Purpose: The purpose of this retrospective studies is to evaluate the real effectiveness, with clinical and radiologic evalutation, of the eccentric glenosphere and also how a correct position can prevent the scapular notching.

Material and Methods: We inplanted in 18 patients, with eccentric arthopaty, a 36 mm eccentric glenoshere.24 months’ clinical and radiographic follow up. All patient were assessed preoperatively and postoperatively with the Constant Score. In the post-operative radiographic control we have taken in consideration: the presence of notching, psna (prosthesis-scapular neck angle), pgrd (peg glenoid distance), glenoid inclination, craniocaudal position of the glenosphere in relation to the glenoid.

Results: The ROM increased in all level. All of the 18 shoulder had no notching. The craniocaudal position of the glenosphere in relation to the glenoid is 4,3 mm. The PSNA was 92° and the PGRD was 21.2.

Conclusion: The inferior scapular notching is the most important complicance of reverse prosthesis. The results of our study indicate that : the correct positioning of the metal back, at the center of the glenoid (better biomechanics stability), without overhang and with eccentric glenosphere, permits to lower the center of rotation of 4 mm avoiding the notch and so increasing the adduction and abduction range of motion.

Proximal tibial fractures often are caused from trauma with high energy forces with associated soft tissue lesions. The authors report their experience with 45 cases of proximal tibial fractures treated with less invasive system plates (LISS) with good clinical and radiographic results after 5 years follow-up. There is evidence of good stabilisation of the fractures with this conservative soft tissue method combined with early rehabilitation.

Published experimental data on BMP-7(OP-1), carried by collagen type 1 (Osigraft), related to reconstructive surgery attest that: it accelerates and improves the incorporation of strut allograft; the combination of OP-1 with auto or allograft results in an improvement of critical size defect healing from radiological, histological and mechanical perspective.

In human revision hip surgery, OP-1 has been used with morcellized allograft, proximal femoral allograft and bulk femoral head allograft for acetabular or femoral reconstruction: a faster and more evident new bone formation as well as a faster incorporation of grafts has been shown compared to what expected without OP-1 usage.

Even if OP-1 usage in hip surgery is not approved by regulatory agencies, because of lack of randomised clinical studies, we decided to use it in patients with serious acetabular defects (II/III GIR).

In our experience, we treated eight patients with OP1, in conjunction with allografts. Clinical, radiographic and densitometric analysis has been done at 3, 6 and 12 months.

Preliminary densitometric results show that the quantity and features of new formed bone are superimposable to natural bone.