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Introduction Background: Optimal femoral component rotation in total knee arthroplasty (TKA) is crucial to establish a balanced knee reconstruction. Unbalanced knees can lead to instability, patellofemoral problems, persistent pain, stiffness, and generally poorer outcomes including early failure. There are several methods to achieve the femoral component rotation such as balanced gap technique, measured resection technique, and bone landmarks such as transepicondylar line (TEA) and Whiteside line. The purpose of this study was to compare the balan ced gap technique with the TEA technique.

The paper presents the creation of a database of motion norms to support the maintenance management system in an industrial production company, implemented by a team from the Faculty of Mechanical Engineering, VSB - Technical University of Ostrava. This database is intended for filling and optimal use of maintenance modules of ERP systems and for use in the processes of preparation of maintenance and service orders. The article focuses on the methodology of creation, characteristics, use and availability of this database and its application in industrial practice. [ABSTRACT FROM AUTHOR]

The aim of this study was to present the mid-term results of ultra-short cementless stem total hip arthroplasty (THA) in patients with Crowe type II developmental dysplasia of the hip. The study consists of 68 patients (75 THAs) with a Proxima stem implanted between 2006 and 2015. The clinical results include Harris Hip Scores. Radiological follow-up reports on stem migration, bony trabecular development and radiolucent lines. Kaplan-Meier survival analysis was performed. The mean age of patients was 48.4 years, with a mean follow-up 114 months. The average Harris Hip Score improved significantly from 45.1 preoperatively to 97.6 at the final evaluation (p < 0.001). Stem migration was observed in five hips (in all of them up to the 6th postoperative month, without any further progression of migration or radiological loosening). Bony trabecular development was detected in modified Gruen zones (1, 2, 4, 6, 7 for Proxima stem): in zone 1 (0%), 2 (49.3.0%), 4 (38.7%), 6 (82.7%), 7 (0%). Radiolucent lines were observed around one cup (DeLee and Charnley zone I) and three stems (none was loose, all three with fibrous stable fixation). Complications were found in three hips (4.0%): intraoperative periprosthetic femoral fracture (threated with cerclage wire) in two hips and squeezing hip in one patient (with perioperative ceramic inlay breakage and exchange). No hip was revised. The implant survival was 100.0% both clinically and radiologically. Observations in the mean follow-up of 114 months show that the results (clinical and radiological) of the Proxima stem in patients with Crowe type II DDH are promising., (© 2024. The Author(s).)

Competing Interests: None declared.

The aim of this study is to present the results of single-stage total hip arthroplasty (THA) after Dynamic Hip Screw (DHS) failure, or secondary posttraumatic osteoarthrosis. From 2003 to 2020, 15 THAs were performed in group of 15 patients for the treatment of DHS failure, or for late complications following femoral neck and pertrochanteric fractures. The mean follow-up period after arthroplasty was 46.9 months (range 7-139). The patients were evaluated retrospectively-both clinically and radiographically, focussing on the demography, infection rate and other complications (revision surgery), during the year 2023. 9 males and 6 females were included in the study, with a mean age of 56.5 years (range 29-93) at the time of primary osteosynthesis. Each of them had proximal femoral fracture treated primarily with a DHS and then late one-stage revision surgery, with hardware removal and THA implantation. The median time between DHS osteosynthesis and THA was 41.2 months (range 4-114). Four patients (26.6%) had complications after THA, with the need for revision in two cases (13.3%). Dislocation rate was 6.6% (one case), with the need for repeated-revision of THA. The infection rate was 6.6% (one patient) with the need for revision of THA. Peroperative periprosthetic femoral fracture was observed in 13.3% (two patients) without any other problems. Six patients (40%) died during the follow-up period. Single-stage total hip arthroplasty with concomitant hardware removal bears a high- mortality rate, with a higher incidence of postoperative complications compared to elective THA., (© 2023. The Author(s).)

Background: Mid-term results (clinical and radiographic) of ultra-short anatomical cementless stem total hip arthroplasty (THA) in patients with osteonecrosis of the femoral head (ONFH) has not often been presented. The aim of this study is to evaluate THA using the Proxima stem in patients with ONFH in the mid-term., Methods: The study consists of 73 patients (97 THAs) with a Proxima stem implanted between 2006 and 2015. The mean age of patients was 47.4 years, with a mean follow-up 105.2 months. The clinical results include preoperative and postoperative Harris Hip Scores (HHSs). Radiological follow-up reports on stem migration, bony trabecular development and radiolucent lines. The complications and revisions were registered. Kaplan-Meier survival analysis was performed to determine the implant survival., Results: The average HHS improved significantly from 40.3 preoperatively to 98.0 at the final evaluation ( p   ˂  0.0001). Stem migration (subsidence and "varisation") was observed in 11 hips (in 9 of them up to 6th postoperative month without any further progression, in 2 with progressive migration and radiological loosening). Bony trabecular development was detected in modified Gruen zones (1,2,4,6,7 for Proxima stem): in zone 1 (0%), 2 (67.0%), 4 (64.9%), 6 (64.9%), 7 (0%). Radiolucent lines were observed in 1 cup and 6 stems (2 were loose, 4 with fibrous stable fixation). Complications were found in 5 hips (5.1%): squeezing hip once, repeated dislocation in 1, 1 early deep infection, and 2 loose stems. 2 hips (2.1%) were revised (dislocation, infection). The implant survival was 98.9% and 97.9% clinically and radiologically, respectively., Conclusions: Observations in the mid-term show that the clinical and radiological results of the Proxima stem in patients with ONFH are promising. The stem design preserves the proximal femoral bone stock. The bony trabecular appearance confirms physiological proximal femoral load transmission.

The aim of this study was to present the midterm results of total hip arthroplasty with ultra-short anatomical cementless stem in the primary treatment of displaced intracapsular femoral neck fractures in patients younger 60 years. From 2006 to 2015, 17 hip arthroplasties (with the Proxima stem) were performed in group of 17 patients for the treatment of acute femoral neck fractures Garden type III and IV. The mean follow-up period was 112.7 (range: 64-148) months. Patients were evaluated retrospectively - clinically and radiographically, using the Harris hip scoring system during the year 2020. Seven males and ten females (mean age: 45.0 years) were included in the study. Each of them had one or more risk factors (time delay, comminution of the femoral neck, corticosteroids usage, the presence of coxarthrosis, rheumatoid arthritis, alcohol abuse, etc…), because of which the osteosynthesis was not performed. Harris hip scores were 6.3 preoperatively and 82.9 at the final follow-up. Three patients (17.6%) had complications: luxation, aseptic stem loosening (migration with subsidence - "varisation" and thigh pain) and deep infection. One patient (5.9%) with infection was revised. In carefully selected younger patients with displaced intracapsular femoral neck fracture, where the osteosynthesis as first treatment option should be associated with high risk of complication (avascular femoral head necrosis, non-union) due to the presence of risk factors, the primary total hip arthroplasty could be performed. The ultra-short cementless stem offers promising results in these rare cases in the midterm.

Total elbow arthroplasty as a treatment option for open elbow fracture is relatively rare described. We reported a 39 years old polytrauma patient with complex open elbow fracture (Gustilo-Anderson type IIIB). The patient presented with large soft tissues defect on dorsal part of the left elbow, ulnar palsy due to the irreparable loss of the ulnar nerve, distal triceps loss due to the complete loss of the olecranon, loss of both humeral condyles with collateral ligaments and complex elbow instability. Only few similar cases have been published. Reconstructive surgery included repetitive radical debridement, irrigation, vacuum assisted closure system therapy, external fixation, coverage of the soft tissue defect with fascia-cutaneous flap from the forearm. Four months after the injury, total elbow arthroplasty with autologous bone graft (from the proximal radius) inserted in the ulnar component, was performed. At 3 years postoperatively, the patient is able to perform an active flexion from 0° to 110° with full prono-supination. Only passive extension is allowed. The ulnar neuropathy is persistent. Patient has no signs of infection or loosening of the prosthesis., Competing Interests: Declaration of competing interest The authors state that there are no conflicts of interest regarding the publication of this article., (Copyright © 2020 Chinese Medical Association. Production and hosting by Elsevier B.V. All rights reserved.)

Background: The aim of this study was to evaluate the clinical and radiological outcomes (in mid-term) after "shortening" scarf osteotomy of the fifth metatarsal for the treatment of bunionette deformity., Methods: We retrospectively reviewed the functional score - American Orthopaedic Foot and Ankle Society (AOFAS) Lesser Toe Metatarsophalangeal-Interphalangeal Scale, radiographic results - 4th/5th intermetatarsal angle, varus angle of the 5th metatarsophalangeal joint and complications in a consecutive series of 34 feet (27 patients) with bunionette. Nine males and 18 females (mean age: 45 years) were included in the study. Three males and four females were operated bilaterally The patients were operated on between 2004 and 2015, and evaluated during 2017., Results: The average AOFAS score improved from 59.4 to 93 at a mean follow-up of 7.2 years. The 4th/5th intermetatarsal angle and varus angle of the 5th metatarsophalangeal joint decreased from 13.9°/19.5° preoperatively to 6°/5.9° at final follow-up. No neurovascular damage was recorded. Complications arose in five feet (14.7%): delayed union (n=1), early infection (n=1), distal screw migration (n=1), asymptomatic non-union (n=1), transverse metatarsalgia (n=1). The osteotomy healed within less than three months except twoo (delayed union, non-union). Three feet needed additional surgery: screw removal (n=2), Weil osteotomy of 2nd-4th metatarsals (n=1)., Conclusions: "Shortening" scarf osteotomy is an acceptable, but not complication-free, treatment option for the bunionette deformity and offers promising results in the mid-term., (Copyright © 2019 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.)

Introduction: The aim of this study has been to present outcomes after cementless arthroplasty for developmental dysplasia Crowe type IV of the hip, with transverse subtrochanteric shortening osteotomy and using the S-ROM stem., Methods: We evaluated radiographs, functional scores and complications in a consecutive series of 23 patients (28 hips) with high dislocation of the hip. The average age of patients at surgery was 49.9 (range 22-68) years. The operations were performed between 2007 and 2013. Patients were assessed retrospectively-clinically and radiographically during the year 2018., Results: The mean follow-up period was 94 (range 60-134) months. The average Harris hip score improved from 39.9 to 84.0. The mean leg length discrepancy decreased from 5 cm preoperatively to 1.4 cm at the final follow-up. All acetabular components were implanted into the true acetabulum, and all prostheses were stable at the latest examination. No neurovascular damage was recorded. We have identified specific complications in seven hips (25%) in total: Intraoperative femoral fracture required fixation in four hips; three hips (10.7%) needed revision: Recurrent dislocation, with the need for cup reorientation, occurred in two hips (in one of them, this was followed by the subsequent need for resection of heterotopic ossification); there was one aseptic stem loosening with the need of one-stage revision. All the osteotomies healed within 8 months., Conclusion: Hip arthroplasty with transverse shortening femoral osteotomy, using S-ROM stem, is an acceptable, but not complication-free treatment method in patients with Crowe type IV developmental hip dysplasia, in the midterm.

The study was aimed at the clinical and biomechanical analyses of the sliding hip screw breakage with the use of finite element method. We have identified two patients with the sliding screw breakage. In the first patient, the biomechanical analysis revealed the reduced stress values σ HMH not exceeding the yield limit or strength limit of the implant. The yield limit was exceeded in second one. Clinical and biomechanical analyses have demonstrated that adherence to technical requirements of the appropriate osteosynthesis implementation is the principal condition of timely healing since it prevents the material failure.

Purpose: The aim of this study was to evaluate early results of acetabular revisions of total hip replacement using fully cementless trabecular titanium (TT) acetabular modular implants (Delta Trabecular Titanium, Limacorporate, Udine, Italy)., Methods: Between March 2009 and May 2012 TT was used in 81 revisions. The mean age at the time of revision was 68 years (32-84 years). There were nine patients revised for type 1, 11 for type 2A, 27 for type 2B, six for type 2C, 15 for type 3A and 13 for type 3B acetabular defects according to the Paprosky classification. Frozen morselised bone allografts were used in 53 cases and bulk structural allografts in three cases. Clinical evaluations were made using a modified functional Merle d'Aubigné-Postel score. The mean follow-up period was 38.14 months (24-62 months)., Results: The mean pre-operative Merle d'Aubigné-Postel functional score was 4.7 and 9.8 at the time of last follow-up. There was one revision due to instability of the acetabular component. A cage system-Delta Revision TT-was successfully used in this case. Three cases with Paprosky type 3B defect showed cranial migration of the acetabular component by 6 mm, but stabilised after six months. No dislocations associated with acetabular surgery have occurred in the cohort. There have been no dissociations of the modular component. A fatigue fracture of the hemispherical module occurred in the revised case. No other hardware mechanical failures have been recorded., Conclusions: TT cups, hemispherical modules and augments facilitate reliable and reproducible biological fixation in acetabular revision surgery with excellent results. Extended follow-up is necessary to evaluate the long-term performance of TT modular implants.

Revisions of fractured, uncemented and extensively porous-coated femoral stems are challenging. In this article, we report three cases of revision surgeries for broken, cementless, and extensively porous-coated femoral stems with Solution stems (DePuy, Warsaw, Indiana). In all cases, minimally invasive endofemoral revision was successfully performed without femoral osteotomy or cortical fenestration. Removal of distal broken femoral stem was performed with hollow trephine technique under fluoroscopy. For revision arthroplasty of the femoral component, Solution stems of larger diameter were used. Endofemoral approach reduces duration of surgery and the amount of blood and bone loss. Minimally invasive technique for broken and uncemented femoral stem is recommended.

Three pathologically modified bones (cranium, left mandible, iliac bone) of a cave bears (Ursus spelaeus) were found in the Last Glacial deposits (OIS 3) in the caves of the Vel'ká Fatra carst, Slovak republic. Despite of thorough paleontological examination, the bear bones were examined by experts in forensic medicine, traumatology and stomatology, too. The pathological changes were found in the tooth bed on the right side of the maxilla at the place of M1, being interpreted as a result of odontogenic purulent inflammation of soft tissues of tooth bed and surrounding bone. The iliac bone has an abnormally formed acetabulum with damaged and deformed osseous upper border, which could be a result of immoderate pressure of the head of femur, following with the mineral dysbalance (decalcification) or fracture of limbus acetobuli caused by injury. The mutual cooperation of all the abovementioned experts was declared as a very fruitful.

The aim of this work was to investigate variations of temperature in acrylic bone cement SmartSet HV during its polymerization as the function of mixing technique (hand mixing and vacuum mixing) and sample thickness. The temperature of 25-mm diameter samples differing in their thickness was monitored using a parallel plate measuring system of the compact rheometer preheated to the body temperature. The curves representing the temperature measured and average values of times needed to obtain the peak temperatures of the test samples prepared by different techniques of mixing are presented and discussed. It was found that the maximum temperature and also the times of peak temperatures rose with sample thickness but at different rate for each technique of mixing.

Sodium alendronate is a bisphosphonate of the IInd generation with a strong antiresorptive effect. Its favourable effect on reduction of the incidence of vertebral and non-vertebral fractures was repeatedly confirmed. The objective of the multicentre study was to evaluate the effect of administration of 10 mg of sodium alendronate combined with 1000 mg of elemental calcium administered in the course of three months on the N-terminal telopeptide(NTx) a sensitive marker of bone resorption. The group comprised 275 postmenopausal women with densitometrically confirmed osteoporosis. After three months treatment a 53% decline of NTx values occurred as compared with baseline values. This finding confirms the favourable effect of sodium alendronate on bone remodelling. A decline of the concentration of bone markers is one of the good predictors of the effectiveness of treatment focused on reduction of atraumatic osteoporotic fractures.