Achondroplasia in female twins: surgical indications.

Although in literature achondroplasia has been described profusely, reports on achondroplastic twins are limited. We present two cases of monozygotic female twins with achondroplasia, who underwent limb-lengthening surgical procedure with external fixation in the following five steps: tibia, femur, tibia; femur, homer. Both the cases presented a good limb length and an optimal correction of associated deformities after the treatment, fulfilling the indications. Surgical indications were mostly led by the axial deviations of the lower limbs, and the timing of the limb-lengthening procedures has been the same in both couples showing the importance of this aspect.

Clinical evaluation and treatment of posterior impingement in dancers.

Os trigonum impingement is a frequent cause of posterior ankle pain in ballet dancers because they need extreme plantar flexion during the execution of relevé in demipointe and en pointe positions. Clinical examination and standard and modified x-rays should be carried out to clearly identify the site and entity of the impingement. If a posterior impingement is clinically diagnosed, standard and modified magnetic resonance imaging should be also performed. From September 2005 to September 2006, we considered 186 young trainee ballet dancers. Twelve suffered from posterior ankle pain, and six of these had os trigona. We treated all the ballet dancers nonoperatively, and nine of them had good results. Conservative treatment failed in only three cases after 1-4 mos of physical and medical therapies, and, in these cases, good results were obtained through surgical excision of the accessory ossicle. Modified x-ray and magnetic resonance imaging help to determine the site and entity of the posterior impingement. If this is properly diagnosed, good results can be obtained through a nonoperative approach in a majority of cases.

[Traditional techniques and experimental therapeutic approach for the restore of degenerate cartilages]. / Tecniche tradizionali e approcci terapeutici sperimentali per la rigenerazione di lesioni cartilaginee.

Cartilage is unable to repair itself. The actual treatments for cartilage lesions primarily cover up symptoms only and this had led to develop alternative means to restore degenerated cartilage, above all by using cell therapy. The therapeutic approaches initially focused on the implantation of autologous chondrocytes, but this technique proved unsatisfactory. The discovery that several adult human tissues contain mesenchymal stem cells (MSCs) capable of differentiating into chondrocytes raised the possibility of using MSCs to repair cartilages. In the present study we investigated whether mesenchymal stem cells from adipose tissue (hADAS) are able to differentiate into cartilage cells. We isolated cells from lipoaspirates, characterized them detecting specific surface markers by FACS analysis and immunofluorescence. We differentiate hADAS towards condrogenic line in a culture media supplemented with some specific factors and in a specific condition called pellet culture. The isolation of hADAS cells is reproducible and characterized by an high reproductivity, non dependent from the donor age. The expression of surface markers suits with the literature data. The cells differentiated towards chondrogenic line in pellet culture show a different morphology from the undifferentiated cells. The potential application of MSC therapy provides new hope for the development of innovative treatments for the repair of cartilage lesions and disorders.