Dear friends, here I am again. This is the fourth and last Journal Club for the year 2015, a meeting that I proposed and strongly desired, with the aim of offering new inducements to my team.

It’s been a very challenging and advantageous year. Some research projects have come to life, others have already borne fruit and there are some in progress,
I proudly shared with you the recent publication ofPosterior Talar Shifting in Mobile-Bearing Total Ankle Replacement” in “Foot Ankle Int” scientific magazine.

Exactly for this success, for this last meeting I have chosen to have a deeper look into those which, at first, were considered contra-indication of ankle replacement and that are not objective limitations anymore.

Dr Luigi Manzi’s introduction. A passionate comment on his friend, Dr. Gross’ article about the impact of diabetes mellitus on patients treated with total ankle replacement. “Impact of diabetes on outcome of total ankle replacement”.

He accompanied Dr Camilla Maccario, showing that obesity for example, a current sore point in the US, does not affect the outcomes of patients treated with ankle replacement. The commented article is “The effect of obesity on functional outcomes and complication in arthroplasty”.

Dr Andrea Pantalone concluded the analysis of contra-indications taking into consideration the deformity. To this day deformity is not considered a limit anymore, only for less practiced surgeons who don’t perform this kind of intervention on a regular basis.
Discussed article: “Differences in outcomes following total ankle replacement in patients with neutral alignment compared with tibio-talar joint malalignment”.

Then we proceeded to examine ‘the other side of the coin’. Dr Miriam Grassi commented arthrodesis and the factors influence the results of these techniques. Miriam found inspiration from the article: “Factors affecting the outcomes of uncomplicated primary open ankle arthrodesis”.
Thanks to Dr Christian Indino, we all took a leap into the past. Cristian analysed Henricso’s article about the increase of follow-ups in ankle replacements: “Survival analysis of the single and double coated STAR ankle up to 20 years: long term follow-up of 324 cases from the Swedish Ankle Registry”. His presentation of the editor’s letter and relative reply of it in the article is appreciable.
I will never tire of telling my young colleagues that we should think about these follow-ups when we work on our database.

So, having a look at imaging is fundamental to monitor our results. Dr Claudia discussed this in the article: “Radiographic outcome of pre-operative CT-scan derived patient specific Total Ankle Arthroplasty”.

To conclude the evening I have chosen a topic that is frequently asked in every Masterclass Zimmer I take part in, to talk about prosthesis: discussing the stabilisation of syndesmosis in the prosthesis, especially in ankle valgus. We set off studying the origins: “The fate of the fixed syndesmosis overtime”. Dr Riccardo D’Ambrosio presented this important issue, prelude to one of our future studies.

I closed the evening remembering November successes together with my team. We had so many emotions. The first disarthrodesis performed with lateral method and Zimmer prosthesis. (First time in Europe), the first prosthetic revision of the ankle applying first implant Zimmer prosthesis (First time in the world).
Sharing their battles and victories fills my heart with pride and energy. Thanks to all of you guys.
See you in January, more charged-up than ever!