Acta Chir Orthop Traumatol Cech. 2003; 70(6)

Commonsense design of patella implant: four years of clinical experience with 124 patients.

D G Mendes, O Schwartz, J Onallah, R Imberg, M Said

Acta Chir Orthop Traumatol Cech. 2003; 70(6):329-335

BACKGROUND: Patella resurfacing in Total knee Arthroplasty still is an issue of controversy, that results from the statistically poor performance of patella implants. Since the basic fault of conventional designs, in our opinion, is the inadequate thickness of the polyethylene, an innovative patella was designed and rules of technique were set to optimize the surgical procedure.METHODS: Since July 1998 we have employed the new patella in 124 consecutive patients undergoing total knee arthroplasty. They had the patella routinely resurfaced with an implant of a special design of a concave undersurface and a convex (dome) articulating surface. The...

[Deformities of the forefoot in patients with rheumatoid arthritis--results of surgical treatment].

S Popelka, P Vavrík, J Pech, D Veigl

Acta Chir Orthop Traumatol Cech. 2003; 70(6):336-342

PURPOSE OF THE STUDY: Rheumatoid arthritis affects the foot very frequently. The transversal arch of the foot gradually declines due to the inflammation, the metatarsal heads protrude in the sole of the foot which is accompanied by painful bunions and sometimes also skin necrosis. The great toe turns into a valgus position and pronation. Walking is very painful.MATERIAL: The authors evaluate a group of patients operated on for the deformities of the forefoot between 1995 and 2002.METHODS: In the deformities of the forefoot the authors use resection of the heads of II-V metatarsals. They use a plantar surgical approach during which they remove...

[Early failure of the polyethylene liner in the ABG I total hip prosthesis].

J Gallo, P Kamínek, J Zapletalová, R Novotný, I Cechová, R Ditmar

Acta Chir Orthop Traumatol Cech. 2003; 70(6):343-349

PURPOSE OF THE STUDY: The polyethylene liner has appeared to be a weak point in total hip arthroplasty. An early wear-through or a fracture of the polyethylene liner have been referred to as a catastrophic failure. The aim of the present study is to report our experience with this rare complication in ABG I hip prostheses.MATERIAL: Between September 1994 and January 2000 a total of 506 ABG I prostheses were implanted at our clinic. Due to wear-related complications, revision arthroplasty had to be performed in 90 hips in 23 male and 63 female patients by January 2002. Extensive titanium metallosis associated with polyethylene failure was found...

[Treatment of deep chondral defects of the knee using autologous chondrocytes cultured on a support--preparation of the cartilage graft].

P Visna, L Pasa, J Adler, J Folvarský, D Horký

Acta Chir Orthop Traumatol Cech. 2003; 70(6):350-355

PURPOSE OF THE STUDY: Chondral and osteochondral defects represent an important topic in the knee surgery. The knee traumas are often followed by premature development of osteoarthritis due to limited reparative processes in the cartilage. Today's diagnostic possibilities and progress in arthroscopic techniques promote the early diagnostics and exact classification of osteochondral defects. Authors present therapeutic ways for treatment of cartilage injuries and adjacent part of the subchondral bone. New possible method for treatment of deep chondral defects on the weight-bearing area of the knee is the application of autologous cultivated chondrocytes...

[Treatment of deep chondral defects of the knee using autologous chondrocytes cultured on a support--results after one year].

P Visna, L Pasa, R Hart, J Kocis, I Cizmár, J Adler

Acta Chir Orthop Traumatol Cech. 2003; 70(6):356-362

PURPOSE OF THE STUDY: The treatment of deep chondral defects is one of the key issues in current orthopedics and traumatology. We developed a new technique that greatly improved the outcome of treatment in young active patients. The method is based on transplantation of in vitro cultured autologous chondrocytes carried on the fibrin glue Tissucol.MATERIAL: In the years 2000 to 2002, 19 patients with deep chondral defects were treated by chondrocyte transplantation with the use of Tissucol. At 1 year, 14 defects (average size, 4.31 cm2; range, 2.0 to 10.0 cm2) in 12 patients were evaluated. The defects were localized on the weight-bearing areas...

[The Beznoska uncemented acetabular cup in hip joint arthroplasty].

P Zofka

Acta Chir Orthop Traumatol Cech. 2003; 70(6):363-366

PURPOSE OF THE STUDY: To present the results of a trial of the non-cemented Beznoska cup.MATERIAL: During the period from 1993 to 1997, a total of 43 Beznoska cups were implanted in 40 patients, 17 men and 23 women, with the average age of 61 and 65 years, respectively. Primary hip arthritis was the most frequent indication for arthroplasty. Most cups were used in combination with a cemented stem.METHODS: In 2002, 37 patients were examined. The follow-up period ranged from 5 to 10 years. Clinical evaluation was based on the Harris hip scores. X-ray films were examined for cup osteointegration and wear, and para-articular ossification.RESULTS:...

[New materials suitable for implantation--preparation for implants].

M Adam, M Petrtýl, K Balík, Z Bastl

Acta Chir Orthop Traumatol Cech. 2003; 70(6):367-370

PURPOSE OF THE STUDY: Connective tissue components, particularly collagen and proteoglycan, stimulate cell proliferation and thus promote tissue regeneration. This fact was utilized to test some new implant materials, which were covered by these components, for the speed and quality of their encapsulation.MATERIAL: The materials tested included polyethylene (PE) with either a hydrophobic (HPHO) or a hydrophilic (HPHI) surface and the C-C composite. Before implantation in experimental animals, the materials were coated with a thin layer of collagen-proteoglycan copolymer.METHODS: Collagen was obtained from calf hide (ISC 40 fraction) and proteoglycan...

[Synovectomy of the knee joint].

J Blahut

Acta Chir Orthop Traumatol Cech. 2003; 70(6):371-376

PURPOSE OF THE STUDY: In this retrospective study, the results of arthroscopic and open synovectomy and radiosynovectomy with the use of Yttrium-90 colloid are evaluated.MATERIAL: In a group of 48 patients with different underlying diseases, 51 knee joints were treated by synovectomy in the years 1996 to 2001. Of these, 16 knees were treated by arthroscopic synovectomy (ASS group), nine by open synovectomy (OS group) and 26 by Yttrium 90 radiosynovectomy (YR). The average age was 67 years (range, 30 to 81) and average follow-up was 18 months. The patients' diagnoses involved grade I, II and III gonarthritis in three, 21 and 15 cases, respectively,...

[Primary hyperparathyroidism (osteitis fibrosa cystica generalisata Recklinghausen)].

K Koudela, J Koudelová, B Kreuzberg, V Treska, Z Kinkor, K Koudela

Acta Chir Orthop Traumatol Cech. 2003; 70(6):377-382

The case of a 67-year-old man presenting with parathyroid gland adenoma associated with multiple organ manifestations of a rare normocalcemic form of primary hyperparathyroidism is described. The authors draw attention to the importance of correlating clinical and laboratory examinations with histological, radiological and scintigraphic findings for the establishment of diagnosis. They emphasize the role of two-phase 99mTC-MIBI (methoxyisobutyl-isonitril) scintigraphy not only for diagnostic purposes but also for exact localization of the adenoma by means of a gamma probe during surgery. They also point out the possibility of accompanying pathological...