Osteosarcoma (OS) is the most common primary malignant bone tumor, predominantly affecting adolescents and young adults. Despite advances in surgery and multi-agent chemotherapy, survival rates for metastatic or recurrent OS remain poor, highlighting the need for novel prognostic and therapeutic strategies. This review integrates histopathologic, molecular, and immune perspectives to provide a comprehensive understanding of OS biology in the context of precision medicine. We discuss classic morphologic and radiographic features alongside recent insights into the tumor microenvironment, including the role of tumor-infiltrating lymphocytes, tumor-associated macrophages, and immune checkpoint expression. Emerging molecular markers, such as gene expression–based immune risk signatures, circulating tumor DNA, and gasdermin D overexpression, are evaluated for their prognostic and therapeutic relevance. Key dysregulated pathways, including WNT/β-catenin and JAK/STAT, are examined in relation to metastasis, chemoresistance, and immune evasion, with emphasis on current targeted approaches under development. By bridging histopathology, immunogenomics, and translational research, this work outlines how integrated biomarker assessment can refine patient stratification and guide the implementation of individualized treatment strategies in OS.

Purpose: New alignment classifications based on phenotype reproduction have recently been introduced in total knee arthroplasty (TKA) as alternatives to traditional mechanical alignment. These classifications were designed according to the static hip–knee–ankle angle (sHKA) measurement from long leg radiographs (LLRs). This study aimed to understand whether and how the HKA varied throughout the knee's range of motion (ROM) during robot‐assisted TKA. Methods: This prospective, bi‐centric cohort study involved 107 consecutive patients undergoing primary robot‐assisted TKA. The surgical technique adhered to restricted kinematic alignment (HKA ± 3°) with asymmetric gap balancing principles. The HKA's dynamic variation (dHKA) was assessed intraoperatively at full extension, as well as at 30°, 45°, 60°, 90° and 120°, both before bone cuts and after the positioning of the trial components. The overall cohort was initially analyzed, followed by a subgroup analysis based on varus, neutral and valgus phenotypes. A descriptive analysis was conducted to evaluate dHKA trends. Collected data were then analyzed using one‐way repeated measures analysis of variance with Bonferroni correction and Bland–Altman plots to assess significant variations in dHKA across the ROM during flexion and to quantify outliers from the established safe boundaries of ±3°. Results: Out of 107 knees, the pre‐cut dHKA demonstrated a biphasic trend, decreasing in varus until 60° and then transitioning toward valgus, with significant differences primarily noted at 90° and 120°. Post‐cut, the dHKA exhibited an overall varus trend, increasing from full extension to 60° before experiencing a partial recovery. Significant differences were detected primarily at the initial flexion angles. Outlier rates increased with flexion: pre‐cut from 6.5% to 43.0%, and post‐cut from 1.9% to 30.8%, highlighting progressive inter‐individual variability throughout. Although the analysis was stratified by knee phenotype, the post‐cut dHKA trend did not differ among the various phenotypes or in comparison to the overall cohort trend. Conclusions: The main finding of the current study was that intraoperative dHKA differs significantly from sHKA during robot‐assisted TKA. Moreover, the sHKA was limited in predicting the actual kinematic HKA. Planning the final TKA alignment on static, standing LLRs may have limited value compared to intraoperative planning conducted with enabling technologies. Level of Evidence: Level 3.

Background: Proximal femur fractures are common in elderly patients and are strongly associated with frailty, increased mortality, and functional decline. The Clinical Frailty Scale (CFS) has emerged as a key predictor of outcomes, influencing perioperative management and rehabilitation strategies. This study aims to evaluate the impact of frailty on mortality, surgical timing, and length of hospital stay (LOS) in patients with hip fractures. Methods: This single-center retrospective study analyzed data from patients aged ≥ 65 years admitted with AO type 31A and 31B proximal femur fractures between 2018 and 2023. Patients were stratified according to CFS scores to assess the relationship between frailty and in-hospital mortality, surgical delay, and LOS. Multivariate logistic regression was performed to identify independent risk factors. Results: Among 2312 patients (median age: 85 years), frailty was a significant predictor of mortality ( p = 0.019). Patients with CFS 7–9 had a 6.6-fold higher mortality risk than those with CFS 1–3. Delays in surgery beyond 48 h were associated with a doubled risk of mortality ( p = 0.009), particularly in frail patients. Prolonged LOS (> 7.1 days) correlated with an increased incidence of infections, cardiovascular events, and mortality ( p < 0.001). Conclusions: Frailty significantly impacts hip fracture prognosis in elderly patients, increasing mortality, complications, and LOS. Early identification of frail patients and prioritization of timely surgery are crucial to improving outcomes. Future studies should explore tailored surgical strategies and optimized rehabilitation protocols to enhance recovery in this high-risk population.

Background: Total hip and knee arthroplasty are common procedures for end-stage osteoarthritis, with rehabilitation playing a central role in functional recovery. Conventional face-to-face programs are often limited by accessibility, costs, and logistical barriers. Digital telerehabilitation has been increasingly investigated as an alternative. This review aims to summarize current evidence on its effectiveness, patient-reported outcomes, satisfaction, and economic impact. Materials and Methods: A narrative review was conducted using Medline, Web of Science, and Scopus up to April 2025. Randomized controlled trials and longitudinal studies evaluating telerehabilitation after total hip or knee arthroplasty were included. Data were extracted on functional performance, pain, autonomy, quality of life, patient satisfaction, and cost-effectiveness. Results: Across multiple RCTs, telerehabilitation produced functional outcomes generally comparable to conventional rehabilitation, with some studies reporting superior short-term improvements. For example, in a retrospective trial, Timed Up and Go improved by −8.0 ± 2.6 s in the digital group versus −4.9 ± 2.5 s with standard care (p < 0.01). Tablet-assisted programs reduced Five Times Sit-to-Stand times to 11.7 s at 6 months compared with 14.7 s in controls (p = 0.05). In hip arthroplasty, digital rehabilitation resulted in higher active flexion (97.4° vs. 89.9°, p = 0.018) and abduction (51.7° vs. 43.8°, p = 0.024). Quality-of-life measures, such as EQ-5D VAS, also showed improvements (82.9 ± 4.3 vs. 68.7 ± 4.6 at 6 months). Some studies reported higher patient satisfaction, for instance, a VR-based RCT found GPE at day 15 of 4.76 ± 0.43 in the intervention group versus 3.96 ± 0.65 in controls (p < 0.001). Conclusions: Telerehabilitation after hip and knee arthroplasty appears to produce short-term functional and patient-reported outcomes comparable to conventional rehabilitation in selected populations. Evidence of superiority is limited and heterogeneous, and long-term effectiveness, equity, and cost-effectiveness remain uncertain. Heterogeneity in protocols and digital literacy barriers highlight the need for standardized guidelines and further independent validation.

Background: An ankle sprain is a frequent musculoskeletal injury, often leading to chronic instability and an increased risk of post-traumatic osteoarthritis. Kinesio Tape, an elastic adhesive tape, is widely used in rehabilitation for its supposed benefits in reducing pain, controlling edema, and improving ankle function. However, its effectiveness in managing acute ankle sprains remains debated. Methods: This systematic review aims to evaluate the evidence on the impact of Kinesio Taping on pain reduction, edema control, and return to sport in patients with acute ankle sprains. A systematic review was conducted in line with the PRISMA guidelines. The literature from PubMed, MEDLINE, and the Cochrane Library was searched for studies published from 2004 to 2024. Seven studies met the inclusion criteria, involving 247 patients with acute ankle sprains. Data on patient demographics, follow-up duration, Kinesio Taping protocols, and clinical outcomes were extracted and analyzed. Results: The review revealed mixed findings. Some studies reported short-term pain relief and reduced need for analgesics in the Kinesio Taping group, especially when combined with manual therapy. However, no significant differences were found in the edema control compared to bracing or casting. Functional recovery, as assessed by scales like the Karlsson scoring scale, showed no clear advantage for Kinesio Taping over other treatments. Conclusions: Kinesio Taping provides limited benefits for ankle sprain management, particularly in terms of long-term functional recovery and edema reduction. While it may offer short-term pain relief, it should be considered as an adjunctive treatment rather than a primary intervention.

Background: Femoral neck fractures (FNF) are a significant cause of morbidity and mortality in older adults, often requiring total hip arthroplasty (THA). However, THA is associated with high dislocation rates, particularly in patients with neurological disorders due to factors such as muscle weakness, cognitive impairments, and frequent falls. Dual mobility cups (DMCs) have been proposed as a solution to enhance stability and reduce dislocation rates in this high-risk population. This systematic review aims to evaluate the effectiveness of DMCs in reducing dislocation rates and improving clinical outcomes in patients with FNF and neurological disorders undergoing THA. Methods: Following PRISMA guidelines, a systematic search was conducted across PubMed, Cochrane, Embace and Google Scholar up to June 2024. Studies included randomized controlled trials, clinical trials, and retrospective studies focused on DMC use in THA for patients with neurological conditions. Outcomes analyzed included dislocation rates, complications, and patient-reported outcomes such as mobility levels. Results: Data from 12 studies (2017–2023) involving 588 patients were included. The overall mean age of participants was 76.85 years, with 229 males and 376 females. Neurological conditions included Parkinson’s disease, dementia, stroke, and others. Dislocation rates were significantly low, with only 2 dislocations reported (0.34%), compared to historically higher rates in standard THA. Complication rates were modest (6%) and primarily involved periprosthetic fractures and infections. Functional outcomes, assessed using tools like the Harris Hip Score (HHS) and WOMAC, demonstrated significant postoperative improvement, with most patients achieving “good” to “excellent” outcomes. Conclusion: Dual mobility cups in THA significantly reduce dislocation rates and provide favorable functional outcomes in patients with FNF and neurological disorders. DMCs appear to be a safer alternative for high-risk populations, offering improved stability and quality of life. Future studies should focus on long-term outcomes, including implant durability and revision rates.