Introduction. We evaluate the midterm results of thirty patients who underwent autologous chondrocytes implantation for talus osteochondral lesions treatment.Materials and Methods. From 2002 to 2009, 30 ankles with a mean lesion size of 2,36 cm²were treated. We evaluated patients using American Orthopaedic Foot and Ankle Surgery and Coughlin score, Van Dijk scale, recovering time, and Musculoskeletal Outcomes Data Evaluation and Management System.Results. The mean AOFAS score varied from 36.9 to 83.9 at follow-up. Average of Van Dijk scale was 141.1. Coughlin score was excellent/good in 24 patients. MOCART score varied from 6.3 to 3.8.Discussion. This matrix is easy to handle conformable to the lesion and apply by arthroscopy. No correlation between MRI imaging and clinical results is found.Conclusions. Our results, compared with those reported in literature with other surgical procedures, show no superiority evidence for our technique compared to the others regarding the size of the lesions.

Of the fifth metatarsal in the treatment of this disorder. Methods: From 1996 to 2006, thirty consecutive percutaneous distal osteotomies of the fifth metatarsal were performed in twenty-one patients for the treatment of a painful prominence of the head of the fifth metatarsal. Combined procedures were performed, including a first metatarsal osteotomy in sixteen feet for hallux valgus treatment and a distal open osteotomy of the second metatarsal for painful dorsal dislocation of the second metatarsophalangeal joint in eight feet. The patients were assessed at a mean of ninety-six months with a radiographic and clinical protocol that made use of the American Orthopaedic Foot & Ankle Society (AOFAS) Lesser Toe Metatarsophalangeal-Interphalangeal Scale. Results: The AOFAS score improved from a mean and standard deviation of 51.9 ± 10.2 points preoperatively to 98.4 ± 2.6 points at the time of final follow-up. In 73% of feet there was complete resolution of pain at the fifth metatarsophalangeal joint without any functional limitation (AOFAS score of 100). In 20% of the cases the AOFAS score was 95 points with some decrease in function and a need to use comfortable shoes. In the remaining 7% of patients the AOFAS score was 93 points with mildly asymptomatic malalignment. No nonunions or recurrences were observed. Conclusions: The percutaneous procedure described here is a reliable technique to perform a distal transverse osteotomy of the fifth metatarsal to correct a painful varus fifth-toe deformity with prominence of the fifth metatarsal head. The clinical results are comparable with those reported with traditional open techniques, with the advantages of a minimally invasive surgical procedure, substantially shorter operating time, and a reduced risk of complications. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence....

Objective: Information technology-based innovation is playing an increasingly key role in healthcare systems. The use of three-dimensional (3D)-printed bone fracture replicas in orthopaedic clinical practice could provide a new tool for fracture simulations and treatment, and change the interaction between patient and surgeon. We investigated the additional value of 3D-printing in the preparation and execution of surgical procedures and communication with patients, as well as its teaching and economic implications. Methods: Fifty-two patients with complex articular displaced fractures of the calcaneus, tibial plateau, or distal radius were enrolled. 3D-printed real-size models of the fractured bone were obtained from computed tomography scans and exported to files suitable for 3D-printing. The models were handled by trauma surgeons, residents, and patients to investigate the potential advantages and procedural improvements. The patients’ and surgeons’ findings were recorded using specific questionnaires. Results: 3D-printed replicas of articular fractures facilitated surgical planning and preoperative simulations, as well as training and teaching activities. They also strengthening the informed consent process and reduced surgical times and costs by about 15%. Conclusion: 3D-printed models of bone fractures represent a significant step towards more-personalized medicine, with improved education and surgeon–patient relationships.