Objectives: Nowadays estimating paediatric bone age is done using methods based on standards from the 50’s and 70’s. These methods are often difficult to perform, they require experience in the analysis of multiple bones and are based on subjective measures. Many times, the age calculated stands within a wide range of age interval. We investigate a new method based on AP foot X-rays.

Material and Methods: 971 radiographs taken from 220 paediatric patients (0–18 years old) were analyzed. 34 different ratios were designed by measuring ossification centres of the bones of the first and second foot rays. These ratios were statistically studied searching for the relation with variables as gender, laterality, foot pathology and forefoot formulae. Finally, regression lines and curves from each ratio were calculated as well as their correlation with chronological age.

Results: The best suited correlations are obtained with the ratios calculated from the epiphysis of the proximal phalange of the first and second toes. With them, multiple regression analysis is able to establish an equation that estimates bone age, with a chronological age correlation of 0,86 for general population, 0,85 for boys and 0,90 for girls (p< 0,01). It is applicable for either feet, and valid for every forefoot formula or pathologic feet.

Conclusions: This new method is designed to estimate bone age in children using either plain radiographs or digital images. The method is objective, precise, universal and easy to calculate. It proves a good correlation in children between 1 and 13 years old. It is based on a modern population and adjusted with lineal regression equations to both genders.

Purpose: The role of arthroscopic treatment for degenerative knee joint disease remains controversial. The aim of this work was to evaluate the efficacy of arthroscopic debridement and to establish its indication for the treatment of knee osteoarthritis in patients aged less than 50 years.

Material and methods: Arthroscopic debridement was performed from 1994 to 2002 in 192 patients, 72 men and 120 women, mean age 59 years (51–75). We noted clinical history, particularly conditions contraindicating major surgery, and prior lower limb trauma, particularly involving the same knee. Patient weight and activity level were considered. The preoperative work-up included a functional examination (Freeman), and a radiographic study used to class the osteoarthritis as early, moderate or advanced and measure the knee axis. We performed joint wash out in all cases associated with different debridement procedures. Chondropathy was evaluated with the Marshall classification. A new functional evaluation and subjective evaluation was performed at last follow-up.

Results: Severe disease was present in the history of 5.2% of the knees; 9.3% had had prior surgery and 82% presented moderate osteoarthritis, mainly involving all three compartments. Type II or III chondropathy was found in 92% of knees. At mean follow-up of 28 months (5–108), the mean function score improved from 69.4/110 preoperatively to 89.5/110 and 75.4% of patients considered their knee had improved. Five patients required secondary arthroplasty. Poor outcome was associated with type III or IV chondroplasty involving the three compartments and the presence of the mentioned history. Age was not correlated with poor outcome.

Discussion: We studied a population with overt osteoarthritis who were treated with a minimally aggressive method, mainly for palliation. Only 2.6% underwent total arthroplasty after arthroscopic treatment. There was a clear improvement in function, mainly pain relief. The large majority of the patients were satisfied with the outcome and did not require further medical treatment except occasionally. The less satisfactory results were obtained in patients with more advanced disease who could not undergo arthroplasty because of concomitant medical conditions.