Surgical repair of muscle laceration: biomechanical properties at 6 years follow-up

Muscle injuries are challenging problems for surgeons. Muscle trauma is commonly treated conservatively with excellent outcome results while surgical repair is advocated for larger tears/lacerations, where the optimal goal is restore of function. Repair of muscle belly lacerations is technically demanding because the sutures pull out and the likelihood of clinical failure is high. Different suture techniques have been described but still the best suture is debated. We show a case of a pure vastus medialis muscle laceration surgically repaired at 6 years of follow-u

Surgical repair of muscle laceration: biomechanical properties at 6 years follow-up

Muscle injuries are challenging problems for surgeons. Muscle trauma is commonly treated conservatively with excellent outcome results while surgical repair is advocated for larger tears/lacerations, where the optimal goal is restore of function. Repair of muscle belly lacerations is technically demanding because the sutures pull out and the likelihood of clinical failure is high. Different suture techniques have been described but still the best suture is debated. We show a case of a pure vastus medialis muscle laceration surgically repaired at 6 years of follow-u

Microfracture and Hydrogel Scaffolds for the Treatment of Osteochondral Injuries of the Knee: Clinical Results at 4 Years Follow-Up

n/

Achilles Tendon Rupture and Dysmetabolic Diseases: A Multicentric, Epidemiologic Study.

Introduction: Achilles tendon ruptures are common. Metabolic disorders, such as diabetes mellitus, hypercholesterolemia, thyroid disorders, and obesity, impair tendons health, leading to Achilles tendinopathy and likely predisposing patients to Achilles tendon ruptures. Materials and methods: Patients who visited the Orthopedic Outpatient Clinics and the Accident and Emergency Departments of five different hospitals in Italy were recruited. Through telephone interviews, we administered a questionnaire to all the patients who had undergone surgical ATR repair, evaluating their past medical history, sport- and work-related activities, drug use, and post-operative rehabilitation outcomes. Results: "Return to work activities/sport" was negatively predicted by the presence of a metabolic disorder (beta = -0.451; OR = 0.637) and 'open' surgery technique (beta = -0.389; OR = 0.678). "Medical complications" were significantly predicted by metabolic disorders (beta = 0.600 (0.198); OR = 1.822) and was negatively related to 'mini-invasive' surgery (i.e., not 'open' nor 'percutaneous') (beta = -0.621; OR = 0.537). "Immediate weightbearing" and "immediate walking without assistance" were negatively predicted by 'open' technique (beta = -0.691; OR = 0.501 and beta = -0.359 (0.174; OR = 0.698)). Conclusions: Metabolic conditions can strongly affect post-operative outcomes following surgical repair of acute Achilles tendon tears

ISMuLT Guidelines for muscle injuries

Muscle injuries are frequent in high demand sports. No guidelines are available in the scientific literature. ISMuLT, the "Italian Society of Muscles, Ligaments and Tendons", in line with its multidisciplinary mission, is proud to cover this gap

I.S.Mu.L.T - Rotator cuff tears guidelines

Despite the high level achieved in the field of shoulder surgery, a global consensus on rotator cuff tears management is lacking. This work is divided into two main sessions: in the first, we set questions about hot topics involved in the rotator cuff tears, from the etiopathogenesis to the surgical treatment. In the second, we answered these questions by mentioning Evidence Based Medicine. The aim of the present work is to provide easily accessible guidelines: they could be considered as recommendations for a good clinical practice developed through a process of systematic review of the literature and expert opinion, in order to improve the quality of care and rationalize the use of resources

I.S.Mu.L.T. Achilles Tendon Ruptures Guidelines

This work provides easily accessible guidelines for the diagnosis, treatment and rehabilitation of Achilles tendon ruptures. These guidelines could be considered as recommendations for good clinical practice developed through a process of systematic review of the literature and expert opinion, to improve the quality of care for the individual patient and rationalize the use of resources. This work is divided into two sessions: 1) questions about hot topics; 2) answers to the questions following Evidence Based Medicine principles. Despite the frequency of the pathology andthe high level of satisfaction achieved in treatment of Achilles tendon ruptures, a global consensus is lacking. In fact, there is not a uniform treatment and rehabilitation protocol used for Achilles tendon ruptures

Muscle injuries: a brief guide to classification and management

Muscle injuries are frequent in athletes. Despite their high incidence, advances in clinical diagnostic criteria and imaging, their optimal management and rehabilitation strategies are still debated in literature. Furthermore, reinjury rate is high after a muscle lesion, and an improper treatment or an early return to sports can increase the rate of reinjury and complications. Most muscle injuries are managed conservatively with excellent results, and surgery is normally advocated only for larger tears. This article reviews the current literature to provide physicians and rehabilitation specialists with the necessary basic tools to diagnose, classify and to treat muscle injuries. Based on anatomy, biomechanics, and imaging features of muscle injury, the use of a recently reported new classification system is also advocated

Fatality rate and predictors of mortality in an Italian cohort of hospitalized COVID-19 patients

Clinical features and natural history of coronavirus disease 2019 (COVID-19) differ widely among different countries and during different phases of the pandemia. Here, we aimed to evaluate the case fatality rate (CFR) and to identify predictors of mortality in a cohort of COVID-19 patients admitted to three hospitals of Northern Italy between March 1 and April 28, 2020. All these patients had a confirmed diagnosis of SARS-CoV-2 infection by molecular methods. During the study period 504/1697 patients died; thus, overall CFR was 29.7%. We looked for predictors of mortality in a subgroup of 486 patients (239 males, 59%; median age 71 years) for whom sufficient clinical data were available at data cut-off. Among the demographic and clinical variables considered, age, a diagnosis of cancer, obesity and current smoking independently predicted mortality. When laboratory data were added to the model in a further subgroup of patients, age, the diagnosis of cancer, and the baseline PaO2/FiO2 ratio were identified as independent predictors of mortality. In conclusion, the CFR of hospitalized patients in Northern Italy during the ascending phase of the COVID-19 pandemic approached 30%. The identification of mortality predictors might contribute to better stratification of individual patient risk

Short-term effectiveness of bi-phase oscillatory waves versus hyperthermia for isolated long head biceps tendinopathy

ntroduction: Long head biceps (LHB) tendinopathy is a common cause of anterior shoulder pain. Isolated LHB pathology is most common among younger people who practise overhead sports. The authors conducted a short-term prospective randomised study to test the effectiveness of two different methods for the treatment of isolated LHB tendinopathy: biphasic oscillatory waves and hyperthermia. Study design: The study is a prospective rando - mised study (Level II). Material and methods: The authors identified 20 patients who had clinical and ultrasound (US) evidence of LHB tendinopathy. No patient was a highlevel athlete. The patients were randomly assigned to two groups. Group A (10 patients) was treated with bi-phasic oscillatory waves, while Group B received hyperthermia. During the treatment period, no other electromedical therapy, injections with corticosteroids, oral analgesics or nonsteroidal anti-inflammatory drugs were allowed. All the patients were assessed at baseline (T0), immediately after the end of the treatment period (T1) and 6 months after the end of treatment (T2) using a visual analogic scale (VAS) and Constant-Murley Score (CMS). Furthermore, all patients underwent US examinations at T0 and at T1. All the US examinations were performed by the same radiologist. Results: The VAS scores showed a highly statistically significant reduction of pain at T1 both in Group A (65%; p=0,004) and in Group B (50%; p=0,0002). The CMS also showed a statistically significant improvement between the pre-intervention, the post-treatment and the short-term follow-up in both groups. In addition, the peritendinous fluid evident on US examination at T0 was no longer present in all cases at T1. Conclusion: These findings suggest that both biphasic oscillatory waves and hyperthermia are able to relieve pain in patients with isolated LHB ten - dinopathy. This is a Class II level of evidenc