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Considering a stage of the pathological process patients (boys at the age of 8-12 years) were divided into two (2) groups. Group I included 14 patients with the fragmentation stage (Perthes disease Stage II). Group 2 included 15 children with Perthes disease Stage III (the stage of re-ossification). Perthes disease regardless of the stage of the disease was characterized by the increase in oxygen-dependent and lysosomal phagocytic activity of neutrophils, the increase in the number of early extracellular traps, as well as by increased concentrations of pro-inflammatory cytokines (IL-1β and TNFa), IgE, decreased concentrations of IL-18. The fragmentation stage was characterized by moderate activation of cellular immunity with a prevailing increase in the number of T-lymphocytes with early activation markers (CD25). At the re-ossification stage the predominance of T-lymphocytes was observed with late activation markers (HLADR), being accompanied by moderate activation of humoral immunity (increased concentrations of class A and G serum immunoglobulins). The obtained data can be used as additional criteria for clarifying Perthes disease stage, predicting osteonecrosis development when making decision of the feasibility of performing reconstructive surgeries on the joint.

Purpose: To Study immune status in patients with coxarthrosis consequent to treatment of congenital hip dysplasia and Perthes' disease as well as to determine additional variables indicating arthrosis progression.Materials and methods: The authors analyzed results of preoperative immune examination of 13 male patients aged 11,4±0,7 years (10-13) with coxarthrosis of type I-II developed consequently to treatment of hip dysplasia and Perthes' disease. Based on obtained anatomical and functional outcomes the authors divided the patients into two groups. First group included 8 patients with postoperative improvement of joint function and absence of disease progression. Second group (5 patients) was featured by functional deterioration and arthrosis advancing.Results: Patients of the second group demonstrated statistically significant elevation in certain parameters of humoral (circulating immune complex) and cellular immunity (CD3+HLA-DR (%), CD3+HLA-DR (109/l)) as well as interleukin-6.Conclusion: Obtained results have proven that initial immune parameters (IL-6, circulating immune complex, lymphocytes with activation markers) can be used as additional variables for decision making in regard to option and advisability of reconstructive joint preserving procedures in patients with coxarthrosis consequent to treatment of hip dysplasia and Perthes' disease.

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