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Background: The aim of this study was to assess the reliability of the videotape scoring system collected during knee arthroscopy for meniscal tears, and to test the consistency with intra-operative findings., Methods: Fifty-seven patients undergoing arthroscopic treatment of meniscal tears were included in the analysis. The cartilage damage was assessed intra-operatively, at six sites, using the Outerbridge scoring system. The meniscal tears were graded according to the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) classification. The presence of synovial inflammation was scored, at four different sites, according to the macro-score method. The total cartilage, meniscal and synovial scores were calculated for each knee by the sum of the maximum grade of the lesions at each anatomic site. In order to assess the reliability of the arthroscopic scoring system, the videotapes recorded during the arthroscopy were reviewed by two independent observers one year after the surgery and compared with the scores completed by the surgeon during the operation., Results: The total cartilage score showed substantial inter-rater and intra-rater reliability, and moderate consistency with the intra-operative score provided by the surgeon. The total meniscal score showed substantial inter-rater and intra-rater reliability, and good consistency with the intra-operative findings. The total synovial score showed substantial inter-rater agreement, substantial intra-rater reliability, and moderate consistency with intra-operative findings., Conclusions: The videotape scoring system provided a reliable and reproducible system for recording the intra-operative state of the whole joint pathology in patients undergoing arthroscopic treatment of meniscal tears., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Human aging is associated with a progressive loss of muscle mass and strength and a concomitant fat accumulation in form of inter-muscular adipose tissue, causing skeletal muscle function decline and immobilization. Fat accumulation can also occur as intra-muscular triglycerides (IMTG) deposition in lipid droplets, which are associated with perilipin proteins, such as Perilipin2 (Plin2). It is not known whether Plin2 expression changes with age and if this has consequences on muscle mass and strength. We studied the expression of Plin2 in the vastus lateralis (VL) muscle of both healthy subjects and patients affected by lower limb mobility limitation of different age. We found that Plin2 expression increases with age, this phenomenon being particularly evident in patients. Moreover, Plin2 expression is inversely correlated with quadriceps strength and VL thickness. To investigate the molecular mechanisms underpinning this phenomenon, we focused on IGF-1/p53 network/signalling pathway, involved in muscle physiology. We found that Plin2 expression strongly correlates with increased p53 activation and reduced IGF-1 expression. To confirm these observations made on humans, we studied mice overexpressing muscle-specific IGF-1, which are protected from sarcopenia. These mice resulted almost negative for the expression of Plin2 and p53 at two years of age. We conclude that fat deposition within skeletal muscle in form of Plin2-coated lipid droplets increases with age and is associated with decreased muscle strength and thickness, likely through an IGF-1- and p53-dependent mechanism. The data also suggest that excessive intramuscular fat accumulation could be the initial trigger for p53 activation and consequent loss of muscle mass and strength.

The molecular mechanisms underlying spermine osteo-inductive activity on human adipose-derived stem cells (ASCs) grown in 3-dimensional (3D) cultures were investigated. Spermine belongs to the polyamine family, naturally occurring, positively charged polycations that are able to control several cellular processes. Spermine was used at a concentration close to that found in platelet-rich plasma (PRP), an autologous blood product containing growth and differentiation factors, which has recently become popular in in vitro and in vivo bone healing and engineering. Adipose tissue was surgically obtained from the hypodermis of patients undergoing hip arthroplasty. Patient age negatively affected both ASC yield and ASC ability to form 3D constructs. ASC 3D cultures were seeded in either non differentiating or chondrogenic conditions, with or without the addition of 5 μM spermine to evaluate its osteogenic potential across 1, 2, and 3 weeks of maturation. Osteogenic medium was used as a reference. The effects of the addition of spermine on molecular markers of osteogenesis, at both gene and protein level, and mineralization were evaluated. The effects of spermine were temporally defined and responsible for the progression from the early to the mature osteoblast differentiation phases. Spermine initially promoted gene and protein expression of Runx-2, an early marker of the osteoblast lineage; then, it increased β-catenin expression and activation, which led to the induction of Osterix gene expression, the mature osteoblast commitment factor. The finding that spermine induces ASC to differentiate toward mature osteoblasts supports the use of these easily accessible mesenchymal stem cells coupled with PRP for orthopedic applications.

The different incidence of various kinds of maxillofacial fractures in children are examined and the causes of such differences are analyzed. The most significant are the variations in morphology of the maxillofacial skeleton during the children's growth and the physical-statistic problems strictly connected. Attention is drawn on the diagnostic difficulties of traumas due to fractures during childhood, sometimes unknown, especially with regard to the heavy functional and aesthetic exits which may occur.

A total of 42 cases of patellar pain in subjects aged an average of 17.2 years submitted to arthroscopy are analyzed. Femoropatellar balance, where indicated, led to resolution of disorders with full resumption of sports activity. In the remaining cases chondromalacia showed the features of an affection with a spontaneously favorable course, confirming the common orientation towards conservative treatment. Arthroscopy is effective for a correct classification of cartilaginous lesions, and it is a good instrument to use when attempting to achieve recovery of patellofemoral joint when disorders are caused by a lack of equilibrium.

Total hip arthroplasty means sacrificing the joint capsule and the mechanoreceptors contained therein. Recent neurophysiological experiences seem to redefine the sensorial and proprioceptive role of the joint capsule in favor of the activity of the muscular mechanoreceptors, particularly in the area of the coxofemoral joint. The authors have examined the sensorial lesion caused by total hip arthroplasty in a group of 20 patients. Clinical testing was conducted prior to surgery, 7 and 40 days later. The tests were aimed at exploring the perceptive and proprioceptive activity of the hip, and showed marked decrease in all of the receptorial activity one week after surgery. After 40 days perceptive function was completely recovered, as the scores for tests conducted were the same as those obtained prior to surgery: proprioceptive activity was instead considerably improved, with significant changes in most parts of the tests. The authors conclude by observing that total hip arthroplasty does not cause permanent lesion of the perception of joint movement; furthermore, renewed coxofemoral mechanics allow for a better proprioceptive response with strengthening of static and dynamic antigravitational reactions.