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deformity when there is a varus deformity of the tibial plafond and degenerative arthritis of knee and ankle ( Fig. 2 ). However, most authors have performed peri-talar osteotomies for joint preservation in asymmetrical ankle arthritis. Common joint
Sengkang General Hospital, Singapore
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Osteoarthritis (OA) is a global health issue with myriad pathophysiological factors and is one of the most common causes of chronic disability in adults due to pain and altered joint function.
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The end stage of OA develops from a destructive inflammatory cycle, driven by the pro-inflammatory cytokines interleukin-1β (IL-1β) and tumour necrosis factor alpha (TNFα).
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Owing to the less predictable results of total knee arthroplasty (TKA) in younger patients presenting with knee OA, there has been a surge in research evaluating less invasive biological treatment options, one of which is autologous protein solution (APS).
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APS is an autologous blood derivative obtained by using a proprietary device, made of APS separator, which isolates white blood cells (WBCs) and platelets in a small volume of plasma, and APS concentrator, which further concentrates platelets, WBCs and plasma proteins, resulting in a concentrated solution with high levels of growth factors including the anti-inflammatory mediators against IL-1β and TNFα.
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A single intraarticular injection of APS appears to be a promising solution for treatment of early-stage OA from current evidence, the majority of which comes from preclinical studies.
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More clinical studies are needed before APS can be widely accepted as a treatment modality for OA.
Cite this article: EFORT Open Rev 2021;6:716-726. DOI: 10.1302/2058-5241.6.200040
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appropriate care and treatment. 11 Magnetic resonance imaging (MRI) is an indispensable tool for detection of the initial lesion of ONFH with 90–100% sensitivity. 12 , 13 Despite the lack of concrete data regarding the most optimal joint-preservation
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School of Surgery, University of Western Australia, Perth, Australia
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The Trillat procedure, initially described by Albert Trillat, is historically one of the first techniques for addressing recurrent anterior shoulder instability, incorporating fascinating biomechanical mechanisms.
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After lowering, medializing, and fixing the coracoid process to the glenoid neck, the subcoracoid space is reduced, the subscapularis lowered, and its line of pull changed, accentuating the function of the subscapularis as a humeral head depressor centering the glenohumeral joint. Furthermore, the conjoint tendon creates a ‘seatbelt’ effect, preventing anteroinferior humeral head dislocation.
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Even though contemporary preferences lean towards arthroscopic Bankart repair with optional remplissage, bone augmentation, and the Latarjet procedure, enduring surgical indications remain valid for the Trillat procedure, which offers joint preservation and superior outcomes in two distinct scenarios: (i) older patients with massive irreparable cuff tears and anterior recurrent instability with an intact subscapularis tendon regardless of the extent of glenoid bone loss; (ii) younger patients with instability associated shoulder joint capsule hyperlaxity without concomitant injuries (glenoid bone loss, large Hill–Sachs lesion).
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Complications associated with the Trillat procedure include recurrent anterior instability, potential overtightening of the coracoid, leading to pain and a significant reduction in range of motion, risk of subcoracoid impingement, and restriction of external rotation by up to 10°, a limitation that is generally well-tolerated.
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The Trillat procedure may be an effective alternative technique for specific indications and should remain part of the surgical armamentarium for addressing anterior shoulder instability.
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Preservation Surgery ; vol 1 . New York, NY : Springer-Verlag New York Inc. , 2015 . 18. Nho SJ Leunig M Larson CM Bedi A Kelly BT , eds. Hip Arthroscopy and Hip Joint Preservation Surgery ; vol 2 . New
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the foot becomes stiffer and less adaptable. Joint preservation and decreased deterioration of the deformities can be obtained by balancing of the affected muscles; therefore, various soft-tissue procedures are prefered while the deformity is flexible
Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy.
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According to Ayoub and Gad, 5 age (younger than 30 years) and post-operative neck-shaft angle (lower than 130°) are the main predicting factors for the best outcomes of surgical joint preservation techniques. On the contrary, time elapsed since the
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Perthes disease, torsional abnormalities together with the development of new surgical approaches and procedures, have revolutionized the field of joint preserving surgery. The utilization of joint preservation operations including hip arthroscopy
Institut du mouvement et de l’appareil locomoteur, Marseille, France
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compartment cartilage status was recorded at the first and second stages of arthroscopy, before and after MOWHTO, according to the International Cartilage Regeneration and Joint Preservation Society grade (ICRS) ( 25 ). ICRS grade 1 involved superficial
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treatment of giant-cell tumor around the knee: a retrospective study of 27 cases . Medicine (Baltimore) 2018 ; 97 : e13154 . 22. Ayerza MA Aponte-Tinao LA Farfalli GL Restrepo CA Muscolo DL . Joint
