Aims: To evaluate the long-term results of arthroscopic meniscal repair of any longitudinal meniscal tear in red-red or red-white zone. Methods: 60 patients 30.5 years old average (range 15 to 50) underwent arthroscopic meniscal repair (Ç inside-out È technique, Jacobs-Staue-bli method, 1988) and were followed up 30.1 months on average. 34 patients (50%) had an additional ACL rapture, which was repaired at the same operation. Postoperatively, all patients followed a particular program of rehabilitation using a controlled motion knee brace: immediate weight-bearing with the brace locked in 10¡, motion without weight-bearing from 10 to 90 degrees of ßexion for the þrst six weeks and then weight-bearing in motion was allowed. Results: Patients were re-examined and average Lysholm score was 95, while recurrence occurred in 5 patients (7.3%) and 3 of them submitted to meniscectomy. The rest of the patients returned to their former activities in a six-month period, including those who underwent an ACL reconstruction. Conclusions: Arthroscopic meniscal repair has excellent functional results and should always be applied on any longitudinal meniscal tear in red-red or red-white zone. Additional ACL ruptures should be treated at the same time.

Aim: We report on the use of external þxation as an alternative þxation of femoral fractures in patients where internal þxation is a borderline indication. Patients and method: From 1991 to 2001, twenty-þve patients with femoral diaphysis fractures were treated by external þxation. Indications included candidates with multiple injuries and unstable general condition, open fractures IIIA, B, C, neglected open fractures with or without infection, comminuted shaft fractures, gunshut injuries and infections after internal þxation. The fractures were stabilized with a unilateral external þxation or with a special anti-varus frame. Results: In twenty patients, external þxation was the deþnitive method of stabilization, while in þve, it was a temporary method. The average time to union was 5 months. Complications included: pin tract infection, restricted knee motion, and loss of reduction. Conclusion: External þxation should not be routinely used for þxation of femoral fractures, but may be considered in multiply injured and critically ill patients. As in any method of þxation, the surgeon must be familiar with the device used, the mechanical and the application properties of such devices, and, most importantly, the postoperative management of the patient.

Aims: a) To review donor site morbidity and record problems coming out during bone harvesting, b) to evaluate bone graft adequacy and effectiveness. Methods: Senior author operated 127 patients using cancellous bone autografts (from May 1988 to September 2001). Bone grafts were obtained from iliac crest (83 patients), proximal tibial metaphysis (39 patients) and other donor sites (5 patients). In all cases intraopera-tive problems and early postoperative problems were recorded. Late postoperative problems were evaluated either subjectively (questionnaire) or clinically for 109 patients. Minimum length of follow up was 12 months. Results: In all the cases, the goals of graft harvesting were accomplished. Generally, grafts were adequate in quantity and quality (apart from 2 cases in which grafts were taken from proximal tibial metaphysis). Blood loss from the proximal tibia was less than iliac bone. Iliac pain was more severe than tibial, resulting to delayed mobilization and pain could persist for a long period of time. Conclusions: Proximal tibial metaphysis, as a donor site, is associated with far less morbidity than iliac and it should be chosen in patients with lower-extremity fractures or nonunions. Harvesting from tibia is adequate and easier comparing to iliac. Tibial bone grafts were as effective as iliac, despite that iliac bone graft is widely used and generally referred as a better quality autologus bone graft.

The arthroscopic meniscal repair is being applied nowadays successfully in any longitudinal tear of the medial or the lateral meniscus wliicli is located in zones II and 111 (in consistency with the zones of menisci vascularity according to Miller, Wagner, Hamer).

The material of this study includes 68 consecutive cases of patients who underwent arthroseopic meniscal repair. Thirty four of them (50%) were in conjunction with anterior cruciate ligament tear, which was treated at the same time. The patients age ranged from 15 to 50 (average 30.5 years). The length of follow up averaged 30.1 months. In all cases ilic “inside out” technique was performed according to Jacobs – Staenbli method. Postoperatively, all the patients followed a particular program of rehabihtation with the aid of a controlled motion knee brace, immediate weight-bearing with the brace locked in 10°, and motion without weight – bearing from 10 to 90 degrees of flexion for the first six weeks. Weight – bearing in motion was followed after the sixth week.

The reexamination of the patients and the evaluation of the results was subjective and was performed according to the Lyshota score (average 95%). Recurrence occurred in 5 paiicms within 6 months, 3 of whom were submitted to menisccctomy. The rest of the patients returned to their former activities in a six month period.

The arthroscopic meniscal repair provides excellent results and should always be applied when there is an indication, because the salvage of the meniscus contributes -among others- to the prevention of degenerative articular cartilage disease (osteoarthrosis).