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
• dislokace kloubu * MeSH
• kontrola infekce MeSH
• lidé středního věku MeSH
• lidé MeSH
• náhrada kyčelního kloubu * škodlivé účinky   MeSH
• odstranění implantátu škodlivé účinky   MeSH
• retrospektivní studie MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• fibrilace síní farmakoterapie   chirurgie   klasifikace   MeSH
• hodnocení rizik MeSH
• implantované elektrody MeSH
• kardiochirurgické výkony metody   MeSH
• kardiostimulace umělá metody   MeSH
• katetrizační ablace metody   MeSH
• lidé MeSH
• odstranění implantátu metody   normy   škodlivé účinky   MeSH
• prostředky srdeční resynchronizační terapie MeSH
• srdeční arytmie * diagnostické zobrazování   chirurgie   klasifikace   MeSH
• Check Tag
• lidé MeSH

The authors describe an unusual complication in dental implantology – soft- and hard-tissue thermal necrosis of the alveolar process. The thermal damage of the tissue around the cervical region of two transitional implants arose after the amputation of the apex of these titanium miniimplants while using improper rotational instrument. The therapy was reduced to explantation of causal miniimplants and to small augmentation using hydroxyapatite without barrier membrane. The rest of the defect regenerated spontaneously.

• MeSH
• absces etiologie   farmakoterapie   chirurgie   MeSH
• hojení ran MeSH
• implantace zubů * mortalita   škodlivé účinky   MeSH
• lidé středního věku MeSH
• lidé MeSH
• odstranění implantátu * přístrojové vybavení   škodlivé účinky   MeSH
• osteonekróza * etiologie   terapie   MeSH
• vysoká teplota škodlivé účinky   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH
• práce podpořená grantem MeSH

AIM: This study was designed to evaluate feasibility and effectiveness of hysteroscopic intervention in the management of symptoms related to the displaced levonorgestrel-releasing intrauterine system (LNG-IUS). MATERIAL AND METHODS: One hundred and thirteen patients with displaced LNG-IUS presenting with irregular uterine bleeding, pelvic pain or asymptomatic displacement were recruited for hysteroscopic examination. Displaced LNG-IUS was relocated by hysteroscopic intervention and the effect on symptoms and LNG-IUS position was followed. RESULTS: The displaced LNG-IUS was successfully relocated by hysteroscope in 112 (99.1%) of 113 cases. Following LNG-IUS relocation, 71 (79.8%) patients of 89 with preoperative irregular uterine bleeding had amenorrhea or vaginal spotting, and 14 of 15 (93.3%) patients with preoperative pelvic pain became asymptomatic. LNG-IUS expulsion was recorded in two patients 7 and 21 days after hysteroscopy. CONCLUSION: Displaced LNG-IUS can cause clinical symptoms (e.g. irregular bleeding, pain). Hysteroscopic relocation of displaced LNG-IUS is a feasible method in the management of these symptoms. Risk of spontaneous expulsion associated with hysteroscopy is low.

• MeSH
• dospělí MeSH
• hysteroskopie * MeSH
• kohortové studie MeSH
• levonorgestrel aplikace a dávkování   MeSH
• lidé středního věku MeSH
• lidé MeSH
• metroragie etiologie   prevence a kontrola   MeSH
• migrace nitroděložního tělíska škodlivé účinky   MeSH
• mladý dospělý MeSH
• následné studie MeSH
• nitroděložní tělíska hormonální škodlivé účinky   MeSH
• odstranění implantátu škodlivé účinky   metody   MeSH
• pánevní bolest etiologie   prevence a kontrola   MeSH
• studie proveditelnosti MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH