István Gergely | G.E. Palade UMPhST of Targu Mures (original) (raw)

Papers by István Gergely

Acta Medica Transilvanica, 2018

European Scientific Journal, ESJ, 2015

Aim of this paper. Is to study the iliopsoas impingement with threedimensional modeling (3D) afte... more Aim of this paper. Is to study the iliopsoas impingement with threedimensional modeling (3D) after total hip arthroplasty in extended position of the hip in case of 28 and 36 mm diameter prosthetic heads and the acetabular component in malposition (retroversion). Material and methods. We performed a 3D reconstruction of the pelvic bone, the left femur and left iliopsoas muscle of a 27 year old male based on CT images. After that we created a solid body that we used for the arthroplasty performed in the variants mentioned above and we used the finite element method for the analyses. Results. There were no traces of impingement with the 28 mm and 36 mm diameter femoral head, when the joint is in extension. When the acetabular component was in malposition, we found a stress aerie on the iliopsoas muscle and acetabular component meeting point. Conclusion. In our research, we demonstrated by 3D modeling and finite element analysis that after total hip arthroplasty using a large diameter ...

Acta Microbiologica et Immunologica Hungarica, 2015

The vomeronasal organ (VNO) is the receptor structure of the vomeronasal system (VNS) in vertebra... more The vomeronasal organ (VNO) is the receptor structure of the vomeronasal system (VNS) in vertebrates. It is found bilaterally in the submucosa of the inferior part of the nasal septum. There are ongoing controversies regarding the functionality of this organ in humans. In this study we propose the immunohistochemical evaluation of changes in components of the human vomeronasal epithelium during foetal development. We used 45 foetuses of different age, which were included in three age groups. After VNO identification immunohistochemical reactions were performed using primary antibodies against the following: neuron specific enolase, calretinin, neurofilament, chromogranin, synaptophysin, cytokeratin 7, pan-cytokeratin and S100 protein. Digital slides were obtained and following colorimetric segmentation, surface area measurements were performed. The VNO was found in less than half of the studied specimens (42.2%). Neuron specific enolase and calretinin immunoexpression showed a decre...

Proprioception could be defined as the perception of limb position in the space. In last few deca... more Proprioception could be defined as the perception of limb position in the space. In last few decades, extensive research has been conducted, dedicated to the sensory role of anterior cruciate ligament and to the analysis of how its damage influences knee joint function. Even though knee proprioception is a widely studied topic, we still do not understand exactly the role of intact and injured anterior cruciate ligament in proprioception and what factors affect proprioceptive rehabilitation after anterior cruciate ligament reconstruction. The aim of this paper is to synthesize the theoretical framework of knee proprioception and the sensory role of anterior cruciate ligament. This study can be viewed as providing a theoretical foundation for a very complex research question.

Journal of Personalized Medicine, Apr 15, 2021

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

With a sample of 40 study subjects undergoing total knee arthoplasty with cemented total endopros... more With a sample of 40 study subjects undergoing total knee arthoplasty with cemented total endoprosthesis, a prospective observational study was performed in order to evaluate the effectiveness of the rehabilitation programme developed by the Department of Clinical Orthopaedics and Traumatology of Tîrgu-Mureş County Hospital, by evaluating the development of functional results obtained during regular evaluations, The follow-up period for the patients was 3 (three) months. Comparing average joint mobility measured at three months after surgery, a statistically insignificant difference was noted between the operated and the opposite-considered healthy-knee. By comparing averages function tests and WOMAC score obtained at each evaluation, a significant improvement in the patients'' functionality was found. This rehabilitation protocol has proven effective in ensuring rapid functional recovery, three months after surgery patients showing normal mobility without having to limit the...

Cuvinte cheie: fracturi periprotetice, clasificarea Vancouver, artroplastia totală de șold Rezuma... more Cuvinte cheie: fracturi periprotetice, clasificarea Vancouver, artroplastia totală de șold Rezumat: Creșterea numărului de artroplastii totale de șold (ATS) și a speranței de viață au condus la o creștere a frecvenței fracturilor periprotetice de femur. În acest studiu am evaluat rezultatele obținute după tratamentul acestor fracturi, utilizând recomandările grupului Vancouver. O serie consecutivă de 39 cazuri de fracturi periprotetice de femur după ATS (23 femei, 16 bărbați, vârsta medie 66±7 ani) tratate de aceeași echipă operatorie între 2000-2009, au fost urmărite în medie 84 de luni (42-148 luni). Fracturile au fost clasificate pe baza sistemului Vancouver și tratate prin metode ortopedice, reducere chirurgicală și osteosinteză sau prin revizia artroplastiei de șold. Am obținut o rată de consolidare de 84,61% după tratamentul inițial, respectiv 97,43% după a doua intervenție. Fracturile periprotetice cu un implant stabil au consolidat în majoritatea cazurilor. Rata complicațiilor a fost de 25,64%. Pe baza rezultatelor noastre susținem utilizarea sistemului Vancouver ca algoritm terapeutic în astfel de cazuri.

În acest studiu clinic randomizat, dublu-orb, am evaluat comparativ eficacitatea injecţiilor intr... more În acest studiu clinic randomizat, dublu-orb, am evaluat comparativ eficacitatea injecţiilor intra-articulare cu polinucleotide și hialuronat de sodiu la pacienţi cu gonartroză decompensată algic. Am randomizat 30 de pacienţi în 2 loturi de câte 15, care au beneficiat de 3 infiltraţii intra-articulare la nivelul genunchiului, la intervale de 1 săptămână, cu polinucleotide (Condrotide TM-n= 15) sau hialuronat de sodiu (Synocrom®-n= 15). Perioada de urmărire a fost de 3 luni după finalizarea tratamentului. Pentru evaluare am folosit Scala Analog Vizuală pentru durere, scorul Knee Osteoarthritis Outcome Score şi scorurile de genunchi şi funcţional Knee Society Score înaintea administrării primei infiltraţii, şi apoi la 4, 8 şi 16 săptămâni. Nivelul durerii s-a îmbunătăţit statistic semnificativ la ambele loturi, în timp ce valorile scorurilor KSS au prezentat o îmbunătățire semnificativă doar la lotul tratat cu polinucleotide. Am concluzionat că injecțiile intra-articulare cu polinucleotide reprezintă o alternativă viabilă în tratamentul gonartrozei.

In total knee arthroplasty for cases with valgum axial deformity, ligament balancing requires spe... more In total knee arthroplasty for cases with valgum axial deformity, ligament balancing requires special attention due to specific changes in osseous configuration and periarticular soft tissues. In this study we followed a consecutive series of patients with knee osteoarthritis and valgus axial deviation who underwent total knee arthroplasty with posterior stabilized endoprostheses. We used either a medial or lateral parapatellar approach, depending on the degree of deviation. The patients were followed clinically and radiologically on average 4.1 years, and we recorded the clinical and functional Knee Society Score. We found a statistically significant improvement in all followed parameters: clinical and functional scores increased from the average preoperative values of 33.73 and 29.8 points to 93.5 and 86.73 points at 1 year, and 93.15 and 87.3 points at 4 years postoperatively (p=0.0001), with no cases of endoprosthetic component loosening. Cuvinte cheie: gonartroză, genu valgum, ...

The middiaphyseal metatarsal Scarf osteotomy has become increasingly popular over the years becau... more The middiaphyseal metatarsal Scarf osteotomy has become increasingly popular over the years because it provides great versatility, high stability and early weight-bearing. Even so, only a few studies exist in the literature with regard to long-term outcomes. In this paper we report the results of our study on 23 patients with a mean follow-up of 9 years. Between January 1998 and December 2003, 31 patients (41 feet) underwent this type of osteotomy. During the follow-up, 8 cases were lost. Clinical evaluation based on the American Orthopaedic Foot and Ankle Society score proved a significant improvement from 52 to 85 points (p - 0.0001). Radiological assessment pointed the reduction of first intermetatarsal angle (IMA) with a mean of 5 degrees (p - 0.0001) and hallux valgus angle with 19 degrees (p-0.0001). These results confirm the reliability of Scarf osteotomy in the treatment of moderate- to-severe hallux valgus deformities.

Acinetobacter baumanii is known as the second most common cause of hospital-acquired infections, ... more Acinetobacter baumanii is known as the second most common cause of hospital-acquired infections, following the Pseudomonas aeruginosa. Demand for total articular replacement is increasing rapidly in every year, so we can aspect an exponential growth of rate of periprosthetic joint infection. This paper is a case report of a patient treated in our septic department, wearing a total hip endoprosthesis and reoperated several times in another surgical ward. The resulting infection was superficial, we could manage it with a proper debridement and targeted antibiotherapy. At the long term checkups , the patient was complaint-free, with no further signs of infection. It is expected that this type of infections to increase in the future. The difficulty of this treatment is given by the rapid development of antibiotic resistance.

With a sample of 80 subjects undergoing total knee arthroplasty with cemented total endoprosthesi... more With a sample of 80 subjects undergoing total knee arthroplasty with cemented total endoprosthesis, a prospective observational study was conducted on the influence of continuous passive mobilization on the development of joint mobility and on the quality of life. Patients in group I have performed daily active gym sessions, whereas the patients in group II received daily passive motion exercises. Comparing the average goniometric measurements between the two groups, the results revealed significantly differences from the second day to 6 weeks postoperatively: the joint mobility of patients in group II was significantly better than the mobility of patients in group I. At the 3 and 6 months postoperative evaluation, no significant differences were noted in the patients' mobility and quality of life. Skin complications were more common with patients in group II. Our findings show that continuous passive motion does not have clinically important effects on long term active knee fle...

European Scientific Journal, ESJ, 2015

Nowadays the number of primary arthroplasties is growing and revision arthroplasty is becoming in... more Nowadays the number of primary arthroplasties is growing and revision arthroplasty is becoming increasingly necessary. In this study we intend to examine the effectiveness of arthroplasties and assess the quality of life. We included 35 patients with revision arthroplasty and 35 primary hip arthroplasty patients who had surgery between 2011 and 2012 in the study. To examine the results we used the modified Harris hip score and the Rosser matrix, which was completed before surgery and 2-3 years after the procedure. We observed a statistically significant improvement: from 34 preoperative Harris hip score 75 at the 2 years postsurgery assessment and 72 at the 3 years postoperative assessment (p <0.0001). Significant improvements were also registered when assessing the health state with the Rosser matrix. The effect for the Harris score had a value of 2.06 which testifies the revision surgery has a high effectiveness. This means that with this kind of procedures dramatic improvement...

The increase in total hip replacement (THR) rates and rising life expectancy made periprosthetic ... more The increase in total hip replacement (THR) rates and rising life expectancy made periprosthetic femoral fractures after THR more common. In this study we evaluated the results of treating these types of fractures using the Vancouver group recommendations. We assessed a consecutive series of 39 periprosthetic femur fractures after THR (23 women, 16 men aged 66±7 years) treated by the same operative team between 2000 and 2009 and followed for a mean of 84 months (42- 148). Fractures were classified according to the Vancouver system and treated non-operatively, with open reduction and internal fixation or with revision surgery. We obtained a 84.61% union rate with initial treatment that increased to 97.43% after the second procedure, with fracture union in the majority of cases with a stable implant and a 25.64% complication rate. Based on our results, we support the use of the Vancouver system as a treatment algorithm in these cases. Cuvinte cheie: fracturi periprotetice, clasificare...

We conducted a randomized, double-blind clinical trial to assess the efficacy of intra-articular ... more We conducted a randomized, double-blind clinical trial to assess the efficacy of intra-articular injections of polynucleotides versus hyaluronan in patients with symptomatic knee osteoarthritis. The 30 patients enrolled were randomized in two groups and received 3 intra-articula r knee injections at 1 week intervals with either polynucleotides (Condrotide TM , n=15) or hyaluronan (Synocrom®, n=15). The patients were followed for 3 months after the end of treatment, with clinical evaluation before administering the first injection and then at 4, 8 and 16 weeks afterward. We used the Visual Analog Scale for pain assessment and calculated the Knee Osteoarthritis Outcome Score and Knee Society Scores (knee and functional). We found a statistically significant decrease of pain levels in both groups, with Knee Society Scores showing a statistically significant improvement only in the polynucleotide group. We concluded that the use of polynucleotid e injections in the treatment of knee art...

Currently, ankle arthrodesis is still considered the treatment of choice in advanced stages of an... more Currently, ankle arthrodesis is still considered the treatment of choice in advanced stages of ankle osteoarthritis. Harvesting a bone graft from the distal tibia and sliding and fixing it in the talus leads to a strong stabilization without the need for osteosynthesis material. In this study we aimed to evaluate the clinical course, osseous consolidation and the frequency of complications of this technique. We included 32 cases of ankle arthrodesis in 32 patients (21 men, 11 women, mean age 48±22 years) that were followed for a mean of 3.7 years (1-6 years). We found a statistically significant improvement of the AOFAS Ankle-Hindfoot Scale score (p=0.02) and consolidation in 31 cases (96.87%) after a medium of 13 weeks. There were two cases of superficial soft tissue necrosis and one case without bone fusion. The method is simple, reproducible and provides excellent clinical results with a high rate of consolidation.

We have performed a prospective observational study on 90 patients on the effectiveness of the co... more We have performed a prospective observational study on 90 patients on the effectiveness of the conservative treatment of knee osteoarthritis. All patients included in the study received oral Nonsteroidal anti-inflammatory drugs (NSAIDs) treatment. The pharmacological therapy was completed with physiotherapy sessions in case of group I, or different electrotherapy procedures in group II. Patients in group III received only pharmacological treatment. Evaluation of patients was performed before treatment, on the 10-day of treatment, 3 and 6 months after finalization. Comparing the goniometric average values, physical therapy was proven effective in achieving and maintaining long term joint mobility. Regarding pain intensity at the 6-month assessment only with patients in group I, there were statistically significant differences compared with the values obtained before the treatment. Among the tested methods of treatment, the best and long lasting therapeutic results were obtained by combining the drug with a kinetic treatment.

Aim: the increasing number of total hip arthroplasties in case of young, physically active patien... more Aim: the increasing number of total hip arthroplasties in case of young, physically active patients means an increasing number of revision surgeries as well. For these patients the use of ceramic bearings could be an appropriate solution because of its reduced wear and a predicted longer lifetime. In this paper we would like to present our short experiences with non-cemented, ceramic-on-ceramic total hip prosthesis, in case of young patients. Materials and Methods: between January 2011 and December 2012, 32 hip arthroplasties were performed in case of 31 young patients diagnosed with avascular necrosis of the femoral head. The clinical and radiological follow-up of these patients was carried out for an average of 1,5 year. The average age was 47 years (25-51) in the moment of the surgery. The clinical assessment of the patients were carried out by the Harris Hip Score and Visual Analog Scale, performed before and 3, 6, 12 month after surgery. The radiological evaluation was based on...

Journal of Personalized Medicine

Background: Prior trials investigating the treatment of symptomatic osteoarthritis (OA) with hyal... more Background: Prior trials investigating the treatment of symptomatic osteoarthritis (OA) with hyaluronic-acid-derived products injections have provided optimistic results. The study was directed to assess the effectiveness of an innovative hyaluronic-acid-based hydrogel (Hymovis®) in the treatment of symptomatic knee OA. Methods: A prospective, single-center, clinical trial was performed. Thirty-five patients with degenerative knee OA were included. Inclusion criteria were: age between 45–80, radiographic Kellgren grade II or III osteoarthritis, minimum 35 mm score on the Visual Analogue Scale (VAS), pain for at least 6 months and agreement to participate in the study. Patients received two injections at a one-week interval. The evaluator assessed the patients using the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and VAS. Evaluation was performed before, at 2 and 6 months after the injections. Results: A significant improvement on the WOMAC Index pain subscal...

Revista de Chimie

The all-inside technique for ACL reconstruction uses the semitendinous muscle tendon as a graft, ... more The all-inside technique for ACL reconstruction uses the semitendinous muscle tendon as a graft, and postoperative pain is slightly reduced. Through the full tibial tunnel technique, better anatomical graft placement is obtained with promising results, yet there are only few scientific articles comparing the two techniques. The main objective is evaluation of results after ACL reconstruction by comparing the clinical results of the two surgical techniques. A prospective study was conducted that included 63 eligible patients according to pre-established criteria. The technique used was randomly indicated to each patient. Demographics and clinical examination results were collected and subsequently stored. The assessment tools used were the International Knee Documentation Committee (IKDC), Knee injury and Osteoarthritis Outcome Score (KOOS) and the Visual Analogue Scale (VAS) with a 6-month follow-up period. The statistical analysis was performed for preoperative follow-up scores, at...

Acta Medica Transilvanica, 2018

European Scientific Journal, ESJ, 2015

Aim of this paper. Is to study the iliopsoas impingement with threedimensional modeling (3D) afte... more Aim of this paper. Is to study the iliopsoas impingement with threedimensional modeling (3D) after total hip arthroplasty in extended position of the hip in case of 28 and 36 mm diameter prosthetic heads and the acetabular component in malposition (retroversion). Material and methods. We performed a 3D reconstruction of the pelvic bone, the left femur and left iliopsoas muscle of a 27 year old male based on CT images. After that we created a solid body that we used for the arthroplasty performed in the variants mentioned above and we used the finite element method for the analyses. Results. There were no traces of impingement with the 28 mm and 36 mm diameter femoral head, when the joint is in extension. When the acetabular component was in malposition, we found a stress aerie on the iliopsoas muscle and acetabular component meeting point. Conclusion. In our research, we demonstrated by 3D modeling and finite element analysis that after total hip arthroplasty using a large diameter ...

Acta Microbiologica et Immunologica Hungarica, 2015

The vomeronasal organ (VNO) is the receptor structure of the vomeronasal system (VNS) in vertebra... more The vomeronasal organ (VNO) is the receptor structure of the vomeronasal system (VNS) in vertebrates. It is found bilaterally in the submucosa of the inferior part of the nasal septum. There are ongoing controversies regarding the functionality of this organ in humans. In this study we propose the immunohistochemical evaluation of changes in components of the human vomeronasal epithelium during foetal development. We used 45 foetuses of different age, which were included in three age groups. After VNO identification immunohistochemical reactions were performed using primary antibodies against the following: neuron specific enolase, calretinin, neurofilament, chromogranin, synaptophysin, cytokeratin 7, pan-cytokeratin and S100 protein. Digital slides were obtained and following colorimetric segmentation, surface area measurements were performed. The VNO was found in less than half of the studied specimens (42.2%). Neuron specific enolase and calretinin immunoexpression showed a decre...

Proprioception could be defined as the perception of limb position in the space. In last few deca... more Proprioception could be defined as the perception of limb position in the space. In last few decades, extensive research has been conducted, dedicated to the sensory role of anterior cruciate ligament and to the analysis of how its damage influences knee joint function. Even though knee proprioception is a widely studied topic, we still do not understand exactly the role of intact and injured anterior cruciate ligament in proprioception and what factors affect proprioceptive rehabilitation after anterior cruciate ligament reconstruction. The aim of this paper is to synthesize the theoretical framework of knee proprioception and the sensory role of anterior cruciate ligament. This study can be viewed as providing a theoretical foundation for a very complex research question.

Journal of Personalized Medicine, Apr 15, 2021

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

With a sample of 40 study subjects undergoing total knee arthoplasty with cemented total endopros... more With a sample of 40 study subjects undergoing total knee arthoplasty with cemented total endoprosthesis, a prospective observational study was performed in order to evaluate the effectiveness of the rehabilitation programme developed by the Department of Clinical Orthopaedics and Traumatology of Tîrgu-Mureş County Hospital, by evaluating the development of functional results obtained during regular evaluations, The follow-up period for the patients was 3 (three) months. Comparing average joint mobility measured at three months after surgery, a statistically insignificant difference was noted between the operated and the opposite-considered healthy-knee. By comparing averages function tests and WOMAC score obtained at each evaluation, a significant improvement in the patients'' functionality was found. This rehabilitation protocol has proven effective in ensuring rapid functional recovery, three months after surgery patients showing normal mobility without having to limit the...

Cuvinte cheie: fracturi periprotetice, clasificarea Vancouver, artroplastia totală de șold Rezuma... more Cuvinte cheie: fracturi periprotetice, clasificarea Vancouver, artroplastia totală de șold Rezumat: Creșterea numărului de artroplastii totale de șold (ATS) și a speranței de viață au condus la o creștere a frecvenței fracturilor periprotetice de femur. În acest studiu am evaluat rezultatele obținute după tratamentul acestor fracturi, utilizând recomandările grupului Vancouver. O serie consecutivă de 39 cazuri de fracturi periprotetice de femur după ATS (23 femei, 16 bărbați, vârsta medie 66±7 ani) tratate de aceeași echipă operatorie între 2000-2009, au fost urmărite în medie 84 de luni (42-148 luni). Fracturile au fost clasificate pe baza sistemului Vancouver și tratate prin metode ortopedice, reducere chirurgicală și osteosinteză sau prin revizia artroplastiei de șold. Am obținut o rată de consolidare de 84,61% după tratamentul inițial, respectiv 97,43% după a doua intervenție. Fracturile periprotetice cu un implant stabil au consolidat în majoritatea cazurilor. Rata complicațiilor a fost de 25,64%. Pe baza rezultatelor noastre susținem utilizarea sistemului Vancouver ca algoritm terapeutic în astfel de cazuri.

În acest studiu clinic randomizat, dublu-orb, am evaluat comparativ eficacitatea injecţiilor intr... more În acest studiu clinic randomizat, dublu-orb, am evaluat comparativ eficacitatea injecţiilor intra-articulare cu polinucleotide și hialuronat de sodiu la pacienţi cu gonartroză decompensată algic. Am randomizat 30 de pacienţi în 2 loturi de câte 15, care au beneficiat de 3 infiltraţii intra-articulare la nivelul genunchiului, la intervale de 1 săptămână, cu polinucleotide (Condrotide TM-n= 15) sau hialuronat de sodiu (Synocrom®-n= 15). Perioada de urmărire a fost de 3 luni după finalizarea tratamentului. Pentru evaluare am folosit Scala Analog Vizuală pentru durere, scorul Knee Osteoarthritis Outcome Score şi scorurile de genunchi şi funcţional Knee Society Score înaintea administrării primei infiltraţii, şi apoi la 4, 8 şi 16 săptămâni. Nivelul durerii s-a îmbunătăţit statistic semnificativ la ambele loturi, în timp ce valorile scorurilor KSS au prezentat o îmbunătățire semnificativă doar la lotul tratat cu polinucleotide. Am concluzionat că injecțiile intra-articulare cu polinucleotide reprezintă o alternativă viabilă în tratamentul gonartrozei.

In total knee arthroplasty for cases with valgum axial deformity, ligament balancing requires spe... more In total knee arthroplasty for cases with valgum axial deformity, ligament balancing requires special attention due to specific changes in osseous configuration and periarticular soft tissues. In this study we followed a consecutive series of patients with knee osteoarthritis and valgus axial deviation who underwent total knee arthroplasty with posterior stabilized endoprostheses. We used either a medial or lateral parapatellar approach, depending on the degree of deviation. The patients were followed clinically and radiologically on average 4.1 years, and we recorded the clinical and functional Knee Society Score. We found a statistically significant improvement in all followed parameters: clinical and functional scores increased from the average preoperative values of 33.73 and 29.8 points to 93.5 and 86.73 points at 1 year, and 93.15 and 87.3 points at 4 years postoperatively (p=0.0001), with no cases of endoprosthetic component loosening. Cuvinte cheie: gonartroză, genu valgum, ...

The middiaphyseal metatarsal Scarf osteotomy has become increasingly popular over the years becau... more The middiaphyseal metatarsal Scarf osteotomy has become increasingly popular over the years because it provides great versatility, high stability and early weight-bearing. Even so, only a few studies exist in the literature with regard to long-term outcomes. In this paper we report the results of our study on 23 patients with a mean follow-up of 9 years. Between January 1998 and December 2003, 31 patients (41 feet) underwent this type of osteotomy. During the follow-up, 8 cases were lost. Clinical evaluation based on the American Orthopaedic Foot and Ankle Society score proved a significant improvement from 52 to 85 points (p - 0.0001). Radiological assessment pointed the reduction of first intermetatarsal angle (IMA) with a mean of 5 degrees (p - 0.0001) and hallux valgus angle with 19 degrees (p-0.0001). These results confirm the reliability of Scarf osteotomy in the treatment of moderate- to-severe hallux valgus deformities.

Acinetobacter baumanii is known as the second most common cause of hospital-acquired infections, ... more Acinetobacter baumanii is known as the second most common cause of hospital-acquired infections, following the Pseudomonas aeruginosa. Demand for total articular replacement is increasing rapidly in every year, so we can aspect an exponential growth of rate of periprosthetic joint infection. This paper is a case report of a patient treated in our septic department, wearing a total hip endoprosthesis and reoperated several times in another surgical ward. The resulting infection was superficial, we could manage it with a proper debridement and targeted antibiotherapy. At the long term checkups , the patient was complaint-free, with no further signs of infection. It is expected that this type of infections to increase in the future. The difficulty of this treatment is given by the rapid development of antibiotic resistance.

With a sample of 80 subjects undergoing total knee arthroplasty with cemented total endoprosthesi... more With a sample of 80 subjects undergoing total knee arthroplasty with cemented total endoprosthesis, a prospective observational study was conducted on the influence of continuous passive mobilization on the development of joint mobility and on the quality of life. Patients in group I have performed daily active gym sessions, whereas the patients in group II received daily passive motion exercises. Comparing the average goniometric measurements between the two groups, the results revealed significantly differences from the second day to 6 weeks postoperatively: the joint mobility of patients in group II was significantly better than the mobility of patients in group I. At the 3 and 6 months postoperative evaluation, no significant differences were noted in the patients' mobility and quality of life. Skin complications were more common with patients in group II. Our findings show that continuous passive motion does not have clinically important effects on long term active knee fle...

European Scientific Journal, ESJ, 2015

Nowadays the number of primary arthroplasties is growing and revision arthroplasty is becoming in... more Nowadays the number of primary arthroplasties is growing and revision arthroplasty is becoming increasingly necessary. In this study we intend to examine the effectiveness of arthroplasties and assess the quality of life. We included 35 patients with revision arthroplasty and 35 primary hip arthroplasty patients who had surgery between 2011 and 2012 in the study. To examine the results we used the modified Harris hip score and the Rosser matrix, which was completed before surgery and 2-3 years after the procedure. We observed a statistically significant improvement: from 34 preoperative Harris hip score 75 at the 2 years postsurgery assessment and 72 at the 3 years postoperative assessment (p <0.0001). Significant improvements were also registered when assessing the health state with the Rosser matrix. The effect for the Harris score had a value of 2.06 which testifies the revision surgery has a high effectiveness. This means that with this kind of procedures dramatic improvement...

The increase in total hip replacement (THR) rates and rising life expectancy made periprosthetic ... more The increase in total hip replacement (THR) rates and rising life expectancy made periprosthetic femoral fractures after THR more common. In this study we evaluated the results of treating these types of fractures using the Vancouver group recommendations. We assessed a consecutive series of 39 periprosthetic femur fractures after THR (23 women, 16 men aged 66±7 years) treated by the same operative team between 2000 and 2009 and followed for a mean of 84 months (42- 148). Fractures were classified according to the Vancouver system and treated non-operatively, with open reduction and internal fixation or with revision surgery. We obtained a 84.61% union rate with initial treatment that increased to 97.43% after the second procedure, with fracture union in the majority of cases with a stable implant and a 25.64% complication rate. Based on our results, we support the use of the Vancouver system as a treatment algorithm in these cases. Cuvinte cheie: fracturi periprotetice, clasificare...

We conducted a randomized, double-blind clinical trial to assess the efficacy of intra-articular ... more We conducted a randomized, double-blind clinical trial to assess the efficacy of intra-articular injections of polynucleotides versus hyaluronan in patients with symptomatic knee osteoarthritis. The 30 patients enrolled were randomized in two groups and received 3 intra-articula r knee injections at 1 week intervals with either polynucleotides (Condrotide TM , n=15) or hyaluronan (Synocrom®, n=15). The patients were followed for 3 months after the end of treatment, with clinical evaluation before administering the first injection and then at 4, 8 and 16 weeks afterward. We used the Visual Analog Scale for pain assessment and calculated the Knee Osteoarthritis Outcome Score and Knee Society Scores (knee and functional). We found a statistically significant decrease of pain levels in both groups, with Knee Society Scores showing a statistically significant improvement only in the polynucleotide group. We concluded that the use of polynucleotid e injections in the treatment of knee art...

Currently, ankle arthrodesis is still considered the treatment of choice in advanced stages of an... more Currently, ankle arthrodesis is still considered the treatment of choice in advanced stages of ankle osteoarthritis. Harvesting a bone graft from the distal tibia and sliding and fixing it in the talus leads to a strong stabilization without the need for osteosynthesis material. In this study we aimed to evaluate the clinical course, osseous consolidation and the frequency of complications of this technique. We included 32 cases of ankle arthrodesis in 32 patients (21 men, 11 women, mean age 48±22 years) that were followed for a mean of 3.7 years (1-6 years). We found a statistically significant improvement of the AOFAS Ankle-Hindfoot Scale score (p=0.02) and consolidation in 31 cases (96.87%) after a medium of 13 weeks. There were two cases of superficial soft tissue necrosis and one case without bone fusion. The method is simple, reproducible and provides excellent clinical results with a high rate of consolidation.

We have performed a prospective observational study on 90 patients on the effectiveness of the co... more We have performed a prospective observational study on 90 patients on the effectiveness of the conservative treatment of knee osteoarthritis. All patients included in the study received oral Nonsteroidal anti-inflammatory drugs (NSAIDs) treatment. The pharmacological therapy was completed with physiotherapy sessions in case of group I, or different electrotherapy procedures in group II. Patients in group III received only pharmacological treatment. Evaluation of patients was performed before treatment, on the 10-day of treatment, 3 and 6 months after finalization. Comparing the goniometric average values, physical therapy was proven effective in achieving and maintaining long term joint mobility. Regarding pain intensity at the 6-month assessment only with patients in group I, there were statistically significant differences compared with the values obtained before the treatment. Among the tested methods of treatment, the best and long lasting therapeutic results were obtained by combining the drug with a kinetic treatment.

Aim: the increasing number of total hip arthroplasties in case of young, physically active patien... more Aim: the increasing number of total hip arthroplasties in case of young, physically active patients means an increasing number of revision surgeries as well. For these patients the use of ceramic bearings could be an appropriate solution because of its reduced wear and a predicted longer lifetime. In this paper we would like to present our short experiences with non-cemented, ceramic-on-ceramic total hip prosthesis, in case of young patients. Materials and Methods: between January 2011 and December 2012, 32 hip arthroplasties were performed in case of 31 young patients diagnosed with avascular necrosis of the femoral head. The clinical and radiological follow-up of these patients was carried out for an average of 1,5 year. The average age was 47 years (25-51) in the moment of the surgery. The clinical assessment of the patients were carried out by the Harris Hip Score and Visual Analog Scale, performed before and 3, 6, 12 month after surgery. The radiological evaluation was based on...

Journal of Personalized Medicine

Background: Prior trials investigating the treatment of symptomatic osteoarthritis (OA) with hyal... more Background: Prior trials investigating the treatment of symptomatic osteoarthritis (OA) with hyaluronic-acid-derived products injections have provided optimistic results. The study was directed to assess the effectiveness of an innovative hyaluronic-acid-based hydrogel (Hymovis®) in the treatment of symptomatic knee OA. Methods: A prospective, single-center, clinical trial was performed. Thirty-five patients with degenerative knee OA were included. Inclusion criteria were: age between 45–80, radiographic Kellgren grade II or III osteoarthritis, minimum 35 mm score on the Visual Analogue Scale (VAS), pain for at least 6 months and agreement to participate in the study. Patients received two injections at a one-week interval. The evaluator assessed the patients using the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and VAS. Evaluation was performed before, at 2 and 6 months after the injections. Results: A significant improvement on the WOMAC Index pain subscal...

Revista de Chimie

The all-inside technique for ACL reconstruction uses the semitendinous muscle tendon as a graft, ... more The all-inside technique for ACL reconstruction uses the semitendinous muscle tendon as a graft, and postoperative pain is slightly reduced. Through the full tibial tunnel technique, better anatomical graft placement is obtained with promising results, yet there are only few scientific articles comparing the two techniques. The main objective is evaluation of results after ACL reconstruction by comparing the clinical results of the two surgical techniques. A prospective study was conducted that included 63 eligible patients according to pre-established criteria. The technique used was randomly indicated to each patient. Demographics and clinical examination results were collected and subsequently stored. The assessment tools used were the International Knee Documentation Committee (IKDC), Knee injury and Osteoarthritis Outcome Score (KOOS) and the Visual Analogue Scale (VAS) with a 6-month follow-up period. The statistical analysis was performed for preoperative follow-up scores, at...