This report describes the case of a young male who had been followed-up between the ages of 14-21 years at different health facilities for symptoms initially considered to be caused by tumor, then by chronic osteomyelitis or ankylosing spondylitis and finally diagnosed as the SAPHO syndrome. Musculoskeletal symptoms of the SAPHO syndrome include focal, probably aseptic chronic osteomyelitis, synovitis and formation of hyperostoses. Therapy of the SAPHO syndrome is predominantly conservative. However, in this case we had to employ arthroscopic synovectomy first, for severe synovitis resistant to any conservative therapy approach. Later, left total hip replacement has been performed for advanced hip joint damage accompanied by intense pain and significant range of motion reduction. At the present time, the patient is 51/2 years after synovectomy of the knee and 5 years after the hip joint replacement. The knee joint is without effusion or functional limitations, with intermittent pains only. The hip prosthesis in the risk area is fully integrated without signs of component loosening, with very good functional outcome. While synovectomy can be obviously fully recommended in cases like this, the total joint replacement should be considered unique and indicated only rarely after careful consideration of all circumstances.We consider this approach absolutely exceptional also because we have not found reference to similar case in any national or international professional literature available.

• MeSH
• artroskopie * MeSH
• dospělí MeSH
• kolenní kloub chirurgie   MeSH
• lidé MeSH
• náhrada kyčelního kloubu * MeSH
• nemoci kloubů chirurgie   MeSH
• syndrom získané hyperostózy chirurgie   MeSH
• synovektomie * MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• práce podpořená grantem MeSH

Total joint replacement of the temporomandibular joint (TJR) can be associated with intraoperative and postoperative complications. We report herein the occurrence of a postoperative open bite malocclusion, the result of condylar hyperplasia affecting the non-operated joint at 1 year after unilateral total joint replacement.

• Klíčová slova
• complication, condylar hyperplasia, total joint replacement,
• MeSH
• artroplastiky kloubů škodlivé účinky   MeSH
• dospělí MeSH
• hyperplazie patologie   MeSH
• lidé MeSH
• počítačová rentgenová tomografie MeSH
• processus condylaris mandibulae diagnostické zobrazování   patologie   MeSH
• protézy kloubů škodlivé účinky   MeSH
• temporomandibulární kloub diagnostické zobrazování   patologie   chirurgie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

In 2004, total alloplastic temporomandibular joint (TMJ) replacement began in the Czech Republic and Slovakia. This paper presents initial subjective and objective data compiled between 2005 and 2009 from those cases. Data were collected from 27 patients (38 joints) reconstructed with the Biomet-Lorenz stock and custom TMJ prostheses during a mean follow-up period of 24 months. The variables of pain and mouth opening were evaluated pre- and postoperatively. Patients classified pain on a scale of 0-5 (none - unbearable). The extent of opening was investigated by a physician (the distance between the points of the incisors on the upper and lower jaw was measured). The most common indication for replacement was ankylosis. There was an improvement in pain score in 15 patients. 4 patients reported worsening of pain and 8 patients did not complain of pre- or postoperative pain. Mandibular opening increased from a mean of 17.7 mm preoperatively to a mean of 29.1mm postoperatively. There were complications related to the surgery, but no significant complications related to the devices. Total alloplastic TMJ replacement appears to be a safe and effective method of reconstruction in the patients in this initial study.

• MeSH
• ankylóza chirurgie   MeSH
• artralgie chirurgie   MeSH
• artroplastiky kloubů metody   MeSH
• dospělí MeSH
• lidé MeSH
• nemoci temporomandibulárního kloubu chirurgie   MeSH
• neparametrická statistika MeSH
• obličejová bolest chirurgie   MeSH
• osteoartróza chirurgie   MeSH
• pooperační komplikace MeSH
• protézy kloubů * MeSH
• rozsah kloubních pohybů MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH
• Slovenská republika MeSH

The temporomandibular (TM) joint is one of the most used joints in the human body, and any defect in this joint has a significant influence on quality of life. The objective of this study was to create a parametric numerical finite element (FE) analysis to compare the effect of surgical techniques used for total TM joint replacement implantation on loading the TM joint on the other side. Our hypothesis is that for the optimal function of all total TM joint replacements used in clinical practice it is crucial to devise a minimally invasive surgical technique, whereby there is minimum resection of masticatory muscles. This factor is more important than the design of the usually used total TM joint replacements. The extent of muscle resection influences the mechanical loading of the whole system. In the parametric FE analyses, the magnitude of the TM joint loading was compared for four different ranges of muscle resections during bite, using an anatomical model. The results obtained from all FE analyses support our hypothesis that an increasing extent of the muscle resection increased the magnitude of the TM joint overloading on the opposite side. The magnitude of the TM joint overloading increased depending on the muscle resection to 235% for bite on an incisor and up to 491% for bite on molars. Our study leads to a recommendation that muscle resection be minimised during replacement implantation and to a proposal that the attachment of the condylar part of the TM joint replacement be modified.

• MeSH
• analýza metodou konečných prvků MeSH
• artroplastiky kloubů * MeSH
• biomechanika MeSH
• kvalita života MeSH
• lidé MeSH
• počítačová simulace * MeSH
• síla skusu * MeSH
• temporomandibulární kloub patofyziologie   chirurgie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH

PURPOSE OF THE STUDY: Rhizarthrosis-osteoarthritis of the thumb carpometacarpal (CMC) joint is usually a primary idiopathic disease. Total joint arthroplasty (TJA) is one of the surgical treatment options for symptomatic advanced thumb CMC arthritis. This retrospective study aims to evaluate the mid-term functional and radiological results of TJA with the minimum follow-up period of 3 years after the surgery. MATERIAL AND METHODS: Presented are the results of 136 total trapeziometacarpal joint replacements in the group of 105 patients consisted of 96 women and 9 men. Used prostheses were ELiS® implant (27 cases), Ivory® implant (42 cases), Touch® Dual mobility (67 cases). The follow-up period was minimally 3 years postoperatively. In all the patients, along with range of motion and radiologic evaluation of implant position, the function and pain of operated joint were evaluated using DASH and VAS score at regular intervals pre- and postoperatively. RESULTS: At a mean of 85 months (range 38-126 months) post-operatively, patients in 116 cases (85%) reported full satisfaction and absence of symptoms and difficulties. In 12 cases (9%) some slight residual post-exercise pain was reported. In eight cases (6%) patients suffered from episodic rest-pain, but with a lower intensity than in the preoperative period. Postoperatively, the patients declared subjective improvement in hand function. The total DASH score and VAS score decreased in all patients, while ROM increased. The course of all of TJA surgeries was complication-free. Five patients needed revision surgery. In two patients a dislocation has occurred and in three cases a loosening of the cup's implant was reported. The most frequent postoperative complication was the occurrence of transient paraesthesias of the thumb in eight cases (6%). CONCLUSIONS: TJA is the method of choice in management of advanced symptomatic osteoarthritis of the thumb CMC joint. Mastering surgical technique, TJA represents safe and effective treatment method in advanced degenerative changes of the thumb CMC joint and it's benefits exceed possible perioperative and postoperative risks.

• Klíčová slova
• Rhizarthrosis, Thumb CMC joint, Total joint arthroplasty, Trapezium component,
• MeSH
• artroplastiky kloubů * metody   MeSH
• dospělí MeSH
• karpometakarpální klouby * chirurgie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• osteoartróza * chirurgie   MeSH
• palec ruky * chirurgie   MeSH
• protézy kloubů MeSH
• retrospektivní studie MeSH
• rozsah kloubních pohybů MeSH
• senioři nad 80 let MeSH
• senioři 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

BACKGROUND: This paper compares long term success rate of MTP joint replacement for hallux rigidus. We provide long term results of MTP joint replacement with the use of the ToeFit Plus™ System. MATERIALS AND METHODS: Our group consisted of 19 total joint replacements and 12 hemiarthroplasties in 18 and 11 patients respectively, performed between 2005-2009. The average follow-up period was 12.2 years (range 9.8-13.7, SD 1.1) for total arthroplasty group and 11.1 years (range 9.5-13.9, SD 1.7) for hemiarthroplasty group. In all followed patients AOFAS score was calculated along with the range of motion assessment. RESULTS: Average AOFAS score improved from 37 preoperatively to 79 at the time of last follow-up in total arthroplasty group and from 45 to 86 in the hemiarthroplasty group, with consideration to the statistically considerable difference of both groups. The total range of motion improved on average from 14° to the current 32° in patients with total arthroplasty and from 15° to 32° with hemiarthroplasty. The total number of cases that required surgical revision was 7 (37%) in total arthroplasty group and 2 (17%) in hemiarthroplasty group. CONCLUSION: Due to the high percentage of failure that was shown in our long term results, we no longer utilise the ToeFit Plus™ System.

• Klíčová slova
• Aseptic loosening, Hallux rigidus, Hemiarthroplasty, Metatarsophalangeal joint replacement, ToeFit Plus, Total joint arthroplasty,
• MeSH
• artroplastiky kloubů * MeSH
• hallux rigidus * diagnostické zobrazování   chirurgie   MeSH
• hemiartroplastika * MeSH
• lidé MeSH
• metatarzofalangeální kloub * chirurgie   MeSH
• následné studie MeSH
• protézy kloubů * MeSH
• rozsah kloubních pohybů MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Temporomandibular joint total joint replacement, like any surgery, can be associated with either intraoperative or postoperative complications. Intraoperative complications may include injuries to local anatomical structures (e.g., blood vessels, nerves, middle ear, and external auditory canal), or poor positioning and/or adaptation of the prosthesis components to the host bone. Postoperative complications may include infection, hematoma, heterotopic bone formation, implant failure, pain, salivary fistula, foreign body or allergic reactions, and malocclusion. This article reports the occurrence of a postoperative open-bite malocclusion complication, the result of maxillary artery hemorrhage.

• MeSH
• artroplastiky kloubů škodlivé účinky   MeSH
• dospělí MeSH
• lidé MeSH
• nemoci temporomandibulárního kloubu komplikace   chirurgie   MeSH
• osteoartróza komplikace   chirurgie   MeSH
• otevřený skus etiologie   MeSH
• počítačová rentgenová tomografie MeSH
• protézy kloubů * MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

Comminuted fractures of the elbow are very rare and in most cases very complex and the successful treatment can be a challenge for the treating surgeon. Due to the elbow joint's complex functional anatomy, the multi-fragmentary nature of many fractures and concomitant destabilizing associated injuries, comminuted fractures of the elbow still present a serious challenge for the orthopedic surgeon. Especially in more severe communicated injuries an osteosynthesis or endoprosthesis must be discussed with the patient. There is a lack of clear treatment recommendations based on solid evidence. An overview of the literature including a treatment algorithm to guide decision making for the distal humeral fracture in the adults is presented and own results are analyzed. Key words: comminuted fracture of elbow, total joint replacement of the elbow, elbow prosthesis, elbow arthroplasty, distal humeral fracture.

• MeSH
• dospělí MeSH
• klinické rozhodování MeSH
• lidé MeSH
• loket chirurgie   MeSH
• medicína založená na důkazech MeSH
• poranění lokte * MeSH
• totální endoprotéza loketního kloubu metody   MeSH
• tříštivé fraktury chirurgie   MeSH
• vnitřní fixace fraktury metody   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• srovnávací studie MeSH

OBJECTIVE: To determine factors associated with orthopaedic surgeons' decision to recommend total joint replacement (TJR) in people with knee and hip osteoarthritis (OA). DESIGN: Cross-sectional study in eleven countries. For consecutive outpatients with definite hip or knee OA consulting an orthopaedic surgeon, the surgeon's indication of TJR was collected, as well as patients' characteristics including comorbidities and social situation, OA symptom duration, pain, stiffness and function (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]), joint-specific quality of life, Osteoarthritis Research Society International (OARSI) joint space narrowing (JSN) radiographic grade (0-4), and surgeons' characteristics. Univariable and multivariable logistic regressions were performed to identify factors associated with the indication of TJR, adjusted by country. RESULTS: In total, 1905 patients were included: mean age was 66.5 (standard deviation [SD], 10.8) years, 1082 (58.0%) were women, mean OA symptom duration was 5.0 (SD 7.0) years. TJR was recommended in 561/1127 (49.8%) knee OA and 542/778 (69.7%) hip OA patients. In multivariable analysis on 516 patients with complete data, the variables associated with TJR indication were radiographic grade (Odds Ratio, OR for one grade increase, for knee and hip OA, respectively: 2.90, 95% confidence interval [1.69-4.97] and 3.30 [2.17-5.03]) and WOMAC total score (OR for 10 points increase: 1.65 [1.32-2.06] and 1.38 [1.15-1.66], respectively). After excluding radiographic grade from the analyses, on 1265 patients, greater WOMAC total score was the main predictor for knee and hip OA; older age was also significant for knee OA. CONCLUSION: Radiographic severity and patient-reported pain and function play a major role in surgeons' recommendation for TJR.

• Klíčová slova
• Hip, Knee, Osteoarthritis, Surgery, Total joint replacement,
• MeSH
• artróza kolenních kloubů diagnóza   chirurgie   MeSH
• artróza kyčelních kloubů diagnóza   chirurgie   MeSH
• kvalita života MeSH
• lidé MeSH
• náhrada kyčelního kloubu * MeSH
• ortopedové psychologie   MeSH
• prospektivní studie MeSH
• průřezové studie MeSH
• rentgendiagnostika MeSH
• rozhodování * MeSH
• senioři MeSH
• stupeň závažnosti nemoci MeSH
• totální endoprotéza kolene * MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH

This prospective study examined the content of metals released from total joint arthroplasty into joint fluid, whole blood and periprosthetic tissues. We determined the levels of Ti, V, Nb, Co, Cr, and Mo, using inductively coupled plasma mass spectrometry, in samples from patients who underwent reoperation of total hip or knee arthroplasty. All of the patients (n = 117) included in the study had either metal on polyethylene or ceramic on polyethylene-bearing pairs. First, our results conclusively showed that the majority of released metals were deposited in periprosthetic tissues. In this context, the bloodstream turned out to be an ineffective biomarker of the effects occurring in local tissues. Second, there was a clear time-dependent nature of metallic accumulation. Based on our extensive dataset, we found significantly elevated levels of the released metals in joint fluid and periprosthetic tissues originating from loosened implants compared to stable ones, as well as recognizable differences between the groups with stable implants and aseptic loosening. Finally, it was proved that the concentrations of metals decreased dependent on the distance of the tissue from the implant. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 107B: 454-462, 2019.

• Klíčová slova
• inductively coupled plasma mass spectrometry, joint fluid, metal release, periprosthetic tissue, total joint replacement,
• MeSH
• dospělí MeSH
• kovy farmakokinetika   MeSH
• kyčelní protézy škodlivé účinky   MeSH
• lidé středního věku MeSH
• lidé MeSH
• náhrada kyčelního kloubu * MeSH
• prospektivní studie MeSH
• protézy kolene škodlivé účinky   MeSH
• selhání protézy škodlivé účinky   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• synoviální tekutina metabolismus   MeSH
• totální endoprotéza kolene * 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
• práce podpořená grantem MeSH
• Názvy látek
• kovy MeSH