Marko Pećina

Publications (23)15.24 Total impact

• Article: Surgical scientific publication and the 1991-1995 war in Croatia.

  Vanja Dukić, Nikola Udiljak, Nina Bartolić, Martina Vargović, Robert Kuduz, Natasa Boban, Marko Pećina, Ozren Polasek
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  ABSTRACT: The aim of this study was to evaluate surgical scientific publication in relation to the 1991-1995 war in Croatia, based on the articles indexed in Medline database that were published in 1980-2005 period. The number of articles was extracted from PubMed and analysed with trend analysis, which is preferred analytic approach over calculation of crude publication rates. The results indicate sporadic pre-war output, which was almost completely reduced by the onset of war. During wartime, a significant increasing trend in the number of published surgical articles that were related to warfare was detected (p = 0.003). During the post-war period a gradual shift towards surgical articles that were not related to warfare was detected, also marked by the significant increasing trend (p = 0.027). Both trends were significantly steeper than the overall Croatian biomedical output, suggesting that surgical scientific articles were being published more dynamically than in other biomedical areas in Croatia. The results suggest that war in Croatia has had a strong modifying effect on the surgical scientific output.
  Collegium antropologicum 06/2011; 35(2):409-12. · 0.61 Impact Factor
• Article: [Histologic assessment of tissue healing of hyaline cartilage by use of semiquantitative evaluation scale].

  Andreja Vukasović, Alan Ivković, Davor Jezek, Ivan Cerovecki, Drazen Vnuk, Mario Kreszinger, Damir Hudetz, Marko Pećina
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  ABSTRACT: Articular cartilage is an avascular and aneural tissue lacking lymph drainage, hence its inability of spontaneous repair following injury. Thus, it offers an interesting model for scientific research. A number of methods have been suggested to enhance cartilage repair, but none has yet produced significant success. The possible application of the aforementioned methods has brought about the necessity to evaluate their results. The objective of this study was to analyze results of a study of the effects of the use of TGF-beta gene transduced bone marrow clot on articular cartilage defects using ICRS visual histological assessment scale. The research was conducted on 28 skeletally mature sheep that were randomly assigned to four groups and surgically inflicted femoral chondral defects. The articular surfaces were then treated with TGF-beta1 gene transduced bone marrow clot (TGF group), GFP transduced bone marrow clot (GFP group), untransduced bone marrow clot (BM group) or left untreated (NC group). The analysis was performed by visual examination of cartilage samples and results were obtained using ICRS visual histological assessment scale. The results were subsequently subjected to statistical assessment using Kruskal-Wallis and Mann-Whitney tests. Kruskal-Wallis test yielded statistically significant difference with respect to cell distribution. Mann-Whitney test showed statistically significant difference between TGF and NC groups (P = 0.002), as well as between BM and NC groups (P = 0.002 with Bonferroni correction). Twenty-six of the twenty-eight samples were subjected to histologic and subsequent statistical analysis; two were discarded due to faulty histology technique. Our results indicated a level of certainty as to the positive effect of TGF-beta1 gene transduced bone marrow clot in restoration of articular cartilage defects. However, additional research is necessary in the field. One of the significant drawbacks on histologic assessment of cartilage samples were the errors in histologic preparation, for which some samples had to be discarded and significantly impaired the analytical quality of the others. Defects of structures surrounding the articular cartilage, e.g., subchondral bone or connective tissue, might also impair the quality of histologic analysis. Additional analyses, i.e. polarizing microscopy should be performed to determine the degree of integration of the newly formed tissue with the surrounding cartilage. The semiquantitative ICRS scale, although of great practical value, has limitations as to the objectivity of the assessment, taking into account the analytical ability of the evaluator, as well as the accuracy of semiquantitative analysis in comparison to the methods of quantitative analysis. Overall results of histologic analysis indicated that the application of TGF-beta1 gene transduced bone marrow clot could have measurable clinical effects on articular cartilage repair. The ICRS visual histological assessment scale is a valuable analytical method for cartilage repair evaluation. In this respect, further analyses of the method value would be of great importance.
  Acta medica Croatica: c̆asopis Hravatske akademije medicinskih znanosti 01/2011; 65(3):227-35.
• Source

  Available from: Mario Slaus

  Article: Osteochondritis dissecans of the knee in a subadult from a medieval (ninth century A.D.) site in Croatia.

  Mario Slaus, Tatjana Cicvara-Pećina, Ivica Lucijanić, Marko Pećina, Davor Stilinović
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  ABSTRACT: Although osteochondritis dissecans of the knee has been known for a long time, we still do not fully understand why it develops. This prompted us to present and describe an example of osteochondritis dissecans identified in the Osteological Collection of the Croatian Academy of Sciences and Arts. The case of osteochondritis dissecans described in this report was recovered from the Gluvine kuće cemetery in the Dalmatian hinterland, approximately 28 km north-east of Split. A total of 77 graves were excavated and the individual exhibiting osteochondritis dissecans was recovered from grave number 16 that belongs to the younger phase of the cemetery that lasted during the second half of the 9th century A.D. Osteochondritis dissecans was noted in a subadult individual. The pathological changes consistent with osteochondritis dissecans are present on both medial femoral condyles. The lesion on the right femoral condyle is an oval crater-like defect with well defined margins and a porous floor of rough trabecular bone. The lesion on the left femoral condyle is basically, with two small provisions, identical to the one on the right side. The first is that it is slightly smaller, while the second is that unlike its antimere, it has a well preserved bone fragment that fits perfectly into the ostechondritic pit. Radiographic analyses of the femoral condyles support a diagnosis of osteochondritis dissecans and show a well-demarcated radiolucent defect in the articular surfaces of both joints surrounded by a thin sclerotic repair zone. According to the classification systems this degree of change corresponds to stage 3 or grade 3 osteochondritis dissecans--a detached but non-displaced fragment. Returning, for a second, to the opinion that prompted us to present this case, it is clear that during the last 1100 years there have been no significant morphological or radiological changes in the characteristics of osteochondritis dissecans.
  Acta clinica Croatica 06/2010; 49(2):189-95. · 0.25 Impact Factor
• Article: Sagittal osteotomy of the patella after Morscher.

  Marko Pećina, Alan Ivković, Damir Hudetz, Tomislav Smoljanović, Sasa Janković
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  ABSTRACT: The aim of this study was to present long-term results of sagittal osteotomy of the patella after Morscher. The study included 70 patients treated for patellar dysplasia with a postoperative follow-up from nine to 20 years. There were 59 females and 11 males with an average age of 21 years at the time of operation. Results were evaluated for the entire group of 70 patients and then presented separately for the 30 patients in whom sagittal osteotomy of the patella was performed as a single procedure and 40 patients in whom, in addition to sagittal osteotomy of the patella, medialisation and ventralisation or distalisation of the tibial tuberosity were also performed. The mean value of the Wiberg patellar angle was 112 degrees preoperatively and 140 degrees postoperatively. In the whole group of patients excellent results were obtained in 24 (35%), good results in 30 (42%), fair results in 13 (19%) and poor results in three (4%) patients. In 30 patients with sagittal osteotomy as a single operation excellent results were obtained in 13 (43%), good results in 14 (47%) and fair results in three (10%) patients, while in the 40 patients with sagittal osteotomy and additional surgical procedures, 11 (27%) were excellent, 16 (40%) good, ten (25%) fair and three (8%) had poor results. Sagittal osteotomy of the patella after Morscher is an enrichment of the spectrum of the secondary-causal and preventive procedures for the treatment of patello-femoral disorders.
  International Orthopaedics 12/2009; 34(2):297-303. · 2.03 Impact Factor
• Article: The use of bone morphogenetic protein in lumbar spine surgery.

  Tomislav Smoljanović, Ivan Bojanić, Marko Pećina
  The Journal of Bone and Joint Surgery 09/2009; 91(8):2045-6; author reply 2046-7. · 3.27 Impact Factor
• Source

  Available from: srce.hr

  Article: Overuse injuries in female athletes.

  Alan Ivković, Miljenko Franić, Ivan Bojanić, Marko Pećina
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  ABSTRACT: The last three decades have witnessed a tremendous increase in female sports participation at all levels. However, increased sports participation of female athletes has also increased the incidence of sport-related injuries, which can be either acute trauma or overuse injuries. Overuse injuries may be defined as an imbalance caused by overly intensive training and inadequate recovery, which subsequently leads to a breakdown in tissue reparative mechanisms. This article will review the most frequent overuse injuries in female athletes in the context of anatomical, physiological, and psychological differences between genders.
  Croatian Medical Journal 01/2008; 48(6):767-78. · 1.80 Impact Factor
• Source

  Available from: mef.hr

  Article: Regeneration of the skeleton by recombinant human bone morphogenetic proteins.

  Tomislav Smoljanović, Lovorka Grgurević, Mislav Jelić, Mario Kreszinger, Miroslav Haspl, Drazen Maticić, Slobodan Vukicević, Marko Pećina
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  ABSTRACT: Recombinant human bone morphogenetic proteins (rhBMPs) have past a long journey in human orthopaedic surgery during the last 15 years. From the first reports of the use of rhBMPs in hostile environments such as critically-sized bone defects, avascular femoral head necrosis, unstable thoracolumbar vertebral fractures, instability between the atlas and axis due to rheumatoid arthritis; over the use for nonunions of long bones and the scaphoid, reconstructive and revision surgeries of the hip, acute fractures, allograft nonunions, congenital pseudarthrosis, and various approaches of lumbar and cervical spine fusions, rhBMPs overgrow to a safe and reliable device in the treatment of open tibial shaft fractures, nonunions of long bone fractures, anterior lumbar interbody fusion and revision posterolateral lumbar fusions. Systematic review of the published literature of rhBMPs is presented.
  Collegium antropologicum 10/2007; 31(3):923-32. · 0.61 Impact Factor
• Article: [Osteoporotic fractures in the elderly].

  Marko Pećina, Tomislav Smoljanović, Tatjana Cicvara-Pećina, Spomenka Tomek-Roksandić
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  ABSTRACT: The epidemiology of injuries is a significant factor in the structure of mortality and causes of hospitalization of elderly people. Epidemiologically, consequences of injury, i.e. their complications, from reduced mobility, sores, contractures, infections, all over to mortality from hypostatic pneumonia, are strongly emphasized in the elderly. In 2005, more than 17.0% of Croatian population were older than 65 years of age, and 27.0% of the population were over 60. Osteoporotic bone fractures are frequent among the elderly; 5,489 hip fracture cases were registered in Croatia during 2005, and 382 of them died from fracture complications. In total, 97.38% of the dead patients were over 65 years of age. Besides hip fractures, other typical osteoporotic fractures are fractures of vertebral bodies, distal part of the radius, humerus, pelvic bones, etc. Regardless of conservative or surgical treatment for osteoporotic fracture, it is essential to stress out that after the care of fractured bone has been provided, appropriate diagnostic examinations and pharmacological treatment of osteoporosis should also be done. Orthopedic and traumatic surgeons all over the world have to understand that conservative or surgical treatment of osteoporotic fracture of any localization is just one link in this complex chain of managing the disease - osteoporotic treatment.
  Archives of Industrial Hygiene and Toxicology 03/2007; 58(1):41-7. · 1.05 Impact Factor
• Article: Scientific production of research fellows at the Zagreb University School of Medicine, Croatia.

  Ozren Polasek, Ivana Kolcić, Zoran Buneta, Nada Cikes, Marko Pećina
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  ABSTRACT: To evaluate scientific production among research fellows employed at the Zagreb University School of Medicine and identify factors associated with their scientific output. We conducted a survey among research fellows and their mentors during June 2005. The main outcome measure was publication success, defined for each fellow as publishing at least 0.5 articles per employment year in journals indexed in the Current Contents bibliographic database. Bivariate methods and binary logistic regression were used in data analysis. A total of 117 fellows (response rate 95%) and 83 mentors (100%) were surveyed. The highest scientific production was recorded among research fellows employed in public health departments (median 3.0 articles, interquartile range 4.0), compared with those from pre-clinical (median 0.0, interquartile range 2.0) and clinical departments (median 1.0, interquartile range 2.0) (Kruskal-Wallis, P =0.003). A total of 36 (29%) research fellows published at least 0.5 articles per employment year and were considered successful. Three variables were associated with fellows' publication success: mentor's scientific production (odds ratio [OR], 3.14; 95% confidence interval [CI], 1.31-7.53), positive mentor's assessment (OR, 3.15; 95% CI, 1.10-9.05), and fellows' undergraduate publication in journals indexed in the Current Contents bibliographic database (OR, 4.05; 95% CI, 1.07-15.34). Undergraduate publication could be used as one of the main criteria in selecting research fellows. One of the crucial factors in a fellow's scientific production and career advancement is mentor's input, which is why research fellows would benefit most from working with scientifically productive mentors.
  Croatian Medical Journal 11/2006; 47(5):776-82. · 1.80 Impact Factor
• Source

  Available from: Jelka Petrak

  Article: Scientific biomedical journals in Croatia.

  Aleksandra Misak, Jelka Petrak, Marko Pećina
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  ABSTRACT: To assess the current situation in biomedical journal publishing in Croatia, according to the journals editorial and publishing characteristics. A survey questionnaire with 38 questions was sent to the editors-in-chief of 43 biomedical journals in Croatia. Thirty-seven journals were analyzed. In 2000, there were 14 general and 23 specialized biomedical journals in Croatia. Twenty-five journals received financial support from the government. Six journals were indexed in MEDLINE, with two of them also in Current Contents, 20 in other bibliographic databases, and 11 were not indexed at all. Twelve journals published articles in English, 11 in Croatian, and 14 in either English or Croatian. Only 9 journals were available on-line: 5 offered abstracts only and 4 offered full-text articles. There were more indexed than non-indexed journals that were financially supported by the government (p=0.031) and published in English or either English or Croatian (p=0.011). Indexed journals published more pages (p=0.020) and received more articles (p=0.030) per year. Five journals provided salary for the editorial staff and 4 paid the reviewers services. Median number of subscribers was 250 (range, 0-7,000) and median circulation 650 (range, 300-7,200). Finances, number and quality of articles, and problems with the review process were perceived by editors as the most important problems. Many journals had financial problems despite receiving governmental or other support. Low number/quality of articles received and inefficient review process could reflect the self-containment of Croatian medical community, which comprises around 11,000 physicians and dentists. Large ranges in circulation, number of subscribers, and number of pages published per year, as well as in indexing rates, might imply large differences among the journals in their target readership and editorial policies and performance.
  Croatian Medical Journal 03/2002; 43(1):8-15. · 1.80 Impact Factor
• Article: Acetabular roof reconstruction with pedicled iliac graft.

  Domagoj Delimar, Nikola Cicak, Hrvoje Klobucar, Marko Pećina, Kresimir Korzinek
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  ABSTRACT: 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.
  International Orthopaedics 02/2002; 26(6):344-8. · 2.03 Impact Factor
• Article: [Unicondylar knee arthroplasty with "Repicci" model].

  Miroslav Haspl, Goran Bićanić, Miroslav Jelić, Marko Pećina
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  ABSTRACT: Development of mini invasive techniques for implantation of unicondylar knee prostheses has increased general interest in this type of surgery. Indications are single compartment arthrosis, patients over 50 years of age with total body weight of less then 80 kg with small axis deviations and ligaments preserved. Important contraindications are systemic diseases. Authors present mid-term postoperative results for 25 patients and 26 knees after implantation of unicondylar knee prosthesis type Repicci. Average age at time of surgery was 64.3, predominantly women and in all patients varus deformity with medial compartment arthrosis was seen. According to the Ahlback classification patients were from type 1 to type 4. Average follow up was 31.8 months. We achieved good axial correction with femorotibial angle of 6.2 degrees postoperatively, with flexion of 118 degrees and only in 3 knees extension lag was seen of an average of 8.3 degrees. According to the Knee Society Questionnaire, knee score was 60 points preoperatively and 86.8 points postoperatively and functional score was 30.9 points preoperatively and 71.1 points postoperatively. Pain level, according to the Visual Analogue Scale, was preoperatively 6.8 points and 2 points postoperatively (10 was max). We conclude that the unicondylar knee arthroplasty is a good solution for patients with early degenerative changes in one knee compartment. This type of operative procedure will be more used because of numerous advantages when compared to other treatment options.
  Lijec̆nic̆ki vjesnik 127(7-8):172-6.
• Article: [Rib stress fractures in rowers: three case reports and review of literature].

  Tomislav Smoljanović, Ivan Bojanić, Iskra Troha, Marko Pećina
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  ABSTRACT: Rib stress fractures with an occurrence rate of between 2 and 12% of all other overuse injuries of rowers are the cause of the most time lost from on-water training and competition. As the rib stress fractures are very infrequent in the general population, of otmost importance is to think about such possibility in case of rib cage pain in athlete without a history of trauma. That is why we present our three cases of rowers in whom we suspected the existence of rib stress fractures. The review of the literature related to rib stress fractures in rowers with the newest knowledge of etiology, clinical picture, diagnostics, differential diagnosis and treatment of stress fractures is reported.
  Lijec̆nic̆ki vjesnik 129(10-11):327-32.
• Article: [Surgical treatment of hallux valgus with new method: operative technique and review of 100 cases].

  Ivica Lucijanić, Goran Bićanić, Tatjana Cicvara Pećina, Marko Pećina
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  ABSTRACT: We present the operative technique and treatment results for a new three-dimensional method for hallux valgus correction. Lucijanić procedure was developed at the Department of Orthopaedic Surgery, General Hospital Karlovac, where patients enrolled in this study were treated from 2001 to 2008. Clinical and radiological evaluation was performed in 100 cases with a mean follow-up of 4.5 years. Mean American Orthopaedic Foot and Ankle Society score improved from 48.56 preoperatively to 92.34 points postoperatively. Average recovery time and return to work was 7.7 weeks. Result was excellent or good in 93%, fair in 5% and poor in 2% of feet. On the average hallux valgus angle decreased from 29.7 degrees to 9.3 degrees and on the average intermetatarsal angle decreased from 12.5 degrees to 5.2 degrees. First metatarsal inclination angle on average increased 5.3 degrees. First metatarsophalangeal joint congruence and tibial sesamoid position were corrected. The new method allows for correction of hallux valgus deformity in all three planes and for metatarsalgia attenuation.
  Lijec̆nic̆ki vjesnik 133(1-2):20-5.
• Article: SINDROMI PRENAPREZANJA U PODRUČJU KUKA

  Alan Ivković, Tomislav Smoljanović, Ivan Bojanić, Marko Pećina
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  ABSTRACT: groin strain; osteitis pubis; iliopsoas tendinitis and bursitis; tendinitis of the rectus femoris muscle; hip external rotator syndrome; gluteus medius syndrome; snapping hip; hamstring syndrome
  Croatian Sports Medicine Journal (hsmv@kif.hr); Vol.20 No.2.
• Source

  Available from: srce.hr

  Article: Prijelomi zamora

  Ivan Bojanić, Hrvoje Ivan Pećina, Marko Pećina
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  ABSTRACT: Stress fractures are common overuse injuries, ranging between 1.1% and 3.7% of all athletic injuries. Causes are many and usually involve repetitive submaximal stress. There is a wide research evidence showing that training errors cause stress fractures in as many as 22% to 75% of cases. Intrinsic factors such as hormonal imbalance may also contribute to the onset of stress fractures, especially in women. During medical examination, it is essential always to bear in mind the possibility of stress fracture. Clinical diagnosis is therefore the basic procedure, followed by other diagnostic methods in the following order: radiology, scintigraphy, and MRI. Most stress fractures are uncomplicated and can be managed through rest and restriction from precipitating activities for 4-6 weeks. A subset of stress fractures can present a high risk for progression to complete fracture, delayed union, or nonunion. Specific sites for this type of stress fracture are the femoral neck, the anterior cortex of the tibia, the tarsal navicular, the fifth metatarsal (Jones fracture), and the great toe sesamoids. Therefore, high-risk stress fractures require aggressive treatment, and in some cases even surgical intervention is appropriate.
  Archives of Industrial Hygiene and Toxicology (arhiv@imi.hr); Vol.52 No.4.
• Source

  Available from: srce.hr

  Article: 20 GODINA NAKON REKONSTRUKCIJE STRAŽNJE UKRIŽENE SVEZE UMJETNIM LIGAMENTOM GORE-TEX: PRIKAZ SLUČAJA

  Tomislav Smoljanović, Alan Ivković, Igor Borić, Sven Seiwert, Miroslav Hašpl, Marko Pećina
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  ABSTRACT: Twenty years ago the Gore-Tex expanded polytetrafluoroethylene (PTFE) prosthetic ligament was used as feasible salvage procedure in patients with failed, multiply operated knees, or knees with gross instability. At the Department of Orthopaedic Surgery we operated 13 patients and replaced the posterior cruciate ligament (PCL) with the Gore-Tex prosthetic ligament. Recently we had opportunity to evaluate clinical, arthroscopic, magnetic resonance imagining (MRI) and patohystologic (PH) findings in patient F. K. twenty years after the reconstruction. Due to osteoarthritic changes arthroscopic toilette of the knee was performed. On that occasion arthroscopic evaluation and biopsies for microscopic examination were carried out. MRI performed prior to arthroscopy revealed tidy continuity and volume of PCL with advanced arthritic changes of knee. MRI findings were consistent to clinical findings of good knee stability. Arthroscopy revealed the Gore-Tex prosthetic ligament completely coated with thicken synovial membrane i.e. fibrosis. Partial removal of the synovial membrane showed continuity of characteristic PTFE strands. The continuity of PCL was established by the probe. After that, few pieces of synovial membrane from sheath of PCL and from other parts of synovial membrane of the knee were taken. One PTFP strand of artificial PCL was collected as well. Patohystological findings clearly excluded inflammatory reaction in synovial membrane of the knee. Furthermore, synovial membrane of Gore-Tex prosthetic ligament sheath was found to contain mature fibrotic tissue with multinuclear giant cells and fragments of foreign polarizing material. This case report demonstrated good biocompatibility and good knee stability twenty years after replacement of the PCL with the Gore-Tex prosthetic ligament in patient with gross instability. It is interesting to mention that there was no deterioration of PTFE strands.
  Croatian Sports Medicine Journal (hsmv@kif.hr); Vol.22 No.1.
• Article: Sindromi prenaprezanja u području koljena

  Marko Pećina, Ivan Bojanić, Miroslav Hašpl
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  ABSTRACT: Overuse injuries are frequent in the knee joint. The reason for this is that the knee joint is engaged in all sports activities. Furthermore, the joint area has numerous attachment points for muscles and tendons and numerous bursae. Another reason is that the specific joint between the patella and femur (patellofemoral joint) constitutes a part of the knee joint. Speaking in general terms, all overuse injuries in the knee joint can be divided in four groups according to the aspect: anterior aspect - patellofemoral pain syndrome, patellar tendinitis (jumper's knee), Osgood-Schlatter disease, Sinding Larson Johanson disease, stress fracture of the patella, fat pad syndrome; medial aspect - plica syndrome, semimembranosus tendinitis, pes anserinus tendinitis (bursitis), breaststroker's knee, medial retinaculitis; lateral aspect - Iliotibial band friction syndrome (runner's knee), Popliteal Tendinitis, Bicipital tendinitis; posterior aspect - fabellitis, medial gastrocnemius strain. There are numerous possible reasons for pain caused by overuse injuries around the knee joint, but two are the most frequent: patellar tendinitis (jumper's knee) and Iliotibial band friction syndrome (runner's knee). This paper gives a brief overview of overuse injuries of the knee joint including their definition, anatomy, aetiology, clinical symptoms and signs, and non-operative and surgical treatment.
  Archives of Industrial Hygiene and Toxicology (arhiv@imi.hr); Vol.52 No.4.
• Article: Fizikalne procedure u liječenju sindroma prenaprezanja sustava za kretanje

  Sanda Dubravčić-Šimunjak, Miroslav Hašpl, Ivan Bojanić, Marko Pećina
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  ABSTRACT: As a rule, the treatment of the overuse syndrome in the locomotorÕs system is non-surgical, and surgical treatment is needed on rare occasions. Non-surgical treatment should start as soon as possible. The first step is to halt or modify sports activities. The treatment includes administration of non-steroidal anti-inflammatory drugs, physical therapy, stretching exercises, and the strengthening of affected muscles. The programme should be adapted to the patient, taking into account the localization and the degree of the injury, as well as his/her sport or work-related activities. The RICE therapeutic programme is important in the treatment of overuse syndromes, especially within the first 72 hours from the occurrence of first symptoms, as it shortens the duration of convalescence for as much as 50%-70%. Beside stabilisation of the joint with optimal loading of antagonistic muscles, stretching exercises have the leading position in prevention and treatment of overuse injuries. During rehabilitation, it is necessary to change activity, its duration and intensity. When a person successfully resumes its sports activities with full load, the rehabilitation is considered completed. No surgical or non-surgical method can warrant a hundred percent recovery for any localization of overuse injury. Prevention, education, and close co-operation between the physician, athlete, and the coach is therefore crucial and is receiving increasing attention.
  Archives of Industrial Hygiene and Toxicology (arhiv@imi.hr); Vol.52 No.4.
• Source

  Available from: srce.hr

  Article: Prednja koljenska bol u sportu i radu

  Miroslav Hašpl, Sanda Dubravčić-Šimunjak, Ivan Bojanić, Marko Pećina
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  ABSTRACT: Anterior knee pain is not a disease, but a syndrome with numerous causes. This paper describes its appearance in the patellofemoral joint in sportsmen and in untrained people. Chondromalacia patellae is a condition of the cartilage, not a disease, that is, it is never diagnosed alone. Relative muscular insufficiency, especially of the knee extensors, may occur in children and adolescents, as they grow rapidly. The consequence is a unbalance of active stabilizers and the disturbance of the slippery trail of patella, particularly in the presence of dysplasia of patellofemoral joint. The impingement syndrome pain occurs in sportsmen and people overloading the patellofemoral joint. Other causes of anterior knee pain should be excluded in clinical examination and slippery trail of patella, its position, and signs of instability should be determined. This paper gives an overview of patellar chondromalacia, lateral pressure syndrome, patellar subluxation, patellar acute and recurrent luxation, and idiopathic anterior knee pain. The treatment is basically conservative. Stretching exercises and the strengthening of certain groups of femoral muscles serves to regain the balance, thus normalising the slippery trail and taking off the burden from the patellofemoral joint. If conservative treatment fails, surgery is the alternative.
  Archives of Industrial Hygiene and Toxicology (arhiv@imi.hr); Vol.52 No.4.