Ugradnja totalne endoproteze koljena već je više od 50 godina standardni operativni
postupak liječenja terminalnog stadija artroze koljena. Najčešći operativni pristup koji se koristi
za ugradnju ...totalne endoproteze koljena je medijalni parapatelarni pristup. Medijalni parapatelarni
pristup ima mnogo prednosti, no glavni mu je nedostatak dezinsercija hvatišta m.
vastus medialis s njegova hvatišta na pateli. U pokušaju da se izbjegne oštećenje muskulature
pri ugradnji totalne proteze koljena razvilo se nekoliko pristupa koji imaju cilj omogućiti preglednost
operativnog polja kao i standardni medijalni parapatelarni pristup, ali bez dezinsercije
hvatišta m. vastus medialis. U ovom članku navode se vrste pristupa na koljeno koji se smatraju
minimalno invazivnima, no jedino se kod subvastus pristupa u potpunosti čuva
muskulatura koljena pri ugradnji totalne endoproteze koljena. Kod subvastus pristupa vastus
medialis se tupo odmakne, a njegovo hvatište na pateli ostaje u potpunosti očuvano. Naglašavamo
da stupanj invazivnosti pristupa ne određuje dužina kožnog reza već mogućnost minimalnog
oštećenja muskulature. U članku se prikazuje detaljan opis subvastus pristupa na koljeno
pri ugradnji totalne endoproteze.
Using ultrasound in evaluation of infant's hip development can reduce surgical procedures, hospitalization and late presentation of developmental dysplasia of the hip (DDH). The increasing incidence ...of DDH after ultrasound examination is observed and published by many authors. In a prospective study, radiograph of every single ultrasonographic positive hip in infants older than three months, was taken and analyzed in order to see whether it affects infants splintage rate in treating DDH. In a period of 30 months, clinical and simple static ultrasonographic examinations according to Graf were performed on 1430 consecutive infant hips in patients aged between 4 and 6 months. Sonographic positive hips were radiographed and acetabular index (AI) values on simple AP radiographs were analyzed. The sonographic DDH incidence was 51.75 per 1000 hips (51.75 per thousand). After X-ray examination of all 74 ultrasonographic positive hips, only 44 remained abnormal and required treatment indicating a true DDH incidence of 30.77 per 1000 hips (30.77 per thousand). The difference in incidence per ultrasonographic and X-ray positive hips is statistically significant p < 0.01 (t = 5,536). The rational approach in detection of DDH in a child more than 3 months old is to do radiographic assessment of every sonographic positive hip.
This study evaluated a new tibial torsiometer that is universally applicable to all limb sizes and requires no special training, jigs, or radiographic equipment. To compare the reliability of ...measurements obtained with the torsiometer, 160 tibias were evaluated with both the torsiometer and computed tomography. Results for both methods were identical in 51 tibias, within 1 degrees in 66 tibias, and within 2 degrees in 43 tibias. The difference between the two methods was not significantly different. No significant differences were found among examiners. This device should prove to be useful for the quantification of tibial torsion.
Purpose
The aim of the present study was to examine the acute effects of graded physiological strain on soccer kicking performance.
Methods
Twenty-eight semi-professional soccer players completed ...both experimental and control procedure. The experimental protocol incorporated repeated shooting trials combined with a progressive discontinuous maximal shuttle-run intervention. The initial running velocity was 8 km/h and increasing for 1 km/h every 3 min until exhaustion. The control protocol comprised only eight subsequent shooting trials. The soccer-specific kicking accuracy (KA; average distance from the ball-entry point to the goal center), kicking velocity (KV), and kicking quality (KQ; kicking accuracy divided by the time elapsed from hitting the ball to the point of entry) were evaluated via reproducible and valid test over five individually determined exercise intensity zones.
Results
Compared with baseline or exercise at intensities below the second lactate threshold (LT
2
), physiological exertion above the LT
2
(blood lactate > 4 mmol/L) resulted in meaningful decrease in KA (11–13 %;
p
< 0.05), KV (3–4 %;
p
< 0.05), and overall KQ (13–15 %;
p
< 0.01). The light and moderate-intensity exercise below the LT
2
had no significant effect on soccer kicking performance.
Conclusions
The results suggest that high-intensity physiological exertion above the player’s LT
2
impairs soccer kicking performance. In contrast, light to moderate physiological stress appears to be neither harmful nor beneficial for kicking performance.
Full text
Available for:
EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
There are only a few reported cases of synovial chondromatosis affecting pisotriquetral joint (PT). Osteoarthritis of the PT is also rare and can be as disabling as osteoarthritis of any other joint. ...We report this to be the unique case of synovial chondromatosis of the PT joint with secondary osteoarthritis.
Highlights • The physiological load influences balance. • The static balance and dynamic balance are both affected. • Already at the intensity 60–65% of HRmax the significant decrease of balance ...abilities happens. • Above the anaerobic threshold the additional decrease in balance occurs.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Purpose
As the blood loss after the total knee arthroplasty (TKA) is not only a potentially serious medical problem but also an economical concern, the purpose of the study was to investigate the ...effectiveness of different combinations of knee positioning and the applied wound dressings on blood saving after TKA.
Methods
A randomized controlled trial including 147 TKA-operated patients was conducted. The subjects were assigned to one of the four groups; Group 1—controls, Group 2—flexion, Group 3—flexion and compression, Group 4—compression. The main outcome measures of the study were the blood loss volumes during the procedure and in the intensive care rooms and the decreases in haemoglobin, haemotocrit and red blood cells on the first and the second postoperative day.
Results
The MANOVA results showed no differences between the groups in any of the observed parameters. The post-hoc comparisons of the each group to the control group also revealed no influence of any of the proposed blood saving techniques on the actual blood loss.
Conclusion
No significant differences among the four proposed blood saving methods were determined.
Full text
Available for:
EMUNI, FSPLJ, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, SBNM, UL, UM, UPUK
19.
Ultrasound-assisted calcaneoplasty Madarevic, Tomislav; Rakovac, Ivan; Ruzic, Lana ...
Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA,
09/2014, Volume:
22, Issue:
9
Journal Article
Peer reviewed
Purpose
The endoscopic technique for resection of a postero-superior part of calcaneus served as a golden standard during the last 10 years, and it has mostly replaced the open techniques. In an ...effort to reduce the morbidity and the recovery time, we had introduced the ultrasound-assisted technique.
Methods
In the period of 1 year, 15 patients with the prominent postero-superior part of calcaneus and retrocalcaneal bursitis were operated through the single skin incision using the ultrasound-assisted technique. The prominent part of calcaneus was resected with a bone abrader under the ultrasound control to the point when there was no impingement between Achilles tendon and calcaneus in maximal dorsal flexion. The patients were evaluated preoperatively and postoperatively with the AOFAS score and Ogilvie-Harris score. The strength test of the muscle triceps surae, as well as the proprioceptive test, was also undertaken.
Results
Initially, the follow-up was meant to last 6 months, but there were no differences in results between 6 weeks and 3 months postoperatively, so it was concluded that the 3-month follow-up is sufficient and relevant. All 15 patients were available for follow-up. All measured variables significantly improved (AOFAS, Ogilvie-Harris), and all the patients were satisfied with the postoperative result. Only one minor complication occurred: superficial infection.
Conclusion
The ultrasound-assisted calcaneoplasty enables a precise resection of the postero-superior part of calcaneus and removal of the retrocalcaneal impingement. This method could become clinically relevant as it enables effective treatment of Haglund deformity, and results of this study presented rapid functional recovery.
Level of evidence
Case series with no comparison group, Level IV.
Intra-articular calcaneal fracture as a skiing injury in children is extremely rare. We report on what we believe is a unique and previously unreported mechanism of a skiing injury, which caused ...intra-articular calcaneal fracture in a young competing skier, a member of the Croatian national ski team. This 14-year-old boy sustained a heel injury while training for giant slalom. There was no fall on the heel or obvious axial force that could have caused this type of calcaneal fracture. The skier had sophisticated equipment and used carving skies. We speculated that, when the skier tried to establish the lost balance during the fall, a violent contraction of triceps muscle occurred. Instead of an injury of a well-protected tuber or Achilles tendon, the strong pulling force of the Achilles tendon was transmitted more distally and anteriorly, generating axial compression force, which caused an intra-articular fracture of the calcaneus bone. Obviously, the existing ski boot did not sufficiently protect the calcaneus bone. We postulate that the calcaneal tuber and Achilles tendon were protected on the expense of the intra-articular calcaneal fracture. Our case warns of the possibility of a serious foot injury in young top skiers in spite of extensive improvement in the ski equipment. Sophisticated carving skis could be a contributing factor to an injury.
