Background: Ankle arthroscopy is indicated for both diagnosis and treatment of a large spectrum of common ankle disorders. It has certain advantages over the open procedure; however, it is important to recognize that there are some complications associated with it. Infections after this procedure are quite uncommon, with an overall estimated incidence of 2%. Given the low incidence of infections after ankle arthroscopy, not a great deal of literature on the topic has been published. The present review aims to provide an overview of the incidence, diagnosis, and treatment of infections after ankle arthroscopy. Methods: A systematic review of the literature indexed in the PubMed, MEDLINE, and Cochrane Library databases using search term “ankle arthroscopy infections” was performed in November 2023. No restrictions were applied concerning the date of publication. The Preferred reporting items for systematic reviews and meta-analyses (PRISMA) were followed. Among all surgical operations for the treatment of ankle and foot pathologies, we included articles with a described superficial or deep infection after ankle arthroscopy. Results: The search resulted in 201 studies. Only 21 studies met our inclusion criteria, and they were included in this systematic review. We evaluated 1706 patients who underwent 1720 arthroscopic tibiotalar procedures at an average age of 42 years old. Out of the 1720 procedures, 41 (2%) were complicated by infection. We divided infectious complications into superficial (68%; 28/41) and deep (32%; 13/41) infections. The most common pathogen isolated was Staphylococcus aureus. Arthroscopic arthrodesis was found to be the most affected by deep infections. Conclusions: Infection after ankle arthroscopy is an uncommon complication. Superficial infections were successfully treated with antibiotics, while surgical debridement, arthroscopic drainage, and intravenous antibiotics were necessary in cases of deep infections. Considering the amount of information on pathogens associated with knee and shoulder infections, there is still a lack of literature on pathogens associated with ankle infections, which makes their management difficulty.

Introduction: The elbow is a rare site for bone tumors, and for this reason, the literature provides little data on the epidemiology of metastatic lesions involving the distal humerus, proximal ulna, and radius. Before performing surgery of the metastatic bone, it is first necessary to consider both patients’ and metastatic lesions’ features in order to better choose the best possible treatment. This systematic review aims to collect data on elbow metastases, delineate primary tumors leading to such metastases, guide surgical treatment decisions, and evaluate reconstructive techniques and associated complications. Material and Methods: A systematic literature review was conducted in April 2024, searching the PubMed, MEDLINE, and Cochrane Library databases using specific search terms related to elbow metastases. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) was followed. Eligible studies reported at least one patient with metastatic bone disease involving the elbow region and specified the undertaken treatment. For studies reporting multiple skeletal sites, only elbow-specific data were extracted. We excluded recurrences of primary elbow tumors. The methodological quality of included studies was assessed with the modified Coleman Methodology Score (mCMS). Results: In total, 28 articles (103 patients) were included. The studies were predominantly case reports (68%), with a mean mCMS of 31. Gender was reported for only 41 patients: 71% were male and 29% female. The mean age at diagnosis of elbow metastatic lesion was 55 years old. Renal cell carcinoma was the most common primary tumor (28%), followed by breast (9%) and lung cancer (6%). The distal humerus was the most frequently affected site (85%). A surgical approach was adopted in 90% of cases, whereas 10% of patients were managed conservatively. Forty-five patients underwent wide tumor resection followed by reconstructive surgery while forty-eight patients received a surgical treatment for either pathological fractures or impending fractures. Conclusions: When treating elbow metastasis, a thorough evaluation of the patient is crucial, considering the patient’s functional status, pain management needs, and overall prognosis; all these features influence the treatment of choice. The selected treatment should aim to provide optimal functional outcomes and minimize complications. For patients with pathological or impending fractures, single or double plate fixation is typically the preferred approach. For patients with severe, symptomatic lesions unresponsive to conservative therapy, resection followed by the implantation of a modular prosthesis usually offers the best clinical and functional outcomes.

Background: Hallux rigidus (HR) is a common forefoot disorder, and surgical treatment is typically guided by the severity of the condition, as defined by the Coughlin and Shurnas four-grade classification. This study aimed to compare clinical and functional outcomes in patients undergoing first metatarsophalangeal joint arthrodesis (FMTPJA) with or without the use of an interfragmentary (IF) screw in addition to a dorsal plate. Methods: We retrospectively evaluated a cohort of patients who underwent surgery with a FMTPJA, dividing patients in two groups: patients who underwent FMTPJA through dorsal plate associated with an interfragmentary screw (WIS group) and patients who underwent FMTPJA through dorsal plate without an interfragmentary screw (WOIS group). The primary outcomes were analyzed using the FAAM score and FAAM sport score. Secondary outcomes included VAS, patient satisfaction, recovery time to return to sports, and the level of postoperative sports activity compared to preoperative levels. Results: In paired analyses, the WOIS group showed statistically significant improvements in both the FAAM and FAAM sport scores (p = 0.01). In contrast, the WIS group showed significant improvement only in the FAAM sport score (p = 0.01), while the FAAM score did not reach statistical significance (p = 0.42). Multivariate analysis revealed that a higher preoperative FAAM score predicted a higher postoperative FAAM score (p = 0.75), while the use of an IF screw was associated with a lower expected postoperative FAAM score (p = 0.25). Increased BMI and older age were significantly associated with lower postoperative FAAM scores. Conclusions: Both surgical techniques led to significant clinical improvements. However, patients in the WOIS group showed a trend toward faster recovery and higher postoperative sports activity levels, particularly in the athletic population. Although no statistically significant differences were found between groups overall, these findings suggest potential benefits of avoiding an IF screw in selected patients. Further prospective studies are warranted to better delineate the clinical impact of screw usage in FMTPJA.

Background: Radial head arthroplasty is commonly used for unreconstructable radial head fractures, particularly in cases associated with elbow instability. Both loose-fit monobloc and cemented bipolar radial head prostheses are available, but comparative evidence regarding their clinical and radiographic outcomes remains limited. This study aimed to compare mid-term outcomes between these two implant designs. Methods: A retrospective observational study was conducted on 26 patients who underwent radial head arthroplasty for acute radial head fractures between November 2020 and October 2023. Fourteen patients received a loose-fit monobloc radial head prosthesis, while twelve received a cemented bipolar prosthesis. Clinical, functional, and radiographic outcomes were assessed at a minimum follow-up of 24 months. Outcome measures included range of motion, pain, elbow stability, satisfaction, ADL (activities of daily living), IADL (instrumental activities of daily living), SF-12 (12-Item Short Form Health Survey), Oxford Elbow Score, Mayo Elbow Performance Score, DASH (disability of the arm, shoulder and hand score) score, implant loosening, heterotopic ossification, and complications. Results: No statistically significant differences were observed between the two groups in pain, satisfaction, range of motion, elbow stability, functional scores, radiographic loosening, or complication rates. The cemented bipolar group showed slightly better flexion–extension and pronation–supination values, whereas the loose-fit group showed a numerically lower rate of elbow instability; however, these differences were not statistically significant. No cases of aseptic loosening, periprosthetic osteolysis, or undesired implant loosening were observed. The complication rate was 36% in the loose-fit group and 33% in the cemented group. One patient in the loose-fit group required revision surgery due to implant overstuffing. Conclusions: Both loose-fit monobloc and cemented bipolar radial head prostheses provided acceptable mid-term functional scores; however, the relatively high overall complication rate (33–36%) highlights the need for careful implant selection, particularly with loose-fit implants, to avoid overstuffing and postoperative stiffness. Given the small cohort, these findings do not imply therapeutic equivalence.