endoprosthesis

 Objective: to make assessment of clinical and laboratory indices in patients with deep periprosthetic infection and knee endoprosthesises aseptic instability. Material and Methods. 80 patients with septic and aseptic instability of knee endoprosthesises have been surveyed. All patients were subjected to comprehensive clinical and laboratory examination (intra-articular fuid cytology and microbiology testing, joint tissue histology testing, ELISA was employed for determining the levels of skeletal tissue remodeling markers). Results. The complete combination of several examination criteria specifc for knee periprosthetic infection was

Objective: to assess the accuracy of the femoral neck resection using the developed "Device for positioning tools for the installation of the femoral component of the hip prosthesis". Material and Methods. On the basis of the Department of traumatology and orthopedics of Voronezh state medical University n.a. N.N. Burdenko conducted experimental studies on 40 models of plastic bones. In the comparison group resection was performed using the proposed device, in the control group — using a standard guide. Results. Experimental studies have demonstrated higher accuracy of femoral neck osteotomy in the comparison group. The average value of the neck filing angle in the frontal plane in the comparison group was 3.2° higher than in the control group (p<0.05), and in the sagittal difference was 3.1°. The average distance from the line of the osteotomy to the apex of the greater trochanter in both groups was not significantly different (p=0.62). Conclusion. The use of the developed device allows to perform osteotomy of the femoral neck with high accuracy, as well as to control the position of the leg endoprosthesis, which helps to reduce the number of complications and improve the quality of life of patients.

Aim: research of rehabilitation process problem areas after hip and knee joints replacement. Material and Methods. Program of monitoring and evaluation of medical, organizational, social and psychological components of rehabilitation was developed. Sociological study of 1175 patients who have undergone in 2015-2016 total hip and knee joints replacement was conducted. Results. It was revealed an absence of real interaction between key parties of rehabilitation processes based on significant disproportion between high level (more than 80%) of patients' satisfaction of rehabilitation organizing and low activity of health managers (9.4%). Despite of declared patients' high rehabilitation quality permanent pain noted by 45% of respondents, move freely without additional support is available only for about 50% of patients. Conclusion. Rehabilitation management and its' quality are the key values for locomotor system functional recovery. Provided study has designated main problems of rehabilitation quality evaluation after hip and knee joints replacement.

The aim of the research is to study the indices of cellular immunity in patients before and after hip joint endoprosthesis. Materials and methods. The indices of cellular element of immunity (quantitative and qualitative composition of T-lymphocytes (CD3+), T-helpers (CD3+CD4+), cytotoxic T-lymphocytes (CD3+CD8+), B-lymphocytes (CD3-CD19+), natural killers (CD3-CD16+CD56)) in 20 patients with post-traumatic osteoarthrosis of III grade preoperatively and in the dynamic follow-up on the 3rd, 7th and 21st day post-surgically. Results. Patients with osteoarthrosis showed expressed immunological impairments both before and after endoprosthesis mostly affecting T-cellular immunity element and manifesting in immunoregulatory subpopulations imbalance as well as in T-suppressors decrement, T-helpers increment and NK-cells enlargement in patients after endoprosthesis. Conclusion. Patients with osteoarthrosis showed expressed immunological impairments both before and after joint endoprosthesis. Surgical intervention resulted in the aggravation of the pre-surgical disturbances in immunodeficiency.

Objective: to improve surgical results of patients with complete tears of anterior cruciate ligament by synthetic implant Don-M. Materials and Methods. 7 patients with ACL complete tear who underwent two-bundle plastics with synthetic en-doprosthetic implant Don-M were investigated. Results. The application of ACL two-bundle plastics with synthetic Don-M implant allowed reaching complete knee joint stability during the first several hours after surgery and completely restore knee joint motion range in the course of 6 months. Conclusion. The application of ACL two-bundle plastics is anatomically justified and provides knee joint stability as well as early activation and rehabilitation opportunities.