Introduction and purpose. Articular cartilage injuries represent a significant clinical challenge due to the tissue’s limited intrinsic healing capacity, often progressing to osteoarthritis and chronic disability. Traditional treatments remain largely symptomatic, prompting extensive research into regenerative therapies aimed at restoring functional cartilage tissue. Description of the state of knowledge. We conducted a systematic analysis of recent literature (2020-2026) encompassing randomized controlled trials, systematic reviews, meta-analyses, and prospective cohort studies. Evidence was synthesized across multiple therapeutic modalities including mesenchymal stem cells (MSCs), autologous chondrocyte implantation (ACI/MACI), platelet-rich plasma (PRP), osteochondral transplantation, tissue engineering scaffolds, and emerging technologies such as 3D bioprinting, gene therapy, and exosome-based treatments. Matrix-associated autologous chondrocyte implantation (MACI) demonstrates significant long-term efficacy with large effect sizes (>0.8) in patient-reported outcomes at 2-15 years follow-up. Mesenchymal stem cells from various sources (bone marrow, adipose tissue, synovium, umbilical cord) show promise in clinical trials, with synovium-derived MSCs exhibiting particularly high chondrogenic potential. Comparative studies indicate that ACI/MACI and expanded MSC transplantation outperform microfracture for focal cartilage defects. Summary. Regenerative therapies have evolved significantly, with cell-based approaches demonstrating superior outcomes compared to traditional marrow stimulation techniques. However, challenges persist regarding optimal cell source, dosage, delivery methods, and long-term durability. Standardized protocols, large-scale randomized trials, and integration of emerging technologies are essential to advance the field toward personalized, effective cartilage regeneration strategies.

Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder in children and adolescents and is associated with substantial functional impairment. Although psychostimulants are considered first-line pharmacotherapy, a significant proportion of patients experience inadequate response, poor tolerability, or contraindications to stimulant use. Consequently, non-stimulant medications remain an important component of ADHD management. Guanfacine extended release (GXR), a selective α2A-adrenergic receptor agonist, is approved for the treatment of pediatric ADHD and represents a well-established non-stimulant option. Evidence derived from randomized controlled trials, meta-analyses, and systematic reviews indicates that GXR is effective as monotherapy and as adjunctive therapy to psychostimulants in children and adolescents aged 6–17 years. Across studies, GXR demonstrates clinically meaningful reductions in core ADHD symptoms compared with placebo, with reported effect sizes generally ranging from 0.5 to 0.8. The most commonly reported adverse events are sedation-related symptoms, including somnolence and fatigue, which are typically mild to moderate and tend to decrease with ongoing treatment. Cardiovascular effects are usually modest and consist mainly of small reductions in blood pressure and heart rate, with clinically significant events occurring infrequently. Overall, available data indicate that guanfacine extended release is an effective and generally well-tolerated non-stimulant treatment for ADHD in pediatric and adolescent populations. Its clinical utility is particularly relevant in patients with insufficient response or intolerance to stimulants, as well as in those requiring adjunctive pharmacotherapy. Further studies are warranted to evaluate long-term outcomes and to better define its comparative effectiveness in specific clinical subgroups.

Background: In modern sports, the line between healthy dedication and unhealthy obsession is becoming increasingly blurred. While classic eating disorders like anorexia and bulimia are well-known, Orthorexia Nervosa (ON) and Muscle Dysmorphia (MD) are growing problems that affect athletes of all genders but often go unnoticed. Objective: This review summarizes current knowledge regarding the prevalence, causes, and health consequences of ON and MD in athletes, based on literature acquired from PubMed, Embase, and Web of Science. Results: Evidence clearly shows that athletes are at a much higher risk for both conditions compared to the general population. Because strict diets and constant body monitoring are considered "normal" in sports, these disorders are often difficult to spot. Key risk factors include perfectionistic personality traits, pressure to meet weight requirements in certain sports, and the influence of social media, which promotes unrealistic body standards. Conclusion: Both ON and MD can lead to serious physical health issues, such as Relative Energy Deficiency in Sport (RED-S). Current findings highlight an urgent need for better screening tools designed specifically for athletes. Furthermore, a significant change in how we educate athletes and coaches about mental health and nutrition is necessary.

Background: Metabolic syndrome (MetS) affects approximately 25-30% of adults worldwide and is traditionally associated with cardiovascular complications. However, emerging evidence suggests that MetS may also substantially increase the risk of musculoskeletal disorders, including osteoarthritis, sarcopenia, and osteoporosis. Objectives: This review synthesizes current evidence on the molecular and pathophysiological mechanisms connecting MetS to musculoskeletal disorders, with particular focus on chronic inflammation and insulin resistance as central mediators. Methods: A comprehensive literature search was conducted across PubMed and Google Scholar, focusing on publications from 2018-2026. Search terms included metabolic syndrome, chronic inflammation, insulin resistance, musculoskeletal disorders, adipokines, osteoarthritis, and sarcopenia. After reviewing and ranking for relevance, 40 high-impact studies were selected to form the evidence base for this review [40]. Results: The literature reveals that chronic inflammation in MetS, characterized by elevated pro-inflammatory cytokines (IL-6, TNF-α, IL-1β) and dysregulated adipokines (leptin, adiponectin, resistin), creates a systemic inflammatory environment that directly impacts musculoskeletal tissues. Conclusions: Chronic inflammation and insulin resistance represent critical mechanistic links between MetS and musculoskeletal disorders. Interventions targeting inflammation and insulin sensitivity—including lifestyle modifications, omega-3 fatty acids, metabolic drugs (metformin, GLP-1 agonists), intermittent fasting, and inflammasome-targeting approaches—may offer benefits for both metabolic and musculoskeletal health.

Introduction: Knee osteoarthritis (KOA) is one of the most common degenerative joint diseases, affecting millions of people worldwide. It is characterized by progressive cartilage degradation, chronic pain, joint stiffness, and functional impairment. Traditional treatment methods, including pharmacotherapy and intra-articular injections of corticosteroids or hyaluronic acid, provide limited and often short-term relief. Platelet-rich plasma (PRP) has emerged as a promising regenerative therapy due to its high concentration of growth factors that may stimulate tissue healing and reduce inflammation. Objective: The aim of this study is to review the latest literature on the use of platelet-rich plasma injections in patients with knee osteoarthritis. Material and methods: A literature review was conducted on databases such as PubMed, Google Scholar, and SciSpace using the terms: "knee osteoarthritis", "platelet-rich plasma", "PRP injections", "intra-articular injections", "knee OA treatment". Conclusions: Knee osteoarthritis is a highly prevalent condition that significantly impacts quality of life. Platelet-rich plasma has demonstrated positive effects on pain reduction and functional improvement in patients with KOA. PRP injections lead to superior outcomes compared to placebo and hyaluronic acid, with therapeutic effects lasting 12-24 months. However, there is lack of standardization in PRP preparation protocols, and further studies are necessary to establish optimal treatment parameters.

Introduction and Purpose: Complex fractures represent a significant challenge in orthopedic trauma, requiring sophisticated surgical techniques, multidisciplinary collaboration, and innovative fixation methods to optimize patient outcomes. This comprehensive review synthesizes current evidence on the management of complex fractures, focusing on modern surgical approaches, fixation innovations, patient outcomes, complications, and evolving treatment strategies. Description of the State of Knowledge: A narrative review was conducted across multiple databases, yielding 69 high-quality papers published primarily between 2020-2025, with selected seminal earlier studies included. Evidence was synthesized from systematic reviews, meta-analyses, randomized controlled trials, and prospective cohort studies addressing complex fracture management. Modern management emphasizes orthoplastic collaboration, minimally invasive techniques, and technological innovations including 3D printing, robotic-assisted surgery, and advanced imaging. Orthoplastic approaches demonstrate reduced infection rates (2.4-37%), with reported union rates ranging from >80% to near-complete union in selected series, and enhanced functional outcomes. Three-dimensional printing technology significantly reduces operative time, blood loss, and fluoroscopy use while improving anatomical reduction. Minimally invasive plate osteosynthesis achieves excellent functional outcomes in 65% of cases with rapid union rates. Complications remain a concern, with infection rates varying from 2.4% to 20% depending on fracture severity and management approach. Summary (Conclusions): Contemporary complex fracture management requires integrated multidisciplinary care, selective application of innovative technologies, and individualized treatment strategies. Future directions include artificial intelligence integration, personalized implant design, and enhanced biological augmentation strategies.