Saratov JOURNAL of Medical and Scientific Research

Fedonnikov A.S.

«Saratov State Medical University n.a. V.I. Razumovsky», Vice Rector for Research, Candidate of Medical Science

Rehabilitation after hip and knee joints replacement: several results of medical and sociological monitoring

Year: 2017, volume 13 Issue: №4 Pages: 796-799
Heading: Health Service Organization Article type: Original article
Authors: Fedonnikov A.S., Andriyanova Е.А., Erugina M.V, Norkin I.A.
Organization: Saratov State Medical University
Summary:

Aim: research of rehabilitation process problem areas after hip and knee joints replacement. Material and Methods. Program of monitoring and evaluation of medical, organizational, social and psychological components of rehabilitation was developed. Sociological study of 1175 patients who have undergone in 2015-2016 total hip and knee joints replacement was conducted. Results. It was revealed an absence of real interaction between key parties of rehabilitation processes based on significant disproportion between high level (more than 80%) of patients' satisfaction of rehabilitation organizing and low activity of health managers (9.4%). Despite of declared patients' high rehabilitation quality permanent pain noted by 45% of respondents, move freely without additional support is available only for about 50% of patients. Conclusion. Rehabilitation management and its' quality are the key values for locomotor system functional recovery. Provided study has designated main problems of rehabilitation quality evaluation after hip and knee joints replacement.

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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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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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A comprehensive evaluation of cervical spine surgery outcomes

Year: 2017, volume 13 Issue: №2 Pages: 266-273
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Ostrovsky W, Schanitsyn IN, Bajanov SP, Fedonnikov AS.
Organization: Saratov State Medical University
Summary:

Aim: study of diagnostic value of different assessment scales to evaluate outcomes of surgeries in degenerative and post-injury deformities of cervical spine. Material and Methods. Between January and December 2015, 110 consecutive patients with degenerative and traumatic lesions of cervical spine were selected for surgery and results of treatment were followed. Preoperatively and 12 months postoperatively the patients filled in a questionnaire that included a VAS, Odom's scale, NDI, modified JOAand the Zung Depression Scale. To assess the results of the intervention, the concept of "effect size" was used. Distribution of different scores classified according to Odom's criteria as excellent/good and fair/poor. Results. All scores improved in all group of patients. For VAS, NDI and modified JOA scores the effect size was largest. NDI, JOAand ZDS seemed to correlate well with the classification of outcome by Odom. Conclusion. It is suggested many scales to assess the outcomes of the cervical spine surgery based on different criteria; nevertheless, there are no generally accepted and validated methods that can be used to analysis the outcome of cervical spine surgery. We conclude that investigated

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A competency-based model for training of specialists in vertebrology at higher medical school

Year: 2016, volume 12 Issue: №2 Pages:
Heading: Pedagogics and Education Article type: Short message
Authors: Norkin I.A., Fedonnikov A.S., Zaretskov V.V., Andriyanova E.A., Levchenko K.K., Zaretskov A.V., Belonogov V.N.
Organization: Saratov State Medical University
Summary:

The field of medicine facing the issues of diagnosis and treatment of spine diseases and injuries requires training of specialists in vertebrology taking into consideration the modern standards of higher professional education and medical care conditions. The article deals with the training of the specialists using a competency-based model

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Perspectives for vertebrology teaching development in higher medical schools

Year: 2015, volume 11 Issue: №2 Pages: 210-212
Heading: Pedagogics and Education Article type: Author's opinion
Authors: Norkin I.A., Zaretskov V.V., Levchenko K.K., Fedonnikov A.S., Zaretskov A.V., Kireev S.N.
Organization: Saratov State Medical University
Summary:

The article deals with the issues on improving the efficiency of vertebrology teaching in specialist training at pre-and postgraduate stages. Modern epidemiologic trends for spine traumas and diseases form the increasing interest to the problems of care and prevention of the considered pathology and define the necessity of single-skilled specialists training. Developing vertebrology into a separate discipline that is studied at medical universities at both pre- and postgraduate stages is one of the topic issues for higher medical schools where the search of effective ways of its realization is stressed.

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VALIDATION OF THE MODEL OF INFORMATIONAL INTERACTION OF THE INSURER AND THE MEDICAL INSTITUTION DURING THE EXPERT ESTIMATION OF THE MEDICAL CARE QUALITY

Year: 2007, volume 3 Issue: №4 Pages: 29-34
Heading: Health Service Organization Article type: Original article
Authors: A.S. Fedonnikov
Organization: Saratov State Medical University
Summary:

One of the important tasks of any medical institution is the ensuring of medical care quality, which is carried out in the terms of mandatory medical insurance. Protection of the right of ensured citizens is accomplished by the procedure of expert estimation of the medical care quality. In this case the effectiveness of expert work becomes the crucial problem of mandatory medical insurance organization. The article contains the results of analysis of expert work in MMI system in 2002-2006 both at the level of the Russian Federation and the Saratov Region and the description of the model of informational interaction of the insurer and the medical institution during the expert estimation of the medical care quality.