Antibiotic impregnated hip spacers are popular nowadays and represents the gold standard for treating periprosthetic joint infection (PJI). Although providing excellent results in resolving infection, antibiotic impregnated hip spacers are subject to risks, including mechanical failure, spacer's dislocation, fracture and periprosthetic femoral fractures. In this review, we reviewed the last 10 years literature to valuate the rate of mechanical failures and complications related to spacers use.
This is a new and an effective video-assisted transthoracic approach easing anterior Vertebral Body Tethering for patients with Adolescent Idiopathic Scoliosis. Herein all of the technical steps are described in detail. The results for the study group are discussed thoroughly in the light of literature. This new approach, which requires simultaneous coordination of the Thoracic and Orthopedic surgeons, will inspire and guide both patients and physicians in the related branches.
INTRODUCTION: In recent years, the exercise prescription has given unequivocal benefits in cancer patients. The purpose of this review is to analyze indications of exercise therapy in the patient with bone metastases, analyzing the benefits, limits and appropriate indications of physical activity according to the individual clinical situation of the patient. EVIDENCE ACQUISITION: The present systematic review was conducted using a thorough database search of PubMed, EMBASE and SCOPUS. Authors independently screened all articles identified concerning exercise therapy in metastatic bone patients, to assess their suitability to the research focus. EVIDENCE SYNTHESIS: Authors included 12 articles as full-text in 19 papers, dated from 2000 to 2018. Among these, 8 were randomized controlled trials, 3 single-arm studies and 1 multi-arm interventional study. Aerobic and/or resistance exercise training was prescribed in all the studies analyzed. The mean follow-up was 10.7 +/- 11.2 (range 1-36) months. Significant benefits were reported in fatigue, pain and physical function with no increasing incidence of pathologic fractures. CONCLUSIONS: Exercise therapy in patients with bone metastases is useful in tackling bone loss, showing anticancer effects and increasing patient's quality of life with very low adverse effects rate (2,2%). The prescription of exercises in this kind of patients can be complex for the possible increasing risk of pathological fractures and pain levels. It is therefore strictly necessary to personalize the exercises according to patient's abilities, skeletal site and type of metastatic lesion.
BACKGROUND: The decision to validate the Cincinnati Knee Rating System (CKRS) comes from the necessity of bringing to Italy a specific measurement tool for knee pathologies that can be used as a diagnostic support in medical and rehabilitation areas. Thus, the aim of this study was to translate and culturally adapt the original CKRS into Italian and evaluate its psychometric properties. METHODS: After receiving permission from the developers of the original instrument, the CKRS was translated using international guidelines. The reliability and validity of the culturally adapted scale were assessed following the "Consensus-Based Standards for the Selection of Health Status Measurement Instruments" (COSMIN) checklist. RESULTS: The included participants were 124, population was evaluated telephonically twice, within 24 hours, from the same rater. The Cronbach's Alpha of the entire scale showed a value of 0.76. The test-retest reliability showed values for Intraclass Correlation Coefficient (ICC)>0.70 for all sub-scales, but also for the total scale (0.85), with values ranging from 0.76-0.91. Construct validity was assessed with Pearson correlation coefficient with the Lhysolm Knee Scoring Scale (LKSS). The analysis showed statistically significant data with the first and second subscale and total score. CONCLUSIONS: The present study gives evidence about the reliability and validity of the CKRS for health professionals and researchers. The results confirm that it could be easily used for research and clinical field. This study should encourage rehabilitators worldwide to validate the test in their own cultural context so that it can become a reference measure in assessing knee diseases.
