Acta Chirurgiae Orthopaedicae Et Traumatologiae Cechoslovaca[JOURNAL]
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200 papers
[Comparison of the Clinical Examination, Magnetic Resonance Imaging and Intraoperative].
Madeja R, Sklienka P, Pometlová J … +3 more , Frydrýšek K, Madejová D, Douša P
Acta Chir Orthop Traumatol Cech · 2025 Dec · PMID 41503634 · Publisher ↗
PURPOSE OF THE STUDY: Diagnosing shoulder pathologies is rather challenging. The reason is not only the anatomical structure and biomechanics of the joint, but also the concomitant conditions, specifically of cervical sp...
PURPOSE OF THE STUDY: Diagnosing shoulder pathologies is rather challenging. The reason is not only the anatomical structure and biomechanics of the joint, but also the concomitant conditions, specifically of cervical spine, which can significantly contribute to the pathophysiology. The aim of this study was to evaluate the diagnostic accuracy of clinical examination and magnetic resonance imaging in relation to the actual intraoperative finding in patients with selected shoulder pathologies. MATERIAL AND METHODS: The data of patients in whom shoulder arthroscopy was performed at the Department of Trauma Surgery, University Hospital Ostrava in the 2018-2019 period were extracted retrospectively from the hospital information system. Our attention was focused on 4 diagnoses, namely rotator cuff tear (RCT), anterior shoulder instability due to lesion of the anterior capsular-labral complex (STA), shoulder impingement syndrome (impingement) and SLAP lesion - superior labral anterior posterior tear (SLAP). RESULTS: The study included 71 patients, of whom 46 were men (65%) and 25 women (35%). The difference in the median age of men and women was not significant (p = 0.740). High specificity (clinical examination 91.8%, MRI 91.8%) and low sensitivity (clinical examination 58.0%, MRI 61.0%) were evident in all diagnoses. In shoulder instability (STA) the sensitivity was significantly higher than in the other diagnoses. The accuracy of both methods was also high (clinical examination 79.9%, MRI 81.0%). DISCUSSION: These matters have already been described in literature. Nonetheless, most of the studies compared the MRI and arthroscopy findings. Our study reflects the actual diagnostic procedure, i.e. the examination of the patient, referral for MRI for suspected pathology and subsequent surgery to confirm or rule out the diagnosis. Magnetic resonance imaging can detect also other pathological findings that are not apparent during shoulder arthroscopy. CONCLUSIONS: High specificity of clinical examination as well as MRI was confirmed by this study. The sensitivity of both examination methods was significantly lower, except for the diagnosis of anterior shoulder instability (STA), where it was satisfactorily high for both methods. In the case of a positive clinical finding, in rotator cuff tear (RCT) diagnosis the MRI scan provides higher accuracy and eliminates false positives, which was, however, not confirmed in the other diagnoses. In the case of a negative clinical finding, the MRI helps refine the diagnoses. This does not apply to the STA diagnosis, where we may assume that a negative finding of clinical examination will most likely mean a negative intraoperative finding and this negative predictive value will not be increased by the MRI.
[Revision Arthroplasty for Periprosthetic Femoral Fracture Complicated by Multidrug-Resistant Escherichia coli: Case Report and Minireview].
Kraus J, Krausová V, Bartoš H … +1 more , Novotný T
Acta Chir Orthop Traumatol Cech · 2025 Dec · PMID 41503625 · Publisher ↗
Periprosthetic infections caused by multi-resistant bacteria are one of the most fearsome complications in current orthopedics. Despite using aseptic modern practices, the number of infectious complications caused by mul...
Periprosthetic infections caused by multi-resistant bacteria are one of the most fearsome complications in current orthopedics. Despite using aseptic modern practices, the number of infectious complications caused by multidrug-resistant strains is rising worldwide. We present a case of a woman with a non-healing wound after hip arthroplasty revision surgery performed in Egypt for periprosthetic femoral fracture. Upon admission, 11 days after surgery, she presented with a purulent secretion from surgical wound and signs of sepsis. Carbapenem-resistant E. coli was proven from a wound swab. Two-stage revision with a 6-week-long interval of targeted parenteral antibiotic therapy was indicated. During explantation, excessive femoral bone loss after inadequately performed trauma revision surgery was discovered. After antibiotic hip spacer period, the patient underwent implantation of a cemented tumorous revision hip implant followed by 6 weeks of antibiotic therapy. The patient was discharged in more than satisfactory condition, being self-sufficient using French crutches. In follow-up visits during next 2 years, no relapse of carbapenem-resistant infection occurred. In patients hospitalized or operated in high-risk areas, epidemiological anamnesis is of great importance and the possibility of importing multi-resistant bacteria should be considered. Infections caused by these bacteria prolong therapy and increase the cost of treatment significantly. The combination of arthroplasty extraction and targeted antibiotic therapy is recommended to treat periprosthetic infections.
[Posterior Wall Reconstruction Using Iliac Strut Graft in Posterior Acetabular Wall Fracture].
Haghighat S, Malekzade M, Mousapour A … +3 more , Salimi Y, Feizolahi V, Ramezani G
Acta Chir Orthop Traumatol Cech · 2026 Jan · PMID 41502416 · Publisher ↗
PURPOSE OF THE STUDY: Reconstruction of acetabular posterior wall fractures is challenging. This study evaluates the use of iliac crest graft to reconstruct the posterior wall of the acetabulum. MATERIAL AND METHODS: The...
PURPOSE OF THE STUDY: Reconstruction of acetabular posterior wall fractures is challenging. This study evaluates the use of iliac crest graft to reconstruct the posterior wall of the acetabulum. MATERIAL AND METHODS: The study population included all patients with high-grade acetabular posterior wall fractures who were treated with acetabular posterior wall reconstruction using iliac strut graft. In this study, patients with high-grade acetabular posterior wall fracture (based on Letournel and Judet's classification of acetabular fracture equivalent to grade 2 or 3 and based on AO type A1 classification) were treated with acetabular posterior wall reconstruction using iliac strut patients over 70 years old and under 18 years old were excluded from the study. RESULTS: In this study, 14 patients, 10 men and 4 women, with posterior acetabular wall fractures were treated using the acetabular posterior wall reconstruction method using iliac strut graft. The average age of these patients was 60 years. One patient had evidence of avascular necrosis after 6 months. In all 8 patients, the radiological results showed that the femoral head did not completely match the acetabulum after the operation. The condition of the 48-year-old patient was good to excellent. Three patients under 50 years of age without post-traumatic osteoarthritis at the time of reconstruction had good clinical results and good radiological results. Patients with post-traumatic osteoarthritis at the time of reconstruction had poor clinical and radiological results and sometimes required THA. CONCLUSIONS: The results of this study show that reconstruction of the posterior wall of the acetabulum with iliac crest graft is a suitable option for children or adult patients without post-traumatic osteoarthritis at the time of reconstruction. Mid-term follow-up showed good to excellent clinical results. However, this method is not recommended for adult patients with post-traumatic osteoarthritis during reconstruction. Such patients are likely to require THA.
[Seeking a New Radiological Measure to Predict Rotator Cuff Tears: Investigating the Coracoclavicular Distance in an MRI-Based Study].
Eskara H, Gencer B, Durdi A … +2 more , Aman T, Kurtulmus T
Acta Chir Orthop Traumatol Cech · 2026 Jan · PMID 41502414 · Publisher ↗
PURPOSE OF THE STUDY: Rotator cuff tears are a common disease and various radiological measurement methods are still being investigated to make the diagnosis. The aim of this study was to investigate whether the coracocl...
PURPOSE OF THE STUDY: Rotator cuff tears are a common disease and various radiological measurement methods are still being investigated to make the diagnosis. The aim of this study was to investigate whether the coracoclavicular distance is associated with rotator cuff tears. MATERIAL AND METHODS: Shoulder magnetic resonance imaging (MRI) examinations of 101 patients who underwent shoulder arthroscopy due to rotator cuff tears and 158 patients with normal MRI findings were evaluated retrospectively. Coracohumeral distance, acromiohumeral distance and supraspinatus volume were measured. RESULTS: When the acromiohumeral distance, coracoclavicular distance and supraspinatus volume were compared between the groups, each measurement was found to be statistically significantly lower in the tear group (Group 2) (p<0.001). In the analysis of ROC for the detection of full-thickness supraspinatus tear, the following findings were observed: if the coracoclavicular distance measured less than 12.4mm, a sensitivity of 89% and specificity of 73% were determined. Similarly, if the acromiohumeral distance measured less than 7.5mm, a sensitivity of 73% and specificity of 84% were determined. In full-thickness supraspinatus tears, if the supraspinatus volume measured below 51 cm3, a sensitivity of 89% and specificity of 72% were determined. CONCLUSIONS: Our study, conducted on a limited population, demonstrated that coracoclavicular distance is a significant metric for detecting supraspinatus tears. We believe that we have identified a new parameter that may be useful in the diagnosis of rotator cuff tears.
[Calcifying Aponeurotic Fibroma, a Rare Benign Entity to Consider: a Systematic Review of Literature].
Otera S, Bizzarri M, Pernazza A … +2 more , Zoccali G, Zoccali C
Acta Chir Orthop Traumatol Cech · 2025 Dec · PMID 41502409 · Publisher ↗
PURPOSE OF THE STUDY: Calcifying aponeurotic Fibroma (CAF) is a benign neoplasm that most commonly onsets in the distal extremities during the childhood. It usually presents as a slow growing non-painful mass. The purpos...
PURPOSE OF THE STUDY: Calcifying aponeurotic Fibroma (CAF) is a benign neoplasm that most commonly onsets in the distal extremities during the childhood. It usually presents as a slow growing non-painful mass. The purpose of this study is to carry out a systematic literature review aimed to delineate the main clinical characteristics of this nosologically entity to define the therapeutic approach and outcome. MATERIAL AND METHODS: A systematic literature review was conducted from March to June 2022 using five major databases: PubMed, Scopus, Embase, MEDLINE, and the Cochrane Library. Studies published in English between 1953 and 2022 reporting clinical cases of Calcifying Aponeurotic Fibroma (CAF) were considered. Eligible studies included case reports and case series; non-English articles, animal studies, and papers lacking sufficient clinical detail were excluded. Two independent reviewers screened the studies following PRISMA guidelines. Extracted data included patient demographics, tumor characteristics, clinical presentation, diagnostic method, treatment strategy, histological findings, clinical outcome, and follow-up duration. RESULTS: 74 papers were identified and 44 were considered relying on their title and content. 125 patients in total,49 females and 76 males have been included. The lesions were clinically presented as an indolent mass, sometimes associated with functional impairment and discomfort; the extremities were the most common localization. The diagnosis was made in 35 cases with a biopsy and in 60 cases it was obtained after the histological examination on the entire operating specimen without doing a preoperative biopsy. In the remaining 30 cases, there was no information about biopsy or histological examination. A total amount of 91 cases were surgically treated with wide excision and 68 of those had regular follow-up. The mean follow-up was 46.2 months, and local recurrence was observed in 20 cases of 68 (29.4%). DISCUSSION: Calcifying Aponeurotic Fibroma is a rare benign tumor, typically arising in the distal extremities of children and young adults. Although often indolent, it can exhibit locally aggressive behavior and recur after excision. Atypical sites and extensive forms suggest a broader clinical spectrum than previously recognized. Imaging aids diagnosis, but histological confirmation is essential due to overlap with other pediatric fibromatoses. The tumor shows myofibroblastic differentiation, frequent calcification, and occasional cartilage formation. While wide excision remains the preferred treatment to reduce recurrence, conservative surgery may be considered to preserve function in sensitive locations. Malignant transformation appears anecdotal and unconfirmed. CONCLUSIONS: CAF has been found to be a benign disease that affects both genders with similar frequency; it is rare even if it is probably underestimated. Surgical treatment should be as extensive as possible in order to reduce the risk of local recurrence. Further researches are however necessary to support the evidence provided by this first literature review.
[Minimally Invasive Osteosynthesis with Intramedullary Nail: Evaluation of Outcomes].
Pompach M, Carda M, Boštík P … +3 more , Prchal D, Dráč P, Peml M
Acta Chir Orthop Traumatol Cech · 2026 Jan · PMID 41502395 · Publisher ↗
PURPOSE OF THE STUDY: Fractures of the calcaneus are always very serious injuries that, due to their nature or when inadequately treated, can have permanent consequences. Minimally invasive methods, such as the C-nail, h...
PURPOSE OF THE STUDY: Fractures of the calcaneus are always very serious injuries that, due to their nature or when inadequately treated, can have permanent consequences. Minimally invasive methods, such as the C-nail, help reduce both intraoperative and postoperative risks. The aim of the study is a retrospective evaluation of a group of 260 patients with 280 calcaneus fractures treated surgically with the C-nail in the period from 2011 to 2023. The hypotheses of a lower incidence of postoperative infection, a lower risk of sural nerve injury, and a higher AOFAS functional score need to be confirmed or disproved. Thanks to the higher biomechanical stability of the C-nail and the minimally invasive approach, a lower incidence of postoperative complications is expected. MATERIAL AND METHODS: In the period 2011-2023, 304 patients with 324 calcaneus fractures were operated on using the C-nail. A total of 260 patients were followed up at 12 months after surgery. The values of Böhler's angle and incongruence of the posterior articular surface of the calcaneus were recorded from X-ray and CT documentation immediately after the injury, postoperatively, and 12 months after surgery. Furthermore, complications were monitored, namely the development of infection, neurological symptoms (sural nerve injury), presence of osteoarthritis, and the non-union formation. The functional outcome was assessed 12 months after surgery using the AOFAS (American Orthopaedic Foot and Ankle Society) scoring system. Data from the available medical literature were used as a control set. RESULTS: The patients in the study group underwent surgery at the age between 17 and 75 years. Men represented 88.5% of cases, women 11.5% of cases. A total of 48.0% of patients were smokers and 8.2% were patients with diabetes. The patients were classified based on the CT scan as type I (n=19), type II (n=175), type III (n=62) and type IV (n=24) according to Sanders classification. Eight patients in the group sustained an open calcaneus fractures. The mean Böhler angle measured preoperatively was 7.9°, the Böhler angle measured immediately after surgery was 30.9° on average. A slight decrease to the mean value of 28.6°was observed one year after surgery. Based on the CT scan, the mean preoperative step-off was 6.0mm, while the mean postoperative step-off was 0.9mm. The mean AOFAS score at 12 months after surgery was 91.9 points. DISCUSSION: When analyzing both surgical methods, the study confirmed that the calcaneal nailing method has comparable functional outcomes compared to the open lateral approach and the use of a locking plate. Comparative studies prove higher biomechanical resistance of the calcaneal nail and lower incidence of soft tissue damage than the use of calcaneal plates. Osteosynthesis with a C-nail can be indicated for all types of intra-articular calcaneal fractures. This method can also offer benefits to high-risk patients, for example, to patients with well-controlled diabetes, smokers or elderly patients. The group included cases where nailing was used in open fractures with satisfactory results. As for hypothesis No. 1, the incidence of infection in our study was 0.3% (ELA up to 2.69 %), as for hypothesis No. 2, the incidence of sural nerve injury was 0% (ELA up to 6.25%), and as for hypothesis No. 3, the AOFAS score was 91.9 points (ELA up to 72 points). CONCLUSIONS: Osteosynthesis with a C-nail can be used for all types of intra-articular calcaneal fractures. The aim of the study was to evaluate the X-ray and functional outcome of intramedullary osteosynthesis at 12 months after surgery. A lower incidence of postoperative complications was recorded in the group. The established hypotheses were confirmed, namely a lower incidence of infection, zero percentage of sural nerve injury, and an increased AOFAS functional score. It is a surgical method that produces outcomes comparable to those of the open lateral approach and the use of a locking plate.
[Comparative Analysis of First Metatarsophalangeal Arthrodesis: Implant Survival, Failure Modes, and Functional Outcomes across Three Fixation Techniques].
Jindra J, Apostolopoulos V, Rapi J … +3 more , Kubíček M, Nachtnebl L, Tomáš T
Acta Chir Orthop Traumatol Cech · 2026 Jan · PMID 41502385 · Publisher ↗
PURPOSE OF THE STUDY: First metatarsophalangeal (I. MTP) arthrodesis is a well-established surgical procedure for treating hallux rigidus. Despite its widespread use, the optimal fixation method remains debated. This stu...
PURPOSE OF THE STUDY: First metatarsophalangeal (I. MTP) arthrodesis is a well-established surgical procedure for treating hallux rigidus. Despite its widespread use, the optimal fixation method remains debated. This study compares implant survival, failure modes, and functional outcomes across three fixation techniques: two crossed screws, dorsal plate fixation, and dorsal plate fixation with a lag screw. MATERIAL AND METHODS: A retrospective analysis was conducted on 83 patients (89 fusions) who underwent I. MTP arthrodesis between January 2014 and October 2023. Patients were categorized into three groups based on the fixation method: Group A (two crossed screws, n=31), Group B (dorsal plate, n=29), and Group C (dorsal plate with a lag screw, n=29). Implant survival, failure rates, hardware removal, and clinical outcomes were evaluated using radiographic assessment and the American Orthopedic Foot and Ankle Society-Hallux Metatarsophalangeal Interphalangeal (AOFAS-HMI) scoring system. RESULTS: The overall implant survival rate was 96.54% at one year and 93.98% at ten years. No significant differences in implant survival rates were observed among the three groups. Group C had the highest union rate (93.1%). Asymptomatic pseudoarthrosis was most common in Group B (17.24%). The hardware removal rate was higher in the plate groups (10.34%) compared to the two-screw group (3.1%). The mean AOFAS score was 83.30 (±9.29), with no statistically significant differences between groups. Patient satisfaction was highest in Group C (96.6%) and lowest in Group A (87.1%). CONCLUSIONS: The long-term overall implant survival rate was excellent, with similar survival rates observed across all groups. Functional outcomes, assessed using the AOFAS score, were satisfactory and comparable among the fixation techniques. Hardware removal rates were higher in the groups that utilized plate fixation.
[Surgical Treatment of a Posterior Malleolus Fracture: Literature Review].
Kašák P, Čapek L, Beran T
Acta Chir Orthop Traumatol Cech · 2026 Jan · PMID 41502381 · Publisher ↗
Fractures of the posterior margin of the distal end of the tibia, also referred to as posterior malleolus fractures, represent an important but often underestimated component of ankle injuries. They are rarely isolated b...
Fractures of the posterior margin of the distal end of the tibia, also referred to as posterior malleolus fractures, represent an important but often underestimated component of ankle injuries. They are rarely isolated but rather occur as part of more complex fractures classified as Weber type B and C, or they accompany high-energy pilon tibial fractures and spiral fractures of the tibial shaft. In recent decades, there has been a significant shift in the understanding of biomechanical importance of the posterior malleolus, which plays a key role in maintaining the stability of the distal tibiofibular syndesmosis and preserving the congruency of the ankle joint surface. Indications for surgical treatment as well as surgical approaches and fixation techniques have changed dramatically. This review article aims to summarize current knowledge of these fractures, with a focus on anatomy, diagnosis, classification, and particularly surgical treatment options, including the choice of approach and methods of fragment reduction. The literature search was conducted in the PubMed and Web of Science databases, focusing on publications released before the end of 2024. The search included the following keywords: "posterior malleolus fracture," "posterior tibial margin," "ankle fracture," "CT classification," "syndesmosis injury," and "surgical fixation." Original clinical studies, review articles, anatomical and biomechanical studies as well as case reports that provide clinically relevant information on the diagnosis and surgical management of these fractures were included in the review. The introduction of CT imaging has significantly contributed to a better understanding of the morphology of the posterior margin and led to the development of new classification systems (Haraguchi, Bartoníček and Rammelt, Mason), which serve as a guide in selecting the optimal surgical approach. Fixation of the posterior malleolus has a positive effect on ankle and syndesmotic stability even in small fragments. The choice of surgical approach is individualized - the posterolateral, posteromedial, transfibular, or modified lateral approach are used most commonly. Direct reduction and stabilization of the fragment allow for more accurate restoration of the joint surface and are associated with a lower risk of secondary displacement compared to indirect fixation. Surgical treatment of posterior tibial margin fractures should rely on a precise CT scan-based diagnosis and careful assessment of fracture morphology. Direct visualization, anatomical reduction, and fixation of the fragment provide better clinical and functional outcomes and should be preferred in displaced or complex fractures.
[Efficacy of Intra-Articular Platelet-Rich Plasma in Knee Osteoarthritis: a Systematic Review and Meta-Analysis].
Sloviak M, Štefančík M, Gallo J
Acta Chir Orthop Traumatol Cech · 2025 Dec · PMID 41502222 · Publisher ↗
PURPOSE OF THE STUDY: The treatment of knee osteoarthritis (KOA) must be comprehensive and personalised. Administration of platelet-rich plasma (PRP) is one of the interventions that has been investigated for a long time...
PURPOSE OF THE STUDY: The treatment of knee osteoarthritis (KOA) must be comprehensive and personalised. Administration of platelet-rich plasma (PRP) is one of the interventions that has been investigated for a long time. Professional medical societies have so far failed to adopt a clear and consistent stance on this therapy, despite a number of randomized clinical trials (RCTs) conducted in the past. The aim of our review was to evaluate the results of RCTs published over the last 5 years. We do believe that a meta-analysis based on the best of the available studies will help articulate the national position on this treatment modality. MATERIAL AND METHODS: Our review covers all RCTs evaluating the effect of PRP on KOA that were published between 2020 and 2024. PubMed, OVID and Scopus databases were searched for the relevant data. The effect of PRP administration was evaluated using the total WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index), VAS (Visual Analogue Scale) pain and IKDC (International Knee Documentation Committee) scores at time periods up to 6 weeks, at 3 and 6 months. The level of bias was assessed with the use of the Cochrane Risk of Bias 2. Cochrane RevMan Web was used for data analysis. The guidelines of PRISMA 2020 (Preferred Reporting Items of Systematic Reviews and Meta-Analyses) were followed. RESULTS: Eighteen RCTs with a total of 971 patients were included in the meta-analysis. The meta-analysis revealed that the patients with KOA reported a systematic subjective improvement seen on the WOMAC, IKDC and VAS pain scores after intra-articular administration of PRP. Importantly, the results reached their peak and the values exceeded the minimal clinically important difference at 3 and 6 months after administration. When compared to placebo and hyaluronic acid, the intra-articular administration of PRP achieved better results. DISCUSSION AND CONCLUSIONS: Intra-articular administration of PRP in the treatment of KOA is a popular treatment modality appreciated by orthopaedic surgeons, rheumatologists as well as patients. Depending on the initial assessment, the PRP treatment offers pain relief for up to 12 months after administration, together with a marked improvement in function of the affected knee. Even though the PRP is frequently administered in the clinical practice, it is not recommended by prestigious professional medical societies because of its relatively small effect and the absence of knowledge concerning the optimal patient responding reliably to this method. In our study, however, a consistent pain relief and functional improvement was shown in KOA patients after the PRP administration, experienced over a period of months. We therefore assume that based on our findings the Czech Society for Orthopaedics and Traumatology and the Czech Society of Rheumatology could enlist PRP among the recommended non-operative KOA treatment modalities.
[Ultrasound-Guided Interventions for the Ankle and Foot].
Novotný T, Mezian K, Naňka O
Acta Chir Orthop Traumatol Cech · 2025 Aug · PMID 40878604 · Publisher ↗
Ultrasound-guided interventions for the ankle and foot offer precise treatment for musculoskeletal conditions. This article reviews injections of the talocrural joint, first metatarsophalangeal joint, Achilles tendon (vi...
Ultrasound-guided interventions for the ankle and foot offer precise treatment for musculoskeletal conditions. This article reviews injections of the talocrural joint, first metatarsophalangeal joint, Achilles tendon (via stripping and retrocalcaneal bursa injections), plantar aponeurosis, and tibialis posterior tendon, detailing probe selection, patient positioning, and procedural techniques. Precise needle guidance is emphasized to prevent complications like nerve injury and tendon rupture. Text is supplemented with anatomical notes.
[Ultrasound-Guided Interventions for the Knee].
Novotný T, Mezian K, Naňka O
Acta Chir Orthop Traumatol Cech · 2025 Aug · PMID 40878603 · Publisher ↗
Ultrasound imaging of the knee is a highly valuable modality that enhances diagnostic accuracy and optimizes the precision of injection therapy. This article reviews the application of ultrasound in various knee interven...
Ultrasound imaging of the knee is a highly valuable modality that enhances diagnostic accuracy and optimizes the precision of injection therapy. This article reviews the application of ultrasound in various knee interventions, including intra-articular injections, treatments for prepatellar bursitis and patellar ligament tendinopathy, pes anserinus, iliotibial band procedures, and guidance for popliteal fossa pathologies. Detailed guidance is provided on probe selection, patient positioning, and procedural techniques for specific anatomical targets. Key considerations include optimizing needle placement using in-plane and out-of-plane techniques, ensuring accurate interventions, minimizing risks such as cartilage injury or vascular complications, and achieving effective therapeutic delivery. Text is supplemented with anatomical notes.
[Ultrasound-Guided Interventions for the Hip].
Novotný T, Mezian K, Naňka O
Acta Chir Orthop Traumatol Cech · 2025 Aug · PMID 40878602 · Publisher ↗
Ultrasound imaging of the hip is a highly valuable modality that enhances diagnostic precision and facilitates injection therapy with remarkable accuracy. This article reviews the use of ultrasound in various hip interve...
Ultrasound imaging of the hip is a highly valuable modality that enhances diagnostic precision and facilitates injection therapy with remarkable accuracy. This article reviews the use of ultrasound in various hip interventions, including intra-articular injections, iliopsoas and trochanteric bursa treatments, lateral femoral cutaneous nerve blocks, and interventions for adductor and hamstring tendinopathies. Comprehensive guidance is offered on probe selection, patient positioning, and step-by-step procedural protocols tailored for specific conditions and anatomical targets. Key aspects include optimizing needle placement using in-plane and out-of-plane techniques, minimizing procedural risks such as neurovascular injury, and ensuring effective delivery of therapeutic agents. Text is supplemented with anatomical notes.
[Ultrasound-Guided Interventions for the Wrist and Hand].
Mezian K, Novotný T, Naňka O
Acta Chir Orthop Traumatol Cech · 2025 Aug · PMID 40878601 · Publisher ↗
Ultrasound-guided interventions for the wrist and hand provide valuable therapeutic options for managing various conditions. This article reviews common procedures including injections into the radiocarpal joint, first m...
Ultrasound-guided interventions for the wrist and hand provide valuable therapeutic options for managing various conditions. This article reviews common procedures including injections into the radiocarpal joint, first metacarpophalangeal joint, ganglions, and tendon sheaths, as well as the interventional management of De Quervain's tenosynovitis, trigger finger, and carpal tunnel syndrome. Detailed instructions are provided on probe selection, patient positioning, and procedural techniques tailored to each anatomical target. The importance of careful needle placement, and appropriate risk management is emphasized. Risks such as nerve injury, tendon rupture, and damage to adjacent structures are considered. Advanced techniques like hydrodissection in carpal tunnel syndrome are also described. Text is supplemented with anatomical notes.
[Ultrasound-Guided Interventions for the Elbow].
Novotný T, Mezian K, Naňka O
Acta Chir Orthop Traumatol Cech · 2025 Aug · PMID 40878600 · Publisher ↗
Ultrasound imaging of the elbow is an invaluable tool that enhances diagnostic precision and facilitates therapeutic procedures with high accuracy. Compared to palpation-guided techniques, ultrasound-guided interventions...
Ultrasound imaging of the elbow is an invaluable tool that enhances diagnostic precision and facilitates therapeutic procedures with high accuracy. Compared to palpation-guided techniques, ultrasound-guided interventions significantly improve precision. This article reviews ultrasound-guided techniques for elbow joint interventions, including intra-articular injections, tennis elbow, golfer's elbow, triceps and distal biceps tendinopathy, and ulnar nerve neuropathy. Practical guidance is provided on probe selection, patient positioning, and step-by-step procedural details. Special emphasis is placed on optimizing needle placement and minimizing risks such as nerve injury or other inadvertent damage. Ultrasound-guided procedures represent a pivotal advancement in conservative orthopedics and rehabilitation, enabling precise treatment delivery and improving patient outcomes. Text is supplemented with anatomical notes.
[Ultrasound-Guided Interventions for the Shoulder].
Mezian K, Novotný T, Naňka O
Acta Chir Orthop Traumatol Cech · 2025 Aug · PMID 40878599 · Publisher ↗
Ultrasound imaging of the shoulder is a highly valuable modality that enhances diagnostic accuracy and facilitates precise injection therapy for a variety of shoulder conditions. This article provides a review of ultraso...
Ultrasound imaging of the shoulder is a highly valuable modality that enhances diagnostic accuracy and facilitates precise injection therapy for a variety of shoulder conditions. This article provides a review of ultrasound-guided interventions, including intra-articular injections of the glenohumeral joint, subacromial-subdeltoid bursa, injections into the biceps tendon recess, and acromioclavicular joint. Comprehensive guidance is presented on probe selection, patient positioning, and step-by-step procedural protocols tailored to specific anatomical targets. Emphasis is placed on optimizing needle placement using in-plane and out-of-plane techniques, minimizing risks such as neurovascular injury or inadvertent intratendinous injection, and ensuring effective delivery of therapeutic agents. Additional considerations include the use of advanced techniques like capsular hydrodilatation in management of adhesive capsulitis. Text is supplemented with anatomical notes.
[Introduction to Ultrasound-Guided Musculoskeletal Interventions].
Mezian K, Novotný T, Naňka O
Acta Chir Orthop Traumatol Cech · 2025 Aug · PMID 40878598 · Publisher ↗
The text is an introduction to six articles on ultrasound-guided musculoskeletal interventions for the major extremity joints. Each article provides a detailed overview of injections for the shoulder, elbow, wrist and ha...
The text is an introduction to six articles on ultrasound-guided musculoskeletal interventions for the major extremity joints. Each article provides a detailed overview of injections for the shoulder, elbow, wrist and hand, hip, knee, ankle, and foot. The text of this manuscript emphasizes general advantages, techniques, and practical considerations of ultrasound guided injections. It highlights the benefits of ultrasound guidance over traditional palpation-based methods, emphasizing improved accuracy, safety, and therapeutic efficacy. Various ultrasound-guided techniques, including in-plane and out-of-plane needle approaches and indirect marking methods, are discussed. Key factors influencing procedural success, such as needle visibility optimization, proper ultrasound settings, and aseptic precautions, are explored in detail. Additionally, the article briefly describes training methods for mastering ultrasound-guided injections.
Thoracomelia in Poland Anomaly.
Sagerfors M, Thórdardóttir Á, Widehammar C
Acta Chir Orthop Traumatol Cech · 2025 Aug · PMID 40878456 · Publisher ↗
Poland Anomaly (PA) represents pectoral muscle hypoplasia in combination with various forms of hand anomalies. We report a case of PA with pectoral hypoplasia, an upper limb deficiency and an accessory extremity/digit on...
Poland Anomaly (PA) represents pectoral muscle hypoplasia in combination with various forms of hand anomalies. We report a case of PA with pectoral hypoplasia, an upper limb deficiency and an accessory extremity/digit on the ipsilateral thoracic wall (thoracomelia). To our knowledge, this is the first reported case of thoracomelia in PA.
Chronic Instability following Isolated Subtalar Dislocations: a Case Series and Proposal for Routine MRI.
Abul MS, Sevim ÖF, Güneş HM … +2 more , Hekim Ö, Eceviz E
Acta Chir Orthop Traumatol Cech · 2025 Aug · PMID 40878455 · Publisher ↗
PURPOSE OF THE STUDY: Subtalar dislocations are rare orthopedic emergencies characterized by simultaneous dislocation of the talocalcaneal and talonavicular joints without an associated talar neck fracture. While these i...
PURPOSE OF THE STUDY: Subtalar dislocations are rare orthopedic emergencies characterized by simultaneous dislocation of the talocalcaneal and talonavicular joints without an associated talar neck fracture. While these injuries are commonly managed with closed reduction and immobilization, they are often associated with chronic instability and other long-term complications due to underdiagnosed soft tissue injuries.This study aims to evaluate the role of magnetic resonance imaging (MRI) in the management of isolated medial subtalar dislocations and propose a routine MRI protocol to predict and address chronic instability. MATERIAL AND METHODS: A prospective case series was conducted, including 13 patients with isolated medial subtalar dislocations. All patients underwent MRI to assess soft tissue injuries, particularly the calcaneofibular ligament (CFL) and anterior talofibular ligament (ATFL). Functional outcomes were evaluated using the Visual Analog Scale (VAS) for pain and the American Orthopaedic Foot & Ankle Society (AOFAS) scores. RESULTS: MRI identified complete or partial tears of the CFL and ATFL in the majority of patients. Patients with complete ligament tears reported worse outcomes, with lower AOFAS scores and higher VAS pain scores, compared to those with partial or no ligament involvement. Conservative management was effective in mild cases, while surgical reconstruction was required for patients with significant instability. CONCLUSIONS: Routine MRI in the management of isolated subtalar dislocations enhances the detection of soft tissue injuries, facilitating timely interventions and reducing the risk of chronic instability. Integration of MRI into the diagnostic and follow-up protocol for improved patient outcomes.
[Inclusion of AMIS surgical approach in the Methods Used for Total Hip Arthroplasty: Learning Curve, Risks, Surgical Technique].
Palásek P, Pastucha M
Acta Chir Orthop Traumatol Cech · 2025 Aug · PMID 40878454 · Publisher ↗
PURPOSE OF THE STUDY: The study aims to point out the risks and matters associated with the inclusion of a new anterior approach in total hip replacement methods and to determine when and whether the values of investigat...
PURPOSE OF THE STUDY: The study aims to point out the risks and matters associated with the inclusion of a new anterior approach in total hip replacement methods and to determine when and whether the values of investigated parameters would come close to those of the established surgical technique. Another aim was to compare the blood loss in AMIS and DLA approaches. MATERIAL AND METHODS: The study covers 62 total hip arthroplasties in a breakdown by surgical approach. It investigated the progress of the entire surgical team - surgeon's learning curve, time curve of preparation for surgery, placement of the acetabular component, blood loss, and postoperative haemoglobin drop. The control group consisted of patients in whom the established surgical technique, i.e. the direct lateral approach, was used. The component placement was assessed on standard centered AP view radiographs of the operated joint by using the ellipse method to calculate the Liaw's anteversion and inclination. RESULTS: A total of 62 surgeries were included in the study. The AMIS group (31 surgical procedures) was composed of 19 women and 12 men, with the mean age of 70 years. The preparation of the operating field took 11.5 minutes on average and the duration of surgery from incision to suture was 66 minutes. The blood loss reached 295 ml, with the mean Hb drop of 16 g/l. The mean anteversion and inclination were 22° and 43°, respectively. The DLA group (31 surgical procedures) was composed of 14 women and 17 men, with the mean age of 67.5 years. The preparation of the operating field took 8 minutes on average and the duration of surgery from incision to suture was 53 minutes. The blood loss reached 300 ml, with the mean Hb drop of 21 g/l. The mean anteversion and inclination were 17° and 43°, respectively. The duration of the 1st to 10th AMIS surgeries was 80 minutes; the duration of the 11th to 20th surgeries was 58 minutes; and in the case of the 21st to 31st surgeries it was 55 minutes. CONCLUSIONS: The results showed that there is no need to worry about an excessively long learning curve of the surgeon and the entire team when introducing a new surgical procedure as long as they have a positive attitude thereto. The data obtained in other countries reveal that the AMIS approach is on the rise ever more often. The authors therefore hope that this study will contribute to its widespread adoption.
There Is a Difference in Patients' Opinions and Scientific Evidence Regarding Robot Assisted Total Joint Arthroplasty: a Questionnaire.
Uzel K, Azboy N, Başarir KE … +3 more , Kiliçkap AE, Bayin SB, Azboy I
Acta Chir Orthop Traumatol Cech · 2025 Aug · PMID 40878453 · Publisher ↗
PURPOSE OF THE STUDY: This study aimed to evaluate patients' knowledge and opinions about robotic total hip arthroplasty (THA) and total knee arthroplasty (TKA). MATERIAL AND METHODS: In order to assess patients' knowled...
PURPOSE OF THE STUDY: This study aimed to evaluate patients' knowledge and opinions about robotic total hip arthroplasty (THA) and total knee arthroplasty (TKA). MATERIAL AND METHODS: In order to assess patients' knowledge and opinions about robotic THA and TKA surgery, a descriptive questionnaire consisting of a total of 17 questions assessing patients' demographic information (age, gender, education level, occupation, income level, marital status) and their knowledge and opinions about robotic surgery was designed and applied to 200 participants by face-to-face interviews. RESULTS: The mean age of participants was 62.6 ± 7.1 years (range: 43-82), with 53% female. Among participants, 39% were university graduates, 9% were healthcare professionals, and 61.5% had an income between 10,000-20,000 Turkish lira. 60% (n = 120) had information about robotic surgeries, primarily sourced from newspapers, TV (35%), and social media (33%). 68.3% believed robotic surgery positively impacts surgical outcomes, and 77.5% preferred robotic surgery for knee and hip procedures. Those informed via social media had a mean age of 57.6 ± 6.5 years, while those informed through patient recommendations had a mean age of 64.0 ± 6.9 years (p = 0.001). Higher education levels correlated with increased knowledge of robotic surgery (p = 0.001), as did private-sector employment and higher income (p = 0.001, p = 0.001). CONCLUSIONS: This study is an important step to understand the awareness and attitudes of robotic surgery among patients. There is a difference between the level of knowledge of the participants about robotic surgery and real scientific facts. Lack of knowledge and misconceptions about robotic surgery may affect patients' decision-making processes. Orthopaedic surgeons has responsibility to evaluate the new technological products in the light of strong scientific evidence when recommending to their patients. Also, media sources and social media platforms should maintain accurate information on emerging technologies.
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