TOTAL SHOULDER ARTHROPLASTY, AN OVERVIEW, INDICATINS AND PROSTHETIC OPTIONS.

Shoulder arthroplasty (SA) has improved significantly over the last twenty years. It offers the effective treatment for patients with severe shoulder dysfunctions. The indicationsfor this procedure have recently expanded tremendously. However, the most common are glenohumeral osteoarthritis, inflammatory shoulder arthropathies, rotator cuff-tear arthropathy, complex fractures of the proximal humerus and osteonecrosis of a humeral head. There is range of the procedures, such as resurfacing of humeral head, anatomictotal shoulder arthroplasty, hemiarthroplasty and reverse shoulder arthroplasty. All of them could significantly improve patients quality of life. The outcomes of the shoulder arthroplasty are very satisfying in terms of pain relief and considerable improvements in shoulder function as well as in motion. However, this procedure is not so popular as knee or hip arthroplasties. The reasons for this phenomenon are not clear. The complication rate is considerably low. The most common are periprosthetic fractures, infections, implant loosening and instability. The reasonable solution is a conversion to reverse total shoulder arthroplasty. The survivorship of the prosthesis is up to 12 years, which is acceptable by patients. Long term result are still not clear. Surgeons performing SA opt for deltopectoral approach which provides good exposure of the joint also for revisions. The aim: To summarize knowledge about SA based on current literature.

FAT TISSUE AND SYNTHESIZED BY HER ADIPOKINES AS MARKERS INDICATING THE DEVELOPMENT AND PROGRESS OF OSTEOARTHRITIS.

Arthrosis as osteoarthritis is a global problem that affects more and more people and is associated with severe chronic pain, reduced mobility and, consequently, disability. The etiology of degenerative disease is complex and depends on many factors. However, its course was not fully understood. One of the factors affecting the development of arthrosis is obesity. Obesity is a growing problem. Over the past 30 years, the number of overweight people has almost doubled. In people suffering from obesity, whose body mass index is above 30kg/m2, the risk of developing degenerative changes in articular cartilage is six times higher than the risk of developing this disease in people with normal body weight. Osteoarthritis is detected when the symptoms get worse where the changes are already at some stage. Therefore, a lot of research is currently underway to find suitable biomarkers, which would indicate the potential development of degenerative changes in the future and at the same time the possibility of inhibiting their activity. One of them may be adipokines, which are synthesized by adipose tissue and affect cartilage. In obese people, adipokines may contribute to the inflammation of the low charterer, whichaccompanies both obesity and arthrosis. These compounds can be specific biomarkers to assess the degree of progression and severity of osteoarthritis. The aim: To assess the importance of obesity and adipokines produced by adipose tissue as specific markers of arthrosis.