Tibial tuberosity fractures are rare in childhood, most frequently due to excessive quadriceps muscle contraction. On performing long jump, a 15-year-old boy sustained tibial tuberosity avulsion ...fracture type II according to Watson-Jones. The patient was treated operatively with fragment repositioning and screw fixation. Ten months after the injury and rehabilitation, he resumed his sports activities with full range knee motion.
The aim of this research was to determine if the age of healthy subjects older than 40 years of age has an influence on the concentration of β2‐microglobulin in the serum of subjects of different ...populations. We examined the values of β2‐microglobulin in the serum of 51 healthy subjects aged 40–86 years using the microparticle enzyme immunoassay AxSYM β2‐microglobulin test. The reference values of β2‐microglobulin according to the nonparametric statistical method is 0.95–2.73 mg/L. A correlation was found between β2‐microglobulin and age: 40–50 years (0.94–1.54 mg/L), 51–65 years (0.96–2.62 mg/L), and >65 years (1.13–2.84 mg/L). There was no significant statistical difference of β2‐microglobulin between genders (P > 0.05); however, there was a statistically significant difference between the concentration of β2‐microglobulin and the subjects' age. (Spearman's rank correlation coefficient ρ = 0.66; P < 0.01). A direct correlation between age and the concentration of β2‐microglobulin was observed. This research is a contribution to determining reference values of β2‐microglobulin in subjects of different populations.
Revizijska artroplastika kuka s masivnim gubitkom kosti i zdjeličnim diskontinuitetom do sada nema standardizirani tretman. U radu je prikazan slučaj pacijentice kojoj je dijagnosticiran zdjelični ...diskontinuitet 4 godine nakon prethodne artroplastike kuka. Pacijentica boluje od reumatoidnog artritisa, a primljena je na bolničko liječenje zbog boli u kuku, skraćenja noge, ograničenja kretnja i nemogućnosti hoda. Učinjena je preoperativna rendgenska slika zdjelice s kukovima koja je pokazala zdjelični diskontinuitet, a intraoperativno je utvrđeno da se radi o tipu IV b, tj. diskontinuitetu udruženom s kavitarnim i segmentalnim defektom acetabuluma. Radi postizanja stabilne konstrukcije, kao bitnog preduvjeta za postizanje koštane konsolidacije, učinjena je osteosinteza stražnjeg nosača rekonstrukcijskom pločicom po A.O.-metodi, a nakon toga defekt je popunjen koštanim presadcima iz koštane banke. Ugrađena je adekvatna revizijska bescementna čašica, a vijcima se nastojala postići dobra fiksacija većih modeliranih koštanih presadaka te fiksacija čašice za preostali dio zdjelice. Time je postignuta dobra inicijalna stabilnost konstrukcije. Radi postizanja urašćivanja kosti i izbjegavanja mehaničkog neuspjeha preporučeno je rasterećenje u razdoblju od 3 do 6 mjeseci nakon operacije. Metodom rekonstrukcije koju smo primijenili dobili smo zadovoljavajući klinički rezultat nakon dvije godine praćenja, a radiološki nema znakova razlabavljenja konstrukcije pa se može govoriti o izlječenju diskontinuiteta.
Revision total hip arthroplasty with massive bone loss and pelivic discontinuity has no standardized treatment up until now. This report presents a case of a female patient with a diagnosed pelvic ...discontinuity 4 years after the previous hip arthroplasty. The patient is suffering from rheumatoid arthritis, and was admitted to hospital treatment for hip pain, leg shortening, limitated range of motion and the inability to walk. Pelvic discontinuity was identified in preoperative radiographs of the pelvic and hip region, and intraoperatively it was determined that it was a type IV b discontinuity according classifications for acetabular defects defined by AAOS, and subclassification of type IV according Berry et al., that is discontinuity associated with cavitary and segmental acetatabular bone loss. In the goal of achieveing a stable construction, as a vital prerequisite for achieving bone consolidation, an osteosynthesis of the posterior column was done with a reconstructive plate by A.O. method, and afterwards the defect was filed with bone transplants from the bone transplant bank. An adequate revision cementless cup was installed, and screws were used to achieve a good fixation of the bigger modeled bone transplants and the fixation of the cup for the remainder of the pelvis. By that method a good inicial stability of construction was achieved. In the goal of achieving bone ingrowth and avoidance of mechanical failure it was advised an avoidance of weight bearing in the period of 3-6 months after the operation. With the method of reconstruction we applied after 2 years of follow-up the cinical result was satisfactory, and radiologicaly there are no signs of construction loosening so it can be claimed that the discontinuity was cured.
Purpose
Prevention of the knee osteoarthritis following meniscectomy is implantation of an allotransplant or an artificial meniscus. We present retrospective study of our early results of the ...treatment using polyurethane meniscal scaffold.
Methods
From 2016 to 2020, we implanted nine polyurethane scaffolds (Actifit) after partial meniscectomy, five males and four females, age 36 (16–47), BMI 26.7 (17.2–35.9) kg/m
2
. Functional status, activity, pain, and MRI were assessed.
Results
FU 20.8 (6–48.5) months, 35.2 (0–68) months from the meniscectomy to the implantation. The average implant length was 46.1 (35–60) mm, average number of sutures was 7.6 (5–10). Lysholm score before surgery was 61.7 (49–85), after the surgery 86.4 (62–95) with
p
0.0045, Tegner activity score before meniscectomy was 5.8 (4–7), after 3.8 (2–5), and after the scaffold implantation 4.6 (3–7) with
p
0.0488. Before surgery, VAS score was 3.1 (2–4), and after 7.7 (5–9) with
p
0.0042.
Pursuant to the Genovese classification, the last follow-up MRI showed a type 2 meniscal morphology in four cases and a type 3 in five cases. Seven patients had type 1 and two had type 2 signal intensity. On average, the absolute extrusion of a transplanted meniscus was 3.67 mm, and the relative extrusion was 0.58 mm. Extrusion progress was not detected.
Conclusion
Significantly improved knee functionality, increased level of physical activity, and reduced pain. MRI analysis revealed the meniscal transplant morphology and volume loss, as well as its extrusion without progression.
In patients with chronic renal failure, many complications may develop that involve all organ systems, especially the locomotor system. Spontaneous concurrent bilateral rupture of the quadriceps ...tendons is a very rare complication in patients with chronic renal failure, usually occurring in patients under 50 years of age. Although there are numerous causes that lead to tendon weakness and rupture, most authors agree that secondary hyperparathyroidism plays a major role in the pathogenesis of tendon rupture. Soft tissue and perivascular calcifications, diminished local circulation, reduced tendon elasticity, impaired collagen metabolism, nerve lesions, repeated trauma, and articular swelling contribute to tendon weakness and rupture. A patient is presented in whom spontaneous concurrent bilateral quadriceps tendon rupture occurred at the age of 34, after seven years of hemodialysis therapy. Timely diagnosis and operative management with primary tendon suturing followed by physiotherapy produced a good anatomical and functional result.
Abstract
The aim of this research was to determine if the age of healthy subjects older than 40 years of age has an influence on the concentration of β
2
‐microglobulin in the serum of subjects of ...different populations. We examined the values of β
2
‐microglobulin in the serum of 51 healthy subjects aged 40–86 years using the microparticle enzyme immunoassay AxSYM β
2
‐microglobulin test. The reference values of β
2
‐microglobulin according to the nonparametric statistical method is 0.95–2.73 mg/L. A correlation was found between β
2
‐microglobulin and age: 40–50 years (0.94–1.54 mg/L), 51–65 years (0.96–2.62 mg/L), and >65 years (1.13–2.84 mg/L). There was no significant statistical difference of β
2
‐microglobulin between genders (
P
> 0.05); however, there was a statistically significant difference between the concentration of β
2
‐microglobulin and the subjects' age. (Spearman's rank correlation coefficient ρ = 0.66;
P
< 0.01). A direct correlation between age and the concentration of β
2
‐microglobulin was observed. This research is a contribution to determining reference values of β
2
‐microglobulin in subjects of different populations.
Acute patellar dislocation is a common injury in young athletes, which occurs due to inappropriate biomechanical relations and anatomic deviations in the area of knee joint. In these unfavorable ...conditions, abrupt and vigorous strain of the quadriceps muscle of the thigh may result in lateral patellar dislocation. A case is presented of a young male athlete with acute patellar dislocation and consequential osteochondral fracture. Although x-ray showed normal knee finding, typical history, clinical examination and magnetic resonance image of the knee indicated arthroscopy, which confirmed the diagnosis ofpatellar dislocation. The osteochondral fragment was found and fastened by screws, thus reconstructing the articular surface of the patella. Medial patellar stabilizers were strengthened and lateral stabilizers loosened, thus re-establishing its anatomic slide way. On second-look operation, the screws were removed. In this case, good anatomic and functional outcome was achieved by timely operative treatment, joint surface reconstruction and rehabilitation.
Akutna luksacija ivera ozljeda je mladih sportaša i posljedica je nepovoljnih biomehaničkih odnosa, kao i anatomskih odstupanja u području koljenskog zgloba. U tim nepovoljnim okolnostima naglim i ...snažnim napinjanjem četveroglavog mišića natkoljenice može doći do lateralne luksacije ivera. Prikazali smo slučaj mladog muškarca s akutnom luksacijom ivera te posljedičnim koštano-hrskavičnim prijelomom. Iako je rendgenska slika pokazala uredan nalaz koljena, tipična anamneza, klinički pregled i MR koljena pretrage su kojima se postavlja dijagnoza, a onda je dijagnoza ozljede indikacija za operacijsko ili konzervativno liječenje. Artroskopski je potvrđena dijagnoza, pronađen je koštano-hrskavični ulomak i učvršćen vijcima te tako učinjena rekonstrukcija zglobne površine ivera. Pojačani su medijalni, a opušteni lateralni stabilizatori ivera i uspostavljen je njegov anatomski klizni put. Drugim kirurškim zahvatom učinjen je »second look« te su izvađeni vijci. Pravodobnim operativnim liječenjem, rekonstrukcijom zglobne plohe i provedenom rehabilitacijom postigli smo dobar anatomski i funkcionalni rezultat.
