The osteonecrosis of the medial femoral condyle, depending on the area occupied, causes pain and may progress into osteoarthritis. For the management of osteonecrosis numerous treatment methods have been described, as conservative, drilling, osteotomy and others.

The aim of our study is to evaluate the results of management of knee osteonecrosis with unicompartmental arthroplasty.

We studied 16 knees in 15 patients (all women) with osteonecrosis of the medial femoral condyle. The size of osteonecrosis was greater than 3.5 cm, as revealed by MRI. The mean age of patients was 72 years (range 64–80 years). The time elapsed from the onset of symptoms to surgical treatment ranged from 3 to 10 months.

All patients were followed clinically and by X-ray 1 to 6 years post-operatively and scored with Knee Society Score. The result in 14 patients was excellent and in 1 was good.

In conclusion, unicompartmental knee arthroplasty is a satisfactory method of treatment of osteonecrosis, which provides immediate relief from pain, long-term satisfactory outcome and avoids multiple operations

The aim of this study was to evaluate and compare the results of acromioplasty in two groups of patients operated upon for impingement syndrome using two different techniques, In one group the insertion of the devoid was partially divided (deltoid off strategy) while in the other the insertion of the deltoid was preserved (deltoid on strategy).

Twenty-one patients, suffering from impingement syndrome of the shoulder, were operated during the period 1996–2001. Preoperatively all patients presented with positive impingement test and they were complaining of night pain as well as pain during activity. Two different techniques were used. In 2 group of 10 patients. the “deltoid off’”strategy was applied and the acromioplasty was performed with the use of an osteotome. In a second group of 11 patients the “deltoid on” strategy was applied and the acrormioplasty was performed by using a high speed burr.

Eight out of 10 patients of the first group were satisfied with the results of the operation, whereas all the 11 patients of the second group were satisfied. The return to full activity in patients with the “deltoid off” strategy was 10 weeks in average, while in the “deltoid on” group it was 8 weeks. Night pain subsided in ail patients in both groups. Two patients of the first group complained of mild pain with daily living activities, while 10 out of the 11 patients of the second group had no pain at all. Finally 2 patients of the first group and none of the second group presented residual painful arc.

We conclude that the “deltoid on” technique for treatment of the impingement syndrome of the shoulder appears more simple and reliable, has less morbidity and gives better clinical results, compared to the “deltoid off” technique.

The aim of this study was to evaluate the results of total hip arthropiasty in osteoarthritis secondary to congenital hip disease.

During the period 1986 to 1999, we performed 48 hip replacements with congenital hip disease. According to classification of Chanophylakidis there were 18 dysplastic hips without dislocation, 17 hips with low dislocation and 12 hips with high dislocation The mean age of the patients was 49 years (range from 31 to 64) Depended on the pathology of each case, different types of prostheses or combinations of them were used. The acetabular cup was placed in the anatomic position and in the majority of cases a component of 22 aim was used. In 28 cases the bottom of the acetabulum was fractured and protruded in order to fit the cup (acetabuloplasty). In these cases copious amounts of auto- and aiiografts were used and the cup was fixed with PMMA, Special femoral stems for CDH were used and in the majority of cases they were fixed with PMMA. In 17 cases with good acetabular bone stock and good femoral canal a standard prosthesis was used without PMMA. In 31 cases the hip was approached after osteotomy of the grater trochader and in 17 cases an anterolateral approach was used.

Intra-operatively there were many problems and difficulties but we had no true complications. Early postoperative complications presented in eight patients and had to do with 2 haematomas, 3 DVT, 1 mild PE and 2 superficial infections. There was no case of deep infection, neurovascular damage, dislocation or fracture. The late results after a mean of 6, £ years were very satisfaaory. There was improvement of the HIP SCORE from 38 to 83 and subjective satisfaction of nearly all the patients. The late complications were limited and they concerned three migrations of the acetabular cup, one aseptic loosening of the femora) stem and one extensive osteoiysis the proximal femur. All the above cases were revised successfully.