Routine postoperative radiographs are common after total knee arthroplasty (TKA), yet their value for assessing early joint balance is unclear. Immediate supine, non-weight-bearing anteroposterior radiographs may show coronal gap asymmetry, but its long-term significance remains uncertain. This study evaluated whether medial–lateral joint space differences on day-one radiographs correlate with midterm patient-reported outcomes. A retrospective cohort of 637 mechanically aligned primary TKAs (556 patients, 2012–2017) was analysed. Medial and lateral gaps were digitally measured on immediate postoperative supine AP and lateral radiographs. Gap asymmetry was expressed as an absolute difference and as a medial-to-lateral ratio. Patient-reported outcome measures (PROMs)—Oxford Knee Score (OKS), pain VAS, and EQ-5D VAS—were assessed at ≥ 3 years. Multivariable linear and logistic regression adjusted for age, sex, and BMI examined associations between radiographic imbalance and outcomes. Median follow-up was 5.4 years. The median lateral–medial gap difference improved from 4.9 mm preoperatively to 0 mm postoperatively. In women < 70 years, each 1-mm medial opening was associated with a 1-point lower OKS and 2.4-point lower EQ-5D VAS. A 100
The acetabulum is a common site for metastatic lesions. When lytic lesions involve this region, the surgical approach often consists of intralesional treatment and reconstruction to restore stability and ambulation. Reconstruction using a hook acetabular cage represents a viable reconstructive option. The aim of this study was to evaluate the reliability of the hook acetabular cage for reconstruction after curettage of secondary tumors of the acetabulum. Patients undergoing intralesional surgery for acetabular roof metastases between 2006 and 2022 at two referral centers were included; surviving patients were required to have at least 1 year of follow-up. Staging involved whole-body CT or FDG-PET; local extension was assessed with radiographs, CT, and MRI. All cases were evaluated by a multidisciplinary tumor board. Statistical analysis included descriptive data, implant survival, and overall survival (OS) using the Kaplan–Meier method. Twenty patients (10 men and 10 women), with a mean age of 61.6 ± 15.5 years, were included. Seventeen patients had acetabular metastases from solid tumors, whereas three had acetabular involvement from multiple myeloma. During a mean follow-up of 34.2 ± 29.1 months, six patients (30
Despite advancements in understanding and treating anterior knee pain linked to lower limb torsional deformities, a definitive consensus on diagnostic criteria, clinical indications, and therapeutic strategies for "miserable malalignment syndrome" remains elusive. This systematic review synthesizes current research to unify understanding of this complex condition. Findings highlight varied definitions and surgical approaches, underscoring standardization challenges. This systematic review aimed to synthesize current research to provide a more unified understanding of this complex condition. While studies report favorable anatomical correction and symptomatic relief, inconsistent clinical outcome scores and limited long-term follow-up hinder robust comparisons. Conservative measures are often ineffective due to underlying mechanical imbalance; surgical interventions, primarily derotational osteotomies of the femur and/or tibia, offer the most direct anatomical correction. However, optimal level, extent, and timing of these osteotomies-whether single or double level, staged or simultaneous-are debated. Liße et al.'s proposed diagnostic criteria offer a valuable step towards standardized identification of true miserable malalignment syndrome. Future research, particularly robust multi-center studies with standardized outcome measures, is critically needed to establish clearer, evidence-based guidelines, ultimately improving patient care and long-term outcomes for this challenging condition.
Arthroscopic bone block surgery for the treatment of recurrent posterior glenohumeral instability (PGHI) is currently a valid option in the hands of an experienced surgeon. The aim of this retrospective study is to evaluate the clinical and radiological results of this procedure at a minimum 2-year follow-up, emphasizing the importance of a proper rehabilitation protocol. Eleven patients with a history of recurrent posterior shoulder instability underwent arthroscopic bone block surgery from autologous iliac crest graft, from 2019 to 2024. All the patients were selected considering Moroder’s ABC classification, the level of pain (Numeric Pain Rating Scale, NPRS), functional abilities assessed via the Constant–Murley Score (CMS), the Rowe score, imaging, at baseline and least 2 years after surgery. The Constant–Murley Score improved from 66 to 87 points, the Rowe score improved from 16 to 77 points, the level of pain (NPRS) decreased after treatment. The bone block was found to be intact in 8 patients, while the presence of a focus of resorption was observed in 3 patients, especially around the screws. This single-center, retrospective study of 11 patients shows how the surgical bone block procedure for recurrent forms of glenohumeral instability produces good clinical and functional outcomes when performed in the presence of an expert surgeon and with a specific post-operative rehabilitation program.
Heterotopic ossification (HO) is a well-known complication after joint arthroplasty but remains poorly characterized following total ankle arthroplasty (TAA). This study evaluated the temporal progression and anatomical distribution of HO after an anterior approach TAA and explored the potential influence of postoperative rehabilitation protocols on its development. This retrospective observational study included a consecutive series of patients undergoing primary TAA via an anterior approach. Standardized clinical and radiographic assessments were performed from 12 months postoperatively. HO was evaluated radiographically, graded, and analysed according to anatomical quadrant and temporal evolution. Postoperative rehabilitation protocols were recorded and examined as potential factors influencing HO severity. Radiographic HO was observed in all patients, yielding a 100
