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Life
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Orthopedic Disease Treatment and Management: Innovations, Challenges, and Future Directions
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Orthopedic Disease Treatment and Management: Innovations, Challenges, and Future Directions

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: 31 October 2025 | Viewed by 4030

Special Issue Editor

Dr. Mihnea Ioan Gabriel Popa

E-Mail Website
Guest Editor
Orthopedics and Traumatology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
Interests: orthopedic surgery; arthroplasty; musculoskeletal regeneration; orthopedic trauma

Special Issue Information

Dear Colleagues,

Orthopedic diseases represent a diverse and complex challenge in modern medicine, encompassing conditions ranging from degenerative joint diseases to complex musculoskeletal trauma and orthopedic infections. Recent advancements in biomaterials, surgical techniques, regenerative medicine, and personalized treatment strategies have revolutionized patient outcomes, and yet many clinical dilemmas persist. The integration of cutting-edge technologies, including artificial intelligence, 3D printing, and patient-specific implants, is reshaping this field, allowing for more precise, efficient, and durable orthopedic interventions.

This Special Issue will showcase pioneering research and clinical studies addressing both surgical and non-surgical approaches in orthopedic disease management. Topics of interest include minimally invasive and robotic-assisted surgeries, biomechanics-driven implant design, the role of biologics in musculoskeletal repair, and emerging strategies in infection control and osteoarticular reconstruction. Additionally, the impact of rehabilitation protocols, multidisciplinary collaborations, and perioperative optimization on functional recovery will be explored.

By bringing together global experts in orthopedic research and practice, this Special Issue will provide a platform for groundbreaking discoveries and evidence-based approaches that will shape the future of orthopedic care. We welcome high-quality original research, systematic reviews, and clinical studies that contribute to the evolution of treatment paradigms and patient-centered orthopedic care.

Dr. Mihnea Ioan Gabriel Popa
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. Life is an international peer-reviewed open access monthly 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
  • musculoskeletal regeneration
  • biomaterials and implants
  • minimally invasive techniques
  • periprosthetic joint infections
  • regenerative medicine
  • biomechanics and implant design
  • orthopedic trauma and reconstruction
  • rehabilitation and functional recovery
  • AI and robotics in orthopedics

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Published Papers (4 papers)

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Research

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15 pages, 1622 KB  
Article
Finite Element Investigation of Patellofemoral Contact Mechanics: Influence of Tibial Tuberosity Lateralisation and Trochlear Dysplasia on Extensor Mechanism Stability
by Georgian Iacobescu, Antonio-Daniel Corlatescu, Loredana Iacobescu, Bogdan Serban and Catalin Cirstoiu
Life 2025, 15(9), 1442; https://doi.org/10.3390/life15091442 - 15 Sep 2025
Viewed by 91
Abstract
Background: Patellofemoral instability arises from the interplay between trochlear morphology and malalignment of the extensor vector. Although each factor is individually well described, their combined mechanical effects have not been quantified within a single finite element framework. Objective: To investigate how lateral trochlear [...] Read more.
Background: Patellofemoral instability arises from the interplay between trochlear morphology and malalignment of the extensor vector. Although each factor is individually well described, their combined mechanical effects have not been quantified within a single finite element framework. Objective: To investigate how lateral trochlear inclination (LTI) and tibial tuberosity position interact to influence patellofemoral contact mechanics and stability across clinically relevant knee flexion angles. Methods: A subject-specific finite element model of the femur–patella–tibia complex was reconstructed from high-resolution CT data. Cortical and cancellous bone, patellar cartilage, the MPFL, and patellar tendon were included. Three trochlear morphologies were simulated (LTI = 15°, 10°, 5°) under native alignment (Case A) and after 10 mm lateral tibial tuberosity translation (Case B). Flexion at 30°, 60°, and 90° was imposed via solver-applied tibial displacement. Primary outcomes were contact pressure, contact area, MPFL stress, and lateral patellar translation. Instability was defined as >5 mm lateral translation or >50% reduction in contact area, consistent with the biomechanical literature. Model convergence (<5% variation) and validation against cadaveric pressure data were performed; a sensitivity analysis tested material property variation (±15%). Results: The native model reproduced peak pressures (3.6 MPa at 60°) within 9% of experimental benchmarks. Decreasing LTI enlarged the contact patch and lowered mean pressures (−18%) but increased MPFL stress (+37%). Tibial tuberosity lateralisation reduced mean pressures further (−25%), yet, when combined with shallow trochlear slopes (≤8°), produced >5 mm lateral patellar translation and near-complete loss of cartilage contact by 60°, simulating lateral dislocation. Sensitivity testing confirmed robustness to material property uncertainty. Conclusions: Shallow trochlear inclination dissipates articular load but destabilises the patella, an effect magnified by tibial tuberosity lateralisation. While these findings highlight thresholds at which stability may be compromised, they derive from a single-subject model and should be interpreted as hypothesis-generating rather than prescriptive. Broader validation across multiple geometries and loading conditions is required before clinical translation. Full article
(This article belongs to the Special Issue Orthopedic Disease Treatment and Management: Innovations, Challenges, and Future Directions)
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20 pages, 1710 KB  
Article
Predictive Model for Estimating the Length of Stay in Hip Arthroplasty Patients by Machine Learning—H.I.P.P.O Score
by Andrei Danet, Razvan Spiridonica, Georgian Iacobescu, Adrian Cursaru, Bogdan Cretu, Bogdan Serban, Sergiu Iordache, Antonio-Daniel Corlatescu and Catalin Cirstoiu
Life 2025, 15(9), 1408; https://doi.org/10.3390/life15091408 - 7 Sep 2025
Viewed by 392
Abstract
Introduction: Total hip arthroplasty is a major orthopedic intervention, which is increasingly performed, and involves a variable duration of postoperative hospitalization. Estimating this duration is essential for optimizing resources and improving perioperative planning. Materials and Methods: The retrospective study included 85 patients admitted [...] Read more.
Introduction: Total hip arthroplasty is a major orthopedic intervention, which is increasingly performed, and involves a variable duration of postoperative hospitalization. Estimating this duration is essential for optimizing resources and improving perioperative planning. Materials and Methods: The retrospective study included 85 patients admitted to an orthopedic clinic between 2020 and 2025, undergoing primary hip arthroplasty. Pre- and postoperative clinical, biological, and surgical data were collected. Based on these variables, the H.I.P.P.O. (Hip Intervention Patient Prognostic Outcome) score was developed, using a Random Forest algorithm to predict the length of stay (short, medium, long). Results: The model achieved an overall accuracy of 80%. The most important predictors were as follows: day of surgery, type of prosthesis, preoperative fibrinogen, INR, APTT, preoperative hemoglobin, age, and presence of liver cirrhosis. The H.I.P.P.O. score allowed efficient stratification of patients and showed a high capacity to identify cases at risk of prolonged hospitalization (F1 score = 0.857). Conclusions: The H.I.P.P.O. score is a practical, interpretable, and clinically applicable tool that integrates biological and organizational factors to predict the length of stay after hip arthroplasty. It can support surgical decision making and optimize perioperative management. Full article
(This article belongs to the Special Issue Orthopedic Disease Treatment and Management: Innovations, Challenges, and Future Directions)
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12 pages, 1519 KB  
Article
Arthroscopic Repair Versus Conservative Treatment in Degenerative Cuff Tears: Midterm Results
by Maria Rosario Camacho-Sanchez, Irene Calzado-Alvarez, Jose Carlos Minarro, Diana Maria Dussan-Arango, Clementina López-Medina and Alberto Izquierdo-Fernandez
Life 2025, 15(8), 1254; https://doi.org/10.3390/life15081254 - 7 Aug 2025
Viewed by 631
Abstract
(1) Background and aim: The benefit of surgical treatment compared to conservative management is unclear in degenerative cuff tears, and there is limited evidence regarding midterm functional outcomes. This study sought to compare the midterm functional outcomes of surgical versus conservative treatment for [...] Read more.
(1) Background and aim: The benefit of surgical treatment compared to conservative management is unclear in degenerative cuff tears, and there is limited evidence regarding midterm functional outcomes. This study sought to compare the midterm functional outcomes of surgical versus conservative treatment for rotator cuff tears. (2) Methods: All patients on the waiting list for arthroscopy of cuff tears in a single center between 2013 and 2015 were analyzed. They were divided into two groups: those who underwent surgery (arthroscopy group) and those who declined the procedure (orthopedic group). The primary endpoint was shoulder functionality, evaluated with the CMS, SST, and SPADI-SP questionnaires. Inverse probability of treatment weighting (IPTW) was used to account for differences between the groups. (3) Results: Of 57 patients (67 (62–71) years old, 47% women), 32 were in the arthroscopy group and 25 in the orthopedic group. Functionality was assessed at a median of 7 (7–8) years after diagnosis. The patients in the arthroscopy group were younger (p = 0.023) and more frequently women (p = 0.074). No significant differences were observed in the type of tear (p = 0.205) or laterality (p = 0.164). Functional outcome analysis showed more favorable scores in the surgical group: constant (74.5 ± 16.6 vs. 58.4 ± 23, p = 0.016), SST (7.3 ± 3.1 vs. 4.9 ± 4.2, p = 0.016), and SPADI-SP (35.7 ± 26.6 vs. 56.1 ± 30.4, p = 0.006). (4) Conclusions: In this cohort of patients with cuff tears, arthroscopic repair was associated with better clinical and functional midterm results compared to conservative treatment, although the benefit was less evident in older patients and those with complete tears. Full article
(This article belongs to the Special Issue Orthopedic Disease Treatment and Management: Innovations, Challenges, and Future Directions)
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Review

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21 pages, 695 KB  
Review
Injectables in the Therapy of Mid-Portion Achilles Tendinopathy, a Descriptive Review
by Daniela Poenaru, Claudia Gabriela Potcovaru, Miruna Ioana Sandulescu, Mariana Constantinovici and Delia Cinteza
Life 2025, 15(5), 824; https://doi.org/10.3390/life15050824 - 21 May 2025
Viewed by 2391
Abstract
Achilles mid-portion tendinopathy is defined as a painful thickening of the tendon, identified also on different imagistic examinations, occurring in sport people as well in inactively middle-aged individuals. The chronic and/or relapsing evolution interfere with daily living and alter the quality of life. [...] Read more.
Achilles mid-portion tendinopathy is defined as a painful thickening of the tendon, identified also on different imagistic examinations, occurring in sport people as well in inactively middle-aged individuals. The chronic and/or relapsing evolution interfere with daily living and alter the quality of life. Eccentric physical exercise is a cornerstone in her management and several injectable agents are used in clinical settings to reduce pain and improve function. According to the presumed pathogenic mechanisms, many classes of agents are in use: corticosteroids, protease inhibitors, sclerosing agents, pro-inflammatory agents, autologous products. The modalities of administration, either intra- or peritendon, the timing and number of sessions are displayed. Practical approach of chronic mid-portion Achilles tendinopathy consists of rest, tendon protection, eccentric exercise and therapeutical injections. The clinicians must choose between a spectrum of agents active on different pathogenic mechanisms, with benefits in the short and medium term. Future research may be focused on comparison between the different agents and on long term evolution. Full article
(This article belongs to the Special Issue Orthopedic Disease Treatment and Management: Innovations, Challenges, and Future Directions)
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