Bogojevska doksevska, Milena

Preferred name

Official Name

Bogojevska doksevska, Milena

Main Affiliation

milena.bogojevska@medf.ukim.edu.mk

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Closed Reduction in Developmental Dysplasia of the Hip in Patients Older than One Year
(Pensoft Publishers, 2020-06-30)
Bozinovski, Zoran
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Tokmakova, Keti P
Besides an effective screening method for developmental dysplasia of the hip, there is certain number of children in whom the condition has been overseen or they have never been screened and the parents have noticed the odd walking pattern in their toddler. Treatment of such patients is controversial. One of the recommended treatment methods because of the short-term hospitalization, but often considered unsuccessful is closed reduction of the hip followed by cast immobilization.
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Optimizing the value of the posterior condylar offset, proximal tibial resection and slope in order to achieve the right balance of the posterior cruciate ligament - clinical application of the molding function of the two parts of the PCL
(2017-02-01)
Bogojevski, Ljubomir
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In order to achieve the right balance of the posterior cruciate ligament using the skeletal method is very difficult, almost impossible (Mahoney). Our hypothesis for the right balance of the PCL by using the skeletal method is based on several defined facts: - PCL is a union based of two anatomically independent, but functionally synergic parts, posteromedial and anterolateral part. - The length of the posteromedial part of the PCL is determined by the belonging of the medial compartment and is shortest in varus and longest in valgus deformation. - The length of the anterolateral part of the PCL, placed centrally is unchangeable (cca 38 mm) in every knee and is independent from the anatomical appearance (deformation). - The cylindrical shape of the distal posterior part of the femur (Ficat) depends of the molding function of the PCL (Kapandji) and is a result of the proportion of the both parts of the PCL that is consisted of: shorter posteromedial part, less bone stock on the medial and more bone stock on the lateral condyle (varus knee) and vice versa, longer posteromedial part, more bone stock on the medial condyle and less on the lateral (valgus knee). According to that, the neutral bone stock is achieved by equalization of the lengths of the two parts (common radius of the cylinder) of the PCL, that is basis for the interligamentary balance of the posterior cruciate ligament. </jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p> The basic characteristics of the interligamentary balance of the PCL that we started in 2008 are the following: 1. Posterior condylar offset is equal to the even length of the both part of the PCL. 2. Decrease of the values of proximal tibial resection from 10 in varus to 4-6 in valgus. 3. Femoral valgus cut from 6 in excessive varus deformity to 4 in valgus. </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> The clinical evaluation of the cases divided in groups excessive varus, mean varus, valgus type 1, 2 (Krakow) showed right distribution in the groups of the postoperative ROM and intraoperative tenacity of the PCL (POLO test and palpation test), as a confirmation to the hypothesis. </jats:p></jats:sec><jats:sec><jats:title>Conclusions:</jats:title><jats:p> The ligamentary apparatus of the knee by the molding function depends on the skeletal morphology of the distal posterior femur to the degree that there aren’t two identical knees (Kapandji). According to that, every PCL has its own knee. </jats:p></jats:sec>
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Analysis of the results of implantation of total hip endoprothesis in severe dysplastic coxarthrosis
(Macedonian Academy of Sciences and Arts/Walter de Gruyter GmbH, 2014)
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The aim of this study is to affirm the importance of operative treatment of severe dysplastic coxarthrosis through analysis of the results of implantation of total cementless endoprothesis in patients with DDH Crowe types III and IV.
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Avascular Necrosis of the Hip Joint and Femoral Head Related with Long COVID-19 or Post-COVID-19: Case Report Study
(Scientific Foundation SPIROSKI, 2024-02-25)
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Jovanovski, Mario
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Savin, Tanja
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Novachkova-Siljanovska, Bojana
<jats:p>BACKGROUND: Post-COVID conditions can include a wide range of ongoing health problems. As a consequence of long COVID-19 or post-COVID-19 an increase in osteonecrosis has been detected in different series of patients. CASE PRESENTATION: We present two patients diagnosed with COVID-19 and pneumonia, one with moderate and the other with severe clinical picture. They were treated with corticosteroid equivalent to prednisolone 993.5 mg (400–1587 mg) which correlates with steroid dose documented in the literature as causative for avascular necrosis (ANV) in patients with COVID-19. After the mean time of 65 days, due to pain in the groin and difficulty in movement, magnetic resonance imaging (MRI) was performed in both patients and AVN was diagnosed. Compared to our results, the literature records a longer time required for the development of AVN in patients without COVID-19, which is 6–36 months. This indicates the potency of the virus itself to cause disturbances in the microcirculation, and thus the development of AVN. The bone damage correlates with the degree of inflammation and the severity of the clinical picture. CONCLUSION: After a course of COVID-19 as part of a long COVID-19, ANV should be considered a possible complication, especially in patients who have clinical manifestations. Early detection of AVN and diagnosis using MRI on clinical suspicion would help early intervention with bisphosphonate therapy in patients with osteonecrosis of the hip. If the disease is detected in the more advanced stage, it is necessary to perform a surgical intervention and even a possible hip replacement.</jats:p>
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Influence of vancomycin and meropenem loading on compressive strength of polymethyl methacrylate bone cement
(Институт за јавно здравје на Република Македонија = Institute of public health of Republic of Macedonia, Co-publisher Scientific foundation Spiroski, 2025)
Popovska, Danica
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Shabani, Ilir
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The rise of antibiotic resistance of certain bacteria to commonly used agents in antibiotic- loaded polymethyl methacrylate (PMMA) bone cement has led to the search for new antibiotic agents. A potential problem in introducing new antibiotics into the PMMA mixture is disruption of the mechanical properties of bone cement, which is intended for mechanical fixation of joint implants. The aim of this study was to test compressive strength of bone cement loaded with vancomycin, meropenem or their combination. Materials and methods: Five groups of samples (PMMA, PMMA+2.5%w/w vancomycin, PMMA+2.5%w/w meropenem, PMMA+1.25%w/w vancomycin and 1.25%w/w meropenem and PMMA+2.5%w/w vancomycin and 2.5%w/w meropenem) were prepared and tested for compressive strength according to specifications of the ISO5833:2002 international standard. Results: All tested groups had compressive strength significantly above the minimum value of 70 MPa set by the standard (87.9 – 98.6MPa, p<.0001). All groups of antibiotic-loaded bone cement had significantly lower compressive strength than PMMA. Conclusion: All tested groups met the basic compressive strength criteria for clinical use in arthroplasty procedures.
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THE ROLE OF OBESITY AS NONOCCUPATIONAL RISK FACTOR IN PATIENTS WIT CARPAL TUNNEL SYNDROME
(Macedonian Association of Physiologists and Anthropologists, 2020)
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Antevski, Spaso
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Zaevska, Zorica
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THE IMPORTANCE OF FOLLOWING THE ORIGINAL PONSETI METHOD IN TREATMENT OF CLUBFOOT: THE IOWA EXPERIENCE
(Македонско друштво на ортопеди и трауматолози = Macedonian Association of Orthopedics and Traumatology, 2022)
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Bogojevski, Ljubomir
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Dr. Ignacio Vives Ponseti, an American orthopaedic surgeon with Spanish origin, was born on June the 3rd, 1914 and died at the age 95 in Iowa, USA, on October 18th 2009. He was a brilliant pediatric orhopaedic surgeon, best known for his method of nonoperative treatment of clubfoot, that has become a gold standard of clubfoot treatment. His iconic paper on clubfoot management (1963) is one of the few manuscripts in orthopaedic literature which has radically changed the practice as we know it now. The Ponseti method is easy to learn but, unfortunately easy to modify because modification negatively affects the treatment outcome. That emphasizes the need to learn and follow the exact steps explained by Dr. Ponseti. The first author of this article had the opportunity to learn this method in the place where it all started, guided by Dr. Jose Morcuende, the successor of Dr. Ponseti who continues his legacy in the brightest way possible. After return from the stay at Iowa Stead Family Children’s Hospital 16 patients and 23 feet were treated with best possible adherence to the Ponseti Method. We began using the original Ponseti method in October 2019. Since then, 16 patients, 7 bilateral, 9 unilateral (23 feet in total) have been treated and evaluated. We strove as much as possible to reproduce Ponseti’s strict casting protocol faithfully, as explained in the paper. Usually, for correction of the first three components 4 to 10 casts are necessary, changed on a weekly basis. Equinus is the last deformity to be corrected. In order to avoid prolonged casting and concomitant appearance of rocker bottom deformity, the correction of equinus is facilitated by a simple operative procedure in local anesthesia. Sixty five percent of the patients had good results, 31% had acceptable results, in one patient there was poor result. Compared to the original Ponseti paper from 1963, there is not any significant difference in the results, except the bigger percent of poor results that involves only one patient in our series.
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Operative aplication of autologous bone marrow mesenchimal cells in the treatment of avascular necrosis of the femoral head
(2018)
Velkovski V
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Nikolikj Dimitroska E
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Shabani I
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Efficacy of Alendronate in Preventing Periprosthetic Bone Loss after Implantation of a Primary Hip Endoprosthesis
(Scientific Foundation SPIROSKI, 2022-07)
Shabani, Ilir
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BACKGROUND: Total hip arthroplasty (THA) is now the gold standard for the surgical treatment of coxarthrosis. The appearance of bone loss after implantation of the hip endoprosthesis over time reduces the primary stability of the implant and leads to progressive loosening of the implant or periprosthetic fracture, which are considered to be the most common causes of hip revision. AIM: The aim of this study is to evaluate the value of alendronate application in reducing periprosthetic osteolysis reduction after implantation of total cementless hip endoprosthesis. METHODS: The study analyzed 50 patients operated on with implantation of a cementless THA. The first group of 25 patients received oral alendronate, calcium, and Vitamin D3 postoperatively. The second group of 25 patients was examined and followed postoperatively without any therapy. Patients were examined by RTG and dual energy X-ray absorption (DXA) methods at 6, 12, and 18 months. RESULTS: The study showed a difference in the values of bone mineral density and bone mineral content in the interval of 6,12, and 18 months, using the DXA method. CONCLUSION: Alendronate therapy after total hip implantation reduces periprosthetic bone loss, maintains bone mineralization, and strengthens the implant.
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THE EFFECT OF WIDE SWADDLING ON ALPHA HIP ANGLE IN NEWBORNS AND INFANTS
(Институт за јавно здравје на Република Македонија = Institute of public health of Republic of Macedonia, 2025-05)
Komnenovikj, Marina
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Shabani, Ilir
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Developmental dysplasia of the hip (DDH) is one of the most common diseases of the musculoskeletal system. Hip dysplasia occurs in 1:100, which means that it is 10 times more common than hip dislocation. The position of flexion and abduction in newborns and infants is the most common recommendation to improve hip development. The aim of this research is to evaluate the effects of wide swaddling, i.e., to determine whether wide swaddling influences hip maturation in the first months after birth and whether it has an effect on increasing the alpha angle of the hip during ultrasound examination. Materials and methods: A prospective, clinical, stratified study was conducted on male and female newborns and infants with type Ia, Ib and IIa hip according to the Graf method. The subjects were divided into two groups. The first group included 20 newborns and infants using wide swaddling (40 hips monitored). The second group consisted of 23 newborns and infants who were not swaddled (46 hips monitored). The wide swaddling method involved using an additional cloth diaper and one wide swaddle diaper. Subjects underwent hip ultrasound according to the Graf method during the first hip examination at 4–8 weeks of age, and again two months after the initial assessment. Results: a simple procedure such as wide swaddling influences an increase in the alpha angle of the hip. There is an effect on hip development with faster transition from type IIa to type I according to the Graf method. After two months, the progression of hip maturation in the swaddling group was evident, while hips in the non-swaddling group remained type I and II, indicating that there is also a normal maturation in the other group. Further research is necessary to evaluate the long-term effects of wide swaddling on hip development.

Bogojevska doksevska, Milena

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