Saratov JOURNAL of Medical and Scientific Research

Girkalo M.V.

Saratov Scientific Research Institute of Traumatology and Orthopedics, Chief Research Assistant, the candidate of sciences

Clinical and laboratory indices of periprosthetic infection in patients with knee endoprosthesis instability

Year: 2019, volume 15 Issue: №2 Pages: 283-286
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Shpinyak S.P., Galashina E.A., Babushkina I.V., Girkalo M.V., Kauts O.A., Grazhdanov K.A.
Organization:
Summary:

 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

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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.

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Combined osteoplasty of metaepiphysial defects in total knee arthroplasty with osteoplastic biomaterial

Year: 2012, volume 8 Issue: №4 Pages: 971-974
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Girkalo М.V., Gavrilov М.А., Kozlov V.V.
Organization:
Summary:

The research goal is to study the results of osteoplastic biomaterials application to reach the improvement of primary and long-term secondary stability of fixation. Materials and methods: 62 patients with bone defect of metaepiphy-sis of type 2 according to AORI have been included into the research. Total knee arthroplasty with osteoplasty of the defect has been carried out in all the patients. In the basic group (n=32) combined osteoplasty has been used, and in comparison group (n=30) cement osteoplasty has been applied. In cases with total arthroplasty in the basic group modifying standard resections, structural autograft of laminar form has been received simultaneously. After preparing the floor of the defect its plasty has been carried out: in the basic group the defect has been filled with osteoconductive biomaterial, and in the comparison group — with polymethylmethacrylate to restore the anatomical configuration of condyles. Besides, before cement fixation of the prosthesis in the basic group the received autograft has been put on the restored implant plateau. Results: Assessing the results during the period from 2 to 4 years objective criteria have included the data of X-ray imaging, biomechanical research and WOMAC test. In the postoperative period significant differences have not been revealed. In the follow-up period in the group with application of the combined osteoplasty joint remodulation of autograft and osteoplastic biomaterial with regenerative restoration of bone tissue of the implant plateau has been observed. Conclusion: The described technique may reduce the relative risk of revision arthroplasty.

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Total Knee Arthroplasty in the Combined Contracture

Year: 2009, volume 5 Issue: №3 Pages: 410-414
Heading: Traumatology and Orthopedics Article type: Original article
Authors: M.M Girkalo, М.А. Gavrilov, N.H. Bakteeva, O.J. Voskresensky, G.A. Korshunova, V.V. Kozlov
Organization: Saratov Scientific Research Institute of Traumatology and Orthopedics, Saratov State Medical University
Summary:

We have offered modified access to a knee to work out a method for restoration of extensive apparatus of the knee. 91 patients with degenerative damages of the knee were under out su-pervision. All patients were differentiated in groups according to the form of access and pa-thology of the knee. At all stages of studying the following method of investigation were made: goniometry — for estimation of the knee functional condition; electroneiromyography — for reveling deficiency of muscular activity and determination of its kind. Patient's satisfac-tion by operation was defined by means of WOMAC scale subjective indexes. The received digital material was subjected to statistical processing. Thus, it has been proved that applica-tion of the modified access to a knee offered by us in total knee arthroplasty in patients with combined contracture in comparison with traditionally applied technologies of extensive ap-paratus releasing allows in short terms to restore the volume and force of movements in a knee that reduces time of rehabilitation and improves quality of patient's life

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