Vol 22, No 1 (2015)

Articles
Nachal'nye etapy distraktsionnogo osteogeneza
Mironov S.P., Omel’yanenko N.P., Karpov I.N., Ivanov A.V., Khlystova A.V.
Abstract
Analysis of literature data dedicated to the study of distraction osteosynthesis is presented. In accordance with the ideas of the mechanisms of reparative regeneration in distraction osteosynthesis, the main factors responsible for the triggering of reparative regeneration are artificially created tissue “deficit” and tension-stress effect on the vascular network that was formed during the latent period. Consecutive local effect of growth factors and other peptide regulators provides sufficient level of reparative osteogenesis within the whole distraction period. The volume and quality of newly formed bone tissue depend upon the spatial and temporal characteristics of distraction as well as on the potentialities of concrete individual.
N.N. Priorov Journal of Traumatology and Orthopedics. 2015;22(1):6-11
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Comparison of Fibroarchitectonics and Strength Properties Preservation Criteria of Lyophilized Allografts with Different Type of Fibrous Framework
Shangina O.R., Khasanov R.A., Bulgakova L.A., Musina L.A.
Abstract
An overall estimation of the structure and strength properties of lyophilized connective tissue allografts from 73 cadavers of both sexes, aged from 20 to 50, was performed. Criteria for preservation of their fibroarchitectonics depending upon the type of the connective tissue fibrous framework and presence of the main substance were determined. It was shown that lyophilization process was accompanied by changes in architectonics and reduction of strength properties in allografts made of dense formed connective tissue with orientated (Achilles tendon) and mixed (dura mater, broad fascia) type of fibrous framework. A spatial non-orientated type of derma fibrous framework in weight bearing foot segments stipulated preservation of architectonics and plastic properties after lyophilization.
N.N. Priorov Journal of Traumatology and Orthopedics. 2015;22(1):12-17
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Experimental Modelling of the Processes for Connective Tissue Reparative Regeneration under Unfavorable Conditions
Vlasov M.V., Bugrov S.N., Bogos’yan A.B., Musukhina I.V.
Abstract
The purpose of the work was to elaborate experimental model for transverse tenotomy with intersection of facial membranes and mesenteric vessels as well as to study the process of connective tissue reparative regeneration under created conditions. Experiment was performed on 25 chinchilla rabbits of both sexes, aged 1 month with weight 1376 ± 124.8 g. Processes of Achilles tendon reparative regeneration was studied on days 15, 21, 30, 60 and 90 after operation. Histomorphologic study showed that within 30 days after tenotomy the substitution of defect zone with friable, reach in cells and gradually maturating fibrous tissue took place. By the end of day 60 a considerable part of the defect was substituted by dense fibrous connective tissue assumed a scar pattern. On day 90 after tenotomy a reverse development of the defect zone with focal substitution of dense fibrous tissue by friable unformed connective tissue containing histiocytes, lymphoid cells and inclusions of fatty tissue foci was observed. At that term histologic structure of the specimen showed its relatively low mechanical strength. The achieved data enabled to demonstrate that performance of tenotomy with traumatization of peritendinous tissues adversely affected the dynamics and pattern of reparative processes in the tendinosus defect zone.
N.N. Priorov Journal of Traumatology and Orthopedics. 2015;22(1):18-22
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Repair of Partial Thickness Articular Hyaline Cartilage Injuries with Multipotent Mesenchymal Stromal Bone Marrow Cells Transplantation in Rabbits
Chailakhyan R.K., Shekhter A.B., Tel’pukhov V.I., Ivannikov S.V., Gerasimov Y.V., Vorobieva N.N., Moskvina I.L., Bagratashvili V.N.
Abstract
Possibility of hyaline cartilage integrity restoration using multipotent mesenchymal stromal cells (MMSC) was studied on the rabbit model of partial thickness articular hyaline cartilage defect without subchondral plate damage. Size of defect made up 0.5 cm in diameter and 1.5 mm deep. Autologous bone marrow was harvested from the resected upper flaring portion of the ilium, single cell suspension was prepared and cultured in matrasses. Grown MMSC were centrifuged and the sediment was transferred into the cartilage defect. The cells were covered with either vicryl or gelatin sponge, or vicryl mesh. Histologic examination was performed in 4 months. It was shown that the most active regeneration of hyaline cartilage tissue, that substituted the largest part of a defect, was noted when MMSC were covered with vicryl mesh. One of the advantages of vicryl mesh use was that it neither protruded above the cartilaginous plate nor compressed the cells, and slowly resolved.
N.N. Priorov Journal of Traumatology and Orthopedics. 2015;22(1):23-27
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In Vitro Evaluation of the Composite Alginate - Calcium Phosphate Materials for Prototyping Technologies in Bone Defects Substitution
Sergeeva N.S., Komlev V.S., Sviridova I.K., Kirsanova V.A., Akhmedova S.A., Kuvshinova E.A., Fedotov A.Y., Teterina A.Y., Barinov S.M.
Abstract
Porous granular composite biomaterials based on sodium alginate and calcium phosphate component: 1% sodium alginate; sodium alginate with gelatin (80/20); calcium phosphate ceramics (CHA, TCP and OCP) and composite materials alginate/CHA, alginate/TCP, alginate/OCP, alginate/gelatin (80/20)/TCP and alginate/TCP/CHA/OCP were investigated for cytotoxicity and matrix (for cells) properties in dynamics of cultivation (up to 21 days). Two adhesive cell lines - immortalized human fibroblasts (HF, strain 1608 hTERT) and human osteosarcoma (MG-63) were used for in vitro MTT assay. OCP material showed its cytotoxicity while all its composites possessed weak matrix properties. For further research on the development of prototyping technologies 3 samples of composite materials were selected: alginate/CHA, alginate/TCP and alginate/gelatin (80/20)/TCP that are characterized by cytocompatibity and the presence of either expressed or moderate matrix properties of the surface for cells.
N.N. Priorov Journal of Traumatology and Orthopedics. 2015;22(1):28-34
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Efficacy of Gen-Activated Osteoplastic Material Based on Octacalcium Phosphate and Plasmid DNA containing vegf Gene for Critical-sized Bone Defects Substitution
Bozo I.Y., Deev R.V., Drobyshev A.Y., Komlev V.S., Rozhkov S.I., Eryomin I.I., Dalgatov I.G., Volozhin G.A., Grachyov V.I., Fedotov A.Y., Isaev A.A.
Abstract
Gene-activated osteoplastic materials are a principally new class of medical devices for bone plasty. The purpose of the study was to evaluate the biological action of the material based on octacalcium phosphate and plasmid DNA containing vascular endothelial growth factor (VEGF) gene. Study material was implanted into 10 mm diameter rabbit parietal bone defects. Formation of bone regenerates around material granules even in the center of the defect and the presence of bone marrow in intertrabecular space on day 60 after implantation was detected. In control group of animals - implantation of carrier without gene constructions - regeneration took place mainly on the bone defect margins. Use of gene-activated osteoplastic material resulted in pronounced osteoinduction that provided both acceleration of the regeneration and increase of new bone tissue formation intensity.
N.N. Priorov Journal of Traumatology and Orthopedics. 2015;22(1):35-42
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Hip Reconstruction with Demineralized Allografts in Revision Arthroplasty
Chekanov A.S., Voloshin V.P., Lekishvili M.V., Ochkurenko A.A., Martynenko D.V.
Abstract
Long term results of revision arthroplasty with hip joint reconstruction using demineralized allograft based on cranial vault flat bones are presented. Since 2005 nine patients (14 substitutions) aged from 46 to 67 years were operated on. Control of implanted material remodeling was performed in 12 months after surgery and then annually up to 8 years. No one case of implanted material suppuration was observed. Roentgenologic control showed relatively early remodeling of allografts in 1.5-2 years after intervention. Remodeling process was characterized by the increase of roentgenologic density in plasty site. Positive results were achieved 8 patients (13 substitutions) that made up 93%.
N.N. Priorov Journal of Traumatology and Orthopedics. 2015;22(1):43-46
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On the Safety of Osteoplastic Materials
Volkov A.V.
Abstract
Experimental and clinical studies of osteoplastic materials of various groups were performed. IT was shown that implantation of osteoplastic materials stipulated the development of chronic productive inflammation by the type of foreign body response while the process of bone formation in the regenerate containing osteoplastic material entailed resorption of newly formed bone tissue on its surface. Analysis of the reasons of low biocompatibility of the materials was performed and scheme for osteoplastic material safety and efficacy study planning was proposed.
N.N. Priorov Journal of Traumatology and Orthopedics. 2015;22(1):46-51
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Ordinary and Activated Osteoplastic Materials
Deev R.V., Drobyshev A.Y., Bozo I.Y.
Abstract
Osteoplastic materials are highly required medical devices for bone defects substitution and filling the areas of bone tissue atrophy. Based on analysis of modern groups of osteoplastic materials, features of their composition, mechanisms of biological action, and indications for clinical use, the applied classification which divides the medical items into ordinary and activated categories is proposed. The main differential criterion is the presence of certain biologically active components in the material composition: growth factors, cells or gene constructions encoding growth factors that are standardized by qualitative and quantitative parameters. Pronounced osteoinductive and (or) osteogenic properties of activated osteoplastic materials enable counting on their effectiveness in replacement of large bone defects.
N.N. Priorov Journal of Traumatology and Orthopedics. 2015;22(1):51-69
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Use of Dabigatran Etexilate for Prevention of Venous Thromboembolic Complications in Long Bone Fractures
Miromanov A.M.
Abstract
Complex dynamic examination of 68 patients with fractures of lower extremities long bones. In first comparative group (36 patients, mean age 36.3±1.4 years) prevention of thromboembolic complications was performed with parenteral direct anticoagulants followed by vitamin K antagonists. In second group (32 patients, mean age 39.3±2.0 years) dabigatran etexilate was used. Duration of anticoagulant therapy made up 30 days. It was noted that in fractures of long bones of the extremities application of dabigatran etexilate ensured effective, prognosticating, stable anticoagulant action and did not require routine control of coagulation parameters that enabled to recommend that drug for wider use in trauma and orthopaedic patients.
N.N. Priorov Journal of Traumatology and Orthopedics. 2015;22(1):70-75
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Skriningovaya diagnostika skolioza metodom komp'yuternoy stabilometrii
Davydov O.D., Montile A.I., Marchuk Y.V., Montile A.A.
Abstract
The study involved 47 young people aged 18 to 20 years. Among them, 11 people with previously diagnosed idiopathic scoliosis of the 1 st and 2 nd levels were the group "scoliosis", 36 persons without orthopedic and neurological disorders were the group "norm." A method of computed stabilometry was used. We obtained functional dependences that characterized the distribution of movement rate of foot pressure center on support surfaces in the frontal plane, which differed parametrically in both groups. Diagnostic feature, namely the number of movement intervals with the constant velocity of 0.02 seconds was identified, which allowed to include the subject in the scoliosis risk group. Clinical testing method was carried out in two groups of children aged 7-8 years. The first group, "scoliosis control", had 12 children with clinically confirmed diagnosis of the 1 st and 2 nd degrees idiopathic scoliosis. In the second group of "normal control" 12 children were without orthopedic and neurological disorders. The sensitivity of this method was 92%.
N.N. Priorov Journal of Traumatology and Orthopedics. 2015;22(1):76-80
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Surgical Treatment of Ledderhose Disease in Patient with Mucopolysaccharidosis Type I (Hurler-Sheie)
Koryshkov N.A., Mikhailova L.K., Khodjiev A.S.
Abstract
Case report of a 29 years old female patient with mucopolysaccharidosis type I and Ledderhose disease is presented. Examination of plantar surfaces showed tumor like protrusions up to 6.5 cm, of irregular shape and extremely painful at palpation, on both feet. Resection of plantar aponeurosis and fibrotic nodes on both feet was performed against a background of pathogenetic enzyme replacement therapy. No complications were observed in postoperative period. This case illustrates that in such patients performance of early surgical intervention at specialized departments is possible and reasonable, as it enables to restore weight bearing ability of the foot as well as significantly increases the quality of life.
N.N. Priorov Journal of Traumatology and Orthopedics. 2015;22(1):81-83
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Use of Rivaroxaban for Prevention of Thromboembolism after Major Joints Arthroplasty under Conditions of Real Clinical Practice in Russia (on the data of prospective multicenter non-interventional study SOPRANO)
Zagorodniy N.V., Bukhtin K.M.
Abstract
Results of first Russian local prospective multicenter observational study with participation of 2293 patients who received rivaroxaban for prevention of thromboembolism after major joints arthroplasty are presented. The study was performed under conditions of “real clinical practice”, i.e. without any changes in postoperative management. Demographic indices, prevalence of aggravating anamnestic factors that determined the risk of thromboembolism development, and adverse effects (AE) against the background of drug intake were studied. Interruptions of rivaroxaban intake were noted in 5% of patients. The number of AE made up 52 in 45 patients and only in 11 cases AE were associated with rivaroxaban intake. Drug efficacy and tolerance was assessed by physicians as excellent and good in 97.9% and 98.8% of patients, respectively. The overwhelming majority (98.4%) of patients appreciated the convenience of oral anticoagulant intake. It was stated that under conditions of the organizational peculiarities of medical care in Russia the efficacy of rivaroxaban was comparable to that, demonstrated in foreign studies.
N.N. Priorov Journal of Traumatology and Orthopedics. 2015;22(1):84-90
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Experimental Analysis of Strength Characteristics of Devices for Acetabular Osteosynthesis
Solod E.I., Lazarev A.F., Gavryushenko N.S., Fomin L.V., Sakharnykh I.N., Stoyukhin S.S.
Abstract
Three common elementary acetabular fractures, i.e. transverse fracture, fractures of anterior and posterior column, were simulated on plastic pelvis models. Comparative testing of three types of osteosynthesis - with reconstructive plate, cannulated screws and pins or using our new CITO flattened fine thread screws 3 mm in diameter were performed under similar conditions. Strength of cannulated screw and CITO screw was evaluated. Testing was performed on servo-hydraulic universal testing machine. The most stable fixation was achieved with cannulated screw and CITO screw. The latter was inferior in strength however ensured required rigid fixation.
N.N. Priorov Journal of Traumatology and Orthopedics. 2015;22(1):91-94
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