Results of the operated joint arthroscopy were presented for 16 patients with complications after knee arthroplasty. The reasons for arthroscopic intervention were: implant instability - 1 case, breaking of implant hinge - 1 case, arthrofibrosis - 2 cases, recurrent hemarthrosis with synovial membrane vessels malformation - 2 cases, reactive aseptic necrosis - 4 cases and resistant medial pain syndrome resulting from neuropathy of the infrapatellar branch of subcutaneous femoral nerve - 6 cases. Arthroscopy after knee arthroplasty enables with high accuracy to diagnose knee joint pathology, to avoid revision arthrotomy, to minimize intraoperative trauma, to improve functional results and patient’s quality of life as well as to reduce the cost of treatment.

Introduction. Pelvic ring fracture with complex bone fragments displacement is associated with the urethral distraction injury in about 10% of cases. Emergency care for these patients includes the provision of trauma management and urinary diversion followed by delayed urethroplasty.Purpose of the study. To determine the effect of extramedullary osteosynthesis in a pelvic ring fracture on the outcome of treatment in patients with post-traumatic urethral strictures.Materials and methods. The study included 17 patients with post-traumatic urethral strictures associated with pelvic ring fractures (Types B, C). The average age of the patients was 35.8 ± 10.2 (19 - 61) yrs. All patients underwent submerged osteosynthesis and cystostomy drainage as an emergency. Localization of strictures: 10 (58.8%) - membranous, 7 (41.2%) - bulbo-membranous. Length of strictures: 1.47 ± 0.5 (0.5 - 2.5) cm. Post-traumatic period: 6.6 ± 1.3 (4 - 10) mo.Results. All patients underwent anastomotic urethroplasty. No early postoperative complications were identified. Spontaneous urination was restored by 14 - 15 days in all patients. Early urethral stricture relapses were revealed in 9 (52.9%) patients during 3-mo follow-up. These patients underwent removal of the metal structures fixing the pelvic bones. Repeated urethroplasty was performed a month later. Subsequent relapses of urethral stricture were not detected in any of 17 cases with a median follow-up of 28 (12 - 128) mo.Conclusion. Surgical treatment of urethral strictures associated with a pelvic ring fracture and osteosynthesis is advisable after removal of the metal structures fixing the pelvic bones. This is since the excessed retropubic screws protrusion (> 0.2 - 0.3 mm) is associated with a large area of periurethral fibrous inflammation and causes high relapse risks of stricture disease (52.9%) in the case of urethral surgery preceding the removal of metal structures.

Results of the operated joint arthroscopy were presented for 16 patients with complications after knee arthroplasty. The reasons for arthroscopic intervention were: implant instability - 1 case, breaking of implant hinge - 1 case, arthrofibrosis - 2 cases, recurrent hemarthrosis with synovial membrane vessels malformation - 2 cases, reactive aseptic necrosis - 4 cases and resistant medial pain syndrome resulting from neuropathy of the infrapatellar branch of subcutaneous femoral nerve - 6 cases. Arthroscopy after knee arthroplasty enables with high accuracy to diagnose knee joint pathology, to avoid revision arthrotomy, to minimize intraoperative trauma, to improve functional results and patient’s quality of life as well as to reduce the cost of treatment.