Patellar dislocation – conservative or surgical treatment

Dariusz Lusina, Mateusz Curyło, Marcin Mikos, Katarzyna Placek, Jan W. Raczkowski


Dariusz Lusina, Mateusz Curyło, Marcin Mikos, Katarzyna Placek, Jan W. Raczkowski – Patellar dislocation – conservative or surgical treatment. Fizjoterapia Polska 2022; 22(4); 28-31

DOI: https://doi.org/10.56984/8ZG1A60LR

Abstract
Patellar dislocation is an emergency, requiring immediate medical intervention, followed by the cooperation of the orthopedist and physiotherapist in returning to full health, as well as reducing the risk of relapse. The kneecap is an integral part of the knee joint and is responsible for its proper functioning. Among the methods of treatment used, there are conservative and surgical methods. The article is an attempt to answer the question whether there is an advantage of some methods over others. Materials available on the PubMed and Cochrane Library websites were used to obtain answers to the question asked. Due to different standards of management, the advantage of surgical over conservative has not been established, but there are researchable factors that may help in making therapeutic decisions.

Key words:
patellar dislocation, conservative treatment, surgical treatment

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The impact of inpatient physiotherapy on parameters of acid-base equilibrium after corrective surgery of congential heart defects in children age 0-2

Piotr Dominiak

Piotr Dominiak – The impact of inpatient physiotherapy on parameters of acid-base equilibrium after corrective surgery of congential heart defects in children age 0-2. Fizjoterapia Polska 2001; 1(4); 361-365

Abstract
Background. Congenital heart defects constitutes the most significant problem in pediatric cardiology, occupying second place among the causes of infant death in Poland. One can observe a constant lowering of the indicated age for surgery in order to prevent secondary structural changes in and around the heart, and negative psychological effects on parents and children. The goal of this article is to evaluate the effectiveness of the author’s own method of physiotherapy during inpatient care of children aged 0-2 years following total surgical correction of the most commonly occurring congenital heart defects. Material and methods. Ina group of 32 patients recovering from total corrections of ASD II, VSD, PDA and CoA, age 0-2 years, 384 tests were performed on arterialized capillary blood during the first the days after surgery. The tests were performed before, immediately after, and 30 minutes after physiotherapy, and then results were compared. The patients were divided into two sub-groups: subgroup I consisted of 20 patients after total correction of ASD II and VSD, in whom 270 tests were performed, while subgroup II included 12 patients after total correction of PDA and CoA, in whom 114 tests were performed. Results. The results indicated that a postero-lateral thoracotomy produces a leftward shift in acid-base equilibrium; under the influence of physiotherapy, however, the direction of change is identical in both sub-groups. Extracorporeal circulation did not exchange in the lungs (a statistically significant increase in pO2 and SO2 30 minutes after physiotherapy). Conclusion. The physiotherapy program here applied, including elements of he Vojta method, can be used beginning in the first days after surgery.

Key words:
congenital heart defects, surgical treatment, physiotherapy, Acid-Base Equilibrium

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Physiotherapy tacticsafter hip joint resurfacing

Karol Ochocki, Jarosław Pasek, Tomasz Stołtny, Maciej Szczęśniak, Szymon Szymański, Kamil Dworak, Wojciech Gąsior, Michał Czarnecki, Rafał Szczygieł, Bogdan Koczy

Karol Ochocki, Jarosław Pasek, Tomasz Stołtny, Maciej Szczęśniak, Szymon Szymański, Kamil Dworak, Wojciech Gąsior, Michał Czarnecki, Rafał Szczygieł, Bogdan Koczy – Physiotherapy tacticsafter hip joint resurfacing. Fizjoterapia Polska 2021; 21(1); 148-157

Abstract
Hip resurfacing arthroplasty (capoplasty) is a surgical procedure involving the replacement of diseased articular surfaces. Renal failure, female reproductive period, allergy to metal, acetabular diameter below 46 mm in preoperative planning are now absolute contraindications for capoplasty. The available literature shows that this procedure is performed in young, physically active people, usually under 55 years of age. The growing expectations of patients regarding the return to professional and sports activity mean that appropriate and systematic physiotherapy is important after the procedure. In the paper, the authors present the current position on the physiotherapeutic procedure after hip resurfacing arthroplasty.
Key words:
hip resurfacing, operation treatment, physiotherapy, physical movement, physical therapy
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A Comparative analysis of early results of surgical treatment of Achilles tendon injuries with the minimally invasive and classic methods – physiotherapy options. A Randomized Controlled Trial

Michał Konik, Ireneusz Kotela, Jacek Lorkowski, Tomasz Chruściak, Emilia Sołtan, Monika Chruściak, Sebastian Zduński

M. Konik, I. Kotela, J. Lorkowski, T. Chruściak, E. Sołtan, M. Chruściak, S. Zduński – A Comparative analysis of early results of surgical treatment of Achilles tendon injuries with the minimally invasive and classic methods – physiotherapy options. A Randomized Controlled Trial. Fizjoterapia Polska 2020; 20(5); 182-191

Abstract
Background. The Achilles tendon is the strongest tendon in the human body. Despite the high incidence of injuries and a well-known problem of treating heel tendon injuries, there has been no consensus on the proper treatment, (both surgical and rehabilitation) in professional literature so far. Choosing an operating method that gives “better” treatment results can facilitate the choice of a more effective treatment. It should also be remembered that a properly conducted rehabilitation process is an extremely important element following the surgery.
Aim of the study. The study aimed to evaluate the effectiveness of the surgical treatment of patients with Achilles tendon injuries using the minimally invasive and classic methods.
Material and Methods. The study material included 62 patients treated surgically for Achilles tendon injury in the Department of Orthopedics and Traumatology of CSK MSW in Warsaw in the years 2011-2016. 31 patients were operated using the minimally invasive method (the study group) and 31 patients using the conventional method (the control group). The research group consisted of 27 men and 4 women. The comparative group consisted of 27 males and 4 females. The following research tools were used to evaluate the treatment results: 1. Author’s questionnaire 2. AOFAS score (American Orthopedic Foot and Ankle Society Score) 3. Measuring instrument for maximum force moments in ankle joint JBA “Staniek” 4. HUR stabilographic platform 5. Ultrasonography.
Results. 4 patients, (12.9%) in the control group re-ruptured the tendon after operative treatment. In the study group, 2 patients (6.5%) experienced a complete heel tendon rupture in the postoperative period. The problem of postoperative wound healing disorders was observed among 2 patients (6.5%) from the study group. In the group treated with the classical technique, 5 (16.1%) patients experienced a delay in the healing of the surgical wound due to bacterial infection. Paresthesia, from the sural nerve was observed in only 1 patient in the MIS (Minimal Invasive Surgery) group. 27 patients (87.1%) returned to their sports activity after percutaneous surgery, and 22 patients (71%) after conventional treatment. On average, patients from both groups needed 6 months to return to sports activities.
Conclusions. 1. The number of renewed ruptures after minimally invasive treatment of a damaged Achilles tendon is low and comparable to that of a group of patients treated with the classic technique. 2. Postoperative wound healing disorders are rare in both groups. 3. Calf nerve injury was reported only in one case, while using a minimally invasive procedure. 4. Patients return to work and sports at the same time after surgery in both groups which is influenced by properly implemented physiotherapy 5. Patients presented a similar balance control on the stabilographic platform in both groups. 6. Similar values of maximum force moments in ankle joint were recorded in both groups. 7. In the ultrasound image, there were no morphological differences in Achilles tendon formation in either study group.
Key words:
Achilles tendon, surgical treatment, injury, rupture, physiotherapy
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