Materials and methods. The authors studied gait biomechanics in respect of time, velocity and dynamics in 34 patients with verified ACL rupture including 11 patients (first group) before the surgery and 23 patients (second group) after the surgery. Patients of the first group were followed in the period from 1 week up to 6 years (mean-18 months), of the second group-from 1.5 months up to 5.5 years (mean-13 months). Patients of the second group underwent standard arthroscopic ACL reconstruction with semitendinous and gracillis tendon autograft. Biomechanical gait examination was performed using strap down inertial motion sensors that register rotation angles in space. The authors measured time phases of gait cycle, movements in hip and knee joints in three mutually perpendicular planes as well as walking shock load. Results. Time phases of gait cycle in both groups demonstrated normal values both on healthy and affected limbs. Movements in hip and knee joints were within the normal range, no reliable differences in the analogous indices for each limb were reported. Shock load in walking was registered within 1.6 g, symmetrical on both sides; shock load dynamics was absent in the group of patients after the surgery. Study results did not identify functional disorders during random flat surface waking that would be specific for ACL lesion as compared to normal values and to intact limb. However, a certain tendency was observed towards an increase of flexion-extension movement range in the knees following ACL reconstruction. The reported differences were not credible. Conclusion. The authors did not observe any specific functional knee joint instability during normal activities in the first group of patients with ACL rupture. On the one hand, that means that ACL lesion does not manifest in such circumstances, on the other-knee joint instability does not progress during flat surface walking at a random pace. The obtained results give certain ground to reconsider the concept of "knee joint instability".

The use of bioresorbable materials in the anterior cruciate ligament reconstruction is a promising direction. Thus today there is no single point of view on the long-term results of using absorbable interference screws. The article presents an analysis of the results of surgical treatment of 30 patients with use of bioresorbable materials, operated on for rupture of the anterior cruciate ligament (ACL) in the department of traumatology and orthopedics from 2010 to 2016 in the Federal Scientific Clinical Center FMBA of Russia. The aim of our study was to evaluate in vivo transformation of bioresorbable screws and bone assimilation into the tibial canal in long-term period after surgery, as well as the effect of the polymeric material and bone on these processes.

В статье представлен анализ результатов хирургического лечения 71 пациента, прооперированных по поводу разрыва передней крестообразной связки (ПКС) в отделении травматологии и ортопедии Федерального научно-клинического центра ФМБА России с 2013 по 2016 г. Всем пациентам была выполнена первичная артроскопическая пластика ПКС аутотрансплантатом из сухожилий нежной и полусухожильной мышц. Мы оценивали состояние оперированного коленного сустава по данным МРТ через 3 -6 -12 -24 месяца после операции. На основании критериев МР-исследований были сделаны выводы, что неоднородное диффузное изменение МР-сигнала от трансплантата на Т2, PD FS может прослеживаться в первые 2 года после операции, отражая процесс лигаментизации. В первые 3 месяца мы также наблюдали увеличение диаметра трансплантата, которое в дальнейшем регрессировало. Процесс лигаментизации заканчивается в течение 2 лет после операции, в результате чего МР-сигнал от трансплантата должен быть схожим с нативной ПКС.Êëþ÷åâûå ñëîâà: передняя крестообразная связка, лигаментизация, трансплантат, МРТ. GRAFT LIGAMENTIZATION OF ANTERIOR CRUCIATE LIGAMENTAkhpashev A.A., Dzhambinova E.A., Zvezdkina E.A., Kanaev A.S., Tkalin A.N.The article presents an analysis of surgical treatment results of 71 patients, operated on for rupture of the anterior cruciate ligament (ACL) in the department of traumatology and orthopedics FSСС FMBA of Russia in 2013-2016. All patients underwent primary arthroscopic ACL reconstruction with autograft from tendons gracilis and semitendinosus. We assessed the condition of the operated knee joint on MRI after 3 -6 -12 -24 months after surgery. Based on the criteria of MR studies, we concluded that the non-uniform diffuse change of MR signal from the graft on T2, PD FS can be traced in the first 2 years after surgery, reflecting process of ligamentization. In the first three months we also observed an increase in the diameter of the graft, which further regressed. Process of ligamentization ends within two years after the operation, whereby the signal from the MR-graft should be similar to the native ACL.

The authors describe in detail the biochemical processes that occur over time and with the collapse of the polymer in the bone. Originally used scanning electron microscopy to assess the condition of clamps, which spent several years in the bone. The data obtained is objective evidence that the biological activity of the implant in the bone and again emphasize the importance of the choice of materials to be implanted in the human body.

A significant part of the knee joint (KJ) damages comprise the lesions of its menisci. Both traumatic and degenerative menisci damages are frequent indications for surgical treatment. In the available literature there are a few articles devoted to the study of the KJ function when walking before and after meniscus resection. We have studied the biomechanical changes characteristic of KJ meniscus damage, before and after surgical treatment. The study included 24 patients who were operated on for meniscus rupture of both traumatic and degenerative nature. During the arthroscopic intervention, we performed a meniscus resection within the damaged unstable tissues. In the postoperative period all patients received rehabilitation treatment. The control group included 20 healthy adults (14 males and 6 females). The median age was 29.7 years. The biomechanics of gait was studied: the time of the step cycle, movements in the hip joints (HJ) and KJ in three mutually perpendicular planes and shock loads during walking. The time characteristics of the step cycle remain normal both before and after surgery. The load on the affected limb increases in the postoperative period. The amplitude of movements in HJ and KJ is reduced before treatment and restored after it. KJ meniscus damage does not lead to a significant change in the biomechanics of walking. The recorded parameters of the step cycle do not change, i.e. the existing changes do not affect the time structure; 3 months after surgical treatment on the side of the lesion, shock loads increase to normal values, the amplitude of HJ extension, KJ flexion and rotational movements in it increases. The function of operated KJ was normalized in conditions of walking on a flat surface.