The aim: To compare the efficiency of analgetic action of Ultrasound-guided FICB and prolonged EA as the components of perioperative multimodal analgesia in ERAS-structure in obese patients undergoing THR. Materials and methods: The retrospective study included 80 patients with obesity, who underwent elective anterolateral THR under conditions of low-flow inhalation anesthesia with sevoflurane in combination with PEA (n1=38) or with FICB (n2=42). Primary endpoints: VAS pain level during the first postoperative day. Results: Static and dynamic VAS pain scores were similar in both groups during the first 6 hours. Since the 8th postoperative hour, there was a statistically significant increase in both static and dynamic VAS pain scores in the FICB group. A significant difference in static and dynamic VAS pain scores was obtained with a trend toward an increase in the PEA group within 48 hours (p < 0.05). Conclusions: USG- FICB is an effective, practically feasible, minimally invasive and safe regional method for eleclive anterior-lateral THR and can be an alternative to PEA in obese patients.

Summary. Of all knee injuries, the most common one is the anterior cruciate ligament (ACL) injury. The ACL plays a key role in the stability of the knee joint: it limits the anterior dislocation of the tibia and ensures the stability of rotational movements. In physically active patients, surgical reconstruction of the ACL injury is the gold standard of treatment. The development of biomechanical, biological, clinical research, and tissue engineering provides the basis for disagreement about the methods of reconstruction of ACL injuries. This review outlines modern approaches to the surgical treatment of the ACL.