Saratov JOURNAL of Medical and Scientific Research

Persova E.A.

Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery of Saratov State Medical University n.a. VI. Razumovsky, Junior Research Assistant of the Department of Innovation Projects in Traumatology and Orthopedics, Candidate of Medical Science

Peculiarities of remodeling of hyalin cartilage at early stages of development of degenerative-distrophic processes of knee joints

Year: 2018, volume 14 Issue: №1 Pages: 70-75
Heading: pathological anatomy Article type: Original article
Authors: Gladkova E.V., Romakina N.A., Ananyeva O.E., Belova S.V., Babushkina I.V., Persova E.A., Karyakina E.M.
Organization: Saratov State Medical University
Summary:

The aim is to develop methods for detection of hyaline cartilage metabolic imbalance in patients with initial degenerative dystrophic changes in the substantiated pathogenetically knee. Material and Methods. Subject of inquiry: 50 women aged from 35 up to 57 (49.1 ±2.4), among them 36 patients with an early stage of knee osteoarthrosis made up an experimental group, 14 women without any musculoskeletal disease clinical presentations made up a control group. We carried out a complex examination including physical assessment, study of orthopaedic status, interview with the use of KOOS (Knee Injury and Osteoarthritis Outcome Score) scale, roentgenography and MRI of the knee and also a number of laboratory tests: enzyme-linked immunosorbent assay determination of the content of cytokine profile indices (IL-1, TNF-a, IL-6), cartilage oligomeric matrix protein (COMP) and bone (SerumCrossLaps and bone isozyme of alkaline phosphatase (BAP)) tissue metabolism markers in blood serum in all the groups of patients. Results. In all the patients of the experimental group the roentgenologic stage of osteoarthrosis was defined as 0-1 according to J. Lawrence and J. Kellgren, but at the same time knee degenerative changes were objectivized on the series of MR images in the form of MR signal changes of the articular cartilage, erosions and cysts, degenerative meniscus. We observed increased serum cartilage oligomeric matrix protein (COMP) in the same group and that is characteristic of hyaline cartilage destruction activation. We also detect disorders in bone tissue remodeling in the form of bone resorption intensification (Serum CrossLaps), osteogenesis increase (BAP) and activation of proinflammatory cytokine system link (IL-1, TNF-a). Conclusion. The leading pathogenetic links of the early degenerative changes of the knee are hyperproduction of proinflammatory cytokines (IL-1, TNF-a), destruction of the hyaline cartilage and disorder in bone tissue remodeling. Assessment of biochemical predictors of cartilage and bone tissue degradation along with the instrumental methods of diagnosis is of great theoretical and practical importance in the system of early detection of incipient osteoarthrosis.

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The peculiarities of bone and cartilage tissue remodeling in patients after hip joint replacement

Year: 2017, volume 13 Issue: №3 Pages: 723-727
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Gladkova Е.М., Karyakina E.V., Tsareva Е.Е., Persova Е.А., Belova S.V.
Organization:
Summary:

The aim: to study the peculiarities of structural and metabolic state of bone and cartilage tissue in patients in the first 12 months after total hip replacement with respect to their immune state and lipid peroxidation activity. Material and Methods. Significant laboratory predictors of initial signs of aseptic instability were singled out allowing estimating the peculiarities of bone tissue remodeling as well as humoral and cellular immunity state. Results. The obtained results demonstrated that impairments in T-lymphocyte system in patients with initial signs of aseptic instability of en-doprosthesis were accompanied by reduction of its total number (CD3+), among that due to the population of cytotoxic (CD3+CD8+) cells with simultaneous increase of T-helpers (CD3+CD4+) number. Activation of serum proosteoclasto-genic factors (TNF-a and IL-1(3) was noticed on the background of anti-inflammatory humoral immunity failure (IL-10). Conclusion. The estimation of cellular immunity state, content of pro- and anti-inflammatory cytokines in blood serum combined with the bone tissue state markers and indexes of lipid peroxidation and antioxidant system as well as dual-energy absorptiometry allows identifying patients with high risk of further development of aseptic instability in hip joint implant in the period of up to 12 months postsurgically which can be useful while planning prevention management of implant or its components instability.

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Possibility of laboratory predictors use in assessment of aseptic instability progression in total hip replacement

Year: 2011, volume 7 Issue: №2 Pages: 437-441
Heading: Clinical Laboratory Diagnostics Article type: Original article
Authors: Karyakina Е.V., Persova Е.А., Gladkova Е.V.
Organization: Saratov Scientific Research Institute of Traumatology and Orthopedics
Summary:

The research work presents the results concerning opportunities assessment in prediction of total hip replacement in patients with coxarthrosis. It is done according to the level of biochemical markers of resorption and bone formation, determined in the blood serum by the method of solid-phase immune analysis. On the basis of monitoring of clinical and laboratory data of 50 patients and examination of 30 practically healthy persons biochemical predictors of endo-prosthesis aseptic instability in total hip replacement have been determined

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Instrumental and laboratory assessment of stressful remodelling processes in bone tissue at total hip replacement

Year: 2010, volume 6 Issue: №2 Pages: 423-428
Heading: Traumatology and Orthopedics Article type: Original article
Authors: E.V. Karjakina, E.A. Persova, E.V. Gladkova
Organization: Saratov Scientific Research Institute of Traumatology and Orthopedics
Summary:

Research objective is to estimate stressful remodelling features of bone tissue according to the densitometry data and to the level of biochemical markers of bone resorption and formation in total hip replacement (THR).
Bone tissue mineral density (BTMD), condition of calcium-phosphoric metabolism and biochemical markers of bone formation (osteocalcin and bone isoenzyme of alkaline phosphatase) and resorption (С-terminal bodypeptide of the I type collagen) have been determined in 52 patients with coxarthrosis of ll-lll stages with marked joint dysfunction before and after THR. The control group included 24 donors. The data were considered to be reliable when the probability index was р<0,05.
The reliable (р<0,05) change of BTMD was determined only in 3-6 months after the operation, whereas the change of biochemical markers of remodeling had already been done after 1,5-3 months, allowing to define the group of patients with obvious negative bone balance: strong predominance of resorption processes without compensation of the subsequent adequate osteogenesis, that subsequently could lead to significant bone tissue deficiency in the area adjacent to the endoprosthesis. Changes of indices of calcium-phosphoric metabolism were not certain during the investigation term.
ln conclusion it is to state that biochemical markers of remodeling in comparison with BTMD allow to estimate objectively features of adaptive bone tissue remodeling after THR in earlier periods and to define group of patients with sharp intensification of metabolism and obvious negative bone balance

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ASEPTIC INSTABILITY OF HIP ENDOPROSTHESIS IN PATIENTS WITH COXARTHROSIS

Year: 2009, volume 5 Issue: №3 Pages: 375-378
Heading: Clinical Laboratory Diagnostics Article type: Original article
Authors: Е.М. Karjakina, E.A. Persova
Organization: Saratov Scientific Research Institute of Traumatology and Orthopedics
Summary:

Research Objective — study of bone tissue remodeling features at aseptic instability (Al) of the femoral endoprosthesis in patients with coxarthrosis according to a level of biomechanical markers of bone resorption and formation.
41 patients with coxarthrosis have been examined, a primary total hip replacement was carried out in 27 patients of them (the comparison group), the endoprosthesis re-replacement was performed in 14 patients of the basic group with endoprosthesis Al. Among the examined patients there were 20 men and 21 women aged from 46 to 67. The control group contained 13 donors. All the patients were made double-energy x-ray absorptiometry, formation markers (osteo-calcin and alkaline phosphatase bone isoenzyme) and bone resorption (C-terminal first type collagen telopeptide) and calcium — phosphoric metabolism state were determined. The significant data were considered to be the data with probability index p<0,05.
Bone tissue remodeling imbalance at Al of the femoral endoprosthesis in patients with coxarthrosis was characterized by the expressed prevalence of resorption processes over the osteogenesis, and higher speed of metabolic processes were expressed more in the group of the men with Al.
The hip re-replacement at implant Al is carried out in metabolically unfavorable conditions of bone remodeling. The impartial assessment of Al features at the presurgical stage will allow to fulfil the adequate medicamentous correction of available abnormalities

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Some Peculiarities of Bone Tissue Remodelling at Hip Joint Inflammatory and Degenerative Diseases

Year: 2009, volume 5 Issue: №2 Pages: 227-230
Heading: Clinical Laboratory Diagnostics Article type: Original article
Authors: E.V. Karyakina, E.A. Persova
Organization: Saratov Scientific Research Institute of Traumatology and Orthopedics
Summary:

During the assessment of peculiarities of bone tissue remodelling in inflammatory and non inflammatory lesions of hip joint, according to the levels of biochemical indices in the blood serum, some unilateral changes of bone tissue metabolism have been revealed in advanced rheumatoid arthritis and osteoarthrosis. More severe disturbances of bone remodelling in case of rheumatoid arthritis are obviously connected with peculiarities of the rheumatoid inflammation pathogenesis.

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