Acta Chir Orthop Traumatol Cech. 2005; 72(1)

[Our experience with revision total knee arthroplasty].

D Musil, J Stehlík, M Stárek

Acta Chir Orthop Traumatol Cech. 2005; 72(1):6-15

PURPOSE OF THE STUDY: In the period from 1990 and June 2003, 885 total knee replacements were performed at the orthopedic ward of the Ceske Budejovice Hospital. Of these, 19 (2.14 %) patients underwent revision surgery; in addition, 25 patients who had had primary surgery in other hospitals were operated on. Of these 44 patients, 25 were followed up and evaluated. The aim of the study was to evaluate the pre-operative treatment including examination for bacterial infection by cultivation, the selection of an optimal procedure (one- or two-stage operation, surgical approach and implantation technique) and postoperative therapy.MATERIAL: The 25 evaluated...

[Arthroscopy of the hip joint].

L Pasa, R Hart, J Kocis, V Muzík, R Veselý

Acta Chir Orthop Traumatol Cech. 2005; 72(1):16-21

PURPOSE OF THE STUDY: Arthroscopic examination of joints has recently gained wide application. Due to hip joint shape and a difficult approach to it, hip arthroscopy has long remained outside the attention and abilities of arthroscopists. The authors present their first experience with operative hip arthroscopy that offers new options for the treatment of intra-articular pathology of the hip joint.MATERIAL: In the years 2001-2003, 24 hip arthroscopies were performed. The following pathological conditions were diagnosed and treated: loose bodies, chondral lesions of the femoral head and acetabulum, ruptures of the labrum acetabuli and ligamentum...

[Harms technique of C1-C2 fixation with polyaxial screws and rods].

J Stulík, T Vyskocil, P Sebesta, J Kryl

Acta Chir Orthop Traumatol Cech. 2005; 72(1):22-27

PURPOSE OF THE STUDY: The Harms technique of stabilizing C1-C2 by fixation with polyaxial screws and rods is a further option for atlantoaxial fixation from the dorsal approach. Harms and Melcher published this method in 2001, but the operation had first been performed by Harms in August 1997. The aim of this study is to evaluate the first results and try to assign the Harms C1-C2 fixation an appropriate standing in the in broad range of options for stabilization of the atlantoaxial complex.MATERIAL: Between December 2002 and January 2004 we carried out the Harms fixation of C1-C2 on 22 patients admitted to the Department of Spine Surgery, Motol...

[Infectious complications after arthroscopic replacement of the cruciate ligaments].

J Váchal, J Kríz, D Jehlicka, P Novák

Acta Chir Orthop Traumatol Cech. 2005; 72(1):28-31

PURPOSE OF THE STUDY: Infection following replacement of the cruciate ligaments of the knee joint may result in not only graft failure but also complete destruction of the joint. The aim of this study was to report the authors' experience with the diagnosis and therapy of this, fortunately occasional, complication.MATERIAL: In the period from October 1999 till June 2003, a total of 2372 arthroscopic operations of the knee joint were carried out; of these, 908 were cruciate ligament replacements. Three surgeons using the same technique were involved. An autologous graft taken from the ligamentum patellae and fixed with interference screws was used...

[Anterior cruciate ligament reconstruction -- long-term results evaluated clinically and by means of a rollimeter].

P Masát, T Trc, I Dylevský, V Havlas

Acta Chir Orthop Traumatol Cech. 2005; 72(1):32-37

PURPOSE OF THE STUDY: Anterior cruciate ligament (ACL) reconstruction has recently become a widely used method of treating chronic instability. We have performed this operation in our department since 1996. The aim of this study was to evaluate the effect of this operation in a long-term perspective, using the rollimeter, a new device facilitating objective assessment of anterior stability of the knee.MATERIAL: Of 150 patients undergoing surgery for lesions of the anterior cruciate ligaments at the Department of Orthopedics for Children and Adults, 2nd Faculty of Medicine, Charles University and Motol Teaching Hospital, in the years 1996-2000,...

Prophylaxis of heterotopic bone formation by radiotherapy -- a comparison between pre- and postsurgical activity.

A Roth, J Füller, M Fährmann, J Anders, A Sachse, K Sander, R Venbrocks

Acta Chir Orthop Traumatol Cech. 2005; 72(1):38-41

INTRODUCTION: Heterotopic bone formation after total hip replacement is estimated to occur in about 30% of all patients. It may develop into restriction of mobility and persisting pain.MATERIAL AND METHODS: From 1991 to 1998, 90 patients with uncemented total hip replacement and known risks to develop heterotopic bone formation were treated by radiotherapy (14 patients received 5 x 3 gy between the first and the fifth postoperative day, 13 patients received 1 x 7 gy between 24 hours postoperative, 63 Patients received 1 x 7 gy between 24 hours preoperative) using gamma ray or high-energy photons. The distance between radiation and surgical procedure...

Radiological changes around the stem after cementless hip implantation in case of the anatomic medullary locking hip system -- five years results.

A Roth, T Winzer, J Babisch, R Fuhrmann, K Sander, R Venbrocks

Acta Chir Orthop Traumatol Cech. 2005; 72(1):42-46

INTRODUCTION: We present radiological results regarding the development of stress shielding around the stem of the AML hip endoprosthesis and discuss the clinical significance of it and preventive measures against stress shielding.MATERIAL AND METHODS: 391 patients (216 female and 122 male) with an AML-hip-endoprosthesis between 1991 and 1992 were followed clinically and radiologically during 5 years postoperatively. It was searched for a statistical correlation of stress shielding with a pre-existing osteoporosis of the proximal femur (Barnett-Nordin index), the diameter of the stem, a varus position of the stem and thigh pain.RESULTS: Stress...

[Partial denervation of the wrist by excision of the interosseous nerves from the dorsal approach].

I Cizmár, I Svízenská, M Masek, T Bujok, D Ira

Acta Chir Orthop Traumatol Cech. 2005; 72(1):47-51

PURPOSE OF THE STUDY: The aim of the study was to optimize, on the basis of an anatomical study, the technique of partial denervation of the wrist in terms of safety for preserving motor innervation of the quadrate pronator muscle, and to include this technique in the range of reconstruction operations for the treatment of degenerative carpal diseases.MATERIAL AND METHODS: The technique of partial denervation of the wrist, using excision of the sensitive branches of the dorsal and volar interosseous nerves, carried out by one-stage surgery from the dorsal approach is presented in a group of 28 patients. The partial denervation was always performed...

[Treatment of talar chondral lesions by solid chondral graft -- first experience].

P Valis, M Repko, M Krbec, R Chaloupka, A Sprláková, J Adler, M Nýdrle

Acta Chir Orthop Traumatol Cech. 2005; 72(1):52-56

The aim of this report is to draw attention to new possibilities of treating chondral lesions of the talus, using a solid chondral graft consisting of autologous chondrocytes grown on a three-dimensional matrix of the tissue glue Tissucol. This method is used in grade II to grade IV chronic lesions and grade IV acute lesions, as classified according to the Berndt and Harty system. Patients' age at implantation should not exceed 40 years. When a lesion is found by arthroscopy on the talar dome, a part of cartilage from a non-weight-bearing surface, most frequently the neck of the talus or the anterior edge of the tibia, is collected. The cartilage is...

The European school of total hip arthroplasty and 35 years of total hip arthroplasty in the Czech Republic.

O Cech, V Dzupa

Acta Chir Orthop Traumatol Cech. 2005; 72(1):57-76

The development of the European total hip arthroplasty in the sixties of 20th century is associated mainly with the names of G. K. McKee, J. Charnley and M. E. Muller. The SICOT meeting in Paris in 1966 introduced THA as a new method of treatment of osteoarthritis of the hip and paved the way for the commercialization of the manufacturing of prostheses. The success of this method consisted primarily in the fixation of individual components by bone cement and application of metal-to-polyethylene and metal-to-metal joints. The book presents these historical events as they have been reflected in the development of THA in the countries of the former Czechoslovakia...