Total knee arthroplasty: surgical treatment for patients with advanced diseases and extensive deformation of the knee

Jerzy Widuchowski, Damian Kusz, Wojciech Widuchowski, Adam Pierzchała

Jerzy Widuchowski, Damian Kusz, Wojciech Widuchowski, Adam Pierzchała – Total knee arthroplasty: surgical treatment for patients with advanced diseases and extensive deformation of the knee. Fizjoterapia Polska 2004; 4(4); 403-410

Abstract

Total knee arthroplasty has become a common surgical intervention in cases of widespread deformation of the knee joint due to the progress of arthritis or rheumatoid arthritis, and is now considered the method of choice for these patients. TKA is based on removing the destroyed parts of the knee and replacing them with new metal or plastic elements. It is commonly stated that TKA is a process of replacing an old destroyed joint with a new artificial one. In the present study, the authors show the types of knee prostheses and how they are installed. Emphasis is placed on the rules for prosthesis selection in relation to the level of the knee joint disease, especially the level of the destruction of anatomical structures. The authors also present the indications for surgical intervention, as well as preoperative procedures.

Key words:
total knee replacement, arthritis of the knee, rheumatoid arthritis of the knee
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An attempt at using focused shockwave therapy to treat selected orthopedic diseases – a preliminary report

Andrzej Franek, Damian Kusz, Jacek Durmała, Piotr Król, Robert Wilk, Ewa Detko, Bartosz Wnuk, Paweł Dolibog, Edward Błaszczak, Patrycja Dolibog, Lidia Wiercigroch, Jakub Taradaj

Andrzej Franek, Damian Kusz, Jacek Durmała, Piotr Król, Robert Wilk, Ewa Detko, Bartosz Wnuk, Paweł Dolibog, Edward Błaszczak, Patrycja Dolibog, Lidia Wiercigroch, Jakub Taradaj – An attempt at using focused shockwave therapy to treat selected orthopedic diseases – a preliminary report. Fizjoterapia Polska 2012; 12(2); 147-158

Abstract
Background. Focused shockwaves have been successfully used in orthopaedics and physiotherapy for over twenty years. The aim of this study was to evaluate the usefulness of focused shockwaves in treating patients with osteonecrosis of the femoral head (OFH), as well as their effectiveness as a therapy for tennis elbow and symptomatic heel spurs.Material and methods. The study has covered to date 6 patients with osteonecrosis of the femoral head (OFH) (stages I, II and III on the ARCO scale), 10 patients with tennis elbow (TE) and 6 patients with symptomatic heel spurs (HS). The patients were treated using focused shockwaves.Results. After treatment ended, pain intensity was noted to be statistically significantly lower in all groups of patients. In the OFH patients functional improvement could also be observed, as well as increased strength of wrist flexors and extensors and of finger flexors in the TE patients. The OFH and HS patients obtained better results in tests carried out on the tensometric platform. Conclusion. Focused shockwave is an effective and safe physical modality for treating early stages of osteonecrosis of the femoral head, tennis elbow and symptomatic calcaneal spurs; its main advantage is good analgesic effect right after treatment. However, the delayed effects of the therapy need to be investigated to confirm its effectiveness.
Key words:
focused shockwave, necrosis of the femoral head, tennis elbow, calcaneal spurz
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