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Background:The ‘medial thigh lift’ was first described by Lewis in 1957, but did not receive the widespread acceptance because of the various postoperative complications, such as scar migration with vulvar deformities and early recurrence of ptosis. For this reason, Lockwood developed a technique of anchoring the dermis to the Colles’ fascia, to make the surgical outcome more stable over time and to prevent scar migration. In this article, we describe our approaches to the medial thigh lift in post-bariatric surgery patients.Materials and Methods:A total of 45 females underwent medial thigh reduction. In 15 patients with Grade 2 on Pittsburgh Scale (PS), we performed a thigh lift with a horizontal scar; in 15 patients with Grade 2 on PS, we used a technique with a vertical scar; in 15 patients with Grade 3 on PS, the above-mentioned two procedures were combined. When it was really necessary, we also did the liposuction of the medial thigh. The patients were observed every 6 months with a 60-month median follow-up (range: 12–108 months).Results:In six patients was observed scar enlargement due to poor wound healing (one patient with a horizontal scar, three patients with a vertical scar and two with the combined procedure). In two patients with a horizontal scar, minimal scar migration was observed. In three patients, the recurrence of ptosis was evident (one patient with a horizontal scar and two patients with the combined procedure). No skin necrosis was observed.Conclusion:The medial thigh lift surgery is remarkably simple and free of major complications, if the basic anatomy of this region is understood, in order to preserve important structures such as the great saphenous vein and femoral vessels. The only complication is the presence of extensive and visible scars along the thigh, in the case of vertical procedure, and along the inguinal canal, with a possible distortion of the labia major, in the case of horizontal procedure.

Introduction: Osteoarthritis (OA) is a common chronic joint disease characterized by pain, deformity, instability, reduction of motion and function. It is one of the main causes of disability in older adults, affecting about 10% of men and 18% of women over the age of sixty. There are several Guidelines that support the general clinical decision-making process. However, it is necessary to define an integrated management model for patients with OA to ensure an appropriate and quality healthcare. Methods: The objective of the analysis is to determine the economic burden linked to the prevalence and incidence of OA in the acute and chronic phases from the perspective of the National Health Service (NHS) and the entire society. A comparison was made between the management according to the clinical practice and the appropriate management according to National and International Guidelines, determining for each scenario the level of resources absorbed. Results: Patients who started a nonsteroidal anti-inflammatory drug (NSAID)-based therapy in clinical practice resulted in a higher absorption of resources of €363.87 than the same patient managed by referring to National and International Guidelines. Conclusions: OA is associated with a high economic burden and it is a priority problem for public health internationally. The savings resulting from our research, if generalized to the entire Italian population, would lead to a significant reduction of OA economic burden, thus allowing a reallocation of the available resources to other NHS’ sectors.