Aim

to compare the medium term clinical and functional results of total hip arthroplasty after intertrochanteric osteotomy and primary total hip replacement.

Aim: To compare 2 methods of osteosynthesis (pinning and plate and screws) in displaced intraarticular fractures of the calcaneus

Material and method: Between 2001 and 2005, 82 displaced intraarticular fractures of the calcaneus were surgically treated in our department. Fractures were classified according to Bohler’s classification: 18 Bohler type II and 64 Bohler type III fractures.

Open reduction and reconstruction with osseous grafts (autologous grafts in 22 cases and heterologous grafts in 52 cases) were used in 74 cases. In 8 cases (all of Bohler II type) grafts weren’t used. Osteosynthesis with plate and screws was performed in 26 cases and with pins in 56. The 2 groups were similar in what concerns age, sex ratio, BMI, degree of comminution. The surgical procedure was delayed in both groups (average − 6 days). Pins were removed at 6 weeks and the plates at 12 months.

Results: A number of clinical parameters (pain evolution, moment of partial and full weight bearing, achievement of clinical and radiological union, ankle and forefoot mobility, etc.) were similar in both groups. Skin complications were more frequent in the plate group even if similar lateral surgical approaches were used. Pain along peroneal tendons was much more frequent in the plate group.

Conclusions: Even if theoretically osteosynthesis with plate and screws assures a better fixation, in practice it has similar clinical results with the pinning. The number of complications is higher after plate osteosynthesis. The pins can be extracted with local anesthesia, while plate extraction requires lumbar or general anesthesia and a full extent surgical procedure.

Aim: evaluation of articular cartilage defects repair of the knee by mosaicplasty. Methods: 12 cases of 12 knees (8 males and 4 females) that underwent cartilage repair by mosaicplasty for femoral condyle defects were reviewed. Mean patient age at time of surgery was 34 years old (23 Ð 47 years). All cases were diagnosed by arthroscopy and 3 underwent preoperatively MRI. Postoperatively 5 cases were investigated by MRI, 9 underwent a second-look arthroscopy and in 2 cases we performed a needle biopsy. The average followup period from surgery was 12 months. The mean period from surgery to follow-up arthroscopy was 7 months. Results: Clinical results were appreciated by HSS Score. According to this scale the mean rate of our results was 90. All cases that underwent a second-look arthroscopy showed a good articular surface. Needle biopsy demonstrated regeneration of hyaline cartilage, even if some structural differences occurred. Conclusions: Mosaicplasty seems to be an efþcient alternative for treatment of limited cartilage defects. Needle biopsy demonstrated that regenerated hyaline cartilage in the gaps among mosaicplasty areas has not the same structure and quality like the natural cartilage. Therefore degeneration is possible and long term careful observation is needed.