Journal of Clinical Medicine

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10 pages, 838 KiB

Open AccessArticle

Short- to Mid-Term Clinical and Radiological Results of Selective Laser Melting Highly Porous Titanium Cup in Primary Total Hip Arthroplasty

by Filippo Familiari, Alessandro Barone, Marco De Gori, Lorenzo Banci, Michelangelo Palco, Roberto Simonetta, Giorgio Gasparini, Michele Mercurio and Giuseppe Calafiore

J. Clin. Med. 2024, 13(4), 969; https://doi.org/10.3390/jcm13040969 - 8 Feb 2024

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Abstract

(1) Background: The aim of this study was to evaluate short- to mid-term clinical and radiological results in patients undergoing primary total hip arthroplasty (THA) with the use of a Selective Laser Melting 3D-printed highly porous titanium acetabular cup (Jump System Traser [...] Read more.

(1) Background: The aim of this study was to evaluate short- to mid-term clinical and radiological results in patients undergoing primary total hip arthroplasty (THA) with the use of a Selective Laser Melting 3D-printed highly porous titanium acetabular cup (Jump System Traser^®, Permedica Orthopaedics). (2) Methods: We conducted a retrospective study and collected prospective data on 125 consecutive patients who underwent primary THA with the use of highly porous titanium cup. Each patient was evaluated preoperatively and postoperatively with a clinical and radiological assessment. (3) Results: The final cohort consisted of 104 patients evaluated after a correct value of 52 (38–74) months. The median Harris Hip Score (HHS) significantly improved from 63.7 (16–95.8) preoperatively to 94.8 (38.2–95.8) postoperatively (p < 0.001), with higher improvement associated with higher age at surgery (β = 0.22, p = 0.025). On postoperative radiographs, the average acetabular cup inclination and anteversion were 46° (30°–57°) and 15° (1°–32°), respectively. All cups radiographically showed signs of osseointegration with no radiolucency observed, or component loosening. (4) Conclusions: The use of this highly porous acetabular cup in primary THA achieved excellent clinical, functional, and radiological results at mid-term follow-up. A better clinical recovery can be expected in older patients. The radiological evaluation showed excellent osseointegration of the cup with complete absence of periprosthetic radiolucent lines. Full article

(This article belongs to the Special Issue Joint Surgery and Sports Medicine Research: In Health and Disease)

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14 pages, 2619 KiB

Open AccessArticle

Rehabilitation of Soccer Players’ Knee Injuries: Cartilage Reconstruction, Anterior Cruciate Ligament Surgery, and Intensive Recovery—A Pilot Study

by Bartłomiej Kacprzak and Karolina Rosińska

J. Clin. Med. 2023, 12(21), 6893; https://doi.org/10.3390/jcm12216893 - 1 Nov 2023

Cited by 1 | Viewed by 2916

Abstract

Knee injuries, particularly anterior cruciate ligament (ACL) damage and cartilage defects, are highly prevalent among athletes and affect their sports performance and long-term joint function. The purpose of this research was to evaluate the effectiveness of a comprehensive combination therapy approach for individuals [...] Read more.

Knee injuries, particularly anterior cruciate ligament (ACL) damage and cartilage defects, are highly prevalent among athletes and affect their sports performance and long-term joint function. The purpose of this research was to evaluate the effectiveness of a comprehensive combination therapy approach for individuals with ACL and cartilage injuries. Twelve professional soccer players aged 18 to 30 years underwent bone–tendon–bone ACL reconstruction, microfracture cartilage repair surgery, and hyaluronic acid scaffold treatment. Early postoperative rehabilitation included immediate supervised physiotherapy and complete weight bearing. Follow-up assessments involved clinical evaluations, functional joint assessments, and magnetic resonance imaging (MRI) scans to measure cartilage defect repair and symptom alleviation. The results showed that patients resumed pain-free activities within 3–4 weeks and returned to their pre-injury level within 4.5 months. MRI demonstrated the absence of inflammatory reactions, repair of marrow edema, and the emergence of new cartilage. Six months and one year after surgery, the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Short Form (36) Health Survey (SF-36) questionnaire results demonstrated considerable improvement in patients’ health condition and quality of life. Overall, the study suggests that the combination of Hyalofast membranes, microfracture surgery, tissue adhesive, and intensive postoperative physical therapy may be a potential alternative to commonly used treatments for patients with ACL rupture, allowing them to recover efficiently and return to sports activities. Full article

(This article belongs to the Special Issue Joint Surgery and Sports Medicine Research: In Health and Disease)

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13 pages, 511 KiB

Open AccessArticle

Injury Patterns and Incidence in an Elite Youth Football Academy—A Prospective Cohort Study of 138 Male Athletes

by Johannes Weishorn, Ayham Jaber, Severin Zietzschmann, Jan Spielmann, Tobias Renkawitz and Yannic Bangert

J. Clin. Med. 2023, 12(19), 6138; https://doi.org/10.3390/jcm12196138 - 22 Sep 2023

Cited by 2 | Viewed by 1437

Abstract

Background: There is a lack of evidence regarding injury incidence in German elite youth football academies, and the risk of re-injury is unknown. Therefore, the objectives of this study were (1) to determine injury patterns and incidence in an elite youth football academy [...] Read more.

Background: There is a lack of evidence regarding injury incidence in German elite youth football academies, and the risk of re-injury is unknown. Therefore, the objectives of this study were (1) to determine injury patterns and incidence in an elite youth football academy in Germany, (2) to monitor overuse-/trauma-related injuries over the course of the season, and (3) determine the risk of re-injury. Methods: A prospective cohort study was conducted in the 2012/2013 season among 138 male players from an elite youth football academy in Germany. Injuries were recorded according to the consensus statement on injury definitions and data collection in studies of football injuries. Injury incidence was reported as the number of injuries per 1000 h of exposure and the number of injuries per squad season. Results: A total of 109 injuries were reported, resulting in a cumulative time-loss of 2536 days. A squad of 25 players sustained 19.7 injuries per season, with an average of 23.3 days (15.7–30.9; 95% CI lower-upper) of absence per injury. Ligament sprains (28%), muscle strains (19%) and physeal injuries (12%) were the most common causes of time-loss. Physeal injuries were the most common severe type of injury (29%), with a mean time-loss of 29.7 days (18.2–41.2; 95% CI lower-upper). Re-injuries accounted for 3% of all injuries and resulted in significantly more time-loss than non-re-injuries (60 vs. 23 days; p = 0.01). Conclusion: In the youth academies studied, a team of 25 players sustained an average of 19.7 injuries per season, resulting in a cumulative time-loss of 459 days. Physeal injuries are a major contributor to severe injuries and therefore require special attention. Full article

(This article belongs to the Special Issue Joint Surgery and Sports Medicine Research: In Health and Disease)

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11 pages, 3450 KiB

Open AccessArticle

Postoperative Rehabilitation after Anterior Cruciate Ligament Reconstruction through Telerehabilitation with Artificial Intelligence Brace during COVID-19 Pandemic

by Wei-Jen Liao, Kun-Tsan Lee, Liang-Yu Chiang, Che-Han Liang and Chao-Ping Chen

J. Clin. Med. 2023, 12(14), 4865; https://doi.org/10.3390/jcm12144865 - 24 Jul 2023

Cited by 4 | Viewed by 2779

Abstract

Background: Due to the rapid spread of the coronavirus disease-19 (COVID-19), most of the patients expressed a reluctance to undergo postoperative rehabilitation at a rehabilitation clinic. Therefore, in this scenario it was necessary to reshape the crucial role of postoperative rehabilitation of these [...] Read more.

Background: Due to the rapid spread of the coronavirus disease-19 (COVID-19), most of the patients expressed a reluctance to undergo postoperative rehabilitation at a rehabilitation clinic. Therefore, in this scenario it was necessary to reshape the crucial role of postoperative rehabilitation of these patients. We conducted a telerehabilitation program based on an artificial intelligence brace (AI brace) which can monitor the progress of rehabilitation through an app and an internet server. Our hypothesis was that home-based telerehabilitation might provide clinical outcomes comparable to face-to-face, hospital-based rehabilitation programs in terms of effectiveness. Methods: A retrospective cohort study enrolled patients who received anterior cruciate ligament reconstruction (ACLR) between January and September 2020. Patients were divided into two groups: the tele-AI group received telerehabilitation with an AI brace while the FTF group had face-to-face, hospital-based rehabilitation. Clinical knee functional scores and Tegner Activity Scale (TAS) were assessed and analyzed until 12 months after the operation. Results: The tele-AI group had higher IKDC scores at 3 months (p = 0.0443) and 6 months (p = 0.0052) after surgery and higher KOOS scores at 1 month (p = 0.0365) and 6 months (p = 0.0375) after surgery. However, no significant difference between the two groups was detected at the end of the follow-up. The tele-AI group had higher TAS than FTF group after 1 year. Conclusions: Telerehabilitation after ACLR seems to provide a superior short-term outcome compared to hospital-based rehabilitation during the COVID-19 pandemic. Full article

(This article belongs to the Special Issue Joint Surgery and Sports Medicine Research: In Health and Disease)

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13 pages, 697 KiB

Open AccessArticle

Diagnostic Role of mNGS in Polymicrobial Periprosthetic Joint Infection

by Jian Mei, Hongxin Hu, Si Zhu, Haiqi Ding, Zida Huang, Wenbo Li, Bin Yang, Wenming Zhang and Xinyu Fang

J. Clin. Med. 2023, 12(5), 1838; https://doi.org/10.3390/jcm12051838 - 24 Feb 2023

Cited by 10 | Viewed by 1885

Abstract

Objectives: The purpose of this study was to explore the clinical value of metagenomic next-generation sequencing (mNGS) in the diagnosis of polymicrobial periprosthetic joint infection (PJI). Methods: Patients with complete data who underwent surgery at our hospital between July 2017 and January 2021 [...] Read more.

Objectives: The purpose of this study was to explore the clinical value of metagenomic next-generation sequencing (mNGS) in the diagnosis of polymicrobial periprosthetic joint infection (PJI). Methods: Patients with complete data who underwent surgery at our hospital between July 2017 and January 2021 for suspected periprosthetic joint infection (PJI), according to the 2018 ICE diagnostic criteria, were enrolled, and all patients underwent microbial culture and mNGS detection, which were performed on the BGISEQ-500 platform. Microbial cultures were performed on two samples of synovial fluid, six samples of tissue, and two samples of prosthetic sonicate fluid for each patient. The mNGS was performed on 10 tissues, 64 synovial fluid samples, and 17 prosthetic sonicate fluid samples. The results of mNGS testing were based on the interpretation of mNGS results in the previous literature and the assertions of microbiologists and orthopedic surgeons. The diagnostic efficacy of mNGS in polymicrobial PJI was assessed by comparing the results of conventional microbial cultures and mNGS. Results: A total of 91 patients were finally enrolled in this study. The sensitivity, specificity, and accuracy of conventional culture for the diagnosis of PJI were 71.0%, 95.4%, and 76.9%, respectively. The sensitivity, specificity, and accuracy of mNGS for the diagnosis of PJI were 91.3%, 86.3%, and 90.1%, respectively. The sensitivity, specificity, and accuracy of conventional culture for the diagnosis of polymicrobial PJI were 57.1%, 100%, and 91.3%, respectively. mNGS had a sensitivity, specificity, and accuracy of 85.7%, 60.0%, and 65.2%, respectively, for the diagnosis of polymicrobial PJI. Conclusions: mNGS can improve the diagnosis efficiency of polymicrobial PJI, and the combination of culture and mNGS is a promising method to diagnose polymicrobial PJI. Full article

(This article belongs to the Special Issue Joint Surgery and Sports Medicine Research: In Health and Disease)

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12 pages, 1508 KiB

Open AccessArticle

Correlation between the Signal Intensity Alteration of Infrapatellar Fat Pad and Knee Osteoarthritis: A Retrospective, Cross-Sectional Study

by Zheng Liu, Jiangyi Wu, Wei Xiang, Jinhui Wu, Shu Huang, Yizhao Zhou, Hui Xia, Zhenhong Ni and Baorong Liu

J. Clin. Med. 2023, 12(4), 1331; https://doi.org/10.3390/jcm12041331 - 7 Feb 2023

Cited by 2 | Viewed by 1571

Abstract

Infrapatellar fat pad (IPFP) inflammation is a common pathological manifestation in knee osteoarthritis (OA). However, the significance of IPFP signal intensity alteration for clinical diagnosis and treatment of knee OA needs further research. We assessed IPFP signal intensity alteration (0–3), IPFP maximum cross-sectional [...] Read more.

Infrapatellar fat pad (IPFP) inflammation is a common pathological manifestation in knee osteoarthritis (OA). However, the significance of IPFP signal intensity alteration for clinical diagnosis and treatment of knee OA needs further research. We assessed IPFP signal intensity alteration (0–3), IPFP maximum cross-sectional area (CSA) and IPFP depth, meniscus injury, bone marrow edema, and cartilage injury from magnetic-resonance imaging (MRI) in 41 non-KOA patients (K-L grade 0 and grade I) and 68 KOA patients (K-L grade 2,3 and 4). We found that IPFP signaling was altered in all patients with KOA whose alteration was closely related to the K-L grading. We found that the IPFP signal intensity was increased in most OA patients, especially the ones in the late stage. There were significant differences in IPFP maximum CSA and IPFP depth between groups in KOA and non-KOA patients. Moreover, Spearman correlation analysis showed that IPFP signal intensity was moderately positively correlated with age, meniscal injury, cartilage injury, and bone marrow edema, and negatively correlated with height, while not correlated with visual analogue scale (VAS) scoring and body mass index (BMI). In addition, women have higher IPFP inflammation scores on MRI than men. In conclusion, IPFP signal intensity alteration is associated with joint damage in knee OA, which may have clinical significance for diagnosing and treating KOA. Full article

(This article belongs to the Special Issue Joint Surgery and Sports Medicine Research: In Health and Disease)

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9 pages, 677 KiB

Open AccessArticle

The Ratio of IL-6 to IL-4 in Synovial Fluid of Knee or Hip Performances a Noteworthy Diagnostic Value in Prosthetic Joint Infection

by Xudong Su, Yuelong Chen, Qian Zhan, Bo Zhu, Li Chen, Chen Zhao, Jianye Yang, Li Wei, Zhenghao Xu, Keyu Wei, Wei Huang, Leilei Qin and Ning Hu

J. Clin. Med. 2022, 11(21), 6520; https://doi.org/10.3390/jcm11216520 - 3 Nov 2022

Cited by 2 | Viewed by 1385

Abstract

The diagnosis of prosthetic joint infection (PJI) is still a challenge, the ratio of interleukin-6 (IL-6) to IL-4 in the joint fluid of knee or hip was used to analyze whether the diagnostic accuracy of PJI can be improved. Between January 2017 and [...] Read more.

The diagnosis of prosthetic joint infection (PJI) is still a challenge, the ratio of interleukin-6 (IL-6) to IL-4 in the joint fluid of knee or hip was used to analyze whether the diagnostic accuracy of PJI can be improved. Between January 2017 and May 2022, 180 patients who developed pain after revision total hip or knee arthroplasty were enrolled retrospectively. 92 patients of PJI and 88 of aseptic failure were included. PJI was as defined by the Musculoskeletal Infection Society (MSIS). The content of IL-6 and IL-4 in synovial fluid of knee or hip were measured, and the areas under the receiver operating characteristic curve (ROC) and IL-6/IL-4 curve were analyzed to obtain a better diagnostic effect. The area under the curve of IL-6/IL-4 in synovial fluid of knee or hip was 0.9623, which was more accurate than ESR 0.5994 and C-reactive protein 0.6720. The optimal threshold of IL-6/IL-4 ratio was 382.10. Its sensitivity and specificity were 81.32% and 98.86%, respectively. The positive predictive value for the diagnosis of PJI was 98.91%. This study showed that the level of IL-6/IL-4 in synovial fluid of knee or hip could further improve the diagnostic accuracy for PJI. Full article

(This article belongs to the Special Issue Joint Surgery and Sports Medicine Research: In Health and Disease)

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Other

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11 pages, 3305 KiB

Open AccessCase Report

Superomedial Scapula Angle Osteochondroma with Winging in a Young Female Patient—Case Report and Literature Review

by Cosmin Faur, Ahmed Abu-Awwad, Jenel-Marian Patrascu, Jr., Simona-Alina Abu-Awwad and Cristina Tudoran

J. Clin. Med. 2023, 12(15), 5106; https://doi.org/10.3390/jcm12155106 - 3 Aug 2023

Cited by 1 | Viewed by 1144

Abstract

(1) Background: Osteochondromas are the most common benign bone tumors, primarily found in long bones, while scapular osteochondromas are rare and account for less than 1% of all osteochondromas. (2) Methods: We present a case of a young female patient with a unique [...] Read more.

(1) Background: Osteochondromas are the most common benign bone tumors, primarily found in long bones, while scapular osteochondromas are rare and account for less than 1% of all osteochondromas. (2) Methods: We present a case of a young female patient with a unique presentation of scapular osteochondroma. The patient exhibited superomedial scapula angle osteochondroma with winging, a rare manifestation of scapular osteochondroma. The patient had a slow-growing mass on the left scapula for several years. Physical examination revealed a visible deformity with significant winging of the scapula. Imaging studies demonstrated a large osteochondroma arising from the superomedial angle of the left scapula, with a bony stalk. (3) Results: Surgical excision was performed, and histopathological analysis confirmed the diagnosis of osteochondroma. Following the surgery, the patient experienced a significant improvement in scapular winging. A comprehensive literature review revealed only a limited number of reported cases of scapular osteochondroma with winging, underscoring the significance of this case report as a valuable addition to the existing literature. The diagnosis of scapular osteochondroma should be considered in the differential diagnosis of patients presenting with a scapular mass, particularly when associated with winging. Surgical excision is the recommended treatment, and complete excision is crucial to prevent recurrence. (4) Conclusions: This case report highlights a rare presentation of scapular osteochondroma with winging and emphasizes the importance of considering this diagnosis in patients with scapular masses accompanied by winging. The successful surgical intervention in our case resulted in significant improvement. Clinicians should be aware of this entity and consider prompt surgical intervention for complete excision, ensuring optimal patient outcomes and preventing recurrence. Further research and additional case reports are necessary to enhance our understanding of scapular osteochondroma and its varied clinical presentations. Furthermore, comprehensive studies involving larger patient cohorts are necessary to explore the full spectrum of clinical presentations of scapular osteochondromas. By documenting and analyzing a wider range of cases, including variations in tumor location, size, and associated symptoms, researchers can identify patterns and establish more accurate diagnostic criteria. This will facilitate early detection and appropriate management of scapular osteochondromas, ultimately improving patient outcomes. Full article

(This article belongs to the Special Issue Joint Surgery and Sports Medicine Research: In Health and Disease)

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