Background As the coronavirus pandemic spreads, more and more people are infected with SARS-CoV-2. The short- and medium-term effects of the infection have been described, but the description of the long-term sequelae is lacking in the literature. Methods Patients healed from Covid-19 from February 2020 to May 2020 were considered for inclusion in this study, regardless of the severity of the disease during the acute phase. Eligible patients were consecutively contacted and a semi-structured interview was administered between February and March 2021 by trained medical staff. Results 303 patients were eligible and accepted to participate in the study and were enrolled. Most patients (81%) reported at least one symptom of those surveyed, and the most prevalent symptoms related to fatigue (52%), pain (48%) and sleep disorders (47%). Sensory alterations were present in 28% of surveyed patients, but in most of these cases (74% of those affected by sensory alterations or 20% of the overall sample) symptoms reported were either anosmia or dysgeusia. Higher prevalence was generally observed with increasing age, although the most relevant differences were observed when comparing young vs middle-aged adults. Conclusion At 12-months after acute infection, COVID-19 survivors were still suffering of symptoms identified at shorter follow-up including fatigue, pain and sleep disorders among the most frequent. A more severe impairment in the acute phase did not seem to predict more severe complications.

No abstract

Background: The rapid diffusion of Coronavirus disease (COVID-19) in Northern Italy led the Italian government to dictate a national lockdown from 12 March 2020 to 5 May 2020. The aim of this observational cohort study is to analyze the differences in the number of pediatric patients’ admission to the Emergency Room (ER) and in the type and causes of injury. Methods: The pediatric population during the pandemic was compared to a similar group of patients admitted to the ER in 2019. Sex, age, triage color-code at admission, cause of trauma and presence of symptoms related to COVID-19 infection, discharge diagnosis and discharge modes were investigated. Results: The lockdown period led to a reduction of 87.0% in ER admissions with a particular decrease in patients older than 12 years old. Moreover, a trend towards more severe codes and an increase in home-related injuries were observed during the pandemic, whereas the diagnosis of fracture was less frequent in the pre-pandemic group (p < 0.0001). Conclusions: A significant decrease in the ER attendances was reported during the lockdown. A shift in the cause and type of injury was observed; only the most serious traumas sought medical care with a higher percentage of severe triage codes and fractures.

One year after SARS-CoV-2 infection, most patients (81%) presented at least one symptom with the most prevalent being fatigue and weakness (52%), muscle and joint pain (48%), sleep disorders (47%), neurological and cognitive impairment (36%), and respiratory disorders (36%).

Background: The coronavirus disease 2019 (COVID-19) pandemic outbreak has posed new problems in the context of patients suffering from other diseases. In particular, musculoskeletal sequelae related to the state of debilitation associated with COVID-19 are important to consider in elderly patients undergoing surgery after lower limbs fracture, especially in the post-operative period. The objective of this study was to evaluate whether COVID-19 influenced biochemical parameter, recovery and mortality of surgically treated patients suffering from lower extremity fractures. Methods: Laboratory and clinical data of 30 patients were extrapolated and analyzed in the pre-operative and post-operative periods. Among these patients, 13 had COVID-19 infection (COVID-19 +), whereas 17 had no signs of COVID-19 infections (COVID-19 −). Long-term clinical and functional outcomes were also analyzed. Results: Lower calcium, slightly higher values of CRP and much higher values of CPK and AST were observed pre-operatively in COVID-19 + patients, who also showed higher prevalence of long-term sequelae than COVID-19 − patients. Conclusions: COVID-19 affects long-term outcome of elderly patients with lower limb fractures in a multifactorial way. First, the virus directly damages the muscle tissue. Secondly, the lung function impairment worsens the overall performance, making rehabilitation more challenging.

Purpose Primary objective in most of the published literature on computer‐assisted total knee arthroplasty (TKA) has so far been the comparison of axial alignment and components position, obtained either through navigation systems or through conventional instrumentation. We have found no studies aimed at assessing the intraoperative reliability of a navigation system in relation to bone cuts height. Aim of our study was therefore to establish bone cut accuracy of a pinless navigation system. Methods From January 2014 to February 2016, 44 consecutive patients requiring total knee replacement (TKR) were enrolled in a prospective study. Primary end point of the study was to assess the accuracy of the DASH iPOD TOUCH Navigation System (Brainlab AG, Feldkirchen, Germany) by measuring the real thickness of both tibial and femoral osteotomies. We compared the data indicated by the navigation system with the intraoperative anatomical measurements done with the aid of a caliper. In addition, the radiographic alignment was compared with the data derived from the navigator. Results The device proved to be precise. Differences between the two methods of measurement are distributed over a millimeter range. Radiological measurements showed that 95.5% of tibial components were within the range of 3° varus/valgus; same results were obtained by the navigation system; instead, 90.1% of femoral components were within the range of 3° varus/valgus based on the radiological measurement, whereas according to the navigation system, 86.4% were in this range. Conclusions The DASH iPOD TOUCH Navigation System is a precise and reliable instrument to assist in TKA navigation.

Background: The rapid diffusion of Coronavirus disease (Covid-19) in Northern Italy led Italian government to dictate national lockdown since March 12th 2020 to May 5th 2020. Aim of the study is to analyze the differences in the number of pediatric patients’ admission to the Emergency Room (ER) and in the type and causes of injury. Methods: The pediatric population was divided in a Pandemic group (PG) and Non-Pandemic group (NP). Sex, age, triage color-code at admission, declared cause of trauma and presence of symptoms related to COVID-19 infection, discharge diagnosis and discharge modes were investigated. Results: The Lockdown period led to a reduction of 87.0% in the ER admissions with a particular decrease in patients older than 12 years old from 41.8% in NG to 22.3% in PG. Moreover, a trend towards more severe codes was observed in the PG and the diagnosis of fracture was less frequent in NG (p<0,0001) and injuries at home were more frequent (34.8% compared to 6.8% in NG).Conclusions: A significant decrease in the ER attendances in our Trauma Hub center was reported after the outbreak of Covid-19 pandemic. Furthermore, a shift in the cause and type of injury undoubtedly was observed and only the most serious traumas sought the medical care with an higher percentage of severe triage codes and fractures.Level of evidence: III

Menisci are crucial structures for knee homeostasis. After a meniscal lesion, the golden rule, now, is to save as much meniscus as possible; only the meniscus tissue that is identified as unrepairable should be excised, and meniscal sutures find more and more indications. Several different methods have been proposed to improve meniscal healing. They include very basic techniques, such as needling, abrasion, trephination and gluing, or more complex methods, such as synovial flaps, meniscal wrapping or the application of fibrin clots. Basic research of meniscal substitutes has also become very active in the last decades. The aim of this literature review is to analyze possible therapeutic and surgical options that go beyond traditional meniscal surgery: from scaffolds, which are made of different kind of polymers, such as natural, synthetic or hydrogel components, to new technologies, such as 3-D printing construct or hybrid biomaterials made of scaffolds and specific cells. These recent advances show that there is great interest in the development of new materials for meniscal reconstruction and that, with the development of new biomaterials, there will be the possibility of better management of meniscal injuries