Knee arthroplasty, commonly performed to treat osteoarthritis, necessitates precise surgical techniques for optimal outcomes. The introduction of systems such as the Persona Knee System (Zimmer Biomet, Warsaw, IN, USA) has revolutionized knee arthroplasty, promising enhanced precision and better patient outcomes. This study investigates the application of robotic planning specifically in knee prosthetic surgeries, with a focus on Persona Knee System prostheses. We conducted a retrospective analysis of 300 patients who underwent knee arthroplasty using the Persona Knee System between January 2020 and November 2023, including demographic data, surgical parameters, and preoperative imaging. Robotic planning was employed to simulate surgical procedures. The planning process integrated preoperative imaging data from a specific program adopted for conducting digital preoperative planning, and statistical analyses were conducted to assess correlations between patient characteristics and surgical outcomes. Out of 300 patients, 85% presented with minor deformities, validating the feasibility of robotic planning. Robotic planning demonstrated precise prediction of optimal arthroplasty sizes and alignment, closely aligning with preoperative imaging data. This study highlights the potential benefits of robotic planning in knee arthroplasty surgeries, particularly in cases with minor deformities. By leveraging preoperative imaging data and integrating advanced robotic technologies, surgeons can improve precision and efficacy in knee arthroplasty. Moreover, robotic technology allows for a reduced level of constraint in the intraoperative choice between Posterior-Stabilized and Constrained Posterior-Stabilized liners compared with an imageless navigated procedure.

Background: Pelvic insufficiency fractures (PIF) are typical in geriatric populations with reduced bone quality, most commonly in elderly postmenopausal women. These fractures are usually caused by low-energy forces over the bones during ordinary life and cause disabling pain. Treatment options range from conservative to operative. The aim of this study is to assess the outcomes of treatments for pelvic insufficiency fractures, determining optimal approaches between surgical intervention and conservative management. Methods: This literature review systematically examines articles focusing on patients with PIF, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and using PubMed, Medline, and the Cochrane Library database. We took into account only full-text articles in indexed journals with available English abstracts, considering data about patient demographics, surgery, and outcomes. Results: After screening 128 articles, this study reviewed 20 manuscripts involving 1499 patients, mostly elderly females and focusing on sacrum fractures. Common treatments included conservative methods and sacroplasty, with a few complications reported. Osteoporosis was the prevalent comorbidity, and the survival rate post-treatment was high at 92.3%. Mobility outcomes varied, with some patients experiencing significant autonomy loss. The average follow-up period was over 17 months. Conclusions: This study found a cautious approach to surgery (timing of three weeks), which is reserved only for specific patterns, and it leads to increased autonomy and a lower risk of mortality. Due to the lack of pre- and postoperative scores as well as conflicting results, it is imperative to undertake further studies and research to be able to compare the alternative treatments efficiently.

Introduction: The use of cementation in total hip arthroplasty (THA) has evolved over the years, with a notable shift toward cementless and hybrid techniques. The aim of this study is to evaluate data from an Italian registry on the type of fixation used in THA implants and their corresponding survival rates in a large patient cohort with long-term follow-up, and to compare these data with the most recent literature. Methods: From January 2000 to December 2020, a total of 137,256 primary THA procedures were performed, of which 10.4% were fixed with stem cementation. There were 4857 revision implants, of which 11.4% were implanted with stem cementation. Results: The trend showing a significant shift toward cementless fixation methods is particularly pronounced in younger patients, with cementless implants comprising 99.5% of procedures in patients under 40 years of age. As patient age increases, the use of cemented or hybrid fixation methods becomes more common. This trend aligns with existing literature, in which cementation is often preferred for elderly patients due to concerns about bone quality and the potential for better immediate fixation provided by cemented stems. At 10 years, the implant that showed the highest survival rate was the fully cemented implant, with a rate of 94.8%. This study also reports the causes of failure based on the different fixation techniques. Conclusions: The development of standardized guidelines that consider patient-specific factors such as age, bone quality, and comorbidities in the choice of fixation type could help reduce variability in practice and improve overall outcomes in hip arthroplasty.

Bone stock preservation in young and active patients undergoing hip arthroplasty is the principal determinant of reconstructive complexity at revision, an event that national registry data identify as more likely for most young individuals, with a lifetime revision risk up to 35%. Standard diaphyseal stems, despite their proven longevity in elderly cohorts, produce predictable proximal stress shielding that depletes the metaphyseal envelope over time, narrowing the surgical options available at every subsequent intervention. Two femoral strategies have evolved in response: hip resurfacing arthroplasty and short-stem total hip arthroplasty. Each addresses proximal bone loss through distinct biomechanical principles and with different patient selection criteria, complication profiles and revision implications. Although acetabular bone preservation has been comparatively less studied in the literature, it remains clinically relevant because it may affect bone stock quality at the time of revision. We synthesize the available evidence on both femoral and acetabular bone-sparing strategies, with respect to patient selection, surgical technique, survivorship, patient-reported outcomes, complications and revision implications. Our goal is to provide a structured clinical reference for implant selection in this demanding patient population. A comprehensive literature review was performed using PubMed and Google Scholar (October 2000–May 2026) and 99 peer-reviewed studies were included and synthesized using a structured narrative approach.