Vitamin C, a potent reducing and antioxidant agent, plays an important role in the body, aiding in the growth of cartilage and bones. It is also involved in mechanisms that help reduce inflammation and its effects on the body. In addition, vitamin C decreases pro-inflammatory cytokines, such as IL-6, which produce acute-phase proteins such as CRP and influence inflammatory markers such as ESR. We carried out a study with 110 patients who underwent total knee replacement surgery. We divided the patients into two groups, in which the intervention group received 15 g of parenteral vitamin C during the immediate postoperative period while the control group did not. Patients who received 15 g of vitamin C after total knee replacement surgery had decreased inflammatory markers, specifically CRP and ESR. Overall, administering vitamin C in the post-surgical period results in improved management of inflammation, as evidenced by a decrease in CRP and ESR values. This leads to faster recovery and better healing outcomes for patients undergoing total knee replacement surgery. Furthermore, the beneficial effects of vitamin C in reducing proinflammatory cytokines, reducing the need for opioid analgesics, and its mild adverse effects make it a promising adjuvant in managing postoperative recovery.

Background: Reconstruction of limbs with extensive bone loss often requires complex surgical procedures, which can be technically demanding, time-consuming, and physically and psychologically burdensome for patients. Historically, the lack of alternatives for large bone defects often led to primary amputation. Modern musculoskeletal practice allows for reconstruction using autologous or allogeneic bone grafts, or through more complex procedures such as the Masquelet technique or distraction osteogenesis. However, these methods share a common challenge: the need for a docking site procedure in cases of insufficient bony fusion of the transport segment. The aim of this study was to identify predictive factors for the need for a docking site procedure. Methods: A retrospective analysis was conducted on 93 patients treated for lower extremity bone defects between January 2013 and June 2023. Of these, 39 patients (41.9%) underwent segmental bone transport and formed the study cohort for the predictive model analysis. Patients of all ages and both genders were included, regardless of the etiology and size of the defect. The need for a docking site procedure was analyzed using logistic regression, ROC analysis, and ANOVA. Results: The study included 93 patients (73 male, 19 female) aged 7 to 83 years. The mean defect size was 76.46 mm (range: 12.1 to 225.1 mm). The mean transport duration was 149.97 days, with a mean transport speed of 0.61 mm/day. Among the 39 segmental transport patients, a docking site procedure was performed in 64.1% (n = 25). Logistic regression and ROC analysis were performed on this subgroup (n = 39, with 25 events). Significant predictors for the need for a docking site procedure were age (p = 0.024), vascular injury (p = 0.009), transport duration (p = 0.001), and transport speed (p < 0.001). ROC analysis demonstrated that transport speed (AUC = 0.931) and transport duration (AUC = 0.911) showed strong discriminative ability for predicting docking site procedure necessity, suggesting potential utility as clinical decision-support parameters. Conclusions: The study identified transport duration and speed as potentially valuable predictive factors in this retrospective cohort for the need of a docking site procedure, though prospective validation is required. A transport duration exceeding 290.5 days significantly increased the likelihood of requiring a docking site procedure. These findings can help optimize treatment planning and improve long-term limb preservation.

The coronavirus disease 2019 pandemic has significantly affected people worldwide. Herein, we present a case of massive heterotopic ossification (HO) of the right hip following severe SARS-CoV-2 infection. The exact origin of HO development is still unknown, but a critical illness, chronic immobilization and hypoxia are important risk factors. Considering the location and size of the HOs in this case, modified Ludloff’s medial approach of the hip was used. This approach allows for good exposure and access to the medial and inferior part of the hip joint and the successful extirpation of the pathologic tissue.

(1) Background: The reconstruction of periacetabular defects after tumor resection remains one of the most challenging procedures in orthopaedic oncology. The modular LUMiC^® system was designed to improve fixation stability and reduce implant-related complications compared with earlier hemipelvic prostheses. We investigated patient and implant survival after LUMiC^® reconstruction, complication types and functional outcomes. (2) Methods: Eighteen patients (8 men, 10 women; mean age 58.9 years) underwent LUMiC^® endoprosthetic reconstruction between 2011 and 2025. Kaplan–Meier analysis was used to estimate patient and implant survival. Complications were categorized according to Henderson. Functional results were evaluated at follow-up using MSTS and TESS. (3) Results: Mean follow-up was 35.52 months (SD 36.89). Overall implant survival was 72.2%. Instability (27.8%) and infection (16.7%) were the leading complications. Two-thirds of patients required at least one revision (mean 3.1 revisions per case). Metastatic disease reduced patient survival (p = 0.012) but did not affect implant longevity (p = 0.31). Functional outcomes were available for only 3 of 18 patients and should therefore be regarded as exploratory. Mean MSTS was 58.9% (SD 21.43) and mean TESS was 73.4% (SD 6.836). (4) Conclusions: Despite high revision rates, the LUMiC^® prosthesis provides durable fixation. Early revision does not appear to compromise implant survival. However, the small and heterogeneous cohort represents a limiting factor of this study.

Background: Proximal femoral replacement (PFR) is a critical limb-salvage strategy for managing massive proximal femoral bone loss due to oncologic and non-oncologic conditions. Although oncologic outcomes are well described, evidence surrounding PFR for infection, periprosthetic fracture, and mechanical failure remains limited. This study evaluates short- to mid-term outcomes following PFR for multiple indications and compares primary with revision procedures. Methods: We retrospectively reviewed all patients undergoing PFR at a Level I trauma center from 2009 to 2023. Cases were categorized by procedure type (primary vs. revision) and indication (tumor, infection, other causes). Outcomes included operative time, complications according to the Henderson classification, reoperation rates, and functional outcomes. Results: A total of 81 patients (84 procedures) were included with a median follow-up of 7 months (IQR 0–31); 57.1% were lost to follow-up. The overall complication rate was 42.9%, significantly higher in revision procedures than in primary PFRs. Infection (Henderson Type IV) was the most frequent complication and occurred predominantly in revision surgeries. No cases of aseptic loosening (Type II) were identified. Reoperation was required in 29% of all procedures, with the highest rates observed in infection cases. Conclusions: PFR remains a reliable limb-salvage option for extensive proximal femoral deficiency. Revision procedures, especially infection-related cases, carry substantially higher risks of complications and reoperation. In contrast, primary oncologic PFRs showed comparatively favorable outcomes. Infection remains the principal barrier to durable results, underscoring the need for optimized perioperative strategies. Level of evidence: Therapeutic Level III (retrospective cohort study).