Background: The standard of the surgical treatment for arthrosis of the knee joint (KJ) at the later stages is total arthroplasty, which allows relieving the pain and eliminating the existing deformity. However, there are not enough data on the long-term results after the surgery that is important for understanding the dynamics of the recovery and predicting the result. Aims: Study of clinical, functional, and biomechanical symptoms in patients after total arthroplasty of the knee joint in the long-term period. Methods: 22 patients after knee joint replacement and 20 relatively healthy adults (control group) were examined in long-term periods. The biomechanics of walking was studied at an arbitrary pace. The temporal characteristics of the gait cycle, shock loads and movements in the hip joints (HJ) and KJ were recorded. We recorded the time characteristics of the walking cycle, shock loads and movements in the hip joint (HJ) and KJ. The patients were divided into two subgroups according to the results of the biomechanical study. The patients from subgroup 1 had good functionality with a swing amplitude of the knee joint of 50 degrees or more, the movement algorithm was preserved. The patients from subgroup 2 had a swing amplitude of up to 50 degrees, the movement algorithm was impaired. Results: The temporal characteristics of the waking cycle of knee arthroplasty patients did not differ significantly from the control group in the long term. Abduction-adduction and rotation movements in HJ and KJ show a decrease in the amplitudes, more pronounced in the second subgroup. The main changes in the kinematics of the hip joint are characterized by a decrease in the range of motion and a longer extension time during the support period, which was found for both sides, especially in the second subgroup. The greatest changes were observed in the kinematics of the knee joints movements. They included a decrease in the amplitude of all the movements, not only on the endoprosthesis side, but also on the opposite side. Conclusions: There is no complete restoration of the knee joint function after total arthroplasty in the long term. The function of both lower limbs is symmetrically decreased. The fact of functionally different (less severe and more severe) results may be associated with the initial functional state of the joint before arthroplasty or with the subsequent period of rehabilitation.
The use of bioresorbable materials in the anterior cruciate ligament reconstruction is a promising direction. Thus today there is no single point of view on the long-term results of using absorbable interference screws. The article presents an analysis of the results of surgical treatment of 30 patients with use of bioresorbable materials, operated on for rupture of the anterior cruciate ligament (ACL) in the department of traumatology and orthopedics from 2010 to 2016 in the Federal Scientific Clinical Center FMBA of Russia. The aim of our study was to evaluate in vivo transformation of bioresorbable screws and bone assimilation into the tibial canal in long-term period after surgery, as well as the effect of the polymeric material and bone on these processes.
Soft tissue sarcomas are a rare heterogeneous group of malignant tumor of different origin. The small quantity patients with this diagnosis leads to a lack of scientific data on the treatment of such patients. This article presents a clinical case of a patient with spindle-cell paravertebral sarcoma of soft tissues of pelvic localization, who get surgical treatment in the volume of reconstructive plastic surgery with endoprosthesis of the sacroiliac joint.
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