We report the long-term radiographic results of the total hip arthroplasty with use of the cementless porous coated Harris-Galante (H-G) stem. Seventy-five consecutive patients, eighty-eight hips formed the basis of this study. Fifty patients were male, twenty-five patients were female, and thirteen patients were bilateral. The mean age of patients at operation was 42 years. They were followed up for an average of thirteen years four months (ten years two months to fourteen years four months). The diagnosis was avascular necrosis of the femoral head in 49 cases, degenerative osteoarthritis in 32 cases. Clinical results were estimated by modified Harris hip score and thigh pain, and radiographic results by periodically checked plain X-ray film. The average Harris hip score increased from 60 points preoperatively to 83 points at the most recent follow-up examination. The hip pain score increased from 31 points to 41 points. Clinically severe thigh pain was observed in 3 cases (4%). In radiographic evaluation, subsidence more than 5mm was seen in 2 cases (2%). Periprosthetic osteolytic lesion was observed in 15 cases (17%), but the lesions do not influence stability of the stem. Femoral stem stability by Engh was stable in 72 cases, fibrous stable in 12 cases, unstable in 4 cases. Pedestal formation, cortical hypertrophy of the distal femur, and stress shielding was observed more than 40%. Subcollar resorption was identified in 29% and ectopic ossification in 15%. Revision of the femoral stem was needed in 4 cases for aseptic loosening. At 10 years probability of survival of the stem using Kaplan-Meyer method was 95.5%. Use of the cementless H-G stem yielded the excellent long-term outcome, but osteolysis and stress shielding would be the main problems to solve.

We treated 52 patients with impingement of the anterolateral soft tissues of the ankle by arthroscopic debridement. All had a history of single or multiple inversion injuries, without instability. One half had negative stress radiographs (stable group), while the others were positive (unstable group). Their mean age was 31 years and there were 35 men and 17 women. The results were assessed at a mean follow-up of 30 months.

Three patients (6%) had a fair result, while 49 (94%) had an excellent or good outcome. No difference was found in the final results between the two groups (p > 0.05). We conclude that anterolateral impingement of the ankle should be considered in a patient with chronic anterolateral pain after an injury, regardless of the stability of the ankle.

Cancer-induced bone diseases are often associated with increased bone resorption and pathological fractures. In recent years, osteoprotective agents such as bisphosphonates have been studied extensively and have been shown to inhibit cancer-related bone resorption in experimental and clinical studies. The third-generation bisphosphonate, ibandronate (BM 21.0955), is a potent compound for controlling tumour osteolysis and hypercalcaemia in rats bearing Walker 256 carcinosarcoma.

We have studied the effect of ibandronate given as an interventional treatment on bone strength and bone loss after the onset of tumour growth in bone. Our results suggest that it is capable of preserving bone quality in rats bearing Walker 256 carcinosarcoma cells. Since other bisphosphonates have produced comparable results in man after their success in the Walker 256 animal models our findings suggest that ibandronate may be a powerful treatment for maintaining skeletal integrity in patients with metastatic bone disease.