The use of biologic therapies for the management of knee osteoarthritis (OA) has largely increased in recent years. The purpose of this study was to evaluate the efficiency and the therapeutic potential of platelet-rich plasma (PRP) and autologous adipose tissue (AAT) injections as a treatment for knee OA. Sixty participants were enrolled in the study: 20 healthy ones and 40 with minimal to moderate knee OA (KL I-III). The OA patients were randomly assigned either to the PRP or to the AAT group. The PRP samples showed a low expression level of NF-κB-responsive gene CCL5 and high expression levels of classic inflammatory and TNF-l INF responses. The AAT injection product was prepared using a Lipogems device, and its regenerative potential as well as the ability for expansion of mesenchymal stem cells were tested in the cell culture conditions. The patient assessments were carried out five times. Significant improvement was observed regardless of the treatment method in the VAS, KOOS, WOMAC and IKDC 2000 subjective evaluations as well as in the functional parameters. Intra-articular injections of AAT or PRP improved pain, symptoms, quality of life and functional capacity with a comparable effectiveness in the patients with mild to moderate knee osteoarthritis.

Introduction One of the treatment options in chronic damage or unsuccessful suturing of the Achilles tendon is a surgical treatment consisting of its reconstruction using the tendon of semitendinosus and gracilis muscle. The multitude of types of reconstruction causes discrepancies in rehabilitation protocols. All of them aim to return to full functional fitness as the ultimate goal. Aim This study aims to present the proprietary rehabilitation protocol after Achilles tendon reconstruction using the tendon of semitendinosus and gracilis muscle. Material and methods The presented rehabilitation program lasts about 12 months and is divided into six stages. Stage I consists of standing up and anticoagulant exercises, and isometric exercise. Stage II, lasting up to 2 weeks after the procedure, consists of the patient’s independent work in the home environment. Stage III, lasting up to 4 weeks, involves learning to walk and putting weight on the limb in a cam Walker. In the third stage, after the postoperative wounds have healed, exercises in water conditions are started. Stage IV, lasting from 4 weeks after the operation, involves loading the limb with support, increasing the range of dorsiflexion motion, and progressive muscle strengthening. Stage V, which lasts up to 8–12 months after surgery, eliminates functional deficits and prepares the patient for a functional biomechanical assessment. Stage VI is the stage of work on the compensation of deficits resulting from the analysis of the results of the functional biomechanical assessment necessary to return to the full sports activity. Results The rehabilitation time, in accordance with the assumptions of the above protocol, is 8–12 months. After this time, the patient should proceed to a functional biomechanical assessment. Discussion and conclusions The rehabilitation protocol presented by our team describes in detail the stages of post-operative rehabilitation after Achilles tendon reconstruction with a hamstring graft. It provides the conditions necessary for the patient to meet before starting the next phase and returning to sport. Our requirements are consistent with the assumptions available in the scientific base. Keywords: Achilles tendon reconstruction, return to sport, rehabilitation program.

Introduction Timed Up and Go test (TUG), 5 Times Sit to Stand test (STS) and 10-meter Walk test (WT) are often used in clinical trials. Aim The purpose of this study is to determine the test-retest reliability of TUG, STS, 10WT and maximal voluntary isometric contraction (MVIC) of the knee extensors and flexors and to determine a minimal detectable change (MDC) for those tests in a population of patients with knee osteoarthritis (OA) who will undergo conservative treatment. Material and methods Sixty-one patients with symptomatic knee OA were included in this study. The testing protocol consisted of TUG, STS, 10WT and maximal voluntary isometric contraction (MVIC) of knee extensors and flexors. Participants were tested twice. Results TUG, STS, 10WT and MVIC and standardised MVIC of knee extensors and flexors showed an excellent test-retest reliability. Standard Error of Measurement and MDC95 for TUG was 0.37s and 1.01s, respectively; for STS was 0.69s and 1.91s, respectively; for 10WT was 0.23s and 0.65s, respectively; for MVIC of extensors was 19.66N and 54.5N, respectively; for MVIC of flexors was 9.73N and 26.96N, respectively; for standardised MVIC of extensors was 0.22 and 0.62, respectively; for standardised MVIC of flexors was 0.11 and 0.31, respectively. Conclusions TUG, STS, 10WT, and MVIC measurements have excellent test-retest reliability in mild to moderate knee OA patients. Changes greater than 1.01s for TUG, 1.91s for STS, 0.65s for 10WT, 0.62 for standardised MVIC of knee extensors and 0.31 for standardised MVIC of knee flexors may be used as clinically significant.

No abstract

Introduction Pain in the hip joint area related to the femoro-acetabular impingement syndrome, local cartilage damage, or labrum tear is an increasingly common cause of orthopedic consultations. In the case of failure of conservative treatment, the treatment of choice is the arthroscopic treatment of the lesions and arthroplasty. As after any surgical procedure, an important aspect is subsequent rehabilitation, which may increase the positive effect of the treatment. Aim This article aims to present the original rehabilitation procedure after hip arthroscopy. Material and methods The presented rehabilitation program lasts about 5–9 months and consists of four stages. The first stage, lasting two weeks, mainly focuses on protecting the treated structures, reducing pain, and preventing adhesions and blood clots. Stage two, which lasts up to 4–6 weeks, is to restore the correct gait pattern and progress exercises from stage one. In the third stage, which lasts up to 12 weeks, rehabilitation focuses on regaining the full range of motion, muscle strength, and endurance similar to the non-operated leg. After a positive functional assessment, the patient progresses to the fourth stage, which prepares him to return to the entire sports activity. The decision to return to sport is based on the relevant results of the functional assessment and clinical examination. Results This work presents the original protocol of rehabilitation after arthroscopic procedures of the hip joint. Comparing the rehabilitation process, criteria for progression, and the time to return to sport, the protocol proposed by us is in line with the currently accepted rehabilitation trends in the world. Conclusions The rehabilitation protocol proposed by our team was based on the authors’ experience and the available literature. The rehabilitation process has been divided into 4 phases with precise criteria for progression. Biomechanical Functional Assessment plays an important role in the control of the entire course of rehabilitation. Keywords: hip arthroscopy, rehabilitation protocol, functional evaluation