Browsing by Author "Spasovski, Dusko (25028865800)"

Ninety-nine hips treated by the Chiari pelvic osteotomy were included in this study designed as a retrospective review. The group consisted of 36 male and 50 female patients, with mean age of 15.6 years. Each was diagnosed with developmental dysplasia of the hip (DDH) or avascular necrosis of the femoral head-Legg-Calve- Perthes disease (LCP)-and postreduction avascular necrosis (PAN). Five hip parameters (the acetabular angle of Sharp, the center-edge (CE) angle of Wiberg, the percentage of femoral head uncoverage, the acetabular depth ratio, and the Shenton-Menard arch continuity) were evaluated. Functional outcome was assessed according to Harris hip score (HHS) and McKay criteria for clinical evaluation. The postoperative results showed improvement in all the radiographic parameters. The angle of Sharp showed a decrease of 8.62° (p<0.01). The CE angle of Wiberg showed an increase of 28.76° (p<0.01), and the uncoverage of the femoral head showed a decrease of 51.51% (p<0.01). The improvement of HHS was 11.93 (p<0.05). The patients' satisfaction was indicated by grade 4.1±0.94 and the doctor's satisfaction by grade 3.7±1.16. The Chiari pelvic osteotomy, in spite of the development of biologically better procedures, has retained its position in the treatment of adolescent hip disorders. © Springer-Verlag 2010.

Objective: To define productivity indicators in healthcare department which reflect department functioning and enable productivity measurements over years. Methods: A combination of two methodologies, the Seven Steps of Determining Productivity Indices and the Objectives Matrix Method, was applied at the Department for Pediatric Orthopedics and Traumatology of the Institute for Orthopedic Surgery "Banjica" in Belgrade in order to determine and analyze productivity indicators during the period from 2005 to 2010. Results: Based on Departments' measurable inputs and outputs, productivity indicators were defined, divided in three categories: department, surgeons and nurses. By observing single indicators in Objectives Matrix, the score increased for average length of hospital days which shortened over the observed six years. The relationship between the number of surgeries and the number of working hours in the operating theater increased, as well as the indicators of the productivity of nurses. Productivity indicators of the Department regarding ambulatory working hours were constant in case of ultrasound exams, while those regarding emergency and consultative exams were decreased. Conclusion: Although the methods of the Seven Steps of Determining Productivity Indices and Objectives Matrix have been developed for the needs of industrial organizations, the paper shows that their application is possible in healthcare services as well. Productivity follow-up using indicators and total weighted score during years, enables healthcare managers to analyze low-productivity fields where improvements are needed.

Assessments and testing of young athletes often exclude the fundamental and functional movement capacity, which are critical for healthy motor development of adolescents. The aim of this study was to evaluate functional capacity of young female volleyball players and determine if participation in volleyball leads to development of movement dysfunctions. Two-hundred fifty-eight (258) adolescent female volleyball players (14.3 ± 1.7 yrs) underwent the functional movement screen. Person correlation showed no significant relationship between functional tests and playing experience, while age showed significant, but weak relationship with total functional score (r = 0.189; p < 0.005). Overall, 44% of participants scored less than 14. Paired sample t-tests show significant bilateral asymmetries in hurdle step, in-line lunge, and shoulder mobility tests. Functional movement screen was useful in identifying functional limitations and asymmetries in young female athletes. However, as neither age nor playing experience were strongly associated with functional score, more attention should be given to the qualitative movement assessment of individual tests, rather than the composite score. © 2021. All Rights Reserved.

Assessments and testing of young athletes often exclude the fundamental and functional movement capacity, which are critical for healthy motor development of adolescents. The aim of this study was to evaluate functional capacity of young female volleyball players and determine if participation in volleyball leads to development of movement dysfunctions. Two-hundred fifty-eight (258) adolescent female volleyball players (14.3 ± 1.7 yrs) underwent the functional movement screen. Person correlation showed no significant relationship between functional tests and playing experience, while age showed significant, but weak relationship with total functional score (r = 0.189; p < 0.005). Overall, 44% of participants scored less than 14. Paired sample t-tests show significant bilateral asymmetries in hurdle step, in-line lunge, and shoulder mobility tests. Functional movement screen was useful in identifying functional limitations and asymmetries in young female athletes. However, as neither age nor playing experience were strongly associated with functional score, more attention should be given to the qualitative movement assessment of individual tests, rather than the composite score. © 2021. All Rights Reserved.

[No abstract available]

Purpose: We studied changes of contact stress distribution in the hip joint after Tonnis triple pelvic osteotomy applied in the treatment of dysplasia and hip joint incongruence in adolescents. Methods: In a group of 75 patients, 54 (72 %) female, who underwent surgery by triple pelvic osteotomy in adolescence for developmental disorder of the hip and avascular necrosis of the femoral head, a three-dimensional hip joint model was used based on the radiography of the pelvis with hips. The following biomechanical parameters were calculated: resultant hip force normalised to body weight (R/Wb), inclination of the resultant hip force (θ-R), the position of the stress pole (θ), peak contact hip stress (Pmax), and peak contact hip stress normalised to body weight (Pmax/Wb). Gait quality was also assessed. Results: After surgery the Wiberg CE angle was increased by 17.85 (114 %), resultant hip force normalised to body weight (R/Wb) was decreased by 0.107 (3.3 %), the position of the stress pole was shifted medially by 27.59 (63.5 %), and peak contact hip stress normalised to body weight (Pmax/Wb) was decreased by 2249.74 (55.9 %). Waddling gait was reduced from 17 (23.9 %) to four cases (5.6 %). All changes were statistically highly significant (p<0.01). Conclusions: The effect of Tonnis triple pelvic osteotomy lies in the improvement of stress distribution across the acetabular cartilage of the hip joint, thus slowing down the degenerative damage of the hip joint. © 2012 Springer-Verlag Berlin Heidelberg.

Background/Objectives: Numerous studies have demonstrated the safety and efficacy of intraarticular stem cell injections for treating osteoarthritic knee joints, reporting symptom reduction and pain relief within a few months of treatment. Here, we report the results of a 7-year follow-up after a single intraarticular injection of 0.5–1 × 107 autologous adipose tissue-derived mesenchymal stem cells in patients with OA (Kellgren-Lawrence grade 2 to 4). Methods: Nine patients were treated, and two patients had bilateral disease. Patients were evaluated clinically and radiologically using X-ray and MRI. A comprehensive statistical analysis was undertaken to evaluate the obtained results. Results: All clinical scores and range of motion significantly improved within the first six months after injection. At the 18-month time point, a significant improvement in cartilage structure was observed on MRI while X-ray showed no changes in subchondral bone of distal femur and proximal tibia. At the 60-month time point, the clinical scores were still improved compared to baseline, except for the range of motion, which decreased almost back to the baseline level. At 84 months, the clinical scores decreased significantly toward the baseline level, but the MRI structural characteristics of cartilage still remained significantly better than those measured at baseline. Conclusions: Adipose tissue-derived stem cell therapy has substantial long-term clinical effects on patients with knee osteoarthritis. © 2024 by the authors.