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Intraarticular distal radius fractures affect predominantly young people by contrary to "loco typico" fractures concerning old patients with osteoporosis. They are usually caused by high energy trauma and their treatment needs anatomic reposition. Between August and December 2004 there were performed 10 wrist arthroscopies in distal intraarticular radius fractures: 3 women and 7 men, age from 20 to 63 years, average 41. In all cases arthroscopy revealed larger displacement than assessed by standard radiographs and multiple associated soft tissue injuries were detected: lesions of TFCC in 5 patients, cartilage lesions of carpal bones in 6 and I degree SL interosseous ligament lesion in 4 patients. Arthroscopy in distal radius fractures allows detailed articular surface displacement assessment and reposition under "eye control". Additionally associated soft tissue injuries, which are not visible in standard X-ray examination are detected and treated.

Background. The aim of our study was to assess the impact on surgical outcome of using ceramic implants in Posterior Lumbar Interbody Fusion (PLIF). Material and methods. We collected data from 51 consecutive patients operated using this method from 1998 to 2002. Only patients presenting with clinical signs from one level were qualified for this surgery. The level most often operated was L4-L5 (31 patients). Results. Outcomes were assessed according to both subjective criteria and the Oswestry Disability Scale (ODS). A good outcome (under 15 points on the ODS) was achieved in 22 patients (43.1%), a satisfactory outcome (15-25 points on the ODS) in 18 patients (35.4%), and a poor outcome (over 26 points on the ODS) in 11 patients (21.5%). Conclusions. Ceramic implants consist of biomaterial with good mechanical properties and enable shearing of high forces in the lower spine. The application of the ceramic implants reduces the operation time comparing with PLIF using the metallic implants. The ceramic implants are infiltrated by the bone tissue of the adjacent vertebrae and are the alternative for more expensive metallic implants.

Background. This article describes the diagnosis and surgical management of disk herniations and cervical spondylosis using Tibone implants. The aim of the study was to answer the question: Is decompression and interbody fusion at one clinically active level enough to provide a good outcome, or is it necessary to extend the operative procedure in the presence of multisegmental lesions in order to avoid symptoms from other levels? Material and methods. We studied 42 consecutive patients operated from 1999 to 2002 by means of decompression and anterior interbody fusion using Tibone implants. Results. The outcome was good in 32 cases (76.2%), satisfactory in 8 cases (19%), and poor in 2 cases (4.8%). Conclusions. The results we obtained indicate that precise clinical examination is crucial in determining the level and extent of surgery required. The comparison of data from x-rays and MRI images and a clinical investigation are required to make the decision whether or not to operate. The presence of lesions in x-rays and MRI images at levels other than those clinically active is not a sufficient indication for decompression and fusion at these levels.

Articular cartilage has only a limited capacity for regeneration. Articular cartilage damage, that does not penetrate to the subchondral layer of the bone, is not likely to repair itself and heal, but usually leads to degeneration of the articular surfaces. Damage that penerates to the subchondral layer is healed by the formation of fibrous cartilage, instead of the normal hyaline cartilage. From the biomechanical point of view, the problem here is that fibrous cartilage is resistant to strong tension only, while hyaline cartilage serves to resist strong pressure, provide a smooth articular surface, and withstands constant and heterogeneous compressing and shearing forces. For this reason the management of deep articular cartilage deficits has always posed a major challenge for physicians. The purpose of this article is to review the methods used to repair damaged articular cartilage.