Acute Calcific Tendinitis of the Longus Colli: A Case Report and Review of the Literature.

Acute calcific tendinitis of the longus colli (ACTLC) is a rare, self-resolving condition caused by calcium hydroxyapatite crystal deposition in the longus colli muscle tendons. We present a case of a 46-year-old female with a history of hypertension who presented with right-sided neck pain, worsening abdominal pain, nausea, bloody emesis, and generalized body aches in the context of recent alcohol use. Physical examination revealed neck pain with limited range of motion, induration, and tenderness in the right and posterior neck areas. Laboratory findings showed elevated white cell count, inflammatory markers, and metabolic acidosis with an elevated anion gap and lactic acid level. Computed tomography (CT) of the neck with contrast demonstrated amorphous calcification in the longus colli tendons and retropharyngeal effusion, consistent with the diagnosis of ACTLC. The patient was treated with nonsteroidal anti-inflammatory drugs (NSAIDs) and supportive care, leading to symptom resolution. This case highlights the importance of considering ACTLC in the differential diagnosis of acute neck pain and the role of CT imaging in establishing the diagnosis. Prompt recognition and appropriate management of ACTLC can prevent unnecessary interventions and lead to improved patient outcomes.

Analysis of the Morphology, Rheology, and Clinical Applicability of a Hybrid Injectable with Hyaluronic Acid and Hydroxyapatite.

BACKGROUND: Treating signs of aging requires skeletal restructuring, facial contour redefinition, and sagging skin treatment. Hence, HarmonyCa® was recently introduced in the market, combining hyaluronic acid and hydroxyapatite. However, there are no studies evaluating the physicochemical properties of this material. PURPOSE: To analyze the morphology, rheology, and clinical applicability of HarmonyCa® over a 180-day follow-up. METHODS: A morphological analysis with scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS) and rheology measurement with a rheometer. The clinical applicability analysis included a tissue ptosis patient who received the product and was reassessed 30 and 180 days after applying HarmonyCa®. RESULTS: SEM and EDS analyses showed two distinct morphologies related to hydroxyapatite and hyaluronic acid. The rheological measurements of HarmonyCa® showed G' and G″ of 51.56 and 44.01 Pa, respectively. The tan δ value was 0.8503, and G* was 108.1 Pa. The clinical outcomes were satisfactory. CONCLUSION: HarmonyCa® presents a good synergy between hyaluronic acid and hydroxyapatite. Also, the rheological analysis showed moderate viscosity for the product, with a clinical indication for subcutaneous application. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Synthesis and characterization of hydroxyapatite nanoparticles from calcium hydroxide fouled with gases evolved from smokestack of glass industry.

In glass industry, the evolved gases and fumes from burning the gas fuel absorbed in calcium hydroxide to minimize the pollution of environment. After a period of time, the calcium hydroxide fouled with sulphate and carbonate as action of the absorbed SO3 and CO2 gases. Based on our interest to treatment the solid waste materials, this study intended to convert the obtained waste of calcium hydroxide fouled with gases to valuable products. Firstly, this waste was treated with water, caustic soda and acids. The results confirmed the conversion of waste to pure calcium sulfate by treatment with 6 v/v% sulfuric acid. Secondly, the obtained calcium sulfate was reacted with ammonium dihydrogen phosphate solution for preparation of calcium hydroxyapatite (HAp) nanoparticles. The produced HAp sample was characterized by X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), transmission electron microscopy (TEM) and scanning electron microscopy (SEM), thermal gravimetric analysis (TGA) and N2 adsorption measurements. The obtained findings confirmed that the HAp can be produced after calcination at 700 °C, nanorods-like of sizes ranged from 11 to 15 nm and with main surface functional groups of hydroxyapatite. TGA and DTA data indicated that HAp is thermally stable up to 700 °C. Also, the obtained HAp has Ca/P molar ratio of 1.60 and exhibited high total surface area of 146 m2/g with mesoporous structure which make this material can be used in medical and water purification applications.

Bipolar Radiofrequency and Non-Crosslinked Hyaluronic Acid Plus Calcium Hydroxyapatite in the Treatment of Stress Urinary Incontinence.

BACKGROUND: Stress urinary incontinence (SUI) causes both physical and psychological problems to women and their partners. Recently, vaginal radiofrequency (RF) application, as well as the administration of non-crosslinked hyaluronic acid (NCLHA) together with calcium hydroxyapatite (CaHA), has attracted attention for SUI treatment. The current, comparative study evaluated the efficacy and safety of these technologies acting separately and in a combined treatment. METHODS: Sixty women with mild to moderate SUI, aged between 46 and 76 years (mean age 63.2) were divided into three groups intended for different treatments: group I, RF vaginal treatment only, group II, NCLHA plus CaHA periurethral injection only, group III, combined treatment including a single periurethral injection of NCLHA plus CaHA followed by four vaginal applications of RF at intervals of 3-5 days. The clinical effects of the treatments were evaluated by ICIQ-LUTSqol (Polish version) and UDI-6. RESULTS: The obtained results suggest that the symptoms of SUI and the quality of life of the patients improved significantly in each group after the therapies compared to the pre-treatment levels and were more persistent in the third HA + RF group compared to the HA or the RF group.

An Innovative Treatment Using Calcium Hydroxyapatite for Non-Surgical Facial Rejuvenation: The Vectorial-Lift Technique.

BACKGROUND: The facial aging process entails alterations in the volume, shape, and texture of all skin layers over time. Calcium hydroxyapatite (CaHA) is a well-established safe skin filler with unique properties to resolve some skin alterations by stimulating neocollagenesis. The vectoral-lift (V-lift) technique targets the global repositioning of facial structures by addressing distinct anatomical injection planes. It includes deep facial augmentation with Radiesse PlusTM to retain ligament restructuring and superficial subcutaneous enhancement with diluted Radiesse DuoTM. Herein, we present cases that illustrate the use of this approach. METHODS: This pilot study enrolled 36 participants (33 women and three men; ages 37-68 years) in a Brazilian clinical setting, and all patients underwent a single treatment. Photographs were taken at rest, in frontal and oblique views, before injection, and 90 days after treatment. RESULTS: Treatment resulted in elevation of the upper and middle face, notable improvements in the infraorbital hollow, and adjustment of the mean facial volume. CONCLUSIONS: The V-lift technique is a three-dimensional pan-facial treatment that relies on ligament support and face vectoring to obtain a lifting effect and facial contour restoration. It encompasses deep facial augmentation involving the use of Radiesse PlusTM for restructuring and retaining ligaments and Radiesse DuoTM for superficial subcutaneous enhancement. This approach targets a global repositioning of the facial structures by addressing distinct anatomical injection planes. It achieves a repositioning of the overall facial anatomy without requiring a substantial volumetric expansion. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Complications of collagen biostimulators in Brazil: Description of products, treatments, and evolution of 55 cases.

BACKGROUND: Complications of temporary and permanent fillers have been extensively studied. However, there is a lack of comparative data regarding poly-L-lactic acid (PLLA), calcium hydroxyapatite (CaHA), and polycaprolactone (PCL) known as collagen biostimulators. AIMS: This study addressed the complications of collagen biostimulators concerning their diagnosis, type of product, treatment, and monitoring. PATIENTS/METHODS: An electronic questionnaire was sent to Brazilian dermatologic ultrasound experts to identify complications related to biostimulators. The type of biostimulator, location of application, number of vials injected, application plan, time between injection treatment and complication, injector profile, treatment, and prognosis were assessed. RESULTS: Fifty-five cases were identified, of which 49.1% were caused by PLLA-Elleva®, 23.6% by CaHA (alone or combined with hyaluronic acid), 20.0% by PLLA-Sculptra®, and 7.3% by PCL. The most affected area was the face (72.7%), with nodules being the most common clinical form (89.1%), generally occurring late (60.0%) (>1 month). Only one case was injected at an incorrect depth (musculoaponeurotic system-SMAS). Despite several treatments, including saline (45.5%), hyaluronidase (25.5%), diluted corticosteroids (23.6%), and energy-based devices (10.9%), only five cases showed complete resolution. Hyaluronidase was beneficial in complications related to fillers when there was an association of calcium hydroxyapatite with hyaluronic acid (p < 0.01). CONCLUSIONS: Complications from collagen biostimulators were more common on the face, typically manifesting about 1 month after treatment. These issues seemed to be related more to the properties of the products rather than inadequate technique. Furthermore, hyaluronidase demonstrated efficacy only in cases where there was an association with HA.

De novo vesico-acetabular fistula presenting with septic arthritis: Case report and literature review.

Vesico-acetabular fistula formation is a rare condition typically associated with total hip arthroplasty. Clinical features can include pain of the hip and flank, haematuria, and dysuria. We report the case of a 67-year-old female with a past medical history of bilateral pelvic fractures and calcium hydroxyapatite deposition disease of the hip joint, who developed vesico-acetabular fistula in the absence of surgery. This was then complicated by septic arthritis. We highlight the ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) findings of the case and review the previous case reports describing the vesico-acetabular fistula.

The gold protocol: A combined treatment approach for neck rejuvenation with calcium hydroxyapatite, botulinum toxin, and hyaluronic acid in the same session.

BACKGROUND: The signs of aging seem to be more visible on the neck compared to other locations, especially if a patient has already gone through facial rejuvenation procedures. Treatment of the aging neck imposes a challenge to the clinician, since one single approach is usually not enough to achieve the desired result, requiring multiple injections and sessions, which apart from being painful for the patients, is time-consuming for the clinician. AIM: To describe the use of calcium hydroxyapatite, incobotulinum toxin type A and Cohesive poly-densified matrix hyaluronic acid diluted in the same syringe and injected in the same session for neck rejuvenation. PATIENTS AND METHODS: Fifteen women, older than 18 years, with cervical skin flaccidity grade 1-4 in a previously validated 5-point rating scale (Dermatologic Surg, 2016; 42, S94), who sought neck rejuvenation were injected in this pilot study with a single session with a combined hybrid mixture of calcium hydroxyapatite, incobotulinum toxin type A, and Cohesive poly-densified matrix hyaluronic acid and followed up for 90-180 days. RESULTS: At the 4-month post injection evaluation, 93.3% of the patients presented at least 1-grade improvement in the 5-point scale as evaluated by the investigator. No serious adverse events were reported, being most mild and transient in nature. CONCLUSION: CaHA, incoBonTA, and CPM-HA have complementary mechanisms of action and may be injected from the same syringe in the same session, boosting the final outcome, with high patient satisfaction, and ease of process for both patients and clinicians.

Hydroxyapatite deposition disease, an overlooked differential diagnosis in the emergency department: a case series and review of literature.

Hydroxyapatite crystal deposition disease (HADD) poses diagnostic challenges in the emergency department (ED) as it may clinically present similarly to infection and other musculoskeletal conditions. Misdiagnosis often leads to unnecessary treatments and resource over-utilization. This review article provides an overview of HADD in seven patients who presented to the ED secondary to an acute presentation of this disease process. HADD is a prevalent pathology, which commonly involves the shoulder, followed by the hip, elbow, wrist, and knee. Predisposing risk factors, such as diabetes and certain genetic factors, have also been identified. Clinical history and imaging, particularly radiographs, play a vital role in diagnosing HADD, with characteristic calcification patterns observed in different stages of the disease. Conservative nonsurgical therapy is the mainstay of treatment, providing effective symptom relief in over 90% of cases. By recognizing HADD as a crucial differential diagnosis for patients with acute or chronic pain, healthcare resource utilization can be optimized, leading to improved patient care in the ED.

Treatment of Atrophy of the Labia Majora: Calcium Hydroxyapatite or Hyaluronic Acid?

PURPOSE: The study aimed to evaluate and compare the efficacy and safety of treating atrophied labia majora with hyaluronic acid (HA) and calcium hydroxyapatite (CaHA). METHODS: Ten participants complaining of sagging or loss of volume in the labia majora were evaluated and randomly assigned to two groups-treated with CaHA or AH. Photographic documentation was taken and appreciated by the participants and by blind observers. RESULTS: The study showed an improvement in labia majora regarding volumization and flaccidity that was more significant after 90 days of treatment in both treatments. Besides flaccidity, volume replacement resulted in better balance and proportion between the labia majora and labia minora. The evaluators, independent and blind, judged that in 80% of the cases of the HA group and in 50% of cases of the CaHA group, there was an excellent improvement. CONCLUSION: CaHA and HA are both effective and safe for treating the intimate region, and this study cannot prove the superiority of one over the other. An appropriate assessment involving the analysis of sagging and/or volume loss and the creation of a sequential treatment protocol, involving CaHA and HA, seems to be the best solution. LEVEL OF EVIDENCE I: Evidence obtained from at least one properly designed randomized controlled trial. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Pressure alopecias: A review.

Pressure-induced alopecias (PAs) are an infrequent group of scarring and nonscarring alopecias that occur after ischemic obstruction of capillaries that leads to circumscribed areas of hair loss. Initially described after prolonged surgeries or immobilization, type 1 PA occurs after sustained external pressure to the skin, mainly the scalp prominences. Alopecia induced by cosmetic procedures, referred in this review as type 2 PA, is reported with increased frequency in literature and predominantly emerges from pressure exerted by the volume of injectables. It is important to differentiate type 2 PA from vascular occlusion-induced alopecia because they represent distinct entities. Clinically, PA may present with erythema, swelling, and tenderness; however, alopecia might be the sole manifestation. Crusts and ulceration are associated with a worse outcome and a higher risk of scarring alopecia. Prompt diagnosis is paramount to prevent complications. Trichoscopy, although considered nonspecific, may provide relevant clues for an accurate diagnosis. Hair regrows in most cases, but prognosis depends on ischemia severity and timely treatment with reperfusion therapies or mobilization. Treatment of hair loss is usually not necessary because the disease in most cases is self-limited and reversible. The role of topical minoxidil and corticosteroids remains unknown.

Aplicación orbitaria de productos de relleno para optimización de simetría en pacientes con microftalmia o cavidades anoftálmicas adquiridas: revisión de la literatura / Aplicación orbitaria de productos de relleno para optimización de simetría en pacientes con microftalmia o cavidades anoftálmicas adquiridas: revisión de la literatura Orbital administration of fillers for optimization of symmetry in patients with microphthalmos or acquired anophthalmic sockets: A review

El tratamiento de la asimetría facial en pacientes con microftalmos o cavidades anoftálmicas adquiridas suele requerir cirugías reconstructivas agresivas. En los últimos años se han publicado trabajos sobre el uso de rellenos para optimizar la simetría del tejido orbitario, como técnicas mínimamente invasivas.Por este motivo, hemos realizado una revisión sistemática de la literatura publicada hasta el momento sobre la administración orbitaria de rellenos para el tratamiento de la pérdida de volumen. Se identificaron 14 artículos que cumplían con los criterios de selección; en los que se analizó el material utilizado, la técnica de inyección, el estudio anatómico de los pacientes antes del procedimiento y la presencia de complicaciones asociadas. Los materiales utilizados como relleno son: la grasa autóloga, la hidroxiapatita cálcica, el colágeno, el ácido hialurónico o el gel de poliacrilamida. Se aplicaron técnicas estándar de inyección peribulbar y retrobulbar, con escasas complicaciones asociadas, siendo la má grave el desarrollo de cuadros vaso-vagales. El seguimiento de los pacientes suele limitarse en la mayoría de los estudios a 12 meses, con variaciones significativas en la exoftalmometría posprocedimiento. En conclusión, la utilización de rellenos parece una práctica segura y con buenos resultados, aunque se precisan estudios con tiempo de seguimiento más prolongado que los publicados hasta el momento. (AU)

The treatment of facial asymmetry in patients with microphthalmos or acquired anophthalmic cavities usually requires aggressive reconstructive surgeries. In recent years, studies have been published on the use of fillers to optimize orbital tissue symmetry, as minimally invasive techniques.For this reason, we performed a systematic review of the literature published to date on the use of fillers for the treatment of volume loss in acquired anophthalmic or microphthalmic cavities. Fourteen articles were reviewed in which the material used, the injection technique, the anatomical study of the patients before the procedure and the presence of associated complications were analyzed.Various materials have been used as fillers, including autologous fat, calcium hydroxyapatite, collagen, hyaluronic acid, or polyacrylamide gel. Standard peribulbar and retrobulbar injection techniques were applied, with few associated complications, the most serious being the development of vasovagal symptoms. Patient follow-up is usually limited in most studies to 12 months.In Conclusion, the use of fillers seems to be a safe practice, with good results and few complications, although studies with longer follow-up times than those published to date would be required. (AU)

Calcinosis cutis / Calcinosis cutis

Caso clínico: presentamos el caso de una mujer de 48 años con dolor en senos maxilares y zonas temporales, en la que se apreciaron placas cálcicas subcutáneas faciales al realizar una tomografía axial computarizada (TC). La exploración física y los datos del laboratorio fueron normales. Reinterrogando a la paciente, comentó que un año antes se le había administrado un producto de relleno facial que contiene hidroxiapatita cálcica (CaHA) (Radiesse®). Discusión: las microesferas de CaHA son radiopacas por lo que pueden observarse en las radiografías convencionales, y sobre todo en la TC. Las características de las imágenes, habitualmente bilaterales, separadas del hueso, junto con el antecedente de inyección previa de este material, debe orientar al clínico para reconocer este hallazgo y diferenciarlo de otras condiciones patológicas. Dada la popularidad que ha adquirido esta técnica de rejuvenecimiento facial, conviene que los clínicos conozcamos las características de las imágenes producidas por el depósito de esta sustancia. (AU)

Case report: we report the case of a 48-year-old woman with pain in the maxillary sinuses and temporal areas. The presence of subcutaneous facial calcific plaques was confirmed in computed tomography (CT). Both the physical examination and the lab test results were within normal limits. Upon further questioning, the patient mentioned that she had been administered a facial filler product containing calcium hydroxyapatite (CaHA) (Radiesse®) the year before. Discussion: CaHA microspheres are radiopaque, making them visible through conventional x-rays, especially CT scans. The characteristic imaging features, typically bilateral and separate from the bone, along with the history of previous injection of this material, should help the clinician recognize this finding and isolate it from other conditions and diseases. Because of the popularity of this facial rejuvenation technique, clinicians should be familiar with the imaging characteristics associated with the deposition of this substance. (AU)

Global facial rejuvenation with one treatment of incobotulinumtoxinA, hyaluronic acid, and calcium hydroxyapatite results in long-term patient-reported satisfaction.

Background: Global facial rejuvenation using injectables (neuromodulators and fillers) has reported patient satisfaction after 2 treatments: an initial and touch-up treatment at 2-4 weeks afterward. In practice, patients typically receive only 1 treatment and do not return for a touch-up treatment within a month. Objective: The purpose of this study was to assess patient-reported satisfaction after only 1 treatment, thus mimicking real-world scenarios. Methods: Patients with facial photoaging (Glogau facial aging scale ≥2) were treated with calcium hydroxyapatite, hyaluronic acid 22.5 mg/mL, and incobotulinumtoxinA injections for full facial rejuvenation, with no touch-up treatments. Patients completed the FACE-Q Satisfaction with Facial Appearance survey at baseline and 1- and 3-month post-treatment. The treating physician completed the Global Aesthetic Improvement Scale at 1- and 3-month post-treatment. Results: Twenty-two patients were enrolled in the study, with 1 patient lost to follow-up. There was a significant improvement in mean FACE-Q scores at 1-month (80.1, P = .01) and 3-month (77.9, P = .02) compared to baseline (71.4). Mean Global Aesthetic Improvement Scale scores at 1-month (2.1) and 3-month (2.2) were not statistically significant, indicating sustained improvement at 3 months. The product amount used per patient varied and was not correlated with either score. Limitations included a lack of a control group and follow-up ending at 3 months. Strengths included assessment of patient satisfaction after only 1 treatment, compared to other studies allowing 2 treatments. Limitations: Limitations include a small sample size and lack of a control group. Conclusion: Global full facial rejuvenation using 1 treatment of calcium hydroxyapatite, hyaluronic acid 22.5 mg/mL, and incobotulinumtoxinA provides sustained patient-reported satisfaction at 3 months.

Orbital administration of fillers for optimization of symmetry in patients with microphthalmos or acquired anophthalmic sockets: A review.

The treatment of facial asymmetry in patients with microphthalmos or acquired anophthalmic sockets usually requires aggressive reconstructive surgeries. In recent years, studies have been published on the use of fillers to optimize orbital tissue symmetry, as minimally invasive techniques. For this reason, we performed a systematic review of the literature published to date on the use of fillers for the treatment of volume loss in acquired anophthalmic or microphthalmic cavities. Fourteen articles were reviewed in which the material used, the injection technique, the anatomical study of the patients before the procedure and the presence of associated complications were analyzed. Various materials have been used as fillers, including autologous fat, calcium hydroxyapatite, collagen, hyaluronic acid, or polyacrylamide gel. Standard peribulbar and retrobulbar injection techniques were applied, with few associated complications, the most serious being the development of vasovagal symptoms. Patient follow-up is usually limited in most studies to 12 months. In Conclusion, the use of fillers seems to be a safe practice, with good results and few complications, although studies with longer follow-up times than those published to date would be required.

Study of nano-hydroxyapatite tagged alkaline protease isolated from Himalayan sub-alpine Forest soil bacteria and role in recalcitrant feather waste degradation.

Purified calcium serine metalloprotease from Stenotrophomonas maltophilia strain SMPB12 exhibits highest enzyme activity at pH 9 and temperature range between 15 °C-25 °C. Enzyme supplemented with 40 µM Ca-Hap-NP (NP-protease) showed maximum elevated activity of 17.29 µmole/min/ml (1.9-fold of original protease activity). The thermostability of the enzyme was maintained for 1 h at 60 °C over an alkaline pH range 7.5-10, as compared to the NP untreated enzyme whose activity was of 8.97 µmole/min/ml. A significant loss of activity with EDTA (1.05 µmole/min/ml, 11.75 %), PMSF (0.93 µmole/min/ml, 10.46 %) and Hg2+ (3.81 µmole/min/ml, 42.49 %) was also observed. Kinetics study of NP-protease showed maximum decreases in Km (28.11 %) from 0.28 mM (NP untreated enzyme) to 0.22 mM (NP-protease) along with maximum increase in Vmax (42.88 %) from 1.25 µmole/min/ml to 1.79 µmole/min/ml at varying temperatures. The enhanced activity of NP-protease was able to efficiently degrade recalcitrant solid wastes like feather to produce value-added products like amino acids and helps in declogging recalcitrant solid wastes. The nano-enabled protease may be utilized in a smaller amount for degrading in bulk recalcitrant solid proteinaceous waste at 15 °C temperature as declogging agents providing an eco-friendly efficient process.

Mitigating Infectious Complications of Injection Pharyngoplasty with Calcium Hydroxyapatite for Velopharyngeal Insufficiency: Retropharyngeal Abscess and Osteomyelitis.

Velopharyngeal insufficiency is a complex condition with various treatment options. In this case, a patient with a cleft palate who was treated for velopharyngeal insufficiency with calcium hydroxyapatite injection pharyngoplasty developed persistent cervical pain on postoperative day 6. CT imaging showed a hypodense structure in the right retropharyngeal tissue, and cultures tested positive for Streptococcus intermedius and Staphylococcus aureus. An MRI later revealed skull base osteomyelitis. The infection was controlled via surgical intervention and antibiotics. This case highlights potential severe complications from injection pharyngoplasty and it underscores the importance of early recognition and management of infectious complications.

The use of bovine-derived hydroxyapatite xenograft for defect filling in opening-wedge high tibial osteotomy.

High tibial osteotomy is a reliable procedure for the correction of knee varus deformity. An opening-wedge high tibial osteotomy (OW-HTO) is the most popular technique. The results of the bone defect after opening the wedge needed special treatment to ensure bone healing. This study aims to evaluate the use of bovine-derived hydroxyapatite graft for defect filling after OW-HTO. Methods: A retrospective study was performed on all patients who received OW-HTO at Prof. Dr R. Soeharso Orthopaedic Hospital from November 2019 to December 2022. A total of 21 patients (24 knees) were included in this study. Clinical dan radiological evaluation was performed on all patients preoperative and postoperatively. The mean of the follow-up period was 12.6 months with a minimum of 4 months follow-up. Results: Primary medial uni-compartment knee osteoarthritis was the most common diagnosis, with 17 of 24 cases (70.8%). Mechanical axis deviation was changed from 31 mm medial deviation (range: 8-52 mm) to 0.45 mm medial deviation (range: 13 - (-8) mm). The anatomic tibiofemoral angle was corrected from a preoperative mean of 4.7° of varus to a mean of 5.8° of valgus postoperatively. Bone defect height was mean 15.9 mm with a range of 10-23 mm. Bone defect width was mean 46.7 mm (range: 34-60 mm). Hydroxyapatite graft integration with the host bone was found in all patients during the final follow-up period. Conclusions: Bovine-derived hydroxyapatite graft is a safe and effective material for bone defect filling in OW-HTO procedures with a high bone union rate.

Efficacy of Pegylated Hyaluronic Acid Filler Enriched with Calcium Hydroxyapatite: A 24-Week Post-Market, Observational, Prospective, Open-Label, Single-Center Study.

Recently, thanks to the greater discovery of the mechanisms of facial aging, an alternative to invasive plastic surgery has found space with less invasive aesthetic procedures, also based on an increasingly pressing request. We are specifically referring to dermal filler injection into or under the skin which leads to immediate rejuvenation and aesthetic improvements. In this study, we wanted to analyze the results obtained through the use of NEAUVIA Organic Stimulate, particularly with regard to its effectiveness, which is a cross-linked polymeric hydrogel, containing stabilized sodium hyaluronate 26 mg/mL and calcium hydroxyapatite (1%), glycine and L-proline in buffer pyrogen-free water, in its main indication, namely, the temporary correction of congenital and acquired deficiencies of the soft tissues of the face by intradermal injection. Initially, 70 patients were enrolled, but 10 did not complete the study due to non-observance of the investigation rules, so they were excluded from the protocol. The collected data demonstrate an efficient mechanical effect of the pegylated polymeric acid matrix enriched with low concertation of calcium hydroxyapatite and in accordance with other evidence in vitro and in vivo, and the mechanical support of the interstitial connective space improves the homestays of the anatomical layer rebalancing the physiological activity of the dermis cells.