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The aim of this article is to describe surgical technique and early results of Total Ankle Replacement (TAR) from lateral approach using Zimmer TM prosthesis. The study uses theoretical knowledge which is the result of research conducted by other authors, and practical knowledge due to the fact that our center performs that type of operation. Arthrodesis as the current standard in the treatment of advanced degenerative ankle disease, apart from its advantages, also has many disadvantages. The relative durability and reduction of the patients' pain have been achieved at the expense of the adjacent joints. Their accelerated arthrosis is the result of compensatory loads as a consequence of change in foot biomechanics. That determined implementation of solutions that will guarantee elimination of pain in the ankle joint, preserve its motor function and improve gait, while having no negative impact on the mobility of adjacent joints.

The purpose of the study was to assess the effect of autologous activated platelet-rich plasma on healing of a bone substitute - tricalcium phosphate hydroxyapatite in experimental long bone defects using an animal model. The experiment involved an animal model of femoral defect. 24 Termond white rabbits were used in the study. We evaluated the effect of autologous platelet-rich plasma on tricalcium phosphate using classical radiology, micro-CT studies, strength tests and histological evaluation. Radiological and histological assessment did not show a beneficial effect of PRP together with a bone substitute in comparison to filling the defects only with bone replacement material. The only benefit of adding platelet-rich plasma to a bone substitute was shown in microCT imaging. Autologous, activated platelet-rich plasma combined with hydroxyapatite tricalcium phosphate has a positive effect on the remodeling of the newly formed bone tissue, increasing its density.

Platelet-rich plasma (PRP) preparations can be used in bone tissue healing but there are numerous doubts among clinical orthopedists about effectiveness of this method.The studies were carried out in 12 rabbits of white termond breed. In operating room we operationally generated cylindrical, unicortical defects of the diameter of 4 mm in the middle of the shafts of both femurs. The defects in the left bones were left without filling and served as controls, and 0.7 ml of the ready-to-use PRP was administered to the defects in the right bones (experimental group). We evaluated the usefulness of the diagnostic methods applied: biomechanical tests, micro-CT tests, densitometry, typical radiology, macroscopic measurements, histopathological examinations.The macroscopic measurements showed a statistically significant increase in the dimension in the area of the right defect filled with PRP in relation to the control group. In experimented group, the assessment of the X-ray images showed the formation of a callus cuff around the defects. Densitometric examinations showed no statistically significant differences between defects in the experimental and control group. The analysis of the micro-CT examina- tions showed an increase in the total volume of the tissue examined (Vb) and the low density tissue fraction (Vb2) in the experimental group. The biomechanical examinations revealed signi- ficant decrease in the maximum breaking force (F max) necessary to break the bone in the experi- mental group in relation to the control group.Platelet-rich plasma (PRP) stimulates bone formation in the area of bone defects and may accelerate bone regeneration.

Yttrium aluminum garnet (YAG) layers, doped with some rare-earth ions can be used as thin film solid-state lasers. Thin films of Nd3+-doped YAG have been grown on undoped YAG substrates by the isothermal liquid phase epitaxy (LPE) dipping technique. The layers have been obtained from a supercooled molten garnet-flux high temperature solution. Y3−xNdxAl5O12 films (2–30 μm) grown on the (111) plane of YAG substrate have been investigated as a function of neodymium concentration using electron spin resonance (ESR) and X-ray diffraction techniques. According to those measurements it can be concluded that the obtained thin films possess high quality.

The authors of this article describe the surgical procedure for fixation of spondylolisthesis using transpedicular fixation, and offer a comparative evaluation of the DERO, CD, C-CD, SOCON, and STRYKER systems.br /The evaluation involved 36 patients operated in the Rehabilitation Clinic at the Lublin Academy of Medicine during the period 1994-2000. In 11 cases the DERO fixation system was used; in 5 cases, fixation with CD or C-CD instrumentation; in 15 cases, using the SOCON system; and in 5 cases with the STRYKER instrumentation.br /Indications for surgery included pain and symptoms of nerve root irritation with sciatic neuralgia. The concomitant neurological symptoms resulted from the displacement into the vertebral canal of fragments of the nucleus pulposus, or from bone-related stenosis of the vertebral canal and intervertebral foramina.br /Surgical treatment involved decompression of the nerve elements and internal fixation. In all the cases reported here posterior and postero-lateral spondylodesis was performed, while in 20 cases interbody spondylodesis was additionally performed, in 14 cases using interbody plugs.br /The authors analyze the reasons for complications, such implants working loose and fatigue fractures.

Introduction. Authors discussed problems of spine trauma in children and adults. They stressed anatomical and mechanics differences of the spine trauma in each group.br /Up to days methods of evaluation and operation of the spine trauma gave better opportunity to achieve good surgical treatment results.br /Materials an methods. Seventy four patients under eighteen and five hundred twenty eight over eighteen were treated in Rehabilitation Department Medical Academy of Lublin from 1986 to 2001. In all cases CT or MRI evaluations were carried out.br /Results. Authors pointed out the differences between children and adult spine trauma.br /The authors believe that good internal stabilizations should: give good correction of the axe of the spine, include only damaged movement segments and give opportunity for possible anterior or posterior spondylodesis.br /Conclusions. 1. Type of the spine trauma related to the biological age of the vertebrae, 2.Multilevel damaged of the spine occurs more often in children, in children there were less damage of the spine cord.

Background. Since 1920 there had been many attempts to explain the etiopatogenesis of Scheuerman disease. There were many definitions of clinical and radiological symptoms related to the failure of the corpus vertebrae. Up to days radiological methods (CT, MRI) gave opportunity for the more precise evaluation of the corpus vertebrae and the other structures in the spine, which is very helpful to choose the righ treatment.br /Material and methods. Clinical and radiological documentations in over 600 patients with the corpus vertebrae diseases with different localizations and clinical symptoms were studied.br /There were separated patients with ostechondrosis, chondrodysplasis, juvenile spondylosis and heritage disease of the spine.br /Results. Based on the analysis of the documentations the authors found out that disturbances of the ontogenesis refer to all end plates or its front part sometimes included neighbouring part of the vertebrae. There were different types of disturbances of the height of the vertebrae; some with the wedging of the vertebrae, some without any decrease of the bone structures. In all cases inter vertebral disc had been softly damaged, no dislocation had been noticed.br /Conclusions. Due to radiological evaluation partition on four groups had been proposed considering clinical symptoms. Such partition is helpful to choose method of the treatment.

Background. Delays and negligence in the treatment of spinal deformations have both objective and subjective causes and often occur simultaneously. The aim of our study was to evaluate and analyze the pathomorphological features of spine deformation in young patients following the program suggested by Karski, especially flexion-rotations exercises. Material and methods. We analyzed 36 post-surgical patients who performed flexion-rotation exercises for varying lengths of time. In additional to information regarding the course and manner of treatment with flexion-rotation exercises obtained from anamnesis, clinical and X-ray examinations were carried out. Results. Upon analysis of the progress of treatment with flexion-rotation exercises, correction of deformityof presumed abduction contracture of the right hip, and forced positions, we observed exceptionally rapid progression of scoliosis. Conclusions. Flexion-rotation exercises do not reduce the extent of spinal deformities, and may even accelerate the process of scoliosis. Unexpectedly rapid progress of sciolosis was confirmed in 3 patients treated by this method using complete radiological examination. Prolonging flexion-rotation exercises in progressive scoliosis is harmful, since it contributes to postponing the proper surgical treatment and reduces its effectiveness by giving the changes a permanent character.

[corrected] Three-dimensional surgical correction of scoliosis was introduced in the 1980s by Cotrel-Dubousset. Initially only laminar and pedicular hooks, two rods (correcting and stabilizing), and transverse links joining both rods were used to correct and stabilize the spine. When implant systems had been developed and modernized, transpedicular screws in the lumbar segment were used, followed by titanium implants. The aim of our study was to evaluate the outcome after surgical correction of scoliosis using the three-dimensional correction method with spondylodesis.We studied 171 patients with scoliosis treated surgically by the three-dimensional method of correction in the years 1992-2002. These were patients with idiopatic scoliosis not exceeding 70-80 degrees , depending on the degree of correction in extension tests. In 28 cases, titanium implants were used. In most cases, transpedicular screws were used in the lumbar spine, on the convex side of the scoliosis. Tytanium implants were used to enable diagnosis by CT or MRI after surgery.The mean angle of scoliosis before surgery was 56 degrees (range 40 degrees -90 degrees ). After surgical correction the mean angle was 16 degrees (range 5 degrees -37 degrees ); however, in long-term follow-up, the mean angle had increased slightly to 18 degrees (range 8 degrees -50 degrees ). The observation period was 2 to 16 years. There were complications in 9.3% of these cases, mainly late sterile negative tissue reactions to steel implants. Infectious and neurological adverse reactions were not observed.The best outcome after surgical treatment was achieved in grade II scoliosis. The scale of correction amounted to an average 70%. Transpedicular screws in the lumbar spine enabled a reduced range of stabilization. Titanium implants enabled radiological diagnosis by MRI and CT after surgery.

Most of works on passively Q-switched microchip lasers emitting at 1064 nm have been done with neodymium-doped YAG crystals as gain material and Cr/sup 4+/:YAG as saturable absorber. The bulk Cr/sup 4+/:GGG Czochralski grown passive Q-switches were also investigated. We have used a technique of liquid phase epitaxy (LPE) to grow Cr/sup 4+/:YAG, Cr/sup 4+/:GGG and Co/sup 2+/:YAG thin films of saturable absorber. X-ray diffraction analysis, optical transmission spectra measurements and passive Q-switching experiments were performed to characterize the obtained layers. Absorption saturation measurements of Cr/sup 4+/:YAG, Cr/sup 4+/:GGG and Co/sup 2+/:YAG layers were carried out at 1.06 /spl mu/m and 1.54 /spl mu/m, respectively.

Most of the work on passively Q-switched microchip lasers emitting at 1064 nm has been done with neodymium-doped YAG crystals as gain material and Cr 4+ :YAG as saturable absorber. The bulk Cr 4+ :GGG Czochralski grown passive Q-switches were also investigated. We have used a technique of liquid phase epitaxy (LPE) to grow Cr 4+ :YAG, Cr 4+ :GGG and Co 2+ :YAG thin films of saturable absorber. X-ray diffraction analysis, optical transmission spectra measurements and passive Q-switching experiments were performed to characterize the obtained layers. Absorption saturation measurements of Cr 4+ :YAG, Cr 4+ :GGG and Co 2+ :YAG layers were carried out at 1.06 μm and 1.54 μm, respectively.

We have used liquid phase epitaxy technique to grow Cr/sup 4+/ doped GGG and YAG monocrystalline thin films as a saturable absorber for passive Q-switching of Nd:GGG, Yb:YAG and Nd:YAG microchip lasers. Comparison of laser performance and influence of epitaxial film saturable absorber properties on microchip characteristics (repetition rate, pulse energy and pulse length) were reported.

Liquid phase epitaxy (LPE) is a suitable technique to produce diode laser-pumped solid state lasers with a planar waveguide structure. The thin films of Nd3+, Ga3+ and Lu3+ doped YAG have been grown form a supercooled molten garnet-flux high temperature solution on undoped YAG substrates by the standard LPE dipping technique. The emission spectra and fluorescence lifetimes have been measured for Nd:YAG layers with different concentration of Nd3+ ions. Additionally, the films were investigated versus concentration of neodymium, gallium and lutetium using ESR, x-ray diffraction and micro interferometric techniques. According to above measurements it can be concluded that the obtained epitaxial structures are of good quality.© (2000) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.

On the basis of three operated patients a posterior, lateral and antero-lateral approaches to the atlas and axis are presented. The type of approach depends on location and extent of a lesion in the vertebra.