Papers by Vladimir Harhaji
The American Journal of Sports Medicine, 2009
Background Two previous studies have examined the association between an increased posterior tibi... more Background Two previous studies have examined the association between an increased posterior tibial slope and anterior cruciate ligament (ACL) injuries as measured on plain radiographs. The study results were contradictory, with 1 reporting a statistical difference and the other showing no association. Purpose To determine if there is a difference in posterior tibial slope angle between patients with a history of noncontact ACL injury and a control group with no history of ACL injury. A secondary objective was to examine differences in tibial slope angle between male and female subjects within each group. Study Design Case-control study; Level of evidence, 3. Methods We identified all noncontact ACL injuries that were treated operatively at the United States Military Academy, West Point, New York, from 2004 to 2007. We digitally measured the posterior tibial slope from plain film radiographs of 140 noncontact ACL injuries, stratified them by sex, and compared them with a control coh...
Medicinski pregled, 2010
In order to prevent anterior cruciate ligament injuries it is necessary to define risk factors an... more In order to prevent anterior cruciate ligament injuries it is necessary to define risk factors and to analyze the most frequent causes of injuries - that being the aim of this study. The study sample consisted of 451 surgically treated patients, including 400 sportsmen (65% of them being active and 35% recreational sportsmen), 29% female and 71% male; of whom 90% were younger than 35. Sports injuries, as the most frequent cause of anterior cruciate ligament injuries, were recorded in 88% of patients (non-contact ones in 78% and contact ones in 22%), injuries occurring in everyday activities in 11% and in traffic in 1%. Among sportsmen, reconstruction of the anterior cruciate ligament was most frequently performed in football players (48%), then in handball players (22%), basketball players (13%), volleyball players (8%), martial arts fighters (4%). However, the injury incidence was the highest among the active basketball players (1 injured among 91 active players). Type of footwear,...
Medicinski pregled, 2011
Avulsion fractures of the anterior inferior iliac spine are rare injuries of the pelvic ring and ... more Avulsion fractures of the anterior inferior iliac spine are rare injuries of the pelvic ring and occur during sports activities. Hereby is presented a case of a 22-year-old professional football player who was diagnosed to have an avulsion fracture of the anterior inferior iliac spine on the right side four months after the initial injury and he was treated surgically with the excision of the avulsed fragment. The football player recovered completely and returned to his usual sports activities. Two years later, due to the pain in the hip an x-ray and MR image were made, which established the existence of crescent formation, a heterotopic bone, in the area of the anterior inferior iliac spine, which was surgically removed. Physical and medical therapy was conducted and after four months, the professional athlete was back playing football. Two years after the surgical excision of heterotopic ossification, the patient was completely asymptomatic with the same ROM without any thigh musc...
Medicinski pregled, 2014
Introduction. Infections after anterior cruciate ligament reconstructions are rare, but, on the o... more Introduction. Infections after anterior cruciate ligament reconstructions are rare, but, on the other hand, they are difficult to be treated. The aim of this study was to analyze causes of infections, risk factors, diagnostics, and possibilities of their prevention. Material and Methods. Seventeen deep infections (1.2%) were found in 1425 patients who had undergone anterior cruciate ligament reconstructions. Fifteen patients were males and two were females. Out of 475 professional athletes nine (1.9%) had this postoperative complication. Eleven patients with septic arthritis were allergic to penicillin. Three of them had immunosuppressive diseases. Results. Staphylococcus aureus was isolated in eleven cases (65%), other Staphylococcus and Streptococcus groups were found in four and three patients, respectively; while one patient had infection although the punctate was negative. Out of 965 patients with the patellar tendon grafts, ten (1.03%) had this complication, while the incidenc...
Medicinski pregled, 2013
Introduction. The aim of study was to analyze risk factors, mechanisms of injury, symptoms and ti... more Introduction. The aim of study was to analyze risk factors, mechanisms of injury, symptoms and time that elapsed from injury until operation of complete quadriceps tendon ruptures. Material and Methods. This retrospective multicenter study included 30 patients operated for this injury, of whom 28 (93.3%) were men. The average age was 53.7 years (18-73). Twenty-six patients had reconstruction of unilateral rupture and four of bilateral one. Results. Eighty percent of them had some risk factors for rupture of the tendon with degenerative changes. Eight patients had diabetes, seven patients were on renal dialysis, two patients had secondary hyperparathyroidism, five patients were obese and two patients had former knee operations. These injuries occurred in 80% following minor trauma caused by falls on stairs, on flat surfaces and squatting. The most frequent symptoms were: pain, swelling, lack of extension of knee and defect above patella, and three cases were initially misdiagnosed. D...
Acta chirurgica iugoslavica, 2013
Anterior cruciate ligament (ACL) is the most common surgically treated knee ligament. If we take ... more Anterior cruciate ligament (ACL) is the most common surgically treated knee ligament. If we take into account the fact that incidence of ACL injuries is growing, it is clearly that the interest of orthopedic surgeons for this pathology is also growing. Increasing number of this operations leads to increasing of complications, which requires its analysis. One of the most common failure of ACL reconstruction is a bad position of the graft in the femoral condyle. This study aimed to analyze the positioning of the graft in to the femur by two generally accepted techniques - transtibial technique and technique through the antero-medial portal. The analysis included postoperative radiographs in 60 patients, of whom 30 were operated by transtibial technique and 30 by technique through anteromedial portal. Radiographic analysis involved the measurement of the AP digital imaging, the tunnel projection X ray measurements and measurements of the computed tomography (CT), which was here a contr...
Srpski Arhiv Za Celokupno Lekarstvo, 2020
Introduction/Objective. Low bone mineral density (BMD) is commonly associated with alterations of... more Introduction/Objective. Low bone mineral density (BMD) is commonly associated with alterations of nutritional status. The aims of the present study were to evaluate the prevalence of low BMD and its associated nutritional risk factors in Vojvodina population and to use linear regression equations to predict the BMD by using a simple marker of nutritional status, body mass index (BMI). Methods: In this retrospective, cross-sectional study, the study population was subjects who were undergoing assessment of BMD between January to December 2017 and met the study inclusion criteria. A total of 1974 patients (1866 women and 108 men) were included in this analysis of nutritional status according to anthropometry and BMI index, and dual-energy X-ray absorptiometry (DEXA) measurements of BMD of the femoral neck and lumbar spine. The relationship between BMI and BMD was analysed by linear regression equation. Results: Median age was 63 (56-70) years. Considering nutritional status category, ...
Meniscus of the Knee - Function, Pathology and Management, 2019
Knee arthroscopy is one of the most used operative treatments in orthopedic surgery. The first kn... more Knee arthroscopy is one of the most used operative treatments in orthopedic surgery. The first knee arthroscopy was performed by Prof. K. Takagi, from Tokyo, Japan, in 1920. With further improvement, he made the first black and white photos of the inside of the knee (1932) and, soon, the first color photos (1939). Independently from Takagi, Dr. Eugen Bircher from Arau, Switzerland, in 1921 published the results of 20 “arthro-endoscopies,” and that was the first time the word “arthroscopy” was mentioned in literature. In New York, USA, Dr. Michael Burman described in detail the incision points and technique of joint spreading that we use today. In 1957, Dr. Masaki Watanabe published the first Atlas of Arthroscopy. The first Arthroscopy Course in English language was held in Philadelphia, USA, in 1972. The International Arthroscopy Association, with Dr. Watanabe as president, was established in 1974. In clinical knee arthroscopy, the following division proved to be very useful: the me...
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INTRODUCTION Modern literature concerning reconstructions of Anterior Cruciate Ligament is mostly... more INTRODUCTION Modern literature concerning reconstructions of Anterior Cruciate Ligament is mostly focused on the choice of graft (hamstring or bone-tendon-bone), its placing, tensioning and fixation. The bone-hamstring-bone graft consists of compressed cancellous bone on its ends and it has been developed to achieve a more rigid fixation of the graft. The aim of this study was to compare the postoperative results in surgically treated patients two years after the reconstruction of anterior cruciate ligament. MATERIAL AND METHODS The study included 55 patients divided into two groups according to the implanted graft: bone-tendon-bone and bone-hamstring-bone graft. The results were assessed by Tegner and Lysholm scoring systems, arthrometric measurements, functional tests and International Knee Documentation Committee standard. RESULTS The average postoperative results did not show a statistically significant difference (p < 0.05) between the two groups (94 in the bone-tendon-bone ...
Analytic joined statisticalthermodynamic expression for entropy as a function of state for measur... more Analytic joined statisticalthermodynamic expression for entropy as a function of state for measuring the disorder of the corresponding micro state and the mechanical parameters which feature in the Hooke's law on elasticity as a measure of macro state was used in the situation of the isothermal elongation of viscoelastic ligament biostructure simultaneously with the external force of constant intensity to determine the change of entropy and the resultant reactive elastic force in the function of relative elongation. The sample used for the analysis and testing of the original joined theory shown with adequate equations is tested on linear biostructure approximating the data of Lig. collatelare fibulare which strengthens the lateral side of the knee joint. The obtained results for the tested linear biostructure according to which the minimal value of the difference in dS corresponds to the state of maximal entropy and the minimal value of elastic force indicates the acceptable level of elongation at which a reversible process is still possible, with low probability, are presented. This leads to the conclusion that, according to the results obtained here, the biostructure under examination can withstand the elongation which is approximately equal to twice the initial length L 0. The relation between the friction force F tr and the elasticity force F e for the initial state is 1.0417, which indicates that the friction force is to a certain extent higher than the elastic force. With elongation, this ratio changes in favour of the friction force and becomes more prominent with advanced age.
Open pelvic fractures are devastating injuries, rare, and with high mortality. Leading causes of ... more Open pelvic fractures are devastating injuries, rare, and with high mortality. Leading causes of mortality are: haemorrhage, infection and associated injuries. The aim of this paper is to point out methods of treating these injuries and great number of prognostic mortality factors. Material - in period from January 2011 to December 2015, 221 patients with pelvis ringfracture were treated in three large clinical centers of Serbia, of which 13(5%) had an open fracture type. We have classified pelvic ring fractures according to the Young - Burgess classification. We have classified injuries according to Gustilo at I, II, and III degree, and the location of the wound according to Faringer classification was distributed in zone I, II and III. Urogenital and intra-abdominal injuries were monitored, and severity of injuries was determined according to Severity Score Injury (ISS) and Trauma Score (TS). Results - there were 6(46%) women and 7(54%) men at the average age of 41(13 - 76). Injur...
Summary Introduction. Infections after anterior cruciate ligament re- constructions are rare, but... more Summary Introduction. Infections after anterior cruciate ligament re- constructions are rare, but, on the other hand, they are difficult to be treated. The aim of this study was to analyze causes of in- fections, risk factors, diagnostics, and possibilities of their pre- vention. Material and Methods. Seventeen deep infections (1.2%) were found in 1425 patients who had undergone anterior cruciate ligament reconstructions. Fifteen patients were males and two were females. Out of 475 professional athletes nine (1.9%) had this postoperative complication. Eleven patients with septic arthritis were allergic to penicillin. Three of them had immunosuppressive diseases. Results. Staphylococcus au- reus was isolated in eleven cases (65%), other Staphylococcus and Streptococcus groups were found in four and three patients, respectively; while one patient had infection although the punc- tate was negative. Out of 965 patients with the patellar tendon grafts, ten (1.03%) had this complication, ...
Introduction. Rupture of lateral collateral ligament of the knee is most often joined with other ... more Introduction. Rupture of lateral collateral ligament of the knee is most often joined with other ligament ruptures. Isolated rupture of this ligament is rare and there are few papers about treatment options and results. Here we reported a case of isolated lateral collateral ligament rupture and the treatment outcome. Case report. A patient, 22 years old male, injured his left knee while playing American football. While landing on the outstretched left leg, he felt a sudden pain in his knee. The patient could not continue the competition. Initial orthopedic examination revealed lateral opening and further diagnostic procedure (magnetic resonance imaging) revealed isolated grade III rupture of lateral collateral ligament with avulsion fracture of the fibular head, and distension of anterior and posterior cruciate ligaments. Patient was surgically treated with metal sutures passed through conjoined tendon and proximal fibula. Postoperatively patient worn above knee cast for 6 weeks and...
Srpski arhiv za celokupno lekarstvo
Introduction/Objective. The Sarcopenia Quality of Life (SarQoLR) questionnaire is a patient-repor... more Introduction/Objective. The Sarcopenia Quality of Life (SarQoLR) questionnaire is a patient-reported outcome measure specific to sarcopenia. The objective was to translate the SarQoLR questionnaire from English into Serbian and to investigate its psychometric performance. Methods. A five-stage forward-backward methodology with pre-test was used to translate the questionnaire. The validation sample in this study consisted of elderly, community-dwelling volunteers of both sexes. Three methods were used to screen for and diagnose sarcopenia: the SARC-F questionnaire (high/ low risk), low handgrip strength [probable sarcopenia in the European Working Group on Sarcopenia in Older People (EWGSOP2) algorithm], and the complete EWGSOP2 criteria. We investigated the questionnaire?s discriminative power, internal consistency, construct validity, and floor and ceiling effects. Results. The SarQoLR questionnaire was translated into Serbian. The validation study included 699 participants. In tot...
Medical review
Introduction. The aim of the study was to determine whether there is was statistically significan... more Introduction. The aim of the study was to determine whether there is was statistically significant difference in patients of different age and gender regarding quality of life and causes of postoperative knee instability after anterior cruciate ligament reconstruction. Material and Methods. The study included 776 subjects, aged 15 to 59 (average age 27 years), who we divided into groups by age and gender. All volunteered to complete the Knee injury and Osteoarthritis Outcome Score questionnaire. We examined the postoperative instability using clinical tests in order to determine its causes and incidence among the groups of patients. Results and Discussion. The average values related to pain during sports activities were the highest in the youngest group of patients, up to 18 years of age (81 points). Postoperative instability was reported by 27 patients (3.5%), more frequently by males. Among the causes of instability, the most common was a new sports injury, in 11 cases (40%), and ...
Medical review
Introduction. The aim of study was to analyze the results and complications of anterior cruciate ... more Introduction. The aim of study was to analyze the results and complications of anterior cruciate ligament reconstructions, treatment and prevention possibilities. Material and Methods. We performed 210 operations: 175 with patellar tendon graft and 35 with hamstring tendons. Men were 7 times more present in our survey. The average age being 27.1 years. The average follow up was 3.2 years. The participants answered a modified Knee Ostedoarthritis Outcome Scale questionnaire set. We used clinical examination tests (Range of motion, Lachman and pivot shift) and postoperative X-rays. Results. The complication?s rate was 9% (19 patients). In patellar tendon group we registered one patellar fracture and pulmonary tromboembolism and two cases of cyclops lesions. Septic arthritis was more common among professional athletes and in hamstring tendons group. Reoperations had to be performed: in 5 cases of infections (continous irrigation and drainage), two arthrofibrosis and one osteosynthesis ...
Vojnosanitetski pregled
Introduction. Rupture of lateral collateral ligament of the knee is most often joined with other ... more Introduction. Rupture of lateral collateral ligament of the knee is most often joined with other ligament ruptures. Isolated rupture of this ligament is rare and there are few papers about treatment options and results. Here we reported a case of isolated lateral collateral ligament rupture and the treatment outcome. Case report. A patient, 22 years old male, injured his left knee while playing American football. While landing on the outstretched left leg, he felt a sudden pain in his knee. The patient could not continue the competition. Initial orthopedic examination revealed lateral opening and further diagnostic procedure (magnetic resonance imaging) revealed isolated grade III rupture of lateral collateral ligament with avulsion fracture of the fibular head, and distension of anterior and posterior cruciate ligaments. Patient was surgically treated with metal sutures passed through conjoined tendon and proximal fibula. Postoperatively patient worn above knee cast for 6 weeks and...
Medicinski pregled, 2017
Introduction. The aim of study was to analyze the results and complications of anterior cruciate ... more Introduction. The aim of study was to analyze the results and complications of anterior cruciate ligament reconstructions, treatment and prevention possibilities. Material and Methods. We performed 210 operations: 175 with patellar tendon graft and 35 with hamstring tendons. Men were 7 times more present in our survey. The average age being 27.1 years. The average follow up was 3.2 years. The par-The participants answered a modified Knee Ostedoarthritis Outcome Scale questionnaire set. We used clinical examination tests (Range of motion, Lachman and pivot shift) and postoperative X-rays. Results. The complication's rate was 9% (19 patients). In patellar tendon group we registered one patellar fracture and pulmonary tromboembolism and two cases of cyclops lesions. Septic arthritis was more common among professional athletes and in hamstring tendons group. Reoperations had to be performed: in 5 cases of infections (continous irrigation and drainage), two arthrofibrosis and one osteosynthesis of patella. Graft had to be removed in 2.5% of cases and revisions happened mostly because of impropriate position of bone tunnels and new trauma. One algodystrophic syndrome happened in hamstring tendons group. Complications were successfully treated in 12 cases but 5 patients had knee contractures, so average Knee Ostedoarthritis Outcome Scale score was 88.2 points in comparison to 93.8 points in patients without complications. Seventy-three percent of patients returned to nonrestricted (sport) activities. Complications can compromise the final results of anterios cruciate ligament reconstructions. We registered similar complication rates between different grafts. Some of complications had almost every eleventh patient that resulted with reoperation at every eighteenth of them. Conclusion. The most of complications can be prevented and treated successfuly althought many questions are still left opened.
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Papers by Vladimir Harhaji