Twenty-five post-traumatic leg length discrepancies combined with axial deviation in 22 patients were treated with the Taylor spatial frame. We retrospectively analysed the accuracy of correction, the complication rate and the clinical outcome including the duration of treatment. The cases were divided into three sub-groups according to the level of the osteotomy. The mean age at operation was 22.7 years; the mean follow-up was 21.1 months. The patients presented uniplanar and multiplanar deformities in combination with leg length discrepancy. Twenty-one of 25 cases showed a frontal plane malalignment preoperatively. Only three of those 21 cases continued to show minimal malalignment postoperatively. The preoperative mechanical axis deviation present in 15 of 17 lower extremities was fully corrected in 13 extremities. The 25 lengthening and correction procedures were associated with a total of 61 difficulties, including 44 problems, seven obstacles and ten complications. In conclusion, the Taylor spatial frame allows accurate results in correction of complex post-traumatic deformities with minimal morbidity.

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We studied the outcome of patellofemoral arthroplasties using the Autocentric prosthesis implanted in our clinic between 1994 and 2004. New insight on indications and contraindications motivated us to find risk factors in the failure of this prosthesis. Twenty-four patients had surgery for patellofemoral arthritis not responding to exhaustive nonoperative measures. The mean age at the time of patellofemoral arthroplasty (PFA) was 63.4 (SD 11.3, range 38-81) years with a mean follow-up of 4.8 (SD 2.9, range 2-11) years. Additional interventions were necessary in 21 knees during follow-up in our population, and seven knees required total knee arthroplasty (TKA) mainly due to progressive tibiofemoral osteoarthritis and maltracking of the patella. The patient outcomes and quality of life scores showed disappointing results, even after revision to TKA. This retrospective analysis underlines the importance of strict indications for patellofemoral arthroplasty and, in particular, of contraindications.

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