Gabriel Mihai Mekeres

Total hip arthroplasty (THA) is the definitive treatment for end-stage hip osteoarthritis, reliably relieving pain and restoring joint function. However, patient-reported quality of life (QoL) after THA remains heterogeneous, with recovery trajectories influenced by a range of biological, psychological, and social factors. A comprehensive synthesis of these determinants is lacking, limiting our ability to optimize individualized perioperative care and long-term outcomes. This review examines the various factors impacting quality of life (QoL) before and after hip arthroplasty. An analysis of 67 studies reveals significant postoperative enhancements in physical function, pain alleviation, and overall patient satisfaction. Identified key factors encompass physical activity, mental health status (anxiety and depression), lifestyle choices (diet and weight management), and social support systems, particularly from spouses and family members. The review indicates that, although these elements positively influence recovery, it also recognizes limitations including dependence on subjective, self-reported QoL measures, possible selection biases, and inconsistencies in study design. The results indicate that a com-prehensive, patient-focused strategy—integrating organized rehabilitation, psychological assistance, and family engagement—can markedly improve recovery and long-term QoL for arthroplasty patients. Nonetheless, additional research employing standardized protocols and extended follow-up durations is essential to corroborate these findings and guide clinical practice. The early implementation of tailored, multidisciplinary perioperative pathways—including structured rehabilitation programs, routine psychological screening and intervention, nutritional counseling for weight management, and active family involvement—may optimize functional recovery, reduce complications, and maximize long-term QoL in patients undergoing THA. This review highlights the importance of a multidisciplinary approach to enhance post-surgical quality of life, thereby advancing the understanding of patient-centered recovery strategies in orthopedic care.

Background: Scars are a natural consequence of the healing process, but with an impact on the psychological and social level for the individual, which can even lead to withdrawal and social stigmatization. We aimed to analyze the psychosocial impact determined by post-traumatic scars, using psychometric scales, to assess the effectiveness of the Mekereș’ Psychosocial Internalization Scale (MPIS), and to identify relevant predictors of traumatic and surgical scar internalization.Methods: Our cohort included 293 participants, 149 women and 144 men, aged 18–64 years who were screened for scar characteristics and completed a set of psychological scales. We compared the results obtained in two subgroups: 153 subjects with posttraumatic scars and 140 with surgical scars.Results: Relevant predictors for posttraumatic scar internalization (R² = 0.721) are adaptation time, age of the occurrence and subjective appraisal, while for the depression, and hopelessness relevant predictors are the subjective appraisal of the scars and the posttraumatic quality of life.Conclusion: The psychological and social reporting of the aftermath of trauma, that has been followed by scar-ring, is an indicator of how a person will react and could indicate the susceptibility to psycho-pathology.

Background: Scars affect patients after trauma, burns, or surgical procedures and can generate both physical and psychosocial changes. The aesthetic damage represents the modification of a person’s physical appearance, in its bodily integrity, causing numerous sufferings and determining social or economic consequences. The aim of this research is to evaluate the advantages and disadvantages offered by the available psychosocial and physical scar scales in assessing the physical, aesthetic, psychosocial, and juridical consequences of scars. This will aid to inform medical examiners about the most valued existing scales to allow them to select the most appropriate instrument to manage their patient. Methods: A broad search of relevant scientific studies on the psychosocial determinants of post-traumatic and surgical scars was conducted by using the following international database tools: PsycINFO, MedLine Social Science Index, Scopus, Web of Science, published from 1960 until 2022. Results: We analyzed 63 scientific studies to assess the advantages and limits of several psychometric and physical scar evaluation scales. Conclusions: The researchers analyzed in this review highlight the advantages and limitation of existing instruments, evidencing the demand for future scar evaluation instruments and a scar-assessing algorithm that takes into account the physical, aesthetic, psychosocial, and legal consequences of scars.

(1) Background: Total hip arthroplasty (THA) is one of the most common procedures used for adult hip reconstruction, employing mainly two types of prostheses: cemented (CHP) and cementless (CLHP). This study aims to analyze the impact of the COVID-19 pandemic on THA with CHP and CLHP, in terms of the benefit/cost ratio. (2) Methods: This article represents a retrospective analysis of the differences concerning the benefit/cost ratio between THA with the two types of prostheses in 2950 patients admitted for THA in the two orthopedic clinics of our hospital between 1 January 2015–1 March 2020 in comparison with 1005 THA subjects seen between 1 April 2020–31 December 2022. (3) Results: In the first period, THA with CHP was performed in 45.83% of cases, while CLHP was used in 54.16% of patients. During the COVID-19 period, CHP was inserted in 52% of THA patients, while the other 48% had CLHP inserted, with a hospitalization duration reduced by over 50% for both types of implants (p ˂ 0.001). (4) Conclusions: CHP offered good outcomes, with quicker mobilization, and shorter hospitalization duration, compared to CLHP, but optimization of the patients’ management can be achieved mainly by reducing the length of hospitalization through an appropriate preoperative patient evaluation through a multidisciplinary approach, an aspect that was proven during the COVID-19 pandemic.

(1) Background: Vertebro-medullary trauma (VMT) causes osteo-articular injuries in a varied anatomical lesion associated with multiple clinical manifestations and therapeutic indications. The neurological evaluation of patients who have suffered a spinal cord injury (SCI) is costly in testing the motor and sensory function. To standardize the assessment, several scales are used that measure the neurological deficit in order to guide subsequent treatment according to complete or incomplete SCI. The aim of this study is to identify and present the relevant tools for assessing SCI. (2) Methods: Relevant SCI studies were used for a fact-finding investigation from a rational and critical perspective of this field of research. The relationship between clinical tools and those with a psychosocial component was assessed based on studies reported in the literature. (3) Results: SCI severity scales have been proposed throughout to be able to estimate the functional prognosis of victims of these traumatic events. These tools can be divided into scales for assessing the neurological deficit due to trauma, and functional scales that assess the ability to perform daily activities, self-care, etc. (4) Conclusions: The closest scale to the need for standardization and the most accurate assessment of neurological deficits secondary to SCI is ASIA/IMSOP.

Introduction. Ischemic stroke accounts for approximately 85% of all vascular accidents and has a high number of identified risk factors, including transient ischemic attack, smoking, metabolic syndrome, alcohol consumption, elevated cholesterol levels and artery stenosis carotid. Diabetes mellitus (DM) is a well-established risk factor for ischemic stroke. Material and method. This prospective longitudinal observational study highlights the importance of localization of ischemic stroke, including 340 patients with acute ischemic stroke with / without diabetes mellitus. The database was collected in a Microsoft Excel document. The correlation analysis was processed in the MedCalc 14.1 program where correlation tests included in the program were used. Results. The predominant localization of ischemic stroke in diabetic patients was the middle cerebral artery followed by the posterior cerebral artery and the double localization compared to the group witness where the same trend is maintained (p = 0.22). The correlation between the localization of the acute ischemic stroke with the age 64.5 for MCA, 64.6 for PCA, and 73.57 for DL (CI 95%, p= 0.02). The correlation of the NIHSS severity score with the location of ischemic strokes was also obtained: average NIHSS score 18.9 points for MCA, 18.5 for PCA, 24 for DL (CI 95, p < 0.0001). The data obtained from the Kaplan-Meier analysis on the survival rate of the patients (divided by the vascular territory involved), provided an expected result difference (statistically significant, p < 0.0001). Conclusions. There is no statistically significant difference between diabetic vs. non-diabetic patients regarding the localization correlated with DM, the double location being statistically insignificant between the two batches. The double location having a higher frequency in elderly patients.