BACKGROUND: Reconstruction of a dysplastic acetabulum in a patient with osteoarthritis of the hip may be accomplished with a variety of surgical techniques. The aim of our study was to assess the outcomes of total hip replacement with the uncemented CLS expansion shell and a structural femoral head autograft to augment the deficient acetabulum in patients with osteoarthritis secondary to congenital hip disease. METHODS: Between 1990 and 1994, we used a CLS expansion shell with a structural femoral head autograft in forty-three consecutive patients (forty-three hips) with osteoarthritis secondary to congenital hip disease. The ratio of male to female patients was 5:38, and the mean age of the patients was forty-eight years. According to the preoperative radiographic assessment, the dysplasia was categorized as Crowe type I in six patients, Crowe type II in thirty-one patients, and Crowe type III and type IV in three patients each. No patient was lost to follow-up. The mean duration of follow-up was 120 months. Plain radiographs were made immediately after surgery and at the latest follow-up evaluation. Clinical outcomes were determined with use of the Harris hip score and the Merle d'Aubigné and Postel score, and a radiographic analysis was performed. RESULTS: Postoperatively, the mean Harris hip score had improved 58 points for patients with Crowe type-I and II dysplasia, 47 points for patients with Crowe type-III dysplasia, and 46 points for patients with Crowe type-IV dysplasia (p < 0.05 for all). At the latest follow-up examination, the mean Harris hip score for all patients was 92.6 points. The mean Merle d'Aubigne and Postel score was 8.3 points preoperatively and 15.8 points at the time of the latest follow-up. The mean coverage of the shell by the graft immediately after surgery was 32.2%. Osteointegration of the CLS expansion shell was evident radiographically in all forty-three hips at the latest follow-up evaluation. There were no failures of the bone grafts. Clinical survival of the CLS expansion shell with a structural femoral head autograft was 100% at a mean of ten years after surgery. The rate of survival of the shell, with radiographic signs of loosening as the end point, was 88.2% at ten years. CONCLUSIONS: The CLS uncemented expansion shell, when used with a structural femoral head autograft, provides a reliable reconstruction, augments deficient acetabular bone stock, and allows placement of the socket at or close to the anatomic center of hip rotation in patients undergoing total hip arthroplasty to treat the sequelae of congenital hip disease.

• MeSH
• acetabulum abnormality   chirurgie   MeSH
• artróza kyčelních kloubů etiologie   chirurgie   MeSH
• autologní transplantace MeSH
• dospělí MeSH
• femur transplantace   MeSH
• kyčelní protézy MeSH
• lidé středního věku MeSH
• lidé MeSH
• náhrada kyčelního kloubu přístrojové vybavení   MeSH
• retrospektivní studie MeSH
• výsledek terapie MeSH
• vývojová kyčelní dysplazie komplikace   chirurgie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

PURPOSE: Proximal femoral fractures are among the most commonly sustained fractures. The current treatment of stable proximal femoral fractures located in trochanteric region primarily involves the use of two systems: extramedullary dynamic hip screws and intramedullary hip nails. Given that these fractures are mainly found in the elderly population, the necessity of a repeat, due to failure of the first, may jeopardize the patient's life. Decisive factors contributing to the healing of a fracture (or the failure thereof) include fracture pattern, technical implementation of the operation (i.e., position of the implant), implant's properties and its changes in relation to the surrounding bone tissue during loading. Each screw insertion variant results in damage to various load-bearing bone structures, which can be expected to influence healing quality and stability of newly formed bone. METHOD: With the aid of a numerical model and finite element methods, the authors analyzed several different positions of IMHN/PFH-nails in the proximal femur, with the objective of determining positions with an increased risk of failure. RESULTS AND CONCLUSION: In model situations, it has been shown that in stable fractures results do not depend on absolutely precise positioning and small deflections in the nails and neck screws positions do not significantly increase the risk of failure for the entire fixation. Damage to load-bearing structures relative to various implant placements does not impact the resultant overall fixation stability. Therefore, it is not necessary to re-introduce implants in the ideal position, which can lead to reduced patient radiation doses during surgery.

• Klíčová slova
• Bone fixation, Complications, Finite element method analyses, Intramedullary hip nail, Stable pertrochanteric fracture,
• MeSH
• analýza metodou konečných prvků MeSH
• biomechanika MeSH
• femur zranění   chirurgie   MeSH
• fraktury kyčle chirurgie   MeSH
• intramedulární fixace fraktury přístrojové vybavení   metody   MeSH
• kostní hřeby * MeSH
• lidé MeSH
• neúspěšná terapie MeSH
• rizikové faktory MeSH
• senioři MeSH
• teoretické modely MeSH
• zatížení muskuloskeletálního systému MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH

There is a great deal of data available, in part contradictory, on the best fixation technique to use for total hip arthroplasty (THA) in hip osteoarthritis. Both the cementless and the cemented versions offer excellent long-term outcomes - if the respective technique is applied correctly. However, as far as we know, no recommendation has been made regarding cemented vs. cementless THA in primary myelofibrosis. The case described here concerns a very active 76-year-old patient with primary myelofibrosis. This is a rare hematological disease. It develops from clonal hematopoiesis with impaired blood formation and progressive bone marrow fibrosis. An MRI scan of the patients pelvis showed a marked spotted change over all of the imaged bone. Ultimately, in preoperative planning we decided in favor of a proven cementless implant (Allofit Alloclassic cup and the CLS Spotorno stem from Zimmer). Complication-free osseous integration of the cementless implants was observed. Histologic analysis of the bone showed a focally sclerotically altered bone structure. Neither osteoporosis nor osteopenia were found. In our opinion, taking into account all other indication criteria, there is no reason not to perform a cementless THA implantation in the presence of primary myelofibrosis. Key words: hip, primary myelofibrosis, cementless, THA, total hip replacement.

• MeSH
• cementování MeSH
• lidé MeSH
• náhrada kyčelního kloubu * MeSH
• primární myelofibróza chirurgie   MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

Osteoarthritis (OA) can be used as a common name for a group of overlapping pathological conditions when the balance between the processes of degradation and synthesis, in individual parts of the cartilage, is disturbed and leads to gradual cartilage destruction. A preventive approach toward OA helps with a timely diagnosis and subsequent treatment of this disease. One of the significant risk factors affecting development of hip joint OA is the mechanism and magnitude of mechanical loading on the joint. The main motivation for this work was to verify the hypothesis involving a pathologic cycle (overloading - change of locomotion - overloading) as contributory to the development of OA and whether it can be stopped, or at least partly decelerated, by a suitable change of movement stereotypes. Providing that there is a natural balance of muscular action, from the beginning of OA, the development of OA can be significantly decelerated. The return to a natural force balance can be achieved using suitable exercise and strengthening of muscular structures. In order to verify the hypothesis, we undertook experimental measurements of gait kinematics and a computational analysis of the hip joint using the Finite Element Method.

• MeSH
• analýza metodou konečných prvků MeSH
• artróza kyčelních kloubů patofyziologie   rehabilitace   MeSH
• biomechanika MeSH
• chůze (způsob) fyziologie   MeSH
• chůze fyziologie   MeSH
• hodnocení rizik MeSH
• kloubní chrupavka patofyziologie   MeSH
• kyčelní kloub patofyziologie   MeSH
• lidé MeSH
• počítačová grafika MeSH
• posturální rovnováha fyziologie   MeSH
• rozsah kloubních pohybů fyziologie   MeSH
• software MeSH
• techniky fyzikální terapie MeSH
• zatížení muskuloskeletálního systému fyziologie   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Hip joint dysplasia in dogs occurs mainly in large and heavy breeds. It brings about changes on the acetabulum (socket) and the head of thigh bone, thus causing pain, tiredness, refusal to jump and refusal of increased activity. Even though presently the genetic basis of development of this disease, numerous literary sources indicate existence of pre-disposing factors that facilitate development in later stages of life. Diet and unbalanced development of skeleton and support tissues-ligaments, joint capsule and musculature also have the effect on development of dysplasia. We have analyzed acquired results of X-ray examination of dogs-German shepherds. The size of the group was 4 206 and the examination was aimed at incidence of hip-joint dysplasia during the period of 1977-1995 in the Slovak Republic. We have found out that in 1977 there were 70.7% positive cases out of the total number of examined individuals. Gradual exclusion of dogs with heavier grades of dysplasia (D, E) decreased occurrence of dysplasia to current rate of 40.8%. We considered it to be a high incidence rate. Internal structure of the positive group has changed. The number of dogs with the lightest grade of dysplasia (B) has increased, while the number of heavier grade dysplasia (C, D, E) decreased. In other breeds of dogs, of which more than 20 have been examined at the clinic, the following results have been acquired: Slovak chuvash-32%, Bavarian and Hannover bloodhound-30.6%, Rotweiler-28.6%, Newfoundland dog-26.3%, Bern sheep-dog-13.6%. At the same time we analyze the incidence of dysplasia in dogs whose parents were negative. Group of descendants of 11 negative males and 28 females consisted of 73 dogs. Through x-ray examination, 42.5% of dogs were found to have dysplasia B, C and D at the age of 1 year.

• MeSH
• dysplazie kyčelního kloubu u psů diagnostické zobrazování   epidemiologie   MeSH
• kyčelní kloub diagnostické zobrazování   MeSH
• psi MeSH
• radiografie MeSH
• zvířata MeSH
• Check Tag
• psi MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Slovenská republika epidemiologie   MeSH

PURPOSE OF THE STUDY: It is the aim of our study to present the results of our way of treatment of the periprosthetic fractures, with the cemented as well as the cement-free stems. MATERIAL: From 1.1.1988 until 31.3.2005 we operated 42 periprosthetic fractures of the hip in 41 patients. 31 of our patients were females, 10 of them males. In 22 cases we operated the right side, 18 times the left side and once we had to operate both sides, but at different times. We used the Vancouver classification scale for the grading of the fractures. In our study we excluded type A fractures; we registered 41 type B fractures and one only type C fracture. The reason for periprosthetic fracture in all these 42 cases was definitely a trauma. In 6 cases we found pre-existing loosening of the stem. We have grouped our patients under two headings: 1. Primary cemented stems (n=13) 2. Primary cement-free stems (n=29) The average age at the time of primary operation was 63.6 years in the group of cemented stems and 67.2 years with the cement-free implants. METHODS: The principle of this operation lies in a stable technique of osteosynthesis. If one operates on a stable stem one uses a one and only technique of osteosynthesis. Patients who also suffer from a loosening of the stem, are treated by replacement of the stem combined with a particular form of osteosynthesis. We generally use a transgluteal access with an L-shaped detachment of the Musc. vastus lateralis. In the group of cemented stems (n=13) we carried out a replacement of the stem 6 times and in the group of cement-free stems (n=29) we had to replace the implant on 7 occasions. Analysing the osteosynthesis technique we find the use of titanium cerclages and titanium elements on 35 occasions, in both groups taken together. As implant for the stem we preferred the modulated revision stem according to Zweymüller. Clinical post-operational examination of our patients was carried out according to the Merle d'Aubigne score and two x-rays at different levels. RESULTS: After an average post-operational check-up time of 3 years and 2 months, we were able to examine 8 patients with cemented stems (61.5%), 4 of whom had replacement of the stem by a cement-free implant. In the cement-free group we evaluated 24 patients after an average time of 4 years and 11 months. In this group we had 5x a replacement of the stem, 3x of these we could operate cement-free. The post-operational radiological check showed an excellent building-up of bone structure without any dislocation of the implant in all 32 cases. DISCUSSION: The average age of our patients shows 77 years with those with cemented stems and 74.5 years in the ones with cementfree implants. Analysis of the cemented stems shows a loosening rate of more than 50%, which coincides with the findings of many other authors. After a couple of years using cups of polyethylene we were confronted with the problem of the so-called Polyethylene disease. These alterations may finally lead to a loss of bone quality, to mechanical loosening of the implant and an increase in danger of fracture. When we discuss the group of patients with cement-free stems and compare them to those with cemented ones, we find a number of quite different characteristics. B2 fractures appear in a quite higher number of patients with cemented and loosened stems. In this regard, our own study is congruent with the studies of other authors. In the cement-free group we had 75% B1 fractures with a stable stem. The explanation for these figures is, that the cement-free implants were well incorporated in the bone structure. CONCLUSIONS: The choice of operative procedure when treating periprosthetic hip fractures depends on the type of fracture and the stability of the prosthesis. Our own very positive experiences and the then emerging results lead to a certain strategy in procedure. That means, for us, the use of a cement-free modulated revision stem according to Zweymüller combined with a particular technique of osteosynthesis, using titanium cerclages and titanium elements.

• MeSH
• cementování MeSH
• fraktury kyčle chirurgie   MeSH
• kyčelní protézy * MeSH
• lidé středního věku MeSH
• lidé MeSH
• náhrada kyčelního kloubu MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• vnitřní fixace fraktury * metody   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

UNLABELLED: PURPOSE OF THE STUDY Ultrahigh molecular weight polyethylene (UHMWPE) is today the most frequently used bearing surface in total joint replacements (TJR) because of its properties, i.e., excellent biocompatibility, good mechanical and tribological performance and high wear resistance. UHMWPE liners are the most loaded TJR components and, therefore, their properties are decisive for TJR longevity. This study had three objectives: 1) to evaluate the oxidative degradation of explanted UHMWPE components; 2) to look for a statistically significant relationship between the extent of oxidative degradation and the durability of joint replacements; and 3) to investigate whether the durability of a TJR was related to the type of sterilisation used in manufacture. MATERIAL AND METHODS The study included 26 acetabular components obtained at revision arthroplasty between 2004 and 2013 from patients in whom a Beznoska/Poldi total hip replacement was used in the period from 1977 to 2002. The average age of the patients at the time of primary implantation was 57.9 years, the average longevity of the components removed was 18.63 years (range, 6.9 to 27.9 years). Samples of worn out and unworn areas from explanted components were processed in a three-step procedure in order to finally obtain 2-mm microtome sections. These were studied by infrared microspectroscopy. Oxidative damage to UHMWPE was determined as the oxidation index (OI); radiation damage to UHMWPE during sterilization was evaluated as the transvinylene index (VI); oxidation-induced changes in the polymer structure and its properties were characterised as the crystallinity index (CI); and local changes in mechanical properties due to oxidative degradation were assessed as microhardness (MH). Spearman's correlation coefficient and the Wilcoxon two-sample test were used for statistical analysis. RESULTS The OI values (average and maximum) in both worn out and unworn surface areas were related to component longevity. The difference between the oxidation index of ruptured components and that of the other components was statistically significant. Significant differences were also found between the average and maximum OI values of worn out areas and those of unworn surfaces. The relationship between the average oxidation index in both the unworn and worn out areas of UHMWPE components and the longevity of cracked components was statistically significant. DISCUSSION Our results show that the OI values obtained by microspectroscopy correlated with both the microscopic damage and the longevity of UHMWPE liners and the correlation was statistically significant also in relation to the longevity of total replacements. Relationships amongst OI, VI, CI and MH values as well as their relation to failure and longevity of total replacements are discussed. CONCLUSIONS It can be concluded that infrared microspectroscopic measurement of OI values is a simple and fast method to characterise UHMWPE liners. In addition, the IR spectra also show other supplementary characteristics, such as VI and CI indices. These values provide information on the quality of various UHMWPE types currently used in TJR surgery. The types of UHMWPE which exhibit high oxidative degradation should be avoided in clinical practice due to increased risk of early TJR failure. Responsible orthopedic surgeons should be aware of this fact and, if possible, collaborate with an independent, noncommercial laboratory in order to evaluate the quality of various UHMWPE liners used in their hospitals. KEY WORDS: UHMWPE, oxidation, total joint replacement, infrared spectroscopy, microhardness.

• MeSH
• biokompatibilní materiály chemie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• náhrada kyčelního kloubu přístrojové vybavení   MeSH
• oxidační stres fyziologie   MeSH
• polyethyleny chemie   MeSH
• reoperace MeSH
• selhání protézy MeSH
• senioři MeSH
• spektrofotometrie infračervená MeSH
• testování materiálů metody   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• biokompatibilní materiály MeSH
• polyethyleny MeSH
• ultra-high molecular weight polyethylene MeSH Prohlížeč

BACKGROUND: Idiopathic scoliosis does not only cause structural changes in the spine, but also functional changes of the musculoskeletal system. RESEARCH QUESTION: Does idiopathic scoliosis lead to asymmetric hip loading in severe Lenke type 1 deformity? METHODS: 23 patients (18 girls, 5 boys) aged 15 ± 2.8 years with an adolescent idiopathic main thoracic curve (Cobb angle 48.8°+/- 9.2°) were included. Measured X-ray parameters were: Cobb angle of primary thoracic and secondary lumbar curve, translation of the C7- plumb line, apical thoracic vertebra and apical lumbar vertebra from the central sacral vertical line. Subjects were examined by means of kinematic and kinetic gait analysis. The symmetry index (SI) was calculated as a ratio of hip frontal moments during a single stance for both sides when the symmetrical load was considered SI = 0 + /- 29.36 (0 +/- 1 SD of the mean SI of the healthy population). The Pearson correlation coefficient was used to show the relation between hip loading and radiologic measures of spinal deformity. RESULTS: Only 34.8% of subjects with Lenke type 1 deformity showed symmetrical hip loading. Significant negative correlation was proved between SI and apical thoracic vertebra translation (R = - 0541; p < 0,05) as well as between SI and coronal imbalance (R = -0,5197; p < 0,05). There was no correlation between SI and the magnitude of the primary thoracic curve (R = -0.19; p = 0.385). Coronal imbalance correlates positively with translation of apical thoracic vertebra (R = 0,7255; p < 0,05). SIGNIFICANCE: Two-thirds of subjects with Lenke type 1 deformity showed asymmetrical hip loading. This asymmetry is related to the translation of the apical thoracic vertebra and coronal imbalance and is not related to the magnitude of the main thoracic curve. On the contrary, the secondary lumbar curve plays role in the compensatory mechanism of the trunk.

• Klíčová slova
• Adolescent idiopathic scoliosis, Gait analysis, Hip frontal moment, Loading asymmetry, Symmetry index,
• MeSH
• bederní obratle diagnostické zobrazování   MeSH
• fúze páteře * MeSH
• hrudní obratle MeSH
• lidé MeSH
• mladiství MeSH
• radiografie MeSH
• retrospektivní studie MeSH
• skolióza * diagnostické zobrazování   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

PURPOSE OF THE STUDY For an orthopedic surgeon it is difficult or even impossible to estimate the real quality of ultrahigh molecular weight polyethylene (UHMWPE) liners that are used in the total joint replacements (TJR) just on the basis of information given by the manufacturers. At the same time, the quality of the UHMWPE liner can impact strongly on the total lifespan of the implanted TJR. This work aims at independent, objective comparison of properties of the UHMWPE liners for total hip replacements (THR), which are most frequently used in the Czech Republic. MATERIAL AND METHODS We analyzed seventeen most frequently implanted UHMWPE cups of different manufacturers implanted in the Czech Republic between 2014 and 2015 and four control samples prepared by standard industrial-scale procedures according to our instructions, whose modification (crosslinking, thermal treatment, stabilization and sterilization) was known in detail. The UHMWPE polymer was characterized by four independent microscale methods, suitable for relatively small and irregular specimens such as THR cups: infrared microspectroscopy (IR), differential scanning calorimetry (DSC), and thermogravimetric analysis (TGA). RESULTS The employed methods yielded quite complete information about the investigated UHMWPE materials. IR spectra enabled us to calculate oxidation indexes (OI, measure of oxidative damage), trans-vinylene indexes (VI, measure of absorbed radiation dose during crosslinking and/or sterilization) and crystallinity indexes (CI, amount of crystalline phase that strongly influences mechanical performance). DSC curves were employed in calculation of crystallinities (wc, proportional to CI) and melting points (Tm, proportional to the average thickness of crystalline lamellae). MH measurements confirmed that the observed structure changes showed a real impact on mechanical properties. TGA experiments gave rough estimate of stabilization and, consequently, possible long-term oxidation resistance. Significant correlations among oxidative damage (OI), crystallinity (CI, wc) and microhardness (Hv) were statistically proven. The highest oxidative degradation was usually observed in samples thermally treated by annealing and/or sterilized by gamma irradiation. DISCUSSION The results confirmed our expectations that the UHMWPE liners from various manufacturers can be significantly different as far as their molecular structure, supermolecular structure, and mechanical properties are concerned. The differences among the various UHMWPE can be expected to increase after the implantation during in vivo. CONCLUSIONS From the clinical practice point of view, the results showed the following facts: (i) In the field of THR, all manufactures prefer crosslinked types of UHMWPE due to their increased wear resistance; non-crosslinked UHMWPEs are regarded as obsolete. (ii) Most of the manufacturers prefer ethylene oxide or gas plasma sterilization to gamma sterilization because the gammasterilized UHMWPEs exhibit lower long-term oxidation resistance. (iii) Modern trend is the stabilization of UHMWPEs with vitamin E. Key words: UHMWPE, hip replacements, oxidative degradation, infrared spectroscopy, microhardness.

• MeSH
• lidé MeSH
• náhrada kyčelního kloubu * MeSH
• polyethyleny * MeSH
• testování materiálů MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH
• Názvy látek
• polyethyleny * MeSH
• ultra-high molecular weight polyethylene MeSH Prohlížeč

PURPOSE OF THE STUDY Analysis of the tissue harvested around the total hip replacement isolated from re-operated patients in order to: (1) characterize complexity of structural processes developing in the region of the total hip replacement and, (2) to define the role and significance of histological structures of this tissue, mainly in relation to implant loosening, from the viewpoint of formal and causal pathogenesis. MATERIAL AND METHODS Biopsied material isolated from periarticular tissue of re-operated patients (n=19) after THR was analyzed using the methods of light optic, fluorescent (TUNEL), and transmission electron microscopy. RESULTS Histological analysis revealed fibroproliferaive processes and epithelioid granulomatosis cell reaction around the implant with the formation of giant multinuclear syncythial (osteoclastlike) structures as a response to foreign bodies. These structures phagocyte fragments of foreign material (polyethylene particles from the implant, cement fragments). All the used methods revealed a range of regressive changes in the layers of foreign microparticles (inside giant multinuclear cells) typical of fibrinoid necrosis in collagen fibres and apoptosis. In certain cases, progressive changes as chondroid and synovial differentiation (metaplasia) were observed. DISCUSSION Total hip replacement, despite all positive aspects for patients, may cause permanent inflammatory processes in its surrounding. This may result in an extensive fibroproduction of a differently thick layer of connective tissue around the implant. An important factor of loosening of THR is probably osteoclastic resorption in the area of "bone-implant" interface, as a result of the interaction between the inflammatory mechanisms around the implant. CONCLUSION In the postoperative period, there occur fibroproliferative changes in the periarticular tissue and large population of multinuclear cells. In our view, these cells play a role in the production of wear particles from the implant and microparticles of bone tissues and bone cement. Fibroproliferative process may be considered as an immune response to the implanted foreign material.

• MeSH
• granulační tkáň diagnostické zobrazování   patologie   MeSH
• koncové značení zlomů DNA in situ MeSH
• kyčelní kloub patologie   MeSH
• kyčelní protézy * MeSH
• lidé středního věku MeSH
• lidé MeSH
• mikroskopie elektronová rastrovací transmisní MeSH
• náhrada kyčelního kloubu * MeSH
• reakce na cizí těleso patologie   MeSH
• reoperace MeSH
• selhání protézy * MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ultrasonografie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH