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The study purpose — to evaluate the clinical results and the condition of bone tunnels after anterior cruciate ligament reconstruction with a semitendinosus tendon graft using cortical fixation and corrugated sutures.Materials and Methods. The results anterior cruciate ligament reconstruction with a semitendinosus tendon autograft were analyzed in 57 patients aged 18 to 53 years. The patients of the first group (n = 27) underwent anterior cruciate ligament reconstruction with a semitendinosus tendon graft using cortical fixation on the femur and tibia in combination with corrugated sutures at the proximal and distal ends of the graft. The patients of the second group (n = 30) underwent anterior cruciate ligament reconstruction in a similar way, but without the use of corrugated sutures. Clinical results were assessed using the Lysholm and IKDC scales. The degree of bone tunnels widening was evaluated by CT data in 6 months after the surgery.Results. In the first group, the degree of postoperative bone tunnels widening was significantly lower (for the femoral tunnel by 18% and tibial — by 17%) compared with the second group (for the femoral tunnel by 30% and tibial — by 31%). Scores by the IKDC 2000 and Lysholm scales were higher in the corrugated sutured group. Although, the treatment outcome was interpreted as equally good for both groups. The time for graft preparation was on average 6 minutes longer in the first group. This slightly increased the duration of the surgery.Conclusion. The anterior cruciate ligament reconstruction with a semitendinosus tendon graft using cortical fixation on the femur and tibia in combination with corrugated sutures ensured the tight contact of the tendon inside the bone tunnels without additional implants and reduced the degree of tunnels widening. This is important for a possible re-grafting. The proposed method does not significantly affect the clinical outcomes.

A comparative assessment of knee joint alloplasty (KJA) results in patients with gonarthrosis with and without concomitant pathology of type 2 diabetes mellitus (DM 2) was carried out. The data of 104 patients were analyzed, who underwent prosthetics of the knee joints in 2003-2020 at the Center for Traumatology and Orthopedics at the Semashko Russian Railways Hospital (mean age 65,2 (10,5) years, mean observation period — 14 years, from 4 to 17 years). Primary total knee arthroplasty was performed with cement prostheses manufactured by Biomet (Aigisi, Avangard) and Eskulap. The patients were divided into 2 groups: group 1 - 56 patients without signs of DM, group 2 — 48 patients with DM. Comparison of the characteristics of patients without diabetes and with DM2 who underwent KJA showed that there were no signifcant differences in the incidence of intraoperative complications; patients with DM2 had slightly longer inpatient treatment and frequency of postoperative complications. Analysis of the clinical and functional state using the Knee Society Score indicated that in patients without diabetes the dynamics of improvement in the functional status of the knee joint was slightly more pronounced, and after 1 year there were statistically signifcant differences in terms of this scale. Evaluation of long¬term complications over a long observation period showed that the absolute majority of patients in both groups had no complications; however, in the group of patients with diabetes, the proportion of patients without complications was slightly lower than among patients without DM: 25,0 and 5,4% respectively. It was concluded that, during the decision-making on arthroplasty, surgical risk should be assessed for patients with diabetes, taking into account possible complications and the presence of other associated diseases. One of the main goals of the preoperative preparation of the considered patient category should be the stabilization of the blood plasma glucose level.

BACKGROUND: By reason of the high urbanization of the population the mortality rate in combined injury cases remains stably high, despite the CT-scans have appeared in the arsenal of many hospitals. There are a lot of questions: how to reduce the time of diagnosis in favor of therapeutic measures, determine the sequence of actions in different situations? AIM: To determine the degree of informativeness of clinical and instrumental methods for diagnosing combined injuries in an accident. MATERIALS AND METHODS: Were done a retrospective analysis of the results of treatment of 517 patients with combined trauma delivered to the emergency department of the Omsk City Clinical Hospital and the V.P. Demikhovs City Clinical Hospital of the Moscow for 20172019. All patients were examined by a multidisciplinary team using modern diagnostic methods including laparoscopic examination, CT according to the whole body program. RESULTS: The results of the data analysis showed that clinical examination, radiography and ultrasound do not allow the diagnosis to be carried out in full, revealing up to 80% of all injuries. CONCLUSION: FAST protocol has a high degree of informativeness at the early hospital stage (efficiency 83%, reliability 81%). When using modern computed tomographs with subsequent digital analysis of reconstructions, the value of performing radiographs in an urgent situation decreases. MSCT is the gold standard in the diagnosis of combined trauma, has a high diagnostic efficiency compared to other methods of radiation diagnostics.