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BackgroundSurgical methods in treatment of joint osteoarthritis (OA) aim at meeting the increasing expectations of people with active lifestyles. Ankle joint arthroplasty has been performed increasingly more often as an alternative to arthrodesis. The aim of this study was to compare arthrodesis and arthroplasty in the treatment of ankle osteoarthritis.Material/MethodsThe study involved 56 patients (45 males and 11 females) aged 21–72 years (mean 51) presenting with end-stage ankle OA: 29 patients (52%) underwent arthroplasty (Group A) and 27 patients (48%) underwent arthrodesis (Group B). Patients underwent surgery between 2004 and 2016 at a single clinical center. The observation period ranged from 6 to 150 months (mean 55 months). To assess the results of surgical treatment, quality of life (Health Assessment Questionnaire-HAQ, 12-Item Short-Form Survey-SF-12) and functional (American Orthopedic Foot & Ankle-AOFAS, Kofoed, Takakura) scores were used. For pain assessment, Visual Analog Scale was used (VAS).ResultsAfter the surgery, group A and B had a statistically significant improvement in the joint function and pain relief according to AOFAS (A: 32.6 to 68.2; B: 27.4 to 61.3), Kofoed (A: 31.8 to 68; B: 25.9 to 60.3), Takakura (A: 30.6 to 62.9; B: 25.4 to 49.3), and VAS scores (A: 7.28 to 4.14; B: 7.33 to 3.78) compared with preoperative scores. After the surgery, quality of life scores improved in both groups, for HAQ (A: 0.91 to 0.53; B: 1.34 to 0.56) and for SF-12 (A: 26.6 to 36.8; B: 25.6 to 38.0).ConclusionsThe comparison of total ankle arthroplasty and ankle arthrodesis in treatment of end-stage ankle osteoarthritis did not reveal any significant differences.

It has been suggested that patients with knee post-traumatic arthritis (PA), associated or not to haemarthrosis (HA), display altered oxidant and anti-oxidant systems in their synovial fluid. This study aimed to establish whether this is really the case. Synovial fluid samples were obtained by transdermal arthrocentesis from 69 patients with PA (36 of them had HA) and 22 control subjects. The activities of synovial fluid zinc-copper superoxide dismutase (ZnCuSOD) and manganese superoxide dismutase (MnSOD) isoenzymes, catalase (CAT), glutathione peroxidase (GPX), glutathione reductase (GR) and glutathione-S-transferase (GST) enzymes, and malondialdehyde (MDA) concentration and synovial fluid viscosity were measured in the study groups. Patients with PA had significantly increased activities of all antioxidant enzymes, except CAT, and MDA concentration than did the controls. However, synovial fluid viscosity was found to be decreased in the study group, mainly in the HA subgroup. Results suggest that excessive free radicals production may exist in synovial fluid of PA patients and may contribute to knee joint destruction.

Background Oxidative stress is a disruption of the pro-oxidative-antioxidant balance, caused by excessive production or ineffective removal of reactive oxygen species. Material/Methods The study included 42 male patients aged 38 to 69 years. The first group consisted of 21 men with osteoarthritis after primary hip arthroplasty using the Smith & Nephew Birmingham Hip Resurfacing implant. The second group included 21 men after hip arthroplasty using the femoral neck SPIRON K-implant. In both groups, concentrations of ions, the antioxidant system in the blood, and parameters of oxidative stress were evaluated twice. Clinical assessment using the Western Ontario and McMaster Universities Osteoarthritis Index, Harris Hip Score, and Short Form (12) Health Survey (SF-12) scales was performed. Results Concentrations of metal ions in the blood and the level of oxidative stress were significantly higher in the resurfacing group than in the femoral neck arthroplasty group. The response of the antioxidant system was significantly greater in the femoral neck arthroplasty group. During clinical evaluation, groups did not show significant differences, with the exception of greater shortening of the operated limb and a lower score in the mental-sphere of the SF-12 scale in the resurfacing arthroplasty group. Conclusions Resurfacing hip arthroplasty increased oxidative stress, increased the concentration of metal ions, and did not affect alignment of the abbreviation of the operated limb. A significant improvement in the quality of life of patients in the mental sphere according to the SF-12 occurred after the application of resurfacing arthroplasty, in the first month after the procedure.

An adequate level of physical activity has a substantial effect on both mental and physical human health. Physical activity is largely dependent on the function of the musculoskeletal and articular system. One of the most frequent diseases of this system is degenerative joint disease. Due to the changing and more demanding lifestyles and patients’ willingness to be involved in sports activity, the expectations of hip joint arthroplasty are becoming increasingly high. Alleviating pain ceases to be the only reason for which patients choose surgical interventions, while the expectations often include involvement in various sports. Only few studies contain recommendations concerning the frequency, type and intensity of sports activity which are acceptable after hip joint arthroplasty. The aim of the study was to evaluate function and physical activity of people following cementless short-stem hip joint arthroplasty in the observation of at least five years. The study group comprised 106 patients who underwent total hip arthroplasty due to degenerative joint diseases, chosen according to inclusion criteria. Patients underwent routine physical examinations following the Harris Hip Score protocol, responded to the UCLA scale and questionnaires concerning pre-surgical and current physical activity. Our results demonstrated that hip joint arthroplasty in people suffering from degenerative joint diseases has a beneficial effect on their level of functioning and physical activity. Although physical activity and the level of functioning obviously reduced as a person aged, the level of physical activity continued to be very high in both groups, with function of the hip joint evaluated as very good.