Aim : In our clinic are carried out annually, 20 high tibial osteotomy with Maquet’s technique, from 1980 up to 2002. This surgical procedure is indicated in degenerative, medial unicompartamed knee osteoarthritis with range of motion complete from at least 10° to 90° or more, in patients with age till 60 years old, active and ingreased body weight. The philosophy of this surgical procedure is the correction of mecanical axis of the lower limb. The lower limb’s axonometry preoperatively gives us precious information with regal of the mecanical axis from the normal and postoperatively clues on the success of the procedure

Material – method : From January 1998 up to December 2002 we have done 55 high tibial osteotomies – Maquet’s technique. In this work we studied 40 cases, aged from 42 to 61 years (m.a. 54), 32 women and 8 men. The patients were submitted in axonometry lower limb pro and post operatively. In two cases post operatively we were forced to correct the mecanical axis again. The final results ware very good and stable

Results : In our cases we did axonometries of the operated lower limb;s preoperatively and two weeks and six months after the operation. we noticed that the correction of the axis two weeks after operation.

Conclusion : The lower limb’s axonometry is very useful and we consider it necessary for the high tibial osteotomy according Maquet. It is easy to be done, cheep and painless for the patients The information we get is critical preoperatively for the procedure and postoperatively fop the prognosis of the results.

Aim: To describe the technique and the mid term results of anterior shoulder instability arthroscopic reconstruction.

Patients-methods: Between March and December 2000 29 patients-28 males with ages ranging between 19–29 years (mean age 23 y.) and 1 female 24 years old-underwent arthroroscopic stabilization of anterior shoulder instability. During the procedure the anterior-inferior part of the labrum was reattached to the glenoid using bioabsorbable and metallic suture anchors. In selected patients in which capsule plication after anchors’ insertion was insufficient additional capsular shrikange or/and rotators’ interval closure was also performed.

Results: Postoperatively patient evaluation took place using Rowe-Zarins scale. According to this score 22 patients (75,9%) had excellent or very good outcome. Three (3) patients (10,35%) were lost during follow up while 1 (3,45%) died. From the remaining 25 patients 2 had recurrence of the instability (6.9%) and in 1 patient (3,45%) a stiff shoulder was noticed and arthroscopically resolved. Finally a disengaged metallic suture anchor was noticed incidentally during routine radiographic examination in one patient (3,45%).The anchor was successfully removed under arthroscopic visualization without compromising the final outcome.

Conclusions: Arthroscopic reconstruction of anterior shoulder instability when precisely performed after correct patient selection is an effective technique achieving results comparable to those of traditional open procedures.

Aim: The description of technique and early results of arthroscopic rotator cuff tears (RCT) reconstruction.

Patients-Methods: Âetween 01/2001 and 02/2003 26 patients, ranging in age from 33–82 (mean age 61,5 y.) – 17 males, 9 females – with RCT underwent arthroscopic reconstruction including debridement, sub-acromial decompression and mobilization of the rotator cuff. The RCT was then repaired with the arm in neutral position using “side to side” suturing technique and rotator cuff anchors when needed. Postoperatively, rehabilitation program included initially passive, active kinisiotherapy while exercises under resistance were finally performed..

Results: All patients were evaluated using ASES and UCLA scores pre-and postoperatively. Pain relief postoperatively was noticed in almost all reconstructed patients. In order to indentify functional improvement range of motion and strength were seperately evaluated. Range of motion just as pain remission was notably improved in almost all patients while strength ameliorate most in patients with complete restoration of rotator cuff tear. The interval between reconstruction and full patients’ recovery ranged between 3 months – pat. < 60 years – to 6–8 months – pat. > 60 years.

Conclusions: Arthroscopic RCT reconstruction although a demanding technique achieves satisfactory early results—mainly regarding pain relief and range of motion improvement- comparable to those of open repair reducing also postoperative morbidity.

Aim: Traumatic shoulder dislocation in patients older than 50 years is an unusual injury with specific anatomic lesions and different treatment considerations than these encountered in younger patients. We present our experience in treating such kind of injuries.

Patients-methods: Between January December 2002 9 patients-4 males, 5 females – with ages ranging between 50–72 years (mean age 64 y.), have been treated in our department suffering from first traumatic shoulder dislocation. Rehabilitation program and overall recovery progress was observed in an outpatient basis while postoperative outcome was evaluated using ASES and UCLA rating scores.

Results: In 4 patients rotator cuff tear was found and reconstructed by suturing the lesion. One (1) of these patients, who had a coexisted bony Bankart lesion, presented 1 ½ month postoperative with recurrence of dislocation. Bony Bankart lesion prevented reduction in 2 patients and was reconstructed using open stabilization in one and arthroscopic to the other. HAGL lesion was detected in another patient and treated with open reduction and shoulder stabilization. Finally 2 patients with shoulder dislocation and coexisted greater tuberosity fracture were treated with closed reduction.

Conclusions: Ttraumatic shoulder dislocation in patients older than 50 years consists a distinct entity which if inadequately treated leaves the shoulder with severe functional impairment. Recurrent shoulder dislocation is an unusual complication in such patients but on the other hand rotator cuff tears and glenoid bony lesions are frequently encountered necessitating treatment. Postoperative patients should be examined in small intervals with a high degree of suspicion for the above mentioned coexisted lesions.

From June 1983 up to the end of 2000, we performed Chiari’s osteotomy at 61 dysplastic hips in 54 women from 18 – 53 years (M.A. 35 years). In 47 cases, the osteotomy was performed at left and in 14 at right hip. In all cases the angle CE was measured preoperatively and after the operation.

The angle was measured from −20° up to +18° (Mean 13°), preoperatively. The increase of the CE angle means better covering of femoral head, improvement of hip function for the many years and creation of good anatomic conditions in acetabulum for hip replacement in the future.

Purpose: The barrel – vault tibial osteotomy by Maquet proves to be a solution when dealing with osteoarthritic knees in varus deformity in young adults.

Material – method : 60 knees from 60 patients operated from January 2000 until October 2002. 50 of them where females 52 –72 (m.a. 59 y.o.),(35 right knees and 15 left knees) and 10 males 48 –72 y.o. (m.a. 56 y.o.),(7 right knees – 3 left knees).

The type of operation in which they were subjected was barrel – vault tibial osteotomy (Maquet’s technique) and stabilization of the tibial with a particular external fixation system (STAR) for tibial osteotomy. The stability of the fixation with this system was proved to be absolutely satisfactory and permits immediate mobilization of the patient’s knee and of the patient himself. The entire system is removed 8 weeks post- operatively.

Results : All patients have been improved both from the point of mobility and subjective complains.

Conclusions : The use of the STAR external fixation system for the tibial osteotomy creates tibial stability which allows the immediate post – operative mobilization both of the suffering knee and of the patient as well.