Olecranon Fossa Fenestration Approach to the Coronoid and Anterior Elbow: The Way OFF.

Hypertrophic osteoarthritis of the elbow is a challenging condition that can vary from mild to severe, affecting patients' quality of life due to pain and loss of range of motion. A consensus about its treatment does not exist. Open arthrolysis with capsular release, synovectomy, Outerbridge-Kashiwagi fenestration, and removal of loose bodies and osteophytes demonstrated good results.

Anatomic physeal-sparing MPFL reconstruction in skeletally immature patients shows favourable outcomes at a minimum of 24-month follow-up.

Purpose: Recurrent patellar dislocation is a prevalent orthopaedic issue among active paediatric and adolescent populations. Bony surgical procedures are not recommended in growing patients; therefore, the focus of surgery is on restoring the medial patellar ligaments, with different reconstructive techniques available. This retrospective case series focuses on the 2-year outcomes of medial patellofemoral ligament (MPFL) reconstruction in skeletally immature patients with open physis.

A reduced scapulo-humeral angle contributes to the development of scapular notching in reverse total shoulder arthroplasty.

Purpose: Scapular Notching (SN) is one of the most common postoperative complications for a patient after Reverse Total Shoulder Arthroplasty (RTSA). Despite employing various strategies to mitigate SN risk, the overall incidence remains far from zero. This article introduces a new risk factor, the scapulo-humeral angle (SHA), as a key element influencing the risk for SN.

Outcomes of Medial Closing-Wedge Distal Femoral Osteotomy for Femoral- and Tibial-Based Valgus Deformity.

Background: In carefully selected patients with an arthritic valgus knee, distal femoral osteotomy (DFO) can improve symptoms at medium- to long-term follow-up, reducing osteoarthritis progression. To date, there is no clear evidence in the current literature regarding the role of postoperative joint line obliquity (JLO) in valgus deformity correction.

Purpose: To assess the clinical and radiological outcomes of medial closing-wedge DFO (MCW-DFO) for the treatment of valgus knees, considering both tibial- and femoral-based deformities, as well as to verify the efficacy and safety of MCW-DFO according to JLO boundaries (≤4°).

Proximal radioulnar joint, but not posterolateral, instability in patients with symptomatic minor instability of the lateral elbow.

Background: The elbow joint is stabilized laterally by a complex of bony and ligamentous structures, such as the lateral ulnar collateral ligament and radial lateral collateral ligament (RLCL). Pathogenesis of many elbow conditions like symptomatic minor instability of the lateral elbow (SMILE) is based on ligamentous incompetency. The aim of this study is to measure ligament elongation in SMILE patients and determine the correlation with the development of this pathologic condition.

Electric scooter-related orthopedic injuries: the experience of an Italian orthopedic center and literature review.

Background: With the increasing prevalence of electric scooters, a concomitant increase in the number of specific injuries, emergency department (ED) admissions and hospital admissions have been reported.

Objectives: Analyze patient flow changes in the ED with a focus on e-scooter-related injuries through a case series and a comparison with the contemporary literature.

Data Sources: A systematic literature review was performed on Medline/PubMed and Embase using terms related to the topic.

Optimised fast-track protocols in total knee arthroplasty determine shorter hospitalisation time and lower perioperative/postoperative complications.

Purpose: This literature review aims to present evidence-based clinical recommendations for the eight most debated topics related to perioperative management in total knee arthroplasty: counselling, prehabilitation, transfusion risk, tranexamic acid, drainage, analgesia, urinary catheter and compression stockings.

Methods: A multidisciplinary team conducted a systematic review on these topics. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for the literature review and result presentation.

Allografts use in orthopedic surgery: trend change over the past 11 years from a regional tissue bank.

Allografts are the second most transplanted tissue in medicine after blood and are now increasingly used for both primary and revision surgery. Allografts have the advantages of lower donor site morbidity, availability of multiple grafts, and shorter operative time. The Banks represents the bridge between Donor and Recipient and guarantees the quality and safety of the distributed allografts Given the increasing interest in these tissues, a retrospective analysis of data collected from the Regional Musculoskeletal Tissue Bank registry over an 11-year period (2009-2019) was conducted.

A 70° Arthroscope Provides Better Visualization of the Medial Side of the Elbow Than a 30° Arthroscope.

Purpose: To assess and quantify the improvement in visualization of humeral insertion of the medial collateral ligament (MCL) using a 70° scope compared with a 30° scope during elbow arthroscopy.

Methods: Twenty patients undergoing elbow arthroscopy for different pathologic conditions were enrolled in this single-center study. Visualization of the medial gutter of the elbow was evaluated by using both the 70° and the 30°scope.

Look for the POLESTAR (POsteroLateral Engagement of Soft Tissue And Radial head) while navigating around elbow dislocation.

Background: Elbow dislocation is frequently associated with bony and osteochondral posterolateral capitellar lesions that are often under-reported. We aim to examine the radiologic signs of posterolateral lesions on computed tomography (CT).

Methods: A retrospective analysis of CT scans was performed.

Diagnostic and prognostic role of synovial tissue analysis in juvenile idiopathic arthritis: a monocentric study.

Objectives: This study investigates the diagnostic role of synovial tissue analysis in children presenting with arthritis and assesses its prognostic significance to predict clinical outcome in juvenile idiopathic arthritis (JIA).

Methods: Synovial samples of paediatric patients undergoing synovial biopsy between 1995 and 2020 were analysed histologically and immunohistochemically. Relationships between histological/immunohistochemical parameters and clinical variables were assessed.

Italian Orthopaedic and Traumatology Society (SIOT) position statement on the non-surgical management of knee osteoarthritis.

Background: Knee osteoarthritis (OA) is a chronic disease associated with a severe impact on quality of life. However, unfortunately, there are no evidence-based guidelines for the non-surgical management of this disease. While recognising the gap between scientific evidence and clinical practice, this position statement aims to present recommendations for the non-surgical management of knee OA, considering the available evidence and the clinical knowledge of experienced surgeons.

Operational strategies to deal with the COVID-19 emergency: recommendations from the Italian national society SIAGASCOT following the introduction of vaccines against the SARS-CoV-2 infection.

Background: This article aims to present the operational recommendations adopted by the Italian national society for orthopaedic surgery, arthroscopy, and sports medicine (SIAGASCOT) in managing patients eligible to undergo elective orthopaedic surgery during the COVID-19 pandemic after the beginning of a national vaccination campaign.

Materials And Methods: An extensive literature search, analysing medical databases and scientific societies protocols, was performed to support this document. A four-step approach was used: 1-definition of priorities; 2-definition of significant clusters of interventions; 3-extraction of recommendations from international literature; and 4-adaptation of the recommendations to the specific features of the Italian healthcare system.

The meniscal extrusion index is a reliable indirect sign of different meniscal lesion patterns: a classification based on percentage of meniscal extrusion.

Purpose: This study's goal is to propose a straightforward classification system based on the MEI (Meniscal Extrusion Index), a measure of meniscal extrusion, that relates to various meniscal lesion patterns and has clinical and biomechanical significance. The study's secondary goal is to determine whether the standard 3 mm meniscal extrusion parameter still has value by correlating the MEI with it.

Methods: 1350 knee MRIs that were performed over the course of 2 years made up the study cohort.

A Worldwide Analysis of Adipose-Derived Stem Cells and Stromal Vascular Fraction in Orthopedics: Current Evidence and Applications.

The biological enhancement of tissue regeneration and healing is an appealing perspective in orthopedics. We aimed to conduct a systematic review to describe the global distribution of studies investigating the use of adipose tissue derivates in orthopedics and to provide information on their quality and on the products available. The quality of the included studies was assessed using the modified Coleman Methodology Score (mCMS) and the Cochrane risk-of-bias tool for randomized trials.

Exploring the prevalence and clinical impact of fibromyalgia syndrome in patients with shoulder diseases: a cross-sectional study.

Objectives: Fibromyalgia (FM) is a musculoskeletal syndrome characterised by widespread chronic pain often associated with systemic manifestations such as mood disturbances, persistent fatigue, unrefreshed sleep, and cognitive impairment, substantially impacting patients' health-related quality of life. Based on this background, this study aimed to evaluate the prevalence of FM syndrome in patients referring to an outpatient clinic in a central orthopaedic institute for a painful shoulder. The demographic and clinical characteristics of patients fulfilling the criteria for FM syndrome were also correlated with the severity of symptoms.

Platelet-rich plasma does not improve clinical results in patients with rotator cuff disorders but reduces the retear rate. A systematic review and meta-analysis.

Purpose: To assess whether the use of Platelet-rich plasma (PRP) produces a clinical benefit in patients with rotator cuff disorders, treated either conservatively or surgically.

Methods: A systematic review was performed according to PRISMA guidelines on three databases (PubMed, Cochrane Library, Web of Science) to identify randomised controlled trials (RCTs) on the use of PRP in patients with rotator cuff disorders, treated either conservatively or surgically. A meta-analysis was performed on articles reporting results for Constant, UCLA, VAS, SST scores and retear rate.

Bone marrow lesions in the knee are associated with meniscal lesions and cartilage pathologies according to the six-letter system.

Purpose: This study aims to find a correlation between bone marrow lesions (BMLs) in knee MRI and pathologies of joint structures. In addition, according to the six-letter system classification, the authors analyzed a potential association between the area affected by BMLs and the specific type of joint lesion.

Methods: The authors screened all the knee MRIs performed in the investigation center between 2017 and 2018 to identify the presence of BMLs.

The Dynamic Effect of Anterior Cruciate Ligament Deficiency on Patellar Height.

Background: The anterior tibial translation (ATT) in case of Anterior Cruciate Ligament (ACL) tear can lead to dynamic alterations of the extensor apparatus biomechanics. The aim of this study is to evaluate the dynamic effect of isolated ACL deficiency on patellar height. The hypothesis is that the ATT of ACL-insufficient knees dynamically reduces patellar height.

Good patient satisfaction with low complications rate after trochleoplasty in patellofemoral instability.

Purpose: Trochlear dysplasia has been recognized as the most common factor in patients with patellofemoral dislocation. Trochleoplasty is a surgical procedure whose primary goal is to modify the femoral trochlea's abnormal shape in patients suffering from patellar instability, requiring good surgical skills, correct indication, and accurate patient information.

Methods: The review aims to describe preoperative planning, patient selection, most common surgical techniques, and clinical results of trochleoplasty in patellar instability in a reproducible manner.