The clinical and radiographic outcomes of 88 patients who underwent primary total hip arthroplasty with either conventional polyethylene or cross-linked polyethylene (XLPE) from the same manufacturer were compared. There were no significant differences between the 2 subpopulations regarding average age, gender, side affected, or prosthetic stem and cup size. The average follow-up was 104 months (range, 55 to 131 months). To the authors' knowledge, this is the longest follow-up for this particular insert. Clinical and radiographic evaluations were performed at 1, 3, 6, and 12 months and then annually. Results showed that XLPE has a significantly greater wear reduction than that of standard polyethylene in primary total hip arthroplasty. At the longest available follow-up for these specific inserts, XLPE proved to be effective in reducing wear.

BACKGROUND Müller-Weiss disease (MWD) is an idiopathic foot condition characterized by spontaneous tarsal “scaphoiditis” in adults. Frequently bilateral and affecting females during the 4 th -6 th decades of life, the pathogenesis of MWD remains unclear: It has been traditionally considered a spontaneous osteonecrosis of the navicular. The typical presentation of MWD is a long period of subtle discomfort followed by prolonged standing, atraumatic, disabling pain. Currently, there is no gold standard for the treatment of patients with MWD. Most support initial conservative therapy. Operative treatment should be considered for failure of conservative therapies longer than 6 months. The indication for surgery is severity of symptoms rather than severity of deformities. Operative treatment options include core decompression, internal fixation of the tarsal navicular, open or arthroscopic triple fusion, talo-navicular or talo-navicular-cuneiform arthrodesis, and navicular excision with reconstruction of the medial column. CASE SUMMARY In this study, we report four patients affected by MWD. Clinical and radiographic assessment, follow-up and treatment are reported. CONCLUSION As it is frequently misdiagnosed, MWD is challenging for orthopedic surgeons. Early diagnosis and effective treatment are mandatory to avoid sequelae.

Soccer is the most popular sport worldwide and is known to be correlated to high risk of of injuries, which negatively influence the performance of the single player and team: higher positions in league or cup standings are achieved by clubs with injury-prevention programs. Prevention is fundamental for athletes allowing them to play at the highest level in complete safety: however, only a few studies reported the effectiveness of preventive programs especially in young players.The aim of this study is twofold: firstly, reporting season injuries in young professional footballers and assessing their risk factors; secondly, demonstrating how a specific prevention program reduce injuries incidence. 32 professional footballers («Primavera» under-19 Italian league 2014/2015) were included and compared with the previous season («Allievi» under-17 Italian league 2013/2014) because of 95% of the team was formed by the same players.An injury-prevention program was introduced: core training, active warm-up, static stretching and cryotherapy were inserted into a program of football technical, tactical and physical exercises, co-operated by technical and medical staff. For each injury we collected: type, days of absence, severity, body segment, match or training features, pathogenesis, recurrence, therapy. Therefore, incidence, burden injury and availability were calculated. Analysis was made by MedCalc® (P-value <0,05).We collected 45 injuries: 5 contusions, 9 overexertion-related disorders, 10 sprains, 6 tendonitis, 8 muscle tears, 1 knee ligament strain, 5 bone fractures and 1 skin wound. Injuries mostly occurred during training (60.00%) than matches (33.33%) and 3 extra-soccer activities (6.67%). Incidence was 5,6/1000hs, burden injury of 72.92 days of absence/1000hs and average availibility 87%. Prevention program was significantly effective: injuries were similar (46 vs 45) in the two consecutive seasons even though a doubled-time sport performance (3847.40hs vs 8050.18) (p=0.01). Injuries prevention is relevant for footballers. Our proposals resulted very effective, decreasing predictable injuries.

The extra-articular impingement of the greater trochanter against the ileum is an underrated cause of early dislocation in total hip arthroplasty. In this preliminary study, the authors assess the effectiveness of an anterior longitudinal osteotomy of the greater trochanter for preventing dislocation. A total of 115 patients underwent a total hip arthroplasty through a posterolateral approach. All patients underwent clinical and radiological follow-up at 1, 3, and 6 months. No dislocation was reported. All patients demonstrated fast recovery of range of motion and walking. No trochanter fractures were observed. The osteotomy of the greater trochanter is an effective surgical technique that decreases anterior impingement and consequently lowers the dislocation rate in primary total hip arthroplasty. [Orthopedics. 2015; 38(8):490-493.].

A successful and minimally invasive treatment for adolescent flexible flatfoot is subtalar arthroeresis. This study examines the short-term results of subtalar arthroereisis with a new PEEK device (Pit’Stop®); additional research will be required to determine the device’s true potential, but the preliminary findings are very encouraging, with a high success rate and a low complication rate (0.08).