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While several intraoperative devices have been described in the literature for assessing leg length discrepancy (LLD), none have been utilized during total hip arthroplasty (THA) performed via the Anterior Minimally Invasive Surgery (AMIS) approach. The aim of this prospective study was to evaluate the efficacy and accuracy of a compass device in assessing leg length during THA performed using the AMIS technique. A prospective study was conducted involving 35 patients who consecutively underwent unilateral primary THA using the AMIS technique at our department from September 2017 to December 2018. LLD was measured by comparing preoperative and postoperative anteroposterior radiographs of the pelvis, independently assessed by two observers. The mean preoperative LLD was 3.6 (SD 3.9, range, 0.2-19.3) mm. The mean postoperative LLD was 2.5 (SD 3.0, range, 0-12.2) mm. A postoperative LLD of less than 5 mm was observed in 88.2% of cases, with 94.1% having values less than 10 mm. In conclusion, the compass device emerged as a valuable tool for ensuring precise limb length control in THA with the AMIS approach, offering both efficiency and cost-effectiveness in clinical practice.

Fractures of the patella in childhood and adolescence are a rare occurrence, and they are differentiated from those occurring the adult. Between 1975 and 1995, 76 cases of fracture of the patella in patients aged under 15 years were treated at our institute. A mean clinical-radiographic follow-up of 2 years was available for all of the patients; 18 patients were followed-up after a considerable amount of time (mean 18 years). After analyzing the specific features that distinguish there fractures when they affect a subject who is still growing, the authors report the results obtained and the short and long-term complications observed.

Background: It was hypothesised that fin swimming have unique physiopathologic features in particular concerning low back involvement., Methods: Retrospective study., Setting: elite competitive fin swimmers., Participants: 17 males and 14 females aged from 16 to 23 years., Intervention: piroxicam, sport interruption for a week, proper warming-up and wearing suggestions during out-of-water exercises in the symptomatic group. Absence of intervention in the asymptomatic one., Measures: anthropometric measures (weight, height, legs length discrepancy), isokinetic measures (trunk flexor/extensor ratio) and conventional radiological investigation were taken for all subjects., Results: Low back pain was present in 14 subjects during off season but only 7 referred discomfort in competitive season. 78.5% of symptomatic subjects showed radiological abnormalities while imaging changes were present in 52.9% of the asymptomatic group. Flexor/extensor ratio isokinetically evaluated was less than one in 6 athletes complaining back discomfort. Non steroid medication, physiotherapy, training and wearing cares was suggested. Authors report a pain free return to competition in 57% and a partial resolution in 28% of those symptomatic cases who were not used to training cares (in particular proper "out-of-water" warming up) and wearing precautions (complete wiping and suitable thermic clothing after swimming)., Conclusions: In fin swimming low back pain can be related to the existence of environmental and intrinsic factors. In our series no significant difference in imaging changes was pointed out among asymptomatic or painful athletes. Therefore a cyclic load on the column, in absence of training precautions can make spine abnormalities (in particular schisis, facet derangement and pars lesion) symptomatic.

The use of interference screws in the reconstruction of the anterior cruciate ligament has increased over the years. Despite doubtless advantages there are some problems, too, some involving method of fixation, others the metallic nature of the screws. With the purpose of overcoming the latter, the authors evaluated the possibility of using interference screws made of bioabsorbable material. This preliminary study was conducted on two animal models (bovine and ovine); as a comparison parameter the torsional pair of screw insertion was used. A substantial similarity in the results thus obtained was observed that, together with the minor difficulties observed in the surgical field, contributes to the indication of the ovine model as preferential, based also on successive tests of functional validation conducted in vivo.

A total of 42 cases of patellar pain in subjects aged an average of 17.2 years submitted to arthroscopy are analyzed. Femoropatellar balance, where indicated, led to resolution of disorders with full resumption of sports activity. In the remaining cases chondromalacia showed the features of an affection with a spontaneously favorable course, confirming the common orientation towards conservative treatment. Arthroscopy is effective for a correct classification of cartilaginous lesions, and it is a good instrument to use when attempting to achieve recovery of patellofemoral joint when disorders are caused by a lack of equilibrium.

The authors propose two cases of subtrochanteric nonunion (one infected) treated by Gamma nailing. Early movement and the fact that weight-bearing is allowed are particularly advantageous for functional recovery. This method is proposed as a good alternative to open osteosynthesis with bone grafting.

The results and complications of knee arthroscopy performed using local (982) and truncular anesthesia (523) at the out-patient arthroscopy clinic of the Rizzoli Orthopaedic Institute between 1982 and 1994 were analyzed. Furthermore, the literature on technique and surgical indications for the use of out-patient arthroscopy with a 3 in 1 block was reviewed.

It is commonly known that in acetabuloplasty according to the Pemberton-Zanoli method the insertion of the graft produces an immediate increase in the height of the iliac wing which in successive months could become hypergrowth caused by the hyperactivity of the underlying Y cartilage. A total of 40 cases of insufficiency of the acetabular roof treated by this method were examined based on measurements on follow-up radiograms and an evaluation of the spino-malleolar distance until puberty. The clinical evaluation showed that in 82.5% of cases there is dysmetria that is less than or equal to 0.5 cm. An evaluation of radiograms at the end of growth of the ilium [correction of ileum] did not reveal significant variations between the hemipelvis submitted to surgery and the contralateral one either in cases treated by acetabuloplasty alone or in those in which intertrochanteric osteotomy was associated. Acetabuloplasty according to the Pemberton-Zanoli method is thus effective in the treatment of acetabular dysplasia at a young age, obtaining long-lasting effects and ones that do not cause dysmetria in the adult.