The use of biologic therapies for the management of knee osteoarthritis (OA) has largely increased in recent years. The purpose of this study was to evaluate the efficiency and the therapeutic potential of platelet-rich plasma (PRP) and autologous adipose tissue (AAT) injections as a treatment for knee OA. Sixty participants were enrolled in the study: 20 healthy ones and 40 with minimal to moderate knee OA (KL I-III). The OA patients were randomly assigned either to the PRP or to the AAT group. The PRP samples showed a low expression level of NF-κB-responsive gene CCL5 and high expression levels of classic inflammatory and TNF-l INF responses. The AAT injection product was prepared using a Lipogems device, and its regenerative potential as well as the ability for expansion of mesenchymal stem cells were tested in the cell culture conditions. The patient assessments were carried out five times. Significant improvement was observed regardless of the treatment method in the VAS, KOOS, WOMAC and IKDC 2000 subjective evaluations as well as in the functional parameters. Intra-articular injections of AAT or PRP improved pain, symptoms, quality of life and functional capacity with a comparable effectiveness in the patients with mild to moderate knee osteoarthritis.

Background: Knee osteoarthritis (OA) is a common, chronic, progressive and degenerative disease which affects patients' quality of life and may cause disability and social isolation. OA is a huge economic burden for the patient and a large strain for the whole healthcare system. Articular cartilage has a small potential to repair, with progressively more clinicians emphasizing cellular therapy. Subcutaneous fat tissue in human body is a large reservoir of mesenchymal stem cells (MSCs) and is been harvested in minimally invasive, simple procedure. Up to date there is no prospective randomized controlled studies demonstrating effectiveness and role of adipose tissue injections in OA treatment. The purpose of this study is to assess functional and clinical changes among patients with symptomatic knee OA treated with intra-articular injections of autologous adipose tissue or platelet rich plasma (PRP) and to compare efficacy of both therapeutic methods. Methods: This is a prospective, randomized, controlled study. Patients who meet inclusion criteria will be allocated to Fat Tissue group or PRP group randomly. Subjects will receive an intra articular injection with autologous adipose tissue and PRP respectively. Patients will be assessed five times: before treatment and 1, 3, 6 and 12 months after the treatment. The assessment consists of patient reported outcome measures (The Knee injury and Osteoarthritis Outcome Score, International Knee Documentation Committee 2000, the Western Ontario and McMaster Universities Osteoarthritis Index, the Health Questionnaire EQ-5D-5 L), three functional tests (The Timed Up and Go Test, The 5 Times Sit to Stand Test, The 10 m Walk Test) and Maximal Isometric Voluntary Contraction. Discussion: This study protocol has several strengths and weaknesses. One of strongest point of this study is the wide, multidimensional functional assessment which will give a large amount of objective data. On the other hand, lack of blinding has to be considered as a risk of both subject and investigator bias.

Introduction One of the treatment options in chronic damage or unsuccessful suturing of the Achilles tendon is a surgical treatment consisting of its reconstruction using the tendon of semitendinosus and gracilis muscle. The multitude of types of reconstruction causes discrepancies in rehabilitation protocols. All of them aim to return to full functional fitness as the ultimate goal. Aim This study aims to present the proprietary rehabilitation protocol after Achilles tendon reconstruction using the tendon of semitendinosus and gracilis muscle. Material and methods The presented rehabilitation program lasts about 12 months and is divided into six stages. Stage I consists of standing up and anticoagulant exercises, and isometric exercise. Stage II, lasting up to 2 weeks after the procedure, consists of the patient’s independent work in the home environment. Stage III, lasting up to 4 weeks, involves learning to walk and putting weight on the limb in a cam Walker. In the third stage, after the postoperative wounds have healed, exercises in water conditions are started. Stage IV, lasting from 4 weeks after the operation, involves loading the limb with support, increasing the range of dorsiflexion motion, and progressive muscle strengthening. Stage V, which lasts up to 8–12 months after surgery, eliminates functional deficits and prepares the patient for a functional biomechanical assessment. Stage VI is the stage of work on the compensation of deficits resulting from the analysis of the results of the functional biomechanical assessment necessary to return to the full sports activity. Results The rehabilitation time, in accordance with the assumptions of the above protocol, is 8–12 months. After this time, the patient should proceed to a functional biomechanical assessment. Discussion and conclusions The rehabilitation protocol presented by our team describes in detail the stages of post-operative rehabilitation after Achilles tendon reconstruction with a hamstring graft. It provides the conditions necessary for the patient to meet before starting the next phase and returning to sport. Our requirements are consistent with the assumptions available in the scientific base. Keywords: Achilles tendon reconstruction, return to sport, rehabilitation program.

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The invention of inertial measurement units allowed the construction of sensors suitable for human motion tracking that are more affordable than expensive optical motion capture systems, but there are a few factors influencing their accuracy, such as the calibration methods and the fusion algorithms used to translate sensor readings into angles. The main purpose of this study was to test the accuracy of a single RSQ Motion sensor in comparison to a highly precise industrial robot. The secondary objectives were to test how the type of sensor calibration affects its accuracy and whether the time and magnitude of the tested angle have an impact on the sensor’s accuracy. We performed sensor tests for nine repetitions of nine static angles made by the robot arm in eleven series. The chosen robot movements mimicked shoulder movements in a range of motion test (flexion, abduction, and rotation). The RSQ Motion sensor appeared to be very accurate, with a root-mean-square error below 0.15°. Furthermore, we found a moderate-to-strong correlation between the sensor error and the magnitude of the measured angle but only for the sensor calibrated with the gyroscope and accelerometer readings. Although the high accuracy of the RSQ Motion sensors was demonstrated in this paper, they require further study on human subjects and comparisons to the other devices known as the gold standards in orthopedics.

Introduction Elbow pain and related problems are commonly seen in doctors’ or physiotherapists’ general practice. Patient-rated questionnaires are a helpful tool in quantifying functional abilities and subjective feelings of patients who struggle with elbow problem. To the authors knowledge up to date there are no Polish versions of questionnaires related to elbow problems. Aim The purpose of this study is to translate and adapt four elbow questionnaires to suit Polish patients: Oxford Elbow Score (OES), American Shoulder and Elbow Surgeons-Elbow (ASES-E) and Mayo Elbow Performance Score (MEPS) and Summary Outcome Determination (SOD). This is initial phase and in the next, adapted questionnaires will be validated. Materials and methods Cultural adaptation of the selected questionnaires to the Polish culture has been conducted in five stages according to the international guidelines and was supervising by committee. Cultural adaptation process included translating each score from English into Polish, reversetranslation and testing of created version on a group of 30 people. Results There have been no major difficulties during cultural adaptation process. The only problem was certain words which had no equivalents in Polish. Testing of the prefinal versions did not bring any objections. Conclusions In conclusion, new Polish versions of OES, ASES-E, MEPS and SOD score will be very useful in elbow assessment, in daily practice of doctors and physiotherapists. They will help to unify evaluation of the patients and give a possibility of comparing the results of different treatment methods.

Background and objectives: The Achilles tendon, the largest tendon in the body, is vulnerable to injury because of its limited blood supply and the combination of forces to which it is subjected. Given the relevance of the Achilles tendon in the proper function of the foot and ankle, the primary goal of the present study was to use a holistic approach for a comprehensive evaluation of Achilles tendon reconstruction results on multiple levels. Materials and Methods: The study was designed in the following way: 30 patients with partial or total Achilles tendon tears were subjected to the minimally invasive Achilles tendon reconstruction. Patients were then subjected to the clinical, functional and isokinetic tests 12 and 24 months after the treatment. The clinical evaluation included calf circumference measurements and subjective patient-reported tests: ATRS, EQ-5D-5L and VAS scales. The functional evaluation was based on three tests: the weight-bearing lunge test, the heel rise test and single leg hop. Isometric and isokinetic evaluation was performed using a Biodex 3 dynamometer. Results: The calf circumference of the operated limbs was significantly lower than the non-operated limb 12 months after the surgical procedure, however this improved at the second evaluation. All subjective outcomes improved significantly 24 months after the surgery. Significantly better results in the function of the operated limbs were also obtained 24 months after the surgery. However, most of the muscle strength parameters of the operated limbs were already comparable to non-operated ones 12 months after the surgery and were comparable between two evaluation times. The overall results of this extensive evaluation are highly satisfactory and patients returned to their normal physical activity. From a medical point of view, it is assumed that the healing process is completed 12 months after the surgery, however, importantly, our results indicate that we should consider the healing process and the rehabilitation process separately.

Given the relevance of the Achilles tendon in proper function of the foot and ankle, the primary goal of the present study was to use a holistic approach for a comprehensive evaluation of Achil-les tendon reconstruction results on multiple levels. 30 patients with partial or total Achilles ten-don tears were subjected to the minimally invasive Achilles tendon reconstruction. Patients were then subjected to the clinical, functional and isokinetic tests 12 and 24 months after the treatment. The overall results of this extensive evaluation are highly satisfactory and patients returned to their normal physical activity.