[Partial prosthesis of the shoulder joint--personal experience].

Hemiarthroplasty of the shoulder is a treatment of choice for severe types of proximal humeral fractures. From 2001 to 2003, 8 hemiarthroplasties were performed at the University Clinic for Orthopaedic Surgery and Traumatology, Clinical Center Novi Sad. The aim of this study was to retrospectively assess functional outcomes of those patients. By determing the factors that affected the outcome, we would try to improve results of future patients.

Healing of the articular disc of the wrist in dogs.

The healing potential of the articular disc of the wrist (antebrachiocarpal) joint was investigated in 30 adult dogs (35 joints). In 28 joints a complete section of the entire disc was carried out and sutured in 10; a partial lesion was made in 7. The dogs were killed at varying intervals from 2 weeks to 8 months and healing studied by naked eye inspection and histological examination. At 3, 6 and 8 months the tears in all specimens were completely healed by mature fibrous tissue containing fibrocartilaginous elements, whether or not they had been sutured. In peripheral areas the defect was filled by an ingrowth of young fibroblastic tissue arising from the synovium, whereas in the central areas the repair appeared to originate from neighbouring bone. We have demonstrated the ability of the mostly avascular disc to repair itself. Suturing did not enhance the healing process.

[Osteopoikilosis--case report]. / Osteopoikilosis--prikaz slucaja.

A very rare case of osteopoikilosis, a disease which is an asymptomatic, genotypical osteopathy with an unknown cause, is described. Most often it is discovered by accidental radiography and it is characterized by the appearance of spotted and oval foci of compact cortical and lameral bone inside the canselous bones. The most common localization of these disorders are epiphyses and metaphyses of the long bones. The disorders have a static character and they do not demand any kind of treatment.

[Morphologic characteristics and static resistance of transplanted patellar ligaments after replacement of the cruciate ligaments in the knee--an experimental study in a dog]. / Morfoloske osobine i staticka otpornost autotransplantata ligamenta patele nakon zamene prednjeg ukrstenog ligamenta kolena--eksperimentalna studija u psa.

An experimental study on transplantation validity of patella's ligament, when transplanting front crossed ligament, was performed on 106 knees in 53 grown-up dogs. The investigation had three stages. Three months after the transplantation of the front crossed ligament with the medial third part of the patella's ligament animals were sacrificed and in one group the static resistance and the resistance to elongation, by using special tweezers (Alfred Amsler Co., Schafhausen, Switzerland), was investigated. The results showed that the patella's ligament is very suitable for transplantation because its resistance and strength were almost identical with the same parameters of intact front crossed ligament. Revascularization of the new ligament using Spaltenholz's technique was done in the second group, and three months after the operation, complete revascularization of transplants took place. The synovial membrane which covers the new ligament represents the main source of fresh blood vessels on one side, while similar process takes place along the bone tunnels where the new ligament was fixed. The new ligament histologic analysis carried out in the third group of experimental animals showed that after three months the transplant acquires the structure which is very similar to the front crossed ligament. The obtained results of the investigation show that the patella's ligament is a very good biologic material for transplantation of the crossed ligament.

Detailed anatomy of the antebrachiocarpal joint in dogs.

A comparative study of the anatomy of the antebrachiocarpal (AC) articulation was carried out in 30 adult dogs with 60 joints. Although a considerable degree of similarity was found between the AC joint in dogs and the corresponding wrist joint in humans, a number of differences between these two homologous joints were also noted. The distal end of the ulna in dogs directly articulates with the ulnar carpal and accessory carpal bones forming a specialized antebrachiocarpal arrangement more adapted to running. The accessory carpal bone in dogs is a massive, long bone and is strikingly different from its homologue in humans, the pisiform bone. The joint between the accessory and ulnar carpal bones, which corresponds to the piso-triquetral joint in humans, is always connected with the AC joint, whereas in humans this communication could be found occasionally. The large radial carpal bone in dogs, characteristic for carnivores, corresponds to the fused scaphoid and lunate bones in humans, in whom this type of fusion is very rarely found. The palmar ulnocarpal and radiocarpal ligaments in dogs are distinctly intra-articular, whereas in humans these ligaments are intracapsular. One of the controversies of the AC joint in dogs is a structure located between the distal-most parts of the radius and ulna forming a strong bond between these two bones and a part of the antebrachial articular surface. It is cartilage-like and is composed of typical fibrocartilaginous tissue.(ABSTRACT TRUNCATED AT 250 WORDS)

[Early functional and anatomic results after total condylar knee prosthesis implantation]. / Rani funkcionalni i anatomski rezultati nakon ugradnje totalne kondilarne endoproteze kolena.

The results of total knee replacement in 30 patients have been analyzed. Total knees were implanted during 1990, and the shortest follow-up time after the operations amounted to 6 months. All 30 total condylar prosthesis were of Insall-Burstein posterior stabilized design. The average age of the operated patients was 61 years. Osteoarthritis caused serious knee damage in 21 patients and was the indication for the operation; in 7 patients it was rheumatoid arthritis; in 1 patient synovitis villonodularis; and severe posttraumatic osteoarthrosis in 1 patient. In 18 patients axial knee deformity was noted prior to operation in the sense of valgus or varus. The continuous passive motion machine was used in the postoperative treatment of all patients. Clinically acceptable results were obtained in 90%. Wound healing complications were noted in 2 patients. Full axial deformity correction was achieved in all the patients with a full extension and flexion of over 90 degrees in the operated knees. Preliminary results after the implantation of this type of prosthesis are very encouraging and justify it's further routine use.

[Incorporation of nonvascularized auto- and allotransplanted bone into the site of bone defects]. / Inkorporacija nevaskularizovanih kostanih auto i alotransplantata na mesto kostanog defekta.

It is generally accepted viewpoint that free bone grafts do not survive transplantation, that the incorporation of the autograft is faster and safer than the one of the allograft, and that the immunological processes disturb the process of revascularisation and reossification of the graft, although they stimulate the process of absorbtion. The process of graft incorporation into the host's bone was followed up in 8 dogs, i.e. 16 knees. In 10 knees the medial tibial condyle was replaced by autogenic implants made of patella, thickness of 6-8 mm. and fixed by Kirschner wire. The process of allograft incorporation was studied in 6 knees, where the medial tibial condyle was replaced by the donor's graft. The process of the graft incorporation was followed-up by x-ray studies and after sacrificing the animals during the interval starting from 2 months to a year since the operation had been performed, while in the allograft group the follow-up was during the interval starting from 1 up to 5 months. The obtained results point out that the incorporation of the bone grafts thinner that 1 cm happens within first 8-10 months after the operation. The process of incorporation during this period happens at almost the same speed in both groups. If there are no technical errors while implanting, practically all the grafts of this thickness will be incorporated into the host's bone, i.e. completely reosified and revascularized. The congruity of the joint and the rigidity of the fixation play the main role in the fate of the graft within the first months after the operation.

[Degenerative arthritis of the knee joint after allotransplantation of the joint surface without immunosuppression]. / Degenerativni artritis kolenog zgloba nakon alotransplantacije zglobne povrsine bez primene imunosupresije.

Degenerative arthritis of the knee joint after resurfacing of the knee with fresh osteochondral allograft occurs frequently and was noticed a long time ago. The main causes can be: incongruity of the joint, when the allograft slips so that its surface is out of normal line, inadequate internal fixation different methods of cartilage preservation which are lethal to cartilage, broken grafts as well as immunological reaction to the graft. The experiment was conducted on 5 dogs, i.e. 10 knees. As for operated knees, the medial tibial condyle was replaced by fresh osteochondral allograft taken from the other animal, without preservation, performing precise operative technique and rigid internal fixation. These allografts were followed-up by x-raying them and after sacrifying the animals. The following-up of the development of the degenerative process continued up to 6 months after transplantation. The obtained results point out all the attitudes concerning all the other arthroplastic procedures (such as the precise reconstruction of the joint surface and the rigid internal fixation) should be respected. In spite of this, degenerative arthritis still exists in some cases as the result of immunological reaction to the graft, the process which may start within 6 months after transplantation.