Динамика и корреляция данных рентгенологического и артроскопическогоисследования коленного сустава при ревматоидном синовите

Objective: to compare the data of knee joint X-ray and arthroscopic studies in the presence of rheumatoid synovitis. Subjects and methods. Sixty-seven patients who had undergone 72 arthroscopic synovectomic operations on 72 joints for chronic knee-joint synovitis in the presence of rheumatoid arthritis (RA) were examined. Preoperative knee-joint X-ray study was carried out with the standard projections in all the patients. In most cases, the magnitude of X-ray changes corresponded to grade 1 according to the Larsen classification. The degree of articular cartilage destruction was intraoperatively estimated. Repeated X-ray films were made 6 and 30-36 months after arthroscopy. Results. It has been fount that in 72,2% of cases, the true articular cartilage changes detectable by arthroscopic revision were ascertained to coincide in their magnitude with the X-ray changes determined by the Larsen classification or to exceed them. Conclusion. In knee-joint RA, arthroscopic revision can provide the fullest information on the severity of pathological changes; however, X-ray study aids to a certain degree in the prediction of arthroscopic findings, including those of articular cartilage pathology.Целью данного исследования явилось сравнение данных рентгенологического и артроскопического исследования коленного сустава на фоне ревматоидного синовита. Материал и методы. Обследовано 67пациентов, у которых на 72 суставах выполнено 72 операции артроскопической синовэкто-мии по поводу хронического синовита коленного сустава на фоне ревматоидного артрита (РА). В предоперационном периоде всем пациентам проводили рентгенографию коленных суставов в стандартных проекциях. Степень рентгенологических изменений в большинстве случаев соответствовала 1-й стадии по классификации Larsen. Во время операции оценивали степень разрушений суставного хряща. Повторные рентгенограммы выполняли через 6 мес и через 30-36 мес после артроскопии. Результаты исследования. Установлено, что в 72,2% наблюдений истинные изменения суставного хряща, выявляемые при артро-скопической ревизии, совпадают по тяжести с рентгенологическими изменениями, определяемыми по классификации Larsen, или превосходят их. Заключение. При РА коленного сустава данные артроскопической ревизии позволяют получить наиболее полную информацию о тяжести патологических изменений, однако рентгенологическое исследование в определенной степени помогает прогнозировать артроскопические находки, в том числе в отношении патологии суставного хряща

Leibniz Seminorms and Best Approximation from C*-subalgebras

We show that if B is a C*-subalgebra of a C*-algebra A such that B contains a bounded approximate identity for A, and if L is the pull-back to A of the quotient norm on A/B, then L is strongly Leibniz. In connection with this situation we study certain aspects of best approximation of elements of a unital C*-algebra by elements of a unital C*-subalgebra.Comment: 24 pages. Intended for the proceedings of the conference "Operator Algebras and Related Topics". v2: added a corollary to the main theorem, plus several minor improvements v3: much simplified proof of a key lemma, corollary to main theorem added v4: Many minor improvements. Section numbers increased by

CHANGES AND CORRELATION OF THE DATA OF KNEE JOINT X-RAY AND ARTHROSCOPIC STUDIES IN RHEUMATOID SYNOVITIS

Objective: to compare the data of knee joint X-ray and arthroscopic studies in the presence of rheumatoid synovitis. Subjects and methods. Sixty-seven patients who had undergone 72 arthroscopic synovectomic operations on 72 joints for chronic knee-joint synovitis in the presence of rheumatoid arthritis (RA) were examined. Preoperative knee-joint X-ray study was carried out with the standard projections in all the patients. In most cases, the magnitude of X-ray changes corresponded to grade 1 according to the Larsen classification. The degree of articular cartilage destruction was intraoperatively estimated. Repeated X-ray films were made 6 and 30-36 months after arthroscopy. Results. It has been fount that in 72,2% of cases, the true articular cartilage changes detectable by arthroscopic revision were ascertained to coincide in their magnitude with the X-ray changes determined by the Larsen classification or to exceed them. Conclusion. In knee-joint RA, arthroscopic revision can provide the fullest information on the severity of pathological changes; however, X-ray study aids to a certain degree in the prediction of arthroscopic findings, including those of articular cartilage pathology

Arthroscopic synovectomy in rheumatoid synovitis of knee joint

Objective. To determine indications to and efficacy of arthroscopic synovectomy (AS) via anteriolateral portal in rheumatoid arthritis (RA) with knee joint synovitis. Material and methods. 139 pts with RA and knee joint synovitis were included. Kneeswelling, pain, restriction of movement score (from 0 to 3) were assessed at baseline and at the end of the study. Coefficient of conservative treatment inefficacy (duration of treatmentwithout significant improvement) was counted. Value of this coefficient multiplication by the sum of the above mentioned measures was used to determine indications to AS. AS was indicated in 111 cases (79,9%). It was performed in 72 pts (group 1). In 39 pts of group 2 this operation was not performed. 28 pts without indications to AS (group3) continued conservative treatment. Before the operation and after 6 months pts filled SF-36 questionnaire to assess quality of life. We used Russian version of SF-36 which was prepared to assess quality of life of Saint Petersburg adult inhabitants. This version possesses necessary psychometric features and is appropriate for conducting studies of quality of life and health status of Russian population. Results. AS provided significant improvement. All Clinical measures in group 1 showed similar mean improvement approximately by 1 (from 0,83 to 0,95, p<0,001). Integral measures (physical health and psychological health) in group 1 pts were higher (by 3,4 and 3,8 respectively). In group 3 all clinical measures values decreased to 0-1 while 30,8-48,7% assessments in group 2 pts showed 2 and in 5,1% - 3 for restriction of movement. Conservative treatment in rheumatoid synovitis is not equally effective for all pts. It does not provide sufficient effect in presence of indications to synovectomy. On the other hand in pts with less severe form of the disease not having indications to synovectomy such therapy provides fast and significant clinical improvement during 6 months of follow up. Conclusion. In pts with rheumatoid synovitis of knee joint having indications to this operation AS provides better results than conservative treatment only

Hip Arthroplasty in Patients with Hip Dysplasia by Individual Augments: Early Results

Relevance. The altered hip anatomy makes total hip arthroplasty in patients with hip dysplasia a difficult and non-standard task. The acetabulum is deformed with femoral head in subluxation or dislocation. The most important task of surgery is to restore the anatomical position of the hip center of rotation.The study purpose — to evaluate the early results of hip arthroplasty with individual augments in the patients with hip dysplasia.Materials and Methods. Since 2017, nine patients with hip dysplasia have undergone surgery using individually printed augments. All patients were women with average age 51.3±14.5 years (23 to 67). The mean follow-up was 14.3±5.2 months (8 to 20). Patients were evaluated using follow-up X-rays, a visual analogue scale (VAS), Harris Hip Score (HHS), and Western Ontario and McMaster Universities Arthritis Index (WOMAC).Results. There was no a single case of endoprosthesis dislocation, loosening of components, prosthetic infection or revision surgery in the analyzed group of patients. The planned sizes of the acetabular components were equal to the placed in 7 cases (77.8%). In two cases (22.2%), the acetabular components were 2 mm larger because the surgeon wanted a greater degree of press-fit fixation. The restoration of the anatomical position of the acetabular component was noted. Before the surgery, the femoral head was on average 22.7±11.7 mm (10 to 43 mm) higher. After the surgery, the level of the acetabular component was on average only 0.75±2.1 mm (1.7 to 5 mm), p = 0.008. Also, there were a decrease in pain and quality of life improvement by VAS from 6.78±1.39 before surgery to 2.22±1.09 at follow-up (p = 0.007), HHS increase from 30.5±18. 1 to 77.59±14.26 (p = 0.008), and WOMAC decrease from 73.3±14.1 to 18.22±8.2 (p = 0.008).Conclusion. The individually printed augments have shown high efficacy for restoration of the anatomical center of rotation and good early results in the patients with hip dysplasia undergone hip arthroplasty