Search results

1

Laparosocopic appendectomy, cost-effectiveness of three different techniques used to close the appendix stump

100%

Matyja M., Strzałka M., Rembiasz K.

Polish Journal of Surgery

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2015

|

vol. 87(12)

634-637

EN

It is generally agreed that laparoscopic appendectomy is a valuable operative method. The aim of the study was to evaluate cost-effectiveness of three different techniques used to close the appendix stump. Material and methods. We conducted a retrospective study that compared three groups of patients who were operated on laparoscopically for acute appendicitis in 2013 at our institution. We used an endoscopic clip to close the appendix stump in the first group (n=20), endoscopic stapler was applied in the second group (n=20), and in the third group of patients the appendix base was closed with a laparoscopic suture (n=20). These groups were matched by age, sex and BMI. Results. The average operative cost was the highest in the second group. Cost of the laparoscopic appendectomy with the application of the endoscopic clip was significantly lower (first group) and comparable to the third group. Observed differences in total hospitalization costs were associated only with the chosen appendix stump closure technique. Conclusions. Clip closure of the appendix base is an easy and cost-effective procedure. The laparoscopic suture technique is the cheapest but technically demanding. According to our experience endoscopic stapler may be useful in some cases, although it is the most expensive method.

2

Lateral Compression Sacral Fractures Have Less Favourable Outcome Compared to Crescent Fractures in Patients Less Than 50 Years Old

100%

Hammad A. S., Abu-Sheasha G. A., Nafady M., El-Bakoury A.

Ortopedia Traumatologia Rehabilitacja

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2021

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vol. 23(6)

417-426

EN

Background. Lateral compression (LC) accounts for a wide spectrum of pelvic ring injuries (PRIs). The primary aim of this study was to assess the health-related quality of life outcomes of surgically fixed LC crescent versus sacral fractures in patients less than 50 years old after high energy trauma. Material and methods. We retrospectively reviewed the database for PRIs treated surgically from December 2011 to January 2019 at our tertiary level trauma centre. The EuroQoL-5D (EQ5D5L) questionnaire was electronically sent to all patients. Multiple linear regression was conducted to determine the predictors of quality-adjusted life-years (QALYs). Results. The study included 37 patients. The mean age was 26 SD 9.46 years. The mean duration of follow-up was 3.78 (r:1-9) years. Twenty-one (56.8%) and 16 (43.2%) patients sustained sacral fractures and crescent fractures, respectively. Multi-regression analysis showed that any patient with LC injury without a sacral fracture is expected to have a utility value of QALY= 0.876. A reduction of 0.072 units in QALYs is expected in the presence of sacral fracture. About 71% of patients with sacral fractures were able to return to work and this probability increased by 40% among patients with crescent fractures (RR=1.4, p=.015). Conclusions. 1. Younger patients with crescent fractures tend to have better quality of life (higher EQ5D and QALYs) compared to those with LC sacral fractures. 2. Moreover, patients with LC sacral fractures have less chance to return to their pre-injury level of work compared to those with crescent fractures.

3

Results of Laparoscopic Appendectomies Performed with the Use of Titanium Clips for Closure of the Appendicular Stump

100%

Strzałka M., Matyja M., Rembiasz K.

Polish Journal of Surgery

|

2015

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vol. 86

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issue 9

418-421

EN

Nowadays laparoscopy is used frequently not only in elective surgery but also in abdominal emergencies, including acute appendicitis. There are several techniques used to close the appendicular stump during laparoscopic appendectomy. The aim of the study was to present the results of minimally invasive appendectomies performed with the use of titanium clips. material and methods. Patients operated on laparoscopically for acute appendicitis with the application of titanium clips between October 2012 and December 2013 were included in the study. We reviewed retrospectively patients` data including: age, sex, duration of the surgical procedure and hospital stay, mortality, intraoperative and postoperative complication rates. Results. There were 93 patients (mean age=33.8 years, SD=15.23) in the analyzed group, including 60 men (mean age=33.5 years, SD= 15.07) and 33 women (mean age=33.9 years SD=15.26). The aver-age duration of the surgical procedure was 66 min (SD= 33.15). The average length of hospital stay was 3.38 days (SD=1.62). No intraoperative complications were observed in the analyzed group. Post-operative complication rate was low (6 cases, 6.5%). No mortality was observed. Conclusions. Laparoscopic appendectomy with the application of titanium clips for closure of the appendicular stump is safe, associated with low complication rates and should be considered as a routine technique in everyday surgical practice.

4

Application of the Single Access Technique in Laparoscopic Surgery

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Strzałka M., Matyja M., Matłok M., Migaczewski M., Budzyński P., Budzyński A.

Polish Journal of Surgery

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2013

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vol. 85

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issue 2

73-77

EN

Laparoscopic single access technique is a next step in development of minimally invasive surgery. The aim of the study was to present results of different laparoscopic single incision procedures and evaluate application of this technique. Material and methods. 102 patients (15 males and 87 females) who underwent laparoscopic single incision procedure from 15th October 2009 to 31st December 2012 were included in the study. Results. In the analyzed period we performed 72 cholecystectomies (70.6%), 8 left adrenalectomies (7.8%), 3 right adrenalectomies (2.9%), 7 splenectomies (6.9%), 5 spleen cysts unroofings (4.9%), 2 appendectomies (2%), 1 Nissen fundoplication procedure (1%), 1 removal of the adrenal cyst (1%) and 3 concomitant splenectomies and cholecystectomies (2.9%). There were 3 technical conversions to multiport laparoscopy, but no conversion to open technique. Complications were observed in 5 patients (4.9%). Average operation time was 79 min (SD=40), average hospitalization time 2.4 day (SD=1.4). Conclusions. Laparoscopic single incision technique is a safe method and can be used as a reasonable alternative to multiport laparoscopy in different minimally invasive procedures especially in young patients to whom an excellent cosmetic effect is particularly important.

5

1000 Liver Transplantations at the Department of General, Transplant and Liver Surgery, Medical University of Warsaw - Analysis of Indications and Results

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Krawczyk M., Grąt M., Barski K., Ligocka J., Antczak A., Kornasiewicz O., Skalski M., Patkowski W., Nyckowski P., Zieniewicz K., Grzelak I., Pawlak J., Alsharabi A., Wróblewski T., Paluszkiewicz R., Najnigier B., Dudek K., Remiszewski P., Smoter P., Grodzicki M., Korba M., Kotulski M., Cieślak B., Kalinowski P., Gierej P., Frączek M., Rdzanek Ł., Stankiewicz R., Kobryń K., Nazarewski Ł., Leonowicz D., Urban-Lechowicz M., Skwarek A., Giercuszkiewicz D., Paczkowska A., Piwowarska J., Gelo R., Andruszkiewicz P., Brudkowska A., Andrzejewska R., Niewiński G., Kilińska B., Zarzycka A., Nowak R., Kosiński C., Korta T., Ołdakowska-Jedynak U., Sańko-Resmer J., Foroncewicz B., Ziółkowski J., Mucha K., Senatorski G., Pączek L., Habior A., Lechowicz R., Polański S., Leowska E., Pacho R., Andrzejewska M., Rowiński O., Kozieł S., Żurakowski J., Ziarkiewicz-Wróblewska B., Górnicka B., Hevelke P., Michałowicz B., Karwowski A., Szczerbań J.

Polish Journal of Surgery

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2012

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vol. 84

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issue 6

304-312

EN

The aim of the study was to analyze indications and results of the first one thousand liver transplantations at Chair and Clinic of General, Transplantation and Liver Surgery, Medical University of Warsaw.Material and methods. Data from 1000 transplantations (944 patients) performed at Chair and Clinic of General, Transplantation and Liver Surgery between 1994 and 2011 were analyzed retrospectively. These included 943 first transplantations and 55 retransplantations and 2 re-retransplantations. Frequency of particular indications for first transplantation and retransplantations was established. Perioperative mortality was defined as death within 30 days after the transplantation. Kaplan-Meier survival analysis was used to estimate 5-year patient and graft survival.Results. The most common indications for first transplantation included: liver failure caused by hepatitis C infection (27.8%) and hepatitis B infection (18%) and alcoholic liver disease (17.7%). Early (< 6 months) and late (> 6 months) retransplantations were dominated by hepatic artery thrombosis (54.3%) and recurrence of the underlying disease (45%). Perioperative mortality rate was 8.9% for first transplantations and 34.5% for retransplantations. Five-year patient and graft survival rate was 74.3% and 71%, respectively, after first transplantations and 54.7% and 52.9%, respectively, after retransplantations.Conclusions. Development of liver transplantation program provided more than 1000 transplantations and excellent long-term results. Liver failure caused by hepatitis C and B infections remains the most common cause of liver transplantation and structure of other indications is consistent with European data.

6

Laparosocopic Appendectomy, Cost-Effectiveness of Three Different Techniques Used to Close the Appendix Stump

100%

Matyja M., Strzałka M., Rembiasz K.

Polish Journal of Surgery

|

2015

|

vol. 87

|

issue 12

634-637

EN

It is generally agreed that laparoscopic appendectomy is a valuable operative method. The aim of the study was to evaluate cost-effectiveness of three different techniques used to close the appendix stump. Material and methods. We conducted a retrospective study that compared three groups of patients who were operated on laparoscopically for acute appendicitis in 2013 at our institution. We used an endoscopic clip to close the appendix stump in the first group (n=20), endoscopic stapler was applied in the second group (n=20), and in the third group of patients the appendix base was closed with a laparoscopic suture (n=20). These groups were matched by age, sex and BMI. Results. The average operative cost was the highest in the second group. Cost of the laparoscopic appendectomy with the application of the endoscopic clip was significantly lower (first group) and comparable to the third group. Observed differences in total hospitalization costs were associated only with the chosen appendix stump closure technique. Conclusions. Clip closure of the appendix base is an easy and cost-effective procedure. The laparoscopic suture technique is the cheapest but technically demanding. According to our experience endoscopic stapler may be useful in some cases, although it is the most expensive method.

7

A Prospective Comparison of Four Methods of Endovenous Thermal Ablation

100%

Dzieciuchowicz Ł., Krasiński Z., Gabriel M., Espinosa G.

Polish Journal of Surgery

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2011

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vol. 83

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issue 11

597-605

EN

The aim of the study was to compare clinical and duplex Doppler results of treatment of varicose veins with four methods of endovenous thermal ablation (EVTA).Material and methods. The results of treatment of varicose veins with 980 nm laser (EVLA980) in 67 extremities, with a radiofrequency ablation (RFA) in 43 extremities, with 810 nm laser (EVLA810) in 46 extremities and with 1470 nm laser (EVLA1470) in 15 extremities were prospectively analyzed. The data on patients' demographics, weight, stage of the venous disease, type of anesthesia, duration of the procedure, linear energy density (LED) applied, intra- and postoperative complications were collected. Thromboprophylaxis was not routinely administered. The patients were followed clinically and with duplex Doppler for 12 (1-24) months.Results. Technical success was achieved in 99% of limbs. The procedure was carried out under local anesthesia in 140 (91%) of patients. In 17 patients bilateral procedure was performed. There were one gastroenemius muscle vein thrombosis and one protruding thrombus from sapheno-femoral junction in EVLA810. No other serious complications were observed. A median LED was higher in EVLA810 than in EVLA980 and EVLA1470, 86.8 (82-94), 59.2 (45.4-74.4) and 58.8 (53-67.7) J/cm, respectively (p<0.001), though only in EVLA980 was below the intended range. Recanalization rates were 7% after EVLA980, 2% after EVLA810 and 0% after RFA and EVLA1470, p=0.14. The vein shrinking was fastest after EVLA1470. Neither neovascularization nor formation of arteriovenous fistulas was observed. Permanent saphenous nerve paresthesia occurred in two patients after RFA.Conclusions. All methods of ambulatory EVTA are safe and effective once the adequate linear energy density is applied.

8

Anterior overlapping sphincteroplasty – who benefits from the surgery?

88%

Mik M., Rośniak K., Narbutt P., Dziki Ł., Tchórzewski M., Trzciński R., Dziki A.

Polish Journal of Surgery

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2015

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vol. 86

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issue 1

33-38

EN

The aim of the study was to identify clinical factors which could influence the results of overlapping sphincteroplasty. Material and methods. Between 2003-2009 the group of 78 incontinent patients (59 women, mean age of 61±13 years), was operated on with anterior overlapping anal sphincteroplasty. Only patients with severe incontinence (>16 pts in Wexner scale) were included. Before surgery and in follow-up period anorectal ultrasound, manometry and incontinence assessment were performed and in follow-up period patients additionally fulfilled survey. The study was prospective. Follow up period was more than 36 months. Results. In survey the excellent results related to 52 patients (66.7%), good in 15 (19.2%) and poor in 11 (14.1%). The squeeze pressure improved more significantly in men 33±11 cm H2O vs. 22±14 cm H2O; p=0.039. In patients <50 year squeeze pressure was significantly larger 32±10 cm H2O vs. 25±12 cm H2O; p=0.045. If the width of a defect within sphincter was less than 60°飀 the improvement in squeeze pressure was higher 33±9 cm H2O vs. 22±15 cm H2O; p=0.031. In Wexner scale male patients better responded to surgery than females 6.94±1.8 vs. 5.12±2.2, p=0.048; as well as patients with smaller scar <60° 6.51±1.4 vs. 4.28±2.3; p=0.042. Conclusions. To succeed in sphincteroplasty the proper qualification to the procedure should be crucial. Clinical assessment prior to surgery with the use of all available non-surgical methods in patients suffer from severe symptoms can help to select optimal group who will benefit from surgery. Male patients may have to obtain better outcome and patients with smaller sphincter defect could likely have also better results from surgery.

9

Radiation-free Insertion of Interlocked Intramedullary Tibial Nail in Closed Extra-articular Displaced Tibial Shaft Fractures in an Emergency Setup

88%

Charak S. S., Chib M. S., Darokhan M. A. U. D., Jamwal P.

Ortopedia Traumatologia Rehabilitacja

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2021

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vol. 23(6)

427-431

EN

Background. Interlocking nailing is considered a gold standard surgical treatment of mid-shaft closed diaphyseal tibial fractures. With increasing exposure of orthopaedic surgeons to radiation, we propose a solution to this health hazard through a study wherein we perform the surgery without any radiation or C-arm exposure. Material and methods. This prospective study was done at GMC Jammu from January 2017 to February 2020 and included 218 patients, with 18 patients having bilateral tibia fractures in the age group 15 to 58 years (mean of 37.6 years), including 63.7% males (n=139) and 36.3% females (n=79). The 236 extra-articular closed tibial mid-diaphyseal fractures were operated on and intramedullary tibial nailing was performed without a single C-arm exposure. Postoperative x-rays were done and reduction assessed by standard acceptable criteria. Results. Among 236 cases in which nailing was done, 227 (96%) patients were successfully distally locked, including 128 (56.3%) locked through the jig and 99 (43.6%) by “hit and trial method.” All cases met acceptability criteria set for management of tibia by nailing. Conclusions. 1. This study strengthens the proof that closed extra-articular diaphyseal fractures of the tibia can be managed by nailing without using the C-arm with excellent results. 2. The C-arm is always available for cases where distal locking could not be achieved. 3. The technique has a great role in centres with limited facilities of intra-operative radiography in emergency operation theatres.

10

Game-Related Volleyball Skills that Influence Victory

88%

Silva M., Lacerda D., João P. V.

Journal of Human Kinetics

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2014

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vol. 41

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issue 1

173-179

EN

The aim of the present study was to identify the volleyball skills that discriminate in favour of victory. Twenty-four games (n=24) from the Senior Men's Volleyball World Championship played in Italy in 2010 were chosen and analyzed with Data Volley software. The discriminating function was used to identify the discriminating variables, using a canonical structuring coefficient of |SC| >.30. The results suggest that service points, reception errors, and blocking errors were the discriminating variables that identify the final outcome of the match (victory/defeat). Moreover, successful service points were the major variable most likely associated with match success (victory). In this sense, increasing the effectiveness of service should be a top priority in coaching elite volleyball teams.

11

How do patients assess outcomes of treatment of prognathism?

88%

Neskoromna-Jędrzejczak A., Bogusiak K., Antoszewski B.

Polish Journal of Surgery

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2015

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vol. 87(8)

395-401

EN

The aim of the study was to analyze the results of patients’ subjective self-assessment of surgical treatment of prognathism. Materials and methods. The study included 35 patients who underwent extraoral vertical ramus osteotomy. Each patient responded to 12 questions contained in the questionnaire created by the authors. Results. All respondents positively assessed their appearance after surgery. In most cases they pointed out the positive impact of treatment on their self-confidence (82.9% of responses). The vast majority of respondents felt improvement in biting off food (91.4%). Conclusions. Patients positively evaluate the outcome of surgical treatment with extraoral vertical ramus osteotomy. The subjective improvement of the facial appearance, as well as chewing and articulation functions took place after the treatment.

12

Reoperative Surgery for Benign Thyroid Diseases

75%

Alesina P., Rolfs T., Walz M.

Polish Journal of Surgery

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2008

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vol. 80

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issue 9

441-445

EN

The aim of the study was to present a retrospective analysis of the experience with completion thyroidectomy for benign thyroid disease in a referral centre.Material and methods. Between October 1999 and December 2007, 2353 thyroid operations were performed for benign diseases. Of these, 113 patients (12 men, 101 women; age: 25-77 years) underwent a reoperation for recurrent goitre (n=107) or recurrent Grave's disease (n=6). A bilateral resection was performed in 33 patients, a unilateral in 80 patients. The mean interval between the initial and the reoperative procedure was 14.5 years.Results. The mean operative time was 78 minutes (range: 20-210) with 68 minutes for unilateral and 96 minutes for bilateral operations. Postoperative complications consisted of transient hypoparathyroidism in 6 patients (5.3%); no patient experienced a permanent hypoparathyroidism. A transient recurrent laryngeal nerve (RLN) palsy occurred in 6 cases (4.1% of "nerves at risk") and a definitive bilateral RLN palsy was registered in a patient with a preoperative unilateral RLN palsy (0.9%). In 4 patients (3.5%) a postoperative bleeding required reoperation. No wound infection was observed. The mean postoperative hospital stay was 2.3 days. Final histology showed a thyroid cancer in 6 patients (5.3%).Conclusion. In experienced hands, reoperative thyroid surgery can be performed safely and with limited morbidity.

13

Wpływ dynamizacji zespoleń złamań krętarzowych na zrost kostny

63%

Koniec W., Marczyński W.

Ortopedia Traumatologia Rehabilitacja

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2022

|

vol. 24(2)

95-106

EN

Background. Ineffectively treated trochanteric fractures lead to disability and thus constitute a significant social problem. The aim of the study was to analyze the effect of dynamization of the fixation of trochanteric fractures on bone union. Material and methods. We conducted a retrospective study involving 149 patients operated on for trochanteric fractures in 2015-2017. The fractures were anastomosed with a DHS extramedullary device or a Gamma 3 intramedullary nail. Results. Bone union was achieved at an average of 11 weeks after the surgery (8-20 weeks). In the extramedullary stabilization (DHS) group, union was achieved after 12 weeks (8 to 16 weeks) (N = 47). In intramedullary stabilization, union was achieved after 10 weeks (8 to 20 weeks) (N = 96). The intramedullary nails were locked statically or dynamically. The time to union in static stabilization was 12.3 weeks (8 to 20 weeks) (N = 31), while in dynamic stabilization it was 9.4 weeks (8 to 16 weeks) (N = 64). Conclusions. 1. This study revealed a measurable biologically beneficial effect of dynamization of the fixation of trochanteric fractures on the time of bone union. 2. Conventional radiographs and CT imaging according to indications significantly facilitate the classification of fractures and selection of the method of stabilization with dynamization. 3. Due to the considerable comminution of the trochanteric massif, double dynamization (cervical-trochanteric and femoral-trochanteric) of fracture fragments is essential, ensuring reduction of fracture gaps and self-reduction of inter-fracture resorptive gaps, which is a prerequisite for optimal union. 4. Allowing early, full weight-bearing of the operated limb within the painless range is an important element of effective dynamization.

PL

Wstęp. Złamania krętarzowe leczone nieskutecznie stają się przyczyną kalectwa stanowiąc znaczny problem społeczny. Celem pracy była analiza wpływu dynamizacji zespoleń złamań krętarzowych na zrost kostny. Materiał i metody. Badanie retrospektywne dotyczyło 149 pacjentów operowanych z powodu złamania krętarzowego w latach 2015-2017r. Złamania zespolono metodą zewnątrzszpikową za pomocą DHS lub śródszpikową gwoździem Gamma 3. Wyniki. Zrost kostny uzyskano średnio po 11 tygodniach od operacji (od 8 do 20 tygodni). W grupie zespoleń zewnątrzszpikowych (DHS) zrost uzyskano po 12 tygodniach (od 8 do 16 tygodni) (N=47). U zespolonych śródszpikowo zrost uzyskano po 10 tygodniach (od 8 do 20 tygodni) (N=96). Zespolenia śródszpikowe blokowano statycznie lub dynamicznie. Czas zrostu w zespoleniach statycznych wynosił 12,3 tygodnia (od 8 do 20 tygodni) (N=31) , natomiast w zespoleniach dynamicznych 9,4 (od 8 do 16 tygodni) (N=64). Wnioski. 1. W analizowanym materiale klinicznym stwierdzono wymierny, korzystny biologicznie wpływ dynamizacji zespoleń złamań krętarzowych na czas uzyskania zrostu kostnego. 2. Sposoby diagnostyki obrazowej RTG i TK wg wskazań znacznie ułatwiają kwalifikację złamań i dobór metody stabilizacji z dynamizacją. 3. Ze względu na znaczną liczbę odłamów masywu krętarzowego istotnym jest podwójna dynamizacja międzyodłamowa; szyjkowo-krętarzowa i trzonowo-krętarzowa zapewniające redukcję szpar złamań oraz samoredukcję szpar resorpcyjnych międzyodłamowych, co warunkuje optymalizację zrostu. 4. Istotnym elementem skutecznej dynamizacji jest wczesne, pełne obciążanie operowanej kończyny w granicach bezbólowych.

14

The Programme and Results of Rehabilitation Treatment after Surgical Anastomosis of the Tendon of the Flexor Pollicis Longus

63%

Wańczyk A., Pieniążek M.

Medical Rehabilitation

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2008

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vol. 12(3)

9-14

EN

Introduction: Damage to the tendon of the flexor pollicis longus (FPL) is a very frequent sequel of injuries in the region of the thumb. The mechanism of injuries can be very different; most often, these are cuts by sharp tools. Damage to other tissues frequently accompanies these injuries. In such cases, surgical junction of a lesioned tendon is the treatment of choice followed by specialistic rehabilitation.Aim of paper: The aim of this study is to present a therapy program and the results of rehabilitation treatment in patients after surgical FPL junction.Material and methods: The study involved patients with damage to FPL tendon, who were treated in the Malopolskie Hand Rehabilitation Centre of the L. Rydygier Hospital in Krakow. The investigation method included physiotherapeutic diagnostic studies comprising measurements of the range of movements, dynamometric measurements of muscle strength, examination of sensation and the NHP test of manipulative capacity. For the assessment of hand function, Swanson’s methodology was applied.Results: Based on twice repeated assessments (at the beginning and at the end of rehabilitation) and their analysis, effectiveness and correctness of applied rehabilitation program were confirmed. Conclusions: Surgical treatment FPL damage requires the immediate introduction of rehabilitation. A broad selection of resources and physiotherapeutic methods applied during such therapy increase the effectiveness of treatment.

15

Analiza wyników zabiegów endoprotezoplastyki stawu biodrowego z zastosowaniem trzpieni z grupy VI według Khanuja i wsp.

63%

Drobniewski M., Krasińska M., Synder M., Borowski A.

Ortopedia Traumatologia Rehabilitacja

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2021

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vol. 23(5)

361-374

EN

Background. Total cementless hip joint arthroplasty is universally recognized as a method of treatment of advanced hip osteoarthritis. Multifaceted research by a wide group of implant specialists has led to the development of special implants that fulfill their purpose even in the most severe deformities of the hip joint. The aim of the study is to present and analyse the results of hip joint arthroplasty with the Antega anatomical stem. Materials and methods. The study enrolled 533 patients (342 women and 191 men) who underwent a total of 595 hip joint arthroplasties with the Antega anatomical stem. The mean age of the patients at surgery was 56.2 years (range: 20-87 years). The mean follow-up period was 7.3 years (range: 5-15.5 years). Results. Pre-operative Merle d’Aubigne-Postel scores (modified by Charnley) were poor in all patients. Mean post-operative improvement was 6.1 points. The outcomes were classified as excellent in 419 cases (70.4%), good in 102 cases (17.1%), satisfactory in 39 (6.6%) and poor in 34 cases. Poor results were usually associated with loosening of one of the prosthetic components. Heterotopic ossification was noted in 37 cases (6.2%). According to the Kaplan-Meier estimator, 10 years’ survival probability was 89.9% for the whole implant and 96.1% for the stem alone. Conclusions. 1. Our follow-up data (from a mean follow-up period of more than 10 years) indicate that the Antega anatomical stem affords excellent clinical and functional results. 2. With good surgical technique and in the absence of complications, the risk of aseptic loosening is minimal. 3. Modification of the Antega stem implantation technique significantly reduces the risk of so-called unexplained thigh pain, which sometimes occurs following hip replacement surgery. 4. As only medium-term follow-up data are available, there may be more cases of loosening (mainly of the acetabular cup) over time, requiring regular long-term follow-up.

PL

Wstęp. Zabieg całkowitej aloplastyki stawu biodrowego jest obecnie powszechnie uznaną metodą leczenia zaawansowanych postaci choroby zwyrodnieniowej tego stawu. Wielokierunkowe badania szerokiej grupy specjalistów nad implantami, doprowadziły do powstania specjalnych wszczepów, które mogą być użyte i spełniają swoje zadanie nawet w najbardziej zaawansowanych deformacjach stawu biodrowego. Celem pracy jest przedstawienie analizy wyników zabiegów aloplastyki stawu biodrowego z zastosowaniem trzpienia anatomicznego Antega. Materiał i metody. Do badań zakwalifikowano 533 pacjentów (342 kobiet i 191 mężczyzn), u których wykonano w sumie 595 zabiegów aloplastyki stawu biodrowego z użyciem trzpienia anatomicznego Antega. Średni wiek pacjentów w dniu zabiegu wynosił 56,2 lat (w zakresie od 20 do 87 lat). Średni okres obserwacji wynosił 7,3 lat (w zakresie od 5 do 15,5 lat). Wyniki. W ocenie przedoperacyjnej wszyscy pacjenci uzyskali wynik zły wg klasyfikacji Merle d‘Aubigne i Postela w modyfikacji Charnleya. Średnia poprawa po operacji według użytej skali wyniosła 6,1 punktów. Wynik bardzo dobry odnotowano w 419 przypadkach (70,4%), wynik dobry w 102 przypadkach (17,1%), wynik dostateczny w 39 (6,6%), a wynik zły w 34 przypadkach. Wyniki złe z reguły związane były z obluzowaniem jednego z elementów endoprotezy. W 37 przypadkach (6,2%) odnotowano obecność kostnienia pozaszkieletowego. Według estymatora Kaplana -Meiera 10-letnie prawdopodobieństwo przeżycia całej endoprotezy wyniosło 89,9%, a samego trzpienia 96,1%. Wnioski. 1. Nasze średnio ponad dziesięcioletnie obserwacje wskazują, że zastosowanie anatomicznego trzpienia Antega daje znakomity wynik kliniczny i funkcjonalny operowanym pacjentom. 2. Przy braku powikłań i prawidłowej technice operacyjnej ryzyko aseptycznego obluzowania jest znikome. 3. Modyfikacja techniki implantacji trzpienia Antega pozwala w znacznym stopniu ograniczyć ryzyko wystąpienia tak zwanych niewyjaśnionych dolegliwości bólowych uda pojawiających się niekiedy po zabiegach aloplastyki stawu biodrowego. 4. Ze względu na średni okres obserwacji należy liczyć się z możliwością zwiększenia się liczby obluzowań, głównie komponentu panewkowego endoprotezy wraz z biegiem lat, co stwarza konieczność regularnych kontroli w dłuższym okresie obserwacji.

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Laparosocopic appendectomy, cost-effectiveness of three different techniques used to close the appendix stump

Lateral Compression Sacral Fractures Have Less Favourable Outcome Compared to Crescent Fractures in Patients Less Than 50 Years Old

Results of Laparoscopic Appendectomies Performed with the Use of Titanium Clips for Closure of the Appendicular Stump

Application of the Single Access Technique in Laparoscopic Surgery

1000 Liver Transplantations at the Department of General, Transplant and Liver Surgery, Medical University of Warsaw - Analysis of Indications and Results

Laparosocopic Appendectomy, Cost-Effectiveness of Three Different Techniques Used to Close the Appendix Stump

A Prospective Comparison of Four Methods of Endovenous Thermal Ablation

Anterior overlapping sphincteroplasty – who benefits from the surgery?

Radiation-free Insertion of Interlocked Intramedullary Tibial Nail in Closed Extra-articular Displaced Tibial Shaft Fractures in an Emergency Setup

Game-Related Volleyball Skills that Influence Victory

How do patients assess outcomes of treatment of prognathism?

Reoperative Surgery for Benign Thyroid Diseases

Wpływ dynamizacji zespoleń złamań krętarzowych na zrost kostny

The Programme and Results of Rehabilitation Treatment after Surgical Anastomosis of the Tendon of the Flexor Pollicis Longus

Analiza wyników zabiegów endoprotezoplastyki stawu biodrowego z zastosowaniem trzpieni z grupy VI według Khanuja i wsp.