Bilateral femur fracture as the first manifestation of multiple myeloma: a case report.

The authors aimed to elaborate on an interesting clinical case of a subject that came to our attention following a low-energy traumatic event, producing a bilateral femur fracture. During the instrumental investigations, findings pointing to multiple myeloma were described, in fact later confirmed by the histological and biochemical investigations. In this specific case, unlike manifestations in most patients with MM, the classic correlated pathognomonic symptoms, such as lower back pain, weight loss, recurrent infections, asthenia, were not present.

Atrophic pseudarthrosis of humeral diaphyseal fractures: medico-legal implications and methodological analysis of the evaluation.

Humeral shaft fractures account for 1- 3% of all fractures and about 20-27% of those involving the humerus. In the past they were often conservatively treated, with an acceptable consolidation rate. Open reduction and internal fixation (ORIF) is the best choice in polytrauma patients, in complex or pathological fractures and in those associated with vascular injuries.

A case of infection and severe soft tissue loss of the elbow. Planning surgical treatment in compliance with good clinical-care practices and medico-legal implications.

Soft tissue loss around  the elbow, with tendons, nerves and bone exposure,  represents a challenging condition, often requiring a complex and accurate surgical reconstruction. Inadequate repair of soft tissue defects may in fact compromise further reconstructive orthopedic procedures, including  osteosynthesis and joint replacement. A correct reparative sequence of these lesions usually starts with an appropriate debridement and removal of all non-viable and infected tissues, followed by soft tissues management through plastic and reconstructive techniques.

Acetabular Chondral Lesions Associated With Femoroacetabular Impingement Treated by Autologous Matrix-Induced Chondrogenesis or Microfracture: A Comparative Study at 8-Year Follow-Up.

Purpose: The aim of this retrospective study was to investigate, at 8 years, the clinical follow-up and failure rate (revision rate/conversion to arthroplasty) of patients with hip chondral lesions associated with femoroacetabular impingement and to compare over time the treatment by microfracture (MFx) and autologous matrix-induced chondrogenesis (AMIC).

Methods: Patients aged between 18 and 55 years, with acetabular grade III and IV chondral lesions (Outerbridge), measuring 2 to 8 cm operated on at least 8 years before enrollment. Exclusion criteria were rheumatoid arthritis, dysplasia, or axial deviation of the femoral head.

Arthroscopic treatment of chondral defects in the hip: AMIC, MACI, microfragmented adipose tissue transplantation (MATT) and other options.

Chondral lesions are currently considered in the hip as a consequence of trauma, osteonecrosis, dysplasia, labral tears, loose bodies, dislocation, previous slipped capital femoral epiphysis and Femoro-Acetabular-Impingement (FAI). The management of chondral lesions is debated and several techniques are described. The physical examination must be carefully performed, followed by radiographs and magnetic resonance imaging (MRI).

Autologous Membrane Induced Chondrogenesis (AMIC) for the treatment of acetabular chondral defect.

Background: Acetabular chondral defect are very frequently associated to FAI. Treatment options are still questionable.

Methods: Between 2008 and 2014, 201 patients over 583 have been arthroscopically treated with the AMIC procedure for grade III and/or IV acetabular chondral lesions.

Hip osteochondral lesions: arthroscopic evaluation.

Background: Hip arthroscopy has allowed the diagnosis and treatment of chondral injuries.

Methods: We retrospectively analysed the intraoperative data of 359 patients treated with hip arthroscopy from January 2012 to December 2013. We estimated the frequency, location and extension of acetabular cartilage (AC) injuries and their correlation to femoroacetabular impingement (FAI).

Sustained five-year benefit of autologous matrix-induced chondrogenesis for femoral acetabular impingement-induced chondral lesions compared with microfracture treatment.

The repair of chondral lesions associated with femoroacetabular impingement requires specific treatment in addition to that of the impingement. In this single-centre retrospective analysis of a consecutive series of patients we compared treatment with microfracture (MFx) with a technique of enhanced microfracture autologous matrix-induced chondrogenesis (AMIC). Acetabular grade III and IV chondral lesions measuring between 2 cm(2) and 8 cm(2) in 147 patients were treated by MFx in 77 and AMIC in 70.

Primary stability of a PGLA/Polydioxanone membrane for potential autologous chondrocyte implantation in the hip joint. A cadaveric study.

The purpose of this cadaveric study was to evaluate the primary stability of a membrane 
(resorbable polyglactin-910/poly-p-dioxanone) for autologous chondrocyte implantation (ACI) inserted by press-fit into defects in the femoral head and acetabulum. The stability of the membrane was evaluated after implantation in a cartilage defect on both sides of the joint in 12 hips in six cadavers. The hip was manually put through a full range of motion for 50 cycles after each lesion had been created and filled, starting with the acetabulum.