Aims: The aim of this study is to determine the forefoot pressure distribution in normal subjects and in patients with metatarsalgia and to present an application of the electronic pedobarography in the design of orthoses. Methods: A control group of 358 normal subjects and a pathological group of 100 patients with metatarsalgia were studied with a wireless portable system for plantar pressure dynamic measurement. Each patient of the pathological group had their metatarsal head loads reequil-ibrated according to the loads obtained in the control group, by means of a set of orthopaedic sights located below the metatarsal heads which supported the lowest load, increasing its pressure support and lightening thus the overloaded metatarsal heads. The aim was to obtain a balance between the þve metatarsal heads similar to the control group. This balance was assessed with the electronic portable system. Results: The pathological group had a signiþcantly higher pressure under the third metatarsal head. The third metatarsal head pressure was significantly decreased, and the þrst, fourth and þfth metatarsal head pressures were signiþcantly increased by means of orthopaedics sights. Conclusions: The forefoot pressure distribution in patients with metatarsalgia differs from normal subjects. Redistribution of metatarsal head loads assessed by means of a electronic system can contribute to the design of orthoses to treat metatarsalgia.

Aims: The purpose of our study was to evaluate the results of using a longitudinal oblong revision (LOR) cup in the management of types III and IV acetabular defects. Methods: Thirty-þve longitudinal oblong revision (LOR) cups were used to reconstruct 29 type III and 6 type IV acetabular defects. Defects were þlled with morcellized allografts in all cases. Structural allografts were used in 2 cases. All patients were followed up for 2 to 6 years (mean, 3.3 years). Results: At latest follow-up, 32 cups were stable (91.4%) and 3 had migrated (8.6%). Two of these cups failed one year after surgery and one four years postoperatively. We found a signiþcant relation between an incomplete cup contact with the acetabular rim and the subsequent failure (p=0.042). The postoperative abduction angle was signiþcantly increased in the group of unstable cups (p=0.032). Pain, limp, use of walking aids, functional level and limb-length discrepancy signiþcantly improved postoperatively (p< 0.0001). Conclusions: For patients with type III and IV acetabular defects, this implant provided encouraging clinical results and showed satisfactory stability at early to midterm follow-up.

Aims: The purpose of this study is to present our experience with the A.B.G.-I hip system after ten years follow-up. Methods: Prospective study about 162 hip prosthesis implanted from 1990 to 1992. We have assessed clinical and radiographic results immediately before surgery and at a minimum follow-up of ten years. Statistical analysis has been developed with S.P.S.S. Results: Sex distribution of the 162 initial prosthesis: 50.71% men and 49.29% women; affected side: right in 50.71%, left in 49.29%. First hip disease: rheumatoid arthritis in 7.48%, osteoarthritis in 77.57% and avascular necrosis in 14.95%. At this moment only 102 prosthesis continue on study: 8 revised (7.27%), 21 patients died (20.39%), 28 disappeared (17.18%) and 4 (2.45%) have not been considered. Clinical assessement let us be very satisþed, with a Merle DñAubigne score improving from 7.9 preoperative to 15.8 at ten years follow-up. Clinical results have been: excellent in 54.81%, good in 27.88% and bad in only 3.85%. Radiographic results are worse than expected: 84.11% of femoral stems developed some grade of stress shielding phenomenon and polyethylene inners wore excessively (mean value = 1.77 mm). The inßammatory response to polyethylene particles originated osteolytic lesions in 88.78% of femurs and 56.48% of periacetabular bones. Today 15.53% of patients in study are waiting for a revision. Conclusions: In spite of the very good clinical results, the radiographic assessement is very concerning. We think the þrst problem is the bad quality of polyethylene inner, that is responsible for grave osteolytic lesions.