The cellular energy metabolism in human musculus gluteus medius (MGM) under normal conditions and hip osteoarthritis (OA) was explored. The functions of oxidative phosphorylation and energy transport systems were analyzed in permeabilized (skinned) muscle fibers by oxygraphy, in relation to myosin heavy chain (MHC) isoform distribution profile analyzed by SDS-PAGE, and to creatine kinase (CK) and adenylate kinase (AK) activities measured spectrophotometrically in the intact muscle. The results revealed high apparent Km for ADP in regulation of respiration that decreased after addition of creatine in MGM of traumatic patients (controls). OA was associated with increased sensitivity of mitochondrial respiration to ADP, decreased total activities of AK and CK with major reduction in mi-CK fraction, and attenuated effect of creatine on apparent Km for ADP compared with control group. It also included a complete loss of type II fibers in a subgroup of patients with the severest disease grade. It is concluded that energy metabolism in MGM cells is organized into functional complexes of mitochondria and ATPases. It is suggested that because of degenerative remodeling occurring during development of OA, these complexes become structurally and functionally impaired, which results in increased access of exogenous ADP to mitochondria and dysfunction of CK-phosphotransfer system.

We studied the effect of impaction of fresh cancellous bone or demineralized bone matrix (DBM) around cancellous screws in 25 cadaver femoral heads. The bone mineral content (BMC) of femoral heads was measured to determine if greater relative increase in holding power will be achieved by impaction-grafting, as the BMC of the specimen decreases. A 60% (p < 0.001) relative increase in the pull-out force was achieved by impaction-grafting with DBM, compared to non-grafted controls. The augmenting effect of fresh cancellous bone graft and DBM did not differ significantly. The relative improvement in holding power was not inversely correlated to femoral head BMC, but was inversely related to the pull-out resistance of non-grafted control screws. These findings suggest that impaction-grafting provides significantly better hold of cancellous screws in femoral heads.

The rod-through-plate fixator has a simple construction and its use expands the treatment possibilities for diaphyseal fractures of long bones.

Hallux Valgus (HV) (also Hallux abducto valgus) is a common deformity of the foot, which causes pain, inflammation and decreased joint mobility in the big toe. There are no universally accepted protocol for treating advanced phase HV, corrective surgery seems to be the most common direction of curing advanced HV deformation. The purpose of this study was to assess the effects of twomonth home exercise programme (HEP) on joint mobility and pain of the first metatarsophalangeal joint (MTP-joint) in women with advanced phase HV deformation. Seven women with mean age 55.6±2.9 years with advanced phase HV deformation (first MTP-joint angle more than 20 degrees) participated in the study. Foot pain in different conditions was assessed with modified Foot Function Index's (FFI) pain subscale before and after HEP. Passive range of motion (PROM) of flexion and extension of the first MTP-joint was measured before and after HEP using a standard mechanical goniometer. A significant increase (p<0.001) in the passive extension of the first MTP-joint was noted after HEP compared with the joint mobility before HEP, also passive flexion increased considerably but no significant difference was noted (p>0.05). Foot pain score decreased significantly (p<0.05) after HEP. In conclusion, in advanced phase HV two-month HEP was an effective therapeutic approach for increasing first MTP-joint mobility and reducing foot pain. Keywords: Hallux valgus, home exercise programme, passive range of motion, foot painRange of motion and pain intensity of the first metatarsophalangeal joint

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