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Topic Review
Slipped Capital Femoral Epiphysis Pathogenesis and Obesity
Slipped capital femoral epiphysis (SCFE) is the most common adolescent hip disorder in children 9–15 years old with an incidence that ranges from 0.33:100,000 to 24.58:100,000. Idiopathic SCFE is strongly associated with obesity, while atypical SCFE is associated with endocrinopathies, metabolic and renal disease, radiation therapy, and chemotherapy. 
  • 806
  • 25 Apr 2023
Topic Review
Suppressive Antibiotic Treatment in PJIs
The treatment of prosthetic joint infections (PJIs) is a complex matter in which surgical, microbiological and pharmacological aspects must be integrated and, above all, placed in the context of each patient to make the best decision. Sometimes it is not possible to offer curative treatment of the infection, and in other cases, the probability that the surgery performed will be successful is considered very low. 
  • 800
  • 23 Jun 2021
Topic Review
Chronic Antithrombotic Agents in Arthroplasty
Total hip and knee arthroplasty are common major orthopedic operations being performed on an increasing number of patients. Many patients undergoing total joint arthroplasty (TJA) are on chronic antithrombotic agents due to other medical conditions, such as atrial fibrillation or acute coronary syndrome. Given the risk of bleeding associated with TJAs, as well as the risk of thromboembolic events in the post-operative period, the management of chronic antithrombotic agents perioperatively is critical to achieving successful outcomes in arthroplasty. 
  • 797
  • 19 May 2021
Topic Review
Management of Bone Defects in Revision Knee Arthroplasty
Worldwide, the number of revisions to total knee arthroplasty procedures is increasing. Revision surgery is a challenging procedure, required for the management of bone loss after removal of the first implant. Although further long-term follow-up studies are needed, the use of cones in revisions of total knee arthroplasty yields reliability in fixation and stability to restore joint lines, especially in challenging surgeries with poor bone stock. The introduction of 3D-printed cones in revision surgery seems to be advantageous for AORI type III bone defects, especially in reducing intraoperative complications and procedure times.
  • 795
  • 12 Dec 2023
Topic Review
Ankle and Foot Arthroplasty and Prosthesis
The foot and ankle serve vital roles in weight bearing, balance, and flexibility but are susceptible to many diverse ailments, making treatment difficult. More commonly, Total Ankle Arthroplasty (TAA) and Total Talus Replacement (TTR) are used for patients with ankle degeneration and avascular necrosis of the talus, respectively. Ankle prosthesis and orthosis are also indicated for use with lower limb extremity amputations or locomotor disability, leading to the development of powered exoskeletons. However, patient outcomes remain suboptimal, commonly due to the misfitting of implants to the patient-specific anatomy. Additive manufacturing (AM) is being used to create customized, patient-specific implants and porous implant cages that provide structural support while allowing for increased bony ingrowth and to develop customized, lightweight exoskeletons with multifunctional actuators. AM implants and devices have shown success in preserving stability and mobility of the joint and achieving fast recovery, as well as significant improvements in gait rehabilitation, gait assistance, and strength for patients. 
  • 794
  • 20 Nov 2023
Topic Review
Percutaneous-Reinforced Osteoplasty for Long Bone Metastases
Percutaneous-reinforced osteoplasty is currently being investigated as a possible therapeutic procedure for fracture stabilization in high-risk patients, primarily in patients with bone metastases or osteoporosis. For these patients, a percutaneous approach, if structurally sound, can provide a viable method for treating bone fractures without the physiologic stress of anesthesia and open surgery. However, the low strength of fixation is a common limitation that requires further refinement in scaffold design and selection of materials, and may potentially benefit from tissue-engineering-based regenerative approaches. Scaffolds that have tissue regenerative properties and low inflammatory response promote rapid healing at the fracture site and are ideal for percutaneous applications. On the other hand, preclinical mechanical tests of fracture-repaired specimens provide key information on restoration strength and long-term stability and enable further design optimization.
  • 789
  • 20 Oct 2022
Topic Review
Stem Cell-Derived Extracellular Vesicles in Bone Defects
The repair of critical bone defects is a hotspot of orthopedic research. With the development of bone tissue engineering (BTE), there is increasing evidence showing that the combined application of extracellular vesicles (EVs) derived from mesenchymal stem cells (MSCs) (MSC-EVs), especially exosomes, with hydrogels, scaffolds, and other bioactive materials has made great progress, exhibiting a good potential for bone regeneration. 
  • 782
  • 29 Jul 2022
Topic Review
Treatment of Thumb Carpometacarpal Joint Osteoarthritis
Thumb carpometacarpal joint (CMCJ) arthritis is the second most common location for degenerative osteoarthritis in the wrist and hand and several surgical treatments have been proposed so far, from arthrodesis to motion sparing procedures—such as trapeziectomy alone or in combination with interposition of autograft, allograft and ligamentoplasty.
  • 776
  • 19 Apr 2022
Topic Review
Elbow Stiffness Imaging Diagnosis
Loss of elbow motion can lead to disability in everyday gestures, recreational activities, and work. Unfortunately, the elbow joint is particularly prone to stiffness because of its complex anatomy and biomechanics. The etiology of elbow stiffness is varied and must be diagnosed accurately in order to allow optimal treatment, which may be challenging for surgeons and physiotherapists. Its treatment can be either conservative, arthroscopic or surgical, with a trend for arthroscopic procedures when conservative treatment fails. There is no consensus on the optimal imaging workup for elbow joint stiffness, which may have an impact on patient management. 
  • 767
  • 08 Dec 2021
Topic Review
Cementless Total Knee Arthroplasty
Considering the increasing number of young and active patients needing Total Knee Arthroplasty (TKA), orthopedic surgeons are looking for a long-lasting and physiological bond for the prosthetic implant. Multiple advantages have been associated with cementless fixation including higher preservation of the native bone stock, avoidance of cement debris with subsequent potential third-body wear, and the achievement of a natural bond and osseointegration between the implant and the bone that will provide a durable and stable fixation. 
  • 766
  • 18 Mar 2024
Topic Review
Reverse Total Shoulder Arthroplasty
Reverse total shoulder arthroplasty (RTSA) is designed to medialize the glenohumeral joint center of rotation through offset lateralisation and inferiorization of the humerus, thereby increasing the deltoid moment arm.
  • 765
  • 17 Jan 2022
Topic Review
Hypoxia-Inducible Factor and Oxidative Stress in Tendon Degeneration
Tendinopathy is a debilitating condition marked by degenerative changes in the tendons. Its complex pathophysiology involves intrinsic, extrinsic, and physiological factors. While its intrinsic and extrinsic factors have been extensively studied, the role of physiological factors, such as hypoxia and oxidative stress, remains largely unexplored.
  • 761
  • 31 Jan 2024
Topic Review
Epigenetic Factors Related to Low Back Pain
Low back pain (LBP) is one of the most common causes of pain and disability. Treatment and interventions for acute and chronic low back pain often fail to provide sufficient levels of pain relief, and full functional restoration can be challenging. Considering the significant socio-economic burden and risk-to-benefit ratio of medical and surgical intervention in low back pain patients, the identification of reliable biomarkers such as epigenetic factors associated with low back pain could be useful in clinical practice.
  • 757
  • 31 Jan 2023
Topic Review
Immunomodulatory Actions of Mesenchymal Stromal Cells (MSCs)
Cellular therapy offers regeneration which curbs osteoarthritis of the knee. Among cellular therapies, mesenchymal stromal cells (MSCs) are readily isolated from various sources as culture expanded and unexpanded cellular population which are used as therapeutic products. Though MSCs possess a unique immunological and regulatory profile through cross-talk between MSCs and immunoregulatory cells (T cells, NK cells, dendritic cells, B cells, neutrophils, monocytes, and macrophages), they provide an immunotolerant environment when transplanted to the site of action.
  • 754
  • 23 Nov 2021
Topic Review
Therapies in Osteogenesis Imperfecta
Osteogenesis imperfecta (OI) is a rare skeletal dysplasia characterized as a heterogeneous disorder group with well-defined phenotypic and genetic features that share uncommon bone fragility. 
  • 754
  • 22 Feb 2024
Topic Review
Pelvic Ring Injuries
Pelvic ring injuries have an estimated annual incidence of 14–37 per 100,000 inhabitants each year. Treatment can be either non-operative or operative, depending on the injury as well as patient characteristics. The operative treatment of pelvic ring injuries remains a challenging task for surgeons due to the complex three-dimensional (3D) shape of the pelvis, morphological variations, limited access to fracture sites, and narrow bone corridors for screw placement. The goal of operative treatment is to restore pelvic symmetry and achieve stable fracture fixation, which allows for early mobilization and good functional outcome at the long-term. 
  • 749
  • 01 Oct 2021
Topic Review
Preventive Techniques of Bone Tumor Surgical Site Infection
The management of malignant bone tumors requires multidisciplinary interventions including chemotherapy, radiation therapy, and surgical tumor resection and reconstruction. Surgical site infection (SSI) is a serious complication in the treatment of malignant bone tumors. Compared to other orthopedic surgeries, the surgical treatment of malignant bone tumors is associated with higher rates of SSIs. In patients with SSIs, additional surgeries, long-term administrations of antibiotics, extended hospital stays, and the postponement of scheduled adjuvant treatments are required. Therefore, SSI may adversely affect functional and oncological outcomes. To improve surgical outcomes in patients with malignant bone tumors, preoperative risk assessments for SSIs, new preventive techniques against SSIs, and the optimal use of prophylactic antibiotics are often required. Previous reports have demonstrated that age, tumor site (pelvis and tibia), extended operative time, implant use, body mass index, leukocytopenia, and reconstruction procedures are associated with an increased risk for SSIs. Furthermore, prophylactic techniques, such as silver and iodine coatings on implants, have been developed and proven to be efficacious and safe in clinical studies.
  • 741
  • 30 Sep 2022
Topic Review
Pilates Method in Patients with Multiple Sclerosis
Multiple sclerosis (MS) is a chronic autoimmune and inflammatory neurological disease that affects the myelinated axons in the central nervous system, characterized by neurological deterioration over time. The Pilates Method is a rehabilitation tool with verified benefits in pain management, physical function, and quality of life in many different physiotherapy areas. It could be beneficial for patients with multiple sclerosis (pwMS).
  • 740
  • 21 Feb 2022
Topic Review
Sports and Children with Hemophilia: Current Trends
Hemophilia is a sex-linked recessive disorder characterized by a lack of blood factors necessary for clotting. Sports activities have benefits in children with hemophilia in terms of both physical and psychological wellness. Sports activity is necessary for children with hemophilia to preserve joints’ range of motion, reduce joint bleeding, improve muscle mass and strength, enhance proprioception and prevent secondary chronic diseases.
  • 738
  • 02 Dec 2021
Topic Review
Orthobiologics in Achilles Tendinopathy
Orthobiologics are biological materials that are intended for the regeneration of bone, cartilage, and soft tissues. Achilles tendinopathy (AT) or tendinitis of the heel is one of the most common ankles and foot overuse injuries. This musculoskeletal disorder usually affects professional and recreational athletes who engage in vigorous physical activities, such as jumping and running, but it may also develop in sedentary individuals. Achilles tendon injuries are often quite devastating because, unlike some tissue types, tendons are poorly vascularized structures that rely upon synovial fluid diffusion to provide nutrition. The typical features of Achilles tendinopathy are failed healing responses, persistent inflammation, and predominant catabolic reactions. Therefore, the application of orthobiologic tools represents a viable solution, considering their demonstrated efficacy, safety, and relatively easy manipulation. Perhaps a synergistic approach regarding the combination of these orthobiologics may promote more significant clinical outcomes rather than individual application.
  • 732
  • 25 Mar 2022
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