Acta Chir Orthop Traumatol Cech. 2004; 71(2)

[A cannulated articulating spacer--a functional implant for treatment of infected hip joint prostheses].

D Jahoda, A Sosna, I Landor, P Vavrík, D Pokorný

Acta Chir Orthop Traumatol Cech. 2004; 71(2):73-79

PURPOSE OF THE STUDY: Two-stage revision arthroplasty with the use of a spacer is generally accepted as a reliable method for treating infected hip replacements. Spacers made from antibiotic-loaded bone cement give good results in treatment of deep infections, but this technique is demanding in terms of spacer shaping. In addition, the conventional spacer may dislocate or fracture during patient mobilization. We attempted to avoid the disadvantages of conventional spacers by the construction of a cannulated articulating spacer. This is a special implant consisting of a polyethylene acetabulum, a stem, a modular neck and a head. Both the acetabulum...

[Diclofenac 75mg. and 30 mg. orfenadine (Neodolpasse) versus placebo and piroxicam in postoperative analgesia after arthroscopy].

J Málek, I Nedělová, M Lopourová, M Stefan, R Kostál

Acta Chir Orthop Traumatol Cech. 2004; 71(2):80-83

PURPOSE OF THE STUDY: Arthroscopy is often performed in an out-patient department or as one-day surgery. Opioids often used as postoperative analgesics may have unwanted side effects that may postpone the patient's discharge from hospital. This study was designed to evaluate a substitute for the most frequently used opioid pethidine. For pain relief, non-steroid anti-inflammatory drugs are recommended, but they offer a limited choice for parenteral administration. We used a new agent (Neodolpasse) based on diclophenac and orphenadine, and compared its efficacy with piroxicam and placebo.METHODS: A total of 119 patients scheduled for knee joint...

[Long-term results of unicompartmental knee joint replacement].

V Kankovský, Z Ptácek, P Kubát

Acta Chir Orthop Traumatol Cech. 2004; 71(2):84-92

PURPOSE OF THE STUDY: To evaluate the long-term results of unicompartmental knee joint alloplasty (UKA) in a group of 21 patients. On the basis of their own results and literature data, the authors discuss effective strategies for treatment of unicompartmental osteoarthritis of the knee joint.MATERIAL: A group of 21 patients, who were implanted a total of 22 unicompartmental knee replacements, type St. Georg, Waldemar Link, between 1986 and 1992, were followed-up till 2002. Since two patients living permanently abroad were excluded, the group at the final evaluation consisted of 19 patients with a total of 20 knee replacements.METHODS: In 2002,...

[Long-term results of the Schenker cementless femoral component].

V Dzupa, O Cech, M Sesták, Z Klézl

Acta Chir Orthop Traumatol Cech. 2004; 71(2):93-100

PURPOSE OF THE STUDY: The aim of the work is to evaluate the results achieved in the group of patients with implanted Schenker cementless femoral component (Schenker, Switzerland) and discuss the method of solution of loosening of these components in the group of patients who underwent revision surgery.MATERIAL: The first part of the followed-up group comprised 16 patients (11 women, 5 men) with the total of 18 operated on hips who underwent primary hip arthroplasty between 1989 and 1992 (Poidi cemented cup, Schenker cementless femoral component). The average follow-up period was 140 months (range 120 to 156 months). The second part of the group...

[Total endoprosthesis replacement after hip joint arthrodesis].

P Hajný, J Kolman

Acta Chir Orthop Traumatol Cech. 2004; 71(2):101-105

PURPOSE OF THE STUDY: To evaluate mid-term results of conversion of arthrodesis to total hip replacement in terms of X-ray findings and benefits for the patient.MATERIAL: Ten patients who had undergone hip joint arthrodesis were clinically examined and X-rayed and the findings evaluated. The most common indications for arthrodesis were posttraumatic lesions or the sequelae of a dysplastic hip joint, Perthes disease and inflammatory hip arthritis. The average age was 24.6 years (range, 15-37) at the first operation (arthrodesis) and 42.5 years (range, 30-61) at the second operation (hip arthroplasty). The average follow-up was 9.3 years (range,...

[Arthroscopy in the diagnosis and therapy of wrist disorders].

J Pilný

Acta Chir Orthop Traumatol Cech. 2004; 71(2):106-109

PURPOSE OF THE STUDY: Arthroscopy of the wrist is a method facilitating the establishment of diagnosis in patients with wrist complaints which may also serve for surgical management of some of the causes of wrist pathology. The author presents his first experience with carpal arthroscopy as a diagnostic method as well as a therapeutic technique performed in one or two stages.MATERIAL: A total of 34 patients, 12 women and 22 men, in the age range of 14 to 64 years, underwent carpal arthroscopy. This was performed to treat acute or chronic conditions in 16 and 18 patients, respectively.METHODS: Arthroscopy was carried out with the hand in vertical...

[The shape of the acromion and its effect on the subacromial space].

M Lisý, P Hreusík, B Steno

Acta Chir Orthop Traumatol Cech. 2004; 71(2):110-114

PURPOSE OF THE STUDY: A great variability of the shape of acromion exists in the population. The shape of the acromion plays a great role in development of the pathology of the subacromial space. Quantification of the anatomical changes using radiological examination (X-ray. CT) is a major contribution to the diagnosis of the subacromial space disorders and to differential diagnosis of painful affections of the shoulder. The aim of the study was to assess the prevalence of the degenerative changes in the subacromial space and their relation to the shape of the inferior space of acromion in our population.MATERIAL AND METHODS: In 50 randomly chosen...

[A rare shortening of the first metatarsus of the foot and its treatment with distraction arthrodesis].

M Janecek, R Hart, J Kucera, P Visna, J Kocis

Acta Chir Orthop Traumatol Cech. 2004; 71(2):115-118

Multiple toes may develop on the medial or lateral side of the forefoot or in its middle. This may involve duplication of only the distal phalanx or the whole hallux including the metatarsal. In a duplicated big toe, the phalanx to be maintained, because short muscles of the leg are attached to it, is usually localized medially. A rare case of dysplasia of the first metatarsus, following a resection indicated in childhood for a hallux triples, is described in a 20-year-old girl. In order to remove hallux insufficiency and an overloading of the middle metatarsals, the authors decided to carry out a one-stage prolongation of the first metatarsal, using...

[Traumatic atlanto-occipital dislocation].

J Kocis, P Wendsche, V Muzík

Acta Chir Orthop Traumatol Cech. 2004; 71(2):119-123

The authors present two cases of survival after atlanto-occipital dislocation (AOD). Atlanto-occipital dislocation is in majority of cases lethal and only rarely compatible with life. AOD is often missed mainly in polytrauma in unconscious patients when the life endangering injury detracts attention from the examination of the upper cervical spine. The authors point out to the fact that with the improvement of the work of the rescue service and a fast transport of the patient to the hospital the number of these injuries may be expected to grow.