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Diagnostics
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Clinical Diagnosis and Management in Orthopaedics and Traumatology
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Clinical Diagnosis and Management in Orthopaedics and Traumatology

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: 30 November 2025 | Viewed by 3299

Special Issue Editor

Dr. Attilio Basile

E-Mail Website
Guest Editor
Orthopaedic and Traumatology Unit, Department Emergency and Acceptance, San Camillo-Forlanini Hospital, 00153 Rome, Italy
Interests: foot deformities; ankle joint; hallux valgus; subtalar joint; foot and ankle; orthopaedic trauma; feet

Special Issue Information

Dear Colleagues,

Orthopaedics is a dynamic field that continuously evolves with advancements in research, technology, and clinical practices. This Special Issue will explore the latest developments and innovations shaping the future of orthopaedic diagnosis and management.

This Special Issue will present a selection of papers reflecting the breadth and depth of current orthopaedic research. The topics range from cutting-edge surgical techniques, such as minimally invasive surgery and navigation- and robotic-assisted surgeries, to groundbreaking studies in computer-assisted diagnostics, such as imaging technologies enhanced with AI for better interpretation, and 3D modelling, creating a detailed anatomical template to plan surgeries.

In this Special Issue, original research articles and reviews are welcome.  Research areas may include (but are not limited to) the following:

  • Development and refinement of MIS techniques and arthroscopic innovations for various procedures (joint replacement, spinal surgeries, fracture repair, sports medicine);
  • Surgical navigation systems and intra-operative imaging techniques that provide surgeons with immediate feedback during procedures;

Outcome assessment and improvement through data analytics and predictive modelling, developing algorithms to predict surgical outcomes based on patient data and surgical variables.

We look forward to receiving your contributions.

Dr. Attilio Basile
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • joint replacement
  • surgical navigation
  • outcome assessment
  • fracture repair
  • imaging technologies

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (5 papers)

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Research

12 pages, 489 KiB  
Article
Short-Term Outcomes of First Metatarsophalangeal Arthroplasty Using the Silktoe Double-Stemmed Silicone Implant
by Stefano Fieschi, Costanza Redaelli and Anita Fazzini
Diagnostics 2025, 15(11), 1349; https://doi.org/10.3390/diagnostics15111349 - 27 May 2025
Viewed by 56
Abstract
Background: Hallux rigidus is a painful and degenerative pathology of the first metatarsophalangeal (MTP1) joint. In severe cases it is usually appropriate to consider arthrodesis or arthroplasty of the joint. Arthrodesis represents the gold standard, but arthroplasty allows patients to recover mobility. [...] Read more.
Background: Hallux rigidus is a painful and degenerative pathology of the first metatarsophalangeal (MTP1) joint. In severe cases it is usually appropriate to consider arthrodesis or arthroplasty of the joint. Arthrodesis represents the gold standard, but arthroplasty allows patients to recover mobility. Although arthroplasty has slightly inferior functional results to arthrodesis, it has shown very good results in terms of joint mobility, patient satisfaction and pain reduction. The goal of the present study was to evaluate short-term outcomes of patients that received a third-generation double-stemmed MTP1 implant manufactured from high-performance silicon. Methods: In this retrospective study the authors analyzed data of 37 patients who underwent MPT1 joint arthroplasty with SilktoeTM double-stemmed implant using the R 4.2.2 software (R Foundation for Statistical Computing, Vienna, Austria). The indications were hallux rigidus of grade III and grade IV (81.1%), hallux rigidus plus valgus (10.8%), painful or unstable joint following previous surgery (5.4%) and hallux rigidus due to gout (2.7%). Data were collected during routine visits at 1 and 6 months and 1 and 2 years. Results: There were no intraoperative and postoperative complications. There were no revisions or reoperations at a follow-up of two years. The American Orthopaedic Foot and Ankle Society-Hallux Metatarsophalangeal-Interphalangeal Scale (AOFAS-HMI) score was 94.6 ± 7.6 (median, 100; range, 70–100) and the Visual Analogue Scale (VAS) score was 0.4 ± 0.80 (median, 0; range, 0–3.5) at the final follow-up. Conclusions: The data from this study presented excellent short-term results for patients who received an arthroplasty of the MTP1 joint using a third-generation double-stemmed spacer made of high-performance silicone. For all patients who received the SilktoeTM implant, AOFAS-HMI scores of 94.6 and VAS scores of 0.4 were obtained at a two-year follow-up. These values were in line with results reported in the literature for similar devices. Full article
(This article belongs to the Special Issue Clinical Diagnosis and Management in Orthopaedics and Traumatology)
20 pages, 1872 KiB  
Article
Diagnostic Predictors of Recovery Outcomes Following Open Reduction and Internal Fixation for Tibial Plateau Fractures: A Retrospective Study Based on the Schatzker Classification
by Carlo Biz, Carla Stecco, Samuele Perissinotto, Xiaoxiao Zhao, Raffaele Ierardi, Luca Puce, Filippo Migliorini, Nicola Luigi Bragazzi and Pietro Ruggieri
Diagnostics 2025, 15(11), 1304; https://doi.org/10.3390/diagnostics15111304 - 22 May 2025
Viewed by 235
Abstract
Background: Tibial plateau fractures (TPFs) are complex injuries often leading to long-term complications such as knee instability, limited range of motion, and osteoarthritis. Accurate diagnostic evaluations combining subjective and objective assessments are essential for identifying functional limitations, guiding rehabilitation, and improving recovery [...] Read more.
Background: Tibial plateau fractures (TPFs) are complex injuries often leading to long-term complications such as knee instability, limited range of motion, and osteoarthritis. Accurate diagnostic evaluations combining subjective and objective assessments are essential for identifying functional limitations, guiding rehabilitation, and improving recovery outcomes. This study examines the role of diagnostic predictors in differentiating recovery trajectories in two groups of patients treated for closed TPFs by open reduction and internal fixation (ORIF), comparing patients with less severe fractures and patients with more severe fractures (BCFs). Methods: A consecutive series of patients with a diagnosis of TPFs treated by ORIF at our institution between 2009 and 2016 were analyzed in this retrospective study. All injured patients were divided according to the Schatzker classification into two groups: mono-condylar (MCF) and bi-condylar (BCF) fracture patient groups. Diagnostic evaluations included patient-reported outcome measures (PROMs) such as KOOS, IKDC, and AKSS, alongside objective assessments of functional recovery using dynamometers, force platform tests (single-leg stance and squat jump variations), and measurements of active range of motion (AROM). Results: A total of 28 patients were included: 17 in the MCF patient group (Schatzker: 12 II; 5 III; 0 IV) and 11 in the BCF patient group (Schatzker: 6 V; 5 VI). Patients with less severe MCFs exhibited significantly better recovery outcomes, including higher KOOS (86.0 vs. 64.6, p = 0.04), IKDC (80.3 vs. 64.6, p = 0.04), and AKSS (95.3 vs. 70.5, p = 0.02) scores. They also demonstrated greater knee flexion (122.8° vs. 105.5°, p = 0.04) and faster neuromuscular recovery, as evidenced by higher rates of force development (RFD) during dynamic performance tests. Conversely, patients with more severe BCFs showed lower RFD values, indicating slower recovery and greater rehabilitation challenges. Conclusions: Integrating diagnostic tools like PROMs, AROM, and neuromuscular performance tests provides valuable insights into recovery after ORIF for TPFs. Fracture severity significantly impacts functional recovery patients with MCFs showing better outcomes and faster neuromuscular recovery, while subjects with BCFs require a longer rehabilitation treatment focusing on neuromuscular re-education and soft tissue recovery. Full article
(This article belongs to the Special Issue Clinical Diagnosis and Management in Orthopaedics and Traumatology)
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9 pages, 1576 KiB  
Article
Effectiveness and Safety of Transforaminal Spinal Endoscopy: Analysis of 1000 Clinical Cases
by Ignazio Tornatore, Attilio Basile, Alessandro Aureli, Alessio Tarantino, Giuseppe Orlando and Rodrigo Buharaja
Diagnostics 2025, 15(8), 1021; https://doi.org/10.3390/diagnostics15081021 - 17 Apr 2025
Viewed by 306
Abstract
Background: Transforaminal spinal endoscopy is a minimally invasive technique used to treat several spinal conditions. Thanks to its minimally invasive approach, it offers numerous advantages over traditional open surgery, including reduced blood loss, faster post-operative hospital discharge, quicker recovery, and lower complications. [...] Read more.
Background: Transforaminal spinal endoscopy is a minimally invasive technique used to treat several spinal conditions. Thanks to its minimally invasive approach, it offers numerous advantages over traditional open surgery, including reduced blood loss, faster post-operative hospital discharge, quicker recovery, and lower complications. This study aims to evaluate the efficacy and safety of transforaminal spinal endoscopy on a large cohort of patients. Methods: We conducted a retrospective study of 1000 patients who underwent transforaminal spinal endoscopy between January 2015 and December 2023. All patients were treated by a single surgeon in a single hospital. The patients presented with persistent symptoms of radicular pain, neurological deficits related to herniated discs, and foraminal stenosis. All patients underwent transforaminal spinal endoscopy using a transforaminal approach. Clinical outcomes were evaluated using the VAS (Visual Analogue Scale) for pain, the ODI (Oswestry Disability Index) for functional disability, and patient satisfaction. Perioperative complications were recorded and analyzed. Results: Reduction in Pain: The mean VAS score decreased significantly from 8.2 ± 1.3 pre-operatively to 2.1 ± 1.5 at 12 months post-operatively (p < 0.001). Functional Improvement: The mean ODI improved from 56% ± 12% pre-operatively to 18% ± 9% at 12 months post-operatively (p < 0.001) Patient Satisfaction: 92% of patients reported a high level of satisfaction with their treatment results. Complications: Perioperative complications were minimal, with an overall common complication rate of 4%. No major complications or functional impairments were observed. Conclusions: Transforaminal spinal endoscopy is associated with good clinical outcomes and a low complication rate in patients with spinal pathologies. This study supports the adoption of this technique as a first-line treatment for selected patients, offering a less invasive and equally effective option compared to traditional surgery. Full article
(This article belongs to the Special Issue Clinical Diagnosis and Management in Orthopaedics and Traumatology)
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10 pages, 1146 KiB  
Article
Access Pain During Transforaminal Endoscopic Lumbar Discectomy for Foraminal or Extraforaminal Disc Herniation
by Yong Ahn, Ji-Eun Choi and Sol Lee
Diagnostics 2024, 14(20), 2337; https://doi.org/10.3390/diagnostics14202337 - 21 Oct 2024
Viewed by 1047
Abstract
Background/Objectives: Transforaminal endoscopic lumbar discectomy (TELD) under local anesthesia is a promising minimally invasive surgical option for intractable lumbar disc herniation (LDH). However, our understanding of access pain prediction during foraminal pathological procedures is limited. To our knowledge, no predictive rules for access [...] Read more.
Background/Objectives: Transforaminal endoscopic lumbar discectomy (TELD) under local anesthesia is a promising minimally invasive surgical option for intractable lumbar disc herniation (LDH). However, our understanding of access pain prediction during foraminal pathological procedures is limited. To our knowledge, no predictive rules for access pain have been established during TELD for foraminal or extraforaminal LDH. This study, with its potential for predicting access pain during TELD and discussing strategies for pain prevention and management, could significantly benefit the field of endoscopic spine surgery. Methods: This observational study included 73 consecutive patients who underwent TELD for foraminal or extraforaminal LDH between January 2017 and December 2022. Preoperative clinical and radiographic factors affecting significant access pain and the impact of access pain on clinical outcomes were evaluated. Results: The rate of significant access pain was 13.70% (10 of 73 patients). Extraforaminal LDH tended to cause more severe pain than did foraminal LDH during TELD under local anesthesia (p < 0.05). Although the degree of access pain was not related to global clinical outcomes, increased pain was strongly associated with prolonged operative time and length of hospital stay (p < 0.05). Conclusions: TELD could be an effective surgical option for foraminal or extraforaminal LDH under local anesthesia. More access pain might develop during TELD for extraforaminal LDH. The extraforaminal component of LDH could narrow the safe working zone. Significant access pain might prolong the duration of surgery and hospitalization. Thus, a specialized technique is required for the clinical success of TELD. Full article
(This article belongs to the Special Issue Clinical Diagnosis and Management in Orthopaedics and Traumatology)
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8 pages, 2216 KiB  
Article
Clinical Outcomes of a Minimally Invasive Percutaneous Brostrom Technique without Arthroscopic Assistance
by Ettore Vulcano, Gerard F. Marciano and Enrico Pozzessere
Diagnostics 2024, 14(19), 2252; https://doi.org/10.3390/diagnostics14192252 - 9 Oct 2024
Viewed by 1105
Abstract
Background/Objectives: Surgical management of chronic lateral ankle instability has traditionally been performed using an open technique. Arthroscopic-assisted and all-arthroscopic techniques have gained popularity as they have achieved strong clinical outcomes. However, they rely on the surgeon’s arthroscopic skills and familiarity with arthroscopic anatomy. [...] Read more.
Background/Objectives: Surgical management of chronic lateral ankle instability has traditionally been performed using an open technique. Arthroscopic-assisted and all-arthroscopic techniques have gained popularity as they have achieved strong clinical outcomes. However, they rely on the surgeon’s arthroscopic skills and familiarity with arthroscopic anatomy. Recently, a minimally invasive percutaneous technique without arthroscopic assistance has been developed that incorporates the benefits of arthroscopy, such as minimal soft tissue disruption, without the additional requirements of performing an arthroscopic technique. The aim of the current study is to describe the minimally invasive percutaneous technique for chronic lateral ankle instability and report on its clinical outcomes. Methods: Fifty-four consecutive patients without intra-articular ankle pathology underwent lateral ligament repair for chronic ankle instability with a percutaneous technique at a single institution by a fellowship-trained foot and ankle surgeon. Foot Function Index (FFI) score was recorded pre-operatively and post-operatively at final follow-up. All patients had a minimum follow-up of 12 months. Post-operative complications and patient satisfaction were also recorded. Results: A significant improvement (p < 0.001) in FFI compared to pre-operative values (from 55, SD 4.1, to 10, SD 1.9) was observed. A single patient required a return to the operating room for open revision with allograft reconstruction following a fall 2.5 months post-operatively. There were no other complications including infection or nerve injury. The overall rate of satisfaction after surgery was 98.1%, with one patient dissatisfied due to excessive ankle stiffness. Conclusions: The described minimally invasive percutaneous Brostrom procedure is safe and effective for the treatment of chronic lateral ankle instability without intra-articular ankle pathology. Full article
(This article belongs to the Special Issue Clinical Diagnosis and Management in Orthopaedics and Traumatology)
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