Acta Chir Orthop Traumatol Cech. 1992; 59(6)

Total Hip Joint Replacement Using a CoCrMo Metal-Metal-Sliding Pairing.

B G Weber, M F Semlitsch, R M Streicher

Acta Chir Orthop Traumatol Cech. 1992; 59(6):324-329

Late loosening in total-hip replacement is explained by a foreign body reaction of the connective tissue along the bone-implant interface due to polyethylene debris. In contrast, metal-metal prostheses of the McKee type implanted in the sixties, may still work perfectly today without any signs of osteolysis along the bone-cement interface, providing that metal-metal pairing is superior to prostheses with polyethylene cups and providing also that cement anchorage may be adequate for fixation. A new metal-metal total hip joint is presented, that has been implanted 62 times between 1988 and 1990. Key words: total hip replacement, metal-metal pairing.

[Infected fractures of the leg treated by splints.].

A Lortat-Jacob, J Paukovic, P Hardy, J Benoit

Acta Chir Orthop Traumatol Cech. 1992; 59(6):330-334

The authors present their method of treatment of suppurative pseudoarthroses which involves three stages: 1. excision, 2. fixation (stabilization), 3. reconstruction. Their method was inspired by the two-stage technique elaborated by Papineau. The first two stages of treatment are made during one surgical session and involve the removal of all alien and necrotic tissue and tissue altered by inflammation. For fixation of bone segments the authors use an external frame of their own design. Reconstruction is performed by means of spongiose autografts on the 15th day after the first surgical session using the method "support of the revitalized adjacent...

[Arthroscopy with miniarthrotomy in the treatment of damaged menisci and cruciate ligaments of the knee.].

V Drápal, Z Smíd, P Nechvátal

Acta Chir Orthop Traumatol Cech. 1992; 59(6):335-339

The authors describe the therapeutic procedure, surgical technique and results in a group of 100 patients operated at the First Orthopaedic Clinic of the Masaryk University in Brno on account of lesions of the meniscus and cruciate ligaments of the knee joint. The surgery is started by arthroscopic verification of the diagnosis, treatment of menisceal lesions and then the authors proceed by treatment of the lesion of the cruciate ligaments, using Brückner's single-stage method. The evaluation of results of the submitted group is focused on the difference of the plastic operation of the cruciate ligament performed by a anteromedial parapatellar approach...

[Austin procedure for the treatment of hallux valgus part I: surgical technique.].

J Bartonícek, J Stehlík, M Dlouhý

Acta Chir Orthop Traumatol Cech. 1992; 59(6):340-346

Detailed description of the surgical technique of Austin procedure for hallux valgus is given in this study. The operation is suitable for patients without osteoarthritic changes of I. metatarsophalangeal joint. The operation is mostly performed under local anaesthesia and without turniquet. A medial longitudinal approach is used. It is possible to divide the procedure into five basic stages: Y-shaped incision of medial capsule, so-called champagne-glass approach; lateral release of capsule (conjoined tendon); buniectomy of head of the I. metatarsal; horizontal V-shaped osteotomy and lateral dis placement of metatarsal head with subsequent exci sion...

[Austin Procedure for the Treatment of Hallux Valgus Part II: Results.].

J Bartonícek, M Dlouhý, J Stehlík

Acta Chir Orthop Traumatol Cech. 1992; 59(6):347-352

UNLABELLED: The results of Austin's procedure are evaluated in the group of 22 patients, who have been operated on bilaterally. The patients were followed up on average for 30 months (range 6-72 months). Subjective findings: Nineteen patients were quite satisfied with the results of the procedure, 2 patients had some minor problems, 1 patient with avascular necrosis of the metatarsal head was not satisfied. Disability after this operation was on average 11 weeks (range 6-21 weeks). Objective findings: An average correction of the intermetatarsal angle was 5 dg. (from 10 dg. before operation to 5 dg. after operation). An average valgus deformity before...

[Taxonomy of congenital dislocation of the hip joint.].

M Kovanda

Acta Chir Orthop Traumatol Cech. 1992; 59(6):353-354

In congenital dislocation of the hip joint the dislocation or subluxation of the hip joint is primary and so-called dysplasia of the acetabulum (of preluxation) or dysplasia of the proximal end of the femur (pathological anteversion) is secondary. So-called preluxation is only a variation of the normal state, the diagnosis of dysplasia of the acetabulum grade I is not based on any serious anatomical background. This is why the authors do not approve of repeated examinations of preluxations. In the prophylaxis of congenital dislocation of the hip joints the authors emphasize examination of neonates in maternity hospitals based on seeking of the so-called...

[Changes of urinary hydroxylysylpyridinoline in patients with rheumatic diseases and after operation of prostheses of the hip joint.].

R Becvár, A Lichý, J Macek, M Adam

Acta Chir Orthop Traumatol Cech. 1992; 59(6):355-357

Urinary hydroxylysylpyridinoline (MHP), an indicator of the catabolism of cartilage and bone was assessed in patients with various rheumatic diseases - rheumatoid arthritis (RA) and ankylosing spopndylitis (AS). It was also assessed in patients with coxarthrosis (OA) and AS who had an endopro-thesis of the hip joint and in patients with OA who had a re-operation of a loosened total endoprothesis of the hip joint. A group of healthy subjects served as controls. In all groups of patients the MHP values were elevated as compared with controls. In operated patients different values were recorded - in patients with OA the values did not change after operation,...

[Fracturae axis seu epistrophei - Surgical Treatment Part I : Dens axis seu epistrophei.].

J Lohnert, J Látal

Acta Chir Orthop Traumatol Cech. 1992; 59(6):358-362

The authors present their experience with surgical treatment of fractures of the dens axis. In a group of surgical stabilizations after 295 injuries of the spine fractures of the dens axis account for 6.1 %, in the cervical segment 18.4 %. The mean age of the patients was 54.8 years, all were free from neurological deficit. The authors discuss classifications of fractures of the dens and indications for surgical treatment. They present all methods known at present which are used for surgical stabilization as well as their own experience with their use. With regard to favourable functional results in their own material, without any complications during...

[Comments on the Present State of Prevention and Diagnosis of CHD.].

J Vojtassák

Acta Chir Orthop Traumatol Cech. 1992; 59(6):363-365

The author presents a retrospective evaluation of 5170 children submitted at the age of 3 - 4 menths to X-ray examination. The evaluation was made after 10 years as part of prevention of the CHD syndrome. In the examined number there were 1.59 % displasias, 1. 39 % subluxations and dislocation. The ratio of boys and girls was 1: 2.73 in dysplasias and 1 : 8 in subluxations and dislocations. All dysplasias were treated by a Frejka cushion and were normal when checked at the age of 8 months. Treatment with Pavlik straps, used in subluxations and dislocations, led to normal within 9-12 months in 97.22 % of the patients. In two instances (2. 78 %) after-treatment...

[Liberation of the Knee in Post-traumatic Stiffness.].

M Kovanda

Acta Chir Orthop Traumatol Cech. 1992; 59(6):366-367

The long-term results of mobilizing operations of the knee joint are favourable. In post-traumatic stiffness of the knee joint force is contraindicated. By Judet's or Merle d'Aubigné's operation in the majority of patients adequate movement of the knee joint can be restored if stiffness of ligaments is involved. In severe deforming arthroses or ankylosis of bones it is possible nowadays to provide a total endoprosthesis of the knee joint. Key words: post-traumatic stiffness of the knee joint, liberation.

[Collagen - its use as a biomaterial in orthopedics.].

M Adam, H Pohunková

Acta Chir Orthop Traumatol Cech. 1992; 59(6):368-372

Collagen structure and its biological properties' esp. its effect on cell proliferation and differentiation, on aggregation of thrombocytes and its antigenicity are described. Further properties of collagen as biomaterial are discussed. Its effect on bone healing also when supplemented with the tripeptide Gly-hislys is considered. Key words: collagen types, antigenicity of collagen, bone defects, ligaments, bioglass, hydroxyapatite.