Rhizarthrosis is accompanied by decreased mobility, poor grip, and progressive pain. Surgical treatment, which involves various techniques, is the only definitive solution sparing the joint. First carpometacarpal (CMC) joint arthroplasty helps reduce the discomfort associated with rhizarthrosis and restores joint function. From 2020 to the end of March 2024, 35 arthroplasties of the first CMC joint have been performed. In this study, the implant survival was recorded at a five-year follow-up. Evaluation of functional outcomes was conducted using preoperative and postoperative Disabilities of the Arm, Shoulder, and Hand (DASH), visual analogue scale (VAS), and Kapandji scores. Two types of implants were used, and their postoperative DASH and Kapandji scores were compared. The one-year implant survival was 0.97, and the three-year implant survival was 0.86. Range of motion showed significant improvement in patients after the first CMC arthroplasty. The VAS score, which assesses pain, and the DASH score, used to subjectively assess upper extremity disability, showed similar postoperative improvement. There is no significant difference in postoperative outcomes (DASH score and Kapandji score) between the "standard" and "dual mobility" implant types when evaluating postoperative outcomes. One intraoperative and two postoperative complications were observed in this study. First CMC joint arthroplasty effectively relieves pain, improves range of motion, and enhances functional outcomes in patients with rhizarthrosis. Both implant types demonstrated similar postoperative results in terms of DASH and Kapandji scores. While the study observed a few complications, the overall results support the efficacy of first CMC joint arthroplasty as a reliable treatment option for restoring joint function and reducing pain.

• Publication type
• Journal Article MeSH

OBJECTIVES: The purpose of our study was to compare the complication rate and the outcomes of custom-made spacers (C-spacers) and prefabricated articular spacers (P-spacers) in the treatment of periprosthetic infection. PATIENTS AND METHODS: In this retrospective study, 78 patients (44 females, 34 males; mean age: 68.5±9.48 years; range, 47 to 82 years) with articular spacers implanted in our institution were analyzed between January 2009 and December 2019. We recorded implant results as per mechanical complications, infection control, the interval from surgery to definitive hip replacement, and the rate of achieving recovery of joint function after stage two arthroplasty. RESULTS: There were 29 revised spacers; 18 of them were C-spacers and 11 were P-spacers (p=0.0383). A total of 16 dislocations were recorded, of which six were dislocations of C-spacers, and 10 were dislocations of P-spacers (p=0.0082). Additionally, we registered four spacer breakages, all of which occurred in C-spacers (p=0.295). C-spacers failed early, at an mean interval of 2.2 weeks after implantation, and P-spacers failed later, with an mean of 9.3 weeks after implantation (p=0.0187). A total of nine reinfection complications of spacers were registered; only one infection of P-spacers, and eight infections related to C-spacers (p=0.2583). Definitive revision total hip arthroplasty (rTHA) after spacer explantation and successful treatment of the infection occurred in 63 cases out of 78 patients. Definitive rTHA occurred after the use of C-spacers in 41 (78%) patients and after the use of C-spacers in 22 (84%) patients (p=0.7816). C-spacers had a mean interval from spacer implantation to definitive rTHA of 6.56±6.03 months, and P-spacers had a mean interval of 4±1.93 months (p=0.0164). CONCLUSION: Custom-made spacers were shown to have lower mechanical complication rates than prefabricated ones but more infection complications. Prefabricated spacers had more dislocations and fewer breakages. Custom-made spacer mechanical failures occurred earlier compared to prefabricated ones.

• MeSH
• Joint Dislocations * MeSH
• Infection Control MeSH
• Middle Aged MeSH
• Humans MeSH
• Arthroplasty, Replacement, Hip * adverse effects   MeSH
• Device Removal adverse effects   MeSH
• Retrospective Studies MeSH
• Aged MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

PURPOSE OF THE STUDY The authors focused on the topic of tibiotalocalcaneal arthrodesis. It is a surgical procedure used to manage severe comprehensive ankle and hindfoot pathology. The scope of surgery and the negative impact on the walking stereotype are offset by preserving a weight-bearing and pain-free limb. The purpose of the study was to evaluate the group of patients who had undergone surgery at the First Department of Orthopaedic Surgery, St. Anne s University Hospital Brno and to identify the most suitable fixation for arthrodesis. It also aimed to compare the outcomes achieved by the authors with those reported by other departments. MATERIAL AND METHODS The group included patients operated on at the authors department between 2011 and 2021. The surgery was indicated in patients with severe concomitant arthritis of the upper and lower ankle, complex hindfoot instability, Charcot arthropathy. Contraindications included acute infection, decompensated diabetes and heavy smoking. The study compares fixation using a lateral plate, a retrograde nail and a retrograde nail with fibula acting as biological plate. The patients were scored preoperatively and postoperatively using the AOFAS Ankle-Hindfoot Score. Statistical analysis of the results was also carried out. RESULTS The group included 23 patients, of whom a lateral plate was opted for in 7 patients, a retrograde nail in 8 patients and a retrograde nail with fibula used as a biological plate in 8 patients. The patients of the group were followed up for the period ranging from 0.5 to 9 years after surgery. Serious complications were observed by the authors in 6 patients of the group. The failure of osteosynthesis material was reported in 2 cases with lateral plating fixation. A stress fracture above the apex of the nail developed in 2 cases. A serious infection was observed by the authors in 1 patient. The method associated with the lowest incidence of complications was the fixation with a retrograde nail and fibula used as a biological plate. DISCUSSION The forms of fixation for tibiotalocalcaneal arthrodesis have recently advanced considerably, the methods of fixation for arthrodesis in particular. The modern implants enable to compress the individual structures, to provide stable fixation and potentially to avoid long-term plaster cast fixation. Nonetheless, these surgical procedures are associated with a high complication rate. Currently, there is no consensus in international studies on the optimal fixation for arthrodesis. Numerous papers describe complications including postoperative infections, failure of osteosynthesis material and fractures close to osteosynthesis material. The number and the type of complications observed by the authors in their group of patients were similar to those reported by other authors. CONCLUSIONS Tibiotalocalcaneal arthrodesis is a surgical procedure reserved exclusively for patients indicated based on strict criteria and should be performed by an experienced team able to cope with potential complications. In the followed-up group of patients, the optimal method of fixation for arthrodesis appeared to be the fixation with a retrograde nail and fibula used as a biological plate. Key words: tibiotalocalcaneal arthrodesis, retrograde nail, lateral ankle plate, ankle instability, ankle arthrosis, biological plate.

• MeSH
• Arthrodesis adverse effects   methods   MeSH
• Ankle Joint surgery   MeSH
• Bone Nails MeSH
• Humans MeSH
• Joint Instability * etiology   MeSH
• Osteoarthritis * MeSH
• Retrospective Studies MeSH
• Treatment Outcome MeSH
• Check Tag
• Humans MeSH
• Publication type
• English Abstract MeSH
• Journal Article MeSH

PURPOSE OF THE STUDY Partial knee replacement appears to be an appropriate surgical solution of unicompartmental knee joint osteoarthritis in correctly indicated cases. The purpose of our study was to evaluate the mid-term outcomes of unicondylar knee replacement using the Oxford Phase III system in the group of patients treated by the First Department of Orthopaedic Surgery, St. Anne s University Hospital Brno. MATERIAL AND METHODS The prospective study evaluated 47 patients (in 4 patients bilaterally) after the Oxford unicompartmental knee replacement performed between 2011 and 2016. The patients were evaluated using the Knee Society Score (KSS), Oxford Knee Score (OKS) and radiological examination performed at 7.3 years after surgery on average. All the patients were operated on by the same surgeon. RESULTS Based on the questionnaires and the clinical examination, the clinical and functional status was assessed, using the Knee Society Score (KSS). The mean preoperative KSS and FS values were 59.8 and 56.5, respectively. The postoperative KSS and FS values were 91.2 and 83.4. The mean preoperative value of the Oxford Knee Score (OKS) was 27.3. Postoperatively the values reached 40.7 on average. Based on the radiological examination, the lower limb correction of axis in the frontal plane was assessed. The mean axis correction was 3.1°. The mean tibial component slope measured on lateral radiograph was 82.7°. The basic analysis of X-rays did not reveal any component malposition. The implant survival rate was calculated using the Kaplan-Meier cumulative survival curve. In our group of patients, the mean survival rate of Oxford Phase III unicondylar knee replacement at 7.3 years postoperatively is 98.0%. DISCUSSION Many studies have reported excellent results of unicondylar knee replacement and a long survival rate of over 90%. Still debated, however, are the indication criteria and also the importance of the surgeon s experience and mastery of the surgical technique. CONCLUSIONS The results of the study confirm our excellent clinical experience and the survival rate of 98% at the mean follow up of 7.3 years after surgery shows great promise for quality long-term results. Overall, crucial for the success of UKR continues to be the compliance with the indication criteria for surgery. The choice of the type of implant and, last but not least, the correct surgical technique and postoperative rehabilitation programme are also important. Key words: unicompartmental knee replacement, Oxford Phase III, osteoarthritis of the knee.

• MeSH
• Osteoarthritis, Knee * surgery   MeSH
• Knee Joint diagnostic imaging   surgery   MeSH
• Humans MeSH
• Prospective Studies MeSH
• Knee Prosthesis * MeSH
• Retrospective Studies MeSH
• Arthroplasty, Replacement, Knee * adverse effects   MeSH
• Treatment Outcome MeSH
• Check Tag
• Humans MeSH
• Publication type
• English Abstract MeSH
• Journal Article MeSH

Řešení těžkých osových deformit při totální endoprotéze (TEP) kolenního kloubu je vždy výzvou pro operatéra. Autoři v článku rozebírají možnosti řešení této problematiky. Základní dělení deformit kolenního kloubu rozděluje deformity na extraartikulární a intraartikulární. Extraartikulární deformity vyžadují vždy pečlivé předoperační plánování s ohledem na umístění a tíži deformity, stav pacienta, stav končetiny i samotného kolenního kloubu. V jejich řešení přichází v úvahu tři základní možnosti: 1. osteotomie s odloženou implantací totální endoprotézy, 2. osteotomie a implantace totální endoprotézy v jedné době, 3. intraartikulární řešení extraartikulární deformity. Každá z možností má své indikace a technické aspekty. Intraartikulární deformity v zásadě dělíme na deformity valgózní a varózní. I u těchto deformit je základem úspěchu dobré předoperační plánování následované sekvenčním uvolněním měkkých tkání kolenního kloub s kompenzačními resekcemi kostní tkáně.

Solutions of severe axial deformities in TEP of the knee joint are always a challenge for the surgeon. The authors discuss the possibilities of solving this problem. The basic categorisation the of knee joint deformity divides deformities into extraarticular and intraarticular. Extraarticular deformities always require careful pre-operative planning with regard to the location and severity of the deformity, the condition of the patient, the condition of the limb and the knee itself. There are three basic options in their solution 1. osteotomy with delayed implantation of total endoprosthesis 2. osteotomy and implantation of total endoprosthesis at one time 3. intraarticular solution of extraarticular deformity Each option has its indications and technical aspects. Intraarticular deformities are basically divided into valgus and varrous deformities. Even with these deformities, good pre-operative planning is the basis for success, followed by sequential relaxation of soft tissue of the knee joint with compensatory resections of bone tissue.

• MeSH
• Surgical Procedures, Operative methods   utilization   MeSH
• Joint Deformities, Acquired * diagnostic imaging   etiology   surgery   MeSH
• Knee Joint abnormalities   diagnostic imaging   surgery   MeSH
• Humans MeSH
• Meta-Analysis as Topic MeSH
• Bone Diseases diagnostic imaging   surgery   complications   MeSH
• Osteotomy classification   methods   utilization   MeSH
• Arthroplasty, Replacement, Knee * methods   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

Úvod: Periprotetická infekce je potenciálně devastující komplikací. Dvoudobá reimplantace je v léčbě infekce zlatým standardem, je však zatížena vysokou morbiditou a horšími funkčními výsledky ve srovnání s léčbou infekce s ponecháním implantátu in situ. Léčba pomocí débridement s ponecháním endoprotézy je tedy v indikovaných případech považována za vhodnou alternativu. Materiál a metoda: Na naší klinice bylo v letech 2000–2015 ošetřeno uvedenou metodou 63 pacientů. U 38 pacientů se jednalo o infekci endoprotézy kolenního kloubu a u 25 kyčelního kloubu. U pacientů jsme retrospektivně hodnotili vztah úspěšnosti léčby pomocí débridement s ponecháním endoprotézy k typu implantátu, typu infekce podle Tsukayamy, druhu infekčního agens, intervalu mezi počátkem příznaků infekce a ošetřením kloubu a typu ošetření kloubu. Výsledky: Uvedeným způsobem se podařilo eradikovat infekci u 31 pacientů (49 %). Nenalezli jsme signifikantní rozdíly v úspěšnosti léčby ve sledovaných parametrech, kromě úspěšnosti ve vztahu k časovému intervalu mezi začátkem příznaků a ošetřením (p = 0,044). Ve skupině pacientů, u kterých byla dodržena všechna indikační kritéria a preferovaný typ ošetření kloubu (ošetření kloubu do 10 dní, infekce způsobená grampozitivními bakteriemi, infekce typu II a III dle Tsukayamy, ošetření kloubu otevřenou revizí, proplachovou laváží s jodovaným povidonem nebo antibiotickou pěnou, výměna mobilních částí kloubu), byla úspěšnost léčby 82 %. Ve skupině, kde alespoň jedno kritérium nebylo dodrženo, byla úspěšnost 31 %. Rozdíl mezi skupinami je statisticky významný (p = 0,028). Ve skupině pacientů ošetřených pomocí debridement s ponecháním náhrady byli tři pacienti s fatálními výsledky léčby ve srovnání se skupinou, kde byla v první době endoprotéza extrahována. Rozdíl je statisticky významný (p = 0,0495). Diskuze: Léčba infekce pomocí débridement s ponecháním endoprotézy je vhodnou alternativou léčby periprotetické infekce. Při dodržení správných indikačních kritérií a léčebného postupu lze dosáhnout úspěšnosti kolem 80 %. Při nedodržení kritérií může léčba vyústit ve fatální výsledek pro pacienta.

Introduction: Periprosthetic infection is a potentially devastating complication. A two-stage procedure is the “gold standard” for treatment of such infections, however there is still the burden of higher morbidity and has inferior functional results in comparison to treatment with debridement and retention of endoprosthesis. Debridement with retention of arthroplasty is assumed to be an appropriate alternative in indicated cases. Material and Methods: We treated 63 patients with this method between the years 2000 – 2015 at our department. 38 patients had an infected total knee endoprosthesis and 25 had an infected total knee arthroplasty. We evaluate retrospectively the relationship between success of treatment with debridement and retention of arthroplasty and the type of implant, the type of infection according to Tsukayama, the type of infectious agent and the interval between the onset of the symptoms and commencement of the treatment along with the type of joint treatment. Results: With the aforementioned method, we succeeded in eradicating infection in 31 patients (49 %). We didn’t found out significant differences in treatment success based on the surveyed parameters, apart from a link between the success of the treatment and the time interval between onset of the symptoms and treatment (p= 0.044). In the group where all indication criteria and preferred type of treatment were met (treatment to 10 days, Gram positive infection, type II or III according to Tsukayama, open revision, irrigation with povidon iodine or treatment with antibiotic foam, change of mobile parts of endoprosthesis) the success rate was 82 %. In the group where one or more of the criteria wasn’t met, the success rate was 31%. The difference between the groups was statically significant (p= 0.028). There were three patients in the group treated with debridement and retention in which treatment ended with a fatal result, in comparison to the group of primarily extracted infected implants (no fatal result). The difference is statistically significant (p= 0.0495). Discussion: Infection treatment with debridement and implant retention is a convenient alternative of periprosthetic infection treatment. Success rate could be around 80 % when correct indication criteria are met and treatment procedure is carried out correctly. Without meeting the proper criteria, the treatment could lead to fatal results for the patient.

• MeSH
• Anti-Bacterial Agents therapeutic use   MeSH
• Arthroscopy MeSH
• Bacterial Infections microbiology   MeSH
• Time Factors MeSH
• Debridement MeSH
• Prosthesis-Related Infections * therapy   MeSH
• Therapeutic Irrigation MeSH
• Middle Aged MeSH
• Humans MeSH
• Arthroplasty, Replacement, Hip * adverse effects   MeSH
• Postoperative Complications MeSH
• Joint Prosthesis microbiology   adverse effects   MeSH
• Retrospective Studies MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Arthroplasty, Replacement, Knee * adverse effects   MeSH
• Treatment Outcome MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH

Úvod: Dvoudobá replantace je považována metodu volby při infekci TKA. Použití artikulačního spaceru dle Aarona Hofmanna se jeví jako optimální metoda prvního kroku terapie – revize infikované TKA. Principem je zachování maximální možné pohyblivosti kolenního kloubu, prevence atrofie kolem kloubních svalů a efektivní sanace infektu. Materiál a metoda: Autoři prezentují soubor 41 pacientů s infikovanou totální endoprotézou kolene operovaných v letech 1998 – 2016 na I. ortopedické klinice FN u sv. Anny v Brně. Autoři hodnotí úspěšnost operace jak stran sanace infektu, tak stran funkčního výsledku spaceru. Výsledky: Sanace infekce byla úspěšná u 39 pacientů, 27 z nich má již replantovánu TKA. Ostatní pacienti jsou buď chystáni k replantaci, nebo je kvůli závažným komorbiditám či uspokojivému funkčnímu výsledku artikulačního spaceru operace odložena. TKA jsme replantovali v období mezi 3.-31. měsícem po implantaci spaceru, průměrně po 10 měsících. Funkčně se artikulační spacer osvědčil, po běžné rehabilitaci zcela bez pomůcek chodilo 6 pacientů, s ortézou 16 pacientů, o berli bez ortézy 10 pacientů, s použitím ortézy i berlí 7 pacientů a s invalidním vozíkem 1 pacientka. Při následné reimplantaci byla s výhodou kvalitní kostní tkáň s minimální nutností použití dříkových variant. Běžně jsme při revizi použili PS variantu endoportézy. Diskuze a závěr: Autoři v souladu s ostatními pracemi konstatují dobré výsledky metody jak stran sanace infektu tak stran funkčnosti artikulačního spaceru. Prezentují alternativní metody jiných autorů, které využívají statické spacery, popřípadě rozdílný přístup k lokálnímu působení antibiotik. Autoři se také zamýšlejí nad indikacemi a nad časovým odstupem před případnou replantací endoprotézy.

Introduction: Two-stage replantation is considered as the method of choice in the treatment of TKA infections. Using of articulating spacer by Aaron Hofmann seems to be the optimal method of the first step of therapy - revision of infected TKA. The principle is to maintain the maximum possible mobility of the knee joint, preventing muscle atrophy and ensure effective treatment of infection. Materials and Methods: The authors present a group of 41 patients with infected total knee arthroplasty, operated on in ages 1998 – 2016 at Ist. Orthopedic department of MF MU and St. Anna’s university hospital in Brno. The authors evaluate the success of the operation according to treatment of infection and according to functionality of the knee with spacer. Results: Treatment of infection was successful in 39 patients, 27 of them have already been replanted. Other patients are prepared for replantation, or because of serious co-morbidities or satisfactory functional outcome of articulating spacer is surgery delayed. TKA has been replanted between 3 to 31 months after implantation of the spacer, average after 10 months. Functionally articulating spacer approved. After the usual rehabilitation 6 patients didn’t need any crutches and braces, 16 patients used only knee braces, crutches without brace needed 10 patients, 7 patients used both, crutches and brace and one patient used wheelchair. 27 patients were able to walk and provide self-care. During subsequent reimplantation, the good quality of bone was an advantage. Only in few cases, the stem variants of revision knee endoprostheses were necessary. Usually, PS variants were used. Discussion and Conclusion: Excellent results in infect treatment are in concordance with other authors. Authors present alternative methods using static spacers or another preview on using of local acting antibiotics. Indications and laps of time to endoprothesis revision are discussed.

• Keywords
• artikulační spacer,
• MeSH
• Anti-Bacterial Agents administration & dosage   MeSH
• Administration, Topical MeSH
• Bacterial Infections diagnosis   drug therapy   surgery   MeSH
• Coated Materials, Biocompatible MeSH
• Time Factors MeSH
• Adult MeSH
• Gentamicins administration & dosage   MeSH
• Prosthesis-Related Infections * etiology   drug therapy   surgery   MeSH
• Bone Cements * MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Device Removal MeSH
• Prosthesis Design MeSH
• Knee Prosthesis adverse effects   MeSH
• Reoperation MeSH
• Retrospective Studies MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Arthroplasty, Replacement, Knee * adverse effects   MeSH
• Treatment Outcome MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH

• MeSH
• Arthrodesis MeSH
• Arthroplasty MeSH
• Diagnostic Imaging MeSH
• Hallux Rigidus diagnosis   etiology   therapy   MeSH
• Hallux Valgus diagnosis   etiology   therapy   MeSH
• Humans MeSH
• Metatarsalgia diagnosis   etiology   therapy   MeSH
• Orthopedic Procedures MeSH
• Osteotomy MeSH
• Flatfoot etiology   surgery   therapy   MeSH
• Forefoot, Human MeSH
• Toes MeSH
• Foot Deformities, Acquired * diagnosis   etiology   therapy   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

Úvod: Periprotetická zlomenina v oblasti kolenního kloubu může být potenciálně devastující komplikací zejména u pacientů s defektní kostí v periprotetické oblasti. V těchto případech je indikována revizní náhrada kolenního kloubu. Materiál a metoda: V článku autoři hodnotí soubor 15 revizních náhrad kolenního kloubu implantovaných na I. ortopedické klinice v Brně v letech 1977–2013 pro periprotetickou zlomeninu. U 11 pacientů byla revizní náhrada indikována jako primární řešení zlomeniny, u 4 pacientů jako sekundární řešení po selhání osteosyntézy. Výsledky: Zaznamenali jsme 11 pooperačních komplikací, z toho jednou selhání revizní náhrady se zlomením dříku a jednou periprotetickou zlomeninu v oblasti dříku. Průměrné klinické KSS po revizní náhradě bylo 70 bodů (50–90), průměrné funkční skóre bylo 48 bodů (10–80). Závěr: Ačkoli revizní náhrada kolenního kloubu přináší možnost rychlé restituce operovaného kloubu s časnou možností plné zátěže, je zatížena vysokým rizikem komplikací a funkční výsledky jsou horší než u revizních náhrad v ostatních indikacích.

Introduction: Periprosthetic fracture in the knee area can potentially be a devastating complication, especially in the patients with poor bone stock in the periprosthetic area. In such cases revision total knee arthroplasty is indicated. Material and methods: In this paper, the authors evaluate a cohort of 15 revision arthroplasties performed at the 1st Orthopaedic Department of St. Anne's University Hospital, due to periprosthetic fractures, between the years 1977 – 2013. In 11 patients the revision arthroplasty was indicated as the primary solution to the fracture and in 4 patients as a secondary solution after osteosynthesis failed. Results: We recorded 11 postoperative complications; from this number there was one failure of revision arthroplasty caused by broken stem and one periprosthetic fracture in the stem area. The average clinical KSS after revision arthroplasty was 70 points (50 – 90), average functional score was 48 points (10 – 80). Conclusion: Even though revision total arthroplasty allows the possibility of rapid restoration of the operated joint with the possibility of early weight bearing, it is characterised by a high risk of complications and its functional results are generally worse than revision arthroplasties in other indications.

• MeSH
• Middle Aged MeSH
• Humans MeSH
• Periprosthetic Fractures * etiology   surgery   classification   complications   MeSH
• Postoperative Complications MeSH
• Reoperation * methods   statistics & numerical data   adverse effects   MeSH
• Retrospective Studies MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Arthroplasty, Replacement, Knee * adverse effects   MeSH
• Treatment Outcome MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Historical Article MeSH
• Research Support, Non-U.S. Gov't MeSH

Operace totální endoprotézy kolenního kloubu je výkon spojený se silnými algickými podněty jak perioperačně, tak především pooperačně. Práce si klade za cíl zmapovat aktuální možnosti multimodální analgetické terapie. Jsou popsány možnosti klasické farmakoterapie a zároveň v dnešní době velmi aktuální svodné a perineurální analgezie. V článku je rovněž prezentován přístup pracovišť obou autorů k problematice. U popsaných postupů jsou zmíněny indikace a kontraindikace jednotlivých metod a dávkovací schémata v čase.

The total knee replacement surgery is associated with strong pain stimuli during both the perioperative and postoperative period. This article aims to map the current options of multimodal analgesic therapy. Authors describe the possibilities of conventional pharmacotherapy and also perineural analgesia. The article also presents the approaches to the issue followed at both authors' workplaces. For the procedures described in the article, indications and contraindications of each method and dosing schedules over time are mentioned as well.

• Keywords
• totální endoprotéza kolenního kloubu, multimodální analgézie, perineurální analgezie,
• MeSH
• Analgesics administration & dosage   therapeutic use   MeSH
• Analgesia * methods   trends   utilization   MeSH
• Anti-Inflammatory Agents, Non-Steroidal administration & dosage   therapeutic use   MeSH
• Analgesia, Epidural methods   MeSH
• Humans MeSH
• Sciatic Nerve drug effects   MeSH
• Analgesics, Opioid administration & dosage   therapeutic use   MeSH
• Peripheral Nerves drug effects   MeSH
• Perioperative Care MeSH
• Postoperative Complications prevention & control   MeSH
• Postoperative Care methods   rehabilitation   MeSH
• Rehabilitation MeSH
• Arthroplasty, Replacement, Knee * MeSH
• Tramadol administration & dosage   therapeutic use   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH