Introduction: A.K. Henry described the region of the cross-connection between FHL tendon and FDL tendon in the mid-foot. It had been termed “master knot”. Up to now its description was not done exactly.

Aim: In this study we were investigating the exact structure of the tendons connection and possibilities of the tendons transfer in the region of foot; especially for repairing extended or neglected Achilles ruptures.

Methods: Both feet in 30 cadavers (17 men, 13 women) had been prepared. The distance from proximal part of the knot to the distal insertion of FHL and the distance from the end of FHL origin to the proximal part of the knot had been measured. This values had been compared with the foot length.

Results: In the investigated group of cadavers had not been found any direct junction between FHL and FDL tendons proximally from the branching FDL for fingers. There is an interconnection from the FHL tendon to distal part of FDL for 2nd eventually for 3rd finger (distally from FDL branching). We did not find any connection described in anatomical study of E. O’Sullivan (Clinical Anatomy18: 121 – 125, 2005).

The average distance from the point of interconnection on the FHL to its insertion was 13,8 cm (9,8 cm–19,4 cm), from the end of muscle origin 17,9 cm (15,7 cm–19,6 cm).

The approximate distances after the conversion to the foot length were 0,70 times foot length and 0,55 times foot length.

Conclusions: There is no direct junction between FHL and FDL tendons proximally from the branching FDL for fingers. The suture of the tendons distally from the cut of transferred tendon and proximally from FDL branching is necessary to keep the correct flexion of all fingers.

Background: The goal of the current prospective randomised radiological study was to determine the accuracy of conventional and computer-assisted femoral component implantation in surface arthroplasty (SRA).

Methods: The standard implantation of SRA started at author’s institution in 2004; the learning curve lasted one year. From January 2006 have authors available a kinematic navigation system „Ci’ (DePuy International Ltd, Leeds, UK) for navigation of the femoral component of SRA „ASR’ (DePuy International Ltd, Leeds, UK). We analysed on standard radiographs the femoral component positioning after 30 conventionally instrumented (Group 1) and 30 navigated (Group 2) SRA femoral components. Posterolateral approach was used in all cases. The average age of 42 men and 18 women during surgery was 54? 8 (44–64) years; body mass index was 26,3? 3,7 (21,5–39,1) kg/cm2. We evaluated: varus or valgus orientation, horizontal femoral offset, and translation of the component.

Results: The varus-valgus positioning was more accurate in Group 2 (p < 0,05). The tendency to implant the femoral component in mild valgus position (2,8° in Group 1 compared to 2,1° in Group 2), more distally and ventrally in the femoral neck (in Group 1) and with femoral offset increase (4,8mm in Group 1 compared to 3,4mm in Group 2) was found. The femoral offset was restored more accurately in the navigated group (p < 0,05). The difference in component translation in relation to the femoral neck between both groups was statistically significant (p < 0,05) – it was more precise in the navigated group. No notching of the femoral neck was observed in both groups.

Conclusions: It is possible to achieve very accurate positioning of the femoral component with use of the ASR? manual tripod aiming device. But the navigation system enables a more accurate insertion of the femoral component. This benefit clearly weigh against an additional time cost of about 10 minutes because of navigation.

Introduction: Large chronic tears of the supra and infraspinatus tendons lead to pain and dysfunction of the shoulder. If conservative treatment fails and repair is impossible, transfer of the latissimus dorsi (LD) muscle can be attempted to substitute for lost of supero-posterior cuff function.

Method: In 2003 nad 2004, twenty five patients with an average age of 54,8 years (range, 51 to 62 years) who had ongoing pain and impaired function underwent the LD transfer after ultrasonographic examination and diagnostic arthroscopy as a primary surgery. The patients were examined at an average of fourteen months (range, twelve to twenty six months) after the operation. The results were assessed with use of Constant-Murley score pre–and postoperatively.

Results: The mean Constant-Murley score increased from 32,50 points preoperatively to 78,75 points postoperatively. The mean score for pain improved of 8,75 points (from 3,75 to 12,50), activities of daily living improved of 10,00 points (from 6,00 to 16,00), range of motion of 15,00 points (from 14,00 to 29,00) and strengh improved of 11,50 points (from 8,75 to 21,25). 20 patients (80%) were very satisfied and 5 patients (20%) were satisfied. The postoperative pain relief was left as the predominant improvement. No patient was disappointed. All patients stated that they would have the operative procedure again under similar circumstances. There was only one complication – subcutaneous haematoma treated with revision and drainage.

Conclusions: Our results indicate that LD transfer is a reasonable approach for salvage of a massive tear of the supero-posterior rotator cuff. Despite the difficult operation technique and long rehabilitation phase, this procedure improves the subjective and objective findings.