Changes in health-related quality of life (QoL) due to hip, humeral, ankle, spine, and distal forearm fracture were measured in Russian adults age 50 years or more over the first 18 months after fracture. The accumulated mean QoL loss after hip fracture was 0.5 and significantly greater than after fracture of the distal forearm (0.13), spine (0.21), proximal humerus (0.26), and ankle (0.27). Introduction Data on QoL following osteoporotic fractures in Russia are scarce. The present study evaluated the impact of hip, vertebral, proximal humerus, distal forearm, and ankle fracture up to 18 months after fracture from the Russian arm of the International Costs and Utilities Related to Osteoporotic Fractures Study. Methods Individuals age ≥ 50 years with low-energy-induced humeral, hip, clinical vertebral, ankle, or distal forearm fracture were enrolled. After a recall of pre-fracture status, HRQoL was prospectively collected over 18 months of follow-up using EQ-5D-3L. Multivariate regression analysis was used to identify determinants of QALYs loss.

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The European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) treatment algorithm for the management of knee osteoarthritis (OA), published in December 2014, provides practical guidance for the prioritization of interventions. This current paper represents an assessment and endorsement of the algorithm by Russian experts in OA for use in Russian clinical practice, with the aim of providing easy-to-follow advice on how to establish a treatment flow in patients with knee OA, in support of the clinicians’ individualized assessment of the patient. Medications recommended by the ESCEO algorithm are available in Russia. In step 1, background maintenance therapy with symptomatic slow-acting drugs for osteoarthritis (SYSADOA) is advised, for which high-quality evidence is provided only for the formulations of patented crystalline glucosamine sulphate (pCGS) (Rottapharm/Meda) and prescription chondroitin sulfate. Paracetamol may be added for rescue analgesia only, due to limited efficacy and increasing safety signals. Topical non-steroidal anti-inflammatory drugs (NSAIDs) may provide additional symptomatic treatment with the same degree of efficacy as oral NSAIDs but without the systemic safety concerns. To be effective, topical NSAIDs must have high bioavailability, and among NSAIDs molecules like etofenamate have high absorption and bioavailability alongside evidence for accumulation in synovial tissues. Oral NSAIDs maintain a central role in step 2 advanced management of persistent symptoms. However, oral NSAIDs are highly heterogeneous in terms of gastrointestinal and cardiovascular safety profile, and patient stratification with careful treatment selection is advocated to maximize the risk: benefit ratio. Intra-articular hyaluronic acid as a next step provides sustained clinical benefit with effects lasting up to 6 months after a short-course of weekly injections. As a last step before surgery, the slow titration of sustained-release tramadol, a weak opioid, affords sustained analgesia with improved tolerability.

Study of the general organism response to carbonic nano-structural grafts, their osteoinductive properties, possibilities of bone defects substitution and acceleration of the distraction regenerate formation was performed. Four series of experiments were performed on 69 animals (Chinchilla rabbits and adult mongrel dogs). Laboratory and roentgenologic data showed that study grafts possessed pronounced osteoconductive properties, were not toxic and did not cause rejection response. Their application ensured the formation of strong osteo-carbonic block at the interface bone-implant. Distraction regenerate achieved required strength in 37 days after carbonic graft implantation into the bed formed in the regenerate. That enabled to discontinue external fixation with the apparatus.

Novice carbon nanostructural material was investigated to estimate its integration to the bone tissue. Wedge osteotomy of a femur bone performed in experimental circumstance on 26 white rats (control=6, experiment=21). Wedge-shaped (h=4 mm, r=3 mm, α=12) implants were crafted from carbon nano-structural material and used to fill bone’s defect. Rats withdrove from the experiment in 3 months. Mechanical properties of the “bone-wedge-bone” block evaluated by the 3-point bending test. Field emission scanning electron microscope used to investigate biocomposite at the bone-to-implant border. The microelements distribution in the samples measured with energy dispersive X-ray analysis. Biomechanical properties of bone-to-implant biocomposite depend on clinical features of consolidation. Anyway, the toughness (T) of bone-to-implant zone is worse than bone-to-bone regenerate significantly (Tcontr = 56.97 MPa, Texp = 47.68 Mpa, Welsh p-value = 2.689e-07). No Ca, or P reveals in the body of implants. The quality and the thickness of the biocomposite on the bone-to-implant border predetermine clinical results of bone substitution. The absence of microelements inside the body of implants confirms that the implant structure is too subtle. Increasing porosity of material and creation of transverse channels can improve bone conduction and scaffold quality of carbon nano-implants.