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Nicola Maffulli

Tulio Diniz-Fernandes, Alexandre Leme Godoy-Santos, Maria Cristina Santo, Pedro Pontin, Caio Augusto Alves Pereira, Yuri Justi Jardim, Ana Paula Pereira Velosa, Nicola Maffulli, Walcy Rosolia Teodoro, Vera Luiza Capelozzi
Posterior tibial tendinopathy (PTT) can lead to acquired flatfoot in adults. Many patients develop PTT without any identifiable risk factors. Molecular changes in extracellular matrix (ECM) and matrix metalloproteinase (MMP) polymorphism may influence the risk of developing PTT. We aim to investigate the association between matrix metalloproteinase-1 (MMP-1) and (MMP-8) gene polymorphisms with changes in collagen I, III and V in PTT. A case-control study with 22 patients and 5 controls was performed. The MMP-1 (2G/2G) and MMP-8 (T/T) genotypes were determined by PCR-restriction fragment length polymorphism...
March 13, 2018: Histology and Histopathology
Nicola Maffulli
The process of healing in musculoskeletal tissues is complex, and the addition of devices, including platelet-rich plasma and mesenchymal stem cells, to biologically enhance it may favor its optimization. This work shows in a compelling fashion that it is possible to produce the right admixture of physical and biological factors to make it happen in rotator cuff repair.
March 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Nikolaos Malliaropoulos, Georgios Bikos, Maria Meke, Korakakis Vasileios, Xavier Valle, Heinz Lohrer, Nicola Maffulli, Nat Padhiar
Background: Inversion injury to the ankle and hamstring injuries are common problems in most sports. It is not known whether these injuries constitute a predisposing factor or a precursor of injury or re-injury of these anatomical locations. Therefore, we wished to test the hypothesis that a previous inversion ankle injury exerted a significant effect on the chance of an athlete suffering from a subsequent ipsilateral hamstring injury and vice versa. Methods: In an observational cohort study over 17 years (1998-2015), 367 elite track and field athletes, were grouped according to their first traumatic isolated ankle or hamstring injury...
2018: Journal of Foot and Ankle Research
Marcello Zappia, Daniela Berritto, Francesco Oliva, Nicola Maffulli
BACKGROUND: Percutaneous Achilles tendon repair has been developed to minimise soft tissue complications following treatment of tendon ruptures. However, there are concerns because of the risk of sural nerve injury. Few studies have investigated the relationship between the Achilles tendon, the sural nerve and its several anatomical course variants. METHODS: We studied 7 cadaveric limbs (7 Achilles tendons) in which a percutaneous repair of the Achilles tendon was performed...
March 30, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Nicola Maffulli, Francesco Oliva, Gayle D Maffulli, Angelo Del Buono, Nikolaos Gougoulias
BACKGROUND: Surgical management of chronic Tendo Achillis (TA) ruptures usually requires tendon grafting procedures. Several techniques have been described. We examined the outcome of three different less invasive (incisions length less than 3 cm) tendon transfer techniques in the management of patients with a chronic rupture of the TA. METHODS: Of 62 patients (39 males and 23 females; mean age 44.8 years; range 29.3-62 years) with chronic TA ruptures managed operatively, 21 patients had a ≥6cm gap and underwent free ipsilateral semitendinosus (ST) graft (21 patients), whereas patients with smaller gaps had either ipsilateral peroneus brevis (PB) (20 patients) or ipsilateral flexor hallucis longus (FHL) transfer (21 patients)...
February 16, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Gianni Di Vico, Sigismondo Luca Di Donato, Giovanni Balato, Gaetano Correra, Alessio D'Addona, Nicola Maffulli, Donato Rosa
Background: Anterior cruciate ligament tears (ACL) are associated with meniscal lesions, that could involve the posterior horn of the medial meniscus (PHMM). A variety of techniques has been proposed to better visualise the postero-medial (PM) compartment. The aim of the study is to evaluate the prevalence of longitudinal tears of peripheral attachment of the PHMM during arthroscopic ACL reconstruction, and to describe a diagnostic algorithm. Methods: 115 patients who underwent arthroscopic ACL reconstruction were enrolled for the study...
July 2017: Muscles, Ligaments and Tendons Journal
Nikos Malliaropoulos, Shaan Rachid, Vasileios Korakakis, Stephen Andrew Fraser, Georgios Bikos, Nicola Maffulli, Manuela Angioi
Background: No investigation has analysed the RWL approaches since new rules by the International Judo Federation (IJF) regarding weigh-ins have been implemented in international competitions in 2014. The current study analyses the prevalence, most common methods and knowledge surrounding the effects of rapid weight loss (RWL) amongst adult UK judo athletes. Additionally, it examines differences in rapid weight loss behaviour (RWLB) between gender, weight-class, competitive level, age RWL began and "high"/"low" knowledge athletes...
July 2017: Muscles, Ligaments and Tendons Journal
Johnny Padulo, Andrea De Giorgio, Francesco Oliva, Antonio Frizziero, Nicola Maffulli
Writing a scientific article is not an easy task, but it is definitely a great satisfaction to be able to conclude and publish it. Indeed, each publication is a service we make to the entire scientific community and to the advancement of science even before our personal career. There is and there will not be a final book/article for writing a scientific paper. Therefore, some knowledge is a decisive factor to increase the chances of our work being accepted by a specialized scientific journal. The purpose of this editorial is to trace an ideal path, based on our personal experience, useful to properly structure a scientific article, from bibliographic research to cover letter...
July 2017: Muscles, Ligaments and Tendons Journal
Stefano Petrillo, Rocco Papalia, Nicola Maffulli, Piero Volpi, Vincenzo Denaro
Background: Professional soccer (PS) players are at great risk of osteoarthritis (OA) of the knee and hip. Sources of data: Following the PRISMA guidelines, the key words 'osteoarthritis' and 'soccer' or 'football' were matched with 'players' or 'former' or 'retired' and with 'hip' or 'knee' on December 24, 2017 in the following databases: PubMed, Cochrane, Google scholar, Embase and Ovid. Only comparative studies reporting the prevalence rate of OA of both hip and knee joint in former PS athletes (fPSa) and age and sex matched controls were considered...
January 29, 2018: British Medical Bulletin
Umile Giuseppe Longo, Mario Ronga, Nicola Maffulli
Achilles tendinopathy is a common cause of disability. Despite the economic and social relevance of the problem, the causes and mechanisms of Achilles tendinopathy remain unclear. Tendon vascularity, gastrocnemius-soleus dysfunction, age, sex, body weight and height, pes cavus, and lateral ankle instability are considered common intrinsic factors. The essence of Achilles tendinopathy is a failed healing response, with haphazard proliferation of tenocytes, some evidence of degeneration in tendon cells and disruption of collagen fibers, and subsequent increase in noncollagenous matrix...
March 2018: Sports Medicine and Arthroscopy Review
Isabel Andia, Jose Ignacio Martin, Nicola Maffulli
PRPs can be used in the management of tendinopathy if we improve our understanding of pathophysiology and achieve to integrate molecular knowledge about PRP participation in healing mechanisms. Areas covered: We provide new insights into the pathophysiology of tendinopathy, PRP therapies, and the potential links between both. We discuss the place of PRP in promoting tendon repair within what is currently understood of the role of PRP molecules in promoting tendon regeneration. We also highlight the many opportunities for further exploration and identification of strategically designed treatments providing meaningful clinical benefit...
January 4, 2018: Expert Opinion on Biological Therapy
Luca Denaro, Umile Giuseppe Longo, Alberto Corrado Di Martino, Nicola Maffulli, Vincenzo Denaro
BACKGROUND: Even though internal fixation has expanded the indications for cervical spine surgery, it carries the risks of fracture or migration, with associated potential life threatening complications. Removal of metal work from the cervical spine is required in case of failure of internal fixation, but it can become challenging, especially when a great amount of scar tissue is present because of previous surgery and radiotherapy. CASE PRESENTATION: We report a 16 year old competitive basketball athlete who underwent a combined anterior and posterior approach for resection of an osteosarcoma of the sixth cervical vertebra...
December 29, 2017: BMC Musculoskeletal Disorders
Nicola Maffulli, Umile Giuseppe Longo, Joel Locher, Giovanni Romeo, Giuseppe Salvatore, Vincenzo Denaro
Introduction: In advanced stages of ankle osteoarthritis (OA), ankle arthrodesis (AA) or total ankle arthroplasty (TAR) may be necessary. Our purpose is to compare AA and total ankle replacement for the surgical management of end stage ankle OA. Sources of data: We conducted a literature search of PubMed, Medline, CINAHL, Cochrane, Embase and Google Scholar databases using the terms 'ankle' in combination with 'OA', 'arthrodesis', 'arthroplasty', 'joint fusion', 'joint replacement'...
December 1, 2017: British Medical Bulletin
Nicola Maffulli, Alessio Giai Via, Francesco Oliva
BACKGROUND: The Achilles tendon, the largest and strongest tendon in the human body, is nevertheless one of the tendons which most commonly undergoes a complete subcutaneous tear. Achilles tendon ruptures are especially common in middle aged men who occasionally participate in sport. Even though Achilles tendon ruptures are frequent, up to 25% of acute injuries are misdiagnosed, and present as chronic injuries. METHODS: This is a review article about diagnosis and management of chronic Achilles tendon ruptures...
2017: Open Orthopaedics Journal
Manuel Scimeca, Antonietta Salustri, Elena Bonanno, Daniela Nardozi, Cecilia Rao, Eleonora Piccirilli, Maurizio Feola, Virginia Tancredi, Annamaria Rinaldi, Giovanni Iolascon, Augusto Orlandi, Elena Gasbarra, Nicola Maffulli, Maria Luisa Brandi, Umberto Tarantino
Pentraxin 3 (PTX3) is a multifunctional glycoprotein regulating inflammatory response, cell proliferation and migration and deposition and remodelling of the extracellular matrix by a variety of cells. In this study, we investigated the possible role of PTX3 in bone homeostasis. To this end, we compared the expression and function of PTX3 in human osteoblasts of osteoporotic, osteoarthritic patients and young subjects not affected by bone diseases. Immunohistochemical analysis performed on bone head biopsies showed a close association between bone health and the number of osteoblasts expressing PTX3...
October 12, 2017: Cell Death & Disease
Pedro J Benito, Rocio Cupeiro, Ana B Peinado, Miguel A Rojo, Nicola Maffulli
OBJECTIVES: Men and women may lose weight in a different fashion. This study compares the changes in different anatomical regions after a well-controlled weight loss program by sex and initial BMI. METHODS: A total of 180 subjects (48 overweight women, 36 overweight men, and 48 obese women and 48 obese men) were recruited to participate in a 22-week weight loss programme (diet + exercise). RESULTS: Regarding percentage body weight change from baseline, there was no triple interaction (BMI, sex and anatomical region), but there was interaction between BMI and anatomical region (F2,840 = 34...
October 5, 2017: Physician and Sportsmedicine
Leonardo Osti, Matteo Buda, Mattia Andreotti, Raffaella Osti, Leo Massari, Nicola Maffulli
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, tear completion and repair, and lately transtendon repair. This systematic review describes the transtendon repair and examines indications, contraindications, complications and clinical outcome...
September 1, 2017: British Medical Bulletin
Stefano Petrillo, Piero Volpi, Rocco Papalia, Nicola Maffulli, Vincenzo Denaro
Background: Approximately 60% of posterior cruciate ligament (PCL) injury are associated with a posterolateral corner (PLC) tear. Sources of data: We performed a systematic review of the literature according to the PRISMA guidelines. The following key words were searched on Medline, Cochrane, EMBASE, Google Scholar, and Ovid: 'posterior cruciate ligament' or 'PCL' with 'posterolateral corner' or 'PLC' and 'chronic'; 'injury'; 'management'; 'reconstruction'; 'outcomes'; 'complications'...
September 1, 2017: British Medical Bulletin
T P McVeigh, R J Mulligan, U M McVeigh, P W Owens, N Miller, M Bell, F Sebag, C Guerin, D S Quill, J B Weidhaas, M J Kerin, A J Lowery
INTRODUCTION: MicroRNAs (miRNAs) are small noncoding RNA molecules that exert post-transcriptional effects on gene expression by binding with cis-regulatory regions in target messenger RNA (mRNA). Polymorphisms in genes encoding miRNAs or in miRNA-mRNA binding sites confer deleterious epigenetic effects on cancer risk. miR-146a has a role in inflammation and may have a role as a tumour suppressor. The polymorphism rs2910164 in the MIR146A gene encoding pre-miR-146a has been implicated in several inflammatory pathologies, including cancers of the breast and thyroid, although evidence for the associations has been conflicting in different populations...
November 2017: Endocrine Connections
Nicola Maffulli
With the increase of superspecialisation, there has been a recent trend for a rising number of operations for both trauma and orthopaedic ailments. This flies against the results of properly planned, well performed, adequately powered, with clinically relevant outcome measures and long enough follow-up level I studies which challenge the received wisdom that surgery is actually superior to conservative management or even supervised neglect. This editorial outlines some of these issues, and suggests that orthopaedic and trauma surgeons should actually think twice before operating on anything that comes our way...
December 2017: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
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