Tibial plateau fractures: compared outcomes between ARIF and ORIF.

The purpose of this study is to compare arthroscopic assisted reduction internal fixation (ARIF) treatment with open reduction internal fixation (ORIF) treatment in patients with tibial plateau fractures. We studied 100 patients with tibial plateau fractures (54 men and 46 women) examined by X-rays and CT scans, divided into 2 groups. Group A with associated meniscus tear was treated by ARIF technique, while in group B ORIF technique was used. The follow-up period ranged from 12 to 116 months. The patients were evaluated both clinically and radiologically according to the Rasmussen and HSS (The Hospital for Special Surgery knee-rating) scores. In group A, the average Rasmussen clinical score is 27.62 \ub1 2.60 (range, 19\u201330), while in group B is 26.81 \ub1 2.65 (range, 21\u201330). HSS score in group A was 76.36 \ub1 14.19 (range, 38\u201391) as the average clinical result, while in group B was 73.12 \ub1 14.55 (range, 45\u201391). According to Rasmussen radiological results, the average score for group A was 16.56 \ub1 2.66 (range, 8\u201318), while in group B was 15.88 \ub1 2.71 (range, 10\u201318). Sixty-nine of 100 patients in our study had associated intra-articular lesions. We had 5 early complications and 36 late complications. The study suggests that there are no differences between ARIF and ORIF treatment in Schatzker type I fractures. ARIF technique may increase the clinical outcome in Schatzker type II\u2013III\u2013IV fractures. In Schatzker type V and VI fractures, ARIF and ORIF techniques have both poor medium- and long-term results but ARIF treatment, when indicated, is the best choice for the lower rate of infections

Polyamide-Scorpion Cyclam Lexitropsins Selectively Bind AT-Rich DNA Independently of the Nature of the Coordinated Metal

Cyclam was attached to 1-, 2- and 3-pyrrole lexitropsins for the first time through a synthetically facile copper-catalyzed “click” reaction. The corresponding copper and zinc complexes were synthesized and characterized. The ligand and its complexes bound AT-rich DNA selectively over GC-rich DNA, and the thermodynamic profile of the binding was evaluated by isothermal titration calorimetry. The metal, encapsulated in a scorpion azamacrocyclic complex, did not affect the binding, which was dominated by the organic tail

Anatomia, fisiologia ed evoluzione morfologica dell\u2019anca

Anatomia, fisiologia ed evoluzione morfologica dell\u2019anc

Fisiopatologia dell\u2019anca

Fisiopatologia dell\u2019anc

Clinical and radiological results of a stemmed medial pivot revision implant in aseptic total knee revision arthroplasty

Background: Constraint choice in revision total knee arthroplasty depends on the stability of the collateral ligaments and on the severity of bone loss, but the least degree of constraint necessary is recommended. The purpose of this retrospective matched-paired study was to compare clinical results, radiographic outcome and the survival of a stemmed medial pivot revision implant in aseptic revision TKA vs. medial pivot implant in primary TKA.Methods: Records were reviewed for 69 cases of aseptic revision TKA using Advance (R) Medial Pivot Stemmed Revision Knee system between 2002 and 2016. These patients were then matched in a 1:2 ratio control group of patients who received a primary TKA with Advance (R) Medial Pivot system. American Knee Society Score and Visual Analogue Scale pain score were recorded. Alignment, loosening, and incidence of radiolucent lines were evaluated on X-rays. Implant survival was assessed by Kaplan-Meier survival analysis.Results: The primary TKA group had significant superior AKSS clinical and functional score at baseline (52.3 and 68.2 points, respectively) and at last follow up (84.6 and 68.6 points) compared with the revision TKA group (47.9 and 40.9 points; 78.4 and 59.9 points; P < 0.05). No significant difference was observed in the mean change from baseline to last follow up of AKSS score between the two groups (P > 0.05). Radiographical outcome and implant survival were similar in the two groups (P > 0.05).Conclusion: The authors support the use of this revision system in knees with collateral ligaments competence and mild-to-moderate bone defect. (C) 2020 Elsevier B.V. All rights reserved

Femoroacetabular impingement: biomechanical and dynamic considerations.

Femoroacetabular impingement (F.A.I.) is a pathologic process caused by an abnormal shape of the acetabulum, of the femoral head, or both. F.A.I., often referred to as idiopathic, may be secondary to slipped capital femoral epiphysis, congenital hypoplasia of the femur, Legg-Calv\ue9 Perthes disease, post-traumatic mal-union and protrusio acetabuli. From 2009 to 2012 we studied 21 patients (14 males), with a mean age of 52 (33 y - 75 y), affected by idiopathic F.A.I. Every patient underwent pelvic and hip joint X-rays and CT scan with 3D reconstructions, in order to evaluate the morphology of the pelvis and the hip joint and the torsion of the lower limbs (Femoroacetabular ante-retroversion). Our results show an average femoral ante-version angle of 12,4\ub0 (15\ub0-20\ub0 physiological range) in patients affected by CAM impingement and an average acetabular ante-version angle of 13,5\ub0 (15\ub0-20\ub0 physiological range) for those with PINCER impingement. These values, in patients affected by F.A.I., are probably related to morphologic and biomechanical features that may lead to the onset of idiopathic femoroacetabular impingement. In the literature, other studies partially support our findings, suggesting a more critical approach to a patient with idiopathic F.A.I. extending evaluations to nearby articulations

Chromium-induced diffuse dermatitis with lymph node involvement resulting from Langerhans cell histiocytosis after metal-on-metal hip resurfacing

Total Hip Arthroplasty (THA) is a highly effective surgical treatment for severe jointinvolvement. However, due to the release of metal ions in the blood, the patients undergoinghip replacement with metal-on-metal (MOM) bearings may develop signs of allergic skindisease. We report a case of a 60-year-old man who had received MOM hip resurfacing (HR)five years earlier for osteoarthritis and presented with a 3-year history of diffuse dermatitisnot responding to antihistamines and corticosteroids and elevated serum levels of chromiumand cobalt. A patch test revealed chromium-sulfate hypersensitivity. Skin biopsy showednonspecific perivascular lymphocytic infiltrate associated with histiocytes. Biopsy of aninguinal lymph node demonstrated large aggregates of Langerhans cells, suggesting type IVdelayed-type hypersensitivity. Three months following replacement of the prosthesis usingceramic-on-ceramic bearings the dermatitis resolved. Lymph nodes decreased in volume andserum chromium normalized 24 months after revision surgery. The high levels of serum ionsassociated with the metal debris from MOM-THAs may induce sensitization and type IVhypersensitivity reactions. Only replacement of the prosthesis using alternative couplingsurfaces may definitely solve the symptoms. Physicians who are not familiar with this issuemay misdiagnose systemic symptoms and lack adequate treatment.Total hip arthroplasty (THA) is a standard successful treatment for symptomatic osteoarthritisof the hip joint.1 Metal-on-metal (MOM) hip resurfacing (HR) has been developed as analternative to conventional THA in younger and active patients, with comparable long-termoutcomes.2 However, all MOM bearings implants corrode and cause a release of metal ions inthe blood. The prevalence of metal sensitivity among the general population is approximately10% to 15%, with sensitivity to cobalt and chromium of 3%.3 Many concerns still remainregarding the effects of prolonged exposure to increased metal ion levels: hypersensitivity,carcinogenicity, aseptic lymphocyte-dominated vasculitis-associated lesion and pseudotumorformation.3 Allergic dermatitis and reactive histiocytosis caused by orthopedic implants arewell-known.4 To date, and to the best of our knowledge, diffuse dermatitis and associatedlymph node involvement by Langerhans cell histiocytosis after MOM-HR have not beendescribed

Conensus document: update on latex exposure adn use of latex gloves in italian health care settings

This consensus document was prepared by an Italian working group including occupational health professionals involved for many years in the management of glove- and latex-related problems in health care settings. The aim of this document was to address the most significant technical, epidemiological, clinical, environmental and prevention problems related to the use of gloves and latex. The group's recommendations are based on scientific evidence and practical experience but they cannot be considered as final. These topics need to be periodically revised. The following points should be taken into account: glove quality seems to have improved considerably but the information on glove features provided by the manufacturers is often still inaccurate or incomplete; the regulations in force provide that the manufacturers perform tests to supply evidence for the quality of the products but they do not indicate which analytical method should be used and they do not require that the results be reported in the technical data sheets. Thus the manufacturers have only to declare that their products are "in accordance with the rules"; therefore, purchasers should require the manufacturing companies to supply detailed information and verify their reliability. Moreover, the rules should be adapted to higher quality standards; occupational physicians must be involved for the correct choice and purchase of protective gloves; the use of gloves (in particular latex gloves) and latex devices in health care settings should be based on specific criteria: procedures must be available stating which kind of gloves are suitable for specific tasks. When exposure to latex cannot be avoided it is necessary to choose products that have good biocompatibility (e.g., powder free-gloves with low allergen content); once and for all latex powdered gloves should no longer be commercially available! labels for latex devices (including gloves) should report the extractable latex allergen content. Limit values for extractable latex allergens should be established; the use of synthetic rubber gloves should be encouraged since some materials (e.g., neoprene and nitrile rubber) appear to have physical properties and protective efficacy similar to latex, plus good biocompatibility; more studies should be promoted to verify the protective efficacy of new synthetic materials; health care workers should be informed about the advisability and usefulness of using materials other than latex; health care services should not cause additional risks but rather highlight the advantages for workers and patients if the use of latex gloves and devices is minimized