Most people will remember September 3, 2015 as a day like the others. It won’t be like that for my team and I: last night we started our first “Journal Club”.

I heard for the first time of Journal Clubs in 2008 when, still a postgraduate doctor, I was in the US for a research project at Duke University.

In my email box I found an invitation to go to an unknown local restaurant and attached some scientific articles for those who would accept the invitation. Needless to say, I was surprised and many questions went through my head at that very moment. But then I put aside all my doubts and fears and decided to go to the meeting.
At the restaurant, which offered a Greek-American menu, I met a large group of American colleagues. While dining, we discussed about what we had been asked to read and each one of us freely expressed their thoughts and made good use of other people’s views.

Since then and throughout the time of my stay in Durham, I haven’t missed one of those meetings. It’s also thanks to them that I could get to know better, and eventually become friends with, those who at the time were my teachers: professors Nunley, DeOrio and Easley (now President of the American Orthopaedic Foot and Ankle Society).
This kind of experience taught me the importance of being in a team.
Even the greatest surgeons are part of a well balanced and organized group of people with whom they regularly exchange information, points of view and on whom they can rely to carry out a common project.

I’d like to bring this attitude to Italy too, together with my team and their valuable contribution.
In a country where everyone complains about the lack of change, we have to be the first to do something different, to create and spread a new attitude, with a different approach. One of the first steps to take is to share our expertise and knowledge and our different experiences. All this can only bring benefits to our patients.

Our first JC yesterday had its main focus on Osteoarthritis of the ankle.
Every member of my team (Dr. Camilla Maccario, Dr. Luigi Manzi, Dr. Miriam Grassi, Dr. Riccardo D’Ambrosi, Dr. Claudia Silvestri, Dr. Andrea Pantalone) has actively contributed, investigating a particular aspect of the topic during the days before, to then share their thoughts at the dinner.
Young, passionate professionals who open up to new experiences and experiment with new methods already well known and used in other contexts. Doctors who love their work and who invest much of their time keeping themselves up to date and studying, also through a constructive dialogue with their colleagues.
But let’s get to the subject of our meeting.

Camilla (just got back from her fellowship in the United States) compared our current instruments of study for the positioning of prosthesis with those used in Baltimore by Dr. Myerson and Dr. Schon.

  • Effect of Coronal and Sagittal Alignment on Outcome After Mobile-Bearing Total Ankle Replacement Matthias Braito, MD, Dietmar Dammerer, MD, Andrea Reinthaler, MD, Gerhard Kaufmann, MD, Dennis Huber, MSc, and Rainer Biedermann, MD. Foot Ankle Int. 2015 Apr 21.
  • Does Alignment in the Hindfoot Radiograph Influence Dynamic Foot-floor Pressures in Ankle and Tibiotalocalcaneal Fusion? Arno Frigg MD, Benno Nigg PhD, Elysia Davis MSc, Beth Pederson MD, V. Valderrabano MD, PhD. Clin Orthop Relat Res. 2010 Dec; 468(12): 3362-70.

Luigi worked to study the time evolution of the relationship between the limb and prosthesis. The human body, as a living organism, with time learns to use the implant as best it can. It’s important to understand these phenomena in order to implement the rehabilitation techniques.

Miriam compared our experience in dealing with problems with those of other prestigious international schools, focusing in particular on the rare, but nevertheless possible, complications caused by infections.

  • The Management of Infection Following Total Ankle Replacement: Demographics and Treatment. Mark S. Myerson, Raheel Shariff and Alan J. Zonno. Foot Ankle Int published online 31 July 2014
  • The treatment and outcome of periprosthetic infection of the ankle.  B. Kessler,M. Knupp,P. Graber,L. Zwicky,B. Hintermann,W. Zimmerli, P. Sendi. Bone Joint J. 2014 Jun; 96-B(6):772-7.

Newcomers Claudia and Andrea compared the results derived from our recent surgical experiences with those of other schools of thought that, still today, consider arthrodesis (joint fusion) the only reliable solution for osteoarthritis of the ankle.

  • Radiographic and Functional Outcomes Following Bilateral Ankle Fusions. Matthew T. Houdek, Benjamin K. Wilke, Daniel B. Ryssman and Norman S. Turner. Foot Ankle Int published online 23 September 2014
  • Ankle Arthrodesis vs TTC Arthrodesis: Patient Outcomes, Satisfaction, and Return to Activity. Adam Ajis, Ken-Jin Tan and Mark S. Myerson. 2013 34: 657 originally published online 6 March 2013 Foot Ankle Int
  • Comparison of Gait After Total Ankle Arthroplasty and Ankle Arthrodesis. Robert Flavin, Scott C. Coleman, Shay Tenenbaum and James W. Brodsky. Foot Ankle Int 2013 34: 1340 originally published online 13 May 2013
  • Intermediate and Long-Term Outcomes of Total Ankle Arthroplasty and Ankle Arthrodesis. A Systematic Review of the Literature By S.L. Haddad, MD, J.C. Coetzee, MD, R. Estok, RN, BSN, K. Fahrbach, PhD,D. Banel, BA, and L. Nalysnyk, MD, MPH. J Bone Joint Surg Am. 2007 Sep;89(9):1899-905. Review.
  • Comparison of quality of life following total ankle arthroplasty and ankle arthrodesis: Retrospective study of 54 cases F. Dalata,F. Trouillet , M.H. Fessya,, M. Bourdinc, J.-L. Besse. Orthop Traumatol Surg Res. 2014 Nov; 100(7): 761-6.

Last but not least, Riccardo worked on the rationalization of these experiences and on how to improve the way we communicate them to the scientific community.

  • HINTEGRA Total Ankle Replacement: Survivorship Analysis in 684 Patients
    Alexej Barg, MD, Lukas Zwicky, MSc, Markus Knupp, MD, Heath B. Henninger, PhD, and Beat Hintermann, MD. J Bone Joint Surg Am. 2013 Jul 3; 95(13): 1175-83.
  • Intermediate-term Results of Mobile-bearing Total Ankle Replacement
    Paul-André Deleu, MSc1,2, Bernhard Devos Bevernage, MD1,
    Vincent Gombault, MD1, Pierre Maldague, MD1,
    and Thibaut Leemrijse, MD. Foot Ankle Int. 2015 May; 36(5): 518-30.

We will update you regularly on our next meetings.

On a side note, our Italian dinner menu was exquisite.