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The aim of this study was to evaluate the clinical and radiographic results of total hip arthroplasty (THA) for coxarthrosis secondary to developmental dysplasia of the hip (DDH). Examinations were made of 58 hips in 47 patients with DDH who were operated on between 1990-2000 (patients with anatomic centred hips with or without roof graft and/or femoral shortening). The patients were evaluated using the Modified Harris Hip Score preand postoperatively. The average Harris score increased from 47.7 preoperatively to 89.2 postoperatively. The average age of 43 female and 4 male patients was 48 years (24-65). All the patients presented with a limp, which was resolved after surgery in 34% and partially improved in others. The average medialization was 24 mm, and the average distal placement was 32 mm. A total of 28 (48%) complications were observed in 26 patients. Intraoperatively, fissures were detected in the proximal femur in 5, and were fixed with cerclage wiring. One patient with femoral shortening had hip dislocation one week later, so plate screw fixation was revised with open reduction. One patient had anterior thigh pain, heterotopic ossification was observed in three cases, and polyethylene wear in one case. All 20 patients who had superolateral acetabular grafting showed incorporation but there was observed to be resorption in a 20% section that was non-weight-bearing in 3 cases. THA is an effective treatment option for coxarthrosis in neglected DDH. Patients should be informed about the problems they may encounter after surgery and care should be taken in terms of complications such as dislocation, prosthesis infection, and vascular and nerve damage. [ABSTRACT FROM AUTHOR]

Knochen ist elastisch und verformbar. Kehrt ein Knochen nach einem Trauma, chronischem Zug, übermäßigem Druck oder einer Torsion nicht in seine alte Position zurück, verbleiben Schmerzen im Knochen und den beteiligten, nicht dehnbaren Faszien, Sehnen, Kapsel- und Bandstrukturen. Nach den theoretischen Grundlagen dieses manuellen Verfahrens zur Behandlung chronischer Schmerzen im Bewegungsapparat in Teil 1 [ 1 ] und der praktischen Anwendung dieser Technik im Teil 2 [ 2 ] an der unteren und im Teil 3 [ 3 ] an der oberen Extremität wird diesmal gezeigt, wie man mithilfe einer gezielten Behandlungskaskade pathologisch verformte Beckenknochen und den Trochanter major in ihre spannungsfreie, anatomische Ausgangsposition zurückbringen und dadurch die mit ihnen fest verankerten Bandstrukturen entlasten kann, um chronische Schmerzen zu beseitigen. Bone is elastic and deformable. However, if a bone does not return to its former position after trauma, chronic traction, excessive pressure or torsion, pain will remain in the bone and in non-stretchable fasciae, tendons, capsule and ligament structures involved. Following the introduction of the theoretical basis of a new manual method for the treatment of chronic pain in the musculosceletal system in part 1 [ 1 ] and the practical application of this technique in part 2 [ 2 ] on the lower limb and in part 3 [ 3 ] on the upper limb, this time it is demonstrated how a targeted treatment cascade can be used to return pathologically deformed pelvic bones and the greater trochanter to their tension-free, anatomical starting position and thus relieve the ligamentous structures firmly anchored to them in order to eliminate chronic pain. [ABSTRACT FROM AUTHOR]

Introduction: Intra-articular steroid injections (IAS) are a treatment for coxarthrosis. This study examines the efficacy of three fluoroscopy-guided IAS contrast techniques for coxarthrosis: contrast-assisted (Iohexol), air arthrogram-assisted and blind (contrast/air free) and stratifies efficacy based on multiple patient variables. Materials and methods: A cohort of 307 hip IAS was retrospectively analysed over a four-year period. The primary outcome was efficacy of IAS between each technique group, defined by duration of symptomatic relief. The secondary outcome was efficacy based on multiple patient variables. Variables included age, BMI, gender, type of osteoarthritis, grade of osteoarthritis, smoking status, co-morbidity index and duration of pre-injection symptoms. Chi-squared, Pearson, One Way ANOVA and F-tests were used for statistical analysis. Results: Total failure (< 1 week symptomatic relief) was 20% (contrast 20%, air 14%, blind 26%). >3 months of symptomatic relief was experienced by 35%, with the air arthrogram technique containing the largest proportion of IAS achieving > 3months of relief within its own group (contrast 35%, air 38%, blind 28%). Non-smokers experienced a longer duration of symptomatic relief in the air arthrogram group (p = 0.04). Older patients had a longer duration of symptomatic relief with the blind technique (p = < 0.001). There were no significant differences between the three techniques based on the other patient variables. Conclusion: Air arthrogram is an effective method of confirming injection placement in hip IAS for coxarthrosis and the use of a contrast agent (e.g., Iohexol) may not be required. Non-contrast techniques may produce longer duration of symptomatic relief in non-smokers and in older patients. [ABSTRACT FROM AUTHOR]

Copyright of Actualités Pharmaceutiques is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background Steriod-induced osteonecrosis of femoral head (SIONFH) cystic degeneration have a "double-edged sword" effect. The method of activating blood and dredging collate is effective in the treatment of early SIONFH, but its regulatory effect on bone resorption/angiogenesis/osteogenic protein in cystic degeneration remains unclear. Objective To investigate the effect of activating blood and dredging collate method on serum bone resorption/angiogenesis/osteogenic protein in patients with cystic degeneration of SIONFH. Methods Sixty patients with SIONFH admitted to the Hip Joint Research Center of Guangzhou University of Traditional Chinese Medicine from January 2019 to January 2021 were included as the study subjects and divided into the control group and treatment group according to random number table method, with 30 cases in each group. Another 30 volunteers with normal physical examination in hospital at the same period and no history of hormone use were selected as the normal group. The treatment group was treated with Huoxuetongluo capsule (2 g/time, 3 times/day) and calcium carbonate (600 mg/time, 1 time/day), the control group was treated with the same amount of calcium carbonate, and the course of treatment of both groups was 12 months, simultaneously limiting weight-bearing on the affected limb. Fasting serum was collected, and the expression levels of nuclear factor κB receptor activating factor ligand (RANKL), platelet-derived growth factor-BB (PDGF-BB), vascular endothelial growth factor A (VEGFA), osteoprotegerin (OPG) and cadherin-associated protein (CTNNB1) in serum were detected by enzyme-linked immunosorbent assay. The patients were followed up twice at the 6th and 12th month after discharge, and the collapse of femoral head was defined as the end event. Hip pain visual analogue score (VAS), hip function (Harris) score and necrotic area score were used to evaluate the efficacy. Results Baseline RANKL, PDGF-BB, OPG and CTNNB1 levels were compared among the three groups, and the differences were statistically significant (P

Copyright of Hungarian Journal of Anesthesiolog & Intensive Therapy / Aneszteziológia és Intenzív Terápia is the property of Hungarian Society of Anaesthesiology & Intensive Therapy and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Reducing the risk of infectious complications after hip replacement both in the early and late postoperative period remains an important task. Currently, there is a search for laboratory markers of infection development in the field of surgical intervention with high prognostic significance. Violation of the production of catelecidins LL37 may be a factor contributing to the development of infectious and inflammatory complications. To investigate the concentration of cathelicidin in dynamics in patients with hip replacement and the development of postoperative infectious complications.Object and methods. A total of 49 people were examined, who were divided into three groups: the first group – 19 patients after hip replacement with no peculiarities during the postoperative period, the 2nd group – 15 patients after hip replacement: with the development of infection in the early stages (n = 6), and 9 patients with late deep complications within 1 year. The third group (n = 15) consisted of clinically healthy individuals. The results of a laboratory study of LL37 catelecidins in peripheral blood and drainage fluid were analyzed.Results. As a result of the comparative analysis of the results obtained, certain patterns were revealed. Thus, the level of catelecidin in blood serum and drainage fluid in the group of patients with infectious complications was significantly higher than in the group of patients without complications. Blood loss during surgery may be an additional factor contributing to the disruption of the production of antimicrobial peptides. Discriminant analysis revealed that the determination of the level of cathelicidin on the 10th day after surgery and its content in the drainage fluid suggests the development of a postoperative complication in the form of a paraprosthetic infection.

Objective: The aim of the study was to assess lameness in dogs with advanced osteoarthritis of the hip and knee joints after a single autologous point‐of‐care transplantation of the Stromal Vascular Fraction (SVF) into the affected joint. Materials and methods: During a minilaparotomy, 10 g of falciform fat was removed from each patient for each joint to be treated. A modern and time‐saving procedure (ARC TM System, InGeneron GmbH, Houston, USA) was used for the in‐house preparation of the SVF, so that the isolated cells could be applied to the respective joint within 2 h after fat removal. In total, five knee joints of five patients and seven hip joints of four patients were treated. Results: Improvement in lameness according to owner questionnaires was seen in 3 of 5 patients with knee joint arthritis and 2 of 4 patients with hip joint arthritis. Based on gait analysis, only one dog with gonarthrosis and one dog with coxarthrosis showed improvement up to a maximum of 3 months after surgery. Conclusion: This is the first case series on the treatment of osteoarthrosis of the knee or hip joint using point‐of‐care transplantation of the SVF. In individual cases, this method may represent a therapeutic approach for the treatment in dogs with advanced cox‐ or gonarthrosis, although only a short‐term effect can be expected, which calls into question the effort and costs involved. [ABSTRACT FROM AUTHOR]

Background. About 40 % of patients diagnosed with coxarthrosis annually seek medical help and receive social support due to this disease. Increased use of an expensive surgery for treatment of coxarthrosis and projected growth of its prevalence in the population determine the relevance of socio-economic analysis.The aim of the study. To assess the value and structure of economic damage caused by the delivering health and social care to patients with coxarthrosis at the state level of the Russian Federation.Methods. To assess economic damage, we used the average annual number of various categories of patients and disabled people with coxarthrosis in the Irkutsk region for 2008–2017. Three main categories were identified: patients who visited the outpatients’ clinic; patients with total hip replacement; disabled people due to coxarthrosis. For each category, we calculated weighted average damage per 1 conventional patient, taking into account direct and indirect costs and subsequent multiplication by the average annual number of individual categories of patients. Calculations were performed in 2017 prices.Results. The average annual socio-economic damage from coxarthrosis amounted to 1.39 (1.34÷1.43) billion rubles or 0.1 % of the gross regional product. The most of the damage (64.4 %) were indirect costs associated with disability due to coxarthrosis, 22.2 % of the total amount were the costs of hip replacement surgery, 13.4 % were the costs of outpatient visits. Indirect economic losses due to disability in patients of working age were 4.2 times higher than losses due to disability of oldage pensioners.Conclusion. The results of the study confirm the economic feasibility of surgical treatment of coxarthrosis, especially in patients of working age.

Background. In orthopedics, the patients’ quality of life relative to the preoperative and postoperative phase is referred with a low impact compared to other branches of medicine. In this context, our interest focused on assessing the quality of life in patients with traumatic and non-traumatic coxarthrosis by longitudinally following the evolution of the patients. Materials and Methods. The well-established instrument Short Form Survey SF-36 was applied in a retrospective study, conducted on a cohort of 203 participants who underwent THA (Total Hip Arthroplasty). Statistical analysis was generated using GraphPad Prism (version 9.5.1). Results. In the pre-operative phase, physical functioning was more affected in participants with traumatic coxarthrosis, while fatigue was specific to nontraumatic coxarthrosis. Emotional well-being and social functioning were high in patients with traumatic coxarthrosis. One month after surgery, we recorded an increased physical functioning and improvement in the perception of the ability to exercise roles in non-traumatic group. Energy/vitality and general health and wellbeing were at high level in traumatic group, 1st month post-surgery, although pain was still frequent. Age was the sole strong independent predictor of postoperative physical functioning in the traumatic group, while in the non-traumatic group, we identified gender, age, symptoms and type of prosthesis as strong predictors of postoperative physical functioning. The overall results related to daily living activities indicated that the traumatic group displayed more favorable post-surgery evolution and higher autonomy compared to the non-traumatic one. Conclusions. We conclude that SF-36 questionnaire is a specific, useful and inexpensive tool for evaluating the outcomes of orthopedic treatment and patients’ evolution after arthroplasty, especially in terms of functional outcome scores relative to coxarthrosis etiology.

Introduction Hip dysplasia of various genesis is recognized as a common cause of coxarthrosis. Total hip replacement (THR) is the operation of choice for the patients with the final stage of the pathological process. There are different opinions on the impact of previous surgical treatment of hip dysplasia on THR. The aim of the study was to explore the effects of previous surgical treatment on the outcomes of THR in young patients with dysplastic and secondary coxarthrosis. Material and methods Surgical outcomes of 78 patients (58 females and 20 males; 91 joints) with dysplastic and secondary coxarthrosis (age 14-30 years, average age 24.3 ± 4.3 years) treated witrh THR were retrospectively reviewed. Patients were assigned to two groups. Group I (control) included 27 patients (33 joints) with dysplastic coxarthrosis primarily treated with THR. Group II (treatment group) included 51 patients (58 joints) who had previously undergone THR. Results Patients of group II demonstrated longer duration of surgery by 47.89 %, greater blood loss by 16.92 % and the higher complication rate by 42.1 %. Discussion The treatment group showed a significantly increased frequency of late complications in the form of implant instability. Patients of group II demonstrated better functional results estimated with HHS as compared to the outcomes of patients of group I. Conclusion Hip reconstructions performed earlier were associated with technical difficulties, aggressive THR procedure, a greater risk of late complications, but showed no significant effect on the outcomes.

The scientific review presents the treatment of coxarthrosis of various stages by the radiofrequency denervations technique. Full-text articles were searched in open electronic databases PubMed, eLibrary, CyberLeninka for the maximum possible time interval for the time interval from 1990 to 2023. Fifteen scientific articles were selected, in which 302 patients were treated with 489 radiofrequency denervations of the hip joint. The authors provide information about the state of the problem with special attention to the characteristics of various denervation protocols and justification of the choice of target points for exposure from the standpoint of anatomy and innervation of the hip joint. RCD is a modern, interventional, and effective solution to the main symptom, which is pain, according to numerous studies. The introduction of targeted effects on the articular branches of the locking and femoral nerves by radiofrequency denervation into the work of a practitioner can increase the period of remission of exacerbation of coxarthrosis and shorten the period of disability with a high level of intervention safety for the patient. Conducting further research on the role of radiofrequency denervation in coxarthrosis is critical.

OBJECTIVE: No analysis of the perception of the complexity of total hip arthroplasty (THA) has been performed so far. This study aimed to evaluate the perceived complexity of the disorders faced by orthopedic surgeons in the evaluation process prior to THA. SUBJECTS AND METHODS: A three-part online survey was administered to orthopedic surgeons. In the first part, the participants were asked questions about demographic and academic knowledge, as well as their experiences with THA. In the second part, it was asked to rate the complexity of certain disorders, such as soft tissue abnormalities, ankylosis/arthrodesis, dysplastic hip, high dislocated hip, post-traumatic arthrosis, protrusio acetabuli, etc., on a scale of one to five. Perceived complexity was classified as mild if the calculated mean score was <1.67, moderate if it was between 1.67 and 3.34, and complex if it was >3.34. In the last section, the effects of perceived complexity on surgical preferences were investigated. RESULTS: THA administered for femoral neck fracture was graded as the least complex surgical challenge (mean score of 1.85±0.99), while high dislocated hip (Crowe III-IV) was scored with the highest mean score of 4.10±0.99. None of the disorders were evaluated as easy by orthopedic surgeons. Disorders of the high dislocated hip (Crowe III-IV) and protrusio acetabuli were identified as the most complicated cases by surgeons. CONCLUSIONS: Perception of complexity affected preference for surgical approach. Besides, the level of education after participating in a course related to THA may affect the preferences of orthopedic surgeons when planning an operation. [ABSTRACT FROM AUTHOR]

Coxarthrosis, or hip osteoarthritis (OA), is one of the main causes of hip pain, which can affect patients of all ages, being one of the most common reasons for patients presenting to the specialized outpatient clinic. The objective of our research was to determine the number of patients with coxarthrosis who presented to the Department of Orthopaedics and Traumatology within the Emergency County Hospital of Drobeta Turnu Severin, between 2017-2019, the sex, age, social environment of the patients. All patients underwent a thorough clinical examination to determine the risk factors, the favouring factors and their correlation with the paraclinical data obtained through imaging investigation (pelvis X-ray, computer tomography and nuclear magnetic resonance). The study included 462 patients, aged between 23 and 89 years old, who were diagnosed with varying degrees of coxarthrosis within the specialized outpatient clinic. The main risk factors were obesity, osteoporosis, chronic smoking, rural environment, female sex, the existence of a hip injury and intense physical exertion. The main purpose of the research was to analyse a series of data, which would bring information on the incidence, distribution by age groups, sex, living environment and professional activity of the population with coxarthrosis, in order to develop a therapeutic management as effective as possible. Arthrosis is generally characterized by the loss of an important part of the joint cartilage, which causes local pain and reduced mobility. [ABSTRACT FROM AUTHOR]

Deformation due to arthrosis of the hip joint affects 40 % of the total number of patients with osteoarthritis, which is from 7 to 25 % of the adult population. For the activity of the pathological process evaluation we studied biochemical changes in the metabolism of collagen, namely: glycosaminoglycans (GAG), hydroxyproline (HP) fractions, collagenase, hyaluronidase activity, etc. Objective. To determine the biochemical changes in blood serum and articular cartilage depending on the form of progression of idiopathic coxarthrosis. Methods. 23 patients were examined (8 (34.8 %) men, 15 (65.2 %) women, age 45‒75 years and more) with idiopathic arthrosis of the hip joint IV stage (Kellgren-Lawrence). Progression forms of idiopathic coxarthrosis were distinguished: group I -- rapid (the period from the initial to the final stage of the disease was 5 years and less), II -- moderate (5‒10 years), III -- slow (over 10 years). Collagenase activity, HP fractions, total GAG content were determined in patients' blood serum, and collagen content was determined in the cartilage tissue of the femoral head. Results. Compared with the age reference norm in the blood serum of patients of group I activity collagenase increased to 114 %, in II and III -- 122 and 135 %, respectively; the content of the free fraction of GP -- up to 111, 169, 128 %, respectively; GAG concentrations -- up to 110, 122, and 135 %, respectively; protein-bound HP was reduced to 60% in group II, up to 84 % -- in group III. In cartilage tissue, the GAG content decreased in group III to 63 %, II -- 55 %, I -- 47 %; collagen -- 32, 25, 24 % in accordance. Conclusions. The course of idiopathic coxarthrosis is determined by metabolic changes in the components of the organic basis of connective and cartilaginous tissues in blood serum. The most profound changes were found in the synthetic phase of HP metabolism, especially in the group with a rapid course disease. A decrease in the content of organic components of connective tissue (GAG and collagen) was determined. Keywords. Coxarthrosis, stages of progression, biochemical changes, blood serum, articular cartilage. [ABSTRACT FROM AUTHOR]

Background. In orthopedics, the patients’ quality of life relative to the preoperative and postoperative phase is referred with a low impact compared to other branches of medicine. In this context, our interest focused on assessing the quality of life in patients with traumatic and non-traumatic coxarthrosis by longitudinally following the evolution of the patients. Materials and Methods. The well-established instrument Short Form Survey SF-36 was applied in a retrospective study, conducted on a cohort of 203 participants who underwent THA (Total Hip Arthroplasty). Statistical analysis was generated using GraphPad Prism (version 9.5.1). Results. In the pre-operative phase, physical functioning was more affected in participants with traumatic coxarthrosis, while fatigue was specific to nontraumatic coxarthrosis. Emotional well-being and social functioning were high in patients with traumatic coxarthrosis. One month after surgery, we recorded an increased physical functioning and improvement in the perception of the ability to exercise roles in non-traumatic group. Energy/vitality and general health and wellbeing were at high level in traumatic group, 1st month post-surgery, although pain was still frequent. Age was the sole strong independent predictor of postoperative physical functioning in the traumatic group, while in the non-traumatic group, we identified gender, age, symptoms and type of prosthesis as strong predictors of postoperative physical functioning. The overall results related to daily living activities indicated that the traumatic group displayed more favorable post-surgery evolution and higher autonomy compared to the non-traumatic one. Conclusions. We conclude that SF-36 questionnaire is a specific, useful and inexpensive tool for evaluating the outcomes of orthopedic treatment and patients’ evolution after arthroplasty, especially in terms of functional outcome scores relative to coxarthrosis etiology. [ABSTRACT FROM AUTHOR]

Background: DDH with coxarthrosis causes significant deformity and bone deficiency. Various reconstructive techniques have been proposed to treat developmental dysplasia of the hip. However, the existing literature has not yet reached a consensus on the best technique regarding long-term survival. Objectives: This study aims to evaluate the long-term survival of uncemented hydroxyapatite (HA) coated acetabular components augmented with a femoral head autograft. Methods: We retrospectively reviewed the cases of 31 hips in 29 patients (24 female, 5 male, mean age 45.06 years) treated with HA-coated cementless components and femoral head autograft between 2000-2008 with a minimum follow-up of 10 years. Graft resorption, cup loosening and the anatomical hip centre were determined. Functional outcomes were calculated using the Harris Hip Scoring system. The survival of the acetabular component was evaluated using the Kaplan-Meier method. Results: In 24 hips (77,4%), we reconstructed the hip centre anatomically. The remaining cups had variable deviations from the anatomical rotation centre. Only one patient required revision due to loosening. Survival analysis revealed 96.8% survival at 10 years. The mean Harris Hip Score was 39.23 preoperatively and 84.77 at final follow-up. There was no statistical correlation between revision and any of the measured parameters. Discussion: Acetabular reconstruction with a femoral head autograft allows for anatomical cup positioning, early structural support and increases bone stock for future revisions. Although our prior cemented cup study showed that anatomical cup orientation is critical, this study demonstrated the absence of a correlation between implant failure and cup positioning, suggesting that HA-coated cementless cups are more stable and forgiving. Conclusions: HA-coated acetabular cups augmented with femoral head autograft provided long-term, reliable and durable cup fixation in dysplastic hips of young adults. [ABSTRACT FROM AUTHOR]

Introduction. Perioperative pain management associated with hip surgery is challenging. The pericapsular nerve group (PENG) block is a new technique thought to provide better postoperative analgesia in addition to its motor-sparing effects.Aim. This review aims to evaluate the safety and efficacy of the PENG blockade in managing postoperative pain in patients undergoing hip surgery.Methods. The literature was reviewed through four electronic databases: PubMed, Cochrane Library, Google Scholar, and Embase. Results. The initial search yielded 416 articles. Twenty-seven relevant articles were selected based on relevance, recentness, search quality, and citations. Twelve of the studies were related to patients undergoing total hip arthroplasty. Twelve studies were related to patients undergoing total hip surgery due to hip fracture. Finally, three studies were related to patients undergoing hip arthroscopy.Conclusions. The PENG block provides superior analgesia and low opioid consumption in the first postoperative period. However, current evidence is insufficient, and there is a need for high-quality randomized, controlled trials with larger sample sizes.

Study aim: The purpose of this study was to compare the effects of whole-body and local cryotherapy on pain and function of the osteoarthritic hip.

Background. The participation of immune responses in the pathogenesis of degenerative-dystrophic diseases of the synovial joints determines the feasibility of using more rational approaches to assessing the immune status of patients with this pathology. Despite the ongoing immunological studies in patients with degenerative-dystrophic diseases of the hip joint, there are questions related to the functioning of the immune system as a whole, which require additional research.The aim of the study was to establish the features of the relationship between the indicators of the immune status and to identify the factors that determine the nature and severity of immunological disorders in patients with coxarthrosis.Material and methods. The study is based on the results of immunological parameters in 73 patients (mean age – 45.3 ± 2.56 years) with stage III dysplastic coxarthrosis. The data obtained using cluster analysis made it possible to distribute patients into two groups. The first clinical group included 46 patients, the second one – 27 patients. The control group consisted of 28 clinically healthy individuals. Mathematical processing of the results was carried out using the Statistica 6.0 software package (StatSoft Inc., USA) and the mathematical package Mathcad 2001 Pro (MathSoft Inc., USA).Results. The levels of CD4+ and CD8+ cells and IgA were determined as the classification features that make the greatest contribution to the division of the studied groups. Model experiments have shown that a specific combination of the magnitude of each of the noted factors with a certain degree of probability makes it possible to assess the state of the initial immunological reactivity and verify the nature and severity of immunological disorders.Conclusion. The information obtained is of great importance, since it allows predicting the course of the recovery period after surgery and assessing the risk of developing possible postoperative complications in patients with severe articular pathology.

Abstract Background In 2019, Germany had the highest rate of hip replacement surgery and the fourth highest rate of knee replacement surgery among more than 30 OECD countries. The age-standardised rates were estimated at 174 hip joint and 137 knee joint replacements per 100,000 population. Against this background, the contrast between financial incentives for surgery and missing incentives for non-surgical treatment options is repeatedly discussed. Quality indicators (QIs) can serve to measure and transparently present the quality of evidence-based care. Comparing results in the form of audit and feedback has been shown to improve e.g. guideline-compliant ambulatory care. Existing QIs targeting the care of gon- and coxarthrosis mainly focus on discharge management after joint replacement surgery and/or require additional data collection. Therefore, as part of the MobilE-ARTH project, a set of QIs for ambulatory care prior to joint replacement surgery calculable based on routine data is being developed. The present study’s aim is to evaluate the impact of this QI set in terms of providing feedback on the quality of care. Methods The MobilE-ARTH project comprises (Phase 1) developing a QI set following the RAND/UCLA Appropriateness Method, (Phase 2) implementing the QIs in established physician networks of a German statutory health insurance (SHI) within a prospective, non-blinded, cluster-randomised pilot study, and (Phase 3) evaluating the QI set’s effectiveness. The physicians in the intervention networks will (a) receive feedback reports providing information about the routine data-based QIs of their gon- and/or coxarthrosis patients and aggregated results for their network, and (b) be invited to two voluntary, facilitated network meetings. In these network meetings, the physicians can use the information provided on the feedback reports to discuss multiprofessional care pathways for patients with gon- and/or coxarthrosis. Selected indicators of the QI set will serve as primary and secondary outcome measures. Routine data will be analysed within multi-level models using an intention-to-treat approach. Discussion Feedback reports help maintaining clinical standards and closing the gap between evidence and medical practice, thus enabling an overall improvement in health care. Providing physicians with QI-based information on quality of care promotes identifying strengths and weaknesses in medical treatments. Trial registration German Clinical Trials Register, number DRKS00027516 , Registered 25th January 2022 – Prospectively registered.

Osteoarthritis (OA) is a multifactorial disease that can be caused by genetic factors, obesity, joint microtrauma, and excessive physical exercises. The key features of OA include gradual loss of articular cartilage, bone tissue remodeling, development of osteophytes, and subchondral sclerosis. The pathogenesis of OA is based on the loss of glycosaminoglycans, collagen disorganization, and inflammation mediated by a cytokine cascade. OA is a complex disease affecting not only cartilage, but also intraarticular and periarticular tissues. Together, these changes compromise joint function and cause chronic pain. Considerable attention has beer recently paid to OA phenotyping in order to introduce a tailored approach into patient management. Phenotypes are applicable to the three most common peripheral OA locations: gonarthrosis, coxarthrosis, and hand OA. An international group of experts of primary care has developed algorithms for OA patient management, including diagnostic criteria, treatment options, and criteria for referring the patient to a specialist (rheumatologist). Current guidelines recommend non-drug therapy, pharmacotherapy, and surgery. There is a growing interest in phytopharmaceuticals, a heterogeneous group of molecules with a high capacity of suppressing inflammation, oxidative stress, and pain, as well as improving joint function. Mucosate® in capsules (DIAMED-pharma, Russia) is one of currently available complex products with phytocompounds. It contains the NEM® complex (natural eggshell membrane), Harpagophytum root extract, glucosamine sulfate, chondroitin sulfate, and manganese sulfate monohydrate.

Introduction: Hip prosthetic surgery is a commonly performed procedure in orthopedic trauma. It has changed the prognosis of traumatic, degenerative and inflammatory hip diseases. Objective: The aim of this work was to evaluate the functional and anatomical results of a series of total hip replacements in our department in the short and medium term and to compare them with the literature. Patients and methods: This was a retrospective descriptive and analytical study of a series of 96 total hip replacements performed at the University Hospital of Kati, from January 2019 to December 2021. Functional discomfort was assessed in all patients before and after surgery. The prostheses used were of the Aston, AK, Surgival, Evolutus and Sharma types. The anatomical results were assessed by radiological criteria and the functional results by Postel Merle d'Aubigné criteria. Results: In our study, 96 hips were operated on by total prosthesis in 91 patients, including five bilateral cases. The patients were 49 men and 42 women. The average age was 46.9 years. Coxarthrosis associated with necrosis of the femoral head was the most frequent indication for arthroplasty (n=51), followed by femoral neck fracture (n=26). The inclination of the cup was anatomical in 73.3% of cases. The mean femoral offset was 44.1 mm with extremes of 26 and 59 mm. Cup anteversion was normal in 79.4% of cases. The mean preoperative PMA score increased from 5.2 (0 and 15) to 16.9 (4 and 18) late postoperatively. Our results were satisfactory in 89% of cases. Conclusion: Total hip arthroplasty allows, in the vast majority of cases, to recover indolence and perfect functionality of the hip. [ABSTRACT FROM AUTHOR]

Coxarthrosis, or hip osteoarthritis (OA), is one of the main causes of hip pain, which can affect patients of all ages, being one of the most common reasons for patients presenting to the specialized outpatient clinic. The objective of our research was to determine the number of patients with coxarthrosis who presented to the Department of Orthopaedics and Traumatology within the Emergency County Hospital of Drobeta Turnu Severin, between 2017-2019, the sex, age, social environment of the patients. All patients underwent a thorough clinical examination to determine the risk factors, the favouring factors and their correlation with the paraclinical data obtained through imaging investigation (pelvis X-ray, computer tomography and nuclear magnetic resonance). The study included 462 patients, aged between 23 and 89 years old, who were diagnosed with varying degrees of coxarthrosis within the specialized outpatient clinic. The main risk factors were obesity, osteoporosis, chronic smoking, rural environment, female sex, the existence of a hip injury and intense physical exertion. The main purpose of the research was to analyse a series of data, which would bring information on the incidence, distribution by age groups, sex, living environment and professional activity of the population with coxarthrosis, in order to develop a therapeutic management as effective as possible. [ABSTRACT FROM AUTHOR]

Background. Coxarthrosis prevalence rates are necessary to assess the socio-economic significance of this pathology and to calculate the need for endoprosthetics. Information about the provision of medical care to patients with coxarthrosis is presented in the reports of various medical organizations, but in state statistical reports at the regional level this nosological form is not taken into account as a separate line.The aim. To estimate the prevalence of coxarthrosis based on the combined use of medical records from various sources in a region with a specialized clinic for prosthetics of large joints.Materials and methods. A retrospective descriptive epidemiological study based on materials from the Irkutsk region for 10 years (2008–2017) was carried out. Three main sources of data on patients with coxarthrosis were used: continuous and randomized samples based on population visits to polyclinics (n = 24 029), information from the bureau of medical and social expertise on disability (n = 19 081) and information from a specialized clinic on total hip arthroplasty (THAP) (n = 6227). The dynamics of indicators by years, the distribution of patients by sex, age and groups of disabilities have been analyzed. Regional indicators of incidence and prevalence of coxarthrosis were calculated based on extrapolation of sample data.Results. The following average annual regional indicators for patients with coxarthrosis were calculated: primary visits to polyclinics (incidence) – 73.8 (71.9–75.7) with a frequency of visits 1.9 times a year, the frequency of THAP operations – 3,3 (3,0÷3,6), disability – 10.1 (10.0÷10.3). The median age of patients at the initial visit was 61 years (Q1 = 46; Q3 = 76). The proportion of men among different groups of patients ranged from 41 to 44%, the proportion of disabled people among patients of the polyclinic and surgical hospital – from 45.2 to 47.1%. The estimated prevalence of coxarthrosis among the adult population was 413.5 (410,6÷416,4) / 10000.Conclusions. The epidemiological analysis algorithm described in the article is proposed as the first stage in assessing the social and economic significance of coxarthrosis and the regional need for arthroplasty of large joints.

Objective. To analyze the influence of sagittal balance parameters on the risk of dislocations of the head of the femoral component of the hip joint endoprosthesis. Material and Methods. A retrospective analysis of medical records of 113 patients with idiopathic coxarthrosis who underwent unilateral total hip arthroplasty was performed. The study assessed the parameters characterizing the sagittal balance in patients without prosthet- ic femoral head dislocation in the postoperative period (Group 1; n = 60) and in patients treated for prosthetic femoral head dislocation (Group 2; n = 53). Comparison of indicators was carried out by non-parametric Mann – Whitney U-test, and identification of dislocation predictors – by building single- and multi-factor logistic regression models. Differences were considered statistically significant at the achieved significance level p < 0.05. Results. In Group 1, the type 3 sagittal balance according to Roussouly prevailed (48 %), in Group 2 – types 1, 2 and 4 (75 %). In patients with types 1 and 2 sagittal balance, the dislocations of the prosthetic femoral head occured 1.84 times more often than in patients with type 3, and that in patients with type 4 – 1.66 times more often. Conclusion. Patients with Roussouly type 3 sagittal balance have significantly lower risks of postoperative dislocation of the prosthetic femoral head, as compared with those with types 1, 2 and 4.

Purpose: Osteoarthritis (OA), osteoporosis, and bone fractures are frequent aging-related conditions. Regardless of the growing research interest in the effects of hip OA on femoral fracture risk, data about the region specificity of osteodensitometric and hip structure analysis (HSA) parameters of the proximal femora are lacking in aged postmenopausal women with hip OA compared to individuals with femoral neck fragility fracture.Methods: This study included 76 postmenopausal women admitted for total hip arthroplasty due to non-traumatic femoral neck fracture (FN_Fx group, n = 39) and hip osteoarthritis (OA group, n = 37).Results: Osteodensitometric parameters differed significantly between the OA and FN_Fx groups, depicting lower bone mineral density in the FN_Fx group (p < 0.05). The most significant increase in these parameters was registered in the intertrochanteric region of the OA group. Moreover, the OA-induced changes in HSA-derived parameters displayed significant regional heterogeneity, with the intertrochanteric region showing the most notable difference between OA and FN_Fx group.Conclusion: Our data may indicate that OA displayed the most prominent positive effect on the intertrochanteric femoral region, revealing the regional heterogeneity in structural geometry and biomechanical indices of proximal femora in OA individuals. Since we did not observe significant differences in the femoral neck region, we may speculate that OA does not have a substantial protective effect on the femoral neck fracture risk in aged postmenopausal women. [ABSTRACT FROM AUTHOR]

Based on the current state of scientific knowledge, guidelines provide recommendations for the diagnosis and therapy of various diseases. This article summarizes the current recommendations of the most important professional societies for the diagnosis and therapy of coxarthrosis and gonarthrosis. It is agreed that an individual consultation of the patients and an individually tailored therapy concept must be carried out depending on the wishes and the osteoarthritis stage. By no means there are gold standards for any forms of therapy. It is important for the therapist to know the possible treatment options in order to then develop an individually tailored therapy program for his patient. The guidelines serve as an aid for this. This review deals with the different approaches of different professional societies about individual forms of therapy. [ABSTRACT FROM AUTHOR]

The osteoarthritis patient requires an individual consideration of conservative treatment, a joint-preserving surgery or a prosthesis. Currently recognized concepts such as the arthroscopic CAM (Comprehensive Arthroscopic Management) procedure on the shoulder, the arthroscopic correction of the frequently underlying hip impingement and, for example, the wide range of corrective osteotomies around the knee joint are demanding and require a differentiated and individual procedure. The principle applying to these joint-preserving surgeries is, the sooner the better. A protracted treatment diminishes the results. An early corrective intervention in combination with a customized conservative therapy is the most successful concept for many patients. [ABSTRACT FROM AUTHOR]

Hip osteoarthritis (OA) is a prevalent condition causing significant pain and disability. Platelet-rich plasma (PRP) intra-articular injections have emerged as a potential therapeutic option, but their efficacy is still debatable and their safety profile remains under-explored compared to standard treatments. This systematic review aims to evaluate the efficacy and safety of PRP injections in patients with hip OA by analyzing data from randomized clinical trials (RCTs). A comprehensive literature search was conducted in PubMed, Scopus, and the Virtual Health Library (VHL) until October 31, 2022, adhering to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Studies were included if they were RCTs assessing PRP injections for hip OA and reporting adverse events. Data extraction and methodological quality assessment were performed using the Cochrane Risk of Bias Tool (RoB 2 tool). Out of 188 identified studies, five met the inclusion criteria. The studies varied in sample size (43-111 patients) and PRP preparation methods (closed vs. open systems). All studies demonstrated significant pain reduction and functional improvement with PRP. No major adverse events were reported, indicating a favorable safety profile. Minor side effects were transient and resolved without further intervention. Methodological quality ranged from low to high risk of bias. In conclusion, PRP injections appear to be a safe and effective treatment option for managing hip OA, with favorable outcomes compared to hyaluronic acid. Further research is necessary to standardize PRP protocols and assess long-term safety and efficacy., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Almutairi et al.)

Background: In 2019, Germany had the highest rate of hip replacement surgery and the fourth highest rate of knee replacement surgery among more than 30 OECD countries. The age-standardised rates were estimated at 174 hip joint and 137 knee joint replacements per 100,000 population. Against this background, the contrast between financial incentives for surgery and missing incentives for non-surgical treatment options is repeatedly discussed. Quality indicators (QIs) can serve to measure and transparently present the quality of evidence-based care. Comparing results in the form of audit and feedback has been shown to improve e.g. guideline-compliant ambulatory care. Existing QIs targeting the care of gon- and coxarthrosis mainly focus on discharge management after joint replacement surgery and/or require additional data collection. Therefore, as part of the MobilE-ARTH project, a set of QIs for ambulatory care prior to joint replacement surgery calculable based on routine data is being developed. The present study's aim is to evaluate the impact of this QI set in terms of providing feedback on the quality of care.Methods: The MobilE-ARTH project comprises (Phase 1) developing a QI set following the RAND/UCLA Appropriateness Method, (Phase 2) implementing the QIs in established physician networks of a German statutory health insurance (SHI) within a prospective, non-blinded, cluster-randomised pilot study, and (Phase 3) evaluating the QI set's effectiveness. The physicians in the intervention networks will (a) receive feedback reports providing information about the routine data-based QIs of their gon- and/or coxarthrosis patients and aggregated results for their network, and (b) be invited to two voluntary, facilitated network meetings. In these network meetings, the physicians can use the information provided on the feedback reports to discuss multiprofessional care pathways for patients with gon- and/or coxarthrosis. Selected indicators of the QI set will serve as primary and secondary outcome measures. Routine data will be analysed within multi-level models using an intention-to-treat approach.Discussion: Feedback reports help maintaining clinical standards and closing the gap between evidence and medical practice, thus enabling an overall improvement in health care. Providing physicians with QI-based information on quality of care promotes identifying strengths and weaknesses in medical treatments.Trial Registration: German Clinical Trials Register, number DRKS00027516 , Registered 25th January 2022 - Prospectively registered. [ABSTRACT FROM AUTHOR]

After Ganz's first work in 2003 on femoral acetabular impingement (FAI), the interest in this pathology has steadily increased. Several treatments have been proposed and many parameters have been evaluated to reach a diagnosis as accurate as possible. In fact, the resulting cartilage lesions are often associated with early development of osteoarthritis in symptomatic patients. Although there is a considerable percentage of elderly patients who meet radiographic criteria for FAI but are asymptomatic, this disease is commonly underestimated in young adults with coxalgia. The purpose of our study was to investigate these signs in radiographic images in patients under the age of 60 years who have undergone hip replacement surgery to see if FAI criteria were present. We found such signs in most of the patients examined. The most frequent type was mixed impingement. Diagnosis of FAI in symptomatic young adults, in the light of radiographic data, is likely to be underestimated. Early diagnosis and treatment therefore play a non-secondary role. [ABSTRACT FROM AUTHOR]

Objective: To study the pattern of the gastrointestinal (GI) motility and determine the relationship between the indicators of glycemic profile, clinical manifestations of GI syndromes and the type of GI motility impairment in geriatric patients with type 2 diabetes mellitus (T2DM) during joint replacement surgery. Methods: The study involved 350 patients over 70 years old (76±5.0) with osteoarthritis (OA) and concomitant T2DM. GI motility was assessed using computer-aided phonoenterography (CPEG). In addition, monitoring of the level of glycemia (GL) was carried out. To determine correlations between the GL during CPEG and the level of glycated hemoglobin with the GI motility indicators, the assessment points of the study were specified as: 1) with empty stomach; 2) enteral nutrition by sipping; 3) administration of gastrokinetics. Results: The CPEG method revealed three types of intestinal peristalsis (with weak, moderate and strong wave types). The relationship between GI motility and GL was characterized by an «intestinal peak factor» (IPF) coefficient. It was found that the clinical manifestations of GI syndromes correlate with the objective indicator of the GI motility, such as IPF (r=0.6; p=0.012); and GL (r=0.54; p=0.021). It was shown that when taking a standard nutritional formula for nutritional support, the GI motility decreases while the level of glycemia increases, despite the timely taken antihyperglycemic drugs. Therefore, it is necessary to prescribe a specialized nutritional mixture and gastrokinetics, which accelerate the evacuation from the upper gastrointestinal tract (GIT). A correlation was found between GL and GI motility (r=0.49; p

Introduction: Biological changes duo to aging can cause joint problems and coxarthrosis is one of the most common. Due to the consequences and the way it affects people's quality of life, total hip arthroplasty appears as one of the solutions. Thus, the rehabilitation nurse stands out as the professional capable of enhancing functionality and maximizing the person's independence. Objective: Identify the benefits of the rehabilitation nurse’s intervention, in the pre and postoperative period of a person undergoing total hip arthroplasty due to coxarthrosis. Methodology: Unique descriptive case study, based on the CARE guidelines (CAse REport). A specific rehabilitation program was implemented and targeted at the person under study, based on the diagnoses identified and giving particular interest to Functional Motor Reeducation. Results: There was an increase in muscle strength and range of motion in the surgically operated limb, improvements in body balance and independence in performing activities of daily living and a decrease in the risk of falling and pain intensity. Conclusion: Functional capacity improved after surgical intervention and a rehabilitation nursing program.

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Copyright of Arthroskopie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Arthroskopie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Relevance. The frequency of hip dysplasia does not decrease and in different countries of the world ranges from 2 to 50 or more per 1000 newborns. The generally accepted standard for the treatment of children under 1 year of age with hip dysplasia is the functional method. At the same time, the number of patients with untimely revealed hip dysplasia, as well as with an unsatisfactory outcome of functional treatment, for example, according to the A. Lorenz technique, remains at a fairly high level. In this regard, the use of corrective surgical interventions remains relevant. The purpose of this study was to evaluate the medium-term results of the treatment of children with I–II stage dysplastic coxarthrosis using the authors’ rehabilitation algorithm based on the functional state of the hip. Materials and Methods. The study was based on the results of a comprehensive examination of 41 patients (48 hip joints) with stage I–IIa dysplastic coxarthrosis undergone the surgery and rehabilitation according to the authors’ algorithm in the period from 2016 to 2018. To compare the obtained results, we performed a retrospective analysis of the clinical records of 32 patients (39 hip joints) undergone the similar surgery, although with the routine rehabilitation. All patients underwent a clinical examination with a mandatory assessment of step cycle, periarticular muscles endurance, and filling out specialized questionnaires. Radiological evaluation included hip x-ray and multi-spiral computed tomography. To obtain the most objective information of the hip functional state and lower extremities, we used electrophysiological (EMG) and biomechanics (stabilometry) studies. Results. Clinical and functional results were evaluated no earlier than 24 months after the treatment. The patients undergone rehabilitation according to the authors’ algorithm demonstrated the significant (p

This review article is devoted to the natural course of hip femoroacetabular impingement (FAI). The evolution of the understanding and views of surgeons on primary (idiopathic) arthrosis are considered. It is noted that nowadays, the primary arthrosis in fact almost always arises from anatomical variations. Among those are cam- and pincer-deformities, leading to impingement. In most of the major works, a reliable causal relationship of cam-FAI with arthrosis has been proven. Moreover, cam-FAI also carries the risk of impending arthroplasty. The association of pincer-FAI with arthrosis has been controversial. The course of FAI arthrosis, most likely, is not as aggressive as, for example, dysplastic arthrosis, and less often requires arthroplastics. Since cam-FAI is a reliable risk factor for arthrosis and arthroplasty, it could be assumed that timely surgical correction of FAI would stop or slow down arthrosis and avoid arthroplasty. However, at present, this assumption has not been proven, therefore, there is no reason to assert that surgery for FAI in any way affects its natural history in the form of severe arthrosis following by arthroplasty.

Aim. To demonstrate difficulties in diagnosing multiple myeloma at the out-patient stage on the example of a clinical case.Materials and methods. The course of establishing a diagnosis in a 58-year-old patient complaining of pain in the hip joint was analysed on the basis of the patient’s medical records both at the out-patient and in-patient stages.Results. A case of multiple myeloma occurring under the guise of common degenerative-dystrophic diseases is presented. An oncological diagnosis was suspected due to the patient’s complains of persistent pain, which was poorly relieved by non-steroidal anti-inflammatory pain agents, and progressive changes in the general blood test (acceleration of ESR to 40 mm/h, and then to 50 mm/h; reduction of hemoglobin from 145 g/l to 134 g/l). The diagnostic search started with an ultrasound examination of the abdominal cavity and pelvic organs, which revealed both an extensive formation in the pelvis in the right iliac region and the lymphadenopathy of the inguinal lymph nodes. Subsequently, spiral computed tomography of the abdominal cavity and the pelvis was conducted. In all bones at the study level, multiple spherical solid formations with uneven contours causing destruction of bone tissue were detected, allowing myeloma to be suspected. The patient was referred to the Republican Clinical Oncology Dispensary, where a percutaneous biopsy of the retroperitoneal neoplasm, as well as morphological and immunohistochemical studies, were carried out. As a result, the following diagnosis was established: multiple stage IIIA myeloma, first detected, with damage to the thoracic, lumbosacral spine, ribs, pelvic, and thigh bones. The patient was hospitalised in the Hematology Department of the First Republican Clinical Hospital, where he underwent chemotherapy according to the VCD scheme (bortezomib, dexamethasone, cyclophosphomide), and was discharged with improvement.Conclusion. The diagnosis of multiple myeloma is a challenging task for a primary care physician due to the diversity of the clinical picture and the lack of clinical suspicion. At the same time, timely diagnosis of the disease at the out-patient stage can significantly increase the effectiveness of treatment and, therefore, improve the prognosis. Thus, more attention should be paid to the differential diagnosis of degenerative diseases of the musculoskeletal system and multiple myeloma.

Copyright of Revista Portuguesa de Enfermagem de Reabilitação is the property of Associacao Portuguesa dos Enfermeiros de Reabilitacao (APER) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective The destruction of the joint cartilage either by age or trauma can develop coxarthrosis limiting the motion of the patient, which is treated by the replacement of the whole joint with total hip arthroplasty. In this study, we aimed to report our short and mid-term results and discuss with the current literature on postoperative results of cementless total hip arthroplasty (THA) in patients with coxarthrosis. Material and Method One hundred thirty patients (86 female, 44 male) with a mean age of 54.1±9.6 years who underwent total hip arthroplasty with a cementless prosthesis included in the study. The outcomes and complications of the total hip arthroplasty were reviewed from patient's counseling charts, laboratory tests and radiographs. retro Results There was a statistically significant difference between pre (41.75±9.62) and postoperative (90.44±7.51) mean modified Harris Hip Score measurements (p<0.001) indicating the successful outcome. Intraoperative femur fracture occurred in 10 patients (7.6%). Anterior thigh pain (26 patients, 20.0%) and extremity length difference (20 patients, 15.4%) were the most common complications observed. Although 13 patients (10.0%) had heterotopic ossification after total hip arthroplasty, none of the patients had limited motion associated with it. Malpositioning (7 patients, 5.4%), dislocation (3 patients, 2.3%), infection (2 patients, 1.5%) and deep venous thrombosis (1 patient, 0.8%) were among the other complications observed. There were no cases with acetabular cup migration or pain limiting hip movement. Conclusion The cementless THA provides improvement of hip function in patients with coxarthrosis. The preoperative risk assessment of the coxarthrosis patients is necessary to ensure patient's satisfaction, minimize complications and provide long-term durability of the prosthesis. [ABSTRACT FROM AUTHOR]

Background. Degenerative diseases of the hip joints are accompanied not only by pain, but also by changes in the anatomical proportions of the joint. Hip replacement eliminates pain syndrome, in most patients the anatomical proportions of the joints are restored, but if the clinical outcome of arthroplasty can be assessed radiologically, the result of functional recovery is difficult to assess, especially in dynamics. Statographic research today is one of the main diagnostic methods to monitor the recovery of patients after orthopedic surgeries. Purpose: according to statographic studies to determine the parameters that reflect the functional ability of patients to maintain an upright posture and monitor their changes in the recovery process after hip replacement surgery. Materials and methods. We examined 50 patients with degenerative diseases of the hip joint before and after arthroplasty. Data from standard study protocols were analyzed. Results. Before the operation, the oscillation coefficient differs markedly from the norm for all types of stance. Six months after surgery, normalization of swing is observed at single and double leg stance on a healthy extremity, but for the prosthetic limb, the oscillation coefficient does not improve significantly. Before the operation in double leg stance, there was a shift of the center of mass towards a healthy limb, after 6 months the deviation is significantly reduced. At single leg stance, there is a noticeable shift of the body towards a healthy limb, which decreases after arthroplasty. After surgery, patients have a decrease in the deviation of the body backwards in all types of stance, as well as a decrease in the rotation of the body in single leg stance, the load on the operated limb increases. Conclusions. In patients with coxarthrosis, the support ability of the damaged limb is impaired, which is confirmed by the displacement of the center of mass towards a healthy limb, the load on the foot of the affected limb decreases, the ability to maintain balance is reduced in both double and leg single stance. Monitoring these parameters is a mean to control the restoration of the function of maintaining the balance in patients after hip arthroplasty. [ABSTRACT FROM AUTHOR]

Background. The dynamic balance between the immune and neuroendocrine systems and their mutual regulation provide the formation of protective reactions of the body in conditions of pathology and various stress-inducing effects. The aim of the research was to establish the nature of the relationship between the indicators of the immune status and hormonal profile in patients with coxarthrosis before and after hip replacement.Material and methods. The study involved 73 patients with stage HI dysplastic coxarthrosis, who, using cluster analysis according to immunological parameters, were divided into two groups. The first clinical group included 46 patients, the second - 27 patients. The control group consisted of 28 clinically healthy individuals.Results. In the preoperative period, correlations between indicators of the immune status and hormonal profile were different in patients of the 1st and 2nd groups and depended on the level of hormones. Moreover, in patients of the 1st group, the hormones of the stress-limiting system made the greatest contribution to this dependence, and in patients of the 2nd group - peripheral thyroid hormones. After endoprosthetics, the correlation dependence in patients of the 1st group differed from the initial one in a number of indicators of the immune status and hormonal profile, which reflects the coordinated work of these body systems under the influence of stress factors. In patients of the 2nd group, the spectrum of these indicators was limited, which indicates the failure ofmechanisms, in particular, limiting the intensity ofinflammatory reactions after surgery.Conclusion. The relationship of the studied parameters in patients of the 1st group indicates the adaptive nature of the immune and endocrine reactions in response to surgery. In patients of the 2nd group, they reflect disadaptive rearrangement, which leads to an increased risk of postoperative complications.

Objective: To evaluate the results of the GSRS gastroenterological questionnaire as an express test in identifying gastrointestinal dysfunction in patients over 75 years old who have been taking non-steroidal anti-inflammatory drugs (NSAIDs) with coxarthrosis and gonarthrosis in the presence of type 2 diabetes mellitus (T2DM). Methods: Assessment of the severity of gastroenterological complaints carried out with the help of the GSRS questionnaire of quality of life in 100 patients over 75 with coxarthrosis and gonarthrosis. Group I included 60 patients with a concomitant of T2DM; group II included 40 patients without diabetes. Results: The statement and analysis of general clinical data in groups allowed to calculate the frequency of clinical manifestations of gastroenterological syndromes and their average numerical score on the GSRS questionnaire. The average total survey score was significantly higher in the group of patients with coxarthrosis and gonarthrosis on the background of T2DM. Constipation, reflux, and dyspeptic syndromes were not identical in both groups and had statistically significant differences. Confirmed more pronounced violations of motor-evacuation function (MEF) of the gastrointestinal tract in a group of patients with coxarthrosis and gonarthrosis on the background of T2DM. Conclusion: In order to prevent hypo- or hyperglycemic states in the perioperative period in patients with coxarthrosis and gonarthrosis, it is advisable to use the GSRS gastroenterological quality of life questionnaire, which allows identifying oppression of the MEF of the gastrointestinal tract. Patients with coxarthrosis and gonarthrosis and concomitant of T2DM who take long term receiving NSAIDs have a more pronounced dysfunction of the gastrointestinal tract.

Background. Study immediate and long-term results following ankle joint endoprosthesis.Materials and Methods. During the period from 2013 to 2016, we performed 26 ankle joint endoprostheses in patients aged from 19 up to 78 years with arthroses of various etiology. The average operative time was 1,6 hours. Average blood loss was 200 ml. There were 3 cases with an intraoperative fracture of an internal anklebone and they required additional synthesis by one or two screws. In the postoperative period one patient developed some regional necrosis in the postoperative wound area. Developed complications had no impact on observed positive results.Results. In 24 cases of 26 (92.3%) patients were satisfied with surgery results. In 18 of those (69.2%) the volume of postoperative movements significantly increased, but remained less normal. In 3 cases (11.5%) the volume of movements remained at the preoperative limited level, however the pain syndrome while walking was completely stopped. In 3 patients (11.5%) who had no restrictions in movement amplitude neither prior to nor after the operation, the pain syndrome was also stopped. In 92.3% cases the positive results of ankle joint replacement were received. In 2 cases (7.7%) the received results were estimated as unsatisfactory because of deformation and the remaining pain syndrome. We continue observing patients.Conclusion. Ankle joint replacement with modern implants allows to achieve the positive immediate and long-term results in 92.3% cases and it is a hi-tech alternative to arthrodesis procedures.