1,721,091 research outputs found
Management of severe bone and soft-tissue loss: A series of case reports from AO Trauma-Italy.
No full textNot availabl
Total knee arthroplasty in elderly osteoporotic patients
No full textOften in daily practice the choice of a prosthesis does not rise out of considerations about literature evidences, but it seems to be related to the personal experience and "surgical philosophy" of surgeon. The choice of prosthesis in total joint replacement is usually justified by biological and mechanical parameters that the surgeon considers before surgery. Osteoporosis is a disease characterized by a reduced bone mass and a degeneration of the bone tissue; it leads to bone fragility, so to a higher risk of fractures. Bone resistance, as all the changes in the microarchitecture of the bone tissue, is linked to bone density. Because of the bone density variation and/or the changes in the bone micro-architecture, as the bone strength decreases, the risk of fractures increases. It is important to understand all the factors taking part in both normal and abnormal bone remodelling. Osteoporosis does not imply a concrete bone loss, but a change of the bone micro-architecture itself. In these cases the choice of the patient and implant design are very important. In the period between March 1997-July 2002, we implanted 100 consecutive TKA (total knee arthroplasty) Genesis II in 97 subjects (79 female); mean age was 77.1 years old. All TKA were performed because of primary osteoarthritis of the knee. All patients had complete pain relief and excellent knee score. The surgical and medical complications were in accordance with the published literature. We must consider all existing medical conditions, the state of the knee and local needs of the elderly patient. Thus, within these limits, the total knee can improve the ability of patients to manage the activities of daily living and improve their quality of life. ©2011, Editrice Kurtis
Multi-omics analysis of synovial fluid: a promising approach in the study of osteoarthritis
No full textOsteoarthritis (OA), affecting 250 million individuals worldwide, is a significant social health problem. Therefore, the search for synovial fluid (SF) biomarkers that could anticipate the diagnosis of OA is gaining increasing importance in orthopaedics. This review summarizes the recent progresses preformed in the multi-omics approach to OA, mainly focusing on proteome and metabolome analysis of SF. Proteomics of the SF has shown the up-regulation of several components of the classic complement pathway in OA samples, including C1, C2, C3, C4A, C4B, C5 and C4 C4BPA, thus depicting that complement is involved in the pathogenesis of OA. Moreover, proteomics has displayed that some pro-inflammatory cytokines, namely IL-6, IL-8 and IL-18, have a role in OA. The metabolomic profiling of the SF in OA has identified some metabolites as potential biomarkers of OA and has shown the existence of metabolically different OA subgroups. However, further studies with larger samples sizes and matched-control groups are needed to identify SF biomarkers that could be useful in the diagnosis, treatment and follow-up of OA
Klippel-Trenaunay syndrome: a rare cause of disabling pain after a femoral fracture
No full textKlippel-Trenaunay syndrome (KTS) is characterized
by a cutaneous vascular nevus of the involved
extremity, as well as bone and soft tissue hypertrophy of
the extremity and venous malformations. We present the
case of a 52-year-old man with a femoral fracture and a history
of haemangiomas, limb bone hypertrophy and varicosity.
The patient was Wnally diagnosed with KTS and treated
in mini-invasive surgery by endomedullary fracture nailing
in general anaesthesia. Clinical management was particularly
demanding, not only because of the need to monitor
the risk of haemorrhage and thrombosis but also because of
the onset of a rare picture of neuropathic pain with hyperalgesia
and allodynia, never previously reported in patients
aVected by KTS, that required the administration of major
opioid drugs. According to our knowledge, this is the second
case of KTS managed for femoral fracture. Unlike the
previous report in literature, in this case a severe disabling
neuropathic pain complicated the clinical management
Balloon-assisted reduction, pin fixation and tricalcium phosphate augmentation for calcanear fracture
No full textPatellar tendon rerupture in a footballer: our personal surgical technique and review of the literature
No full textPatellar tendon rerupture is a relatively uncommon condition that severely compromises the function of the extensor mechanism of the knee. Few cases described in the literature does not show a unique mode of treatment for this type of lesion. We report the case of a young athlete with traumatic patellar tendon rerupture. The first rupture was treated with the use of Statak anchors. Following a second rerupture incident as a result of a sporting accodent, the tendon was reconstructed with the use of an autologous graft tendon of semitendinosus and biological augmentation with gracilis tendon. For both tendons the distal insertion part was preserved to facilitate the healing process. The treatment was completed with the application of a neutralization cerclage wire and with local injection of plateket reach plasma (PRP). At 12 months follow up, a full recovery of the structure and function of the extensor mechanism was observed and the patient was able to resume normal sports competitive activit
Stress fractures in soccer players: pathogeenesis and extracorporeal shock waves therapy
No full textKlippel-Trenaunay syndrome: a rare cause of disabling pain after a femoral fracture
No full textKlippel-Trenaunay syndrome (KTS) is characterized by a cutaneous vascular nevus of the involved extremity, as well as bone and soft tissue hypertrophy of the extremity and venous malformations. We present the case of a 52-year-old man with a femoral fracture and a history of haemangiomas, limb bone hypertrophy and varicosity. The patient was finally diagnosed with KTS and treated in mini-invasive surgery by endomedullary fracture nailing in general anaesthesia. Clinical management was particularly demanding, not only because of the need to monitor the risk of haemorrhage and thrombosis but also because of the onset of a rare picture of neuropathic pain with hyperalgesia and allodynia, never previously reported in patients affected by KTS, that required the administration of major opioid drugs. According to our knowledge, this is the second case of KTS managed for femoral fracture. Unlike the previous report in literature, in this case a severe disabling neuropathic pain complicated the clinical management
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