Leonardo Osti

• MD
• Professor at University of Ferrara

Rotator cuff tendinopathy (RCT) is the primary reason for shoulder surgery and its clinical management is still challenging. Hyaluronic acid (HA) has been shown to have anti-inflammatory effects in vitro and in vivo under RCT conditions, characterized by an exaggerated oxidative stress (OS). However, molecular mechanisms underlying HA-related effec...

PurposeTo compare clinical and functional outcomes of two groups of patients undergoing reduction and nailing fixation for diaphyseal fractures of the tibia with (PEMF group) and without (control group) post-operative pulsed electromagnetic field (PEMF) application.Methods This is a retrospective study on 50 patients (mean age 43.3 years, 28 males...

Introduction This systematic review evaluated and compared the use of a subacromial spacer implantation (SSI) with arthroscopic superior capsular repair (ASCR) in the management of massive irreparable rotator cuff tears (MIRCTs) with an assessment of clinical and imaging outcomes. Sources of data This systematic review was carried out following th...

Objective The purpose of this radiological study was to assess the posterior laxity of a single model of a total knee arthroplasty design (TKA) having a medially constrained (MC) or a Posterior-Stabilized (PS) polyethylene insert using a well-documented stress x-ray. To the authors knowledge, this is the first report evaluating MC TKA outcomes acco...

Introduction: The present systematic review compared arthroscopic superior capsular reconstruction (ASCR) and latissimus dorsi transfer (ALDT) for the management of massive irreparable rotator cuff lesions. Sources of data: We performed a systematic review searching the literature on Medline, Cochrane and Scopus databases, following the Preferre...

Non-traumatic rotator cuff tears (RCTs) are a frequent and potentially disabling injury. There is growing evidence that hyaluronic acid is effective for pain relief and to counteract inflammation in RCTs, however, its effective role in tendinopathies remains poorly studied. The present study aims to disclose a possible molecular mechanism underlyin...

Matrix metalloproteinases (MMP) are involved in the development of tendinopathy. These potent enzymes completely degrade all components of the connective tissue, modify the extracellular matrix (ECM), and mediate the development of painful tendinopathy. To control the local activity of activated proteinases, the same cells produce tissue inhibitors...

Evaluation of the usefuleness of 3D CT scan to evaluate abnormal tunnel widening in failed ACL reconstruction in order to optimize the surgical approach in ACL revision reconstruction

Introduction This systematic review provides a comprehensive description of different surgical techniques for massive rotator cuff tears (MRCTs) using arthroscopic-assisted latissimus dorsi transfer (A-LDT), reporting clinical outcomes and complications. Sources of data We searched the literature on Medline (PubMed), Web of Science and Scopus data...

Introduction: Partial thickness rotator cuff tears (PTRCTs) are common, with an incidence between 17% and 37%, and a high prevalence in throwing athletes. Different surgical procedures are suggested when partial tears involve the articular portion of the rotator cuff, including arthroscopic debridement of the tear, debridement with acromioplasty,...

Primary traumatic patellar dislocation is common, particularly in young active individuals. A consensus on its management is still lacking. The present work provides easily accessible guidelines to be considered as recommendations for a good clinical practice developed through a process of systematic review of the literature and expert opinion, to...

Introduction: Excessive apoptosis has been hypothesized as possible cause of tendinopathy and tear in the tendons of the rotator cuff (RC). Different mechanisms and molecules play a key role in cell regulation. Biological interventions can affect the process of apoptosis to control the tendinopathy process, and may be useful to design new treatmen...

The number of patients undergoing revision surgery following failure of anterior cruciate ligament (ACL) reconstruction has increased over the recent past, following the overall increased number of primary ACL reconstruction performed. Failure of primary ACL reconstruction can be attributed to technical errors, biological failures, or new traumatic...

Purpose of this study is to compare radiographic findings of two homogeneous groups of athletes after anterior cruciate ligament (ACL) reconstruction, with two different techniques: the modified trans-tibial approach (TTM) and the antero-medial approach (AM). 50 patients, recruited by inclusion criteria, were randomly assigned in two groups (TTM an...

Introduction: Arthroscopy procedures are the gold standard for the management of tibial spine avulsion. This review evaluates and compares different arthroscopic treatment options for tibial spine fractures. Source of data: PubMed, Medline, Ovid, Google Scholar and Embase databases were systematically searched with no limit regarding the year of...

The aim of this study is to report the clinical and functional outcomes following arthroscopic management of anterior impingement, grade III–IV cartilage lesions, and mild to moderate osteoarthritis of the ankle in former soccer players. The study included 15 former male professional soccer players with mild to moderate degenerative changes of the...

Despite the high level achieved in the field of shoulder surgery, a global consensus on rotator cuff tears management is lacking. This work is divided into two main sessions: in the first, we set questions about hot topics involved in the rotator cuff tears, from the etiopathogenesis to the surgical treatment. In the second, we answered these quest...

Background: Management of tears of the anterior and posterior roots of the meniscus is still controversial. We wish to propose a simple technique of suture anchor to repair tears of the anterior root of the medial meniscus. Methods: Twelve patients, active males, underwent arthroscopic repair of the anterior meniscal horn between 2009 and 2011....

Background: Hyaluronic Acid (HA) has been already approved by Food and Drug Administration (FDA) for osteoarthritis (OA), while its use in the treatment of tendinopathy is still debated. The aim of this study was to evaluate in human rotator cuff tendon derived cells the effects of four different HA on cell viability, proliferation, apoptosis and...

The current study tested the hypothesis that the use of pulsed electromagnetic fields after rotator cuff repair is effective in the short term as an adjuvant treatment to reduce local inflammation, postoperative joint swelling, and recovery time, as well as to induce pain relief. Sixty-six patients who underwent shoulder arthroscopy for repair of s...

Pulsed electromagnetic fields (PEMFs) may improve clinical outcomes following microfractures and prevent their decline over time. Sixty-eight patients who underwent partial medial meniscectomy and microfractures to the medial femoral condyle for management of grade III-IV cartilage lesions were randomly divided into two groups using a block randomi...

Purpose: the aim of this quantitative review is to document potential benefit and adverse effects of hyaluronic acid (HA) injection into the shoulder with rotator cuff tears. Methods: a systematic literature search was performed in english PubMed, Medline, Ovid, Google Scholar and Embase databases using the combined key words "hyaluronic acid",...

in the last years the incidence of rotator cuff tears increased and one main cause still waiting to be clarified. Receptors for thyroid hormones in rotator cuff tendons suggest possible effects on tendons metabolism and status. We undertook a retrospective, observational cohort study of 441 patients who underwent arthroscopic and mini-open repair f...

Fatty degeneration is a degenerative condition of the tendon-muscle unit of rotator cuff muscles, characterized by atrophy of muscle fibers, fibrosis, and fatty accumulation within and around the muscles. Many classification may be useful to stage this pathology, especially on Computed Tomography (CT) and magnetic resonance imaging (Mari) findings....

Matrix metalloproteinases (MMP) are involved in the development of tendinopathy. These potent enzymes completely degrade all components of the connective tissue, modify the extracellular matrix (ECM), and mediate the development of painful tendinopathy. To control the local activity of activated proteinases, the same cells produce tissue inhibitors...

[This corrects the article on p. 213 in vol. 3, PMID: 24367783.].

Purpose: Microfractures at the footprint may be a potential additional source of growth factor and enhance the tendon healing at the bone-tendon junction when repairing rotator cuff tears. Methods: Fifty-seven patients who underwent shoulder arthroscopy for repair of complete rotator cuff tears were randomly divided into two groups, using a bloc...

Subcoracoid impingement and stenosis have been described related to anterior shoulder pain and subscapularis tendon tears, but the pathogenesis and related treatment of this condition has still not been explained properly. Variability of coracoid morphology has been described and both traumatic and iatrogenic factors can modify it. Some authors ref...

Arthroscopic repair of the subscapularis tendon has been introduced later than arthroscopic repair of the rotator cuff because of technical difficulties and lack of anatomical knowledge of this tendon, the so-called “forgotten tendon”. The anatomic repair of this tendon is functional to maintain proper biomechanics of the shoulder. A careful evalua...

Type II lesions are common lesions encountered in overhead athletes with controversies arising in term of timing for treatment, surgical approach, rehabilitation and functional results. The aim of our study was to evaluate the outcomes of arthroscopic repair of type II SLAP tears in overhead athletes, focusing on the time elapsed from diagnosis and...

Repair of rotator cuff tears is a common procedure. Prior to approaching this surgery, it should be realized that each surgical step can lead to complications, including those related to positioning and anaesthesia. Stiffness, infection and failure of repair are the more frequent complications reported.

Repair of rotator cuff tears is technically challenging. Full thickness rotator cuff tears have no potential for spontaneous healing, no reliable tendons substitutes are available, and their management is only partially understood. Many factors seem to contribute to the final outcome, and considerable variations in the decision-making process exist...

This review defines the recognized risk factors responsible for the development of knee osteoarthritis after surgical management of meniscal tears. We performed a literature search using Medline, Ovid, Cochrane and Google Scholar using the keywords: 'Meniscal tears', 'meniscectomy', 'osteoarthritis', 'complications' and 'risk factors'. Thirty-two p...

Objective: To determine the plasma levels of nonprotein nitrogen (NPN) and creatinine in healthy patients with rotator cuff tears. Methods: The study included 400 subjects. The study group included 200 patients (93 men and 107 women; mean age, 56.8 years; range, 23-81 years) who underwent arthroscopic repair of a rotator cuff tear from 2004 to 2...

To compare the outcomes of arthroscopic ACL reconstruction procedure in 20 middle-aged patients (12 men and 8 women) and 20 subjects younger than 30 years (control group) at a minimum post-operative follow-up of 24 months. Pre- and post-operative anterior-posterior laxity was assessed by Lachman test, pivot shift test and KT1000 arthrometer at manu...

Sports activities have become a part of the modern lifestyle and the number of related injuries has therefore increased dramatically. This chapter provides a brief review of injury prevention in the light of scientific evidence focusing on the knee, ankle, shoulder, and spinal joints as well as the associated muscles. The results obtained through p...

In athletes with anterior cruciate ligament (ACL) tears combined with meniscal and cartilage injuries, the goals are to restore knee laxity and relieve symptoms, while long-term goals are the return to pre-injury sport activity and to prevent onset of degenerative changes. We compared the post-operative (minimum 5 years) clinical and radiological o...

Stress radiographs have been used for several years to detect the amount of varus/valgus knee laxity and to evaluate the degree of compartmental involvement in degenerative osteoarthritis. However, the popularity of these radiographic methods has been affected by their technical limits due to the x-ray exposure for the personnel involved and the va...

Although no consensus has been reached regarding the management of PCL deficiency, in vitro and in vivo studies have investigated whether the tibial inlay technique restores the anatomical site of insertion of the PCL, prevents elongation, stretching, graft failure, and improves long-term PCL stability. A systematic search using PubMed, Ovid, the C...

Little attention has been focused on the most common risk factors for post-operative glenohumeral arthropathy in patients undergoing open and arthroscopic stabilization. We performed a literature search using Medline, Cochrane and Google Scholar using the keywords: 'Shoulder instability surgery' in combination with 'glenohumeral osteoarthrosis', 'r...

We compared the outcomes of arthroscopically repaired rotator cuff tears in 28 patients older than 65 years (the over 65 group: median age 70 years) with a control group of 28 patients younger than 65 years (the under 65 group: median age 57 years). The groups were similar in regard to sex distribution, surgical technique, and post-operative rehabi...

The optimal management for combined anterior cruciate ligament-medial collateral ligament (ACL-MCL) injuries is controversial. We performed a literature search using Medline, Cochrane and Google Scholar using the keywords: 'ACL' and 'MCL' in combination with 'surgery treatment', 'conservative treatment', 'surgery management', 'conservative manageme...

We report on 22 patients with chronic grade-2 valgus laxity of the knee combined with chronic anterior cruciate ligament (ACL) insufficiency, in whom the two lesions were addressed at the same surgical setting. At a minimum follow-up of 24 months, clinical and functional variables had improved significantly (P < 0.001), and 20 of the 22 patients (9...

We translated and adapted the English RC-QOL (rotator cuff quality of life) questionnaire into Italian and performed reliability and validity evaluations of the Italian RC-QOL version in patients with rotator cuff tears. The RC-QOL English version was translated into Italian by a bilingual orthopaedic surgeon. The back translation of the Italian ve...

Synovial chondromatosis of Hoffa's body is uncommon. Recurrences usually result from incomplete removal of the loose bodies or diseased synovium at the initial surgery. We report a patient with synovial chondromatosis localized into the Hoffa's body who presented with anterior knee pain and mechanical symptoms. At the first arthroscopy, all patholo...

The kneeling view is a method to objectively measure posterior knee laxity. However, the actual amount of load applied and the reliability of this method in term of side to side difference are not known. We studies these issues in a group a 25 healthy volunteers who underwent measurements of posterior knee laxity in both knees. A standard digital s...

We compared the clinical and quality of life related outcome of rotator cuff repair performed using either a mini-open or an arthroscopic technique for rotator cuff tears of less than 3 cm. The records of 64 patients who underwent rotator cuff repair between September 2003 and September 2005 were evaluated. Thirty-two patients underwent a mini-open...

A group of 43 patients who underwent arthroscopic capsular shrinkage for MDI at the UCLA Medical Center between September 1996 and October 1998 was reviewed. Thirty-six patients, 15 males and 21 females, with an average age of 27 years, were available for follow-up at an average of 25 months. All patients were evaluated according to the modified RO...

Avulsion fractures of the tibial eminence have been well described in children and adults with an increased in incidence resulting from road traffic and athletic accidents. According to the literature, only surgical treatment is advocated because of the high incidence of the nonunion and instability following conservative treatment. Open reduction...

The authors present a critical analysis of the literature in order to evaluate the current prospects and advantages of cartilage cell cultures for in vivo transplants. The analysis is relative to their use or to the treatment of isolated osteochondral lesions of the knee, and it is preceded by an analysis of the methods used in the treatment of thi...

Algo-dysfunctional syndrome (ADS) of the temporo-mandibular joint (TMJ) is frequently encountered and, since its clinical expression is extremely polymorphic, it is often misdiagnosed. As there are many causes for ADS, even in a single patient, in line with the most recent interpretations found in the literature, an attempt was made to determine ho...

This 3-day, multicenter, open-label, randomized, controlled trial was undertaken to assess the postoperative analgesic effect and therapeutic safety of intramuscular tramadol compared with intramuscular ketorolac in 48 patients undergoing orthopedic surgery and having postoperative pain assessed as 75 mm or more on a 100-mm visual analogue scale. T...

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The authors present the results obtained in the treatment of rheumatoid knee by arthroscopic synovectomy. A total of 29 knees operated on in 25 patients after a mean follow-up of 38 months based on the Laurin evaluation scale were re-examined. There was significant improvement for pain, synovitis, and overall function (mean values pre- and postoper...

The authors present their experience in the arthroscopic treatment of fracture-avulsion of the intercondyloid eminence in the adult with a variation in the original method. In fact, an ACUFEX tibial guide is used for reconstruction of the ACL positioning 2 Kirschner wires with hole at the margins of the fragment, successively sliding the metal wire...

It is the purpose of this paper to introduce a new cervical orthosis with multiplanar adjustment. Many orthoses are available to the physician today, but all of them may be classified based on function into two groups: 1) orthoses that immobilize the neck in a fixed position; 2) orthoses that immobilize the patient in a position that may be set in...

F. Merlo, G. Cerullo, L. Osti, G. Dirienzo, and M. Filisio: Diagnosis of anterior cruciate ligament lesions: comparison between acute and chronic cases. Analysis of clinical and arthrometric evaluation. J. Sports Traumatol. rel, res. 19: 7, 1997. The purpose of the study was to evaluate the clinical datum of possible variations in ligament laxity o...

Samenvatting Onderzocht werden 38 patiënten met een artroscopisch bewezen volledige ruptuur van het lca die minder dan drie weken na oplopen van het letsel waren geopereerd. De patiënten, onder wie 27 mannen en 11 vrouwen, hadden een gemiddelde leeftijd van 26 jaar (16 tot 43). Alle proefpersonen hadden preoperatief mri ondergaan.

We reviewed 38 patients with arthroscopically-proven complete ACL tears operated on less than three weeks after injury. Their average age was 26 years (16 to 43), with 27 males and 11 females. All patients had had MRI preoperatively. The same examiner performed the Lachman, anterior-drawer, and pivot-shift tests without anaesthesia, recording the d...

We measured the initial fixation strength of a new graft, bone-hamstring-bone (BHB), for reconstruction of the anterior cruciate ligament (ACL) in 79 porcine knees and compared it with that of the normal porcine ACL and of the bone-patellar tendon-bone (BPB) graft. All specimens were subjected to ultimate load to failure and cyclic loading tests to...

In this double blind study, seven out of fourteen patients who had received a cementless hydroxyapatite-covered hip prosthesis were given calditriol (1 μg daily), and seven an inert placebo for a period of four months. At the end of this period, total body bone densitometry (TBBD) and absorptiometric measurements in the regions of interest (ROIs) c...

Arthroscopic partial lateral meniscectomies performed for isolated meniscal tears, without associated ligamentous injury, in 41 athletes between August 1, 1988 and June 1, 1991 were reviewed for clinical and functional outcome. The study population was composed of 27 males and 14 females, with an average age of 26 years (range 17-40). Thirty-seven...

Intrameniscal ossicles of the knee are rare lesions. We present two cases. The first case occurred in a male soccer player who had knee trauma, with radiographic findings of a meniscal ossicle. Meniscal motions were normal, and symptoms resolved with conservative measures. The second case was found in a male athlete with acute medial compartment in...

An objective index of anterior cruciate ligament (ACL) tears based on posterior cruciate ligament (PCL) shape has been introduced. The PCL shapes on magnetic resonance imaging (MRI) were measured in 67 patients (31 normal ACL, 31 torn ACL, and five partial ACL tears, all confirmed by arthroscopy). All of the measurements were performed in a blinded...

Fifty-five ankle arthroscopies performed for anterolateral ankle impingement between January 1987 and April 1992 were reviewed for functional outcome and patient satisfaction. There were 33 men and 22 women with an average age of 34 years (range 20-67). All patients reported a previous history of ankle injury, and 60% of the patients had at least o...

Ganglion cysts on the anterior cruciate ligament (ACL) should be suspected in any patient having pain and clicking sensation during terminal knee extension. Previous investigators have reported incidental findings of ganglion cysts on the ACL. However, we report a symptomatic case of a ganglion cyst on the ACL that was treated successfully with art...

Authors present their results with the use of synthetic salmon calcitonin to treat 21 patients who underwent implantation of hip endo- or arthroprosthesis. Clinical data as well as laboratory, radiographic and scintigraphic documentation are presented.