scholarly journals The first experience of arthroscopy in the case of aseptic necrosis of the femoral head

2021 ◽  
pp. 39-44
Author(s):  
Maxim Golovakha ◽  
Vadym Kirichenko ◽  
Olexandra Grytsenko ◽  
Rostyslav Tytarchuk ◽  
Stanislav Bondarenko
Keyword(s):  
Femoral Head ◽  
Avascular Necrosis ◽  
Hip Joint ◽  
Comparison Group ◽  
Long Term Results ◽  
Control Group ◽  
Study Group ◽  
Hip Joint Replacement ◽  
Therapeutic Exercises

Observation of patients with avascular necrosis of the femoral head formed a hypothesis about inability to eliminate the hip contracture by tunneling the femoral head on the background of drug therapy and therapeutic exercises, which causes an unsatisfactory outcomes. Therefore, the was idea to use arthroscopy for performing capsulotomy, synovectomy and removal of free cartilage and bone fragments. Objective. To evaluate efficiency of arthroscopy in patients with avascular necrosis of the femoral head. Methods. In the period from 2010 to 2018, 60 patients were observed. With the I–II stages, absence of inflammatory processes in the joint, body mass index less than 35. In the comparison group (28 patients) we made  only tunneling of the femoral head, in the study group (32) at first  we performed arthroscopy of the hip joint, capsulotomy, synovectomy, removal of cartilage fragments, and only then — tunneling. We analyzed the proportion of hip joint replacement that was performed in the long term follow up and the intensity of pain by visual analog scale. Results. During arthroscopy we often revealed the joint cartilage lesions — 30 %, articular labrum lesions — 5 %, synovitis — 100 %, CAM impingement — 90 %. In the study group in the first 2 weeks after surgery, the pain was severe more than in the comparison group. Then the pain rate became the same in both groups. In the control group in the period from 3 to 5 years after tunneling of the femoral head, arthroplasty was performed in 11 patients (39.3 %), in the study group for 2 to 3 years after surgery — 8 (25.0 %). Conclusions. Analysis of long-term results of tunneling of the femoral head with arthroscopy of the hip joint in patients with avascular necrosis of the femoral head showed improvement in hip function, no disease progression in 60–75 % patients in 2–3 years after surgery.

scholarly journals Role and effectiveness of complex and supervised rehabilitation on overall and hand function in systemic sclerosis patients—one-year follow-up study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Michał Waszczykowski ◽  
Bożena Dziankowska-Bartkowiak ◽  
Michał Podgórski ◽  
Jarosław Fabiś ◽  
Arleta Waszczykowska
Keyword(s):  
Systemic Sclerosis ◽  
Hand Function ◽  
Exercise Program ◽  
Rehabilitation Program ◽  
Long Term Results ◽  
Home Exercise ◽  
Control Group ◽  
Study Group

AbstractThe aim of this study was to estimate the long-term results of complex and supervised rehabilitation of the hands in systemic sclerosis (SSc) patients. Fifty-one patients were enrolled in this study: 27 patients (study group) were treated with a 4-week complex, supervised rehabilitation protocol. The control group of 24 patients was prescribed a home exercise program alone. Both groups were evaluated at baseline and after 1-, 3-, 6-, and 12-months of follow-up with the Disability of the Arm, Shoulder and Hand Questionnaire (DAHS) as the primary outcome, pain (VAS—visual analog scale), Cochin Hand Function Scale (CHFS), Health Assessment Questionnaire Disability Index (HAQ-DI), Scleroderma-HAQ (SHAQ), range of motion (d-FTP—delta finger to palm, Kapandji finger opposition test) and hand grip and pinch as the secondary outcomes. Only the study group showed significant improvements in the DASH, VAS, CHFS and SHAQ after 1, 3 and 6 months of follow-up (P = 0.0001). Additionally, moderate correlations between the DASH, CHFS and SHAQ (R = 0.7203; R = 0.6788; P = 0.0001) were found. Complex, supervised rehabilitation improves hand and overall function in SSc patients up to 6 months after the treatment but not in the long term. The regular repetition of this rehabilitation program should be recommended every 3–6 months to maintain better hand and overall function.

scholarly journals The significance of polymorphisms of gene coagulation factors VII and XIII in the pathogenesis of non-traumatic avascular necrosis of the femoral head

2021 ◽  
Vol 27 (1) ◽  
pp. 43-47
Author(s):  
M.A. Panin ◽  
◽  
N.V Zagorodnii ◽  
A.V. Boiko ◽  
L.M. Samokhodskaya ◽  
...  
Keyword(s):  
Femoral Head ◽  
Avascular Necrosis ◽  
Coagulation Factors ◽  
Group Differences ◽  
Unknown Etiology ◽  
Control Group ◽  
Study Group ◽  
Control Groups ◽  
Aseptic Necrosis ◽  
And Control

Introduction Non-traumatic avascular necrosis of the femoral head (ANFH) is a poly-etiologic and socially significant disease in the age of 20 to 50 years and is associated with disability. Research on the identification of necrosis causes/predictors is a relevant issue. Purpose To study the contribution of polymorphisms in the genes of coagulation factors F7 and F13 in the aetiology of non-traumatic avascular necrosis of the femoral head. Methods Polymorphisms of the genes of coagulation factors F7 and F13 were studied; comparative analysis of the frequency of important allelic variants of F7genes (Arg353Gln) and F13 (Val134Leu) in patients with a verified diagnosis of aseptic necrosis (study group) and in healthy patients (control group) was performed. The study group included 41 patients (all males) with aseptic necrosis of the femoral head of unknown etiology. Results The frequency of gene alleles in the F7 Arg353Gln in the study group were: GG in 30 out of 41 patients (73.2 %), GA in 11 out of 41 patients (26.8 %), and none of 41 patients had a polymorphic variant AA. The frequency of alleles of this type of gene in the control group was as follows: GG in 7 out of 320 subjects (2.2 %), GA in 66 out of 320 patients (20.6 %), AA in 247 out of 320 (77.2 %). Significant differences were identified in the frequencies of homozygous genotypes, AA (χ2 = 100.215, p < 0.001) and GG (χ2 = 205.770, p < 0.001) in the study and control groups respectively. As for the heterozygous GA genotype, the differences were not significant (χ2 = 0.834, p = 0.362). The GG genotype of the gene Val134Leu F13 WAS 2.8 times more frequent in patients of the study group, differences were statistically significant (26.8 % against 9.7 %, χ2 = 10.388; p = 0.002). The presence of the TT genotype of the gene Val134Leu F13 was almost five times more frequent (χ2 = 18.956, p < 0.001) in healthy individuals (control group). Differences in the frequency of allele T in homo/ and heterozygous combinations (TT and GT) in the study and control groups was also significant (72.7 % vs 90.1 %, respectively, χ2 = 4.946, p = 0.027). Discussion Polymorphisms of coagulation factors genes F7 and F13 have a significant effect on the genesis of non-traumatic avascular necrosis of the femoral head. Risk factor of ANFH development is homozygous GG genotype in the gene Arg353Gln F7. Low probability of the disease is due to a protective role of AA genotype of the gene Arg353Gln F7 and TT genotype of the gene Val134Leu F13.

Core decompression for avascular necrosis of the femoral head: correlation between long-term results and preoperative MR staging.

Radiology ◽  
1990 ◽  
Vol 175 (2) ◽  
pp. 533-536 ◽  
Author(s):  
J Beltran ◽  
C T Knight ◽  
W A Zuelzer ◽  
J P Morgan ◽  
L J Shwendeman ◽  
...  
Keyword(s):  
Femoral Head ◽  
Avascular Necrosis ◽  
Core Decompression ◽  
Long Term Results

scholarly journals Prevention of embolism in patients with atrial fibrillation after resection of left atrium appendage during open heart surgery (pilot study)

2018 ◽  
Vol 10 (2) ◽  
pp. 52-57 ◽  
Author(s):  
A V Sotnikov ◽  
M V Melnikov ◽  
V A Marinin ◽  
Yu V Kisil ◽  
K V Samko
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrium ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Radical Resection ◽  
Long Term Results ◽  
Control Group ◽  
Study Group ◽  
Open Heart

Aim. To assess the potential of prevention cardiogenic embolism by resection of left atrium appendage (LAA) during open heart surgery in patients with atrial fibrillation (AFib). Materials and methods. Study design - cohort prospective. Study group consisted of 19 patients with AFib whom during open heart surgery for coronary and/or valvular disease additional radical resection of LAA was made. After removal of the appendage two-layer linear suture to left atrium was performed without leaving a stump. Control group consisted of 20 patients with AFib, in whom during open heart surgery LAA remained intact. Long-term results were studied using CROQ telephone questionnaire. Results. There was no hospital mortality in both groups. Long-term results in control group were followed up to 6 years, in study group up to 2 years. Radical resection of LAA in patients with AFib reduced the risk of thromboembolic events in long-term period. In control group there were 4 strokes (2 of them were fatal), but no strokes in study group (p < 0,05). Conclusion. Radical resection of LAA in patients with AFib during open heart surgery for coronary and/or valvular disease prevents cardiogenic arterial embolism. (For citation: Sotnikov AV, Melnikov MV, Marinin VA, et al. Prevention of embolism in patients with atrial fibrillation after resection of left atrium appendage during open heart surgery (pilot study). Herald of North-Western State Medical University named after I.I. Mechnikov. 2018;10(2):52-57. doi: 10.17816/mechnikov201810252-57).

scholarly journals COMPARATIVE STUDIES OF EFFICACY OF PHOTODYNAMIC THERAPY AND CRYOTHERAPY FOR TREATMENT OF ACTINIC KERATOSIS

2016 ◽  
Vol 5 (3) ◽  
pp. 19-29
Author(s):  
T. E. Sukhova ◽  
K. A. Changlyan ◽  
A. V. Molochkov ◽  
V. A. Molochkov ◽  
S. V. Korenev ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Actinic Keratosis ◽  
Adverse Reactions ◽  
Long Term Results ◽  
Patient Treatment ◽  
Control Group ◽  
Study Group ◽  
Complete Regression ◽  
Free Survival

The results of a study on the effectiveness of photodynamic therapy with a photosensitizer fotoditazin and cryotherapy for actinic keratosis are represented in the article. The study included 80 patients with 215 lesions, among them erythematous form of actinic keratosis was diagnosed in 151 (70.2%) cases, hyperkeratotic form – in 46 (21.4%) cases, a pigmented form – in 12 (5.6%) and an atypical variant of the disease – in 6 (2.8%) cases. According to histological type the distribution of tumor was as follows: 19 (54.3%) cases were diagnosed as hypertrophic type, 6 (17.1%) – atrophic, 8 (22.9%) – bowenoid and 2 (5.7% ) – pigmented type. Patients from the study group received one session of photodynamic therapy using laser unit "LAMI" (662 nm) after 2 hours of application of fotoditazin 0.5% gel at dose of 0,2-0,3 ml per 1 cm2 of actinic keratosis focus with the following parameters: the energy density of the laser radiation – 200 J/cm2, power density – 0.14–0.48 W/cm2. In the control group patients underwent cryotherapy with liquid nitrogen with an exposure of 30-60 sec. The comparative analysis of the immediate results showed a tendency for the efficacy of photodynamic therapy to increase (the rate of complete regression was 92.5%) compared with cryotherapy (85.0%) (p>0,05). There were also a tendency for long-term results after photodynamic therapy to improve: three-year recurrence-free survival was 94.6% and 88.2%, respectively. For the photodynamic therapy there were significantly fewer adverse reactions, the epithelization time in lesions was significantly shorter. Compared with cryotherapy the photodynamic therapy provided significantly better cosmetic results (p <0.01), and can be used for out-patient treatment of patients with actinic keratosis.><0.01) and can be used for out-patient treatment of patients with actinic keratosis.

Early Avascular Necrosis of the Femoral Head: Relationship of the Findings of Preoperative MRI and the Long-Term Results of Core Decompression

1997 ◽  
Vol 37 (4) ◽  
pp. 745
Author(s):  
Dal Soo Park ◽  
Soon Tae Kwon ◽  
Dong Kweon Jeon ◽  
Gun Young Jeong ◽  
Hong Lim Jang ◽  
...  
Keyword(s):  
Femoral Head ◽  
Avascular Necrosis ◽  
Core Decompression ◽  
Long Term Results ◽  
Relationship Of

scholarly journals Long-term results of 32-mm alumina-on-alumina THA for avascular necrosis of the femoral head

2012 ◽  
Vol 13 (1) ◽  
pp. 21-27 ◽  
Author(s):  
Giuseppe Solarino ◽  
Andrea Piazzolla ◽  
Angela Notarnicola ◽  
Lorenzo Moretti ◽  
Silvio Tafuri ◽  
...  
Keyword(s):  
Femoral Head ◽  
Avascular Necrosis ◽  
Long Term Results

Complex Functional Evaluation of Long-Term Results of Femoral Neck and Head Revascularization in Degenerative Dystrophic Hip Joint Diseases

2012 ◽  
Vol 19 (1) ◽  
pp. 35-41
Author(s):  
Evgeniy Aleksandrovich Nazarov ◽  
V G Papkov ◽  
A V Seleznev ◽  
R F Musaeva ◽  
E A Nazarov ◽  
...  
Keyword(s):  
Femoral Head ◽  
Femoral Neck ◽  
Hip Joint ◽  
Long Term Results ◽  
Functional Evaluation ◽  
Joint Diseases ◽  
Hip Joints ◽  
Functional Changes ◽  
Ct And Mri

Long-term results (7 to 26 years) after femoral neck and head revascularization were analyzed for 41 patients with degenerative dystrophic hip joint diseases: 27 patients with aseptic femoral head necrosis (AFHN), 9 patients with coxarthrosis, 5 - with cystoid remodeling of adjacent surfaces. Results were assessed by Harris scale. Degree of functional changes in hip joints was determined using computed stabilometry. Indirect proof of implanted vascular bundle vitality were radiologically, CT and MRI detected canals in the femoral neck and head that where the implants had been inserted. It was shown that revascularization was most effective (100 points by Harris scale) in patients with early (pre-radiologic) stage of AFHN and in patients with cystic remodeling.

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