Z. Blagojevic

Predicting ACL rupture in the population actively engaged in sports activities based on anatomical risk factors.

The purposes of this article were identification (ie, verification and gradation) of anatomical risk factors that lead to anterior cruciate ligament (ACL) injury and determination of the probability of ACL injury among the population actively engaged in sports activities. We evaluated 66 patients divided into 2 groups: 33 patients in the examined group diagnosed with ACL lesion, and 33 patients in the control group diagnosed with patellofemoral pain. Patients were matched by age, sex, type of lesion, and whether the lesion was left or right sided. Measurements were carried out by radiography and magnetic resonance imaging. The study examined 32 anatomical factors. After identifying factors that lead to ACL injury, the following were determined: the coefficient of significance for each individual factor via the discriminant analysis and the canonical discriminant (i.e., canonical correlation). Fifteen factors in men and 8 factors in women were differentiated as having influence on ACL injury. Based on these factors, it was determined whether the patients belonged to the examined or the control group with a success rate of 100% in men (100% sensitivity and specificity) and 91.7% in women (100% sensitivity and 83.3% specificity). The anatomy of the ACL prone to rupture and of the skeletal structures influencing it is significantly different from the anatomy of the ACL ligament resistant to injury. The probability of precise prognosis of ACL injury based on differentiated anatomical factors is 88.9% in men and 75.7% in women actively engaged in sports activities.

The Third Branch of the Main Trunk of the Left Coronary Artery in Cercopithecus aethiops sabaeus. Is the Nonhuman Primate Model Appropriate

The aim of this study was to investigate the morphometry of branching patterns of the main trunk of the left coronary artery (MT of LCA) in nonhuman primates, and comment on the current nomenclature. The biometric study was performed using stereomicroscopic dissection of hearts of healthy and fertile nonhuman primates (Cercopithecus aethiops sabaeus) of both sexes. Our results reveal that the MT of LCA terminates in a bifurcation into the anterior interventricular branch (AIB) and the circumflex branch (CB) (74.6%), trifurcation into the AIB, CB, and diagonal branch (DB) (23.6%), or occasionally quadrifurcation into the AIB, CB, and two DBs (1.8%). This is similar to the case in humans. Furthermore, two morphological aspects of the DB spatial distribution, in addition to its branching pattern, resemble the DB in humans. Myocardial bridges observed over the DB in the Cercopithecus aethiops heart further contribute to the similarity with humans. The resemblance of the DB and its branches to their human counterparts make them a suitable model for experimental study on coronary circulation. Anat Rec, 2011.

Hamstring Regeneration Following Harvest for Anterior Cruciate Ligament Reconstruction

The semitendinosus (ST) and gracillis (Gr) tendons are commonly used as a replacement graft during the anterior cruciate ligament (ACL) reconstruction. There are many advantages of using the hamstrings tendons, including the ease of harvesting, suitable morphology for use as a graft, lower donor site morbidity, early rehabilitation, and patient satisfaction.

A Method for Prediction of Femoral Component of Hip Prosthesis Durability due to Aseptic Loosening by Using Coffin/Manson Fatigue Model

The purpose of this work is to develop a new model estimate of the fatigue life of a hip prosthesis due to aseptic loosening as a multifactorial phenomenon. The formula developed here is a three-parameter model based on Basquins law for fatigue, eccentric compression formula for the compressive stress and torsion in the prosthesis due to the horizontal components of the contact force. With our model, we can accurately predict the durability of a hip prosthesis due to the following four parameters: body weight, femoral offset, duration, and intensity of daily physical activities of a patient. The agreement of the prediction with the real life of the prosthesis, observed on 15 patients, is found to be adequate. Based on the formula derived for a particular implant, there was a high degree of concurrence between the model-predicted and actual values of aseptic loosening (durability) proved by the Mann–Whitney U test. By virtue of the validated model, it is possible to predict, quantitatively, the influence of various factors on the hip life. For example, we can conclude that a 10% decrease of a patients body mass, with all other conditions being the same, causes 5% increase of the hip fatigue life.

Discoid Lateral Meniscus Incidence During Knee Arthroscopy

Abstract Discoid meniscus is a morphological anomaly of the lateral meniscus that appears in 1–5% of meniscectomies. A precise diagnosis remains difficult to make, and many dilemmas hinder effective treatment. To evaluate the incidence of discoid meniscus in patients who underwent knee arthroscopy, as well as the discoid meniscus type, follow-up problems, combined knee lesions, and postoperative results. This retrospective study included 1357 patients who received knee arthroscopy during the period between January 2007 and December 2013. We analysed the discoid meniscus incidence, sex distribution, type distribution (Monllau classification), noted preoperative symptomatology, rupture incidence and type (O’Connor classification), anomaly presence and other intra-articular lesion correlations. The IKDC score was used to evaluate the operative treatment results. The DLM incidence was 1.03%. The most common type of discoid meniscus was complete 5 (35.71 %). The dominant symptom was pain, which was reported by 12 (85.71%) patients. Eleven (78.57 %) patients exhibited ruptures, and the most common type was horizontal, which was reported in 4 (36.36%) cases. The number of ruptures was significantly higher in patients older than 18 (9 patients; 90%), compared to those younger than 18 (2 patients; 40%). Operative treatment resulted in an improvement for all patients in terms of subjective symptom reduction. The incidence of DLM in our study was 1.03%, and the dominant symptom was pain in the knee (85.71%). The most common lesion of the meniscus was a horizontal split, primarily in patients older than 18 years. Patients also presented with joint intra-articular lesions; the most common type was ACL rupture. In all patients, an improved postoperative IKDC score was reported.

Challenges and advances in the care of injuries in the Republic of Serbia

There are many problems that trauma care system in Serbia is facing today. Few of them are: 1) Lack of categorization of trauma centers; 2) Diversity in managing of trauma patients among institutions; 3) There is no trauma management training, 4) Inappropriate cooperation between pre hospital trauma care and hospital trauma care; 5) There is no standard in managing of trauma patients as well as procedures. To improve trauma care quality throughout the country we must learn from the experiences of other countries. The aim of this paper was to report representative data about organization, management, stuff and equipment of ambulance and emergency services in Serbia. We analyzed 12 out of 138 parameters we obtained from the relevant institutions.

Izazovi u unapređenju zbrinjavanja povređenih u Republici Srbiji

There are many problems that trauma care system in Serbia is facing today. Few of them are: 1) Lack of categorization of trauma centers; 2) Diversity in managing of trauma patients among institutions; 3) There is no trauma management training, 4) Inappropriate cooperation between pre hospital trauma care and hospital trauma care; 5) There is no standard in managing of trauma patients as well as procedures. To improve trauma care quality throughout the country we must learn from the experiences of other countries. The aim of this paper was to report representative data about organization, management, stuff and equipment of ambulance and emergency services in Serbia. We analyzed 12 out of 138 parameters we obtained from the relevant institutions.

Previdi u zbrinjavanju teško povređenih

Question of missed injuries is more offen a question of human errors: task execution errors, procedural errors, communication errors, decision errors and noncompliance. Missed injuries are those which are not identified in the first three days of hospitalization. This theme is not popular among physicians. Literature data mention percent from 3 - 29% missed injuries overall. The underlying causes errors are: false attributin, false negative prediction and false lebeling. False attribution involves a tendency to incorrectly link a clinical observation with an arroneous cause. This tendency also ignores one of the fundamental principles of the management of traumatic injury: that the index of suspicion should proceed on the basis of assumed wors resonable case scenario. Weaknesses of traumasistems: high patients volume, high-risk patients, long hours, changing set of resources, and problems sush bad admission planing, defficite anamnesis, defficite diagnostic procedures, bad communication, improvisation etc.

Efekti sekcije lateralnih retinakula kolena u operativnom lečenju simptomatske patelofemoralne inkongruencije

Biomechanical malfunction of the knee extensor mechanism in the patello femoral joint is regarded as patella malalignment but major patients complaints are anterior knee pain and patellar slipping. Lateral retinacular release is one of the basic surgical procedures in the treatment of patellar malalignment. The aim of the study was to estimate the achievements of the lateral retinacular release in solving particular biomechanical disorders of the patello femoral joint, as well as individual patients complaints. Evaluation of objective parameters x-ray and clinical findings before and after the operation, shows statistically highly significant difference, thus confirming implementation of the fore mentioned surgical procedure. Despite the fact that anterior knee pain subsided postoperatively in the number of patients, statistically significant values, comparing to the preoperative findings, could not be obtained. Incidence of the patellar slipping has shown statistically significant reduction two years following the surgery. Achieving proper biomechanical alignment of the patello femoral joint is obviously not sufficient to provide relief of subjective complaints, especially concerning anterior knee pain, although considerable improvements were registered in the number of patients.