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Revision total hip arthroplasty (RTHA) is a challenging procedure when we speak about acetabular defects and recurrent instability. There are multiple reasons like the number of previous revisions, implant position, bone quality, patient characteristics and etc. Managing acetabular defects with porous trabecular metal augments has excellent survivorship, but when addressing instability, there are some unsolved issues. Management options include the use of large femoral heads, constrained acetabular liners, and dual mobility cups (DMC). These cups have increased jump distance and reduced likelihood of dislocation while not relying on locking mechanisms, therefore are the preferred option in RTHA. We present single-center series of 13 patients undergoing revision THA with a specific DMC cemented into a newly implanted or well-fixed trabecular metal (TM) revision shell. All patients underwent cementation of a single specific cemented DMC design (Novae Stick, SERF, Decines, France) in a Trabecular Metal Revision Shell (Zimmer Biomet, Warsaw, IN, US). The mean follow-up is 15,2 months, and there were no dislocations of the implanted DM cups. The mean HHS improved significantly from 35.9 (range 15–80) preoperatively to 80.1 (range 64-93) postoperatively (p = 0.001). The results of this small clinical series demonstrate that cementing a DMC in a well-fixed TM revision shell leads to no dislocation or dissociation of the cement interface and acetabular construct loosening in the short term

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.

Background: Acetabular revision with extra-large (jumbo) cementless cups is an effective treatment for many cavitary and segmental peripheral bone defects. However, hip center elevation may occur with the use of a jumbo cup owing to the superior direction of reaming and the increased diameter of the component compared with the native acetabulum. Purposes: The primary goal of this study was to evaluate the radiographically observed hip center elevation with the use of jumbo cups in acetabular and total hip revision at our institution. Materials and methods: We retrospectively reviewed control radiographic images of 43 consecutive patients treated with acetabular and total hip revision arthroplasty with a press-fit cementless cup. The difference between the height of the rotation center of the acetabular cup and the height of the rotation center of the contralateral native hip relative to the inter teardrop line was radiographically measured. Results: The radiographically measured mean elevation of the rotation center of the jumbo cup was 8,75 mm, which yielded an average increase in the height of the rotation centre of 83,6. A mean vertical shift of the rotation center of 0,72 mm was estimated for every 1 mm increase in the size of the jumbo cup. Conclusions: Our results indicate that the use of jumbo cups in revision hip arthroplasty leads to elevation of the rotation center of the hip with an average of 9 mm. This could be considered by the surgeon in an attempt to restore leg length, stability and biomechanics of the prosthetic hip.

PURPOSE: To assess the dislocation rate after total hip arthroplasty with dual mobility cup (DMC) for displaced femoral neck fractures and to compare the results with that of conventional total hip arthroplasty (THA) and bipolar hemiarthroplasty (BHA) in the same clinical setting at our institution. MATERIALS AND METHODS: 49 cases (47 patients) treated with total hip arthroplasty with DMC, 38 cases (38 patients) with BHA and 29 patients (29 cases) operated on with conventional THA were retrospectively reviewed. RESULTS: In the DMC total hip arthroplasty group, there were no dislocations (0%). %). One dislocation (3,1%) occurred in the BHA group, and 3 dislocations occurred (11,1%) in the THA group. ). There was a statistically significant difference in favour of DMC group compared to THA group regarding dislocation rate (p=0,05). Dislocation rate did not differ significantly between DMC and BHA groups. There was no significant difference in mortality, complications and re-operation rate between groups. CONCLUSION: Dual mobility cups significantly reduce dislocation rate in total hip arthroplasty performed for displaced femoral neck fractures compared to conventional total hip arthroplasty while similar advantage over bipolar hemiarthroplasty could not be demonstrated in the current study.

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.

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.