Dusko Spasovski

• MD, PhD
• Clinical assistant at University of Belgrade

Background/Objectives: Numerous studies have demonstrated the safety and efficacy of intraarticular stem cell injections for treating osteoarthritic knee joints, reporting symptom reduction and pain relief within a few months of treatment. Here, we report the results of a 7-year follow-up after a single intraarticular injection of 0.5–1 × 10⁷ autol...

Background: Perthes disease is a juvenile form of osteonecrosis of the femoral head that affects children under the age of 15. One hundred years after its discovery, some light has been shed on its etiology and the biological factors relevant to its etiology and disease severity. Methods: The aim of this study was to summarize the literature findin...

Background: Osteoarthritis (OA) is a chronic degenerative joint disease, considered to be the fourth leading cause of disability and the second cause of inability to work in men. Recently, adipose derived mesenchymal stem cells (AD-MSCs) came in focus of regenerative medicine as promising tool for treatment of OA. It has been shown that administra...

Laboratory and clinical muscle analysis has revealed that even in the absence of bioelectrical and motor activity, skeletal muscles have certain basic level of tension. This is called Human Resting Muscle Tone (HRMT). It results from viscoelasticity of connective tissue, titin action in muscle fibers and the trixotrophy of muscle tissue (nonlinear...

Unlabelled: Perthes disease is one of the most common forms of pediatric femoral head osteonecrosis with an unknown etiology. Coagulation factors were the first genetic factors suspected to have a role in the pathogenesis of this disease, but studies showed inconsistent results. It is described that inflammation is present during early stages of P...

Introduction: Perthes disease is idiopathic avascular osteonecrosis of the hip in children, with unknown etiology. Inflammation is present during development of Perthes disease and it is known that this process influences bone remodeling. Objective: Since genetic studies related to inflammation have not been performed in Perthes disease so far,...

Modified, reversal technique of fixation in digital replantation using K-wires was analyzed. The results obtained from the standard technique and reversal technique of fixation using K-wires were compared. The aim was to compare the results of osteofixation using K-wires in digital replantation when either standard or reversal, modified technique w...

Congenital pseudarthrosis of tibia is a rare congenital deformity with progressive evolution. Treatment is vague and difficult, and many methods have been used--from once mandatory early amputation to contemporary operative (Ilizarov method, free microvascular fibular graft) and adjuvant methods (electrostimulation, biphosphonates, bone morphogenet...

Sažetak: Uvod: Merenje zdravlja i kvaliteta ţivota kod dece je veoma sloţeno i praćeno je nizom metodoloških problema, a oteţavajuću okolnost predstavljaju specifiĉnosti deĉijeg uzrasta. Dosadašnja istraţivanja ukazuju da na kvalitet ţivota pacijenata pored fiziĉkih karakteristika znatno utiĉu i druge dimenzije: socijalna, psihološka, kognitivna. D...

Objective: To define productivity indicators in healthcare department which reflect department functioning and enable productivity measurements over years. Methods: A combination of two methodologies, the Seven Steps of Determining Productivity Indices and the Objectives Matrix Method, was applied at the Department for Pediatric Orthopedics and Tra...

Pelvic ring injuries usually result from high-energy trauma, and cranial and abdominal multiple injuries are frequently present. Malgaigne fracture is referred to pelvic ring disruption at two sites, and is often treated surgically for its instability. We present a case of nonoperative treatment of Malgaigne pelvic fracture. A 17-year-old girl sust...

Introduction: The aim of the study was to determine the validity of acetabular component position of the noncemented total hip endoprosthesis after Chiari pelvic osteotomy. Material and methods: The study involved 75 patients operated on at the Institute of Orthopedic Surgery "Banjica" in the period from 1990-2009. The first group consisted of 3...

Use of flexible intramedullary rods is an efficient and less invasive treatment option, although shortening and rotational malunion occasionally occur as a result of the reduced axial and rotational stability. This technique should be considered for mildly displaced fractures patients with unstable general condition. It is minimally invasive proced...

Purpose: We studied changes of contact stress distribution in the hip joint after Tonnis triple pelvic osteotomy applied in the treatment of dysplasia and hip joint incongruence in adolescents. Methods: In a group of 75 patients, 54 (72 %) female, who underwent surgery by triple pelvic osteotomy in adolescence for developmental disorder of the h...

Associated bone tissue defect and infection, commonly result in non-healing, i.e., by the development of infected tibial nonunion. The aim of the paper was to present experiences acquired in the treatment of this problem by the application of the Ilizarov method. The analyses enrolled 16 patients diagnosed with infected tibial nonunion.The Ilizarov...

Femoroacetabular impingement is an undesirable contact between acetabular rim and femoral neck and presents abnormality of proximal femoral part and acetabulum, as well. Two forms may appear: cam impingement and pincer impingement. Femoroacetabular impingement related to Legg-Calvé-Perthes disease may be caused by various reasons, as the consequenc...

Kinesiological analysis of tarsal bones provides better understanding of foot disorders, especially in early childhood, when radiography is hindered by delayed ossification of foot bones. Children begin to walk in the age of 9-15 months, with rearfoot inversion only in initial contact phase, while inversion during terminal stance phase is delayed....

Clubfoot, or talipes equinovarus, is a deformity consisting of equinus, varus, and adductus foot deformity. The true etiology of congenital clubfoot is unknown; several theories have been proposed. The pathology of the individual bones contributes to the clubfoot deformity and soft tissue contractures around the ankle and talocalcaneonavicular join...

Foot arches are defined by the position of bones and stabilized by active and passive soft tissue structures. The most significant foot arches are longitudinal, medial and lateral. During lifetime they develop and change, while the most significant disorder represents the flatfoot. During the first two years of life, the flatfoot in full weight bea...

Hallux valgus is a complex deformity of the forefoot. Beside the lateral deviation of the first metatarsophalangeal joint angle exceeding 15-20 degrees and intermetatarsalvarus exceeding 8-9 degrees, it is also characterized by extensive changes of the soft tissue arch, sesamoid mechanism and metatarsocuneiform joint. It occurs almost exclusively i...

During the period of development foot deformities can occur, not only during the growth and development, but also in the later age. The most frequent foot deformity is flatfoot, congenital club foot and hallux valgus. Prior to the decision on surgical treatment of the deformity, whenever possible the patient should be referred for physical therapy...

Ninety-nine hips treated by the Chiari pelvic osteotomy were included in this study designed as a retrospective review. The group consisted of 36 male and 50 female patients, with mean age of 15.6 years. Each was diagnosed with developmental dysplasia of the hip (DDH) or avascular necrosis of the femoral head--Legg-Calve-Perthes disease (LCP)--and...

The aim of the paper was to present the results achieved with triple pelvic osteotomy in the treatment of residual hip dysplasia, with special interest in identifying recurrences and complications and how to avoid them. 60 patients (76 hips) with developmental dysplasia of the hip (DDH), treated by the triple pelvic osteotomy according to Tönnis an...

Introduction: Ultrasound represents a method of examination of hips of newborn babies capable of defining hip condition and distinguishing stable and unstable hips based on morphological elements. It is accepted in a large number of countries as a method of examination of high risk newborns, or as a method of systematic screening. Objective: The...

Introduction. Insufficient femoral head coverage is found in a variety of diseases, with acetabular dysplasia as the most frequent disorder and triple pelvic osteotomy as the most recently introduced surgical treatment. Objective. This study analyses pre- and postoperative pathoanatomic characteristics of triple in comparison to Salter and Chiari o...

This article presents the results of Legg-Calve-Perthes (LCP) disease treatment using triple pelvic osteotomy. Thirty patients were analysed. The conditions for inclusion in the study were complete medical documentation and follow-up until the disease was resolved. Postoperatively, no patients were immobilised. Rehabilitation was initiated early in...

The Institute for Orthopaedic Surgery "Banjica" in Belgrade provides tertiary healthcare services on national level. After decades of constant development, a recent decline coincided with the decade of great social and governmental disturbance, the transition period after the dissociation of former Yugoslavia. In order to overcome the crisis, we us...

Our aim has been to present the functioning of orthopaedic and trauma services in the healthcare system of Serbia. In the introduction, we present geographic, demographic, political and economic elements, which define more closely the position of Serbia in the Southeastern Europe. Further, the healthcare system of Serbia, organized in four levels,...

Serbia, a middle-income country, is located in southeastern Europe, with territory of 88,361 km(2) and 9,400,000 inhabitants. Average month salary is US$542 and the registered unemployment rate is 22%. The country is administratively divided into 30 districts (193 municipalities). The healthcare system is territorially organized. In the state capit...

Introduction: Paget disease, localized on thoracal vertebrae, presents a significant challenge in diagnostics and treatment. Presenting with progressive neurological symptoms, it has a broad differential diagnostic spectrum and requires additio-nal radiological, neurological and endocrinological evaluation. Besides drug therapy, an operative decom...

Legg-Calvé-Perthes disease represents avascular necrosis of the femoral head in a growing child. It commonly affects children aged 2-14 years, mostly boys, and has familiar pattern. The etiology of this disease is unknown. It is based on avascular necrosis due to variations of the femoral head vascular supply, trauma, coagulation of endocrine distu...

This study retrospectively determined the incidence rates of hip fractures in Belgrade, Serbia and Montenegro, during the period 1990-2000. All patients with hip fractures treated at all Belgrade hospitals were identified from the Republic of Serbia's Ministry of Health National Health Care database. Patient demographics, type of hip fracture, and...

The paper presented the results of diagnostics and treatment of patients with diagnosis of chondroblastoma, treated at the Institute of Orthopedic Surgery "Banjica", Belgrade. A total of 30 patients were analyzed, involving the period from 1975-2004. All important data were obtained using the complete medical documentation, physical examination, ra...

Chondroblastoma of bone is rare bone tumor, representing around 1% of benign bone lesions. It is considered a benign lesion, although primary malignant form as well as malignant alteration in the form of chondrosarcoma has been documented. It occurs predominantly in the second decade, more commonly in males. Predilection sites include proximal hume...

Ewing's tumor of bone is the second primary malignant bone tumor. Localized lesion is found in nearly 80% of cases and metastatic lesions are present in 20% at the time of diagnosis. Treatment protocols were analyzed, prognostic parameters were evaluated, and overall survival as well as survival until relapse of disease was studied. Prognostic feat...

The purpose of this investigation was to evaluate epidemiologic features of Ewing sarcoma in children treated in the Institute for Orthopedic Surgery "Banjica: as well as to establish relation of these features to clinical findings. Study involved 78 patients treated over 20-year period (1980-2000). Analysis included standard epidemiologic data (ag...

Ewing tumor family consists of Ewing tumor of bone, extraosseous Ewing tumor, primitive neurectodermal tumor and Askin tumor. All of them share genetic abnormality, reciprocal translocation (11; 22) (q24; q12), and originate from the same primordial stem cell. Ewing tumor is the most common form, found in 60% of cases. It is the second primary mali...

The authors present the possibilities of ultrasound diagnostics of developmental dislocation of the hip. Special attention has been paid to Graf's method, originally developed in Austria and Germany that has been introduced in many countries all over Europe, including our country. The method in details, normal and pathological anatomy of the infant...

Septic arthritis of the hip represents a serious pathological condition which results in severe sequelae and high invalidity. The most serious sequelae are seen in neonatal and infantile period, when normal growth and development are brutally disturbed, followed by proximal femoral destruction and acetabular dysplasia, which in return result in ana...

Authors reviewed their eight-year long experience with triple pelvic osteotomy. They explained the way of introduction of this procedure into everyday clinical practice. Seventy hips were operated using Tonnis-Vladimirov method in fifty nine patients of an average age of 15 years and one month. Treatment results were evaluated, both anatomically an...

Septic arthritis of the hip in infancy is a serious condition which, if left untreated, results in disastrous sequelae and gross invalidity. Treatment is difficult and requires precise perception of characteristic clinical symptoms and signs, application of appropriate diagnostic procedures (laboratory analyses, ultrasound, radiography, joint aspir...

The objective of this study was to estimate the incidence of hip fractures in Belgrade for the period 1990-2000, and to determine distribution of fractures according to sex, age, and causes of injuries. Data based on medical records of the National Health Service in Belgrade were collected from all orthopedic hospitals and departments in Belgrade....

Authors have reviewed their eight years long experience with triple pelvic osteotomy. They are explaining the way of introduction of this procedure in everyday clinical practice. Sixty six hips were operated using Tonnis-Vladimirov method in fifty five patients of the average age of 15 years and four months. Treatment results were evaluated, both a...

1 Institut za ortopedsko­hirurške bolesti "Bawica", Beograd; 2 Institut za ortopedsku hirurgiju i traumatologiju, Klinički centar Srbije, Beograd KRATAK SADRŽAJ Ciq istraživawa je bio­ da se u­tvrde epidemio­lo­ške o­dlike Ju­ingo­vo­g (Ewi­ n­g) sarko­ma ko­d bo­lesnika lečenih u­ Insti­ tu­tu­ z­a o­rto­pedsko­­hiru­rške bo­lesti "Bawica" u­ Beo­...