Type of research: applied Duration from: 01/01/91. to 12/31/95. Papers on project (total): 37
Papers on project quoted in Current Contents: 9
Institution name: Medicinski fakultet, Zagreb (108) Department/Institute: Department of Orthopaedic Surgery, School of Medicine, Universi- ty of Zagreb Address: Šalata 6 City: 10000 - Zagreb, Croatia
Communication
Phone: 385 (0) 41 274 254
Fax: 385 (0) 41 277 810
Phone: 385 (0)
E-mail: orlic&mamef.mef.hr
Phone: 385 (0)
Summary: The implantation of hip joint endoprosthesis (EP) is one of
the greatest achievements in orthopaedic surgery. At present, research is
aimed at permanent fixation of EP in bone bed. Refinements of both the
shape od EP and cementation techniques, with the application of autologous
autotransfusion, with the educations of the treated patients, are being
made to improve the quality of treatment. Uncemented EP are ussually
applied in younger patients and in revision surgery. Personal expirience
in use of cementless EP of patients under the 50 years of age is
analysed. Reconstruction of the hip joint by implantation of EP enables
overcoming of numerous problems of young persons, such as limping,
difference in the leg length, painfulness, early development of
degenerative changes and for some persons very important visible cosmetic
problems and sexual difficulties. Application of special, tumoral, modular
cementless EP which is highly differentiated surgical procedures,
necessiates special technical preparations and the experiences of most
distinguished centralised orthopaedic institutions. Results of treatment
with other treatments possibilities in osteosarcoma, Ewing sarcoma or
chondrosarcoma are analysed, as well as complication after resection of
tumoral and total hip replacement. Use of the most up-to date hip EP now
makes it possible to restore painlessness movability and to improve
quality of life of treated patients. Completition of orthopaedic
treatment, no matter how radical, maz even in objectivelz extremelz severe
conditions result in good quality of life. Quality of life is good in the
treated children, and also younger patients. Beetwen 407 uncemented
endoprothesis, 325 (79,6%) were patzients younger than 55 years. Extremely
high degree of reintegration to normal life justifz applications of
endoprotheses in children and younger patients. Complications, among them
infection in thje area of the endoprosthesis, are dangeres and expenssiv,
both for patients and helth organisations. Patients informations greatly
assist to patients concerned with the hip problem and therefore improve
the quality of life and vaule of operative procedures. Limb salvage
surgery can be done even during the war and post- war time. Beetwen 51
malignant bone tumours, endoprothesis was implantated in 14 of them.
Diofferent modality of treatament according tp the econimical situation
and the technical possibilities are justifying our efforts to have better
results of the treatment with endoprothesis.
Keywords: hip, hip endoprostheses, cementless hip endoprostheses, revision surgery, autologous autotransfusion and hip endoprostheses, reaming of the medullary canal, Chiari pelvic osteotomy, hanging hip, diagnostic procedures in locomotour toumors, embolisation, angiography, osteosarcoma, Ewing sarcoma, chondrosarcoma, complications after treatment of bone tumors, treatment in the war situation, external fixators.
Research goals: To find the criteria for the treatment of
differental diseases ofthe locomotor system in younger patients with
imlantatedendoprosthesis in the case of degenerative disease,
congenitalhip displasia, tumours or war injuries. With biomechanical
consideration of load transmission, clinicalexperience of the operative
implantatins techincs or applicationof the autologous autotransfusion is
analysed. Together with thetheoretical investigations, the design of own
cementlessendoprosthesis model is prepared, with the better shape
andimplantation technics. The instrumentation for application ofthese
model will be developed. The value of other ways of the treatment of bone
tumours, and theinfluence on the possibilities of implantation of
special,tumoral cementless endoprosthesis is considered. In the same time
with the clinical experiences permanentscientific education of patients
with written materials for thepersons with implanted artificial hip joint,
about different lifesituations is necessary the function of new hip will
be more longer.