|
|
Possibilities of influencing the healing and ligamentization of the graft during anatomical reconstruction of the anterior cruciate ligament - Results of the Prospective Randomised Study
Kasl, Jan ; Matějka, Jiří (advisor) ; Paša, Libor (referee) ; Pilný, Jaroslav (referee)
Aims Prospective, randomized, non-blinded study, on the effects of use of platelet-rich fibrin (PRF) in anterior cruciate ligament reconstruction surgery. Methods Initially, 40 patients between 2012 and 2014 were enrolled in the study and randomized for the treatment with (n=20, intervention group) or without (n=20) the use of PRF (controls). The average age was 29.1 years at inclusion, with 12 female and 28 male patients. Vivostat ® PRF was obtained from patient blood and applied onto the hamstring graft. Magnetic resonance imaging (MRI) documented healing was evaluated at 6 and 12 months. Clinical outcome parameters as well as standardized evaluation of knee laxity using the GenouRob device were collected at 12 months. Results Thirty-three patients completed the full follow-up (17 intervention, 16 control). In two cases, a graft tear was documented (occurred in the control group). However, there were no differences in the remodeling progress in MRI using the log-rank test (p=0.07). There was no difference in the return to pre-injury sport levels (p=0.232), Lysholm and IKDC scores (p=0.259 and p=0.364 respectively). Knee laxity measurements showed no differences between the intervention and control groups. Discussion Similar results we found in our study have recently been published by other world...
|
|
|
Treatment of humeral diaphyseal fractures using Hackethals retrograde elastic nailing - a clinical and experimental verification of this method in contemporary traumatology
Obruba, Petr ; Džupa, Valér (advisor) ; Horák, Zdeněk (referee) ; Paša, Libor (referee)
Hackethal's bundle nailing of diaphyseal humeral fractures was historically reliable and cheap method, used for stabilization of simple humeral shaft fractures. After arrival of solid nails, this technique was successively abandoned, initially in Germany, followed by countries of Central Europe. Several cliniques are at present still using this technique successfully. Goal of this work was to establish, whether the declared stability of this technique is comparable to those of more evolved methods, whether this technique does not cause higher amount of complications, and to describe how the stability of nails bundle depends on number and diameter of used implants. The cost efficiency of different modern osteosynthetic methods used for stabilization of humeral shaft fractures was also analyzed. For verification of determined hypotheses, two clinical and one experimental studies were developed. First clinical study was focused on success rate of osteosynthesis and it's complications. In studied population of 50 patients, 4 of them (8%) developed a non-union, which was in all cases caused by wrong indication or technical error during implantation. Superficial infection was observed once, no deep infection had developed. Nine patients (18%) have healed in rotational or axial malalingement that had no...
|
|
|
Scapular fractures: Clinical anatomy, radiodiagnostics, classification-it's importance for operative treatment
Tuček, Michal ; Bartoníček, Jan (advisor) ; Paša, Libor (referee) ; Skála-Rosenbaum, Jiří (referee)
Fractures of the scapula are not very frequent and account for less than 0.5 per cent of all fractures. In most cases they are caused by high-energy trauma and are associated with other injuries. Until recently, fractures of the scapula were rather neglected and treated mostly conservatively. Lately, hover the situation has changed. The number of patients with a scapula fracture is increasing, the interest in this issue is growing and discussion focuses more and more on operative treatment of these fractures. The dissertation thesis provides a comprehensive overview of diagnostics, classification and treatment of scapula fractures. In the anatomical section we have described weak areas in the construction of the scapula that predispose incidence of fracture lines. We have studied topographic relations of individual structures on the posterior aspect of the scapula from the viewpoint of the Judet approach and its modifications in individual types of fractures of the scapular body and neck. In the radiological section we have compared efficiency of individual imaging methods with the aim to evaluate the possibilities of individual radiographic methods, 3D CT reconstructions in particular, from the viewpoint of an exact determination of the type of the fracture, number of fragments and their...
|
|
|
Benefits of the Acetabular Microfracture Technique in Arthroscopic Treatment of Chondral Defects in Femoroacetabular Impingement Syndrome: Two-year Results of a Multicenter Prospective Randomized Study
Rafi, Moheb ; Zeman, Petr (advisor) ; Paša, Libor (referee) ; Pilný, Jaroslav (referee)
1 ABSTRACT Benefits of the Acetabular Microfracture Technique in Arthroscopic Treatment of Chondral Defects in Femoroacetabular Impingement Syndrome - Two-year(s)? Results of a Multicenter Prospective Randomized Study. Purpose of the study Two-year clinical results of a multicenter prospective randomized study in patients with arthroscopically treated Femoroacetabular Impingement syndrome and concurrently performed microfracture for grade IV chondral lesions of the acetabulum. Material and methods The study evaluated a group of 55 patients of the originally enrolled 92 patients with the underlying diagnosis of FAI syndrome with intraoperatively confirmed grade IV acetabular chondropathy of up to 4 cm2 in size, who had undergone a comprehensive hip arthroscopy (correction of structural cam-type and/or pincer-type deformity, labral refixation or partial labral resection etc.) performed by two experienced surgeons. The patients were randomized intraoperatively using a closed envelope method into two groups. In group 1 (31 patients), microfractures for chondral defects was performed, while in group 2 the patients underwent a defect debridement procedure only. The studied group included a total of 7 professional and 48 recreational athletes (33 men and 22 women), with the mean age of 34.4 in group 1 and 31.1 in...
|
|
|
Treatment of humeral diaphyseal fractures using Hackethals retrograde elastic nailing - a clinical and experimental verification of this method in contemporary traumatology
Obruba, Petr ; Džupa, Valér (advisor) ; Horák, Zdeněk (referee) ; Paša, Libor (referee)
Hackethal's bundle nailing of diaphyseal humeral fractures was historically reliable and cheap method, used for stabilization of simple humeral shaft fractures. After arrival of solid nails, this technique was successively abandoned, initially in Germany, followed by countries of Central Europe. Several cliniques are at present still using this technique successfully. Goal of this work was to establish, whether the declared stability of this technique is comparable to those of more evolved methods, whether this technique does not cause higher amount of complications, and to describe how the stability of nails bundle depends on number and diameter of used implants. The cost efficiency of different modern osteosynthetic methods used for stabilization of humeral shaft fractures was also analyzed. For verification of determined hypotheses, two clinical and one experimental studies were developed. First clinical study was focused on success rate of osteosynthesis and it's complications. In studied population of 50 patients, 4 of them (8%) developed a non-union, which was in all cases caused by wrong indication or technical error during implantation. Superficial infection was observed once, no deep infection had developed. Nine patients (18%) have healed in rotational or axial malalingement that had no...
|
|
|
Scapular fractures: Clinical anatomy, radiodiagnostics, classification-it's importance for operative treatment
Tuček, Michal ; Bartoníček, Jan (advisor) ; Paša, Libor (referee) ; Skála-Rosenbaum, Jiří (referee)
Fractures of the scapula are not very frequent and account for less than 0.5 per cent of all fractures. In most cases they are caused by high-energy trauma and are associated with other injuries. Until recently, fractures of the scapula were rather neglected and treated mostly conservatively. Lately, hover the situation has changed. The number of patients with a scapula fracture is increasing, the interest in this issue is growing and discussion focuses more and more on operative treatment of these fractures. The dissertation thesis provides a comprehensive overview of diagnostics, classification and treatment of scapula fractures. In the anatomical section we have described weak areas in the construction of the scapula that predispose incidence of fracture lines. We have studied topographic relations of individual structures on the posterior aspect of the scapula from the viewpoint of the Judet approach and its modifications in individual types of fractures of the scapular body and neck. In the radiological section we have compared efficiency of individual imaging methods with the aim to evaluate the possibilities of individual radiographic methods, 3D CT reconstructions in particular, from the viewpoint of an exact determination of the type of the fracture, number of fragments and their...
|
|
| |
|
| |
|
| |
|
| |
guest ::
