Submit to JCM Review for JCM Propose a Special Issue

Journal Menu

Journal Browser

Trauma and Orthopedic Surgery: Recent Developments and Future Challenges

Print Special Issue Flyer
Special Issue Editors
Special Issue Information
Keywords
Benefits of Publishing in a Special Issue
Published Papers

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: closed (31 January 2025) | Viewed by 5761

Share This Special Issue

Special Issue Editors

Dr. Tommaso Greco

E-Mail Website
Guest Editor

Orthopaedics and Trauma Surgery Unit, Department of Ageing, Neurosciences, Head-Neck and Orthopaedics Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy
Interests: trauma surgery; foot and ankle surgery; fracture; arthroplasty; knee surgery; osteoporosis
Special Issues, Collections and Topics in MDPI journals

Dr. Carlo Perisano

E-Mail Website
Guest Editor

Orthopedics and Trauma Surgery Unit, Department of Aging, Orthopedic and Rheumatologic Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
Interests: trauma surgery; orthopedic; hip fracture; arthroplasty; osteoporosis; bone tumors
Special Issues, Collections and Topics in MDPI journals

Dr. Alessio Bernasconi

E-Mail Website
Guest Editor

Orthopaedic and Traumatology Unit, Department of Public Health, University "Federico II" of Naples, Naples, Italy
Interests: trauma surgery; ankle sprain; fracture; foot and ankle surgery

Special Issue Information

Dear Colleagues,

In recent years, there has been a notable increase in the rates of orthopedic and trauma surgeries. Advances in increasingly accurate and thorough imaging, minimally invasive surgical procedures, such as arthroscopy or percutaneous fracture fixation, and in rehabilitation protocols have revolutionized treatment approaches by offering reduced postoperative pain, faster recovery times, and improved functional outcomes. However, this field also faces certain challenges. Continued innovation and research efforts are crucial for further enhancing the field of trauma and orthopedic surgery.

This Special Issue aims to provide an opportunity to explore recent advancements in trauma and orthopedic surgery while highlighting the challenges encountered in clinical research. Therefore, we cordially invite authors and specialists in the field to share their experiences and submit their reviews or original research articles that fit within the scope of this Special Issue.

Dr. Tommaso Greco
Dr. Carlo Perisano
Dr. Alessio Bernasconi
Guest Editors

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. Journal of Clinical Medicine 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
trauma surgery
orthopedic trauma
fracture
arthroplasty
post-operative pain
musculoskeletal imaging

Benefits of Publishing in a Special Issue

Ease of navigation: Grouping papers by topic helps scholars navigate broad scope journals more efficiently.
Greater discoverability: Special Issues support the reach and impact of scientific research. Articles in Special Issues are more discoverable and cited more frequently.
Expansion of research network: Special Issues facilitate connections among authors, fostering scientific collaborations.
External promotion: Articles in Special Issues are often promoted through the journal's social media, increasing their visibility.
e-Book format: Special Issues with more than 10 articles can be published as dedicated e-books, ensuring wide and rapid dissemination.

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

Published Papers (5 papers)

Download All Papers

Order results

Result details

Show export options Show export options

Select all

Export citation of selected articles as:

Research

Jump to: Other

11 pages, 1729 KiB

Open AccessArticle

Periprosthetic Fracture After Cementless Revision Total Hip Arthroplasty with a Tapered, Fluted Monobloc Stem: A Retrospective Long-Term Analysis of 121 Cases

by Oliver E. Bischel, Jörn B. Seeger and Paul M. Böhm

J. Clin. Med. 2025, 14(7), 2409; https://doi.org/10.3390/jcm14072409 - 1 Apr 2025

Viewed by 231

Abstract

Background: The use of tapered monobloc stems in revision total hip arthroplasty (RTHA) has shown excellent results, with low implant-dependent failures due to aseptic loosening. Infection is one of the main failure reasons, but further problems, like periprosthetic fractures (PPFs), may endanger the function and duration of the implant in the long run. Methods: A consecutive series of 121 cases after femoral RTHA with a monobloc device was retrospectively investigated, and a Kaplan–Meier analysis was performed. The mean follow-up was 13.0 (range: 0.8–23.8) years. Results: PPF occurred in six patients during follow-up. The cumulative risk for PPF was 5.2% (95% CI: 1.1–9.4%) after 23.8 years. Female gender was associated with a significantly higher risk compared to male gender (9.1% (95% CI: 2.1–16.1%) after 23.1 years vs. 0% after 23.8 years; log-rank p = 0.0034). Patients operated with stems with a length equal to or longer than the calculated median length were also at a significantly higher risk of PPF during follow-up (10.2% (95% CI: 2.4–17.9%) after 23.8 years vs. 0% after 23.1 years; log-rank p = 0.0158). Diabetes at the time of index operation also significantly influenced the occurrence of a PPF during follow-up (n = 4 patients with PPF out of 107 without (4.0% (95% CI: 0.2–7.8%) after 23.8 years vs. n = 2 out of 14 with diabetes (15.4% (95% CI: 0–35.0%) after 21.1 years; log-rank p = 0.0368). The failure rate with implant removal as an endpoint due to aseptic loosening was 0%, and with infection it was 3.4% (95% CI: 0.1–6.7%), after 23.8 years. Conclusions: Although no removal of the implant due to a PPF was necessary, the cumulative risk for PPF after femoral revision with a tapered and fluted monobloc stem was higher in this long-term follow-up series compared to implant failure due to infection or aseptic loosening. Female gender and diabetes was associated with a significantly higher risk of PPF during follow-up. The use of longer stems than necessary is not preventive of PPF, and should be avoided. Full article

(This article belongs to the Special Issue Trauma and Orthopedic Surgery: Recent Developments and Future Challenges)

► Show Figures

Figure 1

13 pages, 1613 KiB

Open AccessArticle

Epidemiology of Periprosthetic Fractures After Cementless Revision Total Hip Arthroplasty with Tapered, Fluted Stems at a Mid- to Long-Term Follow-Up

by Oliver E. Bischel, Matthias K. Jung, Arnold J. Suda, Jörn B. Seeger and Paul M. Böhm

J. Clin. Med. 2025, 14(5), 1468; https://doi.org/10.3390/jcm14051468 - 22 Feb 2025

Viewed by 517

Abstract

Background: Although tapered and fluted stems are frequently used in revision total hip arthroplasty (RTHA), major complications following the implantation of these implants, like periprosthetic fractures, are less investigated. As epidemiological data do not exist yet, the incidence of PPF in a mid- to long-term follow-up is unknown and potential risk factors have not been detected. Methods: Propensity score matching (PSA) of two retrospectively investigated cohorts after femoral RTHA with either modular (n = 130) or monobloc prosthesis (n = 129) was executed. A total of 186 cases, including 93 of each device, were finally analyzed during a mean follow-up period of 9.1 (0.5–23.1) years. The time-dependent risk of PPF was calculated using a Kaplan–Meier analysis. Results: The cumulative risk for PPF of the whole cohort was 5.7% (95% CI: 1.7–9.8%) at 23.1 years, for the modular device, 13.0% (95% CI: 0–26.0%) after 13.7 years and the monobloc stem, 3.4% (95% CI: 0–7.1%) after 23.1 years, without a significant difference between the two designs (log-rank p = 0.1922). All eight fractures occurred in women and there was one collapse of the fracture after open reduction and internal fixation. The cumulative risk was 10.1% (95% CI: 3.1–17.1%) at 23.1 years compared to 0% after 21.4 years in men (log-rank p = 0.0117). Diabetes was significantly associated with the presence of PPF during follow-up (non-diabetic, 4.4% (95% CI: 0–8.2%) after 21.3 years vs. diabetic, 16.6% (96% CI: 0–34.5%) after 13.3 years; log-rank p = 0.0066). Longer reconstructions showed also a significantly higher fracture risk (equal or longer than median implant length vs. shorter; 10.5% (95% CI: 3.1–17.1%) after 21.4 years vs. 1.0% (95% CI: 0–3.1%) after 23.1 years; log-rank p = 0.0276) but did not correlate with a preoperative defect situation. Conclusions: The cumulative risk for PPF after femoral revision with tapered and fluted devices is a relevant failure reason in this mid- to long-term investigation. There was no difference between the monobloc stem or modular implant. Women and diabetics are at risk, and the choice of a longer implant than necessary is neither prophylactical for PPF nor useful in the case of the operative treatment of a PPF after femoral RTHA with these revision devices. Full article

(This article belongs to the Special Issue Trauma and Orthopedic Surgery: Recent Developments and Future Challenges)

► Show Figures

Figure 1

12 pages, 1604 KiB

Open AccessArticle

Mid-Term Clinical and Radiographic Results of Complex Hip Revision Arthroplasty Based on 3D Life-Sized Model: A Prospective Case Series

by Francesco La Camera, Vincenzo Di Matteo, Alessandro Pisano, Edoardo Guazzoni, Carlo Maria Favazzi, Katia Chiappetta, Emanuela Morenghi, Guido Grappiolo and Mattia Loppini

J. Clin. Med. 2024, 13(18), 5496; https://doi.org/10.3390/jcm13185496 - 17 Sep 2024

Viewed by 1191

Abstract

Background: The pre-operative three-dimensional (3D) assessment of acetabular bone defects may not be evaluated properly with conventional radiographic and computed tomography images. This paper reports mid-term clinical and radiographic outcomes of complex revision total hip arthroplasty (r-THA) based on a 3D life-sized printed model. Methods: Patients who underwent r-THA for septic or aseptic acetabular loosening with acetabular defects Paprosky types IIc, IIIa, and IIIb between 2019 and 2021 were included. The outcomes of the study were to determine clinical and radiographic assessment outcomes at the time of the last follow-up. Results: 25 patients with mean age of 62.9 ± 10.8 (18–83) years old were included. The mean Harris hip score improved from 34.8 ± 8.1 pre-operative to 81.6 ± 10.4 points (p < 0.001). The mean visual analog scale decreased from 6.7 ± 1.4 points pre-operative to 2.4 ± 1.0 points (p < 0.001). The mean limb length discrepancy improved from −2.0 ± 1.2 cm pre-operative to −0.6 ± 0.6 cm (p < 0.001). The mean vertical position of the center of rotation (COR) changed from 3.5 ± 1.7 cm pre-operative to 2.0 ± 0.7 cm (p < 0.05). The mean horizontal COR changed from 3.9 ± 1.5 cm pre-operative to 3.2 ± 0.5 cm (p < 0.05). The mean acetabular component abduction angle changed from 59.7° ± 29.6° pre-operative to 46° ± 3.9 (p < 0.05). Conclusions: A three-dimensional-printed model provides an effective connection between the pre-operative bone defects’ evaluation and the intraoperative findings, enabling surgeons to select optimal surgical strategies. Full article

(This article belongs to the Special Issue Trauma and Orthopedic Surgery: Recent Developments and Future Challenges)

► Show Figures

Figure 1

8 pages, 218 KiB

Open AccessArticle

Incidence of Subclinical Deep Vein Thrombosis after Total Hip and Knee Arthroplasty Is Not Correlated with Number of Tranexamic Acid Doses

by Bogdan-Axente Bocea, Bianca-Iulia Catrina, Mihai-Dan Roman, Nicolas Catalin Ionut Ion, Sorin Radu Fleaca, Cosmin-Ioan Mohor, Antonescu Oana Raluca, Sergiu-Ioan Moga and Romeo Gabriel Mihaila

J. Clin. Med. 2024, 13(13), 3834; https://doi.org/10.3390/jcm13133834 - 29 Jun 2024

Cited by 3 | Viewed by 1198

Abstract

Background: Recent studies increasingly highlight the efficacy of tranexamic acid administration in total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, the optimal dosage of tranexamic acid is still controversial. Methods: The current study analyzes the efficiency of tranexamic acid dosage and the number of administrations in THA and TKA. The objective of this study is to compare the incidence of deep vein thrombosis (DVT) based on the number of dosages. We divided the patients into two groups; one group received a single dosage, and the other group received two dosages. Doppler ultrasound examinations were conducted on the lower limbs of all patients at both six and thirty days postoperatively. The second objective is to compare the decrease in hemoglobin (Hb) in the two groups. Results: The results show that there is no difference in DVT incidence between the patients with different TXA numbers of dosages. There is no statistically significant decrease in Hb between the two groups at day one and day five postoperatively. Day one shows a statistically higher average in the two-dose group, approximately 0.06 g/dL, and day five shows a slightly elevated average in the single-dose group, approximately 0.06 g/dL. Blood transfusion requirements show no significant differences in the groups; one patient in the single-dose tranexamic acid group needed transfusion at day five postoperatively, while two patients in each group required immediate postoperative transfusion. Conclusion: There was no increase in the incidence of deep vein thrombosis among patients receiving two dosages of tranexamic acid. Full article

(This article belongs to the Special Issue Trauma and Orthopedic Surgery: Recent Developments and Future Challenges)

Other

Jump to: Research

19 pages, 1536 KiB

Open AccessSystematic Review

Trends in the Use of Weightbearing Computed Tomography

by Alessio Bernasconi, Yanis Dechir, Antonio Izzo, Martina D’Agostino, Paolo Magliulo, Francesco Smeraglia, Cesar de Cesar Netto, International Weightbearing CT Society and François Lintz

J. Clin. Med. 2024, 13(18), 5519; https://doi.org/10.3390/jcm13185519 - 18 Sep 2024

Cited by 3 | Viewed by 1759

Abstract

Background: This review aimed to critically appraise the most recent orthopedic literature around cone beam weightbearing computed tomography (WBCT), summarizing what evidence has been provided so far and identifying the main research trends in the area. Methods: This scoping review was performed on studies published between January 2013 and December 2023 on the Pubmed database. All studies (both clinical and nonclinical) in which WBCT had been used were critically analyzed to extract the aim (or aims) of the study, and the main findings related to the role of this imaging modality in the diagnostic pathway. Results: Out of 1759 studies, 129 were selected. One hundred five manuscripts (81%) dealt with elective orthopedic conditions. The majority of the analyses (88 studies; 84%) were performed on foot and ankle conditions, while 13 (12%) studies looked at knee pathologies. There was a progressive increase in the number of studies published over the years. Progressive Collapsing Foot Deformity (22 studies; 25%) and Hallux Valgus (19 studies; 21%) were frequent subjects. Twenty-four (19%) manuscripts dealt with traumatic conditions. A particular interest in syndesmotic injuries was documented (12 studies; 60%). Conclusions: In this review, we documented an increasing interest in clinical applications of weightbearing CT in the orthopedic field between 2013 and 2023. The majority of the analyses focused on conditions related to the foot and the ankle; however, we found several works investigating the value of WBCT on other joints (in particular, the knee). Full article

(This article belongs to the Special Issue Trauma and Orthopedic Surgery: Recent Developments and Future Challenges)

► Show Figures

Journal Menu

Journal Browser

Trauma and Orthopedic Surgery: Recent Developments and Future Challenges

Share This Special Issue

Special Issue Editors

Special Issue Information

Keywords

Benefits of Publishing in a Special Issue

Published Papers (5 papers)

Research

Other

Further Information

Guidelines

MDPI Initiatives

Follow MDPI