Measuring Improvement Following Total Hip and Knee Arthroplasty Using the SF-36 Health Survey

The aim of this study was to evaluate the impact of total hip or knee arthroplasty upon quality of life in elderly patients. The study was carried out at the Clinic for Orthopaedic Surgery Lovran on 74 total hip arthroplasty and 70 total knee arthroplasty patients. All patients had completed theMedical Outcomes Study 36-Item Short Form in the week having preceded their surgery and then again postoperatively, 2 years after. The data obtained were statistically processed at the level of physical function, role limitations due to physical problems, role limitations due to emotional problems, social function, mental health, energy or vitality, pain and general health perception, and change in health. The primary total hip arthroplasty patients showed significant improvement at all levels measured. Similarly, the primary total knee arthroplasty patients expressed significant improvement according to all the parameters but the mental health assessment. Comparison of outcomes between the two assessment groups of patients resulted in slightly superior quality of life outcomes in total hip arthroplasty patients. It can be concluded that total hip or knee arthroplasty significantly enhances the health related quality of life in elderly patients

Limb Salvage Surgery in Enneking’s Stage III a – A Case of Leiomyosarcoma

Limb saving surgery is today’s tendency in treating the musculoskeletal tumours. Preserving the limb should not only pursue a good oncological and functional result but also aim at good psychological outcome. Our aim was to treat a very rare case of proximal femoral leiomyosarcoma with present solitary lung metastasis by conservative operative procedures

Keller’s Arthroplasty with Proximal Metatarsal Opening Wedge Osteotomy in Treating Severe Hallux Valgus Deformity – Surgical Techniques and Case Report

The paper presents an operative technique proposed for treating severe Hallux Valgus deformity with arthrosis of the first metatarsal joint in elderly people. The procedure consists of the Keller’s arthroplasty in combination with basal osteotomy of the first metatarsal bone, whereby the head of the metatarsal is displaced laterally and plantarward. The osteotomy is fixed with a reconstructive plate. The results show a significant improvement in the hallux valgus angle, the first metatarsal angle, as well as in the plantar pressure distribution

Arthroscopic Removal of Metal Foreign Bodies from the Knee Joint after Explosive War Injuries

The results of arthroscopic removal of metallic fragments from knee joint due to explosive war injuries are presented. In period from 1991–1995 during war in Croatia we have operated 25 knee joints. Indications for arthroscopy were based on radiographic and clinical findings. The foreign bodies in the joint were found in 19 patients while additional 6 had foreign bodies in the periarticular soft tissues. Arthroscopies were performed on average one month after wounding. The foreign bodies were placed in different parts of the joint with no prediction sites. In 8 knees foreign bodies were freely mobile, and in 11 were anchored to different intraarticular structures. There were no complications during early postoperative period as well as in follow up period

Arthroscopic Removal of Metal Foreign Bodies from the Knee Joint after Explosive War Injuries

The results of arthroscopic removal of metallic fragments from knee joint due to explosive war injuries are presented. In period from 1991–1995 during war in Croatia we have operated 25 knee joints. Indications for arthroscopy were based on radiographic and clinical findings. The foreign bodies in the joint were found in 19 patients while additional 6 had foreign bodies in the periarticular soft tissues. Arthroscopies were performed on average one month after wounding. The foreign bodies were placed in different parts of the joint with no prediction sites. In 8 knees foreign bodies were freely mobile, and in 11 were anchored to different intraarticular structures. There were no complications during early postoperative period as well as in follow up period

Limb Salvage Surgery in Enneking’s Stage III a – A Case of Leiomyosarcoma

Limb saving surgery is today’s tendency in treating the musculoskeletal tumours. Preserving the limb should not only pursue a good oncological and functional result but also aim at good psychological outcome. Our aim was to treat a very rare case of proximal femoral leiomyosarcoma with present solitary lung metastasis by conservative operative procedures

Arthroscopic ankle arthrodesis

Cilj: Uznapredovala artroza gležnja kod koje se bol i smanjena pokretljivost zgloba ne poboljšavaju na konzervativnu terapiju predstavlja indikaciju za artrodezu gležnja. Cilj ovog rada bio je analizirati rezultate liječenja uznapredovale artroze gležnja artroskopskom artrodezom gležnja. Metode: U Klinici za ortopediju Lovran u razdoblju od 2000. do 2010. godine 8 bolesnika liječeno je artroskopskom artrodezom gležnja. Prosječna dob bolesnika bila je 55,5 godina. Kod svih bolesnika radilo se o artrozi četvrtog stupnja po Kellgren-Lawrenceovoj podjeli. Fiksacija mjesta artrodeze učinjena je u 6 bolesnika unutarnjom fiksacijom vijcima, dok je u 2 bolesnika korišten vanjski fiksator. Svi su bolesnici radiološki obrađeni prije i poslije operacijskog zahvata standardnim stojećim snimkama gležnja u dva smjera. Mjereni su tibiotalarni kutovi te je praćeno vrijeme zaraštavanja artrodeze zgloba. Rezultati: Radiološki su rezultati pokazali da je prosječni postoperacijski kut između anatomske uzdužne osi tibije i talusa bio na antero-posteriornim snimkama gležnja 93,85°, a na latero-lateralnim snimkama 107,5°. Koštano cijeljenje na mjestu artrodeze završeno je u razdoblju od 12 tjedana kod svih bolesnika. Zaključak: Dobiveni rezultati, iako analizirani na maloj skupini bolesnika, potvrđuju uspješnost primjene kirurške tehnike artroskopske artrodeze gležnja.Aim: End-stage ankle arthrosis with pain and contracted articulation not responding to conservative therapy procedures represents indication for ankle arthrodesis. This paper was aimed at analysing the outcome of end-stage ankle arthrosis treatment by way of arthroscopic ankle arthrodesis. Methods: The analysis dealt with 8 patients treated at the Clinic for orthopaedic surgery Lovran who underwent arthroscopic ankle arthrodeses in the period from 2000 to 2010. Their mean age was 55.5 years. All of them had sufferred from arthrosis grade four using the scale of Kellgren and Lawrence. At the point of arthrodesis, fixation was performed by means of internal screws in 6 patients and by external fixators in 2 patients. All of them were taken their ankle pre- and post-operation radiographs in standard standing positions in two directions. Their tibiotalar angles were measured and their arthrodesis time to union was followed up. Results: As the radiological results showed, the mean postoperative angle between the tibial and talar anatomical horizontal axes in the antero-posterior ankle radiographs was 93.85°, whereas the one in the latero-lateral radiographs was 107.5°. In all the patients the bone union was completed in 12 weeks. Conclusion: Notwithstanding the small sized group of followed-up patients, the results achieved have confirmed the efficiency of the arthroscopic ankle arthrodesis

The historical evolution of the modern minimally invasive hip arthroplasty

U ovom preglednom radu prikazan je povijesni razvoj suvremene endoprotetike kuka i minimalno invazivnih pristupa na kuk. Implantacijom suvremene, posebno prilagođene endoproteze kuka minimalno invazivnim pristupom omogućen je brži funkcionalni oporavak bolesnika.In this review article the historical evolution of the modern hip arthroplasty as well as minimally invasive hip approaches are described. The use of modern, specially adapted hip endoprothesis which is implanted by a minimally invasive approach, enables the faster functional recovery of the patients

Tibial tubercle avulsion fracture with concomitant reversibile foot paresis in adolescent

Cilj: Cilj rada bio je prikazati da i manje traume u adolescentno doba mogu uzrokovati avulziju tuberositasa tibije te ukazati na mogućnost nastanka kompartment sindroma. Prikaz slučaja: Kod dječaka u dobi od 15 godina pri promjeni smjera kretanja došlo je do avulzije tuberositasa tibije. Ozljeda je popraćena velikim edemom. Nakon operacije razvila se pareza peronealnog živca koja je uz medikamentoznu i fizikalnu terapiju regredirala u cijelosti. Zaključak: Pri sumjnji na avulziju tuberositasa tibije potrebna je žurna dijagnostika i liječenje. Zbog mogućeg nastanka sindroma kompartmenta potreban je pojačan nadzor u perioperacijskom periodu.Aim: to show that even a minor trauma could cause the tibial tubercle avulsion in adolescents and has a high risk of developing compartment syndrome. Case report: A boy aged 15 sustained tibial tubercle avulsion after a minor trauma. During the postoperative period the peronal paresis was observed which regressed on pharmaceutical and physical therapy. Conclusion: Early recognition and treatment of tibial tubercle avulsion is very important. Close monitoring during the perioperative period is recommended

Microfracture Technique in Combination with Intraarticular Hyaluronic Acid Injection in Articular Cartilage Defect Regeneration in Rabbit Model

Although articular hyaline cartilage typically has low potential for regeneration, numerous methods and techniques have been proposed to induce the reparation process. In our work, we used microfracture techniques in combination with intraarticular application of hyaluronic acid in rabbit knee articular cartilage defect. In comparison with the control group, after 6 and 10 weeks we observed a higher potential of healing in the experimental group, with thicker and more organized repair tissue filling the defect. In conclusion, a combination of the microfracture technique and application of hyaluronic acid might be potentially beneficial in inducing articular cartilage defect reparation