• Publikační typ
• abstrakt z konference MeSH

PURPOSE OF THE STUDY: An analysis of long-term results of the all-polyethylene tibial component in Walter-Motorlet cemented condylar knee arthroplasty, with a standard tibial plateau (STP) of our own design. MATERIAL AND METHODS: A total of 49 patients underwent knee replacement; of them, 35 (71.4%) with 38 Walter-Motorlet implants using the STP were evaluated. The average age at the time of evaluation was 87.3 years. The follow-up ranged from 18 to 27 years (average, 24.6 years). Mechanical properties of the STP were tested by experimental measurements and in a photoelasticimetric study. The clinical results were evaluated according to the EULAR Knee Assessment Chart (EKACH). Twenty-four patients (26 knees; 49%) had osteoarthritis (OA) and 11 (12 knees; 23%) had rheumatoid arthritis (RA). Of the 14 (28.6%) patients not included in evaluation, seven (14.3%), with seven knees, required revision arthroplasty and seven (14.3%), with 10 knees, were lost to follow-up. RESULTS: Of the 38 implants evaluated by the EKACH at an average of 24.6 years, subjectively, 14 (36.8%) knees were free from pain and 14 (36.8%) were mildly painful. The remaining 10 (26.4%) joints were acutely painful on walking up or down the hill. In 14 (36.8%) cases the patients experienced their knees as stable. Light domestic chores were routinely performed by 17 patients (10 OA and 7 RA; 48.6%). One (2.9%) OA patient had a full-time job, and nine (25.7%) patients were socially independent. The functional outcome was significantly related to the patient's age at the time of evaluation. Complications included STP aseptic loosening in five (13.1%) and late infection in two (5.2%) knees. Radiography showed translucent zones below an all-polyethylene component in 14 (36.8%) knees. DISCUSSION The five cases of aseptic loosening may have been due to insufficient hardness of a U-shaped polyethylene component and long-term stress at the bone-implant interface. In the majority of knees the anterior cruciate ligament was defective or missing completely. Maintenance of the posterior cruciate ligament facilitates absorption of the greater part of forces at the cement-bone interface, as also reported by other authors. The high incidence of complications associated with patellar components, as described in the literature of the late 1970s and the early 1980s, led us to avoid the primary use of a patellar implant. CONCLUSIONS: Our evaluation showed that, in 73% of the cases, the all-polyethylene tibial component was a suitable and inexpensive implant with very good or good long-term results on average at 24.6 years of follow-up. Since the quality of currently produced polyethylene is high, we recommend the use of all-polyethylene tibial components in all indicated cases.

• MeSH
• artralgie prevence a kontrola   MeSH
• artróza kolenních kloubů patofyziologie   chirurgie   MeSH
• lidé MeSH
• následné studie MeSH
• obnova funkce MeSH
• polyethylen MeSH
• protézy - design * MeSH
• protézy kolene * MeSH
• revmatoidní artritida patofyziologie   chirurgie   MeSH
• selhání protézy MeSH
• senioři nad 80 let MeSH
• totální endoprotéza kolene přístrojové vybavení   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• senioři nad 80 let MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

PURPOSE OF THE STUDY: Surgical procedures on muscles in cerebral palsy are regarded as essential interventions. The tactics for surgery on the triceps surae muscle in the treatment of spastic pes equinus involve several surgical options at different muscle levels. MATERIAL AND METHODS: In the 1992-2008 period, Baker's procedure, prolongation of the triceps muscle in the common part of the gastrocnemius and soleus aponeuroses, was indicated in 114 children, aged between 3 and 18 years, mostly with spastic hemipleia (45.7 %) or diplegia (42.9 %). In both groups, the isolated Baker's procedures and the combined procedures were clinically assessment at 2 and 6 months after surgery. RESULTS: Clinical examination at a follow-up of 8 weeks showed that all patients achieved 5 to 10 degrees of dorsiflexion of the foot. A maximum of Achilles tendon stretch-out was achieved in seven patients (6.14%) after 6 months. In one patient (0.9%) an excessive dorsiflexion was recorded. DISCUSSION: The choice of surgical tactics for treatment of spastic pes equinus is related to a positive or a negative result of the Silfverskiold test, because this shows the degree of contracture of the gastrocnemius and soleus muscles. Prolongation at their joint aponeurosis should be indicated when the test shows partly positive results, and muscle balance at all levels of the lower extremity should be maintained. CONCLUSIONS: Baker's procedure is one of the options to treat spastic pes equinus. The surgery is indicated primarily in isolated pes equinus and in children with spastic hemiplegia with low risk of Achilles tendon excessive elongation. Key words: pes equinus, Silfverskiold test, Baker's procedure.

• MeSH
• dítě MeSH
• equinózní deformity nohy (od hlezna dolů) etiologie   chirurgie   MeSH
• kosterní svaly chirurgie   MeSH
• lidé MeSH
• mladiství MeSH
• mozková obrna komplikace   MeSH
• ortopedické výkony metody   MeSH
• předškolní dítě MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH

• Klíčová slova
• syndrom bolestivého kolena,
• MeSH
• bolest MeSH
• diagnostické zobrazování MeSH
• diferenciální diagnóza MeSH
• kolenní kloub patologie   MeSH
• koleno patologie   MeSH
• terapie MeSH
• Publikační typ
• monografie MeSH

• Konspekt
• Ortopedie. Chirurgie. Oftalmologie
• NLK Obory
• ortopedie
• revmatologie
• radiologie, nukleární medicína a zobrazovací metody

• MeSH
• femur patofyziologie   MeSH
• lidé MeSH
• rotace škodlivé účinky   MeSH
• totální endoprotéza kolene metody   škodlivé účinky   využití   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• srovnávací studie MeSH

• MeSH
• artroplastika MeSH
• hlezenní kloub chirurgie   patologie   MeSH
• kolenní kloub chirurgie   patologie   MeSH
• revmatoidní artritida chirurgie   MeSH
• Publikační typ
• kongresy MeSH

• MeSH
• lékaři MeSH
• ortopedie MeSH
• významné osobnosti MeSH
• Publikační typ
• biografie MeSH

• Konspekt
• Lékařské vědy. Lékařství
• NLK Obory
• dějiny lékařství
• lékařství
• ortopedie

• O autorovi
• Zahradníček, Jan, 1882-1958 Autorita

• MeSH
• kooperační chování MeSH
• lidé MeSH
• revmatické nemoci chirurgie   terapie   MeSH
• Check Tag
• lidé MeSH

• MeSH
• lidé MeSH
• revmatické nemoci chirurgie   MeSH
• Check Tag
• lidé MeSH

• MeSH
• farmakoterapie metody   MeSH
• revmatické nemoci farmakoterapie   MeSH
• Publikační typ
• recenze MeSH