Background/Objectives: Frailty has emerged as a relevant marker of biological vulnerability in patients undergoing complex orthopedic procedures, yet its specific prognostic value in revision total hip and knee arthroplasty remains incompletely synthesized. This systematic review evaluated whether validated preoperative frailty assessment tools are associated with adverse postoperative outcomes after revision total joint arthroplasty and whether available studies allow comparison of prediction performance across instruments. Methods: A systematic search of PubMed/MEDLINE, Embase, the Cochrane Library, Web of Science, Scopus, citation lists, and selected gray-literature sources was performed from inception through January 2026. Gray-literature records and conference abstracts were used only for citation tracking; the synthesis included only full-length peer-reviewed original research articles involving adult patients undergoing revision total hip arthroplasty, revision total knee arthroplasty, or both, with quantitative outcomes according to a validated frailty measure. Because of heterogeneity in frailty tools, outcome definitions, revision indications, and adjustment strategies, findings were synthesized narratively and certainty was assessed by outcome domain. Results: Eleven full-length studies were included, with cohorts ranging from 117 patients to 576,920 admissions, and most were retrospective database analyses. Higher frailty burden was consistently associated with worse short-term outcomes, including complications, prolonged hospital stay, readmission, non-home discharge, resource use, and mortality-related risk stratification. Representative findings included 30-day readmission of 23.8% versus 9.9%, surgical complications of 28.6% versus 7.8%, and odds ratios of up to 10.79 for complications across escalating frailty strata. Prediction studies suggested stronger discrimination for revision-specific or broader models, such as CARDE-B, RAI-rev, and machine-learning approaches, than for simpler generic frailty indices. Conclusions: Frailty is a consistent preoperative marker of elevated short-term perioperative risk after revision arthroplasty. The available evidence supports incorporating frailty assessment into preoperative risk stratification and counseling, but it remains insufficient to establish one universally preferred tool or to prove that frailty screening alone improves outcomes without targeted intervention.

Osteomyelitis of the tibia is a challenging condition, particularly when it occurs as a result of trauma. This abstract presents a case study detailing the successful staged treatment of posttraumatic tibial osteomyelitis utilizing a unique combination of rib graft and serratus anterior muscle. This medical abstract presents a case study of a 52-year-old male with a history of heavy smoking and obliterating arteriopathy of the lower limbs. The patient sustained a traumatic open fracture classified as Type IIIA Gustilo Anderson involving one-third of the distal right tibia diaphysis, with an associated right fibular malleolus fracture. The treatment approach comprised multiple stages, focusing on wound management, infection control, and limb salvage. The initial stage involved the application of an external fixation device in the emergency setting. Seven days later, an osteosynthesis procedure was performed using a Kuntscher nail and wire cerclage. However, complications emerged, with wound dehiscence and purulent secretion observed at 14 days postsurgery. Subsequently, secondary suturing was carried out at the 20-day mark. The second stage of the treatment involved implant removal, wide excisional debridement, pulse lavage, osteoclasia, and relaxation of the peroneal malleolus. A monoplane external fixation system was applied. As a part of postoperative care, aspiration therapy with a vacuum pump was administered, along with a 10-day course of vancomycin according to the antibiogram. Positive clinical signs of healing were noted, and sterile cultures confirmed the results. The third stage of the intervention focused on grafting the osteo-muscular defect, utilizing autografts from the rib and serratus anterior muscle. The external fixator was maintained in place during this phase. In the fourth and final stage, after an 8-week integration period of the musculocutaneous flap, the external fixator was removed, and internal fixation was accomplished with a blocked Less Invasive Stabilization System (LISS) plate inserted using the Minimally Invasive Plate Osteosynthesis (MIPO) technique. This case underscores the significance of a multistage approach in managing complex limb injuries, emphasizing the importance of timely intervention, infection control, and innovative techniques for limb salvage and restoration of function.

The most common acute knee disorders in the emergency department are cartilage and meniscus injuries, anterior cruciate ligament tears and MCL elongations. But even more important is that most of these lesions occur in the active population, both physically and socially, therefore the socio-economic impact of these diseases is huge. Beside the classic treatment methods, lately a new adjuvant procedure brings favorable results: Protein Rich Plasma. PRP is a relatively new technique, introduced around 2000 in orthopedics and traumatology practice, but generally accepted after 2010. It is based on the ability to repair of thr growth factors stored in blood platelets. We will analyze the follow-up patients with meniscal and cartilaginous lesions, the treatment options and their association, as well as the evolution with or without treatment.