Giulio Maria Marcheggiani Muccioli - Academia.edu (original) (raw)

Papers by Giulio Maria Marcheggiani Muccioli

progressi dell'ortopedia a Bologna: Istituti Ortopedici Rizzoli. La IX divisone ed il Laborat... more progressi dell'ortopedia a Bologna: Istituti Ortopedici Rizzoli. La IX divisone ed il Laboratorio di Biomeccanic

Orthopaedic Proceedings, Mar 12, 2021

In 1950, Krueger implanted the first modern shoulder prosthesis [1]. From those days the study of... more In 1950, Krueger implanted the first modern shoulder prosthesis [1]. From those days the study of biomechanics and materials has led to better and better results. Even for the most experienced surgeon, however, the most difficult and interesting challenge is the indication to prosthetics. “When to do surgery?” remains the unavoidable question for an excellent surgical result.

Introduction: Hereditary multiple exostoses (MHE), also known as familiar osteochondromatosis or ... more Introduction: Hereditary multiple exostoses (MHE), also known as familiar osteochondromatosis or diaphyseal aclasis, is an autosomal dominant inherited genetic pathology that is characterized by the presence of multiple benign osteochondromas (exostoses). Knee deformity is common in patients with HME, with nearly a third of patients developing genu valgus. Total knee arthroplasty (TKA) has been used to correct valgus deformities with advanced knee osteoarthritis (OA). However concomitant limb deformities and altered anatomy of the knee make this surgery particularly challenging.Case presentation: We present the case of a 50 years old Caucasian woman, affected by multiple hereditary exostoses, who came to our attention for progressive pain in the right knee. Upon further examination the knee had a prominent valgus alignment, concomitant valgus instability and flexion contraction. The patient was treated with one stage total knee arthroplasty using a semi-constrained design. The patie...

MUSCULOSKELETAL SURGERY, 2021

Total knee arthroplasty in valgus knee deformities continues to be a challenge for a surgeon. App... more Total knee arthroplasty in valgus knee deformities continues to be a challenge for a surgeon. Approximately 10% of patients who undergo total knee arthroplasty have a valgus deformity. While performing total knee arthroplasty in a severe valgus knee, one should aware with the technical aspects of surgical exposure, bone cuts of the distal femur and proximal tibia, medial and lateral ligament balancing, flexion and extension gap balancing, creating an appropriate tibiofemoral joint line, balancing the patellofemoral joint, preserving peroneal nerve function, and selection of the implant regarding constraint. Restoration of neutral mechanical axis and correct ligament balance are important factors for stability and longevity of the prosthesis and for good functional outcome. Thus, our review aims to provide step by step comprehensive knowledge about different surgical techniques for the correction of severe valgus deformity in total knee arthroplasty.

14èmes Journees Lyonnaises de Chirurgie du genou: Advanced Course of Knee Arthroplasty, 2010

The patellofemoral joint, due to its particular bone anatomy and the numerous capsuloligamentous ... more The patellofemoral joint, due to its particular bone anatomy and the numerous capsuloligamentous structures and muscles that act dynamically on the patella, is considered one of the most complex joints in the human body from the biomechanical point of view. The medial patellofemoral ligament (MPFL) has been demonstrated to contribute 60% of the force that opposes lateral displacement of the patella, and MPFL injury results in an approximately 50% reduction in the force needed to dislocate the patella laterally with the knee extended. For this reason, recent years have seen a growing interest in the study of this important anatomical structure , whose aponeurotic nature has thus been demonstrated. The MPFL acts as a restraint during motion, playing an active role under conditions of laterally applied stress, but an only marginal role during natural knee flexion. However, it remains extremely difficult to clearly define the anatomy of the MPFL and its relationships with other anatomic...

Journal of Experimental Orthopaedics, 2020

PurposeTo evaluate clinical ad radiological outcomes of anterior cruciate ligament (ACL) reconstr... more PurposeTo evaluate clinical ad radiological outcomes of anterior cruciate ligament (ACL) reconstruction with an immunochemically modified porcine patellar tendon xenograft controlled against human Achilles tendon allograft at 24-month minimum follow-up.Methods66 patients undergoing arthroscopic ACL reconstruction were randomized into 2 groups: 34 allografts and 32 xenografts treated to attenuate the host immune response. Follow-up was 24-month minimum. Anterior knee stability was measured as KT − 1000 side-to-side laxity difference (respect to the contralateral healthy knee). Functional performance was assessed by one-legged hop test. Objective manual pivot-shift test and subjective (IKDC, Tegner and SF-36) outcomes were collected. MRI and standard X-Ray were performed.Results61 subjects (32 allograft, 29 xenograft) were evaluated at 12 and 24 months. Six of the subjects in xenograft group (20.6%) got an infection attributed to a water-based pathogen graft contamination in processin...

The Bone & Joint Journal, 2017

Aims Our aim was to perform a meta-analysis of the outcomes of revision anterior cruciate ligamen... more Aims Our aim was to perform a meta-analysis of the outcomes of revision anterior cruciate ligament (ACL) reconstruction, comparing the use of different types of graft. Materials and Methods A search was performed of Medline and Pubmed using the terms “Anterior Cruciate Ligament” and “ACL” combined with “revision”, “re-operation” and “failure”. Only studies that reported the outcome at a minimum follow-up of two years were included. Two authors reviewed the papers, and outcomes were subdivided into autograft and allograft. Autograft was subdivided into hamstring (HS) and bone-patellar tendon-bone (BPTB). Subjective and objective outcome measures were analysed and odds ratios with confidence intervals were calculated. Results A total of 32 studies met the inclusion criteria. Five studies used HS autografts, eight reported using BPTB autografts, two used quadriceps tendon autografts and eight used various types. Seven studies reported using allografts, while the two remaining used both...

European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, Jan 25, 2017

Soccer is considered the most popular sport in the world concerning both audience and athlete par... more Soccer is considered the most popular sport in the world concerning both audience and athlete participation, and the incidence of ACL injury in this sport is high. The understanding of injury situations and mechanisms could be useful as substratum for preventive actions. To conduct a video analysis evaluating the situations and mechanisms of ACL injury in a homogeneous population of professional male soccer players, through a search entirely performed on the YouTube.com Web site focusing on the most recent years. A video analysis was conducted obtaining videos of ACL injury in professional male soccer players from the Web site YouTube. Details regarding injured players, events and situations were obtained. The mechanism of injury was defined on the basis of the action, duel type, contact or non-contact injury, and on the hip, knee and foot position. Thirty-four videos were analyzed, mostly from the 2014-2015 season. Injuries occurred mostly in the first 9 min of the match (26%), in ...

Arthroscopy and Sport Injuries, 2016

Osteoarthritis is the most common joint disease. Being exposed to a high-intensity and prolonged ... more Osteoarthritis is the most common joint disease. Being exposed to a high-intensity and prolonged sports activity, athletes are particularly vulnerable to osteoarthritis as a long-term effect of such vigorous physical stress and results in irreversible pathological changes in affected joints.

British journal of sports medicine, Jan 10, 2015

Return to sport and to pre-injury level represents an important outcome after both primary and re... more Return to sport and to pre-injury level represents an important outcome after both primary and revision anterior cruciate ligament (ACL) reconstructions. The aim of the present meta-analysis was to determine the return to sport rate after revision ACL reconstruction. A systematic search was performed of the MEDLINE, Embase and the Cochrane Central Register of Controlled Trials Databases. All the studies that reported return to sport, return to pre-injury sport level and return to high level/competitive sport was considered for the meta-analysis. The overall pooled mean of post-operative knee laxity and pooled rate of positive pivot-shift and objective International Knee Documentation Committee (IKDC) categories was calculated as well. Overall, 472 abstracts were identified and screened for inclusion and only 16 studies reported the rate of return to any level of sport activity at the final follow-up of 4.7 years (range 1.0-13.2 years), showing a pooled rate of 85.3% (CI 79.7 to 90.2...

Sports Injuries, 2011

The surgical treatment of a severe degenerative joint disease (DJD) of the knee with a Total Knee... more The surgical treatment of a severe degenerative joint disease (DJD) of the knee with a Total Knee Arthroplasty (TKA) produces a new surgical normality. To develop a new functional normality starting from this new surgical normality is never an easy step, most of all when the new functional normality is expected to be at a high demand activity level. Postoperative pain resolution is obviously the first and mandatory request to be satisfied in order to progress toward a new complete functional normality. A correct rehabilitation protocol, based on a correctly administered physical activity, is fundamental in reducing the incidence of functional complications which are incompatible with sport activity resumption. Moderate running or jogging is not generally considered a dangerous exercise; however, is not so harmless. Biking is surely the physical activity with the lowest impact on the knee after TKA.

Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2011

Journal of ISAKOS: Joint Disorders & Orthopaedic Sports Medicine, 2018

ObjectivesKinematic Rapid Assessment (KiRA) is a wireless, non-invasive, inertial system with a s... more ObjectivesKinematic Rapid Assessment (KiRA) is a wireless, non-invasive, inertial system with a single tibial sensor developed to measure the pivot-shift (PS) test. The purpose of this study was to in-vivo compare acceleration values acquired by KiRA to the objective International Knee Documentation Committee (IKDC) clinical grading of PS. The comparison was performed in non-anaesthetised patients before and after anterior cruciate ligament (ACL) reconstruction. We hypothesised the existence of a correlation between the side-to-side difference in the measured acceleration range by KiRA and the objective IKDC clinical grading of the PS.MethodsBetween 2010 and 2014, 60 non-professional football players (male/female ratio: 42/18; mean age 34±15.4 years, range 14–51 years) with ACL lesion were enrolled. They underwent over-the-top ACL reconstruction plus lateral extra-articular plasty with autologous hamstrings. All the patients were evaluated before the reconstruction and re-evaluated ...

Knee Surgery, Sports Traumatology, Arthroscopy

The aim of the present study was to compare the in vivo under weight-bearing kinematic behavior o... more The aim of the present study was to compare the in vivo under weight-bearing kinematic behavior of a posterior-stabilized (PS) and an ultra-congruent (UC) total knee arthroplasty (TKA) model during a sit-to-stand motor task, a common activity of daily life. A cohort of 16 randomly selected patients (8 PS Persona Zimmer, 8 UC Persona Zimmer) was evaluated through dynamic radiostereometric analysis (RSA) at a minimum of 9 months after TKA, during the execution of a sit-to-stand. The anteroposterior (AP) translation of the femoral component and the AP translation of the low point of medial and lateral femoral compartments were compared through Student’s t test (p < 0.05). A significantly greater anterior translation of the femoral component was found for the PS group compared to the UC group. The flexion interval where statistical significance was found was between 30° and 0° (p = 0.017). Both groups showed a significantly greater anterior translation of the low point of the lateral compartment with respect to the medial one (PS: p = 0.012, UC: p = 0.018). This was consistent with a medial-pivot pattern. Furthermore, a significantly greater anterior translation of the medial compartment was found in the PS group compared to the UC group (p = 0.001). The same pattern was observed for the lateral compartment (p = 0.006). The TKA designs evaluated in the present study showed comparable in-vivo kinematics with regards to medial pivot pattern but differences in absolute AP translation. Specifically, the UC design showed greater AP stability than the PS design. This finding could be positive in terms of implant stability, but negative in terms of premature polyethylene wear and thus implant failure. This remains to be verified in studies with a larger sample size and longer follow-up. IV.

Shoulder Arthroplasty, 2020

INTRODUCTION This study aimed to intra-operatively quantify the improvements in knee stability gi... more INTRODUCTION This study aimed to intra-operatively quantify the improvements in knee stability given both by anatomic double-bundle (ADB) and single-bundle with additional lateral plasty (SBLP) ACL reconstruction using a navigation system. MATERIALS AND METHODS We prospectively included 35 consecutive patients, with an isolated anterior cruciate ligament injury, that underwent both ADB and SBLP ACL reconstruction (15 ADB, 20 SBLP). The testing protocol included anterior/posterior displacement at 30° and 90° of flexion (AP30–AP90), internal/external rotation at 30° and 90° of flexion (IE 30–IE90) and varus/valgus test at 0° and 30° of flexion (VV0–VV30); pivot-shift (PS) test was used to determine dynamic laxity. The tests were manually performed before and after the ACL reconstruction and the data were acquired by means a surgical navigation system (BLU-IGS, Orthokey, USA). Comparisons of pre- and post-reconstruction laxities were made using paired Student t-test (P=0.05) within the...