In the past decade the clinical and anatomical studies proved that lateral humeral epicondylitis can be successfully treated arthroscopically.Purpose of the study is to identify the optimal method of surgical treatment for patients with lateral humeral epicondylitis.Material and methods. The authors conducted an integral study consisting of two sections: clinical and anatomical. Anatomical section included precision preparation of extensor muscles of the forearm. Clinical section was dedicated to comparative analysis of statistically valid and matched by lesion severity groups of patients who underwent open and arthroscopic procedures. All patients were divided into three groups. Patients of Group I underwent arthroscopic release of extensor carpi radialis brevis tendon (ECRB) without decorticating of the lateral humeral epicondyle. Patients of Group II underwent arthroscopic release of ECRB in combination with decortication of the lateral humeral epicondyle. Patients in Group III underwent an open release of ECRB.Results. Patients who underwent arthroscopic release of ECRB demonstrated less pronounced pain syndrome as compared to patients after ECRB release along with decortication of epicondyle or after open release (р0,05). VAS pain score in Group I decreased from 7 to 1 point, in Group II — from 7 to 3 points, in Group III — from 7 to 4 points. Mean time until full recovery after the surgery was 24,2±7,8 days in Group I, 39,4±5,6 days in Group II and 60,2±15,6 days in Group III (р0,05). Functional outcomes were assessed by Mayo Elbow Performance Score (MEPS) in 9 weeks postoperatively: Group I — improvement from 60 to 79 points, Group II — from 62 to 75 points, Group III — from 60 to 75 points.Conclusion. Drilling or removal of periosteum of the damaged epicondyle does not provide a positive effect. Decortication also has certain disadvantages like postoperative pain intensification leading to lesser range of motion in elbow and increased bleeding of the wound. Patients after simple release of ECRB demonstrated minimal postoperative pain which allows early rehabilitation and return to daily and professional activities.

Material and methods: Anatomical relationships of elbow nerves and bony structures were studied by dissection of non-fixed anatomical material (6 elbow joints). To investigate the variant anatomy of the brachial artery, MRI in 23 patients were performed. In 10 patients the authors used ultrasound to study the topographic relationships of elbow nerve structures at different functional positions of the upper extremity. Variability of the brachial artery deviation, depending on the angle of elbow flexion, was studied in six angiograms of non-fixed anatomical material. Statistical analysis was performed using Instant + and Past 306 software. Results: It was found that elbow flexion of 180°-90° moves the brachial artery away from the bones with a maximum distance from the humerus of 5 cm above the joint space. Distance increases from 23.5±3.1 mm to 23.9±3.1 mm. In 90° elbow flexion radial and median nerves are at the maximum distance from bony structures-16.01±0.43 and 20.48±0.28 mm, respectively. Conclusion: These findings allowed justification of the conclusion that the lateral arthroscopic approaches to the elbow are the safest. It is possible to perform two lateral arthroscopic approaches: optical and instrumental, without conflict with major neurovascular structures. The optimal position for the surgery is 90° elbow flexion.

Objective: to carry out linguistic and cultural adaptation and validation of the Kujala questionnaire that is today one of the most popular orthopedic tools used to evaluate the severity of pain in the anterior part of knee joint.Subjects and methods. In accordance with protocols on this type of investigations, the questionnaire was first translated directly and then back. Furthermore, an intermediate Russian-language version of the Kujala questionnaire was tested in 15 patients, followed by error correction and approval of its final Russian-language version. A study group included 50 patients who complained of obvious pain in the anterior part of knee joint and answered the questionnaire twice (for its test-retest reliability) every two or three days.Results and discussion. The intraclass correlation coefficient (ICC) equal to 0.948 (95% confidence interval, 0.025–0.967) indicated a high test-retest reliability of the Russian-language version of the Kujala questionnaire. Cronbach's alpha coefficient of 0.956 corresponded to a high level of internal consistency, which also suggested that the proposed version of the questionnaire had a high reliability. The criterion-related validity assessment, by calculating the Spearman correlation coefficient between the results of primary and repeated surveys using the Russian-language version of the Kujala questionnaire, as well as between the Russian- language versions of the Kujala questionnaire and the SF-36, showed their high correlation.Conclusion. The findings indicate that the Russian-language version of the Kujala questionnaire is a valid and reliable tool for subjective assessment of the severity of pain in the anterior part of knee joint.

The article is a review of literature sources devoted to the problems of treatment of chronic posterolateral rotational instability of the knee joint. The article briefly describes the anatomy and biomechanics of the main structures of the posterolateral angle, various points of view on their structure and function. The evolution of approaches to surgical restoration of the posterolateral angle since the 1970s is presented below. Modern methods of open, minimally invasive and arthroscopic techniques of anatomical and non-anatomical surgery of the popliteal tendon, lig.popliteofibulare and lig.collaterale fibulare are briefly described. This article reflects the main problems and, according to the authors, topical issues of the need to use a particular method of knee stabilization, depending on the severity of posterolateral instability and the clinical picture.

Achilles tendon disorders are represented by a big group of heterogenous in etiology and pathogenesis conditions, that are quite frequent in patients of various age groups. The diversity of this group of orthopedic disorders and the insufficient information provided on this topic in specialized literature leads to confusion in terminology, which, in turn, leads to misunderstanding the essence of patient’s problem and to mistakes in treatment of such patients.We carried out a content-analysis of contemporary Russian and foreign literature to summarize the existing knowledge and to create the universal nomenclature of the studied pathological conditions for further correct understanding of the problem and creation of classification of disorders and injuries of Achilles tendon.