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Background: Total ankle arthroplasty (TAA) is an effective treatment for severe end-stage ankle osteoarthritis (AO). Despite satisfactory results, range of motion (ROM) is still suboptimal compared to healthy ankles. This issue may stem from different conditions, and the difficulty in accurately restoring the height of the joint line may be one of them. Recent studies in TAA have demonstrated that an elevated joint line is associated with reduced postoperative ROM and poorer functional scores. To improve the accuracy of bone resection and implant positioning, the use of patient-specific instruments (PSIs) has been proposed. The aim of this study is to compare joint line height, ROM, and functional clinical outcomes between standard TAA and TAA using PSI. Methods: A retrospective analysis was conducted on a consecutive cohort of patients who underwent standard TAA and TAA with PSI between January 2020 and December 2022. Radiographic assessments, including measurement of joint line height ratio (JLHR) and ROM, were performed. The clinical outcome was assessed using the Forgotten Joint Score. Result: Fifty-one patients underwent standard TAA, whereas 13 received TAA with PSI. The mean JLHR preoperatively was 1.51 ± 0.24 and postoperatively was 1.56 ± 0.23 in the standard TAA group ( P = .056). Conversely, the mean JLHR of PSI TAA group passed from 1.52 ± 0.19 to 1.41 ± 0.21 after TAA ( P

Background: In this study, we hypothesized that safety footwear (SF) impacts gait patterns, potentially contributing to the podiatric symptoms reported by workers. The purpose of this work was to compare the gait analyses of workers wearing SF and sneakers using inertial sensors while also examining the occurrence of foot problems. Methods: A consecutive cohort of workers from different occupational sectors who wore SF during their work shifts were prospectively assessed through a gait analysis. The gait analysis was conducted under two conditions: first, while wearing SF, and second, while wearing sneakers. In both conditions, inertial sensors were used (Wiva® MOB). Participants also underwent a podiatric physical examination to evaluate foot problems. Results: This study shows that SF resulted in a worsening gait pattern compared to sneakers in both genders. The impact was particularly pronounced in female participants, resulting in a significant decline in walking speed and cadence. Discomfort was reported by 83.3% of participants, with a higher prevalence in females (46.6% vs. 36.6%). The SF group exhibited an elevated prevalence of foot problems, with no significant gender variations. It seems that foot problems are more likely to occur when a foot deformity, such as flat or cavus foot or hallux valgus, is present. Conclusions: This study suggests that SF may contribute to the reported podiatric symptoms among workers. Certain footwear characteristics, including weight, mis-fit, and inadequate design, may be factors associated with footwear discomfort and adverse gait patterns, potentially leading to increased foot problems among workers.

Background: Aneurysms of visceral abdominal arteries represent less than 3 % of all splanchnic aneurysms. Pathology is poorly understood but recent studies have focused on the role of inflammation which it can be further enhanced by a systemic inflammatory disease. Materials and Methods: A systematic literature review was conducted to highlight the unsolved aspects of this pathology and a total of 43 patients were retrieved to whom we added 1 patient treated at our Institution. Results: Mean age at presentation was 54 years with a peak of incidence between the 6th and the 7th decades of life. No racial, sex, and age differences were observed among the two groups (P=NS). In 10 (23 %) patients an inflammatory disease was associated. However, the risk of rupture was similar between patients affected with an inflammatory disease and those with a sporadic presentation (P=NS). Color ultrasound was seldomly used but its role is questionable especially in an emergency setting because of the well-known limitations. On the other hand, computed tomography angiogram always permitted diagnosis. Surgery is the treatment of choice to prevent emergent surgery. If feasible, an endovascular approach should be used either in elective or emergent setting. However, hemodynamically unstable patients should be promptly operated on with an open approach. There were 4 (9 %) deaths 1 before surgery, 3 during operation. Conclusions: Although in our revision we were unable to demonstrate that patients affected with an autoimmune diseases or chronic inflammatory conditions might have a higher risk of visceral aneurysm rupture, we recommend a proactive screening approach based on regular monitor of these patients for the presence of visceral aneurysms.

Abstract Purpose This retrospective radiological analysis aimed to assess the accuracy of implant positioning in patients with ankle arthritis undergoing custom‐made total ankle arthroplasty (TAA) with patient‐specific instrumentation (PSI) compared with preoperative planning. Methods Patients who underwent custom‐made TAA with PSI from January 2018 to March 2023 were retrospectively evaluated, focusing on the tibial anterior surface (TAS) angle, tibial lateral surface (TLS) angle and tibiotalar ratio (TTR). Additionally, data regarding the time from the preoperative computed tomography (CT) scan to surgery, associated procedures and complications were recorded. Results No associated procedures were performed, and only one intraoperative complication, an iatrogenic lateral malleolar fracture, was recorded. In the coronal plane, custom‐made TAA with PSI consistently achieved precise positioning of prosthetic components, even in cases with significant preoperative deformities or bone deficits. However, a statistically significant deviation from the planned values was observed in the sagittal plane (p = 0.007). A notable correlation was identified between the time elapsed from the preoperative CT scan to surgery and the deviation from the planned to the actual postoperative TAS angle (p

Foot and ankle disorders are a very common diseases, represent a risk factor for falls in older people, and are associated with difficulty performing activities of daily living. With an increasing demand for cost-effective and high-quality clinical services, wearable technology can be strategic in extending our reach to patients with foot and ankle disorders. In recent years, wearable sensors have been increasingly utilized to assess the clinical outcomes of surgery, rehabilitation, and orthotic treatments. This article highlights recent achievements and developments in wearable sensor-based foot and ankle clinical assessment. An increasing number of studies have established the feasibility and effectiveness of wearable technology tools for foot and ankle disorders. Different methods and outcomes for feasibility studies have been introduced, such as satisfaction and efficacy in rehabilitation, surgical, and orthotic treatments. Currently, the widespread application of wearable sensors in clinical fields is hindered by a lack of robust evidence; in fact, only a few tests and analysis protocols are validated with cut-off values reported in the literature. However, nowadays, these tools are useful in quantifying clinical results before and after clinical treatments, providing useful data, also collected in real-life conditions, on the results of therapies.

Multiciliated cells (MCCs) serve many important functions, including fluid propulsion and chemo- and mechanosensing. Diseases ranging from rare conditions to the recent COVID-19 global health pandemic have been linked to MCC defects. In recent years, the zebrafish has emerged as a model to investigate the biology of MCCs. Here, we review the major events in MCC formation including centriole biogenesis and basal body docking. Then, we discuss studies on the role of MCCs in diseases of the brain, respiratory, kidney and reproductive systems, as well as recent findings about the link between MCCs and SARS-CoV-2. Next, we explore why the zebrafish is a useful model to study MCCs and provide a comprehensive overview of previous studies of genetic components essential for MCC development and motility across three major tissues in the zebrafish: the pronephros, brain ependymal cells and nasal placode. Taken together, here we provide a cohesive summary of MCC research using the zebrafish and its future potential for expanding our understanding of MCC-related disease states.

Scaffolds are widely used devices for the treatment of osteochondral lesions of the talus (OCLT), aimed at enhancing mechanical stability and fostering chondrogenic differentiation. A systematic review and meta-analysis were performed to evaluate the safety, and clinical and radiological results of scaffolds for OCLT management. On 2 January 2024, a search was performed in four databases (PubMed, Embase, Web of Science, and Scopus), according to PRISMA guidelines. The risk of bias in the included studies was also evaluated. Thirty clinical studies were included in the qualitative analysis: 12 retrospective case series, 3 retrospective comparative studies, 9 prospective case series, 1 prospective comparative study, and 1 Randomized Controlled Trial (RCT). Natural scaffolds, such as bilayer collagen (COLL)I/III and hyaluronic scaffolds, were the most employed. Only minor adverse events were observed, even if more serious complications were shown, especially after medial malleolar osteotomy. An overall clinical and radiological improvement was observed after a mean of 36.3 months of follow-up. Patient age and Body Mass Index (BMI), lesion size, and location were correlated with the clinical outcomes, while meta-analysis revealed significant improvement in clinical scores with hyaluronic scaffolds compared to microfracture alone. This study highlights the safety and positive clinical outcomes associated with the use of scaffolds for OCLT. In the few available comparative studies, scaffolds have also demonstrated superior clinical outcomes compared to microfractures alone. Nevertheless, the analysis has shown the limitations of the current literature, characterized by an overall low quality and scarcity of RCTs.