The nervous structures of anterior cruciate ligament of human knee, healthy and lesioned, studied with confocal scanning laser microscopy.

The presence of nervous structures with proprioceptive function in the human knee ligaments is by now well known. Therefore a lesion of the anterior cruciate ligament (ACL), beyond a loss of mechanical stability, causes the interruption of proprioceptive signals. In the present study, the Authors verified the presence of nervous structures in lesioned ligaments, using bioptic samples taken from the distal portion of residual stumps of ACL, during surgical intervention of the ACL reconstruction.

Anatomical reconstruction versus tenodesis for the treatment of chronic anterolateral instability of the ankle joint: a 2- to 10-year follow-up, multicenter study.

The clinical outcome of anatomical reconstruction or tenodesis in the treatment of chronic anterolateral ankle instability was assessed in a retrospective multicenter study. The anatomical reconstruction group (group A) consisted of 106 patients (mean age at operation 24 +/- 8.4 years) and the tenodesis group (group B) of 110 patients (mean age at operation 26 +/- 11.

[The recent history of substitution procedures for the anterior cruciate ligament].

The evolution of operations to repair or substitute the anterior cruciate ligament is summarized for the period 1903 to the present. The increase in the understanding of the function of the ligament is described and in the light of this experience a programme for the management of these lesions is suggested. In acute lesions in a young sportsman the loss of the stability provided by the central pivot prevents competition at high level and operation to repair, substitute, or reinforce the ligament is recommended.

[Combination auto-heteroplasty in ligament repair in chronic anterior laxity of the knee].

From September 85 to September 88, 130 patients were treated by our own technique for chronic laxity of the knee. All the patients were examined at regular intervals (6, 12 and 24 months) both clinically and by arthroscopy. Neuromorphological studies, an experimental approach with the "Pivot" and evaluation of the results, show that surgery is indicated, especially in young patients, before intraarticular lesions appear.

The surgical treatment of fractures of the acetabulum. Results after five years and proposed new classification.

Thirty-seven fractures of the acetabulum treated surgically at the Orthopaedic Institute in Milan were reviewed 5 years after operation. The overall clinical and radiographic results over this period of time were considered to be satisfactory, but a detailed study of each case enabled us to determine some of the factors which may negatively influence the outcome of this type of fracture. These negative factors were used to devise a new classification based on whether or not there was involvement of the load bearing segment of the acetabulum and on the complexity and comminution of the fracture.

Varizing osteotomy in osteoarthrosis of the hip. (10 years follow up of 21 cases).

The authors discuss the anatomical, structural and biomechanical aspects of osteoarthrosis of the hip that are the determining factors in the success of varizing osteotomy, based on a pre-operative radiological and clinical study of their cases. In describing the surgical technique, they stress the importance of posterior capsulotomy. The case material comprises thirty-two patients, twenty-seven of whom underwent osteotomy.

Fractures and pseudarthrosis of the carpal scaphoid.

The ultimate outcome of fractures of the scaphoid bone is determined by the choice of initial treatment. The special characteristics of the blood supply to the bone, which often increase the risk of non-union, have prompted us to propose the indications for primary surgical treatment based on the radiographic appearances. The authors propose a classification of the radiographic characteristics of fractures of the scaphoid for determining at the outset the treatment most likely to achieve consolidation and hence a more rapid resumption of occupational and sports activities.

An apparatus for the radiographic diagnosis of ligamentous lesions of the ankle dynamic projections.

Functional radiographic investigation is indispensable to the clinical examination of ligamentous lesions of the ankle. It facilitates correct classification of the different lesions. This correlation of clinical findings and precise radiographical images to well defined anatomo-pathological lesions is particularly important in selecting the correct treatment.

Operative indications in fractures of the calcaneus: problems of reduction and fixation.

In fractures of the calcaneus the fundamental importance of complete restoration of the architectural structure of the bone is stressed. To this end, the technique of internal fixation calls for a special device. Three different types of plate are described and the indications for each discussed.