Imre Szerb - Academia.edu (original) (raw)

Papers by Imre Szerb

Research paper thumbnail of The Relationship Between the in Vivo Measured Stiffness and the Histological Stage of Degeneration of Human Knee Articular Cartilage

Purpose: To determine the relationship between the in vivo indentation stiffness and indices of h... more Purpose: To determine the relationship between the in vivo indentation stiffness and indices of histopathological degeneration of human knee articular cartilage. Materials and Methods: Cartilage compressive stiffness was measured in 98 patients during in vivo knee arthroscopies. The age of the patients ranged from 21 to 63 years (mean age 29 years). Male to female ratio of the patients was 37:61. The measurements were performed at eight standard sites. No chondropathic or grade I. chondropathic surfaces were measured. An indentation instrument, Artscan 1000, was used for in vivo measurements. Four plugs were harvested from each knee for histological analysis. The stage of cartilage degeneration was assessed according to Mankin histolopathology score. 16 measurements were performed after ACI. Results: Lateral femoral condyle stiffness (mean + SD; 5.12 ±1.02N) was greater than all other sites and was significantly greater than mean values obtained for medial femoral condyle (4.8 ± 1.2...

Research paper thumbnail of Arthroscopic autogenous osteochondral mosaicplasty for the treatment of femoral condylar articular defects

Knee Surgery, Sports Traumatology, Arthroscopy, 1997

Research paper thumbnail of Treatment of Osteochondritis Dissecans of the Talus: Use of the Mosaicplasty Technique—A Preliminary Report

Foot & Ankle International, 1997

A one-stage autogenous osteochondral grafting technique for the treatment of talar dome osteochon... more A one-stage autogenous osteochondral grafting technique for the treatment of talar dome osteochondritis dissecans is described. Eleven patients with osteochondritis dissecans lesions, 10 mm or greater in diameter, were operated on using the mosaicplasty autogenous osteochondral transplantation technique. Osteochondral cylindrical grafts from the ipsilateral knee were delivered into the talar defect using specially designed tube chisels. These procedures were done by arthrotomy. With follow-up of 12 to 28 months (mean, 16 months), the patients returned to full activities and the results, using the Hannover scoring system, have been excellent.

Research paper thumbnail of Effectiveness evaluation of radiosynovectomy on the radiological progression of osteoarthritis of the knee joint

Joint Diseases and Related Surgery, 2018

Bu çalışmada radyosinovektomi (RSO)'nin diz eklemi osteoartritinin radyolojik ilerlemesi üzerinde... more Bu çalışmada radyosinovektomi (RSO)'nin diz eklemi osteoartritinin radyolojik ilerlemesi üzerindeki etkililiği incelendi. Hastalar ve yöntemler: Çalışmaya 01 Nisan 2003 ve 31 Aralık 2015 tarihleri arasında Uzsoki Hastanesi Ortopedi ve Travmatoloji Bölümünde RSO uygulanan 181 hastanın (72 erkek, 109 kadın; ort. yaş 58 yıl; dağılım, 19-65 yıl) 207 diz eklemi dahil edildi. Toplam 111 sağ ve 96 sol diz tedavi edildi. Ortalama takip süresi 8.7 yıl (dağılım, 1-12 yıl) idi. Yüz seksen bir hastanın 26'sında her iki diz eklemi tedavi edildi. Bulgular: Tedavi edilen 207 diz ekleminden 163'ü takip zamanında RSO zamanındaki evreye göre aynı Kellgren-Lawrence evresine sahipken 44'ü daha kötü sonuçlara sahipti. Bu, tedavi edilen diz eklemlerinin %79'unda radyolojik ilerleme olmadığına işaret etti. Sınıf içi korelasyon katsayısı (ICC) önceki ve sonraki ölçümler arasında anlamlı şekilde güçlü uyum gösterdi (ICC=0.835, p<0.001). Sonuç: Radyosinovektomi tedavi edilen eklemlerin %79'unda radyolojik ilerlemeyi önleyebildi ve takipte 39 olguda sadece bir evre kötüleşme gözlemlendi.

Research paper thumbnail of Moderate and Severe Injuries at Five International Olympic-Style Wrestling Tournaments during 2016-2019

Journal of Sports Science and Medicine, 2022

As a contact sport, wrestling may result in injuries. Based on the severity, they are classified ... more As a contact sport, wrestling may result in injuries. Based on the severity, they are classified as mild, moderate, severe and critical. All injuries occurring at international competitions are documented in a cloud-based surveillance system. The purpose of this study was to analyze the incidence and characteristics of moderate and severe (including critical) wrestling injuries that occurred during five international Olympic-style wrestling competitions in 2016-2019. Three Wrestling World Championships and two European Wrestling tournaments were organized by the Hungarian Wrestling Federation in 2016-2019. A total of 2483 wrestlers in three Olympic wrestling styles have competed in 3007 matches. Data from all injuries were recorded and analyzed to define rates, locations, types and severity, and to compare with previous reports. A total of 53 wrestlers sustained 55 injuries, which is equivalent to an overall injury incidence rate of 9.1‰ (9.1/1000 athletic exposures). Greco-Roman an...

Research paper thumbnail of Mosaicplasty: long-term follow-up

Bulletin (Hospital for Joint Diseases (New York, N.Y.)), 2005

The successful treatment of chondral and osteochondral defects of the weightbearing surfaces is a... more The successful treatment of chondral and osteochondral defects of the weightbearing surfaces is a challenge for orthopaedic surgeons. Autologous osteochondral transplantation is one method that can be used to create a hyaline or hyaline-like repair in the defect area. Ten years of clinical experience with autologous osteochondral mosaicplasty are described. Clinical scores, imaging techniques, arthroscopy, histological examination of biopsy samples, and cartilage stiffness measurements were used to evaluate the clinical outcomes and quality of the transplanted cartilage in a total of 831 patients who underwent mosaicplasty. According to our investigations, good-to-excellent results were achieved in 92% of the patients treated with femoral condylar implantations, in 87% of those treated with tibial resurfacing, in 79% of those treated with patellar and/or trochlear mosaicplasties, and in 94% of those treated with talarprocedures. Long-term donor-site disturbances, which were assessed...

Research paper thumbnail of O1213 Cartilage Stiffness as an Indicator of Early Degenerative Process in the Knee

Aims: The relationship between the structural and histological changes of articular hyaline carti... more Aims: The relationship between the structural and histological changes of articular hyaline cartilage and the stiffness of this tissue was evaluated. Methods: Artscan 1000, an articular stiffness tester was used for in vivo measurements during arthroscopy indicated on orthopaedic or trauma disorders. 100 patients were involved in the study. Measurements were performed at eight standard sites: medial and lateral femoral condyles, medial and lateral tibial condyles, medial and lateral facet of the patellofemoral joint and medial and lateral facet of the patella. Standard 10N predefined loading force was applied during the measurements. The indenter force produced by the deformed cartilage tissue is used as the indicator of cartilage stiffness. Results: Clinical measurements revealed a topographical variation of the stiffness of normal cartilage. In general, the femoral cartilage is stiffer than tibial or patellar one. The stiffest cartilage was measured at the lateral femoral condyle....

Research paper thumbnail of Systematic Literature Review and Expert Opinion for the Use of Viscosupplementation with Hyaluronic Acid in Different Localizations of Osteoarthritis

Orthopedic Research and Reviews

Osteoarthritis (OA) is a significant cause of disability. Considering the increasing diffusion of... more Osteoarthritis (OA) is a significant cause of disability. Considering the increasing diffusion of the viscosupplementation (VS) with hyaluronic acid (HA), the International Symposium Intra Articular Treatment (ISIAT) appointed a Technical Expert Panel (TEP) to identify the criteria for successful VS with a specific HA in OA; this through a systematic literature review (SLR), performed following the PRISMA guidelines interrogating Medline, Embase, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Grey Matters and American College of Rheumatology (ACR/EULAR) databases and the opinion of international experts. The research included only studies on adults and humans without limitations of language or time of publication. Researchers extracted both quantitative and qualitative data from each study. Mixed Methods Appraisal Tool (MMAT) was used to perform quality analysis for the level of evidence. The SLR retrieved 385 papers, 25 of which were suitable for the analysis. The TEP focused on the different formulations of the product Sinovial ® [HA 0.8%, HA 1.6%, HA 2%, 800-1200 kDa, HA 3.2% (1400-2100 kDa/65-110 kDa)]. The choice was due to the vast amount of evidence available. The TEP weighed the evidence in two rounds of a Delphi survey; the results, and any disagreement, were discussed in a final session. Three domains were considered: 1) the patients' characteristics associated with the best results; 2) the contraindications and the conditions linked to increased risk of failure; 3) the clinical conditions in which VS is considered appropriate. The TEP concluded that VS with HA is safe and effective in the treatment of knee and hip OA of grades I to III and that it is possible to undertake VS in other situations (eg grade IV Kellgren-Lawrence-KL); a comprehensive examination of the patient should be performed before the procedure.

Research paper thumbnail of Level of Adiponectin, Leptin and Selected Matrix Metalloproteinases in Female Overweight Patients with Primary Gonarthrosis

The aim of this study was to assess levels of adiponectin (ACRP-30) and leptin in serum and synov... more The aim of this study was to assess levels of adiponectin (ACRP-30) and leptin in serum and synovial fluid (SF) of overweight females with primary gonarthrosis (GOA) and to look for their correlations with clinical status and the level of biochemical OA biomarkers: matrix metalloproteinase (MMP) 1, MMP-9 and tissue inhibitor of metalloproteinase (TIMP-1). The studied group consisted of 39 overweight females undergoing primary total knee arthroplasty as a result of GOA. The stage of GOA was evaluated according to Knee Society Score (KSS), Ahlbäck and Kellgren–Lawrence (K-L) scores. Peripheral blood and SF were obtained. Levels of selected biomarkers were assessed using ELISA kits. The mean level of ACRP-30 in serum valued were 8393.80 ng/mL and in SF, 774.33 ng/mL, the mean concentration of leptin in serum was 32,040.74 pg/mL and in SF, 27,332.12 pg/mL. Levels of leptin in serum and SF correlated with body mass index (BMI), (p = 0.0005, and p = 0.0002, respectively). Levels of ACRP-3...

Research paper thumbnail of Mosaicplasty: long-term follow-up

The successful treatment of chondral and osteochondral defects of the weightbearing surfaces is a... more The successful treatment of chondral and osteochondral defects of the weightbearing surfaces is a challenge for orthopaedic surgeons. Autologous osteochondral transplantation is one method that can be used to create a hyaline or hyaline-like repair in the defect area. Ten years of clinical experience with autologous osteochondral mosaicplasty are described. Clinical scores, imaging techniques, arthroscopy, histological examination of biopsy samples, and cartilage stiffness measurements were used to evaluate the clinical outcomes and quality of the transplanted cartilage in a total of 831 patients who underwent mosaicplasty. According to our investigations, good-to-excellent results were achieved in 92% of the patients treated with femoral condylar implantations, in 87% of those treated with tibial resurfacing, in 79% of those treated with patellar and/or trochlear mosaicplasties, and in 94% of those treated with talarprocedures. Long-term donor-site disturbances, which were assessed...

Research paper thumbnail of Treatment of a combined deformity following tibial tubercle ventromedialization with single proximal tibial closing wedge osteotomy

Joint Diseases and Related Surgery

Incidence of patellar dislocation is highest in adolescents; almost 10 times higher than in adult... more Incidence of patellar dislocation is highest in adolescents; almost 10 times higher than in adults. [1] It is known that 69% of first time patellar dislocations are seen between 10-19 years. [2] There are dynamic factors (weak hip abductors and vastus medialis, tight lateral retinaculum and iliotibial band) and static factors (increased Q-angle, valgus malalignment, patella alta, trochlear dysplasia, lateralization of tibial tuberosity) ÖZ İskelet gelişimi tamamlanmamış hastalarda patellar instabiliteye yaklaşırken olası fizis hasarı göz önünde bulundurulmalıdır. Bu yazıda, pediatrik tibial tüberkül ventromedializasyonunu takiben gelişen; genu rekurvatum, genu valgum ve patella baja'dan oluşan bir kombine diz deformitesi olgusu sunuldu. Hasta ilk başvurusunda 22 yaşında olan bir kadın idi. Kıkırdağın sağlıklı olduğu doğrulandıktan sonra deformite tek bir supratüberküler posteriyor ve medial temelli proksimal tibial kapalı kama osteotomisi ile düzeltildi. Yedinci yıl kontrolünde hastanın ağrısı yoktu, fonksiyonel açıdan memnundu ve radyografik değerlendirme düzgün dizilim gösterdi. Bu olgu patellar instabilite tedavisi sırasında fizis hasarı gelişirse karşılaşılacak zorlukları ve kombine genu rekurvatum, genu valgum ve patella baja deformitelerini tedavi eden tek bir iyi planlanmış supratüberküler proksimal tibial osteotominin etkililiğini, kullanımının yaygınlaşması için anatomik ve klinik çalışmalara gerek olsa da göstermektedir.

Research paper thumbnail of Effect of a balance-training programme on postural balance, aerobic capacity and frequency of falls in women with osteoporosis: A randomized controlled trial

Journal of Rehabilitation Medicine

Loss of balance and falling are serious risk factors for patients with osteoporosis. Falls often ... more Loss of balance and falling are serious risk factors for patients with osteoporosis. Falls often result in fractures that require medical attention and may even be fatal. In addition to pharmacological therapy, there is clinical evidence to support the importance of exercise to prevent falls and improve balance. The effect of a 1-year complex balance-training programme, combining exercises to improve postural balance with aerobic elements, was studied in female patients with established osteoporosis. The women in the exercise group improved their postural control and balance, increased their aerobic capacity, and had fewer falls than those who did not undertake the exercise programme. Objective: To investigate the effect of a 12-month complex balance-training programme on static and dynamic postural balance, aerobic capacity and frequency of falls in women with established osteoporosis. Design: Randomized controlled trial in which the intervention group was assigned a 12-month exercise programme (3 times a week for 30 min) and the control group had no intervention. Subjects: A total of 100 osteoporotic women with at least one previous fracture. Methods: Performance-based Timed Up and Go (TUG), Berg Balance Scale (BBS) and stabilometric platform tests were used to evaluate balance. Aerobic capacity was measured by bicycle ergometry. Frequency of falls was assessed using a falls diary. Results: After 1 year, there was a statistically significant difference between the improvement achieved in the intervention and control groups on the performance-based TUG, BBS and stabilometric platform tests (p < 0.05). Mean metabolic equivalent (MET) value decreased in the intervention group, from 4.91 to 3.82 (a significant difference from the change achieved in the control group; p = 0.05). Relative risk of falls was 0.534 at 1 year (p = 0.17). Conclusion: The 12-month balance-training programme significantly improved postural balance and increased aerobic capacity in women with established osteoporosis.

Research paper thumbnail of Effectiveness of balance training programme in reducing the frequency of falling in established osteoporotic women: A randomized controlled trial

Clinical Rehabilitation, 2016

To investigate the effect of a 12-month sensomotor balance exercise programme on postural control... more To investigate the effect of a 12-month sensomotor balance exercise programme on postural control and the frequency of falling in women with established osteoporosis. Randomized controlled trial where the intervention group was assigned the 12-month Balance Training Programme and the control group did not undertake any intervention beyond regular osteoporosis treatment. A total of 100 osteoporotic women - at least with one osteoporotic fracture - aged 65 years old and above. Balance was assessed in static and dynamic posture both with performance-based measures of balance, such as the Berg Balance Scale and the Timed Up and Go Test, and with a stabilometric computerized platform. Patients in the intervention group completed the 12-month sensomotor Balance Training Programme in an outpatient setting, guided by physical therapists, three times a week, for 30 minutes. The Berg Balance Scale and the Timed Up and Go Test showed a statistically significant improvement of balance in the intervention group (p = 0.001 and p = 0.005, respectively). Balance tests using the stabilometer also showed a statistically significant improvement in static and dynamic postural balance for osteoporotic women after the completion of the Balance Training Programme. As a consequence, the one-year exercise programme significantly decreased the number of falls in the exercise group compared with the control group. The Balance Training Programme significantly improved the balance parameters and reduced the number of falls in postmenopausal women who have already had at least one fracture in the past.

Research paper thumbnail of Mosaicplasty for the treatment of osteochondritis dissecans of the talus: two to seven year results in 36 patients

Foot & ankle …, 2001

UK PubMed Central (UKPMC) is an archive of life sciences journal literature.

Research paper thumbnail of In Vivo Arthroscopic Cartilage Stiffness Measurement in the Knee

Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2006

The purpose of this study was to map the biomechanical properties of normal human articular carti... more The purpose of this study was to map the biomechanical properties of normal human articular cartilage in vivo. Instantaneous compressive stiffness was measured in the knee articular cartilage of 87 patients. Lateral femoral condyle stiffness (mean Ϯ SD; 5.12 Ϯ 1.02 N) was greater than at all other sites and was significantly greater than mean values obtained for the medial femoral condyle (4.8 Ϯ 1.22 N), medial and lateral trochlea (4.2 Ϯ 0.92 and 4.6 Ϯ 1.27 N, respectively), medial and lateral patella (3.1 Ϯ 0.66 N and 3.3 Ϯ 1.01 N, respectively), and medial and lateral tibial condyle (2.4 Ϯ 1.17 N and 3.2 Ϯ 1.16 N, respectively) for all subjects (P Ͻ .05, Wilcoxon signed-rank test). This study enabled comparison measures of suspected degenerative cartilage.

Research paper thumbnail of A radiosynoviorthesis a haemophiliás betegek poszttraumás ízületi bevérzéseinek kezelésében

Magyar Traumatológia Ortopédia Kézsebészet Plasztikai Sebészet

Research paper thumbnail of Radiosynoviorthesis in the treatment of posttraumatic joint bleedings of hemophilic patients (concerning hip, knee and ankle joints)—Hungarian experience

Research paper thumbnail of Efficacy assessment of radiosynoviorthesis on the progression of radiological osteoarthritic features of hip and ankle joint in patients with osteoarthritis and rheumatoid arthritis

Nuklearmedizin

Objective The study objective was to evaluate the long-term effect of radiosynoviorthesis (RSO) o... more Objective The study objective was to evaluate the long-term effect of radiosynoviorthesis (RSO) on the progression of radiological and nuclear-medical osteoarthritic features of hip and ankle joint in patients with osteoarthritis and rheumatoid arthritis. Patients and Methods The study included 89 hip joints of 81 patients, of which 48 had osteoarthritis (OA) and 33 had rheumatoid arthritis (RA). In terms of ankle joints, 64 patients were included of which 43 suffered from OA and 21 from RA. The mean follow-up time was 9.2 years for OA and 8.9 years for RA patients. Patients with RA were the active control group. Structural alterations of the hip joints were evaluated following Kellgren-Lawrence score and of ankle joint following Takakura score for both disease entities. For the evaluation of synovitis 2-phase bone scintigraphy was performed. Results RSO could prevent radiologic status deterioration among 70.6 % of hip osteoarthritic patients and 73.7 % among the hip RA patients. No...

Research paper thumbnail of Strukturális anomáliák talaján kialakult recidív patella ficamok minimál invazív ellátása

Magyar Traumatológia Ortopédia Kézsebészet Plasztikai Sebészet

Research paper thumbnail of Mosaicplasty: long-term follow-up

Bulletin (Hospital for Joint Diseases (New York, N.Y.)), 2005

The successful treatment of chondral and osteochondral defects of the weightbearing surfaces is a... more The successful treatment of chondral and osteochondral defects of the weightbearing surfaces is a challenge for orthopaedic surgeons. Autologous osteochondral transplantation is one method that can be used to create a hyaline or hyaline-like repair in the defect area. Ten years of clinical experience with autologous osteochondral mosaicplasty are described. Clinical scores, imaging techniques, arthroscopy, histological examination of biopsy samples, and cartilage stiffness measurements were used to evaluate the clinical outcomes and quality of the transplanted cartilage in a total of 831 patients who underwent mosaicplasty. According to our investigations, good-to-excellent results were achieved in 92% of the patients treated with femoral condylar implantations, in 87% of those treated with tibial resurfacing, in 79% of those treated with patellar and/or trochlear mosaicplasties, and in 94% of those treated with talarprocedures. Long-term donor-site disturbances, which were assessed...

Research paper thumbnail of The Relationship Between the in Vivo Measured Stiffness and the Histological Stage of Degeneration of Human Knee Articular Cartilage

Purpose: To determine the relationship between the in vivo indentation stiffness and indices of h... more Purpose: To determine the relationship between the in vivo indentation stiffness and indices of histopathological degeneration of human knee articular cartilage. Materials and Methods: Cartilage compressive stiffness was measured in 98 patients during in vivo knee arthroscopies. The age of the patients ranged from 21 to 63 years (mean age 29 years). Male to female ratio of the patients was 37:61. The measurements were performed at eight standard sites. No chondropathic or grade I. chondropathic surfaces were measured. An indentation instrument, Artscan 1000, was used for in vivo measurements. Four plugs were harvested from each knee for histological analysis. The stage of cartilage degeneration was assessed according to Mankin histolopathology score. 16 measurements were performed after ACI. Results: Lateral femoral condyle stiffness (mean + SD; 5.12 ±1.02N) was greater than all other sites and was significantly greater than mean values obtained for medial femoral condyle (4.8 ± 1.2...

Research paper thumbnail of Arthroscopic autogenous osteochondral mosaicplasty for the treatment of femoral condylar articular defects

Knee Surgery, Sports Traumatology, Arthroscopy, 1997

Research paper thumbnail of Treatment of Osteochondritis Dissecans of the Talus: Use of the Mosaicplasty Technique—A Preliminary Report

Foot & Ankle International, 1997

A one-stage autogenous osteochondral grafting technique for the treatment of talar dome osteochon... more A one-stage autogenous osteochondral grafting technique for the treatment of talar dome osteochondritis dissecans is described. Eleven patients with osteochondritis dissecans lesions, 10 mm or greater in diameter, were operated on using the mosaicplasty autogenous osteochondral transplantation technique. Osteochondral cylindrical grafts from the ipsilateral knee were delivered into the talar defect using specially designed tube chisels. These procedures were done by arthrotomy. With follow-up of 12 to 28 months (mean, 16 months), the patients returned to full activities and the results, using the Hannover scoring system, have been excellent.

Research paper thumbnail of Effectiveness evaluation of radiosynovectomy on the radiological progression of osteoarthritis of the knee joint

Joint Diseases and Related Surgery, 2018

Bu çalışmada radyosinovektomi (RSO)'nin diz eklemi osteoartritinin radyolojik ilerlemesi üzerinde... more Bu çalışmada radyosinovektomi (RSO)'nin diz eklemi osteoartritinin radyolojik ilerlemesi üzerindeki etkililiği incelendi. Hastalar ve yöntemler: Çalışmaya 01 Nisan 2003 ve 31 Aralık 2015 tarihleri arasında Uzsoki Hastanesi Ortopedi ve Travmatoloji Bölümünde RSO uygulanan 181 hastanın (72 erkek, 109 kadın; ort. yaş 58 yıl; dağılım, 19-65 yıl) 207 diz eklemi dahil edildi. Toplam 111 sağ ve 96 sol diz tedavi edildi. Ortalama takip süresi 8.7 yıl (dağılım, 1-12 yıl) idi. Yüz seksen bir hastanın 26'sında her iki diz eklemi tedavi edildi. Bulgular: Tedavi edilen 207 diz ekleminden 163'ü takip zamanında RSO zamanındaki evreye göre aynı Kellgren-Lawrence evresine sahipken 44'ü daha kötü sonuçlara sahipti. Bu, tedavi edilen diz eklemlerinin %79'unda radyolojik ilerleme olmadığına işaret etti. Sınıf içi korelasyon katsayısı (ICC) önceki ve sonraki ölçümler arasında anlamlı şekilde güçlü uyum gösterdi (ICC=0.835, p<0.001). Sonuç: Radyosinovektomi tedavi edilen eklemlerin %79'unda radyolojik ilerlemeyi önleyebildi ve takipte 39 olguda sadece bir evre kötüleşme gözlemlendi.

Research paper thumbnail of Moderate and Severe Injuries at Five International Olympic-Style Wrestling Tournaments during 2016-2019

Journal of Sports Science and Medicine, 2022

As a contact sport, wrestling may result in injuries. Based on the severity, they are classified ... more As a contact sport, wrestling may result in injuries. Based on the severity, they are classified as mild, moderate, severe and critical. All injuries occurring at international competitions are documented in a cloud-based surveillance system. The purpose of this study was to analyze the incidence and characteristics of moderate and severe (including critical) wrestling injuries that occurred during five international Olympic-style wrestling competitions in 2016-2019. Three Wrestling World Championships and two European Wrestling tournaments were organized by the Hungarian Wrestling Federation in 2016-2019. A total of 2483 wrestlers in three Olympic wrestling styles have competed in 3007 matches. Data from all injuries were recorded and analyzed to define rates, locations, types and severity, and to compare with previous reports. A total of 53 wrestlers sustained 55 injuries, which is equivalent to an overall injury incidence rate of 9.1‰ (9.1/1000 athletic exposures). Greco-Roman an...

Research paper thumbnail of Mosaicplasty: long-term follow-up

Bulletin (Hospital for Joint Diseases (New York, N.Y.)), 2005

The successful treatment of chondral and osteochondral defects of the weightbearing surfaces is a... more The successful treatment of chondral and osteochondral defects of the weightbearing surfaces is a challenge for orthopaedic surgeons. Autologous osteochondral transplantation is one method that can be used to create a hyaline or hyaline-like repair in the defect area. Ten years of clinical experience with autologous osteochondral mosaicplasty are described. Clinical scores, imaging techniques, arthroscopy, histological examination of biopsy samples, and cartilage stiffness measurements were used to evaluate the clinical outcomes and quality of the transplanted cartilage in a total of 831 patients who underwent mosaicplasty. According to our investigations, good-to-excellent results were achieved in 92% of the patients treated with femoral condylar implantations, in 87% of those treated with tibial resurfacing, in 79% of those treated with patellar and/or trochlear mosaicplasties, and in 94% of those treated with talarprocedures. Long-term donor-site disturbances, which were assessed...

Research paper thumbnail of O1213 Cartilage Stiffness as an Indicator of Early Degenerative Process in the Knee

Aims: The relationship between the structural and histological changes of articular hyaline carti... more Aims: The relationship between the structural and histological changes of articular hyaline cartilage and the stiffness of this tissue was evaluated. Methods: Artscan 1000, an articular stiffness tester was used for in vivo measurements during arthroscopy indicated on orthopaedic or trauma disorders. 100 patients were involved in the study. Measurements were performed at eight standard sites: medial and lateral femoral condyles, medial and lateral tibial condyles, medial and lateral facet of the patellofemoral joint and medial and lateral facet of the patella. Standard 10N predefined loading force was applied during the measurements. The indenter force produced by the deformed cartilage tissue is used as the indicator of cartilage stiffness. Results: Clinical measurements revealed a topographical variation of the stiffness of normal cartilage. In general, the femoral cartilage is stiffer than tibial or patellar one. The stiffest cartilage was measured at the lateral femoral condyle....

Research paper thumbnail of Systematic Literature Review and Expert Opinion for the Use of Viscosupplementation with Hyaluronic Acid in Different Localizations of Osteoarthritis

Orthopedic Research and Reviews

Osteoarthritis (OA) is a significant cause of disability. Considering the increasing diffusion of... more Osteoarthritis (OA) is a significant cause of disability. Considering the increasing diffusion of the viscosupplementation (VS) with hyaluronic acid (HA), the International Symposium Intra Articular Treatment (ISIAT) appointed a Technical Expert Panel (TEP) to identify the criteria for successful VS with a specific HA in OA; this through a systematic literature review (SLR), performed following the PRISMA guidelines interrogating Medline, Embase, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Grey Matters and American College of Rheumatology (ACR/EULAR) databases and the opinion of international experts. The research included only studies on adults and humans without limitations of language or time of publication. Researchers extracted both quantitative and qualitative data from each study. Mixed Methods Appraisal Tool (MMAT) was used to perform quality analysis for the level of evidence. The SLR retrieved 385 papers, 25 of which were suitable for the analysis. The TEP focused on the different formulations of the product Sinovial ® [HA 0.8%, HA 1.6%, HA 2%, 800-1200 kDa, HA 3.2% (1400-2100 kDa/65-110 kDa)]. The choice was due to the vast amount of evidence available. The TEP weighed the evidence in two rounds of a Delphi survey; the results, and any disagreement, were discussed in a final session. Three domains were considered: 1) the patients' characteristics associated with the best results; 2) the contraindications and the conditions linked to increased risk of failure; 3) the clinical conditions in which VS is considered appropriate. The TEP concluded that VS with HA is safe and effective in the treatment of knee and hip OA of grades I to III and that it is possible to undertake VS in other situations (eg grade IV Kellgren-Lawrence-KL); a comprehensive examination of the patient should be performed before the procedure.

Research paper thumbnail of Level of Adiponectin, Leptin and Selected Matrix Metalloproteinases in Female Overweight Patients with Primary Gonarthrosis

The aim of this study was to assess levels of adiponectin (ACRP-30) and leptin in serum and synov... more The aim of this study was to assess levels of adiponectin (ACRP-30) and leptin in serum and synovial fluid (SF) of overweight females with primary gonarthrosis (GOA) and to look for their correlations with clinical status and the level of biochemical OA biomarkers: matrix metalloproteinase (MMP) 1, MMP-9 and tissue inhibitor of metalloproteinase (TIMP-1). The studied group consisted of 39 overweight females undergoing primary total knee arthroplasty as a result of GOA. The stage of GOA was evaluated according to Knee Society Score (KSS), Ahlbäck and Kellgren–Lawrence (K-L) scores. Peripheral blood and SF were obtained. Levels of selected biomarkers were assessed using ELISA kits. The mean level of ACRP-30 in serum valued were 8393.80 ng/mL and in SF, 774.33 ng/mL, the mean concentration of leptin in serum was 32,040.74 pg/mL and in SF, 27,332.12 pg/mL. Levels of leptin in serum and SF correlated with body mass index (BMI), (p = 0.0005, and p = 0.0002, respectively). Levels of ACRP-3...

Research paper thumbnail of Mosaicplasty: long-term follow-up

The successful treatment of chondral and osteochondral defects of the weightbearing surfaces is a... more The successful treatment of chondral and osteochondral defects of the weightbearing surfaces is a challenge for orthopaedic surgeons. Autologous osteochondral transplantation is one method that can be used to create a hyaline or hyaline-like repair in the defect area. Ten years of clinical experience with autologous osteochondral mosaicplasty are described. Clinical scores, imaging techniques, arthroscopy, histological examination of biopsy samples, and cartilage stiffness measurements were used to evaluate the clinical outcomes and quality of the transplanted cartilage in a total of 831 patients who underwent mosaicplasty. According to our investigations, good-to-excellent results were achieved in 92% of the patients treated with femoral condylar implantations, in 87% of those treated with tibial resurfacing, in 79% of those treated with patellar and/or trochlear mosaicplasties, and in 94% of those treated with talarprocedures. Long-term donor-site disturbances, which were assessed...

Research paper thumbnail of Treatment of a combined deformity following tibial tubercle ventromedialization with single proximal tibial closing wedge osteotomy

Joint Diseases and Related Surgery

Incidence of patellar dislocation is highest in adolescents; almost 10 times higher than in adult... more Incidence of patellar dislocation is highest in adolescents; almost 10 times higher than in adults. [1] It is known that 69% of first time patellar dislocations are seen between 10-19 years. [2] There are dynamic factors (weak hip abductors and vastus medialis, tight lateral retinaculum and iliotibial band) and static factors (increased Q-angle, valgus malalignment, patella alta, trochlear dysplasia, lateralization of tibial tuberosity) ÖZ İskelet gelişimi tamamlanmamış hastalarda patellar instabiliteye yaklaşırken olası fizis hasarı göz önünde bulundurulmalıdır. Bu yazıda, pediatrik tibial tüberkül ventromedializasyonunu takiben gelişen; genu rekurvatum, genu valgum ve patella baja'dan oluşan bir kombine diz deformitesi olgusu sunuldu. Hasta ilk başvurusunda 22 yaşında olan bir kadın idi. Kıkırdağın sağlıklı olduğu doğrulandıktan sonra deformite tek bir supratüberküler posteriyor ve medial temelli proksimal tibial kapalı kama osteotomisi ile düzeltildi. Yedinci yıl kontrolünde hastanın ağrısı yoktu, fonksiyonel açıdan memnundu ve radyografik değerlendirme düzgün dizilim gösterdi. Bu olgu patellar instabilite tedavisi sırasında fizis hasarı gelişirse karşılaşılacak zorlukları ve kombine genu rekurvatum, genu valgum ve patella baja deformitelerini tedavi eden tek bir iyi planlanmış supratüberküler proksimal tibial osteotominin etkililiğini, kullanımının yaygınlaşması için anatomik ve klinik çalışmalara gerek olsa da göstermektedir.

Research paper thumbnail of Effect of a balance-training programme on postural balance, aerobic capacity and frequency of falls in women with osteoporosis: A randomized controlled trial

Journal of Rehabilitation Medicine

Loss of balance and falling are serious risk factors for patients with osteoporosis. Falls often ... more Loss of balance and falling are serious risk factors for patients with osteoporosis. Falls often result in fractures that require medical attention and may even be fatal. In addition to pharmacological therapy, there is clinical evidence to support the importance of exercise to prevent falls and improve balance. The effect of a 1-year complex balance-training programme, combining exercises to improve postural balance with aerobic elements, was studied in female patients with established osteoporosis. The women in the exercise group improved their postural control and balance, increased their aerobic capacity, and had fewer falls than those who did not undertake the exercise programme. Objective: To investigate the effect of a 12-month complex balance-training programme on static and dynamic postural balance, aerobic capacity and frequency of falls in women with established osteoporosis. Design: Randomized controlled trial in which the intervention group was assigned a 12-month exercise programme (3 times a week for 30 min) and the control group had no intervention. Subjects: A total of 100 osteoporotic women with at least one previous fracture. Methods: Performance-based Timed Up and Go (TUG), Berg Balance Scale (BBS) and stabilometric platform tests were used to evaluate balance. Aerobic capacity was measured by bicycle ergometry. Frequency of falls was assessed using a falls diary. Results: After 1 year, there was a statistically significant difference between the improvement achieved in the intervention and control groups on the performance-based TUG, BBS and stabilometric platform tests (p < 0.05). Mean metabolic equivalent (MET) value decreased in the intervention group, from 4.91 to 3.82 (a significant difference from the change achieved in the control group; p = 0.05). Relative risk of falls was 0.534 at 1 year (p = 0.17). Conclusion: The 12-month balance-training programme significantly improved postural balance and increased aerobic capacity in women with established osteoporosis.

Research paper thumbnail of Effectiveness of balance training programme in reducing the frequency of falling in established osteoporotic women: A randomized controlled trial

Clinical Rehabilitation, 2016

To investigate the effect of a 12-month sensomotor balance exercise programme on postural control... more To investigate the effect of a 12-month sensomotor balance exercise programme on postural control and the frequency of falling in women with established osteoporosis. Randomized controlled trial where the intervention group was assigned the 12-month Balance Training Programme and the control group did not undertake any intervention beyond regular osteoporosis treatment. A total of 100 osteoporotic women - at least with one osteoporotic fracture - aged 65 years old and above. Balance was assessed in static and dynamic posture both with performance-based measures of balance, such as the Berg Balance Scale and the Timed Up and Go Test, and with a stabilometric computerized platform. Patients in the intervention group completed the 12-month sensomotor Balance Training Programme in an outpatient setting, guided by physical therapists, three times a week, for 30 minutes. The Berg Balance Scale and the Timed Up and Go Test showed a statistically significant improvement of balance in the intervention group (p = 0.001 and p = 0.005, respectively). Balance tests using the stabilometer also showed a statistically significant improvement in static and dynamic postural balance for osteoporotic women after the completion of the Balance Training Programme. As a consequence, the one-year exercise programme significantly decreased the number of falls in the exercise group compared with the control group. The Balance Training Programme significantly improved the balance parameters and reduced the number of falls in postmenopausal women who have already had at least one fracture in the past.

Research paper thumbnail of Mosaicplasty for the treatment of osteochondritis dissecans of the talus: two to seven year results in 36 patients

Foot & ankle …, 2001

UK PubMed Central (UKPMC) is an archive of life sciences journal literature.

Research paper thumbnail of In Vivo Arthroscopic Cartilage Stiffness Measurement in the Knee

Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2006

The purpose of this study was to map the biomechanical properties of normal human articular carti... more The purpose of this study was to map the biomechanical properties of normal human articular cartilage in vivo. Instantaneous compressive stiffness was measured in the knee articular cartilage of 87 patients. Lateral femoral condyle stiffness (mean Ϯ SD; 5.12 Ϯ 1.02 N) was greater than at all other sites and was significantly greater than mean values obtained for the medial femoral condyle (4.8 Ϯ 1.22 N), medial and lateral trochlea (4.2 Ϯ 0.92 and 4.6 Ϯ 1.27 N, respectively), medial and lateral patella (3.1 Ϯ 0.66 N and 3.3 Ϯ 1.01 N, respectively), and medial and lateral tibial condyle (2.4 Ϯ 1.17 N and 3.2 Ϯ 1.16 N, respectively) for all subjects (P Ͻ .05, Wilcoxon signed-rank test). This study enabled comparison measures of suspected degenerative cartilage.

Research paper thumbnail of A radiosynoviorthesis a haemophiliás betegek poszttraumás ízületi bevérzéseinek kezelésében

Magyar Traumatológia Ortopédia Kézsebészet Plasztikai Sebészet

Research paper thumbnail of Radiosynoviorthesis in the treatment of posttraumatic joint bleedings of hemophilic patients (concerning hip, knee and ankle joints)—Hungarian experience

Research paper thumbnail of Efficacy assessment of radiosynoviorthesis on the progression of radiological osteoarthritic features of hip and ankle joint in patients with osteoarthritis and rheumatoid arthritis

Nuklearmedizin

Objective The study objective was to evaluate the long-term effect of radiosynoviorthesis (RSO) o... more Objective The study objective was to evaluate the long-term effect of radiosynoviorthesis (RSO) on the progression of radiological and nuclear-medical osteoarthritic features of hip and ankle joint in patients with osteoarthritis and rheumatoid arthritis. Patients and Methods The study included 89 hip joints of 81 patients, of which 48 had osteoarthritis (OA) and 33 had rheumatoid arthritis (RA). In terms of ankle joints, 64 patients were included of which 43 suffered from OA and 21 from RA. The mean follow-up time was 9.2 years for OA and 8.9 years for RA patients. Patients with RA were the active control group. Structural alterations of the hip joints were evaluated following Kellgren-Lawrence score and of ankle joint following Takakura score for both disease entities. For the evaluation of synovitis 2-phase bone scintigraphy was performed. Results RSO could prevent radiologic status deterioration among 70.6 % of hip osteoarthritic patients and 73.7 % among the hip RA patients. No...

Research paper thumbnail of Strukturális anomáliák talaján kialakult recidív patella ficamok minimál invazív ellátása

Magyar Traumatológia Ortopédia Kézsebészet Plasztikai Sebészet

Research paper thumbnail of Mosaicplasty: long-term follow-up

Bulletin (Hospital for Joint Diseases (New York, N.Y.)), 2005

The successful treatment of chondral and osteochondral defects of the weightbearing surfaces is a... more The successful treatment of chondral and osteochondral defects of the weightbearing surfaces is a challenge for orthopaedic surgeons. Autologous osteochondral transplantation is one method that can be used to create a hyaline or hyaline-like repair in the defect area. Ten years of clinical experience with autologous osteochondral mosaicplasty are described. Clinical scores, imaging techniques, arthroscopy, histological examination of biopsy samples, and cartilage stiffness measurements were used to evaluate the clinical outcomes and quality of the transplanted cartilage in a total of 831 patients who underwent mosaicplasty. According to our investigations, good-to-excellent results were achieved in 92% of the patients treated with femoral condylar implantations, in 87% of those treated with tibial resurfacing, in 79% of those treated with patellar and/or trochlear mosaicplasties, and in 94% of those treated with talarprocedures. Long-term donor-site disturbances, which were assessed...