Trufit resorbable scaffolds, made of semiporous copolymer, are press-fit introduced in chondral defects of articular surfaces in order to promote filling and regeneration of damaged bone and cartilage tissues. In another previous work, we have presented our good and promising results obtanied at 1 yy follow-up. Then, we have had the chance to go on on follow-ups and check patients through second-look arthroscopies and serial MRI's: IKDC score showed 38 points improvement. WOMAC score showed statistically significant pain improvement in 89% of cases and function improvement in 86% of cases. Serial MRI's of the knees showed progressive incorporation of the synthetic plugs and no adverse inflammatory reaction. Second-look arthroscopies showed complete and flush fill of the defects and their resurfacing with hyaline-like tissue under different stages of maturation.

Recently, we have been able to check, clinically and by serial MRI's, the first patients operated 24 months ago. Despite the mantainance of clinical very good results, as showed by other authors, MRI images showed a delayed biologic process of incorporation of the plugs. This finding has not to be misinterpreted as an implant failure and the post-op rehabilitation has to be continued in order to give regenerating cartilage time to complete the maturation process.

After previous experience with hip screws and gamma nails, based on recent biomechanical studies, we started treating femoral neck fractures with PFN nail. The proximal femural nail is made of titanium, has two lengths, and a distal flexible component of various diameters with which the femoral neck area can be stabilised with an 11.5-mm cephalic screw and an anti-rotation 6.5-mm screw, both of variable lengths.

From January 2002 to January 2004, 80 of 100 trochanteric fractures were treated with PFN nail. Most fractures were of the 31.A2 and 31.A3 AO type. Mean surgery time was 40 min. Patients began ROM exercises on the first post-operative day and assisted weight-bearing on the fourth and were controlled at 1, 2, and 6 months and then yearly.

No important intra-operative complications and no post-operative fractures have been encountered. However, we do report one case of screw cut-out. About 80% of results were good-excellent.

We can state that the use of PFN nail is of particular value since its unique technical features seem to reduce post-operative complications and surgical stresses, due to less invasiveness, intra-operative complications, and, due to the enhanced stability granted by additional cephalic screws and reduced size and increased flexibility of the distal part of the nail. Finally, we emphasise some surgical tips for best results: respect of correct nail introduction point, minimal proximal reaming, gentle introduction of the nail and particular attention to cephalic screw position and length.