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J Orthop Traumatol. 2018 Dec 7;19(1):21. doi: 10.1186/s10195-018-0514-y.
Long-term results of the M2A-38-mm metal-on-metal articulation.
Trevisan C(1), Piscitello S(2), Klumpp R(2), Mascitti T(2).

(1)UOC Ortopedia e Traumatologia, Ospedale Bolognini ASST Bergamo Est, Seriate,
Italy. carlo.trevisan@tiscali.it.
(2)UOC Ortopedia e Traumatologia, Ospedale Bolognini ASST Bergamo Est, Seriate,
Italy.

BACKGROUND: Large-diameter head metal-on-metal (MoM) bearings in total hip arthroplasty (THA) are associated with increased whole blood levels of chromium (Cr) and cobalt (Co), adverse reactions to metal debris (ARMD) and poor survival rates. The prevalence of high metals concentrations, ARMD and the risk of revision surgery may vary significantly among different prostheses and long-term studies are few. This single-center study reports the long-term results of the 38-mm MoM bearing system.
MATERIALS AND METHODS: Between 2003 and 2009, 80 patients received primary cementless THA using the large head metal-on-metal articulating surface M2A-38 cup (Biomet, Inc., Warsaw, IN, USA) at a single institution. Forty-five patients (53 hips) were retrospectively reviewed for a mean follow-up of 127 months.
RESULTS: Two cups were revised. The cumulative implant survival rate was 98% at 10 years and 74% at 13 years. In the whole sample, the median Co and Cr concentrations were 4.8 µg/L (IQR 1.2-4.9 µg/L) and 2.5 µg/L (IQR 0.6-3.0 µg/L), respectively. The incidence of Co or Cr levels > 7 μg/L was 15.5% and the incidence of ARMD was 3.8%. Co and Cr levels showed no correlation with cup inclination, Harris Hip Score, or total Hip Disability and Osteoarthritis Outcome score.
CONCLUSIONS: Our results confirm that the problems of release of metal ions with the possible increase of metal circulating levels and of adverse reactions may also occur in the long term with this brand of MoM large head, and that a structured follow-up program is mandatory.
LEVELS OF EVIDENCE: Level 4.
DOI: 10.1186/s10195-018-0514-y
PMCID: PMC6286272
PMID: 30535952

Foot (Edinb). 2018 Dec;37:11-15. doi: 10.1016/j.foot.2018.06.003. Epub 2018 Jun 18.
The Cunéo and Picot fracture-dislocation of the ankle: A case report and review of the literature.
Klumpp R(1), Compagnoni R(2), Zeppieri M(3), Trevisan CL(4).

Author information:
(1)ASST Bergamo Est, Ospedale "Bolognini", Seriate, Bergamo, Italy. Electronic
address: rayklu@gmail.com.
(2)ASST "Gaetano Pini" - CTO, 20122 Milano, Italy.
(3)Azienda Ospedaliero-Universitaria "Santa Maria della Misericordia", Udine,
Italy.
(4)ASST Bergamo Est, Ospedale "Bolognini", Seriate, Bergamo, Italy.

The Cunéo and Picot fracture-dislocation is an atypical trimalleolar fracture-dislocation of the ankle with unique anatomopathologic and radiographic
features, which has not been reported in English literature. We report a case of a 42-year-old woman that was diagnosed with a trimalleolar fracture-dislocation and treated surgically with an open reduction and osteosynthesis of the lateral and medial malleolus. At one-month follow-up, X-rays showed secondary displacement of the medial malleolus requiring revision surgery. The patient complained of persisting pain, with X-rays showing no signs of apparent fracture displacement. A CT scan performed after hardware removal 10 months after trauma showed severe ankle arthritis and fracture malunion at the level of the syndesmosis. The patient was retrospectively diagnosed with a Cunéo and Picot fracture-dislocation. The treatment of trimalleolar fractures is discussed, especially regarding the correct indication of synthesis of the posterior malleolus. Cunéo and Picot fractures are usually inherently unstable even if the posterior malleolar fragment may be small and can easily be recognized from standard X-rays. Whenever this type of fracture is not correctly recognized and managed by osteosynthesis of only the medial and lateral malleolus, clinical
outcomes and radiographic follow-ups tend to be unsatisfactory. Fixation of the posterior malleolus is indicated in the management of Cunéo and Picot fractures.
Level of clinical evidence: 4.
Copyright © 2018 Elsevier Ltd. All rights reserved.
DOI: 10.1016/j.foot.2018.06.003
PMID: 30321853

Aging Clin Exp Res. 2018 Oct 1. doi: 10.1007/s40520-018-1047-1. [Epub ahead ofprint]
Year to year comparison of 2000-2015 in hip fracture management: same survival rate despite older and more fragile patients.
Trevisan C(1)(2), Gallinari G(1), Klumpp R(2), Menon A(3)(4), Compagnoni R(5)(6).

Author information:
(1)Università degli Studi di Milano Bicocca, Via Grigna 11, 20900, Monza, Italy.
(2)ASST Bergamo Est, Ospedale Bolognini, Via Paderno 21, 24068, Seriate, Italy.
(3)Laboratory of Applied Biomechanics, Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan,
Italy.
(4)1° Clinica Ortopedica, ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, Piazza Cardinal Ferrari 1, 20122, Milan, Italy.
(5)Laboratory of Applied Biomechanics, Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan,
Italy. riccardo.compagnoni@gmail.com.
(6)1° Clinica Ortopedica, ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, Piazza Cardinal Ferrari 1, 20122, Milan, Italy.
riccardo.compagnoni@gmail.com.

PURPOSE: The aim of this study was to compare clinical data, comorbidities and survival rates at 30 days and 1 year in two groups with femoral fractures, the first including patients admitted in 2000, and the other including patients admitted in 2015. The hypothesis of the study is that patients admitted in 2015 have more comorbidities and will therefore have a lower survival rate at 30 days and 1 year from trauma.
METHODS: Patients admitted to the hospital with proximal femoral fractures in 2000 (90 patients) and 2015 (167 patients) were retrospectively reviewed. The following data were collected: age, gender, source of admission, ASA score, comorbidities, time from admission to surgery and length of hospital stay. The Charlson Comorbidity Index (CCI) score, a measure of comorbidity, and the Nottingham Hip Fracture Score (NHFS), a predictor of 30-day and 1-year mortality after hip fracture, were both calculated.
RESULTS: Patients in the 2015 group were older and more institutionalized before fracture (p < 0.05), with a significant increase in Alzheimer's disease, chronic obstructive pulmonary disease, congestive heart failure and renal impairment. The length of stay was significantly lower in 2015. The NHFS and CCI were significantly higher in 2000. Mortality at 30 days and 1 year did not differ significantly in 2000 when compared to 2015. The CCI had the best predictive ability for mortality in both groups at 30 days and 1 year.
CONCLUSIONS: The increase of comorbidities was not found to be correlated to increased mortality. This could be explained by enhanced patient management permitting earlier mobilization and weight bearing.
DOI: 10.1007/s40520-018-1047-1
PMID: 30276632

Transfus Apher Sci. 2018 Apr;57(2):272-276. doi: 10.1016/j.transci.2018.03.006.Epub 2018 Mar 27.
An algorithm for predicting blood loss and transfusion risk after total hip arthroplasty.
Trevisan C(1), Klumpp R(2), Auriemma L(3), Compagnoni R(4).

Author information:
(1)Department of Orthopaedics and Traumatology, University of Milano-Bicocca, Italy; Department of Orthopaedics and Traumatology of the Hospital ASST Bergamo Est, Via Paderno 21, I-24068, Seriate, Bergamo, Italy. Electronic address: carlo.trevisan@tiscali.it.
(2)Department of Orthopaedics and Traumatology of the Hospital ASST Bergamo Est, Via Paderno 21, I-24068, Seriate, Bergamo, Italy; ASST Bergamo Est, Via Paderno 21, I-24068, Seriate, Bergamo, Italy. Electronic address: raymond.klumpp@asst-bergamoest.it.
(3)ASST Bergamo Est, Via Paderno 21, I-24068, Seriate, Bergamo, Italy. Electronic address: laura.auriemma@asst-bergamoest.it.
(4)Clinica Ortopedica, ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, Piazza Cardinal Ferrari 1, I-20122, Milan, Italy; Laboratory of Applied Biomechanics, Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, I-20133, Milan, Italy. Electronic address: riccardo.compagnoni@gmail.com.

INTRODUCTION: Patients receiving blood transfusions after total hip arthroplasty have increased morbidity and longer lengths of stay compared to non-transfused patients. The aim of this study is to create an algorithm in order to identify patients at risk for transfusion after total hip replacement and define a safe point in hemoglobin levels after which the need for blood, transfusion can be excluded.
METHODS: This retrospective study analyzed hemoglobin (Hb) levels for 5 days in patients undergoing total hip replacement. An algorithm was implemented to identify the critical trends of Hb levels in the first two postoperative days, trying to identify the patients at high risk of transfusion. Specificity, sensibility and efficiency were calculated in relation to the capability of the algorithm to correctly identify transfused patients.
RESULTS: The algorithm found a pre-operative Hb ≥ 13 g/dl as a cut off between patients at low-risk or high-risk for transfusion. When parameters were
calculated considering the best efficiency with the least number of false negatives, the algorithm showed a specificity of 84% and a sensitivity of 70%
with an efficiency of 80.6%. Hb values >10 g/dl in the first operative day for low-risk patients and Hb level > 11 g/dl the second post-operative day for
high-risk patients led to exclusion of the need for transfusion.
CONCLUSIONS: The algorithm suggested critical Hb levels to predict transfusion. In association with clinical data, the suggested critical values of Hb may be useful to schedule lab tests and a safe early discharge.
Copyright © 2018 Elsevier Ltd. All rights reserved.

 

Musculoskelet Surg. 2017 Apr 27. doi: 10.1007/s12306-017-0478-8. [Epub ahead of print]
Comparison of clinical results and patient's satisfaction between direct anterior approach and Hardinge approach in primary total hip arthroplasty in a community hospital.
Trevisan C(1,)(2), Compagnoni R(3), Klumpp R(2).

Author information:
(1)Università degli Studi Milano Bicocca, Milan, Italy. (2)ASST Bergamo Est - Ospedale Bolognini - Seriate, Seriate, Italy. (3)ASST Centro Specialistico
Ortopedico Traumatologico Gaetano Pini - CTO - Milano, Milan, Italy. riccardo.compagnoni@gmail.com.

INTRODUCTION: Aim of the study is to compare clinical results and patient's satisfaction between direct anterior approach and Hardinge approach in primary total hip arthroplasty. METHODS: A group of 30 patients operated with DAA (group B) were compared to 39 patients operated by Hardinge approach (group A). Peri- and postoperative complications, Harris Hip Score (HHS), implant positioning, experienced pain and patient satisfaction were evaluated at a mean follow-up of 30 months. RESULTS: HHS at follow-up was significantly better in group B (92.2 ± 11.9 vs 95.2 ± 4.5 p = 0.04 Student's t test). There was no difference in femoral stem positioning while cup inclination was significantly better in group B (40.6° ± 6.6° vs 44.3° ± 7.9°, p = 0.04 Student's t test). Overall pain recalled by patients was significantly lower in group B. CONCLUSION: The introduction of DAA does not affect patients' final outcome but comes with comparable functional recovery and greater patient satisfaction.
DOI: 10.1007/s12306-017-0478-8
PMID: 28452043

Knee. 2017 Jun;24(3):675-679. doi: 10.1016/j.knee.2017.03.008. Epub 2017 Apr 10.
Angioleiomyoma in the posterior knee: A case report and literature review.
Klumpp R(1), Compagnoni R(2), Patelli G(1), Trevisan CL(1).

Author information:
(1)ASST Bergamo Est, Ospedale "Bolognini", Seriate, Bergamo, Italy.
(2)ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini - CTO, Milano, Italy. Electronic address: riccardo.compagnoni@gmail.com.

The authors present a case of angioleiomyoma situated in the posterior knee. A 47-year-old Caucasian woman presented in 2011 with recurrent stabbing pain on the lateral aspect of her right knee. She reported having pain for the last 6years. She had no history of trauma. In 2008 she was treated with a diagnostic arthroscopy and transposition of the tibial tuberosity, with no benefit to her symptoms. Electromyography of the lower limbs showed asymmetry of the amplitude of sensitive action potential of the superficial fibular nerve. Based on the clinical suspicion of entrapment of the common fibular nerve at its bifurcation, a surgical exploration was performed, but pain persisted. In 2014, ultrasonography localized at the trigger point showed a solid ovular formation of 1cm in diameter situated on the posterior aspect of the external femoral condyle in proximity to the joint capsule, which was confirmed by magnetic resonance imaging (MRI). Surgical excision of the 1-cm diameter tumor mass relieved the symptoms immediately and permanently. Histology evidenced the presence of a solid-type angioleiomyoma. The presence of an angioleiomyoma at the knee joint is very rare and few cases are reported in the literature. To the authors' knowledge this is the first time an angioleiomyoma in the posterior knee has been described. In case of unexplained and persistent pain in and around the knee, clinicians should be aware of the atypical locations of this tumor, considering that its surgical excision alone may relieve symptoms permanently.
Copyright © 2017 Elsevier B.V. All rights reserved.
DOI: 10.1016/j.knee.2017.03.008
PMID: 28408163  [Indexed for MEDLINE]


Musculoskelet Surg. 2015 Dec;99(3):231-6. doi: 10.1007/s12306-015-0381-0. Epub 2015 Aug 21.
Influence of personality psychology on outcome of total hip arthroplasty: a cross-sectional study on 69 patients.
Trevisan CL(1), Klumpp R(1), Recalcati W(1), Compagnoni R(2).

Author information:
(1)Azienda Ospedaliera "Bolognini" - Seriate, Seriate, Italy. (2)Azienda Ospedaliera "Bolognini" - Seriate, Seriate, Italy. riccardo.compagnoni@gmail.com.

AIM: Patient's satisfaction after total hip arthroplasty is influenced by many surgical and rehabilitation aspects, but is not available in the literature, a
study that analyses the correlation between patient's psychology and clinical results of this procedure. The aim of this study was to investigate the
relationship between memory of pain, clinical outcome and subjective satisfaction with the Multidimensional Health Locus of Control.
METHODS: We conducted a cross-sectional study on a cohort of 69 patients operated of total hip arthroplasty in our department from November 2008 to August 2011. Pre- and post-operative hip function was assessed by the Harris Hip Score. At the follow-up visit, patient satisfaction was assessed by means of the Patient Satisfaction Questionnaire. The memory of pain was evaluated by a modified questionnaire of pain experience. Multidimensional Health Locus of Control was evaluated in all patients, and results were connected with patient's subjective satisfaction and pain indexes. RESULTS: Patients were divided into two groups about patient satisfaction, those with GPS > 15 and those with GPS ≤ 15. Patients very satisfied showed a
significantly higher mean value of IHLC. Regarding pain experience, patients were divided into two categories: those recalling less pain with OvP score ≤11 (Q1 < 3, avg. score Q2-Q4 ≤ 3) and those recalling more pain with OvP score >11. IHLC score resulted significantly higher in patients recalling less pain. DISCUSSION: Multidimensional Health Locus of Control can be considered a predictor of patient's satisfaction after an invasive surgical procedure as total hip arthroplasty.
DOI: 10.1007/s12306-015-0381-0
PMID: 26293114
 

 

Aging Clin Exp Res. 2013 Oct;25 Suppl 1:S83-4. doi: 10.1007/s40520-013-0075-0. Epub 2013 Sep 18.
Surgical versus conservative treatment of distal radius fractures in elderly.
Trevisan C(1), Klumpp R, Nava V, Riccardi D, Recalcati W.

Author information:
(1)UOC Ortopedia Lovere, AO Bolognini Seriate, Lovere , Italy, carlo.trevisan@tiscali.it.

The distal radius fractures (DRFs) are the second most common fracture in the elderly population. Despite their frequency, the optimal treatment of these fractures remains controversial. Several dogmatic myths on DRFs management may adversely affect their outcome and despite a strong trend versus surgical options, systematic reviews suggest that conservative treatment remains the safest option for DRFs in most cases.
DOI: 10.1007/s40520-013-0075-0
PMID: 24046043  [Indexed for MEDLINE]
 

Aging Clin Exp Res. 2011 Apr;23(2 Suppl):22-4.
Secondary prevention of fractures and compliance to treatment in osteoporosis.
Trevisan C(1).

Author information:
(1)UO Ortopedia e Traumatologia, AO Bolognini - Seriate (BG), and Ospedale SS Capitanio e Gerosa, Lovere (BG), Italy. carlo.trevisan@tiscali.it

Osteoporosis is a mechanical incompetence of bone which finally leads to fracture. The occurrence of a fracture for a minor trauma is the definitive
evidence of bone fragility and an indication of an higher probability for other fractures. Fracture at any site is a strong risk factor for a subsequent
fracture, therefore any patient with a prevalent fracture is an ideal candidate for treatment due to the high risk for recurrence and to a favourable
cost-benefit ratio. Most of the available pharmacological agents approved for osteoporosis treatment are effective in reducing fracture risk in this class of patients. Unfortunately, poor compliance is very common in patients treated for osteoporosis and this leads to reduced benefits and ineffectual costs. Dose regimen simplification is neither the only nor the most important solution to improve compliance, and a multifaceted strategy targeting cognitive, behavioural and emotional factors should be employed.
PMID: 21970911  [Indexed for MEDLINE]

 


Calcif Tissue Int. 2010 Jun;86(6):436-46. doi: 10.1007/s00223-010-9356-1.
Decreased periprosthetic bone loss in patients treated with clodronate: a 1-year randomized controlled study.
Trevisan C(1), Ortolani S, Romano P, Isaia G, Agnese L, Dallari D, Grappiolo G, Cherubini R, Massari L, Bianchi G.

Author information:
(1)Department of Orthopedics, University of Milano-Bicocca, Milan, Italy.

The efficacy of clodronate to reduce bone loss around uncemented stems after total hip arthroplasty(THA) was evaluated. Ninety-one patients operated with uncemented THA were randomized to receive either intramuscular clodronate at a dose of 100 mg weekly for 12 months or no treatment. Periprosthetic and contralateral bone mineral density (BMD) scans were performed and biochemical markers of bone turnover measured at baseline and at 3, 6, and 12 months. At month 12, with the exception of Gruen zones 4 and 5, patients treated with clodronate showed less bone loss at all zones, reaching statistical significance (P�.05) in Gruen zones 2 and 6 (difference of 6.6 and 5.9%, respectively). Analysis of data according to gender revealed sex-related differences in bone loss and efficacy of treatment. After 12 months, the difference in bone loss between treated and untreated women in five out of seven Gruen zones ranged from 6.2 to 13.3% (SS at zones 2 and 6), whereas comparison between treated and untreated men showed no BMD differences in all zones(P[0.05). Median percent changes in serum levels of markers of bone metabolism by gender were consistent
with BMD changes. A 1-year treatment with intramuscular clodronate determined a significant reduction of bone loss after THA. This was mainly attributed to its greater efficacy in the female population, which is at higher risk for bone loss. This observation suggests the need for the characterization of high-risk subjects as potential candidates for prevention strategies.
DOI: 10.1007/s00223-010-9356-1
PMID: 20390409  [Indexed for MEDLINE]


 

Clin Rheumatol. 2016 Oct;35(10):2517-22. doi: 10.1007/s10067-016-3228-7. Epub 2016 Mar 16.
Risk factors in transient osteoporosis: a retrospective study on 23 cases.
Trevisan C(1,)(2,)(3), Klumpp R(4), Compagnoni R(4).

Author information:
(1)UOC Ortopedia Ospedale Bolognini Seriate, ASST Bergamo Est, Seriate, BG, Italy. carlo.trevisan@tiscali.it. (2)Scuola di Specialità in Ortopedia e
Traumatologia, Università degli Studi Milano Bicocca AO Bolognini, Seriate, BG, Italy. carlo.trevisan@tiscali.it. (3)Orthopedic Dept. Ospedale Bolognini,
Seriate, Italy. carlo.trevisan@tiscali.it. (4)UOC Ortopedia Ospedale Bolognini Seriate, ASST Bergamo Est, Seriate, BG, Italy.

The aim of this study is to verify the prevalence of risk factors for transient osteoporosis (TO) in a cohort of patients selected by strict diagnostic criteria. Retrospective observational cohort study on outpatients' data. Inclusion criteria were: (1) acute onset of pain at a lower limb joint exacerbated by weight bearing; (2) no history of trauma, tumors, rheumatic diseases, or infection; (3) presence bone marrow edema on MRI in a weight bearing joint without signs of intraarticular lesions; (4) no hyperesthesia and/or allodynia and/or sweeting changes. The following risk factors were search for in all patients: (1) previous episode of TO; (2) disorders of bone metabolism; (3) cigarette smoke; (4) sudden lower limb overuse; (5) presence of osteoporosis/osteopenia. Twenty-three patients (8 females, 15 males, mean age 48.4 years) fulfilled the inclusion criteria. An average of 1.96 risk factors for TO was present in the cohort. The most frequent risk factor was overuse (in 15 patients, 65.2 %) and the second risk factor was bone metabolism disorders (in 10 patients, 43.5 %). Seven patients (30.4 %) were heavy smokers (more than 20 cigarettes per day) and seven
patients showed a previous episode of TO. Six patients (26.1 % of the overall cohort but 60 % of those investigated with DEXA) resulted osteoporotic or osteopenic. Our results suggest there are risk factors that must be investigated in these patients. The presence of these risk factors might support the thesis that their disorder is tied to a decoupling between microdamage accumulation and self-reparative ability of bone tissue. The identification of risk factors with a precise diagnostic pathway can accelerate the diagnostic process and reduce recurrences.
DOI: 10.1007/s10067-016-3228-7
PMID: 26979746  [Indexed for MEDLINE]

 
Clin Cases Miner Bone Metab. 2015 Jan-Apr;12(Suppl 1):39-42. doi: 10.11138/ccmbm/2015.12.3s.039. Epub 2016 Apr 7.
Aseptic osteonecrosis of the hip in the adult: current evidence on conservative treatment.
Klumpp R(1), Trevisan C(1).

Author information:
(1)Orthopedics and Traumatology, AO Bolognini, Seriate (BG), Italy.

Treatment of Avascular Osteonecrosis (AVN) of the femoral head to prevent progression to an arthritic hip is a challenging subject. Many conservative
treatment options have been proposed in the literature. Weight bearing restriction as a stand-alone therapy is insufficient in preventing disease
progression but it may be useful when combined with pharmacological agents or surgery. Bisphosphonate treatment in AVN might be efficient in early stages of disease, however there are no clear recommendations on length of treatment and therapeutic dosage and, considered the limited evidence and potential side effects of treatment, it could be considered in a pre-collapse stage in selected cases. Current literature suggests that low molecular weight heparin could lower disease progression in idiopathic AVN with quality of evidence being very low. Also the evidence to support the use of statins or vasodilators in the treatment of osteonecrosis is very low and their use cannot be recommended. Extracorporeal shock wave therapy may improve pain and function in early stages of disease with a low evidence, but there doesn't seem to be a significant change in time to the occurrence of femoral head collapse. Only one study has been conducted with pulsed electromagnetic fields therefore no recommendation can be given on clinical use of PEF in AVN. Evidence on hyperbaric oxygen therapy in the treatment of AVN is very limited and the high cost of treatment and the limited availability of  structures that can provide the service poses other concerns about its feasibility. Based on current evidence, conservative treatment may be considered in early stages of asymptomatic AVN instead of observation only.
DOI: 10.11138/ccmbm/2015.12.3s.039
PMCID: PMC4832407
PMID: 27134631


Aging Clin Exp Res. 2013 Oct;25 Suppl 1:S75-6. doi: 10.1007/s40520-013-0085-y. Epub 2013 Sep 18.
Considerations on evolution and healing of vertebral fractures.
Klumpp R(1), Trevisan C, Nava V, Riccardi D, Recalcati W.

Author information:
(1)Reparto di Ortopedia e Traumatologia, Ospedale "S.S. Capitanio e Gerosa", Via
Martinoli, 9, 24060, Lovere (BG), Italy, rayklu@gmail.com.

Only little is known when talking about the evolution of a vertebral fracture. From the few studies available in the literature, we can deduce that the risk a vertebral compression fracture has to worsen its deformity is consistent. It is important to try to make a prognosis on how the fracture is going to heal based on the type of fracture encountered. A chapter of its own is the occurrence of a vertebral fracture non-union that is difficult to diagnose and treat, but comes along with a poor prognosis.
DOI: 10.1007/s40520-013-0085-y
PMID: 24046049  [Indexed for MEDLINE]

 

 
Clin Cases Miner Bone Metab. 2013 Jan;10(1):61-4. doi: 10.11138/ccmbm/2013.10.1.061.
Bisphosphonate treatment for osteolysis in total hip arthroplasty. A report of four cases.
Trevisan C(1), Nava V, Mattavelli M, Parra CG.

Author information:
(1)UOC of Orthopaedics and Traumatology, Hospital "SS. Capitanio e Gerosa - Lovere", AO Bolognini Seriate, Lovere (BG), Italy.

Aseptic loosening due to wear debris is the most frequent modality of failure in total hip arthroplasty. Bisphosphonates, a class of molecules which inhibit bone resorption showed an inhibitory effects on particles-induced osteolysis in vitro and in animal models. We report the clinical, radiographic and densitometric outcome of four postmenopausal women with total hip arthroplasty affected by peri-prosthetic osteolysis treated with neridronate due to their unwillingness to be operated. After neridronate treatment, there was general improvement in pain and function: VAS decrease 13 points (15%), the Harris Hip Score increase 9 points (15%). An average number of 3.3 x-ray per patients with an average follow-up of 23 months (range 12-34) were  collected and evaluated. In all the patients except one, serial radiographs didn't show any progression of radioluciencies lines or periprosthetic osteolysis. Bone density was evaluated by Dual energy X-ray absorptiometry after an average follow-up of 21 months (range 6-46 mo): periprosthetic BMD around the whole stem and the cup increased respectively 2.4% and 7.1%. Treatment was well tolerated and no significant side effects were registered. This retrospective collection of a small group of patients suggest that bisphosphonates should be clinically useful in preventing periprosthetic wear debris mediated osteolysis and claim for dedicated clinical trials.
DOI: 10.11138/ccmbm/2013.10.1.061
PMCID: PMC3710013
PMID: 23858314


Aging Clin Exp Res. 2011 Apr;23(2 Suppl):22-4.
Secondary prevention of fractures and compliance to treatment in osteoporosis.
Trevisan C(1).

Author information:
(1)UO Ortopedia e Traumatologia, AO Bolognini - Seriate (BG), and Ospedale SS. Capitanio e Gerosa, Lovere (BG), Italy. carlo.trevisan@tiscali.it

Osteoporosis is a mechanical incompetence of bone which finally leads to fracture. The occurrence of a fracture for a minor trauma is the definitive
evidence of bone fragility and an indication of an higher probability for other fractures. Fracture at any site is a strong risk factor for a subsequent
fracture, therefore any patient with a prevalent fracture is an ideal candidate for treatment due to the high risk for recurrence and to a favourable
cost-benefit ratio. Most of the available pharmacological agents approved for osteoporosis treatment are effective in reducing fracture risk in this class of patients. Unfortunately, poor compliance is very common in patients treated for osteoporosis and this leads to reduced benefits and ineffectual costs. Dose regimen simplification is neither the only nor the most important solution to improve compliance, and a multifaceted strategy targeting cognitive, behavioural and emotional factors should be employed.
PMID: 21970911  [Indexed for MEDLINE]


Altre Pubblicazioni

  1. C. Trevisan, R. Klumpp, G. Mazzarella, C. Cazzaniga, R. Compagnoni. ALGORITMO PREDITTIVO DELLA PERDITA EMATICA E NECESSITÀ DI TRASFUSIONI NEL FAST-TRACK DELLA PROTESICA D’ANCA. Giornale Italiano di Ortopedia e Traumatologia 2016, vol. XLII 03(suppl.1): S391.

 

  1. Trevisan C, Klumpp R, Compagnoni R, Gallinari G. UN ALGORITMO IN GRADO DI PREVEDERE PERDITE EMATICHE E RISCHIO DI EMOTRASFUSIONE IN SEGUITO A INTERVENTO DI ARTROPROTESI D’ANCA. Giornale Italiano di Ortopedia e Traumatologia 2016, vol. XLIV 03(suppl.1): S302.

 

  1. Trevisan C, Gallinari G, Klumpp R, Compagnoni R, Menon A. CONFRONTO 2000-2015 NELLA GESTIONE DELLE FRATTURE DI FEMORE NELL’ANZIANO: STESSA SOPRAVVIVENZA IN PAZIENTI PIÙ FRAGILI. Giornale Italiano di Ortopedia e Traumatologia 2016, vol. XLIV 03(suppl.1): S442.

 

  1. Trevisan C, Klumpp R, Compagnoni R, Leone P, Piscitello P. La biomeccanica delle fratture del femore prossimale è direttamente correlata all’anatomia del collo del femore e alla qualità dell’osso. Giornale Italiano di Ortopedia e Traumatologia 2015, vol. XLI 04(suppl.1): S129.

 

  1. C. Trevisan, W. Recalcati, R. Klumpp, V. Nava, G. Mazzarella, P. Biffi. CONFRONTO DEI RISULTATI CLINICI E DI POSIZIONAMENTO DELLE COMPONENTI TRA VIA ANTERIORE MINI-INVASIVA E LATERALE DIRETTA NELL’ARTROPROTESI D’ANCA. Giornale Italiano di Ortopedia e Traumatologia 2015, vol. XLI 04(suppl.1): S389.

 

  1. C. Trevisan, R. Klumpp, S. Piscitello, P. Leone, R. Compagnoni. PATOGENESI, CRITERI DIAGNOSTICI E TRATTA MENTO DELL’OSTEOPOROSI TRANSITORIA SULLA BASE DI UNA REVISIONE DI 23 CASI. Giornale Italiano di Ortopedia e Traumatologia 2015, vol. XLI 04(suppl.1): S442.

 

  1. Trono M, Alecci V, Ceccarelli M, Pagnuzzato C, Pleitavino F, Prati P, Romano L, Trevisan C, Valente M, Trimarchi A, Lucidi G. Learning  curve for mini-invasive anterior hip approach: a multicentric study. Abstracts from the International Combined Meeting BHS-SIdA, 26-27 November 2015, Milan, Italy Hip Int 2015; 25 (Suppl 1): S10. DOI: 10.5301/hipint.5000333

 

  1. Trevisan C, Klumpp R, Piscitello S, Leone P, Compagnoni R. Biomechanical restoration of hip parameters is successful using the direct anterior approach with a tapered wedge stem. Abstracts from the International Combined Meeting BHS-SIdA, 26-27 November 2015, Milan, Italy Hip Int 2015; 25 (Suppl 1): S2-S59 DOI: 10.5301/hipint.5000333

 

  1. Trevisan C, Klumpp R. Chirurgia nelle fratture da fragilità dell’anziano: omero e polso. In: La fragilità scheletrica nell’osteoporosi e le sue conseguenze. Tarantino U, Moretti B eds. CIC edizioni internazionali Roma 2014, pp. 101-111.

 

  1. Comparison of clinical out come and patient satisfaction between direct anterior and lateral approach in hip arthroplasty. J. Orthopaed Traumatol 2013: 14 (suppl 1): S15.

 

  1. Multicenter study on the learning curve in minimally invasive directr anterior approach for hip arthroplasty: the experience of the AMIAA Group. J. Orthopaed Traumatol 2013: 14 (suppl 1): S58.

 

  1. Trevisan C La vertebro e la cifoplastica: pros. Atti del X congresso nazionale SIOMMMS. Osteoporosi.it anno 2010 n.4: 73.ù
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  1. Trevisan C, Nava V, Klumpp R, Baiguini P. Pianificazione tridimensionale nella protesi totale d’anca e correzione delle dismetrie. Minerva Ortop Traumatol 2009: 60 suppl.1: 146.

 

  1. Trevisan C La vertebro e la cifoplastica: pros. Atti del X congresso nazionale SIOMMMS. Osteoporosi.it anno 2010 n.4: 73.

 

  1. Trevisan C. Approccio clinico e riabilitativo alle fratture vertebrali. In: Medicina Fisica e Riabilitazione, Valobra GN, Gatto R e Monticone M eds. UTET Torino 2008,  vol.3: pp.1947-1963.

 

  1. Negrini S, Bonaiuti D, Monticone M, Trevisan C. Medical causes of low back pain. In: Interventional Spine: an algorithmic approach. Slipman CW, Derby R, Simeone FA, Mayer TG eds. Saunders Elsevier, Philadelphia PA USA, 2008: pp803-811.