Bužanova 20, Zagreb

Orthopedics

A team of top orthopedists and traumatologists

We cover a wide spectrum of injuries and disorders of the musculoskeletal system. But we must bear in mind that the same injury or disorder does not equally affect each person and that is why we treat each patient in an individual manner. Our philosophy makes us to apply the least invasive approach, the surgery being our last option.

Kaliper polyclinic employs a team of top orthopedists and traumatologists dealing with a wide spectrum of lesions and injuries of the musculoskeletal system ranging from bone fractures,  ligament or tendon lesions to worn-out joints.

In accordance with our philosophy the welfare of the patient is our top concern and in our treatment we opt for the least harmful and least invasive approach. That is why surgery is our last option.

Kinds of treatment

FRACTURE TREATMENT

Most bone fractures do not demand a surgical treatment but a conservative approach based on orthosis, splints and plaster casts. Operation is necessary only in a small number of cases. In either  case, after sanitizing the injury, a high quality program of physical rehabilitation is in order with the aim of achieving the full functioning of the ailing member.

TREATMENT OF LIGAMENT INJURIES

Ligament injuries are most frequent in professional or recreation athletes, but they also occur to the passive and senior population. The most endangered are the knee ligaments. In sports such as handball, football and basketball such injuries are particularly frequent, although  efforts on prevention lower the rate of lesion. Contact us if you have recently suffered ligament injury and are not satisfied with the outcome of a previous treatment or if you want to enter a prevention program.

TREATMENT OF TENDON INJURIES

We often have to do with patients who have been coping for some time with a lesion of the tendon of shoulder rotatory cuff.  The crucial problem here is that the injured tendon after some time degenerates into fat tissue and cannot be repaired. If your problem are shoulder tendons it is crucial  that you should see the doctor at once in order to intervene on time and deal with the problem as soon as possible.

Beside shoulder tendons, the lesions of the quadriceps (in the knee area) and Achiles’ tendon (in the calf and foot area) are rather frequent. Such lesions require surgical treatment, followed by post-operative rehabilitation which is indispensable for the full recovery of the injured tendon.

TREATMENT OF DAMAGED CARTILAGE

The treatment of osteoarthritis always requires an individualized approach. It most often starts with physical therapy and changes in everyday activities; along with strengthening the muscles, a reduction of the body mass is crucial. In case this does not help, the therapy will include pain- and inflammation killers (possibly administered directly to the joint), and shots of hyaluronic acid, plasma, enriched with thrombocytes or stem cells.

In case the pain does not subside after a conservative treatment or in case the damage caused by arthrosis is too serious, the solution is surgery. Our aim is to postpone for as long as possible the insertion of an artificial joint. The possibilities range from corrective osteotomies enabling a transfer of mechanical burdening from the damaged joint to its sound portion, or a partial substitution of the damaged joint with an artificial one.

TREATMENT OF ARTHROSIS (OSTEOARTHRITIS)

The treatment of osteoarthritis always demands an individualized approach. Most often  it starts with physical therapy and  a change in everyday activities. 

TREATMENT OF MENISCUS LESIONS

Certain movements may damage the meniscus: these are usually rapid and sudden movements not allowing the muscles to stabilize the knee, which results in considerable pressure on the meniscus. The patients feel pain or shooting in the inner or outer side of the knee followed by a swelling of the knee area which will develop within 24 hours.

The damage is established by clinical examination and confirmed by magnetic resonance test. To soothe the pain from the damaged meniscus it is sometimes sufficient to apply conservative methods such as rest, medicines and cooling. In case of fracture, however, surgical treatment is in order. A least invasive procedure is most frequently applied by which only the damaged part of the meniscus is taken away.

TREATMENT OF THE OVER-STRAINING SYNDROME  – THE TENNIS ELBOW AND GOLFERS ELBOW

Both tennis elbow and golfer’s elbow belong to the group of damages referred to as over-straining syndrome. They occur in two parts of the elbow: in the outer side when it is colloquially referred to as tennis elbow and in the inner side referred to as golfer’s elbow. These lesions, however, more frequently happen to persons not involved in sports than to tennis players or golf players; most often they are a professional risk.

The most frequent symptoms are a reduced function of the arm accompanied by a sensation of pain spreading along the muscle of the lower arm. Different treatments are applied depending on the stage of the disability. In mild cases it is sufficient to move away the cause, which was over-straining, to immobilize the joint and teach the patient  how to exercise the arm by extending and contracting the tendons and the muscles.

In case of persisting pain and swelling, physical therapy, pain- and inflammation killers are applied. In a certain number of patients wearing orthoses or plaster casts proved useful as well as locally applied anti-inflammatory shots. Only in most serious cases the physician and the patient jointly decide to resort to surgery.

To make any treatment successful it is essential to reduce or to move away the factors responsible for the disability, which is over-straining in this particular case. That is why we make a point of explaining to the patient the mechanism that is at the root of the disorder.

TREATMENT OF COMPRESSIVE NEUROPATHIES

The most frequent compressive neuropathy is the syndrome of the carpal tunnel. It is a consequence of pressure on the nervus medianus on the part of the fist closest to the wrist. The symptoms develop slowly: they start with occasional numbing in fingers during the night or in the morning and later  on throughout the day. Beside this the thumb and the fingers may become swollen and may hurt. At a later stage muscular weakness may develop, but the patients notice it only when they start dropping objects. The most frequent cause is overcharging of tendons in that part of the fist and is connected with certain jobs such as typing or cleaning and weight-lifting. Masons, masseurs and physiotherapists are often affected.

TREATMENT OF MUSCULOSKELETAL TUMORS

Bone cancer may be primary and it develops in bone cells or secondary, in which case it has spread from other parts of the body (breasts, lungs or intestines). The types of primary bone cancer are osteosarcoma, malignant fibrous histiocytoma and hondrosarcoma.

Osteosarcoma is the most common type of bone cancer and it affects the young between the age of 10 and 25, a period of intensive bone growth. Chemotherapy followed by surgery is the protocol. The same goes for fibrous histiocytoma. The Ewing sarcoma develops between 10 and 20 years of age and is treated with a combination of surgical intervention, radiation and chemotherapy.  Hondrosarcoma develops in the cartilage, usually between the age of 50 and 60 and can be treated surgically.

It is essential that one should recognize the symptoms and diagnose the disorder accordingly.

The symptoms of bone cancer include:

  • pain in the bones increasing with time
  • swelling in the vicinity of the affected area
  • lower mobility
  • a palpable tumor mass
  • muscular atrophy
  • skin alterations
  • pathological bone fractures

REVISION OPERATIONS

All endoprostheses i.e. “artificial joints”  have a limited term of duration. Their average duration is 15 years because they become “loose” and unstable. This causes painful moving which becomes increasingly such with time. That is why an annual orthopedic examination is recommended.

When the prosthesis becomes loose, a revision operation is in order the aim of which is taking away the unstable component and fitting in a new one. Considering an ever increasing number of operations fitting in endoprostheses, the number of revision operations is so increased that they have become standard procedures.

BIOTECHNOLOGY AND INFILTRATION INJECTIONS

Cartilage ailments and injuries are treated by means of these methods. The cartilage in the joints , especially the hip cartilage, suffer considerable burdening and are chaffed and damaged in the process. Impaired cartilage is an indication of aging of the joint. Since there is no such thing as “artificial cartilage” we are obliged to save the one we have.  Here we resort to methods such as viscosupplementation, blood and stem cells therapy.

Viscosupplementation includes a direct application of hyaluronidate in the joint. Hyaluronidate is a natural component of the joint. It acts mainly as a lubricant alleviating the collisions within the joint. In some cases the quantity of hyaluronidate is diminished in joints which causes mechanical strain and damages of the cartilage. Injecting medication from the  viscosupplements group temporarily makes the hyaluronidate return to the joint  and thus reduces  the pain. One such shot can alleviate pain during a 4 to 6 months period.

Blood therapy (PRP) has a considerable positive effect on the recovery of cartilage damages. The procedure is as follows: blood is taken  from the patient and is processed in the laboratory so as to obtain blood extracts which will be injected in the damaged joint. This method is successfully  combined with surgical techniques in cartilage treatment.

The treatment of joints by means of stem cells is a modern and innovative form in the  domain of regenerative orthopedics. Regenerative orthopedics rests on the biotechnological revolution and its aim is full recovery of damaged tissues of the musculoskeletal system. This method is quick, quite non-invasive and completely painless, which are its main advantages. It leads to a speedy recovery of the patient.

Before the procedure, fat tissue is taken from the patient, because this tissue contains a large number of stem cells, as many as 500 times more than  the marrow. The stem cells from fat tissue possess a unique property: they can transform into any cell type. Their potential is particularly visible in cartilage reparation, bone regeneration, arthritis treatment and tendon healing.

The stem cells from fat tissue that are processed and injected in the joint get transformed into connective tissue and cartilage where they repair the damages. Scientific studies prove that after a stem cell treatment all measurable elements of joint function get improved while pain is reduced.

LOCALIZATION

Here are the most common injuries of particular joints we diagnose and treat in Kaliper polyclinic:

SHOULDER

  • arthrosis/osteoarthritis of the shoulder /worn-out shoulder
  • fractures and injuries in the shoulder area (humerus, clavicula, scapula)
  • damaged tendon of the rotatory cuff and biceps of the upper arm
  • shoulder instability
  • luxation on the acromioclavicular joint
  • bursitis in the shoulder area
  • calcifications of the tendinitis
  • collision syndromes

ELBOW

  • worn-out elbow or post-traumatic arthrosis
  • fractures and injuries in the elbow area
  • elbow instability
  • tennis elbow/golfers elbow
  • OCD of the capitellum
  • bursitis in the elbow area
  • compression syndromes in the elbow area

THE WRIST AND THE FIST

  • fractures and injuries in the wrist and fist area
  • compression syndromes

HIP

  • worn-out hip or post-traumatic hip arthrosis
  • hip dysplasia
  • fractures and injuries in the hip area

KNEE

  • worn-out knee or post-traumatic knee arthrosis
  • fractures in the knee area
  • sports injuries
  • Mb Asgood-Schlatter
  • luxation of the patella
  • rupture of the meniscus
  • rupture of the front cruciate ligaments, strain of the medial collateral ligaments
  • chondromalatia of the patella

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