Hrvoje Mokrovic - Academia.edu (original) (raw)
Papers by Hrvoje Mokrovic
Medicina Fluminensis : Medicina Fluminensis, Sep 2, 2013
Medicina Fluminensis, 2020
Anterolateralni mekotkivni sindrom sraza gležnja je stanje kod kojeg dolazi do uklještenja kronič... more Anterolateralni mekotkivni sindrom sraza gležnja je stanje kod kojeg dolazi do uklještenja kronično upalno promijenjenih hipertrofiranih mekih tkiva unutar zgloba između prednjega ruba tibije i vrata talusa pri dorzalnoj fleksiji stopala. Predstavlja jedan od češćih uzroka kroničnog bola u gležnju zaostalih nakon ozljede. Javlja se kao komplikacija uganuća gležnja u 1 do 2 % slučajeva. Ozljeda ligamenata i prednje zglobne kapsule, kao i okolnog masnog tkiva, dovodi do lokalne upalne reakcije tkiva te zbog ponavljajuće mikrotraume do kroničnog sinovitisa uz hiperplaziju i fibrozu mekih tkiva. Dijagnoza se temelji na anamnezi i kliničkom pregledu te rendgenološkoj obradi, upotpunjenima ultrazvučnom pretragom i magnetskom rezonancijom (MR). U većini slučajeva anterolateralni mekotkivni sraz zahtijeva operacijsko liječenje. Artroskopija gležnja predstavlja zlatni standard u operacijskom liječenju.
Bolno rame je jedno od najčešćih stanja s kojim se susreću liječnici u ortopediji i čini oko 20% ... more Bolno rame je jedno od najčešćih stanja s kojim se susreću liječnici u ortopediji i čini oko 20% patologije koštano-mišićnog sustava. Rameni je zglob zahvaljujući svojim biomehaničkim osobinama najpokretljiviji zglob u ljudskom tijelu, no ujedno i relativno nestabilan zglob, što ga čini posebno osjetljivim na ozljede. Uzroci bolnog ramena mogu biti različiti: upala i lezija tetiva rotatorne manžete, bolesti akromioklavikularnog zgloba, adhesivni kapsulitis, nestabilnosti ramena te artroza glenohumoralnog zgloba. Kliničkom slikom dominira bolnost uz koju je često prisutna smanjena gibljivost ramenog zgloba. S obzirom na važnu ulogu ramena u svakodnevnim aktivnostima iznimno je važno na vrijeme prepoznati uzrok bolnog ramena te započeti s adekvatnim liječenjem.Shoulder pain is one of the most common causes why people come to visit orthopaedic surgeons. It makes approximately 20% of musculoskeletal pathology. The shoulder`s biomechanical characteristics make it the most mobile joint bu...
Medicina Fluminensis, Sep 2, 2013
Sažetak. Cilj: Uznapredovala artroza gležnja kod koje se bol i smanjena pokretljivost zgloba ne p... more Sažetak. Cilj: Uznapredovala artroza gležnja kod koje se bol i smanjena pokretljivost zgloba ne poboljšavaju na konzervativnu terapiju predstavlja indikaciju za artrodezu gležnja. Cilj ovog rada bio je analizirati rezultate liječenja uznapredovale artroze gležnja artroskopskom artrodezom gležnja. Metode: U Klinici za ortopediju Lovran u razdoblju od 2000. do 2010. godine 8 bolesnika liječeno je artroskopskom artrodezom gležnja. Prosječna dob bolesnika bila je 55,5 godina. Kod svih bolesnika radilo se o artrozi četvrtog stupnja po Kellgren-Lawrenceovoj podjeli. Fiksacija mjesta artrodeze učinjena je u 6 bolesnika unutarnjom fiksacijom vijcima, dok je u 2 bolesnika korišten vanjski fiksator. Svi su bolesnici radiološki obrađeni prije i poslije operacijskog zahvata standardnim stojećim snimkama gležnja u dva smjera. Mjereni su tibiotalarni kutovi te je praćeno vrijeme zaraštavanja artrodeze zgloba. Rezultati: Radiološki su rezultati pokazali da je prosječni postoperacijski kut između anatomske uzdužne osi tibije i talusa bio na antero-posteriornim snimkama gležnja 93,85°, a na latero-lateralnim snimkama 107,5°. Koštano cijeljenje na mjestu artrodeze završeno je u razdoblju od 12 tjedana kod svih bolesnika. Zaključak: Dobiveni rezultati, iako analizirani na maloj skupini bolesnika, potvrđuju uspješnost primjene kirurške tehnike artroskopske artrodeze gležnja.
Collegium antropologicum, 2011
This report describes a case of a 29-year old patient with congenital pseudoarthrosis of the dist... more This report describes a case of a 29-year old patient with congenital pseudoarthrosis of the distal tibia previously treated unsuccessfully by a conventional surgical method. Tibial congenital pseudoarthrosis is a rare disease characterized by segmental osseous weakness resulting in deformation of the bone and spontaneous fractures which progresses to a tibial nonunion. In our case we used intramedullary stabilization with bone grafting and six month after operation congenital pseudarthrosis of the tibia healed.
ABSTRACT Sports activities represent high risk for lumbal spine injuries. The most common injurie... more ABSTRACT Sports activities represent high risk for lumbal spine injuries. The most common injuries of the spine in athletes are musculoligamentous sprains and strains, which occur mainly at the lumbosacral region. Sprains are ligamentous injuries caused by sudden violent contraction, sudden torsion, severe direct blows, or a forceful straightening from a crouched position. Strains are defined as tears, either partial or complete, of the muscle-tendon unit. Muscle strains and tears most frequently result from violent muscular contraction during an excessively forceful muscular stretch. The main simptoms are low back pain and muscle spasms. Treatment is conservative.
332 sažetak. Bolno rame je jedno od najčešćih stanja s kojim se susreću liječnici u ortopediji i ... more 332 sažetak. Bolno rame je jedno od najčešćih stanja s kojim se susreću liječnici u ortopediji i čini oko 20% patologije koštano-mišićnog sustava. Rameni je zglob zahvaljujući svojim biomehaničkim osobinama najpokretljiviji zglob u ljudskom tijelu, no ujedno i relativno nesta-bilan zglob, što ga čini posebno osjetljivim na ozljede. Uzroci bolnog ramena mogu biti različiti: upala i lezija tetiva rotatorne manžete, bolesti akromioklavikularnog zgloba, adhesivni kapsuli-tis, nestabilnosti ramena te artroza glenohumoralnog zgloba. Kliničkom slikom dominira bol-nost uz koju je često prisutna smanjena gibljivost ramenog zgloba. S obzirom na važnu ulogu ramena u svakodnevnim aktivnostima iznimno je važno na vrijeme prepoznati uzrok bolnog ramena te započeti s adekvatnim liječenjem. Ključne riječi: bolno rame, glenohumeralni zglob, rotatorna manžeta abstract. Shoulder pain is one of the most common causes why people come to visit ortho-paedic surgeons. It makes approximately 20% of musculos...
International Orthopaedics, 2021
The goal of total hip endoprosthesis is to achieve painless and functional hip for long term. Acc... more The goal of total hip endoprosthesis is to achieve painless and functional hip for long term. Accurate reconstruction of hip anatomy largely depends on the implant design. In order to select an implant in correspondence with the native hip, the proximal femoral morphology has been in focus of many studies in the past years. The purpose of this study is to analyze proximal femoral geometry in the Croatian population by radiographic evaluation. We conducted a retrospective study analyzing conventional radiographies of the hip, obtained within the last four years from the database of Clinic for Orthopaedic Surgery Lovran. The number of studied patients was 300,168 women and 132 men. The proximal femoral geometric parameters assessed were as follows: femoral head diameter, femoral neck length, neck-shaft angle, angle of femoral neck anteversion, and lateral femoral offset. The results obtained were compared between genders and with results of other studies. Proximal femoral anatomy diff...
Medicina Fluminensis, Mar 2, 2015
In the past 60 years, primary THA has been one of the most successful and most performed orthopae... more In the past 60 years, primary THA has been one of the most successful and most performed orthopaedic procedure. Over the years, hip arthroplasty has changed, and research continues to improve its results. Better materials and design provide patients with an increased range of motion with enhanced stability and very low wear. In recent years, there have been a number of reports describing the performance of THA through smaller incisions using minimally invasive surgical techniques, aimed to spare the soft tissue, especially the abductor musculature. These techniques allow less post-operative pain, reduced blood loss, shorter hospitalization, better functional recovery and faster return to everyday routine. However, tissue sparing techniques can result in numerous complications related to the learning curve. Today four minimally invasive approaches have been described and many of their modifications. All of them are technically demanding, and may require specialized instruments and equipments. This article describes in detail the surgical technique of a minimally invasive anterolateral hip approach with patients in the supine position, including the preoperative setting, with pearls and tips based on the authors' experience.
Medicina Fluminensis, Sep 2, 2013
Sažetak. Kompresija neuroloških struktura od strane hernije diska u kralježnici s osjetno-motorni... more Sažetak. Kompresija neuroloških struktura od strane hernije diska u kralježnici s osjetno-motornim deficitom predstavlja indikaciju za operativno liječenje. Devedesetih godina prošlog stoljeća dolazi do razvoja mini invazivnih dekompresijskih tehnika i primjene endoskopske discektomije u liječenju diskus hernije. Koncept ovakvog načina operiranja proizašao je iz komplikacija dosadašnje klasične kirurgije kralježnice te relativno visokog postotka recidiva. Osnovno načelo ove metode je minimalno invazivni pristup koji omogućava veću preciznost prilikom izvođenja zahvata, manje oštećenje tkiva, skraćenje vremena potrebnog za oporavak i brži povratak na posao. Najširu primjenu endoskopska discektomija ima u području kirurgije lumbalnog diska.
Collegium Antropologicum, Jan 29, 2014
We report the first case of osteochondritis dissecans (OCD) affecting a large area of lateral and... more We report the first case of osteochondritis dissecans (OCD) affecting a large area of lateral and medial femoral condyles with adult-onset in the same knee of the 22-year old professional athlete with respect to result of applied therapeutic procedure. After a clinical examination, radiograph and magnetic resonance imaging showed a huge bicondylar OCD. Through arthrotomy, the osteochondral fragment was fixed with biodegradable pins combined with two threaded 4 mm cobalt-chrome cancellous screws. By using this surgical fixation procedure, osteochondral fragments healed completely, which is evidenced artroscopically one year after a new trauma episode which resulted in the lateral meniscus reinjury. According to our knowledge this is the first reported case of bicondylar OCD affecting adult knee. In the rare case of such a large osteochondral defect, when fixation with biodegradable pins could be insufficient, a combination with cancellous screws can bring good results, even in professional athletes.
Medicina Fluminensis, Mar 2, 2015
In the past 60 years, primary THA has been one of the most successful and most performed orthopae... more In the past 60 years, primary THA has been one of the most successful and most performed orthopaedic procedure. Over the years, hip arthroplasty has changed, and research continues to improve its results. Better materials and design provide patients with an increased range of motion with enhanced stability and very low wear. In recent years, there have been a number of reports describing the performance of THA through smaller incisions using minimally invasive surgical techniques, aimed to spare the soft tissue, especially the abductor musculature. These techniques allow less post-operative pain, reduced blood loss, shorter hospitalization, better functional recovery and faster return to everyday routine. However, tissue sparing techniques can result in numerous complications related to the learning curve. Today four minimally invasive approaches have been described and many of their modifications. All of them are technically demanding, and may require specialized instruments and equipments. This article describes in detail the surgical technique of a minimally invasive anterolateral hip approach with patients in the supine position, including the preoperative setting, with pearls and tips based on the authors' experience.
Collegium antropologicum
This report describes a chondromyxoid fibroma of the second metacarpal bone in a 32-year-old fema... more This report describes a chondromyxoid fibroma of the second metacarpal bone in a 32-year-old female patient. Chondromyxoid fibroma is a rare, benign, slow-growing bone tumor of cartilaginous origin. Tumor has a high recurrance rate. Our aim was to show successful treatment of a metacarpal chondromyxoid fibroma with wide resection and implantation of finger join endoprosthesis.
Medicina Fluminensis : Medicina Fluminensis, Sep 2, 2013
Medicina Fluminensis, 2020
Anterolateralni mekotkivni sindrom sraza gležnja je stanje kod kojeg dolazi do uklještenja kronič... more Anterolateralni mekotkivni sindrom sraza gležnja je stanje kod kojeg dolazi do uklještenja kronično upalno promijenjenih hipertrofiranih mekih tkiva unutar zgloba između prednjega ruba tibije i vrata talusa pri dorzalnoj fleksiji stopala. Predstavlja jedan od češćih uzroka kroničnog bola u gležnju zaostalih nakon ozljede. Javlja se kao komplikacija uganuća gležnja u 1 do 2 % slučajeva. Ozljeda ligamenata i prednje zglobne kapsule, kao i okolnog masnog tkiva, dovodi do lokalne upalne reakcije tkiva te zbog ponavljajuće mikrotraume do kroničnog sinovitisa uz hiperplaziju i fibrozu mekih tkiva. Dijagnoza se temelji na anamnezi i kliničkom pregledu te rendgenološkoj obradi, upotpunjenima ultrazvučnom pretragom i magnetskom rezonancijom (MR). U većini slučajeva anterolateralni mekotkivni sraz zahtijeva operacijsko liječenje. Artroskopija gležnja predstavlja zlatni standard u operacijskom liječenju.
Bolno rame je jedno od najčešćih stanja s kojim se susreću liječnici u ortopediji i čini oko 20% ... more Bolno rame je jedno od najčešćih stanja s kojim se susreću liječnici u ortopediji i čini oko 20% patologije koštano-mišićnog sustava. Rameni je zglob zahvaljujući svojim biomehaničkim osobinama najpokretljiviji zglob u ljudskom tijelu, no ujedno i relativno nestabilan zglob, što ga čini posebno osjetljivim na ozljede. Uzroci bolnog ramena mogu biti različiti: upala i lezija tetiva rotatorne manžete, bolesti akromioklavikularnog zgloba, adhesivni kapsulitis, nestabilnosti ramena te artroza glenohumoralnog zgloba. Kliničkom slikom dominira bolnost uz koju je često prisutna smanjena gibljivost ramenog zgloba. S obzirom na važnu ulogu ramena u svakodnevnim aktivnostima iznimno je važno na vrijeme prepoznati uzrok bolnog ramena te započeti s adekvatnim liječenjem.Shoulder pain is one of the most common causes why people come to visit orthopaedic surgeons. It makes approximately 20% of musculoskeletal pathology. The shoulder`s biomechanical characteristics make it the most mobile joint bu...
Medicina Fluminensis, Sep 2, 2013
Sažetak. Cilj: Uznapredovala artroza gležnja kod koje se bol i smanjena pokretljivost zgloba ne p... more Sažetak. Cilj: Uznapredovala artroza gležnja kod koje se bol i smanjena pokretljivost zgloba ne poboljšavaju na konzervativnu terapiju predstavlja indikaciju za artrodezu gležnja. Cilj ovog rada bio je analizirati rezultate liječenja uznapredovale artroze gležnja artroskopskom artrodezom gležnja. Metode: U Klinici za ortopediju Lovran u razdoblju od 2000. do 2010. godine 8 bolesnika liječeno je artroskopskom artrodezom gležnja. Prosječna dob bolesnika bila je 55,5 godina. Kod svih bolesnika radilo se o artrozi četvrtog stupnja po Kellgren-Lawrenceovoj podjeli. Fiksacija mjesta artrodeze učinjena je u 6 bolesnika unutarnjom fiksacijom vijcima, dok je u 2 bolesnika korišten vanjski fiksator. Svi su bolesnici radiološki obrađeni prije i poslije operacijskog zahvata standardnim stojećim snimkama gležnja u dva smjera. Mjereni su tibiotalarni kutovi te je praćeno vrijeme zaraštavanja artrodeze zgloba. Rezultati: Radiološki su rezultati pokazali da je prosječni postoperacijski kut između anatomske uzdužne osi tibije i talusa bio na antero-posteriornim snimkama gležnja 93,85°, a na latero-lateralnim snimkama 107,5°. Koštano cijeljenje na mjestu artrodeze završeno je u razdoblju od 12 tjedana kod svih bolesnika. Zaključak: Dobiveni rezultati, iako analizirani na maloj skupini bolesnika, potvrđuju uspješnost primjene kirurške tehnike artroskopske artrodeze gležnja.
Collegium antropologicum, 2011
This report describes a case of a 29-year old patient with congenital pseudoarthrosis of the dist... more This report describes a case of a 29-year old patient with congenital pseudoarthrosis of the distal tibia previously treated unsuccessfully by a conventional surgical method. Tibial congenital pseudoarthrosis is a rare disease characterized by segmental osseous weakness resulting in deformation of the bone and spontaneous fractures which progresses to a tibial nonunion. In our case we used intramedullary stabilization with bone grafting and six month after operation congenital pseudarthrosis of the tibia healed.
ABSTRACT Sports activities represent high risk for lumbal spine injuries. The most common injurie... more ABSTRACT Sports activities represent high risk for lumbal spine injuries. The most common injuries of the spine in athletes are musculoligamentous sprains and strains, which occur mainly at the lumbosacral region. Sprains are ligamentous injuries caused by sudden violent contraction, sudden torsion, severe direct blows, or a forceful straightening from a crouched position. Strains are defined as tears, either partial or complete, of the muscle-tendon unit. Muscle strains and tears most frequently result from violent muscular contraction during an excessively forceful muscular stretch. The main simptoms are low back pain and muscle spasms. Treatment is conservative.
332 sažetak. Bolno rame je jedno od najčešćih stanja s kojim se susreću liječnici u ortopediji i ... more 332 sažetak. Bolno rame je jedno od najčešćih stanja s kojim se susreću liječnici u ortopediji i čini oko 20% patologije koštano-mišićnog sustava. Rameni je zglob zahvaljujući svojim biomehaničkim osobinama najpokretljiviji zglob u ljudskom tijelu, no ujedno i relativno nesta-bilan zglob, što ga čini posebno osjetljivim na ozljede. Uzroci bolnog ramena mogu biti različiti: upala i lezija tetiva rotatorne manžete, bolesti akromioklavikularnog zgloba, adhesivni kapsuli-tis, nestabilnosti ramena te artroza glenohumoralnog zgloba. Kliničkom slikom dominira bol-nost uz koju je često prisutna smanjena gibljivost ramenog zgloba. S obzirom na važnu ulogu ramena u svakodnevnim aktivnostima iznimno je važno na vrijeme prepoznati uzrok bolnog ramena te započeti s adekvatnim liječenjem. Ključne riječi: bolno rame, glenohumeralni zglob, rotatorna manžeta abstract. Shoulder pain is one of the most common causes why people come to visit ortho-paedic surgeons. It makes approximately 20% of musculos...
International Orthopaedics, 2021
The goal of total hip endoprosthesis is to achieve painless and functional hip for long term. Acc... more The goal of total hip endoprosthesis is to achieve painless and functional hip for long term. Accurate reconstruction of hip anatomy largely depends on the implant design. In order to select an implant in correspondence with the native hip, the proximal femoral morphology has been in focus of many studies in the past years. The purpose of this study is to analyze proximal femoral geometry in the Croatian population by radiographic evaluation. We conducted a retrospective study analyzing conventional radiographies of the hip, obtained within the last four years from the database of Clinic for Orthopaedic Surgery Lovran. The number of studied patients was 300,168 women and 132 men. The proximal femoral geometric parameters assessed were as follows: femoral head diameter, femoral neck length, neck-shaft angle, angle of femoral neck anteversion, and lateral femoral offset. The results obtained were compared between genders and with results of other studies. Proximal femoral anatomy diff...
Medicina Fluminensis, Mar 2, 2015
In the past 60 years, primary THA has been one of the most successful and most performed orthopae... more In the past 60 years, primary THA has been one of the most successful and most performed orthopaedic procedure. Over the years, hip arthroplasty has changed, and research continues to improve its results. Better materials and design provide patients with an increased range of motion with enhanced stability and very low wear. In recent years, there have been a number of reports describing the performance of THA through smaller incisions using minimally invasive surgical techniques, aimed to spare the soft tissue, especially the abductor musculature. These techniques allow less post-operative pain, reduced blood loss, shorter hospitalization, better functional recovery and faster return to everyday routine. However, tissue sparing techniques can result in numerous complications related to the learning curve. Today four minimally invasive approaches have been described and many of their modifications. All of them are technically demanding, and may require specialized instruments and equipments. This article describes in detail the surgical technique of a minimally invasive anterolateral hip approach with patients in the supine position, including the preoperative setting, with pearls and tips based on the authors' experience.
Medicina Fluminensis, Sep 2, 2013
Sažetak. Kompresija neuroloških struktura od strane hernije diska u kralježnici s osjetno-motorni... more Sažetak. Kompresija neuroloških struktura od strane hernije diska u kralježnici s osjetno-motornim deficitom predstavlja indikaciju za operativno liječenje. Devedesetih godina prošlog stoljeća dolazi do razvoja mini invazivnih dekompresijskih tehnika i primjene endoskopske discektomije u liječenju diskus hernije. Koncept ovakvog načina operiranja proizašao je iz komplikacija dosadašnje klasične kirurgije kralježnice te relativno visokog postotka recidiva. Osnovno načelo ove metode je minimalno invazivni pristup koji omogućava veću preciznost prilikom izvođenja zahvata, manje oštećenje tkiva, skraćenje vremena potrebnog za oporavak i brži povratak na posao. Najširu primjenu endoskopska discektomija ima u području kirurgije lumbalnog diska.
Collegium Antropologicum, Jan 29, 2014
We report the first case of osteochondritis dissecans (OCD) affecting a large area of lateral and... more We report the first case of osteochondritis dissecans (OCD) affecting a large area of lateral and medial femoral condyles with adult-onset in the same knee of the 22-year old professional athlete with respect to result of applied therapeutic procedure. After a clinical examination, radiograph and magnetic resonance imaging showed a huge bicondylar OCD. Through arthrotomy, the osteochondral fragment was fixed with biodegradable pins combined with two threaded 4 mm cobalt-chrome cancellous screws. By using this surgical fixation procedure, osteochondral fragments healed completely, which is evidenced artroscopically one year after a new trauma episode which resulted in the lateral meniscus reinjury. According to our knowledge this is the first reported case of bicondylar OCD affecting adult knee. In the rare case of such a large osteochondral defect, when fixation with biodegradable pins could be insufficient, a combination with cancellous screws can bring good results, even in professional athletes.
Medicina Fluminensis, Mar 2, 2015
In the past 60 years, primary THA has been one of the most successful and most performed orthopae... more In the past 60 years, primary THA has been one of the most successful and most performed orthopaedic procedure. Over the years, hip arthroplasty has changed, and research continues to improve its results. Better materials and design provide patients with an increased range of motion with enhanced stability and very low wear. In recent years, there have been a number of reports describing the performance of THA through smaller incisions using minimally invasive surgical techniques, aimed to spare the soft tissue, especially the abductor musculature. These techniques allow less post-operative pain, reduced blood loss, shorter hospitalization, better functional recovery and faster return to everyday routine. However, tissue sparing techniques can result in numerous complications related to the learning curve. Today four minimally invasive approaches have been described and many of their modifications. All of them are technically demanding, and may require specialized instruments and equipments. This article describes in detail the surgical technique of a minimally invasive anterolateral hip approach with patients in the supine position, including the preoperative setting, with pearls and tips based on the authors' experience.
Collegium antropologicum
This report describes a chondromyxoid fibroma of the second metacarpal bone in a 32-year-old fema... more This report describes a chondromyxoid fibroma of the second metacarpal bone in a 32-year-old female patient. Chondromyxoid fibroma is a rare, benign, slow-growing bone tumor of cartilaginous origin. Tumor has a high recurrance rate. Our aim was to show successful treatment of a metacarpal chondromyxoid fibroma with wide resection and implantation of finger join endoprosthesis.