Background. The frequency of early complications after reverse shoulder arthroplasty remains high enough, and the overall complication rate is reported from 4.7% to 38%. Methods. We did 23 primary reverse shoulder arthroplasty and used clinical information after these operations in our study. As a comparative material, we used date from registers of foreign countries, as well as information from special literature. Results. Early complications were found in five cases (21.7%) in our study: two cases (8.7%) of a periprosthetic fracture; three patients (13.2%) had dislocation components. We studied these complications and formulated rules preventive measures. Conclusions. (1) The most common early complications after revers total shoulder arthroplasty were instability components, periprosthetic fracture. (2) These types of complications arise due to unbalanced soft tissues, inadequate selection of the size of the glenosphere, interposition of soft tissues, and inadequate term of loads on the operated limb. (3) The number of these complications can be reduced by observing preventive measures at all stages of treatment.
Patellar resurfacing is one of the unsolved problems of knee arthroplasty due to the high frequency of patella-femoral complications. In the present analytical review the authors traced the evolution of patellar resurfacing, analyzed the literature on the etiology of anterior knee pain and patellar biomechanics, discussed the indications for replacement or preservation the patella.
The high prevalence of hammertoe deformity in the population, the effect of this pathology on the ability and the quality of life allow us to consider this pathology as a important medical problem. The most common surgery is arthrodesis of the proximal interphalangeal joint with a Weil-osteotomy. Specific complication is a floating toe, which leads to overload of adjacent toes and metatarsal heads. For to correct the instability of the metatarsophalangeal joint, the flexor to extensor transfer Girdlestone-Taylor can be used. However, the use of this procedure had limitations associated with difficult surgery techniques and below the average cosmetic result of the procedure. In the study of the causes of hammertoe deformity, the conclusion of the importance of the plantar plate of the metatarsophalangeal joint was made. Plantar plate repair leads to the stabilization of the metatarsophalangeal joint, reduces the risk of developing a floating toe, leads to the restoration of the support function and normal biomechanics of movement and foot function. Simultaneously, the plantar plate repair technically complicates surgical treatment. An promising direction of treatment is minimally invasive technologies for correction of hammertoe deformity that can reduce the risk of infectious complications, improve the cosmetic result of the surgery and reduce the risk of postoperative contracture in the joint, the time of the operation and rehabilitation, postoperative pain, emotional stress for the patient. However, the technique this type of surgery is more difficult, it requires a long training of the surgeon. The potential risk of intraoperative damage to various anatomical structures increases, which requires use of special tools during surgery. The choice of the surgical procedures is based on the individual characteristics of the pathological changes in the patients foot, the equipment of the operating room and the experience of the surgeon. It is necessary to evaluate the elasticity of the deformity, the stability of the metatarsophalangeal joint, the presence and severity of concomitant overloading metatarsalgia, as well as to take into account the subjective personalized requirements and expectations of the patient.
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