Open Access Open Access  Restricted Access Access granted  Restricted Access Subscription or Fee Access

Vol 23, No 3 (2016)

Articles
Dislocations of the Femoral Component of Hip Implant: Determination of Spatial Relative Position of Components
Pavlov V.V., Prokhorenko V.M.
Abstract
Dislocation of the femoral component is a common complication of total hip arthroplasty. In 44% of cases it results from the incorrect position of implant components. The aim of the study was to evaluate the efficacy of the elaborated method for determination of implant components position at preoperative planning of revision hip arthroplasty in recurrent dislocations of the femoral component. Thirty patients aged 25 - 75 years with recurrent femoral component dislocation after primary hip arthroplasty were examined. To verify the dislocation a plain anterior-posterior roentgenogram of pelvis was performed followed by MSCT of pelvis, femoral bones and knee joints. Drawing up of necessary lines and angles enabled to evaluate objectively the correctness of hip implant components position. By measurement results all patients were divided into 3 groups and in each group an appropriate type of surgical intervention was used. The proposed methods of preoperative planning enabled to determine objectively the cause of femoral component dislocation, to choose an adequate variant of surgical intervention and to exclude the risk of femoral component dislocation recurrence in 96.7% of cases.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(3):5-10
views
Total Knee Arthroplasty Outcomes Depending on the Degree 11 of Angular Deformity
Zykin A.A., Malyshev E.E., Pavlov D.V., Korolyov S.B.
Abstract
The analysis of total knee arthroplasty results was performed in 106 patients operated on for III stage of deforming gonarthrosis. All patients were divided into 2 groups depending on the presence of the angular extremity axis deformity. Clinical and functional assessment was performed using visual analog scale, Joseph & Kaufman scale, SF-36 questionnaire. Treatment results were evaluated in 3, 6 months and 1, 3, 5 years after intervention. In the group of patients with axial leg deformity the duration of surgical intervention, intraoperative blood loss and postoperative hospitalization period were higher than in patients with normal leg axis but the differences were not significant. The height of the implant insert was 12 (8-14) mm with normal axis and 14 (14-15) mm with axial deformity ( p =0.000187). Correction of the leg axis during arthroplasty required larger bone cuts and soft tissue release but the parameters characterizing leg axis normalization did not differ statistically significant between the groups. However in 5 years after intervention the patients with normal lower extremity axis showed reliably better results by all scales and questionnaires.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(3):11-15
views
New Approaches to Systematization and Treatment of Impression Monocondylar Tibial Plateau Fractures
Gilev M.V., Volokitina E.A., Antoniadi Y.V., Kutepov S.M.
Abstract
Treatment results for 109 patients (mean age 56 ± 1.7 years) with monocondylar impression tibial plateau fractures (ITPF) are presented. Patients from the control group (n=63) were operated on during the period from 2008 to 1010, patients from the main group (n=46) - from 2011 to 2013. Patients from the main group were treated with regard for injury localization relative to plateau center according to proposed operational classification of impression fractures (by CT data) and algorithm to choose the osteosynthesis technique depending on the anatomic and morphologic peculiarities of the intra-articular injury. In patients from the main group the evaluation by Rasmussen scale 36 months after intervention showed excellent results in 15 (38.4%), good - in 22 (56.4%), satisfactory - in 5 (12.8%) of patients, no poor results were recorded, and in patients from the control group - in 6 (11.5%), 8 (15.3%), 36 (69.3%) and 3 (5,8%) patients, respectively. Three (7.6%) complications (secondary displacement of fragments (2), knee contracture (1)) were observed in the main group, and 11 (20.9%) in the control group (20.9%) - local infectious inflammatory process (4), secondary displacement of plateau fragments (6), condylar sag (1). Perfected tactics of treatment of patients with ITPF enabled to achieve 3.48 times more excellent and good results (p<0.05).
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(3):16-22
views
Potentialities of Platelet-Rich Plasma Use in Treatment of Knee Osteoarthrosis
Khalimov E.V., Savel’ev S.N., Khalimov A.E., Nuriev R.F., Ochkurenko A.A.
Abstract
Results of the use of platelet-rich plasma (PRP) in patients with knee osteoarthrosis are presented. The study included 86 patients with I-III degree of knee osteoarthrosis (141 knee joints). All patients received 2 intraarticular injections of PRP with 14 days interval. Pain severity was assessed by visual analog scale in 6 and 12 months after treatment. The most significant positive dynamics was observed in patients with II degree - 50.6±2.32, 16.3±2.31 ( р <0,5) and 16.3±2.40 points initially and in 6 and 12 months, respectively. In III degree, despite the aggravation of symptoms by 12th month, the value of pain severity was better than the initial one, i.e. 79.3±2.32 vs 64.6±2.40 points initially and in 12 months, respectively (p<0.01). The received data confirm the efficacy PRP in treatment of early degrees of knee osteoarthrosis and perspective of future studies in that field.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(3):23-27
views
Auto Preservation and Use of Auto Rib at Two-Step Surgical Treatment of Spine Deformities
Kolesov S.V., Sazhnev M.L., Snetkov A.A., Kaz’min A.I.
Abstract
The possibility of preservation and use of a resected rib for dorsal fusion at final correction of spinal deformity was studied. Treatment results for 80 patients aged 15 to 45 years, with severe spine deformity (scoliosis or kyphoscoliosis) were analyzed. In all patients two step surgical interventions was performed. Either transpedicular or hybrid (screws and sublaminar cerclage) fixation of the vertebral column were performed in 37 and 43 cases, respectively. After ventral release the resected ribs were stitched to subcutaneous fatty tissue and preserved until the time of final dorsal correction. The follow-up period made up 1 - 2 years. Fusion formation and autograft reconstruction was confirmed by radiologic methods. It was shown that rib auto preservation technique was a simple one, did not require special preservation conditions and allowed to preserve sufficient volume of autograft for final spinal deformity correction.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(3):28-32
views
Biochemical Changes in Tissues and Synovial Fluid of Hip Joint in Congenital and Degenerative-Dystrophic Diseases in Children and Adolescents
Kozhevnikov O.V., Kralina S.E., Furtseva L.N., Bogdanova I.A., Savost’yanova N.M.
Abstract
Results of biochemical analysis of hip tissues (femoral head cartilage, proximal femur bone tissue, scarry tissue from hip cavity) and synovial fluid in 72 children and adolescents (aged 1 - 18 years) with congenital and pathologic hip dislocation, Legg-Calve-Perthes disease, femoral head aseptic necrosis and early coxarthrosis are presented. In tissue samples the content of hydroxyproline, hexuronic acids and hexoses was determined. In synovial fluid the content of hyaluronic acid, total protein and protein fractions, albumin, glucose and alkaline phosphatase activity was analyzed. It was detected that in congenital and acquired hip pathology the articular cartilage showed increased content of hydroxyproline, disorders of glycosaminoglycan metabolism and shift in glycoprotein metabolism indicative of destructive changes of basic cartilaginous tissue substance. Changes of synovial fluid chemical composition confirmed the disturbance of synovium permeability and were closely related to the clinical picture of metabolic-dystrophic changes in the joint.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(3):33-40
views
Effect of Baby Walkers on the Development of Locomotor Skills in Infants
Sharov A.N., Krivova A.V.
Abstract
A retrospective cohort study of the effect of baby walkers on the locomotor skills in children was performed. The study included 358 infants aged 11 to 15 months. To simplify the calculation we introduced the “walkers-day” index that was equal to 1 hour of walkers use per day for 1 month. The delay of non-assisted locomotion for 0.33 months (10.04 days) was observed in all walkers’ users and for 0.43 months in babies who used walkers within the interval of 1-21 “walkers-days”. It was stated that use of walkers was a risk factor of walking inability at the age of 11-12 months (Pearson coefficient (C) = 0.110, p<0.05; relative risk (RR) = 1.439 (95% confidence interval (CI) 1.027-2.016) and caused the increase of lower extremity extensors tonus (C=0.417, p<0.01; RR=3.555 (95% CI = 2.535-4.990). The obtained data allow to state that baby walkers exert a negative influence on locomotor development and to abandon their use.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(3):40-46
views
Optimization of Approaches to the Prevention of Thromboembolic Complications after Total Hip Arthroplasty
Borisova L.V., Nikolaev N.S., Dobrovol’skaya N.Y., Vuimo T.A., Orlova A.V., Kachaeva Z.A., Didichenko S.N.
Abstract
To choose the optimum scheme of anticoagulant therapy for the prevention of thromboembolic complications after total hip arthroplasty 86 patients were examined. The patients were randomly divided into 3 groups. In group 1 (n=29) prevention of thromboembolic complications was performed by subcutaneous injection of enoxaparin (40 mg) started 12 hours before the surgery. In group 2 (n=28) enoxaparin (40 mg) was started 12 hours after surgical intervention. In those groups thromboprophylaxis with enoxaparin was continued during hospitalization period and at discharge the patients were given recommendations to take dabigatran etexilate up to 35 days. In group 3 (n=29) patients received oral dabigatran etexilate, 110 mg 1 - 4 hours after surgery, followed by 220 mg once-daily both at hospital and out-patient stage of treatment. The average duration of hospitalization made up 8.9±1.2 days. Minimum fibrinogen and D-dimer levels as well as maximum APTT values were observed in patients from group 3 on the 5th postoperative day. Thromboelastogram showed that on day 5 both plasma and platelet hypocoagulation were most expressed in 3rd group. Preoperative thrombodynamics showed high rate of clot growth and high percentage of spontaneous clots formation in all three groups that assumed initial hypercoagulation with maximum decrease of the frequency of spontaneous clots formation against the background of dabigatran prophylaxis. The lowest number (3,4%) of thromboembolic complications, i.e. distal thromboses, were observed in patients from dabigatran etexilate group. Assessment of anticoagulant prophylaxis costs showed a clear advantage of the 3rd group.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(3):46-52
views
Modern Methods of Visualization in Diagnosis, Staging and Elaboration of Treatment Tactics for Primary Malignant Bone Tumors. Part I
Machak G.N., Morozov A.K., Snetkov A.I., Karpov I.N., Kochergina N.V., Bludov A.B., Ryzhkov A.D.
Abstract
At present the oncologists have great potentialities in diagnostic techniques that enable to determine not only the structural but functional characteristics of the tumor as well. The use of modern technologies of medical visualization for diagnosis, determination of the disease stage and effectiveness of neoadjuvant chemotherapy in patients with bone sarcomas of high degree (G3-G4) malignancy is presented.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(3):53-62
views
Early Diagnosis and Treatment of Patients with Mucopolysaccharidosis IV and VI
Mikhailova L.K., Sokolova T.V., Polyakova O.A.
Abstract
Mucopolysaccharidosis (MPS) is an orphan pathology characterized by polymorphism of clinical manifestations and development of typical skeletal changes. However in early childhood the clinical picture is not clear that leads to misdiagnosis and results in inadequate management of patients including unjustified surgical intervention. Early clinical and roentgenologic changes specific to mucopolysaccharidosis IV and VI that enable to suspect the pathology development, to perform required examination with compulsory confirmation by DNA testing results and prescribe vital enzyme replacement therapy as soon as possible are presented. Early diagnosis and initiation of etiotropic treatment and timely correction of the occurring pathology ensure prevention of fatal complications.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(3):63-70
views
Treatment of Knee Medial Osteoarthrosis Using Open Corrective Osteotomy of the Tibia
Prizov A.P., Kopylov A.A., Epstein A.A., Lazko F.L., Kubashev A.A., Belyak E.A., Zagorodniy N.V., Kulikova O.I.
Abstract
Treatment results using high open corrective tibial osteotomy with tricalcium phosphate block (OTIS 50) and fixation by angle-stable mini plate (OTIS C PLUS) are presented for a 47 years old female patient with 3rd stage gonarthrosis. Evaluation of functional condition was performed by Joseph and Kaufman scale that made up 72 and 95 points before and 3 years after surgery, respectively. Control knee arthroscopy and histologic examination results showed partial restoration offibrous hyaline cartilage in the injured knee compartment.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(3):71-74
views
Use of Rivaroxaban for Prevention of Venous Thromboembolic Complications in Elderly Patients after Hip Arthroplasty
Afanas’ev A.P., Kardanov A.A., Karandin A.S., Korolev A.V.
Abstract
Results of retrospective analysis of the efficacy and safety of venous thromboembolic complications prevention using anticoagulants (low-molecular-weight heparins and rivaroxaban) in elderly (over 75 years) patients after hip arthroplasty are presented. Ninety four patients were divided into 2 groups (n=47) depending on the applied anticoagulant. Follow up period was 6 months after hospitalization. Asymptomatic thrombosis was diagnosed by duplex ultrasonography only in 1 (2.1%) patient from low-molecular-weight heparin group. No one case of either bleeding or hemorrhage was recorded. It is stated that rivaroxaban ensured effective thromboprophylaxis and safety after hip arthroplasty in elderly patients when no restrictions related to the use of low-molecular-weight heparin injections are present.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(3):74-77
views
Efficacy and Safety of Two-Level Brachial Plexus Block at Locking Intramedullary Shoulder Osteosynthesis
Dubinenkov V.B., Lyuboshevskiy P.A., Larionov S.V., Koryshkov N.A., Shushpanova E.V.
Abstract
Results of the comparative study of the efficacy and safety of one- and two-level brachial plexus block (BPB) at locking intramedullary shoulder osteosynthesis are presented. Fifty five patients (mean age 43.4±3.2 years) with humeral diaphysis fracture were operated on. In the main group of patients (n=28) two-level BPB was performed: interscalene block was combined with supraclavicular brachial plexus block and superficial brachial plexus block (SBPB). In control group (n=27) one-level interscalene and superficial BPB and SBPB were performed. Severity of pain syndrome was assessed by visual analog scale. It was shown that two-level BPB ensured better anesthetic, postoperative analgesic effect and higher percent of successful regional anesthesias as well as decreased the requirement in narcotic analgesics on the first postoperative day. The number of complications did not differ significantly between the groups.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(3):78-80
views
Spontaneous Resorption of Intervertebral Disc Herniations
Kuleshov A.A., Krupatkin A.I., Murav’yova N.V.
Abstract
The data on the possibility of intervertebral disc herniation regress at terms from 3 to 12 months are presented. Immune response of the organism and the factor of peripheral fibrous ring neovascularization play an important role in the process of disc herniation resorption. Transligamentous and sequesteredherniations are resorbed better than the subligamentous ones. To intensify the intervertebral disc herniation resorption it is necessary to activate microcirculation of the injured spinal motion segment.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(3):81-89
views
views
Book review “Simulation training in neurosurgery” by V.A. Byval’tsev, E.G. Belykh
Hernesniemi J., Kivelev J.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(3):90-91
views
Organization of Russian Joint Implants Production - Import Subtituting Project
- -.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(3):92-93
views
O.A. Malakhov
- -.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(3):94-94
views

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies