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.

Introduction: At the 2nd Orthopaedic Clinic of Turin the subcutaneous rupture of the Achillis tendon is treated with the Ma-Grifþth technique, followed by cast for eight weeks, weight bearing is possible after 2 months. Aim of this work is to evaluate 61 patients operated. Materials and methods: 61 patients were evaluated, divided into 2 groups: group A) 20 male patients treated from 1991 to 1996, mean age 37 years, follow-up 3,3 years, in the 1997 they had a clinical, echosonographic and isokinetic evaluation. Group B) 41 patients, 4 female, treated from 1997 to may 2002, mean age 37,5, mean follow-up 3,6 years, in the 2002 they were clinically evaluated. Results: Group A): the ecographic analysis revealed the thickening of the operated tendon, the isokinetich analysis revealed the same range of movement of the not-affected side, without lack of strength. Group A and B): at the clinical evaluation a normal walking and all the patients came back to the athletic activities in 5 months.

The 5% of the cases presented cicatricial adhaesions, the 10% of the cases presented a light hypoesthesia of the sural nerve. Only one rupture occurred after the re-beginning of the sport activity. Conclusion: This technique has several vantages, like the mini-invasivity, the rapidity of esecution and a low rate of severe complications and gave us good results, therefore we think that could be indicated in the non agonistic patient.