Orto&Trauma with Dr. Polotrauma

While arthroscopy provides reliable outcomes for femoroacetabular impingement syndrome, some cases will require conversion to total hip arthroplasty. In a large cohort, 10.4% of hips were converted to arthroplasty at mid-term follow-up. This conversion rate reached 36.2% in hips with advanced Tönnis grades and 33.3% in hips with severe Outerbridge chondral lesions. Age was an independent predictor...

Researchers assessed patients who were available for long-term evaluation at a median 37 years follow-up after permanent epiphysiodesis. The results demonstrated that 65% of patients achieved a good clinical outcome with adequate leg length equalization. Furthermore, the intervention did not cause significant long-term adverse events, with mild osteoarthritis observed in only two patients decades...

Surgical management requires tailored approaches depending on bone quality and joint preservation. Open reduction and internal fixation achieves a reported success rate of 90% in treated patients, making it the preferred method when stable fixation and bone grafting are possible. Total elbow arthroplasty serves as a reliable salvage procedure for complex or unreconstructible fractures, showing a s...

Severe pelvic trauma is heavily associated with polytrauma and massive blood loss. Fortunately, approximately 85% of the hemorrhage associated with these injuries is venous and can be controlled with maneuvers that reduce and stabilize pelvic volume. Furthermore, 21.2% of unstable ring fractures occur concurrently with chest trauma. The presence of gross hematuria should also raise clinical suspic...

This orthopaedic publication serves as an international platform, with 70% of published articles originating outside Italy. To assist prospective authors, the editorial board released practical guidelines on manuscript preparation. They advise keeping the introduction concise, limited to up to 500 words, to clearly outline the literature gap and study purpose. For clear and reproducible method rep...

Camera-based movement analysis offers dynamic functional evaluations without the radiation exposure of traditional imaging. While computed tomography remains standard, the determination of femoral antetorsion by CT shows interobserver variability of mean 15.6°. In contrast, optical systems can detect any marker on rigid segments with accuracy of fewer than less than 1 mm. However, clinicians must...

Fracture-related infections are severe adverse events with incidence rates of approximately 1–2% in closed fractures and up to 30% in open fractures. Accurate diagnosis requires clear clinical criteria and rigorous tissue sampling before starting empirical antibiotics. When the implant remains stable, thorough debridement and antimicrobial therapy can achieve bony union for 71% of patients. Fractu...

Secondary prevention of fragility fractures requires active intervention. Research indicates that range 5% to 30% of osteoporotic patients who sustain hip fractures receive appropriate medical treatment for their underlying bone disease. Preoperative optimization also reveals critical nutritional deficits. Hypovitaminosis D is present in 97% of orthopedic trauma patients who are not already taking...

Research evaluating preoperative weight changes found that 19.2% of patients were in the group with significant preoperative BMI gain after booking. The average length of stay was longest in this group at mean 50.3 h. Furthermore, this group showed the lowest discharge-to-home rate at 88.7%, highlighting a greater need for rehabilitation facilities. However, these fluctuations did not increase the...

Shoulder injuries are common, accounting for range 8% to 13% of athletic injuries. When evaluating dislocations, structural damage is almost universal, with a Bankart lesion occurring in 97% of first-time glenohumeral dislocations. Furthermore, recurrence is a major concern, as range 50% to 64% of young patients face a risk of recurrent dislocation. The Emergent Evaluation and Treatment of Shoulde...

A survey of international shoulder specialists explored the limits for anatomical shoulder replacements. The median limit reported by a participant for still performing an anatomical arthroplasty was a glenoid retroversion of median 20° and a posterior humeral head subluxation of median 70%. For patient age, a participant reported a median limit of median 70 years for still performing anatomical s...

Meniscal tears are common, affecting at least 55% of patients undergoing reconstruction. However, lesion patterns vary by timing and athletic demand. Early surgery yields higher detection rates for ramp tears, found in 19% of patients treated early. Conversely, high athletic demand is associated with lateral compartment damage, with lateral meniscus posterior horn tears seen in 25% of professional...

Many rotator cuff tears are silent at first, but time alters their course. Population screening reveals that 22.2% of women in cross-sectional cohorts had a complete tear. Even without pain, the pathology advances over the years. Surveillance imaging demonstrates that 49% of asymptomatic shoulders experience tear progression. Understanding this natural history helps clinicians guide patients throu...

This systematic review evaluated gender disparities affecting patients and physicians within the field. While the proportion of women entering medical school has reached 44.23%, only 16.7% of orthopaedic residents are female. Furthermore, female physicians remain underrepresented as beneficiaries of academic recognition, receiving 8% of orthopaedic society awards. Recognizing implicit biases and e...

Orthopaedic surgeons write 7.7% of opioid prescriptions. The risk of adverse events and misuse is significant, since 21% of patients who receive their initial opioid prescription progress to episodic use. This is a critical issue, as opioids are involved in 61% of drug overdose deaths. Multimodal analgesia combined with cognitive and physical strategies can maintain comfort while ensuring patient...

This retrospective study evaluated the prognostic value of soft tissue injury biomarkers on preoperative magnetic resonance imaging across 128 patient cases included in the study analysis. Multivariate analysis showed that posterior medial support complex injury acts as an independent risk factor for poor postoperative prognosis per intertrochanteric fracture patient, showing an odds ratio of 4.05...

This review asks whether osteoarthritis should still be treated as one disease or reclassified into distinct clinical, structural and molecular phenotypes to guide personalised care. Osteoarthritis affects 7.6% of the world population, with prevalence rising sharply and a further rise of more than 60% projected by 2050 on top of the increase already recorded. Large genomic work, including one anal...

Gastrocnemius recession is increasingly utilised as the primary intervention for adult foot and ankle pathologies associated with equinus contracture. In analyzing this procedure for midfoot to forefoot overload syndrome, 94% of the treated patient population reported satisfaction with their surgical outcomes. The rate of adverse events remained notably low, demonstrating the 3% incidence when eva...

Surgical management of chronic Achilles tendon ruptures requires careful selection of techniques like tendon transfers or grafts based on defect size. The primary objective for affected individuals is returning to previous activity levels. Recent meta-analysis data of professional athletes showed return to play was achieved by 76%. Additional findings from the comprehensive review of published stu...

This randomized controlled trial investigated the utility of capsular reconstruction versus excision during anterolateral total hip arthroplasty, enrolling 148 patients who were randomized to either excision or reconstruction. The excision group demonstrated a mean intraoperative blood loss of mean 242.1 ± 98.9 mL, with similar outcomes in the reconstruction cohort. Furthermore, No patients requir...

Despite increasing representation in the medical field, orthopedic surgery remains a specialty with notable gender disparities. The recent survey evaluating perceived discrimination found that 84.8% of female respondents were told they were unsuitable for the field solely due to their gender. Furthermore, 85% of women reported experiencing verbal or physical harassment from superiors or patients....

This review evaluates the clinical utility of patient-specific instrumentation, custom implants, and additively manufactured components in unicompartmental knee arthroplasty. A meta-analysis of multiple studies comprising 444 knees did not reduce alignment outliers, and patient-specific guides required conversion to standard instruments in 13% of cases. Conversely, an analysis of consecutive cemen...

Robotic-arm unicompartmental knee arthroplasty aims to improve precision, but comparative data on adverse events remains limited. This retrospective analysis found that the rate of adverse events was lower for the robotic patient group (3.7%) than for those who underwent conventional surgery (13.2%). Specifically, the robotic approach was associated with the odds ratio of 0.08 for implant malposit...

This systematic review asked which treatments actually help patients with complex regional pain syndrome (CRPS) after trauma or orthopaedic surgery. Because study designs varied so widely, findings could not be pooled and are reported per individual study. Diclofenac lowered pain scores to 4.9 in neuropathic pain patients, and continuous lidocaine infusion brought meaningful pain reduction in 76%...

This multi-centric cohort asked whether dual mobility cups perform as well in overweight and obese patients undergoing primary total hip arthroplasty as in normal weight patients. Included patients underwent surgery at a mean age of mean 70 ± 13.19 years and were followed for a mean follow-up period of mean nine ± 6.2 years. Functional scores were excellent across groups, with the obese subgroup r...