Saratov JOURNAL of Medical and Scientific Research

total joint replacement

The peculiarities of bone and cartilage tissue remodeling in patients after hip joint replacement

Year: 2017, volume 13 Issue: №3 Pages: 723-727
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Gladkova Е.М., Karyakina E.V., Tsareva Е.Е., Persova Е.А., Belova S.V.

The aim: to study the peculiarities of structural and metabolic state of bone and cartilage tissue in patients in the first 12 months after total hip replacement with respect to their immune state and lipid peroxidation activity. Material and Methods. Significant laboratory predictors of initial signs of aseptic instability were singled out allowing estimating the peculiarities of bone tissue remodeling as well as humoral and cellular immunity state. Results. The obtained results demonstrated that impairments in T-lymphocyte system in patients with initial signs of aseptic instability of en-doprosthesis were accompanied by reduction of its total number (CD3+), among that due to the population of cytotoxic (CD3+CD8+) cells with simultaneous increase of T-helpers (CD3+CD4+) number. Activation of serum proosteoclasto-genic factors (TNF-a and IL-1(3) was noticed on the background of anti-inflammatory humoral immunity failure (IL-10). Conclusion. The estimation of cellular immunity state, content of pro- and anti-inflammatory cytokines in blood serum combined with the bone tissue state markers and indexes of lipid peroxidation and antioxidant system as well as dual-energy absorptiometry allows identifying patients with high risk of further development of aseptic instability in hip joint implant in the period of up to 12 months postsurgically which can be useful while planning prevention management of implant or its components instability.

2017_03-2_723-727.pdf259.91 KB

Comprehensive approach to the assessment of the functional status of patients with degenerative joint diseases of the lower extremities

Year: 2017, volume 13 Issue: №3 Pages: 510-514
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Romakina N.A., Korshunova G.A., Kireev S.I., Sertakova A.V., Norkin I.A.
Organization: Scientific Research Institute of Traumatology Orthopedics and Neurosurgery of Saratov State Medical University n.a. V.I. Razumovsky

Aim: development of an integrated biomechanical index that reflects the state of kinematic and static function in patients who need replacement of large joints as well as evaluation of the myoneural complex of lower extremities activity of category of patients. Material and Methods. 103 patients with osteoarthrosis of the hip and knee joints. A biomechanical survey included podography, stabilometry and dynamometry. An electrophysiological study of the peripheral nerves of the lower extremities with the determination of the amplitude of the muscle response and late neuronal responses was carried out. The level of activity of the gluteal muscles was determined. Results. The most sensitive indicators reflecting the state of biomechanical status were identified, specialized software for the integral biomechanical index calculation was developed. Conclusion. Methods of clinical biomechanics allow specialists to assess the state of kinematic and static function of the musculoskeletal system, matching of the integral biomechanical index with the data of neurophysiological monitoring makes possible to select individual tactics of treatment.

2017_03_510-514.pdf408.3 KB