Search

Background (1) To evaluate patient-reported outcomes and revision surgeries after various operative interventions for osteochondral lesions of the talus (OLT) in a prospective single center series over 10 years, and (2) to identify predicting factors related to subjective ankle status and quality of life pre- and postoperatively. Methods Ninety-nine patients underwent operative treatment due to primary or recurrent OLT, with an average follow up 3.5 (1.8) years. Treatment outcome was followed clinically (FAOS, EQ-5D, Tegner activity scale) and by pursuing any serious adverse events or graft failures. Results There were 80 responding patients (81%) for the study. The mean lesion size was 2.0 (1.1) cm2. All FAOS values increased from preoperative to final follow-up values (Symptoms 60–68, Pain 58–69, ADL 71–80, Sport 36–54, QoL 30–45). EQ-5D increased from 0.49 to 0.62, while Tegner activity scale change from 3.2 to 3.4. There were 19 (24%) serious adverse events recorded; 13 (16%) of them were graft-related. Graft survival rates were 100% at 1 year, 94% (males)/93% (females) at 2 years, and 77% (males)/47% (females) at 5 years. Female gender, higher BMI, and higher Kellgren-Lawrence ankle OA score were negative predictors for preoperative patient-reported ankle joint status. The foremost improvement after operative intervention was observed in patients with large osteochondral lesions without postoperative adverse events. Conclusion Various operative interventions for OLT significantly improved patients’ ankle status and quality of life. High graft survival rates were demonstrated over first two years, but notable decline was confirmed thereafter, especially in female patients.

Femoroacetabular impingement (FAI) is an anatomical hip condition caused by malformations on femoral head and acetabular rim resulting in abnormal contact across the joint. FAI can cause the labral, cartilaginous, and tissue damage that leads to early osteoarthritis. FAI can be divided into three groups: cam (bump on femoral head- neck junction), pincer (acetabular over coverage), or mixed (most common) by the characteristic morphological changes of the bony structures. The exact ethology of FAI is still unclear, mostly considered as idiopathic. Cam lesions demonstrate a near 3:1 male predominance and are more often seen in the younger population. Pincer is typically seen in middle-aged women. A plain radiography of the pelvis and hips is considered as the primary imaging modality for diagnosing FAI, which can be used to quantify the severity. MRI and direct MRI arthrography allow assessment of concomitant labral and chondral injuries. Conservative treatment is typically considered first-line treatment for mild to moderate FAI syndrome, but usually not to successful. However, the outcomes following postoperative surgical intervention have demonstrated excellent results. The most common surgical treatment option for FAI is done arthroscopically, other procedures such as a reverse periacetabular osteotomy or surgical dislocation of the hip are rarely indicated. Keywords: Femoroacetabular impingement; cam, pincer; hip arthroscopy

Nowadays, hip dysplasia is recognized and treated mainly conservatively due to good screening program and early detection. There are still some cases found after first year of life, in later childhood and in adults. These cases are treated with pelvic osteotomies to improve femoral head coverage and joint stability and to decrease the hip stress with the final goal to preserve the joint in longer term. There are three subtypes of pelvic osteotomies. The ones pertaining to first type are redirectional osteotomies, which are incomplete osteotomies with the aim to reduce overall volume and redirect the acetabulum by a hinge located between triradiate cartilage and pubic symphysis. This type in-cludes Salter, Pemberton, Dega and San Diego osteotomies. The osteotomies pertaining to the second type are reorientational osteotomies, which are complete osteotomies with the aim to reorient the whole acetabulum. This type includes periacetabular and triple osteotomies. The osteotomies per-taining to the third type are salvage osteotomies which enlarge the acetabulum and medialise the hip center in arhritic and/or incongruent joint and are performed in hips in which the reorientational osteotomy is contraindicated. This type includes shelf and Chiari osteotomies. In University Medical Centre Ljubljana, most of the above-mentioned osteotomies are being performed, however, yearly numbers are small. Redirectional osteotomies have been performed for many years in the Pediatric orthopaedic department and yearly number is under 10 cases. Reorientational osteotomies on young adults are made through minimally invasive approach for periacetabular osteotomy described by Soebbale at al. (2015). In selected cases, electromagnetic surgical navigation system is used for more precise positioning of the acetabular fragment. Keywords: Hip dysplasia, pelvic osteotomy, periacetabular osteotomy, hip preservation, hip pain

Human skeletal stem cells (hSSCs) were recently identified as podoplanin (PDPN)/CD73/CD164-positive and CD146-negative cells that decline with age, and play a role in the pathogenesis of osteoarthritis (OA). The aim of this study was to identify the hSSC-like properties of bone-derived mesenchymal stem/stromal cells (MSCs) of patients with late and early OA. Methods: First, we performed gene expression profiling for the hSSC markers in 32 patients with late and early OA, and donors without OA. Having identified the low expression of hSSC markers in late OA patients, we further performed trilineage differentiation and immunophenotyping for hSSC makers in the selected subsets from each donor group. Results: Our results show no differences in osteogenesis, chondrogenesis, and adipogenesis between the MSCs from the three groups. However, the immunophenotyping shows lower CD164 in MSCs from early OA patients in comparison with late and no OA subjects (p = 0.002 and p = 0.017). Conclusions: Our study shows that the in vitro hSSC-like properties of bone-derived MSCs are similar in patients with early and late OA, and in donors without OA. However, the lower percentage of CD164-positive MSCs in early OA patients indicates the potential of CD164 as a marker of the onset of OA. Nasl.z nasl. zasl. Opis vira z dne 20.06.2022. Št. članka: 899. Abstract. Bibliografija: str. 13-15. ARRS, SI, Mezenhimske matične celice-nosilci endogene regenerativne sposobnosti tkiv v boju proti staranju mišično-skeletnega sistema ARRS, SI, Napredna imunološka zdravila in celični pristopi v farmaciji University Medical Centre Ljubljana, SI, Mesenchymal stem cells in hip synovium

Intraarticular nodular fasciitis arising in the joint synovium is an uncommon lesion. Most cases have been reported in the knee and rarely in other joints. A USP6 gene fusion has so far been documented in only four cases of intraarticular nodular fasciitis, three were located in the knee and one in the proximal interphalangeal joint. In all three cases located in the knee, MYH9 was detected as a USP6 fusion partner. We analysed three cases of intraarticular nodular fasciitis for the presence of USP6 fusion by targeted RNA sequencing. Two cases were located in the hip (a 25-year-old female and 48-year-old male) and one in the shoulder (a 38-year-old male). We detected a MYH9-USP6 fusion in the two hip cases and a COL1A1-USP6 fusion in the shoulder case. Our findings provide additional evidence that intraarticular nodular fasciitis is a form of nodular fasciitis arising in the joint synovium, harbouring a USP6 fusion. Although a MYH9-USP6 fusion seems to predominate in intraarticular nodular fasciitis, other fusion partners of the USP6 gene may also be involved. Detection of a USP6 fusion by targeted RNA sequencing may assist in confirming the diagnosis in selected cases.

To compare self-reported joint status, quality of life, level of activity and pain management in patients scheduled for surgical treatment of seven common ankle disorders: osteoarthritis (OA), primary osteochondral lesion of talus (P-OLT), recurrent osteochondral lesion of talus (R-OLT), lateral ankle instability (INST) and anterior (ANT-IMP), posterior (POST-IMP) and combined (COMB-IMP) ankle impingements. The cross-sectional study design was implemented. Hospital records of 610 patients that were admitted for surgical intervention on the ankle joint over a seven year period were reviewed. Patient selection (over 18 years, no systemic musculoskeletal illnesses, only one isolated ankle pathology) resulted in 123 eligible patients for current study (OA 22, P-OLT 19, R-OLT 18, INST 15, ANT-IMP 20, POST-IMP 13, COMB-IMP 16). Foot and Ankle Outcome Score (FAOS), European quality of life in a visual analogue and in five dimensions (EQ-VAS, EQ-5D-3L), Tegner activity scale (TAS) and pain medication usage were recorded at the admission and compared across these seven groups. All evaluated ankle disorders induced the following: (a) subjective joint-specific dysfunction - FAOS cumulative: 42 (OA), 50 (R-OLT), 65 (P-OLT), 65 (INST), 63 (ANT-IMP), 61 (POST-IMP), 60 (COMB-IMP); (b) decreased quality of life - EQ-5D-3L: 0.41 (OA), 0.44 (R-OLT), 0.56 (P-OLT), 0.62 (INST), 0.64 (ANT-IMP), 0.56 (POST-IMP), 0.60 (COMB-IMP) and (c) decreased activity level - TAS: 2.1 (OA), 2.7 (R-OLT), 3.7 (P-OLT), 4.0 (INST), 4.7 (ANT-IMP), 4.4 (POST-IMP), 5.1 (COMB-IMP). FAOS subscales, EQ-5D-3L and TAS were significantly lower in OA and R-OLT patients. Between 31% (POST-IMP) and 68% (OA and R-OLT) of patients required pain medication over one month prior to the assessment. All analysed ankle disorders in patients amenable for surgical treatment induced a considerable decline in patients` perceived ankle function, quality of life and activity level. The worst subjective ankle status was reported equally by OA and R-OLT patients, while patients with the other five disorders reported comparable values.

Preservation surgery of the hip with open or arthroscopic approach has always been challenging as complex 3-D anatomy and limited surgical access make intraoperative evaluation difficult. Recent advances in computer technology offer a wide range of innovative solutions with a goal to improve accuracy and safety of corrective procedures on human joints. The author critically reviews currently available literature in the field of computer assistance in hip preservation surgery. Basic features of unique planning software and navigation surgical system used in treatment of femoroacetabular impingement and hip dysplasia are introduced. Currently available software provides preoperative identification of hip deformity on CT-based 3-D model and planning of the surgical correction using kinematic protocols. Real-time intraoperative 3-D orientation is possible, and execution of surgical correction can be performed either with navigation of surgical tools or with printed templates. Computer assistance in hip preservation surgery is in the developing phase. First clinical experiences of its use in treatment of femoroacetabular impingement, hip dysplasia, hip tumors, and avascular necrosis of the femoral head are promising. Computer assistance has been applied for treatment of several hip disorders. Technical advances are suggested and quality basic studies and clinical trials are encouraged for the novel technology to become more user friendly and widely accepted.

Adult tissues are reservoirs of rare populations of cells known as mesenchymal stem/stromal cells (MSCs) that have tissue-regenerating features retained from embryonic development. As well as building up the musculoskeletal system in early life, MSCs also replenish and repair tissues in adult life, such as bone, cartilage, muscle, and adipose tissue. Cells that show regenerative features at least in vitro have been identified from several connective tissues. Bone marrow and adipose tissue are the most well recognized sources of MSCs that are already used widely in clinical practice. Regenerative medicine aims to exploit MSCs and their tissue regeneration even though the underlying mechanisms for their beneficial effects are largely unknown. Despite many studies that have used various tissue-derived MSCs, the most effective tissue source for orthopedic procedures still remains to be identified. Another question that needs to be addressed is how to evaluate autologous MSCs (i.e., patient derived). Previous studies have suggested the features of bone-marrow-derived MSCs can differ widely between individuals, and can be changed in particular in patients suffering from some forms of degenerative disorder, such as osteoarthritis. The synovium is a thin membrane that protects the synovial joints, and it is a rich source of MSCs that show great potential for regenerative medicine. Here, we review synovium-derived MSCs from reports on basic and clinical studies. We discuss their potential to treat cartilage defects caused by either degeneration or trauma, and what needs to be done in further research toward their better exploitation for joint regeneration.

There is no evidence that anatomically correct anterior cruciate ligament reconstruction (ACLR) offers lower rate of degenerative changes development or that it would lead to a better outcome. The significance and understanding of the abnormal anterior tibial translation (ATT) in ACLR patients is yet to be established. Sixty subjects (40 patients at 5.9 years after ACLR, 20 healthy controls) underwent 3 T MRI. Quantitative cartilage T2 mapping and morphological whole organ magnetic resonance imaging score (WORMS) evaluation was performed. Self-reported questionnaires were used for subjective clinical evaluation. Correlations were calculated with the following MRI measurements; femoral tunnel inclination, ACL graft inclination, lateral and medial compartment ATT. In the ACLR group positive correlation was found between the patellar cartilage T2 values and sagittal ACL graft inclination. In the ACLR group lateral compartment ATT showed negative correlation with ACL graft inclination and subjective clinical evaluation, and positive correlation with morphological degenerative changes. Femoral tunnel showed positive correlation with ACL graft inclination in the same plane. Increased ATT offers worse clinical outcome and increased rate of degenerative changes. Furthermore, ATT is affected by the ACL inclination. Inclination of the drilling tunnel affects ACL graft inclination; thereby independent drilling techniques provide superior results of anatomical ACL graft positioning.

Adult tissues are reservoirs of rare populations of cells known as mesenchymal stem/stromal cells (MSCs) that have tissue-regenerating features retained from embryonic development. As well as building up the musculoskeletal system in early life, MSCs also replenish and repair tissues in adult life, such as bone, cartilage, muscle, and adipose tissue. Cells that show regenerative features at least in vitro have been identified from several connective tissues. Bone marrow and adipose tissue are the most well recognized sources of MSCs that are already used widely in clinical practice. Regenerative medicine aims to exploit MSCs and their tissue regeneration even though the underlying mechanisms for their beneficial effects are largely unknown. Despite many studies that have used various tissue-derived MSCs, the most effective tissue source for orthopedic procedures still remains to be identified. Another question that needs to be addressed is how to evaluate autologous MSCs (i.e., patient derived). Previous studies have suggested the features of bone-marrow-derived MSCs can differ widely between individuals, and can be changed in particular in patients suffering from some forms of degenerative disorder, such as osteoarthritis. The synovium is a thin membrane that protects the synovial joints, and it is a rich source of MSCs that show great potential for regenerative medicine. Here, we review synovium-derived MSCs from reports on basic and clinical studies. We discuss their potential to treat cartilage defects caused by either degeneration or trauma, and what needs to be done in further research toward their better exploitation for joint regeneration.

Surgical ACL reconstruction performed with a tourniquet induces compression and ischemic stress of the quadriceps femoris (QF) muscle which can accelerate postoperative weakness. Given that low-load blood flow restricted (BFR) exercise is potent in enhancing muscle oxygenation and vascular function, we hypothesized that short-term preconditioning with low-load BFR exercise can attenuate QF muscle endurance deterioration in the postoperative period. Twenty subjects undergoing arthroscopic ACL reconstruction performed 5 exercise sessions in the last 8 days prior to surgery. They were assigned into either BFR group, performing low-load BFR knee-extension exercise, or SHAM-BFR group, replicating equal training volume with sham occlusion. Blood flow (near-infrared spectroscopy) and surface EMG of QF muscle during sustained isometric contraction at 30% of maximal voluntary isometric contraction (MVIC) torque performed to volitional failure were measured prior to the intervention and again 4 and 12 weeks after surgery. There was an overall decrease (p = 0.033) in MVIC torque over time, however, no significant time-group interaction was found. The time of sustained QF contraction shortened (p = 0.002) in SHAM-BFR group by 97 ± 85 s at week 4 and returned to preoperative values at week 12. No change in the time of sustained contraction was detected in BFR group at any time point after surgery. RMS EMG amplitude increased (p = 0.009) by 54 ± 58% at week 4 after surgery in BFR group only. BFm increased (p = 0.004) by 52 ± 47% in BFR group, and decreased (p = 0.023) by 32 ± 19% in SHAM-BFR group at week 4 after surgery. Multivariate regression models of postoperative changes in time of sustained QF contraction revealed its high correlation (R2 = 0.838; p < 0.001) with changes in BFm and RMS EMG in the SHAM-BFR group, whereas no such association was found in the BFR group. In conclusion, enhanced endurance of QF muscle was triggered by combination of augmented muscle fiber recruitment and enhanced muscle perfusion. The latter alludes to a preserving effect of preconditioning with BFR exercise on density and function of QF muscle microcirculation within the first 4 weeks after ACL reconstruction.

Aim:The aim was to present the surgical technique and clinical outcome in a series of patients treated with gamma-probe-assisted arthroscopic removal of osteoid osteoma in the hip joint.Methods:The case series consisted of 10 patients diagnosed with osteoid osteoma of the hip, who were treated by arthroscopic nidus removal. An endoscopic gamma probe was used intraoperatively to locate the nidus and to control the extent of its removal. Residual osteoma cavities were additionally treated with an arthroscopic radiofrequency ablator. Microfracturing was performed when the osteochondral defect was in the weight-bearing area and osteochondroplasty was done in cases of concomitant cam deformity. Nonarthritic Hip Score (NAHS), Tegner activity score, quality of life questionnaire (EQ-5D) and postoperative magnetic resonance imaging (MRI) were used for evaluation before and post-surgery, with a minimum follow-up of 2 years.Results:The relative reduction of the gamma irradiation count immediately after removal of the nidus was 44.9% (range 33.3–54.5%). Postoperatively, all patients experienced prompt pain relief and a significant improvement according to all patient reported outcomes. Control MRI revealed fibro-cartilaginous tissue repair of post-osteoma osteochondral defects in the weight-bearing area; 1 patient showed signs of early degeneration.Conclusions:The results of this case series demonstrated the safety and high efficacy of gamma-probe-assisted arthroscopic removal of the osteoid osteoma from the hip joint. Endoscopic gamma probe was recognised as a very useful device for locating the nidus of the osteoid osteoma exactly and preventing incomplete or excessive removal of the bone.

Objective. The majority of the literature regarding sports injuries is concentrated on specific characteristics related to sports injuries and injuries at sport activities at all. We strove to establish whether the success of the rehabilitation process can be predicted based on numerous psychosocial variables. Methods. Our sample comprised of 68 competing athletes who underwent an operative knee surgery. The rehabilitation process for athletes lasted one or 6 months; all athletes obtained serious injuries by the standards of National Athletic Injury Reporting System (1). The following variables were measured: coping with pain (SIP 15), rehabilitation behaviours (SIRBS), motivation for rehabilitation, anxiety (STAI X1) and social support. A questionnaire that measures the functioning of the knee (2000 IKDC) was taken as an indicator of the rehabilitation success. Participants were tested both prior to and following the process of rehabilitation. Results. Our results showed that the success of psychological rehabilitation could be predicted from changes in certain psychosocial variables (a decrease in anxiety and an increase in susceptibility, self-efficacy and catastrophizing). After the rehabilitation, only 10 % of athletes were able to reach the criteria of a successful physical and psychological rehabilitation. Conclusions. We can conclude that since selected psychological variables were found to have a high loading on psychological rehabilitation there it makes sense to control these variables.

A case of a 42-year-old male patient with symptomatic juxtaarticular osteoid osteoma of the capitulum humeri is presented. After the clinical diagnosis was confirmed with plain radiographs, bone scan, computer tomography and magnetic resonance imaging, the patient underwent arthroscopic removal of the lesion. A partial synoviectomy was performed first and then the center of the lesion was marked with Kirschner wire using the X-ray monitoring. The marked lesion was transarticularly removed with a motorized shaver device. Post-operatively, the patient reported prompt relief of pain that had not reoccurred during 1 year of follow up. To the authors' knowledge, this is the first report of the arthroscopic removal of juxtaarticular osteoid osteoma of the humeral capitulum which promises to be an effective and less invasive alternative to the existing treatment options.

Introduction The influence of polyacetal wear particles on aseptic loosening of non-cemented isoelastic femoral stems with polyacetal coating remains unclear. The aim of our study was to use nuclear methods to prove the presence of polyacetal wear particles, to determine their morphology and to check their distribution in the tissues around loosend hip prosthetic components. Methods Tissue samples obtained during retrieval of 4 aseptic loosened primary hip prostheses with isoelastic stems made of polyacetal were subjected to nuclear analyses. Proton microbrobe method (mikro-PIXE) was used to prove the presence of polyacetal wear particles and to check for their morphology by detection of barium, which is molecularly in BaSO 4 embedded in polyacetal. Thermal neutron activation was used to determine distribution pattern of polyacetal wear in the peri-prosthetic tissues. Results Against expectations, polyacetal wear particles were found rather rare, larger than 100 µm and present in pseudo-membrane samples around the loosened stem, but virtual l y absent in tissues away from their origin. Concentration of BaSO 4 in polyacetal wear particles in pseudo-membrane samples was similar to the one in polyacetal coating (conc. Ba = 14217 µg/g and 14800 µg/g, respectively). Conclusion According to the results, the primary cause of the loosening of the isoelastic stems with polyacetal coating is most probably mechanical restlessness, which is responsible for local production of the large polyacetal wear particles responsible to accelerate the process of loosening. PIXE method and thermal neutron activation are sensitive quantitative nuclear methods suitable for direct or indirect detection of wear particles in the tissue around loosened prostheses and to determine morphology of wear particles and their distribution in the tissues.

The aim of this research was to investigate the causes of the emergence of sports injuries and to explain the differences in psychological response with regard to the severity of the injury. We examined 68 competing Slovene athletes with surgically treated knee injury. The estimated time of rehabilitation of the more severely injured athletes was six months, while those who sustained less severe injuries faced a monthlong rehabilitation. We measured the athletes’ personality traits, their athletic identity, coping with pain, rehabilitation beliefs, motivation and social support provided by their family and their coach as well as their colleagues. The results showed that the group of more severely injured athletes demonstrated behaviour that is less inhibited in response than the group of athletes with less severe injuries. The psychological response proved to be almost the same in both groups, except for the higher levels of catastrophizing, and a higher individual coping response found in the group of more severely injured athletes. Furthermore, masculinity was found to predict self-efficacy and the individual coping response, the strength of athletic identity predicted motivation and rehabilitation value, while emotional lability predicted catastrophizing and self-efficacy. Athletes with lower athletic identity, lower masculinity and higher emotional lability are more exposed to adjustment difficulties after sustaining an athletic injury. In our opinion, the strategies for successful rehabilitation after a sports injury should be aimed at the identification of athletes with personality traits that pose a higher risk of experiencing adjustment difficulties, at promoting adequate motivation, increasing coach support and at the application of cognitive-behavioural strategies., Cilj je ovog istraživanja bio utvrditi uzroke nastajanja sportskih ozljeda te objasniti razlike u psihološkom odgovoru na ozljede različite težine. Istražili smo 68 slovenskih natjecatelja koji su bili podvrgnuti kirurškoj operaciji koljena. Procijenjeno vrijeme rehabilitacije za teže ozlijeđene sportaše iznosilo je šest mjeseci, dok je za one ispitanike s manje teškim ozljedama ono iznosilo jedan mjesec. Mjerili smo sportaševe osobine ličnosti, njihov sportski identitet, sposobnost suočavanja s boli, povjerenje u rehabilitacijski proces te motivacijsku i sociološku potporu koju su sportaši dobivali od svoje obitelji, trenera i kolega. Rezultati su pokazali da je grupa ispitanika koja je bila teže ozlijeđena pokazala oblik ponašanja koji je manje inhibirao reakciju na ozljedu no što je to slučaj s grupom ispitanika koji su bili lakše ozlijeđeni. Psihološki odgovor bio je gotovo isti u obje grupe, s iznimkom veće razine katastrofiziranja i individualnog suočavanja u grupi ispitanika koji su bili teže ozlijeđeni. Nadalje, pokazalo se da razina muškosti objašnjava samoučinkovitost i razinu individualnog suočavanja, snaga sportskog identiteta predviđa motivaciju i rehabilitacijsku vrijednost, dok je emocionalna nestabilnost predviđala razinu katastrofiziranja i samoučinkovitosti. Sportaši s nižom razinom sportskog identiteta, muškosti i većom razinom emotivne nestabilnosti bili su više izloženi poteškoćama u prilagodbi nakon ozljeđivanja. Prema našem mišljenju, strategije za uspješnu rehabilitaciju nakon sportske ozljede trebale bi biti usmjerene na identifikaciju sportaša s osobinama ličnosti koje predstavljaju veći rizik za doživljavanje poteškoća u prilagodbi na trenutačno stanje, zatim na poticanje odgovarajuće motivacije, povećavanje potpore trenera te primjenu kognitivno-bihevioralnih strategija.

The aim of our study was to evaluate adaptive changes in the dominant shoulders of female professional overhead athletes, their mutual association, and relation between adaptive changes and shoulder injury. Thirty-six female professional volleyball and handball players were divided into two groups: 14 athletes were included in the symptomatic group (positive shoulder injury history and specific shoulder tests) and 22 athletes were included in the asymptomatic group (negative shoulder injury history and specific shoulder tests). Clinical examinations with specific shoulder tests, evaluation of rotational mobility, and symptoms of malposition and dyskinesis of the dominant scapula (SICK scapula syndrome) were performed. Glenohumeral rotators were isokinetically tested at 60 and 150°/s, with evaluation of stability ratios and rotator fatigability. On average, the participants had decreased internal rotation (P

Artroskopija kuka intenzivno se razvija posljednjih desetak godina te ubrzano preuzima primat u liječenju raznih ozljeda i oštećenja i u samom kuku i u njegovoj neposrednoj blizini. Osnovna prednost artroskopske kirurgije kuka prema klasičnoj otvorenoj metodi operacijskog liječenja jest u izbjegavanju otvorene dislokacije kuka čime se smanjuje morbiditet bolesnika te ubrzavaju rehabilitacija i povratak svakodnevnim aktivnostima. Uspješnost artroskopskog zahvata ovisi o pravilnoj indikaciji za zahvat, iskustvu i vještini operatera, pravilno provedenoj rehabilitaciji te suradljivosti bolesnika, kao i o njegovim realnim očekivanjima. Osnovnim indikacijama za artroskopiju kuka danas se smatraju ozljede i oštećenja acetabularnog labruma i/ili zglobne hrskavice, femoroacetabularni sindrom sraza, ozljede i oštećenja ligamenta glave femura, slobodna i strana zglobna tijela te različite bolesti sinovijalne membrane (sinovijalna hondromatoza, pigmentirani vilonodularni sinovitis i druge upalne artropatije poput reumatoidnog artritisa). U ovom članku opisujemo indikacije, tehniku, komplikacije, kao i perspektivu artroskopije kuka, uz detaljan pregled suvremenih literaturnih podataka., In the last ten years, hip arthroscopy has been developing intensively and it is rapidly gaining primacy in the treatment of various injuries and damages to the hip itself and its immediate vicinity. The basic advantage of hip arthroscopy surgery versus classic open surgery is avoiding an open dislocation of the hip and, thus, reducing patient’s morbidity and accelerating his/her rehabilitation, which leads to a quicker return to everyday activities. The success of arthroscopic surgery depends on the correct indication for the surgery and on the experience and the skill of the operator. It also depends on the properly conducted rehabilitation and the patient’s compliance, as well as on the patient’s realistic expectations. Indications for hip arthroscopy today are the following: injury and damage to acetabular labrum and/or articular cartilage, femoroacetabular impingement syndrome, injuries and damages to the ligament of the femoral head, loose and foreign joint bodies as well as different conditions of synovial membrane (synovial chondromatosis, pigmented villonodular synovitis and other inflammatory arthropathy such as rheumatoid arthritis). In this article we describe the indications, technique, complications and the prospect of hip arthroscopy, with a detailed overview of contemporary literature data.

Intraarticular nodular fasciitis is a rare lesion that has only recently been recognised. We present a case of intraarticular nodular fasciitis of the hip joint in a 25-year-old woman, who presented with a 9-month-history of right groin pain and a decreased range of right hip motion. A polypoid mass, composed of five nodules attached to the synovial membrane of the distal peripheral compartment of the hip was removed arthroscopically, together with two detached nodules. Histopathological examination revealed a myofibroblastic proliferation typical of nodular fasciitis. Complete resolution of symptoms and restoration of function was achieved, without recurrence 2 years after removal of the lesion. To the best of our knowledge, this is the first case of intraarticular nodular fasciitis of the hip, presenting a new indication for arthroscopic treatment.