12 research outputs found
Ilizarov bone transport combined with the Masquelet technique for bone defects of various etiologies (preliminary results)
BACKGROUND: The Ilizarov bone transport (IBT) and the Masquelet induced membrane technique (IMT) have specific merits and shortcomings, but numerous studies have shown their efficacy in the management of extensive long-bone defects of various etiologies, including congenital deficiencies. Combining their strong benefits seems a promising strategy to enhance bone regeneration and reduce the risk of refractures in the management of post-traumatic and congenital defects and nonunion that failed to respond to other treatments. AIM: To combine IBT and IMT for the management of severe tibial defects and pseudarthrosis, and present preliminary results of this technological solution. METHODS: Seven adults with post-traumatic tibial defects (subgroup A) and nine children (subgroup B) with congenital pseudarthrosis of the tibia (CPT) were treated with the combination of IMT and IBT after the failure of previous treatments. The mean number of previous surgeries was 2.0 Β± 0.2 in subgroup A and 3.3 Β± 0.7 in subgroup B. Step 1 included Ilizarov frame placement and spacer introduction into the defect to generate the induced membrane which remained in the interfragmental gap after spacer removal. Step 2 was an osteotomy and bone transport of the fragment through the tunnel in the induced membrane, its compression and docking for consolidation without grafting. The outcomes were retrospectively studied after a mean follow-up of 20.8 Β± 2.7 mo in subgroup A and 25.3 Β± 2.3 mo in subgroup B. RESULTS: The βtrue defectβ after resection was 13.3 Β± 1.7% in subgroup A and 31.0 Β± 3.0% in subgroup B relative to the contralateral limb. Upon completion of treatment, defects were filled by 75.4 Β± 10.6% and 34.6 Β± 4.2%, respectively. Total duration of external fixation was 397 Β± 9.2 and 270.1 Β± 16.3 d, including spacer retention time of 42.4 Β± 4.5 and 55.8 Β± 6.6 d, in subgroups A and B, respectively. Bone infection was not observed. Postoperative complications were several cases of pin-tract infection and regenerate deformity in both subgroups. Ischemic regeneration was observed in two cases of subgroup B. Complications were corrected during the course of treatment. Bone union was achieved in all patients of subgroup A and in seven patients of subgroup B. One non-united CPT case was further treated with the Ilizarov compression method only and achieved union. After a follow-up period of two to three years, refractures occurred in four cases of united CPT. CONCLUSION: The combination of IMT and IBT provides good outcomes in post-traumatic tibial defects after previous treatment failure but external fixation is longer due to spacer retention. Refractures may occur in severe CPT
ΠΡΠΎΠ³Π½ΠΎΠ· ΡΠΎΡΠΈΠ°Π»ΡΠ½ΠΎ-ΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π±ΡΠ΅ΠΌΠ΅Π½ΠΈ Ρ ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΎΠ±ΡΡΡΡΠΊΡΠΈΠ²Π½ΠΎΠΉ Π±ΠΎΠ»Π΅Π·Π½ΠΈ Π»Π΅Π³ΠΊΠΈΡ Π² Π ΠΎΡΡΠΈΠΉΡΠΊΠΎΠΉ Π€Π΅Π΄Π΅ΡΠ°ΡΠΈΠΈ Π² 2022 Π³ΠΎΠ΄Ρ
Chronic obstructive pulmonary disease (COPD) is characterized by a high level of morbidity and mortality and is associated with significant social and economic losses for the health care system and society.Aim. To predict the socio-economic burden of COPD in the Russian Federation in 2022, including the cost of drug treatment.Methods. The socio-economic burden of COPD in the Russian Federation in 2022 was predicted with and without taking into account the impact of COVID-19. The analysis of the cost of illness included the calculation of direct and indirect costs due to COPD. Data of Federal State Statistics Service, the State Guarantee Program of Free Medical Care for Citizens of Russian Federation, and data from the regional register of drug treatment of patients with COPD were used. Costs of medical care (ambulatory, hospital, and emergency care) were calculated based on compulsory health insurance tariffs. The disability benefits payments were calculated based on number of disabled persons and the amount of the disability benefit in each group. Indirect costs (or economic losses) included losses from products which were not produced due to disability and premature mortality of working-aged adults.Results. The predicted total economic losses due to COPD in 2022 will be 428.5 billion rubles when taking into account the impact of COVID-19, and 378.9 billion rubles when not accounting for COVID-19. Losses in the economy due to decreased labor productivity because of premature deaths (86%) are major part of the main burden. The cost of drug therapy for patients with COPD in outpatient settings will amount to over 17 billion rubles.Conclusion. Potential economic burden of COPD in 2022 depends on the incidence of COVID-19 and could be 0.34% of the GDP. Priority should be given to measures aimed at preventing the occurrence of COPD by correcting risk factors in the population, early diagnosis, slowing the progression of the disease and preventing exacerbations. Prevention of respiratory infections including COVID-19 in patients with COPD plays a special role.Π₯ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠ°Ρ ΠΎΠ±ΡΡΡΡΠΊΡΠΈΠ²Π½Π°Ρ Π±ΠΎΠ»Π΅Π·Π½Ρ Π»Π΅Π³ΠΊΠΈΡ
(Π₯ΠΠΠ) Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΠ·ΡΠ΅ΡΡΡ Π²ΡΡΠΎΠΊΠΈΠΌ ΡΡΠΎΠ²Π½Π΅ΠΌ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π΅ΠΌΠΎΡΡΠΈ ΠΈ ΡΠΌΠ΅ΡΡΠ½ΠΎΡΡΠΈ ΠΈ Π°ΡΡΠΎΡΠΈΠΈΡΠΎΠ²Π°Π½Π° ΡΠΎ Π·Π½Π°ΡΠΈΡΠ΅Π»ΡΠ½ΡΠΌ ΡΠΎΡΠΈΠ°Π»ΡΠ½ΡΠΌ ΠΈ ΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΈΠΌ ΡΡΠ΅ΡΠ±ΠΎΠΌ (ΠΠ£) Π΄Π»Ρ ΡΠΈΡΡΠ΅ΠΌΡ Π·Π΄ΡΠ°Π²ΠΎΠΎΡ
ΡΠ°Π½Π΅Π½ΠΈΡ ΠΈ ΠΎΠ±ΡΠ΅ΡΡΠ²Π°.Π¦Π΅Π»ΡΡ ΡΠ°Π±ΠΎΡΡ ΡΠ²ΠΈΠ»ΡΡ ΠΏΡΠΎΠ³Π½ΠΎΠ· ΡΠΎΡΠΈΠ°Π»ΡΠ½ΠΎ-ΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π±ΡΠ΅ΠΌΠ΅Π½ΠΈ Π₯ΠΠΠ Π² Π ΠΎΡΡΠΈΠΉΡΠΊΠΎΠΉ Π€Π΅Π΄Π΅ΡΠ°ΡΠΈΠΈ (Π Π€) Π² 2022 Π³., Π²ΠΊΠ»ΡΡΠ°Ρ Π·Π°ΡΡΠ°ΡΡ Π½Π° Π»Π΅ΠΊΠ°ΡΡΡΠ²Π΅Π½Π½ΡΡ ΡΠ΅ΡΠ°ΠΏΠΈΡ.ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΡΠΈΠ²Π΅Π΄Π΅Π½ ΠΏΡΠΎΠ³Π½ΠΎΠ· ΡΠΎΡΠΈΠ°Π»ΡΠ½ΠΎ-ΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π±ΡΠ΅ΠΌΠ΅Π½ΠΈ Π₯ΠΠΠ Π² Π Π€ Π² 2022 Π³. Ρ ΡΡΠ΅ΡΠΎΠΌ ΠΈ Π±Π΅Π· ΡΡΠ΅ΡΠ° Π²Π»ΠΈΡΠ½ΠΈΡ COVID-19. ΠΠ½Π°Π»ΠΈΠ· ΡΡΠΎΠΈΠΌΠΎΡΡΠΈ Π±ΠΎΠ»Π΅Π·Π½ΠΈ Π²ΠΊΠ»ΡΡΠ°Π» ΡΠ°ΡΡΠ΅Ρ ΠΏΡΡΠΌΡΡ
ΠΈ ΠΊΠΎΡΠ²Π΅Π½Π½ΡΡ
Π·Π°ΡΡΠ°Ρ, ΠΎΠ±ΡΡΠ»ΠΎΠ²Π»Π΅Π½Π½ΡΡ
Π₯ΠΠΠ. ΠΡΡΠΎΡΠ½ΠΈΠΊΠ°ΠΌΠΈ Π΄Π°Π½Π½ΡΡ
ΡΠ»ΡΠΆΠΈΠ»ΠΈ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΠΈ Π€Π΅Π΄Π΅ΡΠ°Π»ΡΠ½ΠΎΠΉ ΡΠ»ΡΠΆΠ±Ρ Π³ΠΎΡΡΠ΄Π°ΡΡΡΠ²Π΅Π½Π½ΠΎΠΉ ΡΡΠ°ΡΠΈΡΡΠΈΠΊΠΈ, ΠΡΠΎΠ³ΡΠ°ΠΌΠΌΡ Π³ΠΎΡΡΠ΄Π°ΡΡΡΠ²Π΅Π½Π½ΡΡ
Π³Π°ΡΠ°Π½ΡΠΈΠΉ Π±Π΅ΡΠΏΠ»Π°ΡΠ½ΠΎΠ³ΠΎ ΠΎΠΊΠ°Π·Π°Π½ΠΈΡ Π³ΡΠ°ΠΆΠ΄Π°Π½Π°ΠΌ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ, Π΄Π°Π½Π½ΡΠ΅ ΡΠ΅Π³ΠΈΠΎΠ½Π°Π»ΡΠ½ΠΎΠ³ΠΎ ΡΠ΅Π³ΠΈΡΡΡΠ° ΠΎ ΠΌΠ΅Π΄ΠΈΠΊΠ°ΠΌΠ΅Π½ΡΠΎΠ·Π½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ Π±ΠΎΠ»ΡΠ½ΡΡ
Π₯ΠΠΠ. ΠΠ° ΠΎΡΠ½ΠΎΠ²Π°Π½ΠΈΠΈ ΡΠ°ΡΠΈΡΠΎΠ² Π½Π° ΠΎΠΏΠ»Π°ΡΡ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ ΠΏΠΎ ΠΎΠ±ΡΠ·Π°ΡΠ΅Π»ΡΠ½ΠΎΠΌΡ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΌΡ ΡΡΡΠ°Ρ
ΠΎΠ²Π°Π½ΠΈΡ ΡΠ°ΡΡΡΠΈΡΠ°Π½Ρ Π·Π°ΡΡΠ°ΡΡ Π½Π° ΠΎΠΊΠ°Π·Π°Π½ΠΈΠ΅ Π°ΠΌΠ±ΡΠ»Π°ΡΠΎΡΠ½ΠΎΠΉ, ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠ½ΠΎΠΉ ΠΈ ΡΠΊΠΎΡΠΎΠΉ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ. ΠΠ±ΡΠ΅ΠΌ Π²ΡΠΏΠ»Π°Ρ ΠΏΠΎΡΠΎΠ±ΠΈΠΉ ΠΏΠΎ ΠΈΠ½Π²Π°Π»ΠΈΠ΄Π½ΠΎΡΡΠΈ ΡΠ°ΡΡΡΠΈΡΡΠ²Π°Π»ΡΡ ΠΏΠΎ ΡΠΈΡΠ»Ρ ΠΈΠ½Π²Π°Π»ΠΈΠ΄ΠΎΠ² ΠΊΠ°ΠΆΠ΄ΠΎΠΉ Π³ΡΡΠΏΠΏΡ ΠΈ Π²Π΅Π»ΠΈΡΠΈΠ½Π΅ ΠΏΠΎΡΠΎΠ±ΠΈΡ ΠΏΠΎ ΠΈΠ½Π²Π°Π»ΠΈΠ΄Π½ΠΎΡΡΠΈ. ΠΠ΅ΠΏΡΡΠΌΡΠ΅ Π·Π°ΡΡΠ°ΡΡ Π²ΠΊΠ»ΡΡΠ°Π»ΠΈ ΠΏΠΎΡΠ΅ΡΠΈ Π΄Π»Ρ ΡΠΊΠΎΠ½ΠΎΠΌΠΈΠΊΠΈ ΠΎΡ Π½Π΅ΠΏΡΠΎΠΈΠ·Π²Π΅Π΄Π΅Π½Π½ΠΎΠΉ ΠΏΡΠΎΠ΄ΡΠΊΡΠΈΠΈ ΠΈΠ·-Π·Π° ΡΡΡΠ°ΡΡ ΡΡΡΠ΄ΠΎΡΠΏΠΎΡΠΎΠ±Π½ΠΎΡΡΠΈ ΠΈ ΠΏΡΠ΅ΠΆΠ΄Π΅Π²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠΉ ΡΠΌΠ΅ΡΡΠΈ Π² ΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΈ Π°ΠΊΡΠΈΠ²Π½ΠΎΠΌ Π²ΠΎΠ·ΡΠ°ΡΡΠ΅.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π‘ ΡΡΠ΅ΡΠΎΠΌ Π²Π»ΠΈΡΠ½ΠΈΡ COVID-19 ΠΏΡΠΎΠ³Π½ΠΎΠ·ΠΈΡΡΠ΅ΠΌΡΠΉ ΡΠΎΠ²ΠΎΠΊΡΠΏΠ½ΡΠΉ ΠΠ£ ΠΎΡ Π₯ΠΠΠ Π½Π° 2022 Π³. ΡΠΎΡΡΠ°Π²ΠΈΡ 428,5 ΠΌΠ»ΡΠ΄ ΡΡΠ±., Π±Π΅Π· ΡΡΠ΅ΡΠ° β 378,9 ΠΌΠ»ΡΠ΄ ΡΡΠ±. Π ΡΡΡΡΠΊΡΡΡΠ΅ ΠΎΡΠ½ΠΎΠ²Π½ΠΎΠ³ΠΎ ΠΠ£ ΠΏΡΠ΅Π²Π°Π»ΠΈΡΡΡΡ ΠΏΠΎΡΠ΅ΡΠΈ Π² Π²ΡΠ»Π΅Π΄ΡΡΠ²ΠΈΠ΅ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΡ ΠΏΡΠΎΠΈΠ·Π²ΠΎΠ΄ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ ΡΡΡΠ΄Π°, ΠΎΠ±ΡΡΠ»ΠΎΠ²Π»Π΅Π½Π½ΡΠ΅ ΠΏΡΠ΅ΠΆΠ΄Π΅Π²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠΉ ΡΠΌΠ΅ΡΡΡΡ (86 %). ΠΠ°ΡΡΠ°ΡΡ Π½Π° ΠΌΠ΅Π΄ΠΈΠΊΠ°ΠΌΠ΅Π½ΡΠΎΠ·Π½ΡΡ ΡΠ΅ΡΠ°ΠΏΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Π₯ΠΠΠ Π½Π° Π°ΠΌΠ±ΡΠ»Π°ΡΠΎΡΠ½ΠΎΠΌ ΡΡΠ°ΠΏΠ΅ ΡΠΎΡΡΠ°Π²ΡΡ > 17 ΠΌΠ»ΡΠ΄ ΡΡΠ±.ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΠΎΡΠ΅Π½ΡΠΈΠ°Π»ΡΠ½ΡΠΉ ΠΠ£ ΠΎΡ Π₯ΠΠΠ Π² 2022 Π³. Π·Π°Π²ΠΈΡΠΈΡ ΠΎΡ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π΅ΠΌΠΎΡΡΠΈ COVID-19 ΠΈ ΠΌΠΎΠΆΠ΅Ρ Π΄ΠΎΡΡΠΈΠ³Π½ΡΡΡ 0,34 % Π²Π°Π»ΠΎΠ²ΠΎΠ³ΠΎ Π²Π½ΡΡΡΠ΅Π½Π½Π΅Π³ΠΎ ΠΏΡΠΎΠ΄ΡΠΊΡΠ°. ΠΠ΅ΡΠ²ΠΎΠΎΡΠ΅ΡΠ΅Π΄Π½ΠΎΠ΅ Π²Π½ΠΈΠΌΠ°Π½ΠΈΠ΅ Π΄ΠΎΠ»ΠΆΠ½ΠΎ Π±ΡΡΡ ΡΠ΄Π΅Π»Π΅Π½ΠΎ ΠΌΠ΅ΡΠ°ΠΌ, Π½Π°ΠΏΡΠ°Π²Π»Π΅Π½Π½ΡΠΌ Π½Π° ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΡ Π²ΠΎΠ·Π½ΠΈΠΊΠ½ΠΎΠ²Π΅Π½ΠΈΡ Π₯ΠΠΠ Π·Π° ΡΡΠ΅Ρ ΠΊΠΎΡΡΠ΅ΠΊΡΠΈΠΈ ΡΠ°ΠΊΡΠΎΡΠΎΠ² ΡΠΈΡΠΊΠ° Π² ΠΏΠΎΠΏΡΠ»ΡΡΠΈΠΈ, ΡΠ°Π½Π½ΡΡ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΡ, Π·Π°ΠΌΠ΅Π΄Π»Π΅Π½ΠΈΠ΅ ΠΏΡΠΎΠ³ΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ ΠΈ ΠΏΡΠ΅Π΄ΡΠΏΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΠ΅ ΠΎΠ±ΠΎΡΡΡΠ΅Π½ΠΈΠΉ. ΠΡΠΎΠ±ΡΡ ΡΠΎΠ»Ρ ΠΈΠ³ΡΠ°Π΅Ρ ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠ° ΡΠ΅ΡΠΏΠΈΡΠ°ΡΠΎΡΠ½ΡΡ
ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΉ Ρ Π±ΠΎΠ»ΡΠ½ΡΡ
Π₯ΠΠΠ, Π²ΠΊΠ»ΡΡΠ°Ρ COVID-19
Morphological Changes in the Tibial Nerve During the Treatment of Large Tibia Defects Using Ilizarov Apparatus Combining with the Masquelet Technique: Experimental Study
Background. The use of Masquelet technology in combination with non-free osteoplasty according to Ilizarov in order to compensate large defects of the lower leg bones provides proper bone union and recurrence-free course of the disease, but the problem of patient rehabilitation remains relevant. The course and duration of the recovery period depend on the morphofunctional state of the tibial nerves. The purpose of this study was to determine morphological changes in the tibia nerve of dogs during the experimental treatment of large tibial defects using Ilizarov apparatus combining with the Masquelet technique. Materials and Methods. A defect of the upper third of the tibia in the form of false joint was created in 10 mongrel dogs. Then this defect was replaced with 25 mm diastasis, into which a cement spacer was placed. After 30 days, the latter was removed. At the level of the lower third, transverse osteotomy was performed, as well as distraction of 1 mm rate for 4 times per day, until complete contact of the fragments in the defect zone. The tibial nerves were studied within the periods of 60 days of fixation (F60) and 30 days after the fixator removal (FR30). Results. There were no mechanical damages of the nerves. During the experiment a part of epineural veins and arteries had obliterated lumens, two-fold decrease in the numerical density of endoneural arterioles, venules and capillaries was observed in FR30 β 97.5Β±2.5 in 1 mm2Β (normally β 182.0Β±22.0), that evidenced of microcirculatory disorders progressing towards the end of the experiment. Patterns of Wallerian degeneration were found along with typical damages to fibers during distraction osteosynthesis demyelination and axonal degeneration. In F60 the proportion of modified fibers was 7.7Β±1.5%, which was 4.8 times higher (Ρ = 0.52Γ10-5) above normal, the numerical densities and dimensional characteristics of fibers decreased. At the end of the experiment, the proportion of modified conductors 2.3-fold exceeded the norm (p = 0.33Γ10-4) β 3.7Β±0.4%, the numerical density of fibers remained 10.2% below the norm (p = 0.0362), making up 17436Β±865, but the average axon diameter and thickness of myelin sheaths were restored. Conclusion. Microcirculatory dysfunction, axonal atrophy, demyelination, Wallerian degeneration of a part of myelin nerve fibers and a decrease in their number revealed in the tibial nerves during the treatment of large tibia defects using the Masquelet technique combining with Ilizarov non-free bone grafting indicated the need for the use of adequate neurometabolic pharmacotherapy and effective rehabilitation
FEATURES OF THE PATHOMORPHOLOGICAL DIAGNOSIS OF MICROCRYSTALLINE ARTHROPATHIES IN THE PRACTICE OF SURGICAL MATERIAL EXAMINATION
The development of microcrystalline arthritides is most frequently associated with the formation of monosodium urate (MSU) and calcium pyrophosphate (CPP) crystals. Their identification is of crucial importance in recognizing these diseases. Objective: to determine the possibilities of histological techniques in identifying MSU and CPP crystals and to evaluate the effectiveness of the techniques. Subjects and methods. Twenty-four tissue blocks (fragments of the affected areas of the elbow joint, the interphalangeal joint of the index finger, and hip joint) from 7 patients were examined. Paraffin sections were stained with a 0.5% alcohol solution of eosin, as well as with hematoxylin and eosin. Tissue specimens were examined and digitized using an AxioScope.A1 stereo microscope with Zenblue software (Carl Zeiss MicroImaging GmbH, Germany). Results and discussion. When staining the tissue sections with hematoxylin and eosin, microcrystals were not visualized; the major portions of MSU crystals was dissolved during fixation and staining, whereas CPP crystals were masked with hematoxylin as focal basophilic aggregates. The staining technique with an alcohol solution of eosin and short formalin fixation (within 12 hours) made it possible to avoid dissolution of MSU crystals and to visualize both MSU and CPP crystals, and to determine their shape and color. Conclusion. Light microscopy of the tissue sections stained with an alcohol solution of eosin along with short formalin fixation is a reliable method to differentiate MSU and CPP crystals. In patients undergoing endoprosthetic replacement, the significance of this technique for the pathomorphological study of surgical material consists in assessing inflammatory activity and in eliminating a disease, such as microcrystalline arthropathy