Browsing by Author "Vukasinovic, Zoran (7003989550)"

The aim of the study was to evaluate the reliability and durability of alumina-on-alumina ceramic in comparison to metal-on-highly cross-linked polyethylene (CoCr/HXLPE) bearing couples. This prospective randomised study involved 150 patients (157 hips). All patients (mean age: 54.7 years) obtained an identical fibre metal midcoat femoral stem and fibre metal-coated acetabular shell. In 78 patients (82 hips) we used alumina, while in 72 patients (75 hips) metal-polyethylene bearing couples were used. During a mean 50.4-month follow-up period (51 ± 8 alumina and 50 ± 8.9 metal-polyethylene) no statistically significant changes in clinical and radiographic parameters were noted between the two groups. There was no ceramic breakage and no need for revision surgery due to the ceramic liner. The alumina bearing couples proved to be as reliable as CoCr/HXLPE. © 2009 Springer-Verlag.

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.

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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.

Objective: In order to measure patients' satisfaction in the Institute of Orthopaedic Surgery "Banjica" there was study about quality of healthcare services, quality of employees practice, as well as, quality of healthcare treatments and other services. Methodology: The questionnaires, focus group interviews, were conducted with 90 patients, consumers of healthcare services in Institute of Orthopaedic Surgery "Banjica" from August to November 2010. Interviews were anonymous, which gives freedom of opinion in patients' population. Results: The results show that patients' satisfaction with healthcare services in this Institute is very high. According to the results, it is 85.8% patients which are very satisfied with healthcare services. Evaluation of general satisfaction, 70.1% of patients have opinion that this Institute is more competitive then others on healthcare orthopaedic market place in Serbia. Patients will choose this Institute again for their healthcare problems (85.6%), which show that this Institute has very satisfied patients and patients which will give good recommendation for the Institute. Conclusions: Satisfaction of patients is key point in healthcare organizations, because their satisfaction is real measure of healthcare institutions work and measure of branding institutions in patients' mind. Also, patients' satisfaction shows real position of healthcare institutions on market place. The truth is that healthcare organizational strength comes from within the team of people that work there, which fulfils patients' satisfaction with their practices as doctors, nurses, technicians and others medical staff. This research present that the Institute of Orthopaedic Surgery "Banjica" is well positioning on healthcare marketplace and that patients are very satisfied with healthcare services in this Institute. According to research, Institute in further work have to follow modern approaches in medicine and management field, in order to keep leader position on healthcare orthopaedic market place.

It is rare for traumatic amputation of the big toe to occur as a single injury. This trauma is especially significant in children for influencing foot development and for possible psychological impact. Two cases of successful replantation of completely amputated big toes in two girls, 2 years 7 months and 5 years 2 months old, are presented. Follow-up was 10 years. In the younger child, the replanted big toe was 49.2 percent shorter compared to the contralateral side, because growth was limited by the affected growth zone in the proximal phalanx. In the older child, the growth zone of the bone was intact, with consequent bone growth unimpaired, and an initial shortage of 10.4 percent was reduced to 2 percent compared to the contralateral side. Copyright © 2006 by Thieme Medical Publishers, Inc.