Lumbar disc replacement with a modern articulating disc prosthesis was first done in 1984, using the Charité SB I prosthesis. Since then other discs, easier to implant, have been developed (Prodisc, Maverick, Centurion).

We present short-term (6 to 18 month) clinical results of implantation of 121 Centurion disc prostheses in 93 consecutive patients. This modular three-component titanium/polyethylene disc is inserted as one unit and suitable for minimal interventional approaches.

The mean age of the patients was 43 years (23 to 63). The primary diagnosis was degenerative disc disease, with 16 patients having symptoms of spinal stenosis. Forty-four patients underwent single-level disc replacements and 28 double-level disc replacements. Nine patients had a fusion of another level at the time of the index procedure and 12 patients had disc replacement at a junctional level after previous fusion procedures. At 6-month follow-up of 50 patients, clinical outcome was excellent in 27 patients, good in 16, fair in four and poor in three. The Oswestry score improved from 51.2 ±16.0 preoperatively to 13.2 ± 17.8 (p < 0.01) at 6 months. One of the first 29 patients was lost to follow-up. In the other 28 there were 16 excellent, seven good, three fair and two poor outcomes. The Oswestry score improved from 49.7 ± 17.5 preoperatively to 13.0 ± 14.9 (p < 0.01) at 1 year.

Good short-term clinical results were achieved in a heterogeneous patient group, largely with advanced disc degeneration and severe disc space narrowing. Using a new insertion mechanism, posterior placement within the disc space and disc space distraction could be reliably achieved even in preoperatively collapsed and immobile disc spaces.

This paper introduces a new biological material for the treatment and augmentation of ligament and tendon deficiencies, and presents a variety of uses in orthopaedic conditions. The membrane was originally tested and used in cardiac valve replacement, where it is still in use.

Manufactured from bovine pericardial tissue, the collagen biolink membrane is treated chemically by cross-linking with gluteraldehyde. Aldehydes are chemically capped to prevent inflammatory response. The result is a strong collagenous material that provides a non-stretch bio-integrate for ligament replacement/augmentation. The membrane is fashioned to meet the particular ligament/tendon requirement.

This material is well suited for use in foot and ankle surgery, as well as in other situations, especially rotator cuff surgery. It may revolutionise ligament and tendon surgery.