The complex structure Rizzoli-Castel San Giovanni Orthopaedics includes a hospital department currently equipped with 15 beds of orthopaedics and a medical office for specialist visits. There are 22 orthopaedic beds, of which at least 1 is for day surgery. The rooms provide nursing rooms with two-three beds and bathroom. In the patient rooms are available personal wardrobe, bedside table, table and chairs, head lights with call device and night light.

Clinical activity

The complex structure of Orthopaedic - Castel San Giovanni is characterized by the diagnosis and treatment of congenital and acquired deformities of the musculoskeletal system, mainly oriented to minimally invasive surgical techniques.

Disorders of the hip

The facility is specialized in primary and revision prosthetic surgery, especially in cases of complex osteoarthritis, historically a prerogative of the Rizzoli Orthopaedic Institute of Bologna, such as early arthrosis, trauma or deformity outcomes.

The strong point is the mini invasive technique before "bikini", developed in the Orthopaedic and Traumatological Clinic I (directed by Prof. Faldini) that allows you to reach the joint without detaching the muscles that are the "hip motors". The previous approach to "bikini", pioneered in the early 2000s, is now a reference standard in prosthetic surgery, internationally recognized has been awarded at the prestigious American Academy of Orthopaedic Surgeons in many variants (primary surgery, revision, in the deformity). The advantages of the anterior minimally invasive approach are the total respect of the anatomy that allows very low blood losses that do not normally require transfusion, a functional recovery almost immediate and the simplification of rehabilitation, reduced to simple exercises to be performed independently at home.

The use of innovative implants in highly osteointegrated biocompatible materials such as porous titanium and hydroxylapatite coating, and ceramic head allow you to return to a normal life, perform heavy work and also practice sports with high impact that include running, or skiing.

Non-prosthetic joint "rescue" surgery for patients with isolated articular cartilage lesions, avascular necrosis or deformity. An early diagnosis of hip pain allows today to identify numerous pathologies that if operated early can avoid (or delay) the need for a hip prosthesis. Identification of these conditions (acetabular femoral conflict, avascular necrosis, dysplastic hip, lip lesions, osteochondrosis, osteochondritis), can be treated with minimally invasive targeted interventions based on the resolution of the specific problem in order to slow down or stop the arthrosis process. 

The rehabilitation path, based on the fast-track protocol, is designed to promote early mobilization and a rapid return to daily activities, with an early discharge at home in total autonomy, without the need for long periods of rehabilitation. The patient is usually trained by the rehabilitation staff at the time of discharge to dress independently, go to the bathroom walk around the house and do the stairs.

Diseases of the knee

The structure is specialized in both primary and revision prosthetic surgery, especially in cases of severe post-traumatic arthrosis or outcome of deformity, historically the domain of the Rizzoli Orthopaedic Institute of Bologna. Depending on the degree of arthrosis, partial replacement of the joint (single-compartment prosthesis) with rapid clinical functional recovery, or total prosthetic replacement of the knee, or revision of a mobilized or painful prosthetic implant is possible.

The strong point is the FAST (Faldini Sport Total Knee Replacement) technique developed at Clinica Ortopedica e Traumatologica I, which allows prosthetic replacement of the knee through the use of innovative non-cemented implants obtained by 3D printing of porous titanium, that allow a "biological cementation" able to exceed the limits of the use of acrylic cement for prosthetic fixation. The surgical technique, saving ligaments with the conservation of the posterior cruciate and the personalized alignment on the patient’s characteristics (also by using surgical navigation) allows a physiological recovery of the joint movement able to face with the prosthetic implant an almost normal life.

The advantages of the minimally invasive approach are the total respect of the anatomy that allows very low blood losses that normally do not require transfusion, a rapid functional recovery with the simplification of rehabilitation, reduced to simple exercises to be performed independently at home. 

In addition to prosthetic knee surgery, the facility is specialized in "rescue" surgery to avoid or delay prosthetic treatment: early diagnosis of joint deformities such as varus, valgus or recurved knee, or femoropaemiarotulea, allows corrective osteotomy interventions with reduced invasiveness and early functional recovery.

Special attention is paid to complex three-dimensional deformities of the knee with femoro-patellar alteration, which involve the 3D study of anatomy and the identification of problems to be corrected with three-dimensional osteotomies.

The facility is also specialized in the diagnosis and arthroscopic treatment of meniscal, ligamentous and cartilaginous lesions, typical of sports patients. Each individual injury, carefully studied, can be treated with a personalized reconstruction process such as the biological reconstruction of the anterior cruciate ligament with the tendons of the gracile and semitendinosus.  Meniscal lesions can be treated with either remediation or suture, up to, in selected cases to transplant, while joint cartilage damage can be treated with regenerative medicine techniques based on stem cells.

Foot and ankle disorders

The facility is specialized in ankle and foot surgery, particularly in the correction of deformities and prosthetic surgery. The most common deformities of the forefoot such as the hallux valgus, the stiff hallux, hammer or claw fingers and the Morton’s neuroma, are treated with minimally invasive interventions based on small incisions that allow the operation without pain and the recovery of the walk a few hours after the intervention. Strong point among these interventions is the SERI technique (invented by prof. Sandro Giannini in the late '90s) internationally recognized as the leader of minimally invasive foot corrective interventions. Thanks to the reduction in invasiveness and the use of special footwear that allows you to walk with your foot on the ground, bilateral intervention is now a standard Reference when both feet are to be treated.

More complex deformity of the retropedium, such as flat foot, hollow foot, pronatory syndrome are commonly treated with minimally invasive corrective techniques that can stop arthrosis progression. Even complex surgery of deformities is done without using screws or metal plates, so that the foot is free from synthetic media at the end of the healing process.

Among the strengths of the activity of the structure is the treatment of problems of articular cartilage of the ankle, with the possibility of treating osteochondral lesions by using stem cells, with the "Giannini technique" developed at Clinica Ortopedica e Traumatologica I in the late '90s, and still considered a reference standard.

Treatment of ankle arthrosis by means of FAR (Faldini Ankle Rizzoli) prosthesis, an innovative 3D implant that can cover the tibial and astragalic parts with a saving of bone tissue compared to traditional techniques.

Hand and wrist disorders

The facility specializes in the treatment of hand pathologies, with a particular focus on trapezio-metacarpal prosthesis replacement, wrist arthroscopic surgery and minimally invasive techniques for carpal tunnel syndrome.

For advanced re-arthrosis, second-generation prostheses are used, developed based on the best hip prosthetic technologies and miniaturized for this joint. Thanks to a non-cemented anatomical design, dual mobility system and hydroxylapatite coating, these prostheses guarantee stability, functionality and durability. The DUAL-FAST protocol, studied by Clinica I, allows a quick and safe post-operative recovery, with the maintenance of strength and joint mobility.

For pathologies of the wrist of sports and degenerative origin, the use of an advanced arthroscopic technique, supported by a specific tower for traction, allows not only to visualize the problem, but also to treat it without violating the articular capsule. This approach maximizes the preservation of anatomical structures, reduces postoperative pain and accelerates recovery, allowing a quick return to daily activities and sports.

Another area of excellence is the ultrasound neurolysis for carpal tunnel syndrome, developed in the ECHO-Tunnel study. Through a micro-incision on the wrist, this technique avoids the traditional palm cutting, reducing surgical trauma and ensuring a faster recovery and less painful.

In addition to these advanced technologies, the department deals with the treatment of major diseases of the hand, including Dupuytren’s disease, snapping finger, De Quervain tendonitis, post-traumatic disorders and degenerative conditions. The multidisciplinary and highly specialized approach guarantees effective treatments, minimally invasive and oriented to the best possible functional recovery.daily activities and sports.

Diseases of the spine

In the structure are performed interventions to the spine, in the tradition and experience of the Orthopaedic and Traumatological Clinic I of the Orthopaedic Institute Rizzoli of Bologna as disc hernias, Canal stenosis and spondylolisthesis with reduced invasiveness techniques to allow the patient early discharge with rapid functional recovery. Proper outpatient framing with state-of-the-art diagnostic examinations such as high-field MRI and panoramic column x-rays for pelvic spine balance study allows to customize the type of intervention to the patient in order to reduce Minimising the risk of recurrence-reintervention. Depending on the type of pathology, micro-discectomy is performed with incision of about 3 cm for the removal of the herniated disc, micro-foraminotomy or laminectomy. The instructional videos on these techniques performed by prof. Faldini in Clinica I have been awarded at the American Academy of Orthopaedic Surgeons and included in the Ortho Video Library (multimedia library for updating US surgeons). 

Vertebral stabilizations are performed with titanium screws and arthrodesis with 3D intersomatic cage for the treatment of spondylolisthesis, stenosis and degenerative scoliosis or in fracture outcomes.

The cervical discectomy procedure performed by anterior miniinvasive, has been awarded by the American Academy of Orthpaedic Surgeons and is now a reference standard as it allows to reduce recovery time and allow the patient an early reintegration into social and working life. All spinal surgery is performed with a high standard of safety developed at the Rizzoli Orthopaedic Institute in Bologna, with the use of continuous neurophysiological monitoring techniques in the operating room that make it possible to identify any maneuver poorly tolerated by the spinal cord or spinal roots so as to minimize the risk of postoperative nerve paralysis. 

There is a specialist clinic for growing spinal deformities such as scoliosis, kyphosis, Scheuermann’s disease, curved back and spondylolisthesis. Deformities are treated with innovative orthopaedic techniques based on the use of personalized corsets and physiotherapy in order to stop the worsening and reduce the risk of progression to surgery. The prescribed and tested orthoses are designed in a personalized way so as to reduce the size (it is now customary to leave the neck free with modern corsets) and weight, so that they can be widely tolerated during the relationship life of the small patient.