Background/Objectives: This retrospective study aims to evaluate the safety and functional outcomes of simultaneous bilateral total knee arthroplasty (TKA) compared to two-stage bilateral TKA procedures. Osteoarthritis is the leading cause of knee joint replacement globally, so we sought to determine whether the one-stage approach could be deemed non-inferior to the two-stage method in terms of perioperative complications and postoperative recovery. Methods: We analyzed two cohorts: 43 patients underwent one-stage bilateral TKA, while 66 patients received two-stage TKA. The data collected included demographic details, comorbidities, postoperative complications, and functional outcomes assessed by the Oxford Knee Score (OKS), European Quality of Life, and Visual Analogue Scale scores at preoperative and five years postoperative follow-ups. Results: The results showed statistically significant improvements in quality-of-life measures for both groups, with the one-stage group exhibiting greater enhancement in OKS (p < 0.05). Complication rates were similar across both procedures, with no significant differences in infection rates or other adverse events. Conclusions: This study suggests that the one-stage approach to treat bilateral knee arthritis could reduce subjective stress and healthcare costs, presenting a safe alternative for appropriately selected patients. However, the findings highlight the necessity of considering patients’ overall health status when planning surgical interventions. Further research involving larger populations is recommended to validate our conclusions.

Hemophilic arthropathy (HA) is a complication of hemophilia, which is a genetic disorder characterized by a deficiency in blood clotting factors. HA is characterized by joint damage with inflammatory responses, pain, and movement limitations due to recurrent bleeding in the joints. The inflammatory reactions contribute to the activation of coagulation factors, which can exacerbate bleeding and further damage the affected joints. Therefore, the interaction between inflammation and coagulation plays a crucial role in the progression and complications of HA. Management strategies often focus both on inflammation and coagulation to alleviate symptoms and preserve joint function. Temperature can influence the inflammatory response and coagulation. The aim of this work was to understand how temperature management can positively or negatively influence the HA. We have carried out a narrative review of the available literature. This review explores the impacts of temperature on biological processes, and it discusses the possible clinical implications for the HA treatment. Our research shows that cold exposure has anti-inflammatory and analgesic effects, while heat is linked to pro-inflammatory cytokine release. Both hot and cold treatments are ill-advised for hemophilia patients. Heat stimulates neo-angiogenesis, and cold hampers coagulation, posing risks for increased bleeding in individuals with hemophilia.

Background/objectives: Total hip arthroplasty (THA) is an effective treatment for end-stage hip disorders, improving pain, function, and quality of life. For bilateral hip disease, choosing between one-stage (simultaneous) and two-stage (staged) bilateral THA is critical. One-stage THA may reduce hospitalization but carries higher risks. This study evaluates whether one-stage bilateral THA is non-inferior to two-stage THA in safety and functional recovery.Methods: A retrospective study of patients undergoing bilateral THA between January 2010 and November 2019 compared one-stage (84 patients) and two-stage (63 patients) procedures. Surgeries used a postero-lateral approach with H-Max and DeltaTT implants. Outcomes included pain (VAS), function (Oxford Hip Score, EQ-5D, Forgotten Joint Score), and complications. Follow-ups were conducted at 1, 3, and 6 months, and at 5 years for both groups.Results: Both groups showed significant improvements in pain and function scores with no differences between them. Forgotten Joint Score was also comparable. Complications, including urinary infections and hematomas, were similar, and no revisions occurred in the one-stage group, compared to a 1.6% revision rate in the two-stage group. Hemoglobin decrease and transfusion rates were comparable.Conclusions: Both approaches resulted in improved symptoms and quality of life with similar complication rates. The one-stage group had fewer complications and no revisions, suggesting potential cost savings. These findings support the safety of one-stage bilateral THA, emphasizing the need for careful patient selection and surgical expertise.

Purpose: To evaluate the Fast Anterior Medium Approach (FAMA) as an alternative to traditional anterior cervico-thoracic approaches, enhancing access to the C7-T1-T2 and T2-T4 junctions while minimizing postoperative morbidity. The cervico-thoracic junction is one of the most challenging regions to access surgically due to its deep location and proximity to critical neurovascular structures. Conventional approaches, including postero-lateral thoracotomy and transmanubrial techniques, are associated with high morbidity. The FAMA technique was designed to provide enhanced exposure while reducing surgical trauma. Methods: A cadaveric study was performed to understand how FAMA approach could find application in spine surgery in order to obtain wider access to the cervico-thoracic spine with lower post-operative morbidity compared to the surgical procedure with sternotomy. This approach involves controlled dislocation of the sterno-clavicular joint to extend anterior access without requiring sternotomy. Results: The approach allowed excellent exposure of the thoracic apex, enabling safe spinal stabilization procedures with minimal disruption to surrounding structures. No major neurovascular injuries occurred. Conclusion: The FAMA approach represents a viable alternative to conventional cervico-thoracic surgical techniques, offering improved visualization and accessibility while preserving anatomical integrity. This technique has the potential to reduce morbidity and improve patient recovery. Larger-scale studies are required to validate these findings.