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Diagnostics
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Novel Technologies in Orthopedic Surgery: Diagnosis and Management
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Novel Technologies in Orthopedic Surgery: Diagnosis and Management

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

Deadline for manuscript submissions: 31 October 2025 | Viewed by 4740

Special Issue Editor

Dr. Giuseppe Salvatore

E-Mail Website
Guest Editor
Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Roma, Italy
Interests: orthopedics; bone injuries; trauma; orthopedic diseases

Special Issue Information

Dear Colleagues,

Technological advancements in the medical field have resulted in safer and more effective procedures, individualized care, and enhanced efficiency. The development of technologies by engineers, scientists, and innovators, with the aim of increasing precision and safety within the operating room, has greatly benefited the field of orthopedic surgery.

Since certain technologies have been shown to provide dramatic advantages compared to traditional techniques, an increasing number of orthopedic surgeons are utilizing and refining tools to improve patient care. This Special Issue will explore cutting-edge diagnostic tools and technologies that are transforming the way orthopedic surgeons approach patient care. From advanced imaging techniques to innovative biomechanical assessments, these novel technologies are drastically enhancing diagnostic accuracy and precision.

Computer navigation and augmented reality

Computer navigation aims to assist in the planning and performing of surgery more consistently and precisely. Augmented reality brings real-time virtual data, such as information regarding implant placement, anatomical structures, and preoperative planning, into the surgeon's field of view.

Robotics

Thanks to the assistance of robotic technologies, surgeons can execute surgeries with more accuracy and precision. Enhancements in implant placement and alignment can result in enduring and more efficient implants. Additionally, real-time navigation and feedback from robotic systems can help to minimize mistakes, lowering the possibility of intraoperative complications.

Digital Templating

Digital templating is the process of precisely planning and sizing orthopedic implants via the utilization of powerful imaging software. With the assistance of these technologies, surgeons can accurately choose and place implants through the development of virtual templates for the patient's anatomy. Digital templating decreases implant inventory, accelerates surgery, and increases surgical precision.

3D Printing

Precision and customization during surgical procedures can be increased through the use of this technology to create surgical equipment and implants that are unique to each patient. Surgeons can also use this technology to plan complex surgeries, optimizing implant sizing with the help of 3D-printed models.

Artificial Intelligence

Massive amounts of patient data can be analyzed via artificial neural networks to discover trends and predict results, thus providing the best guidance on therapy selection and enhancing patient outcomes.

Overall, this Special Issue aims to provide readers with an overview of the current available technology in orthopedic surgery, highlighting its advantages in empowering diagnosis, intraoperative precision, and patient satisfaction.

Dr. Giuseppe Salvatore
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

  • orthopedic surgery
  • orthopedic diagnosis
  • orthopedics
  • computer navigation and augmented reality
  • robotics
  • digital templating
  • 3D Printing
  • artificial intelligence
  • machine learning
  • deep learning

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Published Papers (4 papers)

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Research

15 pages, 8713 KiB  
Article
Morton’s Neuroma or Intermetatarsal Bursitis—A Prospective Diagnostic Study of Intermetatarsal Pain
by Sif Binder Larsen, Cecilie Mørck Offersen, Eva Dyrberg, Jens Kurt Johansen, Naja Bjørslev Lange, Birthe Højlund Bech, Michael Bachmann Nielsen and Søren Tobias Torp-Pedersen
Diagnostics 2025, 15(11), 1339; https://doi.org/10.3390/diagnostics15111339 - 26 May 2025
Viewed by 39
Abstract
Background: Intermetatarsal bursitis (IMB) is emerging as a diagnostic consideration for patients with forefoot pain. However, few investigations have been conducted into the incidence of IMB among patients with forefoot pain. The symptoms of IMB are described as mimicking those of Morton’s neuroma [...] Read more.
Background: Intermetatarsal bursitis (IMB) is emerging as a diagnostic consideration for patients with forefoot pain. However, few investigations have been conducted into the incidence of IMB among patients with forefoot pain. The symptoms of IMB are described as mimicking those of Morton’s neuroma (MN). Currently, the best method to differentiate between MN and IMB is radiological evaluation. Based on this, the aim of this study was to investigate the incidence of IMB and MN in a prospective cohort of patients with intermetatarsal pain diagnosed with radiological evaluation and compared to a control group. Methods: This study included 26 patients and 13 controls. All participants underwent magnetic resonance imaging (MRI) and ultrasound (US) of one forefoot. Results: Among the 26 patients, 5 (19.2%) had MN and 14 (53.8%) had IMB on MRI compared to US, with which 25 (96.2%) cases of IMB and 0 with MN were identified. In the control group, both modalities found asymptomatic web space pathology in four cases (30.8%), and US identified normal intermetatarsal bursas in five cases. Additionally, our results indicate that MN patients have more severe pain and a longer history of pain compared to IMB patients. Conclusions: Based on our MRI results, we conclude that IMB is frequent in patients with intermetatarsal pain. Differentiation between MN and IMB with US is complex and should be performed with caution and an understanding of both conditions. Normal intermetatarsal bursas are also visible on US as hypoechoic but non-expansive masses. Full article
(This article belongs to the Special Issue Novel Technologies in Orthopedic Surgery: Diagnosis and Management)
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13 pages, 4708 KiB  
Article
Reduction in Synovitis Following Genicular Artery Embolization in Knee Osteoarthritis: A Prospective Ultrasound and MRI Study
by Louise Hindsø, Per Hölmich, Michael M. Petersen, Jack J. Xu, Søren Heerwagen, Michael B. Nielsen, Robert G. C. Riis, Adam E. Hansen, Lene Terslev, Mikkel Taudorf and Lars Lönn
Diagnostics 2024, 14(22), 2564; https://doi.org/10.3390/diagnostics14222564 - 15 Nov 2024
Cited by 1 | Viewed by 1664
Abstract
Background/Objectives: Genicular artery embolization (GAE) has demonstrated potential as a treatment for knee osteoarthritis by targeting inflammation and pain, although current evidence remains limited. This study used imaging biomarkers to objectively assess synovitis and possible ischemic complications following GAE. Methods: This was a [...] Read more.
Background/Objectives: Genicular artery embolization (GAE) has demonstrated potential as a treatment for knee osteoarthritis by targeting inflammation and pain, although current evidence remains limited. This study used imaging biomarkers to objectively assess synovitis and possible ischemic complications following GAE. Methods: This was a prospective, single-center trial including participants with mild-to-moderate knee osteoarthritis. Ultrasound, contrast-enhanced (CE), and non-CE-MRI were performed two days before and one and six months after GAE. Ultrasound biomarkers included synovial hypertrophy, effusion, and Doppler activity. A combined effusion-synovitis score was assessed on non-CE-MRI, while CE-MRI allowed differentiation between synovium and effusion and was used to calculate whole-joint and local synovitis scores. The post-GAE MRIs were reviewed for ischemic complications. Results: Seventeen participants (aged 43–71) were treated. Significant reductions were observed in ultrasound-assessed synovial hypertrophy and Doppler activity, as well as in CE-MRI local and whole-joint synovitis scores. While reductions in effusion were noted in both ultrasound and MRI, these changes did not reach statistical significance. At one month, MRI revealed three cases of nonspecific osteonecrosis-like areas, which resolved completely by six months. Conclusions: This study demonstrated a reduction in synovitis and no permanent ischemic complication following GAE in knee osteoarthritis. Larger studies with longer follow-up are needed to confirm the long-term efficacy and safety of the procedure. Full article
(This article belongs to the Special Issue Novel Technologies in Orthopedic Surgery: Diagnosis and Management)
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14 pages, 5880 KiB  
Article
Higher Accuracy of Arthroscopy Compared to MRI in the Diagnosis of Chondral Lesions in Acute Ankle Fractures: A Prospective Study
by Ali Darwich, Dominik Nörenberg, Julia Adam, Svetlana Hetjens, Mohamad Bdeir, Andreas Schilder, Steffen Thier, Sascha Gravius and Ahmed Jawhar
Diagnostics 2024, 14(16), 1810; https://doi.org/10.3390/diagnostics14161810 - 20 Aug 2024
Viewed by 1042
Abstract
Even after successful surgery for acute ankle fractures, many patients continue having complaints. A possible explanation is the presence of concomitant chondral lesions. The aim of this study is to investigate the accuracy of MRI compared to that of arthroscopy in the assessment [...] Read more.
Even after successful surgery for acute ankle fractures, many patients continue having complaints. A possible explanation is the presence of concomitant chondral lesions. The aim of this study is to investigate the accuracy of MRI compared to that of arthroscopy in the assessment of chondral lesions in acute ankle fractures. In this prospective single-center study, patients presenting with acute ankle fractures over a period of three years were identified. A preoperative MRI was performed within a maximum of 10 days after trauma. During surgery, ankle arthroscopy was also performed. The International Cartilage Repair Society (ICRS) cartilage lesion classification was used to grade the detected chondral lesions. To localize the chondral lesions, the talar dome was divided into eight zones and the tibial/fibular articular surfaces into three zones. In total, 65 patients (28 females) with a mean age of 41.1 ± 15 years were included. In the MRI scans, 70 chondral lesions were detected (69.2% of patients) affecting mostly the tibial plafond (30%) and mostly graded as ICRS 3. The mean lesion area measured was 20.8 mm2. In the arthroscopy, 85 chondral lesions were detected (70.8% of patients) affecting mostly the medial surface of the talar dome (25.9%) and mostly graded ICRS 3. The mean lesion area measured was 43.4 mm2. The highest agreement between the two methods was observed in the size estimation of the chondral lesions. The present study shows the reduced accuracy of MRI when compared to arthroscopy in the assessment of traumatic chondral lesions in the setting of acute ankle fractures especially regarding lesion size. MRI remains an essential instrument in the evaluation of such lesions; however, surgeons should take this discrepancy into consideration, particularly the underestimation of chondral lesions’ size in the preoperative planning of surgical treatment and operative technique. Full article
(This article belongs to the Special Issue Novel Technologies in Orthopedic Surgery: Diagnosis and Management)
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10 pages, 1899 KiB  
Article
Robot-Assisted 2D Fluoroscopic Needle Placement—A Phantom Study
by Yannick Scharll, Nenad Radojicic, Gregor Laimer, Peter Schullian and Reto Bale
Diagnostics 2024, 14(16), 1723; https://doi.org/10.3390/diagnostics14161723 - 8 Aug 2024
Viewed by 1402
Abstract
Rationale and Objectives: To evaluate the targeting accuracy of a novel robot-assisted guidance technique relying on one pair of 2D C-arm images. Material and Methods: In total, 160 punctures were carried out semi-automatically by using a novel robotic device. The needle’s paths were [...] Read more.
Rationale and Objectives: To evaluate the targeting accuracy of a novel robot-assisted guidance technique relying on one pair of 2D C-arm images. Material and Methods: In total, 160 punctures were carried out semi-automatically by using a novel robotic device. The needle’s paths were planned based on one pair of 2D fluoroscopic images from different angles. Conically shaped aluminum tips inside a gelatin-filled plexiglass phantom served as targets. The accuracy of the needle placement was assessed by taking control CTs and measuring the Euclidean distance (ED) and normal distance (ND) between the needle and the target point. In addition, the procedural time per needle placement was evaluated. Results: The accomplished mean NDs at the target for the 45°, 60°, 75° and 90° angles were 1.86 mm (SD ± 0.19), 2.68 mm (SD ± 0.18), 2.19 mm (SD ± 0.18) and 1.86 mm (SD ± 0.18), respectively. The corresponding mean EDs were 2.32 mm (SD ± 0.16), 2.68 mm (SD ± 0.18), 2.65 mm (SD ± 0.16) and 2.44 mm (SD ± 0.15). The mean duration of the total procedure, including image acquisition, trajectory planning and placement of four needles sequentially, was 12.7 min. Conclusions: Robotic guidance based on two 2D fluoroscopy images allows for the precise placement of needle-like instruments at the first attempt without the need for using an invasive dynamic reference frame. This novel approach seems to be a valuable tool for the precise targeting of various anatomical structures that can be identified in fluoroscopic images. Full article
(This article belongs to the Special Issue Novel Technologies in Orthopedic Surgery: Diagnosis and Management)
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