Biomedical subjects

Nikola Cicak

Publications and source records attributed to Nikola Cicak.

6 recordsLinked to original sources

PubMed2006

Arthroscopic transosseous suture anchor technique for rotator cuff repairs.

The skin is incised 1 to 2 cm distal to the lateral portal. A transosseous tunnel is created through the greater tuberosity by a sharp penetrator, entering 1.5 to 2 cm distal to the top of the greater tuberosity. The penetrator exits medially, between the tip of the greater tuberosity and the articular surface of the humeral head, in the middle of the footprint. The first anchor, a 5-mm Spiralok (DePuy Mitek, Norwood, MA) is placed at the penetrator's exit site on the footprint. Using a specially designed suture leader, the lateral limb of the suture in the anchor, which passes through the previously created transosseous tunnel, is taken from the anchor and pulled out. The other suture end is passed through the supraspinatus tendon. The second suture, placed superficially in the anchor, is passed from the anchor through the supraspinatus tendon, as a mattress suture. If more anchors are required, the procedure should be repeated. The transosseous suture limb and the suture limb that is passed through the supraspinatus tendon are tied through the lateral portal. The knot tying is then performed with a sliding Delimar knot. The mattress suture, passing through the supraspinatus tendon, is tied through the anterior lateral portal. The knot tying procedure is repeated depending on the number of anchors.

Arthroscopy↗

PubMed2005

Arthroscopic extracapsular plication to treat multidirectional instability of the shoulder.

Successful arthroscopic treatment of multidirectional shoulder instability requires that the surgeon reduce the volume of the capsule. This goal can be achieved by using the extracapsular plication technique. There are several advantages to using pancapsular plication and an intra-articular knot. Much better potential for capsular healing exists when the outer layer of the capsule, which is composed of fibrous tissue, is tied extra-articularly. With the intra-articular plication technique, the inner layer of the capsule is synovia, which has less healing capacity. The amount of capsule plication that can be achieved with the extra-articular plication technique exceeds what is possible with the intra-articular plication technique. This is very important in patients who have a large degree of instability in the anterior, the posterior, and, particularly, the inferior direction. Thermal capsulorrhaphy enhances other arthroscopic stabilization procedures. Thermal striping helps to reduce capsular redundancy if laxity persists. However, with arthroscopic extracapsular plication, the capsular tissue can be shortened without using thermal energy.

Arthroscopy↗

PubMed2003

Functional and electromyographic results after open rotator cuff repair.

Fifty-one patients treated for full-thickness rotator cuff tears were followed up an average of 4 years after surgery (range, 2-6.4 years). The shoulder function was assessed according to the Constant classification, each patient did strength measurements, and had electromyographic evaluation of the supraspinatus and infraspinatus muscles. The mean value of the Constant score for the surgically treated shoulder was 2.7 points. Forty-five patients (88.2%) had satisfactory scores and six patients (11.8%) had unsatisfactory scores. The result of treatment was significantly correlated to the size of the tear and the time elapsed from injury to surgery. However, no correlation was found between the result of the treatment and the type of surgery, mode of postoperative rehabilitation, and age. The strength measurement of abduction and of external rotation indicated significantly reduced power in surgically treated shoulders compared with contralateral shoulders. There was a significant difference of the infraspinatus motor unit potential interference pattern reduction between surgically treated and the contralateral shoulder. There was a positive correlation between electromyographic findings and the results of rotator cuff reconstruction.

Adult↗

PubMed2003

[Rotator cuff rupture].

The rotator cuff is the complex of four muscles that arise from the scapula; supscapularis, supraspinatus, infraspinatus and teres minor. The long head of the biceps tendon may be considered a functional part of the rotator cuff. The rotator cuff is key structure of the shoulder which gives dynamic stability and movements. Rotator cuff tears my occur as consequence of impingement syndrome or degenerative changes. Most tears occur in the supraspinatus tendon. The patients are usually older than 40 years. On clinical examination there is weakness of abducation and external rotation of the arm. Open or arthroscopic repair should be performed in active individuals.

Humans↗

PubMed2002

Acetabular roof reconstruction with pedicled iliac graft.

Reconstruction of the acetabular roof in patients with hip dysplasia shows disappointing mid-term results due to insufficient incorporation and collapse of the bone graft. We have developed a new reconstructive method using a pedicled iliac graft. We simulated surgical reconstruction of the acetabular roof in ten cadaver specimens. The purpose was to evaluate whether the deep circumflex artery was long enough to allow transfer of the graft without requiring micro-vascular anastomosis. In all cadavers, the length of the pedicle was sufficient to reach any desired position of the acetabular roof. The use of such a pedicled structural graft may provide good primary stability and allow local bony remodelling and incorporation under load.

Acetabulum↗

PubMedDate not supplied

[Emergencies in shoulder joint surgery].

Emergency in orthopaedics compared to classical surgery presents a completely different issue. Some orthopaedic conditions do not require immediate surgery, but they have to be solved within weeks or months, and are therefore addressed as relatively urgent conditions. If this kind of surgery is delayed, condition may deteriorate, and in some cases it becomes impossible to perform reconstructive surgical procedure. Considering this, some shoulder conditions require urgent and some relatively urgent surgery. When time limits are concerned that means these patients have to be operated on within 3 to 6 weeks, or during first three months after the initial trauma.

Emergencies↗