Pub Date : 2024-04-14DOI: 10.15674/0030-59872024138-42
K. Lyzohub, M. Lyzohub
Поєднання таких факторів як загальна анестезія та зміна положення тіла після індукції мають вплив на системну та церебральну гемодинаміку. Мета. Bиявити вплив зміни положення тіла та загальної анестезії на пікову систолічну швидкість внутрішньої сонної артерії (ПСШВСА) у пацієнтів під час проведення артроскопії. Методи. 85 пацієнтів із фізичним статусом за ASA I–II, середнього віку (33,0 ± 11,3) років, проведено артроскопію плечового суглоба під загальним наркозом. Основними вимірюваннями були систолічний артеріальний тиск (САТ), діастолічний артеріальний тиск (ДАТ), середній артеріальний тиск та ПСШВСА. Основні вимірювання: в положенні лежачи на столі перед індукцією, через 3 хв після введення в наркоз в положенні лежачи та в положенні пляжного крісла (ППК). Індукцію та забезпечення загальною анестезію проводили сибазоном, пропофолом і фентанілом. Дані проаналізовано статистично. Методи описової статистики використовували для розрахунку середнього, стандартного відхилення, мінімального і максимального значень вибірки. Порівняння проводили за допомогою Т-тесту для повторних порівнянь з розрахунком різниці середніх зі стандартним відхиленням (M ± SD), критичного значення критерію (t) та його статистичної значущості (p). Для порівняння динаміки зміни параметрів було проведено загальний лінійний аналіз з визначенням значення критерію Піллаї та його значення. Аналіз проводився в пакеті IBM SPSS Statistics 20.0. Результати. Початкові дані САТ, ДАТ та середнього артеріального тиску достовірно знижувались після індукції та після позиціонування, але індукція не вплинула на показник ПСШВСА. Після позиціювання до ППК було констатовано значне зниження показників ПСШВСА. Висновки. Констатовано достовірне зниження САТ, ДАТ, середнього артеріального тиску після индукції та подальшого позиціювання хворих у ППК. Постіндукційна гіпотензія не впливає на динаміку ПСШВСА, але виявлено достовірне її зниження після позиціювання.
{"title":"Systemic and cerebral hemodynamic changes in patients undergoing shoulder arthroscopy in the beach chair position","authors":"K. Lyzohub, M. Lyzohub","doi":"10.15674/0030-59872024138-42","DOIUrl":"https://doi.org/10.15674/0030-59872024138-42","url":null,"abstract":"Поєднання таких факторів як загальна анестезія та зміна положення тіла після індукції мають вплив на системну та церебральну гемодинаміку. Мета. Bиявити вплив зміни положення тіла та загальної анестезії на пікову систолічну швидкість внутрішньої сонної артерії (ПСШВСА) у пацієнтів під час проведення артроскопії. Методи. 85 пацієнтів із фізичним статусом за ASA I–II, середнього віку (33,0 ± 11,3) років, проведено артроскопію плечового суглоба під загальним наркозом. Основними вимірюваннями були систолічний артеріальний тиск (САТ), діастолічний артеріальний тиск (ДАТ), середній артеріальний тиск та ПСШВСА. Основні вимірювання: в положенні лежачи на столі перед індукцією, через 3 хв після введення в наркоз в положенні лежачи та в положенні пляжного крісла (ППК). Індукцію та забезпечення загальною анестезію проводили сибазоном, пропофолом і фентанілом. Дані проаналізовано статистично. Методи описової статистики використовували для розрахунку середнього, стандартного відхилення, мінімального і максимального значень вибірки. Порівняння проводили за допомогою Т-тесту для повторних порівнянь з розрахунком різниці середніх зі стандартним відхиленням (M ± SD), критичного значення критерію (t) та його статистичної значущості (p). Для порівняння динаміки зміни параметрів було проведено загальний лінійний аналіз з визначенням значення критерію Піллаї та його значення. Аналіз проводився в пакеті IBM SPSS Statistics 20.0. Результати. Початкові дані САТ, ДАТ та середнього артеріального тиску достовірно знижувались після індукції та після позиціонування, але індукція не вплинула на показник ПСШВСА. Після позиціювання до ППК було констатовано значне зниження показників ПСШВСА. Висновки. Констатовано достовірне зниження САТ, ДАТ, середнього артеріального тиску після индукції та подальшого позиціювання хворих у ППК. Постіндукційна гіпотензія не впливає на динаміку ПСШВСА, але виявлено достовірне її зниження після позиціювання.","PeriodicalId":137495,"journal":{"name":"ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS","volume":"171 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140706427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-14DOI: 10.15674/0030-59872024119-26
O. Barkov, V. Tuliakov, Valerija Aplevich
Objective. To investigate the peculiarities of the development of postoperative complications after surgical treatment of degenerative diseases of the lumbar spine with transpedicular fixation of the vertebrae and their relationship with changes in preoperative laboratory parameters. Methods. A retrospective analysis of the biochemical examination data of 35 patients with degenerative diseases of the lumbar spine who underwent discectomy with transpedicular fixation was performed. In four groups of patients with postoperative complications: 10 patients — inflammation of the what fabrics around metal structures and 5 patients — instability of the metal structure. The results of the examination of 20 people without specified complications served as a comparison group. Comparison was made with a control group (20 practically healthy people). Results. Patients have a significant increase in serum ALT activity by 42.29 and AST by 63.55 %, by 38.37 % of the level of CS content, by 37.21 % of total glycoproteins compared to those in the control group. In patients with soft tissue inflammation around the serum instrument zone, the content of LDLP was recorded by 29.27 %, by 23.53 % of the UA, by 12.34 % of TP results higher by 32.01 % ALT activity and 83 %, 49 % AST, 54.96 % AlP activity, 31.40 % — AlP/AcP, 60.47 % — concentration of CS, 95.57 % — total glycoproteins than in persons in the control group. In the serum of patients with the development of instability of metal structures, 28.55 % was observed by activity of the ALT, AlP — by 38.47 %, AcP — by 48.84 %, less by 58.35 % of AlP/AcP, the CHOL content of 13 88 %, higher by 25.43 % of the LDLP content than such persons in the control group. Content of the P was lower by 31.51 % and the Ca/P ratio was higher by 38.95 %, the content of CS by 83.72 %, total glycoproteins — by 48.83 %. Conclusions. Comparative analysis of the results of preoperative clinical and laboratory examination of patients with degenerative spinal diseases with transpedicular fixation which is reflected in the deviations of their preoperative laboratory parameters from such persons with uncomplicated course of the postoperative period after similar surgery.
{"title":"THE USE OF LABORATORY CRITERIA IN THE RISK ASSESSMENT OF POSTOPERATIVE COMPLICATIONS AFTER TRANSPEDICULAR FIXATION OF THE LUMBAR SPINE","authors":"O. Barkov, V. Tuliakov, Valerija Aplevich","doi":"10.15674/0030-59872024119-26","DOIUrl":"https://doi.org/10.15674/0030-59872024119-26","url":null,"abstract":"Objective. To investigate the peculiarities of the development of postoperative complications after surgical treatment of degenerative diseases of the lumbar spine with transpedicular fixation of the vertebrae and their relationship with changes in preoperative laboratory parameters. Methods. A retrospective analysis of the biochemical examination data of 35 patients with degenerative diseases of the lumbar spine who underwent discectomy with transpedicular fixation was performed. In four groups of patients with postoperative complications: 10 patients — inflammation of the what fabrics around metal structures and 5 patients — instability of the metal structure. The results of the examination of 20 people without specified complications served as a comparison group. Comparison was made with a control group (20 practically healthy people). Results. Patients have a significant increase in serum ALT activity by 42.29 and AST by 63.55 %, by 38.37 % of the level of CS content, by 37.21 % of total glycoproteins compared to those in the control group. In patients with soft tissue inflammation around the serum instrument zone, the content of LDLP was recorded by 29.27 %, by 23.53 % of the UA, by 12.34 % of TP results higher by 32.01 % ALT activity and 83 %, 49 % AST, 54.96 % AlP activity, 31.40 % — AlP/AcP, 60.47 % — concentration of CS, 95.57 % — total glycoproteins than in persons in the control group. In the serum of patients with the development of instability of metal structures, 28.55 % was observed by activity of the ALT, AlP — by 38.47 %, AcP — by 48.84 %, less by 58.35 % of AlP/AcP, the CHOL content of 13 88 %, higher by 25.43 % of the LDLP content than such persons in the control group. Content of the P was lower by 31.51 % and the Ca/P ratio was higher by 38.95 %, the content of CS by 83.72 %, total glycoproteins — by 48.83 %. Conclusions. Comparative analysis of the results of preoperative clinical and laboratory examination of patients with degenerative spinal diseases with transpedicular fixation which is reflected in the deviations of their preoperative laboratory parameters from such persons with uncomplicated course of the postoperative period after similar surgery.","PeriodicalId":137495,"journal":{"name":"ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS","volume":"69 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140704770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-14DOI: 10.15674/0030-59872024170-78
Olena Karpinska, A. Levytskyi, V. Pylypko
Funnel-shaped chest deformity is the most common anomaly of the chest wall development, occurring in 8 out of every 1 000 children. The defect is noticeable at birth in approximately 86 % of patients with chest deformity. Objective. To conduct a systematic review comparing the treatment of funnel-shaped chest deformity in children and young people under 20 years of age by surgical methods according to Ravitch and Nuss by the number of complications that occur in the short (up to 30 days) and long-term periods (2–3 years). Methods. A search of scientometric databases revealed 1 734 sources, of which 8 papers were selected for further analysis. Results. We evaluated systematic reviews and meta-analyses comparing methods of treatment of lumbar deformity in children and adolescents. It was determined that there are currently no randomized trials comparing these procedures in children and adolescents. A comparative analysis of the risk of complications in the surgical treatment of the funnel-shaped sternum in children and young adults using the Ravitch and Nuss methods determined that there is no difference in the overall incidence of complications between the Nuss and Ravitch procedures when considering the pediatric population in terms of overall, early, and late complications. With the development of the Nuss technology, complications associated with plate mixing are practically non-existent, and the development of new methods of controlling operations, anesthesia and further patient management has reduced the development of both postoperative and long-term complications. Conclusions. According to the results of the meta-analysis of the risk of early and late complications, it is impossible to definitively determine the advantage of any surgical method for the correction of lumbar deformity of the chest. The number of Nuss surgeries has been increasing over the years, which means that the minimally invasive approach is the method of choice for patients and surgeons, although questions remain about achieving structural stability and the method of Nuss correction in severe deformities. The lack of definitive conclusions is more related to the methodological problems of the analyzed data, including a limited number of observations and a large age difference in the observation groups, the lack of a standard for presenting data to describe the patient's condition (magnitude and type of deformity, primary complications of the cardiac and respiratory systems, the presence of complicating factors).
{"title":"META-ANALYSIS OF RAVITCH AND NUSS PROCEDURES FOR THE TREATMENT OF FUNNEL-SHAPED CHEST DEFORMITY IN CHILDREN AND ADOLESCENTS","authors":"Olena Karpinska, A. Levytskyi, V. Pylypko","doi":"10.15674/0030-59872024170-78","DOIUrl":"https://doi.org/10.15674/0030-59872024170-78","url":null,"abstract":"Funnel-shaped chest deformity is the most common anomaly of the chest wall development, occurring in 8 out of every 1 000 children. The defect is noticeable at birth in approximately 86 % of patients with chest deformity. Objective. To conduct a systematic review comparing the treatment of funnel-shaped chest deformity in children and young people under 20 years of age by surgical methods according to Ravitch and Nuss by the number of complications that occur in the short (up to 30 days) and long-term periods (2–3 years). Methods. A search of scientometric databases revealed 1 734 sources, of which 8 papers were selected for further analysis. Results. We evaluated systematic reviews and meta-analyses comparing methods of treatment of lumbar deformity in children and adolescents. It was determined that there are currently no randomized trials comparing these procedures in children and adolescents. A comparative analysis of the risk of complications in the surgical treatment of the funnel-shaped sternum in children and young adults using the Ravitch and Nuss methods determined that there is no difference in the overall incidence of complications between the Nuss and Ravitch procedures when considering the pediatric population in terms of overall, early, and late complications. With the development of the Nuss technology, complications associated with plate mixing are practically non-existent, and the development of new methods of controlling operations, anesthesia and further patient management has reduced the development of both postoperative and long-term complications. Conclusions. According to the results of the meta-analysis of the risk of early and late complications, it is impossible to definitively determine the advantage of any surgical method for the correction of lumbar deformity of the chest. The number of Nuss surgeries has been increasing over the years, which means that the minimally invasive approach is the method of choice for patients and surgeons, although questions remain about achieving structural stability and the method of Nuss correction in severe deformities. The lack of definitive conclusions is more related to the methodological problems of the analyzed data, including a limited number of observations and a large age difference in the observation groups, the lack of a standard for presenting data to describe the patient's condition (magnitude and type of deformity, primary complications of the cardiac and respiratory systems, the presence of complicating factors).","PeriodicalId":137495,"journal":{"name":"ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS","volume":"177 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140706584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-16DOI: 10.15674/0030-59872023487-92
Dmytro Zubov, Iurii Poliachenko, Oleksandr Kostrub, R. Blonskyi, O.M. Magomedov, Oleksii Dolgopolov, I. Zasadnyuk
Objective. To handle biotechnological aspects in manufacturing processes of three-dimensional living bone equivalent for restoration of critical sized bone defects for innovative treatment of combat-related casualties. Methods. To fabricate living bone equivalent we used devitalized xenogeneic bone scaffolds (DBM chips) and autologous fibrin hydrogel seeded with autologous cultured bone marrow-derived multipotent mesenchymal stem/stromal cells (BM-MSCs). Quality/identity control of cell cultures was assured by donor and cell culture infection screening (IFA, PCR), flow cytometry (cell phenotype), karyotyping (GTG banding), functional assays (CFU assay, multilineage differentiation assay). Results. The BM-MSC cultures had a normal karyotype and appropriate phenotype, multilinear differentiation potential and functional properties, appropriate CFU frequency and hadn’t any signs of cell senescence. The FDA/PI combined staining showed the demineralized bone chips’ regular seeding with viable cells. Conclusions. An actual regenerative medicine approach to organ-saving transplantation of the three-dimensional living bone equivalent for combat-related casualties requires further preclinical and clinical approbation for thorough studies on the bone integrity restoration, forming new bone tissue in a site of bone defect, and duration of rehabilitation period compared to the gold standard of the conventional bone defect cure.
{"title":"Biotechnological aspects of the working-out and manufacturing of living bone equivalent","authors":"Dmytro Zubov, Iurii Poliachenko, Oleksandr Kostrub, R. Blonskyi, O.M. Magomedov, Oleksii Dolgopolov, I. Zasadnyuk","doi":"10.15674/0030-59872023487-92","DOIUrl":"https://doi.org/10.15674/0030-59872023487-92","url":null,"abstract":"Objective. To handle biotechnological aspects in manufacturing processes of three-dimensional living bone equivalent for restoration of critical sized bone defects for innovative treatment of combat-related casualties. Methods. To fabricate living bone equivalent we used devitalized xenogeneic bone scaffolds (DBM chips) and autologous fibrin hydrogel seeded with autologous cultured bone marrow-derived multipotent mesenchymal stem/stromal cells (BM-MSCs). Quality/identity control of cell cultures was assured by donor and cell culture infection screening (IFA, PCR), flow cytometry (cell phenotype), karyotyping (GTG banding), functional assays (CFU assay, multilineage differentiation assay). Results. The BM-MSC cultures had a normal karyotype and appropriate phenotype, multilinear differentiation potential and functional properties, appropriate CFU frequency and hadn’t any signs of cell senescence. The FDA/PI combined staining showed the demineralized bone chips’ regular seeding with viable cells. Conclusions. An actual regenerative medicine approach to organ-saving transplantation of the three-dimensional living bone equivalent for combat-related casualties requires further preclinical and clinical approbation for thorough studies on the bone integrity restoration, forming new bone tissue in a site of bone defect, and duration of rehabilitation period compared to the gold standard of the conventional bone defect cure.","PeriodicalId":137495,"journal":{"name":"ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS","volume":" 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139619245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Upper and lower limb injuries resulting from battlefield trauma is a complex multidisciplinary problem. Efficacy of the treatment of segmental bone defects in patients with combat trauma is a subject of analysis for improving its results. Purpose. An analysis of the modern treatment strategies of the segmental bone defects in patients with battlefield trauma under conditions of distraction osteogenesis (based on data available in the literature and own clinical experience). Methods. Analytical review of scientific works and analysis of treatment results of 39 patients with segmental bone defects associated with battlefield trauma and treated using distraction osteogenesis were conducted. Results. Patients with segmental limbs defects require special attention of a multidisciplinary team of specialists to identify reconstructive opportunities to save the limb. Distraction osteogenesis — is an effective method of treating of segmental fractures and shortening of the limbs, infectious complications that led to bone defect formation. Bone transport with ring external fixator (ExFix) is considered as a classical method. Authors analyzed and illustrated with three clinical cases their own results of application of different distraction osteogenesis technique. Conclusions. Different types of ExFix can be applied independently or in combination with internal fixators. The use of an intramedullar nail along which distraction osteogenesis is carried out allows to provide better control of the axis of the limb and transported fragment, reduce the residence time in the ExFix, and, moreover, external fixation devices with a simpler configuration can be used. Transport along the plate allows to maintain proper axial relationships in the presence of short periarticular fragments and improve the quality of fixation but it also increases the risks of FRI and re-operations.
{"title":"EXPERIENCE OF THE SEGMENTAL BONE DEFECTS' TREATMENT FOR PATIENTS WITH COMBAT TRAUMA USING THE METHOD OF DISTRACTION OSTEOGENESIS","authors":"Serhiy Hariyan, Oleksandr Tsybulskyi, Vasyl Makhovskyi, Zoia Salii","doi":"10.15674/0030-59872023471-78","DOIUrl":"https://doi.org/10.15674/0030-59872023471-78","url":null,"abstract":"Upper and lower limb injuries resulting from battlefield trauma is a complex multidisciplinary problem. Efficacy of the treatment of segmental bone defects in patients with combat trauma is a subject of analysis for improving its results. Purpose. An analysis of the modern treatment strategies of the segmental bone defects in patients with battlefield trauma under conditions of distraction osteogenesis (based on data available in the literature and own clinical experience). Methods. Analytical review of scientific works and analysis of treatment results of 39 patients with segmental bone defects associated with battlefield trauma and treated using distraction osteogenesis were conducted. Results. Patients with segmental limbs defects require special attention of a multidisciplinary team of specialists to identify reconstructive opportunities to save the limb. Distraction osteogenesis — is an effective method of treating of segmental fractures and shortening of the limbs, infectious complications that led to bone defect formation. Bone transport with ring external fixator (ExFix) is considered as a classical method. Authors analyzed and illustrated with three clinical cases their own results of application of different distraction osteogenesis technique. Conclusions. Different types of ExFix can be applied independently or in combination with internal fixators. The use of an intramedullar nail along which distraction osteogenesis is carried out allows to provide better control of the axis of the limb and transported fragment, reduce the residence time in the ExFix, and, moreover, external fixation devices with a simpler configuration can be used. Transport along the plate allows to maintain proper axial relationships in the presence of short periarticular fragments and improve the quality of fixation but it also increases the risks of FRI and re-operations.","PeriodicalId":137495,"journal":{"name":"ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS","volume":" 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139618917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-16DOI: 10.15674/0030-598720234103-108
Yanina Golovina, O. Vyrva
Multicentric osteosarcoma (M-OGS) is classified as a special type of osteosarcoma, which is characterized by multicentric bone lesions without visceral organs involvement in the tumor process. Synchronous type of the lesion is noted when several foci of osteosarcoma are diagnosed at the same time, whereas metachronous type may develop additional foci 6 months after the primary tumor diagnosis. This type of osteosarcoma is very rare with only a few articles describing this pathology. Objective. Present a clinical case of rare pathology — multicentric osteosarcoma. Materials and methods. Clinical, radiological, pathomorphological data of a patient with multicentric osteosarcoma. Data on the results of treatment of the patient. Results. Multicentric osteosarcoma It accounts for about 1.5 % of all cases reported worldwide. Fuchs et al described a multifactorial etiology of this pathology, considering it a part of hereditary diseases, such as Rothmund-Thomson, Li-Fraumani, Bloom syndromes. Patients with Pagetʼs disease or McCuneAlbright syndrome have also been diagnosed with multicentric M-OGS. Tumor genetic predisposition has been described as one of the etiology factors, where a genetic mutation is detected. While studying the nature of multicentric M-OGS, various scientists have created classifications of this lesion. Taking to account all clinical and radiological data, a differential diagnosis comes to multiple metastatic lesions of carcinoma, chronic recurrent osteomyelitis and hyperphosphatasia. Conclusions. Multicentric osteosarcoma is a highly malignant and aggressive tumor that has a characteristic clinical presentation in the form of multiple bone lesions without visceral organs involvement. Mandatory patient monitoring after a comprehensive treatment allows to detect a spread of tumor process, as well as verify this rare pathology and choose the best treatment course.
{"title":"MULTICENTRIC OSTEOSARCOMA AS A RARE TYPE OF OSTEOSARCOMA (CASE REPORT)","authors":"Yanina Golovina, O. Vyrva","doi":"10.15674/0030-598720234103-108","DOIUrl":"https://doi.org/10.15674/0030-598720234103-108","url":null,"abstract":"Multicentric osteosarcoma (M-OGS) is classified as a special type of osteosarcoma, which is characterized by multicentric bone lesions without visceral organs involvement in the tumor process. Synchronous type of the lesion is noted when several foci of osteosarcoma are diagnosed at the same time, whereas metachronous type may develop additional foci 6 months after the primary tumor diagnosis. This type of osteosarcoma is very rare with only a few articles describing this pathology. Objective. Present a clinical case of rare pathology — multicentric osteosarcoma. Materials and methods. Clinical, radiological, pathomorphological data of a patient with multicentric osteosarcoma. Data on the results of treatment of the patient. Results. Multicentric osteosarcoma It accounts for about 1.5 % of all cases reported worldwide. Fuchs et al described a multifactorial etiology of this pathology, considering it a part of hereditary diseases, such as Rothmund-Thomson, Li-Fraumani, Bloom syndromes. Patients with Pagetʼs disease or McCuneAlbright syndrome have also been diagnosed with multicentric M-OGS. Tumor genetic predisposition has been described as one of the etiology factors, where a genetic mutation is detected. While studying the nature of multicentric M-OGS, various scientists have created classifications of this lesion. Taking to account all clinical and radiological data, a differential diagnosis comes to multiple metastatic lesions of carcinoma, chronic recurrent osteomyelitis and hyperphosphatasia. Conclusions. Multicentric osteosarcoma is a highly malignant and aggressive tumor that has a characteristic clinical presentation in the form of multiple bone lesions without visceral organs involvement. Mandatory patient monitoring after a comprehensive treatment allows to detect a spread of tumor process, as well as verify this rare pathology and choose the best treatment course. ","PeriodicalId":137495,"journal":{"name":"ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS","volume":"37 35","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139528585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-16DOI: 10.15674/0030-59872023479-86
V. Staude, Konstantyn Romanenko, Anna Staude
Rehabilitation treatment in the case of posttraumatic deformities of long bones of lower extremities (PDLBLE) in the distant period after trauma is aimed at the restoration of support ability of lower extremity while walking and standing. Objective. To work out the set of the exercises targeted on the restoration of muscle-stabilizer function in patients with (PDLBLE) Methods. Research group — 40 patients who received closed injuries of the long bones of the lower limbs, initial trauma occured 6–12 months ago. Among them were 21 women. (52.5 % of persons; age 27–73 years) and 19 men (47.5 % of people, age 29–77 years). The comparison group included 40 healthy volunteers, among which there were 12 women (30 % of persons; age 24–50 years) and 28 men (70 % of people, age 31–49 years). The assessment was carried out before and after rehabilitation for 2 weeks. Parameters evaluated: pain scores on VAS, the results of restoring the support ability using the scale of Tyazhelov O. A. Results. The results of observations are given, where in addition to descriptive statistics (minimum, maximum, average meanings), parameters of support ability and VAS, in patients and volunteers before and after treatment, cumulative group indicators (CG) were calculated for each group at the beginning (CG0) and 2 weeks after rehabilitation (CG1); the «rehabilitation» coefficient as a ratio of group indicators before and after treatment was calculated as well. Cumulative group indicator after rehabilitation (CG1) increased to 2 995 points, which indicates an increase in support ability. Cumulative group VAS score after rehabilitation (CG1) decreased to 116 points from 200 points before rehabilitation — reduction of pain in patients. After rehabilitation, volunteers showed a slight increase in the cumulatory group indicator (CG1) to 3 917 points. Conclusions. The system of rehabilitation of patients with PDLBLE in the remote period after injuries proved its effectiveness in restoring muscle-stabilizers vertical position of the trunk, pelvis, lower limbs and pain reduction.
{"title":"RECOVERY OF STABILIZING MUSCLES THAT PROVIDE A VERTICAL POSITION OF THE TRUNK IN PATIENTS WITH POST-TRAUMATIC DEFORMITIES OF THE LONG BONES OF THE LOWER LIMBS IN THE DISTANT PERIOD","authors":"V. Staude, Konstantyn Romanenko, Anna Staude","doi":"10.15674/0030-59872023479-86","DOIUrl":"https://doi.org/10.15674/0030-59872023479-86","url":null,"abstract":"Rehabilitation treatment in the case of posttraumatic deformities of long bones of lower extremities (PDLBLE) in the distant period after trauma is aimed at the restoration of support ability of lower extremity while walking and standing. Objective. To work out the set of the exercises targeted on the restoration of muscle-stabilizer function in patients with (PDLBLE) Methods. Research group — 40 patients who received closed injuries of the long bones of the lower limbs, initial trauma occured 6–12 months ago. Among them were 21 women. (52.5 % of persons; age 27–73 years) and 19 men (47.5 % of people, age 29–77 years). The comparison group included 40 healthy volunteers, among which there were 12 women (30 % of persons; age 24–50 years) and 28 men (70 % of people, age 31–49 years). The assessment was carried out before and after rehabilitation for 2 weeks. Parameters evaluated: pain scores on VAS, the results of restoring the support ability using the scale of Tyazhelov O. A. Results. The results of observations are given, where in addition to descriptive statistics (minimum, maximum, average meanings), parameters of support ability and VAS, in patients and volunteers before and after treatment, cumulative group indicators (CG) were calculated for each group at the beginning (CG0) and 2 weeks after rehabilitation (CG1); the «rehabilitation» coefficient as a ratio of group indicators before and after treatment was calculated as well. Cumulative group indicator after rehabilitation (CG1) increased to 2 995 points, which indicates an increase in support ability. Cumulative group VAS score after rehabilitation (CG1) decreased to 116 points from 200 points before rehabilitation — reduction of pain in patients. After rehabilitation, volunteers showed a slight increase in the cumulatory group indicator (CG1) to 3 917 points. Conclusions. The system of rehabilitation of patients with PDLBLE in the remote period after injuries proved its effectiveness in restoring muscle-stabilizers vertical position of the trunk, pelvis, lower limbs and pain reduction.","PeriodicalId":137495,"journal":{"name":"ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS","volume":"30 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139528685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-16DOI: 10.15674/0030-59872023498-102
Bohdan Romanyshyn, Alexander Schchurovsky, G. Ulrich Exner
Slipped capital femoral epiphysis (SCFE) is a hip condition that occurs in teens and preteens who are still growing. Treatment for SCFE involves surgery to stop the head of the femur from slipping any further. Without early detection and proper treatment, SCFE can lead to potentially serious complications, including rapid degeneration of the femoral head and/or painful arthritis in the hip joint. Objective. Our case is presented to familiarize with the technique of safe surgical hip dislocation for the treatment of intraarticular hip pathologies. Case report and Methods. After collision while playing the 11 year old girl developed left hippain still allowing to walk. Imaging documented an acute slipped femoral capital epiphysis with the metaphysis articulating against the acetabulum. The patient was underwent open reduction could be performed using the DUNN procedure modified by GANZ. 6 weeks later prophylactic screw stabilization of the healthy right hip followed. Results. At 9 months follow-up the patient walks painfree with symmetric range of motion. Conclusion. The goal of treatment is to prevent the mildly displaced femoral head from slipping any further. This is always accomplished through surgery. Early diagnosis of SCFE provides the best chance of stabilizing the hip and avoiding complications. When treated early and appropriately, long-term hip function can be expected to be very good. Once SCFE is confirmed, the child will not be allowed to put weight on their hip and will be admitted to the hospital. In most cases, surgery is performed within 24 to 48 hours. In patients with unstable SCFE, the surgeon may first make an open incision in the hip, then gently manipulate (reduce) the head of the femur back into its normal anatomic position. The surgeon will then insert one or two metal screws to hold the bone in place until the growth plate closes. Sometimes surgeon may recommend inserting a screw into the unaffected hip at the same time to reduce the risk of SCFE. Our case demonstrates the value of open reduction of a severely dislocated femoral capital epiphysis in a case otherwise probably needing endoprosthetic hip replacement for restitution of hip function or hip arthrodesis at short-term follow-up
股骨头骨骺滑脱（SCFE）是一种髋关节疾病，多发于仍在发育的青少年和学龄前儿童。治疗 SCFE 的方法包括通过手术阻止股骨头进一步滑动。如果不及早发现和正确治疗，SCFE 可能会导致严重的并发症，包括股骨头快速退化和/或髋关节疼痛性关节炎。目的。介绍我们的病例是为了让大家熟悉安全的髋关节脱位手术技术，以治疗髋关节内病变。病例报告和方法。11 岁的女孩在玩耍时发生碰撞，导致左侧髋关节疼痛，但仍能行走。影像学检查显示她患有急性股骨头骨骺滑脱，骨骺与髋臼相接。患者接受了由 GANZ 改良的 DUNN 手术。6 周后，对健康的右髋部进行预防性螺钉固定。手术结果。随访9个月后，患者行走无痛，活动范围对称。结论。治疗的目的是防止轻度移位的股骨头进一步滑动。这始终需要通过手术来实现。SCFE的早期诊断为稳定髋关节和避免并发症提供了最佳机会。如果早期治疗得当，髋关节的长期功能会非常好。一旦确诊为 SCFE，患儿的髋部就不能负重，必须住院治疗。大多数情况下，手术会在 24 到 48 小时内完成。对于不稳定的 SCFE 患者，外科医生可能会首先在髋部开一个切口，然后轻轻地将股骨头操作（缩小）到正常的解剖位置。然后，外科医生会插入一到两颗金属螺钉来固定骨骼，直到生长板闭合。有时，外科医生可能会建议同时在未受影响的髋部植入一颗螺钉，以降低发生 SCFE 的风险。我们的病例证明了股骨头骨骺严重脱位开放复位术的价值，否则可能需要进行人工髋关节置换术来恢复髋关节功能，或在短期随访时进行髋关节固定术。
{"title":"Сompletely slipped capital femoral epiphysis in an 11 year old girl successfully treated bu DUNN’s open reduction through GANZ’ surgical dislocation of the hip (clinical case)","authors":"Bohdan Romanyshyn, Alexander Schchurovsky, G. Ulrich Exner","doi":"10.15674/0030-59872023498-102","DOIUrl":"https://doi.org/10.15674/0030-59872023498-102","url":null,"abstract":"Slipped capital femoral epiphysis (SCFE) is a hip condition that occurs in teens and preteens who are still growing. Treatment for SCFE involves surgery to stop the head of the femur from slipping any further. Without early detection and proper treatment, SCFE can lead to potentially serious complications, including rapid degeneration of the femoral head and/or painful arthritis in the hip joint. Objective. Our case is presented to familiarize with the technique of safe surgical hip dislocation for the treatment of intraarticular hip pathologies. Case report and Methods. After collision while playing the 11 year old girl developed left hippain still allowing to walk. Imaging documented an acute slipped femoral capital epiphysis with the metaphysis articulating against the acetabulum. The patient was underwent open reduction could be performed using the DUNN procedure modified by GANZ. 6 weeks later prophylactic screw stabilization of the healthy right hip followed. Results. At 9 months follow-up the patient walks painfree with symmetric range of motion. Conclusion. The goal of treatment is to prevent the mildly displaced femoral head from slipping any further. This is always accomplished through surgery. Early diagnosis of SCFE provides the best chance of stabilizing the hip and avoiding complications. When treated early and appropriately, long-term hip function can be expected to be very good. Once SCFE is confirmed, the child will not be allowed to put weight on their hip and will be admitted to the hospital. In most cases, surgery is performed within 24 to 48 hours. In patients with unstable SCFE, the surgeon may first make an open incision in the hip, then gently manipulate (reduce) the head of the femur back into its normal anatomic position. The surgeon will then insert one or two metal screws to hold the bone in place until the growth plate closes. Sometimes surgeon may recommend inserting a screw into the unaffected hip at the same time to reduce the risk of SCFE. Our case demonstrates the value of open reduction of a severely dislocated femoral capital epiphysis in a case otherwise probably needing endoprosthetic hip replacement for restitution of hip function or hip arthrodesis at short-term follow-up","PeriodicalId":137495,"journal":{"name":"ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS","volume":" 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139618726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-16DOI: 10.15674/0030-598720234121-127
N. Diedukh, N. Grygorieva, A. Musiienko
Objective. To assess the impact of magnesium deficiency on bone metabolism based on an analytical analysis of current literature, as well as to systematize data on the impact of magnesium deficiency on the development of osteoporosis, bone regeneration, and to consider it as a risk factor for fracture. Methods. The review is based on the analysis of literature sources from PubMed, Scopus, Web of Science, Cochrane Library, Google, Google Scholar, and RLNS. The search was conducted by keywords: magnesium, deficiency, magnesium and bone tissue, magnesium and osteoporosis, magnesium and fractures, magnesium and bone regeneration. Results. Magnesium is a key element in the metabolic and regulatory processes of the body. Its effects on bone tissue are direct and indirect. The direct magnesium effect on genes involved in osteogenesis is accompanied by proliferation of mesenchymal stem cells and osteoblasts, but magnesium deficiency leads to their reduction and apoptosis. In case of magnesium deficiency, the number and activity of osteoclasts increases. Magnesium regulates bone mineralization in a concentration-dependent manner. Magnesium deficiency increases bone resorption and affects osteopenia and osteoporosis, which can occur indirectly through decreased vitamin D levels, increased biosynthesis of parathyroid hormone, increased oxidative stress and biosynthesis of proinflammatory cytokines. However, data on bone mineral density at different skeletal sites in magnesium deficiency are ambiguous. Magnesium deficiency is considered a risk factor for fracture. It is of great importance for bone regeneration, affecting in various ways: it stimulates the proliferation and differentiation of mesenchymal stem cells and osteoblasts, periosteum cells, increases the movement of osteoblasts to the area of traumatic bone injury, and activates signaling pathways. At the early stage of regeneration magnesium has a positive effect on macrophages, its specificity of action is inhibition of transformation of M2 macrophages into M1 at the tissue-specific stage of regeneration. One of the mechanisms stimulating regeneration may be the effect of magnesium on axons, release and increase of calcitonin-related polypeptide α. Conclusions. Since hypomagnesemia is a potentially modifiable factor, this opens up prospects for maintaining bone health and requires further research in this area.
目的根据对现有文献的分析，评估镁缺乏对骨代谢的影响，并系统整理有关镁缺乏对骨质疏松症发展、骨再生影响的数据，并将其视为骨折的风险因素。方法。本综述基于对来自 PubMed、Scopus、Web of Science、Cochrane Library、Google、Google Scholar 和 RLNS 的文献资料的分析。搜索关键词包括：镁、缺乏、镁与骨组织、镁与骨质疏松症、镁与骨折、镁与骨再生。研究结果镁是人体新陈代谢和调节过程中的关键元素。它对骨组织的影响有直接和间接之分。镁对参与成骨的基因的直接影响伴随着间充质干细胞和成骨细胞的增殖，但缺镁会导致它们的减少和凋亡。在缺镁的情况下，破骨细胞的数量和活性会增加。镁以浓度依赖的方式调节骨矿化。缺镁会增加骨吸收，影响骨质疏松症和骨质疏松症，这可通过维生素 D 水平下降、甲状旁腺激素生物合成增加、氧化应激和促炎细胞因子生物合成增加而间接发生。然而，有关镁缺乏症不同骨骼部位骨矿密度的数据并不明确。镁缺乏症被认为是骨折的风险因素之一。镁对骨再生具有重要意义，它以多种方式对骨再生产生影响：刺激间充质干细胞和成骨细胞、骨膜细胞的增殖和分化，增加成骨细胞向创伤性骨损伤区域的移动，激活信号通路。在再生的早期阶段，镁对巨噬细胞有积极作用，其特异性作用是在再生的特定组织阶段抑制 M2 型巨噬细胞转化为 M1 型。刺激再生的机制之一可能是镁对轴突的影响、降钙素相关多肽α的释放和增加。 结论。由于低镁血症是一个潜在的可调节因素，这为维持骨骼健康开辟了前景，需要在这一领域开展进一步研究。
{"title":"Effect of magnesium deficiency on bone health","authors":"N. Diedukh, N. Grygorieva, A. Musiienko","doi":"10.15674/0030-598720234121-127","DOIUrl":"https://doi.org/10.15674/0030-598720234121-127","url":null,"abstract":"Objective. To assess the impact of magnesium deficiency on bone metabolism based on an analytical analysis of current literature, as well as to systematize data on the impact of magnesium deficiency on the development of osteoporosis, bone regeneration, and to consider it as a risk factor for fracture. Methods. The review is based on the analysis of literature sources from PubMed, Scopus, Web of Science, Cochrane Library, Google, Google Scholar, and RLNS. The search was conducted by keywords: magnesium, deficiency, magnesium and bone tissue, magnesium and osteoporosis, magnesium and fractures, magnesium and bone regeneration. Results. Magnesium is a key element in the metabolic and regulatory processes of the body. Its effects on bone tissue are direct and indirect. The direct magnesium effect on genes involved in osteogenesis is accompanied by proliferation of mesenchymal stem cells and osteoblasts, but magnesium deficiency leads to their reduction and apoptosis. In case of magnesium deficiency, the number and activity of osteoclasts increases. Magnesium regulates bone mineralization in a concentration-dependent manner. Magnesium deficiency increases bone resorption and affects osteopenia and osteoporosis, which can occur indirectly through decreased vitamin D levels, increased biosynthesis of parathyroid hormone, increased oxidative stress and biosynthesis of proinflammatory cytokines. However, data on bone mineral density at different skeletal sites in magnesium deficiency are ambiguous. Magnesium deficiency is considered a risk factor for fracture. It is of great importance for bone regeneration, affecting in various ways: it stimulates the proliferation and differentiation of mesenchymal stem cells and osteoblasts, periosteum cells, increases the movement of osteoblasts to the area of traumatic bone injury, and activates signaling pathways. At the early stage of regeneration magnesium has a positive effect on macrophages, its specificity of action is inhibition of transformation of M2 macrophages into M1 at the tissue-specific stage of regeneration. One of the mechanisms stimulating regeneration may be the effect of magnesium on axons, release and increase of calcitonin-related polypeptide α. Conclusions. Since hypomagnesemia is a potentially modifiable factor, this opens up prospects for maintaining bone health and requires further research in this area.","PeriodicalId":137495,"journal":{"name":"ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS","volume":" 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139618927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-16DOI: 10.15674/0030-59872023436-42
V. Filipenko, Stanislav Bondarenko, F. Leontyeva, V. Tuliakov, O. Vysotskyi
Predicting the risk of developing thrombotic complications is an extremely important task when planning total arthroplasty of large joints (TAJ). Objective. Based on the retrospective analysis of the results of the biochemical examination of patients with degenerative diseases of large joints before and after TAJ, determine the changes in the markers of the hemostasis system and inflammatory processes, which are the most informative for the preoperative prediction of the development of hypercoagulable conditions. Methods. In the blood serum of 39 patients with degenerative diseases of the hip and knee joints of III–IV stages according to Kellgren–Lawrence before and after TAJ, the following were investigated: prothrombin time, international normalized ratio (INR); the content of fibrinogen, soluble fibrin-monomeric complexes (SFMC), D-dimer, antithrombin III, glycoproteins (GP), sialic acids, C-reactive protein (SRP), seroglycoides, haptoglobin; activated partial thrombin time (APTT), fibrinolytic activity (FA). The control group consisted of 30 practically healthy donors. The results. Before TAJ, the serum content of GP patients was 28.80 % higher than the control indicators; haptoglobin — by 20.00; CRP — 82.88; SFMC — 33.60; fibrinogen — 60.32; D-dimer — 41.04 %. The INR was reduced by 25.40 %, the content of antithrombin III — by 21.90 %, FA slowed down by 63.00 %. After TAJ, the content of total HP in the blood serum ofpatients exceeded the indicator of the control group by 55.80 %, sialic acids by 35.60 %; seroglycoides — 55.26; haptoglobin — 61.42; CRP — 151.33 %. An additional reduction of 10.58 %, prothrombin time, APTT — by 15.40 %, antithrombin III activity — 19.10 %, increase in fibrinogen content — 34.90 % was observed; D-dimer — 25.10; SFMC — 36.18; prolongation of FA time — by 29.30 %. Conclusions. To prevent the development of thrombophilic conditions after TES, it is necessary to monitor the most informative markers: increase in FA time, content of fibrinogen, D-dimer, SFMC and haptoglobin.
在规划大关节全关节成形术（TAJ）时，预测发生血栓并发症的风险是一项极其重要的任务。研究目的基于对大关节退行性疾病患者在 TAJ 手术前后生化检查结果的回顾性分析，确定止血系统和炎症过程标志物的变化，这些标志物对术前预测高凝状态的发生最有参考价值。研究方法对 39 名髋关节和膝关节退行性疾病（根据 Kellgren-Lawrence 分级为 III-IV 期）患者在 TAJ 手术前后的血清中的以下指标进行了调查：凝血酶原时间、国际标准化比率（INR）；纤维蛋白原、可溶性纤维蛋白单体复合物（SFMC）、D-二聚体、抗凝血酶 III、糖蛋白（GP）、硅酸、C 反应蛋白（SRP）、血清凝血酶原、血红蛋白的含量；活化部分凝血酶时间（APTT）、纤维蛋白溶解活性（FA）。对照组由 30 名身体健康的供体组成。研究结果在接受 TAJ 治疗前，GP 患者的血清含量比对照组指标高 28.80%；血红蛋白高 20.00%；CRP 高 82.88%；SFMC 高 33.60%；纤维蛋白原高 60.32%；D-二聚体高 41.04%。INR降低了25.40%，抗凝血酶III含量降低了21.90%，FA降低了63.00%。TAJ 治疗后，患者血清中的总 HP 含量比对照组指标高出 55.80 %，硅酸高出 35.60 %，血清糖苷酸高出 55.26 %，血红蛋白高出 61.42 %，CRP 高出 151.33 %。此外，还观察到凝血酶原时间减少了 10.58%，APTT 减少了 15.40%，抗凝血酶 III 活性减少了 19.10%，纤维蛋白原含量增加了 34.90%；D-二聚体减少了 25.10%；SFMC 减少了 36.18%；FA 时间延长了 29.30%。结论为防止 TES 后出现血栓嗜性情况，有必要监测最有参考价值的指标：FA 时间的延长、纤维蛋白原含量、D-二聚体、SFMC 和血红蛋白。
{"title":"CHANGES IN INDICATORS OF THE COAGULATION SYSTEM AND MARKERS OF INFLAMMATION IN THE BLOOD OF PATIENTS WITH DEGENERATIVE DISEASES OF LARGE JOINTS IN THE CASE OF TOTAL ARTHROPLASTY","authors":"V. Filipenko, Stanislav Bondarenko, F. Leontyeva, V. Tuliakov, O. Vysotskyi","doi":"10.15674/0030-59872023436-42","DOIUrl":"https://doi.org/10.15674/0030-59872023436-42","url":null,"abstract":"Predicting the risk of developing thrombotic complications is an extremely important task when planning total arthroplasty of large joints (TAJ). Objective. Based on the retrospective analysis of the results of the biochemical examination of patients with degenerative diseases of large joints before and after TAJ, determine the changes in the markers of the hemostasis system and inflammatory processes, which are the most informative for the preoperative prediction of the development of hypercoagulable conditions. Methods. In the blood serum of 39 patients with degenerative diseases of the hip and knee joints of III–IV stages according to Kellgren–Lawrence before and after TAJ, the following were investigated: prothrombin time, international normalized ratio (INR); the content of fibrinogen, soluble fibrin-monomeric complexes (SFMC), D-dimer, antithrombin III, glycoproteins (GP), sialic acids, C-reactive protein (SRP), seroglycoides, haptoglobin; activated partial thrombin time (APTT), fibrinolytic activity (FA). The control group consisted of 30 practically healthy donors. The results. Before TAJ, the serum content of GP patients was 28.80 % higher than the control indicators; haptoglobin — by 20.00; CRP — 82.88; SFMC — 33.60; fibrinogen — 60.32; D-dimer — 41.04 %. The INR was reduced by 25.40 %, the content of antithrombin III — by 21.90 %, FA slowed down by 63.00 %. After TAJ, the content of total HP in the blood serum ofpatients exceeded the indicator of the control group by 55.80 %, sialic acids by 35.60 %; seroglycoides — 55.26; haptoglobin — 61.42; CRP — 151.33 %. An additional reduction of 10.58 %, prothrombin time, APTT — by 15.40 %, antithrombin III activity — 19.10 %, increase in fibrinogen content — 34.90 % was observed; D-dimer — 25.10; SFMC — 36.18; prolongation of FA time — by 29.30 %. Conclusions. To prevent the development of thrombophilic conditions after TES, it is necessary to monitor the most informative markers: increase in FA time, content of fibrinogen, D-dimer, SFMC and haptoglobin.","PeriodicalId":137495,"journal":{"name":"ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS","volume":"52 47","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139527582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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