New Method of Autoplasty of Knee Articular Surface Defects in Patients With Destructive-Dystrophic Diseases

Abstract

Aim - to evaluate the results of the treatment of patients with destructive-dystrophic diseases of the knee using a new method of autoplasty of articular surfaces. Materials and methods. The results of surgical treatment of 42 patients with destructive-dystrophic diseases of the knee were studied. All patients underwent surgical treatment with the use of a new method of autoplasty of articular surfaces. The operation is based on the technique of "classical" mosaic chondroplasty, but in addition we form a non-free muscle flap and pass it under the basis of osteo-cartilaginous autografts in the defect zone through a specially created canal. Comparative evaluation of surgical treatment results of the indicated clinical group of patients was carried out 3, 6 and 36 months after the operation. Treatment response was assessed according to the following indicators: WOMAC-index, Lequesne index, parameters of the rheovasography, functional electromyography and podometry. These indices allowed us to calculate integral indicators Хвц with the use of which we managed to develop mathematical models of clinical and functional state of the lower limb and analyze them. Results. Comparative analysis of the mathematical models (clinical and functional state of the lower limb) demonstrated that the use of the proposed method of autoplasty provided more expressed clinical remission and functional recovery of the lower limb after 12 months after the operation. The dynamics of changes in the integral index value in the early postoperative period clearly shows its tendency towards the normal value; this tendency is even more pronounced in the late postoperative period. This shows the positive progress of the ongoing reparative processes in the knee joint and better quality of restoration of the functional state of the lower limb. Conclusion. The proposed method of autoplasty of articular surfaces of the knee joint provides significantly greater clinical and functional recovery of the knee and may be recommended for clinical use.