[Methods of rapid prototyping in preoperative planning in musculoskeletal reconstructive surgery]. / Metody szybkiego prototypowania w planowaniu przedoperacyjnym w zabiegach chirurgii rekonstrukcyjnej narzadu ruchu.

Rapid Prototyping and CT based 3D modelling implementation in orthopaedic reconstructive surgery is presented in the article. Bone models rendered in SLS (Selective Laser Sintering) were used in pre-operative planning. Physical models were made based on imaging data obtained in standard CT scans. Better pre-planning, surgical team preparation and an insight into possible difficulties are the obvious advantage of the method as well as resulting reduced complication rate. Its clinical applicability was confirmed during surgical procedures.

Impact of preoperative knee deformity on the outcome of total knee replacement using the PFC system.

Backgrund. The purpose of our study was to evaluate the impact of preoperative knee deformity on TKR results and the effectiveness of unconstrained PFC systems in the correction of these deformities in knees affected by degenerative disease. Material and methods. We performed a retrospective study of 91 consecutive TKRs performed between 1995-2000 in 79 patients (71 women and 8 men, mean age 67.2 years), during which 74 PFCs and 17 PFCSs were implanted. The mean follow-up was 48.3 months (range: 13-58 years). Functional status was evaluated using the Knee Society Score (KSS), and the radiological results were assessed on the basis of standard plain x-ray pictures. Results. We found 26.7% excellent outcomes, 67.8% good, 3.3% fair and 2.2% poor. There were no statistically significant differences between the anatomical and radiological outcomes of TKR in knee joints with flexion, valgus or varus preoperative deformities. The effectiveness of the unconstrained system of total knee arthroplasty in correction of the flexion or valgus/varus knee joint deformity was very good, given proper patient selection and meticulous surgical technique. Conclusions. Clinical and radiographic studies show that preoperative knee deformation has no impact on the early results of TKR with an unconstrained PRC system. The functional and radiographic results of TKR with an unconstrained PFC system confirm the very high effectiveness of this technique in the correction of preoperative deformation of the knee with degenerative changes. The results of TKR with un-constrained PFC systems in short-term follow-up (1-5 years) are very good.

[Treatment of fragmented femur fracture following unilateral hip hemiarthroplasty and total knee arthroplasty]. / Zaopatrzenie wieloodlamowego zlamania trzonu kosci udowej po jednostronnej alloplastyce polowiczej stawu biodrowego i calkowitej stawu kolanowego.

In this paper is presented a case of the 80 years old patient with femur fracture after unilateral hip arthroplasty because of femur neck fracture and knee arthroplasty following osteoarthritis. First was done the stabilization of the fracture using a plate. Because of second fracture and damage the plate stabilization next operation was done using intramedullary Küntscher nail which was non typically inserted and with additional fixation by bone cement. The result were good stabilization and healing of the fracture after 4 months.