The results of surgical treatment of 222 patients with lumbar osteochondrosis complicated by nerve root syndrome with proved nerve compression show that prolonged conservative treatment including physiotherapy, distraction, manual therapy aggravates the patients condition due to stimulation of the proliferative processes in spinal canal. Timely surgical treatment allows to prevent the complications, decrease the disability duration and to return the patient to everyday life and work with minimum economic and time costs.

Background. In two-stage deep periprosthetic infection treatment, many authors describe mechanical complications associated with the implantation of a spacer in the first stage that affect the functional outcome of the treatment.Purpose. To evaluate the functional results of using 3D spacers for IIIA and IIIB defects according to the classification system described by W.G. Paprosky during the first stage treatment of hip deep periprosthetic joint infection (PJI).Methods. From 2017 to 2020, 24 patients underwent first-stage revision arthroplasty with hip PJI and IIIA and IIIB acetabular bone defects according to the classification system described by W.G. Paprosky. The patients were divided into 2 groups: group 1 received articulating spacers, and group 2 received custom-made spacers made using 3D technology. Function was evaluated by the Harris Hip Score, WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) and VAS (visual analogue scale). Statistical analyses were performed using IBM SPSS Statistics version 22.0 for Windows. Student's t-test, Wilcoxon's signed-rank test (to compare parameters before and after surgery) and the Mann-Whitney rank-sum test were used.Results. In the first group, the average VAS score was 3.3 (± 1.4), the Harris Hip Score was 51.3 (± 9.4), and the WOMAC score was 42.9 (± 5.9); in the second group, the VAS score was 1.3 (± 0.9), the Harris Hip Score was 69.7 (± 3.6), and the WOMAC score was 30.1 (± 2.4). The rating scale data showed a statistically significant improvement in the function of patients in the second group (p <0.05).Conclusion. Custom-made 3D spacers used during the first stage of treatment for deep periprosthetic hip infection yield larger improvements in function and quality of life than do articulating spacers.Trial registration. Local Ethics Committee at the Sechenov First Moscow State Medical University Ministry of Health of Russia (Sechenov University) № 386 13.12.2016.

Introduction: Durability and better function are the challenging issue of any tribological pair. Ceramic on Ceramic (CoC) friction pairs should provide long-term wear and functional results.Objectives: To evaluate the mid-term results of using the monoblock acetabular system Maxera Cup (Zimmer Biomet) in cementless total hip arthroplasty.Materials and Methods: We evaluated the THA with Monoblock Maxera Cup (Zimmer Biomet) acetabular system in 93 patients. The mean follow-up was 4 years (49.5 ± 11.7 months). All 103 total hip arthroplasty cases in 93 patients were divided into 3 groups according to the diameters of CoC friction pairs (40, 44, 48 mm) used. The achieved functional results were evaluated using the Harris Hip Score (HHS) scale. Results: When assessing long-term results, the average score on the HHS scale significantly increased. During the first year after surgery, there was a 2.2-fold improvement in functional results. There was inconsistent creaking in the implanted joint in only 2.6% of cases with a CoC friction pair with a diameter of 44 mm. Conclusions:The CoC monoblock provides good joint function as perceived by the patient. Acoustic effects, in the form of a minor creaking, did not affect the functional results.

Purpose: To evaluate the functional results of using 3D spacers for IIIA and IIIB defects according to the classification system described by W.G. Paprosky during the first stage of deep hip periprosthetic joint infection (PJI) treatment. Patients and methods:From 2017 to 2020, 24 patients with hip PJI and IIIA and IIIB acetabular bone defects according to the W.G.Paprosky classification underwent first-stage revision arthroplasty. The patients were divided into 2 groups: group 1 received articulating spacers, and group 2 received 3D custom-made spacers. Function was evaluated by the Harris hip score (HHS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and visual analogue scale (VAS). Statistical analyses were performed using IBM SPSS Statistics version 22.0 for Windows. Student's t-test, Wilcoxon's signed-rank test (to compare parameters before and after surgery) and the Mann-Whitney rank-sum test were used. Results:In the first group, the average VAS score, HHS, and WOMAC score were 3.3 (± 1.4), 51.3 (± 9.4), and 42.9 (± 5.9), respectively; in the second group, the average VAS score, HHS, and WOMAC score were 1.3 (± 0.9), 69.7 (± 3.6), and 30.1 (± 2.4), respectively. The rating scale data showed a statistically significant improvement in the function of patients in the second group (p < 0.05). Conclusion:Custom-made 3D spacers used during the first stage of treatment for deep periprosthetic hip infections yielded larger improvements in function and quality of life than articulating spacers.