Saratov JOURNAL of Medical and Scientific Research

2017, volume 13

Quality of life and health risk factors in officers departed from Armed Forces

Year: 2017, volume 13 Issue: №3 Pages: 791-795
Heading: Health Service Organization Article type: Original article
Authors: Konovalov О.Е., Breusov A.V., Popov A.V, Breusov R.A.
Organization: Peoples' Friendship University of Russia
Summary:

Objective: assessment of quality of life, identify of health risk factors for officers discharged from the Armed Forces, and development of step-by-step system for medical and social assistance to reserve soldiers (retired). Material and Methods. Anonymous questioning of 358 officers in different time periods, including the last year of service before departure, with the subsequent processing of the data using the statistical program SPSS. Results. It was established that the highest indicators of quality of life were from the military in reserve (RET.) more than 3 years, and the lowest from the military a year before the departure from the Armed Forces and in the first year after the departure. Conclusion. The authors proposed a step system of health and social care for members of the military reserve (retired) and an algorithm for its implementation, including regulations of interdepartmental interaction and integration of all organizations providing medical care.

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Differentiated approach to surgical treatment of patients with rigid posttraumatic deformities of thoracic and lumbar spine

Year: 2017, volume 13 Issue: №3 Pages: 772-779
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Shul'ga А.Е., Zaretskov V.V., Bogomolova N.V., Korshunova G.A., Smol'kin A.A.
Organization:
Summary:

The aim: to investigate the outcomes of surgical treatment of patients with rigid posttraumatic deformities in thoracic and lumbar spine on the basis of the comparative analysis of different approaches to the planning of operative intervention management. Material and Methods. A comparative analysis of the results of surgical treatment of 138 patients (main group) with old injuries of thoracic and lumbar spine was carried out with the help of the proposed surgery managing algorithm and 86 patients (comparison group) — without taking the given algorithm into account. The choice of surgery managing in the main group of patients was based on the study of the spinal deformity degree, pain syndrome intensity and life quality indices of patients before and after surgery. Results. In the main group in 122 (88,4%) patients after the surgery spinal deformity correction exceeding 80% was achieved, pain syndrome regressed in accordance with the visual analog scale up to 3 points and less, life quality indices improved up to the level of 0-25%. Conclusion. The application of the proposed algorithm approach enables surgeons to get persistent positive outcomes in the majority of cases.

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The dynamics of patients' life quality indices under the conditions of two-stage knee joint replacement

Year: 2017, volume 13 Issue: №3 Pages: 768-772
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Shpinyak S.P., Fedonnikov A.S., Barabash А.Р., Barabash Ju.A.
Organization:
Summary:

 The aim: to analyze the changes in the life quality indices of the patients with deep periprosthetic joint infection of the knee under the two-stage surgical treatment. Material and Methods. 57 patients who underwent two-stage revision-ary treatment in Research Institute of Traumatology, Orthopedics and Neurosurgery were interviewed with life quality questionnaire Short Form Medical Outcomes Study (SF 36 v.1). Interview results were compared with standardized population indices of SF-36 scales for males and females. Results. In all groups regardless of sex there was a general tendency for an increase in physical and psychological health component up to mean population values after the first stage of surgery and further growth after the second stage. Rehabilitation potential of psychomotor health was higher in women than in men. The ability to handle stress was lower in direct ratio with the patients' age. Conclusion. Two-stage reendoprosthetic treatment with articulating antimicrobial spacer implantation having high grade of fixation is an effective treatment method for deep periprosthetic infection which increases physical health and improves social functioning of patients.

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Computer modeling of biomechanical systems «femoral bone — endoprosthesis / transplant — tibia» in different methods of anterior cruciate ligament plastics in knee joint

Year: 2017, volume 13 Issue: №3 Pages: 764-768
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Shormanov A.M., Ivanov D.V., Norkin A.l., Ulyanov V.Yu., Bakhteeva N.Kh., Klimov S.S., Chibrikova Yu.A.
Organization: Saratov State Medical University
Summary:

The aim: to specify the indices of dislocation (displacement) and effective stress in biomechanical systems «femoral bone — endoprosthesis / transplant — tibia» in different methods of anterior cruciate ligament by computer modeling of a knee joint geometrically, physically and mechanically similar to human. Material and Methods. Steady-state tasks of the stress given on a knee joint after anterior cruciate ligament plastics fulfilled by different methods were resolved numerically by the method of finite elements implemented in the system of finite element analysis. Results. Maximum dislocations comprised 3.45 mm. for the method of single-beam plastics of ACL, 0.35 mm. for two-beam plastics and 0.93 mm. for plastics with semi-tendinous and gracilis tendons. Maximum stress were 1190 MPa for single-beam plastics of ACL, 141 MPa for two-beam plastics and 150 MPa for plastics with semi-tendinous and gracilis tendons. Conclusion. Finite element modeling of different ways of ACL plastics indicates higher stability of synthetic endoprosthesis under rising stress in case of two-beam plastics and transplant of semi tendinous and gracilis tendons compared to the single-beam plastics.

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Medical and sociological issues of rehabilitation of patients after hip and knee joints replacement

Year: 2017, volume 13 Issue: №3 Pages: 761-764
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Fedonnikov A.S., Erugina M.V., Andriyanova E.A., Norkin I.A.
Organization: Saratov State Medical University
Summary:

The aim: research of medical and social issues of rehabilitation after hip and knee joints replacement. Material and Methods. Sociological study of 1175 patients who have undergone in 2015-2016 total hip and knee joints replacement was conducted. Results. Within the scope of medical surveillance after the surgery 69.8% of patients made regular visits to orthopedic specialists after joint replacement, but only 9.4% of surveyed patients confirm the practice of active monitoring of rehabilitation on the part of health services. There had been determined a high level of declared patients satisfaction (more than 80%) with weak health managers activities argue considerable informational gap between the key parties of rehabilitation. Conclusion. Provided study has designated problem areas of patient and health system communication in rehabilitation after hip and knee joints replacement.

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Role of humoral immunity markers and bone tissue metabolism in paraimplant inflammation pathogenesis after primary knee arthroplasty

Year: 2017, volume 13 Issue: №3 Pages: 756-761
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Ulyanov V.Ju., Bondarenko A.S., Galashina E.A., Chibrikova Ju.A,. Avilov R.G., Kupina E.S.
Organization: Saratov State Medical University
Summary:

The aim: is to study the peculiarities of paraimplant inflammation pathogenesis after primary knee arthroplasty on the basis of dynamic changes of humoral immunity markers and bone tissue metabolism. Material and Methods. Research object includes 140 cases: 50 patients with paraimplant inflammation make up the main group; 30 patients with early aseptic instability make up the first experimental group; 30 patients undergoing primary arthroplasty make up the second experimental group; 30 conditionally healthy blood serum donors make up the control group. We determined the content of humoral immunity markers (circulating immune complexes binding C3d and containing IgG, triggering receptor expressed on myeloid cells) and bone tissue metabolism (tumor necrosis factor a, interleukin 1 (3, bone isoen-zyme of alkaline phosphatase) by the method of hardphase immune-enzyme analysis in all the groups. Results. We noticed elevated activity of circulating immune complexes binding C3d and containing IgG, triggering receptor expressed on myeloid cells, proinflammatory cytokines and alkaline phosphatase in blood serum of patients with paraimplant inflammation; proinflammatory cytokines and alkaline phosphatase — in patients with early aseptic instability; there were no changes in the studied indicators- in patients undergoing primary arthroplasty. Conclusion. Increased expression of triggering receptor expressed on myeloid cells causing release of proinflammatory cytokines and also elevated activity of circulating immune complexes binding C3d and containing IgG and bone isoenzyme of alkaline phosphatase play a significant role in paraimplant inflammation pathogenesis after primary knee arthroplasty.

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Coxar-throsis in infancy and adolescence: opportunities of preventive treatment

Year: 2017, volume 13 Issue: №3 Pages: 751-755
Heading: Traumatology and Orthopedics Article type: Review
Authors: Norkin I.A., Sertakova A.V., Rubashkin S.A., Zotkin V.V., Gerasimov V.A., Timaev M.Kh., Chibrikova Yu.A., Kupina E.S.
Organization:
Summary:

The review systematizes scientific data on the major groups of heterogeneous diseases which have infant and adolescence coxarthrosis as their outcome and contains materials on etiology, pathogenesis, diagnostic, treatment and precaution methods of complication (dystrophic changes in hip joints) for each disease.

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Decompressive stabilizing operations in the treatment of complicated aggressive hemangiomas of transitional spine.

Year: 2017, volume 13 Issue: №3 Pages: 746-751
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Likhachev S.V., Arsenievich V.B., Salina E.A., Stepukhovich S.V., Norkin A.l., Mizyurov S.A., Zaretskov V.V.
Organization: Saratov State Medical University
Summary:

The aim: to study the efficiency of surgical treatment of complicated aggressive hemangiomas in transitional spine. Material and Methods. Decompressive stabilizing operations were made to 26 patients aged 35-52 years with hemangiomas of vertebral bodies. Individual surgical features varied due to the character and level of the injury. Results. In the experimental patients' group in admission there was neurological deficit of compressional origin associated with the critical values of luminal narrowing due to the epidural component of the neoformation. Stable antalgic effect and decrease in neurological deficit were seen postsurgically. Conclusion. While choosing the surgical option of decompressive stabilizing treatment a surgeon should take into account roentgenomorphometric features of the injured vertebrae. Adequately planned intervention fulfilled with the account of the injury character allows obtaining favorable outcomes as well as LQ improvement, neurological deficit decrease and the elimination of pain syndrome.

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MBST-exposure opportunities as a monotherapy of chronic dorsalgia

Year: 2017, volume 13 Issue: №3 Pages: 743-746
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Levchenko КК, Kitaev IV, Arleninova OV, Zaretskov AV, Adamovich GA, Belonogov VN, Tikhov AA, Chibrikova Yu.A., Biryukova AV.
Organization: "Clinic of Joint and Spine Diseases Artromedtsentr" (Saratov)
Summary:

The aim: to analyze the clinical effect of MBST-exposure monotherapy, a magnetic resonance method, on the pain syndrome caused by degenerative dystrophic changes of vertebral column structures. Material and Methods. 132 patients both male and female with cervical and lumbar dorsopathy were enrolled into the study. Treatment course included 9 sessions of 60 min. daily. MRI-results of corresponding spine regions and visual analogue pain intensity scale were used as assessment tools for treatment efficiency before, immediately after, 3, 6 and 12 months after MBST-treatment. Results. The objective results of structural transformation of pathological formations in vertebral motional segments correlated with significant decrease of pain syndrome at all stages of control tests. Conclusion. MBST-exposure is an effective method of non-invasive, notouch monotherapy for patients with chronic dorsalgia caused by degenerative dorsopathy.

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Computer modeling of the system "bone — hybrid anchor" for proximal humerus fracture and scientific numeral outcomes for basic loads

Year: 2017, volume 13 Issue: №3 Pages: 738-742
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Kauts О.A., Barabash А.Р., Barabash Ju.A., Grazhdanov К.А., Rusanov A.G., Ivanov D.V.
Organization:
Summary:

The aim: to study the indices of stress-deforming state of biomechanical system «bone — hybrid anchor» in proximal humerus fractures. Material and Methods. The study of anchorage stiffness in juxta-articular fracture (type 11A3 by AO/ASIF) through applying three load types: axial (200 N), transverse (30 N) and torsional (5 N*m) was conducted followed by CAD modeling in SolidWorks and the analysis of stress-deforming state of the system «bone — anchor». Results. While studying the stability of «bone — anchor» system it was found that a new device for proximal humerus fracture ostheosynthesis under the applied loads do not decompose with maximal translocations of bone fragments and maximums of equivalent stress being present under torsional load and comprise 1.6 mm. and 152 Mpa respectively. Conclusion. The application of hybrid devices for juxta-articular fractures of humerus allows carrying out minimally traumatic anchorage with the following early functionality of the injured segment.

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