Walter Albisetti

University of Milan, Milano, Lombardy, Italy

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Publications (72)79.5 Total impact

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    ABSTRACT: Background: This randomized, double-blind, parallel-group clinical trial aims to assess the equivalence of intra-articular polynucleotides compared to standard hyaluronic acid (HA) viscosupplementation in the treatment of knee osteoarthritis (OA). Methods: 75 patients affected by knee OA were assessed for eligibility and 72 were enrolled and randomized to receive either intra-articular polynucleotides (Condrotide-36 patients) or hyaluronic acid (Hyalubrix-36 patients) at the Orthopedic Institute "Gaetano Pini" (Milan). All patients underwent three intra-articular injections of Condrotide or Hyalubrix with an interval of 1week. Participants, care givers, and investigators responsible for outcome assessment were all blinded to group assignment. Primary outcome measurements (KOOS and pain level (1) at rest, (2) at weight-bearing and (3) during physical activity) were evaluated at baseline (T0) and after one (T1), two (T2), six (T6), ten (T10), and 26 (T26)weeks. Secondary measurements included the determination of COMP serum levels at T0, T6 and T26. Results: The reduction of pain and the increase of KOOS values from baseline were statistically significant for both treatments; nevertheless, for parameter KOOS "symptoms" the treatment with Condrotide showed significant results already after twoweeks (at T2 p=0.003) while the results obtained with Hyalubrix became significant only after 18 weeks (at T18 p=0.01). No significant adverse events were reported. Conclusions: Condrotide is as effective as Hyalubrix in reducing knee OA symptoms but showed an earlier response on pain reduction and can therefore be considered a valid alternative to the use of HA in the treatment of OA, avoiding the adverse events of NSAIDs and of intra-articular corticosteroids.
    No preview · Article · Jun 2014 · The Knee
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    A Memeo · F Verdoni · O De Bartolomeo · W Albisetti · L Pedretti
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    ABSTRACT: Non-union rate in forearm fractures is generally less than 2% when a proper technique is used; this rate increases when ulnar lesions are involved. We present a case series of seven young patients whose average age was 14 years (range 11-19 years) at the time of surgery and who presented with a forearm post-traumatic non-union that was previously treated in different ways (three isolated ulnar non-union, two isolated radial non-union and two combined). Average follow-up was 34 months (range 9-72 months). Surgical treatment began with the removal of the previous synthesis and with curettage of the non-union area. The Acumed ulnar rod, Acumed radial rod and Thalon elastic nail (all of them are unreamed and locked nails) together with autologous platelet-rich plasma (PRP) obtained with the Biomet System (concentration of 158.2×10(4) platelets/μL) were chosen to treat the patients. X-rays and clinical controls were conducted every 30 days until recovery. All patients recovered: average recovery was 23 weeks from operation (range 16-36 weeks) and nails were removed 3 months after complete healing. Six patients had excellent results and one patient had a good result (Patient 2, forearm pronosupination 60-0-40 degrees). The purpose of the case series was to establish a better way of treatment and to find a technique that could avoid the use of bone grafts, because obtaining autologous bone requires a further surgical procedure that can be really invasive depending on the amount of bone needed. All patients in the study showed complete recovery, with excellent clinical outcomes. Although there were only seven patients in this case series, and there is a need to analyse more patients, this study showed that the use of a specific locking nail system can provide proper stability to ulnar or radial atrophic non-union despite rotational forces, and when combined with autologous growth factors (PRP) is sufficient to promote bone healing in young patients without the necessity to take autologous bone grafts.
    Preview · Article · Sep 2013 · Injury
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    ABSTRACT: A tight control of magnesium homeostasis seems to be crucial for bone health. On the basis of experimental and epidemiological studies, both low and high magnesium have harmful effects on the bones. Magnesium deficiency contributes to osteoporosis directly by acting on crystal formation and on bone cells and indirectly by impacting on the secretion and the activity of parathyroid hormone and by promoting low grade inflammation. Less is known about the mechanisms responsible for the mineralization defects observed when magnesium is elevated. Overall, controlling and maintaining magnesium homeostasis represents a helpful intervention to maintain bone integrity.
    Full-text · Article · Aug 2013 · Nutrients
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    ABSTRACT: The study was designed to compare the clinical results of traditional single-bundle (SB) anterior cruciate ligament (ACL) reconstruction with those of double-bundle (DB) ACL reconstruction. This study comprised 80 patients aged 18 to 45 years with an isolated ACL lesion: 40 patients underwent SB reconstruction, and 40 patients underwent DB reconstruction. Patients were assessed preoperatively with functional assessment including the International Knee Documentation Committee 2000 knee subjective form and visual analog scale, as well as physical examination (including the pivot-shift test and instrumented knee laxity measurement). Vertical jump assessment with the Optojump system (Microgate, Bolzano, Italy) has been introduced as a method to compare functional ability between the 2 surgical techniques. The same protocol was repeated 6 months, 12 months, and 2 years after surgery. No statistically significant differences were noted between the groups concerning subjective evaluation, thigh girth difference, mean visual analog scale score, range of motion, and Lachman and anterior drawer tests (P = not significant). A statistically higher number of patients in the SB group showed a positive pivot-shift test and a higher side-to-side difference when measured with the KT-1000 arthrometer (MEDmetric, San Diego, CA) than in the DB group (P < .001). Better mean jumping performance results were reported in the DB group compared with the SB group (P < .001). The average performance results for the injured limb were not significantly reduced compared with those of the uninjured limb in the DB group 12 months after surgery. At 2 years, a restoration of jumping ability in the ACL-reconstructed limb was achieved in both groups regardless of the technique used. DB ACL reconstruction has been proven to be superior to the SB technique with regard to knee stability and vertical jump performance. Level II, prospective comparative study.
    No preview · Article · Jul 2013 · Arthroscopy The Journal of Arthroscopic and Related Surgery
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    ABSTRACT: Inflammation is a common albeit overlooked cause of local and systemic bone loss which results from an imbalance between bone formation and bone resorption. The Wnt pathway, which plays an essential role in the regulation of bone turnover, has been proposed as a potential molecular link between inflammation and inflammatory bone loss. We here recapitulate present knowledge about sclerostin, a Wnt pathway inhibitor, and bone damage in inflammation. A better understanding of sclerostin action and regulation might help in designing an effective treatment strategy in inflammatory bone loss.
    No preview · Article · May 2013 · European Journal of Inflammation
  • M Berruto · F Uboldi · L Gala · B Marelli · W Albisetti
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    ABSTRACT: Purpose: Dynamic laxity is clinically demonstrated with the pivot-shift (PS) test. Recently, a new system that measures the acceleration of the tibia during the PS test was validated. The goal of the present study was to use the accelerometer "KiRA" to evaluate the efficacy of measuring PS. Methods: Between 2010 and 2011, a total of 100 patients with anterior cruciate ligament (ACL) lesions were enrolled. They underwent surgical reconstruction of the ACL. Among them, 30 patients were re-evaluated at least 6 months after surgery. Each patient underwent a clinical examination (Lachman test, anterior drawer test, and PS test) and then was subjected to an instrumental examination: KT1000 evaluation to quantify the Lachman test and KiRA to quantify the PS test. Results: The accelerometer found a positive acceleration difference in favour of the pathologic knee. In the 100 patients evaluated preoperatively, the analysed acceleration parameters on the pathologic knee were found to be significantly different with respect to the contralateral joint. Correlating the clinical subjective data with numerical data, we identified mean reference values for every grade of the PS test (negative, glide, and clunk). Conclusion: Our experience showed us that the use of KiRA accelerometer for quantitative measurement of the PS is both promising and reliable. The efficacy of this instrument is strictly related to an inevitable learning curve and to proper execution of the test. It has the value of being easy to set up and easy to use in both the clinic and the operating room.
    No preview · Article · Feb 2013 · Knee Surgery Sports Traumatology Arthroscopy
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    ABSTRACT: Synthetic ligament for anterior cruciate ligament (ACL) reconstruction has been widely used in the past. Long-term follow-up has demonstrated the unreliability of many of these devices in ACL surgery, and problems may arise for the surgeon approaching a patient with failed artificial ligament reconstruction. The aim of this study is to investigate whether revision surgery may improve clinical and radiographic outcomes in patients with failed synthetic ACL reconstruction. Fourteen patients who were treated in the past with ACL reconstruction with synthetic grafts underwent two-stage revision surgery. Follow-up averaged 4.2 years (range 2-6 years). Mean KOOS score was 75.8 (SD 10.2); IKDC score was B in two patients, C in nine and D in three. The improvement compared to preoperative status was not statistically significant (p > 0.05). Four patients were positive to Lachman and anterior drawer tests. Mean side-to-side anterior laxity averaged 4.3 mm (SD 1.2). Biopsy specimens documented the presence of foreign body granulomatous reaction, giant foreign body cells and polyethylene wear particles. The level of osteoarthritis worsened at follow-up compared to preoperative status (p < 0.05). ACL revision surgery with autografts in patients who underwent previous failed primary synthetic ligament reconstruction does not improve clinical outcomes and does not influence the natural history of knee osteoarthritis started from artificial ligament debris.
    No preview · Article · Dec 2012 · European Journal of Orthopaedic Surgery & Traumatology
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    Article: Editoriale
    Walter Albisetti · Massimo Berruto · Alberto Ventura · I. Curatori

    Full-text · Article · Dec 2012 · Archivio di Ortopedia e Reumatologia
  • A. Memeo · L. Pedretti · L. Rossi · F. Calabrò · W. Albisetti
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    ABSTRACT: Mesenchymal stem cells can be used in the treatment of a great number of musculoskeletal paediatric pathologies in order to find less invasive and more efficient therapies. Nowadays, according to our experience, we use MsC for the treatment of bone cyst, congenital and posttraumatic nonunion, delayed bone union during limb lengthening, osteochondral detachments and necrosis of the femoral head.
    No preview · Article · Dec 2012 · Archivio di Ortopedia e Reumatologia
  • A. Memeo · L. Pedretti · C. Maccario · W. Albisetti
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    ABSTRACT: Il tasso di pseudoartrosi nelle fratture dell’avambraccio si aggira intorno al 2%, ma aumenta quando vi è anche la presenza di una lesione a carico dell’ulna. Abbiamo impostato una nuova strategia per il trattamento della pseudoartrosi ulnare, combinando l’uso di un chiodo endomidollare con l’infiltrazione nel sito di pseudoartrosi di plasma autologo ricco di piastrine (PrP). Presentiamo tre diversi casi riguardanti giovani pazienti affetti da pseudoartrosi atrofica dell’ulna. La pseudoartrosi, radiograficamente documentata, è stata trattata chirurgicamente mediante la rimozione dei mezzi di sintesi precedentemente impiantati, il curettage del focolaio di pseudoartrosi e la sintesi con chiodo endomidollare ulnare con infiltrazione del PrP. I controlli clinico-radiografici a 20 mesi dall’intervento hanno mostrato regolari processi riparativi in assenza di deviazioni assiali e deficit funzionale. Crediamo che l’utilizzo di gel piastrinico autologo rappresenti un utile co-trattamento nei casi di pseudoartrosi atrofica; tuttavia l’utilizzo combinato tra chiodo ulnare e PrP richiede ulteriori approfondimenti.
    No preview · Article · Dec 2012
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    ABSTRACT: Spine fusion is considered to be the gold standard for the treatment of most degenerative and traumatic spinal conditions. Bone graft is still the best choice to achieve fusion and currently autologous and allograft bone are the main sources for bone grafting procedures. Autologous bone has by far the most osteogenic potential, but it is limited and it can lead to a donor site pain condition. Allograft bone is an important source when structural or large volumes of grafts are required. Concerns related to the use of both autografts and allografts has led to the search for alternatives, but synthetic bone graft substitutes as yet offer only a partial solution to the management of localized bone loss. They possess some of the desired mechanical qualities of bone as well as osteointegrative/conductive properties, but are largely reliant on viable periosteum/bone for their success. The advent of composite synthetic bone graft substitutes and biologically active factors is moving closer to the goal of obtaining a synthetic bone graft substitute that mimics the native bone in both mechanical and osteogenic properties.
    No preview · Article · Dec 2012 · Archivio di Ortopedia e Reumatologia
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    ABSTRACT: Background: Patients with Gitelman syndrome, a hereditary salt-wasting tubulopathy, have loss-of-function mutations in the SLC12A3 gene coding for the thiazide-sensitive sodium chloride co-transporter in the distal convoluted tubule. Since the bulk of filtered phosphate is reabsorbed in the proximal tubule, renal phosphate wasting is considered exceptional in Gitelman syndrome. Methods: We investigated the renal handling of inorganic phosphate in 12 unselected Italian patients affected with Gitelman syndrome (5 females and 7 males, aged 6.0-18 years, median age 12 years) and in 12 healthy subjects matched for gender and age (controls). The diagnosis of Gitelman syndrome among the patients had been made clinically and confirmed by molecular biology studies. Results: The biochemical hallmarks of Gitelman syndrome, namely hypochloremia, hypokalemia, hypomagnesemia, increased urinary excretion of sodium, chloride, potassium and magnesium and reduced urinary excretion of calcium, were present in the 12 patients. In addition, both the plasma inorganic phosphate concentration (median and interquartile range: 1.28 [1.12-1.36] vs. 1.61 [1.51-1.66)] mmol/L) and the maximal tubular reabsorption of inorganic phosphate (1.08 [0.99-1.22] vs. 1.41 [1.38-1.47] mmol/L) were significantly lower (P < 0.001) in Gitelman patients than in control subjects. Circulating levels of 25-hydroxyvitamin D, intact parathyroid hormone and osteocalcin were similar in patients and controls. Conclusions: The results of our case-control study disclose a hitherto unrecognized tendency towards renal phosphate wasting with mild to moderate hypophosphatemia in Gitelman syndrome.
    No preview · Article · Sep 2012 · Pediatric Nephrology
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    ABSTRACT: Clubfoot is one of the most common congenital abnormalities and, therefore, only a proper and early treatment can avoid a permanent deformity. Since clubfoot can determine many different clinical patterns, conservative treatment includes several strategies in order to face this pathology timely, such as Ponseti’s method and the French functional method. A review of the latest international literature about the comparison between these two methods allows to state that the choice of one or the other must vary following the severity of the deformity, the social and economic context of the patient’s family but, mainly, the specific problems of each individual patient, who will have to undergo a long follow-up period in order to check the good outcome of the treatment and to avoid relapses.
    No preview · Article · Apr 2012 · Archivio di Ortopedia e Reumatologia
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    ABSTRACT: “Cartilagine - Istruzioni per l’uso”, un titolo certamente particolare ma non casuale per un libro pensato, immaginato e realizzato con criteri diversi rispetto a quelli che guidano le opere più tra dizionali. Anzitutto un libro che nasce con una doppia anima: una cartacea, più classica ed una seconda versione tablet, assolutamente originale e rivoluzionaria, certamente più giovane, frizzante, dinamica e al passo con i più moderni e accattivanti sistemi di comunicazione. Una vera novità nel panorama della produzione editoriale scientifica italiana, fortemente voluta dal Comitato Cartilagine e Biotecnologie della SIGASCOT. Partendo da questi presupposti il libro non poteva che essere costruito con criteri diversi: più incisivi, immediati, quasi visivi. Tante tabelle, molti riassunti per punti dei vari concetti espressi dagli Autori, con l’intento di sintetizzare, riassumere, focalizzare, in modo da facilitare e mantenere alta la soglia dell’attenzione di chi legge. E alla fine di ogni Capitolo dei Take Home Messages in grado di puntualizzare e riassumere i principali concetti espressi da ciascun Autore. Una sorta di Instant Book, agile e di facile consultazione, alla cui realizzazione hanno contribuito le più qualificate scuole italiane che da sempre si sono occupate con grande competenza e professionalità di una patologia complessa come quella cartilaginea.
    No preview · Chapter · Jan 2012

  • No preview · Chapter · Jan 2012
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    ABSTRACT: An adequate intake of magnesium (Mg) is important for bone cell activity and contributes to the prevention of osteoporosis. Because (a) Mg is mitogenic for osteoblasts and (b) reduction of osteoblast proliferation is detected in osteoporosis, we investigated the influence of different concentrations of extracellular Mg on osteoblast-like SaOS-2 cell behavior. We found that low Mg inhibited SaOS-2 cell proliferation by increasing the release of nitric oxide through the up-regulation of inducible nitric oxide synthase (iNOS). Indeed, both pharmacological inhibition with the iNOS inhibitor l-N(6)-(iminoethyl)-lysine-HCl and genetic silencing of iNOS by small interfering RNA restored the normal proliferation rate of the cells. Because a moderate induction of nitric oxide is sufficient to potentiate bone resorption and a relative deficiency in osteoblast proliferation can result in their inadequate activity, we conclude that maintaining Mg homeostasis is relevant to ensure osteoblast function and, therefore, to prevent osteoporosis.
    No preview · Article · Dec 2011 · The Journal of nutritional biochemistry
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    ABSTRACT: The most common elbow lesions found in pediatric practice are supracondylar fractures. We compared two groups of 34 patients each with a supracondylar humerus fracture grade III (Gartland classification). The first group was treated with percutaneous pinning with Kirschner wires, with patients in a supine position, sometimes preceded by transkeletal traction. The second group was treated with percutaneous pinning with Kirschner wires, with patients in a prone position, within 6 h of the trauma. No statistically significant differences with regard to clinical outcomes and neurovascular complications were revealed in the comparison. Therefore, we can state that both treatment techniques used are valid.
    No preview · Article · Dec 2011 · Journal of pediatric orthopaedics. Part B / European Paediatric Orthopaedic Society, Pediatric Orthopaedic Society of North America
  • G. A. La Maida · A. Acerbi · W. Albisetti · B. Misaggi
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    ABSTRACT: Viene presentato il caso clinico di una giovane donna che ha subito un grave politrauma con una grave lesione fratturativa del rachide toracico. Il necessario e immediato intervento di decompressione e stabilizzazione eseguito presso altro ospedale non ha permesso un adeguato ripristino della stabilità vertebrale a causa di un erroneo inquadramento classificativo iniziale della lesione. Infatti nei mesi successivi al primo intervento è comparsa una grave deformità vertebrale per mancata guarigione della frattura vertebrale a causa di una non adeguata stabilizzazione della lesione altamente instabile. Il caso clinico presentato dimostra l’importanza dell’impiego sistematico di un adeguato sistema classificativo nella valutazione di una frattura vertebrale, al fine di poter pianificare sin dall’inizio il miglior intervento chirurgico e ridurre al minimo il rischio di insuccesso e di revisione chirurgica a distanza.
    No preview · Article · Dec 2011
  • Antonio Memeo · Leopoldo Pedretti · Francesca Miola · Walter Albisetti
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    ABSTRACT: Ten skeletally immature patients were treated with an arthroscopic-assisted anterior cruciate ligament reconstruction with bone-patellar tendon bone autograft (compass, 50-55°; holes, 7-9 mm). Radiological assessments (standard radiograph), Orthopädische Arbeitsgruppe Knie (OAK) score and KT 1000, were conducted on all patients, 1 year after surgery. Skeletal maturity had been reached by all patients and no complications were observed. All patients returned to their preinjury sport level. Drilling more vertical tunnels when bone-tendon-bone autograft was chosen to avoid partial epiphysiodesis and offers good functional and isometric results.
    No preview · Article · Aug 2011 · Journal of pediatric orthopaedics. Part B / European Paediatric Orthopaedic Society, Pediatric Orthopaedic Society of North America
  • Francesco Sala · Camilla Federica Salerno · Walter Albisetti
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    ABSTRACT: A docking site is the terminus of travel of two segments of bone that are gradually brought into approximation, normally associated with the bone transport technique in limb reconstruction. Traumatic pseudoaneurysm of the peroneal artery have been reported following different types of trauma and orthopedic procedures performed in the distal leg. One uncommon case of delayed peroneal artery pseudoaneurysm following surgical docking site is described. The diagnosis was supported by angiography. Embolization with coil was a successful method of treatment. We recommend a safe method of osteotomy with good bone exposure and adequate soft tissue protection.
    No preview · Article · Aug 2011 · MUSCULOSKELETAL SURGERY