Introduction Shoulder replacement is a classical indication in 3 and 4 part humeral head fractures, but the results reported in literature are not so good like arthritis. This is for some aspects as healing of tuberosity, rotatory cuff repair and difficult in positioning of prosthesis for lack of landmarks. The aim of this study is to assess the overall outcome of 30 patients treated with shoulder prosthesis for proximal humeral fractures.

Methods Quality of life assessment, specific shoulder patients perspective and objective parameters were correlated with position of stem. Height and version of the stem, evaluated with CT scan as reported in Literature, were studied and correlated whether with the other side or with subjective and objective data.

Subjective data included SF-36, DASH, Simple shoulder test; active and passive ROM, muscles strength etc. represented objective data. A rigorous statistical analysis was performed.

Results No statistical significative correlation were detected between position and subjective outcome. Different data are found for objective data as ROM, that appears correlate with position of stem.

Conclusion No papers about these aspects of shoulder replacement exist in Literature.

The authors believe that better knowledge of correlation between outcome and technical aspects in shoulder replacement could be important to define surgical practice criteria.

Introduction MRI accuracy in detecting knee lesions is a discussed controversy. Not always different knee lesions, diagnosed by MRI are confirmed by arthroscopy. The aim of this study is to correlate the accuracy of history, physical examination and MRI in evaluating meniscal and ACL lesions.

Methods A prospective comparative study was performed to compare anamnestic and clinical data, MRI findings and arthroscopic findings to better understand the role of these methods and to assess if there are significative differences between various knee disorders. One hundred patients undergoing to arthroscopy for knee injuries were evaluated before surgery, registering anamnestic data, clinical examination and MRI findings. At the time of surgery every finding was registered and then compared with the previous acquired data.

Results The most accurate data for diagnosis appears from history and clinical examination. The study showed a statistically significative differences between the RMI and arthroscopic findings. Differences between radiologist were detected in MRI data.

Conclusion The results of such type of study, underlining the reliability and accuracy of patient’s history, clinical examination and MRI, comparing the different results among them and in various knee injuries. The accuracy of every test is the first step for an evidence based decision analysis process and represent a step forward an efficacious and economical pattern in diagnosis.

Shoulder replacement has increased exponentially over the past decades due to good results reported in literature and improvement of surgical technique and devices efficacy. Previous studies suggested the effectiveness of shoulder replacement in fractures, assessing objective parameters as range of motion and radiographic images and evaluating the of postoperative complications and subsequent revision; pain relief, physical function level and health related quality of life (QoL) improvement were often left out. A prospective study was conducted on 21 patients surgically treated with shoulder emiarthroplasty for proximal humeral fractures (18 women and 3 men, mean age at follow-up 70 years – range: 57–82). The purpose of the present study is to collect the patient-relevant outcomes in a homogeneous sample (for surgeon, surgery, implant, inclusion-exclusion criteria, neurological status) of patients who underwent shoulder replacement for proximal humeral fractures. Preoperatively patients were evaluated through x-rays (trauma series), Ct-scans were performed when necessary for surgical decision. Postoperatively, two independent examiners examined all patients clinically and radiographically. For patient-oriented standardized measure SF-36, DASH (Disability of Arm, Shoulder and Hand questionnaire), ASES (American Shoulder and Elbow Surgeon), OSQ (Oxford Shoulder Questionnaire) and SST (simple Shoulder test) were chosen. Outcomes of our series were statistically compared with literature data and widely analyzed. This kind of data are unavailable in literature and could represent the first step towards the definition of outcome for this kind of procedure.

Introduction: Quality of life is becoming in the last years an essential element of evaluation of treatments. The aimof this prospective cohort study is to assess the quality of life and the speciþc patient perspective on knee replacement. A pre- and post-operative patient-oriented study was conducted on patients operated on knee replacement for symptomatic knee arthritis to measure their quality of life. Material and Methods: There were 50 patients, mean age 71.3 (5.1 SD) years, affected by knee arthritis. The SF-36 questionnaire (ofþcial Italian version) and Oxford validated Italian version questionnaire (OKQ) were administered preoperatively and post-operatively (at 2 years of follow-up Ð SD 1.5). The results were compared within and with those of an age-matched and sex healthy sample (n=351) published in Literature. The appropriated statistical analysis was used on results data. Results: The SF-36 domain scores for the pre- and post-operative data were respectively the following: PF 32.50±24.43 and 50,81±27.21; RF 13.63±28.58 and 63.09±47.18; BP 14.47±11.44 and 50.45±28.61; GH 55.08±15.36 and 56.71±20.29; VT 44.77±15.77 and 58.19±16.84; SF 55.08±25.15 and 71.81±25.60; RE 42.00±46.31 and 65.09±40.14; MH 58.72±16.85 and 61.71±20.14; PCS 27.00±6.22 and 38.71±9.51; MCS 46.13±11.10 and 47.76±9.43. The OKQ respectively 47.00±7.86 and 27.72±10.66. Appropriated statistical tests were performed. Conclusions: Knee replacement signiþcantly improve patientsñ perception of their own health. Moreover the patient-oriented speciþc measure give results really reassuring on knee replacement results. A better knowledge of the health status changes induced by knee replacement might help further deþne the indications to surgery and cost-beneþt relationship.