Giuseppe Filardo

• Chief Research Advisor at Istituto Ortopedico Rizzoli

Introduction Intra-articular injections of mesenchymal stromal cells concentrates showed promising results in the treatment of knee osteoarthritis (OA). Among these, bone marrow aspirate concentrate (BMAC) has been widely adopted in clinical practice. More recently, microfragmented adipose tissue (MFAT) has been proposed as a more suitable solution...

Purpose The aim of this study was to quantify differences in the shear wave speed (SWS) between a conservatively treated Achilles tendon (AT) after rupture and the unaffected contralateral tendon. Methods Twenty‐nine participants who received conservative treatment following Achilles tendon rupture (ATR) were enrolled. Measurements were taken duri...

Objective The aim of this study was to establish the minimal clinically important difference (MCID) thresholds for the International Knee Documentation Committee (IKDC) subjective and Visual Analogue Scale (VAS) pain scores in patients affected by knee chondral and osteochondral lesions treated with cell-free scaffold implantation. Design For the...

Purpose Bone marrow lesions (BMLs) of the knee are a common magnetic resonance imaging finding and are present in a wide range of pathologies, including traumatic contusions and fractures, following cartilage surgery alterations, osteoarthritis, transient BMLs syndromes, subchondral insufficiency fractures of the knee and spontaneous osteonecrosis...

Objective: The aim of this meta-analysis was to investigate whether home-based physical therapy (HPT) is as safe and effective as the conventional inpatient/outpatient physical therapy (CPT) after total knee arthroplasty (TKA). Methods: Three databases (PubMed, Web of Science, and Cochrane) were systematically searched on 8 January 2024. Randomized...

This study aims to investigate the association between chronic lateral meniscus posterior root tears (LMPRTs) and chondral or osteochondral lesions of the lateral femoral condyle (LFC), particularly in cases involving prior anterior cruciate ligament (ACL) injuries. Given the challenges in diagnosing LMPRTs and the biomechanical significance of the...

Introduction: The aim of this systematic review was to quantify the data available on corticosteroids (CS), hyaluronic acid, (HA), platelet-rich plasma (PRP), and cell-based therapies for knee osteoarthritis (OA) treatment. Methods: A literature search was conducted on PubMed, Cochrane, and Web of Science according to the PRISMA guidelines. Incl...

Purpose Idiopathic flexible flatfoot (IFF) is a frequent condition in children. Patients refractory to conservative treatments may benefit from surgical procedures. The aim of this study was to evaluate clinical outcomes and sport activity levels in a large cohort of paediatric patients treated with calcaneo‐stop (CS) for the symptomatic IFF. Meth...

Purpose Multiple clinical factors may concur to determine the clinical trajectory leading towards total knee arthroplasty (TKA) in patients affected by knee osteoarthritis (OA). The aim of this study was to identify the main factors influencing progression to TKA in a large population of knee OA patients. Methods A total of 7552 knees were selecte...

Knee cartilage lesions are frequent in football players, but evidence for surgical treatment is lacking. The aim of this International Cartilage Regeneration & Joint Preservation Society, Fédération Internationale de Football Association, and Aspetar (ICRS-FIFA-Aspetar) consensus was to develop specific expert-based, patient-specific practical reco...

Purpose To quantify the influence of baseline values of a specific patient‐reported outcome measure (PROM) on the minimal clinically important difference (MCID) calculation in a homogeneous series of knee osteoarthritis patients treated with platelet‐rich plasma (PRP) injections. Methods A data set of 312 patients with knee osteoarthritis treated...

Purpose Subchondral bone marrow lesions (BMLs) are present in a wide range of pathologies with different prognoses. Thus, a careful diagnosis is mandatory to address them with the proper treatment. The aim of this review was to examine BMLs aetiology and their relationship with biomechanical and biological factors, to identify BMLs and help clinici...

Background Platelet-rich plasma (PRP) has emerged as a promising therapeutic intervention for knee osteoarthritis (OA), attracting substantial clinical and research attention. However, the clinical relevance of the treatment benefit remains controversial. Purpose To evaluate the effectiveness of PRP compared with placebo in patients with knee OA i...

Purpose: The aim of this study was to investigate how meniscal extrusion, assessed either with ultrasounds or magnetic resonance (MR), correlates with clinical symptoms in knee osteoarthritis (OA). Methods: One hundred patients with symptomatic knee OA were enrolled (60.3 ± 9.7 years). Patients underwent MR evaluation and ultrasound analyses (clino...

Aim Anatomic total shoulder arthroplasty (TSA) is commonly used for glenohumeral osteoarthritis (OA) in patients with an intact rotator cuff. The aim of this study was to quantify advantages and disadvantages of the stemmed and stemless designs in terms of clinical outcome and complications. Methods A review was developed based on the PRISMA state...

Background Assessing health-related quality of life (HRQoL) is a widely employed method in orthopedics to evaluate patient well-being and measure the effectiveness of surgical interventions. Understanding the relationship between specific baseline factors and preoperative HRQoL can help clinicians identify patients at risk for low quality of life a...

Purpose This systematic review with meta‐analysis evaluates the long‐term efficacy of matrix‐assisted autologous chondrocyte transplantation (MACT) in terms of functional scores using scaffolds made of hyaluronic acid (HA) or collagen (C). Methods Nineteen articles met the eligibility criteria for the analysis. Fourteen studies focused on patients...

Introduction Knee osteotomy combined with meniscal allograft transplantation (MAT) showed promising results to treat unicompartmental knee osteoarthritis (OA) secondary to meniscal deficiency and knee malalignment. However, there is still no high-level evidence to demonstrate whether the combination of these two treatments is superior to osteotomy...

This study aim was to analyze the joint temperature of patients affected by bilateral knee osteoarthritis (OA) using infrared thermography to investigate whether thermographic imaging patterns are influenced by the severity of symptoms and joint degeneration. Sixty-sixpatients ranging from 43 to 78 years old (63.3 ± 8.8 years) with bilateral knee O...

Background The early assessment of the severity of polytrauma patients is key for their optimal management. The aim of this study was to investigate the discriminative performance of the NACA score in a large dataset by stratifying the severity of polytraumatized patients in correlation to injury severity score (ISS), Glasgow Coma Scale (GCS), and...

Purpose The aim of this systematic review and survival analysis was to quantify the benefits of orthobiologic augmentation therapies for the treatment of avascular necrosis (AVN) of the femoral head and identify the most effective approach to delay the need for total hip arthroplasty (THA). Methods A systematic review of the literature was perform...

Purpose: The Minimal Clinically Important Difference (MCID) is important to assess the clinical relevance of treatment results. The aim of this study was to establish the MCID values for VAS, WOMAC, and HHS scores in patients treated with intra-articular orthobiologic injections for hip osteoarthritis (OA). Methods: Ninety-six patients (62.5% men,...

Purpose The association of adipose tissue-derived injectable products with platelet-rich plasma (PRP) has been promoted for osteoarthritis (OA) treatment. The aim of this study was to investigate the preclinical and clinical evidence supporting the potential of this combined approach to treat OA. Methods A systematic review was performed in Januar...

Background Arthroscopic meniscectomy is one of the most performed surgical procedures in orthopaedics. Different approaches have been proposed to improve patient recovery but with unsatisfactory results. Platelet-rich plasma (PRP) augmentation has been proposed as a strategy to improve the recovery after meniscectomy. Purpose To investigate the cl...

Background: The early assessment of the severity of polytrauma patients is key for their optimal management. The aim of this study was to investigate the discriminative performance of the NACA score in a large dataset by stratifying the severity of polytraumatized patients in correlation to Injury Severity Score (ISS), Glasgow Coma Scale (GCS), and...

Background Platelet-rich plasma (PRP) is one of the most frequently used orthobiologic products for the injection treatment of patients affected by knee osteoarthritis (OA). Some preliminary evidence supports the influence of platelet concentration on patients’ clinical outcomes. Purpose To analyze if platelet concentration can influence the safet...

Background Platelet-rich plasma (PRP) is increasingly used for the injection treatment of knee osteoarthritis (OA). However, the role of leukocytes contained in PRP is controversial, with some preclinical studies suggesting detrimental effects and others emphasizing their contribution in secreting bioactive molecules. Purpose To compare the safety...

Background/Objectives: Crude extracts from the Brassica genus have recently emerged as promising phytochemicals for preventing bone loss. While the most documented evidence suggests that their general biological activity is due to glucosinolates’ (GLSs’) hydrolysis products, the direct activity of GLSs is beginning to be uncovered. However, the con...

Purpose The aim of this study was to quantify meniscal extrusion through ultrasound (US) evaluation in supine and standing positions and to compare the results with those documented through magnetic resonance (MR) imaging in patients affected by knee osteoarthritis (OA). Methods Sixty patients (38 men, 22 women, mean age 60.8 ± 9.7 years) with kne...

Purpose This systematic review aimed to investigate in animal models the presence of disease‐modifying effects driven by non‐bone marrow‐derived and non‐adipose‐derived products, with a particular focus on umbilical cord and placenta‐derived cell‐based therapies for the intra‐articular injective treatment of osteoarthritis (OA). Methods A systemat...

Background: Platelets and lymphocytes levels are important in assessing systemic disorders, reflecting inflammatory and immune responses. This study investigated the relationship between blood parameters (platelet count (PLT), mean platelet volume (MPV), lymphocyte count (LINF), and platelet-to-lymphocyte ratio (PLR)) and osteoarthritis (OA) severi...

Purpose The aim of this study was to evaluate if the operated knee environment remains abnormal in patients successfully treated with anterior cruciate ligament reconstruction (ACL‐R). Methods Thirty asymptomatic patients were enrolled (28 men, 2 women, age 28.6 ± 6.54 years, body mass index: 24.9 ± 3.0 kg/m²) and evaluated at 42.2 ± 12.5 months a...

Purpose Intra-articular corticosteroid (CS) injections for knee osteoarthritis (OA) management are endorsed by several scientific societies, while the use of hyaluronic acid (HA) and platelet-rich plasma (PRP) is more controversial. Aim of the study was to quantify and compare the clinical effectiveness of CS injections with respect to HA and PRP i...

Background The effectiveness of nonsurgical treatment of patellar tendinopathy is questioned due to the conflicting results of placebo-controlled randomized controlled trials (RCTs) in which placebo arms often show impressive results. Purpose To quantify the magnitude of placebo effect of the different nonsurgical treatments of patellar tendinopat...

Purpose The aim of this study was to quantify sleep quality and define its evolution in patients treated for rotator cuff tears (RCTs) with arthroscopic rotator cuff repair (ARCR) and to understand its correlation with patients' depression and anxiety. Methods The patients were part of the ‘ARCR_Pred cohort study’, a prospective multicentre cohort...

Objectives The purpose of this study was to compare the survival rates and clinical outcomes of patients who received medial MAT+HTO (MAT+HTO group) with a control group undergoing isolated medial MAT (MAT group), to define if a surgically corrected varus malignment may affect patient’s outcomes and the survivorship of MAT over time. The hypothesis...

Osteochondritis dissecans (OCD) can lead to detrimental effects in the affected joints. Osteochondral autologous transplantation (OAT) allows to restore the articular surface with an autologous osteochondral unit. While short-term results are documented, there is a lack of long-term data. Aim of this study was to analyze the long-term clinical resu...

Purpose A cell‐free biomimetic osteochondral scaffold was developed to treat cartilage knee lesions, with positive clinical results documented in small case series. However, clear evidence on patient and lesion characteristics that might affect the outcome is still lacking. The aim of this study is to analyse a large cohort of patients treated with...

Introduction: Osteoarthritis (OA) is a prevalent cause of disability worldwide, affecting millions and posing significant socioeconomic burdens. Various conservative measures like hyaluronic acid (HA) and platelet-rich plasma (PRP) injections aim to manage OA symptoms and delay surgical interventions. Despite the increasing utilization of PRP, con...

Purpose When dealing with the health status of the knee articular surface, the entire osteochondral unit has gained increasing attention, and in particular the subchondral bone, which plays a key role in the integrity of the osteochondral unit. The aim of this article was to discuss the current evidence on the role of the subchondral bone. Methods...

Purpose The aim of this consensus was to develop evidence‐ and expert‐based patient‐focused recommendations on the appropriateness of intra‐articular platelet‐rich plasma (PRP) injections in different clinical scenarios of patients with knee osteoarthritis (OA). Methods The RAND/UCLA Appropriateness Method was used by the European Society of Sport...

Purpose The association between fluoroquinolone intake and Achilles tendinopathy (AT) or Achilles tendon rupture (ATR) is widely documented. However, it is not clear whether different molecules have the same effect on these complications. The purpose of this study was to document Achilles tendon complications for the most prescribed fluoroquinolone...

Background A few studies have documented the long-term results of chondrocyte-based procedures for the treatment of patellofemoral cartilage lesions, but specific results are lacking after matrix-assisted autologous chondrocyte transplantation (MACT) for patellar and trochlear lesions. Purpose To document the clinical results of MACT for the treat...

Purpose Patellar cartilage lesions are a frequent and challenging finding in orthopaedic clinical practice. This study aimed to evaluate a chitosan‐based scaffold's mid‐term clinical and imaging results patients with patellar cartilage lesions. Methods Thirteen patients (nine men, four women, 31.3 ± 12.7 years old) were clinically evaluated prospe...

The currently available osteoarthritis (OA) treatments offer symptoms’ relief without disease-modifying effects. Increasing evidence supports the role of human mesenchymal stem cells (MSCs) to drive beneficial effects provided by their secretome and extracellular vesicles (EVs), which includes trophic and biologically active factors. Aim of this st...

Purpose The purpose of this study was to quantify and compare the clinical relevance of the different intra‐articular corticosteroids (CS) effects in vivo for osteoarthritis (OA) treatment. Methods The search was conducted on PubMed, Cochrane, and Web of Science in October 2023. The PRISMA guidelines were used. Inclusion criteria: animal or human...

Background Meniscal allograft transplantation (MAT) is a viable option for patients experiencing unicompartmental knee pain after total or subtotal meniscectomy. Nonetheless, caution is recommended when suggesting this procedure in the presence of knee osteoarthritis (OA) because of the higher risk of poor survival and outcomes. Purpose/Hypothesis...

Purpose Distal radius fractures (DRFs) represent up to 18% of all fractures in the elderly population, yet studies on the rate of complications following surgery are lacking in the literature. This systematic review aimed to quantify the rate of complications and reinterventions in patients treated with volar plate for distal radius fractures, and...

Purpose Aim of this systematic review of preclinical evidence was to determine the effects of intra‐articular corticosteroid (CS) injections in joints affected by osteoarthritis (OA). Methods A systematic review was performed on animal studies evaluating intra‐articular CS injections for OA joints. The search was performed on PubMed, Cochrane, and...

Background Satisfactory clinical results of meniscal allograft transplantation (MAT) have been reported in recent years. However, it remains unclear whether the clinical outcomes of MAT when combined with an osteotomy are inferior to those of isolated MAT. Purpose To compare the survival rates and clinical outcomes of patients who received isolate...

Purpose The aim of this study was to prospectively evaluate the long‐term clinical results and failure rate of patients treated with complex salvage procedures using a combined mechanical and biological approach to address unicompartmental knee osteoarthritis (OA) and postpone the need for joint replacement. Methods Thirty‐nine patients (40.3 ± 10...

Purpose The purpose of this study was to investigate if patient's gender significantly affected the long‐term outcome of patients undergoing total knee arthroplasty (TKA) and to provide a cross‐gender comparison of a large patient sample from a single regional register. Methods The Registry of Prosthetic Orthopedic Implant of Emilia Romagna (RIPO)...

Aims Robotic-assisted unicompartmental knee arthroplasty (R-UKA) has been proposed as an approach to improve the results of the conventional manual UKA (C-UKA). The aim of this meta-analysis was to analyze the studies comparing R-UKA and C-UKA in terms of clinical outcomes, radiological results, operating time, complications, and revisions. Method...

Purpose Rotator cuff (RC) disorders are the most common cause of shoulder disability. The aim of this study was to quantify the evidence on the sex‐related differences in RC repair. Methods A systematic review of the literature was performed in January 2023 in PubMed, Wiley Cochrane Library and Web of Science on research articles on humans with RC...

Purpose The aim of this study was to assess how gender might affect the clinical outcome and survival of meniscal allograft transplantation (MAT). Methods A total of 358 patients (23.2% women, 76.8% men) were treated with fresh‐frozen nonirradiated allografts implantated arthroscopically using a single‐ or double‐tunnel technique without bone plug...

Objective To systematically review the literature and analyze clinical outcomes and return-to-sport after surgical management of cartilage injuries in football players. Design A systematic literature review was performed in August 2023 on PubMed, WebOfScience, and Cochrane Library to collect studies on surgical strategies for cartilage lesions in...

Osteochondral defect repair with a collagen/collagen-magnesium-hydroxyapatite (Col/Col-Mg-HAp) scaffold has demonstrated good clinical results. However, subchondral bone repair remained suboptimal, potentially leading to damage to the regenerated overlying neocartilage. This study aimed to improve the bone repair potential of this scaffold by incor...

Purpose Platelet‐rich plasma (PRP) augmentation has been proposed to improve the results of anterior cruciate ligament reconstruction (ACLR). The present study aims to quantify the available evidence to support the use of PRP as biological augmentation in ACLR surgery. Methods A systematic literature search was conducted on the PubMed, Cochrane, W...

Purpose The aim of this European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA) consensus is to provide recommendations based on evidence and expert opinion to improve indications, decision‐making and administration‐related aspects when using blood‐derived orthobiologics (for simplicity indicated as PRP—platelet‐rich plasma—wi...

Background Hamstring (HS) strength deficits and imbalances have been identified as risk factors for sustaining ACL injuries and muscular strains, with HS injuries being the most prevalent muscle injuries in soccer athletes. Objective The aim was to investigate HS eccentric strength before and after a football match in male and female athletes. The...

Background Hamstring (HS) strength deficits and imbalances have been identified as risk factors for sustaining anterior cruciate ligament (ACL) injuries and muscular strains, with HS injuries being the most prevalent muscle injuries in soccer athletes. The aim of this study was to investigate HS eccentric strength before and after a soccer match in...

Purpose Regenerative techniques for articular cartilage lesions demonstrated heterogeneous clinical results. Several factors may influence the outcome, with sex being one of the most debated. This study aimed at quantifying the long‐term influence of sex on the clinical outcome obtained with a regenerative procedure for knee chondral lesions. Meth...

Purpose A persisting gender bias has been recently highlighted in orthopaedics and sports medicine. The aim of this study was to evaluate the volume of gender‐specific data and gender‐specific results in the treatment of a common tendon disease, Achilles tendinopathy. Methods Pubmed, Cochrane, and Web of Science were searched to identify all clini...

Purpose To quantify the clinical relevance of intra‐articular corticosteroid effects compared to placebo for the injective treatment of knee osteoarthritis (OA). Methods The PubMed, Cochrane Library and Web of Science databases were searched on May 3, 2023. This study was conducted in accordance with the PRISMA guidelines. The inclusion criteria w...

Introduction Hamstring strength deficits have been identified as risk factors for ACL and muscular injuries, with hamstring strain being the most prevalent muscle injuries in soccer. The aim of this study was to investigate hamstring eccentric strength before and after a soccer match in soccer athletes. Material and Methods Hamstring eccentric str...

Purpose The aim of this study was to quantify the impact of concomitant meniscal lesions on knee laxity using a triaxial accelerometer in a large population of patients affected by anterior cruciate ligament (ACL) injury. Methods A total of 326 consecutive patients (261 men and 65 women, mean age 31.3 ± 11.3) undergoing primary ACL reconstruction,...

Purpose The aim of this study was to assess how physicians perceive the role of the reimbursement system and its potential influence in affecting their treatment choice in the management of patients affected by osteoarthritis (OA). Methods A survey was administered to 283 members of SIAGASCOT (Italian Society of Arthroscopy, Knee, Upper Limb, Spor...

The use of minimally manipulated adipose tissue (MM-AT) products is gaining increasing interest for the treatment of knee osteoarthritis (OA). MM-AT represents an easy way to exploit adipose tissue properties, although clinical evidence is still limited, as well as their benefits with respect to more documented orthobiologics like platelet-rich pla...

Purpose The aim of this systematic review was to analyse the available clinical evidence on intra-articular knee injections for the treatment of degenerative cartilage lesions and osteoarthritis (OA) in sport-active patients. Methods A literature search was performed in July 2023 according to the PRISMA guidelines on three electronic databases (Pu...

Background The clinically relevant healing process of a ruptured and repaired Achilles tendon (AT) can last more than a year. The purpose of this cross-sectional study was to test if shear wave tensiometry is able to detect AT loading changes between a surgically managed AT rupture versus the unaffected contralateral tendon. Our secondary aims were...

Effective communication within the realm of scientific publishing remains pivotal for the broad dissemination of research findings and new clinical insights to the global medical community. The integration of visual and textual elements has gained prominence as an instrumental means to facilitate comprehension and bridge cognitive divides across di...

Articular cartilage lacks intrinsic regenerative capabilities, and the current treatments fail to regenerate damaged tissue and lead only to temporary pain relief. These limitations have prompted the development of tissue engineering approaches, including 3D culture systems. Thanks to their regenerative properties and capacity to recapitulate embry...

Purpose The study of the placebo effect is key to elucidate the ‘real effect’ of conservative interventions for plantar fasciitis. The aim of this meta-analysis was to quantify the impact of placebo in the different conservative treatments of plantar fasciitis. Methods A systematic literature review was performed on double-blind placebo-controlled...