The first purpose of this study was to verify the association between Instability Severity Index Score (ISIS) and Recurrent Shoulder Dislocation (RSD) after a first episode treated conservatively. The second aim is to identify the risk factors associated with RSD after a primary acute shoulder anterior dislocation treated conservatively. A total of 111 patients with first traumatic anterior shoulder dislocation treated at a single trauma centre between January 2014 and March 2016 were enrolled. The main predictive variables of risk factors and the ISIS score were calculated. Among the 85 patients included, 26 cases of RSD were observed (30.6%). Considering the whole population, no significant association between ISIS and RSD were reported. Regarding other risk factors, high-risk working activities and rotator cuff injury had a significantly higher RSD risk. Sex, dominant limb, familiar history, hyperlaxity, contact or overhead sports, competitive sport, post-reduction physiokinesitherapy, return to sports activity time, Hill-Sachs lesion, bony Bankart lesion and great tuberosity fracture did not seem to influence the risk of RSD. No correlation between ISIS score and RSD in patients treated conservatively after a first episode of shoulder dislocation were reported. The only risk factors with a significant association to RSD were high-risk working activities and rotator cuff injury.

Introduction. A recent attractive option regarding mesenchymal stem cells (MSC) application is the treatment of bone cystic lesions and in particular aneurysmal bone cysts (ABC), in order to stimulate intrinsic healing. We performed a retrospective evaluation of the results obtained at our institution. Methods. The study group consisted of 46 cases with an average follow-up of 33 months. Forty-two patients underwent percutaneous treatment as the first approach; four patients had curettage as first treatment. In all cases, autologous bone marrow concentrate (BMC) was associated too. The healing status was followed up through a plain radiograph 45 days and 2 months after the procedure. Results and Conclusions. At the final follow-up, thirty-six patients healed with a Neer type II aspect, nine healed with a type I aspect, and one patient was not classified having total hip arthroplasty. Bone marrow concentrate is easy to obtain and to manipulate and can be immediately available in a clinical setting. We can assert that the use of BMC must be encouraged being harmless and having an unquestionable high osteogenic and healing potential in bone defects.

Background Synovial sarcoma is a rare malignant tumor that generally requires a multidisciplinary therapeutic approach. In this study we report the experience of a single surgeon, evaluating surgical and oncological outcomes of the cases he treated through his 30 years carrier. Methods We enrolled patients treated surgically between 1988 and 2018. Surgical and medical treatments, as well as surgical and oncological results, were investigated. Results One hundred and thirty cases were included. Surgical resection was carried out achieving wide margins in 90% of the cases. At their latest follow‐up, 76 patients were continuously disease free, 16 were no evidence of disease, and other 16 were alive with disease. Twenty cases were dead of disease and two dead of other causes. Twenty‐five patients (19%) had local recurrence of synovial sarcoma through their postoperative intercourse. Thirty‐seven patients (28%) were diagnosed with at least a metastasis during their follow‐up. The global survival of our population, at each patient's latest follow‐up, was 82%. Cases with tumor size above 5 cm had a significantly higher risk to develop metastasis (p = 0.002). Conclusions Synovial sarcoma is a threatening disease and represents a challenge for oncological physicians and surgeons. Early diagnosis and multidisciplinary approach are mandatory to limit the spread of synovial sarcomas, maximizing the effectiveness of surgery and the other treatments.

<p><strong>Aim</strong> <br />To evaluate radiological and clinical outcomes of a case series of patients affected by glenohumeral instability (Bankart lesion) or superior labrum tear from anterior to posterior (SLAP) lesions treated by arthroscopic repair using all-suture anchors.<br /><strong>Methods <br /></strong>Patients were operated by a single surgeon at a single Institution. Exclusion criteria were chondral lesions of the glenoid,<br />rotator cuff lesions, previous surgery at the index shoulder, or a bony Bankart lesion. Position and numbers of anchors used depended on the dimension and type of lesion. The DASH (Disability of the Arm, Shoulder and Hand) and Constant scores were used for subjective and clinical evaluation at follow-ups (FUs); also, at  1-year FU, MRI scan was obtained to evaluate bone reaction to the implanted devices.<br /><strong>Results<br /></strong> Fifty-four patients were included. A mean of 2.7 devices per patient (145 in total) were implanted. Mean FU was 30 (range 12 – 48) months. No patient reported recurrent instability, nor hardware-related complications were registered. MRI analyses showed that 119 (82%) implants did not alter surrounding bone (grade 0), 26 (18%) implants were surrounded by bone oedema (grade 1), while no bone tunnel enlargement nor a bone cyst (grade 2 or 3, respectively) were registered.<br /><strong>Conclusion<br /></strong> This study confirmed the efficacy and safety of a specific all-suture anchor system in the arthroscopic repair of the glenoid labrum for glenohumeral instability or a SLAP lesion. In the short- and mid-term period, these devices were associated with good clinical and radiological outcomes without clinical failures or reaction at bone-device interface.</p>

No abstract