lorenzo alirio diaz balzani

Scopus Publications

Intra-patient comparison of trapeziectomy with LRTI and dual mobility prosthesis for trapeziometacarpal osteoarthritis: a multicenter observational study
Francesco Smeraglia, Enrico Carità, Giulia Frittella, Federico Tamborini, Lorenzo Diaz, Alberto Donadelli, Matteo Guzzini
European Journal of Orthopaedic Surgery and Traumatology, 2025
Purpose Thumb osteoarthritis is a debilitating condition that affects a large portion of the elderly population. Conservative treatments for this condition often fail, and a surgical solution is required. Many different surgical techniques have been described, but the current literature has not yet demonstrated the superiority of one over the others. In this study, we analyzed the clinical and radiological findings of a population of 26 patients who were operated on both hands but with different techniques. Methods One hand underwent trapeziectomy with suspension arthroplasty, while the other hand was operated on with a double mobility trapeziometacarpal prosthesis. Results Our findings show that, while on the long-term follow-up the two techniques are equally valid, in the short term, the hands that were operated on with the prosthesis had a faster recovery of strength and pain. Conclusion Therefore, we reckon that double mobility trapeziometacarpal prostheses are a better choice of treatment, especially for patients who require a faster recovery for work or leisure activities.
The Impact of Surgical Approach on Mid-Term Clinical Outcomes Following Hemiarthroplasty for Femoral Neck Fractures: A Systematic Review and Meta-Analysis of Postero-Lateral Versus Direct Lateral Approaches
Gianmarco Marcello, Francesco Rosario Parisi, Lorenzo Alirio Diaz Balzani, Alessandro Del Monaco, Emanuele Zappalà, Giuseppe Francesco Papalia, Chiara Capperucci, Erika Albo, Augusto Ferrini, Biagio Zampogna, Rocco Papalia
Journal of Clinical Medicine, 2025
Background: Femoral neck fractures in the elderly often necessitate hemiarthroplasty, but the optimal surgical approach remains a highly debated topic. The postero-lateral and direct lateral approaches are commonly employed, each with benefits and drawbacks. Despite their widespread use, robust, long-term comparative studies on definitive outcomes, including pain, functional recovery, and complication rates, are notably lacking. This systematic review and meta-analysis aim to address this critical gap by meticulously comparing these approaches with long-term follow-up. Methods: A systematic literature search was performed, including only comparative studies with a minimum 1-year follow-up. A meta-analysis was performed for the primary outcome measures: operative time, dislocations, infections, perioperative fractures and reoperations. Secondary outcomes included a qualitative synthesis of patient-reported outcomes (quality of life, pain, and satisfaction). Methodological quality was assessed using RoB 2.0 for randomized controlled trials and MINORS criteria for cohort studies. Results: Our meta-analysis provides robust quantitative evidence. The direct lateral approach is associated with a significantly lower risk of post-operative dislocations (I2 = 58%; OR = 2.86, 95% CI: 2.53 to 3.22; p < 0.00001) and a significantly lower rate of reoperation (I2 = 0%; OR = 1.25, 95% CI: 1.12 to 1.40; p = 0.0001) compared to postero-lateral approach. Operative time, infection, and perioperative fracture rates were found to be statistically comparable. However, patient-reported outcomes yielded inconsistent results across studies, often becoming non-significant after adjusting for confounders. Conclusions: This meta-analysis shows that the direct lateral approach is associated with lower rates of dislocation and reoperation compared with the postero-lateral approach, while patient-reported outcomes remain variable across studies. Further high-quality comparative trials are needed to confirm these associations and guide surgical decision-making.
Prognostic factors for return to work in patients affected by chronic low back pain: a systematic review
F. Russo, G. F. Papalia, L. A. Diaz Balzani, G. Stelitano, B. Zampogna, L. Fontana, G. Vadalà, S. Iavicoli, R. Papalia, V. Denaro
Musculoskeletal Surgery, 2024
Chronic low back pain (LBP) represents a leading cause of absenteeism from work. An accurate knowledge of complex interactions is essential in understanding the difficulties of return to work (RTW) experienced by workers affected by chronic LBP. This study aims to identify factors related to chronic LBP, the worker, and the psycho-social environment that could predict and influence the duration of an episode of sick leave due to chronic LBP.Studies reporting the relation between prognostic factors and absenteeism from work in patients with LBP were included. The selected studies were grouped by prognostic factors. The results were measured in absolute terms, relative terms, survival curve, or duration of sick leave. The level of evidence was defined by examining the quality and the appropriateness of findings across studies in terms of significance and direction of relationship for each prognostic factor.A total of 20 studies were included. Prognostic factors were classified in clinical, psycho-social, and social workplace, reaching a total of 31 constructs. Global conditions with less favorable repercussions on worker’s lives resulted in a delay in time to RTW. Older age, female, higher pain or disability, depression, higher physical work demands, and abuse of smoke and alcohol have shown strong level of evidence for negative outcomes.High global health well-being, great socioeconomic status, and good mental health conditions are decisive in RTW outcomes. Interventions that aim at RTW of employee’s sick-listed with LBP should focus on psycho-social aspects, health behaviors, and workplace characteristics.
Dual-mobility total hip arthroplasty in patients younger than 55 years old: a systematic review
Biagio Zampogna, Giuseppe Francesco Papalia, Augusto Ferrini, Guglielmo Torre, Ferruccio Vorini, Lorenzo Alirio Diaz Balzani, Pasquale Farsetti, Rocco Papalia
Archives of Orthopaedic and Trauma Surgery, 2023
Strabismus and postural control: a systematic review
G. F. Papalia, G. Mangano, L. A. Diaz Balzani, G. Cupo, G. Giurazza, A. Di Zazzo, M. Coassin, R. Papalia
Musculoskeletal Surgery, 2022
The role of physical activity as conservative treatment for massive rotator cuff tears in elderly patients: a systematic review
Lorenzo Alirio Diaz Balzani, Rocco Papalia, Anna Maria Alifano, Erika Albo, Giuseppe Francesco Papalia, Mauro Ciuffreda, Chiara De Andreis, Chiara Fossati, Vincenzo Denaro
Acta Orthopaedica Belgica, 2022
The aim of this systematic review is to determine the effectiveness on functional and pain outcomes of different exercise protocols as a conservative treatment for massive, irreparable rotator cuff tears in elderly patients. A literature search was carried out consulting Pubmed -Medline, Cochrane central and Scopus to select randomized clinical trials, prospective and retrospective cohort studies or case series, that evaluated functional and pain outcomes after physical therapy in patients aged 65 or over, affected by massive rotator cuff tears. The present systematic review followed the Cochrane methodology for systematic reviews and the reporting was implemented using through the PRISMA guidelines. The Cochrane risk of bias tool and MINOR score were used for methodologic assessment. Nine articles were included. Data concerning physical activity, functional outcomes and pain assessment were obtained from the included studies. The exercise protocols assessed within the included studies were extremely wide with equally different methods of evaluation of the outcomes. However, most of the studies demonstrated a trend of improvement after the treatment, in terms of functional scores, pain, ROM and quality of life. An intermediate methodological quality of the included papers was assessed through the risk of bias evaluation. Our results showed a positive trend in patients who underwent physical exercise therapy. Our conclusion is that further studies of a high level of evidence are needed to achieve consistent evidence to improve clinical practice in the future.
Sensorimotor integration within the primary motor cortex by selective nerve fascicle stimulation
Federico Ranieri, Giovanni Pellegrino, Anna Lisa Ciancio, Gabriella Musumeci, Emiliano Noce, Angelo Insola, Lorenzo Alirio Diaz Balzani, Vincenzo Di Lazzaro, Giovanni Di Pino
Journal of Physiology, 2022
The integration of sensory inputs in the motor cortex is crucial for dexterous movement. We recently demonstrated that a closed‐loop control based on the feedback provided through intraneural multichannel electrodes implanted in the median and ulnar nerves of a participant with upper limb amputation improved manipulation skills and increased prosthesis embodiment. Here we assessed, in the same participant, whether and how selective intraneural sensory stimulation also elicits a measurable cortical activation and affects sensorimotor cortical circuits. After estimating the activation of the primary somatosensory cortex evoked by intraneural stimulation, sensorimotor integration was investigated by testing the inhibition of primary motor cortex (M1) output to transcranial magnetic stimulation, after both intraneural and perineural stimulation. Selective sensory intraneural stimulation evoked a low‐amplitude, 16 ms‐latency, parietal response in the same area of the earliest component evoked by whole‐nerve stimulation, compatible with fast‐conducting afferent fibre activation. For the first time, we show that the same intraneural stimulation was also capable of decreasing M1 output, at the same time range of the short‐latency afferent inhibition effect of whole‐nerve superficial stimulation. The inhibition generated by the stimulation of channels activating only sensory fibres was stronger than that due to intraneural or perineural stimulation of channels activating mixed fibres. We demonstrate in a human subject that the cortical sensorimotor integration inhibiting M1 output previously described after the experimental whole‐nerve stimulation is present also with a more ecological selective sensory fibre stimulation. imageKey points Cortical integration of sensory inputs is crucial for dexterous movement. Short‐latency somatosensory afferent inhibition of motor cortical output is typically produced by peripheral whole‐nerve stimulation. We exploited intraneural multichannel electrodes used to provide sensory feedback for prosthesis control to assess whether and how selective intraneural sensory stimulation affects sensorimotor cortical circuits in humans. Activation of the primary somatosensory cortex (S1) was explored by recording scalp somatosensory evoked potentials. Sensorimotor integration was tested by measuring the inhibitory effect of the afferent stimulation on the output of the primary motor cortex (M1) generated by transcranial magnetic stimulation. We demonstrate in humans that selective intraneural sensory stimulation elicits a measurable activation of S1 and that it inhibits the output of M1 at the same time range of whole‐nerve superficial stimulation.
Results of simultaneous unicompartmental knee arthroplasty and anterior cruciate ligament reconstruction: A systematic review
Erika Albo, Stefano Campi, Biagio Zampogna, Guglielmo Torre, Giuseppe Francesco Papalia, Lorenzo Alirio Diaz Balzani, Anna Maria Alifano, Rocco Papalia, Vincenzo Denaro
Journal of Clinical Medicine, 2021
This systematic review aimed to investigate the clinical and functional outcomes and complication rate of simultaneous anterior cruciate ligament reconstruction (ACLR) and unicompartmental knee arthroplasty (UKA). A systematic search in PubMed–Medline, Cochrane Library, and Google Scholar was carried out to identify eligible randomized clinical trials, observational studies, or case series that reported on clinical and functional results of combined ACLR and UKA in adults with a unicompartmental knee osteoarthritis and ACL deficiency. Four retrospective studies and three prospective studies were included in this review. A total of 169 patients were included with a mean follow-up of 6.3 years. The Mean Oxford Knee Score improved from 29.4 to 43.9 at the final follow-up. All the other reported scores significantly improved after surgery. The overall revision rate was 3.5%. The MINORS score ranged from 8 to 14. Association analysis of MINORS score and year of publication, through Pearson’s coefficient, showed no significant association (p = −0.089). Simultaneous ACLR and UKA is a safe procedure with a significant postoperative improvement of functional and clinical outcomes for patients with ACL injury that complain of knee instability and isolated medial compartment pain.
The effects of physical exercise on balance and prevention of falls in older people: A systematic review and meta-analysis
Giuseppe Francesco Papalia, Rocco Papalia, Lorenzo Alirio Diaz Balzani, Guglielmo Torre, Biagio Zampogna, Sebastiano Vasta, Chiara Fossati, Anna Maria Alifano, Vincenzo Denaro
Journal of Clinical Medicine, 2020
The aims of this systematic review and meta-analysis were to evaluate the effects of physical exercise on static and dynamic balance in the elderly population, and to analyze the number of falls and fallers. A systematic literature search was conducted using PubMed–Medline, Cochrane Central, and Google Scholar to select randomized clinical trials that analyzed the role of exercise on balance and fall rate in patients aged 65 or older. Sixteen articles were included in this review. Applying the Cochrane risk-of-bias tool, three studies were determined to be at low risk of bias, nine at unclear risk of bias, and four at high risk of bias. The meta-analysis showed improvements in dynamic balance (p = 0.008), static balance (p = 0.01), participants’ fear of falling (p = 0.10), balance confidence (p = 0.04), quality of life (p = 0.08), and physical performance (p = 0.30) in patients who underwent physical exercise compared to controls. The analysis of the total numbers of falls showed a decreased likelihood of falls in patients who participated in exercise programs (p = 0.0008). Finally, the number of patients who fell at least once was significantly reduced in the intervention group (p = 0.02). Physical exercise is an effective treatment to improve balance and reduce fall rates in the elderly.
Osseointegration for lower and upper-limb amputation a systematic review of clinical outcomes and complications
Journal of Biological Regulators and Homeostatic Agents, 2020
Return to sport activity in the elderly patients after unicompartmental knee arthroplasty: A systematic review and meta-analysis
Rocco Papalia, Biagio Zampogna, Guglielmo Torre, Lorenzo Alirio Diaz Balzani, Sebastiano Vasta, Giuseppe Papalia, Antonio De Vincentis, Vincenzo Denaro
Journal of Clinical Medicine, 2020
Return to sport after anatomic and reverse total shoulder arthroplasty in elderly patients: A systematic review and meta-analysis
Rocco Papalia, Mauro Ciuffreda, Erika Albo, Chiara De Andreis, Lorenzo Alirio Diaz Balzani, Anna Maria Alifano, Chiara Fossati, Andrea Macaluso, Riccardo Borzuola, Antonio De Vincentis, Vincenzo Denaro
Journal of Clinical Medicine, 2020
Infection after spinal surgery and procedures
Alberto Di Martino, Rocco Papalia, Erika Albo, Luis Carlos Díaz, Luca Denaro, et al.
European Review for Medical and Pharmacological Sciences, 2019
Restoring tactile sensations via neural interfaces for real-time force-and-slippage closed-loop control of bionic hands
Loredana Zollo, Giovanni Di Pino, Anna L. Ciancio, Federico Ranieri, Francesca Cordella, Cosimo Gentile, Emiliano Noce, Rocco A. Romeo, Alberto Dellacasa Bellingegni, Gianluca Vadalà, Sandra Miccinilli, Alessandro Mioli, Lorenzo Diaz-Balzani, Marco Bravi, Klaus-P. Hoffmann, Andreas Schneider, Luca Denaro, Angelo Davalli, Emanuele Gruppioni, Rinaldo Sacchetti, Simona Castellano, Vincenzo Di Lazzaro, Silvia Sterzi, Vincenzo Denaro, Eugenio Guglielmelli
Science Robotics, 2019
TFCC Lesions in Children and Adolescents: Open Treatment
Sandra Pfanner, Lorenzo Diaz, Dariush Ghargozloo, Vincenzo Denaro, Massimo Ceruso
Journal of Hand Surgery Asian Pacific Volume, 2018
Targeted muscle reinnervation for improved control of myoelectric upper limb prostheses
Journal of Biological Regulators and Homeostatic Agents, 2017
Meniscal extrusion as booster of osteoarthritis
Journal of Biological Regulators and Homeostatic Agents, 2017
Intrarticular injections of hyaluronic acid for Trapezio-Metacarpal osteoarthritis: A systematic review
Journal of Biological Regulators and Homeostatic Agents, 2017
Intraoperative application Platelet rich fibrin , postoperative injections OF PRP or microfracture only for osteochondral lesions OF THE knee : A FIVE-YEAR RETROSPECTIVE EVALUATION
Journal of Biological Regulators and Homeostatic Agents, 2016
Radiofrequency energy in the arthroscopic treatment of knee chondral lesions: A systematic review
Papalia Rocco, Diaz Balzani Lorenzo, Torre Guglielmo, Paciotti Michele, Maffulli Nicola, Denaro Vincenzo
British Medical Bulletin, 2016
Hamstring tendon regeneration after harvest for anterior cruciate ligament reconstruction: A systematic review
Rocco Papalia, Francesco Franceschi, Stefano D'Adamio, Lorenzo Diaz Balzani, Nicola Maffulli, Vincenzo Denaro
Arthroscopy Journal of Arthroscopic and Related Surgery, 2015
Pharmacological interventions for the treatment of Achilles tendinopathy: A systematic review of randomized controlled trials
N. Maffulli, R. Papalia, S. D'Adamio, L. Diaz Balzani, V. Denaro
British Medical Bulletin, 2015
The arthroscopic treatment of shoulder instability: Bioabsorbable and standard metallic anchors produce equivalent clinical results
Rocco Papalia, Francesco Franceschi, Lorenzo Diaz Balzani, Stefano D'Adamio, Vincenzo Denaro, Nicola Maffulli
Arthroscopy Journal of Arthroscopic and Related Surgery, 2014
Scaffolds for partial meniscal replacement: An updated systematic review
R. Papalia, F. Franceschi, L. Diaz Balzani, S. D'Adamio, N. Maffulli, V. Denaro
British Medical Bulletin, 2013
Two-stage procedure in anterior cruciate ligament revision surgery: A five-year follow-up prospective study
Francesco Franceschi, Rocco Papalia, Angelo Del Buono, Biagio Zampogna, Lorenzo Diaz Balzani, Nicola Maffulli, Vincenzo Denaro
International Orthopaedics, 2013

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