Surgical outcomes were analyzed for 108 patients with infectious complications developed at different terms after large joints arthroplasty. When complications develop in the early postoperative period than independently of the process depth and in stable implant components radical surgical debridement of the inflammation focus is indicated. In the rest of cases the removal of all implant components with subsequent either joint arthrodesis or revision arthroplasty using spacers of different modifications should be performed. We consider spacer application to be a method of choice as it enables to preserve extremity function and to perform revision arthroplasty in future.

Background. Treatment of knee osteoarthritis (OA) in early stages as well as the pain syndrome associated with it usually suggests the combination of medicines and physical therapy means. However, no method has proven its absolute efficiency yet. Transcatheter arterial embolization of popliteal branches is a new minimally invasive treatment that is currently being studied and tested. The objective of our research was the analysis as well as generalization of the outcomes of the pain syndrome in knee OA treatment with the selective embolization of popliteal branches. Materials and Methods. The reviewed articles were retrieved from PubMed database and eLIBRARY digital library considering the criteria like the emboli material, size, and type; possible complications and their effect on the outcome; the patient enrolment criteria for this type of surgical management; the short and long-term outcomes. Results. Transcatheter arterial embolization of popliteal branches is a new minimally invasive method of knee OA treatment. All authors revealed the pathology growth of the vasculature and its complete embolization as a result of the intervention. The review articles present a significant abatement in patients resistant to conventional medical treatment, minimal possible complications, and good long-term outcomes. Conclusion. Since this method of knee OA management is new and understudied, and the number of the published findings does not exceed two hundred it required further thorough investigation and randomized clinical trials.

Objective: to evaluate the immediate and long-term outcomes of revision knee replacement using porous metaphysical sleeves and cones. Material and methods. The research involved 134 patients who underwent revision arthroplasty of their knee joints. The patients were divided into two groups according to the type of metaphyseal fixator: sleeves (Group 1) — 97 patients, and cones (Group 2) — 37 patients. The evaluation of the surgical outcomes was carried out at discharge from the hospital (in 7-12 days) as well as 6, 12, and 24 months after their surgeries. The survival rate of the implants was analyzed by the Kaplan — Meyer method. A revision with total replacement of the implant or its components was considered to be a critical event. Results. The analysis of the survival rate of the implants using various metaphysical fixators showed that the groups with metaphyseal sleeves and cones do not differ statistically (Log Rank criterion (Mantel — Cox) p=0.108). Conclusion. The medium term follow-up revealed no difference in clinical, functional or radiological outcomes of revision knee arthroplasty using porous cones or metaphyseal sleeves in 2A, 2B, and 3 (by Anderson Orthopaedic Research Institute classification) bone loss replacements.

Purpose. To study the short-term results of revision knee arthroplasty performed using metaphyseal sleeves. Patients and methods. During the period from 2013 to 2015 the total number of 40 patients was operated on. Type I femoral defects (by AORI classification) were diagnosed in 11 (27.5%), type II - in 26 (65.0%), type III - in 3 (7.5%) cases. Type I tibial defects were diagnosed in 2 (5.0%), type IIa - in 24 (65.0%), type IIb - in 11 (27.0%) and type III - in 3 (7.54%) cases. Metaphyseal femoral sleeves were used in 8 and metaphyseal tibial sleeve - in 40 patients. Results. Follow up period made up from 12 to 43 (mean 32.8) months. Excellent and good results by KSS scale were achieved in 30 (75.0%) of patients, by functional KSS scale - in 24 (60.0%) patients. Mean point by Knee Society Total Knee Arthroplasty Roentgenographic Evaluation scale in patients with femoral and tibial metaphyseal sleeves made up 2.35 versus 0.375 that confirmed the absence of progressive bone resorption. No one case of aseptic instability of the revision implant was observed. Repeated surgical intervention due to reinfection and knee joint contracture with pain syndrome was performed in 2 (5.0%) patients. Conclusion. The obtained data enable to recommend the use of metaphyseal sleeves for revision knee arthroplasty in patients with tibial and femoral defects of types II and III by AORI classification.