Section: Kończyna dolna i obręcz biodrowa

July 9, 2022

Surgical difficulties of osteochondroma excision. Review of 4 cases

Osteochondromas constitute one of the most common benign bone tumours. They can grow in different bones. Surgical difficulties result from osteochondromas located in the pelvis or spine. Sometimes, however, osteochondromas located in long bones can cause surgical issues. The objective of the study was to present surgical difficulties of excising osteochondromas in long bones. Between 2016-2019, 53 patients with osteochondromas […]
July 9, 2022

The growth outcome of calcaneus reconstruction at skeletal maturity using a vascularized iliac-crest graft flap. A 3-year-old’s case

The reconstruction of very distal tissue loss of the lower limb requires coverage of the noble structures of the foot’s plantar face (blood vessels, nerves, tendons…) and rebuilding the sole to allow walking. We report the case of a 3 year-old patient, the victim of a lawn mower accident, with mutilation of both feet, and describe the results of the […]
July 9, 2022

Complete traumatic rupture of the proximal gluteus maximus attachment combined with the degloving injury. A case presentation and surgical technique

Rupture of the proximal attachment of the gluteus maximus muscle is an extremely rare injury and can be considered a Morel-Lavallée lesion, which is a closed internal degloving injury usually caused by shear forces that traumatically separate the skin and subcutaneous tissue from the underlying fascia. According to previous literature, Morel-Lavallée lesions are rarely recognized early, which increases the difficulty […]
July 9, 2022

Amputation sequelae of both forefoot and its consequences after embolism syndrome in the course of Covid 19. Case report

The case described in the article refers to a 52-year-old diabetic male after foot amputation in the course of Covid 19 at the level of the Lisfranc joint on the right and the Chopart joint on the left. A slight varus position of the right foot with shortening of the gastrocnemius muscle required correction of the deformity to relieve pain […]
June 21, 2022

Periprosthetic fractures in the hip joint – own study by the Department of Orthopedics and Traumatology in Kalisz

Every year, the number of total hip replacement treatments increases and along with it, so does the number of local and systemic complications, including periprosthetic fractures. These fractures usually occur among elderly people with deteriorated bone quality and other general and neurological disorders. Treatment of periprosthetic femoral fractures imposes a difficult and complex medical problem, which requires adequate experience and a rational […]
June 21, 2022

The comparison of results in treating primary degenerative lesions of the hip joint using the cementless total hip arthroplasty method with the Corail and Fitmore stems

The aim of this study is to clinically assess the results of a total hip arthroplasty surgery among patients with idiopathic hip degenerative lesions. These patients were treated using endoprosthesis with the standard Corail stem and the short Fitmore stem. The scope of this assessment includes surgeries carried out in the Provincial Hospital Complex in Kalisz in the Department of Orthopedics and […]
June 21, 2022

The results of knee arthrodesis with dedicated modular intramedullary nail as a limb salvage procedure in infection complications of knee arthroplasty

Introduction. Complications after arthroplasty often result in irreversible disability. In some cases, for the extremity to be salvaged, permanent knee joint arthrodesis is a last-chance procedure. Modular implant design simplifies surgical technique and knee arthrodesis without bone-on-bone contact, immediately provides full weight bearing and restores limb length and alignment. Puropose. The aim of this article was to perform a clinical evaluation of […]
June 21, 2022

A study on the quality of life of patients awaiting knee replacement in the population of central Poland

Introduction. Quality of life is a multidimensional and subjectively perceived concept. One of the main reasons for its decrease is osteoarthritis. Aim. The aim of this study was to analyze factors affecting the quality of life in the group of patients with knee osteoarthritis while waiting for TKA surgery. Material and methods. The study was conducted on 66 patients living […]
June 21, 2022

Treatment of intra-articular calcaneus fractures – a review of current treatment options

Treatment of calcaneal fractures remains a challenge for the orthopedic surgeon and is still controversial. There is no consensus on whether surgery is a better option that non-operative treatment. The indications for non-operative treatment are non-displaced extra-articular fractures and intra-articular fractures with fragment displacement of less than 2 mm on CT image (Sanders type 1) This type of treatment should be considered […]
June 21, 2022

Anterior cruciate ligament – to repair or not to repair?

Anterior cruciate ligament injuries are one of the most frequent knee joint injuries, leading to instability which limits return to sport activity, and is one of osteoarthritis risk factors. Treatment issues are present since 1895, when Mayo Robertson performed first documented open ACL repair. Positive short-term results of open suturing led to rising popularity of this method, which in 70’s and 80’s […]
June 21, 2022

Scaffolds for knee chondral lesions – indications and technical tips

Chondral lesions following an injury to the knee joint have poor healing potential and may lead to osteoarthritis. Nowadays, more and more research is focused on tissue regeneration and the prevention of osteoarthritis development. Efforts to restore the articular cartilage using advanced procedures like autologous chondrocyte implantation led to the development of scaffolds. Although the use of a scaffold-based technique is a […]
June 21, 2022

Definitive fixation of pelvic and acetabular fractures – current concepts

Introduction. The most challenging injury in orthopedic surgery is pelvic trauma. There are different concepts of treatment strategies, specially in final treatment of pelvic ring and acetabular fractures. Objectives. Analysis of recent studies and evaluation of treatment methods. Materials and Methods. Analysis of 22 recent studies. Five papers met our inclusion criteria, that equated 745 patients. Results. Patients hemodynamically unstable need […]
June 21, 2022

Analysis of the cost of periprosthetic joint infections after total knee and hip arthroplasty and the effect of revision methods on the cost

Introduction. Periprosthetic joint infections (PJI) are known to increase medical costs, whereas the factors affecting this increase are variable. Aim. This retrospective case-control study aims to categorize and analyze the expenditures that increase costs in PJI and to evaluate the cost effect of revision methods. Material and methods. The patients who underwent primary arthroplasty or aseptic revision surgery of the knee […]
June 21, 2022

Supercapsular percutaneously assisted total hip arthroplasty minimal invasive posterior hip approach (SuperPATH)

Introduction. SuperPATH approach is a new minimal invasive approach for hip replacement with subsequent less soft tissue damage. Material and Methods. For this treatment, we operated 13 hips in 12 patients with coxarthrosis. Four men and eight women. Average age was 58 (42-71) years. Follow-up continued for 24,6 months (19-33). Results. Conversion to postero-lateral approach was needed in 3 patients. 66% […]
June 21, 2022

Results of the acetabular custom-made implants usage in extensive acetabular deficiency. Literature review

The treatment of massive acetabular deficiency is a challenging problem even for the most experienced orthopaedic surgeons and the acetabular custommade implants are a relatively promising treatment option for severe bone defects. The aim of this study is to summarize and evaluate outcomes of using acetabular custom-made implants. This review material consists of the results of the selective literary research into custom-made […]
June 21, 2022

Biomechanical evaluation of patients after severe treatment of Achilles tendon Injuries using MIS procedure

Introduction. Achilles tendon is the strongest tendon in the human body. In 1977 Ma and Griffith described the technique of percutaneous anaplasty of the damaged Achilles tendon as a compromise between surgical and conservative treatment. Choosing an operating method that gives “better” treatment results can facilitate the choice of a more effective treatment. Aim. The aim of the study was to evaluate […]
June 21, 2022

Assessment of closed wedge osteotomy in the material of the Department of Orthopedics and Traumatology in Kalisz as a treatment method for severe and moderate hallux valgus

Hallux valgus constitutes of a progressive adduction of the hallux in the first metatarsal joint, accompanied by progressive varus in the first ray, pronation of the first metatarsal bone and medial displacement of the head of the first metatarsal bone. It may be accompanied by more or less severe degenerative changes in the MTPJ and a deformity in the IP joint. Hallux […]
June 21, 2022

Hip sonography worldwide – experience, results, problems

Introduction. There is a confusion in the literature about the value of baby hip sonography to detect DDH. One of the reasons is, that different examination techniques with different results are used and the final results are mixed up. Materials and methods. The principles of the „Graf technique“ with well-known common mistakes are described with the typing as a mirror of […]
June 21, 2022

The cleaning problem of simulated intraoperative contamination on stem taper surfaces – an in vitro study

For over 50 years the Morse-taper represents the most common connection in modular hip implants. However, taper corrosion is still an ongoing issue that can lead to loosening of the hip replacement. Intraoperative factors have a crucial influence on the stability of the taper connection. One factor that is discussed in current literature is the cleanliness of the taper. Although mentioned in […]
June 21, 2022

Robotics and navigation in total knee arthroplasty

In the last two decades we could realize a lot of technical support to perform total knee arthroplasties, starting with the robotic systems in the nineties of the last century. Following those methods the navigation systems were introduced first in a computed tomogram based version second in image free versions. Now we are discussing about the advantages of patient specific instruments or […]
June 21, 2022

Kinematic alignment in total knee arthroplasty

The ultimate goal of total knee arthroplasty (TKA) is to produce a well aligned and balanced knee replacement. The current standard is to create the neutral overall alignment of the lower limb with a joint line perpendicular to the mechanical axis disregarding native joint line orientation and constitutional alignment which are the philosophies of mechanical alignment (MA). Recent studies have questioned if […]
June 21, 2022

Treatment of pediatric diaphyseal femoral fractures with intramedullary fixation

Femoral fractures are found in the daily practice of pediatric orthopedic traumatologists. This is related to the specificity of the child’s skeletal system, different biology and methods used to treat these injuries. Diaphyseal femoral fractures account for approximately 3% of all long bone fractures in children and adolescents. They usually occur as a result of high energy injuries. This type of damage […]
June 21, 2022

High tibial osteotomy

Introduction. We are currently experiencing revival of High Tibial Osteotomy (HTO) procedure. After having been forgotten in the 70s, when knee-joint arthroplasty gained popularity, it became more popular again at the beginning of this century and the procedure methodology has been refined. This procedure is widely performed to treat medial knee arthrosis. The main goals of HTO are pain relief, correction of […]
June 21, 2022

Treatment of hypertrophic pseudarthrosis developed in the femoral subtrochanteric area after intramedullary nail breaking – new application of the LAP system for peri-implant fractures

Hypertrophic pseudarthrosis of the proximal femur is a frequent complication emerging after bloody reposition of the facture with an intramedullary nail. The literature provides no answer to the question how to fix the fragment of fracture ensuing the pseudarthrosis arthroplasty, when proximal fragment is only 10 cm long, to ensure complete and long-standing union and make the fixation stable. We operated a […]
June 21, 2022

Bilateral deep chevron deformity of the first metatarsophalangeal joint – a case report

Most reports divide first metatarsophalangeal (MTP I) joint surface into round, square or chevron shaped. The angular deviation of join surface described as distal metatarsal articular surface (DMAA) is a common situation and is widely known parameter for evaluation of hallux valgus severity. We found no works considering deep chevron shape of metatarsal head together with large DMAA angle. We would like […]
June 21, 2022

Two-time multi-fragment periprosthetic fracture along with loosening of the stem of cementless Excia arthroplasty treated using of the cable system and Prevision arthroplasty

Periprosthetic fracture is a frequent complication following implantation of the hip arthroplasty. There are numerous modes of treatment of such injuries, depending on the type and location of the fracture with a particular stress put on the implant stability. Yet the literature provides no convincing evidence whether postponement of the reposition of the periprosthetic fracture over a week after the arthroplasty implantation, […]
June 21, 2022

Atypical subtrochanteric and diaphyseal femoral fractures associated with a bisphosphonate therapy

Along with the assessment of the long-term benefits of using bisphosphonates in the treatment of osteoporosis, there have been reports indicating that these drugs may induce atypical fractures with specific localization and morphology as well as problems with the healing of these fractures. The aim of the study was to evaluate atypical fractures with particular emphasis on the clinical management algorithm. The […]
June 21, 2022

Radiographic analysis of stability after implantation of three different cementless short femoral stems – five year follow-up

Introduction. In a five-year follow-up comparative study we will present the outcomes after implantation of three cementless short femoral stems : MINIHIP (Corin), SMF (Smith&Nephew) and FURLONG EVOLUTION (jRi). Material and methods. We have analysed the data of 180 patients (88 females, 92 males), in three groups of 60 patients, each group using a different implant. Evaluation of the radiographic outcomes was […]
June 21, 2022

Intravascular papillary endothelial hyperplasia (Masson’s tumor) – rare localization in forefoot area. Case report

Masson’s tumor is benign change on vascular basis located in skin and subcutaneous tissue of limbs, corpus , neck and head. In this report we present a case of rear tumor location in the foot of 30 year old male. Atypical nad recurrent clinical history of the tumor, non traumatic origin, clinical manifestation suggesting ganglioma, unconsistent imagining and insufficient biopsy results can […]
June 21, 2022

Failure of the femoral stem – condyle junction in a semiconstrained knee prosthesis. Analysis of two cases

Failure of the stem – condyle junction in a modular knee prosthesis is a rare phenomenon, but it has been described and carries serious consequences. Loosening of the femoral component increases the loads acting on the stem – condyle junction and increases the risk of fatigue fracture of the implant. The aim of this paper was to describe two cases of such […]
June 21, 2022

Initial evaluation of outcomes of surgical treatment of patients with advanced degenerative disease of the first metatarsophalangeal joint

Nowadays, arthrodesis is the most commonly performed surgical treatment in the treatment of severe degenerative diseases of the first metatarsophalangeal joint (MTP-1). So far, the MTP-1 arthrodesis has been treated as the “gold standard” for patients with severe hallux rigidus. This has been proven in a number of retrospective and comparative studies. However, the classical arthrodesis has not yet been compared with […]
June 21, 2022

Developmental dysplasia of the hip risk factors – what is a real problem and should be taken into consideration in worldwide screening programs? Literature review

Developmental Dysplasia of the Hip (DDH) is the most common condition of the mouvement apparatus in children. If untreated, it leads to early degenerative changes of the joint with all the associated issues for the patient. Risk factors are important part of the diagnostic proces, however part of them seems to be less important that previously thought. In the article actual publications […]
June 21, 2022

Bifocal osteoid osteoma of the talus treated with thermal ablation and navigation 3D – case report

Osteoid osteomas (OO) are common bone tumours. They are responsible for 10% of all benign bone tumours. Most often, they are located in long bones, especially of the lower limb. Less than 3% of all osteoid osteomas occur in the foot[1]. Such rare presentation affects placing an accurate diagnosis, making it difficult and taking longer. Simultaneous manifestation in more than one focus […]
June 21, 2022

The need to personalize the rehabilitation process of patients after hip arthroplasty

Introduction. The usually occurring pain associated with osteoarthritis causes a significant reduction in mobility. This article presents the need to personalize the rehabilitation of patients after hip arthroplasty taking into account age and weight. Material and Methods. The study included 158 patients who were patients of the orthopedic clinic of the SPSK4 Polyclinic in Lublin. All respondents were subjected to partial or […]
June 21, 2022

The application of local infiltration analgesia as multimodal analgesia in postoperative pain managment after total knee arthroplasty – review of the literature

Total knee arthroplasty is one of the most common orthopaedic procedures all over the world. Despite minimal invasive surgical techniques, the procedure is accompanied by the postoperative pain in various intensification. In this article we focus on the multimodal anlagesia, particulary taking local infiltration analgesia (LIA) in consideration. Review of current literature allows us to state that LIA decreases the level of […]
June 21, 2022

Infection cure rate and functional results after 40 two-stage and 28 one-stage cemented reimplatations for knee prosthesis infected by methicillin resistant staphylococcus aureus

Introduction. The study compares infection cure rate and functional results after one- and two-stage revision of total knee prosthesis due to MRSA infection. Material and methods. Results of 28 one-stage cemented revisions with addition of 5% of vancomycin and 40 two-stage revisions with hand-made, articulating cement spacer containing 5% of vancomycin were compared. The average follow up was 4.5 years ( […]
June 21, 2022

Comminuted patella fracture in a patient of advanced age, with xeroderma, treated with a low-invasive, originally modified method using non-absorbable sutures

As an intra-articular fracture, patella fracture should be treated with a precise reposition of fragments and stable metal fixation, which enables possibly early passive and active movements of the knee joint. As regards advanced-age patients with xeroderma in the pre-patellar area and poor-quality osseous tissue preventing any stable fixation, it is necessary to take into account a transdermal reposition of fracture and […]
June 21, 2022

Reconstruction of massive acetabular bone loss with pelvic discontinuity

We present a case of a 66-year-old female patient with a history of multiple revision arthroplasties on the right hip, who was admitted due to another episode of acetabular component displacement. The patient presented with massive acetabular bone loss and pelvic discontinuity. She was implanted with custom-made triflange acetabular component. The device was fixed to the iliac wing, pubis and ischium, and […]
June 21, 2022

Peri-implant femoral shaft fracture in patient with healed femoral neck fracture treated operatively using Targon FN system

Pursuant to the recent literature recommendations, we managed 31B1 fracture with Targon FN plate (BBraun/Aesculap, Germany) in our hospital. Patient reported to our center 14 weeks after operation, complaining about pain ailments in the proximity of the operated area. Patient did not sustain any other injuries. X-ray examination revealed the healed fracture of the femoral neck and fracture below a lower screw […]
June 21, 2022

The use of dual-articulation prostheses in treating femoral neck fractures – a preliminary report

The authors present their own experience with the use of dual-articulation prostheses in a group of patients with femoral neck fractures. The aim of the study was to assess the possible reduction of the risk of dislocation after hip arthroplasty in a group of patients particularly prone to dislocation, that is patients with traumatic femoral neck fracture [1]. The material included 16 […]
June 21, 2022

Treatment outcomes for long bones osteomyelitis using an intramedullary nail coated with antibiotic-loaded polymethyl methacrylate – a preliminary report

Introduction. Inflammations of long bones are severe complications of fractures. The gradual development of industry and its automotive branch generates a higher number of injuries, including high-energy fractures, mostly open [1,2]. These injuries, which are primarily infected, despite the use of empirical antibiotic therapy, lead to osteomyelitis. Intramedullary nails coated with polymethyl methacrylate (PMMA) containing a targeted antibiotic help heal the inflammation and […]
June 21, 2022

Complications after surgical treatment of pilon fractures – a case report

The paper reports a case of a 36-year-old professional soldier who suffered a pilon fracture of the right tibia. Initially, a wrong surgical technique was applied, which resulted in another surgery. The radiographic outcome of the second surgery was good. It is now 10 months after the accident and 7 months after the second surgery. The clinical condition is gradually improving. The […]
June 21, 2022

Analysis of the course of treatment of patients with corticosis using endoprosthesis in the context of the need to personalize the rehabilitation process

Introduction. Total hip replacement is a common and succesful treatment of the osteoarthritis of the hip. Material and Methods. During the work on this article, an analysis of scientific articles on corticosis and hip arthroplasty has been made, with particular emphasis on studies investigating the influence of age and body weight on the obtained results of treatment. The second method of […]
June 21, 2022

Resection arthroplasty of the knee – early treatment outcomes and rehabilitation efficiency

Introduction. Resection arthroplasty of the knee is frequently used in patients with bone tumours. Rehabilitation plays an important role in optimizing the functioning of the patients. The aim of this study was to asses treatment and physical performance outcomes after modular prosthesis surgery and to demonstrate rehabilitation methods. Material and methods. A total of 36 resections of the tumours localized in the […]
June 21, 2022

Antimicrobial biomaterials in the prevention and local treatment of infection in orthopedics

According to current views, infection around the orthopedic implant and in chronic osteomyelitis is associated with the development of a bacterial biofilm, which is a barrier to systemic administered antibiotics. This results in the inability to cure the infection with systemic antimicrobial therapy because the doses guaranteeing activity in the biofilm will be toxic to the patient. The antibiotic concentration effective against […]
June 21, 2022

The effects of unplanned surgical intervention on the long-term treatment outcomes of patients with osteosarcoma

Primary bone tumors are relatively rare but their diagnosis and treatment is difficult and connected with a high risk of complications. The most common primary bone sarcoma is the osteosarcoma, which in Poland it constitutes about 1% of all bone neoplasms and less than 1% of all malignancies. It is confirmed that the inappropriately performed diagnosis and treatment in soft sarcoma negatively […]
June 21, 2022

Intramedullary nails coated with Antibiotic Loaded Acrylic Cement (ALAC) containing 5% of culture specific antibiotic in therapy for infected long bone fractures and nonunions

Introduction. Treatment of fractures or non-union of long bones with infection requires debridement of the medullary cavity, antibiotics in high concentrations in the bone and biofilm, elimination of dead space in the place of debridement and mechanical stability at the site of infection. External tabilization is inconvenient for the patient and makes skin plastics difficult. Material and methods. There were 13 patients […]
June 21, 2022

Mineralogical assessment of the femoral heads and articular cartilage of the femur in patients with avascular necrosis (AVN)

The aim of this study was to analyze changes in the mineralization of the femoral head and articular cartilage of the femur in patients with primary avascular necrosis (AVN). The study included the femoral heads of nine patients with AVN, aged between 30 and 68 years. The surgical specimens of femoral heads were obtained during the procedure of hip replacement. The measurements […]
June 21, 2022

Does the inclination angle really matter? Evaluation of short-stem hip arthroplasty with different articulations based on selected radiological parameters

Introduction. With this increasing number of total hip arthroplasties, problems with the finite lifespan of the implants used become more and more critical. The proper functioning of a hip prosthesis depends on numerous factors. Among the most important are the type of joint surface used and the correct orientation of the endoprosthesis components. Material and methods. The study group consisted of patients […]
June 21, 2022

Reconstruction eff ectiveness of long standing injuries of anterior talo-fi bular ligament

Introduction: Ankle sprains are among the most common injuries during sport and daily activities. They predominantly involve ankle lateral complex injuries, especially anterior talo-fi bular ligament. If miss-diagnosed, they can lead to chronic instability of the joint, followed by osteoarthritis and the disturbance of the proper mobility of the knee and hip joints. Aim: The evaluation of the foot functioning during daily […]
June 21, 2022

C-reactive protein levels as a cardiovascular risk factor in patients with and without periodontal disease who are undergoing hip and/or knee arthroplasty

Introduction. A number of diseases, including coronary artery disease are now considered as chronic low-grade inflammatory conditions. Their progression is accelerated by other underlying infectious conditions, including periodontal disease. The aim of the study was to assess if periodontal disease is associated with an increased concentration of inflammatory biomarkers in patients scheduled for joint replacement, who represent a group at elevated cardiovascular risk. […]
June 21, 2022

Analysis of complications resulting from femoral neck fracture treatment using Targon FN system

The study was aimed to assess the outcomes of the operative procedure applied in the patients with the femoral neck fracture, treated with the Targon FN system, manufactured by Aesculap, and identify relationships between the outcome of treatment of the femoral neck fracture, patient’s body mass, length of the period between the moment of injury and surgery, age of patient, prescribed medications. […]
June 21, 2022

Management and results in 16 cases of periprosthetic fracture and infection after hip and knee arthroplasty. Experience in 2005-2015

Introduction. Periprosthetic fracture (PPF) with periprosthetic joint infection (PJI) is a serious complication of both total hip replacement (THR) and total knee artthoplasty (TKA). Materials and methods. Results were evaluated in 16 patients (17 prostheses) aged 35-82 years, operated due to infection and fracture after THR (8) and TKA (9). Observation period 3-13 years (average 6.5 years). Etiology of infection: S. aureus […]
June 21, 2022

Bicompartmental locked bucket-handle tears of menisci concealing the concomitant anterior cruciate ligament injury for 2 years – case report

Locked bucket-handle tears of both medial and lateral menisci, called in the literature “Jack and Jill lesion”, with simultaneous anterior cruciate ligament (ACL) injury are an extremely rare phenomenon. It is highly differentiated in the field of trauma mechanism, treatment options and postoperative care. This is the first described case when a bicompartmental locked bucket-handle tears of menisci masked a torn ACL […]
June 21, 2022

Fasciocutaneous cross leg flap combined with stabilization of lower extremities with Ilizarov fixator as a effective salvage procedure for treatment of soft tissue defects with infection and exposure of tibia – case report

Chronic active tibia osteomyelitis accompanied by soft tissue defects with exposed bone, infected pseudoarthrosis or pathological fractures are a reconstructive challenge to the orthopedic surgeon. We present a case of a 68 year-old patient with chronic tibia osteomyelitis associated with a wound exposing tibia diaphysis. The successful local debridement and reaming of a tibia followed by local antibiotic delivery and cross-leg flap […]
June 21, 2022

Prophylaxis and treatment of heterotopic ossifications after total hip arthroplasty – contemporary view and proposition of the algorithm

Heterotopic ossification (HO) is the abnormal formation of mature bone in extraskeletal soft tissues, which may commonly occur after Total Hip Arthroplasty (THA). Despite the high incidence of HO and multiple clinical studies examining the phenomenon, the pathophysiology and etiology of HO remain unclear. In advanced cases, HO may significantly decrease results of surgery by impairing range of motion in joint and […]
June 21, 2022

An attempt to explain the causes of hip development normalization in children with developmental dislocation, whose parents discontinued non-surgical treatment

Despite the discontinuation of non-surgical treatment of children with DDH, the development of the hip after a few years or a decade or so turned out to be correct in about 50% of the subjects. The authors present examples and analyze the reasons for effective stimulation of the acetabulum roof and proximal femoral roof growth zones in these children. They emphasize that […]
June 21, 2022

Remarks on the etiopathogenesis and diagnosis in Osgood-Schlatter and Sever-Haglund diseases based on the Doppler ultrasound of apophyses

Assuming the mechanical significance of injuries in the etiopathogenesis of Osgood-Schlatter and Sever-Haglund diseases, it should be recognized that the areas susceptible to damage in growing apophyses are the growth zones and the newly formed bone. The SMI Doppler ultrasound (visualization of microvascular flows) helps to determine the precise location of the lesion, i.e. the area of the greater vascular microflow within […]
June 21, 2022

Femur lengthening with a telescopic ISKD nail – long-term clinical and radiological results

Introduction. Among various modern systems of limb lengthening, lengthening with an intramedullary nail seems to be most modern and comfortable for the patient. The aim of this study was to evaluate the femur lengthening with a self-distracting intramedullary skeletal kinetic distractor (ISKD). Material and methods. This is a retrospective study, conducted in one hospital and involved 10 patients with a mean […]
June 21, 2022

Periprosthetic distal femoral fracture after total knee arthroplasty – case report

Periprosthetic fractures are uncommon complications after primary total knee arthroplasties (TKA). We present a case report of 65-year-old woman with periprosthetic fracture of the femur, 7 years after TKA. The patient was operated due to gonarthrosis. Because of proper endoprothesis components fi xation, open reposition and internal stabilization of the fracture was performed. Patient was re-operated twice. First time because of the […]
June 21, 2022

“Frozen hip” – rare cause of lack of motion of the hip. Literature review

The term frozen hip rarely appears in literature. The reason for this situation is the diffi culty of the diagnosis, the rarity of the disease, and non-specifi c course of illness. Classic X-ray may not show any signifi cant pathology. One of the most eff ective methods of diagnosis is arthrography [1]. Because of the insidious nature of the disease, it may […]
June 21, 2022

Results of treatment of pertrochanteric femoral fractures with DHS sliding plate in patients treated at Orthopedic and Traumatology Department in Lublin in the years 2005-2012

Introduction: Pertrochanteric femoral fractures are one of the most common injuries especially among elderly patients. Operative treatment with the use of adequate fi xation gives a chance for rapid recovery and decrease of complications of prolonged immobilization. Aim: The aim of the study is presentation of the results of treatment of pertrochanteric fractures with the use of DHS sliding plate. Material […]
June 21, 2022

Dislocation of the knee – mechanisms, complications

Introduction: Dislocations of the knee constitute 0.02-0.2% of all orthopedic injuries. Statistically, they are four times more common in men than in women. They often undergo spontaneous reposition. Quite often they are connected with severe vascular and nervous complications. Aim: The aim of this study is to determine the mechanisms of dislocation of the knee, their impact on early treatment procedure […]
June 21, 2022

Epidemiology, morphology and treatment’s features of the talus fractures in own material

Introduction: In the orthopaedic literature, the problem of the talus fractures is rarely drawn out and publications include material analyzing no more than 15-20 patients. Objective: The aim of this study is to present the epidemiology, mechanisms of injury, and the morphology of the talus fractures in patients hospitalized in the Department of Orthopaedics and Traumatology at the Medical University of Lublin. […]
June 21, 2022

The eff ectiveness of treatment of injury of the Achilles tendon

Introduction: Injuries of Achilles tendon are among the most common injuries of tendon structures in human body. During recent years there were a lot of publications describing prospective clinical trials and dealing with the topics of diagnostics, treatment and post-operation aftercare in Achilles tendon. Meanwhile there are a few information about at least a mid- or long-term results about treatment of Achilles […]
June 21, 2022

Pathological femoral shaft fracture in a patient with a history of lobular carcinoma treated with bisphosphonates. A surgical approach

Pathological fracture of the femur accounts for as much as 45.5% of all pathological fractures [1,2,3]. There is a number of surgical approaches to such trauma: resection arthroplasty or fracture reposition, intramedullary nailing fixation or plate fixation using angular stable screws [4-15]. First of all, a patient with pathological femoral shaft fracture should be early recognized and treated with a minimally invasive […]
June 21, 2022

Comminuted calcaneal fracture with avulsion of Achilles insertion treated with the use of intramedullary nailing in the modified original method

Calcaneal fracture has always posed a diagnostic and therapeutic problem. A thorough knowledge of the morphology of fracture, correct time to begin treatment and minimally-invasive surgery that allows for early physical mobilization of the operated limb are of critical importance in the treatment of calcaneal fractures. We operated a male patient with a high-impact injury with the use of a low-invasive, our […]
June 21, 2022

Results and observations in operative treatment of displaced intra- articular calcaneal fractures with use of Calcanail®

Introduction. Since the introduction of the Calcanail® in 2011 more and more surgeons have been treating calcaneal fractures with use of this method. It is mainly because of its safety concerning wound healing and final outcomes comparable to ORIF. This paper is to show the intraoperative problems the surgeon may encounter beginning with this method as well as final results in comparison […]
June 21, 2022

The role of hyaluronic acid in the treatment of early knee osteoarthritis

Osteoarthritis is a chronic degenerative process, including the destruction of articular cartilage. The progressive nature of the disease impairs motor function, which in combination with the pains leading to a signifi cant deterioration in the quality of life. Current methods of treatment of osteoarthritis cover a wide spectrum, ranging from patient education and elimination of risk factors, through drug therapy, physical therapy […]
June 21, 2022

Adenocarcinoma of the lung versus synovial sarcoma – metastatic tumor imitating primal tumor of the knee joint – case report

The knee joint is an area of appearance of primary bone tumors, soft tissue tumors and metastasis. The one of the most frequent primary tumor, that is giving metastasis to the knee joint, is a lung cancer. Synovial sarcoma is a tumor that origins from the mesenchymal tissue. The majority of the synovial sarcomas are located in the extremities, with two-thirds being […]
June 21, 2022

The impact of an underlying inflammatory disease on the cardiovascular risk of hip or knee replacement patients

Introduction. Hip or knee replacement operations are associated with a significant periprocedural risk. This risk can be further aggravated by some underlying conditions such as inflammatory diseases. Aim. The aim of the study was to establish the prevalence of cardiovascular risk factors in hip and/or knee replacement patients according to the prevalence of an inflammatory disease. Material and methods. The study included […]
June 21, 2022

Functional and psychological evaluation of patients enrolled into total knee arthroplasty and its effect on the treatment outcome – preliminary reports

Introduction. In knee osteoarthritis, the treatment of choice is knee arthroplasty. The primary indication to perform TKA – Total Knee Arthroplasty is pain preventing the functioning of the patient. Aim. The main aim of this study was the assessment of the effects of knee osteoarthritis treatment of patients undergoing arthroplasty and the influence of psychological and physical factors in predicting pain and […]
June 21, 2022

An analysis of the longitudinal arch of the foot in children by measurements under static and dynamic conditions

Introduction. The human foot is an essential static and dynamic element of the biomechanical chain of the lower extremity. On the one hand, it provides support, on the other hand, it is a driving mechanism facilitating locomotion. While there are many different methods for evaluating the arches of the foot, a unified examination strategy is still lacking. Aim. The aim of the […]
June 21, 2022

Fatigue fracture of both branches of the left pubic bone and ischium with co-existing damage of labrum of hip joint and pars fracture L5 in a long-distance athlete – a case report

Fatigue fractures of the pelvis are significant diagnostic problem due to their rare occurrence. The specificity of these fractures requires proper imaging diagnostics in order to make final diagnosis and to implement appropriate treatment. The work presents a case report and diagnostic-therapeutic procedure in a 28-year-old long-distance athlete with a fatigue fracture in the pelvic region, accompanied by damage to the labrum […]
June 21, 2022

Long-standing extracapsular fracture of the femoral neck: arthroplasty or fixation? Case report

Extracapsular fracture of the femoral neck requires reposition and stabilization with the use of metal systems. What type of surgery should be performed in the event of a long-standing fracture and when it should be qualified as a long-standing fracture are the questions to which no explicit answers have been found so far. We operated a female patient with such fracture, after […]
June 21, 2022

Impending atypical femoral fractures due to prolong bisphosphonate use – case report and literature review

We present a case of 78 year old female, who was treated orally with ibandronic acid. It is widely accepted drug, used in osteoporosis treatment. After several months, she started to suffer because of thigh pain. She was diagnosed with impending atypical femoral fracture after following diagnostic protocol. Immediate discontinuation of further drug use and limited weight bearing on affected extremity, led […]
June 21, 2022

Cementless neck preserving arthroplasty should be the treatment of choice in cases of coxarthrosis in middle-aged men: very good results in a mid-term follow-up study with NANOS stem and Verilast articulation

Introduction. The positive long-term outcomes of total hip replacements (THR) largely depend on the choice of joint articulation type, stem type, but also on the proper qualification of the patients. Material and methods. The study group comprised of 106 operated between 2009 and 2011. The inclusion criteria were: men, aged between 45 and 65 years at the time of surgery, received a […]
June 21, 2022

Evaluation of open repair of Achilles tendon traumatic injury with the use of Kessler’s suture

Introduction: A traumatic injury of the Achilles tendon occurs due to excessive and also occasional physical activity. This kind of injury results from inadequate preparation for physical activity. One of numerous treatment therapies includes a surgical reconstruction of the tendon with the Kessler’s suture. Aim of study: The aim of the study was to evaluate eff ects of surgical repair of […]
June 21, 2022

Clinical logistic regression analysis of the biomechanics of osteosynthesis dynamization in the treatment of pseudarthrosis in infected long bones

Introduction: The study presents a retrospective analysis of the treatment of infected pseudarthrosis in the material of the Bone and Joint Infection Department, Orthopedic Clinic of Centre of Postgraduate Medical Education in Otwock, over 3 years with the minimum clinical follow up of 2 years. Research hypothesis: The hypothesis related to identifi cation of biologically and biomechanically relevant elements of the […]
June 21, 2022

Analysis of the morphology of intraoperative periprosthetic femoral fractures as complications of primary hip arthroplasty, with particular focus on dysplastic coxarthrosis

Intraoperative periprosthetic femoral fractures accompanying hip arthroplasty pose a material problem in surgical practice. Due to a scant number of reports in available literature, we decided to assess their characteristics in a group of patients with symptomatic degenerative changes of the hip in the course of developmental dysplasia of that joint. To this aim, we performed retrospective analysis of descriptive and radiological […]
June 21, 2022

Periprosthetic infections – pathogenesis and diagnostics principles. A systematic review

Along with the increase in life expectancy of society and striving to retain maximal body condition despite of degenerative changes, we observe continuously growing number of large joint replacements due to indications impairing organism’s condition [1,2]. The proportion of infective complications after these procedures amounts to 1-2% [3]. There is many classifi cations simplifying the management and preliminary stating of pathogenesis in cases […]
June 21, 2022

Bone remodelling in proximal femur after Metha stem implantation – DEXA study

Introduction: Number of studies showed the high eff ectiveness of methaphyseal stem implantation in total hip replacement (THR) procedures. This good results inspires us to evaluate the bone behaviour around the methaphyseal stem (METHA Aesculap,Germany) after its implantation. Aim of study: An evaluation of early bone remodelling process around Metha stem during the fi rst months after THR. Material and methods: […]
June 21, 2022

Symptomatology and diagnosis. Patellofemoral pain

Patellofemoral joint (PFJ) and it’s coexisting disorders are an essential clinical problem for orthopaedic surgeons. Literature is lacking of general population epidemiological studies that could confi rm an incidence rate of patellofemoral pain syndrome. Available studies are most often taken on a precise group of sport participants. In literature it is written that complaints coming from an anterior aspect of the knee […]
June 21, 2022

Early term results of usage combined hyaluronic acid and platelet rich plasma in knee osteoarthritis

Introduction: Knee is one of the most common locations of degenerative changes. Various attempts of conservative therapy are undertaken to inhibit progression of the disease and delay the requirement for surgical treatment. One such attempt involves simultaneous injections of hyaluronic acid in combination with platelet rich plasma. Combination of these therapies may have an additive effect and lead to an improvement in […]
June 21, 2022

Results of the Fitmore short-stem total hip arthroplasty at a minimum follow-up of 4 years

Introduction: The use of short stem implants is associated with higher incidence of complications such as stem malpositioning and early implant migration. So far a few studies have addressed the question of the effects of varus short stem alignment. The objective of this study was to evaluate the migration pattern of short stem implant and the influence of stem malpositioning on implant […]
June 21, 2022

Patient with a fracture of the proximal end of the femur in an urban hospital

Proximal femur fractures present a serious social problem and an immense challenge for doctors, nurses and the entire health care system engaged in the treatment process. Patients suffering from this kind of fracture comprised the greatest group among all trauma patients treated surgically in our ward. Consequently, we not only conducted an epidemiological analysis of the tested group of patients and an […]
June 21, 2022

Developmental dislocation of hip treated in the years 1980-2014 in Pediatric Orthopedic Department of the Medical University in Lublin

Introduction: Developmental dysplasia of hip is one of the most common deformities of the movement apparatus in children of the Caucasian race. Aim: Statistical analysis of hospital admittances of children with developmental dislocation of hip (DDH) treated in the years 1980-2014 in Pediatric Orthopedic Department of the Medical University in Lublin. Material and Method: A retrospective study of clinical histories was […]
June 21, 2022

Biosimilar enoxaparin sodium versus the reference medicinal product Clexane – the results of the phase III comparative clinical trial in patients undergoing high venous thromboembolism (VTE) risk knee surgery

This article presents the results of the clinical study, in which the biosimilar enoxaparin sodium was compared to the reference product Clexane in terms of its safety in patients undergoing high venous thromboembolism (VTE) risk knee surgery. This was a multicentre, parallel group, open label, randomised, controlled non-inferiority study conducted at 14 clinical sites in Poland. Adult, male and female patients, scheduled […]
June 21, 2022

Evaluation of the outcomes of cementless metaphyseal hip arthroplasty in the treatment of hip osteoarthritis depending on the type of articulation used in a mid-term follow-up

Osteoarthritis is one of the most prevalent diseases of the locomotor system. Because of its increasing morbidity leading to more and more hip arthroplasty interventions the new types of articulation were developed. The purpose of the study was to evaluate the results of cementless hip arthroplasty depending on the type of the articulation used in patients of the Men’s Department of the […]
June 21, 2022

The use of reamer-irrigator-aspirator and bone-cementcoated intramedullary nails in treatment of long bones’ infection after fractures fi xated intramedullary

Introduction: with the increase in the number of fractures treated operatively, the number of infectious complications, unfortunately, increases as well. In case of diagnosed infection after intramedullary fi xation general “golden standard” is debridement of the infection area and then external fi xation. Aim: the assessment of eff ectiveness of the alternative method – reamer-irrigator-aspirator and intramedullary nail application in treatment […]
June 21, 2022

Knee arthroplasty in a patient with severe haemophilia A with inhibitors – a case report

Haemophilia A (HA) is a genetic disease characterized by defi ciency or defect of VIII plasma factor (fVIII). Standard treatment using purifi ed plasma-derived or recombinant fVIII concentrates may develop inhibitory antibodies against fVIII. Patients with severe disease suff er from frequent bleedings into joints which causes synovial proliferation, chronic synovitis, as well as cartilage and bone destruction. Severe haemophilic knee arthropathy […]
June 21, 2022

Quality of life after pertrochanteric femoral fractures treated DHS plate and intramedullary gamma nail

Background: Usually for treatment of pertrochanteric femoral fractures use DHS plate and intramedullary gamma nails, are a popular method of stabilizing proximal femoral fractures due to low risk of postoperative complications and rapid improvement in joint function. The evaluation of outcomes associated with pertrochanteric treatment has mainly been based on objective measures. Objectives: Based on a review of current literature the purpose of […]
June 21, 2022

Analysis of the results of a randomized clinical trial on justification of suction drainage in primary total hip arthroplasty

Introduction. Since the 1980s, suction drainage has been used as a common practice after primary total hip arthroplasty (THA) in Poland. Multiple recent studies contest the use of suction drainage after THA. Aim. The present study aims at analysis of legitimacy of the use of suction drainage after THA in a randomized controlled clinical trial. Materials and methods. Patients treated at the Endoprosthesoplasty […]
June 21, 2022

Proximal femoral fracture in the elderly and the withholding of informed consent to surgery. How to give the optimal treatment in accordance with the law?

Proximal femoral fractures (PFF), especially neck-of-femur fractures (NOF), are common injuries reported in the daily activities of trauma and orthopaedics departments in Poland and abroad. In order to minimise the risk of death and serious complications it is necessary to focus as much as possible on the early and optimal preparation of the patient for the surgical procedure. From the legal point […]
June 21, 2022

Manual modeling of the antibiotic loaded spacer with patients undergoing a two-stage procedure of total hip joint replacement

Two-stage reimplantation of hip joint endoprosthesis is a recognised procedure in treatment of prosthesis-related infections of hip joint. In the thesis, the authors present a simple technique of manual modeling of the spacer taking into account the shape of a bone site after removal of the endoprosthesis considering the required orientation of the spacer and the joint congruence.
June 21, 2022

Total hip replacement vs femoral neck osteotomy in the treatment of heterotopic ossifi cations, neurogenic in the IV degree by scale Brooker – comparison of treatment results

Introduction: A phenomenon of heterotopic ossifi cation (HO)is a complex process which involves many factors that aff ect each other. It consists in the formation of bone tissue in the locations where such tissue does not physiologically exist. Heterotopic ossifi cation can appear as a result of various injuries, such as burns, postoperative wounds or injuries after an explosion. One of the […]
June 21, 2022

Prospective analysis of application of a local anesthesia of the ropivacaine and epinephrine during total knee arthroplasty

Introduction: Excessive postoperative pain after total knee arthroplasty is not only a patient’s distress but also can lead to negative postoperative recovery.  Objectives: The aim of the study was a prospective, randomized evaluation of the use of intraoperative local anesthetic of the ropivacaine and epinephrine during total knee arthroplasty. Methods: A group of 74 patients scheduled for knee replacement surgery was […]
June 21, 2022

Periprosthetic femur fractures after surgery in clinical material

Introduction: Periprosthetic femur fractures after surgery account for 0.1-4%, and after revision – for 1.8-7.3% of THA complications. The diagnosis is usually not difficult. Risk factors: age, female, osteopenia, revision THA, endoprosthesis loosening, long time (over 10 years) after primary operation. Aim: In this work we present the methods of classification and treatment of post-surgery periprosthetic femur fracture based on the clinical […]
June 21, 2022

The use of the GMRS resection prosthesis in the treatment of infectious complications of primary total knee replacement

Periprosthetic joint infection (PJI) is a rare and difficult to treat complication of total knee arthroplasty. It may lead to serious consequences like prolonged hospitalization, slowdown of postoperative physical improvement, prolonged time for full recovery, limitation of joint function and amputation. It is also a serious clinical problem and economical burden. The final success in PJI treatment requires surgical experience, humility and […]