Saratov JOURNAL of Medical and Scientific Research

Medical rehabilitation after total hip and knee arthroplasty: logistics and resource provision

Year: 2019, volume 15 Issue: №4 Pages: 920-924
Heading: public health Article type: Original article
Authors: Fedonnikov A.S.
Organization: Saratov State Medical University

Aim: analysis of problems of logistics and resource provision of medical rehabilitation of patients after total hip and knee arthroplasty. Material and Methods. In the period of 2013-2018 for 24 Russian regions studied: statistic materials of Federal Ministry of Health (form № 14); territorial government guarantee programs. Results. It was developed an author's scheme of logistics and resource provision of medical rehabilitation, describing 4 of its possible trajectories, guaranteed governmental funding sources, and infrastructure capabilities. It was revealed the regional differentiation and the lack of stable dynamics in tariffs growth for in-patient stage of medical rehabilitation — an increase in the tariff was revealed only in 8% of the regions, in a day hospital — in 29% of the regions. Conclusion. The insufficient amount of financial resources within the framework of budgetary allocations and the basic program of compulsory medical insurance leads to limited access for patients to the trajectory of the completed cycle of medical rehabilitation after these surgical interventions. The current practice reduces the medical and social effectiveness of concerned high-tech medical care programs that in the long run creates a risk of socio-economic devaluation of the medical result achieved at the stage of resource demanding surgical treatment.

1. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016/GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Lancet 2017 Sept 16; 390(10100): 1211-59.
2. Puzin SN, Shurgaya MA, Dmitrieva NV, et al. Epidemiology of Disability of Adult Population in the Russian Federation. Epidemiology and Vaccinal Prevention 2019; 18 (5): 14-23.
3. Cross М, Smith Е, Ноу D, et al. The global burden of hip and knee osteoarthritis: estimates from the global burden of disease 2010 study. Ann Rheum Dis 2014 Jul; 73 (7): 1323-30.
4. BriggsAM, Woolf AD, Dreinhofer K, et al. Reducing the global burden of musculoskeletal conditions. Bull World Health Organ 2018 May 1; 96 (5): 366-8.
5. Perruccio AV, Yip C, Badley EM, Power JD. Musculoskeletal Disorders: A Neglected Group at Public Health and Epidemiology Meetings? Am J Public Health 2017 Oct; 107 (10): 1584-5.
6. Losina E, Katz JN. Total joint replacement outcomes in patients with concomitant comorbidities: A glass half empty or half full? Arthritis Rheum 2013 May; 65 (5): 1157-9.
7. Schmitt J, Lange T, Gunther KP, et al. Indication Criteria for Total Knee Arthroplasty in Patients with Osteoarthritis: A Multi-perspective Consensus Study. Z Orthop Unfall 2017; 155 (5): 539-48.
8. Asilova SU, Ruzibaev DR. Medical-and-social examination and rehabilitation of patients and disabled persons after the hip total arthroplasty. Genij ortopedii 2015; (2): 36-9.
9. Burenina IA. Methodological basis of contemporary rehabilitation (clinical lecture). Bulletin of contemporary clinical medicine 2008; 1 (1): 88-92.
10. About the procedure for organizing medical rehabilitation Russian: Order of the Ministry of Health of Russia from 29.12.2012 № 1705n. URL: at 21.11.2019).

2019_04_920-924.doc39.64 KB

No votes yet