Arthroscopic repair of rotator cuff injury with bioabsorbable suture anchor vs. all-suture anchor: a non-inferiority study.

BACKGROUND: Compare all-suture anchors to traditional anchors through clinical and radiological evaluation at pre-established end-points. MATERIALS AND METHODS: We performed a two-arms non-inferiority study on all-suture anchor (2.3 iconix™, Stryker) device with respect to traditional anchor (5.5 healix Advance™ BR, Depuy/Mitek) device under unpaired samples with size equal to 30 patients per group, all suffering from supraspinatus tendon rupture. We administrated DASH (Disabilities of the Arm, Shoulder and Hand); constant; and SST (Simple Shoulder Test) questionnaires in pre-operative, 3 ± 1 months post-intervention and 8 ± 1 months post-intervention. Questionnaires scores were the primary outcome. We also evaluated RMI at 3 and at 8 months after surgery to assess the presence of oedema or any loosening of the implant. RESULTS: All-suture anchor approach has been proven to have non-inferior performances with respect to traditional anchor approach, according to questionnaires scores at the 3-month endpoint. We observed 26 patients with oedema by MRI (18 in control group, 6 in experimental group). In the 8-month endpoint we found persistent edema in 12 patients (all treated with healix), 2 had mobilitazions (healix), 10 had partial retears (8 healix, 2 iconix) and 1 implant failure (healix). CONCLUSIONS: All suture devices have clinical and functional results comparable to traditional devices, while they tend to give fewer complications in terms of bone edema, loosening and retear rate. The effectiveness of all-suture devices should be further investigated in rotator cuff suture arthroscopic revision surgery, given the advantages they offer.

Painful total knee arthroplasty: Infrapatellar branch of the saphenous nerve selective denervation. A case series.

INTRODUCTION: Total knee arthroplasty (TKA) is a reliable and widespread solution for knee osteoarthritis treatment, but about 20% of the patients complains of persisting pain. Neuroma formation in the IPBSN (infrapatellar branch of the saphenous nerve) is an undervalued cause of persistent anterior pain after TKA. The aim of this study was to evaluate the effectiveness of the selective neuroma denervation on patients satisfaction and pain improvement. MATHERIAL AND METHODS: Between 2014 and 2020, we evaluated 13 patients suffering from persistent anterior knee pain and numbness after TKA who underwent a surgical neurectomy of the IPBSN. After clinical assessment and diagnosis confirmation, we carried out the surgery. Short Form 12 Health (SF12), Oxford Knee Score (OKS), and Numeric Rating Scale (NRS) have been collected before and after the procedure. After the surgical treatment, the symptom's resolution and patients' satisfaction were attested by the achievement of the Minimal ClinicallyImportantDifference(MCID) of the self-administered patient-reported outcome measures (PROMs). RESULTS: Our results showed a statistically significant improvement (p < 0.05) of patients pain perception (mean NRS improvement -4.2, SD 2.5) and overall satisfaction (with a mean increase in OKS of 14.5 points SD 9.4, and in SF12 of 6.5 points SD 4.0). CONCLUSIONS: Hence, our study suggests that selective neuroma denervation may be an effective solution to improve the quality of life of patients who develop this complication after TKA.

Stem Cells in Orthopedic Web Information: An Assessment with the DISCERN Tool.

OBJECTIVE: Regenerative medicine is experiencing a strong expansion worldwide, including the treatment of some common orthopedic pathologies, with an increase in physicians adopting these technologies. This growing interest has been associated with an equally significant spread of websites dedicated to public information on this topic, often lacking scientific bases. This study aims to evaluate the quality of information on the World Wide Web about stem cells for cartilage disorders in orthopedic practice. DESIGN: On February 19, 2021 we performed a search on Google using as keywords "cartilage stem cells," considering only the freely accessible sites in Italian, English, French, and Spanish. We selected the first 50 valid results for each language and evaluated them using the DISCERN scale. RESULTS: A total of 249 sites were observed, of which 49 were discarded as duplicates (8) or not relevant to the topic (41). Of the 200 sites surveyed, 47 were affiliated to a singular surgeon (23.5%), 31 to private stakeholders (15.5%), 73 to information sites (36.5%), 8 to public hospitals (4%), 13 to universities (6.5%), and 28 referred to international scientific journals (14%). Only 76 sites (38%) were rated as fair or better, while the remaining 124 (62%) were classified as poor or very poor. CONCLUSIONS: The quality of the information promoted for stem cells in orthopedics is generally low, although a significant minority of the sites offers good quality information. A greater commitment on the part of surgeons and other stakeholders is desirable to promote information on regenerative medicine through scientific criteria supported by adequate literature.

The rise of registry-based research: a bibliometric analysis.

Background and purpose - The main purpose of arthroplasty registries is to collect information on patients, techniques, and devices to monitor and improve the outcome of the specific procedure. This study analyses the role played by registries in the orthopedic research community and describes publication trends, characteristics, and patterns of this field of research.Patients and methods - A descriptive-bibliometric review was conducted. Scopus was the database used for the research. All articles published from 1991 to December 2020 containing keywords related to registries and arthroplasty were considered. In particular, the following dimensions were analyzed in detail: (i) papers/year; (ii) journals; (iii) countries; (iv) research growth rate; (v) collaboration among countries. VOSviewer software was used to perform the bibliometric analysis. Finally, the 50 most cited papers of the last 10 years were briefly analyzed.Results - 3,933 articles were identified. There has been growing interest in the topic since 2010. Acta Orthopaedica ranked first for the number of articles published. The country with the largest number of articles citing registries was the United States, followed by the United Kingdom and Sweden. The relative number of articles per 100,000 inhabitants is 0.60 for Europe and 0.38 for the United States. The literature in this research area has an average yearly growth rate of 28%.Interpretation - The publication rate in the field of arthroplasty registries is constantly growing with a noteworthy impact in the evolution of this research and clinical area. The growth rate is significantly higher than that of arthroplasty literature (28% vs. 10%) and the collaboration among countries is strong and increasing with time.

[Italian Arthroplasty Registry: learning curve and optimization of data entry procedures.] / Registro Italiano Artroprotesi: curva di apprendimentoe ottimizzazione delle procedure di immissione dei dati.

Arthroplasty registries represent a fundamental tool for the production of evidence in total joint replacement. Italy started in 2005 a national registry (Italian Arthroplasty Registry - RIAP) organised as federation of regional registries under the coordination of the Istituto Superiore di Sanità. However, data collection still appears to be hardened by the additional workload required from clinicians. The aim of the study was to evaluate the data entry times for an inexperienced operator and the relative learning curve. The analysis carried out shows that after 15 cases, a plateau of about two minutes is reached for the compilation of a single case of primary hip and knee arthroplasty, up to 4 minutes for the shoulder and for revision surgery. The work burden for the orthopedist does not seem to justify the reluctance in data collection observed in these years of RIAP experience.