Tissue engineering techniques using novel scaffold materials offer potential alternatives for managing tendon disorders. Tissue engineering strategies to improve tendon repair healing include the use of scaffolds, growth factors, cell seeding, or a combination of these approaches. Scaffolds have been the most common strategy investigated to date. Available scaffolds for tendon repair include both biological scaffolds, obtained from mammalian tissues, and synthetic scaffolds, manufactured from chemical compounds. Preliminary studies support the idea that scaffolds can provide an alternative for tendon augmentation with an enormous therapeutic potential. However, available data are lacking to allow definitive conclusion on the use of scaffolds for tendon augmentation. We review the current basic science and clinical understanding in the field of scaffolds and tissue engineering for tendon repair.

Intervertebral disc degeneration (IVD) is a frequent pathological condition. Conservative management often fails, and patients with IVD degeneration may require surgical intervention. Several treatment strategies have been proposed, although only surgical discectomy and arthrodesis have been proved to be predictably effective. The aim of biological strategies is to prevent and manage IVD degeneration, improve the function, the anabolic and reparative capabilities of the nucleus pulposus and annulus fibrosus cells, and inhibit matrix degradation. At present, clinical applications are still in their infancy. Further studies are required to clarify the role of mesenchymal stem cells and gene therapy for the prevention and treatment of IVD degeneration.

Cartilage defects represent a common problem in orthopaedic practice. Predisposing factors include traumas, inflammatory conditions, and biomechanics alterations. Conservative management of cartilage defects often fails, and patients with this lesions may need surgical intervention. Several treatment strategies have been proposed, although only surgery has been proved to be predictably effective. Usually, in focal cartilage defects without a stable fibrocartilaginous repair tissue formed, surgeons try to promote a natural fibrocartilaginous response by using marrow stimulating techniques, such as microfracture, abrasion arthroplasty, and Pridie drilling, with the aim of reducing swelling and pain and improving joint function of the patients. These procedures have demonstrated to be clinically useful and are usually considered as first-line treatment for focal cartilage defects. However, fibrocartilage presents inferior mechanical and biochemical properties compared to normal hyaline articular cartilage, characterized by poor organization, significant amounts of collagen type I, and an increased susceptibility to injury, which ultimately leads to premature osteoarthritis (OA). Therefore, the aim of future therapeutic strategies for articular cartilage regeneration is to obtain a hyaline-like cartilage repair tissue by transplantation of tissues or cells. Further studies are required to clarify the role of gene therapy and mesenchimal stem cells for management of cartilage lesions.

Intervertebral disc (IVD) degeneration is frequent, appearing from the second decade of life and progressing with age. Conservative management often fails, and patients with IVD degeneration may need surgical intervention. Several treatment strategies have been proposed, although only surgical discectomy and arthrodesis have been proved to be predictably effective. Biological strategies aim to prevent and manage IVD degeneration, improving the function and anabolic and reparative capabilities of the nucleus pulposus and annulus fibrosus cells and inhibiting matrix degradation. At present, clinical applications are still in their infancy. Further studies are required to clarify the role of growth factors and anticatabolic substances for prevention and management of intervertebral disc degeneration.

Background: The ROSA Knee System (Zimmer Biomet, Warsaw, IN, USA) is a robotic system aiming to increase bone resections and component alignment accuracy during TKA. While much is known about its performance in the coronal plane, its accuracy in the sagittal plane remains debated. The present investigation evaluated the system’s accuracy in achieving planned mechanical axis alignment and specific knee angles in both planes. Methods: A retrospective analysis was performed on 55 consecutive patients who underwent robotic-assisted TKA using the ROSA Knee System. Data on the medial proximal tibial angle (MPTA), lateral distal femoral angle (LDFA), hip–knee–ankle angle (HKA), tibial slope (TS), and distal femoral flexion (DFF) were collected pre- and post-operatively using the ROSA software. Planned and achieved angles were compared, with deviations greater than 2° and 3° defined as outliers. Results: The mean differences between planned and achieved angles for LDFA and MPTA were 0.5° ± 1.00° and 0.3° ± 1.3°, respectively, with less than 10% outliers. The hip–knee angle recorded only a minimal deviation from planned values. In contrast, the TS angle showed a statistically significant difference between planned and achieved values, while no significant difference was found for the DFF angle. The surgeon’s experience did not impact alignment accuracy. Conclusions: The ROSA Knee System demonstrates high accuracy in achieving planned alignment in the coronal plane during robotic-assisted TKA, with minimal outliers and reliable predictions for both femoral and tibial angles. However, the ROSA Knee System showed less accuracy in the sagittal plane, particularly for the tibial slope, which did not adversely affect the implant’s stability.

To date, few knowledge is available about safety and effectiveness of one-staged combined hip and knee arthroplasty. The aim of our study was to evaluate, in a comparative fashion, complications and outcomes in patients who underwent one-staged hip and knee arthroplasty. Forty-two patients were enrolled and allocated into two groups of 21 patients each: one-staged hip and knee arthroplasty (group A) and two-staged hip and knee arthroplasty (group B). The follow-up averaged 50.2 months. Postoperative complications and implant survivorship were assessed prospectively. Outcomes were evaluated with Harris Hip score (HSS), Western Ontario Mc-Ministry score for the hip (h-WOMAC), Knee Society score (KSS), and Western Ontario Mc-Ministry knee score (k-WOMAC). Hip and knee range of motion (ROM) were measured both preoperatively and at the last follow-up. Two (9.5%) patients in group A and three (14.3%) patients in group B developed complications (P = 0.8). Although a significant decrease in postoperative haemoglobin (Hgb) values was found in group A patients during the hospital stay, no differences in blood transfusions were found (P = 0.8). No significant differences were found comparing clinical-functional outcomes between the two groups, while a significant reduction of hospital length of stay was shown in group A patients. One-staged combined hip and knee arthroplasty could be considered in patients with co-existing severe hip and knee osteoarthritis, providing similar complications and mid-term outcomes of two-staged procedures. However, the reproducibility safety and reliability of these procedures should be confirmed in prospective comparative randomised trials with more numerous patients. Retrospectively registered