Purpose: There is great interest recently,among Orthopaedic surgeons about Minimally Invasive Surgery (MIS) in knee arthroplasty.We present a retrospective,randomized review of 50 patients,who had their knees replaced during a period of a year and show our experience in indications,surgical technique,early results and comparison to conventional surgery.

Method: Using regional anaestesia and an incision of about 9cm (7–11cm), the components are placed without patellar eversion.We briefly describe regional anatomy in relation to surgical technique.We compare early results using MIS to standard procedure,regarding pain,function and rehabilitation and describe pros and cons of the method.

Results: Early results show faster recovery time, less post-operative pain and effusion and quicker return to normal activities.There were no skin problems. 96% of the knees that recieved MIS had good to excellent KSS and KS scoring Systems score.We certainly need longer results and better experience because the method is technically challenging. Smaller surgical tools are also needed in order the technique becomes better and easier for the surgeon.

Aim: To evaluate long term effects of stress shieldieng phenomenon after cementless total hip arthroplasty. Materials-Methods: 80 female pts with OA were randomly allocated in 4 groups according to the type of the cementless stem which was primarily implanted (A-Zwey-Muller,B-Corail,C- Optifix,DAutophor900S). BMD changes of the operated hip (in seven zones), of the operated, contralateral normal hip and of the Lumbar spine were measured pre-op, at 2, 8 and 12 months and every year thereafter. Results: At ten years, 72 pts were available for follow up, all with satisfactory clinical and radiological results with no evidence of polyethylene wear or endosteal lysis. In all groups, the greatest reduction of BMD (calcar atrophyzone 7) was observed at the 2nd post-op year (A:24%, B:8%, C:14.8%, D:18.5%). In all groups, the greatest increase (zone 4) of BMD was also observed at the 2nd post-op year (A7%, B2%, C2.5%, D6.3%). In all groups a similar pattern of slow but progressive recovery of bone mineral density changes after the 3rd year was observed in both zones, approaching baseline values at 10 years in all groups. Preoperative lumbar BMD (osteopenia), body weight, sex and height were not statisticaly correlated to calcar atrophy. Conclusions:We suggest that the clinical and theoretical relevance of stress shielding phenomenon in total hip replacement has been overestimated in the literature

The etiology of TBMOS is not known yet.Possibly, TBMES and osteonecrosis may not be completely separate and distinct conditions.

We performed a prospective study in 32 patients, among 1150 with knee pain that were examined, who fullfilled the following criteria: no history of trauma, inconclusive radiographs and MR images demonstrating a bone marrow edema pattern.The mean age of the patients was 45 years (35 to 56).Patients were followed up for three years clinical examination, laboratory examination, xrays, MRI and in most cases T99 scanning and CT scanning.

The disease proved to be transient in 8 patients.In three of them edema extended to subchondral bone as in osteonecrosis with an illdefined bandlike signal.The mean width of the signal was 3 mm.In two other cases the type of manifestation has never been reported.

We concluded that TBMES can extend to subchondral bone, as osteonecrosis does, through illdefined low signal band like lesions parallel to the articular surface and then resolve completely.It may also have various types of manifestation.We believe that TBME is a common status of different conditions including early avascular necrosis that the bone repair process managed to overcome.

In many cases, treatment of intercondylar T- or Y- fractures of numerous is complex, technically difficult and consideration to many factors is needed.

The purpose of this study was to review the results of treatment in 20 isolated fractures in 20 patients that were operated between 1991 and 2001. All patients were operated as soon as possible after the laboratory studies were completed. In no case there was a delay beyond the 5th fracture day. The mean age of the patients was 48.4 years and men to women ratio was 6/1. The fractures were closed, type III according to Riseborough and Radin classification. In 8 cases the fracture was fixed with one 3.5 compression plate with lag screws. In 12 cases two 3.5 compression plates oriented in two planes at 90° angles to each other were needed for fixation. The posterior approach included chevron osteotomy of the olecranon and exposure of the ulnar nerve. Minimum follow up period was 9 months. The time needed for the sound union of the fracture, range of motion and elbow axis were some of the factors that were examined.

Five of the eight fractures that were fixed with one plate achieved union in the expected period of time. In two cases delayed union and malalignment was noticed without the need for surgical intervention. In one case grafts were needed to help the union of the osteotomy site. We had one case of myossitis ossificans. All fractures that were fixed with two plates achieved union without any complications. In one case there was a 30° extension lag of the elbow. The rest of the patients, in both groups had a satisfactory range of motion with an extension lag less than 10°.

Conclusions: dual plate fixation of these fractures has a lower non union rate, permits secure fixation, earlier rehabilitation and generally, is superior than one plate fixation.

Achilles tendinitis can result, through inflammatory procedures, to tendon degeneration with microtears and nodules. Current conservative or surgical treatment of this lesion proved to be not effective enough. The reason for this is the absence of sufficient oxygenation in the area. In this study we report the results of a novel technique which tries to improve local vascularity.

We operated on 15 mature rabbits after they were anasthetized. Soleus fibers were trasplanted in the right achilles tendon. A lesion, 10mm long and 2mm wide was created in the inner band of the tendon simulating tendinitis. In the left achilles tendon the same procedure was done without transplantation. The rabbits were divided in three equal groups and were sacrificed in the first week, the 2nd and 3rd month after the operation. Histopathologic examination was done in both achilles tendons. The following parameters were assessed: transplanted muscle viability, inflammation and neoangiogenesis. We also evaluated the contact between muscle and tendon and the quality of tissue that was formed in the tendinitis simulating area.

Inflammatory process was noticed only in the 1st week after surgery. In the other groups viable muscle fibers and tendon tissue was observed. Muscle fibers were in contact with the tendon. The quality of tissue in the tendinitis simulating area was of better quality than in the control group.

We conclude that soleus transplanted muscle fibers in the rabbits achilles tendon seem to be oxygen carriers and improve the healing potential of the area. This fact results in tendon reinforcement.