PRP significantly reduced pain and improved quality of live in patients with low degree of cartilage degeneration. Magnetic resonance imaging did not confirmed any significant cartilage condition improvement.

The purpose of this prospective, randomized and blinded study was to compare the clinical outcomes of distal radial fractures treated with either an intramedullary nail or a volar locking plate. Sixty two patients were enrolled in the study and randomized to treatment with a MICRONAILTM (Group 1, 31 patients) or an adaptive plate (Group 2, 31 patients). Fracture types included were unstable extra-articular metaphyseal distal radial fractures and simple or multifragmentary sagittal articular distal radial fractures (AO classification types A2, A3, B1.1 and B1.2). All patients were evaluated at 6 weeks, 3 months and 12 months after surgery. Outcome measures included standard radiographic parameters, active wrist range of motion, the disabilities of the arm, shoulder and hand (DASH) and Mayo wrist scores. We concluded that treatment of this subset of distal radius fractures with minimally invasive intramedullary nailing gives better clinical outcomes at 6 weeks after surgery than treatment with a volar locking plate. By 3 and 12 months following surgery, there are no significant differences in outcome between the two treatment methods. Disadvantages of the MICRONAIL™ fixation system include risk of injury to the superficial branch of the radial nerve and a narrower spectrum of indications than volar locking plates.

Background: The objective of the present study was to determine if platelet rich plasma (PRP) can increase tibiofemoral cartilage regeneration and improve knee function. Methods: Fourty consecutive and strictly selected patients affected by grade II or III chondromalacia underwent 1 yr of treatment (nine injections) with autologous PRP in a liquid form with 2.0 to 2.5-fold platelet concentration (20 cases) or with hyaluronic acid (HA) (20 patients). Outcome measures included the Lysholm, Tegner, International Knee Documentation Committee (IKDC), Western Ontario and McMaster (WOMAC) Osteoarthritis Index, and Short Form (SF)-36 scores. MRI arthroscopic and histologic assessment were used to evaluate cartilage thickness and degree of degeneration before and after treatment (1 yr after the primary arthroscopy). Results: The study demonstrated significant improvement in Lysholm, Tegner, IKDC, WOMAC, and SF-36 scores in both groups. Cartilage assessment revealed no significant macroscopic or microscopic structural regeneration as well as no cartilage height increase in either group. Higher content of chondrocytes and proteoglycans in cartilage was proven in both groups after treatment without a statistically significant difference between the groups. There were no adverse events observed. Conclusions: PRP and HA significantly reduced pain and improved quality of life in patients with a low degree of cartilage degeneration. MRI and arthroscopic assessment did not confirm any significant cartilage structural improvement. The content of chondrocytes and proteoglycans in cartilage was higher in the PRP group than in the HA group after the treatment but did not reach statistical significance.

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The biomechanical function of the anteromedial (AM) and posterolateral (PL) bundles of the anterior cruciate ligament (ACL) remains controversial. Some studies report that the AM bundle stabilises the knee joint in anteroposterior (AP) translation and rotational movement (both internal and external) to the same extent as the PL bundle. Others conclude that the PL bundle is more important than the AM in controlling rotational movement. The objective of this randomised cohort study involving 60 patients (39 men and 21 women) with a mean age of 32.9 years (18 to 53) was to evaluate the function of the AM and the PL bundles of the ACL in both AP and rotational movements of the knee joint after single-bundle and double-bundle ACL reconstruction using a computer navigation system. In the double-bundle group the patients were also randomised to have the AM or the PL bundle tensioned first, with knee laxity measured after each stage of reconstruction. All patients had isolated complete ACL tears, and the presence of a meniscal injury was the only supplementary pathology permitted for inclusion in the trial. The KT-1000 arthrometer was used to apply a constant load to evaluate the AP translation and the rolimeter was used to apply a constant rotational force. For the single-bundle group deviation was measured before and after ACL reconstruction. In the double-bundle group deviation was measured for the ACL-deficient, AM- or PL-reconstructed first conditions and for the total reconstruction. We found that the AM bundle in the double-bundle group controlled rotation as much as the single-bundle technique, and to a greater extent than the PL bundle in the double-bundle technique. The double-bundle technique increases AP translation and rotational stability in internal rotation more than the single-bundle technique.