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OBJECTIVE: To collect and analyze the 2-year follow-up clinical and MRI results of patients treated with an arthroscopic technique of collagen membrane-based meniscus repair. DESIGN: 53 consecutive patients with combined (horizontal and radial or longitudinal component) and complex meniscal tears (tear extended through avascular zones or/and composed with two or more morphological tear pattern) were treated with an "all-inside" arthroscopic suture of meniscus and wrapping with a collagen membrane (Chondro-Gide) technique with bone marrow blood injection. The IKDC 2000 subjective score, IKDC 2000 clinical evaluation score, Lysholm score and Barret clinical criteria of meniscal healing were recorded. All patients were examinated by MRI 2 years postoperatively, using modified WORMS criteria for meniscal integrity. RESULTS: The 2 year follow-up was achieved in 50 cases. Of these, 2 patients were excluded from the evaluation due to incomplete data and 2 patients underwent partial meniscectomy and were classified as failures. In 46 patients (86.8% of the intended to treat cases), a statistically significant improvement in IKDC 2000 subjective, Lysholm scores and IKDC 2000 clinical assessment between preoperative and the 2-year follow-up time points were obsereved. Barret criteria demonstrated an improved clinical outcome between pre- and post-operative values. MRI revealed a non-homogeneous signal without meniscal tear (WORMS grade 1) in 76% of the operated menisci (13% WORMS grade 2). CONCLUSIONS: The 2-year follow-up data demonstrate that this technique is safe and can offer an additional tool to save the meniscus in the patients otherwise scheduled for meniscal removal. Level of evidence IV.

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INTRODUCTION: Intra-abdominal hypertension and abdominal compartment syndrome have been increasingly recognized as a hip arthroscopy complication over the past decade. In the absence of consensus definitions and treatment guidelines, the diagnosis and management of intra-abdominal hypertension and abdominal compartment syndrome remains variable from institution to institution. CASE PRESENTATION: We report the occurrence of the extravasation of fluid into the abdomen during arthroscopic treatment of femoroacetabular impingement combined with resection of trochanteric bursa and our management of the condition in a 55-year old Caucasian woman. CONCLUSIONS: We present an algorithm of treatment of abdominal compartment syndrome, as a hip arthroscopy complication, according to the consensus definitions and recommendations of the World Society of the Abdominal Compartment Syndrome. In the algorithm options, we have included paracentesis and percutaneous catheter decompression as the main point of treatment. Our algorithm will have a broader clinical impact on orthopedic surgery, anesthesiology and emergency medicine.

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OBJECTIVE: The aim of the study was to: 1) evaluate the differences in pre-post operative knee functioning, mechanical stability, isokinetic knee muscle strength in simultaneous arthroscopic patients after having undergone an anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL) with hamstring tendons reconstruction, 2) compare the results of ACL/PCL patients with the control group. DESIGN: Controlled Laboratory Study. MATERIALS AND METHODS: Results of 11 ACL/PCL patients had been matched with 22 uninjured control participants (CP). Prior to surgery, and minimum 2 years after it, functional assessment (Lysholm and IKDC 2000), mechanical knee joint stability evaluation (Lachman and "drawer" test) and isokinetic tests (bilateral knee muscle examination) had been performed. Different rehabilitation exercises had been used: isometric, passive exercises, exercises increasing the range of motion and proprioception, strength exercises and specific functional exercises. RESULTS: After arthroscopy no significant differences had been found between the injured and uninjured leg in all isokinetic parameters in ACL/PCL patients. However, ACL/PCL patients had still shown significantly lower values of strength in relative isokinetic knee flexors (p = 0.0065) and extensors (p = 0.0171) compared to the CP. There were no differences between groups regarding absolute isokinetic strength and flexors/extensors ratio. There was statistically significant progress in IKDC 2000 (p = 0.0044) and Lysholm (p = 0.0044) scales prior to (44 and 60 points respectively) and after the reconstruction (61 for IKDC 2000 and 94 points for Lysholm). CONCLUSIONS: Although harvesting tendons of semitendinosus and/or gracilis from the healthy extremity diminishes muscle strength of knee flexors in comparison to the CP, flexor strength had improved. Statistically significant improvement of the knee extensor function may indicate that the recreation of joint mechanical stability is required for restoring normal muscle strength. Without restoring normal muscle function and strength, surgical intervention alone may not be sufficient enough to ensure expected improvement of the articular function.

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Aim. The aim of the work was to study whether wearing a corrective brace by adolescent girls with severe idiopathic scoliosis can influence external shape of the trunk. Methods. Comparison of clinical deformity of two groups of girls matched for age and Cobb angle: group (1) of 23 girls, aged 14.9 ± 1.3 years, Cobb angle 55.0° ± 6.8°, who refused surgical treatment and have been wearing Chêneau brace for more than 6 months, compared with group (2) of 22 girls, aged 14.1 ± 1.8 years, Cobb angle 59.7° ± 14.6° never treated with corrective bracing. Clinical deformity was assessed with the Bunnell scoliometer (angle of trunk rotation ATR) and surface topography (posterior trunk symmetry index POTSI and Hump Sum HS). Results. The ATR in the primary curvature was 11.9° ± 3.4° (5°-18°) in group 1 versus 15.1° ± 5.6° (6°-25°) in group 2 (P = 0.027). The HS was 16.8° ± 3.8 versus 19.2° ± 4.6, respectively, P = 0.07. The POTSI value did not differ between groups. Conclusion. Girls with Cobb angle above 45 degrees, who have been subjected to brace treatment, revealed smaller clinical deformity of their back comparing to nontreated girls having similar radiological curvatures.

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PURPOSE: The number of meniscus surgeries, including partial or complete meniscectomy, has increased considerably with the progress in knee arthroscopy. An analysis of treatment results, carried out at several centres by numerous study groups, showed a development of early degenerative changes in the knees of treated patients. METHODS: This study is aimed at developing a fully arthroscopic technique to treat meniscal tears by suturing and wrapping them in collagen matrix, followed by injection of liquid bone-marrow collected from the tibial proximal epiphysis, into the area of meniscal lesion. RESULTS: In this paper, we presented arthroscopic technique for wrapping meniscal tears using the collagen matrix sutured with the Fast-Fix sutures. CONCLUSIONS: Proposed surgical technique is not straightforward to perform, but can be learned by adhering to strict arthroscopic principles. The use of collagen matrix and bone marrow aspirate from bone-marrow blood, including stem cells, creates favourable biological conditions for meniscus healing, which may increase the rate of healing.

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PURPOSE: The aim of the following paper was Polish cultural and linguistic adaptation including adaptation of particular questions, instructions and possible answers to 2000 IKDC knee form and Lysholm's scale. MATERIAL/METHODS: The cultural adaptation process of this questionnaire was made according to indicators of International Quality of Life Assessment (IQOLA) project, placed in Journal of Clinical Epidemiology. Testing version (pre-final test) was carried out on 30 patients suffering from instability of a knee. Patients underwent arthroscopic reconstruction of the anterior cruciate ligament. The period from operation to filling in the questionnaires took 2 years. The questionnaire was filled up twice, at intervals from 2 days to 2 weeks. RESULTS: We received cultural and linguistic adapted knee evaluation scales which are similar to the original version according to the psychometric proprieties such as accuracy of a single question and whole scales. CONCLUSIONS: We were able to develop a reliable, ISAKOS/ESSKA-compliant instrument for subjective knee function evaluation to be used in the population of Polish patients following arthroscopic reconstruction of anterior cruciate ligament. Polish version of IKDC 2000 questionnaire is more reliable--i.e. more useful in clinical evaluation of patients with ACL damage--than the Polish rendition of Lysholm scale.

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PURPOSE: Bone marrow mesenchymal stem cells were introduced into clinical practice due to their ability to differentiate into many types of cells. Autologous matrix-induced chondrogenesis (AMIC) combines the microfracture method with matrix-based techniques that utilizes a collagen membrane to serve as a scaffold for new bone marrow mesenchymal stem cells, allowing effective reconstruction of even large fragments of a damaged cartilage surface. METHODS: All-arthroscopic technique to repair knee cartilage defects using the AMIC technique, which includes the use of a collagen matrix (porcine collagen type I and III) and fibrin glue-technique presentation. CONCLUSION: This technical note introduces an all-arthroscopic AMIC technique to reconstruct extensive cartilage defects (without bone defects). The technique may be used for treatment of all location of knee cartilage lesions. LEVEL OF EVIDENCE: V.

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The purpose of this article is to present the current principles of comprehensive assessment and treatment of patients with myelomeningocele. We present the connection between the level of neurosegmental lesion according to modified Sharrard's classification and functional abilities of the patient. We describe lower limbs deformity typically associated with neurosegmental lesions of spina bifida at different levels (I to VI). The classification of neurosegmental lesion levels is based on an evaluation of muscle strength of individual muscle groups according to the Lovett scale.

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BACKGROUND: The purpose of this study is to present the current approach to and an evaluation of the results of treatment of neurogenic deformities of the hip joints in children with myelomeningocoele (MMC). MATERIAL AND METHODS: The study population consisted of 210 patients with MMC admitted to the Department of Pediatric Orthopaedics and Traumatology in Poznan in the years 1970-2008. The study involved 131 hips (85 patients). The duration of follow-up was 1 to 38 years (mean 17.3 years). The clinical status of patients and treatment results were evaluated with regard to the assignment of the patient to one of 6 groups according to the modified Sharrard and Parsch classification. Radiographic evaluation included the femoral neck angle, anteversion angle, acetabular index, head-acetabular coefficient, centre-edge angle, focusing angle, and Labaziewicz distance angle. The operative treatment in Groups I-II consisted of correction of contractures. In Group III, we performed open reduction of the dislocation or subluxation, Mustard iliopsoas transfer, intertrochanteric femoral osteotomy and Dega's transiliac osteotomy, or shelf procedure. In Group IV patients, we corrected subluxations or dislocations. RESULTS: Surgery in patients from Groups I-II was associated with a high rate of recurrence. In Group III patients, we achieved good joint stability. The transferred iliopsoas muscle was active in 70% of the patients and 65% of the patients in this group became ambulant. More beneficial functional effects were observed after operative treatment in patients from Group IV. CONCLUSIONS: In Groups I-II recurrence of the deformity was often observed. In patients from Groups III-IV, good functional outcomes were noted after comprehensive surgical treatment.

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We present a new technique to prepare insulated channels for the high pressure cell used in broadband dielectric spectroscopy. The cell resists corrosion or other chemical reactions from the reactive sample liquids. The cell maintains electrical insulation between electrode contacts better than 100 GOmega as well as good mechanical properties in broad temperature range of -80 to +100 degrees C and under extremely high pressures up to 1.8 GPa.

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In subjects with scoliosis the thoracic cage deformity is a complex 3D phenomenon. There is a deficiency of simple clinical methods of thorax shape evaluation. The study aimed to introduce and assess an anthropometric technique measuring transverse plane deformity of the thorax in patients with idiopathic scoliosis. Thirty scoliotic girls, aged 14.4+/-1.5 years, thoracic scoliosis type Lenke 1, mean Cobb 54.1+/-24.7 degrees, and 30 healthy volunteers matched for sex and age were examined. Using a Martin anthropometric caliper the length of the long and the short horizontal axes of the thorax were measured at the level of the xiphoid process (upper index) and of the costal arch (lower index), both on maximum inspiration and expiration. Asymmetry index, defined as difference of the length of the long and the short axes expressed as the percentage of the short one, was calculated. The upper asymmetry index in the study group was 35.2+/-18.6 (inspiration) while in the control group it was 13.6+/-13.6, difference significant, p<0.001. The lower asymmetry index in the study group was 26.2+/-12.9 (inspiration) while in the control group it was 12.5+/-11.7, difference significant, p<0.001. In conclusion, thorax asymmetry index revealed significantly higher values in scoliotic patients. Asymmetry of respiratory movements could be measured. This simple technique may be used as a helpful tool for clinicians.

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BACKGROUND: In recent years pedicle screw based constructs have been increasingly used in the operative management of scoliosis. The current principles of screw placement are based on normal anatomy and therefore may not be applicable in cases of severe vertebral deformity due to torsion. The aim of this study was to evaluate the usefulness of computer tomography (CT) in preoperative planning and outcome assessment in operative management of idiopathic scoliosis with severe internal vertebral deformity. MATERIAL AND METHODS: The study presents our own experiences based on analysis of diagnostic and therapeutic decision-making in two patients treated surgically due to Lenke type 1A idiopathic scoliosis. Due to extensive vertebral rotation and radiological appearance suggesting thin pedicles, spine CT with 3D reconstruction was performed as part of extended preoperative work-up in order to determine screw length and diameter, the point of screw introduction and angle of introduction in three planes. Vertebral rotation was evaluated according to the Aaro-Dahlborn method. Segments were also identified where pedicle screws could not be applied due to severe rotation or small pedicle diameter. RESULTS: Preoperative planning of screw placement enabled safe and accurate screw application, as confirmed by postoperative spine CT evidence. Satisfactory correction was achieved in both patients in the coronal and frontal planes. CONCLUSIONS: CT allows detailed preoperative planning of scoliosis surgery and identification of segments in which pedicle screws cannot be safely placed. This may lower the incidence of complications associated with inaccurate pedicle screw placement.

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UNLABELLED: Dysfunction of the knee joint caused by injury of the anterior cruciate ligament is associated not only with mechanical joint destabilization but also damage of receptors in the ligament responsible for joint proprioception. Sensory disorders associated with damage of receptors in the ligaments may produce abnormalities in the posture control. The study aimed at evaluating postural control strategy in patients with chronic anterior cruciate ligament deficiency and determining a relationship between clinical assessment, subjective evaluation of knee joint functioning, and type of postural control. MATERIAL AND METHODS: Postural control with dynamic and static Riva test in one-legged position was assessed in 46 patients (6 women and 40 men), aged between 15 and 52 years (mean 32 years), in whom damage of the anterior cruciate ligament was diagnosed clinically and/or radiologically. Diagnosis was confirmed arthroscopically in all cases. Clinical evaluation was made with the aid of two subjective scales of knee ailments: Lysholm knee scale and subjective knee evaluation form IKDC 2000. Arthrometer Rolimeter by Aircast was used to measure the difference between lower limbs in anterior knee laxity during "anterior drawer" test and Lachman's test. The way of visual proprioceptive control was assessed with both dynamic (DRT) and static (SRT) Riva tests in monopodalic stance. Tests were performed with the DELOS Postural Proprioceptive System (DELOS s.r.l., Corso Lecce, Torino, Italy) in the biomechanical evaluation laboratory at Rehasport Clinic in Poznan. CONCLUSIONS: Strategy of the postural control in both dynamic and static Riva test does not allow differentiating ACL deficient leg from the mechanically stable leg. The obtained results of postural control in dynamic and static Riva test confirm significant value of knee joint mechanical stability for preservation its functional stability. Knee joint extension (hyperextension) may be one of mechanisms maintaining functional knee joint stability.

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BACKGROUND: In patients with structural idiopathic scoliosis the body asymmetries involve the pelvis and the lower limbs; they are included in many theories debating the pathogenesis of idiopathic scoliosis. METHODS: Hip joint range of motion was studied in 158 adolescent girls, aged 10-18 years (mean 14.2 +/- 2.0) with structural idiopathic scoliosis of 20-83 degrees of Cobb angle (mean 43.0 degrees +/- 14.5 degrees ) and compared to 57 controls, sex and age matched. Hip range of rotation was examined in prone position, the pelvis level controlled with an inclinometer; hip adduction was tested in five different positions. RESULTS: In girls with structural scoliosis the symmetry of hip rotation was less frequent (p = 0.0047), the difference between left and right hip range of internal rotation was significantly higher (p = 0.0013), and the static rotational offset of the pelvis, calculated from the mid-points of rotation, revealed significantly greater (p = 0.0092) than in healthy controls. The detected asymmetries comprised no limitation of hip range of motion, but a transposition of the sector of motion, mainly towards internal rotation in one hip and external rotation in the opposite hip. The data failed to demonstrate the curve type, the Cobb angle, the angle of trunk rotation or the curve progression factor to be related to the hip joint asymmetrical range of motion. CONCLUSION: Numerous asymmetries around the hip were detected, most of them were expressed equally in scoliotics and in controls. Pathogenic implications concern producing a "torsional offset" of muscles patterns of activation around the spine in adolescent girls with structural idiopathic scoliosis during gait.

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Injuries involving knee luxation or subluxation generally result in damage to two or three out of the four major ligaments which stabilize this joint. Past treatment of this type of multiligament injuries, consisting in 6- to 12-week immobilization in a plaster cast, does not allow for restoration of the normal, anatomical course of these ligaments. A consequence of this type of healing, which involves the formation of random scars in place of ligaments, is mechanical and functional instability of the knee joint. The goal of this article is to present a classification of multiligament knee injuries and surgical treatment options. We also present our own technique of arthroscopic, concurrent reconstruction of knee joint ligaments. The study material consisted of 20 patients who underwent surgical treatment for multiligament knee injuries in the Department of Pediatric Orthopedics and Traumatology in Poznan. We performed concurrent arthroscopic reconstruction of ACL and PCL in all 20 patients. In addition, reconstruction of the medial complex was performed in 7 patients, and lateral complex was reconstructed in another 7 patients. In three cases we stitched the medial meniscus using a Smith & Nephew FasT-Fix system, and partial menisectomy was performed in 2 patients. The details of the proposed concurrent arthroscopic ACL and PCL reconstruction are extensively discussed. One of the advantages of this operating technique is the exclusive use of autogenous ST and GR tendon grafts for reconstruction of all damaged knee joint structures. The presented operating technique makes possible the reconstruction of all damaged knee joint ligaments in less than two hours, which in turn allows the surgery to be performed in an ischemic setting using an Esmarch band around the limb.

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Injuries of knee generally result in damage to major ligaments which stabilize this joint. Clendenin observed that 20% failure of ligaments of knee it is PCL rapture. A consequence of this type injuries is mechanical and functional instability of the knee joint. The goal of this article is to present our technique of arthroscopic reconstruction of PCL. We also present preliminary results of our treatment options we have applied in 14 surgery patients. The study material consisted of 14 patients who underwent surgical treatment for PCL injuries in the Department of Pediatric Orthopedics and Traumatology in Poznan. The arthroscopic reconstructions of PCL in all 14 patients have been performed by first author with the same operative technique. Knee laxity we assessed before and after PCL reconstructive surgery using arthrometer "Rolimeter" (Aircast). Knee ligament rating scales (Lyscholm and IKDC 2000) have been used to perform subjective, functional assessment of knee joint. The follow up was about 2 years. We fund statistical important improvement in all tested data (p = 0.001). The arthroscopic reconstruction of PCL with autogenic hamstring graft improves function and stability of knee joint. Endurance and size of hamstring grafts are sufficient to restore good mechanical and functional stability of knee joint.

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BACKGROUND: The shape of the torso in patients with idiopathic scoliosis is considered to reflect the shape of the vertebral column, however the direct correlation between parameters describing clinical deformity and those characterizing radiological curvature was reported to be weak. It is not clear if the management proposed for scoliosis (physiotherapy, brace, surgery) affects equally the shape of the axial skeleton and the surface of the body. The aim of the study was to compare clinical deformity of (1) idiopathic scoliosis girls being under brace treatment for radiological curves of 25 to 40 degrees and (2) non treated scoliotic girls matched for age and Cobb angle. METHODS: Cross-sectional study of 24 girls wearing the brace versus 26 girls without brace treatment, matched for age and Cobb angle. HYPOTHESIS: Patients wearing the brace for more than 6 months, when comparing to patients without brace, may present different external morphology of the trunk, in spite of having similar Cobb angle. Material. INCLUSION CRITERIA: girls, idiopathic scoliosis, growing age (10-16 years), Cobb angle minimum 25 degrees , maximum 40 degrees . The braced group consisted of girls wearing a TLSO brace (Cheneau) for more than 6 months with minimum of 16 hours per day. The non-braced group consisted of girls first seen for their spinal deformity, previously not treated. The groups presented similar curve pattern. Methods. Scoliometer exam: angle of trunk rotation at three levels of the spine: upper thoracic, main thoracic, lumbar or thoracolumbar. The maximal angle was noted at each level and the sum of three levels was calculated. Posterior trunk symmetry index (POTSI) and Hump Sum were measured using surface topography. RESULTS: Cobb angle was 34.9 degrees +/- 4.8 degrees in braced and 32.7 degrees +/- 4.9 degrees in un-braced patients (difference not significant). The age was 14.1 +/- 1.6 years in braced patients and 13.1 +/- 1.9 years in un-braced group (p = 0.046). The value of angle of trunk rotation in the main curvature was 8.4 degrees +/- 2.7 degrees in braced and 11.4 degrees +/- 2.7 degrees in un-braced patients (difference extremely significant, p = 0.0003). The value of the sum of angles of trunk rotation at three levels of the trunk was 12.8 degrees +/- 4.6 degrees in braced and 16.5 degrees +/- 3.8 degrees in un-braced patients (difference very significant, p = 0.0038). The POTSI did not differ significantly between the groups (p = 0.78), the Hump Sum values were not quite different (p = 0.07). CONCLUSION: (1) Adolescent girls wearing the brace for idiopathic scoliosis of 25 to 40 degrees of Cobb angle, reveal smaller clinical rotational deformity of their back than non-treated girls having similar radiological deformity. (2) Evaluation of the results of treatment for idiopathic scoliosis should consider parameters describing both clinical and radiological deformity.

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UNLABELLED: The hip joint dislocation is one of the most serious complications associated with severe type of spastic cerebral palsy in children. The natural history of this secondary problem is poorly defined: how often and why the dislocated hip joint is going to be painful. The aim of our study was to specify prevalence of hip pain in the quadriplegic spastic type of cerebral palsy children with dislocated one or two hip joints. The next purpose was to establish correlation between cartilage degenerative changes and pain appearance. MATERIAL AND METHOD: The clinical study population consisted of cerebral palsy children, who presented a unilateral or bilateral dislocation of the hip joint, operated in Department of Pediatric Orthopedics during the period 2002 through 2005. Performed surgical procedures allowed us to evaluate degenerative changes of femoral head cartilage. In 45 operated hips (33 patients) we discovered that 33 had degenerative cartilage lesions which in 25 cases (75%) were associated with pain appearance. RESULTS: We observed correlation between anterior location of the femoral head lesion and pain appearance, between the size of the lesion and intensity of pain complaints and also between femoral antetorsion and magnitude of pain. CONCLUSIONS: Risk factors of pain appearance in spastic dislocated hip joint are degenerative lesions on anterior face of femoral head cartilage, age of the patient, large antetorsion angle and cartilage lesion bigger than 1/4 of femoral head surface.

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BACKGROUND: Adolescent girls treated with a brace for scoliosis are submitted to prolonged stress related to both the disease and the therapy. Currently proposed quality of life questionnaires are focused on the outcome of therapy. Bad Sobernheim Stress Questionnaire (BSSQ) enables monitoring of patients being under treatment with a brace or exercises. The aim of the study was to assess the stress level in conservatively managed scoliotic girls using BSSQ. MATERIALS AND METHODS: 111 girls, aged 14.2 +/- 2.2 years, mean Cobb angle of the primary curve 42.8 degrees +/- 17.0 degrees and mean Bunnell angle of 11.4 degrees +/- 4.5 degrees were examined with two versions of BSSQ (Deformity and Brace). The analysis considered the type of treatment, curve location, correlation of the total score with age, Cobb angle and Bunnell rotation angle. RESULTS: The BSSQ Deformity revealed the median of 17 points in patients managed with exercises (from 4 to 24 points), 18 in patients managed with a brace (from 8 to 24 points) and 12 in patients before surgery (from 3 to 21 points). Braced patients who completed both questionnaires (n = 50) revealed significantly higher score with BSSQ Deformity (median = 18) comparing to BSSQ Brace (median = 9). There was a correlation between the total score of BSSQ Deformity and the Cobb angle (r = -0.34), Bunnell primary curve rotation (r = -0.34) and Bunnell sum of rotation (r = -0.33) but not with the age of patients. CONCLUSION: Scoliotic adolescents managed with exercises and brace suffered little stress from the deformity. The brace increased the level of stress over the stress induced by the deformity. The stress level correlated with clinical deformity (Bunnell angle), radiological deformity (Cobb angle) and the type of treatment (exercises, bracing, surgery). Bad Sobernheim Stress Questionnaires are simple and helpful in the management of girls treated conservatively for idiopathic scoliosis.

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Background. The aim of my paper was to assess distant treatment results of patients who were treated because of hip displasia and the Chiari osteotomy was performed on those patients. Material and methods. I evaluated treatment outcomes of 27 patients who were treated at Poznan University of Medical Sciences, Clinic of Orthopedics, in 1965-1990. The Chiari osteotomy was performed on all patients for hip decenteration or hip subluxation after developmental displasia. 34 hips were evaluated (20 female and 7 male). The average age of patients was 13 years in the moment of the operation. The follow up examination was conducted 10-36 years after the Chiari osteotomy Results. After many years (30 years after the operation on the average), 37% of patients could fit into groups of very good and good results. I could assess the hips before the operation using only parameters marked on anteroposterior films. The radiographs of the hips showed displasia characterized by shallowness and steepness of the acetabulum, an increased apparent neck-corpus angle, low submersion of the femoral head in the acetabulum, and insufficient coverage of the femoral head by the acetabulum. On the radiographs taken one year after the operation I observed very good coverage of the femoral head proved by higher values (above quota) of the Wiberg angle, the Sharp angle, the Heyman and Herndon acetabulum-head indicator. I defined also a course of the osteotomy drafting an osteotomy angle, setting a degree of bone fragments displacement (medialisation), and a height of the osteotomy. Conclusions. 1. The Chiari osteotomy as a hip saving operation allows patients to function in satisfactory clinical conditions for many years. 2. When conducted correctly, the Chiari osteotomy considerably improves femoral head coverage not only in the frontal plane but also in the transverse plane. 3. Too wide osteotomy angle, more than 20 degrees , further than 50% displacement of a distal bone fragment and too low course of the osteotomy in relation to the apex of the femoral head extorted many a time by intraoperative situation, may favor worse patients clinical conditions some time later, considering acceleration of degenerative lesions confirmed before the operation.