Saratov JOURNAL of Medical and Scientific Research

Avilov R.G.

Saratov State Medical University n.a. VI. Razumovsky, Faculty of General Medicine, 6-year-student

The etiological role of opportunistic microflora in the pathogenesis of implant-associated inflammation in patients after primary total knee replacement

Year: 2018, volume 14 Issue: №1 Pages: 30-34
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Babushkina I.V., Bondarenko A.S., Ulyanov V.Yu., Chibrikova Yu.A., Adilov R.G., Kupina E.S.
Organization: Saratov State Medical University
Summary:

The aim: to study etiological role of opportunistic microflora in the pathogenesis of implant-associated inflammation in patients after primary knee joint replacement and antibiotic sensitivity of main agent groups. Material and Methods. The retrospective analysis of microbiological samples of 383 patients with implant-associated inflammation occurred after primary total knee replacement. Results. Gram-positive cocci (63.5%) are the leading agents of implant-associ- ated inflammation, and there is an increase in the etiological role of coagulase-positive Staphylococci. Main agents of Gram-negative group were Enterobacteraceae and non-enzyme bacteria. We revealed high resistance of Staphylo-coccus spp. to antibiotics of various groups. Oxazolidinones and glycylcyclines were the most active among all antibiotic groups. Gram-negative bacteria were highly resistant to cephalosporine and macrolides with carbapenems and fluoroquinolones being most active. Conclusion. Gram-negative Enterobacteraceae, non-enzyme bacteria and Gram-positive cocci are most significant etiological factors in the pathogenesis of implant-associated inflammation in patients after primary total knee 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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Prognostic opportunities for infectious inflammatory complications in primary endoprosthesis of large joints

Year: 2017, volume 13 Issue: №3 Pages: 715-719
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Belova S.V., Mamonova I.A., Puchinyan D.M., Babushkina I.V., Gladkova E.M., Adilov R.G.
Organization: Saratov State Medical University
Summary:

The aim: to study prognostic and diagnostic opportunities for infectious inflammatory complications of primary endoprosthesis of hip and knee joints on the basis of cellular immunity indices. Material and Methods. 174 patients with large joint osteoarthrosis aged 61 ±13 yrs which had undergone total joint replacement were enrolled into the study. The experimental group consisted of 22 patients with infectious inflammatory complications emerging from 6 up to 12 months postsurgically. The comparison group included 152 patients with favorable postsurgical period. We carried out WBC differentiation by subpopulations (lymphocytes, monocytes, granulocytes) and their immunophenotyping. 40 conventionally healthy individuals comprised the control group. The outcomes were estimated using the worked-out score system. Results. In patients with favorable postsurgical period total value of indices equaled not more than 4-6 points. In all the other cases the risk of infectious inflammatory complications is significantly higher and reaches its maximal values in patients with 10-12 points. Conclusion. The assessment of laboratory indices reflecting immune response of the body allows estimating the risk of infectious inflammatory postsurgical complications and diagnosing them in III grade large joint osteoarthorisis patients after total replacement.

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