured intraoperatively in total knee arthroplasty: A step further in calipered kinematic alignment.

Introduction: Kinematic alignment (KA) in total knee arthroplasty (TKA) is by definition a pure femoral resurfacing procedure aiming to restore the individual prearthritic anatomy. However, when a 2 mm compensation is systematically used on the worn side, the variability in cartilage thickness in the unworn compartment might alter the accuracy of the technique. This study aimed to validate two intraoperative femoral cartilage thickness measurement techniques by comparing them to the photographic method, which measures cartilage thickness through pixel analysis of bone-cut images.

Functional alignment in robotic-assisted total knee arthroplasty for valgus deformity achieves safe coronal alignment and excellent short-term outcomes.

Purpose: Functional alignment (FA) in total knee arthroplasty (TKA) prioritizes soft tissue balancing and anatomical restoration without systematic correction to neutral alignment. Most studies have focused on varus deformity, with little evidence available about FA in valgus deformity. The hypothesis of the present study was that FA in robotic-assisted TKA for valgus deformity would demonstrate correction of the coronal alignment and yield satisfactory short-term outcomes.

Eccentricity and greater size of the glenosphere increase impingement-free range of motion in glenoid lateralized reverse shoulder arthroplasty: A computational study.

Introduction: Increasing the impingement-free Range Of Movement (ROM) is crucial for improving patient's functional outcome and reducing the rate of scapular notching. The purpose of this study was to compare, in a virtual model of Reverse Shoulder Arthroplasty with glenoid lateralization (L-RSA): 1) the impingement-free range of movement (ROM) between 155° Grammont-style inlay stem and 135° flushlay stem; 2) the effect of glenosphere size and type (centered vs eccentric) on impingement-free range of movement (ROM) using a 135° Neck Shaft Angle (NSA) flushlay stem.

Materials And Methods: 200 CT-scans of patients undergoing shoulder replacement for Cuff tear Arthropathy were analyzed in the present study.

Femoral cartilage thickness measured on MRI varies among individuals: Time to deepen one of the principles of kinematic alignment in total knee arthroplasty. A systematic review.

Purpose: Kinematically aligned total knee arthroplasty (KA TKA), as a pure resurfacing procedure, is based on matching implant thickness with bone cut and kerf thickness, plus cartilage wear. However, the assumption of a consistent 2 mm femoral cartilage thickness remains unproven. This study aimed to systematically review the available literature concerning magnetic resonance imaging (MRI) assessment of femoral cartilage thickness in non-arthritic patients.

Mechanically aligned total knee arthroplasty does not yield uniform outcomes across all coronal plane alignment of the knee (CPAK) phenotypes.

Purpose: Patient dissatisfaction rates following total knee arthroplasty (TKA) reported in the literature reach 20%. The optimal coronal alignment is still under debate. The aim of this retrospective study was to compare clinical outcomes in different coronal plane alignment of the knee (CPAK) phenotypes undergoing mechanically aligned (MA) TKA.

Femorotibial angle on short knee radiographs fails to accurately predict the lower limb mechanical alignment. A systematic review and meta-analysis on different femorotibial angle definitions and short knee radiograph types.

Introduction: Hip-knee-ankle angle (HKA) on Full Limb Radiographs (FLRs) is the gold standard for coronal knee alignment assessment. Despite the widespread utilization of the more convenient femorotibial angle (FTA) on either antero-posterior (AP) or postero-anterior (PA) short knee radiographs (SKRs), its definition and correlation with HKA remains controversial. This review is the first to systematically investigate FTA-HKA correlation and the effect of different FTA methods and SKRs.

Magnetic Resonance Imaging in the Evaluation of Avulsion Injuries of the Pelvis and Hip in Adolescent Professional Footballers: A Case Series.

Introduction: Pelvic apophyseal avulsion fractures are uncommon injuries that frequently affect adolescents while participating in sports. This occurs because the enthesis cannot withstand the tractional force applied because the apophysis has not yet fully fused. Due to its complex muscular structure, being the origin of several muscles that cross two lower extremity joints, the pelvis has an increased risk for such injuries.

No differences in terms of complications, readmissions, reoperations, and patient-reported outcomes in simultaneous bilateral versus staged bilateral total knee arthroplasty in selected patients.

Background: The safety and the clinical success of simultaneous bilateral total knee arthroplasty (BTKA) is controversial. The aim of this study was to compare complications and patient-reported outcomes following simultaneous BTKA (simBTKA) versus staged BKTA (staBTKA) in patients affected by bilateral symptomatic end-stage knee osteoarthritis (OA).

Methods: Data from patients who underwent simBTKA or staBTKA at a single institution from January 2017 to December 2020, with a minimum 1-year follow up period were retrospectively collected.

Machine learning can predict anterior elevation after reverse total shoulder arthroplasty: A new tool for daily outpatient clinic?

The aim of the present study was to individuate and compare specific machine learning algorithms that could predict postoperative anterior elevation score after reverse shoulder arthroplasty surgery at different time points. Data from 105 patients who underwent reverse shoulder arthroplasty at the same institute have been collected with the purpose of generating algorithms which could predict the target. Twenty-eight features were extracted and applied to two different machine learning techniques: Linear regression and support vector regression (SVR).

Angled BIO-RSA leads to better inclination and clinical outcomes compared to Standard BIO-RSA and eccentric reaming: A comparative study.

Background: Two surgical techniques were compared : Standard BIO-RSA, performed with a glenoid eccentric reaming along with a cylindric bone graft augmentation vs. the Angled BIO-RSA, performed with a glenoid concentric reaming and a defect correction with an angled bone graft.

Methods: Patients undergoing RSA from January 2016 to April 2019, with one of the two techniques being performed, were retrospectively reviewed.

Restricted kinematic alignment is clinically non-inferior to mechanical alignment in the short and mid-term: A systematic review.

Background: In recent years, kinematic alignment (KA) is becoming a valid alternative to mechanical alignment (MA) in total knee arthroplasty (TKA). However, to avoid early failures, the restricted kinematic alignment (rKA) approach has been developed to restore native knee kinematics without reproducing extreme knee phenotype. This systematic review aims to evaluate clinical and radiological outcomes between rKA and MA for TKA.

Allograft Prosthesis Composite (APC) for Proximal Humeral Bone Loss: Outcomes and Perspectives.

(1) Background: Allograft prosthetic composite (APC) represents one of the techniques used for reconstruction in large proximal humeral bone deficits. The present systematic review aimed at summarizing the state of the art of the technique and analyzing its outcomes. (2) Methods: The PRISMA guidelines were followed to perform this systematic review.

Isolated Large Glenoid Fracture and Acute Glenohumeral Dislocation in Elderly Patients: A Case Series Treated Surgically With Reverse Shoulder Arthroplasty and Augmented Glenoid.

Background: One of the most frequent complications in patients affected by traumatic anterior dislocations is bony Bankart lesion. This study evaluates the clinical and functional outcomes of 10 patients with isolated large glenoid fracture and acute glenohumeral dislocation treated with reverse shoulder arthroplasty.

Methods: Patients older than 69 years who underwent reverse shoulder arthroplasty after isolated large glenoid fracture and acute glenohumeral dislocation between 2016 and 2022 at the same institute were selected.

MicroRNA expression changes in the development of rotator cuff tendon injuries.

Traumatic or degenerative rotator cuff (RC) tendon injuries are a leading cause of persistent shoulder pain and reduction of mobility with associated disability and dysfunction, which require each year more than 250,000 surgical repairs in the United States. MicroRNAs (miRNAs) are small noncoding RNAs, that in the posttranscriptional phase lead to the development and function of tissues. The aim of this review was to identify miRNA expression changes in patients with RC pathologies and to determine their relevance as a potential novel diagnostic and potentially therapeutic tool for RC disorders.

Immunonutrition in Orthopedic and Traumatic Patients.

The role of nutrition intervention in surgical settings is constantly developing and evolving. Immunonutrition represents a viable option to reduce perioperative and postoperative complications in surgical oncology. However, as far as we know, little research has been conducted in the orthopedic field.

Short to Early-Mid Term Clinical Outcomes and Survival of Pyrocarbon Shoulder Implants: A Systematic Review and Meta-Analysis.

Background: The appropriate surgical treatment option for young and active patients undergoing shoulder arthroplasty for arthritis remains questionable. Pyrolitic carbon (pyrocarbon) has been shown to improve implant longevity and decrease wear when in contact with cartilage or bone. The present systematic review aimed to evaluate clinical and radiological outcomes as well as the survivorship of pyrocarbon shoulder implants.

Early return to activity of daily living after total hip arthroplasty: a systematic review and meta-analysis.

Background: Total hip arthroplasty (THA) is an orthopaedic procedure that improves the quality of life in patients suffering from hip pain related to osteoarthritis, fractures, and avascular osteonecrosis of the femoral head. Different surgical approaches can be used for THA leading to different recovery times. Because of the lowering medium age of people undergoing THA, it is important to focus on the earlier return of physiological activity after surgery.

Return to Sport After Total Shoulder Arthroplasty and Hemiarthroplasty: A Systematic Review.

Purpose: One of the most frequent concerns of the increasing number of patients undergoing shoulder arthroplasty is the possibility to resume sport after surgery. This systematic review determined the rate of return to sport after total shoulder arthroplasty (TSA) and hemiarthroplasty (HA).

Materials And Methods: The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed to perform this systematic review.

Mid- to long-term outcomes of augmented and nonaugmented anatomic shoulder arthroplasty in Walch B3 glenoids.

Background: In cases of severe osteoarthritis, posterior glenoid wear leads to acquired retroversion of the glenoid. Surgical treatment of glenoids with acquired retroversion and posterior humeral subluxation with anatomic total shoulder arthroplasty (aTSA) is controversial. The purpose of this study was to determine mid- to long-term outcomes and reoperation rates of augmented and nonaugmented aTSA for treatment of glenohumeral osteoarthritis with Walch B3 glenoid deformity.