Autologous bone grafting is common in trauma and orthopaedic surgery. Both the Reamer Irrigator Aspirator (RIA) and Iliac Crest Bone Graft (ICBG) aim to obtain autologous bone graft. Although the process of harvesting a bone graft is considered simple, complications may occur. This study examined morbidity and pain at the donor site, blood loss, and iatrogenic fractures, comparing RIA and ICBG. The source of the autologous bone graft, the alternative graft sites, and the storage modalities of the harvested bone marrow were also evaluated. In May 2021, PubMed, Embase, Scopus, and Google Scholar were accessed, with no time constraints. RIA may produce greater blood loss, but with less morbidity and complications, making it a potential alternative source of bone grafting.

Introduction: Whether mobile-bearing (MB) unicompartmental knee arthroplasty (UKA) performs better than fixed-bearing (FB) implants in patients with monocompartmental osteoarthritis (OA) still remains unclear. Therefore, a meta-analysis comparing MB versus FB for UKA was conducted to investigate the possible advantages of MB versus FB in patient-reported outcome measures (PROMs), range of motion (ROM), and complications. We hypothesised that the MB design performs better than FB. Methods: This systematic review was conducted according to the 2020 PRISMA guidelines. In December 2021, PubMed, Web of Science, Google Scholar, and Embase were accessed, with no time constraints. All the clinical investigations comparing MB versus FB bearing for UKA were accessed. Only studies published in peer-reviewed journals were considered. Studies reporting data on revision settings were excluded, as were those combining unicompartmental and total knee arthroplasty. Results: Data from 25 studies (4696 patients) were collected; 58% (2724 of 4696 patients) were women. The mean length of follow-up was 45.8 ± 43.2. The mean age of the patients was 65.0 ± 5.6 years. No difference was found in range of motion (p = 0.05), Knee Scoring System (p = 0.9), function subscale (p = 0.2), and Oxford Knee Score (p = 0.4). No difference was found in the rate of revision (p = 0.2), aseptic loosening (p = 0.9), deep infections (p = 0.99), fractures (p = 0.6), and further extension of OA to the contralateral joint compartment (p = 0.2). Conclusion: The present meta-analysis failed to identify the possible superiority of the MB implants over the FB for UKA in patients with monocompartmental knee osteoarthritis. Long observational investigations are required to evaluate possible long-term complications and implant survivorship. These results should be interpreted within the limitations of the present study.

Purpose: Both mobile (MB) and fixed (FB) bearing implants are routinely used for total knee arthroplasty (TKA). This meta‐analysis compared MB versus FB for TKA in terms of implant positioning, joint function, patient reported outcome measures (PROMs), and complications. It was hypothesised that MB performs better than FB implants in primary TKA.Methods: This meta‐analysis was conducted according to the 2020 PRISMA statement. In February 2022, the following databases were accessed: Pubmed, Web of Science, Google Scholar, Embase. All the randomized clinical trials (RCTs) comparing mobile versus fixed bearing for primary TKA were considered.Results: Data from 74 RCTs (11,116 procedures) were retrieved. The mean follow‐up was 58.8 (7.5 to 315.6) months. The MB group demonstrated greater range of motion (ROM) (P = 0.02), Knee Society Score (KSS) score (P < 0.0001), and rate of deep infections (P = 0.02). No difference was found in implant positioning: tibial slope, delta angle, alpha femoral component angle, gamma femoral component angle, beta tibial component angle, tibiofemoral alignment angle, posterior condylar offset, radiolucent lines. No difference was found in duration of the surgical procedure. No difference was found in the following PROMs: Oxford Knee Score (OKS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analogue scale (VAS), function and pain subscales of the KSS score. No difference was found in the rate of anterior knee pain, revision, aseptic loosening, fractures, and deep vein thrombosis.Conclusion: There is no evidence in support that MB implants promote greater outcomes compared to FB implants in primary TKA.Level of evidence: Level I.

The current literature has mainly focused on the biology of tendons and on the characterization of the biological properties of tenocytes and tenoblasts. It is still not understood how these cells can work together in homeostatic equilibrium. We put forward the concept of the “tendon unit” as a morpho-functional unit that can be influenced by a variety of external stimuli such as mechanical stimuli, hormonal influence, or pathological states. We describe how this unit can modify itself to respond to such stimuli. We evidence the capability of the tendon unit of healing itself through the production of collagen following different mechanical stimuli and hypothesize that restoration of the homeostatic balance of the tendon unit should be a therapeutic target.

Introduction: Outpatient total hip arthroplasty (THA) is increasingly popular. This meta-analysis investigated the potential advantages of outpatient regimes for THA. Methods: This study followed the PRISMA guidelines. PubMed, Web of Science, Google Scholar, Embase, and Scopus databases were accessed in June 2021. All clinical studies investigating outpatient THA were considered. The outcomes of interest were pain, infection, mortality, revision, dislocation, readmission rates, and deep vein thrombosis (DVT). Results: Data from 102,839 patients were included. A total of 52% (153,168 of 102,839 patients) were women. The mean age of patients was 62.6 ± 4.6 years, the mean BMI was 29.1 ± 1.8 kg/m². Good comparability was found in age, BMI, and gender (p > 0.1). No difference was found in pain (p = 0.4), infections (p = 0.9), mortality (p = 0.9), rate of revision (p = 0.1), dislocation (p = 0.9), and readmission (p = 0.8). The outpatient group demonstrated a greater rate of DVT (OR 3.57; 95% CI 2.47 to 5.18; p < 0.0001). Conclusions: In selected patients, outpatient THA can be performed safely with optimal outcomes comparable with inpatient THA. Clear and comprehensive pre-operative planning should involve a multi-disciplinary group composed of orthopaedic surgeons, anaesthesia and rehabilitation specialists, and physiotherapists. Each centre performing outpatient THA should implement continuous homecoming welfare activity, to supervise physiotherapy and monitor anticoagulant therapy.

Purpose: Tendinopathies and tendon ruptures are a common cause of pain and disabilities. The pathogenesis is considered multifactorial, and currently described as the failed healing response. Traditionally, tendon injuries have been mostly referred to age, overuse or mechanical factors. Recently, some authors have focused their attention on the influence of metabolic diseases and hormones on tendon homeostasis, opening new perspectives. There are even more studies which show how systemic condition and pathologies are able to influence the proliferation of tenocytes, the synthesis of extracellular matrix proteins, and the organization and properties of the extra cellular matrix of the tendons. Methods: In this article, we reviewed the current knowledge about the influence of lipids, glucose and thyroid hormones on the pathogenesis of tendinopathy. Results: Beside the traditional extrinsic and mechanical risk factors, this article showed the importance of metabolism and hormones of tendon health, reinforcing the idea of their great influence on the pathogenesis of tendinopathy. Current literature indicates that hypercholesterolemia, obesity, diabetes mellitus and hypothyroidism are all risk factors for tendinopathies and tendon ruptures. Conclusions: The precise role of each predisposing factor remains incompletely understood, and further epidemiology and laboratory studies should be performed to establish the strength of the association with tendon pathologies and their pathogenetic mechanism. Keywords: inertial measurement unit; acceleration; max speed; metrics; team sports.