Results of joint replacement in femoral neck fractures have been analyzed. During the period from 1994 to 2003 total hip replacement was performed to 399 patients with subcapital fractures including 372 patients in whom the operation was performed as a primary intervention. From 2002 to 2004 the total number of 290 hemiarthroplasty operations with use of module native implant was performed in 286 patients aged 76-101 years. In total joint replacement group intrahospital lethality made up 2% due to the following causes: pulmonary thrombembolia - 3 cases, acute cardiac insufficiency - 1 case, deep decubitus ulcers resulting in sepsis - 2 cases, polyorganic insufficiency on the background of severe concomitant pathology - 1 case. In the early postoperative period the following complications were noted: implant dislocation (5.2% of cases), intraoperative femoral fracture (3.5%). Infectious complications developed in 2 patients and in both cases removal of the implant was required. With mean-term follow-up native implants showed mean-term survival of 92-94% in 272 patients. Mean evaluation by Harris was the following: biometric «Sinko» and «ESI» implants - 83.1 points, PF «Sinko» implants - 89.3 points, combination of «Mathys» friction pair with native femoral component - 91.2 points. «Mathys» implants showed 94.6 points. Results of ЯРТЕЗ joint replacement were evaluated during the period from 1 to 3 years in 183 patients. Intrahospital lethality made up 1.8%. Excellent and good results were achieved in 53.7% of patients. Revision was required in 1.5% of cases. As concluded total hip replacement in femoral neck fracture was the effective treatment technique. It was reasonable both cement and cementless fixation with various implants for the optimum choice of implant in every specific patient. Use of modern module implants enabled to expand the indications for application of arthroplasty in elderly patients.
The model of pin distractor (pat. 75299 RF) that enables to perform intraoperative 3D correc-tion of fragments' displacement has been proposed. Twenty patients with closed fractures of the shin bones have been operated using this device and treatment results have been analyzed. In 4 patients slight (up to 3°) angular displacements have been noted. In 1 patient 0.5 cm shortening of the shin has been present as a result of the previous fracture. Treatment results have been considered as good in all cases.
Combined therapy of osteoarthritis (OA) includes intra-articular injections of hyaluronic acid. A prospective observational multicenter noncomparative study was conducted in compliance with routine clinical practice in patients with knee OA IIII stages in order to assess 1-year long-term safety and efficacy of Hylan G-F 20 (Synvisc-One, one injection of 6 mL). Patients came for observation at 3, 6, and 12 months after intra-articular injection of Hylan G-F 20. The primary objective of the study was evaluation of pain severity while walking and rest by using the WOMAC VA3.1 (Western Ontario and McMaster Universities Osteoarthritis Index) scale after 26 and 52 weeks compared to baseline. Quality of life was measured by EQ-5D (EuroQuality of Lifefive dimensions); patients general condition was measured by PTGA (Patient Global Assessment) and COGA (Clinical Observer Global Assessment). Results of the study were based on data of 121 patients (79.51% women, 21.49% men), mean age 62.97 12.47 years. Positive clinical response was observed in 12 months (52 weeks) after Hylan GF-20 administration: pain severity versus baseline was decreased by 48.92% (p 0.001) as per WOMAC A, stiffness in the joints versus baseline by 49.72% (p 0.001) as per WOMAC B, difficulties in the daily life versus baseline by 41.54% (p 0.001) as per WOMAC C. Seven adverse events were detected in five patients (4%), and one serious adverse event (cardiovascular abnormalities) was noticed during the entire study that was unrelated to the study drug. The extent of clinical response did not correlate with the stage of osteoarthritis. The quality of life was improved by 35.28% (p 0.001) according to the questionnaire EQ-5D. The general condition of the patients was improved by 37.50% (p 0.001) as per COGA and 42,86% (p 0.001) as per PTGA. No patients were discontinued the study due to adverse event or any other reasons. Intra-articular injections of Hylan G-F 20 6 mL were associated with acceptable safety and efficacy, and the therapeutic effect was observed up to 52 weeks.
Objective: to find adverse periprosthetic local tissue reactions after metal-on-metal hip arthroplasty with ASR XL heads. Material and methods: 119 patients with 134 ASR XL head - Corail prostheses were treated in 2007-2009. The results were studied in 94 cases (105 prostheses) - 84%. Average follow-up time consisted 62 ± 3 months. MRI was performed in 12 patients (13 hips) who had clinical nonsatisfaction. Obtained data were compared with 21 MRI (24 hips) of controlled group with good and perfect clinical results. Results. We found variations of normal periprosthetic tissue condition. Adverse reactions were identified in 10 cases. To improve the quality of pictures we developed special MRI adjustments and regimes of work. Conclusion: MRI diagnostics is indicated for the patients with metal-on-metal total hip arthroplasty in order to identify adverse local tissue reactions. The improvement of picture quality needs special adjustment of MRI equipment.
After 359 total hip replacements (305 patients) infectious complications developed in 12 (3.3%) cases. Three cases were analyzed. To arrest the chronic inflammation, filling of residual cavities and substitute dermal defects muscular and myodermal flaps from m.tensor fasciae latae, m.rectus femoris and m. vastus lateralis with axial blood supply were used. Stopping of inflammatory process and radical closing of wound defect was achieved in all cases. In 2 patients it was possible to preserve stable to dislocation hip implants by means of wrapping up the implant neck with muscular flap.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.