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PURPOSE OF THE STUDY In view of increasing interest in a relationship between the surface of an implant and its behaviour and longevity in total hip arthroplasty (THA), the aim of this study is to present the clinical and radiographic results, as well as complications, of hip replacement surgery using the cemented femoral stem SAS I. MATERIAL AND METHODS A total of 298 cemented femoral stems SAS I were implanted in 275 patients at our department between 1996 and 2005. The patient average age was 72.1 years, with the range from 64 to 92 years. The pre-operative diagnoses were as follows: primary osteoarthritis in 179 (30.1%); post-dysplastic osteoarthritis in 41 (13.7%); femoral neck fracture in 44 (14.8%); avascular necrosis of the femoral head in 23 (7.7%); rheumatoid arthritis in nine (3%) and other causes in two (0.7%) patients. Of the 275 patients who had the surgery, 186 (204 THAs) underwent clinical and X-ray examination at an average follow-up of 11.5 years (range, 8 to 17 years). The clinical results were used to calculate the Harris hip score and radiographic evaluation was based on antero-posterior views. RESULTS The group of 186 assessed patients (204 THAs) comprised 106 women and 80 men, who were on average 85.4 years old on evaluation (range, 72 to 92 years). Of the remaining patients, 62 patients (64 THAs) died from causes unrelated to the surgery and 27 patients (30 THAs) were lost to follow-up. The functional outcome of surgery assessed by the Harris hip score was excellent in 61 (32.8%), good in 94 (50.5%), satisfactory in 26 (14%) and poor in five (2.7%) patients. The 93.1% SAS I stem longevity was recorded in relation to aseptic loosening; reimplantation for this indication was performed in 14 THAs. No revision surgery for failure due to valgus/varus deviations of the stem was carried out. Of the 204 hips, 188 had femoral stems aligned in neutral, 12 (5.9%) in valgus and four (2%) in varus positions. DISCUSSION The anatomical femoral stem SAS I is an implant made to fit the proximal femur anatomy. Its highly polished surface allows for optimal fitting with the supporting bone and for even distribution of weight bearing. This results in a low rate of THA failure. In accordance with the relevant literature, the acetabular components is considered to be the weakest element in total hip replacement in terms of aseptic loosening and implant failure. At present, the SAS I stem has no Morse Eurocone taper and this is the chief obstacle hindering its more frequent use in endoprosthetics. CONCLUSIONS The results of our study are in agreement with those of other successfully implanted polished cemented femoral components. Key words: anatomical cemented femoral component, surface adjustment of the femoral stem, complications.

Článek

Stanovení sociální adekvátnosti sluchu - SAS
[Assessment of the social adequacy of hearing]

Otorinolaryngologie a foniatrie. 2000 ; Roč. 49 (č. 1) : s. 29-31.

ISSN 1210-7867
Medvik
Zdroj

Sluch slouží především jako způsob přenášení informací, jako prostředek komunikace.Nepoškozený sluch tedy není charakterizován normálním prahovým audiogramem, ale nepoškoze-nou možností výměny akustických informací, nepoškozenou verbální komunikací. Řečí, jejímslyšením a rozuměním, jsou vytvářeny sociální mezilidské vztahy. Proto sluch existuje předevšímjako faktor tvorby a rozvoje mezilidských sociálních vztahů.Posouzení stavu sluchu je možné buď vzhledem ke kvalitě a kvalitě sluchového vjemu nebo vzhle-dem k jeho sociálně komunikační funkci. Kvalita = jak široce slyší (frekvence) a kvantita = kolikslyší (intenzita) se vyšetřují prahovým tónovým audiogramem. Komunikační schopnosti sluchu pakslovní audiometrií. “Sociální adekvátnost sluchu” se stanoví na základě výpočtu ze slovního audio-gramu a výsledek vyjadřuje na kolik procent porucha sluchu poškozuje komunikační možnostipacienta. Výsledek ihned a dostatečně přesně posuzuje možnosti poškozeného sluchu vzhledem kekomunikaci, k tvorbě sociálních vztahů a také umožňuje přesné a jednoznačné hodnocení sociálněkomunikačního zisku po korekci sluchové vady sluchadlem.

Hearing serves in the first place as a way of transmitting information, as a means of communication. Unimpaired hearing is thus not characterized by a normal threshold audiogram but by an unimpaired possibility of exchange of acoustic information, unimpared verbal communi- cation. By speech, its perception and understanding social interhuman relations are created. Therefore hearing exists above all as a factor of the creation and development of interhuman social relations. The state of hearing can be assessed either as regards quantity and quality of perception or with regard to its social communication function. Quality = implies the range of hearing (frequency) and quantity = the intensity. Both are examined by means of the threshold tone audiogram. The communication capacity of hearing is examined by verbal audiometry. The ihsocial adequacy of hearinglr is assessed by a calculation from the verbal audiogram and the result expresses the percentage by which the impaired hearing interferes with the communicating possibilitis of the patient. The result indicates immediately and sufficiently accurately the possibilities of the impai- red hearing in relation to communication, establishment of social relations and makes also accurate and unequivocal evaluation of the social communication gain after correction with a hearing aid possible.