Aims: Autologous conditioned serum (ACS; marketed as Orthokine®) is an autologous blood product that has previously shown efficacy in treatment of joint osteoarthritis, spinal radiculopathy, tendon and muscle injuries in randomized controlled trials. In this 24-week, randomized, double-blind study, we compared the efficacy and safety of ACS with glucocorticoid (betamethasone) injections in chronic supraspinatus tendinopathy patients.Material and methods: Thirty-two patients with chronic supraspinatus tendinopathy were enrolled in the study. The ACS group received four ACS injections once weekly over four weeks and the glucocorticoid group received three betamethasone injections once weekly over three weeks with a placebo (saline) injection at week 4 into the enthesis and paratenon of the supraspinatus tendon. Study endpoints were pain intensity (VAS) and Constant Shoulder Score (CSS) assessed at weeks 0, 4 and 24.Results: Shoulder pain intensity improved after 4 weeks and significantly improved after 24 weeks in patients treated with ACS compared with those treated with glucocorticoids (pain intensity week 4: ACS=22.0, glucocorticoid=32.0; week 24: ACS=15.0, glucocorticoid=40.0). CSS improved to a similar extent in both groups after 4 weeks. After 24 weeks, ACS patients exhibited significantly greater CSS improvements than glucocorticoid patients. Adverse events (n=8) were reported in betamethasone patients.Conclusions: Compared with betamethasone, ACS therapy improved joint function and reduced shoulder pain more effectively after 4 weeks of treatment; these improvements were sustained to week 24. Combined with its favorable safety profile, ACS appears to be a more effective treatment than glucocorticoids and could enhance the quality of life in patients with chronic rotator cuff tendinopathy

Introduction: Genu recurvatum is characterized by knee hyperextension, gait instability, and pain. It is rarely encountered in routine orthopedic practice, and evidence regarding optimal treatment strategies remains limited. In this case, the absence of trauma, associated varus malalignment, and the unilateral presentation further increased the complexity, with progressive worsening observed over a three-year follow-up period. This report presents a rare case of unilateral genu recurvatum of unknown etiology, treated with corrective proximal tibial osteotomy and posterior tibial slope adjustment, along with postoperative outcomes and a brief review of the literature. Case Presentation: A 32-year-old male patient presented with unilateral genu recurvatum and an intact posterior cruciate ligament (PCL), confirmed by MRI and arthroscopy. Preoperative planning was based on MSCT analysis. An open-wedge proximal tibial corrective osteotomy with plate fixation was performed. Under C-arm-guided fluoroscopy, the planned correction and posterior tibial slope were achieved. The posterior tibial tilt increased from 94° to 101°, improving knee stability and correcting the deformity. Conclusion: Corrective proximal tibial osteotomy with posterior slope adjustment represents an effective treatment option for unilateral genu recurvatum of unknown etiology. This technique provides reliable mechanical axis correction, joint stabilization, and favorable clinical outcomes with relatively rapid postoperative recovery.

Introduction. An isolated fracture of the small tuberosity is a very rare injury that can often be overlooked. This injury is significant due to the function of the subscapularis muscle, which loses its attachment by separating the small tuberosity. Case report. A 45-year-old former athlete suffered a left shoulder injury while falling downhill. Although the clinical picture was not convincing, a CT scan showed a fracture. Open repositioning and osteosynthesis were performed. After rehabilitation, the patient regained full active range of motion in the shoulder joint three months after the operation. The aim of this paper is to present the mechanism of injury, the clinical picture, the necessary diagnostics, and the technique of surgical treatment. The results of other authors whose series are also very small were analyzed. Conclusion. The conclusion of this paper is that such an injury requires surgical treatment to preserve a good range of motion in the shoulder joint.

Introduction/Objective Heel deformity accompanied by pain at the attachment of the Achilles tendon is generally known as Haglund’s syndrome. The prominence of the posterosuperior part of the heel bone generates pressure on the retrocalcaneal bursa and Achilles tendon, causing swelling and pain. The condition itself can be treated using surgical or non-surgical methods. The aim was to present our first experiences in the endoscopic treatment of Haglund’s syndrome, employing the three-portal technique. Methods This study includes ten patients whose surgeries were performed during the period between January 2019, and May 2020. All interventions were endoscopic with the three-portal technique used. The diagnosis was made based on the anamnesis, clinical examination, X-rays, and magnetic resonance imaging diagnostics. For the evaluation of results, the AOFAS (American Orthopedic Foot and Ankle Society) score was used. Results The endoscopic findings in all patients revealed a hypertrophic retrocalcaneal bursa and prominence at the posterosuperior part of the calcaneus, generating pressure on the Achilles tendon. By employing the three-portal technique, considerably better visualization is obtained, enabling easy removal of the degenerated tissue. The radiographic control image was satisfactory. The result of the AOFAS score showed a significant improvement after the surgery. Conclusion The endoscopic approach and the use of the three-portal technique in resolving Haglund’s syndrome is a secure procedure that produces good results. It enables faster recovery and fewer complications compared to open surgery.