No abstract

In the last decade, the Ponseti method has been recognized by most orthopedists around the world as the gold standard for clubfoot treatment. However, the efficiency of the Ponseti method in relapsing forms of congenital clubfoot in children has been under-examined. We analyzed 103 patients with relapsing clubfoot, aged 1 to 9 years, who were treated at the National Center of Rehabilitation and Prosthetics of the Disabled from 2017 to 2019. These patients had a relapse with typical clubfoot contractures without multiplanar deformity of the feet. The treatment process consisted in the application of the method of I. Ponseti for all patients; if indicated, transplantation of the tendon of the anterior tibial muscle was performed.

Intraoperative local infiltration anesthesia significantly reduces the need for opioid anesthesia in the postoperative period, accelerates early activation and rehabilitation due to adequate analgesia, and reduces postoperative blood loss due to vascular spasm in the wound during total knee replacement. Due to the quick adaptation of patients to the joint implant, it is possible to reduce the time spent by patients in hospitals, as well as reduce the cost of treatment.

The use of antifibrinolytic drugs during knee arthroplasty significantly reduces inter- and postoperative blood loss - by 50% compared to the cases when these drugs are not used. The use of Trenaxa makes it possible to reduce the duration of knee arthroplasty by reducing bone blood loss. In our practice, the use of Trenaxa did not provoke a possible complication, such as thrombus formation in the veins of the lower extremities.

The quality of life of patients after total knee replacement is significantly improved. Endoprosthetics of the knee joint leads to the elimination of pain, improving the physical and functional capabilities of the body, which contributes to the re-adaptation of a person to an active social life. We proposed an integrated approach to rehabilitation measures, both medical, social and psychological to achieve this.