Mandus Akonjom - Academia.edu (original) (raw)
Papers by Mandus Akonjom
The Adult Hip - Master Case Series and Techniques
Developmental dysplasia of the hip (DDH) is the most common childhood hip disorder [1]; its preva... more Developmental dysplasia of the hip (DDH) is the most common childhood hip disorder [1]; its prevalence, however, shows remarkable ethnic changes [2, 3]. The anatomical and biomechanical alterations of the acetabulum, femur and pelvis in DDH predispose to hip OA development [4]. Possible deformities encountered in different types of the disease are: 1. The true acetabulum may be shallow with full contact with the femoral head or partly connected with a false acetabulum or severely small, shallow and triangular with complete loss of congruency with the femoral head [5]. 2. Limited bone stock and anterior acetabular segmental wall defects. The bone stock is usually rearranged posteriorly related to acetabulum [6, 7]. 3. Version deformities of the acetabulum; up to 1/3 are retroverted [6, 8, 9]. 4. Insufficient coverage of the femoral head from the acetabulum. 5. Anteversion of the iliac rim [6].
The Adult Hip - Master Case Series and Techniques
Reinforcement rings and cages are implants used in revision THA when the remaining bone stock is ... more Reinforcement rings and cages are implants used in revision THA when the remaining bone stock is deficient. They span the bone defect and act as a scaffold while protecting morcellized or structural allograft during the bone remodelling phase [1]. The use of cages has been reduced over time following the mechanical failure of cages and the introduction of newer techniques of trabecular metal components [1]. 27.1.1 Objective The cages are usually fixed securely but "nonbiologically" to ischium and ilium with the maximum number of screws to provide shortterm mechanical stability to the cup liner. At the same time, they transfer the load to the peripheral host bone protecting morcellized and structural grafts from excessive forces, during the bone remodelling phase [1, 2]. During this period, bone grafting remodels, supports, and bridges areas of bone loss to achieve long
The importance of biomarkers to predict recovery following total hip arthroplasty (THA) is still ... more The importance of biomarkers to predict recovery following total hip arthroplasty (THA) is still unclear to clinicians. To assess the preoperative biomarkers of patients with pseudoarthrosis of the femoral neck and their dynamics in the early postoperative period after THA, 50 patients aged 33 to 82 years old, 18 males and 32 females diagnosed with pseudoarthrosis of the femoral neck after failed internal fixation and failed conservative management were studied. The control group consisted of 30 healthy people aged 27 to 50 years, 13 males, 17 females. Patients’ blood was examined for biochemical markers upon admission, and then on the 7th and 14th days after surgery. Their blood serum content of total protein, albumin, glycoproteins, sialic acids, chondroitin sulfates, haptoglobin, glucose, cholesterol, triglycerides, ALT, AST, alkaline phosphatase, GGT, acid phosphatase, thymol index; interleukins (IL-1, IL-4 and IL-6.) and C-reactive protein was measured. The content of glycoprot...
TRAUMA, Oct 5, 2016
ацетабулярного компонента ендопротеза в умовах остеопорозу і змін анатомії кульшової западини є а... more ацетабулярного компонента ендопротеза в умовах остеопорозу і змін анатомії кульшової западини є актуальною проблемою сучасної ортопедії. Мета: провести порівняльний аналіз міцності кістково-металевого блока для різних типів поверхонь імплантатів в умовах нормального стану кісткової тканини і при моделюванні остеопорозу у щурів. Методи. Проведено експериментальні дослідження міцності стегнової кістки 60 лабораторних щурів. Тварин розподілили на дві групи, по 30 особин у кожній: I-умовно здорові, II-з остеопорозом, який було модельовано методом оваріектомії. У кожній групі сформовано по 6 підгруп тварин, яким у дефект дистального метафіза стегнової кістки (СК) встановлювали імплантати з різних матеріалів: пористий титан, пористий тантал Trabecular Metal (Zimmer), титан з покриттям Gription (DePuy), Stiktite (Smith & Nephew), Trabecular Titanium (Lima), Tritanum (Stryker). Через 90 діб після імплантації тварин виводили з експерименту і проводили біомеханічні дослідження міцності оперованих і контралатеральних СК. Препарат СК фіксували на пристрої головкою вгору. До головки СК прикладали подовжнє осьове навантаження за допомогою металевого штока. Величину навантаження збільшували до повного руйнування препарату і вимірювали. Результати. При нормальній щільності кісткової тканини найбільші руйнівні навантаження витримували СК з імплантатами з пористого танталу Trabecular Metal і Stiktite. В умовах модельованого остеопорозу окремі підмножини становили препарати СК з імплантованим пористим титаном (найслабші) і танталом Trabecular Metal (найміцніші). Висновки. Порівняльний аналіз біомеханічного дослідження показав, що за нормальної щільності кісткової тканини і в умовах моделювання остеопорозу найбільші руйнівні навантаження витримує кісткова тканина з імплантатами з пористого танталу Trabecular Metal.
ORTHOPAEDICS, TRAUMATOLOGY and PROSTHETICS, 2015
Objective: To conduct a retrospective analysis of radiographs and CT scans for studying of typica... more Objective: To conduct a retrospective analysis of radiographs and CT scans for studying of typical changes in acetabulum (A) and proximal femur (F) in patients with the consequences of injuries in the area of the hip joint. Methods: We analyzed radiographs and CT scans in 106 patients. Patients were divided into groups: I — false joint of F neck, II – false joint at the level of per-, inter- and subtrochanteric area of F, III — post-traumatic avascular necrosis of F head, IV — posttraumatic coxarthrosis, V — inveterate fracture dislocation. We performed an assessment of condition of the joint space and endplates, F head shape, peculiarities of A, continuity of the pelvic ring, condition of the neck and the proximal F, gap width in pseudarthrosis, defects of greater and lesser thochanters, migration of proximal F up, the presence of metal construction (MK), its stability, and resorption of bone tissue around it. Status of bone structures we evaluated according to Singh and Barnett-Nordin indices. Results: There were determined distinctive changes in the hip joint in each group: I — lysis of the F neck (dominated by full one in 38 % patients), displacement of the proximal F (67 %), MK (40 %), its migration into the joint cavity (14 %), perforation of the A walls (12 %), and osteoporosis (91 %); II — lysis of the F neck in 43 % patients (in 29 % complete one), defects in greater (71 %) and lesser (86 %) trochanters, dislocation of the proximal F and osteoporosis in 100 %, MK (29 %); III — deformation of the F neck (100 %), defects of the A walls (36 %), displacement of the proximal F (82 %), MK (36 %) and osteoporosis (100 %); IV — deformation of the A wall with its defects (80 %), displacement of the proximal F (86 %), MK (31 %) and osteoporosis (91 %); V — defects of the A wall (100 %), violation of pelvic ring integrity (70 %), displacement of the proximal F (40 %), stable MC (20 %), and osteoporosis (100 %). Conclusion: Considering results obtained after arthroplasty in patients with sequelae of injuries in the hip joint it is possible to optimize preoperative planning and to improve treatment.
HIP International
Background: There is a lack of comparative data on osseointegration (BIC) of acetabular cup surfa... more Background: There is a lack of comparative data on osseointegration (BIC) of acetabular cup surfaces in hip arthroplasty in both normal bone mineral density and in conditions of osteoporosis. Aim: To compare osseointegration of acetabular implants with various types of surfaces in an animal model with normal and osteoporotic bone tissue. Material and Methods: The study was performed on 60 rats. To simulate osteoporosis ovariectomy was performed in 30 animals. Thirty healthy rats served as controls. In standardised defects of the distal metadiaphysis of the femur we implanted: porous tantalum Trabecular Metal (A), Trabecular Titanium (B), Titanium with Gription coating (C), Stiktite (D), and Tritanum (E). Bone apposition (osseointegration) was defined as all areas of direct “bone-to-implant contact” (BIC). Results: No qualitative morphological differences in the evaluation of BIC around different implant types was seen in normal rats and rats with osteoporosis. Connective tissue area...
The Journal of arthroplasty, Jan 19, 2018
ORTHOPAEDICS, TRAUMATOLOGY and PROSTHETICS
ORTHOPAEDICS, TRAUMATOLOGY and PROSTHETICS, 2016
ORTHOPAEDICS, TRAUMATOLOGY and PROSTHETICS, 2016
The Adult Hip - Master Case Series and Techniques
Developmental dysplasia of the hip (DDH) is the most common childhood hip disorder [1]; its preva... more Developmental dysplasia of the hip (DDH) is the most common childhood hip disorder [1]; its prevalence, however, shows remarkable ethnic changes [2, 3]. The anatomical and biomechanical alterations of the acetabulum, femur and pelvis in DDH predispose to hip OA development [4]. Possible deformities encountered in different types of the disease are: 1. The true acetabulum may be shallow with full contact with the femoral head or partly connected with a false acetabulum or severely small, shallow and triangular with complete loss of congruency with the femoral head [5]. 2. Limited bone stock and anterior acetabular segmental wall defects. The bone stock is usually rearranged posteriorly related to acetabulum [6, 7]. 3. Version deformities of the acetabulum; up to 1/3 are retroverted [6, 8, 9]. 4. Insufficient coverage of the femoral head from the acetabulum. 5. Anteversion of the iliac rim [6].
The Adult Hip - Master Case Series and Techniques
Reinforcement rings and cages are implants used in revision THA when the remaining bone stock is ... more Reinforcement rings and cages are implants used in revision THA when the remaining bone stock is deficient. They span the bone defect and act as a scaffold while protecting morcellized or structural allograft during the bone remodelling phase [1]. The use of cages has been reduced over time following the mechanical failure of cages and the introduction of newer techniques of trabecular metal components [1]. 27.1.1 Objective The cages are usually fixed securely but "nonbiologically" to ischium and ilium with the maximum number of screws to provide shortterm mechanical stability to the cup liner. At the same time, they transfer the load to the peripheral host bone protecting morcellized and structural grafts from excessive forces, during the bone remodelling phase [1, 2]. During this period, bone grafting remodels, supports, and bridges areas of bone loss to achieve long
The importance of biomarkers to predict recovery following total hip arthroplasty (THA) is still ... more The importance of biomarkers to predict recovery following total hip arthroplasty (THA) is still unclear to clinicians. To assess the preoperative biomarkers of patients with pseudoarthrosis of the femoral neck and their dynamics in the early postoperative period after THA, 50 patients aged 33 to 82 years old, 18 males and 32 females diagnosed with pseudoarthrosis of the femoral neck after failed internal fixation and failed conservative management were studied. The control group consisted of 30 healthy people aged 27 to 50 years, 13 males, 17 females. Patients’ blood was examined for biochemical markers upon admission, and then on the 7th and 14th days after surgery. Their blood serum content of total protein, albumin, glycoproteins, sialic acids, chondroitin sulfates, haptoglobin, glucose, cholesterol, triglycerides, ALT, AST, alkaline phosphatase, GGT, acid phosphatase, thymol index; interleukins (IL-1, IL-4 and IL-6.) and C-reactive protein was measured. The content of glycoprot...
TRAUMA, Oct 5, 2016
ацетабулярного компонента ендопротеза в умовах остеопорозу і змін анатомії кульшової западини є а... more ацетабулярного компонента ендопротеза в умовах остеопорозу і змін анатомії кульшової западини є актуальною проблемою сучасної ортопедії. Мета: провести порівняльний аналіз міцності кістково-металевого блока для різних типів поверхонь імплантатів в умовах нормального стану кісткової тканини і при моделюванні остеопорозу у щурів. Методи. Проведено експериментальні дослідження міцності стегнової кістки 60 лабораторних щурів. Тварин розподілили на дві групи, по 30 особин у кожній: I-умовно здорові, II-з остеопорозом, який було модельовано методом оваріектомії. У кожній групі сформовано по 6 підгруп тварин, яким у дефект дистального метафіза стегнової кістки (СК) встановлювали імплантати з різних матеріалів: пористий титан, пористий тантал Trabecular Metal (Zimmer), титан з покриттям Gription (DePuy), Stiktite (Smith & Nephew), Trabecular Titanium (Lima), Tritanum (Stryker). Через 90 діб після імплантації тварин виводили з експерименту і проводили біомеханічні дослідження міцності оперованих і контралатеральних СК. Препарат СК фіксували на пристрої головкою вгору. До головки СК прикладали подовжнє осьове навантаження за допомогою металевого штока. Величину навантаження збільшували до повного руйнування препарату і вимірювали. Результати. При нормальній щільності кісткової тканини найбільші руйнівні навантаження витримували СК з імплантатами з пористого танталу Trabecular Metal і Stiktite. В умовах модельованого остеопорозу окремі підмножини становили препарати СК з імплантованим пористим титаном (найслабші) і танталом Trabecular Metal (найміцніші). Висновки. Порівняльний аналіз біомеханічного дослідження показав, що за нормальної щільності кісткової тканини і в умовах моделювання остеопорозу найбільші руйнівні навантаження витримує кісткова тканина з імплантатами з пористого танталу Trabecular Metal.
ORTHOPAEDICS, TRAUMATOLOGY and PROSTHETICS, 2015
Objective: To conduct a retrospective analysis of radiographs and CT scans for studying of typica... more Objective: To conduct a retrospective analysis of radiographs and CT scans for studying of typical changes in acetabulum (A) and proximal femur (F) in patients with the consequences of injuries in the area of the hip joint. Methods: We analyzed radiographs and CT scans in 106 patients. Patients were divided into groups: I — false joint of F neck, II – false joint at the level of per-, inter- and subtrochanteric area of F, III — post-traumatic avascular necrosis of F head, IV — posttraumatic coxarthrosis, V — inveterate fracture dislocation. We performed an assessment of condition of the joint space and endplates, F head shape, peculiarities of A, continuity of the pelvic ring, condition of the neck and the proximal F, gap width in pseudarthrosis, defects of greater and lesser thochanters, migration of proximal F up, the presence of metal construction (MK), its stability, and resorption of bone tissue around it. Status of bone structures we evaluated according to Singh and Barnett-Nordin indices. Results: There were determined distinctive changes in the hip joint in each group: I — lysis of the F neck (dominated by full one in 38 % patients), displacement of the proximal F (67 %), MK (40 %), its migration into the joint cavity (14 %), perforation of the A walls (12 %), and osteoporosis (91 %); II — lysis of the F neck in 43 % patients (in 29 % complete one), defects in greater (71 %) and lesser (86 %) trochanters, dislocation of the proximal F and osteoporosis in 100 %, MK (29 %); III — deformation of the F neck (100 %), defects of the A walls (36 %), displacement of the proximal F (82 %), MK (36 %) and osteoporosis (100 %); IV — deformation of the A wall with its defects (80 %), displacement of the proximal F (86 %), MK (31 %) and osteoporosis (91 %); V — defects of the A wall (100 %), violation of pelvic ring integrity (70 %), displacement of the proximal F (40 %), stable MC (20 %), and osteoporosis (100 %). Conclusion: Considering results obtained after arthroplasty in patients with sequelae of injuries in the hip joint it is possible to optimize preoperative planning and to improve treatment.
HIP International
Background: There is a lack of comparative data on osseointegration (BIC) of acetabular cup surfa... more Background: There is a lack of comparative data on osseointegration (BIC) of acetabular cup surfaces in hip arthroplasty in both normal bone mineral density and in conditions of osteoporosis. Aim: To compare osseointegration of acetabular implants with various types of surfaces in an animal model with normal and osteoporotic bone tissue. Material and Methods: The study was performed on 60 rats. To simulate osteoporosis ovariectomy was performed in 30 animals. Thirty healthy rats served as controls. In standardised defects of the distal metadiaphysis of the femur we implanted: porous tantalum Trabecular Metal (A), Trabecular Titanium (B), Titanium with Gription coating (C), Stiktite (D), and Tritanum (E). Bone apposition (osseointegration) was defined as all areas of direct “bone-to-implant contact” (BIC). Results: No qualitative morphological differences in the evaluation of BIC around different implant types was seen in normal rats and rats with osteoporosis. Connective tissue area...
The Journal of arthroplasty, Jan 19, 2018
ORTHOPAEDICS, TRAUMATOLOGY and PROSTHETICS
ORTHOPAEDICS, TRAUMATOLOGY and PROSTHETICS, 2016
ORTHOPAEDICS, TRAUMATOLOGY and PROSTHETICS, 2016