ANKLE DISTRACTION ARTHROPLASTY: A SYSTEMATIC REVIEW

Epidemiological data suggest 9-15% of ankle joint osteoarthritis (AOA) in the general population. One of the methods of delaying radical intervention is ankle joint distraction arthroplasty of the ankle joint (ADA), including a combination of various techniques. The lack of publications summarizing the maximum possible clinical data on ADA for more than 50 years of the method's history justifies the need for a review. A systematic review of ankle distraction arthroplasty followed the 2020 PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) protocol guidelines. The inclusion criteria were articles with clinical data in full text in English, available on the Internet for the maximum possible period, including the treatment of diseases of the ankle joint using distraction arthroplasty. At the search stage, 4640 publications from 3 sources were identified. 33 articles were selected for analysis of the full texts of the articles. Additionally, 1 article was excluded, as it contains duplicate information from an identical study. The analysis of the full texts of 32 publications was made, according to the parameters indicated earlier. A total of 927 patients underwent ADA. The mean age of the patients was 44.9 ± 12.7 years. Among the causes, post-traumatic AOA was indicated in 26 (81.3%) publications, osteochondral defects (n=2, 6.3%), consequences of poliomyelitis (n=4, 12.5%), congenital deformities (n=4, 12.5%), hemophilia (n= 2, 6.25%), idiopathic juvenile osteoarthritis (n=1, 3.1%), rheumatoid OA (n=1, 3.1%). Despite the more than 50-year history of ADA, there is still no sufficient understanding of this methodology. The goal of future research is to understand the exact indications for ADA depending on the stage, etiology, and type of AOA. ADA is a promising effective method of treatment that allows achieving an improvement in function and a reduction in pain in the medium and long term while preserving the patient's joint

Опыт применения оригинального способа остеосинтеза переднего отдела тазового кольца

Damage to the pelvic ring is a serious medical and social problem. Stabilization of the anterior pelvic ring is necessary for safe early mobilization of patients. The authors have developed a method of osteosynthesis of the anterior section of the pelvic ring with pins, which makes it possible to stabilize the anterior section of the pelvic ring quickly and easily. The article presents clinical experience involving 20 patients treated with the developed method. Excellent and good reposition was achieved in all cases. The functional results rated according to the S.A.Majeed scale were excellent and good in 19 tracked cases. Despite the optimistic results of the research, further study of the possibilities of this method of fixation is required.Повреждения тазового кольца представляют серьезную медико - социальную проблему. Стабилизация переднего отдела тазового кольца необходима для безопасной ранней активизации пациентов. Нами разработан способ остеосинтеза переднего отдела тазового кольца спицами с нарезкой, позволяющий быстро, просто и эффективно стабилизировать передний отдела тазового кольца. В представленном клиническом опыте проанализировано 20 пациентов, которым была выполнена фиксация разработанным способом. Во всех случаях достигнута отличная и хорошая репозиция. В 19 отслеженных случаях функциональные результаты по шкале S.A.Majeed оценены на отлично и хорошо. Несмотря на оптимистичные результаты нашего исследования, требуется дальнейшее изучение возможностей данного способа фиксации

Conservative treatment of avascular necrosis of the femoral head (literature review)

Introduction Avascular necrosis of the femoral head is a debilitating disease affecting people of working age and having an important medical and social role. Total hip arthroplasty is the only effective treatment for late stages of necrosis. Various joint-preserving operations and non-surgical methods can be successfully used for less severe types. There is no unequivocal opinion on the effectiveness of various conservative treatments offered for avascular necrosis of the femoral head. The aim was to summarize data on the role of medications and physiotherapy in treatment of avascular necrosis of the femoral head through the analysis of the modern world literature. Material and methods The original literature search was conducted on key resources including elibrary, PubMed and ResearchGate. Results Outcomes of avascular necrosis of the femoral head treated conservatively were overviewed. The effectiveness of various treatments using bisphosphonates, anticoagulants, statins, prostacyclin derivatives was evaluated. Physiotherapy with shock wave therapy, pulsating electromagnetic fields, and hyperbaric oxygenation was also reviewed. Conservative treatment is reported to be effective only for early (pre-collapse) stages of avascular necrosis of the femoral head. Conclusions A conservative treatment used as a monotherapy for AVN cannot be assessed as a standalone procedure because various combinations of comprehensive treatment are used for the majority of patients. There are no studies in the literature comparing the effectiveness of conservative therapies using iloprost and statins, bisphosphonates and anticoagulants, shockwave and hyperbaric oxygen therapy in homogeneous patient samples. A deeper study of the underlying pathogenesis of avascular necrosis of the femoral head is required to develop personalized treatment strategies. © Panin M.A., Boiko A.V., Abakirov M. Dzh., Petrosyan A.S., Ananin D.A., Awad M.M., 202