Ortopedia, traumatologia, rehabilitacja最新文献

{"title":"Pediatric Anterior Cruciate Ligament Reconstruction.","authors":"Łukasz Wiktor","doi":"10.5604/01.3001.0053.9348","DOIUrl":"10.5604/01.3001.0053.9348","url":null,"abstract":"<p><p>The incidence of anterior cruciate ligament (ACL) injuries in children and adolescents has been growing recently. This problem is a challenge for the treating orthopedic surgeon, especially when the patient is in the prepubertal period with a high growth potential. Since reconstructive procedures require interventions close to active growth plates, they are associated with the risk of postoperative limb length discrepancies and limb deformities. Postponing ACL reconstruction until the end of growth is not a solution, as persistent knee instability increases the risk of secondary intra-articular damage. The key to success is not only knowledge of the anatomy and biomechanics of the pediatric knee but also the ability to predict the remaining growth potential and familiarity with a wide range of reconstructive surgical procedures available for patients at different ages.</p>","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":"25 4","pages":"219-227"},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72015006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Professor Andrzej Zembaty (1935-2022) - Visionary and Co-founder of Polish Physiotherapy.","authors":"Sławomir Jandziś, Beata Skolik, Mariusz Migała","doi":"10.5604/01.3001.0053.9347","DOIUrl":"10.5604/01.3001.0053.9347","url":null,"abstract":"<p><p>Based on an analysis of source materials from the private collection of the Zembaty family, the Medical Library of the Marian Weiss Rehabilitation Center in Konstancin, articles from daily press, and a few publications, we present the professional career, and academic and organizational activities of the late Professor Andrzej Zembaty (1935-2022), Doctor Habilitatus in Physical Culture Studies. While working at the Capital City Rehabilitation Center in Konstancin (Stołeczne Centrum Rehabilitacji), he served as an assistant to and close collaborator of Professor Marian Weiss. Affiliated with the Warsaw University of Physical Education for many years, he was known as a scholar, demanding teacher, author of well-known textbooks, and organizer of physiotherapy education. His vision of the professional development and role of physiotherapists in healthcare was realized only after the enaction of the Physiotherapist Profession Act. He undoubtedly ranks among the pioneers and founders of Polish physiotherapy.</p>","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":"25 4","pages":"207-218"},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72015007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the Influence of Supportive and Sensorimotor Insoles on Flat Feet in Children - a Double-Blind, Prospective, Randomized, Controlled Trial.","authors":"Kira-Henriette Liebau, Alexander P-L Schmitt, Susanne Fröhlich, Claudia Bünzen, Wolfram Mittelmeier, Christoph Schulze","doi":"10.5604/01.3001.0053.9346","DOIUrl":"10.5604/01.3001.0053.9346","url":null,"abstract":"<p><strong>Background: </strong>Besides arch-supportive insoles, sensorimotor insoles are used for the treatment of flatfoot in children. The aim of this study was to compare the effect of both types of insoles on the arch-supporting muscles and clinical aspects in children with flexible flatfoot.</p><p><strong>Material and methods: </strong>52 children with flexible flatfoot (mean age of 8.22.7 years) were enrolled. Supportive, sensorimotor, and placebo insoles were compared. Muscle activity was detected by surface electromyography during the midstance phase. Valgus index, foot and ankle disability index (FADI) and pain were assessed at enrolment and after 6 and 12 months. Mixed-design ANOVA was used for statistical evaluation.</p><p><strong>Results: </strong>Supportive and sensorimotor insoles caused significantly lower activity in the tibialis anterior in comparison to placebo insoles regarding the parameter Mean. No significant differences could be detected between both types of therapeutic insoles. Supportive insoles showed a significant decrease regarding the parameter Amplitude of the peroneus longus. Placebo insoles produced an increase in the valgus index, while both therapeutic insoles did not induce any changes. The sensorimotor insoles induced an increase in FADI, while the supportive and placebo insoles had no significant effect on this parameter.</p><p><strong>Conclusions: </strong>1. Supportive and sensorimotor insoles potentially influence muscle activity in the lower leg. 2. Both could influence the longitudinal arch in flat feet. 3. While placebo insoles caused a deterioration of the valgus index, both kinds of therapeutic insoles could possibly prevent the progression of the flatfoot. 4. Clinical studies including more clinical aspects and long-term observations are necessary.</p>","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":"25 4","pages":"195-206"},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72015004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long Versus Short-segment Stabilization in Patients with Traumatic Thoracolumbar Fractures.","authors":"Battugs Borkhuu, Batsaikhan Batochir, Munkhbayarlakh Sonomjamts, Erdembileg Tsevegmid, Naranbat Lkhagvasuren","doi":"10.5604/01.3001.0053.9344","DOIUrl":"10.5604/01.3001.0053.9344","url":null,"abstract":"<p><strong>Background: </strong>Posterior stabilization surgery is considered the gold standard for restoring spine stability in patients with traumatic thoracolumbar fractures. However, whether long-segment (LS) stabilization or short-segment (SS) stabilization is an optimal approach for achieving more effective restoration of spinal stability remains unclear.</p><p><strong>Material and methods: </strong>Patients who underwent posterior stabilization surgery for traumatic thoracolumbar fractures were included in the study. Radiological parameters were measured using pre- and post-surgical thoracolumbar computed tomography (CT) scans and compared between patients who received LS and SS stabilization.</p><p><strong>Results: </strong>Ninety-eight consecutive patients (mean age 4414, 50% male) who underwent posterior stabilization surgery for traumatic thoracolumbar fractures were included. LS stabilization was performed in 52 patients, while SS stabilization was performed in 46 patients. Among spinal stability parameters measured on pre-surgical thoracolumbar CT scans, the anterior vertebral height (AVH) was significantly lower in the LS stabilization group compared to the SS stabilization group (14.44.0 mm vs. 16.44.0 mm, p=0.017), indicating a more severe compression fracture in the LS stabilization group. However, all parameters improved on post-surgical thoracolumbar CT scans, and there were no significant differences between LS stabilization and SS stabilization groups in terms of the restoration of spinal stability parameters. The type of stabilization (LS vs. SS stabilization) did not show an association with post-surgical measurements of spinal stability parameters (B=0.27, 95% CI -1.87 to 2.42, p=0.800 for superior inferior end plate angle (SIEA), B=0.20, 95% CI -1.33 to 1.74, p=0.796 for AVH, and B=0.39, 95% CI -1.72 to 2.50, p=0.714 for Cobb angle).</p><p><strong>Conclusions: </strong>Both LS and SS stabilization approaches yield similar results in terms of restoring spine stability parameters in patients with traumatic thoracolumbar fractures. The choice of surgical approach should be individualized based on the patient's overall status and the surgeon's experience.</p>","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":"25 4","pages":"173-179"},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72015005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Attempt to Assess the Indications for Reverse Total Shoulder Arthroplasty Based on Biomechanical Analysis.","authors":"Anna Porwoł, Grzegorz Sobota, Przemysław Bereza, Wojciech Marszałek, Damian Kusz","doi":"10.5604/01.3001.0053.9345","DOIUrl":"10.5604/01.3001.0053.9345","url":null,"abstract":"<p><strong>Background: </strong>Starting from the 1950s, shoulder arthroplasty has been developing, one consequence of which has been the concept of reverse shoulder arthroplasty (RSA). Initially, it was supposed to be used only in patients with irreversible rotator cuff damage, but it quickly gained more and more indications for use. The aim of the present study was to assess biomechanical, objective indications for RSA in patients with shoulder osteoarthritis (OA) based on an inertial measurement system with electromyography.</p><p><strong>Material and methods: </strong>20 patients were qualified to this prospective study, 10 each in a control and experimental group. The study was conducted between August 2020 and October 2021. The experimental group consisted of 9 women and 1 man aged 55 to 85 years old, with osteoarthritis of the shoulder associated with rotator cuff damage. The study utilised the myoMotion inertial sensor system (Noraxon, USA) synchronized with the surface electromyography system Myotrace 400 (Noraxon, USA).</p><p><strong>Results: </strong>Movement phase diagrams were used to assess the movement patterns. To examine the movement pattern in the shoulder, three motor tests can be proposed: flexion-extension, flexion in the scapular plane and abduction-adduction. The observation of trends for the operated limb showed the highest absolute improvement in the group with the greatest impairment of the movement pattern in the initial test. However, on final evaluation, these results were still twice as low as those obtained in the group with the least impairment.</p><p><strong>Conclusions: </strong>1. Early qualification of patients with shoulder OA for RSA could mean a greater likelihood of functional and quality-of-life improvement. 2. Movement patterns after RSA may improve, but will probably not return to physiological values.</p>","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":"25 4","pages":"181-194"},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72015003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Femoral Neck Preservation and Diaphyseal Invasion Comparing a Calcar-Metaphyseal Short Stem with its Homonymous Standard Femoral Stem. A Radiographic Study.","authors":"Daniel Godoy-Monzon, Agustin Garcia-Mansilla, Felix Avendaño Duran, Javier Perez Torres, Jose Manuel Pascual Espinosa","doi":"10.5604/01.3001.0053.7976","DOIUrl":"10.5604/01.3001.0053.7976","url":null,"abstract":"<p><strong>Background: </strong>We aim to compare the preoperative planning radiographs of 50 patients in whom both a short stem and its homonymous standard version were programmed, focusing on the preservation of the neck and the invasion of the femoral shaft. The secondary objective was to evaluate the 50 preoperative radiographs with the 50 postoperative radiographs in which the short stem was implanted, measuring the real invasion of the diaphysis and the real preservation of the femoral neck.</p><p><strong>Material and methods: </strong>We measured cut level at the femoral neck and diaphyseal invasion in 50 preoperative x-rays where an Alteon Neck Preserving Stem (ANPS) was templated and we compared it with 50 preoperative x-rays where an Alteon Taper Wedge Stem (ATWS) was templated. After surgery, we compared both parameters previously measured in the preoperative x-rays with the 50 postoperative radiographs where the short stem was implanted obtaining the real bone preservation at the femoral neck and the real diaphyseal invasion length.</p><p><strong>Results: </strong>For templating comparison, mean bone preservation at the femoral neck was 14.87mm (SD 3.64) for the ANPS group and 9.94mm (SD 8.39) for the ATWS group (p &lt;0.001). The mean diaphyseal bone invasion was 47.21mm (SD 5.89) and 76.77mm (SD 8.39) for ANPS and ATWS respectively (p &lt;0.001). After surgery, the mean postoperative bone preservation at the femoral neck was 15.08mm (SD 3.1) with a mean of 0.17mm (SD 0.51) more preservation in the preoperative group.</p><p><strong>Conclusion: </strong>1. ANPS allow bone preservation with limited diaphyseal invasion when compared with his homonymous ATWS in the preoperative templates. 2. ANPS showed a good correlation between preoperative radiographs and real bone preservation of the femoral neck and invasion of the femoral shaft.</p>","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":"1 1","pages":"143-147"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41600584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Total Hip Arthroplasty Performed from a Lateral Approach as Optimal Treatment for Femoral Neck Fractures in Elderly, Active Patients.","authors":"Bogdan Obada, Dan-Marcel Iliescu, Vlad-Alexandru Georgeanu, Lucian Cristian Petcu, Madalina Gabriela Iliescu, Ion-Andrei Popescu","doi":"10.5604/01.3001.0053.7975","DOIUrl":"10.5604/01.3001.0053.7975","url":null,"abstract":"<p><strong>Background: </strong>The aim of the study was to evaluate total hip arthroplasty in terms of clinical and functional outcomes, rate of complications and hospitalization, as a treatment of choice for displaced femoral neck fractures.</p><p><strong>Materials and methods: </strong>We retrospectively reviewed the data of 526 patients with THA operated on in our department between January 2017 and December 2021. Clinical examinations, functional outcome assessment and radiographic evaluation were performed during follow-up. Patients were evaluated at the following time points: postoperatively at 3 days, 6 weeks, 12 weeks and 1 year, and we recorded surgery related data, complications, Visual Analogue Scale pain score, Harris Hip Score, the Western Ontario McMaster Osteoarthritis Index, and range of motion.</p><p><strong>Results: </strong>Low intraoperative blood loss, short surgical time, short hospitalization, early mobilization of the patient and a good range of motion testify that the modified direct lateral approach is a valuable procedure for the patients with THA. A VAS score evaluated at 3 days and 6 weeks indicated a very good overall postoperative experience. The HHS and Womac scores were evaluated at 6 weeks, 12 weeks and 1 year and showed excellent results.</p><p><strong>Conclusion: </strong>THA for active patients with a displaced fracture of the femoral neck is an excellent treatment option which provides lasting pain relief, a high level of function and very low rates of reoperation.</p>","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":" ","pages":"131-141"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43135234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Review of Surgical Management Techniques for Osteochondral Lesions.","authors":"Jarosław Gryglewicz, Szymon Łukasz Dragan","doi":"10.5604/01.3001.0053.7978","DOIUrl":"10.5604/01.3001.0053.7978","url":null,"abstract":"<p><p>Early attempts at surgical management of cartilage lesions date back to the 1950s. Since then, various reconstructive techniques have been developed; unfortunately, none of the methods used has been able to produce a regenerate formed solely of hyaline cartilage. This paper summarizes the most popular techniques for chondral and osteochondral reconstructions of knee joint tissues.The techniques differ in their indications, which depend primarily on the location of the injury, the extent of the damage and the patient's overall health. In cases of deep damage, osteochondral reconstruction is indicated, which involves both repairing the bone defect and creating favorable conditions for the formation of regenerative tissue cartilage.The use of an appropriate repair technique increases the chances of a good therapeutic effect, which is understood as a reduction in pain, resumption of previous activities and slowing down the progression of osteoarthritis.</p>","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":" ","pages":"157-163"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44534423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Rehabilitation with Exergame - Which Muscle Groups are Addressed by Bedside-Based Knee Exercises?","authors":"Hauke Horstmann, Eva Krost, Thomas Sanjay Weber-Spickschen","doi":"10.5604/01.3001.0053.7977","DOIUrl":"10.5604/01.3001.0053.7977","url":null,"abstract":"<p><strong>Background: </strong>Knee exercises are generally recommended following knee-related operations. Nevertheless, compliance in performing self-administered exercises is varying. The use of exergames may alter patient compliance. These computer games encourage the user to exercise. Exergames are not yet used much in orthopedic rehabilitation. The aim of this study was to analyze the influence of different seating positions in electromyography while performing knee exercises with the exergame GenuSport.</p><p><strong>Material and methods: </strong>72 healthy women and men were tested in 6 seating positions using an application-based knee-training device (KT). Positions were 1. user seated 90 upright with straight leg on KT, 2. 90 upright with leg exercising in external rotation on KT, 3. 90 upright with leg exercising in internal rotation on KT, 4. 90 upright with straight leg on 30mm elevated KT, 5. 45 upright with straight leg on KT and 6. 45 upright with straight leg on 30mm elevated KT. Electromyogram was recorded for biceps femoris, rectus femoris, semitendinosus, vastus medialis, adductor magnus and vastus lateralis.</p><p><strong>Results: </strong>No significant difference was shown in position 2, 3 or 4 compared to position 1. In position 5 and 6, EMG reported significantly higher values compared to positions 1 to 4 (ischiocrural: 130% and quadriceps: 90%). The quadriceps was activated significantly less in position 6 compared to 5.</p><p><strong>Conclusion: </strong>1. Bedside-based knee extension exercises are most effective in a seated position of 45 trunk inclination. 2. A slightly more bent knee (KT elevation of 30mm) leads to a higher activation of the ischiocrural muscles.</p>","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":" ","pages":"149-156"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43965858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Finite Element Modeling of Chondrolabral Lesions in Pincer-Type Femoroacetabular Impingement.","authors":"Igor Albertovych Lazarev, Yurlian Yevheniyovych Bursuk, Andrii Mykolayovych Babko, Maxim Vitaliyovych Skyban, Yevhen Yosypovych Bursuk","doi":"10.5604/01.3001.0053.7973","DOIUrl":"10.5604/01.3001.0053.7973","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of chondrolabral lesions due to femoroacetabular impingement (FAI) is 93% in cadaveric material. As a biomechanically determined factor, it can lead to hip destruction and early osteoarthritis in pincer-type impingement. The aim of this work was to study the biomechanism and stress-strain behavior of chondrolabral lesions in pincer-type impingement during daily activity-associated movements.</p><p><strong>Material and methods: </strong>The SolidWorks package was used to build a 3D pelvis model with and without pincer-type impingement in the femoroacetabular (FA) region. Finite element analysis (FEA) in ANSYS was performed to determine von Mises stress, strain and total deformations for the models during 90 hip flexion and 15 internal rotation during daily activities.</p><p><strong>Results: </strong>Maximum stress-strain values increased 2-3.4 times in the bone along the anterior upper acetabular rim, femoral neck and acetabular labrum in the area of the pincer osteophyte compared to the non-pincer condition in the FA model.</p><p><strong>Conclusions: </strong>1. The increase in stress-strain in the contact area at the pincer osteophyte and femoral neck can be a factor of cam-type osteophyte formation and progression of acetabular rim ossification. 2. Daily activity can lead to an increase in maximum stress, as a factor of chondral delamination and destruction of the acetabular labrum. 3. Early surgery is needed to avoid progression of osteoarthritis in pincer-type impingement.</p>","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":" ","pages":"121-129"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45545250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}