The purpose of this study was to compare the clinical results of total knee arthroplasty (TKA) in the early and late postoperative period using subvastus and medial parapatellar approach. A prospective randomized controlled study was conducted in a group of 169 patients (180 TKAs) with 2-year follow-up. Patients were divided into a study group (97 TKAs) with a subvastus approach and a control group (83 TKAs) with a parapatellar approach. Assessment of the results of both operating approaches was based on functional, clinical Knee Society Score, and pain (visual analog scale). Patients in the subvastus group achieved full active extension, better range of motion, and better Knee Society Score results at 12 days, 6 weeks, and 12 weeks earlier than patients in the medial parapatellar group. They also had less pain at 12 days. No statistically significant differences existed between assessed end points in both groups at 24- and 52-weeks, and 24-months postoperatively. The subvastus approach has given patients better early clinical results; however, at longer follow-up, both groups had similar outcomes. The potential benefits of the subvastus approach are: protection of the extensor mechanism from damage, less risk of damaging the blood supply to the patella, earlier clinical recovery, and less pain in the early postoperative period. The subvastus approach is an alternative to the standard medial parapatellar approach in TKA. It can be used with equally good results, especially taking into consideration positive clinical aspects in the early postoperative period.

Implant survival following THA in arthritis with acetabular protrusion depends mainly on proper bone stock reconstruction. 80-85% patients after THA with acetabular bone stock reconstruction achieved very good and good results following an average of 12 years of follow-up. Patients with autogenic bone grafts achieved better outcomes. There was no substantial effect of aetiology, type of endoprosthesis, grade of acetabulum migration on the final outcome.

IntroductionArthroscopy of the knee joint is regarded as the most objective diagnostic method in intra-articular knee joint lesions.AimThe purpose of this study was to assess the objectivity and diagnostic value of orthopaedic examination (OE) and magnetic resonance imaging (MRI) in reference to the arthroscopic result.Material and methodsIn a group of 113 patients treated by arthroscopic surgery for post-traumatic knee pathology between 2008 and 2010 in our department, accuracy of clinical and MRI findings that preceded surgery were studied retrospectively using a statistical method. Sensitivity, specificity, accuracy and predictive negative and positive values were the subject of analysis.ResultsIn the presented trial, sensitivity values of the orthopaedic examination for injuries of the anterior cruciate ligament (ACL), meniscus medialis (MM), meniscus lateralis (ML) and chondral injuries (ChI) were 86%, 65%, 38% and 51%, respectively. Specificity values were 90%, 65%, 100% and 100%, respectively. The MR sensitivity and specificity values were 80%, 88%, 44% and 32%, and 86%, 64%, 93% and 97%, respectively.ConclusionsAssessment of intra-articular knee joint lesions is a difficult diagnostic problem. In making a decision about arthroscopy of the knee joint, an appropriate sequence of examinations should be carried out: OE, MRI and arthroscopy. The improvement in the effectiveness of the orthopaedic examination and MRI can limit the too high frequency of diagnostic arthroscopies, which generates the risk of operation treatment and costs.

This paper presents a case of a massive giant cell tumor of bone (GCTB), Campanacci and Enneking type III, in an atypical location at the proximal end of the radius. In type I and II cases, surgical treatment is the treat­ment of choice: curettage of the lesion, replacement of bone defects with bone grafts or cement. Advanced type III changes frequently require segmental resection and joint reconstruction. In our patient, a segmental resection of the proximal third of the radius and infiltrated surrounding soft tissues was performed without reconstruction of the radius. A good clinical outcome without a relapse has been noted at one year post surgery.