Platelets are an essential component of hemostasis, with an increasing role in host inflammatory processes in injured tissues. The reaction between receptors and vascular endothelial cells results in the recruitment of platelets in the immune response pathway. The aim of the present review is to describe the role of platelets in osteoarthritis. Platelets induce secretion of biological substances, many of which are key players in the inflammatory response in osteoarthritis. Molecules involved in cartilage degeneration, or being markers of inflammation in osteoarthritis, are cytokines, such as tumor necrosis factor α (TNFα), interleukins (IL), type II collagen, aggrecan, and metalloproteinases. Surprisingly, platelets may also be used as a treatment modality for osteoarthritis. Multiple randomized controlled trials included in our systematic review and meta-analyses prove the effectiveness of platelet-rich plasma (PRP) as a minimally invasive method of pain alleviation in osteoarthritis treatment.

Wstęp: Przewlekły kaszel jest częstą dolegliwością, która może pogarszać jakość życia chorych oraz wywoływać liczne powikłania. J edną z częstych jego przyczyn jest choroba refluksowa przełyku (GERD). Do metod diagnostycznych stosowanych w celu potwierdzenia diagnozy kaszlu związanego z GERD należy pH-metria przełyku. Celem badania była ocena przydatności pH-metrii przełyku oraz określenie, który z parametrów mierzonych w czasie jej wykonywania jest najczulszy w diagnostyce kaszlu związanego z GERD. Materiał i metody: U 204 chorych z przewlekłym kaszlem wykonano 24-godzinną pH-metrię przełyku. Kobiety stanowiły 65% pacjentów, a mediana wieku wyniosła 59 lat. Epizod kwaśnego refluksu rozpoznawano, gdy nagły spadek pH poniżej 4 trwał co najmniej 12 sekund. Rozpoznanie GERD opierało się na całkowitym czasie pH poniżej 4, czasie pH poniżej 4 w pozycji stojącej lub leżącej oraz wskaźniku DeMeester. Kaszel związany z GERD diagnozowano, jeżeli epizody kaszlu odnotowane przez pacjentów pojawiały się nie później niż 2 minuty po epizodzie refluksu. Z wiązek pomiędzy epizodem refluksu i wystąpieniem kaszlu oceniono za pomocą następujących parametrów: symptom index (SI ≥ 50%) lub symptom association probability (SAP ≥ 95%). Wyniki: Na podstawie wyników pH-metrii przełyku u 135 chorych (135/204, 66%) wysunięto podejrzenie GERD. U większości z nich (117/135, 87%) diagnozę postawiono na podstawie wskaźnika DeMeester. Wśród pacjentów z GERD 61 osób (61/135, 45%) spełniło kryteria kaszlu związanego z GERD, co stanowiło 30% wszystkich pacjentów. U 36 pacjentów (36/61, 59%) kaszel związany z GERD zdiagnozowano na podstawie parametru SAP, u 12 chorych (20%) na podstawie parametru SI, natomiast u 13 (21%) na podstawie obu parametrów. Współczynnik korelacji Spearmana dla SAP ≥ 95% i SI ≥ 50% wyniósł 0.46 (p < 0.05). Wnioski: Na podstawie wyników pH-metrii GERD został zdiagnozowany 2-krotnie częściej niż kaszel związany z GERD. Parametr SAP jest bardziej czuły niż SI w diagnozowaniu kaszlu związanego z GERD.

Purpose: The purpose of this study was to compare five different femoral torsion measurement methods using computed tomography (CT) and magnetic resonance imaging (MRI), and to develop an MRI‐based rotational profiling technique that is comparable to and as repeatable as CT.Study Design: Diagnostic Study Methods: This prospective study evaluates patients who underwent lower limb rotational profile assessment by MRI and CT between June 2022 and October 2023. Five different measurement methods (Reikerås, Lee, Tomczak, Murphy and Jarrett) were compared to determine the best agreement. The Reikerås method was selected and further evaluated for intraobserver and interobserver reliability, as well as the learning curve, using intraclass correlation coefficients (ICCs). Reliability was assessed using ICCs, while agreement was evaluated through Bland–Altman analysis. Additionally, receiver operating characteristic (ROC) curve analysis with the area under the curve (AUC) was performed.Results: ICCs for the agreement between MRI and CT measurements indicated strong reliability (0.904 ± 0.022). The ICCs for intraobserver and interobserver reliability were 0.887 ± 0.026 and 0.871 ± 0.0471, respectively. Bland–Altman plots revealed a mean difference of −0.98° with limits of agreement ranging from −7.89° to 5.93°. The optimal cut‐off point for CT referral was calculated based on ROC curve analysis of MR‐based femoral torsion assessment, identified using the Youden index, at 19.67°, with an AUC of 0.998 ± 0.003, indicating excellent diagnostic accuracy. The learning curve showed an optimal ICC > 0.966 after 63 readings.Conclusion: The Reikerås MRI measurement method could replace CT, especially in the paediatric population, as it has shown high agreement, comparable reliability and reproducibility. The cut‐off point for this method is 19.67°.Level of Evidence: Level II.

Radial head replacement should be indicated in all cases of radial head fractures when open reduction and internal fixation is anticipated to be difficult or impossible. Although excellent therapeutic results have been ob­tained, this procedure, like any other surgical procedures, may be associated with severe complications, includ­ing contractures, ossification or aseptic synovitis. In these cases, removal of the prosthetic radial head has al­ways been a safe and popular solution producing a satisfactory clinical outcome. However, we present the case of a patient in whom the prosthesis was left in place, but the polyethylene head was replaced with a metal-covered head. The decision to perform this procedure was taken intraoperatively.

Background: COVID-19, a global pandemic, has had a profound impact on the world, overwhelming healthcare systems worldwide. These disruptions were associated with significant disparities in healthcare access to routine consultations and elective surgeries, adversely affecting patient health and altering injury patterns in emergency departments. This retrospective observational study aims to compare patient profiles and treatment during the pandemic compared to the pre-pandemic period. Methods: Patients admitted to the orthopaedic and traumatology department before, during, and after the COVID-19 pandemic. The full (unmatched) cohort comprised 8413 patients (6175 before, 1188 during, and 1050 after the pandemic). To ensure balanced comparisons, propensity score matching (1:2, based on age, sex, and comorbidities) was applied separately to the during- and after-pandemic groups, each matched against pre-pandemic controls. Collected information incorporated demographics, comorbidities, and injury circumstances. Results: After matching, the during-pandemic group (1188 patients) was compared with 2376 pre-pandemic controls, and the after-pandemic group (1050 patients) with 2100 pre-pandemic controls. A higher proportion of same-region re-injuries was observed during and after the pandemic, as well as higher medical leave during the pandemic and post-pandemic, and longer hospital stays of over 10 days during the pandemic and post-pandemic. Injury patterns changed, with an increase in lower leg injuries and a decrease in wrist injuries during the pandemic. Additionally, the proportion of open wounds was lower during the pandemic. Conclusions: The pandemic and post-pandemic periods were associated with marked changes in trauma care, including more conservative treatment, fewer surgeries, and longer hospital stays. Same-region re-injuries were more frequent and sports-related injuries less frequent—patterns that temporally coincided with the periods of repeated lockdowns. Notably, differences persisted into the post-pandemic period. Given the retrospective, observational design, these findings represent associations rather than causal effects.