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EN
To discuss the method and effect of total knee arthroplasty osteotomy and soft tissue release for serious knee joint space narrowing. Clinical data of 80 patients from October 2013 to December 2014 was selected with a retrospective method. All patients have undergone total knee arthroplasty. Then the X-rays plain film in weight loading was measured before and after operation and osteotomy was performed accurately according to the knee joint scores and the conditions of lower limb alignments. The average angle of tibial plateau osteotomy of postoperative patients was 4.3°, and the corrective angle of soft tissue balancing was 10.7°; the postoperative patients’ indicies including range of joint motion, knee joint HSS score, angle between articular surfaces, tibial angle, femoral-tibial angle and flexion contracture were distinctly better than the preoperative indicies (p<0.05) and the differences were statistically significant; the postoperative patients’ flexion contracture and range of joint motion were distinctly better than the preoperative indicies (p<0.05) and the differences were statistically significant. The effective release of the soft tissue of the posterior joint capsule under direct vision can avoid excess osteotomy and get satisfactory knee replacement space without influencing the patients’ joint recovery.
PL
Zabieg obustronnej osteotomii jest przeprowadzany w przypadku nieprawidłowego rozwoju kości żuchwy, w wyniku czego gałąź żuchwy jest zbyt krótka lub zbyt długa. Taka dysfunkcja pociąga za sobą nieprawidłowe działanie całego układu stomatognatycznego. Celem pracy było przeprowadzenie badań doświadczalnych, modelowych, trwałości zespoleń odłamów kostnych żuchwy ludzkiej dla wybranych przypadków obustronnej osteotomii. Na podstawie badań eksperymentalnych zostały przeanalizowane przemieszczenia odłamów kostnych w rejonie zespoleń. W badaniach zostały zastosowane różne typy implantów płytkowych: czterooczkowa otwarta, ośmiooczkowa i dziesięciooczkowa częściowo otwarta, stosowane w zabiegach obustronnej osteotomii gałęzi kości żuchwy. W każdym przypadku zespolenia przeprowadzono badania z zachowaniem jednakowych warunków, w obciążeniu symetrycznym i niesymetrycznym, stosując fizjologiczne wartości sił konieczne do odgryzania i żucia pokarmu. Ocena przemieszczeń odłamów kostnych została przeprowadzona w sposób bezdotykowy, ciągły, za pomocą systemu do cyfrowej korelacji obrazu Q-400.
EN
Bilateral osteotomy is performed in case of incorrect development of mandible, which results in ramus of the mandible being too short or too long. Such dysfunction results in incorrect operation of whole stomatognathic system. The goal of this research was an experimental assessment of durability of mandible osteosynthesis for chosen cases of bilateral osteotomy. Displacements of bone fragments in region of osteosynthesis were analyzed based on experimental research. Several types of plate implants were examined: 4-hole open, 8- and 10-hole partially open. For every case of osteosynthesis the research was conducted while observing same conditions, using symmetrical and asymmetrical load and physiological forces needed for biting and chewing of food. Evaluation of bone fragments displacements was done using system for digital image correlation Q-400.
EN
This paper describes the results of Chiari osteotomy (CO) with simultaneous intertrochanteric osteotomy (IO) in dogs affected by bilateral hip dysplasia, score grade D. The dogs classified for the study were subjected to the following tests before and after surgery: abduction-external rotation test, hip extension test, dorso-lateral subluxation test (DLST), stand test, Ortolani sign, Barlow sign, measurements of the angle of flexion, angle of extension, angle of abduction, angle of adduction, and radiographic examinations determining the score grade for canine hip dysplasia in accordance with the scoring system recommended by the Fédération Cynologique Internationale. The test which most accurately reflected the post-operative improvement in patients was DLST where the negative response increased by 73% after CO and IO procedures. Changes in angle of inclination (AI) values were correlated with an improvement in hip functioning as a result of the administered treatment. The simultaneous application of CO and IO in dogs affected by hip dysplasia resulted in greater improvement of limb functioning in comparison with conventional IO.
EN
The purpose of our study was to evaluate the temporal aspect of the onset of the outcome of a triple pelvic osteotomy (TPO) in a group of 34 dogs younger (but one) than 12 months of age with a homogenous longer follow-up. In each case, lameness and positive Ortolani sign were detected. In some cases, bilateral TPO or denervation of the contralateral hip was performed. Clinical and radiological re-checks were performed in a uniform way for all dogs one and three months after surgery. The mean angle of reduction and subluxation for the operated joints decreased substantially by 17.3 ±1.58 degrees one month after the surgery, without any further statistically significant reduction at three months. Additionally , in 71% of the operated joints, the outcome of the TPO, defined in terms of the absence of the angle of reduction and subluxation, was already established at one month post-surgery and did not change at three months post-surgery. These results indicate that the outcome of the TPO in dogs is established within a month after the surgery and is basically maintained afterwards.
8
Content available remote Sress distribution in varus knee after operative correction of its mechanical axis
51%
EN
An analysis of the results of 121 minus-valgizing osteotomies in genu varum performed in the years 1985-1998 allowed the authors to conclude that the recommended by most researchers hyper-corrective valgus positioning of the knee's mechanical axis after an osteotomy resulted in increased postoperative valgity in 12 cases. This complication nullified the intended effect of the operation and required another corrective procedure. Clinical observations showed that the probable causes of the complications could be different, e.g. a significant decrease of bone density in the joint's exterior section, taking over the body-weight load, and the patient's considerable overweight. Whereas the presumptive cause was a limited capability of remodelling of the overloaded exterior section of the joint. In order to determine the magnitude and distribution of static forces in the knee's articular ends, a series of measurements were made using spatial photoelastic models as exact geometrical copies of specimens from autopsy. The measurements have shown that in the case of the hypercorrective position of the joint's axis, an extremely heavy concentration of forces occurs on the relatively small bearing surface of the outer condyle of the tibia. This creates adverse mechanical conditions and makes it impossible to obtain the intended correction angle.
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