Background: This review aimed to critically appraise the most recent orthopedic literature around cone beam weightbearing computed tomography (WBCT), summarizing what evidence has been provided so far and identifying the main research trends in the area. Methods: This scoping review was performed on studies published between January 2013 and December 2023 on the Pubmed database. All studies (both clinical and nonclinical) in which WBCT had been used were critically analyzed to extract the aim (or aims) of the study, and the main findings related to the role of this imaging modality in the diagnostic pathway. Results: Out of 1759 studies, 129 were selected. One hundred five manuscripts (81%) dealt with elective orthopedic conditions. The majority of the analyses (88 studies; 84%) were performed on foot and ankle conditions, while 13 (12%) studies looked at knee pathologies. There was a progressive increase in the number of studies published over the years. Progressive Collapsing Foot Deformity (22 studies; 25%) and Hallux Valgus (19 studies; 21%) were frequent subjects. Twenty-four (19%) manuscripts dealt with traumatic conditions. A particular interest in syndesmotic injuries was documented (12 studies; 60%). Conclusions: In this review, we documented an increasing interest in clinical applications of weightbearing CT in the orthopedic field between 2013 and 2023. The majority of the analyses focused on conditions related to the foot and the ankle; however, we found several works investigating the value of WBCT on other joints (in particular, the knee).

Severe osteoarthritis of the first metatarsophalangeal joint (MTPJ-1) is commonly treated through arthrodesis. Our aim was to evaluate whether percutaneous approaches to perform MTPJ-1 arthrodesis reduce the nonunion and complication (including reoperation) rate as compared to the standard open technique. This systematic review was designed as per PRISMA checklist; Pubmed, Cochrane, Scopus and Web of Science databases were analyzed; all studies focused on patients diagnosed with MTPJ-1 osteoarthritis and treated through arthrodesis using exclusively crossed screws. Data related to the cohort (size, age, sex, type of osteoarthritis), the study design (level of evidence and type of study), the technique adopted (the number of screws, open/percutaneous approach, technique of preparation of the joint) and the final outcome (nonunion and complication and reoperation rate) were recorded. The quality of studies included was evaluated through the MINORS score (methodological index for nonrandomized studies). The nonunion, complication and reoperation rates of the percutaneous (PERC) vs the open (OPEN) technique were compared through a proportional meta-analysis. Overall, nine studies (including 225 arthrodeses in 211 patients) were analyzed (130 cases in the PERC group vs 95 cases in the OPEN group). In the two groups, the mean (± standard deviation) sample size (PERC: 26.6 ± 5.1 cases; OPEN: 23.7 ± 10.2 cases; p = 0.33), sex distribution (PERC: 81% ± 0.6; OPEN: 57% ± 0.2 females; p = 0.17) and length of follow-up (PERC: 20.8 ± 11.6 months; OPEN: 29.5 ± 16.8 months; p = 0.19), mean age (PERC: 62 ± 5.4 years; OPEN: 59.5 ± 5.4 years; p = 0.26), were not significantly different. The pooled nonunion rate (9% vs 5% in PERC vs OPEN; p = 0.57), complication rate (15% vs 23%; p = 0.46) and reoperation rate (3% vs 5%; p = 0.74) were not significantly different. The quality of studies was moderate and comparable in the two groups (mean MINORS at 8.4 ± 1.5 points vs 11.7 ± 4.3 in PERC vs OPEN; p = 0.08). The nonunion and complication (including reoperation) rate after percutaneous vs open first metatarsophalangeal joint arthrodesis (fixed using screws) are comparable at 2 years of follow-up. Only moderate-quality evidence is available so far in this area. Further comparative and prospective studies with a robust design are needed to clarify which strategy allows to obtain the best outcome after MTPJ-1 arthrodesis. IV.

This study attempts to gain an areal understanding of potential soil loss due to water erosion in the lower Calore River valley (Southern Italy). To this end, the Universal Soil Loss Equation (USLE) was applied to data obtained from the processing of multitemporal satellite images acquired by the Sentinel 2A system, the elaboration of a digital terrain model and that of weather station records, and the re-elaboration of pre-existing information regarding soil characteristics. The information acquired regarding each USLE factor (i.e., rain erosivity, R; soil erodibility, K; slope and length steepness, LS; and cover management, C), was combined in a GIS environment to obtain a Map of the potential risk of soil erosion. The results showed that the potential soil losses due to water erosion are quite worrying, particularly in hilly and foothill agricultural areas, dominated by valuable crops such as vines and olives.

Arthroscopically assisted Reduction and Internal Fixation (ARIF) to fix talar neck fractures is progressively gaining popularity. Our aim was to determine if ARIF in this setting might increase the healing rate and reduce the number of complications as compared to percutaneous fixation (PF) alone. As per PRISMA guidelines, multiple databases (Scopus, Pubmed, Web of Science and Cochrane) were used to retrieve studies reporting on patients diagnosed with a fracture of the talar neck undergone minimally invasive surgery using screws as exclusive fixation method. Data were recorded regarding the design of the study, the cohort, the surgical technique and the outcome achieved (clinical scores and complication rate) with the longest possible follow-up. The methodological quality of studies was evaluated using the MINORS (methodological items for non-randomized studies). Results after ARIF and PF were compared. Six studies were selected (ARIF=11 cases, 2 studies; PF=51 cases, 4 studies). In the two groups, the mean sample size (p = 0.88) and the mean age of patients (p = 0.24) were comparable. Patients were mostly males in the percutaneous fixation group (M/F: 36/15) and mostly females in the ARIF group (M/F: 4/7). The mean follow-up in the ARIF group was 16 months (range, 12-18) and 31 months in the percutaneous fixation group (range, 20-48), but the difference was not significant (p = 0.09). In both groups radiographic healing was achieved in all patients. The pooled complication rate was significantly different in the ARIF group (1 %) as compared to the PF group (19 %; p = 0.04). The incidence of early (before 48 months) peri-talar osteoarthritis was significantly lower in ARIF (0 %) as compared to PF (11 %; p = 0.04). The quality of studies was poor in the ARIF group and moderate in the PF group. In this review based on small-sample studies, we found a similar radiographic healing rate in talar neck fractures treated percutaneously using screws with or without arthroscopy. Arthroscopic assistance allowed to reduce the incidence of complications, and specifically of early (before 48 months) peri-talar osteoarthritis. Larger studies are needed to confirm or disprove these findings. level IV, systematic review of level I to IV studies.