Rehasport Clinic

Resin-based composites (RBCs) are among the most widely used materials for direct dental restorations due to their aesthetics and conservative preparation requirements. However, their clinical application remains highly technique-sensitive, and long-term outcomes are frequently compromised by complications. This systematic review aimed to evaluate the most common clinical challenges associated with direct composite restorations and assess awareness of these complications among dentists, dental students, and patients. A comprehensive search of PubMed, Scopus, Web of Science, and Embase was conducted for studies published between January 2010 and August 2025, following PRISMA guidelines. Twenty eligible studies were included, encompassing survey-based research, clinical follow-ups, and cross-sectional analyses across diverse populations. Quality assessment revealed methodological heterogeneity, with most studies rated as intermediate quality. The most frequently reported complications included secondary caries, restoration fractures, marginal defects, postoperative hypersensitivity, and food impaction. Factors contributing to these failures were multifactorial, encompassing operator technique, material properties such as polymerization shrinkage and moisture sensitivity, patient-related behaviors including poor oral hygiene and parafunctional habits, and inadequate pre- and postgraduate training. Evidence further indicated that repair, rather than replacement, is often a conservative and effective management strategy. The success of composite restorations depends not only on material advancements but also on clinician skill, adherence to evidence-based protocols, and patient cooperation. Continuous professional education and preventive measures remain critical for reducing complications and improving restoration longevity.

Mixed reality refers to the integration of virtual reality into the real-world environment. This digital content can be interacted with in real time. The emergence of mixed reality technology has been made possible by the introduction of head-mounted displays, which are being utilized across multiple surgical specialties. In upper extremity surgery, mixed reality has widespread applications in trauma, corrective surgery, arthroplasty, arthroscopy, and oncology. Preoperatively, mixed reality allows for complex 3D planning. Intraoperatively, surgeons can access this 3D data in a sterile environment. While in its infant stages, mixed reality is likely to become a powerful tool for intraoperative guidance and navigation. Mixed reality can change the paradigm of communication, as it allows the sharing of visual data from the surgeon's perspective, enabling remote assistance and participation.

PurposeMeasurement of glenoid bone loss in the shoulder instability can be assessed by CT or MRI multiplanar imaging and is crucial for pre-operative planning. The aim of this study is to determine the intra and interobserver reliability of glenoid deficiency measurement using MRI multiplanar reconstruction with 2D assessment in the sagittal plane (MPR MRI).MethodsWe reviewed MRI images of 80 patients with anterior shoulder instability with Osirix software using MPR. Six observers with basic experience measured the glenoid, erosion edge length, and bone loss twice, with at least one-week interval between measurements. We calculated reliability and repeatability using the intra-class correlation coefficient (ICC) and minimal detectable change with 95% confidence (MDC95%).ResultsIntra and Inter-observer ICC and MDC95% for glenoid width and height were excellent (ICC 0,89-0,96). For erosion edge length and area of the glenoid were acceptable/good (ICC 0,61-0,89). Bone loss and Pico Index were associated with acceptable/good ICC (0,63 -0,86)) but poor MDC95% (45 - 84 %). Intra-observer reliability improved with time, while inter-observer remained unchanged.ConclusionThe MPR MRI measurement of the anterior glenoid lesion is very good tool for linear parameters. This method is not valid for Pico index measurement, as the area of bone loss is variable. The pace of learning is individual, therefore complex calculations based on MPR MRI are not resistant to low experience as opposed to true 3D CT

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.

There is a very large discrepancy when it comes to the management of the first-time anterior shoulder instability (FTASD) among orthopaedic surgeons all over the world. Such discrepancies have been also observed in Poland regarding the management after FTASD, hence an attempt was made to introduce recommendations and standardize the procedures. Guidelines of management after FTASD in European countries have been introduced so far in the UK and the Netherlands, which resulted in a change of behavior. The authors of the recommendations were committed to expanding the knowledge about FTASD and implementing in Poland the most effective model of management. The aim of this study is to present and discuss the results of a survey conducted among members of the Polish Shoulder and Elbow Society (PSES) on diagnostics, conservative and surgical treatment in the case of FTASD. The results of this survey, together with the results of the conducted DELPHI study, will be used to develop recommendations of the PSES for the management of FTASD

A standing body height is a variable used to calculate pulmonary parameters during spirometry examination. In adolescents with idiopathic scoliosis, the loss of the body height is observed, and it may potentially influence the results of pulmonary testing. The study aimed to analyze pulmonary parameters in adolescents with idiopathic scoliosis in relation to the measured versus the corrected body height. Preoperative pulmonary testing and radiographic evaluation were performed in 39 children (29 females, 10 males) aged 12-17 years. Forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were measured. The single best effort was analyzed. Thoracic Cobb angle ranged 50°-104°. Corrected body height was calculated according to the Stokes' formula. The subgroup analysis was performed for the subjects with curves 50°-74°(N=26) versus 75°-104°curves (N=13). Mean measured body height was 166.1±9.0 cm versus 168.9±8.9 cm mean corrected body height. The %FVC obtained for the measured height was significantly higher than obtained for the corrected height: 84.6% ±15.6 vs. 81.6% ±15.6, p<0.001. The %FEV1 obtained for the measured height was significantly higher than obtained for the corrected height: 79.8% ±16.3 vs. 77.35% ±15.9, p<0.001. The subgroup analysis revealed significant differences in %FVC and %FEV1 calculated for the measured versus the corrected body height, p<0.001. Corrected body height significantly influences the results of pulmonary parameters measurement. In consequence, it may influence the analysis of the pulmonary status of children with idiopathic scoliosis.

Background: Patients with anterior cruciate ligament (ACL) injuries have poorer proprioception than people without such injuries. The effects of proprioceptive training on knee functionality and proprioceptive improvement after ACL reconstruction is still unclear. Methods: The research material consisted of 40 patients after ACL reconstruction. Of the 40 patients, 20 of them were rehabilitated with a standard program and 20 with additional proprioceptive exercises. The subjective and the objective scores were evaluated. Results: No differences were found between the proprioceptive versus the conservative postoperative rehabilitation in the functional nor in the proprioception outcomes of the operated limbs. Conclusions: There is no advantage to function in doing proprioceptive rehabilitation exercises following the ACL reconstruction, when compared with a traditional strengthening program.

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.