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Topic Review
Orthopedic Biocompatible Implant
A biomaterial is  a nonviable material used in a medical device, intended to interact with biological systems. In the field of orthopedics, implantology challenges emerge at the border of local reactions to metallic implants with personalized implant surfaces and general inflammatory reactions as a result of host–implant response.
  • 418
  • 30 Jan 2023
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. 
  • 417
  • 18 Mar 2024
Topic Review
Tranexamic Acid in Anterior Cruciate Ligament Reconstruction
There are several papers that investigate the use of tranexamic acid (TXA) in anterior cruciate ligament reconstructions (ACLR) or other arthroscopic procedures, that show favorable results and little to no complications. In our systematic review we show that TXA use in arthroscopic ACLR decreases postoperative blood loss and pain. Some evidence of improvement in functional scores were observed, but we believe that needs to be addressed in specific long-term result studies.
  • 414
  • 12 Jan 2022
Topic Review
Osteogenesis in Healthy and Senescent Mesenchymal Stem Cells
Mesenchymal stem cells (MSCs) are stem cells with the potential ability to differentiate into various cells and the ability to self-renew and resemble fibroblasts. These cells can adhere to plastic to facilitate the culture process. MSCs can be used in research into tissue biotechnology and rejuvenation medicine. MSCs are also beneficial in recipient tissue and differentiate as a breakthrough strategy through paracrine activity.
  • 410
  • 14 Jan 2022
Topic Review
Analysis of the Classification Systems for Thoracolumbar Fractures
Spinal fractures represent a category of traumatic lesions with a significant impact both medical and social aspects of life. Within this category, thoracolumbar fractures (TLF) form a particular subcategory due to their location with specific biomechanics—the transition from thoracic physiologic kyphosis (fixed) to lumbar lordosis (mobile). Lesions at this level may have severe consequences such as complete/partial motor deficit, local pain or kyphosis.
  • 403
  • 30 May 2022
Topic Review
Biomaterial-Mediated Gene Therapy in Cartilage Repair
Articular cartilage defects caused by various reasons are relatively common in clinical practice, but the lack of efficient therapeutic methods remains a substantial challenge due to limitations in the chondrocytes’ repair abilities. In the search for scientific cartilage repair methods, gene therapy appears to be more effective and promising, especially with acellular biomaterial-assisted procedures. Biomaterial-mediated gene therapy has mainly been divided into non-viral vector and viral vector strategies, where the controlled delivery of gene vectors is contained using biocompatible materials. Genetic therapy, on the other hand, aims to transfer exogenous genes into target cells in order to induce endogenous gene expression to complete treatment. It has been extensively used in cartilage repair. Genetic editing is used to promote stable expressions of various growth factors for osteochondral regeneration. Meanwhile, biomaterial mediation could further localize the effect of genetic therapy by providing a scaffold to limit the genetically modified cells and vectors to within the targeted region; this increases the precision of the treatment, and makes it an ideal approach for treating osteochondral injuries.
  • 388
  • 14 Oct 2022
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.
  • 388
  • 31 Jan 2023
Topic Review
Osteoporosis Pathophysiology
Osteoporosis is a major public health concern affecting millions of people worldwide and resulting in significant economic costs. The condition is characterized by changes in bone homeostasis, which lead to reduced bone mass, impaired bone quality, and an increased risk of fractures. The pathophysiology of osteoporosis is complex and multifactorial, involving imbalances in hormones, cytokines, and growth factors. Understanding the cellular and molecular mechanisms underlying osteoporosis is essential for appropriate diagnosis and management of the condition.
  • 388
  • 07 Dec 2023
Topic Review
Megaprosthetic Reconstructions Following Sarcoma Resection
Megaprostheses have the advantage of a wide availability of different off-the-shelf modular implant systems that allow for individual, exact defect reconstruction, immediate, primary stability and the possibility to start early weight-bearing and functional rehabilitation.
  • 385
  • 09 Feb 2022
Topic Review
Osteoarthritis Treatment Using Stem Cells for Regenerative Therapy
Articular cartilage has very low metabolic activity. While minor injuries may be spontaneously repaired within the joint by chondrocytes, there is very little chance of a severely impaired joint regenerating itself when damaged. Therefore, any significant joint injury has little chance of spontaneously healing without some type of therapy.
  • 377
  • 23 May 2023
Topic Review
Ultrasonography for Injecting (Around) the Lateral Epicondyle
Lateral epicondylitis (LE) is a very common and painful condition seen in the daily practice of musculoskeletal physicians. Ultrasound-guided (USG) injections are commonly performed to manage the pain, promote the healing phase, and plan a tailored rehabilitation treatment. In this aspect, several techniques were described to target specific pain generators i the lateral elbow.
  • 375
  • 03 Mar 2023
Topic Review
Secondary Osteoporosis in Vulnerable Children
By definition, children constitute a vulnerable population, especially when they are chronically ill and/or disabled. A characteristic of chronically ill and disabled children is that they also suffer from indirect effects of their disease, such as immobilization, chronic inflammation, reduced time outdoors in the sun, osteotoxic effects of disease-targeted therapy (like glucocorticoids), and poor nutrition. All these factors may lead to bone fragility due to secondary osteoporosis, a co-morbidity that may be overlooked in the context of serious underlying diseases. 
  • 373
  • 07 Jul 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. 
  • 371
  • 20 Nov 2023
Topic Review
Impaction Bone Grafting for Acetabular Bone Loss
Total hip arthroplasty (THA) is increasingly performed in young patients and the number of revisions is estimated to rise over time. Acetabular osteolysis and bone loss are frequently encountered during revision and may be classified and treated in different ways. Impaction bone grafting (IBG) with morselized allograft offers a viable option. IBG was introduced over 40 years ago in combination with cemented cups, and is also used with uncemented cups. 
  • 369
  • 10 Jun 2022
Topic Review
Physical Therapy Interventions of Osteoarthritis
The number of treatments for OA is extensive, but the effectiveness behind many of them is sporadic. Regarding the Physical Therapy Interventions, one of the best ways to measure the efficiency is the WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) score. The minimum clinical efficiency associated is roughly a decrease of 20% for each WOMAC sub-scales. 
  • 368
  • 13 Jun 2022
Topic Review
Management of Irreparable Posterosuperior Rotator Cuff Tears
Posterosuperior rotator cuff tears range among the most common causes of shoulder complaints. While non-operative treatment is typically reserved for the elderly patient with low functional demands, surgical treatment is considered the gold standard for active patients. More precisely, an anatomic rotator cuff repair (RCR) is considered the most desirable treatment option and should be generally attempted during surgery. If an anatomic RCR is impossible, the adequate choice of treatment for irreparable rotator cuff tears remains a matter of debate among shoulder surgeons. The management of irreparable posterosuperior rotator cuff tears (RCTs) remains a challenge for shoulder surgeons and treatment strategies should be tailored to the individual patient.
  • 361
  • 08 Feb 2023
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. 
  • 357
  • 25 Apr 2023
Topic Review
Lateral Humeral Condyle Fractures in Pediatric Patients
Lateral humeral condyle fractures are frequently seen in pediatric patients and have a high risk of unfavorable outcomes. A fall on the outstretched arm with supination of the forearm is the most common trauma mechanism. A physical examination combined with additional imaging will confirm the diagnosis. Several classifications have been described to categorize these fractures based on location and comminution. Treatment options depend on the severity of the fracture and consist of immobilization in a cast, closed reduction with percutaneous fixation, and open reduction with fixation. These fractures can lead to notable complications such as lateral condyle overgrowth, surgical site infection, pin tract infections, stiffness resulting in decreased range of motion, cubitus valgus deformities, ‘fishtail’ deformities, malunion, non-union, avascular necrosis, and premature epiphyseal fusion. Adequate follow-up is therefore warranted.
  • 356
  • 25 Jun 2023
Topic Review
Venous Thromboembolisms (VTEs) in Total Knee Arthroplasty (TKA)
The entry provides a comprehensive overview of Venous Thromboembolisms (VTEs) in Total Knee Arthroplasty (TKA), a significant orthopedic procedure. It begins by highlighting the persistent threat of VTEs despite improvements in surgical techniques and preventive measures. The prevalence and incidence of VTEs are discussed, showcasing a notable decrease over the years. The clinical significance of VTEs, including their impact on patient outcomes and healthcare costs, is emphasized, underscoring the need for effective management strategies. Various risk factors contributing to VTE development post-TKA are explored, including demographic factors, cardiopulmonary status, preoperative mobilization status, and malignancy. The section on prevention outlines existing guidelines and challenges, with a focus on the efficacy and safety of aspirin as a prophylactic agent. Finally, the conclusion emphasizes the importance of a comprehensive approach to address VTEs in TKA, encompassing evidence-based guidelines, personalized patient care, and strategies to enhance adherence to preventive measures.
  • 350
  • 30 Apr 2024
Topic Review
Immunotherapy Innovations in the Fight against Osteosarcoma
Immunosuppressive elements within the tumor microenvironment are the primary drivers of tumorigenesis and malignant advancement. The presence, as well as the crosstalk between myeloid-derived suppressor cells (MDSCs), osteosarcoma-associated macrophages (OS-Ms), regulatory T cells (Tregs), and endothelial cells (ECs) with osteosarcoma cells cause the poor prognosis of OS.
  • 343
  • 20 Feb 2024
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