Ortopedia, traumatologia, rehabilitacja最新文献

{"title":"Articular Cartilage Lesions Pathomechanism, Diagnosis, Epidemiology, Possibilities for Conservative Treatment.","authors":"Jarosław Gryglewicz,&nbsp;Szymon Łukasz Dragan","doi":"10.5604/01.3001.0053.6690","DOIUrl":"https://doi.org/10.5604/01.3001.0053.6690","url":null,"abstract":"<p><p>Osteoarthritis, which is the most common joint disorder, is one of major reasons for hospitalizations and one of the greatest burdens to health care systems. Osteoarthritis has a complex etiology, but lesions of articular cartilage are a major risk factor. These lesions are often encountered in young active people and usually remain asymptomatic for a long time. Depending on the extent of injury, chondral lesions can be managed conservatively or surgically. An important factor influencing the effectiveness of conservative treatment is the morphology and location of injury. Conservative treatment should be based on patient education and rehabilitation, and supported by pharmacotherapy.</p>","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":"25 2","pages":"105-109"},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10050766","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-term Development of Fibrosarcoma in the Practice of Emergency Medical Teams: a Case Report.","authors":"Łukasz Dudziński,&nbsp;Łukasz Czyżewski,&nbsp;Tomasz Kubiak","doi":"10.5604/01.3001.0053.4746","DOIUrl":"https://doi.org/10.5604/01.3001.0053.4746","url":null,"abstract":"<p><p>Fibrosarcoma is a relatively rapidly growing, poorly delineated spindle cell tumour. It has generally good prognosis and rarely metastasizes. Soft tissue sarcomas account for less than 1% of all malignancies in adults. High rates of sarcomas are, for example, seen in patients with tuberous sclerosis complex. This paper presents the case of a patient with knee joint destruction caused by a fibrosarcoma, on account of which an emergency medical team was summoned several times. We present data from three medical rescue team interventions to a patient with a tumour in the left lower leg. The data was obtained from the documentation generated during the interventions: dispatch order record (DOR) and medical emergency treatment report (METR). The patient had a history of the following chronic diseases (ICD-10): E11.8, I50.9, I10, and M15. Two interventions involved patient transportation to a hospital, whereas the third intervention was completed in the patient&apos;s home. The fibrosarcoma caused only slight pain. Frequent bleeding from an open cancerous wound was the main problem in this patient. Difficulty in wound healing could have been related to complications of diabetes mellitus and the patients advanced age.</p>","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":"25 2","pages":"97-104"},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9675980","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":"Outcomes Following Type C Distal Humeral Fracture Fixation Using Two Different Osteosynthesis Techniques.","authors":"Mahmoud Elbakry,&nbsp;Islam Sarhan,&nbsp;Mohamed Samir Gobba,&nbsp;Mostafa Mahmoud,&nbsp;Neil Ashwood,&nbsp;Mohamed Nagy,&nbsp;Mohamed A Soliman,&nbsp;Amr Samir Rashwan","doi":"10.5604/01.3001.0053.6175","DOIUrl":"https://doi.org/10.5604/01.3001.0053.6175","url":null,"abstract":"<p><strong>Background: </strong>Distal humeral fractures are notorious injuries, and they require surgical fixation. The reliability of reconstruction devices has been a subject of debate. Our primary outcome was to detect differences, if any, between two different groups of patients using the patient-reported outcomes measurement information system (PROMIS) Global-10 form and to compare it with the Mayo elbow performance score (MEPS) results. Other secondary outcomes included the difference in union time between patients who received a reconstruction plate vs those who received a pre-contoured anatomical plate.</p><p><strong>Material and methods: </strong>It is a prospective randomised study which included a total of 30 cases equally distributed into two groups.</p><p><strong>Results: </strong>The mean PROMIS and MEPS scores for group A were 31.5 SD 6.6 and 77.7, respectively, compared to 33.7 SD 6.66 and 73, respectively, for the other group. Time to union was 13.4 weeks for group A and 12.6 weeks for the other group. There was no statistically significant difference between the groups regarding union and function. However, reconstruction plates were more cost effective. The correlation between the MEPS and PROMIS G scores in both groups was statistically significant.</p><p><strong>Conclusion: </strong>1. Recon plates continue to be a cost-effective method of treatment in simple intra-articular fractures. 2.PROMIS is a valuable tool to be used along with other scores in future studies.</p>","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":"25 2","pages":"83-89"},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10050764","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":"Unstable Fractures of the Greater Tubercle of the Humerus. A Case Report.","authors":"Karol Ratajczak,&nbsp;Grzegorz Szczęsny","doi":"10.5604/01.3001.0053.6176","DOIUrl":"https://doi.org/10.5604/01.3001.0053.6176","url":null,"abstract":"<p><p>The paper presents the results of stabilization of an unstable, comminuted fracture of the greater tubercle with absorbable sutures after fixation of a comminuted fracture of the proximal humerus with a reconstructive nail. This unusual procedure was performed upon ascertaining an anatomical reconstruction of the humeral head fragments and mechanical efficiency of the intramedullary nail fixation.Stabilization was performed with absorbable sutures through an extended surgical approach that allowed anchoring the unstable fragments of the greater tubercle to the shaft. The resulting anatomical positioning was additionally reinforced with screws locking the nail in its proximal end. After the procedure, a Dessault orthosis was used for 3 weeks, with intensive rehabilitation afterwards. A final assessment was made one year after the injury. It was based on the patients subjective feelings, the quality of bone union and fragment repositioning, estimated range of motion and limb function with Constant-Murley and QuickDash scores.An excellent treatment result was obtained. The anatomical position and shoulder function was fully restored. The patient reported no pain and no limb dysfunction.Based on these results we concluded that an open reduction and suturing of the unstable bone fragments of the greater tubercle with absorbable sutures allows anatomical repositioning and sufficient stabilization after intramedullary nailing. It may serve as an alternative to the conversion from intramedullary nailing to plate fixation in cases similar to ours.</p>","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":"25 2","pages":"91-96"},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10050765","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":"Functional and Surgical Outcomes of Corpectomy in Patients with Unstable Spinal Fractures.","authors":"Dariusz Sowa,&nbsp;Grzegorz Guzik,&nbsp;Michał Bronisz,&nbsp;Dawid Merkiel,&nbsp;Piotr Biega","doi":"10.5604/01.3001.0053.6159","DOIUrl":"https://doi.org/10.5604/01.3001.0053.6159","url":null,"abstract":"<p><strong>Background: </strong>Unstable fractures of the spine should be managed surgically. An anterior approach allows for precise decompression of the vertebral canal and reconstruction of the fractured vertebral body. The aim of the study was to evaluate the functional and surgical outcomes of anterior surgical approaches for vertebral body removal and prosthetic reconstruction.</p><p><strong>Material and methods: </strong>The objectives of this paper were accomplished by reviewing the course of treatment and treatment outcomes of patients operated on at the Orthopaedic Oncology Department in Brzozw and the Department of Orthopaedics and Traumatology in District Hospital in Stalowa Wola in the years 2020-2021. In total, the treatment of 54 patients was analyzed. The study only included patients with traumatic and pathological fractures who underwent a single-level corpectomy. A total of 18 patients with fractures of the cervical spine, 15 of the thoracic spine and 21 of lumbar spine were treated. Before and after treatment, patients&apos; neurological status was assessed according to the Frankel classification, performance was assessed with the Karnofsky score and pain intensity was analyzed with a VAS. The vertebral wedge angle (alpha), the ratio of the anterior height of the fractured vertebral body to the anterior height of the upper adjacent vertebral body (a/c), the ratio of the anterior height to the posterior height of the fractured vertebra (a/b) and the distance between the vertebral endplates adjacent to the fractured vertebra, measured between their anterior edges (A-B) were assessed. The most common general medical and surgical complications were also evaluated.</p><p><strong>Results: </strong>After the surgery, significant pain relief measured using a VAS was noted (the median was 7 preoperatively and 4 postoperatively) and an improvement in performance according to the Karnofsky score was observed (the median was 50 preoperatively and 70 postoperatively). Out of the 14 patients with neurologic deficits 11 improved, while 5 regained the ability to walk. In four patients, the implant migrated into an adjacent vertebra and three patients suffered a fracture of the upper adjacent vertebra. The correction of the spine deteriorated in all 7 patients. There was no postoperative neurological deterioration of patients and no infectious complications. During the surgery, three patients suffered dura mater injury, which was identified intraoperatively and repaired.</p><p><strong>Conclusions: </strong>1. Corpectomy followed by vertebral body replacement is an effective and safe method that enables the restoration of the shape of the vertebra, restoration of the physciological spinal curvature and direct neural decompression. 2. The treatment outcomes are good. Pain significantly decreases and performance improves in most patients. 3. Treatment complications are rare. The most often observed complication was migration of the implant into an","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":"25 2","pages":"61-71"},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10050762","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":"Assessment of the Reliability of the DoboMed Exercise Method Mastery Evaluation Scale in People with Adolescent Idiopathic Scoliosis.","authors":"Bartosz Wnuk,&nbsp;Michalina Stepanik,&nbsp;Ewelina Milewska-Mączka,&nbsp;Magdalena Huta,&nbsp;Justyna Wolicka,&nbsp;Adrianna Karcz,&nbsp;Joanna Szołtysek,&nbsp;Jacek Durmała","doi":"10.5604/01.3001.0053.6160","DOIUrl":"https://doi.org/10.5604/01.3001.0053.6160","url":null,"abstract":"<p><strong>Background: </strong>Conservative treatment of lateral idiopathic curvatures of the spine is a difficult and complex therapeutic process that is not always successful. Repeated assessments of the patient&apos;s mastery of a given exercise may significantly increase the effectiveness of conservative treatment. The aim of the study was to assess the credibility of an original scale for evaluating DoboMed exercise proficiency in a group of people with adolescent idiopathic scoliosis.</p><p><strong>Materials and methods: </strong>The study was conducted in a group of 41 patients with juvenile idiopathic scoliosis aged 10 to 16 years. In each patient, during a 3-week exercise period, the mastery of the Dobomed exercise method was assessed according to the authors original scale. Four physical therapists conducted this study.</p><p><strong>Results: </strong>The Kendall-Smith concordance coefficient was used in the statistical analysis. On the basis of Kendalls W coefficient, Spearmans R coefficient of similarity was calculated to describe the correlation of all possible pairs of orderings. There was a high level of agreement between the therapists in the assessment of the key elements for mastering the method.</p><p><strong>Conclusion: </strong>1. The original method mastery evaluation scale has clinical value in monitoring the progress of exercises according to the Dobomed method. 2. A high level of agreement between the therapists was noted for those features that are important in mastering the method. 3. Standardisation of our scale for evaluating mastery of DoboMed exercises will allow patients to be monitored with regard to their performance of the exercises also by their parents.</p>","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":"25 2","pages":"73-81"},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10050763","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":"Trapeziometacarpal Osteoarthritis. Conservative and Surgical Treatment. A Diagnostic-Therapeutic Algorithm.","authors":"Michał Kanak, Robert Rokicki, Joanna Wojna","doi":"10.5604/01.3001.0053.4027","DOIUrl":"10.5604/01.3001.0053.4027","url":null,"abstract":"<p><p>Trapeziometacarpal osteoarthritis (carpometacarpal arthritis / CMC-1 arthritis) is a common cause of chronic thumb pain and may significantly worsen patients' quality of life. The thumb is the most important digit of the hand. A diagnostic-therapeutic algorithm for CMC-1 arthritis should be widely known and based on up-to-date evidence-based medical knowledge. The literature describes many medical and surgical treatment approaches. The methods used vary between hospitals and clinics. They also depend on patients' financial capabilities and many other factors.Medical (conservative) treatment appears to be effective in 60% of cases, in particular when the synergy of combining several treatment methods is taken advantage of. The most commonly performed surgical procedures in CMC-1 arthritis fall into two major groups, namely trapeziectomy or arthroplasty. However, there is no proof of superiority of one surgical treatment method over the others, and all of them have their advantages and disadvantages.This paper aims to present the most up-to-date knowledge about: (1) conservative and (2) surgical treatments for CMC-1 arthritis and (3) to propose a diagnostic-therapeutic algorithm for this condition. It is based on the latest literature (mainly works published in the last 5 years) acquired from databases such as PubMed, Clinical Key and Science Direct. The article is the second of a two-part series that presents a diagnostic-therapeutic algorithm for CMC-1 arthritis. The authors believe that it may contribute to broadening knowledge about CMC-1 arthritis, optimizing the therapeutic process and improving care for patients with CMC-1 arthritis in Poland.</p>","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":" ","pages":"23-32"},"PeriodicalIF":0.0,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47974542","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":"Delay in Diagnosis and Treatment of Primary Bone Tumors.","authors":"Daniel Kotrych, Dawid Ciechanowicz, Jakub Pawlik, Adam Brodecki, Agnieszka Białomyzy, Piotr Prowans, Andrzej Bohatyrewicz, Bartłomiej Szostakowski","doi":"10.5604/01.3001.0053.4026","DOIUrl":"10.5604/01.3001.0053.4026","url":null,"abstract":"<p><strong>Background: </strong>Delay in the diagnosis and treatment of bone tumors continues to be a common problem. Prolonged diagnosis can significantly reduce the chances of successful treatment of the disease. Accordingly, the aim of this study was to assess the delay in the diagnosis of primary bone tumors, identify the most common symptoms and analyze the course of the diagnostic and therapeutic path.</p><p><strong>Material and methods: </strong>Thirty-two (K=18; M=14) patients treated surgically for primary bone tumors were included in the retrospective study. Patient records were analyzed. Delay in diagnosis was defined as the time from the onset of symptoms to the initial diagnosis and referral to an orthopedic oncology center.</p><p><strong>Results: </strong>The median delay in diagnosis was 7 (3-12) months. For tumors located in the pelvis, the delay was 10 months, compared to 5 months for the upper limb and 7 months for the lower limb (p=0.2312). The delay was 6 months In patients with osteosarcoma, and 8 months in chondrosarcoma patients (p=0.1786). At the first office visit, an x-ray was ordered in 19 cases (59.4%), of whom 9 patients (47.4%) were referred on to the oncology center. The most common symptoms were pain in the affected area (90.6%), limited mobility (28.1%) and pathological fracture (25%). After admission to an orthopedic department, a biopsy was performed after 5.5 (3-8.2) days. The histology results were ready after another 14 (8-18) days, and surgical treatment was performed after 95 (76-100) days.</p><p><strong>Conclusions: </strong>1. Although patients show typical symptoms of bone tumors, only a small proportion are referred directly to an oncology center. After a primary bone tumor is suspected, further diagnostic and therapeutic activities proceed efficiently, in accordance with the current guidelines.</p>","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":" ","pages":"9-22"},"PeriodicalIF":0.0,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45599826","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":"Outcomes of Treatment of Spinal Fractures with the SpineJack System.","authors":"Dariusz Sowa, Grzegorz Guzik, Michał Bronisz, Dawid Merkiel, Daniel Pyrka, Zuzanna Pyrka","doi":"10.5604/01.3001.0053.4025","DOIUrl":"10.5604/01.3001.0053.4025","url":null,"abstract":"<p><strong>Background: </strong>The use of \"SpineJack\" implants in patients with stable spinal fractures and without neurological deficits enables restoration of the shape of the fractured vertebra and significantly accelerates restoration of normal function. In unstable spinal fractures, additional posterior fixation is recommended. This is not recommended in patients with traumatic spinal stenosis. The aim of the study was to evaluate the surgical and functional outcomes of treatment of patients with the SpineJack implant.</p><p><strong>Material and methods: </strong>The objectives of this paper were accomplished on the basis of an evaluation of the outcomes of treatment of 39 patients operated on at the Orthopaedic Oncology Department in Brzozów and the Department of Orthopaedics and Traumatology in the District Hospital in Stalowa Wola in the years 2020-2021. 71% of patients were men; the mean age of women was 54 years and the mean age of men was 41 years. A total of 30 patients suffered traumatic fractures, while 9 patients suffered non-traumatic (pathological) fractures. Fractures were most often located in the lower parts of the thoracic and upper lumbar spine. Patient radiographs taken on the day before, the first day after and 3 months following the surgery were evaluated to assess the correction of vertebral wedging and cement leakage. Functional status was assessed using ODI, the quality of life was assessed with the EQ-VAS and the severity of pain was measured with a VAS.</p><p><strong>Results: </strong>Pain intensity, measured with a VAS scale after the surgery, significantly decreased from the mean preoperative 6.9 to 2.4 three months post-op. The mean functional status of patients (ODI) before surgery was 74.4, compared to 14.8 at 3 months post-op. Mean Quality of life (EQ-VAS) was 56.4 before the surgery and 72.4 at 3 months post-op. The vertebral wedge angle decreased after surgical treatment, from a mean value of 15.8 degrees before surgery to 8.8 degrees after surgical treatment. At three months following the surgery, the mean loss of correction was 2.2 degrees and occurred in 4 patients. The most frequent complication was cement leakage into the disc and into the spinal canal, occurring in 4 and 2 patients, respectively.</p><p><strong>Conclusions: </strong>1. The use of \"SpineJack\" implants in the treatment of stable vertebral fractures enables the restoration of the shape and reduction of the vertebral wedge angle. 2. The quality of life of patients after vertebral fracture treatment with \"SpineJack\" implants assessed using the EQ-VAS improved significantly. The severity of pain assessed on a VAS scale decreased significantly and the patients' functional status improved according to the ODI. 3.Complications observed during treatment with \"SpineJack\" implants include fractures of the vertebral endplate and cement leakage, mostly asymptomatic.</p>","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":"1 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71287610","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":"Literature Analysis Regarding the Combination of Substances: Glucosamine + Chondroitin in the Treatment of Osteoarthritis.","authors":"Wojciech Marczyński,&nbsp;Witold Tłustochowicz,&nbsp;Wiesław Tomaszewski,&nbsp;Jerzy Białecki","doi":"10.5604/01.3001.0016.2326","DOIUrl":"https://doi.org/10.5604/01.3001.0016.2326","url":null,"abstract":"<p><p>An essential component of joint quality is cartilage. Therefore, the protection of this is a prerequisite for maintaining the condition of each joint. The assessment of the presence of articular cartilage is shown by X-ray of both joints in the standing position. Cartilage protection is possible for 1, 2 and 3 degree of cartilage damage according to the Kellgren and Lawrence scale.The challenge for the physician is to identify the cause of OA in accordance with the principles of Evidence Based Orthopedics/Traumatology, and not merely treat symptomatically, which is usually ineffective.In order to objectively present treatment methods, indications and the period of their implementation, it is biologically reasonable to refer to the needs of cartilage tissue resulting from the analysis of the causes of its damage and indications for justified methods of its protection.Biomechanical and biological elements are important in the process of implementing articular cartilage protection.The biomechanical elements are: limb axis disorders, differences in length, distortions at the level of the support quadrilateral, pelvic triangle and shoulder triangle, as well as balance disorders resulting from disturbances in the segmental proportion of the Fi number according to Leonardo da Vinci.There are many biological elements of the discussed disorder and they concern: the state of articular cartilage structure, matrix structure, matrix biophysical elements, molecular sponge mechanism, chondrocytes, cartilage nutrition and the severity of osteoarthritis (OA).The improvement of the conditions of the biological elements of damaged articular cartilage is considered fundamental and concerns the positive impact on numerous cartilage matrix proteins by chondroprotection. This element of treatment consists in the use of chondroitin sulphate and glucosamine as a drug, administered together in the appropriate dose and for a long time depending on the degree of degradation of the articular cartilage, usually from several to several months. The combination of chondroitin sulfate with glucosamine causes the activation of a much larger number of matrix proteins than each of the preparations separately.The pharmacokinetics of chondroitin sulfate and glucosamine are positive and favor their chondroprotective effect.The pharmacoproteomics of chondroitin sulfate and glucosamine administered together result from the activation of as many joint cartilage matrix proteins as possible. The development of proteomic techniques creates completely new therapeutic possibilities and is used to study the action of individual molecules.A clinically significant fact is that both chondroitin and glucosamine are natural, endogenous components of bone tissue and articular cartilage, so the use of both drugs is biologically compatible and results in numerous elements of cartilage protection.</p>","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":"24 6","pages":"407-416"},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10665573","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}