Saratov JOURNAL of Medical and Scientific Research

Bakhteeva N.Kh.

Saratov State Medical University n.a. V I. Razumovsky, Professor of Traumatology and Orthopedics Department, Doctor of Medical Science

Variability and connections of parameters characterizing hip dysplasia in 4-7-year-old children

Year: 2019, volume 15 Issue: №1 Pages: 61-66
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Zotkin V.V., Anisimova Е.А., Bakhteeva N.Kh., Anisimov D.l.
Organization: Saratov State Medical University
Summary:

Objective: to identify the variability and contingency of parameters characterizing the structure of the hip joint in children 4-7 years of age, among themselves and with the severity of dysplastic changes in the bone and soft tissue structures of the hip joint. Material and Methods. 132 children aged 4-7 years with dysplasia TBS with different degrees of severity of dysplastic changes (177 joints) were examined. The following characteristics of dysplasia joint were under the study: angular radiological parameters, cartilage defect, electroneuromyographic signs, indicators of the biomechanics of gait. The degree of dysplasia (mild, moderate, severe) was assessed by the method developed by the authors to determine the severity of hip dysplastic changes in points. Results. Light changes in the hip joint were diagnosed in 9 patients aged 4-7 years (15 joints); moderate dysplastic disorders were found in 74 patients (96 joints); pronounced signs of dysplasia were found in 49 patients (66 joints). The coefficient of variation of signs characterizing TDS dysplasia varies from 2.8 to 18.8%. The module of correlation coefficients characterizing the binding force of the studied features is in the range from 0.7 to 0.9. Conclusion. The angular radiological parameters, cartilage defect, electroneuromyographic signs, indicators of the biomechanics of gait characterized by considerable variability and are correlated with strong and close power among themselves and with the degree of dysplastic changes of the bone and soft tissue structures of TBS.

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The assessment system of the grade of dysplastic changes in hip joint of children of early age

Year: 2018, volume 14 Issue: №3 Pages: 505-511
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Bakhteeva N.Kh., Anisimova Е.А., Zotkin V.V., Anisimov D.l.
Organization: Saratov State Medical University
Summary:

 Aim: to analyze the method of choice of treatment for children aged 1-3 yrs. with hip joint dysplasia with respect to the complex of pathological changes by the elaboration of CAD programs. Material and Methods. We defined the grade of dysplastic changes in joint components of 82 children with hip joint dysplasia (113 joints) aged 1-3 yrs by CAD program. Results. The grade of dysplastic changes in hip joint (mild — I, moderate — II, severe — III) was identified with the elaborated program and the treatment was administered. We identified 28 children (33 joints) to have mild (I) dysplasia grade, moderate (II) 31 children (42 joints) and severe (III) 23 (38 joints). Mild dysplasia grade (I) corresponded to the score from 5 to 13, and to the option of conservative treatment with dynamic follow-up and coxarthritis prevention, moderate (II) — to the score from 14 to 26 and the option of intertrochanteric detorsion varus corrective osteotomy, severe (III) — to the score from 27 to 39 and the option of pelvis osteotomy and intertrochanteric detorsion varus corrective osteotomy. Conclusion. The treatment of patients with hip dysplasia depends on the grade of dysplastic changes. The elaborated program allows effectively define dysplasia grade and choose treatment method for the patients.

Comparative analysis of clinical outcomes of various methods of anterior cruciate ligament arthroplasty in knee joint in complete rupture of the ligament.

Year: 2018, volume 14 Issue: №2 Pages: 251-259
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Shormanov A.M., Norkin A.l., Klimov S.S., Chibrikova Ju.A., Ulyanov V.Yu., Bakhteeva N.Kh.
Organization: Saratov State Medical University
Summary:

The aim is to carry out the analysis of outcomes of anterior cruciate ligament arthroplasty undertaken by various methods in patients with complete ligament rupture. Material and Methods. 104 patients diagnosed with complete rupture of anterior cruciate ligament (ACL) in knee joint who underwent knee joint arthroplasty fulfilled by various methods were the object of the present study. Clinical outcomes of the treatment were estimated by clinical signs of ACL failure, the degree of functional impairment of knee joint (IKDC 2000) and motor pathology assessed instrumentally. Results. Significantly better function restoration in knee joint occurring as early as 3 months postoperatively has been stated in the group of patients with two-bundle ACL arthroplasty by synthetic implant "DONA-M" on the basis of IKDC subjective knee indices. Negative Lachman test and Pivot shift test were demonstrated as early as 3 months postoperatively by all patients after two-bundle ACL arthroplasty with synthetic implant "DONA-M", reduced support asymmetry 6 months postoperatively was stated in all patient groups as well as run path and surface area in patients with single-bundle ACL arthroplasty by synthetic implant "DONA-M". Conclusion. The use of single- and double-bundle ACL arthroplasty with synthetic implant and ACL arthroplasty with autograft of semitendinosus (ST) and gracilis allows providing equally full-fledge restoration of injured knee joint, without statistically significant differences between the groups, in great majority of patients up to 12 months of follow-up period which is proved by normalized knee joint function, the absence of ACL failure and motor pathology signs estimated instrumentally. Key words: knee joint, anterior cruciate ligament (ACL), co

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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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