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Abstract: Purpose: The aim of this study was to analyze the clinical outcome obtained with arthroscopic second generation autologous chondrocyte implantation (ACI) associated with bone grafting for the treatment of knee osteochondritis dissecans (OCD) at medium term follow-up. Methods: Thirty-four knees affected by symptomatic OCD grade III or IV on the ICRS (International Cartilage Repair Society) scale were treated and prospectively evaluated at 12, 24months of follow-up, and at a final mean 6±1years of follow-up. The mean age at treatment was 21±6years. The average size of the defects was 3±1cm2. Patients were evaluated with IKDC, EQ-VAS, and Tegner scores. Results: A statistically significant improvement in all scores was observed after the treatment. The IKDC subjective score improved from 38±13 to 81±20, and 91% of the knees were rated as normal or nearly normal in the objective IKDC at the final evaluation. EQ-VAS and Tegner scores showed a statistically significant linear trend of improvement over time passing from 52±18 to 83±14 and from 2±1 to 5±3, respectively, at 6years'' follow-up. A better outcome was obtained in men, sport active patients, and smaller lesions. Conclusions: Second generation ACI associated with bone grafting is a valid treatment option for knee OCD and may offer a good and stable clinical outcome at mean 6years of follow-up. Further studies are needed to confirm the results over time, and determine if there is only a symptomatic improvement, or if this procedure may also prevent or delay further knee degeneration. [Copyright &y& Elsevier]

Abstract: We assessed 30 patients with a cemented TKR implant (Interax ISA®, Stryker Orthopaedics) at 1 and 3 years follow-up. We wanted to ascertain whether knee alignment was maintained during the critical period of follow-up in meniscal-bearing PCL-retaining TKR patients and test if correlations exist between alignment variations in the coronal plane and preoperative varus/valgus deformity or tibial component position and migration with respect to the tibia. Lower limb alignment was evaluated by measuring the angle between the tibia and femur anatomical axis directly from the antero-posterior radiographs and the tibial component position with respect to the tibial anatomical axis. The tibial component varus/valgus migration in the tibia was measured by roentgen stereophotogrammetric analysis. The results showed that at 3 years follow-up 40% of patients presented an alignment variation of over 3°. The recurrent deformity was not correlated with the preoperative deformity, nor with the tibial component position with respect to the tibial shaft nor with its migration. After total knee arthroplasty coronal axial variation is a common finding and it depends on the overall limb muscles and ligaments adaptation to prosthetic constraints. [Copyright &y& Elsevier]