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14 pages, 4808 KiB

Open AccessArticle

Stress Shielding around Press-Fit Radial Head Arthroplasty: Proposal for a New Classification System Based on the Analysis of 97 Patients with a Mid-Term Follow-Up and a Review of the Literature

by Giuseppe Giannicola, Andrea Amura, Sebastien Prigent, Carmine Zoccali and Pasquale Sessa

Healthcare 2024, 12(3), 396; https://doi.org/10.3390/healthcare12030396 - 3 Feb 2024

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Abstract

Stress shielding (SS) around press-fit radial head arthroplasty (RHA) was recently reported as a cause of a new type of proximal radial neck resorption (PRNR). Very few studies have analyzed this phenomenon. No comprehensive classification is currently available. We thus decided to clinically [...] Read more.

Stress shielding (SS) around press-fit radial head arthroplasty (RHA) was recently reported as a cause of a new type of proximal radial neck resorption (PRNR). Very few studies have analyzed this phenomenon. No comprehensive classification is currently available. We thus decided to clinically and radiographically analyze 97 patients who underwent a press-fit RHA and who were followed up for a mean period of 72 months (range: 2–14 years). PRNR in the four quadrants of the radial neck was assessed. We designed a novel SS classification based on (1) the degree of resorption of the length of the radial neck and (2) the number of neck quadrants involved on the axial plane. The mean PRNR (mPRNR) was calculated as the mean resorption in the four quadrants. mPRNR was classified as mild (<3 mm), moderate (3 to 6 mm), and severe (>6 mm). Eighty-four percent of the patients presented PRNR. mPRNR was mild in 33% of the patients, moderate in 54%, and severe in 13%. In total, 6% of the patients with mild mPRNR displayed resorption in one quadrant, 18% displayed resorption in two quadrants, 4% displayed resorption in three quadrants, and 72% displayed resorption in four quadrants. All four quadrants were always involved in moderate or severe mPRNR, with no significant differences being detected between quadrants (p = 0.568). mPRNR has no apparent effect on the clinical results, complications, or RHA survival in the medium term. However, longer-term studies are needed to determine the effects of varying degrees of PRNR on implant failure. Full article

(This article belongs to the Special Issue Biotechnology & Orthopaedics. Work in Progress—IORS 2023 Meeting Proceedings)

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10 pages, 7547 KiB

Open AccessArticle

Early Biofilm Formation on the Drain Tip after Total Knee Arthroplasty Is Not Associated with Prosthetic Joint Infection: A Pilot Prospective Case Series Study of a Single Center

by Marco Grassi, Marco Senarighi, Luca Farinelli, Annamaria Masucci, Monica Mattioli-Belmonte, Caterina Licini and Antonio Gigante

Healthcare 2024, 12(3), 366; https://doi.org/10.3390/healthcare12030366 - 31 Jan 2024

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Abstract

Background: Periprosthetic joint infection (PJI) is a devastating complication of arthroplasties that could occur during the surgery. The purpose of this study was to analyze the biofilm formation through microbiological culture tests and scanning electron microscopy (SEM) on the tip of surgical drainage [...] Read more.

Background: Periprosthetic joint infection (PJI) is a devastating complication of arthroplasties that could occur during the surgery. The purpose of this study was to analyze the biofilm formation through microbiological culture tests and scanning electron microscopy (SEM) on the tip of surgical drainage removed 24 h after arthroplasty surgery. Methods: A total of 50 consecutive patients were included in the present prospective observational study. Drains were removed under total aseptic conditions twenty-four hours after surgery. The drain tip was cut in three equal parts of approximately 2–3 cm in length and sent for culture, culture after sonication, and SEM analysis. The degree of biofilm formation was determined using a SEM semi-quantitative scale. Results: From the microbiological analysis, the cultures of four samples were positive. The semi-quantitative SEM analysis showed that no patient had grade 4 of biofilm formation. A total of 8 patients (16%) had grade 3, and 14 patients (28%) had grade 2. Grade 1, scattered cocci with immature biofilm, was contemplated in 16 patients (32%). Finally, 12 patients (24%) had grade 0 with a total absence of bacteria. During the follow-up (up to 36 months), no patient showed short- or long-term infectious complications. Conclusions: Most of the patients who underwent primary total knee arthroplasty (TKA) showed biofilm formation on the tip of surgical drain 24 h after surgery even though none showed a mature biofilm formation (grade 4). Furthermore, 8% of patients were characterized by a positivity of culture analysis. However, none of the patients included in the study showed signs of PJI up to 3 years of follow-up. Full article

(This article belongs to the Special Issue Biotechnology & Orthopaedics. Work in Progress—IORS 2023 Meeting Proceedings)

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12 pages, 4496 KiB

Open AccessArticle

Garrè Sclerosing Osteomyelitis of the Clavicle: Clinical Results after Clavicular Resection

by Andrea Gabriele Calamita, Davide Stimolo, Serena Puccini, Matteo Innocenti and Domenico Andrea Campanacci

Healthcare 2024, 12(2), 202; https://doi.org/10.3390/healthcare12020202 - 15 Jan 2024

Cited by 1 | Viewed by 1271

Abstract

(1) Background: Chronic non-bacterial osteomyelitis (CNO), also known as sclerosing osteomyelitis of Garrè, is a rare inflammatory bone disease with a specific clinical picture, uncertain pathogenesis, and no consensus on an effective treatment. Most frequently affecting other long bones, CNO may rarely involve [...] Read more.

(1) Background: Chronic non-bacterial osteomyelitis (CNO), also known as sclerosing osteomyelitis of Garrè, is a rare inflammatory bone disease with a specific clinical picture, uncertain pathogenesis, and no consensus on an effective treatment. Most frequently affecting other long bones, CNO may rarely involve the clavicle. The aim of this study was to present the results of a series of patients affected by CNO of the clavicle treated with total and partial clavicula resection. In addition, a literature review of different types of treatment of CNO was performed. (2) Methods: We retrospectively reviewed three patients with Sclerosing Osteomyelitis of Garre’ of the clavicle treated with partial resection of the clavicle (one) and with total clavicular resection (two). (3) Results: Patients (two female and one male) were an average age of 35.7 years at the time of the operation. At the 4-year follow-up, the mean active ROM was: 143° forward flexion, 133° abduction, 42° external rotation with an internal rotation of two patients at the interscapular level and one patient at the lumbosacral junction. The mean ASES score was 92/100 (range 87–100). In the literature review, after screening the abstracts and full texts for eligibility, 34 studies met the inclusion criteria. Conclusions: Partial or total clavicular resection resulted an effective treatment of CNO of the clavicle. The procedure seems to be particularly indicated after the failure of more conservative treatments. Full article

(This article belongs to the Special Issue Biotechnology & Orthopaedics. Work in Progress—IORS 2023 Meeting Proceedings)

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13 pages, 2139 KiB

Open AccessArticle

Treatment of Scaphoid Non-Unions with Custom-Made 3D-Printed Titanium Partial and Total Scaphoid Prostheses and Scaphoid Interosseous Ligament Reconstruction

by Alessio Cioffi, Giuseppe Rovere, Francesco Bosco, Ennio Sinno, Leonardo Stramazzo, Francesco Liuzza, Antonio Ziranu, Michele Romeo, Giulio Edoardo Vigni, Nicolò Galvano, Giulio Maccauro, Pasquale Farsetti, Mario Igor Rossello and Lawrence Camarda

Healthcare 2023, 11(24), 3123; https://doi.org/10.3390/healthcare11243123 - 8 Dec 2023

Cited by 1 | Viewed by 1626

Abstract

Purpose: Treatment of scaphoid fracture sequelae is still an unsolved problem in hand surgery. Custom-made 3D-printed titanium partial and total scaphoid prosthesis and scaphoid interosseous ligament reconstruction (SLIL) are performed in cases of non-union and isolated aseptic necrosis of the proximal scaphoid pole [...] Read more.

Purpose: Treatment of scaphoid fracture sequelae is still an unsolved problem in hand surgery. Custom-made 3D-printed titanium partial and total scaphoid prosthesis and scaphoid interosseous ligament reconstruction (SLIL) are performed in cases of non-union and isolated aseptic necrosis of the proximal scaphoid pole and when it is impossible to save the scaphoid bone, respectively. This study aims to evaluate the clinical, functional and radiographic results after these two prosthesis implantations. Methods: Between January 2019 and July 2020, nine partial and ten total scaphoid prostheses were implanted using custom-made 3D-printed titanium implants. Evaluation criteria included carpal height ratio (CHR), radioscaphoid angle, wrist extension and flexion, radial deviation and ulnar deviation of the wrist, grip strength and pinch strength, Visual Analogue Scale (VAS), the Disabilities of Arm, Shoulder, and Hand (DASH) score, and the Patient-Rated Wrist Evaluation (PRWE). Results: Clinical, functional, and radiographic improvements were found in all outcomes analyzed for both patient groups. The VAS pain scale obtained the most remarkable improvement at the one-year follow-up. The results of the DASH scores and the PRWE were good, with a great rate of patient satisfaction at the end of the follow-up. SLIL reconstruction also provided excellent stability and prevented a mid-carpal bone collapse in the short- and medium-term follow-up. Conclusions: A custom-made 3D-printed titanium partial or total scaphoid prosthesis is a viable solution for patients with scaphoid non-union and necrosis or complete scaphoid destruction in whom previous conservative or surgical treatment has failed. Full article

(This article belongs to the Special Issue Biotechnology & Orthopaedics. Work in Progress—IORS 2023 Meeting Proceedings)

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11 pages, 916 KiB

Open AccessArticle

Distal Femur Megaprostheses in Orthopedic Oncology: Evaluation of a Standardized Post-Operative Rehabilitation Protocol

by Lorenzo Andreani, Edoardo Ipponi, Federico Falcinelli, Sara Barderi, Lorenzo Vannucci, Francesco Rosario Campo, Antonio D’Arienzo and Paolo Domenico Parchi

Healthcare 2023, 11(22), 2984; https://doi.org/10.3390/healthcare11222984 - 19 Nov 2023

Cited by 2 | Viewed by 1733

Abstract

Background and Objectives: Megaprostheses are the most used reconstructive approach for patients who have undergone massive resection of their distal femurs due to bone tumors. Although the literature about their outcomes has flourished in recent decades, to date, a consensus on rehabilitative treatment [...] Read more.

Background and Objectives: Megaprostheses are the most used reconstructive approach for patients who have undergone massive resection of their distal femurs due to bone tumors. Although the literature about their outcomes has flourished in recent decades, to date, a consensus on rehabilitative treatment is yet to be established. In this study, we report on our experience with our latest standardized rehabilitation program, evaluating our results in a mid-to-long-term scenario. Materials and Methods: We evaluated the functional results of all our oncologic patients treated between 2016 and 2022 who could follow our standardized post-operative rehabilitative approach, consisting of progressive knee mobilization and early weight-bearing. Results: Sixteen cases were included in our study. The average duration of the patients’ hospitalization was 12.2 days. A standing position was reached on average 4.1 days after surgery, while assisted walking was started 4.5 days after surgery. After a mean post-operative follow-up of 46.7 months, our patients’ mean MSTS score was 23.2 (10–30). Our data suggest that the sooner patients could achieve a standing position (R = −0.609; p = 0.012) and start walking (R = −0.623; p = 0.010), the better their final functional outcomes regarding their MSTS scores. Conclusions: Rehabilitation should be considered a pivotal factor in decreeing the success of distal femur megaprosthetic implants in long-surviving oncologic patients. Correct rehabilitation, focused on early mobilization and progressive weight-bearing, is crucial to maximizing the post-operative functional outcomes of these patients. Full article

(This article belongs to the Special Issue Biotechnology & Orthopaedics. Work in Progress—IORS 2023 Meeting Proceedings)

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10 pages, 1643 KiB

Open AccessArticle

Aneurysmal Bone Cyst of the Pelvis in Children and Adolescents: Effectiveness of Surgical Treatment with Curettage, Cryotherapy and Bone Grafting

by Lorenzo Andreani, Edoardo Ipponi, Elena Serrano, Silvia De Franco, Martina Cordoni, Elena Bechini, Antonio D’Arienzo and Paolo Domenico Parchi

Healthcare 2023, 11(19), 2658; https://doi.org/10.3390/healthcare11192658 - 30 Sep 2023

Cited by 3 | Viewed by 1471

Abstract

Background: Aneurysmal bone cysts (ABCs) are benign but locally aggressive cystic lesions of the bone. Pelvic ABCs are extremely rare and hard to treat due to their high risk of local recurrence and the tough access to pelvic bones. Methods: In this retrospective [...] Read more.

Background: Aneurysmal bone cysts (ABCs) are benign but locally aggressive cystic lesions of the bone. Pelvic ABCs are extremely rare and hard to treat due to their high risk of local recurrence and the tough access to pelvic bones. Methods: In this retrospective study, we evaluated pediatric cases with pelvic ABC treated with curettage, cryotherapy and bone grafting treated in our institution between 2016 and 2022. Complications were recorded, as well as local recurrences. Patients’ post-operative functionality was assessed with the MSTS score. Results: Fourteen consecutive cases were included in our study. Their mean age at surgery was 13.5 years. The mean lesion size was 55 mm. The mean follow-up was 38 months. Two cases (11.8%) had local recurrences, which were successfully treated with further curettage. At their latest FU, 13 cases were continuously disease free (CDF), and one had no evidence of disease (NED). Only one case had a post-operative compilation (wound dehiscence). Patients’ mean post-operative MSTS score was 29.6. Conclusions: Pelvic ABCs are a challenge, even for the most experienced orthopedic surgeon. Our study suggests that the association of an accurate curettage, intraoperative cryotherapy and bone grafting can be a reliable and effective therapeutic option for large-sized ABCs of the pelvis. Full article

(This article belongs to the Special Issue Biotechnology & Orthopaedics. Work in Progress—IORS 2023 Meeting Proceedings)

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10 pages, 282 KiB

Open AccessArticle

The Effect of Fracture Patterns, Pinning Configuration, Surgeon Experience and Subspecialty on Short-Term Radiological Outcomes of Pediatric Supracondylar Humeral Fractures Treated in the Prone Position: A Case-Series

by Andrea Vescio, Giovanni Carlisi, Vincenzo Roberto Macrì, Francesco Sanzo, Giuseppe Gigliotti, Daria Anna Riccelli, Giuseppe Tedesco, Michele Mercurio, Olimpio Galasso, Giorgio Gasparini, Garrett R. Jackson, Jorge Chahla and Filippo Familiari

Healthcare 2023, 11(19), 2648; https://doi.org/10.3390/healthcare11192648 - 28 Sep 2023

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Abstract

Background: The most common treatment modality for supracondylar humerus fractures (SCHFs) in children is closed reduction and percutaneous pinning (CRPP). Nonetheless, debate persists regarding the optimal technique used. Therefore, the purpose of our study was to investigate the impact of surgeon experience, surgeon [...] Read more.

Background: The most common treatment modality for supracondylar humerus fractures (SCHFs) in children is closed reduction and percutaneous pinning (CRPP). Nonetheless, debate persists regarding the optimal technique used. Therefore, the purpose of our study was to investigate the impact of surgeon experience, surgeon subspecialty and pin configuration on short-term radiological outcomes following CRPP of displaced SCHFs. Methods: Patients less than 14 years of age who underwent CRPP for displaced SCHFs in the prone position between January 2018 and December 2022 were analyzed. Patients were separated into subgroups based on fracture type (low vs. high sagittal), pin configuration (lateral, cross, other), number and configuration of K-wires and first operator surgical experience. The following outcome measurements were collected: postoperative Baumann angle (BA), Shaft-Condylar angle (SCA), surgical duration (SD), duration of radiation exposure (DRE) and number of clinical and radiological follow-ups (FU). Results: A total of 44 patients with a mean age of 6 ± 2.5 years were included in the final analysis. The mean post-operative BA and SCA were 74.8° ± 4.9° and 37.7° ± 10.2°, respectively. No significant differences were found in the post-operative Baumann’s angle or SCA among the subgroups. Regarding secondary outcomes, no differences were found among each subgroup regarding SD, DRE and FUs. Conclusion: Short-term radiological outcomes following the treatment of SCHFs treated in the prone position are not affected by fracture patterns and pinning configuration, regardless of the surgeon’s years of experience or subspecialty. Full article

(This article belongs to the Special Issue Biotechnology & Orthopaedics. Work in Progress—IORS 2023 Meeting Proceedings)

13 pages, 1653 KiB

Open AccessArticle

Shoulder and Neck Pain in Swimmers: Front Crawl Stroke Analysis, Correlation with the Symptomatology in 61 Masters Athletes and Short Literature Review

by Giuseppe Rinonapoli, Paolo Ceccarini, Francesco Manfreda, Giuseppe Rocco Talesa, Simonetta Simonetti and Auro Caraffa

Healthcare 2023, 11(19), 2638; https://doi.org/10.3390/healthcare11192638 - 27 Sep 2023

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Abstract

Background: Swimming and, specifically, front crawl, can be included among the “overhead” sports. Overhead sports are a risk factor for some problems of the musculoskeletal system, especially the shoulder. The aim of this study was to assess the incidence of shoulder and [...] Read more.

Background: Swimming and, specifically, front crawl, can be included among the “overhead” sports. Overhead sports are a risk factor for some problems of the musculoskeletal system, especially the shoulder. The aim of this study was to assess the incidence of shoulder and neck pain in a Masters Swimming Team and its correlation with the crawl stroke. Methods: This is an observational study through video-analysis of the stroke and a questionnaire. The participants selected for the present study were 61 athletes of a Masters team, whose prevailing training stroke was the front crawl. Their stroke was analyzed during training using a go-pro camera mounted on a sliding trolley on a track, evaluating their technical defects with their trainer. A questionnaire about frequency of shoulder and neck pain during the last five years was administered to all the participants at the study. Results: From the questionnaire, 45 and 55 out of 61 athletes had suffered from shoulder pain and cervical pain, respectively. Both types of pain were correlated with the weekly swimming volume. The swimmers with hyperflexion of the wrist and prolonged internal rotation in the pulling phase had shoulder problems. Those who suffered from current shoulder pain reduced the underwater time. The four swimmers with an excessive body roll during breathing and those who kept their heads extended, reported cervical pain. Conclusions: Shoulder and neck pain could be prevented with the correction of specific technical errors in crawl stroke. Full article

(This article belongs to the Special Issue Biotechnology & Orthopaedics. Work in Progress—IORS 2023 Meeting Proceedings)

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10 pages, 1130 KiB

Open AccessArticle

Preliminary Results of Preoperative Planning Using 3D Printing and Augmented Reality in Cryotherapy Treatment of Giant Cell Tumor of Bone—CRIO2AR Project

by Antonio D’Arienzo, Branimir Scognamiglio, Francesco Rosario Campo, Fabio Cosseddu, Damiano Alfio Ruinato, Edoardo Ipponi, Marina Carbone, Sara Condino, Vincenzo Ferrari, Lorenzo Andreani, Rodolfo Capanna and Paolo Domenico Parchi

Healthcare 2023, 11(19), 2629; https://doi.org/10.3390/healthcare11192629 - 27 Sep 2023

Cited by 1 | Viewed by 1068

Abstract

Giant Cell Tumor of Bone is a benign tumor with high local aggressive expansion, which, in rare cases, spreads metastasis. Surgical treatment, which often consists of wide curettage to reduce recurrence risk, can lower the quality of life for those affected. Along with [...] Read more.

Giant Cell Tumor of Bone is a benign tumor with high local aggressive expansion, which, in rare cases, spreads metastasis. Surgical treatment, which often consists of wide curettage to reduce recurrence risk, can lower the quality of life for those affected. Along with aggressive surgery, adjuvant intraoperative techniques have been implemented such as PMMA and cryotherapy. One of the most widely used cryotherapy techniques involves the use of probes to generate ice balls, which have been scientifically shown to have various impacts on the tumor. Although this has been acknowledged, no one has yet tested a way to accurately plan the positioning of cryotherapy probes before surgery, according to the research conducted by the authors. CRIO2AR is a randomized clinical prospective ongoing study by which it will be experimented via preoperative planning of ice probes placement using AR and 3D printing technologies. By studying a single clinical case with these technologies, the surgeon gains better awareness of patient’s anatomy and tumor localization. Preliminary results are shown in the article. The first results are confirming that these technologies are applicable in clinical practice. Secondly, preoperative planning is proving to be reliable, easily replicable, and useful for the surgeon. Full article

(This article belongs to the Special Issue Biotechnology & Orthopaedics. Work in Progress—IORS 2023 Meeting Proceedings)

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14 pages, 312 KiB

Open AccessArticle

Telerehabilitation Is a Valid Option for Total Knee Arthroplasty Patients: A Retrospective Pilot Study Based on Our Experience during the COVID-19 Pandemic

by Michele Venosa, Emilio Romanini, Enrico Ciminello, Simone Cerciello, Massimo Angelozzi and Vittorio Calvisi

Healthcare 2023, 11(18), 2489; https://doi.org/10.3390/healthcare11182489 - 7 Sep 2023

Cited by 1 | Viewed by 1544

Abstract

Introduction: Total knee arthroplasty is an effective operation. Post-surgery rehabilitation, based on early and intensive progressive exercise programs, plays a substantial role and telerehabilitation can be an effective safe option. This retrospective study aimed to compare traditional in-presence rehabilitation and telerehabilitation for total [...] Read more.

Introduction: Total knee arthroplasty is an effective operation. Post-surgery rehabilitation, based on early and intensive progressive exercise programs, plays a substantial role and telerehabilitation can be an effective safe option. This retrospective study aimed to compare traditional in-presence rehabilitation and telerehabilitation for total knee arthroplasty, based on our experience during the Italian COVID-19 lockdown. Materials and methods: We retrospectively analyzed 164 patients (94 females and 70 males) enrolled in 2020 within 2 weeks after total knee replacement to perform post-operative outpatient rehabilitation. The clinical results of 82 patients (mean age 66.8 ± 10.2 years) performing telerehabilitation with those obtained from a similar cohort of 82 patients (mean age 65.4 ± 11.8 years) performing traditional in-presence outpatient rehabilitation were compared. Clinical outcomes were examined by comparing the gait speed (Time Up and Go-TUG test), the range of motion, the pain intensity (VAS), the functional status (Oxford Knee Score—OKS and Knee injury and Osteoarthritis Outcome Score—KOOS) and the overall satisfaction (Self-administered patient satisfaction scale) 12 weeks after the beginning of the physiotherapeutic protocol. Results: Telerehabilitation was non-inferior to traditional in-presence rehabilitation in all of the investigated areas and no statistical difference in terms of effectiveness was detected at 12 weeks, as confirmed by the respective patient-reported outcome scores such as TUG test (reduced from 20 ± 2 s to 12 ± 1.5 s for the telerehab cohort and from 18 ± 1.5 s to 13.1 ± 2 s for the in-presence rehabilitation one), pain VAS, OKS (improved from 22 ± 1.3 to 36 ± 2.7 for the telerehab cohort and from 23 ± 2.1 to 35.1 ± 4.2 for the in-presence group), KOOS (improved from 46.2 ± 10.2 to 67.4 ± 3.8 for the telerehabilitation cohort and from 48.4 ± 8.4 to 68.3 ± 6.6 for the other group), and the Self-administered patient satisfaction scale (more than two-thirds of patients globally satisfied with the results of their surgery in both groups). Conclusion: The telerehabilitation program was effective after total knee replacement and yielded clinical outcomes that were not inferior to conventional outpatient protocols. Full article

(This article belongs to the Special Issue Biotechnology & Orthopaedics. Work in Progress—IORS 2023 Meeting Proceedings)

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11 pages, 1665 KiB

Open AccessCase Report

Microfracture- and Xeno-Matrix-Induced Chondrogenesis for Treatment of Focal Traumatic Cartilage Defects of the Knee: Age-Based Mid-Term Results

by Francesco Allegra, Aurelio Picchi, Marco Ratano, Stefano Gumina, Andrea Fidanza and Giandomenico Logroscino

Healthcare 2023, 11(22), 2995; https://doi.org/10.3390/healthcare11222995 - 20 Nov 2023

Cited by 2 | Viewed by 1181

Abstract

The aim of this study was to investigate clinical and instrumental outcomes of the autologous matrix-induced chondrogenesis (AMIC) technique for the treatment of isolated traumatic condyle and femoropatellar cartilage lesions. A total of 25 patients (12 males, 13 females, mean age 47.3 years) [...] Read more.

The aim of this study was to investigate clinical and instrumental outcomes of the autologous matrix-induced chondrogenesis (AMIC) technique for the treatment of isolated traumatic condyle and femoropatellar cartilage lesions. A total of 25 patients (12 males, 13 females, mean age 47.3 years) treated between 2018 and 2021 were retrospectively reviewed and subdivided into two groups based on age (Group A, age < 45 years; Group B, age > 45 years). A clinical evaluation was performed using the International Knee Documentation Committee (IKDC), Lysholm score and Visual Analogue Score (VAS). Cartilage regeneration was evaluated via magnetic resonance (1.5 Tesla) and classified according to a Magnetic resonance Observation of CArtilage Repair Tissue (MOCART) scoring system. At a minimum follow-up of 2 years, Group A patients obtained greater instrumental results in comparison to group B: in fact, the MOCART score was statistically significantly correlated with IKDC (r = 0.223) (p < 0.001) exclusively in group A. Nevertheless, a significant improvement in clinical functionality was shown in Group B (p < 0.001), demonstrating that this technique is safe, reproducible and capable of offering satisfactory clinical results regardless of age. Full article

(This article belongs to the Special Issue Biotechnology & Orthopaedics. Work in Progress—IORS 2023 Meeting Proceedings)

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10 pages, 2481 KiB

Open AccessTechnical Note

Technical Note: Tibial Spine Avulsion Treatment with Arthroscopic Reduction and Internal Fixation with Kirschner Wires in Skeletally Immature Patients

by Vittorio Calvisi, Emilio Romanini, Donato Staniscia, Giovanni Di Brigida and Michele Venosa

Healthcare 2023, 11(17), 2404; https://doi.org/10.3390/healthcare11172404 - 27 Aug 2023

Cited by 1 | Viewed by 1445

Abstract

Introduction: Tibial spine avulsion injury, tibial eminence injury, tibial spine fracture, and anterior cruciate ligament (ACL) avulsion are multiple terms that express the same pathological condition. It can be encountered both in the pediatric and adult population. A wide array of surgical techniques [...] Read more.

Introduction: Tibial spine avulsion injury, tibial eminence injury, tibial spine fracture, and anterior cruciate ligament (ACL) avulsion are multiple terms that express the same pathological condition. It can be encountered both in the pediatric and adult population. A wide array of surgical techniques have been proposed to manage displaced tibial spine avulsions. Anyway, insufficient evidence is currently available to prefer one fixation technique over another, and a gold-standard arthroscopy-based technique is still missing. In this article, we describe a mini-invasive, safe and user-friendly technique for arthroscopic reduction and internal fixation of displaced tibial eminence fractures. Materials and methods: Standard and patient-specific accessory arthroscopic portals allow for full access to knee visualization and management of concomitant intraarticular lesions. After performing the debridement of the inflammatory tissue and the release of eventual interposed tissues in the fracture site, the tibial eminence avulsion can be reduced by using a less-invasive bone impactor. With the knee flexed to 90°, the fracture fragments are then synthesized (under fluoroscopic control) with three thin Kirschner wires inserted in a proximal–distal direction in a cross-shaped geometry. Results: This technique allows a fast surgical and hospitalization time, a punctiform arthrotomy, proximal tibial physis preservation, and an early rehabilitation program. Conclusions: This novel technique seems attractive and very promising since it is respectful of the epiphyseal growth plates and is thus suitable for children and adolescents. Full article

(This article belongs to the Special Issue Biotechnology & Orthopaedics. Work in Progress—IORS 2023 Meeting Proceedings)

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