Papers by Sanamed Medical journal
Urinary infections are, by frequency, in the second place, immediately behind respiratory infecti... more Urinary infections are, by frequency, in the second place, immediately behind respiratory infections. The prevalence of urinary tract infections is generally increasing. UTI (urinary tract infections) is more common in women and very young people. The rates of occurrence generally reflect predisposing factors such as congenital anomalies in childhood, the onset of sexual activity, especially in women, and, of course , postmenopausal changes in older women. It is assumed that 50-60% of women can expect an episode of urinary infection during their lifetime. In postmenopa-usal women, there is a deficit in estrogen. It is one of the important factors that indirectly protects the vagi-nal mucous membranes as well as the uroepitel from infection. Bacteria from the digestive tract colonize the skin of the perineum, then the vulva, the vagina and the outer opening of the urethra. Normal vaginal flora (lac-tobacilli) protects the vagina from colonization by fe-cal bacteria because it lowers pH and creates unfavorable conditions for survival of bacteria.
Introduction: Accessory liver lobes (ALL) are defined as supranumerary liver lobes, composed of n... more Introduction: Accessory liver lobes (ALL) are defined as supranumerary liver lobes, composed of normal liver parenchyma in continuity with the liver, in contrast to ectopic liver lobes (ELL) that have no anatomical continuity with the normal liver. Case report:In this article we report on a rare radiological diagnosis of an synchronous accessory and ectopic liver lobe using ultrasonography (US) and computed tomography (CT). A 59-year-old female with no symptoms was admitted to our hospital due to preventive exam. Abdominal ultrasonography revealed a high echoic 6cm x 5cm soft tissue area in right anterior subhepatic space with distinct margins, a uniform echo and blood flow and was suspected to be abdominal tumor. An enhanced abdominal computed tomography (CT) showed the irregular 65mm x 48mm x 32mm mass in the right hypochondrium below IV and V liver segment with clear margins, a uniform density, texture and contrast enhancement as normal liver tissue. In same patient CT also showed small 16mm x 12mm mass in posterior mediastinum in right retrocrural space so diagnosis of accessory and ectopic liver lobe was confirmed. An accessory liver lobe is adjacent and attached to the liver by its own mesentery, while an ectopic liver lobe is one that is completely detached from the normal liver parenchyma. Conclusion:Ultrasound can show mass in the abdomen, which is most commonly in the subhepatic area, but very rarely can initially diagnose ALL or ELL due to different echogenicity of the liver parenchyma in different acoustic windows. In the case of an atypical CT presentation, an MR examination of the abdomen is indicated but it is very rarely. Fast and accurate radiological diagnosis of ALL and ELL is important in the prevention of unnecessary invasive diagnostic procedures such as laparotomy and thoracotomy which are needed only in cases of complications.
Introduction: Although pleural effusion is a common clinical manifestation, the differential diag... more Introduction: Although pleural effusion is a common clinical manifestation, the differential diagnosis of the cause of the pleural effusion is often challenging , especially in the early differentiation of tuber-culous pleurisy (TP) from other pleural effusion. Case report: We present a previously healthy man who had no contagious or TB contact but developed massive tuberculous pleural effusion which eventually was unexpected tuberculous. He started with therapy per protocol and feeling well. The purpose of this case and review of literature was to remind the physicians that tuberculosis is not a sickening illness, but on the contrary, it is in the expansion. Discussion: When a patient presents with new pleural effusion, the diagnosis of tuberculous pleuritis should be considered. The patient is at great risk for developing pulmonary or extra pulmonary TB if the diagnosis is not made properly. Between 3% and 25% of patients with TB will have TB pleuritic or more in im-munocompromised patients.The treatment for TB ple-uritis is the same as that for pulmonary TB. Conclusion: The gold standard for the diagnosis of tuberculous pleural effusion remains the detection of Mycobacterium tuberculosis in pleural fluid, or ple-ural biopsy specimens, either by microscopy and/or culture, or the histological demonstration of caseating granulomas in the pleura along with acid fast bacilli.
Melanoma is an aggressive malignant tumor that originates from melanocytes and most commonly occu... more Melanoma is an aggressive malignant tumor that originates from melanocytes and most commonly occurs on the skin. Dominantly metastasize to regional lymph nodes, in the brain and lungs and rarely in the gastrointestinal (GI) system. The aim of this report is to present a rare case of metastasis of cutaneous malignant melanoma in the gallbladder, discovered 10 months after excision of the primary melanoma of the skin. A 45-year-old patient was hospitalized in our hospital due to abdominal pain in right upper quadrant and nausea lasting for 7 days. An intraluminal substrate was found in the gallbladder with computed tomogra-phy and later a CT guied biopsy was performed on it, thus proving a metastatic deposit of primary malignant melanoma. Metastatic deposits in the gallbladder are extremely rare finding, and 238 cases have been described in the literature.
Rotation anomalies are usually anomalies seen in children. It is a rare condition in adults. In t... more Rotation anomalies are usually anomalies seen in children. It is a rare condition in adults. In this article, 4 cases are presented. In the first case, reverse rotation anomaly and appendicitis perforation were detected in a patient who had laparotomy at the age of 22 with acute abdomen. It is a unique condition that the patient had a history of previous appendec-tomy. Ladd band may be the cause of acute abdomen due to ileus. The patient in our second case presented a concurrent biliary stone and malrotation with Ladd band. In addition, two elderly patients who underwent hemicolectomy due to intestinal ileus caused by malro-tation were presented with literature review.
Introduction: Patient presents with ear, nose and throat diseases in ENT OPD to otolaryngolo-gist... more Introduction: Patient presents with ear, nose and throat diseases in ENT OPD to otolaryngolo-gist/ENT specialist. ENT diseases are serious public health problems because of their universal distribution the morbidities which they cause due to inherent physiological function that take place in head and neck region. Objectives of our study were to know frequency of ENT diseases in patients presenting at ENT OPD at Ayub Teaching Hospital Abbottabad. Methods: A cross sectional study was done in Ayub Teaching Hospital Abbottabad from December 2015. to August 2016. Patients presenting at ENT OPD of Ayub Teaching Hospital Abbottabad were selected for study. Data about their ENT problems and concerned information were collected from them through well structured questionnaire. Data after collection was entered and analysed using SPSS-16. Results: The minimum age is 1 and maximum age is 80 years. Out of total 250 patients, 129 (51.6%) were males and 121 (48.4%) were females, majority of patients 181 (72.4%) were from Abbottabad and majority of patients 165 (66.0%) were poor. The most common cases in ENT OPD were bilateral ear wax 15.2% followed by acute otitis media 13.2% and allergic rhinitis 13.2%. Conclusion: It is concluded from our research that most common problems of ENT disorders are bilateral ear wax, allergic rhinitis, acute otitis media, chronic supporative otitis media and deviated nasal septum. The most common causes are infection, poor hygiene and poor nutrition.
Background and Aim: Acute upper gastrointestinal bleeding (AUGIB) is one of the most common medic... more Background and Aim: Acute upper gastrointestinal bleeding (AUGIB) is one of the most common medical emergencies. Early detection of at-risk patients is beneficial with respect to treatment and prognosis. We investigated whether severity of ulcers were associated with red blood cell distribution width (RDW), plateletcrit (PCT), mean platelet volume (MPV) and platelet distribution width (PDW). Materials and Methods: All patients presenting to the emergency department with AUGIB between January 2014 and December 2017 were included in the study. Endoscopy reports, complete blood counts, patient demographic characteristics, and endoscopy results were obtained retrospectively from hospital records. Patients with grade I or grade II ulcers (based on the For-rest classification) were compared in regard to these parameters. Results: In total, 373 male and 211 female patients with a mean age ± SD of 66.36 ± 17.36 were included in this study. Ulcers were detected in 396 of 584 patients (67.8%). There were no differences with respect to RDW or platelet indices between groups. Conclusions: Patients presenting with AUGIB should receive rapid diagnosis and treatment. In this study of patients with AUGIB grouped by bleeding ae-tiology, probable early prognostic parameters were not associated with bleeding severity among patients diagnosed with gastric or duodenal ulcers.
Purpose: To evaluate the incidence of posterior capsular opacification after cataract surgery in ... more Purpose: To evaluate the incidence of posterior capsular opacification after cataract surgery in patients on hemodialysis. Patients and Methods: Fifty patients on hemodialysis undergoing cataract surgery and 50 patients undergoing cataract surgery in a similar age group without any systemic disease were compared retrospectively. All patients underwent uneventful phacoemulsification surgery. Hydrophilic mo-noblock, sharp-edged acrylic intraocular lens (Spectra-fold™, Gujarat, India) was used. A complete ophthal-mological examination was performed on the patients who were evaluated at the postoperative 12th month follow-up examination. Posterior capsular opacifica-tion was evaluated by the retroillumination method. According to the reflection from retroillumination, cases with posterior capsular opacification were divided into three groups as mild, moderate and severe. Results: Age groups and male to female ratios were similar. Mean best corrected visual acuity (BCVA) was 0.23 in the hemodialysis group and 0.22 in the control group, preoperatively. At the end of the first year, the mean BCVA was 0.88 in the hemodialysis group and 0.94 in the control group. In the hemodialysis group, the percentage of posterior capsular opacification was 60% and was 14% in the control group; this difference was statistically significant (p < 0.05). While the capsular opacity was mild in all 7 patients in the control group, it-was mild in 19 patients, moderate in 8 and severe in 3 patients in the hemodialysis group. Conclusion: The incidence of posterior capsular opacification after uneventful cataract surgery is found to be higher in patients on hemodialysis than in the normal population.
Introduction: Cervical cancer is the second most common cancer in women worldwide and in Nigeria.... more Introduction: Cervical cancer is the second most common cancer in women worldwide and in Nigeria. Human papilloma virus (HPV), has been implicated as the causative agent of cervical cancer. The fact that HPV vaccination can prevent the occurrence of this deadly cancer is well established. Though the vaccine has been licensed in Nigeria since 2009 with widespread availability, it is yet to be included in National immunization program in Nigeria. This study aimed to assess the predictors and acceptability of the HPV vaccine among senior secondary girls in Ile-Ife. Methods: This descriptive cross-sectional study recruited 400 students randomly selected from various secondary schools in Ife central-local government. The data was collected with the use of a pre-tested interviewer administered questionnaire on knowledge, attitude , and acceptability of cervical cancer, HPV and HPV vaccine. Data were analyzed using descriptive and in-ferential statistics. Results: Most respondents (93.2%) had poor knowledge of cervical cancer, HPV and HPV vaccine. Attitude towards cervical cancer and HPV vaccine was good and the majority (74.5%) had high acceptability for the HPV vaccine. Only 2.8% of the respondents have been vaccinated. Predictors of acceptability of HPV vaccine were younger age group ((AOR) 4.05, CI = 2.30-5.45), good knowledge ((AOR = 2.50, CI = 2.31-6.83), mother' higher level of education (AOR = 1.55, CI = 2.62-4.58), perceived fatality of cervical cancer (AOR = 4.13, CI = 1.49-4.19) and perceived efficacy of the HPV vaccine (AOR = 1.57, CI = 0.49-3.18). Conclusions: The knowledge of secondary school girls in the study area on cervical cancer, HPV and HPV vaccine is poor though the HPV vaccine acceptability is high. The high acceptability of the vaccine in this study is a reflection of the willingness of this vulnerable group to learn more about the subject matter. There is the need to create school health programs that will focus on health educating the students on this preventable cancer and the available vaccine. Including HPV vaccine into National immunization program in Nigeria may also improve awareness of cervical cancer and the vaccine uptake.
Introduction: In this retrospective study, it was aimed to evaluate the correlation between opera... more Introduction: In this retrospective study, it was aimed to evaluate the correlation between operative treatment results and clinical and radiological findings of tibial plateau fractures. Patients and Methods: Between 1996 and 2006, 33 knees were operated for tibia plateau fracture of 32 patients. 29 patients were male and 3 were female. Only 3 cases (9.99%) were open tibial plateau fractures. The mean age was 45 years. Fractures classified using the Schatzker classification were: 17 (52%) type 1, 12 (12%) type 2, 9 (27%) type 5 and 6 (9%) type 6. Patients following the period were at least 44 weeks and maximum 480 weeks (mean 60 weeks). Results: The results of 33 patients were determined by the clinical and radiological system of Ras-mussen. According to clinical findings, 17 cases were excellent, 9 were good, 6 were medium and 1 was poor. According to the radiological findings, 9 cases were excellent, 16 were good, 6 were medium and 2 were bad. The difference between clinical and radiological findings was analyzed with Pearson core analysis and statistically significant (p < 0.005). Comparison was made according to the time between injury and operation and no statistically significant difference was found (p > 0.005). The analyzes of the grade of fracture and the degree of fracture were statistically significant (p < 0.005). 42.4% of all patients had meniscus injury. Therefore, arthroscopy should be used with surgery. Conclusion: Anatomic reduction, rigid fixation of the joint and early mobilization can reduce complications and improve the function of the knee joint in ti-bial plateau fractures.
Sanamed, 2019
Silver nanoparticles (AgNPs) are being used extensively for biomedical purposes regarding to thei... more Silver nanoparticles (AgNPs) are being used extensively for biomedical purposes regarding to their broad antimicrobial activity, however their toxicity has been addressed in only few studies. In the present study, we aimed to prepare and characterize AgNPs, investigate their adverse effect on liver and kidney functions, and also elucidate the hepato-nephro protective ability of tannic acid in male rats. The obtained results showed that AgNPs caused oxidative stress throughout the induction of thiobarbituric acid-reactive substances (TBARS) and the reduction of the activities of antioxidant enzymes (GST, SOD, CAT, GPx) and the levels of glutathione. Hepatic markers enzymes (AST, ALT, ALP, ACP, LDH and GGT), total bilirubin, urea, creatinine and lipid profile were increased, while hematological parameters were decreased. Histopathological investigations indicated marked degeneration of hepatocytes, endothelial cells of renal which with its role has confirmed the hepatotoxicity and nephrotoxicity induced by AgNPs. The presence of tannic acid along with AgNPs showed obvious improvements in the injured liver and kidney tissues. The protective effect of tannic acid against the toxicity of AgNPs might be due to its antioxidant properties and scavenging abilities against active free radicals.
Application of home mechanical ventilators represents the future in the treatment of children wit... more Application of home mechanical ventilators represents the future in the treatment of children with chronic respiratory insufficiency. In this way patients are treated in the home environment, they have full support from their families, they are protected against nosocomial infections and their condition is monitored by medical staff. The role of regional centers is very important in the future development of the home mechanical ventilation network. Doctors in these centers under the full support of the University Children's Hospital physicians can assist and monitor the treatment of children on the household respirators.
Multiple myeloma is a malignant disorder of plasma cells, characterized by uncontrolled and progr... more Multiple myeloma is a malignant disorder of plasma cells, characterized by uncontrolled and progressive proliferation of a single clone of plasma cells. The disease leads to progressive morbidity and eventual mortality by lowering resistance to infection and causing significant skeletal destruction with bone pain, pathological fractures and hypercalcemia. Improved understanding of the multiple myeloma biology along with the discovery of novel anti-myeloma agents has led to a better-quality treatment of these patients. However, it still remains an incurable disease for the vast majority of patients, with a median survival 2-3 years. Patients with multiple myeloma frequently develop complications that are reason for early mortality within 60 days of diagnosis. Acute complications such as hyperviscosity syndrome, hypercalcemia, spinal cord compression, early infection, bone disease and re-nal impairment may be life-threatening. The treatment of these medical emergencies has greatly decreased morbidity and early mortality in patients.
Introduction: The pathogen of multivi-sceral echinococcosis is the same agent as for single organ... more Introduction: The pathogen of multivi-sceral echinococcosis is the same agent as for single organ echinococcosis: Echinococcus granulo-sus.According to the consensus of experts under the aegis of the WHO-IWGE-WHO-Informal Working Group on Echinococcosis options of treatment should be: (1) percutaneous treatment, (2) surgery, (3) anti-in-fective drug treatment or (4) watch and waitapproach or combinations thereof. Case report: The presented case was a seven-year-old Caucasian boy, a permanent resident of rural region near Tuzla, Bosnia and Herzegovina, who had a history of asymptomatic giant liver and small lung hydatid cyst (multivisceral echinococcosis). We consider that the patient was in the phase of secondary hyda-tidosis even before undergoing the first treatment PAIR method of liver and continued with adjunctive chemot-herapy. Two weeks after discharge, during the adjunc-tive chemotherapy he had one of possible complication where pre-existed smal lung hydatid cyst got inflamed and performed an abscess mass and potential septic risk, which required surgical and antibiotic treatment. Surgery and early postoperative course were normal and the patient was discharged with recommendation to continue with previously started adjunctive chemot-herapy (Albendazol) according to treatment protocol. Conclusion: Most infected persons are asympto-matic and clinical manifestations vary according to the anatomic location of the cyst, so we want to indicate the importance of routine ultrasound screening of preschool children, and eventually X ray chest scan.This case report highlights the necessity of caution with choosing appropriate treatment, even though size of cyst can be irrelevant to take surgical treatment in first line instead of medical therapy.
Introduction: Revision knee arthroplasty is not a routine procedure and almost always it is a tec... more Introduction: Revision knee arthroplasty is not a routine procedure and almost always it is a technically demanding operation. The paradigm in revision total knee arthroplasty is to achieve correct alignment of the components, maintenance of the joint space and ligament balance by providing a stable bone – implant fusion. Metaphyseal bone loss is a crucial problem in revision total knee arthroplasty. The bone loss is due to primary arthroplasty technical errors and design, or problematic removal of the implants.
Aim: The aim of this article is to present our experience on total knee revision surgery using tantalum metal cones as a structural bone graft substitute in total arthroplasty failure with gross metaphyseal bone loss categorized by the AORI classification, performed by a specific surgical technique and evaluated by the Knee Society Score (KSS).
Material and methods: From 2013 to 2016 at the University Clinic for Orthopedic Surgery in Skopje 21 patient has been treated with revision total knee arthroplasty. Twelve patients had type 1/type 2 bone defects according to AORI, and nine had type 3 bone defect. We used trabecular metal bone graft in type 3 bone defects. A special emphasis is placed on preoperative planning according to the classification system for ligament and soft tissue damage as well as the AORI classification in order to determine the quantity, location and extent of the bone loss. In our series in patients with type 3 deformities, trabecular metal augments were used. This material resembles the human trabecular bone by its cellular structure and elastic characteristics.
Results: Preoperatively, all the patients had Knee Society Score below 60, most of them were housebound, experiencing great pain and disability. After six months 95% were rated excellent, and on one year follow up, 89% were rated good or excellent (KSS score above 82, mean score 81.5), 1 patient was marked as poor with a complication – dislocation of the prosthesis. In the follow up period there was no infection.
Conclusion: Our results of revision knee arthroplasty by using the trabecular metal augments with at least a year of follow up are excellent according to the KSS compared to the other studies. The disadvantages of the study are mentioned and the need for further investigation is stressed.
Background and Purpose: Frozen shoulder is a common condition commonly affecting 2-5% of the indu... more Background and Purpose: Frozen shoulder is a common condition commonly affecting 2-5% of the industrial population typically between 40 and 60 years of age. Most of the studies were analysed the individual interventions and did not investigate the combination of interventions. The purpose of this study is to find two different forms of massage techniques Trigger Point therapy and Myofascial release in second stage of Frozen Shoulder to reduce pain and improve the Range of motion. Subjects: 30 subjects working in industry with unilateral second stage frozen shoulder lasting 3 months or more and 25% decrease in passive joint mobility relative to the non affected side were enrolled in this study. Methods: Subjects who were willing to participate in the study and to fulfil the inclusion and exclusion criteria were included in the study and they were divided into two Groups (A and B) randomly. Group A was treated with Trigger Point therapy , Myofascial release, Scapula Stabilization Exercises , and Interferential Therapy (IFT) and Group B were treated only with Scapula Stabilization Exercises and IFT. The duration of treatment was 4 weeks and they were assessed at baseline and after 4 weeks. Outcome measures included pain intensity by Visual Analog Scale (VAS) and Range of Motion (ROM) by gonio-meter. Results: Subjects in both Groups improved over 4 weeks after intervention. Significant (p £ 0.05) difference were found between both Groups after 4 weeks in VAS and ROM. But statistically (p £ 0.05) greater change scores were found in the Group A for VAS and ROM than Group B. Discussion and Conclusion: Group A and B was effective in reducing pain and improving the ROM in patients with second stage of Frozen Shoulder. However, subjects in Group A, who received Trigger Point therapy and Myofascial release showed better improvement in reduce pain and improve the ROM than Group B. In conclusion the treatment program consisting of Trigger Point therapy and Myofascial release may be more effective in reducing pain and improving the ROM in second stage Frozen Shoulder among industrial workers.
Objectives: This study aimed to investigate the relationship between physical activitylevel and h... more Objectives: This study aimed to investigate the relationship between physical activitylevel and health related quality of life in elderly people. Design: Between January and April 2017, a cross-sectional study of 114 elderly people (73 males and 41 females) conducted this study. Their mean age was (71 ± 5.24) and the mean body mass index (BMI) was (29 ± 3.31). The participating elderly were classified according to walking duration into two groups, low level of physical activity (walking duration <150 min/week) and high level of physical activity (walking duration > 300 min/week). The health-related quality of life (HRQoL) was measured using the Euro Qol-5dimensions-3 levels scale questionnaire (EQ-5D-3L). Statistical analysis was used to determine the relation between the physical activity and HRQoL scores in elderly people. Results: The measures showed statistically significant differences between high and low physical activity groups (p < 0.05). The group of high physical activity showed higher HRQoL scores more than the group of low physical activity in the all five dimensions. The low level group showed high predominance of the chronic disease. Conclusions: High level of physical activity has a beneficial effect on all dimensions of the HRQoL in elderly people. Effort and awareness should be dedicated to encouraging the active lifestyle among different population especially elderly people.
Background: Vesicovaginal fistula is a major cause of severe morbidity and potential mortality , ... more Background: Vesicovaginal fistula is a major cause of severe morbidity and potential mortality , which can result in marital disruption, rejection, and eventual destitution.
Epidemic viral conjunctivitis caused by adenovirus is the most common infectious conjunctivitis. ... more Epidemic viral conjunctivitis caused by adenovirus is the most common infectious conjunctivitis. The exact incidence of adenoviral conjunctivitis is still poorly known, but there are two well-defined ade-noviral keratoconjunctivitis clinical syndromes: epidemic keratoconjunctivitis (EKC) and pharyngoconjun-ctival fever (PCF). Epidemic keratoconjunctivitis is also the most severe form and presents with watery discharge , hyperemia, chemosis and ipsilateral lympha-denopathy. Diagnosis is mainly clinical, but its etiol-ogy can be confirmed using cell cultures, antigen detection , polymerase chain reaction or immune-chromatography. Multiple treatments have been tried for this disease, but none of them seem to be completely effective. Viruses are resistant to desiccation and certain common surface disinfectants. Prevention is the most reliable and recommended strategy to control this epidemic infection. Global epidemic surveillance system definitely needs to be established to monitor and analyze the epidemic conjunctivitis in the future. There is clearly a need for the national and the military public health institutions to work together on guidelines to handle future challenges.
Biomedical products are complex molecules , produced by living cells. More accurately, they are m... more Biomedical products are complex molecules , produced by living cells. More accurately, they are molecules that are naturally produced in the human body, like hormones or growth factors, monoclonal antibodies, blood products, immunological medicinal products, sera and vaccines, allergens, and advanced technology products such as gene and cell therapy products. Copies of these drugs, known as biosimilars, are comparable but not identical and are not generic version of innovator biological products. Specific regulatory requirements and abbreviated registration process apply in the case of biosimilars, in order to demonstrate efficacy and safety profile and to prove that product is similar to the original biomedical product. Like all medicines, biological medicines work by interacting with the body to produce a therapeutic outcome, but the mechanisms by which they do this may vary from product to product and through indications. Therefore the role of the physicians in treatment of patients with these complex medicinal products is particularly important. Regulatory issues, manufacturing, safety, physicians have part in develop use of biosimilars as much as generic drugs. Even though, the most important factor for market of biosimilar are commercial factor, still, real clinical dilemma of use are present, so it is necessary to have clear regulatory framework and postmar-keting data on the use of biosimilars.
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Papers by Sanamed Medical journal
Aim: The aim of this article is to present our experience on total knee revision surgery using tantalum metal cones as a structural bone graft substitute in total arthroplasty failure with gross metaphyseal bone loss categorized by the AORI classification, performed by a specific surgical technique and evaluated by the Knee Society Score (KSS).
Material and methods: From 2013 to 2016 at the University Clinic for Orthopedic Surgery in Skopje 21 patient has been treated with revision total knee arthroplasty. Twelve patients had type 1/type 2 bone defects according to AORI, and nine had type 3 bone defect. We used trabecular metal bone graft in type 3 bone defects. A special emphasis is placed on preoperative planning according to the classification system for ligament and soft tissue damage as well as the AORI classification in order to determine the quantity, location and extent of the bone loss. In our series in patients with type 3 deformities, trabecular metal augments were used. This material resembles the human trabecular bone by its cellular structure and elastic characteristics.
Results: Preoperatively, all the patients had Knee Society Score below 60, most of them were housebound, experiencing great pain and disability. After six months 95% were rated excellent, and on one year follow up, 89% were rated good or excellent (KSS score above 82, mean score 81.5), 1 patient was marked as poor with a complication – dislocation of the prosthesis. In the follow up period there was no infection.
Conclusion: Our results of revision knee arthroplasty by using the trabecular metal augments with at least a year of follow up are excellent according to the KSS compared to the other studies. The disadvantages of the study are mentioned and the need for further investigation is stressed.
Aim: The aim of this article is to present our experience on total knee revision surgery using tantalum metal cones as a structural bone graft substitute in total arthroplasty failure with gross metaphyseal bone loss categorized by the AORI classification, performed by a specific surgical technique and evaluated by the Knee Society Score (KSS).
Material and methods: From 2013 to 2016 at the University Clinic for Orthopedic Surgery in Skopje 21 patient has been treated with revision total knee arthroplasty. Twelve patients had type 1/type 2 bone defects according to AORI, and nine had type 3 bone defect. We used trabecular metal bone graft in type 3 bone defects. A special emphasis is placed on preoperative planning according to the classification system for ligament and soft tissue damage as well as the AORI classification in order to determine the quantity, location and extent of the bone loss. In our series in patients with type 3 deformities, trabecular metal augments were used. This material resembles the human trabecular bone by its cellular structure and elastic characteristics.
Results: Preoperatively, all the patients had Knee Society Score below 60, most of them were housebound, experiencing great pain and disability. After six months 95% were rated excellent, and on one year follow up, 89% were rated good or excellent (KSS score above 82, mean score 81.5), 1 patient was marked as poor with a complication – dislocation of the prosthesis. In the follow up period there was no infection.
Conclusion: Our results of revision knee arthroplasty by using the trabecular metal augments with at least a year of follow up are excellent according to the KSS compared to the other studies. The disadvantages of the study are mentioned and the need for further investigation is stressed.
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