Combined juvenile polyposis/hereditary hemorrhagic telangectasia (JP/HHT) syndrome is a rare genetic disorder associating both the development of hamartomatous polyps in the gastrointestinal tract and the Rendu-Osler-Weber disease. Patients affected by these two pathologies are exposed to an increased risk of digestive tract cancers and vascular malformations.

In this article, we present the case of a 73-year-old patient diagnosed with juvenile polyposis at the age of 67, following a bifocal left colon cancer. During his lifetime, this patient presented numerous epistaxis episodes without a clearly identified cause. Because his eldest daughter also suffered from repeated episodes of epistaxis, a genetic origin was then suggested.

In order to properly organize the follow-up of their patients, it is important that practitioners likely to see a person suffering from JP/HHT in consultation take into account the possibility that this person might suffer from the JP/HHT syndrome.

The year 2021 enabled us to shed light on the impact of minimally-invasive techniques in hip arthroplasty surgery, continued progress in knee arthroplasty, place of unconventional strategies in the control of implant infections, and interest of a new surgical positioning for performing shoulder arthroscopy techniques.

The optimization of surgical techniques in hip arthroplasty renders it now possible to identify those patients for whom a postoperative blood control proves necessary but also, therefore, for optimizing the patients before the intervention in order to reduce the risk of postoperative anemia and transfusion requirement. The benefit of knee replacement surgery has so far not matched that of hip replacement. Nevertheless, the development of resurfacing strategies respecting the individual anatomy of the patient, supported by modern technology and particularly robotization and using custom-made implants, augurs well for significant progress. Infection is a serious complication of arthroplasty surgery. To the classic strategies were added new therapeutic approaches, such as two-stage surgery in one stage and a better definition of the place of long-term suppressive antibiotic therapy.

Finally, an optimal position for patients benefitting from shoulder arthroscopy is that in the supine position, avoiding the disadvantages of semi-sitting and lateral decubitus positions, with the first associated with increased anesthetic risks and the second with surgical difficulties in the event of conversion to an open approach, with a risk of injury to the brachial plexus.

Arthroplasty has become the standard approach for hip replacement and has even been described as “The operation of the century” in The Lancet. The drive to optimize care has led to many improvements, particularly regarding minimally invasive surgery, thereby enabling faster functional recovery. Thanks to these advances, it is now possible to consider performing a bilateral arthroplasty, when required, in the same operating session, without impacting the final result of both arthroplasties and at a lower cost. The concept of arthroplasty also extends to the structures involved in the movements of the over- and underlying joints, notably with arthroplasties able to restore the pronation-supination movements of the forearm.

The discovery of a soft tissue mass is often trivialized. Yet, when its volume exceeds 5 centimeters and it is located under the fascia, a malignant tumor must be considered, and multidisciplinary care is required. While surgery has long been regarded as the standard therapeutic option, it is now well established that the co-management with radiation therapists offers a better chance of success, especially if it can precede surgery. Strategies combining state-of-the-art radiotherapy techniques to achieve skin saving and surgical management techniques with a very conservative approach to soft tissue management and negative pressure wound therapy significantly improve the tumor control.

The first total hip prostheses were implanted more than 40 years ago. Over the past 10 years, so-called "mini-invasive" surgeries have emerged, enabling patient's muscle mass to be preserved. This type of surgery is associated with a faster functional recovery and shorter hospital stay. Five years ago, we implemented a clinical course on arthroplasty, titled "Optimal Recovery", at the Cliniques Universitaires Saint-Luc. This protocol seeks to optimize the care of patients throughout their care journey, ensuring that standardized procedures be applied as much as possible. Patients benefit from two information sessions, one individual and one group session, and receive an information leaflet, in order to be actively included in the care process, which reduces their stress. Minimally-invasive surgical techniques, along with the adaptation of pre-, intra- and postoperative protocols, including postoperative analgesia and rehabilitation techniques, have likewise been developed in this setting. Implementing this type of care strategy has been associated with a reduction in both hospital stay and postoperative transfusion rates. The good results thereby observed enable bilateral arthroplasty to be performed at the same time, without any significant impact on either duration of the operation or functional recovery.