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The blood collection is less invasive than bone marrow aspiration. Therefore, analysis of circulating miRNAs (exosomal miRNAs and free circulating miRNA) in the peripheral blood circulation can be the indicator for the diagnosis, prognosis, frequent follow-up, and relapse.[27] The exosomal miRNAs are secreted by an active process, while free circulating miRNA is generated by cell death (apoptosis or necrosis). Thus, exosomal miRNAs seem to be the more useful biomarker than free circulating miRNA.[28]. A spacer fracture can be either symptomatic or asymptomatic depending on the fracture localisation. Symptomatic fractures (Figure 5) are usually the consequence of a spacer neck fracture and frequently associated with a subsequent spacer head dislocation. In these cases treatment should consist of revision surgery and spacer exchange. On the other hand, asymptomatic fractures are found in the middle or lower part of the spacer stem (Figure 6) and usually require no further operative treatment.. The most frequent cause for abdominal adhesion formation is surgical trauma. Despite a lot of efforts that have been made in improving surgical techniques (e.g. laparoscopic surgery) and development of medical devices for prevention of adhesion formation, there is no satisfactory strategy, yet.

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