PURPOSE OF THE STUDY It was a prospective, randomised, unblinded study. Effects of the application of platelet-rich fibrin (PRF) on the anatomic anterior ligament reconstruction were examined. MATERIAL AND METHODS A total of 40 patients who underwent a surgery between 2012 and 2014 were enrolled in the study. The patients were randomised into two groups: the group with PRF application (n=20) and the group without PRF application (n=20, control group). The study included 11 women and 29 men, with the mean age at the time of inclusion into the study 29.1 years. Vivostat ® PRF was obtained perioperatively from the patient s blood and applied intraoperatively to the hamstring tendon graft. The ACL graft healing was assessed through magnetic resonance (MRI) at 6 and 12 months postoperatively. The clinical outcomes (the Lysholm score and the IKDC Subjective score, return to pre-injury sport levels, Pivot-shift test, graft failure) as well as standardised laxity measurements using GenouRob arthrometer were performed preoperatively and 12 months after surgery. RESULTS The study was completed by thirty-three (33) patients (17 in the PRF group and 16 in the control group). In two cases, postoperative graft failure was reported (both cases in the control group). No significant differences were found in the process of graft ligamentization evaluated through MRI (p=0.07). No significant difference between the groups was identified with respect to return to pre-injury sport levels (p=0.232), or the Lysholm score and IKDC Subjective score (p=0.259, and p=0.364 respectively). The postoperative knee laxity measurement using Genourob arthrometer did not reveal any significant differences between the PRF group and the control group. DISCUSSION Results similar to those arrived at by our study have recently been published also by other authors worldwide. We can therefore assume that the application of PRF can be of benefit, especially at the early stage of healing. The results still need to be verified on a larger study group, the study design should focus on the development in the early postoperative period. CONCLUSIONS In our study group, no significant difference was observed in the evaluated subjective and objective clinical parameters. Only the parameter regarding the ACL graft failure fell just short of statistical significance, namely to the disadvantage of the group without the PRF application. Key words: anterior cruciate ligament, arthroscopy, anatomic ACL reconstruction, magnetic resonance imaging of the graft, platelet-rich fibrin, graft healing, MRI signal intensity of the graft.
- MeSH
- fibrin bohatý na krevní destičky * MeSH
- kolenní kloub chirurgie MeSH
- lidé MeSH
- nestabilita kloubu * chirurgie MeSH
- poranění předního zkříženého vazu * chirurgie MeSH
- prospektivní studie MeSH
- rekonstrukce předního zkříženého vazu * metody MeSH
- šlachy hamstringů * transplantace MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- randomizované kontrolované studie MeSH
PI-RADS (prostate imaging reporting and data system) je strukturovaný schematický způsob hodnocení a popisu multiparametrického vyšetření prostaty magnetickou rezonancí u pacientů s podezřením na karcinom prostaty. Zavedení klasifikace v roce 2012 vedlo k standardizované interpretaci. PI-RADS 2.1 z roku 2019 aktualizuje systém hodnocení na základ vyhodnocení významujednotlivých změn a odstraňuje některé nejednoznačnosti předchozích verzí. PI-RADS verze 2.1 používá pětibodovou škálu rizika přítomnosti karcinomu získanou kombinací zjištěných změn při multiparametrickém vyšetření v T2w, ADC/DWI a DCE, v každé podezřelé lézi v parenchymu žlázy.
PI-RADS (Prostate Imaging Reporting and Data System) is a structured schematic description of multiparametric magnetic resonance imaging of the prostate in patients suspected of having prostate cancer. The introduction of this classification in 2012 led to more standardized interpretations of findings. Since then, ratings have been upgraded severaltimes. PI-RADS version 2.1, issued 2019 improved the classification systém and repaired the inconsistencies of previous versions. PI-RADS version 2.1 uses 5-point scale of risk of carcinoma presence obtained by combining the observed changes in multiparametric examinations in T2w, ADC/DWI and DCE, in each suspicious lesion in the glandular tissue.
- Klíčová slova
- sektorový model,
- MeSH
- klinické rozhodování metody MeSH
- lidé MeSH
- multiparametrická magnetická rezonance MeSH
- nádory prostaty diagnostické zobrazování patologie MeSH
- prostata * anatomie a histologie diagnostické zobrazování patologie MeSH
- směrnice pro lékařskou praxi jako téma * MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- práce podpořená grantem MeSH
- přehledy MeSH
- Publikační typ
- abstrakt z konference MeSH
- Klíčová slova
- artroskopie kyčelního kloubu,
- MeSH
- artroskopie * metody MeSH
- femoroacetabulární impingement * diagnóza etiologie terapie MeSH
- kyčelní kloub chirurgie patologie MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
- Publikační typ
- abstrakt z konference MeSH
Autoři prezentují kazuistiku 3leté holčičky, u které byla pomocí zobrazovacích metod (USG a CT) prokázána přítomnost střevního parazita (škrkavka dětská, Ascaris lumbricoides) v tenkém střevě komplikovaná vícečetnou intermitentní intususcepcí.
The authors present a case report of a 3-year-old girl, with proving presence of intestinal parasites (roundworm, Ascaris lumbricoides) in the small intestine complicated brains of intermittent intussusception. Ultrasound and CT were major diagnostic tools in this case.
- MeSH
- antinematodní látky terapeutické užití MeSH
- Ascaris lumbricoides izolace a purifikace patogenita růst a vývoj MeSH
- askaridóza * diagnóza komplikace MeSH
- dítě MeSH
- intususcepce * parazitologie radiografie ultrasonografie MeSH
- lidé MeSH
- předškolní dítě MeSH
- tenké střevo parazitologie radiografie ultrasonografie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
PURPOSE OF THE STUDY The study presents a retrospective evaluation of clinical data and arthroscopic findings in a group of our patients with symptomatic knee instability due to a partial tear of the anterior cruciate ligament (ACL). MATERIAL AND METHODS The group included 31 patients diagnosed with symptomatic partial ACL tears, i.e. an isolated tear of the posterolateral (PL) or the anteromedial (AM) bundle. The patients' average age was 26.5 years. A side-to-side difference in ventral knee laxity was assessed using the anterior drawer test and the Lachman test under general anaesthesia before arthroscopy was commenced; rotational knee laxity was evaluated by the pivot shift test. An objective evaluation of side-to-side ventral laxity differences in both knees was performed on the GNRB® arthrometer with an applied pressure of 134 N and 250 N in the conscious patient. During arthroscopic examination, findings on the two ACL bundles were recorded. RESULTS All 31 patients were diagnosed with symptomatic partial ACL tears, of them 22 had a PL bundle lesion and nine had an AM bundle tear. All patients with PL bundle lesions only reported problems in association with pivot sports, and all patients with AM bundle tears had problems regardless of any sports activities. In all patients with isolated AM bundle tears, the lesion was located close to its femoral attachment. In the patients with PL bundle tears, femoral location was found in 68% and tibial location in 32% of the patients. In the patients with partial PL bundle lesions, + and ++ results in the pivot shift test were recorded in 32% and 68% of the treated patients, respectively. The Lachman test showed + and ++ results in 71% and 9% of the patients, respectively. The anterior drawer test had negative results in 87% and positive + results in 13% of the patients. The side-to-side difference on the GNRB arthrometer ranged from 0.4 to 2.3 mm at a pressure of 134 N and from 1.2 to 4.2 mm at 250 N in the patients with isolated PL bundle lesions. In the patients with AM bundle lesions, the results were as follows: pivot shift test, 89% negative. 11% positive +; Lachman test, 56% negative, 44% positive +; anterior drawer test, 89% +, 11% ++; GNRB test, 2.2 to 4.4 mm at 134 N, and 4.3 to 7.1 at 250 N. DISCUSSION The diagnosis of partial ACL lesions, i.e., isolated tears of the AM or the PL bundle, requires accurate knowledge of knee anatomy and its biomechanics. In accordance with other authors our results showed that an arthroscopic examination of both bundles of the ligament as well as knee laxity evaluation under general anaesthesia are most essential for making the definite diagnosis in partial ACL tears. They also confirmed that, in isolated AM bundle lesions, ventral laxity is present more often particularly at a higher degree of knee flexion while, in PL bundle lesions, rotational laxity is more frequent and ranges from 0 to 30 degrees of knee flexion. CONCLUSIONS To make the definite diagnosis of partial ACL tears, patient medical history, clinical knee examination including instability type and degree assessment under general anaesthesia and, most importantly, arthroscopic findings on both ACL bundles are necessary.
PURPOSE OF THE STUDY: In this prospective randomised study, the short-term results of arthroscopic transcapsular iliopsoas tenotomy approached from the peripheral versus the central compartment for internal snapping hip syndrome are presented. MATERIAL AND METHODS: A group of 19 patients (15 women and four men; mean age, 24.3 years) who underwent arthroscopic transcapsular iliopsoas tenotomy for internal snapping hip syndrome in the period between September 2010 and December 2011 were prospectively evaluated. No injury, hip surgery or feeling of hip instability was recorded in their personal histories. Radiographs did not show any dysplasia, retroversion of the acetabulum or cam lesions. The patients were allocated to two groups using sealed envelope randomisation: Group 1 patients (n=10) were treated by tenotomy from the peripheral compartment and group 2 patients (n=9) underwent tenotomy from the central compartment during traction of the lower extremity. The evaluation included pre-operative 3T MRI findings, arthroscopically detected intra-articular lesions, duration of traction and post-operative complications. The pre-operative WOMAC scores were compared with those at one-year follow-up. In comparison of the two groups, the Mann-Whitney exact test was used for WOMAC scores and Fisher's exact test for post-operative complications. Statistical significance was set at a 0.05 level. RESULTS: In comparing post-operative complications, a significant difference (p=0.0468) between the groups was found only for genital paresthesia, which did not occur in group 1. The other differences were not statistically significant. The pre-operative WOMAC scores did not differ significantly between the groups (p=0.79). The post-operative WOMAC scores were significantly higher in group 1 (p=0.02). In each group the change in WOMAC scores was different and was statistically significant in group 1 (p=0.0014). Associated intra-articular hip pathologies, most frequently synovitis of the peripheral compartment, acetabular chondropathy, or labral lesions, were diagnosed in 90% of group 1 patients and in 66.7% of group 2 patients. DISCUSSION: Most of the authors comparing the results of two different ilioproas tenotomy techniques at one-year follow-up did not report any statistically significant differences in WOMAC scores between them. In accordance with the data reported, an increase in the post-operative WOMAC score, i.e., improvement of clinical outcome, was achieved in all our patients and, in group 1, it was significantly higher (p=0.0015), as compared with a similar study by Ilizaliturri. However, further follow-up of the patients and evaluation of long-term results will be necessary. CONCLUSIONS: The technique of arthroscopic ilioproas tenotomy approached from the peripheral compartment resulted in significantly fewer cases of genital paresthesia and provided significantly better clinical outcomes in comparison with tenotomy from the central compartment.
- MeSH
- artroskopie metody MeSH
- bederní svaly chirurgie MeSH
- dospělí MeSH
- kompartment syndrom diagnóza chirurgie MeSH
- kyčel chirurgie MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- mladý dospělý MeSH
- nemoci kloubů diagnóza chirurgie MeSH
- prospektivní studie MeSH
- šlachy chirurgie MeSH
- syndrom MeSH
- tenotomie metody MeSH
- úžinový syndrom chirurgie MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- randomizované kontrolované studie MeSH
- srovnávací studie MeSH
