Enough Already!

This text will explore the re-assertion of right-wing populist and fascist movements as presented and distributed in the media. In particular, attacks on immigrants, women, minorities, LGBTQ people are increasing at a frightening rate, along with the election of politicians who openly support authoritarian discourse and scapegoating. More troubling is how this discourse is inscribed into laws and policies. However, despite the urgency of the situation, what we call “the Left” has so far been unable to definitively respond to these events, whether it is a matter of liberals insisting on hands-off free speech policies, including covering “both sides of the issue” no matter how absurd, or socialists who utilize a tunnel vision focus on economic issues at the expense of women and minorities. In order to effectively resist right-wing movements of this magnitude, a socialist/Marxist feminist analysis is necessary for understanding how racism, sexism, and homophobia are conduits for capitalism, not just ‘identity issues.

Surgical technique: posterior cruciate ligament (PCL) reconstruction using double posteromedial arthroscopic portals

The posterior cruciate ligament (PCL) reconstruction is a technically demanding surgical procedure that requires optimal identification of both the femoral and the tibial anatomical footprints. To aid the tibial tunnel placement and many authors recommend creating a posteromedial (PM) portal. The further addition of a second PM portal, which could be used as a "working portal", may further allow a more straightforward reconstruction by improving the identification of the anatomical footprint, the clearing of the stump, and the graft passage

social reporting in italian public schools in theory and practice

Some of the challenges that schools are currently facing include the stakeholders engagement, the necessity to open schools to the local territory and the need to be accountable for activities and results.The Italian reform of the school system has required schools to overcome their self-referentiality and to make themselves more accountable to stakeholders. The social reporting process can be considered as an effective response to enable schools to become accountable, triggering fruitful stakeholder engagement processes and, at the same time, implementing a management tool.This is an exploratory research paper. It aims to describe, through a questionnaire, the awareness and dissemination degree of social reporting in Public schools located in Southern Italy given the particularities of this area. Frequency percentage and descriptive statistical methods are used to interpret findings. Results show that, although social reporting is well known in theory, it is still under-used by schools in practice.</p

Almost 79% survival rate at 10‐year follow‐up for the patellofemoral joint arthroplasty: An Italian prosthetic registry study

PurposeThe aims of the present study were (1) to evaluate the survival of patellofemoral joint (PFJ) arthroplasty in a large cohort of patients using data obtained from an Italian regional arthroplasty registry and (2) to collect clinical outcomes of a subgroup of patients, with a minimum follow-up of 4 years. The hypotheses were that PFJ arthroplasty is a procedure that had good survival and clinical outcomes, not inferior to those reported in the literature for primary total knee arthroplasty (TKA).MethodsThe Register of Orthopaedic Prosthetic Implants (RIPO) of Emilia-Romagna (ER) (Italy) database was searched for the inclusion of all PFJ arthroplasties implanted between 2003 and 2019. PFJ arthroplasties were excluded if they were implanted in patients who lived outside of the ER. The survival information was extrapolated from the RIPO considering the partial or total revision of the implant as failure; moreover, a subgroup of patients was contacted and interviewed by telephone to collect clinical outcomes. Descriptive statistics were used to summarise the data. The survival curve was calculated and plotted using the Kaplan-Meier method.ResultsA total of 126 arthroplasties in 114 patients were included in the final analysis (mean age at surgery 60.1 +/- 11.5 years old). The main causes of patellofemoral arthroplasty were primary osteoarthritis (88%) and posttraumatic arthritis (7%). The survival was 90.4 +/- 30.6 and 78.8 +/- 51.5 at 5 and 10 years of follow-up, respectively. At the latest follow-up, 23 implants failed (18.3%). The main cause of revision was osteoarthrosis progression (34.8%). A total of 44 patients were contacted by telephone to collect clinical outcomes: Western Ontario and McMaster Universities Osteoarthritis Index, functional Knee Society Score, Forgotten Joint Score and Oxford Knee Score. These patients reported good to excellent scores at a medium follow-up of 10.3 +/- 4.7 years.ConclusionsThe PFJ showed good survival and clinical outcomes and could be considered a valuable option for patients affected by isolated patellofemoral osteoarthritis.Level of EvidenceLevel IV

Do Clinical Outcomes and Failure Rates Differ in Patients With Combined ACL and Grade 2 MCL Tears Versus Isolated ACL Tears?: A Prospective Study With 14-Year Follow-up

Background: A combined injury to the anterior cruciate ligament (ACL) and medial collateral ligament (MCL) is a common injury pattern encountered during clinical practice. Recent systematic reviews have found no consensus on the optimal method of managing this combined ligament injury pattern, and no long-term studies with modern techniques are available in the literature. Purpose: To compare 2 groups of patients who underwent isolated ACL reconstruction in terms of failures and clinical scores at long-term follow-up. In the first group were patients with isolated ACL tears (ACL group), while the second was composed of patients with combined ACL and MCL grade 2 tears (ACL + MCL group). Study Design: Cohort study; Level of evidence, 3. Methods: A total of 57 patients (37 in the ACL group and 20 in the ACL + MCL group) underwent isolated ACL reconstruction with a double-bundle technique between January and December 2005. Patients were contacted for scores on the International Knee Documentation Committee subjective form, Western Ontario and McMaster Universities Osteoarthritis Index, and Tegner activity scale as well as data regarding ipsilateral or contralateral revision ACL surgery. A 2-way analysis of variance for repeated measures was used to statistically assess the differences between the groups. Results: Overall, 49 patients (86%) completed the survey and were therefore included in the study. The minimum follow-up was 14.6 years (range, 14.1-15.2 years). There was a significant reduction in both groups of all the outcome scores between the intermediate and final-follow-up. The number of failures was 3 of 31 (9.7%) in the ACL group and 1 of 18 (5.5%) in the ACL + MCL group; this difference was not significant. Moreover, there were no clinical differences between the groups in terms of graft failures, contralateral lesions, and clinical scores. Conclusion: At 14-year follow-up, no clinical difference or increased failure rate was observed between the study groups, suggesting that isolated ACL reconstruction could represent an appropriate treatment for a combined ACL and MCL grade 2 lesion

High survivorship rate and good clinical outcomes after high tibial osteotomy in patients with radiological advanced medial knee osteoarthritis: a systematic review

IntroductionThe role of valgus producing high tibial osteotomy (HTO) for the treatment of advanced knee osteoarthritis (OA) is still controversial. The aim of the current systematic review was to assess survivorship and patient-reported outcomes (PROMs) of high tibial osteotomy in patients with radiological advanced medial knee OA.MethodsA systematic search of PubMed, Cochrane and EMBASE database was performed in July 2023 in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines. Inclusion and exclusion criteria were applied to identify studies investigating the survivorship rate and PROMs of valgus-producing high tibial osteotomy in patients with advanced knee OA at x-ray assessment in the medial compartment at minimum-two-years follow up. Advanced radiological OA was defined as Kellgren Lawrence (K-L) &gt;= 3 or Ahlbach &gt;= 2. Survivorship was defined as percentage of patients free of total knee arthroplasty (TKA) at follow-up. Clinical interpretation of provided PROMs were performed according to minimal clinically important difference (MCID) and patient acceptable symptom state (PASS) target values reported in literature. Survivorship data and PROMs scores were extracted, and studies were stratified based on selected study features. The quality of included studies was assessed with modified Coleman score.ResultsA total of 18 studies, totalling 1296 knees with a mean age between 46.9 and 67 years old, were included. Average survivorship was of 74.6% (range 60 - 98.1%) at 10-years follow up. The subjective scoring systems showed good results according to MCID and PASS, and postoperative improvements were partially maintained until final follow-up.ConclusionHTO is worth considering as treatment choice even in patients affected by radiological advanced medial knee osteoarthritis. Long term survivorship and good patient reported clinical outcomes could be expected in this population.Level of evidenceIV; systematic review of level III-IV studies

Loss of chondroprotection of medial collagen meniscus implant (CMI) at 20-year follow-up

Objective: The mid-term results of the collagen meniscus implant (CMI) procedure for the replacement of partial meniscus defects have already been described. However, there is a paucity of long-term comparative studies. This study aimed to compare the clinical outcomes, failures, and osteoarthritis progression of patients who underwent partial medial meniscectomy and medial CMI implantation. Methods: Thirty-six nonconsecutive patients with medial meniscus injuries that underwent medial CMI (MCMI) implantation or partial medial meniscectomy (PMM) between 1997 and 2000 were included in a prospective study with an intermediate 10-year follow-up examination and a final follow-up examination at 20-year follow-up. Outcome measures at the 20-year follow-up included the Lysholm score, visual analogue scale (VAS) for pain, International Knee Documentation Committee (IKDC) knee form , and Tegner activity level. Bilateral weight-bearing radiographs were also performed to evaluate hip-knee-angle (HKA) and the medial joint line height (JL). Data regarding complications and failures were also collected. Results: At the 20-year follow-up, 31 patients (83% follow-up rate) with a mean age of 60.7&nbsp;​±&nbsp;​8.9 years were included in the final analysis (21.1&nbsp;​±&nbsp;​1.2 years follow-up). Four reoperations and one failure per group were reported. When comparing the clinical results of the two groups, no difference was found considering the Lysholm score, Knee Injury and Osteoarthritis Outcome Score (KOOS), Tegner, and the IKDC. Moreover, 20 patients underwent radiographic examination (10 MCMI, 10&nbsp;​MM), and no statistically significant difference was reported concerning the JL, HKA, and the presence and incidence of osteoarthritis between the two groups. Conclusion: The CMI implant for partial medial meniscectomy provided good long-term results and a low failure rate. However, differently from the 10 years follow-up, the clinical and the radiological outcomes were not superior compared to the medial meniscectomy group. The present study's result suggests that using a medial scaffold is not chondroprotective. Level of evidence: III, Prospective case-control study