The current standard of care for lupus nephritis has so far been based on sequential immunosuppressive therapy aimed to induce a response, called induction therapy, and to prevent relapse, called maintenance therapy. The results of this approach are deemed unsatisfactory, with only 20-30% of complete renal responses observed at 6-12 months, with at least 20% of patients suffering from chronic kidney failure and 5-20% from end-stage kidney disease at 10 years post-diagnosis. Herein, we have briefly discussed two new treatments, consisting of belimumab and voclosporin, recently registered by drug agencies in the aftermath of controlled trials that demonstrated their superiority given in addition to standard immunosuppressive therapy. Further progress in rheumatoid arthritis is being based on further integrating goals, such as monitoring patients' daily symptoms and well managing co-morbidities like cardiovascular disease. An improved understanding of its pathophysiology has enabled translational research designed to develop new therapeutic strategies including numerous targeted biological and synthetic agents.

Facing the multiple repercussions of the pandemic crisis in terms of young patients’ and their entourage’s mental health, we have maintained our creativity within the psychiatric service for children and adolescents of our clinics. As part of this contribution, we have highlighted two axes for the past year 2021, the first concerning a specific clinical activity based on multi-disciplinarity, with emphasis made on the aspects of prevention, awareness, preparation, and adaptation; the second involved the field of teaching in a domain as complex as it is feared.

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.