Browsing by Author "Mirković, Milan (57190251388)"

Background/Aim. Total hip arthroplasty is the replacement of the hip joint with an artificial one. Standard surgical procedures involve a long skin incision and extensive dissection of healthy tissue. Mini-incision surgery is a modification of standard operative approaches. In addition to a significantly smaller skin incision, the main difference is based on much less damage to soft tissues, especially the muscles that move the hip. The aim of this study was to compare the early results of the mini-incision and a standard approach in total hip arthroplasty and to determine the advantages and disadvantages of the mini-incision surgical technique. Methods. A retrospective study analyzed data based on 63 patients who underwent total hip arthroplasty with a mini-incision and standard approach at the Institute of Orthopaedic Surgery “Banjica”, Belgrade from 2004 to 2010. All the patients suffered from primary coxarthrosis. All operations were carried out by the same surgical team. All patients were clinically evaluated before and after the surgery using the Harris Hip Score (HHS). Results. The group of patients operated on with the mini-incision approach included 32 patients, while 31 patients made up the group of patients operated on with the standard approach. Comparing these groups did not reveal a statistically significant difference in age, body mass index, surgery duration, and HHS before the surgery. A statistically significant difference was determined by comparing intraoperative blood loss, the amount of drainage fluid after the surgery, and the HHS after the surgery. Conclusion. The mini-incision posterolateral approach, compared to the standard approach, apart from an esthetically more acceptable scar, achieves significantly less intraoperative blood loss and better hip function with almost the same risk of complications. © 2022 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Background: Preoperative differentiation of ovarian malignant tumors still remains a challenge. Diffusion-weighted imaging (DWI) provides information about cellularity of the lesion and might facilitate discrimination between different malignant ovarian lesions. Purpose: To evaluate magnetic resonance imaging (MRI) findings of endometrioid adenocarcinoma of the ovary and to determine the value of DWI in the differential diagnosis of malignant and benign adnexal tumors. Material and Methods: The following MRI findings were reviewed in 162 patients (21 endometrioid adenocarcinoma, 103 other malignant tumors, 38 benign tumors): lesion size, morphological appearance, T2-weighted (T2W) signal intensity, T1-weighted (T1W) signal intensity, contrast-enhancement pattern, DWI signals with apparent diffusion coefficient (ADC) calculated for b800 s/mm2 in solid tumor components. Results: The most common morphological appearance was predominantly cystic lesion, found in 90.3% of patients with endometriod adenocarcinoma. The solid parts were slightly hyperintense on T2W images in 19 patients with marked enhancement after contrast administration. No significant difference (P0.13) in conventional MRI features was found between endometrioid adenocarcinoma and other malignant ovarian tumors. Hyperintensity on DWI was more frequently observed in malignant tumors than in benign lesions (P<0.001). ADC values were significantly lower in endometrioid adenocarcinoma than other malignant tumors (0.79=0.21 vs. 0.90=0.19; P0.04) and in all malignant lesions compared with benign tumors (0.88=0.31 vs. 1.33=0.17; P<0.001). Conclusion: DWI with ADC measurement could indicate the presence of endometrioid adenocarcinomas due to a slightly but significantly lower ADC values compared to other malignant ovarian lesions. Thus, DWI is beneficial and should be part of a standard protocol for the evaluation of indeterminate adnexal lesions. © The Foundation Acta Radiologica 2015.

Background: Preoperative differentiation of ovarian malignant tumors still remains a challenge. Diffusion-weighted imaging (DWI) provides information about cellularity of the lesion and might facilitate discrimination between different malignant ovarian lesions. Purpose: To evaluate magnetic resonance imaging (MRI) findings of endometrioid adenocarcinoma of the ovary and to determine the value of DWI in the differential diagnosis of malignant and benign adnexal tumors. Material and Methods: The following MRI findings were reviewed in 162 patients (21 endometrioid adenocarcinoma, 103 other malignant tumors, 38 benign tumors): lesion size, morphological appearance, T2-weighted (T2W) signal intensity, T1-weighted (T1W) signal intensity, contrast-enhancement pattern, DWI signals with apparent diffusion coefficient (ADC) calculated for b800 s/mm2 in solid tumor components. Results: The most common morphological appearance was predominantly cystic lesion, found in 90.3% of patients with endometriod adenocarcinoma. The solid parts were slightly hyperintense on T2W images in 19 patients with marked enhancement after contrast administration. No significant difference (P0.13) in conventional MRI features was found between endometrioid adenocarcinoma and other malignant ovarian tumors. Hyperintensity on DWI was more frequently observed in malignant tumors than in benign lesions (P<0.001). ADC values were significantly lower in endometrioid adenocarcinoma than other malignant tumors (0.79=0.21 vs. 0.90=0.19; P0.04) and in all malignant lesions compared with benign tumors (0.88=0.31 vs. 1.33=0.17; P<0.001). Conclusion: DWI with ADC measurement could indicate the presence of endometrioid adenocarcinomas due to a slightly but significantly lower ADC values compared to other malignant ovarian lesions. Thus, DWI is beneficial and should be part of a standard protocol for the evaluation of indeterminate adnexal lesions. © The Foundation Acta Radiologica 2015.

Introduction/Objective The knee joint is prone to injuries caused by direct or indirect trauma. The meniscus and ligament injuries, cannot be completely diagnosed with clinical examination; therefore, we use additional non-invasive and invasive diagnostic methods such as magnetic resonance imaging (MRI) and arthroscopy. The aim was to compare the accuracy of MRI and objective knee findings based on arthroscopic examination in case of meniscus and anterior cruciate ligament injuries. Methods The study involved 50 patients treated with elective surgery which mandatory involved arthroscopic visualization of the knee structures. We compared the MRI findings, obtained from different institutions, and arthroscopic knee findings for all the patients involved in the study. Results There were 50 patients included in the study with mean age of 31 years. MRI showed that Anterior cruciate ligament was damaged in 41 patients, while arthroscopy confirmed damage in 43 patients. Medial meniscus was damaged in 31 patients on MRI and in 27 on arthroscopic examination. Lateral meniscus was injured in 35 patients on MRI and arthroscopy showed damage in 32 patients. Using χ2 test we found no significant difference between MRI and arthroscopy as diagnostic methods. Wilcoxon signed-rank test shows similar results between MRI and arthroscopy findings. Conclusion A comparative analysis of MRI and arthroscopy diagnostic value in case of anterior cruciate ligament, medial meniscus and lateral meniscus injuries have shown that there is no significant difference between these two methods. © 2022, Serbia Medical Society. All rights reserved.

Introduction/Objective Heel deformity accompanied by pain at the attachment of the Achilles tendon is generally known as Haglund’s syndrome. The prominence of the posterosuperior part of the heel bone generates pressure on the retrocalcaneal bursa and Achilles tendon, causing swelling and pain. The condition itself can be treated using surgical or non-surgical methods. The aim was to present our first experiences in the endoscopic treatment of Haglund’s syndrome, employing the three-portal technique. Methods This study includes ten patients whose surgeries were performed during the period between January 2019, and May 2020. All interventions were endoscopic with the three-portal technique used. The diagnosis was made based on the anamnesis, clinical examination, X-rays, and magnetic resonance imaging diagnostics. For the evaluation of results, the AOFAS (American Orthopedic Foot and Ankle Society) score was used. Results The endoscopic findings in all patients revealed a hypertrophic retrocalcaneal bursa and prominence at the posterosuperior part of the calcaneus, generating pressure on the Achilles tendon. By employing the three-portal technique, considerably better visualization is obtained, enabling easy removal of the degenerated tissue. The radiographic control image was satisfactory. The result of the AOFAS score showed a significant improvement after the surgery. Conclusion The endoscopic approach and the use of the three-portal technique in resolving Haglund’s syndrome is a secure procedure that produces good results. It enables faster recovery and fewer complications compared to open surgery. © 2023, Serbia Medical Society. All rights reserved.