Total Knee Arthroplasty (TKA) is the final treatment option for patients with advanced knee os-teoarthritis, aimed at restoring mobility, improving stability, and alleviating pain. Even with successful TKA and proper component placement, patients may struggle to achieve optimal range of motion and muscle strength without a structured rehabilitation program. Various re-habilitation protocols and adjunctive techniques are available to assist physical therapists during recovery, yet no universal consensus exists on a personalized approach. This narrative review summarizes rehabilitation techniques for pre- and post-TKA recovery published over the past 15 years. Optimal outcomes require preoperative patient education, including lifestyle changes. Postoperatively, initial emphasis is placed on effective pain management to support adherence to rehabilitation. Two main types of programs are used: rapid rehabilitation and standard proto-cols. While both yield similar outcomes, they differ in intensity and speed. Physical therapists may incorporate adjuncts like cold therapy, compression, electrical stimulation, or laser therapy to enhance recovery. It is also crucial to identify complications that may occur after TKA or dur-ing rehabilitation, such as peroneal nerve palsy, flexion contracture, or stiffness, as early detec-tion allows for tailoring the rehabilitation program to each patient’s specific needs.

Background: Fixed drug eruption (FDE) is a non-immediate, CD8+ T cell–mediated hypersensitivity reaction characterized by well-demarcated erythematous–violaceous plaques that recur at the same site after re-exposure to the causative drug. Although NSAIDs and antibiotics are the most common triggers, various other medications may induce FDE, and genetic susceptibility has been linked to specific HLA alleles. Methods: We conducted a clinical evaluation supported by patch testing, oral drug provocation, and assessment of therapeutic alternatives to identify the causative agent and confirm delayed-type hypersensitivity. Results: We report the case of a 53-year-old woman with essential hypertension, autoimmune thyroiditis, and renal lithiasis who developed well-demarcated erythematous plaques with central vesiculation and moderate pruritus on the dorsal hand and posterior calf approximately 8 h after ingestion of a 60 mg etoricoxib tablet. Patch testing was negative, while oral challenge confirmed etoricoxib-induced FDE; celecoxib was subsequently evaluated as a potential safe alternative. Conclusions: This case underscores the importance of an integrated diagnostic approach—including careful history, clinical examination, and confirmatory testing—to accurately diagnose delayed cutaneous drug reactions and to identify safe therapeutic options for patients.

Background: A prominent anterior tibial tuberosity (or tibial tubercle) can be seen in ongoing Osgood–Schlatter disease (OSD) in teenagers or as a sequela of OSD in adults. Current radiological methods do not provide a true anatomical assessment of the tibial tuberosity; therefore, we proposed and developed a Magnetic Resonance Imaging (MRI)-based method for measuring the anterior tibial tuberosity index, aiming to deal with the current lack of effective techniques for accurately assessing these particular morphologic features. Methods: A retrospective study included 47 knees with tibial tuberosity measurements on both true sagittal MPR images of 3D proton density (PD)-weighted MRI sequences and lateral knee radiographs. The same landmarks were followed and the anterior tibial tuberosity index (ATTI) was measured. Results: The comparison of the results obtained by the two methods demonstrates that our method is reliable and reproducible with substantial inter- and intra-observer agreement. The intraclass correlation coefficient was 0.9250 (95% CI: 0.8654 to 0.9582), indicating excellent reliability between the two methods. A strong positive correlation was also identified, with a correlation coefficient of r = 0.8746 (95% CI: 0.7845 to 0.9286, p < 0.0001) between the two methods. No significant deviation from linearity was observed by analyzing the linear model validity using the cusum test (p = 0.62). Conclusions: Based on these results, we encourage the use of 3D PD-weighted MRI sequences for the measurement of the anterior tibial tuberosity on MRI in order to avoid unnecessary exposure to ionizing radiation and potentially obtain a more accurate measurement. Future larger studies should also explore the benefit of utilizing 3D sequences over 2D lateral projections to minimize measuring bias.

Total hip arthroplasty (THA) is commonly performed for conditions like osteoarthritis, avascular necrosis, hip fractures, and hip dysplasia. Complications following THA can result in major proximal femoral defects (MPFD), which are challenging to manage. Megaprostheses provide a solution, offering stability and early weight-bearing, though they present their own challenges. However, maintaining hip symmetry with megaprostheses is challenging in accurately restoring femoral offset, acetabular orientation, and soft tissue tension. These factors can contribute to instability, altered biomechanics, and functional impairment. Therefore, achieving hip symmetry through femoral and acetabular offset, limb length discrepancy (LLD), and center of rotation (COR) is an important consideration. Achieving proper symmetry may improve gait, quality of life, and overall outcomes. This case series includes 10 patients with non-tumoral pathology treated with megaprostheses for complications after THA between 2014 and 2024. Megaprosthesis conversion was performed for sepsis (n = 2), aseptic loosening (n = 4), and periprosthetic fracture (n = 4). Dislocation occurred in 20%, with one case showing restored hip symmetry but dislocating due to trauma and noncompliance. Another case had an LLD of 3 cm, contributing to dislocation. Periprosthetic infection was observed in 20%, managed with a two-stage approach. Although hip symmetry was not fully restored in all patients, strict follow-up and rehabilitation were essential for improving functionality and quality of life. Megaprosthesis is an effective solution for MPFD in non-oncological patients when performed correctly. Restoring hip symmetry is challenging and depends on patient care and compliance, though it is an important factor influencing outcomes.

Spinal infections in general, and infectious spondylodiscitis in particular, are increasingly diagnosed in the Western world, in recent decades. This rise in incidence is associated with an ageing population and with an increased availability of accurate diagnostic modalities. Even so, due to the non-specific nature of clinical manifestations, and of the implicated blood and serum markers, there is a risk of underdiagnosis or misdiagnosis of the disease in its initial stages. Ionizing radiation methods, such as plain radiography (X-ray) and computed tomography (CT), are also not reliable in the early stages of the diseases, and the golden standard of imagistic diagnosis, magnetic resonance imaging (MRI), is not always available or requested. Still, MRI remains the most reliable method in most cases where there is a need for differential diagnosis with other pathologies, namely Andersson lesions, destructive spondyloarthropathy, erosive osteochondritis, micro-crystalline spondylitis, Modic 1 lesion, Charcot spinal arthropathy, osteoporotic fractures, SAPHO syndrome with spinal involvement, and Schmorl’s nodes. Infectious spondylodiscitis is caused by bacteria, and, less frequently, by fungi. Rare cases of parasitic causes have also been reported in the literature. Infectious spondylodiscitis of bacterial causes may be pyogenic, more frequently caused by Staphylococcus spp. or Streptococcus spp., or granulomatous, usually caused by Mycobacterium tuberculosis complex (MTBC) or from classical brucellosis. In all these cases, therapy may be conservative, with antibiotics, or surgical, when the former fails or in patients with significant spinal instability or other neurological manifestations. There are various surgical approaches, each with its own drawbacks, and usually used according to the preference of the attending physician. Even in cases of surgical treatment, antibiotic administration is prolonged, and it is important for a proper scheme to be selected based on antimicrobial susceptibility testing. However, given that in many cases, the causative agent cannot be identified, empirical treatment must be initiated. Finally, newer approaches, including the incorporation of antimicrobial substances, may offer better solutions for improving treatment and rehabilitation outcomes.

Background/Objectives: Leptin is a pleiotropic adipokine linking energy metabolism with innate and adaptive immunity. Its relationship with clinical severity across distinct airway disease phenotypes remains insufficiently characterized. This study examined serum leptin concentrations in adults with allergic rhinitis, non-allergic asthma, and allergic asthma associated with allergic rhinitis. Methods: This single-center retrospective observational study analyzed fully anonymized clinical and laboratory data from 88 adults: patients with allergic rhinitis (n = 31), non-allergic asthma (n = 15), or allergic asthma with allergic rhinitis (n = 22) and healthy controls (n = 20). Serum leptin was measured using a quantitative sandwich enzyme-linked immunosorbent assay. Disease severity was classified using the Allergic Rhinitis and its Impact on Asthma and Global Initiative for Asthma frameworks applicable during the study period. Statistical analyses were performed using IBM SPSS Statistics, version 26.0 (IBM Corp., Armonk, NY, USA), and available original statistical outputs were summarized using retained t statistics and two-sided p values. Results: Stage-specific mean serum leptin concentrations were heterogeneous and non-monotonic. Statistically significant relationships between leptin concentration and disease stage were reported for allergic rhinitis (t = 2.844; p = 0.008), non-allergic asthma (t = 4.240; p = 0.001), and allergic asthma with allergic rhinitis (t = 2.700; p = 0.013). In the allergic rhinitis subgroup, 64.5% of participants had normal weight, 32.3% were overweight, and 3.2% had grade II obesity; weight category was not significantly related to rhinitis stage. Conclusions: The retained analyses indicate statistically significant relationships between serum leptin concentration and clinical disease stage across the investigated airway phenotypes. However, the stage-specific descriptive means were heterogeneous and non-monotonic and therefore do not support a uniform progressive increase in leptin with increasing disease severity. Because complete model outputs and covariate-adjusted estimates were unavailable, these findings should be regarded as exploratory and require prospective validation with appropriate adjustment for adiposity and other relevant metabolic confounders.