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The accumulation of calcium deposits in the tendons of the muscles of the rotator cuff is the cause of calcifying tendonitis of the shoulder. It is most common in people of working age between 30 and 50 years, expressed in pain in the affected shoulder, both at rest and when moving the arm. This condition makes it difficult to carry out daily activities and worsens the quality of life of patients. The purpose of this report is to present the improved functionality of the affected limb from our kinesitherapy program in combination with extracorporeal shock wave therapy. Material and methods: we examined 20 patients with calcifying shoulder tendinitis, which we divided into two groups - experimental and control, 10 for each. The study was conducted at the Clinic of Orthopedics and Traumatology, University Hospital “St. Marina”, Varna. To illustrate the results, we used a visual analog scale (VAS), ROM ( range of motion) and manual muscle testing (MMT). Results: the kinesitherapy program applied by us in combination with extracorporeal shock wave therapy in the respondents from the experimental group showed better results compared to the control group.

The positioning of the glTenoid component in RSA ( Reverse Shoulder Arthroplasty) is one of the factors determining implant survival and postoperative outcomes. Therefore, accurate determination of the glenoid version and inclination in RSA is essential for the surgeon - preoperatively to plan his work and postoperatively - to assess the outcome. Excessive retroversion and superior inclination are prerequisites for unsatisfactory results and are associated with a high frequency of revisions. The glenoid inclination is often described as the angle between the glenoid fossa line and the suprascapular reference line. The study included a 2-year follow-up of patients with reverse shoulder arthroplasty in the Department of Orthopedics. The analysis is based on pre / postoperative CT and three-dimensional reconstruction using Medi Cad software. A comparative analysis was made with the results obtained by X-ray examination. The results showed a high incidence of superior inclination of native glenoid fossae. The obtained ß-inclination angle averaged 13.8 °, and the difference in this radiographically measured parameter was 7.3 °. CT analysis preoperatively significantly improves the position of the glenoid component and avoids the superior inclination of the baseplate of the prosthesis.

creativecommons Index Copernicus Value: 2016 -90,65 SJIF (Scientific Journal Impact Factor): 2017 - 7,61 Global Impact Factor: 2015 - 0,787 JIFACTOR: 2015 - 0,5 back to 2018Jan-Mar;24(1) Journal of IMAB - Annual Proceeding (Scientific Papers) Publisher: Peytchinski Publishing ISSN: 1312-773X (Online) Issue: 2018, vol. 24, issue1 Subject Area: Medicine - DOI: 10.5272/jimab.2018241.1923 Published online: 07 March 2018 Original article J of IMAB. 2018 Jan-Mar;24(1):1923-1927 MENTORING IN THE FIELDS OF PHYSIOTHERAPY AND INTEGRATED CARE Gergana Nenova1ORCID logo Corresponding Autoremail, Paraskeva Mancheva1ORCID logo, Todorka Kostadinova2, Kalin Mihov3ORCID logo, Svetoslav Dobrilov3ORCID logo, 1) Training and research sector of Rehabilitation, Medical College - Varna, Medical University of Varna, Bulgaria. 2) Department of Health Economics and Management, Faculty of Public Health, Medical University of Varna, Bulgaria. 3) Department of Orthopedics and Traumatology, Medical University of Varna, Bulgaria. ABSTRACT: A survey on the opinion of students studying Rehabilitation as a major subject on the role of their mentors and their qualities in the "Student Practice project.” The aim of the study is to investigate the point of view of the students, involved in the "Student Practice" project, about the role and the qualities that mentors and academic coaches (physiotherapists) should possess in order to be created a selection criteria. Subject of the survey are 14 students studying at the Medical College of MU-Varna which study "Rehabilitation". These students participated in the "Students practice" project for the period November 2016 - March 2017. A feedback was sought from them through a questionnaire method with an exclusively prepared for the survey questionnaire. The results of the feedback from trainees showed their increased confidence in dealing with patients and their better integration within the work team. The knowledge and skills acquired by students in the "Student practices" project are a prerequisite for the development of mentoring as a priority for the state’s education policy, with clear indications for choosing the most appropriate mentor and setting clear tasks for the acquisition of specific knowledge.

SUMMARY The aim of the following article is to present the role of multidisciplinary team in the implementation of integrated care for patients scheduled for surgical treatment of osteoarthritis. It can include different professionals from health care and social sectors depending on patients‘ needs. Integrated provision of care is connected to a system evaluation of every aspect of the health status of the patient by different health care professionals and team planning of the procedures needed for the patient. Care provided by multidisciplinary team help for the improvement of activity after surgical intervention, functional abilities, psychological and social health.

Total knee replacement is one of most common orthopedic procedure, which is associated with significant blood-loss. Administration of tranexamic acid is one of the methods to decrease the perioperative bleeding and haemotransfusion necessity. I n the Dept. of Orthopedics and Traumatology since 2013 have been made 383 TKA. In 250 p atients were administrated 500 mg i.v. 10 min prior to first incision and 500 mg i.v. at tourniquet release. Topical use of TXA were used in 58 cases. Patients were administrated with 1,5 g TXA in 100cc NaCl for 3 min. before deflation . Peri and postoperative blood-loss, hemoglobin level decrease and transfusion requirements were observed. Results showed about 45 % lower bleeding than the control group compared to i.v use and about 15% less bleeding compared to the topical application group. All the patients from control group required blood transfusion after surgery due to blood loss - about 890 ml on average. Topical application group shows average blood-loss 560 ml. , and i.v. group about 460 ml blood-loss . None of the patient s with i . v. application of TXA required blood transfusion. B lood loss in the groups administering TXA i.v. or topical is significantly lower with better results in i.v. aplication. Administration of TXA is safe and reliable method for reducing bleeding associated with TKA which decreases necessity of haemotransfusion.

Total hip replacement is rapidly growing procedure because of pain relief ,restoring range of motion and patient’s satisfaction. Primary go is to restore individual geometry of patient’s hip joint, long term components survival and most important- improving patient’s quality of life. In past decades this surgery has several limitations as patient’s age, bone morphology ( incl. anatomical deformities) ,previous surgeries ,etc. Recently , with the development of modern implants ( cups and stems) these limitations are past. Young patients indicated for THA are always great challenge , because their functional requirements , life expectancy ,anatomical variations ( due to congenital or acquired disorders) , greater mobility and higher risk of aseptic loosening. Standart cementless stems have some unsolved issues as fixed intra / extramedular dimentions, proximal stress shielding, impingement, etc. They are based on 2D-planning and often have mismatch between acetabular and femoral center of rotation. Custom femoral stems are based on specific 3D- scan of the hip joint, which presents individual shape of acetabulum and especially femoral canal. This allows optimal bone support for the stem, preserving bone substance , excellent contact bone-stem and most important- restores center of rotation. For the period 2010-2014 we operated 16 patients , 8 were with Osteoarthrosis (OA); 4-with Avascular necrosis (AVN) ; 2 with dysplastic hips (DDH) and two with posttraumatic osteoarthrosis . Follow up is 6-42 months. We perform THA with modified posterior surgical approach with minimal femoral reaming, due to individual femoral rasp with the same size as the customized femoral stem. During the follow up period we found no complications,Harris Hip Score was 97 pts. and 85% of the patients had regular physical exercises for 3 weeks.

Introduction: Practicing mass and professional sport is with growing popularity among young people. Sports like football, basketball, volleyball, and contact disciplines – boxing, martial arts, etc. are highly connected to trauma. Shoulder dislocation is very frequent and in most cases turns into instability. The main cause for it is glenoid and/or humeral bone loss. Material and methods: For the period 2010-2015 in University Hospital “St. Marina” 22 patients with high physical activity were operated – 5 of them are professional sportsmen. Volume of bone lose is measured with CT and the method proposed by Sugaya. Indications for operative treatment were based on history, clinical examination, imaging and ISIS score. The performed operative treatment was coracoid transfer over glenoid rim. Results: All patients had significant for instability bone loss. The postoperative period was smooth and there were no instability recurrences detected during the follow-up period. Conclusions: Glenohumeral instability in sportsmen is a result of recurrent shoulder dislocations, main cause for which is glenoid and/or humeral bone loss. Detecting and measuring the level of this bone loss is of great importance for the correct treatment algorithm leading to joint stability and return to active and competitive sport activities.