The   paper   presents   data   analysis   of  the   Hip   Arthroplasty  Register   of  Vreden   Russian   Research   Institute of Traumatology and Orthopedics, namely information on 37373 primary THA performed at the Vreden Institute and at several other orthopedic centers and 1200 hip replacements at other hospitals of St. Petersburg.There were 1.5 times more women in the studied cohort than men. A significant predominance of women with dysplastic osteoarthritis (72.4%) and rheumatoid arthritis (82.1%) was reported. A male predominance was noted in patients with secondary osteoarthritis (53.1%), post-traumatic changes of hip (61.0%) and osteonecrosis of the femoral head (68.6 %). The mean age of patients was 58.0±12.9 years (95% CI from 57.9 to 58.1, median 59 years). Age data of the study revealed that  patients were 10-12 years younger than reported in the national  arthroplasty registers of other countries.Total  hip arthroplasty was performed  in the  absolute  majority  of patients – 37295  cases (99,8%).  Uncemented implants  were used in 59.3% of cases, hybrid – in 29.6%, cemented – in 10.2%, reverse-hybrid – in 0.9% of all patients. The  most  common  bearing  used  was metal  on  crosslink  polyethylene, which  was applied  in 50.1% of all cases of arthroplasty. The  type  of fixation  of the  implant,  and  the  use of different  bearings  varied  in different  age groups. The paper presents  not only the absolute  numbers  of the data, but also demonstrated the dynamics  of the changes in time starting from 2007.The  present  epidemiological  study  does not  claim the  absolute  completeness of the  presented data,  but  contains the  analysis of the  large number  of cases, comparable  with  follow-ups  of patients in some national  registers  of certain European countries. The authors  analyzed about  10% of all cases of hip replacements performed  on the territory of the Russian Federation in ten-year  period.

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Введение. Рост количества первичных эндопротезирований тазобедренного сустава ведет к неуклонному увеличению ревизионных вмешательств. К категории сложного протезирования относятся и пациенты с обширными повреждениями вертлужной впадины в результате высокоэнергетической травмы. Амплификация клинических случаев требует индивидуального подхода при планировании конфигурации вертлужного компонента. В последние годы клиники активно внедряют в практику технологию 3D-моделирования компонентов эндопротезов тазобедренного сустава. Целью работы явилась оценка краткосрочных и среднесрочных на момент написания статьи результатов эндопротезирования тазобедренного сустава при посттравматическом коксартрозе со значительными дефектами костной ткани с использованием индивидуальных вертлужных компонентов, с представлением клинических случаев. Материалом послужили случаи эндопротезирования с применением индивидуальных имплантов, изготовленных с помощью 3D-принтера, пяти пациентам (мужчинам) трудоспособного возраста, перенесшим высокоэнергетические травмы. Три пациента ранее были прооперированы на тазобедренном суставе от 1 до 5 раз. Изучены анамнез, характеристики пациентов, степень костных дефектов по Paprosky, сроки наблюдения после операции, данные рентгенографии, динамика показателей качества жизни по шкале Харриса. Четверым пациентам успешно имплантирован индивидуальный вертлужный компонент, изготовленный на 3D-принтере; в одном случае его установка оказалась неудачной вследствие избыточной латерализации центра ротации и возникновения технических трудностей при вправлении головки эндопротеза. Срок наблюдения троих пациентов составил 16,7 ± 3,7 мес., двоим операции проведены 3 и 4 мес. назад соответственно. Результаты. Динамическая оценка по шкале Харриса у всех пациентов показала увеличение показателя от 26 ± 5,2 до 77 ± 6,6 балла. Рентгенологический контроль выявил стабильное положение компонентов эндопротеза с удовлетворительной костной интеграцией. Заключение. Исследование показало хорошие краткосрочные и среднесрочные результаты применения индивидуальных вертлужных компонентов, выполненных с помощью 3D-принтера, у пациентов со значительными дефектами костной ткани вертлужной впадины на фоне посттравматического коксартроза. Ключевые слова: ревизионное эндопротезирование тазобедренного сустава, индивидуальный вертлужный компонент, 3D-принтеры в ортопедии, дефекты вертлужной впадины, посттравматический коксартроз Introduction The increase in the number of primary hip joint arthroplasties leads to a steady increase in revision interventions. The category of complex arthroplasty also includes patients with extensive acetabular injuries due to high-energy trauma. Amplification of clinical cases requires an individual approach when planning the configuration of the acetabular component. In recent years, clinics have been actively introducing into practice the technology of 3D-modeling of hip replacement components. The purpose of the study was to assess the short and medium-term results of hip joint arthroplasty in posttraumatic ...

Purpose of the study – to evaluate the antibacterial activity and biological compatibility of alloy coatings based on two-dimensionally ordered linear chain carbon (TDOLCC).Materials and Methods. Coatings based on TDOLCC were synthesized using alloying additions like nitrogen (TDOLCC+N) and silver (TDOLCC+Ag) on the surfaces of titanium plates and polystyrene plates by the ion-stimulated carbon condensation in a vacuum. The authors examined the superficial bactericidal activity of the coatings and its resistance to mechanical effects. Coated plates were evaluated in respect of rate of microbial biofilms formation by clinical isolates with multiple and extreme antibiotic resistance. Specimens were colored with crystal violet solution to visualize the biofilms. Cytotoxic effect of coatings was evaluated in respect of primary culture of fibroblasts and keratinocyte cell line HaCaT.Results. The authors observed pronounced superficial bactericidal effect of TDOLCC+Ag coating in respect of microorganisms of several taxonomic groups independently of their resistance to antibacterial drugs. TDOLCC+Ag coating proved capable to completely prevent microbial biofilm formation by antibiotic resistant clinical isolates of S. aureus and P. aeruginosa. Silvercontaining coating demonstrated mechanical resistance and preservation of close to baseline level of superficial bactericidal activity even after lengthy abrasion treatment. TDOLCC based coatings did not cause any cytotoxic effects. Structure of monolayers formed in cavities coated by TDOLCC+N and TDOLCC+Ag was indistinguishable from the monolayers in cavities of control plates.

Aim. To assess the application of intraoperative neurophysiological monitoring (IONM) for spinal surgeries in accordance with the Federal Center of Traumatology, Orthopedics and Endoprosthesis (Cheboksary, Russian Federation)Material and methods. A total of 366 spinal surgeries, Federal Center of Traumatology, Orthopedics and Endoprosthesis from 2009 to 2015. From 2009 to 2013, the wake-up test was used as a control method in 116 (65.9%) cases.Results. Application of IONM revealed time-dependent risks and facilitated a reduction in the incidence of postoperative neurologic complications by 3-fold (from 2.6% to 0.8%). In the second half of 2013, IONM was introduced for use in clinical practice. Since then, 250 surgeries were performed with IONM. Of these, the wake-up test was required in 9 (3.6%) patients. Clinical implementation of IONM extended the benefits of surgery to patients with severe pathologies. The number of surgeries for congenital pathologies increased by 10-fold (from 1% to 10%) and by 2.6-fold for degenerative diseases. IONM possibility allows control of intraoperative neurologic complications among patients with spinal injuries (5%) and neuro and muscular scoliosis.Conclusions. The application of IONM minimized the need for the wake-up test and significantly decreased the incidence of neurological complications caused by injury to the spinal cord and spinal roots during execution of spinal manipulations.