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Article ; Online: Osteochondral Lesions of Ankle and Knee. Will Future Treatments Really Be Represented by Custom-Made Metal Implants?

Massimiliano Mosca / Alberto Grassi / Silvio Caravelli

Journal of Clinical Medicine, Vol 11, Iss 13, p

2022 Volume 3817

Abstract: Knee and ankle osteochondral lesions are structural defects of the cartilaginous surface and underlying subchondral bone which still represent a daily challenge for the orthopedic surgeon [.] ...

Abstract	Knee and ankle osteochondral lesions are structural defects of the cartilaginous surface and underlying subchondral bone which still represent a daily challenge for the orthopedic surgeon [.]
Keywords	n/a ; Medicine ; R
Language	English
Publishing date	2022-07-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Associated Corrective Procedures of Extra-Articular Asymptomatic Foot Malalignments in Total Ankle Replacement

Silvio Caravelli / Marco Di Ponte / Alberto Grassi / Stefano Zaffagnini / Massimiliano Mosca

Journal of Clinical Medicine, Vol 11, Iss 4544, p

Are They Really Mandatory?

2022 Volume 4544

Abstract: In recent years, total ankle replacement (TAR) has undergone a series of evolutions and changes in terms of materials, prosthetic designs, and surgical techniques [.] ...

Abstract	In recent years, total ankle replacement (TAR) has undergone a series of evolutions and changes in terms of materials, prosthetic designs, and surgical techniques [.]
Keywords	n/a ; Medicine ; R
Language	English
Publishing date	2022-08-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: RANKL-RANK-OPG Pathway in Charcot Diabetic Foot

Tommaso Greco / Antonio Mascio / Chiara Comisi / Chiara Polichetti / Silvio Caravelli / Massimiliano Mosca / Nicola Mondanelli / Elisa Troiano / Giulio Maccauro / Carlo Perisano

International Journal of Molecular Sciences, Vol 24, Iss 3014, p

Pathophysiology and Clinical-Therapeutic Implications

2023 Volume 3014

Abstract: Charcot Foot (CF), part of a broader condition known as Charcot Neuro-Osteoarthropathy (CNO), is characterized by neuropathic arthropathy with a progressive alteration of the foot. CNO is one of the most devastating complications in patients with ... ...

Abstract	Charcot Foot (CF), part of a broader condition known as Charcot Neuro-Osteoarthropathy (CNO), is characterized by neuropathic arthropathy with a progressive alteration of the foot. CNO is one of the most devastating complications in patients with diabetes mellitus and peripheral neuropathy but can also be caused by neurological or infectious diseases. The pathogenesis is multifactorial; many studies have demonstrated the central role of inflammation and the Receptor Activator of NF-κB ligand (RANKL)-Receptor Activator of NF-κB (RANK)-Osteoprotegerin (OPG) pathway in the acute phase of the disease, resulting in the serum overexpression of RANKL. This overexpression and activation of this signal lead to increased osteoclast activity and osteolysis, which is a prelude to bone destruction. The aim of this narrative review is to analyze this signaling pathway in bone remodeling, and in CF in particular, to highlight its clinical aspects and possible therapeutic implications of targeting drugs at different levels of the pathway. Drugs that act at different levels in this pathway are anti-RANKL monoclonal antibodies (Denosumab), bisphosphonates (BP), and calcitonin. The literature review showed encouraging data on treatment with Denosumab, although in a few studies and in small sample sizes. In contrast, BPs have been re-evaluated in recent years in relation to the high possibility of side effects, while calcitonin has shown little efficacy on CNO.
Keywords	charcot foot ; RANKL ; OPG ; osteoarthopathy ; diabetes mellitus ; denosumab ; Biology (General) ; QH301-705.5 ; Chemistry ; QD1-999
Subject code	616
Language	English
Publishing date	2023-02-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Mobile Anatomical Total Ankle Arthroplasty—Improvement of Talus Recentralization

Faisal Alsayel / Mustafa Alttahir / Massimiliano Mosca / Alexej Barg / Mario Herrera-Pérez / Victor Valderrabano

Journal of Clinical Medicine, Vol 10, Iss 3, p

2021 Volume 554

Abstract: Introduction: Total ankle arthroplasty (TAA) is becoming a more frequent treatment option for end-stage ankle osteoarthritis (OA) as outcomes measures are improving. However, there is concern that malalignment of TAA can result in premature failure of ... ...

Abstract	Introduction: Total ankle arthroplasty (TAA) is becoming a more frequent treatment option for end-stage ankle osteoarthritis (OA) as outcomes measures are improving. However, there is concern that malalignment of TAA can result in premature failure of the implant. One of the malalignment issues is the talar sagittal malposition. However, a consensus on the significance of the sagittal translation of the talus in TAA is yet to be established. The aim of this study was, therefore, to clarify whether talus OA subluxation is normalized after the implantation of a mobile TAA. Methods: Forty-nine consecutive patients with symptomatic end-stage ankle OA underwent 50 cementless three-component mobile-bearing VANTAGE TAA with 21 right ankles (42%) and 29 left ankles (58%). Clinical and radiographic outcomes were assessed: Clinical variables: American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score (0–100), visual analogue scale (VAS, 0–10), and ankle range of motion (ROM). Radiological variables: medial distal tibial articular angle (mDTAA), anterior distal tibial articular angle (aDTAA) and lateral talar station (LTS). Results: The clinical results showed the mean improvement in AOFAS hindfoot score from 42.12 ± SE 2.42 (Range: 9–72) preoperatively, to 96.02 ± SE 0.82 (Range: 78–100) at a mean follow-up of 12 months, with a highly statistically significant difference ( p < 0.00001). Pain score (VAS) was 6.70 ± SE 0.28 (Range 0–10) preoperatively, and 0.26 ± SE 0.12 (Range: 0–3) at 12-month follow-up, with a highly statistically significant difference ( p < 0.00001). ROM measurements preoperatively showed a mean of 22.55° ± SE 1.51° (Range: 0–50°), which showed a statistically significant improvement ( p < 0.0001) to 45.43° ± SE 1.56° (Range: 25–60°) 12 months postoperatively. The radiological analyses revealed the following results: On the coronal view, the mDTAA preoperatively was 88.61 ± SE 0.70 (Range: 78.15–101.10), which improved to 89.46 ± SE 0.40 (Range: 81.95–95.80) at 12 months (not ...
Keywords	ankle ; ankle osteoarthritis ; total ankle arthroplasty ; total ankle replacement ; vantage ; Medicine ; R
Subject code	796
Language	English
Publishing date	2021-02-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Variability of Postural Stability and Plantar Pressure Parameters in Healthy Subjects Evaluated by a Novel Pressure Plate

Allegra Fullin / Paolo Caravaggi / Pietro Picerno / Massimiliano Mosca / Silvio Caravelli / Antonio De Luca / Angela Lucariello / Paolo De Blasiis

International Journal of Environmental Research and Public Health, Vol 19, Iss 2913, p

2022 Volume 2913

Abstract: Background: Postural stability and plantar pressure parameters can be assessed by baropodometry; nevertheless, they are often affected by low repeatability. The aim of the study was to test the accuracy and repeatability of a novel resistive sensor ... ...

Abstract	Background: Postural stability and plantar pressure parameters can be assessed by baropodometry; nevertheless, they are often affected by low repeatability. The aim of the study was to test the accuracy and repeatability of a novel resistive sensor pressure plate and to establish the most reliable baropodometric parameters. Methods: Accuracy and repeatability of the FM12050 BTS-Bioengineering plate measurements were assessed by using different weights in static conditions across three sessions. Subsequently, 20 healthy subjects were assessed by 30-s stabilometric analysis in bipedal standing with open eyes across four trials in two sessions, morning and afternoon. Results: Pressure plate repeatability in measuring the static weights was very high, and plate measurements were correlated to the scale measurements (Pearson’s coefficient = 0.99). Percentage of load distribution between left and right foot and in rearfoot and forefoot regions showed the largest repeatability (coefficient of variation < 5%) across trials. Eventually, median and percentiles (25–75%) were reported for each parameter. Conclusions: This study helped to assess the accuracy and repeatability of a novel pressure plate in static conditions and to define the most reliable parameters for the assessment of postural stability and foot morphology. The present healthy-subject stabilometric dataset may be used as reference data in the evaluation of pathological populations.
Keywords	postural stability ; posture ; plantar pressure ; pressure plate ; accuracy ; repeatability ; Medicine ; R
Subject code	621
Language	English
Publishing date	2022-03-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Clinical Radiographical Outcomes and Complications after a Brand-New Total Ankle Replacement Design through an Anterior Approach

Massimiliano Mosca / Silvio Caravelli / Emanuele Vocale / Simone Massimi / Davide Censoni / Marco Di Ponte / Mario Fuiano / Stefano Zaffagnini

Journal of Clinical Medicine, Vol 10, Iss 2258, p

A Retrospective at a Short-Term Follow Up

2021 Volume 2258

Abstract: Recently, the progress in techniques and in projecting new prosthetic designs has allowed increasing indications for total ankle replacement (TAR) as treatment for ankle osteoarthritis. This retrospective work comprehended 39 subjects aged between 47 and ...

Abstract	Recently, the progress in techniques and in projecting new prosthetic designs has allowed increasing indications for total ankle replacement (TAR) as treatment for ankle osteoarthritis. This retrospective work comprehended 39 subjects aged between 47 and 79 years old. The patients, observed for at least 12 months (mean follow up of 18.2 ± 4.1 months), have been evaluated according to clinical and radiological parameters, both pre- and post-operatively. The AOFAS and VAS score significantly improved, respectively, from 46.2 ± 4.8 to 93.9 ± 4.1 and from 7.1 ± 1.1 to 0.7 ± 0.5 ( p value < 0.05). At the final evaluation, the mean plantarflexion passed from 12.2° ± 2.3° to 18.1° ± 2.4° ( p value < 0.05) and dorsiflexion from a pre-operative mean value of 8.7° ± 4.1° to 21.7° ± 5.4° post-operatively ( p value < 0.05). This study found that this new total ankle replacement design is a safe and effective procedure for patients effected by end-stage ankle osteoarthritis. Improvements have been demonstrated in terms of range of motion, radiographic parameters and patient-reported outcomes. However, further studies are needed to assess the long-term performance of these prostheses.
Keywords	total ankle replacement ; new design prosthesis ; end-stage osteoarthritis ; anterior approach ; Medicine ; R
Subject code	796
Language	English
Publishing date	2021-05-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Increased Rotatory Laxity after Anterolateral Ligament Lesion in Anterior Cruciate Ligament- (ACL-) Deficient Knees

Alberto Grassi / Tommaso Roberti di Sarsina / Stefano Di Paolo / Cecilia Signorelli / Tommaso Bonanzinga / Federico Raggi / Massimiliano Mosca / Stefano Zaffagnini

BioMed Research International, Vol

A Cadaveric Study with Noninvasive Inertial Sensors

2021 Volume 2021

Abstract: The anterolateral ligament (ALL) has been suggested as an important secondary knee restrain on the dynamic laxity in anterior cruciate ligament- (ACL-) deficient knees. Nevertheless, its kinematical contribution to the pivot-shift (PS) phenomenon has not ...

Abstract	The anterolateral ligament (ALL) has been suggested as an important secondary knee restrain on the dynamic laxity in anterior cruciate ligament- (ACL-) deficient knees. Nevertheless, its kinematical contribution to the pivot-shift (PS) phenomenon has not been clearly and objectively defined, and noninvasive sensor technology could give a crucial contribution in this direction. The aim of the present study was to quantify in vitro the PS phenomenon in order to investigate the differences between an ACL-deficient knee and an ACL+ALL-deficient knee. Ten fresh-frozen paired human cadaveric knees (n=20) were included in this controlled laboratory study. Intact, ACL-deficient, and ACL+ALL-deficient knees were subjected to a manual PS test quantified by a noninvasive triaxial accelerometer (KiRA, OrthoKey). Kinematic data (i.e., posterior acceleration of the tibial lateral compartment) were recorded and compared among the three statuses. Pairwise Student’s t-test was used to compare the single groups (p<0.05). Intact knees, ACL-deficient knees, and ACL+ALL-deficient knees showed an acceleration of 5.3±2.1 m/s2, 6.3±2.3 m/s2, and 7.8±2.1 m/s2, respectively. Combined sectioning of ACL and ALL resulted in a statistically significant acceleration increase compared to both the intact state (p<0.01) and the ACL-deficient state (p<0.01). The acceleration increase determined by isolated ACL resection compared to the intact state was not statistically significant (p>0.05). The ALL sectioning increased the rotatory laxity during the PS after ACL sectioning as measured through a user-friendly, noninvasive triaxial accelerometer.
Keywords	Medicine ; R
Subject code	796
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	Hindawi Limited
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Intra-Articular Calcaneal Fractures

Silvio Caravelli / Giammarco Gardini / Camilla Pungetti / Paolo Gentile / Carlo Perisano / Tommaso Greco / Vito Gaetano Rinaldi / Giulio Maria Marcheggiani Muccioli / Domenico Tigani / Massimiliano Mosca

Journal of Clinical Medicine, Vol 12, Iss 1, p

Comparison between Mini-Invasive Approach and Kirschner Wires vs. Extensive Approach and Dedicated Plate—A Retrospective Evaluation at Long-Term Follow-Up

2022 Volume 20

Abstract: Introduction: Calcaneal fractures (CF) are the most common tarsal fractures, representing up to 75% of foot fractures and 2% of all fractures. The aim of this retrospective study is to analyze fixation with Kirschner wires through a mini-invasive ... ...

Abstract	Introduction: Calcaneal fractures (CF) are the most common tarsal fractures, representing up to 75% of foot fractures and 2% of all fractures. The aim of this retrospective study is to analyze fixation with Kirschner wires through a mini-invasive approach and dedicated plate and screws through an extended approach at long-term follow-up. Materials and Methods: Patients were radiographically and clinically evaluated at final follow-up, by using the validated American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot score for the clinical–functional assessment, the Short-Form 12 (SF-12) for the physical and psychological domain assessment, and the Visual Analog Scale (VAS) for pain. Results: In total, 38 patients (42 CF) met the inclusion criteria and were retrospectively evaluated and divided into two groups (Kirschner group and plate group) consisting of 19 patients each. The overall mean follow-up was 59.4 ± 11.8 months. The average values of the post-operative clinical outcomes of the two groups KG and PG were, respectively, 70.7 ± 11.9 and 70.1 ± 10.9 (AOFAS), 45.7 ± 6.8 and 46.5 ± 10.8 (SF-12 PCS), 54.7 ± 9.9 and 50.9 ± 11.8 (SF-12 MCS) at the final follow-up. Conclusions: The present study showed that in the cases analyzed, the two surgical approaches used for the treatment of CF achieved comparable clinical outcomes. The only substantial difference found between the two groups of patients was the re-intervention rate that afflicted them.
Keywords	calcaneal fracture ; K-wires ; dedicated plate ; complications ; outcomes ; Medicine ; R
Language	English
Publishing date	2022-12-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: FOOT AND LOWER LIMB DISEASES IN RUNNERS

Francesco Di Caprio / Roberto Buda / Massimiliano Mosca / Antonino Calabrò / Sandro Giannini

Journal of Sports Science and Medicine, Vol 9, Iss 4, Pp 587-

ASSESSMENT OF RISK FACTORS

2010 Volume 596

Abstract: The present study analyzed the impact of the running style and the morphologic and functional characteristics of the foot on the incidence of non-traumatic foot and lower limb disorders in runners. From January 2004 to December 2008, we prospectively ... ...

Abstract	The present study analyzed the impact of the running style and the morphologic and functional characteristics of the foot on the incidence of non-traumatic foot and lower limb disorders in runners. From January 2004 to December 2008, we prospectively examined 166 runners, both recreational and competitive, involved in various running specialities, from three athletics clubs in Northern Italy. They were 86 males and 80 females, with a mean age of 31.1 ± 12.2 years. We considered non-traumatic foot and lower limb diseases reported during the follow-up period, which resulted in a minimum sport rest of two weeks. The incidence of these diseases was examined with respect to general characteristics, type of activity, foot morphology, running style. 59% of athletes reported one or more diseases. The most common were plantar fasciitis (31% of athletes) and Achilles tendinopathies (24%). Overall, the more prone to injuries were males (60.9% of cases), competitive runners (70.9%), middle-distance runners (51.7%), and those using spike shoes (80.3%). Age, body weight and height were not important predictors of running injuries in general. Considering the morphological characteristics of the foot, the most prone to injury were the varus hindfoot (87.5% of cases) and the cavus arch (71.4%). In conclusion, a deep knowledge of the factors predisposing runners to specific diseases, often chronic and highly debilitating for the athlete, may allow implementing effective therapeutic measures
Keywords	Running ; foot ; disease ; Sports ; GV557-1198.995 ; Sports medicine ; RC1200-1245
Subject code	796
Language	English
Publishing date	2010-12-01T00:00:00Z
Publisher	University of Uludag
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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