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  1. Article ; Online: Common inflammatory markers in the screening of knee arthroprosthesis infections.

    Conteduca, Jacopo / Filipponi, Marco / Pichierri, Paolo / Casto, Alberto / Meccariello, Luigi / Rollo, Giuseppe

    Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina

    2024  Volume 21, Issue 1, Page(s) 203–207

    Abstract: Aim To evaluate the sensitivity and specificity of serum C-reactive protein (CRP) in early and late total knee arthroplasty (TKA) infections. Methods Blood tests to determine CRP levels (cut-off 10 mg/L)were conducted before surgery, at 1st day, 7th day ... ...

    Abstract Aim To evaluate the sensitivity and specificity of serum C-reactive protein (CRP) in early and late total knee arthroplasty (TKA) infections. Methods Blood tests to determine CRP levels (cut-off 10 mg/L)were conducted before surgery, at 1st day, 7th day and 15th day after surgery and at 1, 3, 6,12, 24 and 36 months. Patients had routine follow-up visits and radiological evaluations at 14 days and at 1, 3, 6, 12, 24 and 36 months. Infections were recorded and classified according to Widmer classification. The χ2 test or Fisher (in subgroups smaller than 10 patients) exact test was used to compare categorical variables. The statistical significance was set at p <0.05. Results A total of 19 infections were diagnosed during the followup. According to Widmer, five were classified as early post-operative and 14 as late chronic. All patients with early infections had suspected symptoms such as fever, swelling and pain. During the first month, 59 patients who had high CRP level but negative microbiological culture were considered as false positive representing a CRP sensitivity of 80% and a specificity of 67.6%. Fourteen patients had late chronic infection. Conclusion This study suggests that a synovial fluid aspiration should be performed in patients with persistent inflammation symptoms with or without radiographic signs of loosening. Moreover, it recommends the use of different serum and synovial tests for periprosthetic joint infection (PJI) diagnosis.
    Language English
    Publishing date 2024-02-01
    Publishing country Bosnia and Herzegovina
    Document type Journal Article
    ZDB-ID 2378942-6
    ISSN 1840-2445 ; 1840-2445
    ISSN (online) 1840-2445
    ISSN 1840-2445
    DOI 10.17392/1688-23
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  2. Article: Efficacy of the "Salento technique", a modified two-incision approach in distal biceps brachii tendon repair. Surgical description and outcomes analysis.

    Rollo, Giuseppe / Meccariello, Luigi / Rotini, Roberto / Pichierri, Paolo / Bisaccia, Michele / Fortina, Mattia

    Journal of clinical orthopaedics and trauma

    2019  Volume 10, Issue 5, Page(s) 959–964

    Abstract: Introduction: The biceps brachii lesion needs to be treated surgically. A modified two incisions technique is proposed and reviewed. Material and Methods: All patients were treated with the same technique. The outcomes were measured with the Quick-DASH ... ...

    Abstract Introduction: The biceps brachii lesion needs to be treated surgically. A modified two incisions technique is proposed and reviewed. Material and Methods: All patients were treated with the same technique. The outcomes were measured with the Quick-DASH Score (QDS), and the Mayo Elbow Performance Score (MEPS). Postoperative complications and distal biceps tendon strength were registered also.
    Results: At one year from the trauma, the QDS and the MEPS were excellent in all patients. 72.97% fully recovered and returned to work after 6 months from the trauma.
    Discussion: This technique, thanks to its preservation of anatomical structures, provides great outcomes.
    Language English
    Publishing date 2019-02-08
    Publishing country India
    Document type Journal Article
    ZDB-ID 2596956-0
    ISSN 2213-3445 ; 0976-5662
    ISSN (online) 2213-3445
    ISSN 0976-5662
    DOI 10.1016/j.jcot.2019.02.006
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  3. Article: Breakage in Two Points of a Short and Undersized "Affixus" Cephalomedullary Nail in a Very Active Elderly Female: A Case Report and Review of the Literature.

    Rollo, Giuseppe / Rinonapoli, Giuseppe / Pichierri, Paolo / Bisaccia, Michele / Caraffa, Auro / Meccariello, Luigi

    Case reports in orthopedics

    2018  Volume 2018, Page(s) 9580190

    Abstract: Introduction: Trochanteric fractures of the femur are common in elderly individuals with osteoporosis. The use of cephalomedullary nails is increasing, and they are now the most commonly used fixation devices, especially for the treatment of unstable ... ...

    Abstract Introduction: Trochanteric fractures of the femur are common in elderly individuals with osteoporosis. The use of cephalomedullary nails is increasing, and they are now the most commonly used fixation devices, especially for the treatment of unstable trochanteric fractures. The nail breakage is not the most common complication of intramedullary nailing. Many scientific papers report nail breakage in a specific location: through the lag screw hole, the nail shaft, or the distal locking hole.
    Materials and methods: We present a case of an 84-year-old patient treated with modular revision hip arthroplasty due to the breakage in two points of a cephalomedullary nail implanted 3 years earlier for a subtrochanteric fracture.
    Results: After modular revision hip arthroplasty, the functional results and quality of life have been excellent.
    Conclusions: As far as we could determine, this appears to be the first case of a breakage of a cephalomedullary nail in two points after nonunion in a very active elderly female.
    Language English
    Publishing date 2018-09-13
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2684648-2
    ISSN 2090-6757 ; 2090-6749
    ISSN (online) 2090-6757
    ISSN 2090-6749
    DOI 10.1155/2018/9580190
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  4. Article: The challenge of nonunion after osteosynthesis of the clavicle: is it a biomechanical or infection problem?

    Rollo, Giuseppe / Pichierri, Paolo / Marsilio, Antonio / Filipponi, Marco / Bisaccia, Michele / Meccariello, Luigi

    Clinical cases in mineral and bone metabolism : the official journal of the Italian Society of Osteoporosis, Mineral Metabolism, and Skeletal Diseases

    2017  Volume 14, Issue 3, Page(s) 372–378

    Abstract: Introduction: The nonunion rate has been reported between 0.1% and 15%. There are also several predisposing factors for the onset of complications: general factors connected with the patient and specific factors related to the fracture site. The purpose ...

    Abstract Introduction: The nonunion rate has been reported between 0.1% and 15%. There are also several predisposing factors for the onset of complications: general factors connected with the patient and specific factors related to the fracture site. The purpose of our study is to review the etiology of nonunion of the clavicle in its atrophic form and investigate the outcomes of the revision treatment in a single step.
    Materials and methods: Retrospective study on 71 patients suffering from nonunions due to the following treatments: conservative in 13 patients; plate fixation in 12; closed reduction and fixation with K-wire in 24; open reduction and fixation with K-wire. All patients were operated on in beach chair position and classic approach to the clavicle by incising the previous surgical scar. The clinical and radiographic criteria for evaluating the outcomes were: the Short Form (12) Health Survey (SF-12), the Constant Shoulder Score (CSS) and the Disability Disabilities of the Arm, Shoulder and Score (DASH) and radiographic Union Score (RUS) for bone healing. The evaluation endpoint was set at 12 months.
    Results: Blood and culture tests showed 22 infected nonunions and 49 atrophic or oligoatrophic. In only 10 cases, before surgery, the inflammatory markers were positive. The isolated microorganisms were resistant to common antibiotics. In 70 out of 71 cases, plates and screws on the upper side and fibula allogenic splints at the bottom, associated with cancellous bone grafts taken from the patients' iliac crests, were implanted. In one case, however, it was decided to implant the plate on the front edge of the clavicle and the fibula allogeneic splint on the posterior margin, also associated with a cancellous bone graft taken from the patient's iliac crest. The radiographic bone healing was observed in 107.8 (range 82-160) days for the aseptic nonunions, while in 118.4 (range 82-203) days for the septic ones. The non-healing case was a serious failure that led to asubtotal excision of the clavicle.
    Conclusions: The importance of classification and study of nonunions are essential to achieve positive outcomes. The guiding principle of our work is that aseptic nonunions heal in the operating room, while infected nonunions can be challenged and defeated on the operating table. Restoring the correct length of the clavicle interconnection between the sternum and the shoulder cingulum is indispensable to avoid functional deficits of the upper limb. The fibula splint and the tricorticale bone graft have both mechanical and strong biological values to quickly heal the nonunion. The return to pre-injury quality of life has to be our main goal.
    Language English
    Publishing date 2017-12-27
    Publishing country Italy
    Document type Case Reports
    ZDB-ID 2660444-9
    ISSN 1971-3266 ; 1724-8914
    ISSN (online) 1971-3266
    ISSN 1724-8914
    DOI 10.11138/ccmbm/2017.14.3.372
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  5. Article: Plate-and-bone-strut fixation of distal third humeral shaft aseptic non-unions: A consecutive case series.

    Rollo, Giuseppe / Prkić, Ante / Pichierri, Paolo / Eygendaal, Denise / Bisaccia, Michele / Filipponi, Marco / Giaracuni, Marco / Hitov, Philip / Tanovski, Kostadin / Meccariello, Luigi

    Journal of clinical orthopaedics and trauma

    2019  Volume 10, Issue Suppl 1, Page(s) S127–S132

    Abstract: Introduction: Non-union after humeral shaft fractures are seen frequently in clinical practice. The incidence is 2-10% after conservative management and up to 30% after surgical treatment. The purpose of this study is to evaluate the outcomes of plate- ... ...

    Abstract Introduction: Non-union after humeral shaft fractures are seen frequently in clinical practice. The incidence is 2-10% after conservative management and up to 30% after surgical treatment. The purpose of this study is to evaluate the outcomes of plate-and-bone-strut-allograft technique with bone chip augmentation for aseptic non-unions of the distal third of the humerus.
    Materials and methods: 26 consecutive cases were treated using a
    Results: Complete bone healing without complications was achieved in all 26 patients. The average period of radiographic union was 106 days. The average range of flexion-extension was 108° (94°-180°) and pro-supination was 159° (102°-180°). Twelve months after surgery, average Mayo elbow score was 86 (68-100) and the Oxford elbow score was 83 (52-100).
    Conclusion: The plate-and-bone-strut-allograft technique with bone chip augmentation in distal humeral shaft for aseptic non-unions resulted in union of all cases. No adverse events related to the surgery or the materials used were documented.
    Language English
    Publishing date 2019-05-07
    Publishing country India
    Document type Journal Article
    ZDB-ID 2596956-0
    ISSN 2213-3445 ; 0976-5662
    ISSN (online) 2213-3445
    ISSN 0976-5662
    DOI 10.1016/j.jcot.2019.05.004
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  6. Article: Grafting and fixation after aseptic non-union of the humeral shaft: A case series.

    Rollo, Giuseppe / Prkic, Ante / Bisaccia, Michele / Eygendaal, Denise / Pichierri, Paolo / Marsilio, Antonio / Giaracuni, Marco / Meccariello, Luigi

    Journal of clinical orthopaedics and trauma

    2019  Volume 11, Issue Suppl 1, Page(s) S51–S55

    Abstract: Purpose: Non-unions after humeral shaft fractures are seen frequently in clinical practice at about 2-10% after conservative management and 30% after surgical treatment. Non-union, displacement of structures and fixation failure can be hazardous ... ...

    Abstract Purpose: Non-unions after humeral shaft fractures are seen frequently in clinical practice at about 2-10% after conservative management and 30% after surgical treatment. Non-union, displacement of structures and fixation failure can be hazardous complications. The purpose of our study was to evaluate the outcomes of an on-lay bone graft strut construction with bone chips as grafting augmentation in the management of aseptic non-unions of the humeral shaft.
    Methods: From 124 eligible patients with a humeral shaft non-union, we included 48 patients. In all cases an anterolateral humeral approach was used, with an on-lay bone graft using an allograft strut construction and with bone substitute augmentation in the non-union gap. To assess the bone healing on radiographs, we used the non-union scoring system according to Whelan. Patients were followed with objective and subjective scores.
    Results: In all 48 patients we achieved full bone healing without major complications. The average period of union was 124 days. In 40 cases after healing the alignment was neutral, valgus deformation occurred in 6 cases a varus deformation in 2 cases. At twelve months after surgery, all patients recovered with satisfactory range of motion of shoulder and elbow and a good quality of life, without any radial nerve palsies or other major complications.
    Conclusion: Given the satisfactory results of full bone healing, recovery of the range of motion and the lack of major complications as seen in this study, we find that plating with supporting allograft as a good choice of treatment in the cases of aseptic non-union of the humeral shaft.
    Language English
    Publishing date 2019-08-31
    Publishing country India
    Document type Journal Article
    ZDB-ID 2596956-0
    ISSN 2213-3445 ; 0976-5662
    ISSN (online) 2213-3445
    ISSN 0976-5662
    DOI 10.1016/j.jcot.2019.08.020
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  7. Article: The Waterfall Fascia Lata Interposition Arthroplasty "Grika Technique" as Treatment of Posttraumatic Osteoarthritis of the Elbow in a High-Demand Adult Patient: Validity and Reliability.

    Rollo, Giuseppe / Rotini, Roberto / Eygendaal, Denise / Pichierri, Paolo / Prkic, Ante / Bisaccia, Michele / Lanzetti, Riccardo Maria / Lupariello, Domenico / Meccariello, Luigi

    Case reports in orthopedics

    2018  Volume 2018, Page(s) 8253732

    Abstract: Introduction: The elbow interposition arthroplasty is a very common procedure performed mainly on active young patients who need great functionality and for whom total joint replacement is contraindicated and arthrodesis is noncompliant. We are going to ...

    Abstract Introduction: The elbow interposition arthroplasty is a very common procedure performed mainly on active young patients who need great functionality and for whom total joint replacement is contraindicated and arthrodesis is noncompliant. We are going to demonstrate a case of a 34-year-old male suffering from malunion of the distal humerus, elbow stiffness, and manifest signs of arthrosis of the dominant limb, treated with the IA Grika technique at a 5-year follow-up.
    Patients and methods: The chosen criteria to evaluate the injured side and the uninjured side during the clinical and radiological follow-up were the objective function and related quality of life, measured by the Mayo Elbow Performance Score (MEPS), and postoperative complications. To assess flexion and supination forces and elbow muscular strength, a hydraulic dynamometer was used.
    Results: At a 5-year follow-up, the results were excellent as during the first year.
    Conclusions: The Grika technique is a valid and feasible option in the treatment of elbow injuries.
    Language English
    Publishing date 2018-04-22
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2684648-2
    ISSN 2090-6757 ; 2090-6749
    ISSN (online) 2090-6757
    ISSN 2090-6749
    DOI 10.1155/2018/8253732
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  8. Article ; Online: Effect of trochleocapitellar index on adult patient-reported outcomes after noncomminuted intra-articular distal humeral fractures.

    Rollo, Giuseppe / Rotini, Roberto / Eygendaal, Denise / Pichierri, Paolo / Bisaccia, Michele / Prkic, Ante / Stasi, Alessandro / Meccariello, Luigi

    Journal of shoulder and elbow surgery

    2018  Volume 27, Issue 7, Page(s) 1326–1332

    Abstract: Background: Anatomic surgical reduction of intra-articular fractures of the distal humerus is important to achieve the best long-term outcomes and prevent post-traumatic arthritis. In this study we compared the radiographic reduction using the ... ...

    Abstract Background: Anatomic surgical reduction of intra-articular fractures of the distal humerus is important to achieve the best long-term outcomes and prevent post-traumatic arthritis. In this study we compared the radiographic reduction using the trochleocapitellar index. We also correlated the trochleocapitellar index to the functional outcomes next to the comparison of the triceps brachii lifting approach and olecranon osteotomy approach, 2 common approaches for distal humeral fractures.
    Methods: From January 2006 to June 2016, patients with elbow fractures were registered in 4 centers. The trochleocapitellar index, a ratio between the angle of the capitellum and the trochlea to the midline of the distal humerus on anterior-posterior radiographs, was calculated for included patients. Functional outcomes were measured using the Oxford Elbow Score and the Mayo Elbow Performance Score. Bone healing was measured using radiographic union scoring.
    Results: There were 86 patients enrolled: 46 in the olecranon osteotomy group and 40 in the triceps lifting group. Functional outcomes and bone healing did not differ between the approaches. Functional results had a medium correlation with the trochleocapitellar index, which did not differ between the 2 approaches (olecranon osteotomy group, κ = 0.56; triceps lifting group, κ = 0.57; P = .7932).
    Conclusions: The trochleocapitellar index has a moderate predictive value on the functional results after 12 months after open reduction and internal fixation of intra-articular distal humeral factures. There is no difference in reduction, as measured by trochlear index and functional outcome scores, between the olecranon osteotomy approach and the triceps brachii lifting approach groups.
    MeSH term(s) Adult ; Aged ; Elbow Joint/surgery ; Female ; Fracture Fixation, Internal ; Humans ; Humeral Fractures/diagnostic imaging ; Humeral Fractures/surgery ; Intra-Articular Fractures/diagnostic imaging ; Intra-Articular Fractures/surgery ; Male ; Middle Aged ; Muscle, Skeletal ; Olecranon Process/surgery ; Open Fracture Reduction ; Osteotomy ; Patient Reported Outcome Measures ; Radiography ; Range of Motion, Articular ; Treatment Outcome
    Language English
    Publishing date 2018-06-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1170782-3
    ISSN 1532-6500 ; 1058-2746
    ISSN (online) 1532-6500
    ISSN 1058-2746
    DOI 10.1016/j.jse.2018.02.073
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 3973: Show issues Location:
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  9. Article ; Online: Surgical treatment of multifragmentary segmental femur shaft fractures with ORIF and bone graft versus MIPO: a prospective control-group study.

    Rollo, Giuseppe / Ronga, Mario / Bonura, Enrico Maria / Erasmo, Rocco / Bisaccia, Michele / Pichierri, Paolo / Marsilio, Antonio / Pasquino, Andrea / Gomez Garrido, David / Franzese, Raffaele / Schiavon, Andrea / Meccariello, Luigi

    Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina

    2020  Volume 17, Issue 2, Page(s) 498–508

    Abstract: Aim Multifragmentary segmental femoral shaft fracture is a high energy injury frequently associated with life-threatening conditions. The aim of this study was to compare the use of bio metallic open reduction internal fixation (ORIF) (plate with ... ...

    Abstract Aim Multifragmentary segmental femoral shaft fracture is a high energy injury frequently associated with life-threatening conditions. The aim of this study was to compare the use of bio metallic open reduction internal fixation (ORIF) (plate with allograft bone strut) with minimally invasive plate osteosynthesis (MIPO) fixation for the treatment of multi-segmental femoral shaft fracture in terms of outcomes, bone healing and complications. Methods Forty patients with segmental femoral shaft fractures were included and divided into two groups: 20 patients treated with ORIF+, 20 with MIPO. All fractures were classified according to AO (Arbeitsgemeinschaft für Osteosynthesefragen) and Winquist and Hansen Classification. Evaluation criteria were: duration of follow up and surgery, Non-Union Scoring System, Pain Visual Analogic Scale (VAS), objective quality of life and hip function, subjective quality of life and knee function, quality of life the Short Form-12 Survey Questionnaires (SF-12), bone healing and femoral alignment (radiographs), Radiographic Union Score for Hip (RUSH). Results Better results of ORIF in terms of complication rate, RUSH, VAS, regression between RUSH and VAS, average correlation clinical-radiographic results and patients' outcomes (Cohen k) were obtained, and similar results for the length of follow up, surgery duration, perioperative blood transfusion, wound healing. No statistical difference for Harris Hip Score (HHS), Knee Society Score (KSS), quality of life (SF-12). Conclusions The ORIF and bone strut allograft technique had better results compared to the MIPO technique with regards to complication rate, RUSH, VAS, regression between RUSH and VAS, and average correlation clinical-radiographic results and patients' outcomes (Cohen k) in the surgical treatment of multifragmentary segmental femoral shaft fractures.
    MeSH term(s) Femur/surgery ; Fracture Healing ; Hip Fractures ; Humans ; Minimally Invasive Surgical Procedures ; Prospective Studies ; Quality of Life ; Retrospective Studies ; Treatment Outcome
    Language English
    Publishing date 2020-04-22
    Publishing country Bosnia and Herzegovina
    Document type Journal Article
    ZDB-ID 2378942-6
    ISSN 1840-2445 ; 1840-0132
    ISSN (online) 1840-2445
    ISSN 1840-0132
    DOI 10.17392/1150-20
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  10. Article ; Online: Platet Rich Plasma or Hyperbaric Oxygen Therapy as callus accellerator in aseptic tibial non union. Evaluate of outcomes.

    Rollo, Giuseppe / Bonura, Enrico Maria / Falzarano, Gabriele / Bisaccia, Michele / Ribes Iborra, Julio / Grubor, Predrag / Filipponi, Marco / Pichierri, Paolo / Hitov, Philip / Leonetti, Danilo / Russi, Valentina / Daghino, Walter / Meccariello, Luigi

    Acta bio-medica : Atenei Parmensis

    2020  Volume 91, Issue 4, Page(s) e2020188

    Abstract: Background and aim of the work: The incidence of long bone non-unions has been estimated to range between 5-10%. Nonunion of fracture is a delayed complication of fracture. A large bone resection, associated with Ilizarov's osteo-distraction technique, ... ...

    Abstract Background and aim of the work: The incidence of long bone non-unions has been estimated to range between 5-10%. Nonunion of fracture is a delayed complication of fracture. A large bone resection, associated with Ilizarov's osteo-distraction technique, is commonly used in these cases. The war experience was very important for dealing with these injuries. The purpose of this study is to report whether the use of Platelet Rich of Plasma(PRP) or Hyperbric Oxygen Therapy(HOT) as an adjuvant to the osteogenic distraction of Ilizarov with respect to the classical method has advantages.
    Methods: From 183 tibial non union, we enrolled 50 patients suffering by Type B according ASAMI non union classification.  We divided the patients into two groups. The first group was a retrospective group of patient treated by Ilizarov Tecnique plus PRP. Instead the second group, patients were treated by Ilizarov Tecnique associated with  HOT. The chosen criteria to evaluate the two groups during the clinical and radiological follow-up were: the complication after the surgery in the two groups; the duration of surgery; the objective quality Bone results and functional results were evaluated according to ASAMI classification while the subjective quality of  life correlated with Ilizarov frame function by the Short Form 12 Health Survey (SF-12); The correlation between bone regenerate/bone healing and X-rays. The evaluation endpoint was set at 12 months from the remotion of Ilizarov's frame for both groups.
    Results: In comparing the complications  of the two populations, there were a significant statistically difference(p<0.05) in the local skin inflammation and Dockin Point Skin retraction  for HOT group while  in refracture  p<0.05 was for group PRP. From the SF-12 we discovered not statistically differences p<0.05. The average correlation between Bone Regenerate-Bone Healing/ X-rays is absolutely in the PRP as in the HOT, p>0.05. The average Time for remove Ilizarov's Frame in months was 15.37(±7.34; range 9-32) in PRP while in HOT was15.22(± 7.83; range 9-31), p>0.05.
    Conclusions: From our study we can conclude that the association of HOT and PRP with the Ilizarov technique does not improve the functional outcomes but allows a more rapid healing of the regenerated bone and therefore an early removal of the device and a corresponding improvement in the quality of life.
    MeSH term(s) Fracture Healing ; Humans ; Hyperbaric Oxygenation ; Platelet-Rich Plasma ; Quality of Life ; Reproducibility of Results ; Retrospective Studies ; Tibial Fractures/therapy
    Language English
    Publishing date 2020-11-10
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 2114240-3
    ISSN 2531-6745 ; 0392-4203
    ISSN (online) 2531-6745
    ISSN 0392-4203
    DOI 10.23750/abm.v91i4.8818
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    In stock of ZB MED Cologne/Königswinter

    Zs.B 925: Show issues Location:
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