Reported complications of surgery for ASD in the recent literature are frequent (24-36% perioperative plus 11-15% late). Open procedures were the most extensively reported in the literature. Complication rates are similar for OP and MIS. HP presented higher IOC likely due to the combination of OP and MIS respective complications. Small number of studies and heterogeneity in reporting could result in risk of bias in these results. Large-scale registry-based studies can fill this gap in the future. These slides can be retrieved under Electronic Supplementary Material.

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The use of primary cementless stems in femoral revision has gained popularity, but no clear consensus about the correct indication is still present. The aim of our systematic review is to: (1) summarize the available literature focused on the use of cementless primary stem in revision total hip arthroplasty (THA); (2) evaluate whether the use of cementless primary stems could represent a feasible option in hip revision; (3) define the proper indication of this surgical approach. A systematic literature review was performed about the use of cementless primary stems in revision THA. The PRISMA 2009 checklist was considered to edit our review. A total of nine articles were included. The current evidence is primarily Level IV. A total of 439 patients (454 hips) underwent THA revision with primary cementless stem. Partial cementless porous coated stems were used in 246 hips (54.2%). The majority of patients were affected by type I or II Paprosky femoral defects. The mean stem-related survival rate is 95.6% ± 3.8 with a mean follow-up of 4.7 years ± 1.3. Poor standardization of methodological analysis was observed. Current literature shows lacking evidence about primary cementless stems in revision THA. Despite these limitations, we can affirm that primary cementless stems in femoral revision surgery represent a viable option in selected patients. The proper indication is a patient with femoral Paprosky defect types I or II, with low number of previous surgeries and a previous cementless stem.

Regenerative medicine, such as the use of mesenchymal stem cells or platelet-rich plasma, in intradiscal disc degeneration has shown preclinical and clinical positive results. Randomized clinical trials studying the potential of MSCs intradiscal injection have not been conducted, and PRP effect has been studied only preliminarily. Additional more powered high-quality studies are needed to really appreciate the long-term safety and efficacy of regenerative medicine approaches in IDD.