Aim of the study: In order to compare the short-term results of a mini-incision in primary hip replacement with the results of the standard incision we developed a prospective study with 80 patients. Forty of them had a hip replacement using a mini-incision technique, and the 40 remaining patients using a classic approach.

Methods: All the patients were treated with an anatomic non cemented stem (ABG-II, Striker). No statistical differences were found related to age, gender and weight between groups. The patients were distributed into two surgical teams according to the date of their first visit to our service. Each team develop only one kind of procedure.

Results: No differences were found related to the incidence of surgical or postoperative complications, placement of the implants and need of early rehabilitation. Patients having a mini incision were discharged from the hospital only 1 day earlier than those having a standard incision (5.6 days vs. 6.7 days). Only blood transfusion showed a significant improvement: 8% in the mini-incision group and 32% in the standard approach needed a transfusion.

Conclusions: No major improvements were found related to the use of mini-incisions in primary hip replacement. To obtain the positive clinical outcomes related to this new technique some improvements should be done in anesthetics, pain control an early rehabilitation in selected and motivated patients.

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.