INTERNATIONAL ORTHOPAEDICS

Systemic inhibition of bone morphogenetic protein 1.3 as a possible treatment for laminin-related congenital muscular dystrophy
Matic Jelic I, Stokovic N, Ivanjko N, Pecina M, Kufner V, Bordukalo Niksic T and Vukicevic S
Congenital muscular dystrophy (CMD) is a group of rare neuromuscular disorders typically characterized by the onset of symptoms at birth or within the first two years of life. CMDs are relatively rare, but extremely severe pathological conditions currently without a safe and effective therapeutic solution. Merosin-deficient congenital muscular dystrophy type 1A (MDC1A) is among the most frequent CMDs and it is caused by mutations in the LAMA2 gene that encodes for the α2 chain of laminin-211 (merosin). Laminin-211 is a crucial constituent of the basement membrane that provides muscle fibre stability and signal transduction. Bone morphogenetic protein 1.3 (BMP1.3) is evolutionarily conserved and structurally related to mammalian Tolloid-like metalloproteinase (mTld) that is involved in the processing of procollagens, non-collagenous extracellular matrix proteins, and growth factor-related proteins. Recently, it has been shown that BMP1.3 is present in circulation and its levels are elevated in patients with chronic kidney failure, hepatic fibrosis, and acute myocardial infarction. It has been demonstrated that administering the BMP1.3 antibody ameliorated kidney, liver, and heart function in animal disease models. Furthermore, we observed highly enhanced BMP1.3 gene expression in the skeletal muscles of mice with congenital muscular dystrophy. Therefore, we hypothesize that BMP1.3 inhibition represents a novel therapeutic strategy for reversing the progression of CMD. The development of an anti-BMP1.3 therapy might lead to groundbreaking changes in CMD treatment and provide relief to numerous patients suffering from this disabling disease.
Does a delay of surgery due to a multidisciplinary screening process result in neuromuscular scoliosis curve progression in complex Cerebral Palsy?
Chhabra B, Birhiray D, Deveza L, Gremillion M, McHorse G, Dahl B, Gerow F, Hanson D and Smith B
While surgical intervention of scoliosis in cerebral palsy (CP) patients has shown notable improvements in quality of life, the high risk of post-operative complications in CP patients necessitates careful preoperative optimization. A preoperative multidisciplinary (Multi-D) pathway at our tertiary pediatric hospital in effect since 2014 led to a significant reduction in mortality at one year. However, such a strategy delays surgery, potentially increasing the risk of curve progression. This study aims to elucidate the impact of the Multi-D screening process on curve progression in neuromuscular scoliosis among complex CP patients.
Hysterical motility disorders during the First World War: cases from the orthopaedic department of the Red Cross Hospital in Zagreb
Fatović-Ferenčić S and Kuhar M
This paper examines how Vladimir Ćepulić at the orthopaedic department of the Red Cross Hospital in Zagreb described, understood and treated hysterical motility disorders between 1915 and 1917.
Sustainability in orthopaedic hospitals - urgent actions for a changing climate. Can we make orthopaedics climate smart?
Eidmann A, Stratos I, Scarlat M and Rudert M
Orthopaedic deception: when psychiatric disorders mimic musculoskeletal conditions
Geraci G, Di Martino A, Casadei C, Brunello M, Stefanini N and Faldini C
Psychiatric disorders significantly impact orthopaedic practice, often manifesting in ways that can complicate diagnosis and treatment. This narrative review explores psychiatric conditions that mimic musculoskeletal disorders, including Conversion Disorder, Factitious Disorder, Somatic Symptom Disorder, and Malingering. These disorders present a range of challenges, from interfering with accurate diagnosis to contributing to suboptimal clinical outcomes and increased healthcare costs. Is fundamental the role of orthopaedic surgeons in recognizing these conditions, which can present as genuine musculoskeletal symptoms but have underlying psychiatric origins. It emphasizes the need for heightened awareness and proper training to avoid misdiagnosis and ensure timely, appropriate treatment. By examining current literature, the review provides a comprehensive overview of each disorder, detailing their clinical presentations, diagnostic criteria, and treatment strategies. The aim is to enhance orthopedic practitioners' ability to identify and manage these complex cases effectively, improving patient care and reducing the risk of unnecessary interventions.
Arthroscopy combined with bone tunnel technique for treating Berndt and Harty stage III or IV osteochondral lesions of the talus
Xu M, Li R, Chen G, Li L, Chen J and Shi R
To explore the efficacy and feasibility of arthroscopy combined with bone tunnel technique in treating Berndt and Harty stage III or IV osteochondral lesions of the talus (OLT).
Avascular necrosis or rapid destruction of the hip following hip intra-articular corticosteroid injections: a systematic review
Zhao G, Tieu PTM, Lameire DL, Khoshbin A, Waddell J and Atrey A
This study aimed to systematically review the literature to identify the incidence of avascular necrosis (AVN) following hip intra-articular corticosteroid injections (IACSIs) as well as to elucidate risk factors that may predispose patients to AVN following IACSI.
Wide surgical margins may be necessary to reduce recurrence and mortality in patients with localized periosteal chondrosarcoma: retrospective analysis of twenty three patients and literature meta-analysis
Masunaga T, Tsukamoto S, Honoki K, Fujii H, Tanaka Y, Ishida Y, Tanaka Y, Mavrogenis A, Errani C and Kawai A
Periosteal chondrosarcoma (PCS) is the rarest subtype of chondrosarcoma and is recognized as a low-grade malignant tumour, reported to have an 88% ten year overall survival rate. The relationship between surgical margins and clinical outcome is inconsistent; some authors claim that PCS can be successfully treated with marginal resection and others report more local recurrence and distant metastasis with marginal compared to wide resection. This study was intended to report the treatment and prognosis of localized PCS patients from the Japanese National Bone and Soft Tissue Tumor Registry database and to perform a systematic review of the literature to determine the relationship between surgical margins and rates of local recurrence, distant metastasis, and mortality.
Biological augmentation of anterior cruciate ligament reconstruction with bone marrow aspirate concentrate: a systematic review and meta-analysis of randomised controlled trials
Park JY, Ng Hing Cheung JA, Todorov D, Park SY, Lim H, Shin E, Yoon A and Ha J
Biological augmentation of anterior cruciate ligament (ACL) reconstruction with bone marrow aspirate concentrate (BMAC) is gaining attention for its theoretical potential to enhance postoperative healing and recovery. However, its clinical benefits remain uncertain, and its high cost raises questions about efficacy. Hence, we systematically reviewed randomised controlled trials (RCTs) to evaluate the effectiveness of BMAC in ACL reconstruction.
Arthroscopic scaphocapitate fusion without bone graft; clinical and radiological outcomes
Ghoneim S, Kamal R, Semaya A and Hasan M
Scaphocapitate fusion (SCF) is an important surgical option for carpal pathologies, which are difficult to manage as Kienböck's disease. With the advantages of arthroscopy combined with percutaneous fixation techniques, arthroscopic scaphocapitate fusion can have the best outcome for the patient from a functional perspective. This study aims to evaluate the clinical, radiological, and functional results of arthroscopic SCF.
Evaluating the clinical potential of bioceramic-rods for revascularization in osteonecrosis of the femoral head: a systematic review
Lu X, Lu Y, Wang Z, Jin F, Wang Y and Lu J
To evaluate the safety, reliability, and effectiveness of bioceramic rods (BR) in treating osteonecrosis of the femoral head (ONFH), compared with other treatments such as core decompression and autologous bone grafting.
A survey on the perspective and benefits of being an international Visiting Surgeon at a leading Level I Trauma centre
Fratus A, Nirunsuk P, Feng X and Mauffrey C
To investigate the impact on career, leadership positions, and involvement in educational roles among participants in the International Visiting Physician (IVP) program at a leading Level I Trauma centre.
Exploring the role of mentorship in training orthopaedic surgeons
Araújo TC, Avram GM, Scarlat MM and Khanduja V
Baseplate version in reverse shoulder arthroplasty: does excessive retroversion or anteversion affect functional activities of daily living?
Sheth MM, Schiffman CJ, Whitson AJ, Matsen FA and Hsu JE
While bone grafting and augmented components can help restore reverse shoulder arthroplasty (RSA) baseplate version close to neutral, the indication for version correction in RSA is unclear. The purpose of this study was to compare the clinical outcomes of RSA baseplates in high degrees of retroversion and anteversion to components in more neutral version.
The role of cannabis on total hip and knee surgeries outcomes: a systematic review and meta-analysis
Hoveidaei AH, Pouramini A, Mousavi-Nasab MM, Taghavi P, Miri L, Saggar R and Conway JD
Cannabis refers to medications derived from the Cannabis plant. Cannabis has long been used to treat a wide range of conditions. The widespread legalization of cannabis has increased its use. This meta-analysis evaluates the effects of preoperative cannabis usage on TKA and THA outcomes and complications.
Factors associated with mechanical complications following primary total hip arthroplasty through a modified direct anterior approach using custom stems
Nogier A, Tourabaly I, Ramos-Pascual S, Grew B, Saffarini M and Courtin C
To determine the rate and risk factors of mechanical complications (MCs) within two years following total hip arthroplasty (THA) through direct anterior approach (DAA) using custom stems, and to compare findings to other surgical approaches in the literature.
Predicting unicompartmental arthroplasty success: a three year Indian study
Kumar D, Shukla A, Meena O, Reddy S V M, Singh M, Gadi S and Gulab Meshram G
This study evaluated the three year clinical outcomes and predictors of success for unicompartmental knee arthroplasty (UKA) in an Indian population.
Long-term results of revision total hip arthroplasties using cementless stems and allografts for paprosky type IIIB and IV femoral defects short title: Revision hip arthroplasty in type IIIB and IV femoral defects
Kim YH, Park JW, Jang YS and Kim EJ
We determined long-term (1) clinical results of revision total hip arthroplasty (THA) in the presence of Paprosky type IIIB and IV femoral defects using validated scoring instrument; (2) osseointegration and bone remodeling; (3) the fate of cortical strut onlay allograft; (4) rates of revision and osteolysis; and (5) survivorship of the cementless stem.
Removing hardware from anterior approaches following acetabular fractures: a challenging yet indicated procedure
Khalifa A, Fergany A, Ibrahim B and Farouk O
To describe the indications, outcomes, and incidence of complications after hardware removal from anterior approaches following acetabular fractures.
Uncemented reverse total shoulder arthroplasty: is it a safe option for elderly patients with proximal humerus fractures?
Maassen D, Welter J, Fischer M, Pieringer A, Mazel P, Mazzucchelli R, Horn N, Müller A and Hess F
Reverse shoulder arthroplasty (RSA) is a common surgical procedure for elderly patients with proximal humerus fractures. Cement fixation of the humeral stem is considered the gold standard for this procedure. Due to the high prevalence of osteoporosis in this patient population, the risk of intraoperative fractures is increased when uncemented stems are used. Stem loosening is another concern of uncemented stems. However, the use of cement is associated with the risk of cement embolisation, impairment of tuberosity healing, and technical difficulties for later revisions. This study aimed (i) to evaluate the clinical and radiological outcomes of patients treated with uncemented RSA for proximal humerus fractures at two years postoperatively, and (ii) to compare these outcomes between patients with and without decreased low bone quality as measured by the deltoid tuberosity index.
Symptoms and joint degeneration correlate with the temperature of osteoarthritic knees: an infrared thermography analysis
De Marziani L, Zanasi L, Roveda G, Boffa A, Andriolo L, Di Martino A, Zaffagnini S and Filardo G
This study aim was to analyze the joint temperature of patients affected by bilateral knee osteoarthritis (OA) using infrared thermography to investigate whether thermographic imaging patterns are influenced by the severity of symptoms and joint degeneration.