BACKGROUND:The aim of this study was to analyze the causes that lead to secondary damage of the radial nerve and to discuss the results of reconstructive treatment. MATERIAL AND METHODS:The study group consisted of 33 patients treated for radial nerv...

Advances in Clinical and Experimental Medicine jest oficjalnym pismem Uniwersytetu Medycznego im. Piast?w Sl?skich we Wroc?awiu. Publikowane s? w nim prace naukowe polskie, jak r?wnie? zagraniczne.

Percutaneous iliosacral screw fixation is a widely accepted method of stabilizing the posterior pelvic ring. Recently developed tools such as 3D-navigated fluoroscopy and computed navigation seem to prevent a surgeon from conducting screw misplacement. The study aimed to comparatively assess the introduction of sacroiliac screw placement using 2D and 3D fluoroscopy in terms of accuracy and radiation exposure. Iliosacral screws were introduced in 37 patients using 2D (group N1) and in 36 patients using 3D fluoroscopy (group N2) techniques. Overall, 61 and 56 screws were introduced in groups N1 and N2, respectively. Screw placement accuracy was assessed using postoperative computed tomography and Smith’s scale. Intraoperative radiation exposure was also assessed. No differences were noted between groups in terms of screw positioning accuracy and radiation dose. Both 2D and 3D fluoroscopy provide good visualization for safely placing percutaneous iliosacral joint screws. Using 3D fluoroscopy-based navigation in comparison with 2D fluoroscopy is not advantageous.

Anterior cruciate ligament (ACL) reconstruction is the prevailing procedure in cases of ACL rupture. To assess the long-term safety of implementing a synthetic ligament with the Ligament Advanced Reinforcement System (LARS) in primary reconstruction of the ACL. The retrospective analysis involved 403 patients who had undergone ACL reconstruction with the same results in clinical and functional assessments. The patients comprised 2 groups. In group I, a LARS graft was implemented, while in group II, an autograft was used. The Lachman test, anterior drawer test, pivot-shift test, Lysholm scale, IKDC 2000, pain posited to be experienced, the possibility of postoperative complications, the time required to return to work, and revision surgery were all considered and analyzed. The visual analogue scale (VAS) pain score in group I ranged from 37.34 ±8.22 mm on day 3 to 17.21 ±5.45 mm on day 28. In group II, it ranged from 64.72 ±10.20 mm on day 3 (p < 0.05) to 18.67 ±6.57 mm on day 28. The period of time taken to return to office work in group I was 7.04 ±1.82 weeks, and 9.21 ±1.75 weeks in group II (p < 0.05). The time taken to return to physical work in group I was 20.50 ±2.91 weeks, and 21.12 ±3.12 weeks in group II. Postoperative scar and local complications were statistically less prominent in group I. The cost and number of revision surgeries were greater in the first group. Reconstruction of the ACL using a synthetic graft such as LARS yields similar results to an autograft in a cohort follow-up. Long-term results show a large number of revision surgeries when LARS is used. This method should be used with caution.

Due to the low potential for primary biological healing of the anterior cruciate ligament (ACL), the most popular approach is currently reconstruction using a graft. Recent research indicates that the technique of strengthening a damaged ligament with synthetic tapes (internal bracing) may be an alternative to reconstructive treatment, especially in cases of partial ACL damage. To compare and evaluate the possibility of using a synthetic graft (Neoligaments or FiberTape) to treat partial lesions of the ACL. This was a retrospective cohort study. Selected from a pool of 128 patients undergoing primary unilateral intra-articular ACL reconstruction due to partial lesion of the ACL, group I (Neoligaments) and group II (FiberTape) each included 30 patients. Range of motion (ROM), the Lachman test, the anterior drawer test and the pivot-shift test, the Lysholm Knee Scoring Scale, and International Knee Documentation Committee (IKDC) 2000 scale were used for assessment. Follow-up was carried out after 2 years. The knee joint regained anterior stability in both the subjective and objective assessments in all patients in both groups. The subjective results were respectively: in group I, 97.2 ±3.2 points on the Lysholm scale and 93.9 ±6.1 points on the IKDC 2000 scale; in group II, 96.1 ±4.9 points on the Lysholm scale and 93.2 ±6.8 points on the IKDC 2000 scale. Group comparison of the results of the IKDC 2000 scale, Lysholm Scale and ROM obtained postoperatively showed no statistically significant differences between groups. Reconstruction of partial ACL lesions using a synthetic graft allows regained stability of the knee joint. The results of subjective assessment are comparable with the functional assessment results. The comparison between Neoligaments and FiberTape shows the same functional and objective results, although FiberTape is preferable from an economical perspective.

Background. Autologous platelet-rich plasma (PRP) injection is an alternative but widely accepted method for the treatment of degenerative changes in tendon attachments known as enthesopathies. The PRP is considered a safe source for high concentrations of the growth factors involved in the healing process. Despite initial promising outcomes, many recent studies report conflicting results for this treatment. This may be due to differences in the concentrations of platelets and growth factors in PRPs obtained using different methods. Objectives. The aim of this study was to compare PRP preparation systems in terms of morphotic components and selected growth factors to find the most appropriate procedure for the treatment of enthesopathies. Materials and methods. Whole blood samples from 6 healthy male volunteers were collected. Using different commercial kits (Mini GPS III System, Arthrex ACP, and Xerthra, Dr. PRP), 4 PRPs were prepared from the blood of each participant. All samples were analyzed for the content of morphotic components and the following growth factors: transforming growth factor-beta 1 (TGF-beta 1), epidermal growth factor (EGF), vascular endothelial growth factor (VEGF), and platelet-derived growth factor AA (PDGF-AA). Results. The Mini GPS III produced PRP with the highest concentration of platelets and white blood cells (WBC) compared to the other systems included in the study. Significant differences in the levels of EGF and PDGF-AA were found only between the Mini GPS III and Arthrex ACP. There was positive correlation between the content of platelets and the levels of PDGF-AA and EGF. The red blood cells (RBC) concentration positively correlated with PDGF-AA, EGF and VEGF. Conclusions. This study showed differences between the morphotic components and levels of selected growth factors in PRP obtained with the different preparation methods. Due to insufficient data, we cannot argue for or against any of the studied protocols forthe treatment of enthesopathy. Further studies on a larger population are required to validate our results.