The proper function and longevity of the knee joint are ensured by the knee menisci. Their susceptibility to damage and injury is one of the main risk factors for rapid cartilage loss and the development of osteoarthritis. The vascularization pattern and nutritional status of a torn meniscus determine its potential for healing and the success of meniscus surgery. Blood supply is a crucial factor in assessing healing potential. Knee cartilage volume loss and its modification often result from meniscal damage or excision, leading to osteoarthritis. Modern methods for preserving meniscal tissue are currently the treatment of choice. Magnetic resonance imaging (MRI) is the gold standard for assessing meniscus lesions. It provides a comprehensive evaluation of tear stability and progression risk. Additionally, it offers high sensitivity and specificity. Arthrography combined with computed tomography (CT) can be used for patients who are unable to undergo MRI. Other methods, such as X-ray and ultrasound, are not useful for the typical diagnosis of meniscal lesions. Minimally invasive surgery has become the gold standard for both treatment and diagnosis. Modern techniques, such as all-inside compression sutures and other suturing techniques, are also considered. In contrast, in the past, open total meniscectomy was routinely performed as the gold standard, based on the mistaken belief that the menisci were functionless. Currently, new treatment methods for meniscal lesions are being explored, including mesenchymal stem cells, synthetic implants, and platelet-rich plasma (PRP). The crucial role of the menisci in knee biomechanics drives the development of modern solutions focused on preserving meniscal tissue.

Chronic subdural hematoma (CSDH) is a common neurological condition, particularly in the elderly, characterized by a complex pathophysiology involving inflammation, angiogenesis, and recurrent microhemorrhages rather than a purely mechanical process. Although surgical evacuation remains the standard treatment, recurrence rates remain considerable, prompting the search for alternative and adjunctive therapies. This narrative review summarizes current evidence on the pathophysiology, diagnostic approaches, and management of CSDH, with particular emphasis on middle meningeal artery embolization (MMAE). A comprehensive literature search of major medical databases, including PubMed, Scopus, and Web of Science, was performed to identify relevant randomized controlled trials (RCTs), observational studies, and meta-analyses. Available evidence suggests that MMAE may reduce recurrence rates and the need for reoperation, particularly when used as an adjunct to surgery. However, results from RCTs remain mixed, and not all studies have demonstrated significant benefit on primary clinical endpoints. While MMAE has emerged as a promising minimally invasive approach targeting the vascular supply of hematoma membranes, further high-quality studies are required to establish standardized indications, optimize procedural techniques, and clarify long-term outcomes and comparative effectiveness.

Chronic subdural hematoma (cSDH) is an increasingly common neurological disorder in older adults and may present with cognitive decline, gait instability, recurrent falls, and loss of independence rather than overt focal deficits. Because these symptoms overlap with dementia, delirium, parkinsonism, and frailty, diagnosis may be delayed despite the potential for meaningful recovery after treatment. This narrative review summarizes evidence on clinical recognition, treatment, early mobilization, rehabilitation, and patient-centered recovery in older adults with cSDH. A targeted search of PubMed/MEDLINE, Scopus, and Web of Science identified randomized trials, observational studies, systematic reviews, meta-analyses, guidelines, and consensus statements available through July 2026. Surgical decompression may improve cognition and mobility, but the magnitude and durability of recovery vary. Premorbid cognitive and functional status, frailty, malnutrition, postoperative delirium, and complications are associated with outcomes, although causal effects are incompletely established. Postoperative drainage reduces recurrence; selected randomized trials suggest that middle meningeal artery embolization reduces recurrence or treatment failure, whereas evidence for independent cognitive and gait benefits remains limited. Early mobilization may reduce medical complications. Evidence specific to cSDH remains insufficient to prescribe a standardized exercise dose or progression. Multidimensional follow-up and prospective trials using cognitive, gait, quality-of-life, and participation outcomes are needed to determine whether successful hematoma treatment translates into restored independence and meaningful daily function.

Implant-related metal hypersensitivity (MH) after total joint arthroplasty (TJA) is an uncommon and diagnostically challenging complication in which antigen-specific T-cell responses may coexist with nonspecific inflammatory reactions to wear and corrosion products. This narrative review critically summarizes current evidence on the molecular immunopathogenesis, clinical presentation, diagnosis, and management of suspected MH, with particular emphasis on HLA-associated susceptibility and the 2023 European Academy of Allergy and Clinical Immunology (EAACI) mechanistic nomenclature. A structured search of PubMed, Scopus, and Web of Science was used to identify relevant clinical, immunological, and consensus literature. Metal sensitization is substantially more common than clinically relevant implant-associated hypersensitivity, and positive patch or lymphocyte transformation tests do not by themselves establish causality. Current evidence supports selective, clinically contextualized testing after exclusion of infection and mechanical causes; routine preoperative screening in patients without a suggestive history is not recommended. HLA class II associations and metal–peptide–MHC/T-cell receptor interactions provide a plausible molecular basis for interindividual susceptibility, but available genetic data remain insufficient for clinical risk stratification or implant selection. Future studies should integrate standardized phenotyping, quantitative metal exposure, histopathology, and molecular immune profiling before implementing precision arthroplasty.

Glioblastoma (GBM) recurs predominantly from infiltrative disease that persists beyond the contrast-enhancing tumor (CET). This structured narrative review aims to define the invasive margin and peritumoral brain zone (PBZ) as a spatially organized molecular ecosystem, summarize the approaches used to interrogate this compartment, and evaluate how malignant-cell plasticity, host niches, and treatment-induced remodeling contribute to minimal residual disease and recurrence. A structured literature search of PubMed/MEDLINE, Scopus, and Web of Science identified the clinical, translational, preclinical, and review literature available through July 2026; evidence was synthesized qualitatively, with priority given to human tissue studies and single-cell or spatially resolved analyses. Across studies, the margin differs from both tumor core and normal brain and contains heterogeneous malignant states interacting with neural, vascular, immune, hypoxic, and extracellular-matrix-supported niches. Surgery, radiotherapy, and systemic treatment further reshape these interactions through inflammation, vascular injury, senescence, hypoxia, and fibrosis. The main translational challenge is therefore not simply to control the CET, but to identify biologically high-risk non-enhancing tissue and demonstrate that therapy reaches and modifies it. We propose three priorities: image-registered characterization of residual compartments, regional measurement of drug exposure and target engagement, and integration of local margin control with distributed and niche-directed treatment. Prospective validation is required before spatial PBZ biomarkers can guide routine care.