Introduction and purpose: The VIRA system allows reconstruction of the fractured bone and its arthrodesis with the talar bone eliminating all movement of the subtalar joint by means of a minimally invasive approach. The aim is to restore the shape of the foot and prevent joint degenerative changes in the long term without the complications and sequelae of open surgery.

Material and methods: Between November 2004 and June 2006, 30 intraarticular calcaneal fractures in 25 patients were treated surgically by means of the Vira System. Using Sanders’ classification 6 cases were classified as type II, 13 as type III and 11 as type IV. Five patients had open fractures. There was a mean period of 8.7 days between the accident and surgery. Seven cases had associated lesions and fractures in other locations. Only 2 cases required iliac crest grafts in the operated area.

Results: All patients except 10 have returned to their usual occupations. Eight cases evolved favorably but have had a short follow-up. Two cases experienced a delayed healing of the subtalar arthrodesis and had to be reoperated; they required an autologous graft. The mean period of temporary disability in patients discharged from hospital was 163.7 days. Clinical assessment using the AOFAS scale reached a mean value of 76.6 points. No surgical or post-surgical complications were seen in the group studied.

Conclusions: The VIRA System seems capable of achieving its purpose in the first series of patients operated. It allows a quick recovery both postoperatively and in the subsequent evolution without any associated complications. It accelerates the patients’ return to work by decreasing convalescence and minimizing sequelae.

Introduction: Loss of the meniscus frequently leads to progressive arthritic changes in the involved compartment. Replacement of the lost meniscus with a resorbable collagen scaffold has been proved to allow regeneration of meniscal tissue.

MATERIAL AND Methods: Between June 2001 and September 2004, 42 patients, 38 male and 4 female, underwent arthroscopic placement of a collagen meniscus implant (CMI) to reconstruct the damaged medial meniscus. Their age ranged between 22 and 50 years. All patients had an associated ACL insufficiency, 39 secondary to acute ACL tear and 3 ACL graft failures. ACL reconstruction with hamstrings grafts (39) and ACL revision with allograft (3) was performed at the time of CMI implantation. The interval between ACL injury and surgery ranged between 3 weeks and 6 months. Ten patients also had a lateral meniscus tear. All patients were followed with clinical, weight-bearing radiographs, KT-1000 and magnetic resonance examinations for at least 18 months (range, 18– 84 months). The IKDC form was used to record and evaluate the Results:

Results: The length of the implanted CMI ranged between 3 and 5.5 cm and required 4 to 8 stiches.

The IKDC subjective evaluation was normal in 18 patients, nearly normal in 18, abnormal in 5 and severely abnormal in 1. Range of motion was normal in 28 patients and nearly normal in 14. KT 1000 examination was normal in 32 patients, nearly normal in 7, abnormal in 1 and severely abnormal in 2.

The X ray findings were normal in 28 patients, nearly normal in 6 and abnormal in 8.

Complications included 2 saphenous nerve neuritis, 1 ACL graft tear with CMI implant breakage and 2 knee stiffness that required mobilization.

40 patients returned to work. The average time to resume work was 5.5 months

Conclusion: Simultaneous ACL reconstruction and collagen meniscal implantation is a viable and effective option in young active patients with ACL insufficiency and associated meniscal injuries.