Aims: Crosslinked acetabular inserts have been introduced as a solution to the wear related periacetabular osteolysis, caused by the polyethylene wear debris. Laboratory tests and simulators have demonstrated that crosslinked-polyethylene has a higher resistance to wear than conventional polyethylene. However, studies have shown early crack or degeneration of crosslinked inserts. Concerns still remain about the clinical performances of crosslinked inserts. Although questionable, the roentgenographic measurement of the wear of the cup represents an indicator of the performance of the implant. Early catastrophic failures of other inserts taught us that for new materials it is mandatory to conduct an accurate clinical surveillance. In this work the radiographic-evaluated linear wear of a group of cross-linked inserts is compared to that of a non-crosslinked inserts for the same socket at 5 years.

Methods: From 2000 to 2002 we implanted a series of cups in which crosslinked and conventional acetabular inserts were placed randomly. Patients from each group underwent radiographic assessment after implantation, at 3 and 6 months and then yearly. Radiographs were obtained using a digitalized image system, which allowed a computerized bi-dimensional measurement by a specially developed Auto-CAD program. 12 healthy and active patients (6 crosslinke – 6 conevtional UHMWPE) have been selected for measurement.

Results: No macroscopic signs of loosening, mobilization and osteolysis were detected. Despite an increased wear rate for the conventional insert, no statistically sig-nificant differences of the linear wear were detected at five years for the two groups.

Conclusions: Longer follow-up and larger case studies are needed for more definitive conclusions. Nevertheless, this preliminary study shows that crosslinked polyethylene in vivo at 5 years does not give early failures and that its linear wear in the short term does not differ from that of a conventional polyethylene. Several other factors, such as the number and dimension of the debris, which are not detected by roentgenographic measurements, might be taken into consideration. Moreover it has been hypothesized for the crosslinked polyethylene an early plastic deformation, with consequent penetration of the head without wearing, which could affect the measurement on plan radiographs. Despite these limitations, roentgenographic measurements are quick and easy to perform, and therefore might be useful for the clinical practice of the periodical evaluation of the implants.

Aims: ACL lesion is one of the most frequent event in sport injuries. It is generally a complete lesion which does not evolve to a spontaneous healing. In particular, after non surgical treatment, ACL often repairs on PCL with a residual articular laxity. A healing response technique has been described to treat ACL incomplete tears in skeletally immature athletes. Our technique is based on microfractures next to the ACL femoral insertion to obtain a scar reinforcement thanks to the action of mes-enchymal stem cells.

Methods: The authors report their experience using the same surgical technique and rehabilitation protocol in patients selected by type of lesion, age and time from injury.

The authors selected for the study young-middle age active patients, with incomplete ACL lesion: 27 patients (mean age of 23 years) have been evaluated, inclusion criteria was Lachman test < 1 cm, negative Jerk test and a proximal partial tear of ACL on MRI. Before and after surgery the patients have been evaluated using KT1000, MRI, clinical examination and Lysholm score with a 3 years average follow up.

Results: Clinical examination showed a significative improvement in Lysholm score from 63 to 85 and a minor anterior tibial translation measured with KT1000 (from a mean difference between the two legs of 5 mm preoperatively to 2 mm postoperatively). In only one case the ACL didn’t seem to heal and was necessary the traditional reconstruction. MRI at one year pointed out a reparative healing in almost all cases.

Conclusions: according to these results the healing response procedure can restore a subjective and objective stability and knee function, with proper patient selection and strictly following the rehabilitation protocol despite of age and time of lesion.

Aims: Among the Medical Services complex missions in the context of the Olympic event an important issue is to ensure the basic and emergency health care assistance to the athletes, the Olympic Family members, the Olympic staffs, the IOC members, the media staffs, the spectators and to all of the other persons participating to the Olympic events. The base of this program is of organizing a system able of furnishing a quality standard of care which must not be inferior to the one offered daily to the resident population and at the same time the Olympic event must not impact on the quality of care provided to the resident population. Methods: In Salt Lake City, during the XIX Winter Olympic Games, 11986 medical care have been provided. Among the acute visits there have been 231 athletes injuries with 14 athletes hospitalized and 1023 non-athletes injuries. Results: For an easy manage of the system it has been decided to divide the territory of competence in two areas: the Torino urban area and the alpine area. It will be identiþed, for each area, an ofþce district, responsible for all the territories included. Separate resources for the medical assistance will be implemented in the competition area and in spectator areas. The main instrument of the whole system will be the þrst aid teams, made up of members of the regional health care system, the voluntary services, the alpine and speleological rescue corps of Piemonte, the security and rescue service of the sport centers and any other accredited bodies. The dimension of the area involved, together with the need to guarantee timely rescue, stabilization and hospitalization activities, call for the creation of helicopter bases. Conclusions: The greatness of this project will certainly allow to leave a legacy to the host city which will enrich the quality of the health care organization at the service of the residents not only of structures and buildings but also of knowledge and speciþc experiences.