Leonid I. Malyuchenko, Nikolay S. Nikolaev, Vadim V. Yakovlev, Elena V. Preobrazhenskaya
The aim of the study to evaluate the antibacterial activity and biological compatibility of alloy coatings based on two-dimensionally ordered linear chain carbon (TDOLCC) and medium-term results of treatment of periprosthetic infection with their use. Materials and Methods. Coatings based on TDOLCC were synthesized using alloying additions like nitrogen (TDOLCC+N) and silver (TDOLCC+Ag) on the surfaces of titanium plates and polystyrene plates by the ion-stimulated carbon condensation in a vacuum. The authors examined the superficial bactericidal activity of the coatings and its resistance to mechanical effects. The rate of formation of microbial biofilms by clinical isolates with multiple and extreme resistance to antibiotics was assessed by staining the samples with a solution of crystal violet. The cytotoxic effect of the coatings was evaluated in relation to the primary culture of fibroblasts and keratinocyte cells of the HaCaT line. Results. The authors observed pronounced superficial bactericidal effect of TDOLCC+Ag coating in respect of microorganisms of several taxonomic groups independently of their resistance to antibacterial drugs. TDOLCC+Ag coating proved capable to completely prevent microbial biofilm formation by antibiotic resistant clinical isolates of S. aureus and P. aeruginosa. Silvercontaining coating demonstrated mechanical resistance and preservation of close to baseline level of superficial bactericidal activity even after lengthy abrasion treatment. TDOLCC based coatings did not cause any cytotoxic effects. Structure of monolayers formed in cavities coated by TDOLCC+N and TDOLCC+Ag was indistinguishable from the monolayers in cavities of control plates. Conclusions. The high anti-film activity of DU LCC+Ag coatings was proved in experiment and clinical practice at the follow-up stage. The use of a spacer with a test coating allows you to quickly eliminate the inflammatory process, significantly reduce the number of relapses of PJI in cases of CS and TB infections, and reduce the number of hospital stay days. Evaluation of the mid-term results of PJI treatment gives grounds to predict active protection of the implant surface from colonization by microorganisms and the formation of microbial biofilms, which, together with drug antibiotic prophylaxis, provides a good therapeutic and prophylactic effect on the recurrence of periprosthetic infection.
{"title":"Medium-term results of the treatment of periprosthetic infection with carbon-coated spacers impregnated with silver","authors":"Leonid I. Malyuchenko, Nikolay S. Nikolaev, Vadim V. Yakovlev, Elena V. Preobrazhenskaya","doi":"10.17816/2311-2905-7997","DOIUrl":"https://doi.org/10.17816/2311-2905-7997","url":null,"abstract":"The aim of the study to evaluate the antibacterial activity and biological compatibility of alloy coatings based on two-dimensionally ordered linear chain carbon (TDOLCC) and medium-term results of treatment of periprosthetic infection with their use. Materials and Methods. Coatings based on TDOLCC were synthesized using alloying additions like nitrogen (TDOLCC+N) and silver (TDOLCC+Ag) on the surfaces of titanium plates and polystyrene plates by the ion-stimulated carbon condensation in a vacuum. The authors examined the superficial bactericidal activity of the coatings and its resistance to mechanical effects. The rate of formation of microbial biofilms by clinical isolates with multiple and extreme resistance to antibiotics was assessed by staining the samples with a solution of crystal violet. The cytotoxic effect of the coatings was evaluated in relation to the primary culture of fibroblasts and keratinocyte cells of the HaCaT line. Results. The authors observed pronounced superficial bactericidal effect of TDOLCC+Ag coating in respect of microorganisms of several taxonomic groups independently of their resistance to antibacterial drugs. TDOLCC+Ag coating proved capable to completely prevent microbial biofilm formation by antibiotic resistant clinical isolates of S. aureus and P. aeruginosa. Silvercontaining coating demonstrated mechanical resistance and preservation of close to baseline level of superficial bactericidal activity even after lengthy abrasion treatment. TDOLCC based coatings did not cause any cytotoxic effects. Structure of monolayers formed in cavities coated by TDOLCC+N and TDOLCC+Ag was indistinguishable from the monolayers in cavities of control plates. Conclusions. The high anti-film activity of DU LCC+Ag coatings was proved in experiment and clinical practice at the follow-up stage. The use of a spacer with a test coating allows you to quickly eliminate the inflammatory process, significantly reduce the number of relapses of PJI in cases of CS and TB infections, and reduce the number of hospital stay days. Evaluation of the mid-term results of PJI treatment gives grounds to predict active protection of the implant surface from colonization by microorganisms and the formation of microbial biofilms, which, together with drug antibiotic prophylaxis, provides a good therapeutic and prophylactic effect on the recurrence of periprosthetic infection.","PeriodicalId":43463,"journal":{"name":"Travmatologiya i ortopediya Rossii","volume":"121 27","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135138020","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 : 2023-10-25DOI: 10.17816/2311-2905-15531
Nikita Zadneprovskiy, Pavel A. Ivanov, Vladislav V. Kulikov, Yana B. Vladimirova
Abstract
Background. The rapid development of modern surgical methods for the treatment of pelvic bone fractures has revealed the need to develop a new terminological apparatus, since the classical anatomical terminology of the pelvis no longer meets the demands of today's therapeutic and scientific processes. The classical set of anatomical names and landmarks does not allow for a detailed description of all the nuances of injuries and new complex surgical techniques.
Aim of the study is to develop names for some parts of the bones of the pelvis and its regions, which to date do not have their own designations, and to propose the developed terms for professional discussion.
Material and Methods. We analyzed radiologic and CT studies in 150 patients with pelvic bone injury during 2020-2022. A list of potential new anatomical terms was compiled using a systematic literature review and consultation with leading experts in pelvic surgery.
Results. New terms have been developed to designate the pelvic regions and their injuries.
Conclusion. The introduction of new anatomical terms into clinical practice helps to improve the accuracy of diagnosis and planning of pelvic surgery. Standardization of terminology also promotes uniformity of approaches and exchange of experience between medical specialists, which contributes to the quality of surgical practice.
{"title":"SUGGESTIONS FOR INTRODUCING SOME NEW TERMS IN PELVIC AND ACETABULAR SURGERY","authors":"Nikita Zadneprovskiy, Pavel A. Ivanov, Vladislav V. Kulikov, Yana B. Vladimirova","doi":"10.17816/2311-2905-15531","DOIUrl":"https://doi.org/10.17816/2311-2905-15531","url":null,"abstract":"Abstract
 Background. The rapid development of modern surgical methods for the treatment of pelvic bone fractures has revealed the need to develop a new terminological apparatus, since the classical anatomical terminology of the pelvis no longer meets the demands of today's therapeutic and scientific processes. The classical set of anatomical names and landmarks does not allow for a detailed description of all the nuances of injuries and new complex surgical techniques.
 Aim of the study is to develop names for some parts of the bones of the pelvis and its regions, which to date do not have their own designations, and to propose the developed terms for professional discussion.
 Material and Methods. We analyzed radiologic and CT studies in 150 patients with pelvic bone injury during 2020-2022. A list of potential new anatomical terms was compiled using a systematic literature review and consultation with leading experts in pelvic surgery.
 Results. New terms have been developed to designate the pelvic regions and their injuries.
 Conclusion. The introduction of new anatomical terms into clinical practice helps to improve the accuracy of diagnosis and planning of pelvic surgery. Standardization of terminology also promotes uniformity of approaches and exchange of experience between medical specialists, which contributes to the quality of surgical practice.","PeriodicalId":43463,"journal":{"name":"Travmatologiya i ortopediya Rossii","volume":"24 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135113587","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 : 2023-10-18DOI: 10.17816/2311-2905-11174
Evgeniy Sergeevich Golovenkin, Leonid Nikolaevich Solomin
Relevance Multiapical deformities (MD) of the lower limbs - there're hard and widespread orthopedic pathology. Unfortunaly, there're not found any works with a comprehensive assessment of modern views on the problem of treating patients with multiapical deformities of long bones.
Purpose. Using the world literature, to identify the modern position, problems and prospectives of the correction of multialical deformities of the lower limbs.
Methods. PubMed, SAGE Publishing Journals, Embase, MEDLINE, eLIBRARY, КиберЛенинка, Google Scholar resources were used. At analyzis several criterial were used: diagnostic, planning and approaches of correction of the multiapical deformities.
Results. Terms "multiapical deformity" and "multilevel deformity" used as a synonymes. At the same time, term "multilevel deformity" is used to refer to uniapical deformities of different limb segments. The main diagnostic sign of multiapical deformity is the location of the apex outside the bone. In MD planning uses the axis of the middle/intermediate fragment(s). Most authors define it as the middiaphyseal line. Correction of multiapical deformities can be realyzed acute or gradual. Acute correction is more comfortable for the patient. If there are contraindications, it's performed gradually using "Ilizarov hinges" or orthopedic hexapods.
Conclusion. Term "multiapical deformity" is more correct for using to definity the researced pathology. The main diagnostic sign of MD is not absolute and requires clarification. When planning a correction, there are difficulties in the case of using mechanical axes, as well as when it is necessary to determine the axis of a non-linear middle fragment. The "spring technique" of using an orthopedic hexapod has significant advantages, but it's necessary to clarification the optimal characteristics of the elastic rods (springs), the points of their fixation to the frame and method of using the hexapod computer program. The solution of these problems will improve the efficiency of treatment of patients with multiapical deformities.
{"title":"Correction of multiapical deformities of the lower libs: Review","authors":"Evgeniy Sergeevich Golovenkin, Leonid Nikolaevich Solomin","doi":"10.17816/2311-2905-11174","DOIUrl":"https://doi.org/10.17816/2311-2905-11174","url":null,"abstract":"Relevance Multiapical deformities (MD) of the lower limbs - there're hard and widespread orthopedic pathology. Unfortunaly, there're not found any works with a comprehensive assessment of modern views on the problem of treating patients with multiapical deformities of long bones.
 Purpose. Using the world literature, to identify the modern position, problems and prospectives of the correction of multialical deformities of the lower limbs.
 Methods. PubMed, SAGE Publishing Journals, Embase, MEDLINE, eLIBRARY, КиберЛенинка, Google Scholar resources were used. At analyzis several criterial were used: diagnostic, planning and approaches of correction of the multiapical deformities.
 Results. Terms \"multiapical deformity\" and \"multilevel deformity\" used as a synonymes. At the same time, term \"multilevel deformity\" is used to refer to uniapical deformities of different limb segments. The main diagnostic sign of multiapical deformity is the location of the apex outside the bone. In MD planning uses the axis of the middle/intermediate fragment(s). Most authors define it as the middiaphyseal line. Correction of multiapical deformities can be realyzed acute or gradual. Acute correction is more comfortable for the patient. If there are contraindications, it's performed gradually using \"Ilizarov hinges\" or orthopedic hexapods.
 Conclusion. Term \"multiapical deformity\" is more correct for using to definity the researced pathology. The main diagnostic sign of MD is not absolute and requires clarification. When planning a correction, there are difficulties in the case of using mechanical axes, as well as when it is necessary to determine the axis of a non-linear middle fragment. The \"spring technique\" of using an orthopedic hexapod has significant advantages, but it's necessary to clarification the optimal characteristics of the elastic rods (springs), the points of their fixation to the frame and method of using the hexapod computer program. The solution of these problems will improve the efficiency of treatment of patients with multiapical deformities.","PeriodicalId":43463,"journal":{"name":"Travmatologiya i ortopediya Rossii","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135884588","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 : 2023-09-15DOI: 10.17816/2311-2905-13226
Aymen Riahi, Igor I. Shubnyakov, Andrei P. Sereda, Mahomed A. Cherkasov, Ilhom E. Khujanazarov, Rashid M. Tikhilov
Background. According to the analysis of large arthroplasty registers we have noted the increase in the use of non-cemented implants, because the latter shows the same results of implant survival as well as cemented implants. On the other hand, they can affect the quality of the bone around the implant in different ways. These components differ in shape, length, and surface properties. According to the analysis of the arthroplasty register of the Vreden National Medical Research Center of Traumatology and Orthopedics, a significant decrease of the Alloclassic femoral stem using can be noted. In parallel the use of its SL-PLUS MIA modification has increased significantly.
Aims of the study: 1) to determine the influence of changes in the design of the Zweymller-type femoral stem on midterm and long-term outcomes and its survival; 2) to identify the characteristics of adaptive remodeling of periprosthetic bone tissue around these femoral stems; 3) to determine risk factors for aseptic loosening of these femoral stems.
Methods. 492 cases of hip arthroplasty using the Alloclassic and SL-PLUS MIA femoral stems were observed, with an average follow-up 78.6 months. The patients were divided into 2 groups according to the type of femoral stem. The assessment the hip articulation condition was carried out using the HHS and OHS. The intensity of the pain syndrome was assessed by VAS, and the level of patients satisfaction. The dynamic analysis of X-rays was also performed visually.
Results. A significant improvement in clinical and functional results was observed according to the HHS and OHS in both groups of patients, regardless of the type of femoral stem. Analysis of X-rays over time showed differences in the behavior of these two femoral component models. The radiolucent lines around the femoral stem are absent in SL-PLUS MIA group, in Alloclassic stem group radiolucent lines are present even at a minimal period (12 months). We also found that a tight fit of Zweymller femoral stems in the distal shaft is a risk factor for severe stress-shielding syndrome, especially in the funnel channels. But ceteris paribus, a distal tight fit of SL-PLUS MIA stems despite similar geometry of the distal part does not lead to such frequent manifestation of severe stress shielding.
Conclusion. The change in Zweymller stem design from Alloclassic to SL-PLUS MIA improved the nature of adaptive remodeling in the periprosthetic area of the femur. It may improve the long-term results of primary hip arthroplasty, but these differences require closer observation.
{"title":"Impact of Zweymüller Stem Modification on Clinical and Radiological Outcomes","authors":"Aymen Riahi, Igor I. Shubnyakov, Andrei P. Sereda, Mahomed A. Cherkasov, Ilhom E. Khujanazarov, Rashid M. Tikhilov","doi":"10.17816/2311-2905-13226","DOIUrl":"https://doi.org/10.17816/2311-2905-13226","url":null,"abstract":"Background. According to the analysis of large arthroplasty registers we have noted the increase in the use of non-cemented implants, because the latter shows the same results of implant survival as well as cemented implants. On the other hand, they can affect the quality of the bone around the implant in different ways. These components differ in shape, length, and surface properties. According to the analysis of the arthroplasty register of the Vreden National Medical Research Center of Traumatology and Orthopedics, a significant decrease of the Alloclassic femoral stem using can be noted. In parallel the use of its SL-PLUS MIA modification has increased significantly.
 Aims of the study: 1) to determine the influence of changes in the design of the Zweymller-type femoral stem on midterm and long-term outcomes and its survival; 2) to identify the characteristics of adaptive remodeling of periprosthetic bone tissue around these femoral stems; 3) to determine risk factors for aseptic loosening of these femoral stems.
 Methods. 492 cases of hip arthroplasty using the Alloclassic and SL-PLUS MIA femoral stems were observed, with an average follow-up 78.6 months. The patients were divided into 2 groups according to the type of femoral stem. The assessment the hip articulation condition was carried out using the HHS and OHS. The intensity of the pain syndrome was assessed by VAS, and the level of patients satisfaction. The dynamic analysis of X-rays was also performed visually.
 Results. A significant improvement in clinical and functional results was observed according to the HHS and OHS in both groups of patients, regardless of the type of femoral stem. Analysis of X-rays over time showed differences in the behavior of these two femoral component models. The radiolucent lines around the femoral stem are absent in SL-PLUS MIA group, in Alloclassic stem group radiolucent lines are present even at a minimal period (12 months). We also found that a tight fit of Zweymller femoral stems in the distal shaft is a risk factor for severe stress-shielding syndrome, especially in the funnel channels. But ceteris paribus, a distal tight fit of SL-PLUS MIA stems despite similar geometry of the distal part does not lead to such frequent manifestation of severe stress shielding.
 Conclusion. The change in Zweymller stem design from Alloclassic to SL-PLUS MIA improved the nature of adaptive remodeling in the periprosthetic area of the femur. It may improve the long-term results of primary hip arthroplasty, but these differences require closer observation.","PeriodicalId":43463,"journal":{"name":"Travmatologiya i ortopediya Rossii","volume":"110 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135486679","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}
Irina Kirilova, Vadim N. Golnik, Vladimir Peleganchuk, Yuriy Batrak, Vitaliy Pavlov
Background. For many years, the main reasons for revision surgeries after hip arthroplasty remain aseptic loosening and osteolysis, which lead to formation of bone defects of various size and localization. Given the relatively young age of patients undergoing revision, the methods of biological restoration of the bone tissue, such as impaction bone grafting (IBG), are of particular interest.
Aim of the report to demonstrate the delayed outcome of impaction bone grafting using compacted morselized bone allograft.
Case presentation. Complicated clinical case of a 62-year-old patient with Paprosky type IIA bone deficiency in the acetabulum and Paprosky type II bone deficiency in the proximal femur with aseptic loosening of the acetabular and femoral components of the hip prosthesis is presented. During revision arthroplasty with cemented components, IBG of the acetabulum and femur was performed with a reconstructive mesh augmentation of the acetabulum using Stryker X-Change technology. Bone allograft prepared with the use of heat disinfection method served as an osteoplastic material. Follow-up period was 4 years. Control X-rays demonstrate restoration of the center of rotation of the hip, presence of bone masses in the areas of pelvic and femoral bone defects, absence of osteoplastic material resorption and migration of implants during the follow-up period. Clinical assessment shows an improvement of the Harris Hip Score from 34 to 85 points.
Conclusion. Obtained results showed the efficacy of impaction bone grafting with the bone allograft prepared with the use of heat disinfection method in the mid-term period.
{"title":"A CLINICAL CASE OF IMPACT BONE PLASTY IN THE REPLACEMENT OF DEFECTS IN THE ACETABULUM AND FEMORAL COMPONENT DURING REVISION HIP ENDOPROSTHETICS","authors":"Irina Kirilova, Vadim N. Golnik, Vladimir Peleganchuk, Yuriy Batrak, Vitaliy Pavlov","doi":"10.17816/2311-2905-8008","DOIUrl":"https://doi.org/10.17816/2311-2905-8008","url":null,"abstract":"Background. For many years, the main reasons for revision surgeries after hip arthroplasty remain aseptic loosening and osteolysis, which lead to formation of bone defects of various size and localization. Given the relatively young age of patients undergoing revision, the methods of biological restoration of the bone tissue, such as impaction bone grafting (IBG), are of particular interest.
 Aim of the report to demonstrate the delayed outcome of impaction bone grafting using compacted morselized bone allograft.
 Case presentation. Complicated clinical case of a 62-year-old patient with Paprosky type IIA bone deficiency in the acetabulum and Paprosky type II bone deficiency in the proximal femur with aseptic loosening of the acetabular and femoral components of the hip prosthesis is presented. During revision arthroplasty with cemented components, IBG of the acetabulum and femur was performed with a reconstructive mesh augmentation of the acetabulum using Stryker X-Change technology. Bone allograft prepared with the use of heat disinfection method served as an osteoplastic material. Follow-up period was 4 years. Control X-rays demonstrate restoration of the center of rotation of the hip, presence of bone masses in the areas of pelvic and femoral bone defects, absence of osteoplastic material resorption and migration of implants during the follow-up period. Clinical assessment shows an improvement of the Harris Hip Score from 34 to 85 points.
 Conclusion. Obtained results showed the efficacy of impaction bone grafting with the bone allograft prepared with the use of heat disinfection method in the mid-term period.","PeriodicalId":43463,"journal":{"name":"Travmatologiya i ortopediya Rossii","volume":"237 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135353407","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 : 2023-09-15DOI: 10.17816/2311-2905-15522
Tatyana Nikolayevna Erivantseva, Svetlana Yurievna Tuzova, Nikolay Borisovich Lyskov, Yulia Valeryevna Blokhina, Anna Andreevna Isamova
High incidence of injuries, diseases of musculoskeletal system and connective tissue leads to a high demand for modern high-tech materials in the area of orthopedics and traumatology. Development of russian materials is an extremely relevant issue, especially under conditions of restricted supply of foreign products to the Russian Federation. Creation of new products and their subsequent launch to the market require comprehensive protection of unique information about the design, composition or production/manufacturing technology of the product. Analysis of patenting domestic solutions for trauma and orthopedic surgery in the Russian Federation has shown that there are various risks associated with the commercialization of national products. For example, russian developers in a number of cases neglect patent protection of their developments, which puts successful developments at risk of unauthorized copying or claims from other market players. On the other hand, patenting strategy of domestic developers for their products in most cases contains a number of errors, such as narrow bounds of patent protection due to incorrectly drafted patent claims. For example, these can be in formulations that can be easily bypassed in case of commercial interest in the product, preferential patenting of technological processes, lack of comprehensive patent protection of the product. Such patenting errors make the development unattractive for investors and manufacturers, which leads to low commercializability of russian inventions. Thus, russian developers, who have significant scientific potential and competencies to create highly effective national products, do not proceed with technology transfer and cannot bring their promising and in-demand products to the market.
{"title":"ORTHOPEDICS IN THE FOCUS OF INTELLECTUAL PROPERTY","authors":"Tatyana Nikolayevna Erivantseva, Svetlana Yurievna Tuzova, Nikolay Borisovich Lyskov, Yulia Valeryevna Blokhina, Anna Andreevna Isamova","doi":"10.17816/2311-2905-15522","DOIUrl":"https://doi.org/10.17816/2311-2905-15522","url":null,"abstract":"High incidence of injuries, diseases of musculoskeletal system and connective tissue leads to a high demand for modern high-tech materials in the area of orthopedics and traumatology. Development of russian materials is an extremely relevant issue, especially under conditions of restricted supply of foreign products to the Russian Federation. Creation of new products and their subsequent launch to the market require comprehensive protection of unique information about the design, composition or production/manufacturing technology of the product. Analysis of patenting domestic solutions for trauma and orthopedic surgery in the Russian Federation has shown that there are various risks associated with the commercialization of national products. For example, russian developers in a number of cases neglect patent protection of their developments, which puts successful developments at risk of unauthorized copying or claims from other market players. On the other hand, patenting strategy of domestic developers for their products in most cases contains a number of errors, such as narrow bounds of patent protection due to incorrectly drafted patent claims. For example, these can be in formulations that can be easily bypassed in case of commercial interest in the product, preferential patenting of technological processes, lack of comprehensive patent protection of the product. Such patenting errors make the development unattractive for investors and manufacturers, which leads to low commercializability of russian inventions. Thus, russian developers, who have significant scientific potential and competencies to create highly effective national products, do not proceed with technology transfer and cannot bring their promising and in-demand products to the market.","PeriodicalId":43463,"journal":{"name":"Travmatologiya i ortopediya Rossii","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135352939","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 : 2023-09-15DOI: 10.17816/2311-2905-14793
Alexander I. Avdeev, Dmitrii G. Parfeev, Danil D Parshin, Ekaterina V. Sinitsyna
Background. Fracture of the distal clavicle fracture associated with a coracoid process fracture is extremely rare in the practice of an orthopedic surgeon. Therefore, there is no common approach to the treatment of patients with this type of bone injuries of the shoulder girdle.
Aim of the study to demonstrate positive experience of conservative treatment of the coracoid process fracture combined with hook plate fixation for distal clavicle fracture.
Case presentation. We present a rare clinical case of a closed distal clavicle fracture associated with coracoid process fracture. Trauma occurred when the patient fell down the stairs on his abducted upper limb. After examination, the distal clavicle fracture was fixed with a hook plate. Intraoperatively, X-rays showed a satisfactory position of the coracoid process of the scapula. Therefore, it was decided not to fix it additionally. CT scans three months after the surgery showed bone fragments consolidation. Removal of the hook plate and screws from the clavicle was performed.
Conclusion. Presented clinical case illustrates successful treatment result of this type of fractures without fixation of the coracoid process fracture. The hook plating allows to stabilize bone fragments and restore ligament tension, which makes this implant non-alternative for fixation of this type of injuries.
{"title":"Coracoid Process Fracture Associated With a Distal Clavicle Fracture: A Case Report","authors":"Alexander I. Avdeev, Dmitrii G. Parfeev, Danil D Parshin, Ekaterina V. Sinitsyna","doi":"10.17816/2311-2905-14793","DOIUrl":"https://doi.org/10.17816/2311-2905-14793","url":null,"abstract":"Background. Fracture of the distal clavicle fracture associated with a coracoid process fracture is extremely rare in the practice of an orthopedic surgeon. Therefore, there is no common approach to the treatment of patients with this type of bone injuries of the shoulder girdle.
 Aim of the study to demonstrate positive experience of conservative treatment of the coracoid process fracture combined with hook plate fixation for distal clavicle fracture.
 Case presentation. We present a rare clinical case of a closed distal clavicle fracture associated with coracoid process fracture. Trauma occurred when the patient fell down the stairs on his abducted upper limb. After examination, the distal clavicle fracture was fixed with a hook plate. Intraoperatively, X-rays showed a satisfactory position of the coracoid process of the scapula. Therefore, it was decided not to fix it additionally. CT scans three months after the surgery showed bone fragments consolidation. Removal of the hook plate and screws from the clavicle was performed.
 Conclusion. Presented clinical case illustrates successful treatment result of this type of fractures without fixation of the coracoid process fracture. The hook plating allows to stabilize bone fragments and restore ligament tension, which makes this implant non-alternative for fixation of this type of injuries.","PeriodicalId":43463,"journal":{"name":"Travmatologiya i ortopediya Rossii","volume":"184 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135353433","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 : 2023-09-15DOI: 10.17816/2311-2905-12024
Vladimir Klimov, Roman Khalepa, Evgeniya Amelina, Alexei Evsukov, Alexei Krivoshapkin, Sergei Ryabykh
Background. The choice of the method and options for surgical treatment of degenerative pathology of the lumbar spine is difficult due to the lack of clear clinical and radiological criteria for diagnosis and a direct correlation between the severity of the radiological manifestations of the disease and clinical symptoms.
The aim of this study was to analyze the clinical and neurological characteristics of elderly patients with degenerative disorders of the lumbar spine and to identify the dominant clinical and radiologic syndromes.
Methods. Сohort of 1013 patients were operated using MIS technologies (decompression alone, TLIF, LLIF, ALIF) in the period 20132017 (367 male/646 female). The age range is 60-89 years (mean 66 years). The criteria for identifying the leading syndromes: leg pain/back pain with a threshold value of 5 points according to VAS, X-ray criteria for clinical instability by A.A. White and M.M. Panjabi (value 5 points), Cobb angle 10, markers of sagittal imbalance: Index Barrey (II and III), PT increase above target values, L4-S1 and LL deficiency.
Results. Symptoms of compression were identified in 97% of patients. Radiculopathy syndrome was detected in 665 (66%) patients with mean leg pain 7 points, neurogenic intermittent claudication in 319 (31%) patients. Degenerative spondylolisthesis according to radiological criteria was detected in 428 (42%) patients. Degenerative scoliotic deformity had 91 (9%) patients. In accordance with the proposed criteria, the dominant compression syndrome was determined in 624 patients (62%), clinical instability syndrome in 338 (33%), deformity syndrome with sagittal imbalance in 51 (5%).
Conclusion. Syndromic assessment of clinical, neurological and radiological manifestations of degenerative disorders provides the possibility of identifying the dominant syndrome requiring operative surgical treatment and a differentiated approach to choosing the optimal surgical option.
{"title":"Syndromic assessment of degenerative disorders of the lumbar spine in elderly patients","authors":"Vladimir Klimov, Roman Khalepa, Evgeniya Amelina, Alexei Evsukov, Alexei Krivoshapkin, Sergei Ryabykh","doi":"10.17816/2311-2905-12024","DOIUrl":"https://doi.org/10.17816/2311-2905-12024","url":null,"abstract":"Background. The choice of the method and options for surgical treatment of degenerative pathology of the lumbar spine is difficult due to the lack of clear clinical and radiological criteria for diagnosis and a direct correlation between the severity of the radiological manifestations of the disease and clinical symptoms.
 The aim of this study was to analyze the clinical and neurological characteristics of elderly patients with degenerative disorders of the lumbar spine and to identify the dominant clinical and radiologic syndromes.
 Methods. Сohort of 1013 patients were operated using MIS technologies (decompression alone, TLIF, LLIF, ALIF) in the period 20132017 (367 male/646 female). The age range is 60-89 years (mean 66 years). The criteria for identifying the leading syndromes: leg pain/back pain with a threshold value of 5 points according to VAS, X-ray criteria for clinical instability by A.A. White and M.M. Panjabi (value 5 points), Cobb angle 10, markers of sagittal imbalance: Index Barrey (II and III), PT increase above target values, L4-S1 and LL deficiency.
 Results. Symptoms of compression were identified in 97% of patients. Radiculopathy syndrome was detected in 665 (66%) patients with mean leg pain 7 points, neurogenic intermittent claudication in 319 (31%) patients. Degenerative spondylolisthesis according to radiological criteria was detected in 428 (42%) patients. Degenerative scoliotic deformity had 91 (9%) patients. In accordance with the proposed criteria, the dominant compression syndrome was determined in 624 patients (62%), clinical instability syndrome in 338 (33%), deformity syndrome with sagittal imbalance in 51 (5%).
 Conclusion. Syndromic assessment of clinical, neurological and radiological manifestations of degenerative disorders provides the possibility of identifying the dominant syndrome requiring operative surgical treatment and a differentiated approach to choosing the optimal surgical option.","PeriodicalId":43463,"journal":{"name":"Travmatologiya i ortopediya Rossii","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135354147","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 : 2023-09-15DOI: 10.17816/2311-2905-16491
Irina V. Kolesnikova
14 августа 2023 г. на 76-м году жизни после не продолжительной болезни скоропостижно скончался выдающийся ученый, отличный организатор, прекрасный клиницист, эрудированный педагог, общественный деятель, доктор медицинских наук, профессор, академик РАН Сергей Павлович Миронов.
{"title":"Sergei P. Mironov","authors":"Irina V. Kolesnikova","doi":"10.17816/2311-2905-16491","DOIUrl":"https://doi.org/10.17816/2311-2905-16491","url":null,"abstract":"14 августа 2023 г. на 76-м году жизни после не продолжительной болезни скоропостижно скончался выдающийся ученый, отличный организатор, прекрасный клиницист, эрудированный педагог, общественный деятель, доктор медицинских наук, профессор, академик РАН Сергей Павлович Миронов.","PeriodicalId":43463,"journal":{"name":"Travmatologiya i ortopediya Rossii","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135486678","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}
Petr Preobrazhensky, Alexey Fil, Nikolay Kornilov, Alexander Panteleev, Maksim Guatsaev, Alexander Kazemirsky, Andrey V Mazurenko, Andrey Sereda
Background.Nowadays the knee arthroplasty register of the Vreden National Medical Research Center of Traumatology and Orthopedics (hereinafter referred to as the Vreden Center) contains clinical and statistical data on more than 39,000 primary and revision knee replacements, that mimics current state of this kind of surgery in Russia.
Aimofthestudy to analyze the last decade trends in primary knee arthroplasty in largest Russian arthroplasty center.
Methods.Data were obtained from the register of the Vreden Center for the period from 2011 to 2022. Information on knee arthroplasty included epidemiologic and numerous peri-operative data including type of surgery and implant, degree of constrain, primary patella resurfacing etc.
Resultsanddiscussion.From 2011 to 2022, 36,350 (92.3%) primary arthroplasties performed at the Vreden Center.
The number of interventions increased more than twice: from 1,678 in 2011 to 3,924 in 2022. Similar trends observed in Australia and Sweden, where the number of knee arthroplasties increased by 8.2% and 8% in 2021 compared to 2020, respectively. The frequency of primary patellar resurfacing at the Vreden Center was 2.2% over the entire period of observation. On the contrary, the rate of patella replacement increased from 41% in 2005 to 76.1% in 2021 in Australia and from 24.4% in 2015 to 31.9% in 2020 in Switzerland. The partial knee arthroplasty showed enormous growth more than 14 times: from 0.3% in 2011 to 4.3% in 2022 at the Vreden Center. Worldwide unicompartmental knee replacement is still less popular than total and its number widely varies: 4.2% in the USA, 6.9% in Australia, 9.2% in Canada, 11.9% in Norway, 12.8% in Sweden, and 18.4% in Switzerland. Posterior cruciate ligament (PCL) retaining total knee arthroplasties (TKA) prevailed at the Vreden Center: 68.3%, while in other countries it utilize even more widely: 70.5% in Norway, 75% in New Zealand and 93.5% in Sweden.
The total length of hospital stay (LOS) decreased dramatically from 19.6 in 2011 to 8.6 in 2022 at the Vreden Center. Nevertheless, there are still opportunities to improve it: by the way in Canada the average LOS for TKA is 2.3 and the USA 0.8 and 1.7 for partial and total arthroplasty, respectively.
Conclusion.The main current trends of knee arthroplasty in Russia are the following: increase the number of surgeries, reduced LOS, TKA without patella resurfacing and with PCL retention, finally the growth of partial knee arthroplasties.
{"title":"Knee arthroplasty in real clinical practice: analysis of 36,350 cases from the register of the Vreden National Medical Center of Trauma and Ortopedics","authors":"Petr Preobrazhensky, Alexey Fil, Nikolay Kornilov, Alexander Panteleev, Maksim Guatsaev, Alexander Kazemirsky, Andrey V Mazurenko, Andrey Sereda","doi":"10.17816/2311-2905-9349","DOIUrl":"https://doi.org/10.17816/2311-2905-9349","url":null,"abstract":"Background.Nowadays the knee arthroplasty register of the Vreden National Medical Research Center of Traumatology and Orthopedics (hereinafter referred to as the Vreden Center) contains clinical and statistical data on more than 39,000 primary and revision knee replacements, that mimics current state of this kind of surgery in Russia.
 Aimofthestudy to analyze the last decade trends in primary knee arthroplasty in largest Russian arthroplasty center.
 Methods.Data were obtained from the register of the Vreden Center for the period from 2011 to 2022. Information on knee arthroplasty included epidemiologic and numerous peri-operative data including type of surgery and implant, degree of constrain, primary patella resurfacing etc.
 Resultsanddiscussion.From 2011 to 2022, 36,350 (92.3%) primary arthroplasties performed at the Vreden Center.
 The number of interventions increased more than twice: from 1,678 in 2011 to 3,924 in 2022. Similar trends observed in Australia and Sweden, where the number of knee arthroplasties increased by 8.2% and 8% in 2021 compared to 2020, respectively. The frequency of primary patellar resurfacing at the Vreden Center was 2.2% over the entire period of observation. On the contrary, the rate of patella replacement increased from 41% in 2005 to 76.1% in 2021 in Australia and from 24.4% in 2015 to 31.9% in 2020 in Switzerland. The partial knee arthroplasty showed enormous growth more than 14 times: from 0.3% in 2011 to 4.3% in 2022 at the Vreden Center. Worldwide unicompartmental knee replacement is still less popular than total and its number widely varies: 4.2% in the USA, 6.9% in Australia, 9.2% in Canada, 11.9% in Norway, 12.8% in Sweden, and 18.4% in Switzerland. Posterior cruciate ligament (PCL) retaining total knee arthroplasties (TKA) prevailed at the Vreden Center: 68.3%, while in other countries it utilize even more widely: 70.5% in Norway, 75% in New Zealand and 93.5% in Sweden.
 The total length of hospital stay (LOS) decreased dramatically from 19.6 in 2011 to 8.6 in 2022 at the Vreden Center. Nevertheless, there are still opportunities to improve it: by the way in Canada the average LOS for TKA is 2.3 and the USA 0.8 and 1.7 for partial and total arthroplasty, respectively.
 Conclusion.The main current trends of knee arthroplasty in Russia are the following: increase the number of surgeries, reduced LOS, TKA without patella resurfacing and with PCL retention, finally the growth of partial knee arthroplasties.","PeriodicalId":43463,"journal":{"name":"Travmatologiya i ortopediya Rossii","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135352779","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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