The most significant results in experimental and clinical orthopaedic research in Italy within the last three years have been primarily in major congenital diseases, bone tumors, regenerative medicine, joint replacements, spine, tendons and ligaments, The data presented in the following discussion is comparable with leading international results, highlighting Italian orthopaedic research excellemce as well as its shortcomings.There has been continued innovation in orthopaedic research over the past years. The advances in basic science, particularly in molecular and cell biology, in material science and in nanotechnology, has provided the tools for bone engineering, bone imaging and innovative methods for diagnosis and treatment of primitive and metastatic bone tumours. At this point, it seems necessary to examine to what extent are the limitations of these new orthopaedic techniques as well as the prevalent topics that should be explored and the position of the Italian orthopedic research on a global stage.