BACKGROUND: Little evidence has been provided regarding physical performance and flat-footedness in school-age children. Although flat feet may decrease the level of motor performance, findings remain inconsistent. Therefore, the main purpose of the study was to determine whether children with flat feet had poorer physical task performance, compared to normal-footed children. METHODS: A total of 208 primary school boys were included in the study (107 normal-footed and 101 flatfooted boys). Flat footedness (< 42°) was determined using Clark's method. The children were tested by a set of unilateral and bilateral tests selected from the area of explosive power and dynamic balance which included: (i) countermovement jump, (ii) standing broad jump, (iii) the triple crossover hop for distance test, (iv) maximal sprinting speed over 10, 20 and 40 m and (v) the Star Excursion Balance Test. Differences were adjusted for age, body mass index, peak height velocity and physical activity. RESULTS: Flat footed children exhibited significantly poorer results in bilateral standing broad jump (effect size [ES] = 0.34), unilateral standing broad jump for dominant (ES = 0.31) and non-dominant leg (ES = 0.20), the triple crossover hop for distance test for dominant (ES = 0.24) and non-dominant leg (ES = 0.23) and the Star Excursion Balance Test (ES = 0.23-0.43) and were slower in maximal sprinting speed test over 20 m (ES = 0.25) and 40 m (ES = 0.30). CONCLUSIONS: This study shows that children with flat feet performed poorer in some physical performance tasks, compared to the normal feet counterparts.
- MeSH
- cvičení MeSH
- dítě MeSH
- dolní končetina MeSH
- lidé MeSH
- noha (od hlezna dolů) MeSH
- plochá noha * MeSH
- školy MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
PURPOSE: The study evaluates long-term results in patients treated by valgus intertrochanteric osteotomy (VITO) for partial avascular necrosis of the femoral head (ANFH) after fracture of the femoral neck in adolescent age. Although this method is mentioned in literature frequently, there are only few studies in the literature dealing with it in detail. METHODS: Authors evaluated five patients at the interval of 15 to 20 years following VITO. The mean age of the patients at the time of injury was 13.6 years and at the time of VITO 16.7 years. The studied parameters included resorption of necrotic segment of femoral head, development of posttraumatic osteoarthritis and leg shortening. RESULTS: Comparison of radiographs and MRI scans before and after VITO showed resorption of the necrotic segment of the femoral head and its remodeling in all five patients. However, two patients gradually developed slight osteoarthritic changes. In one patient, remodeling of the femoral head occurred during the first 6 years postoperatively. Subsequently, the patient developed severe osteoarthritis with marked clinical symptoms. CONCLUSION: VITO can improve the long-term function of the hip joint in adolescents with ANFH after a femoral neck fracture, but cannot restore completely the original shape and structure of the femoral head.
- MeSH
- fraktury krčku femuru * diagnostické zobrazování etiologie chirurgie MeSH
- kyčelní kloub chirurgie MeSH
- lidé MeSH
- mladiství MeSH
- nekróza hlavice femuru * diagnostické zobrazování etiologie chirurgie MeSH
- osteoartróza * MeSH
- osteotomie škodlivé účinky metody MeSH
- Check Tag
- lidé MeSH
- mladiství MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Implant-associated infection (IAI) is a potential complication following total hip (THA) or knee arthroplasty (TKA). The initial phase of the inflammatory process can be measured by applying one of the inflammatory blood parameters (IBP). This systematic review aims to assess the response of IBP to trauma caused by orthopedic surgery and evaluate the clinical utility of quantitative measurements of IBP as prognostic factors for infection. METHODS: All studies indexed in Ovid MEDLINE (PubMed), Ovid EMBASE, the Cochrane Library and the ISI Web of Science databases, from inception until January 31, 2020, were analyzed. Studies included were those on adults who underwent THA or TKA with minimum follow up of 30 days after surgery. In addition to minimum follow up, data on the prognostic factors for pre- or post-THA/TKA IAI were mandatory. The Quality Assessment of Diagnostic Accuracy tool (version 2) (QUADAS-2) and Standards for Reporting of Diagnostic Accuracy Studies guideline 2015 (STARD) were used for quality assessment. RESULTS: Twelve studies fulfilled the inclusion and exclusion criteria. C-reactive protein was analyzed in seven studies, interleukin-6 in two studies and erythrocyte sedimentation rate in eight studies. White blood cell count and procalcitonin were analyzed in the only study. The overall quality of included studies was low. A potential for other cytokines (IL-1ra, IL-8) or MCP-1 was observed. CONCLUSIONS: This is the first systematic review of IBP response to orthopedic surgery which identified some IBP for pre/post-operative screening, despite insufficient data supporting their prognostic potential for patient risk stratification.
BACKGROUND: The lifetime implants is a key parameter that the surgeon should take into account at the time of the primary total hip arthroplasty (THA). The aim of this study was a clinical and radiographical evaluation of the Delta PF-FIT (LimaCorporate, Italy) THA system with ceramic-on-ceramic articulations. We have not found a clinical or radiographical assessment of this implant in available published literature. METHODS: A total of 197 (F = 94, M = 103) primary THAs were evaluated in 163 patients with a mean follow-up of 7.7 years (range 5.1-11.2 years (SD ± 1.5)) Harris hip Score (HHS) and the Western Ontario and McMaster Universities Arthritis index (WOMAC) were used for the clinical evaluation. The statistical evaluation was processed by standard statistical methods. The study was approved by Ethic Committee of the University Hospital Motol (Reference No. EK-73/19). RESULTS: The mean HHS score was found to be 97.59 points (61-100 range with a ± 5.13 SD, preoperative HSS was 51.21, range 28-73 with a ± 4,77 SD). 186 THAs were evaluated as excellent (90-100 points), 9 THAs rated as good (80-89 points), 1 THA was rated as fair (70-79) points and 1 THA rated as poor (less than 70 points). The mean WOMAC score was 97.38 points (65-100 range with a ± 5.18 SD, preoperative was 50,12, range 27-69 with a ± 4.85 SD). We documented an overall 99.49% Kaplan-Meier survival with a mean follow-up of 7.7 years with the FIT (LimaCorporate) stem revision and any component revision as the endpoint. With the Delta PF (LimaCorporate) cup revision as the endpoint, the survival was 100%. We have not found a previously published clinical or radiographical review of this THA system, the study shows a comparison with other THA implants. CONCLUSION: Evaluation of the Delta-PF-FIT (LimaCorporate, Italy) THA system with the use of ceramic-on-ceramic BIOLOX®Delta articulation surfaces shows very good outcomes.
- MeSH
- artróza kyčelních kloubů chirurgie MeSH
- dospělí MeSH
- Kaplanův-Meierův odhad MeSH
- keramika * MeSH
- kyčelní protézy * MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- náhrada kyčelního kloubu metody MeSH
- následné studie MeSH
- protézy - design MeSH
- rentgendiagnostika MeSH
- reoperace MeSH
- retrospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- stupeň závažnosti nemoci MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: The Lapidus procedure has been used for hallux valgus deformity correction since 1931. In some cases, the arthrodesis results in an unfavourable lateral inclination of first metatarsal head articular surface. The objective of our study was to evaluate the change of orientation of this articular surface in relation to the second metatarsal axis by comparing pre- and postoperative radiographs. The secondary target was to evaluate possible benefits of combination of Lapidus and Akin procedures in the reduction of hallux valgus deformity. METHODS: We evaluated 449 pre- and postoperative radiographs of 134 operations from 2010 to 2015. Routinely used angle measurements were performed on all X-rays. A sum of tangential angle to the second axis and distal articular set angle values was chosen as the best indicator for the deformity correction success. RESULTS: The mean value of these angles total was 5.2° ±9.3° before and 14.2° ±7.8° after the operation. In the group of patients, where the additional Akin osteotomy was used, the mean value was 5.3° ±8.4° before and 6.9° ±10.2° after the surgery. The mean difference in values between the two groups (with and without Akin procedure) was 7.3° of extra correction in favour of the group with the Akin osteotomy. CONCLUSIONS: The mean worsening of the tangential angle after Lapidus operation was 6.1° ±6.9°, which counts for significant deterioration after a surgery. The Akin osteotomy was found to be a valuable addition to the Lapidus arthrodesis, which improves the position of articular surfaces in first metatarsophalangeal joint.
- MeSH
- artrodéza škodlivé účinky metody MeSH
- dospělí MeSH
- hallux valgus diagnostické zobrazování chirurgie MeSH
- lidé středního věku MeSH
- lidé MeSH
- metatarzální kosti diagnostické zobrazování MeSH
- metatarzofalangeální kloub diagnostické zobrazování chirurgie MeSH
- mladiství MeSH
- mladý dospělý MeSH
- osteotomie škodlivé účinky metody MeSH
- pooperační komplikace diagnostické zobrazování etiologie MeSH
- pooperační období MeSH
- předoperační období MeSH
- rentgendiagnostika MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- hodnotící studie MeSH
- srovnávací studie MeSH
BACKGROUND: The aims of this study were to analyse the serum concentrations of clusterin (CLU) in patients with hand osteoarthritis (OA) and in healthy controls, to compare CLU levels between patients with erosive and non-erosive disease, and to examine the association of CLU levels with clinical and laboratory parameters. METHODS: A total of 135 patients with hand OA (81 with erosive and 54 with non-erosive disease) and 53 healthy individuals were included in this study. All patients underwent clinical and hand joint ultrasound examination. The Australian/Canadian (AUSCAN) hand osteoarthritis index, algofunctional index and a visual analogue scale (VAS) for the measurement of pain were assessed. Serum levels of CLU were measured by an enzyme-linked immunosorbent assay (ELISA). RESULTS: Serum levels of CLU were significantly lower in patients with hand OA than in control subjects (p < 0.0001). In addition, patients with erosive hand OA had significantly lower CLU levels than those with non-erosive disease (p = 0.044). Negative correlations between CLU levels and pain as assessed by the AUSCAN score and the VAS were found in patients with erosive hand OA (r = - 0.275; p = 0.013 and r = - 0.220; p = 0.049, respectively). CONCLUSION: The present study demonstrates that lower concentrations of CLU are found in hand OA patients than in healthy individuals, especially in those with erosive disease, and that CLU concentrations have a negative association with hand pain.
- MeSH
- artralgie krev diagnostické zobrazování patofyziologie MeSH
- biologické markery krev MeSH
- down regulace MeSH
- ELISA MeSH
- klouby ruky diagnostické zobrazování metabolismus patofyziologie MeSH
- klusterin krev MeSH
- lidé středního věku MeSH
- lidé MeSH
- měření bolesti MeSH
- osteoartróza krev diagnostické zobrazování patofyziologie MeSH
- prediktivní hodnota testů MeSH
- průřezové studie MeSH
- senioři MeSH
- studie případů a kontrol MeSH
- ultrasonografie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
BACKGROUND: Outcomes of total knee replacement in cases of hemophilic patients are worse than in patients who undergo operations due to osteoarthritis. Previous publications have reported varying rates of complications in hemophilic patients, such as infection and an unsatisfactory range of motion, which have influenced the survival of prostheses. Our retrospective study evaluated the data of hemophilic patients regarding changes in the development of the range of motion. METHODS: The data and clinical outcomes of 72 total knee replacements in 45 patients with hemophilia types A and B were reviewed retrospectively. Patients were operated between 1998 and 2013. All of the patients were systematically followed up to record the range of motion and other parameters before and after surgery. RESULTS: The mean preoperative flexion contracture was 17° ± 11° (range, 0°-40°), and it was 7° ± 12° (range, 0°-60°) postoperatively. The mean flexion of the knee was 73° ± 30° (range, 5°-135°) before the operation and 80° ± 19° (range, 30°-110°) at the last follow-up. The mean range of motion was 56° ± 34° (range, 0°-130°) before the operation and 73° ± 24° (range, 10°-110°) at the last follow-up. CONCLUSIONS: Statistical analysis suggested that the range of motion could be improved until the 9th postoperative week. The patient should be operated on until the flexion contracture reaches 22° to obtain a contracture < 15° postoperatively or until the contracture reaches 12° to obtain less than 5°. The operation generally does not change the flexion of the knee in cases of hemophilic patients, but it reduces the flexion contracture and therefore improves the range.
- MeSH
- dospělí MeSH
- hemofilie A diagnostické zobrazování psychologie chirurgie MeSH
- lidé středního věku MeSH
- lidé MeSH
- následné studie MeSH
- nemoci kloubů diagnostické zobrazování psychologie chirurgie MeSH
- retrospektivní studie MeSH
- rozsah kloubních pohybů fyziologie MeSH
- totální endoprotéza kolene metody psychologie trendy MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Musculoskeletal infections remain a major complication in orthopedic surgery. The local delivery of antibiotics provides the high levels required to treat an infection without systemic toxicity. However, the local toxicity of antibiotic carriers to the mesenchymal stem cells, as a result of both the peak concentrations and the type of carrier, may be significant. METHODS: To address this concern, the elution kinetics of vancomycin and gentamicin from several commercially available antibiotic carriers and several carriers impregnated by a surgeon (10 ml of each sterile carrier were manually mixed with a 500 mg vancomycin and an 80 mg gentamicin solution, and the duration of impregnation was 30 min) were assessed. Moreover, the effects of these antibiotic carriers on stem cell proliferation were investigated. The following two types of stem cells were used: bone marrow and dental pulp stem cells. RESULTS: The high eluted initial concentrations from antibiotic impregnated cancellous allogeneic bone grafts (which may be increased with the addition of fibrin glue) did not adversely affect stem cell proliferation. Moreover, an increased dental pulp stem cell proliferation rate in the presence of antibiotics was identified. In contrast to allogeneic bone grafts, a significant amount of antibiotics remained in the cement. Despite the favorable elution kinetics, the calcium carriers, bovine collagen carrier and freeze-dried bone exhibited decreased stem cell proliferation activity even in lower antibiotic concentrations compared with an allogeneic graft. CONCLUSIONS: This study demonstrated the benefits of antibiotic impregnated cancellous allogeneic bone grafts versus other carriers.
- MeSH
- antibakteriální látky aplikace a dávkování farmakokinetika MeSH
- gentamiciny aplikace a dávkování farmakokinetika MeSH
- kinetika MeSH
- kohortové studie MeSH
- koně MeSH
- kostní cementy farmakokinetika MeSH
- lidé MeSH
- mezenchymální kmenové buňky účinky léků metabolismus MeSH
- nosiče léků aplikace a dávkování farmakokinetika MeSH
- proliferace buněk účinky léků fyziologie MeSH
- vankomycin aplikace a dávkování farmakokinetika MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Preoperative planning with the aid of imaging methods is a principal factor in successful surgery on the shoulder. This work aims to evaluate the variability of glenoid version, spiralling twist and scapular inclination in relation to the frontal axis. Studies focusing on measuring the variability of scapular inclination in the standardised rest position are lacking in the literature. METHODS: We evaluated 104 CT scans of the shoulder. We measured the glenoid version with respect to the scapular axis at three levels. We measured the scapular inclination angle in relation to the sagittal plane and we determined scapular inclination in relation to the frontal axis. Statistical evaluation was performed using the marginal linear model and parameters were estimated using the generalised least squares method, which enables the dependency of measurements performed on the same subject to be taken into consideration. RESULTS: The highest values of retroversion are attained by the glenoid in the cranial section (average -9.96°, range -29.7 to +13.2°). Proof of the spiralling twist is the decline in retroversion at the centre of the glenoid (average -2.09°, range -16.7 to +11.6°). Retroversion decreases further in the inferior direction (average -0.5°, range -20.9 to +17.5°). The average thoracoscapular angle is 45.46°, ranging from 13.1 to 69.0°. The average scapular inclination in relation to the frontal plane is 44.54°, ranging from 21.0 to76.9°. CONCLUSIONS: During preoperative planning, the surgeon should take into consideration not only the glenoid version in relation to the scapular axis, but also the value of the scapular inclination so as to eliminate possible surgical errors, optimise prosthesis implantation and thus decrease the risk of functional restrictions of the joint. CLINICAL TRIAL REGISTRATION: Ethics Committee for Multi-Centric Clinical Trials (EK-554/14,29thApril 2014).
- MeSH
- anatomická variace MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- lopatka anatomie a histologie diagnostické zobrazování MeSH
- mladý dospělý MeSH
- počítačová rentgenová tomografie MeSH
- předoperační péče MeSH
- ramenní kloub anatomie a histologie diagnostické zobrazování MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
BACKGROUND: The aim of this study was to assess the efficacy of choline-stabilized orthosilicic acid (ch-OSA) in patients with symptomatic knee osteoarthritis (OA). METHODS: In a multicenter, double-blind, placebo-controlled study, 211 patients with knee OA (Kellgren and Lawrence grade II or III) and moderate to moderately severe pain were randomly allocated to ch-OSA or placebo for 12 weeks. The primary outcome was the change in the WOMAC pain subscale from baseline to week 12. Secondary outcomes were changes from baseline to week 12 in WOMAC total, WOMAC stiffness, WOMAC physical function, Subject Global Assessment and levels of cartilage degradation biomarkers C-terminal telopeptide of collagen type II (CTX-II) and cartilage oligomeric matrix protein (COMP). Pre-specified subgroup analyses included the effect of gender. RESULTS: A total of 166 (120 women, 46 men) patients were included in the analysis (87 and 79 in the ch-OSA and placebo group, respectively). In the total study population, no differences were observed between the two treatment groups for the different outcomes but significant treatment x gender interactions were found. In men taking ch-OSA, a significant improvement in WOMAC total, WOMAC stiffness and WOMAC physical function as well as a lower increase in biomarker levels of cartilage degradation was observed, but not in women. The change in WOMAC pain showed a similar positive trend in men taking ch-OSA. CONCLUSION: After 12 weeks of treatment, no effect was found of ch-OSA in the total study population on clinical parameters and biomarkers, but a gender interaction was observed. In men, ch-OSA was found effective in reducing symptoms of knee OA, which was associated with a slight but significant reduction of biomarkers that are related to cartilage degradation. TRIAL REGISTRATION: The study was registered retrospectively: ISRCTN88583133 . Registration date: 2015-10-07.
- MeSH
- aplikace orální MeSH
- artróza kolenních kloubů farmakoterapie MeSH
- biologické markery analýza MeSH
- cholin aplikace a dávkování terapeutické užití MeSH
- chrupavka patologie MeSH
- chrupavkový oligomerní matrixový protein analýza MeSH
- dvojitá slepá metoda MeSH
- kolagen typ II analýza MeSH
- kyselina křemičitá aplikace a dávkování terapeutické užití MeSH
- lidé středního věku MeSH
- lidé MeSH
- management bolesti metody MeSH
- měření bolesti MeSH
- senioři MeSH
- sexuální faktory MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- randomizované kontrolované studie MeSH
