Ambulant Centre for Defects of Locomotor Apparatus (ACDLA) in Prague is recognized interdisciplinary workplace in CR with many years of experience in diagnostics and treatment of acquired and hereditary defects of locomotor apparatus and in research on connective tissues. The team of ACDLA assures complex treatment and care for patients with congenital systemic, limb and combined defects including congenital and acquired contractures, deformities of limbs and spine. In Czech Republic, Dr. Marik was one of the first who started to use the method of prolongation of long bones according to compression-distraction method of prof. G.A. Ilizarov. He introduced intramedullary nailing of fractures and deformities at children with osteogenesis imperfecta in which he gained meaningful results owing to individual orthotic treatment, too. In 1994 after 15 years of clinical and research practice, he became the head of Ambulant Centre for Defects of Locomotor Apparatus in Prague.

With co-workers they introduced into clinical practise anthropometric methods and laid the foundations of orthopaedic anthropology. The topic covers with application of pieces of knowledge on skeleton development and its functional adaptation in orthopaedic profession.

The goal is exact description of both congenital and acquired skeletal disorders (after injuries and/or due to metabolic and infectious diseases) at macro-, meso-, micro- and nanolevels. Archaeological material is suitable, too. Etiopathogenetic causes of skeleton abnormalities (gene mutations) and growth disorders are included in the topic.

Special attention is devoted to diagnostics of the joint systemic defects, biochemical assessment of markers of bone metabolism and bone density with the aim of early diagnosis of primary or secondary osteoporosis in children and adults. The ACDLA is equipped with dual energy X-ray absorptiometry (DEXA) – HOLOGIC Discovery Wi which measures bone mineral density and bone mineral content with very low radiation exposure. There is possibility to analyze body composition i.e. proportional content of fat and lean mass.

In frame of comprehensive treatment, we have introduced the outpatient plastic and orthopaedic surgical treatment of children and adults that is carried out under local or general anaesthesia. We are specialized on paediatric orthopaedic surgery, reconstructive surgery of congenital or acquired deformities of feet and hands. Furthermore, in cooperation with Assoc Professor Vaclav Smrcka, MD, PhD, we are focused on plastic operative treatment including cosmetic and aesthetic surgery. The surgery where hospitalization is necessary we carry out in cooperation with the orthopaedic and paediatric departments of the Regional hospital in Příbram.