Conformity with EBM was similar to previous reports. Elaboration of treatment strategy within a formal multidisciplinary staff and treatment within a cancer network are both important prognostic factors for optimal clinical care.

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Paget's disease of bone (PDB) is a localised chronic osteopathy leading to bone deformities, bone hypervascularity, structural weakness and altered joint biomechanics. The pelvis and upper femur are frequently involved, resulting in disabling hip disease, and total hip arthroplasty (THA) may be required. We performed a retrospective study on the management and the outcome of 39 uncemented hydroxyapatite fully-coated THA in patients with PDB of the hip. The follow-up averaged 79.4 months (range 24-194). Functional scores improved significantly and, using the Harris hip score, 84% of patients had an excellent clinical outcome at the latest follow-up. Despite one case of an uncemented acetabular component with probable loosening, no implant revision had been required at our latest follow-up. Signs of implant loosening were found to be significantly more frequent in patients with active disease. For this reason, we advocate the use of pre-operative medication with bisphosphonates to reduce disease activity. Another benefit of this treatment is the significant decrease of intra-operative blood loss. Provided the control of disease activity in the pre-operative period with bisphosphonates is achieved, good outcome of cementless THAs can be expected. Bisphosphonates reduced the risk of implant loosening and excessive intra-operative blood loss

Based on two orthogonal radiologic views, the authors present a morphometric study of the talocrural joint. In 50 normal subjects, 10 parameters were measured and divided into 3 groups: the distal tibial joint surface parameters, the malleolar parameters and the talar parameters. These parameters were treated in both a descriptive and a correlative analysis. If the talocrural joint is a hinge joint whose talar articular surface can be simplified and classed as a cylinder segment, it is possible to calculate its curve radius. Then the correlative analysis allows to define the talar parameters and the corresponding parameters of the distal tibial joint surface. The malleolar parameters are independent factors. This study is the first morphologic analysis to serve as a basis for an ankle arthroplasty.

IV. Retrospective therapeutic study.

Unilateral weight bearing was simulated on 12 cadaver knees to quantitate anterior tibial translation (ATT) after anterior cruciate ligament (ACL) transection and to asses the role of the posteromedial structure and the hamstrings in controlling laxity. With the ACL intact, ATT was 3.5 +/- 2.8 mm in extension and 4.3 +/- 3.6 mm at 60 degrees flexion. After sectioning the ACL, ATT was 6.5 +/- 4.7 mm in extension and 17.5 +/- 10 mm at 60 degrees flexion (P = 0.001). Applying a force in the hamstrings was unable to correct the pathological ATT observed after ACL section. Partial medial meniscectomy did not increase ATT after the ACL section. Disinsertion of the posterior horn of the medial meniscus and total medial meniscectomy increased ATT significantly compared to isolated ACL section. After ACL transection, sectioning the meniscotibial fibers or posteromedial capsule significantly increased ATT (6.5 +/- 0.5 mm in extension). Section of the postero-oblique ligament or popliteus tendon had no effect on ATT.

In this study, footprint and ground reaction forces (GRF) were simultaneously recorded from 32 male subjects running barefoot. Angle between the rearfoot and the forefoot in static (alpha S) and in running (alpha R) conditions, and orientation of both, rearfoot (alpha rf) and forefoot (alpha ff) with the direction of running (DOR), were measured and correlated to selected GRF parameters. The dynamic rearfoot/forefoot angle (alpha R) was correlated, positively with arch deformation (r = 0.58, P < 0.001), vertical Fz loading peak (r = 0.60, P < 0.001), mediolateral, and anteroposterior force rates (r = 0.47 and 0.48, P < 0.01), and negatively with stance time (r = -0.41, P < 0.05) and total course of the force application point path (r = -0.71, P < 0.001). Both a medial and a lateral rotation were observed on footprint between the rearfoot and the forefoot in the horizontal plane. A medially rotated forefoot ("closed foot") was associated to a rigid and inverted foot, whereas a laterally rotated forefoot ("open foot") was associated to a flexible and everted foot.