Saratov JOURNAL of Medical and Scientific Research

Kozadayev M.N.

Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery of Saratov State Medical University n.a. V.I. Razumovsky, Department of Fundamental, Clinical and Experimental Studies, Junior Research Assistant, Candidate of Medical Sciences

Thrombinogenesis in patients with aseptic instability of knee endoprosthesis and periprosthetic infection

Year: 2020, volume 16 Issue: №2 Pages: 478-484
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Girkalo M.V., Shakhmartova S.G., Shpinyak S.P., Mandrov A.V., Kozadaev M.N., Puchinyan D.M.
Organization: Saratov State Medical University
Summary:

Objective: To evaluate thrombinogenesis in patients with periprosthetic infection and aseptic loosening of endoprosthesis after primary knee arthroplasty. Material and Methods: 28 of 52 examined patients who suffered from the loosening of knee endoprosthesis components and 24 from periprosthetic infection; 18 healthy individuals were also engaged into the study. Thrombinogenesis was analyzed with thrombin generation assay in an automated Ceveron alpha coagulometer (Technoclone, Austria) using RB and RC-low activators containing 2 and 5 pmol/ml of tissue factor respectively. Each of the main groups of patients was divided into two subgroups: in patients of the 1st subgroups RC-low activator aggravate thrombinogenesis while in the 2nd subgroups it inhibited the process as compared to the effects of RB activator. Results: In the 1st subgroup of patients with aseptic loosening RC-low activator caused chronometric hyperthrombinogenesis, and in the 2nd — both chronometric and structural ones. In patients with periprosthetic infection the effects of RB and RC-low activators were comparable. Conclusion: In patients with aseptic loosening of the implant and stopped periprosthetic infection that developed after primary knee replacement, the thrombin generation test reveals normal, paradoxical and inert types of thrombinogenesis.

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Hemostasis test parameters in patients requiring revision knee arthroplasty

Year: 2018, volume 14 Issue: №2 Pages: 266-271
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Girkalo M.V., Shakhmartova S.G., Shpinyak S.P., Mandrov A.V., Kozadaev M.N., Puchinyan D.M.
Organization:
Summary:

Objective: comparative analysis of the blood coagulation system in patients requiring revision arthroplasty of the knee joint in connection with the developed infectious and aseptic complications after total arthroplasty. Material and Methods. 37 patients with complications of total knee replacement were examined. Patients were divided into 2 groups: 1st — with signs of suppuration (n=19); 2nd — withsigns of aseptic instability of the endoprosthesis components (n=18). The control group consisted of 22 conditionally healthy people. Studied screening coagulation: activated partial thromboplastin time, prothrombin time, fbrinogen concentration, thrombin time, antithrombin III, protein C, the content of soluble fbrin-monomer complexes and D-dimers. Results. There was an increase in activated partial thromboplastin time in patients of group 2, prothrombin time — in patients of groups 1 and 2 compared with the data obtained in the control group (p<0.001). An increase in the content of soluble fbrin- monomer complexes and D-dimers was recorded in the blood plasma of patients of the 1st and 2nd groups compared to their level in the control group (p<0.001). Conclusion. The data of local coagulogram tests in patients requiring revision arthroplasty of the knee joint refect the signs of maladaptation in the hemostatic system at the preoperative stage of examination. It is worth noting the lack of information content of the screening coagulogram, as its basic tests do not refect changes in the whole system of homeostasis, the search for new informative research methods remains relevant today.

Keywords: -
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The estimation of biocompatibility of polycaprolactone matrices mineralized by vat-erite in subcutaneous implantation tests in white rats

Year: 2018, volume 14 Issue: №3 Pages: 451-456
Heading: Physiology and Pathophysiology Article type: Original article
Authors: Ivanov A.N., Kurtukova М.О., Kozadaev M.N., Tyapkina D.A., Kustodov S.V., Saveleva M.S., Bugaeva I.O., Parakhonsky B.V., Galashina E.A., Gladkova E.V., Norkin I.A.
Organization: Saratov National Research University n.a. N. G. Chernyshevsky
Summary:

Aim: to estimate biocompatibility of matrices produced from polycaprolactone (PCL) and mineralized by vaterite (CaC03) by studying local and systemic manifestations of inflammatory reaction in subcutaneous implantation tests in white rats. Material and Methods. The experiment was conducted on 40 rats divided into four equal groups: control, comparison (rats with imitation of implantation), negative control (rats with implanted non-biocompatible matrices) and experimental group, comprised of animals with implanted PCL/CaC03-matrices. Local inflammatory manifestations were analyzed by morphological assay of implantation area tissues. Systemic inflammatory manifestations were estimated by TNF-a concentration and interleukin-lp (IL-1) in blood serum by ELISA. Results. The changes in cellular population content demonstrate that a PCL/CaC03-matriceonthe21 day after the implantation to rats is evenly colonizing by fibroblast cells and vascularizing. This type of matrices does not provoke intense inflammatory reaction seen in negative control animals and accompanied by systemic manifestations such as statistically significant rise in TNF-a and IL-1 concentrations. Conclusion. The data obtained in the study proving the biocompatibility of PLC/CaC03-scaffolds experimentally substantiate the potential for their use in tissue engineering.

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