Pub Date : 2023-06-16DOI: 10.31139/chnriop.2023.88.2.3
Michał Kanak, W. Bocheński, J. Lesman, Marcin Mostowy
Introduction. Injuries of the ACL are the most common ligamentous injuries of the knee joint, highlighting the importance of tools to easily determine the patients from a risk group. Aims. The aims of this study were: to establish whether the posterior condylar angle (PCA) is a risk factor of ACL injury among 18-30 year-old males and to assess the differences in PCA among patients with isolated ACL injury vs. ACL injury combined with acute MCL, or meniscal injury. Methods and materials. A case group was formed, according to a priori power analysis (α = 0.05, β = 0.95), with 44 patients with an ACL injury and a control group with 44 healthy patients. Then, the case group was subdivided into three subgroups: the MCL and meniscal injured. Two lines were drawn on the axial MRI – the posterior condylar axis and the surgical transepicondylar axis. The PCA was defined as the angle between them. Statistical analyses included U Mann-Whitney, t-student independent-sample tests, linear regression models and correlation analyses. Results. The mean PCA in the control and study group was 1.90° ±1.25° and 1.30° ±2.49°(p = 0.178), respectively. Univariate analyses of PCA in isolated ACL injury vs. ACL injury combined with acute MCL, MM or LM injury had p values of 0.981, 0.814 and 0.813, respectively. Multivariable analysis had p values of 0.744, 0.421 and 0.873, respectively. Intrarater ICCs were 0.931 and 0.928 (excellent reliability) and interrater ICCs was 0.868 (good reliability). Conclusions. PCA is not associated with acute ACL injuries in the studied population. MCL or meniscal injuries did not alter PCA values among patients with an ACL injury.
{"title":"Does the posterior condylar angle (PCA) affect the risk of an anterior cruciate ligament (ACL) tear? A case-control study in males aged 18-30","authors":"Michał Kanak, W. Bocheński, J. Lesman, Marcin Mostowy","doi":"10.31139/chnriop.2023.88.2.3","DOIUrl":"https://doi.org/10.31139/chnriop.2023.88.2.3","url":null,"abstract":"Introduction. Injuries of the ACL are the most common ligamentous injuries of the knee joint, highlighting the importance of tools to easily determine the patients from a risk group. Aims. The aims of this study were: to establish whether the posterior condylar angle (PCA) is a risk factor of ACL injury among 18-30 year-old males and to assess the differences in PCA among patients with isolated ACL injury vs. ACL injury combined with acute MCL, or meniscal injury. Methods and materials. A case group was formed, according to a priori power analysis (α = 0.05, β = 0.95), with 44 patients with an ACL injury and a control group with 44 healthy patients. Then, the case group was subdivided into three subgroups: the MCL and meniscal injured. Two lines were drawn on the axial MRI – the posterior condylar axis and the surgical transepicondylar axis. The PCA was defined as the angle between them. Statistical analyses included U Mann-Whitney, t-student independent-sample tests, linear regression models and correlation analyses. Results. The mean PCA in the control and study group was 1.90° ±1.25° and 1.30° ±2.49°(p = 0.178), respectively. Univariate analyses of PCA in isolated ACL injury vs. ACL injury combined with acute MCL, MM or LM injury had p values of 0.981, 0.814 and 0.813, respectively. Multivariable analysis had p values of 0.744, 0.421 and 0.873, respectively. Intrarater ICCs were 0.931 and 0.928 (excellent reliability) and interrater ICCs was 0.868 (good reliability). Conclusions. PCA is not associated with acute ACL injuries in the studied population. MCL or meniscal injuries did not alter PCA values among patients with an ACL injury.","PeriodicalId":89713,"journal":{"name":"Polish orthopedics and traumatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48730464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-16DOI: 10.31139/chnriop.2023.88.2.6
M. Napiontek
The paper describes the technique and application of a tricortical bone graft harvesting from the lateral malleolus. Graft harvesting does not interfere with the continuity of the fibula. Due to its structure, the graft is equivalent to a similarly structured graft taken from the iliac crest. The graft is used in osteotomies and arthrodesis within the foot and ankle joint, which require a strong piece of bone as a wedge. The author typically uses this type of graft for osteotomy of the anterior part of the calcaneus with an opening wedge (Evans’ osteotomy), calcaneal-cuboid arthrodesis, talo-calcaneal arthrodesis, especially after calcaneal fractures, Green-Grice extra-articular talo-calcaneal arthrodesis and Dwyer II of calcaneus osteotomy for the correction of varus deformity with opening wedge from the middle, opening wedge osteotomy of medial cuneiform and supplement bone defects in techniques requiring lengthening of metatarsals.
{"title":"Tricortical bone graft from lateral malleolus as an alternative for iliac crest graft in the operative treatment of foot deformities: graft harvesting technique and its application","authors":"M. Napiontek","doi":"10.31139/chnriop.2023.88.2.6","DOIUrl":"https://doi.org/10.31139/chnriop.2023.88.2.6","url":null,"abstract":"The paper describes the technique and application of a tricortical bone graft harvesting from the lateral malleolus. Graft harvesting does not interfere with the continuity of the fibula. Due to its structure, the graft is equivalent to a similarly structured graft taken from the iliac crest. The graft is used in osteotomies and arthrodesis within the foot and ankle joint, which require a strong piece of bone as a wedge. The author typically uses this type of graft for osteotomy of the anterior part of the calcaneus with an opening wedge (Evans’ osteotomy), calcaneal-cuboid arthrodesis, talo-calcaneal arthrodesis, especially after calcaneal fractures, Green-Grice extra-articular talo-calcaneal arthrodesis and Dwyer II of calcaneus osteotomy for the correction of varus deformity with opening wedge from the middle, opening wedge osteotomy of medial cuneiform and supplement bone defects in techniques requiring lengthening of metatarsals.","PeriodicalId":89713,"journal":{"name":"Polish orthopedics and traumatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69600403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-16DOI: 10.31139/chnriop.2023.88.2.2
A. Gruca
The author presents an original technique of reconstruction of the ankle joint (including reconstruction of the lateral malleolus) in the congenital absence of the fibula.
作者提出了一种在先天性腓骨缺失的情况下重建踝关节（包括外踝重建）的原始技术。
{"title":"Classics. Fibular hemimelia or deficiency (defectus fibulae)","authors":"A. Gruca","doi":"10.31139/chnriop.2023.88.2.2","DOIUrl":"https://doi.org/10.31139/chnriop.2023.88.2.2","url":null,"abstract":"The author presents an original technique of reconstruction of the ankle joint (including reconstruction of the lateral malleolus) in the congenital absence of the fibula.","PeriodicalId":89713,"journal":{"name":"Polish orthopedics and traumatology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49552730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-16DOI: 10.31139/chnriop.2023.88.2.5
Karol Ochocki, J. Pasek, S. Kasperczyk, B. Koczy, Tomasz Stołtny
Surface arthroplasty, also referred to as resurfacing, is a method of sparing hip arthroplasty, which is a surgical alternative usually reserved for younger, active patients. The introduction of successive generations of implants with metal-on-metal articulation resulted in increased interest in this method of treatment. Despite the unquestionable advantages and promising initial results, resurfacing has some limitations and disadvantages. One of them is the increase in the concentration of metal ions. Although they are necessary for the proper functioning of the human body, in large amounts they can lead to serious reactions of the soft tissues adjacent to the prosthesis, including metallosis, ALVAL (Aseptic Lyphocytic Vasculitis-Associated Lesion), or the formation of pseudotumours. Despite numerous studies and scientific reports, there is a need for further work on the relationship between the concentration levels of metal ions in people after resurfacing and the biological, causal mechanisms of the development of adverse reactions in the body.
{"title":"Surface replacement arthroplasty in the surgical treatment of hip osteoarthritis","authors":"Karol Ochocki, J. Pasek, S. Kasperczyk, B. Koczy, Tomasz Stołtny","doi":"10.31139/chnriop.2023.88.2.5","DOIUrl":"https://doi.org/10.31139/chnriop.2023.88.2.5","url":null,"abstract":"Surface arthroplasty, also referred to as resurfacing, is a method of sparing hip arthroplasty, which is a surgical alternative usually reserved for younger, active patients. The introduction of successive generations of implants with metal-on-metal articulation resulted in increased interest in this method of treatment. Despite the unquestionable advantages and promising initial results, resurfacing has some limitations and disadvantages. One of them is the increase in the concentration of metal ions. Although they are necessary for the proper functioning of the human body, in large amounts they can lead to serious reactions of the soft tissues adjacent to the prosthesis, including metallosis, ALVAL (Aseptic Lyphocytic Vasculitis-Associated Lesion), or the formation of pseudotumours. Despite numerous studies and scientific reports, there is a need for further work on the relationship between the concentration levels of metal ions in people after resurfacing and the biological, causal mechanisms of the development of adverse reactions in the body.","PeriodicalId":89713,"journal":{"name":"Polish orthopedics and traumatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69600291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-16DOI: 10.31139/chnriop.2023.88.2.4
Maciej Piotrowski
A comminuted distal radial fracture is sometimes so fragmented that it is impossible to treat it with fixation using a plate and screws. In this case, we can perform a bridging fracture and joints with an external fixator or a dorsal spanning plate. Unfortunately, both methods completely immobilize the wrist until the implants are removed. In the article is presented an alternative method of bridge fixation. After fracture bridging with a volar spanning plate, the patient immediately has the possibility of dorsal and volar flexion of approximately 30 degrees in each direction. The study group consists of 6 patients treated surgically with a volar spanning plate after an unsuccessful attempt of stable fixation with a volar plate. 5 patients suffered from a distal radius fracture in the AO classification type C3, and one man with an inveterate dorsal dislocation of the wrist and fracture of the radial styloid process type B1. The volar spanning plate was fixed distally in the scaphoid and lunar, and proximally in the shaft of the radius. All patients achieved bone union. There was no destabilization or any damage of the implant. The average dorsal flexion was 48°, and the palmar flexion was 45°. All patients obtained a satisfactory result according to the Mayo scale, without pain. The volar spanning plate may be indicated when intraoperative fixation by a volar plate turns out to be too optimistic. Compared to the external fixator or the dorsal spanning plate, the volar spanning plate does not distract the midcarpal and carpometacarpal joints. What is more, immediately after the operation, the possibility of dorsal and palmar flexion are approximately 30 degrees in each direction, which improves the quality of life in the first weeks of treatment. After removing the implant, there is still a chance to improve the range of motion of the wrist.
{"title":"Volar spanning plate fixation for a distal radius fracture","authors":"Maciej Piotrowski","doi":"10.31139/chnriop.2023.88.2.4","DOIUrl":"https://doi.org/10.31139/chnriop.2023.88.2.4","url":null,"abstract":"A comminuted distal radial fracture is sometimes so fragmented that it is impossible to treat it with fixation using a plate and screws. In this case, we can perform a bridging fracture and joints with an external fixator or a dorsal spanning plate. Unfortunately, both methods completely immobilize the wrist until the implants are removed. In the article is presented an alternative method of bridge fixation. After fracture bridging with a volar spanning plate, the patient immediately has the possibility of dorsal and volar flexion of approximately 30 degrees in each direction. The study group consists of 6 patients treated surgically with a volar spanning plate after an unsuccessful attempt of stable fixation with a volar plate. 5 patients suffered from a distal radius fracture in the AO classification type C3, and one man with an inveterate dorsal dislocation of the wrist and fracture of the radial styloid process type B1. The volar spanning plate was fixed distally in the scaphoid and lunar, and proximally in the shaft of the radius. All patients achieved bone union. There was no destabilization or any damage of the implant. The average dorsal flexion was 48°, and the palmar flexion was 45°. All patients obtained a satisfactory result according to the Mayo scale, without pain. The volar spanning plate may be indicated when intraoperative fixation by a volar plate turns out to be too optimistic. Compared to the external fixator or the dorsal spanning plate, the volar spanning plate does not distract the midcarpal and carpometacarpal joints. What is more, immediately after the operation, the possibility of dorsal and palmar flexion are approximately 30 degrees in each direction, which improves the quality of life in the first weeks of treatment. After removing the implant, there is still a chance to improve the range of motion of the wrist.","PeriodicalId":89713,"journal":{"name":"Polish orthopedics and traumatology","volume":"69 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69600280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-16DOI: 10.31139/chnriop.2023.88.2.1
J. Czubak, Marzena Czubak
The article presents a biography of Adam Gruca, one of the most famous Polish orthopaedic surgeon born December 3, 1893, died June 3, 1983 in Warsaw. He was Professor of medical sciences, and doctor honoris causa at the Medical Academies in Warsaw and Wrocław. The Polish Orthopedic Society was constituted at its first convention in Poznań in 1928, attended by Prof. Adam Gruca and his wife.
{"title":"Year of Professor Adam Gruca (1893-1983). On the 130th anniversary of his birth and the 40th anniversary of his death","authors":"J. Czubak, Marzena Czubak","doi":"10.31139/chnriop.2023.88.2.1","DOIUrl":"https://doi.org/10.31139/chnriop.2023.88.2.1","url":null,"abstract":"The article presents a biography of Adam Gruca, one of the most famous Polish orthopaedic surgeon born December 3, 1893, died June 3, 1983 in Warsaw. He was Professor of medical sciences, and doctor honoris causa at the Medical Academies in Warsaw and Wrocław. The Polish Orthopedic Society was constituted at its first convention in Poznań in 1928, attended by Prof. Adam Gruca and his wife.","PeriodicalId":89713,"journal":{"name":"Polish orthopedics and traumatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69600657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-28DOI: 10.31139/chnriop.2023.88.1.5
M. Jóźwiak, Łukasz Woźniak, Zaid Al-Shakarchi, P. Bernius, M. Wade Shrader, Elisabet Rodby-Bousquest
Introduction. The fourth edition of the Transatlantic Orthopedic Surgery Webinar 2022 took place on December 12th, 2022. The main theme of the webinar was the treatment of crouch gait in children with cerebral palsy (CP). Speakers from Australia, Canada, China, Germany, India, Poland, Spain, Sweden, Turkey, the United Kingdom, and the United States participated. Results. The first general session presented the biomechanics of crouch gait, the function of the hip and knee muscles in children with CP, the principles of prevention and treatment of crouch gait in spastic diplegia, and the natural course and treatment outcomes of CP in adults. The surgical sessions comprehensively presented the surgical techniques for treating crouch gait: percutaneous myofasciotomy in the posterior knee joint, straightening osteotomy of the distal femur in hemiplegia, asymmetric and symmetric diplegia, techniques for shortening and plastically reconstructing the patellar ligament, anterior hemiepiphysiodesis of the distal femur, and transfer of the hamstring muscles to the rectus femoris muscle. The second general session presented postoperative standing and walking rehabilitation protocols and evaluation of treatment outcomes (pain, fatigue, ambulatory activity, motor function, and quality of life). Summary. The most important conclusions from the event were: do not lengthen the Achilles tendon in zone III in crouch gait; laboratory gait analysis is necessary before lengthening the hamstring muscles; hemiepiphysiodesis of the distal femur can be performed when the predicted growth period is less than two years; distal femur osteotomy should be considered during adolescence for knee flexion contracture of 10-40 degrees; treatment possibilities of tendon transfers and myofasciotomies should be remembered, especially in younger patients. The webinar attracted an audience of approximately 1,600 people from 672 centers located in 57 countries. Most participants came from Poland, the United Kingdom, the United States, Norway, Sweden, and India.
{"title":"Diagnosis and treatment of crouch gait in children with cerebral palsy. Report from the 4th Edition of the Transatlantic Orthopedic Surgery Webinar 2022","authors":"M. Jóźwiak, Łukasz Woźniak, Zaid Al-Shakarchi, P. Bernius, M. Wade Shrader, Elisabet Rodby-Bousquest","doi":"10.31139/chnriop.2023.88.1.5","DOIUrl":"https://doi.org/10.31139/chnriop.2023.88.1.5","url":null,"abstract":"Introduction. The fourth edition of the Transatlantic Orthopedic Surgery Webinar 2022 took place on December 12th, 2022. The main theme of the webinar was the treatment of crouch gait in children with cerebral palsy (CP). Speakers from Australia, Canada, China, Germany, India, Poland, Spain, Sweden, Turkey, the United Kingdom, and the United States participated. Results. The first general session presented the biomechanics of crouch gait, the function of the hip and knee muscles in children with CP, the principles of prevention and treatment of crouch gait in spastic diplegia, and the natural course and treatment outcomes of CP in adults. The surgical sessions comprehensively presented the surgical techniques for treating crouch gait: percutaneous myofasciotomy in the posterior knee joint, straightening osteotomy of the distal femur in hemiplegia, asymmetric and symmetric diplegia, techniques for shortening and plastically reconstructing the patellar ligament, anterior hemiepiphysiodesis of the distal femur, and transfer of the hamstring muscles to the rectus femoris muscle. The second general session presented postoperative standing and walking rehabilitation protocols and evaluation of treatment outcomes (pain, fatigue, ambulatory activity, motor function, and quality of life). Summary. The most important conclusions from the event were: do not lengthen the Achilles tendon in zone III in crouch gait; laboratory gait analysis is necessary before lengthening the hamstring muscles; hemiepiphysiodesis of the distal femur can be performed when the predicted growth period is less than two years; distal femur osteotomy should be considered during adolescence for knee flexion contracture of 10-40 degrees; treatment possibilities of tendon transfers and myofasciotomies should be remembered, especially in younger patients. The webinar attracted an audience of approximately 1,600 people from 672 centers located in 57 countries. Most participants came from Poland, the United Kingdom, the United States, Norway, Sweden, and India.","PeriodicalId":89713,"journal":{"name":"Polish orthopedics and traumatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69600589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-28DOI: 10.31139/chnriop.2023.88.1.2
Introduction. Total knee replacement is the most efficient method of treating end-stage osteoarthritis of the knee joint. The surgery aims to relieve patients of pain, restore range of motion and improve patients’ quality lives. Prostheses design is still being modified and improved through cooperation between orthopaedic surgeons and engineers. Some of the most modern solutions aimed to fit native patients’ anatomy as much as possible are anatomic knee systems. Materials and methods. The literature was reviewed, and articles related to the subject were researched. Therefore, publications including keywords such as total knee replacement, anatomic implants and morphometric implants were searched in the PubMed, Cochrane and Google Scholar databases. All data was selected and verified individually. Analysis and synthesis of studies were prepared separately. Results. Many studies describe the advantages of anatomic prostheses over standard prostheses. Anatomical prostheses have a broader range of available sizes, thus providing better coverage of the distal end of the femur and the proximal tibia, allowing for the resection of less bone tissue, which is beneficial in the event of a possible need for a future revision of the endoprosthesis, enabling better selection of the tibial element rotation by better matching to the tibial plateau, which affects the alignment and patellar movement, and the structure of the trochlear geometry that also affects the patellar movement and reduces the risk of trochlear dysplasia. Conclusions. Anatomical implants enable better alignment of the prosthesis elements and the native femoral and tibial bone. Using these models makes it possible to obtain a greater range of motion and, consequently, improved functional outcomes compared to non-anatomical ones. It also enables less bone resection and better radiological outcomes.
{"title":"Anatomical knee endoprostheses – does a better-fit lead to better outcomes? A review article","authors":"","doi":"10.31139/chnriop.2023.88.1.2","DOIUrl":"https://doi.org/10.31139/chnriop.2023.88.1.2","url":null,"abstract":"Introduction. Total knee replacement is the most efficient method of treating end-stage osteoarthritis of the knee joint. The surgery aims to relieve patients of pain, restore range of motion and improve patients’ quality lives. Prostheses design is still being modified and improved through cooperation between orthopaedic surgeons and engineers. Some of the most modern solutions aimed to fit native patients’ anatomy as much as possible are anatomic knee systems. Materials and methods. The literature was reviewed, and articles related to the subject were researched. Therefore, publications including keywords such as total knee replacement, anatomic implants and morphometric implants were searched in the PubMed, Cochrane and Google Scholar databases. All data was selected and verified individually. Analysis and synthesis of studies were prepared separately. Results. Many studies describe the advantages of anatomic prostheses over standard prostheses. Anatomical prostheses have a broader range of available sizes, thus providing better coverage of the distal end of the femur and the proximal tibia, allowing for the resection of less bone tissue, which is beneficial in the event of a possible need for a future revision of the endoprosthesis, enabling better selection of the tibial element rotation by better matching to the tibial plateau, which affects the alignment and patellar movement, and the structure of the trochlear geometry that also affects the patellar movement and reduces the risk of trochlear dysplasia. Conclusions. Anatomical implants enable better alignment of the prosthesis elements and the native femoral and tibial bone. Using these models makes it possible to obtain a greater range of motion and, consequently, improved functional outcomes compared to non-anatomical ones. It also enables less bone resection and better radiological outcomes.","PeriodicalId":89713,"journal":{"name":"Polish orthopedics and traumatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69600460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-28DOI: 10.31139/chnriop.2023.88.1.3
Tomasz Reysner, G. Kowalski, Monika Grochowicka, M. Domagalska
Introduction. Perioperative pain management associated with hip surgery is challenging. The pericapsular nerve group (PENG) block is a new technique thought to provide better postoperative analgesia in addition to its motor-sparing effects. Aim. This review aims to evaluate the safety and efficacy of the PENG blockade in managing postoperative pain in patients undergoing hip surgery. Methods. The literature was reviewed through four electronic databases: PubMed, Cochrane Library, Google Scholar, and Embase. Results. The initial search yielded 416 articles. Twenty-seven relevant articles were selected based on relevance, recentness, search quality, and citations. Twelve of the studies were related to patients undergoing total hip arthroplasty. Twelve studies were related to patients undergoing total hip surgery due to hip fracture. Finally, three studies were related to patients undergoing hip arthroscopy. Conclusions. The PENG block provides superior analgesia and low opioid consumption in the first postoperative period. However, current evidence is insufficient, and there is a need for high-quality randomized, controlled trials with larger sample sizes.
{"title":"The pericapsular nerve group (PENG) block for hip surgery. A narrative review","authors":"Tomasz Reysner, G. Kowalski, Monika Grochowicka, M. Domagalska","doi":"10.31139/chnriop.2023.88.1.3","DOIUrl":"https://doi.org/10.31139/chnriop.2023.88.1.3","url":null,"abstract":"Introduction. Perioperative pain management associated with hip surgery is challenging. The pericapsular nerve group (PENG) block is a new technique thought to provide better postoperative analgesia in addition to its motor-sparing effects. Aim. This review aims to evaluate the safety and efficacy of the PENG blockade in managing postoperative pain in patients undergoing hip surgery. Methods. The literature was reviewed through four electronic databases: PubMed, Cochrane Library, Google Scholar, and Embase. Results. The initial search yielded 416 articles. Twenty-seven relevant articles were selected based on relevance, recentness, search quality, and citations. Twelve of the studies were related to patients undergoing total hip arthroplasty. Twelve studies were related to patients undergoing total hip surgery due to hip fracture. Finally, three studies were related to patients undergoing hip arthroscopy. Conclusions. The PENG block provides superior analgesia and low opioid consumption in the first postoperative period. However, current evidence is insufficient, and there is a need for high-quality randomized, controlled trials with larger sample sizes.","PeriodicalId":89713,"journal":{"name":"Polish orthopedics and traumatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69600514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-28DOI: 10.31139/chnriop.2023.88.1.4
T. Jaszczak, M. Napiontek
Ankle arthrodesis is still the gold standard in the treatment of end-stage degeneration in the ankle joint. The anatomical surgical approach, correct foot alignment and stable fixation are the factors determining the positive effect of surgery. The study presents the technique of ankle arthrodesis by modified Mann’s technique which meets the above-mentioned criteria with the economical use of implants for its stabilization.
{"title":"Ankle arthrodesis by modified Mann’s technique. Step by step","authors":"T. Jaszczak, M. Napiontek","doi":"10.31139/chnriop.2023.88.1.4","DOIUrl":"https://doi.org/10.31139/chnriop.2023.88.1.4","url":null,"abstract":"Ankle arthrodesis is still the gold standard in the treatment of end-stage degeneration in the ankle joint. The anatomical surgical approach, correct foot alignment and stable fixation are the factors determining the positive effect of surgery. The study presents the technique of ankle arthrodesis by modified Mann’s technique which meets the above-mentioned criteria with the economical use of implants for its stabilization.","PeriodicalId":89713,"journal":{"name":"Polish orthopedics and traumatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69600528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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