Purpose The purpose of this study was to assess the safety and preliminary clinical results of platelet-rich plasma (PRP) injections for treating chronic plantar fasciitis. Methods Fourteen consecutive patients with chronic plantar fasciitis receiving three injections of PRP into the plantar fascia were assessed 12 months after the procedure. The modified Roles and Maudsley score and a visual analogue scale (VAS) for pain were used to evaluate the clinical results. Results According to criteria of the Roles and Maudsley score, at 12 months of follow-up, results were rated as excellent in nine (64.3 %), good in two (14.3 %), acceptable in two (14.3 %) and poor in one (7.1 %) patient. VAS for pain was significantly decreased from 7.1±1.1 before treatment to 1.9±1.5 at the last follow-up (p<0.01). Conclusions In this single-centre, uncontrolled, prospective, preliminary study, results indicate that treating chronic plantar fasciitis with PRP injections is safe and has the potential to reduce pain.

Large, multicentre, powered, randomized trials comparing UKA and TKA are needed to identify the best management for medial OA of the knee. Moreover, new score systems for satisfaction of the patient should be formulated.

Numerous classification systems of non-union have been proposed based on: presence or absence of infection, radiographic features, clinical findings, biologic activity, location and shape. The management of pseudarthrosis is strongly related to the type of non-union (infected versus uninfected, atrophic versus hypertrophic). Surgical management of pseudarthrosis is generally effective with a success rate ranging from 75 to 100%. Nevertheless, in a relatively high number of instances several combined treatments are required for the fracture healing. The current gold standard to stimulate the bone regeneration is represented by the revision surgery with the application of autologous bone grafts. However, several approaches have been described to promote and enhance the bone tissue regeneration, including extracorporeal shock wave therapy (ESWT), ultrasound, electromagnetic, bone morphogenic proteins (BMPs) and platelet-rich-plasma (PRP).The aim of the present study was to perform a systematic review of the literature evaluating the current therapies to promote and enhance the bone tissue healing. The systematic review was performed according to PRISMA guidelines with a PRISMA checklist and algorithm.Limitations of the present systematic review are mainly related to the scanty quality of the studies available in the literature. Although the therapies previously described for the management of patients with non-unions seems to be effective, the limitations of the included studies, especially the extensive clinical heterogeneity, make not possible to provide clear recommendations regarding the application of these approaches. The problems remain the need to better understand the most effective treatment options, subject to surgical stabilization as a first step.

Purpose In the athletic population, the prevalence of isolated syndesmotic lesions is high. To detect potential instability of the ankle is crucial to deine those lesions in need of surgical management. The aim was to deine how the extent of tibio-ibular syndesmotic ligament injury inluences the overall stability of the ankle joint in a cadaver model. Methods Twenty fresh-frozen through knee cadaveric leg specimens were subjected to diferent simulated syndesmotic ligament lesions. In Group 1 (n = 10), the order of ligament sectioning was: anterior tibio-ibular ligament (ATFL), supericial deltoid ligament (SDL), deep deltoid ligament (DDL), posterior tibio-ibular ligament (PTFL), and progressive sectioning at 10, 50 and 100 mm of the distal interosseous membrane (IOM). In Group 2 (n = 10), the sequence was: ATFL, PITFL, 10 and then 50 mm of the distal IOM, SDL, DDL, and 100 mm of the distal IOM. Diastasis of 4 mm in the coronal or sagittal plane and external rotation of the ankle greater than 20° were considered indicative of instability. Results Both coronal and sagittal diastasis exceeded 4 mm with injury patterns characterized by IOM lesions extending beyond 5 cm. External rotation of the ankle exceeded 20° with injury patterns characterized by a DDL lesion. Conclusion Coronal and sagittal plane diastases of the tibio-ibular syndesmosis are particularly afected by sequential lesions involving the IOM, whereas increased external rotation of the ankle most depends on DDL. The identiication of the speciic syndesmotic and deltoid ligament injuries is crucial to understanding which lesions need operative management. The knowledge of which pattern of tibio-ibular syndesmotic ligament injury inluences the ankle joint stability is crucial in deining which lesions need for surgical management.

Suprascapular nerve compression is a rare cause of shoulder pain. We report the clinical features, radiological findings, arthroscopic management and outcome of three patients with suprascapular nerve compression caused by labral ganglion cyst associated with SLAP lesion. We performed simultaneous suture anchor SLAP repair and cyst decompression with a blunt probe. Upon a two-year follow-up, patients recovered full shoulder function without pain or limitations in activities of daily living.