Department of Orthopedic and Traumatology @ Policlinico San Donato

Department of the Orthopedic I of the Policlinico San Donato started its activity on January 1st, 2020. Dr. Dagnino and Dr. Fiorentini have been working together for years in other excellent structures always oriented in hip and knee replacement surgeries which even today represent the preponderant part of the activity carried out.

Following the dismissal of other teams within the hospital, from May 2020 it has expanded its peculiarities to also include the part of traumatology. Trying to be able to offer a 360-degree service, other orthopedic branches were also implemented up to the current configuration. To date, as a team, it covers almost all of orthopedics and traumatology pathologies.

Hip pathology: we manage all the pathology starting from the preventive and conservative aspect supported by an excellent physiatry and rehabilitation service, through joint infiltration including ultrasound-guided using hyaluronic acid, steroids and recently also the PRP (platelets riched plasma) through specific dedicated service; in case of hip arthrosis, in addition to traditional surgery with standard and minimally invasive, direct lateral, posterolateral access, we also perform interventions with anterior mini invasive surgery (AMIS) technique without damage to the muscles, for which we are also a reference center and training center with excellence certified by the company that patented this procedure, we often perform interventions on the hips simultaneously bilaterally to avoid double surgery and anesthesia.

Thanks to the excellent anesthesia service that performs post-operative analgesic blocks, use of LIA (local infiltration analgesia), patients with very little pain recover quickly, walk the same day and are discharged in 3 days (statistics of 2020 average discharge 3.4 days). With this technique we also resolve medial femur fractures. We also perform hip replacement surgery and are developing a system for cup revision system with a firm to have new tools and options for the treatment of acetabular defects.

Knee pathology: also, in this field we deal with preventive, conservative and regenerative therapy using infiltrations with PRP, steroids or hyaluronic acid. In the part oriented towards sports traumatology through arthroscopy we treat meniscal and ligament injuries, cartilage injuries, repairs with meniscal suture, reconstruction using allografts, or artificial tendons, use of scaffold for little osteochondral defects. Knee osteoarthritis is treated with standard and minimally invasive techniques. Among the most effective treatments we deal with the implantation of knee unicondylar arthroplasty, medial, lateral and patellar femoral; for this type of surgery, we collaborate with companies for the development of new implants and new tools. In total knee replacement, in addition to standard techniques, we use the latest techniques such as kinematic alignment, use of robots and augmented reality for more precise implants as well as the use of NEXGEN medial pivot and hypoallergenic implants. 

Shoulder Disease: Preventive, Conservative and Regenerative Therapy. Arthroscopy for repair of rotator cuff damage or for instabilities. Recourse to anatomical or inverse prostheses in case of glenohumeral arthrosis.

Hand pathology: Clinics dedicated to this pathology and dedicated sessions by colleagues who are super-specialized in hand surgery. Interventions also carried out in a particular setting with an operating room equipped for this surgery with discharge within a few hours of surgery.

Foot-ankle pathology: dedicated clinics for foot pathology. Corrective interventions and use of ankle prostheses (few centers able to perform this surgery) in inveterate osteoarthritis.

Traumatology: Treatment of afferent fractures from the emergency room and in patients deferred from other facilities. Except for traumas that require neurosurgical support, we manage all traumatology. For wrist and hand fractures, interventions are carried out in specific sessions, in lower limb fractures by adhering to the national program, having a team available, we operate within 48 hours of arrival at the hospital. We also deal with the traumas related to motorcycle racing as a colleague of the team collaborates with the CLINICA MOBILE which gives medical support to MotoGP races.