BACKGROUND: Extended aortic repair is considered a key issue for the long-term durability of surgery for DeBakey type 1 aortic dissection. The risk of aortic degeneration may be higher in young patients due to their long life expectancy. The early outcome and durability of aortic surgery in these patients were investigated in the present study. METHODS: The subjects of the present analysis were patients under 60 years old who underwent surgical repair for acute DeBakey type 1 aortic dissection at 18 cardiac surgery centres across Europe between 2005 and 2021. Patients underwent ascending aortic repair or total aortic arch repair using the conventional technique or the frozen elephant trunk technique. The primary outcome was 5-year cumulative incidence of reoperation on the distal aorta. RESULTS: Overall, 915 patients underwent surgical ascending aortic repair and 284 patients underwent surgical total aortic arch repair. The frozen elephant trunk procedure was performed in 128 patients. Among 245 propensity score-matched pairs, total aortic arch repair did not decrease the rate of distal aortic reoperation compared to ascending aortic repair (5-year cumulative incidence, 6.7% versus 6.7%, subdistributional hazard ratio 1.127, 95% c.i. 0.523 to 2.427). Total aortic arch repair increased the incidence of postoperative stroke/global brain ischaemia (25.7% versus 18.4%, P = 0.050) and dialysis (19.6% versus 12.7%, P = 0.003). Five-year mortality was comparable after ascending aortic repair and total aortic arch repair (22.8% versus 27.3%, P = 0.172). CONCLUSIONS: In patients under 60 years old with DeBakey type 1 aortic dissection, total aortic arch replacement compared with ascending aortic repair did not reduce the incidence of distal aortic operations at 5 years. When feasible, ascending aortic repair for DeBakey type 1 aortic dissection is associated with satisfactory early and mid-term outcomes. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04831073.

• MeSH
• aneurysma hrudní aorty chirurgie   mortalita   MeSH
• aorta thoracica * chirurgie   MeSH
• cévy - implantace protéz * metody   škodlivé účinky   mortalita   MeSH
• disekce aorty * chirurgie   mortalita   MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• pooperační komplikace * epidemiologie   MeSH
• reoperace * statistika a číselné údaje   MeSH
• retrospektivní studie MeSH
• tendenční skóre MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• Geografické názvy
• Evropa epidemiologie   MeSH

BACKGROUND: Acute Stanford type A aortic dissection (TAAD) is a life-threatening condition. Surgery is usually performed as a salvage procedure and is associated with significant postoperative early mortality and morbidity. Understanding the patient's conditions and treatment strategies which are associated with these adverse events is essential for an appropriate management of acute TAAD. METHODS: Nineteen centers of cardiac surgery from seven European countries have collaborated to create a multicentre observational registry (ERTAAD), which will enroll consecutive patients who underwent surgery for acute TAAD from January 2005 to March 2021. Analysis of the impact of patient's comorbidities, conditions at referral, surgical strategies and perioperative treatment on the early and late adverse events will be performed. The investigators have developed a classification of the urgency of the procedure based on the severity of preoperative hemodynamic conditions and malperfusion secondary to acute TAAD. The primary clinical outcomes will be in-hospital mortality, late mortality and reoperations on the aorta. Secondary outcomes will be stroke, acute kidney injury, surgical site infection, reoperation for bleeding, blood transfusion and length of stay in the intensive care unit. DISCUSSION: The analysis of this multicentre registry will allow conclusive results on the prognostic importance of critical preoperative conditions and the value of different treatment strategies to reduce the risk of early adverse events after surgery for acute TAAD. This registry is expected to provide insights into the long-term durability of different strategies of surgical repair for TAAD. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04831073 .

• Klíčová slova
• Aortic arch, Aortic dissection, Ascending aorta, Emergency, Stanford type A,
• MeSH
• aortální aneurysma mortalita   chirurgie   MeSH
• disekce aorty mortalita   chirurgie   MeSH
• dospělí MeSH
• klinické protokoly MeSH
• komorbidita MeSH
• lidé středního věku MeSH
• lidé MeSH
• mortalita v nemocnicích MeSH
• pooperační komplikace epidemiologie   etiologie   MeSH
• prognóza MeSH
• registrace MeSH
• reoperace statistika a číselné údaje   MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• transplantace cév * přístrojové vybavení   metody   MeSH
• výzkumný projekt MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• pozorovací studie MeSH
• Geografické názvy
• Evropa MeSH

BACKGROUND: Atypical and anaplastic meningiomas have reduced progression-free/overall survival (PFS/OS) compared to benign meningiomas. Stereotactic radiosurgery (SRS) for atypical meningiomas (AMs) and anaplastic meningiomas (malignant meningiomas, MMs) has not been adequately described. OBJECTIVE: To define clinical/radiographic outcomes for patients undergoing SRS for AM/MMs. METHODS: An international, multicenter, retrospective cohort study was performed to define clinical/imaging outcomes for patients receiving SRS for AM/MMs. Tumor progression was assessed with response assessment in neuro-oncology (RANO) criteria. Factors associated with PFS/OS were assessed using Kaplan-Meier analysis and a Cox proportional hazards model. RESULTS: A total of 271 patients received SRS for AMs (n = 233, 85.9%) or MMs (n = 38, 14.0%). Single-fraction SRS was most commonly employed (n = 264, 97.4%) with a mean target dose of 14.8 Gy. SRS was used as adjuvant treatment (n = 85, 31.4%), salvage therapy (n = 182, 67.2%), or primary therapy (1.5%). The 5-yr PFS/OS rate was 33.6% and 77.0%, respectively. Increasing age (hazard ratio (HR) = 1.01, P < .05) and a Ki-67 index > 15% (HR = 1.66, P < .03) negatively correlated with PFS. MMs (HR = 3.21, P < .05), increased age (HR = 1.04, P = .04), and reduced KPS (HR = 0.95, P = .04) were associated with shortened OS. Adjuvant versus salvage SRS did not impact PFS/OS. A shortened interval between surgery and SRS improved PFS for AMs (HR = 0.99, P = .02) on subgroup analysis. Radiation necrosis occurred in 34 (12.5%) patients. Five-year rates of repeat surgery/radiation were 33.8% and 60.4%, respectively. CONCLUSION: AM/MMs remain challenging tumors to treat. Elevated proliferative indices are associated with tumor recurrence, while MMs have worse survival. SRS can control AM/MMs in the short term, but the 5-yr PFS rates are low, underscoring the need for improved treatment options for these patients.

• Klíčová slova
• Anaplastic, Atypical, Gamma knife radiosurgery, Meningioma, Radiosurgery, Stereotactic,
• MeSH
• lidé MeSH
• meningeom mortalita   chirurgie   MeSH
• pooperační komplikace epidemiologie   MeSH
• radiační poranění epidemiologie   MeSH
• radiochirurgie * škodlivé účinky   metody   mortalita   MeSH
• reoperace statistika a číselné údaje   MeSH
• retrospektivní studie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH

BACKGROUND: Treatment of aortic-valve disease in young patients still poses challenges. The Ross procedure offers several potential advantages that may translate to improved long-term outcomes. OBJECTIVES: This study reports long-term outcomes after the Ross procedure. METHODS: Adult patients who were included in the Ross Registry between 1988 and 2018 were analyzed. Endpoints were overall survival, reintervention, and major adverse events at maximum follow-up. Multivariable regression analyses were performed to identify risk factors for survival and the need of Ross-related reintervention. RESULTS: There were 2,444 adult patients with a mean age of 44.1 ± 11.7 years identified. Early mortality was 1.0%. Estimated survival after 25 years was 75.8% and did not statistically differ from the general population (p = 0.189). The risk for autograft reintervention was 0.69% per patient-year and 0.62% per patient-year for right-ventricular outflow tract (RVOT) reintervention. Larger aortic annulus diameter (hazard ratio [HR]: 1.12/mm; 95% confidence interval [CI]: 1.05 to 1.19/mm; p < 0.001) and pre-operative presence of pure aortic insufficiency (HR: 1.74; 95% CI: 1.13 to 2.68; p = 0.01) were independent predictors for autograft reintervention, whereas the use of a biological valve (HR: 8.09; 95% CI: 5.01 to 13.08; p < 0.001) and patient age (HR: 0.97 per year; 95% CI: 0.96 to 0.99; p = 0.001) were independent predictors for RVOT reintervention. Major bleeding, valve thrombosis, permanent stroke, and endocarditis occurred with an incidence of 0.15% per patient-year, 0.07% per patient-year, 0.13%, and 0.36% per patient-year, respectively. CONCLUSIONS: The Ross procedure provides excellent survival over a follow-up period of up to 25 years. The rates of reintervention, anticoagulation-related morbidity, and endocarditis were very low. This procedure should therefore be considered as a very suitable treatment option in young patients suffering from aortic-valve disease. (Long-Term Follow-up After the Autograft Aortic Valve Procedure [Ross Operation]; NCT00708409).

• Klíčová slova
• Ross procedure, aortic valve replacement, long-term outcomes, pulmonary autograft, right-ventricular outflow tract,
• MeSH
• analýza přežití MeSH
• aortální chlopeň * patologie   chirurgie   MeSH
• autologní transplantace * škodlivé účinky   metody   MeSH
• chirurgická náhrada chlopně * škodlivé účinky   přístrojové vybavení   metody   MeSH
• dlouhodobé vedlejší účinky * diagnóza   epidemiologie   etiologie   MeSH
• dospělí MeSH
• echokardiografie metody   MeSH
• hodnocení rizik metody   MeSH
• lidé MeSH
• onemocnění aortální chlopně * diagnóza   epidemiologie   chirurgie   MeSH
• pooperační komplikace * diagnóza   epidemiologie   etiologie   chirurgie   MeSH
• prognóza MeSH
• registrace statistika a číselné údaje   MeSH
• reoperace * klasifikace   metody   statistika a číselné údaje   MeSH
• rizikové faktory MeSH
• srdeční chlopně umělé škodlivé účinky   statistika a číselné údaje   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH
• Geografické názvy
• Německo epidemiologie   MeSH

PURPOSE: To analyze the reasons and patient-related and injury-related risk factors for reoperation after surgery for acute subdural hematoma (SDH) and the effects of reoperation on treatment outcome. METHODS: Among adult patients operated on for acute SDH between 2013 and 2017, patients reoperated within 14 days after the primary surgery were identified. In all patients, parameters were identified that related to the patient (age, anticoagulation, antiplatelet, and antiepileptic treatment, and alcohol intoxication), trauma (Glasgow Coma Score, SDH thickness, midline shift, midline shift /hematoma thickness rate, other surgical lesion, primary surgery-trephination, craniotomy, or decompressive craniotomy), and Glasgow Outcome Score (GOS). The reasons for reoperation and intervals between primary surgery and reoperation were studied. RESULTS: Of 86 investigated patients, 24 patients were reoperated (27.9%), with a median interval of 2 days between primary surgery and reoperation. No significant differences in patients and injury-related factors were found between reoperated and non-reoperated patients. The rate of primary craniectomies was higher in non-reoperated patients (P = 0.066). The main indications for reoperation were recurrent /significant residual SDH (10 patients), contralateral SDH (5 patients), and expansive intracerebral hematoma or contusion (5 patients). The final median GOS was 3 in non-reoperated and 1.5 in reoperated patients, with good outcomes in 41.2% of non-reoperated and 16.7% of reoperated patients. CONCLUSIONS: Reoperation after acute SDH surgery is associated with a significantly worse prognosis. Recurrent /significant residual SDH and contralateral SDH are the most frequently found reasons for reoperation. None of the analyzed parameters were significant reoperation predictors.

• Klíčová slova
• Acute subdural hematoma, Brain injury, Contralateral subdural hematoma, Decompressive craniectomy, Reoperation,
• MeSH
• akutní subdurální hematom epidemiologie   etiologie   chirurgie   MeSH
• antikoagulancia terapeutické užití   MeSH
• antikonvulziva terapeutické užití   MeSH
• dekompresní kraniektomie statistika a číselné údaje   MeSH
• dospělí MeSH
• epilepsie farmakoterapie   epidemiologie   MeSH
• Glasgowská stupnice kómat MeSH
• Glasgowská stupnice následků MeSH
• inhibitory agregace trombocytů terapeutické užití   MeSH
• kraniocerebrální traumata komplikace   MeSH
• kraniotomie statistika a číselné údaje   MeSH
• lidé středního věku MeSH
• lidé MeSH
• neurochirurgické výkony statistika a číselné údaje   MeSH
• otrava alkoholem epidemiologie   MeSH
• reoperace statistika a číselné údaje   MeSH
• rizikové faktory MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• sexuální faktory MeSH
• trepanace statistika a číselné údaje   MeSH
• věkové faktory MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antikoagulancia MeSH
• antikonvulziva MeSH
• inhibitory agregace trombocytů MeSH

OBJECTIVE: The optimal time to perform stereotactic radiosurgery after incomplete resection of adrenocorticotropic hormone (ACTH)-producing pituitary adenoma in patients with Cushing's disease (CD) remains unclear. In patients with persistent CD after resection of ACTH-producing pituitary adenoma, the authors evaluated the association of the interval between resection and Gamma Knife radiosurgery (GKRS) with outcomes. METHODS: Pooled data from 10 institutions participating in the International Radiosurgery Research Foundation were used in this study. RESULTS: Data from 255 patients with a mean follow-up of 65.59 ± 49.01 months (mean ± SD) were analyzed. Seventy-seven patients (30%) underwent GKRS within 3 months; 46 (18%) from 4 to 6 months; 34 (13%) from 7 to 12 months; and 98 (38%) at > 12 months after the resection. Actuarial endocrine remission rates were higher in patients who underwent GKRS ≤ 3 months than when treatment was > 3 months after the resection (78% and 65%, respectively; p = 0.017). Endocrine remission rates were lower in patients who underwent GKRS at > 12 months versus ≤ 12 months after the resection (57% vs 76%, respectively; p = 0.006). In multivariate Cox regression analyses adjusted for clinical and treatment characteristics, early GKRS was associated with increased probability of endocrine remission (hazard ratio [HR] 1.518, 95% CI 1.039-2.218; p = 0.031), whereas late GKRS (HR 0.641, 95% CI 0.448-0.919; p = 0.015) was associated with reduced probability of endocrine remission. The incidence of some degree of new pituitary deficiency (p = 0.922), new visual deficits (p = 0.740), and other cranial nerve deficits (p = 0.610) was not significantly related to time from resection to GKRS. CONCLUSIONS: Early GKRS is associated with an improved endocrine remission rate, whereas later GKRS is associated with a lower rate of endocrine remission after pituitary adenoma resection. Early GKRS should be considered for patients with CD after incomplete pituitary adenoma resection.

• Klíčová slova
• Cushing’s disease, pituitary surgery, remission, stereotactic radiosurgery,
• MeSH
• adenom chirurgie   MeSH
• adrenokortikotropní hormon metabolismus   MeSH
• dítě MeSH
• dospělí MeSH
• hypersekrece ACTH v hypofýze diagnostické zobrazování   chirurgie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• nádory hypofýzy chirurgie   MeSH
• následné studie MeSH
• pooperační komplikace epidemiologie   MeSH
• radiochirurgie metody   MeSH
• reoperace statistika a číselné údaje   MeSH
• retrospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• výsledek terapie MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• Názvy látek
• adrenokortikotropní hormon MeSH

INTRODUCTION: The aim of this study has been to present outcomes after cementless arthroplasty for developmental dysplasia Crowe type IV of the hip, with transverse subtrochanteric shortening osteotomy and using the S-ROM stem. METHODS: We evaluated radiographs, functional scores and complications in a consecutive series of 23 patients (28 hips) with high dislocation of the hip. The average age of patients at surgery was 49.9 (range 22-68) years. The operations were performed between 2007 and 2013. Patients were assessed retrospectively-clinically and radiographically during the year 2018. RESULTS: The mean follow-up period was 94 (range 60-134) months. The average Harris hip score improved from 39.9 to 84.0. The mean leg length discrepancy decreased from 5 cm preoperatively to 1.4 cm at the final follow-up. All acetabular components were implanted into the true acetabulum, and all prostheses were stable at the latest examination. No neurovascular damage was recorded. We have identified specific complications in seven hips (25%) in total: Intraoperative femoral fracture required fixation in four hips; three hips (10.7%) needed revision: Recurrent dislocation, with the need for cup reorientation, occurred in two hips (in one of them, this was followed by the subsequent need for resection of heterotopic ossification); there was one aseptic stem loosening with the need of one-stage revision. All the osteotomies healed within 8 months. CONCLUSION: Hip arthroplasty with transverse shortening femoral osteotomy, using S-ROM stem, is an acceptable, but not complication-free treatment method in patients with Crowe type IV developmental hip dysplasia, in the midterm.

• Klíčová slova
• Hip dysplasia, S-ROM stem, Shortening femoral osteotomy,
• MeSH
• dislokace kloubu etiologie   chirurgie   MeSH
• dospělí MeSH
• kyčelní kloub * diagnostické zobrazování   patofyziologie   chirurgie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• náhrada kyčelního kloubu * škodlivé účinky   metody   MeSH
• nestejná délka dolních končetin etiologie   chirurgie   MeSH
• osteotomie * škodlivé účinky   metody   MeSH
• pooperační komplikace * diagnóza   patofyziologie   chirurgie   MeSH
• rentgendiagnostika metody   MeSH
• reoperace * škodlivé účinky   metody   statistika a číselné údaje   MeSH
• retrospektivní studie MeSH
• výsledky a postupy - zhodnocení (zdravotní péče) MeSH
• vývojová kyčelní dysplazie * diagnóza   chirurgie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

INTRODUCTION The authors evaluate the results of endoscopic treatment and analyse the causes of persisting difficulties in retrocalcaneal bursitis unresponsive to conservative treatment. Stated as one of the causes is the possible chronic irritation of minor/partial tears of anterior parts of the distal portion of the Achilles tendon, which have no chance to heal due to continued overload and impingement syndrome of the superior prominence of the calcaneal tubercle. MATERIAL AND METHODS The authors evaluate the group of 24 patients (10 women and 14 men) diagnosed with retrocalcaneal bursitis, who reported more than 12 months of difficulties and in whom the conservative therapy options have already been exhausted. The decision to perform a revision arthroscopy was made by the authors based on chronic long-lasting difficulties, clinical examination, calcaneus radiograph, ultrasound examination and negative response to the performed conservative treatment. The MRI scan was obtained in 4 patients. In 11 patients during arthroscopy the Achilles tendon was intact, in 13 patients (54.2%) minor tears were detected on the anterior aspect of the distal Achilles tendon, not diagnosed preoperatively (by ultrasound examination). In all the patients, resection of the prominence of the calcaneal tubercle was performed, whereas in patients with affected Achilles tendon also the loose tendon fragments were resected. RESULTS A total of 23 patients reported an improvement of their condition, the pain subsided at 21-43 days. Altogether 21 patients returned to activities carried out before the onset of pain. The AOFAS score values measured preoperatively in patients with an intact tendon were 59.5 ± 15.0, in patients with an injured tendon it was 45.57 ± 9.6, while 6 months after the surgery the values were 95.7 ± 6.2, or 88.71 ± 7.8 respectively. In 1 female patient, with one prior surgery, diagnosed with a partial tear of the Achilles tendon, the effect of the surgery was unsatisfactory. After six months the patient underwent an open revision surgery and the Achilles tendon reinsertion. No intraoperative or postoperative complications were observed. DISCUSSION The endoscopic technique facilitates a more visible bone resection, with better control of resection, which is less invasive than the open technique. The source of irritation can be removed, which is not always only the prominence of the calcaneal tubercle, but another cause of persisting problems can also be a microtrauma affecting the anterior portion of the Achilles tendon, with a reactive hyperaemia in bursal tissue. Compared to literature and also based on the results of the authors of this retrospective study, the endoscopic calcaneoplasty is less invasive than the open surgery. It is always necessary to properly diagnose the causes of difficulties and to timely respond to persisting symptoms in patients, not responding satisfactorily to conservative therapy. CONCLUSIONS The findings presented by the authors provide a new perspective on the causes of chronic problems such as the "posterior heel pain" and tend to give preference to the active endoscopic approach in patients with persisting problems, not responding to conservative treatment, predisposed based on the radiological examination and with a positive finding on ultrasound or MRI scan. Key words:retrocalcaneal bursitis, endoscopic calcaneoplasty, arthroscopy.

• MeSH
• Achillova šlacha zranění   MeSH
• artroskopie * škodlivé účinky   metody   MeSH
• burzitida diagnóza   patofyziologie   chirurgie   MeSH
• hodnocení výsledků zdravotní péče MeSH
• lidé středního věku MeSH
• lidé MeSH
• magnetická rezonanční tomografie metody   MeSH
• patní kost diagnostické zobrazování   patologie   MeSH
• pooperační bolest diagnóza   etiologie   chirurgie   MeSH
• rentgendiagnostika metody   MeSH
• reoperace metody   statistika a číselné údaje   MeSH
• ultrasonografie metody   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

URPOSE OF THE STUDY The aim of this study was to summarise the current approaches to diagnostics and therapy of the medial meniscus tear, and to evaluate the short-term results of meniscus repair by outside-in and all-inside techniques. MATERIALS AND METHODS The study included 24 patients who underwent medial meniscus repair for vertical longitudinal tear 10 mm or longer in length localised in the rear two-thirds of meniscus in the red-red or red-white zone at the author's workplace between June 2012 and December 2014. As regards the method, either outside-in or all-inside techniques were used, or the combination of both. The Steadman technique was used in cases of LCA ruptures. Before the surgery standard radiographs of the knee joint of each patient were taken. The Lysholm Knee Score was used to evaluate the function of the knee pre- and postoperatively. The Barrett's criteria were used to evaluate the healing of repaired meniscus. The clinical success was defined as an absence of any of such criteria. The satisfaction of the patients was evaluated by the visual analogue scale (VAS). The patients were followed up for 13.5 (6-36) months. RESULTS The functional results presented by Lysholm Knee Score demonstrate the improvement of all patients. When comparing the score measured before and after the surgery, this score increased from 67.1 ± 11.4 (24-81) preoperatively to 90.4 ± 13.0 (34-100) postoperatively. The outcome was excellent in 11 patients (45.8 per cent), good in 12 patients (50.0 per cent), and poor in one patient (4.2 per cent). According to the Barrett's criteria, 19 repaired menisci were healed (79.2 per cent) = success rate. In five patients at least one of the monitored criteria was positive. In these cases, the result was considered a failure. Patient satisfaction averaged at 8.0 ± 1.5 (3-10). Only one patient with the concurrent anterior cruciate ligament (ACL) tear with poor functional result, positive Barrett's criteria and VAS 3 agrees with the proposed revision surgery. Regarding possible complications, no neurovascular injury, deep vein thrombosis (DVT) or deep infection were reported. DISCUSSION The results presented in this research correspond to the outcomes of other authors, in particular as regards the shortterm follow-up. Other authors state that even the long-term results of Lysholm Knee Score related to meniscus repair are considerably better than the results after meniscectomy. When assessing the Barrett's criteria, the success rate of 79.2 per cent (19 patients) was reached; therefore, the failure rate was 20.8 per cent (5 patients). These results are comparable with the results of other authors whose success rate of meniscus repair ranges between 60 and 90 per cent. Based on the assessment of the VAS patient's satisfaction, the average rate of 8.0 points (3-10) was reached. A similar average rate of the patient's satisfaction amounting to 8.35 ± 1 (6-10) was reached in a similar designated study of Keyhani et al. carried out in 2015. Regarding possible complications, no neurovascular injury, deep vein thrombosis (DVT) or deep infection were reported. Similar observation of the low complication rate can be seen in the research studies of other authors. CONCLUSIONS Our short-term follow-up revealed that the postoperative results of Lysholm Knee Score considerably improved, the satisfaction rate of the patients was high and the failure rate is entirely in line with the values stated in literature. The results of our study confirm that in the indicated cases the meniscus repair is an effective method of treatment of vertical longitudinal tears located in both RR and RW zones. The preserved meniscus is considerably supportive to ensure stability of the knee joint, in particular in the event of concurrent rupture of anterior cruciate ligament, and to prevent early osteoarthritic changes. Nevertheless, it is necessary to carry out further randomized clinical studies with a larger number of patients and a longerterm follow-up to confirm our results. Key words:meniscus tear, meniscus repair, outside-in and all-inside technique, evaluation of results.

• MeSH
• dospělí MeSH
• hodnocení výsledků zdravotní péče MeSH
• kolenní kloub diagnostické zobrazování   patofyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• menisky tibiální chirurgie   MeSH
• mladiství MeSH
• obnova funkce MeSH
• poranění menisku diagnóza   terapie   MeSH
• rentgendiagnostika metody   MeSH
• reoperace * metody   statistika a číselné údaje   MeSH
• šicí techniky * MeSH
• spokojenost pacientů MeSH
• totální endoprotéza kolene * škodlivé účinky   metody   MeSH
• vizuální analogová stupnice MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

PURPOSE OF THE STUDY Aseptic loosening of endoprosthetic components is the most frequent reason for total hip arthroplasty revision. This paper aimed to verify the influence of the type of hip-component fixation of total hip replacement in correlation with the age of patients on aseptic loosening of components during mid-term survival. MATERIAL AND METHODS The retrospective, monocentric study statistically evaluated the data of 67 cases of implanted total hip replacements in 66 patients with the loosening of at least one of the components requiring a revision of the total number of 1,488 primary total hip replacements implanted during the 1995 to 2006 period at a single department. The study compares the implants by Johnson&Johnson (Ultima threaded cups, Duraloc sector, Ultima UHMWPE cups. Mecroblock MR, AML and Ultima straight stems, Charnley and Elite plus cups and stems), Fehling Medical AG (HPQ and Müller cups, Müller Geradschaft stems) and Biomet (Mallory-Head and Müller cups, Bi-Metric cemented and uncemented stems) with respect to the age of patients. First-generation and second-generation cementing techniques were used. Primary arthroplasty of revised endoprostheses were indicated for primary and post-dysplastic coxarthrosis not requiring skeletal reconstruction. In order to determine the influence of age, three age categories were considered: under 54 years of age, 55 to 64 years of age, and elderly individuals aged 65 and over. The data was statistically evaluated by the test for two proportions and the Student's t-test. RESULTS The mean age of patients with total hip replacement loosening was lower than the mean age of the other patients (p < 0.05). The age category 55-64 reported a significantly higher failure rate only for HPQ - Müller-Geradschaft endoprosthesis compared to the uncemented and hybrid version of Mallory-Head - Bi-Metric, Duraloc - AML and Charnley group (p < 0.05). Duraloc - Charnley showed worse results than Mallory-Head - Bi-Metric porous (p = 0.0437). Except for HPQ - Müller-Geradschaft endoprosthesis, there were no statistically significant differences in the achieved revision rate of components used in endoprostheses. In the younger age category, only uncemented and hybrid versions were assessed. Hybrid endoprostheses made by Fehling and Biomet failed more often than uncemented Mallory-Head - Bi-Metric porous (p < 0.05) and Duraloc - AML (p < 0.01). For the category of 65 plus, cemented and hybrid endoprostheses were assessed. A higher revision rate was seen only in HPQ - Müller-Geradschaft endoprosthesis compared to the cemented version of Biomet (p < 0.05). No difference was reported in mid-term survival of the applied cemented and uncemented cups. DISCUSSION Despite the development of uncemented versions of total hip arthroplasty components, the current literature includes opinions supporting the cemented technique of total hip replacement. Especially for elderly patients the implant of uncemented components is questionable. The presented study did not identify a higher mid-term revision rate of uncemented implants, namely with respect to acetabular components, not even in the elderly patients. CONCLUSIONS No difference was found in the mid-term revision rate of evaluated endoprostheses for the medium age category of 55-64 years, regardless of whether cemented or uncemented components were implanted. The only exception was represented by hybrid HPQ-Müller Geradschaft endoprosthesis with a higher revision rate of the femoral and acetabular components. The younger age category showed a lower revision rate for uncemented versions than for the used hybrid versions of endoprostheses. For the group of elderly patients, there was no difference between the survival rate of hybrid and cemented joint replacement. Key words:arthroplasty with total hip replacement, cemented joint replacement, uncemented joint replacement, joint replacement failure, aseptic loosening of total replacement, age, joint replacement survival. 046_053_kubinec 20.2.18 14:12 Stránka 46 47/ Acta Chir Orthop Traumatol Cech. 85, 2018, No. 1 PŮVODNÍ PRÁCE.

• MeSH
• hodnocení výsledků zdravotní péče MeSH
• kostní cementy * škodlivé účinky   terapeutické užití   MeSH
• kyčelní protézy škodlivé účinky   MeSH
• lidé středního věku MeSH
• lidé MeSH
• náhrada kyčelního kloubu * škodlivé účinky   přístrojové vybavení   metody   MeSH
• protézy - design metody   MeSH
• registrace MeSH
• reoperace * metody   statistika a číselné údaje   MeSH
• rizikové faktory MeSH
• selhání protézy etiologie   MeSH
• senioři MeSH
• věkové faktory MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH
• Názvy látek
• kostní cementy * MeSH