Results of 25 total endoprosthesis operations in patients with defects of the elbow joint of various ethiology are analysed. The endoprostheses produced by Endoservis (Russia) and Coоnrad/Mоrrey Zimmer (USA) were used. The technique of operation and postoperative rehabilitation is described in the article. The estimation of results of treatment was performed by «the Estimation of surgery of an elbow» (American Shoulder and Elbow Surgeons (ASES) Assessments; Richards R.R. et al. 1994). Radiographically the results of treatment were estimated by the method of

Цель. Оптимизировать результаты лечения тяжелых травм и их последствий, а также заболеваний локтевого сустава у молодых пациентов, оценить ближайшие и среднесрочные результаты эндопротезирования локтевого сустава у молодых пациентов. Материалы и методы. Проанализированы результаты 52 операций первичного тотального эндопротезирования локтевого сустава у пациентов моложе 40 лет. Применялись эндопротезы фирмы Эндосервис (Россия) и Coonrad-Morrey фирмы Zimmer (США). Разработаны основные показания к операции эндопротезирования локтевого сустава в молодом возрасте. Описана методика операции и послеоперационной реабилитации. Оценка результатов проводилась по «Оценке хирургии локтя» (American elbow surgeons assessment & ASES, Richards R. R. et al., 1994). Результаты. Проведен анализ результатов лечения от 1 года до 10 лет после операции. Хорошие и отличные результаты получены у 78,8 % от всех лечившихся; удовлетворительные -зафиксированы у 15,4 % от всех лечившихся. Неудовлетворительный результат эндопротезирования имел место у 5,8 % от общего числа оперированных больных. Заключение. Эндопротезирование локтевого сустава у молодых пациентов -высокотехнологичное хирургическое пособие, являющееся альтернативным традиционно применяемым, а в ряде случаев методом выбора при лечении ряда тяжелых травм и заболеваний локтевого сустава. Оно должно выполняться в крайних и тяжелых случаях, когда исчерпаны возможности других известных способов. Ключевые слова: локтевой сустав, эндопротезирование, молодые пациенты.Purpose. To optimize the results of treating the elbow severe injuries and their consequences, as well as the elbow diseases in young patients, to evaluate the immediate and mid-term results of the elbow arthroplasty in young patients. Materials and Methods. We have analyzed the results of 52 surgeries of primary total arthroplasty of the elbow in patients at the age below 40 years. We used the implants by Endoservice (Russia) and those Coonrad-Morrey by Zimmer (USA). The main indications for the elbow arthroplasty in young age developed. The technique of surgery and postoperative rehabilitation described. We evaluated the results according to ASES system (Richards R. R. et al., 1994). Results. The results of treatment analyzed within 1-10 years after surgery. Good and excellent results obtained in 78.8 % of all treated patients; satisfactory ones registered in 15.4 % of all treated patients. Unsatisfactory results of arthroplasty occurred in 5.8 % of the total number of operated patients. Conclusion. The elbow arthroplasty in young patients is a high-tech surgical intervention which is a traditionally used alternative, and in some cases it is the method of choice for treatment of some severe injuries and diseases of the elbow. It should be performed in the extreme and severe cases when the limit of other familiar techniques reached. Keywords: the elbow (joint), arthroplasty, young patients.Заболевания и травмы локтевого сустава, приводя-щие к тяжелым последствиям, встречаются достаточно часто и составляют 5,5-9,7 % и 11,4-...

Analysis of short-term (5 - 8 years) and mid-term (10 - 14 years) results of primary total hip replacement using cemented and uncemented fixation implants of foreign (Zimmer) and home (Endoservice) serial production. The study was based on the results of 2620 surgical interventions (2911 operations, out of them 1512 - with ESI, 1399 - with Zimmer implants) performed in two independent clinics. Revision intervention due to aseptic loosening of implant components was required in 62 (ESI) and 66 (Zimmer) cases and the terms of that complication development were practically the same. In 5 to 8 years after operation excellent, good and satisfactory results (70 - 100 points by Harris) were observed in 95.2% of patients operated on using ESI implants and in 94.8% of patients - with Zimmer implants. In 10 - 14 years the indices made up 89.2 and 88.2%, respectively. Thus, the results of different implants application were comparable

There were 105 patients with shoulder replacement under our supervision (terms of supervision were up to 10 years). There were 43 men and 62 women. Age of patients was from 29 to 80 years. Two ways of optimization of shoulder replacement are offered: “Method of preoperative determination of the sizes of a head of shoulder joint endoprosthesis” (Patent of the Russian Federation N 2469670 d.d. 12.20.2012) and “Method for intraoperative navigation of a shoulder stem of joint” (Patent of the Russian Federation N 2467725 d.d. 11.27.2012). We reached the improvement of quality of the operation due to the fact of an installation of the implants which are as much as possible close to the anatomy of a normal shoulder joint by size and position.

Risk factors for the development of purulent complications after large joints arthroplasty were studied by the results of 3641 operations (3210 patients). Hip, knee, shoulder and elbow arthroplasty was performed in 2523, 881, 105 and 132 patients, respectively. Hip and knee revision replacements were performed in 221 cases and in 492 cases surgical interventions were performed for dysplastic coxarthrosis, congenital and acquired deformities, under conditions of bone tissue deficit and other complicated cases. Three hundred fifty one patients were operated on due to acute injury. Periprosthetic infection was diagnosed in 58 cases (1.59%). It was stated that risk factors for periprosthetic infection development included severe concomitant pathology (diabetes mellitus,operations somatic diseases, degree of their severity and duration, HIV infection and other conditions), surgical interventions for dysplastic coxarthrosis and complex total hip replacement. In those cases the risk of complications increased by 1.5-3.5 times. Pyo-inflammatory process in the area of hip joint in history as well as every repeated surgery on the hip increased therisk of postoperative complications significantly. No differences in complication rate depending on the type of fixation and implant manufacturers were noted.