I migliori medici di Ricostruzione delle articolazioni del piede e delle dita dei piedi - TOP-52medici

Il Dott. Joaquim Casañas è un pioniere della microchirurgia dei nervi periferici con mappatura elettrofisiologica intraoperatoria, un'innovazione che migliora la precisione chirurgica al Centro Médico Teknon.

• Oltre 35 anni di specializzazione nella ricostruzione della mano e dei nervi
• Direttore del Traumaunit, un centro di eccellenza a Barcellona
• Esegue avanzati interventi di innesto e trapianto di nervi
• Formatosi presso la Mayo Clinic e i migliori ospedali francesi
• Presidente della Società Spagnola di Chirurgia della Mano

Il Dr. Turan si è formato presso il Dipartimento di Chirurgia Ortopedica della Scuola di Medicina della Northwestern University, portando un'esperienza internazionale nella ricostruzione delle articolazioni del piede.

• Specializzato in chirurgia ortopedica con un focus su procedure relative al piede e alle articolazioni
• Membro di prestigiose organizzazioni tra cui AAOS e AANA
• Ha completato un avanzato percorso di formazione presso il Dipartimento di Ortopedia dell'Università di Uludağ
• Opera presso il Turan Turan Health Group con servizi ortopedici completi

After completing his medical doctorate education at Gazi University School of Medicine, which is located in the capital city of Ankara he carried on to his Orthopaedic and Traumatology fellowship training at the same university. After his fellow training, he completed his mandatory governmental and military duties as an orthopaedic surgeon between 2008 and 2011. He later started his Orthopaedic career in Istanbul Acıbadem Hospitals network. Between 2013 and 2022 he served as an academic member of the Department of Orthopedics and Traumatology at Acıbadem Mehmet Ali Aydınlar School of Medicine where he was entitled Associate Professor in 2021. He is now private practicing in his own clinic in Istanbul. 

Starting from the year 2014 he has been especially focused on the fields of patient-specific orthopaedic surgery, computer-aided surgical planning, 3D printed custom surgical guides and implants. These fields are very novel even throughout the world. He performed many surgeries as the first examples of their own for Turkey. He mainly uses his special interest and knowledge on patient-specific orthopaedics to surgically treat technically challenging cases of malunion, bone deformity and complex arthroplasty cases including revision arthroplasty. 

Specializzato nella ricostruzione complessa del piede e della caviglia con oltre 20 anni di esperienza – formato presso i dipartimenti ortopedici di GATA e della Mayo Clinic.

• Esperto in chirurgia traumatologica e oncologia ortopedica
• Ricerche premiate sui trattamenti dei tumori ossei
• Membro della Società Turca del Piede e della Caviglia
• Professore Associato in Oncologia Ortopedica

La Dott.ssa Piya Assawaboonyadej è specializzata in ricostruzioni ortopediche complesse, con un focus sulle articolazioni del piede e delle dita presso l'Ospedale Intrarat.

• Chirurgo ortopedico certificato con oltre 11 anni di esperienza
• Formazione avanzata in Oncologia Ortopedica e Ricostruzione presso l'Università dell'Iowa
• Membro della società Thailandese dei Tumori Muscoloscheletrici
• Ricerca pubblicata su tecniche artroscopiche per i tumori delle articolazioni del piede

Work Experience:

• 2011-2014 (Haziran) Kütahya Tavşanlı Doç. Dr. Mustafa Kalemli Hospital

• 2014(Haziran)-2019 ( Haziran) Kütahya Özel Anadolu Hospital

• 2019- 2020 İstanbul Arnavutköy Hosptial

• 2020- 2023 Özel İstanbul Şafak Hospital

• 2024 -halen OrtoCare Clinic

Education:

▪ 1989-1993 Erzurum High School

▪ 1993-1994 İzmir 60. Yıl High School

▪ 1994-1997 İzmir 60. Yıl High School

▪ 1997-2004 Dokuz Eylül University Medicine Faculty

▪ 2005-2011 Dokuz Eylül Universtiy Orthopaedics and Traumatology Department

Profesional Experience:

• Joint and Cartilage Surgery and Stem Cell treatment

• Sports Medicine and Joint Arthroscopy

• Joint Arhtroplasty (knee- hip-shoulder prothesis)

• Hand Surgery and Microsurgery

• Spinal Surgery

• Traumatolgy

Postgraduate Education:

• 2006 Orthopaedic Trauma Course

• 2008 Monolateral Eksternal Fixator Course

• 2009 Prof. Dr. Rıdvan Ege Han Surgery Course

• 2009 Advanced Orthoapedic Trauma Course

• 2009 Based Arthroscopy Course

• 2010 AO Trauma Course ( Principles in Operative Fracture Treatment)

• 2010 3.Based İntrameduller Nailing Course

• 2011 AO Trauma Course (Advances in Operative Fracture Treatment)

• 2011 2. Advanced İntrameduller Nailing Course

• 2011 XII. Advanced Artrhroscopy Course

• 2012 Ankle Arthroscopy Course

• 2012 Shoulder Artrhroscopy Course

• 2013 AO Trauma Masters Course

• 2013 Knee Arthroplasty and Revision Arthroplasty Course ( Viyana/ Avusturya)

• 2015 Primer and Revision Knee Artrhroplasty Course( Arthroschool Courses)

• 2016 Master Knee Arthroscopy Course ( Acıbadem Univ./ İstanbul )

• 2020 Live lig spinall instrumentation kursu (Medtronic İstanbul)

Congress and Symposiums

• 2002 Eğitim Programı Geliştirme Sempozyumu

• 2004 III. National Medicine Education Congress

• 2017 National Medicine Student Congress

• 2008 8th İnternational Turkish Spine Congress

• 2009 XXI. National Orthopaedy and Traumatology Congress

• 2010 12. National Hand and Upper Extremity Surgery Congress

• 2001 II. National Medicine Education Congress

• 2011 XXII. National Orthopaedy and Traumatology Congress

• 2012 10. ArthroplastyWinter Congress

• 2012 13th European Federation of National Associations of Orthopaedics and Traumatology Congress

• 2012 13. National Hand and Upper Extremity Surgery Congress

• 2013 Osteosynthese İnternational 2013

• 2013 14th European Federation of National Associations of Orthopaedics and Traumatology Congress

• 2014 10th Central European Orthopaedic Congress

• 2014 24. National Orthopaedy and Traumatology Congress

• 2015 25, National Orthopaedy and Traumatology Congress

• 2016 26. National Orthopaedy and Traumatology Congress

• 2017 Eurospine 2017 Congress Ireland

Bibliography:

• 2011 XXII. Ulusal Türk Ortopedi ve Travmatoloji Kongresi Poster Bildirisi (İNTRAMEDULLER

ÇİVİLEME YÖNTEMİ İLE OPERE EDİLEN TİBİA CİSİM KIRIKLI HASTALARIN TAKİBİNDE

KULLANILAN RADYOGRAFİK KAYNAMA SKORLAMA SİSTEMİNİN GÜVENİLİRLİĞİNİN

HASTA KLİNİĞİ İLE DOĞRULANMASI )

• 2013 Osteosynthese İnternational 2013 and İntramedullary Nailing Courses Oral Presentation

(F1.4 Verification of the reliability of the radiographic union score for tibial fractures in

the follow-up of patients with tibia corpus fractures operated via the intramedullary

nailing technique using the patients’ clinical condition. E. Cekic1, E. Alici2,)

• 2014 10th Central European Orthopaedic Congress Oral Presentation ( The Reliability of

Radiographic Union Score).

• Reliability of the Radiographic Union Score for Tibial Fractures Acta Orthop Traumatol Turc

2014;48(5):533-540 doi: 10.3944/AOTT.2014.14.002

• Prediction of tibial nonunion at the 6-week time point Keir A. Ross, Kevin O’Halloran, Renan C.

Castillo, Max Coale, Justin Fowler, Jason W. Nascone, Marcus F. Sciadini, Christopher T. LeBrun,

Theodore T. Manson, Anthony R. Carlini, Josef E. Jolissaint, Robert V. O’Toole*

• Reprodutibilidade do escore radiográfico de consolidac¸ão das fraturas da tíbia (RUST) Fernando

Antonio Silva de Azevedo Filhoa,b,∗, Ricardo Britto Cotiasa, Matheus Lemos Azib e Armando Augusto

de Almeida Teixeiraa

• Does weight-bearing assignment after intramedullary nail placement alter healing of tibial shaft

fractures? D.A. Greenhilla,∗, M. Poormanb, C. Pinkowskib, F.V. Ramseyb, C. Haydela

• Will My Tibial Fracture Heal? Predicting Nonunion at the Time of Definitive Fixation Based on

Commonly Available Variables

Kevin O’Halloran MD, Max Coale BA, Timothy Costales BS,Timothy Zerhusen Jr BS, Renan C. Castillo PhD,

Jason W. Nascone MD,Robert V. O’Toole MD

• Feasibility and Value of Radiographic Union Score Hip Fracture after Treatment with Intramedullary

Nail of Stable Hip Fractures

• Image quality of cone beam computed tomography for evaluation of extremity fractures in the presence

of metalhardware: visual grading characteristics analysis

1GREG M OSGOOD, MD, 2GAURAV K THAWAIT, MD, 2NIMA HAFEZI-NEJAD, MD,

2DELARAM SHAKOOR, MD,1ADAM SHANER, MD, 3JOHN YORKSTON, PhD, 4WOJCIECH B

ZBIJEWSKI, PhD, 4JEFFREY H SIEWERDSEN, PhDand 2SHADPOUR DEMEHRI, MD

• Correlation Between RUST Assessments of Fracture Healing to Structural

and Biomechanical Properties

Margaret E. Cooke,1 Amira I. Hussein,1 Kyle E. Lybrand,1 Alexander Wulff,1 Erin Simmons,1

Jeffrey H. Choi,1 Jody Litrenta,1William M. Ricci,2 Jason W. Nascone,3 Robert V. O’Toole,3 Elise F.

Morgan,4 Louis C. Gerstenfeld,1 Paul Tornetta III1

• EXPLORING PROGNOSTIC FACTORS ASSOCIATED WITH

ADVERSE OUTCOMES IN PATIENTS WITH FRACTURES OF THE

TIBIAL SHAFT

By RAMAN MUNDI, MD, BHSc

A Thesis Submitted to the School of Graduate Studies in Partial Fulfillment of the

Requirements for the Degree Master of Science

McMaster University

• Value of a radiographic score for the assessment of healing of nailed femoral

and tibial shaft fractures: A retrospective preliminary study

Vasiliki Perlepea,⁎, Andrea Ceratoa, Dan Putineanua, Celine Buglib, Guy Heynend,

Patrick Omoumia,c, Bruno Vande Berga

About me

I graduated from Izmir Dokuz Eylul University with the orthopedics branch. After I graduated, I carried out some

studies focusing on especially on

joint and cartilage surgery and stem cells. In this, I worked with many professional and amateur sport clubs. Also,

I worked on joint replacement surgery

for further aged people. Approximately, I achieved 10 thousand people who took knee and hip replacement

surgery from me. I attended to many international conferences about joint and cartilage surgery. Now I start

Ortocare Clinic for orthopedics and health center. In here, I treat my patients using the most advanced

technologies in the world, such as foot health centers, electromagnetic therapy, cryocabin therapy, backup

therapy and stem cell therapy. In our clinic, I continue to my work on non-surgical treatments, especially antiaging

treatment, and to eliminate pain problems in patients. On top of that, I also carry out some post-operative

rehabilitation and medical plates exercises.

Dr. Murat Kezer is an experienced orthopedic surgeon. He specializes in joint reconstruction, arthroplasty, and sports injuries. He has completed advanced training in MAKO Total and Partial Knee and Hip Replacement. Since 2002, he has attended more than 20 national and international congresses and courses.

Dr. Kezer is a member of the Turkish Medical Association, Hip Knee Arthroplasty Association, International Congress for Joint Reconstruction, and Turkish Society of Orthopaedics and Traumatology. He is known for his skill in hip and knee arthroplasty. He has a strong record of successful surgeries and is dedicated to surgical innovation and patient care.

Ahn Tae Hoon, MD, PhD, is a cardiology specialist and Director of the Cardiovascular Center at Naeun Hospital. He has expertise in coronary artery disease (angina, myocardial infarction), hypertension, valvular heart disease, heart failure, and cardiovascular interventional procedures.

He earned his PhD in Medicine from Korea University College of Medicine. He completed an Internal Medicine residency at Korea University Guro Hospital and a Cardiology fellowship at Korea University Hyehwa Hospital. He also completed clinical training at the Montreal Heart Institute.

He previously served as Professor and Director of the Cardiovascular Center at Gachon University Gil Medical Center. He was a Clinical Professor at Korea University Anam Hospital and at Chung-Ang University Gwangmyeong Hospital. His leadership roles include President of KSIC, KCCC, KVIS, and KSC. He also served as Treasurer of KSC and as Organizing Committee Chair of ENCORE SEOUL.

Education

• (1998-2004), Bachelor's Degree Hacettepe University Faculty of Medicine, Ankara
• (2005-2010), Doctorate / Specialization in Medicine Haydarpaşa Numune Training and Research Hospital

Experience

• 2005-2011, Assistant Doctor Haydarpaşa Numune Training and Research Hospital, Department of Radiology
• 2011-2013, Specialist Doctor Kahramanmaraş Women's and Children's Hospital, Kahramanmaraş Necip Fazıl City Hospital (mandatory service)
• 2013-2022, Specialist Doctor Ministry of Health Fatih Sultan Mehmet Training and Research Hospital, Department of Radiology
• 2022, Associate Professor Ministry of Health Fatih Sultan Mehmet Training and Research Hospital, Department of Radiology

A traumatologist and orthopedic surgeon based in Madrid with nearly 30 years of experience. Throughout his extensive career, he has specialized in the diagnosis and treatment of knee joint pathologies, shoulder joint conditions, sports injuries, ankle disorders, knee joint prosthetics, robotic surgery, and knee trauma.

Graduated from the Faculty of Medicine and Surgery at the University of Navarra, specializing in Orthopedic Surgery and Traumatology at the same institution. Additionally, he earned a doctorate in Medicine and Surgery. Based on the MIR rankings, he was recognized as the resident with the best resume in Spain across all specialties.

Later, he pursued advanced training in shoulder surgery in California and completed internships at ten hospitals in the UK and the USA, including the Mayo Clinic in Rochester, as well as the universities of Miami, Oxford, and Cambridge.

Throughout his professional career, he has served as a medical consultant for various clinics and centers, as well as for professional teams such as the Cleveland Cavaliers (NBA), Cleveland Browns (NFL), and Cleveland Indians (baseball). Additionally, he has worked as a trauma consultant for several football teams, including Atlético Madrid, Getafe, and Real Zaragoza, and has collaborated with Spanish federations for gymnastics, judo, and karate.

**Experience**  

- Director of Rights, Partnerships, and Colors at Olympia Quironsalud.  

- Orthopedic Surgery and Traumatology residency through MIR (rank 80) at the University Clinic of Navarra, Pamplona.  

- Clinical Fellow at the Orthopedic and Traumatology Department, University Clinic of Navarra, Pamplona.  

- Clinical Fellow at Cleveland Clinic Foundation, Cleveland.  

- Assistant Traumatologist at the Dexeus University Institute (ICATME), Barcelona.  

- Assistant Traumatologist at the Galicia Institute of Orthopedic Surgery and Sports Medicine (IGACOTDE), Hospital Santa Teresa, La Coruña.  

- Specialist in Traumatology at CEMTRO Clinic, Madrid.  

- Head of the Knee Department at FREMAP Hospital, Majadahonda.

CLINICAL ROTATIONS ABROAD

- University of Miami. Jackson Memorial Hospital. Florida, USA. 5 months  

- Kleinert Institute of Hand Surgery. Louisville, Kentucky, USA. 1 month  

- John Radcliffe Hospital. Oxford, England. 3 weeks  

- Nuffield Orthopaedic Centre. Oxford, England. 3 weeks  

- Mayo Clinic. Rochester, Minnesota, USA. 3 weeks  

- O'Connor Hospital. San Jose, California, USA. 3 weeks  

- Wellington Hospital. London, England. 1 week  

- Princess Grace Hospital. London, England. 1 week  

- Addenbrooke's Hospital. Cambridge, England. 2 weeks  

- BUPA Cambridge Lee Hospital. Cambridge, England. 2 weeks  

- Cleveland Clinic Foundation. Cleveland, Ohio, USA. 2.5 years  

- 2002. WPOA Scholarship (Australia, New Zealand, Singapore). 4 weeks  

- Orthopaedic Institute of Southern California, USA. 4 weeks

Qualification

- Higher education in medicine and surgery. University of Navarra  

- Doctor of Medicine. University of Navarra  

- Specialist in orthopedic surgery and traumatology. University of Navarra Clinic, clinical fellowship in sports medicine. Cleveland Clinic Foundation  

- Clinical fellowship in foot and ankle surgery. Cleveland Clinic Foundation  

- Diploma in English from the School of Official Languages. A Coruña  

- ECFMG (Educational Commission for Foreign Medical Graduates)

Memberships

- AEA (Spanish Arthroscopy Association)  

- SEROD (Spanish Society for Knee Problems)  

- SECOT (Spanish Society of Orthopedic Surgery and Traumatology)  

- ESSKA (European Society of Sports Traumatology, Knee Surgery, and Arthroscopy) – International Society of Arthroscopy, Knee Surgery, and Orthopedic Sports (ISAKOS)  

- WARTHOG Orthopedic Society  

- MAGELLAN Orthopedic Society – SOMACOT (Madrid Society of Orthopedic Surgery and Traumatology)  

- Fellows Society of the Barry de la Maza Foundation

Other Achievements

- Former board member of SEROD (Spanish Society for Knee Problems)  

- Former board member of AEA (Spanish Arthroscopy Association)  

- Former editor of the journal *Cuadernos de Arthroscocoy* (AEA)  

- President of the AEA-SEROD Joint Congress 2015, Madrid  

- Member of the Arthroscopy Committee of ESSKA (European Society of Sports Traumatology, Knee Surgery, and Arthroscopy)  

- Member of the ESSKA Research Group on Knee Collateral Ligaments  

- Honorary member of the Argentine Arthroscopy Association  

- Patron of the Maria Pagés Foundation and Choreographic Center

EXPERIENCE

1997 – today

Gayrettepe Florence Nightingale Hospital

Orthopedics and Traumatology specialist

1996 – 1997

Cerrahpaşa Faculty of Medicine Department of Orthopedics and Traumatology

Chief Assistant Specialist Doctor

1992 – 1996

Istanbul University Cerrahpaşa Faculty of Medicine

Orthopedics and Traumatology, Specialist

1992 – 1996

Cerrahpaşa Faculty of Medicine Department of Orthopedics and Traumatology

Assistant Physician

1987 – 1991

Adana Reşat Bey Health Center

General practitioner

1985 – 1987

Trabzon Maçka (Compulsory Service)

General practitioner 

CLINICAL FOCUS 

Sports Injuries

Orthopedic Trauma

Knee Arthroscopy

Hip Arthroscopy

EDUCATION

Istanbul University Cerrahpaşa Faculty of Medicine

Medical Education

Objective:
To utilize my expertise in Pediatric Orthopedics, Hand Surgery, Arthroplasty, and Trauma within a progressive medical institution, contributing to patient care, research, and academic development.

Work Experience:

Şırnak State Hospital, Orthopedics and Traumatology Specialist
March 2022 - Present

• Lead orthopedic surgeon specializing in pediatric orthopedics, hand surgery, arthroplasty, and trauma.
• Conducting surgical interventions, consultations, and post-operative care for patients with diverse orthopedic conditions.
• Collaborating closely with multidisciplinary teams to devise and implement comprehensive treatment plans.
• Actively participating in hospital rounds, conferences, and educational initiatives.

İstanbul Şişli Etfal Training and Research Hospital, Orthopedics and Traumatology Residency
July 2017 - February 2022

• Completed a rigorous residency program focused on orthopedic surgery and traumatology.
• Rotated through various subspecialties including pediatric orthopedics, hand surgery, and arthroplasty.
• Assisted in surgical procedures, outpatient clinics, and emergency consultations.

Education:

İstanbul Şişli Etfal Training and Research Hospital, Orthopedics and Traumatology Residency
2017-2022

• Residency training program specializing in orthopedic surgery and traumatology.

Trakya University, Orthopedics and Traumatology Residency
2016-2017

• One-year residency program focusing on orthopedic surgery and traumatology.

Gaziantep University, Faculty of Medicine
2009-2016

• Doctor of Medicine (MD) degree.

İçel Anatolian High School
2005-2009

• High School Diploma.

Professional Memberships:

• Turkish Society of Orthopedics and Traumatology (TOTBİD)
• Turkish Orthopedic and Traumatology Institute (TOTDER)
• Turkish Society of Sports Traumatology, Arthroscopy, and Knee Surgery (TUSYAD)

Skills:

• Proficient in diagnosing and treating orthopedic conditions in both pediatric and adult patients.
• Skilled in performing various orthopedic surgeries including arthroplasty, hand surgery, and trauma procedures.
• Strong interdisciplinary collaboration and communication skills.
• Committed to continuous professional development and continuing medical education.

Experience

2022

Private Nisa Hospital

2022 - 2022

American Hip Institute Chicago, USA

2018 - 2022

Health Sciences University Bağcılar Training and Research Hospital

2016 - 2018

Erzincan Mengücek Gazi Training and Research Hospital

2015 - 2015

Helios Endo Clinic, Hamburg, Germany

2015 - 2015

UPENN Sports Medicine Center, Philadelphia, USA

Education

2021

ISTANBUL UNIVERSITY ISTANBUL FACULTY OF MEDICINE, Department of Sports Medicine, Football Medicine

2016

Health Sciences University, Department of Orthopedics and Traumatology

2009

ISTANBUL UNIVERSITY, FACULTY OF MEDICINE

Oltre 900 procedure di rivestimento dell'anca dal 2003 - Il Dr. Laskowski ha introdotto il metodo BHR in Polonia, la tecnica di sostituzione dell'anca meno invasiva.

• Specializzato in revisioni complesse e correzioni di deformità
• Utilizza protesi 'su misura' per impianti personalizzati
• Formazione presso la Mayo Clinic e i principali centri ortopedici belgi
• Autore di numerosi articoli di ricerca su riviste ortopediche

Il Prof. Dr. Gursel Saka è specializzato in procedure ortopediche complesse, tra cui la ricostruzione delle articolazioni del piede e delle dita presso l'Hisar Hospital Intercontinental.

• Esperto in chirurgia della colonna vertebrale, chirurgia dei traumi e artroplastica
• Finalista al XI Premio Tecnologico TÜBİTAK nel 2014
• Professore Associato presso l'Università delle Scienze della Salute
• Esegue operazioni con successo in Ortopedia e Traumatologia

Il Dr. Selman Dogan è specializzato nella ricostruzione delle articolazioni del piede e delle dita dei piedi, combinando competenze in chirurgia ortopedica e traumatologia sportiva.

• Formazione in oncologia ortopedica presso l'Università Medeniyet
• Esperto in chirurgia traumatologica degli arti inferiori e superiori
• Competente nel trattamento di lesioni ai legamenti e ai tendini

Responsabile di Ortopedia presso il Carolina Medical Center – Il Dr. Luboinski è specializzato in interventi ricostruttivi per lesioni del piede e delle articolazioni.

• Specialista in Ortopedia e Traumatologia da oltre 15 anni
• Esegue procedure avanzate come il trapianto di menisco
• Collabora con atleti delle principali squadre sportive polacche

Dr. Mehmet Aydogan is a specialist in Orthopedics, Traumatology, and Spine Surgery at Memorial Şişli Hospital. He worked in Spine Surgery there in 2024–2025 and has been in Orthopedics since 2026. He previously led the Orthopedic Surgery, Traumatology & Advanced Spine Surgery Center at Emsey Hospital (2018–2022). His experience includes the EURO SPINE Surgical Spine Center of Excellence in Switzerland (2022–2024) and a research fellowship at the UCLA Comprehensive Spine Center (2009–2011). He also held posts at Boğaziçi Spine Center, Medical Park Göztepe, and Florence Nightingale.

Education: MD, Ege University (1990–1996). Residency in Orthopedics and Traumatology at Dr. Lütfi Kırdar Kartal TRH (2000–2004). Publications: 50 journal articles and 37 presentations.

Memberships: TTB, TOTBİD, Turkish Spine Society, MINOD, NASS, SRS, European Spine Society, and APSS.

Specializzato nella ricostruzione delle articolazioni del piede e delle dita del piede usando la terapia con cellule staminali - un approccio raro in ortopedia. In pratica dal 1993 con formazione internazionale.

• Premiato con l'EFORT Traveling Fellowship in Belgio
• Formato nei principali centri negli USA, Israele, Spagna e Austria
• Ha praticato in Spagna per 7 anni
• Si concentra su caviglie, piedi, ginocchia e spalle