Background: The objective of the arthroscopic treatment in tibial spine avulsion fractures (TSAF) is to achieve firm reduction and strong internal fixation while still having the patient undergo a minimally invasive procedure. Material and methods: The study was performed on 12 young patients with avulsion fracture of the anterior tibial spine. All 12 patients had type 3 Modified Meyers and McKeever fractures. The injury mechanism was direct anterior to posterior trauma in full leg length hyperextension with sport trauma reported in all cases. The physical examination revealed decreased range of motion, extension deficit, and pain during walking. Radiology, MRI, and CT pathologic findings described complete fracture of the anterior tibial spine with no clear signs of callus formation at the time of examination. All patients underwent arthroscopic suture surgical treatment. The Tegner, the Lysholm, and the International Knee Documentation Committee (IKDC) scores were used to evaluate subjective outcomes at three and six months after the surgery. Radiographs were used to assess callus formation and healing status of the fracture. Results: The mean IKDC score was 33.4 ± 23.3 (p = 0.032) preoperatively and 84.2 ± 14.3 at final follow-up (p = 0.0032, CI = 95%). The mean Tegner score improved from 3.8 ± 1.1 pre-operatively to 6.7 ± 2.2 at six months follow-up (p = 0.0231, CI = 95%). The Lysholm score differed significantly at baseline compared to final follow-up (53.7 ± 17.3 vs. 87.7 ± 9.9; p = 0.0066, CI = 95%). In all cases (n = 12), the radiographs taken after six months revealed the healing of the fracture in the anatomic position without secondary displacement. No functional knee instability was detected at the end of the study. Conclusions: The study provides preliminary promising results regarding fracture healing, knee stability, and functional subjective scores. Patient selection was a major factor of success prediction for this technique.

The functions and clinical consequences of the fabella, a sesamoid bone found in the posterolateral aspect of the knee joint, are still a reason of intense debate in the scientific literature. Its incidence was reported to range between 20% and 87% and its presence was usually associated with the persistent pain in the posterolateral region of the knee. The aim of our study was to measure the prevalence, anatomic and clinical features of the fabella within a cross-sectional study, conducted in a Romanian orthopaedic center. Between 2015 and 2017, a consecutive series of 562 patients with knee injuries or persistent knee pain has been examined by radiographs and Magnetic Resonance Imaging and a set of anatomical and clinical parameters have been recorded. Collected data was evaluated with RadiANT DICOM Viewer and statistically analyzed with GraphPad Prism 7. The level of significance was set at P <.05. The incidence of the fabella in our study group was 16.93%, lower than previously reported for Caucasian populations. We found statistically significant differences regarding the possible association of the fabella with pain in the posterolateral corner of the knee ( P = .04) and the 2 dimensions of the bone according to gender ( P = .03 respectively P = .01), but the prevalence was not influenced by gender ( P = .6). The anatomic characteristics could be important in differentiating this sesamoid bone from calcifications or loose bodies located in the knee joint region. Due to the high association with the posterolateral knee pain, the fabella should be recorded during knee examination as a differential diagnosis, before any surgical procedure.

The bronchial stump fistula shown by patients undergoing adjusted pulmonary resections is an extremely severe condition affecting the prognosis of this patients. Within our study, we have used an innovative technique of closing the bronchial stump for 38 patients undergoing adjusted pulmonary resections. The suture of the bronchial stump was made through an innovative method, by practicing the suture with isolated 2.0 Prolene wires armed with patches of Polypropylene. The incidence of the bronchial stump fistula for the observed lot was of 5.26% (2 cases), smaller than the one reported in the specialty literature. In this respect, we consider that the use of Polypropylene in the techniques of closing the bronchial blunt can be beneficial.

A challenging problem in orthopedic practice is represented by bone defects may they occur from trauma, malignancy, infection or congenital disease. Bioactive Glasses have a widely recognized ability to foster the growth of bone cells, and to bond strongly with both hard and soft tissues. Upon implantation, Bioactive Glasses undergoes specific reactions, leading to the formation of an amorphous calcium phosphate or crystalline hydroxyapatite phase on the surface of the glass, which is responsible for its strong bonding with the surrounding tissue. This phenomenon sustains a more rapid healing of bone defects and presents great antibacterial properties. In this paper we report on a clinical study that uses S53P4 Bioactive Glass to successfully treat bone defects and testify of the good compatibility of this material with human tissues.