Background/Objectives: Periprosthetic fractures (PFs) can occur in both the upper and lower limbs, commonly resulting from falls at the same level. The frequency of PFs following total hip arthroplasty (THA) ranges from 0.045% to 4.1%, and this incidence is influenced by several factors, including age, gender, the type of prosthesis used, and existing comorbidities. Previous studies on this subject have been small in scale and did not adequately address the associated comorbidities, which pose a challenge for the aging population. This study aims to comparatively assess the incidence of THA-related PFs, immediate postoperative complications, and comorbidities in patients with PFs from three emergency hospitals. Methods: A retrospective observational study was conducted from 1 January to 31 December 2024, in which 54 patients with PFs hospitalized in three emergency hospitals (Bucharest, Oradea, and Ploiești) were evaluated, divided into Group B (n = 29), Group O (n = 14), and Group P (n = 11). Results: Of all patients with PFs, 81.48% had minor complications—grade 1, 9.26% had grade 2 complications (complications requiring medical treatment or other minor interventions), and 3.70% had complications requiring surgery or invasive procedures. Clavien–Dindo grade 5 (patient death) had an incidence of 3.70%. Cardiac pathology was the most common pathology; hypertension predominated in Group O (42.85%). Alzheimer’s disease was associated in 7 patients (12.96%). Without associated pathology, about 13% of patients were identified. Diabetes mellitus also occurred frequently in 31.50%. Data analysis indicates a very weak positive correlation between the Dindo Index and the Charlson Comorbidity Index (r = 0.046), which is not statistically significant (p = 0.628). The effect size, measured by Fisher’s z, is also reported as 0.046. Conclusions: No significant differences were found among the evaluated centers regarding therapeutic approaches, postoperative complications, and associated comorbidities. Furthermore, there is insufficient evidence to suggest a significant association between the Charlson Comorbidity Index and the Clavien–Dindo Index.

"Total hip replacement surgery (THR) is one of the most common surgeries performed in modern orthopedics, and in most cases offers a significant improvement in the quality of the patient's life. However, after some time, wear and osteolysis do appear, which leads to the need for revision surgery. With the indication being widened to a more young and active population, the need for extending the lifespan of the prosthesis is mandatory. Although several bearing surfaces have been studied over the years, and a lot of couplings are in use, the choice of the right combination of materials is still controversial. Biotribology tries to answer some of the current questions regarding the best bearing surface to use, being the branch of science and technology that studies friction, wear, and lubrication of different materials in the human body. In the present day, a large number of materials are in use for total hip replacement, but choosing the right combination of materials is still controversial, and is being done on one hand by the surgeon’s experience and on the other hand by the age and activity of the patient. The objective of this review is to try to present the main advantages and disadvantages of different materials and try to answer the most difficult question of them all: What is the right material to use for THR-bearing surfaces? "

Myxofibrosarcoma (MFS), an aggressive soft tissue sarcoma, is one of the undifferentiated pleomorphic sarcomas; it has a low incidence, affecting people in the sixth to eighth decades of life. It usually involves the extremities and is painless with a slow-growing pattern. Based on the case of a 52-year-old female patient who presented with a painful, massive, rapid-growing, ulcerated tumor of the anterior surface of the left thigh, we performed a literature review regarding the current standard of care for patients with MFS. Computed tomography examination, followed by magnetic resonance imaging and surgical biopsy with histopathological examination, confirmed the diagnosis and the presence of lung and inguinal lymph node metastases. Due to the rapid-growing pattern and the local aggressiveness, our tumor board team recommended emergency excisional surgery, with subsequent reconstructive procedures followed by referral to an oncological center. This review emphasizes the importance of proper and rapid diagnosis, followed by multidisciplinary management, for MFS cases with atypical presentation and distal metastases to improve overall outcomes.

Background: Revision total hip arthroplasty (THA) in the presence of significant acetabular bone loss remains challenging, particularly in Paprosky IIC-III defects, where biomechanical stability and biological fixation are often compromised. Trabecular metal (TM) revision cups were developed to enhance osseointegration through high porosity and an elastic modulus closer to native bone, yet comparative real-world evidence against conventional revision cups remains limited in early follow-up. Methods: We conducted a retrospective comparative cohort analysis of patients undergoing acetabular revision THA for Paprosky IIC-III defects between 2022 and 2024. Ten patients were included, with six receiving TM cups (TM group) and four receiving conventional revision cups (control group). Radiographic osseointegration was assessed through secondary signs of ingrowth (absence of radiolucent lines, bone apposition, and absence of migration), while clinical fixation and early stability were evaluated using postoperative Harris Hip Score (HHS) and complication rates. Minimum follow-up was 12 months. Results: Early radiographic osseointegration was observed in 100% of the TM group versus 50% of the conventional group at 12 months. No cup migration or radiographic loosening occurred in the TM group, while two cases in the control group demonstrated early signs of mechanical instability. Mean postoperative HHS improved more robustly in the TM group (from 41.8 to 78.6) compared to controls (from 40.9 to 68.3). There were no infections or dislocations in either cohort. One patient who received a conventional cup required prolonged protected weight bearing due to suspected partial loss of early fixation. Conclusion: In revision THA for Paprosky IIC-III acetabular defects, TM cups demonstrated markedly higher rates of early osseointegration and lower radiographic loosening at 12 months compared with conventional revision cups. These findings support the preferential use of TM technology in cases of advanced acetabular bone loss, where biological fixation is critical for long-term stability.

Distal tibial fractures usually result from high-energy trauma, affecting young, active people, producing long-term disability and numerous complications. Their treatment is difficult, especially in type C fractures, which affect both the articular surface and the metaphysis, are quite frequent comminuted fractures, and are accompanied by soft tissue injuries. In these situations, External Fixation (EF) is used as a temporary bridging method, either for treating concomitant soft tissue injuries (in open fractures) or for achieving and maintaining reduction in order to prevent blisters or compartment syndrome, possibly resulting from severe displacement, bleeding or oedema. It must be however underlined that EF is rarely a definitive method for these fractures, especially when the ankle is splinted, and it must be followed by definitive Internal Fixation (IF) - the so-called “sequential method”, otherwise restoration of a normal ankle anatomy and function is improbable, resulting in ankle stiffness or even osteoarthritis. This paper presents a case in which this principle was only partially applied, thus requiring corrective surgery followed by a long-term recovery period.