Impact of Zweymüller Stem Modification on Clinical and Radiological Outcomes

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 Zweymüller-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 patient’s 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 Zweymüller 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 Zweymüller 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

Follow-Up After Hip and Knee Arthroplasty: a Review of the Literature and a Report on a Pilot Project at the Vreden National Medical Research Center of Traumatology and Orthopedics

Background. Today in our country, the follow-up of patients after arthroplasty is carried out in accordance with clinical guidelines, the wording of which is based on monographs from 2006, 2008, and 2014, in addition, clinical guidelines for follow-up do not take into account the results of treatment assessed by the patient himself. The purpose of this study was to examine existing systems and develop a proprietary follow-up system for patients after hip and knee arthroplasty. Results. A review of the literature revealed that follow-up of patients after arthroplasty is an unsolved problem, within which there is low coverage, reluctance or forgetfulness of the asymptomatic patient, the problem of accessibility of medical examinations, and an excessive financial burden on the health care system. Since 2022, fixed recommendations for follow-up after arthroplasty have been used in the clinical practice of our center in discharge epicrisis. Recommendations for the frequency of follow-up were formulated by experts based on a comprehensive review of the literature and their own experience. In the first three months, 221 hip and 235 knee evaluation questionnaires were collected through the proposed mechanism, with a progressive increase in the number of questionnaires based on weekly monitoring data. Conclusion. Unfortunately, the outpatient clinic system is not always able to provide qualitative monitoring of patients after arthroplasty due to various reasons, therefore, in our opinion, the implementation of the mechanism of remote monitoring of patients will allow detecting various complications at the stage of early diagnosis, which will contribute to prompt solution of these problems. The remote monitoring system is also an important source of scientific data

Artificial intelligence in traumatology and orthopedics. Reality, fantasy or false hopes?

Background. In recent years, the topic of artificial intelligence (AI) in medicine has been actively discussed not just as a promising solution but the one that can help to improve some results. A significant growth of interest in AI systems all over the world began in the early-mid 2010s, which allowed us to consider the practical application of such systems. The aim of the study is to analyze all the software products (SP) registered in our country as a medical device, including those with AI technology, and to evaluate their applicability in traumatology and orthopedics. Methods. The study included all the SP having a registration certificate of a medical device according to the OKPD2 code 58.29.XX.XXX (services for publishing other software). In the state register of medical devices and organizations (individual entrepreneurs), which is engaged in the production and manufacturing of medical devices, we found 111 registered SP according to the inclusion criterion, as at February 14, 2024. Results. We proposed to categorize all registered SP as follows: systems working with the DICOM standard images (47 pcs, 42%), laboratory data (20 pcs, 18%), microscopy images (7 pcs, 6%), photographic images (5 pcs, 5%), medical information systems (4 pcs, 4%), text data mining systems (3 pcs, 3%), clinical decision support systems (3 pcs, 3%), Holter ECG analysis (2 pcs, 2%), other systems (16 pcs, 14%). Systems applicable to traumatology and orthopedics accounted for 4 pcs (4%). Conclusions. Unfortunately, the real-world applicability of existing solutions in the field of traumatology and orthopedics can be regarded as minimal in comparison with pulmonology, oncology, and laboratory diagnostics, where AI programs have already achieved significant success

Immunobiological Characteristics of the Attenuated African Swine Fever Virus Strain Katanga-350

The African swine fever virus (ASFV) is the cause of a recent pandemic that is threatening the global pig industry. The virus infects domestic and wild pigs and manifests with a variety of clinical symptoms, depending on the strain. No commercial vaccine is currently available to protect animals from this virus, but some attenuated and recombinant live vaccine candidates might be effective against the disease. This article describes the immunobiological characteristics of one such candidate—the laboratory-attenuated ASFV strain, Katanga-350—which belongs to genotype I. In this study, we assessed clinical signs and post-mortem changes, the levels of viremia and the presence of viral DNA caused by injection of ASF virus strains Katanga-350, Lisbon-57, and Stavropol 08/01. Intramuscular injection of this strain protected 80% of pigs from a virulent strain of the same genotype and seroimmunotype (Lisbon-57). At least 50% of the surviving pigs received protection from subsequent intramuscular infection with a heterologous (genotype II, seroimmunotype VIII) virulent strain (Stavropol 08/01). Virus-specific antibodies were detectable in serum and saliva samples between 8–78 days after the first inoculation of the Katanga-350 strain (the observational period). The results suggested that this strain could serve as a basis for the development of a recombinant vaccine against ASF viruses belonging to seroimmunotype I