scholarly journals Comparative Analysis of Knee Joint Fusion with Long Locking Nail and Ilizarov Apparatus in Patients with Deep Infection after Arthroplasty

2020 ◽  
Vol 26 (3) ◽  
pp. 109-118
Author(s):  
L. N. Solomin ◽  
E. A. Shchepkina ◽  
K. L. Korchagin ◽  
F. K. Sabirov
Keyword(s):  
Quality Of Life ◽  
Comparative Analysis ◽  
Blood Loss ◽  
Knee Joint ◽  
Internal Fixation ◽  
Inpatient Treatment ◽  
Deep Infection ◽  
Knee Arthrodesis ◽  
Locking Nail

Relevance. Deep infection after knee arthroplasty requires radical surgical treatment of the infection site, removal of endoprosthesis components, and an antimicrobial spacer placement. If revision knee arthroplasty is impossible, the «gold standard» for this kind of patients is knee joint arthrodesis. The purpose of the study was the comparative analysis of knee joint fusion by external and internal fixation. Materials and Methods. The analysis of 60 cases of knee arthrodesis was carried out. The patients were divided into two groups with 30 patients in each. In the first group, knee arthrodesis was performed with long locking nail, in the second group — with external ring fixation. We compared the groups by intraoperative and drainage blood loss, the inpatient treatment duration, the terms of fusion and complications registered. The patients quality of life was evaluated using the SF-36 questionnaire before surgery, for the periods of 3, 6, and 12 months after the surgery. Results. The comparison of two methods of knee arthrodesis showed that blood loss in the internal fixation compared with external one, was 2.03 times more, the duration of inpatient treatment was 1.4 times less, and the total number of complications was 4.4 times less. However, the complications that affected the treatment outcome in long nail group were 1.5 times more. The differences in the average time of ankylosis formation were not statistically significant (p<0.05). The functional results of the treatment in 3 months after surgery in the group with internal fixation were much better. In 6 months after surgery the quality of life had no significant differences. In 12 months follow-up the indices in both groups were the same. Conclusion. The results of our study suggests us to think, knee joint arthrodesis by long fusion nail should be prefereble. If the nail insertion is technically impossible, and there is the high risk of deep infection recurrence, the external osteosynthesis should be used.

scholarly journals Arthroscopically-assisted knee joint arthrodesis by custom-made intramedullary locking nail with simultaneous femur deformity correction (case report)

2020 ◽  
Vol 27 (1) ◽  
pp. 43-52
Author(s):  
K. L. Korchagin ◽  
D. V. Chugaev ◽  
L. N. Solomin ◽  
E. P. Sorokin ◽  
S. A. Lasunskiy
Keyword(s):  
Blood Loss ◽  
Knee Joint ◽  
Deformity Correction ◽  
High Volume ◽  
Knee Arthrodesis ◽  
Custom Made ◽  
Arthroscopically Assisted ◽  
Minimize Blood Loss ◽  
Locking Nail ◽  
Traditional Approaches

Post-traumatic intra- and extra-articular deformities of the bones forming the knee joint, multiple previous surgeries, fibrous ankylosis of the knee joint is unfavorable background for performing total knee joint arthroplasty. In case of refusal to perform knee arthroplasty, the gold standard is knee arthrodesis. Standard techniques used in performing this operation are traumatic and associated with a high volume of intraoperative blood loss. Using such a surgical option as arthroscopically-assisted arthrodesis can reduce the level of surgical invasive- ness and minimize blood loss, while allowing you to perform this operation no less effectively than using traditional approaches. As a clinical example, we have presented arthroscopically-assisted arthrodesis of the knee joint in a patient with posttraumatic deformity of the femur and fibrous ankylosis of the knee joint with a good medium-term functional result.

scholarly journals Recognition of Factors of Postoperative Complications of Knee Osteoarthritis Patients and Comprehensive Nursing Intervention

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Ying Dong ◽  
Pei Zhang ◽  
Lidan Fan
Keyword(s):  
Quality Of Life ◽  
Total Knee Arthroplasty ◽  
Blood Loss ◽  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Knee Arthroplasty ◽  
Nursing Intervention ◽  
Joint Function ◽  
Total Knee

Knee osteoarthritis (KOA) is a degenerative joint disease characterized by articular cartilage degeneration, cartilage exfoliation, osteophyte formation, and synovitis. It seriously affects the knee joint function and quality of life of patients. Total knee arthroplasty is now the most frequently used therapy for end-stage knee arthritis because it can successfully modify the line of lower extremities, restore knee joint function, alleviate pain, and enhance patients’ quality of life; nevertheless, it may cause significant trauma and bleeding. It can easily lead to infection and anemia. In this study, the control group chose total knee arthroplasty and the observation group chose total knee arthroplasty combined with PRP. The results showed that the knee joint function score, visual analog score, blood transfusion, total blood loss, total postoperative drainage, and complications in the observation group were superior to those in the control group. Total knee arthroplasty takes a long time and needs a lot of soft tissue incision, which leads to a lot of blood loss and can cause a variety of complications. Gel has been shown in studies to successfully decrease blood loss during and after total knee arthroplasty, enhance knee joint function recovery, and improve patient quality of life. In this paper, the complications and causes of knee osteoarthritis after total knee arthroplasty were studied. Combined with comprehensive nursing intervention for postoperative recovery, it helps to improve the formation of thrombin and calcium ion, which can effectively reduce blood loss, relieve pain, and promote the recovery of knee joint function. This study analyzed the application of total knee arthroplasty combined with gel in the treatment of knee osteoarthritis.

scholarly journals Quality-of-life evaluation in chronic wounds: comparative analysis of three disease-specific questionnaires

2017 ◽  
Vol 14 (6) ◽  
pp. 1299-1304 ◽  
Author(s):  
Matthias Augustin ◽  
Katrin Baade ◽  
Kristina Heyer ◽  
Patricia E Price ◽  
Katharina Herberger ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Comparative Analysis ◽  
Chronic Wounds ◽  
Life Evaluation ◽  
Disease Specific

scholarly journals Osteoarthritis of the knee joint. Etiology, treatment, rehabilitation (analytical review of the literature)

TRAUMA ◽  
2021 ◽  
Vol 22 (3) ◽  
pp. 5-11
Author(s):  
Khaled Obeidat ◽  
O.D. Karpinska
Keyword(s):  
Quality Of Life ◽  
Total Knee Arthroplasty ◽  
Knee Joint ◽  
Knee Replacement ◽  
Knee Arthroplasty ◽  
Gait Parameters ◽  
Total Knee ◽  
The Difference ◽  
Knee Pathology

According to epidemiological studies, osteoarthritis accounts for 10–12 % of all cases of musculoskeletal diseases. In the general structure of knee pathology, degenerative diseases make up 57.8 %. The urgency of the problems of gonarthrosis is due to not only its widespread prevalence, but also the high risk of developing knee dysfunction, accompanied by a significant reduction in the quality of life of patients and often leading to partial or permanent disability of patients. Gonarthrosis has significant gender features. Women account for about 70 % of the number of patients, while men had this disease almost 2 times less often, but other data indicate that the incidence of gonarthrosis in men under 60 years of age is higher, and in women it begins to increase after 65 years. Knee replacement is a leading method in the treatment of knee osteoarthritis stages III–IV. The tendency towards an increase in the total number of surgeries leads to an increase in the frequency of complications and unsatisfactory results: according to some authors, from 3.3 to 13.2 % of patients complain of knee replacement outcomes. Studies of long-term complaints after arthroplasty have shown that in addition to pain reduction, some patients had an increase in varus angle when bending the knee while walking but they didn’t mark an improvement in gait parameters compared to preoperative examination. After unilateral total knee arthroplasty, the load patterns of the frontal plane in the operated knee remain pathological in the long run. After knee arthroplasty, there is muscle weakness, and studies have shown changes in all muscles of the lower extremity. Weakening of some muscles led to compensatory strengthening of others. Studies of the effect of preoperative rehabilitation on the outcome of knee arthroplasty have shown its low efficiency. Many studies have studied motor activity of patients after total knee arthroplasty in recent years. Not only gait features, but also movements of the pelvis, trunk and upper extremities are studied. Modern methods of diagnosing spatial oscillations of the body when walking have shown that disorders of body movements — excessive hand movements, pelvic loosening, asymmetrical flexion of the knee joints, etc., after arthroplasty are preserved in patients and restore slowly, and some disorders remain forever. Conclusions. Knee arthroplasty relieves pain, improves quality of life, but according to many authors, patients complain of incomplete restoration of the functionality of the prosthetic limb. According to the researchers, the main cause for incomplete reco-very of gait parameters is the difference in the frontal angles of the knee joint flexion and the difference in the length of the steps. Special training exercises can reduce the asymmetry of the steps, but it is difficult to completely restore the symmetry of the steps within 2 years. Studies of the effect of preoperative rehabilitation on the outcome of knee arthroplasty have shown its low effectiveness.

scholarly journals Effectiveness of pharmacopuncture by “alloplant” biomaterial in complex therapy of knee joint osteoarthritis

2020 ◽  
Vol 19 (1) ◽  
pp. 45-49
Author(s):  
Ruslan K. Urazbakhtin ◽  
Raushaniya N. Kildebekova ◽  
Lira T. Gilmutdinova ◽  
Vadim T. Kaybyshev ◽  
Ravil Sh. Mirkhaydarov ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Drug Therapy ◽  
Knee Joint ◽  
Well Being ◽  
Biologically Active ◽  
Basic Drug ◽  
Group Iii ◽  
Group I ◽  
Immunological Mechanisms

Background. Osteoarthritis is characterized by a decrease in the quality of life, which is currently considered as the main measure of well-being of an individual and a criterion for the effectiveness of treatment and rehabilitation measures. Modern research emphasizes the need for an integrated approach to the treatment of osteoarthritis, which should include pharmacological and non-drug methods of treatment. Aim. The purpose of the study was to evaluate the effectiveness of pharmacopuncture administration of Alloplant biomaterial by patients with osteoarthritis of the knee joint from the standpoint of influencing the immunological mechanisms of the disease. Methods. The randomization methodology was divided into 3 groups, comparable in terms of clinical and functional characteristics. Group I patients (n = 39) have standard basic drug therapy according to the federal clinical guidelines Osteoarthritis approved by the Association of Rheumatologists of Russia (2013), with additions from 2016; in patients of group II (n = 39), in addition to drug therapy, dispersed Alloplant biomaterial was used according to the original method; group III patients (n = 39) against the background of basic drug therapy are additionally prescribed a combination of dispersed Alloplant biomaterial at biologically active points and magnetic therapy with a pulsed magnetic field. Results. Against the background of the treatment of patients with osteoarthritis using pharmacopuncture with Alloplant biomaterial and magnetotherapy, there was a positive dynamics in clinical data with a significant decrease in pain intensity when walking and at rest, stiffness, with the restoration of immune status parameters and an improvement in the quality of life in the field of physical and psychological health . A more pronounced and lasting positive dynamics was observed in patients of group III against the background of the combined effects of pharmacopuncture with Alloplant biomaterial and magnetotherapy. Conclusion. The Alloplant biomaterial has a positive effect in the treatment of patients with stage III osteoarthritis according to the KellgrenLawrens classification. The similarity of the mechanism of action with drugs with a structurally modifying effect on cartilage allows us to recommend pharmacopuncture with Alloplant biomaterial for widespread use in the treatment of osteoarthritis.

scholarly journals REHABILITATION DIAGNOSIS OF PATIENTS WITH GONARTHROSIS ON THE BASIS OF INTERNATIONAL CLASSIFICATION OF FUNCTIONING, LIMITATION OF LIFE ACTIVITY AND HEALTH

2021 ◽  
pp. 6-14
Author(s):  
О. О. Bespalova ◽  
P. F. Rybalko ◽  
A. M. Sitovskyi ◽  
T. Y. Tsjupak ◽  
I. V. Savchuk
Keyword(s):  
Quality Of Life ◽  
Knee Joint ◽  
Functional Independence ◽  
International Classification ◽  
Knee Joints ◽  
International Classification Of Functioning ◽  
Inclusion Criteria ◽  
Rehabilitation Intervention

Excessive training loads during sports cause chronic functional overload of the joints and their trauma, which reduces the quality of life of athletes, limits activity and participation, termination of sports careers, and in severe cases - disability. In sports practice, one of the most common sites of osteoarthritis is the knee joints (gonarthrosis). Gonarthrosis of the knee joint is a degenerative-dystrophic disease in which the destruction of hyaline cartilage, deformation of bone tissue and the qualitative composition of synovial fluid. A key link in the development of an individual program of rehabilitation intervention is the formulation of a rehabilitation diagnosis. The aim of the research: to determine the rehabilitation diagnosis of patients with gonarthrosis of the knee joints on the basis of the International Classification of Functioning, Restriction of Life and Health (ICF). Materials and methods: theoretical (analysis and generalization of scientific-methodical and clinical literature); clinical (analysis of medical records, communication, palpation, clinical and functional testing; physical examination); scale methods for assessing the condition of patients (Leken index, pain scale, depression scale (CES-D), assessment of quality of life according to the SF-36 questionnaire); instrumental (goniometry, manual-muscular testing). The research involved 7 veteran athletes aged 45 to 49 years with primary gonarthrosis stage II. Inclusion criteria: current athletes - men of different specializations; primary gonarthrosis of the second radiological stage according to Kellgren; duration of pain not less than 4 months; the level of pain when walking on the scale of YOUR 45 and more; age of patients older than 45 years; informational consent of patients to participate in the research. Inclusion criteria: secondary gonarthrosis of the knee joint; the presence of comorbidities; severe condition of the patient; knee surgery; planning of arthroplasty of the knee joint; intra-articular injections; lack of information consent. Rehabilitation diagnosis is the most complete reflection of the patient's current problems, which affect the level of his functioning, activity and participation, and are significant for him. It is established by all members of the multidisciplinary team, and is based on the results of comprehensive rehabilitation diagnostics. The main tool for establishing a rehabilitation diagnosis are the categories and domains of IFF. Rehabilitation diagnosis of patients with gonarthrosis: moderate structural changes in the knee joints (s750.2), episodic moderate pain (b28014.2), short-term morning stiffness (b7800.2), decreased mobility of the knee joint (b710.2), his stability (b7150.2) and support function, decrease in muscle tone (b7350.2) and strength of the quadriceps femoris (b7300.2), which limits domestic activity and prolongs it over time (d450.1); difficulties in changing body position (d410.2), moving up stairs and moving long distances (d460.3), which limits participation in active forms of recreation. Patients report poor mood, depression due to health and forced restriction of participation (b152. 1), and concerns about future careers. Conclusions. Rehabilitation care is provided to patients in several stages, one of which is the formulation of a rehabilitation diagnosis. Rehabilitation diagnosis was established, in which the current problems of patients at the level of structure and function, activity and participation, as well as contextual factors that contribute, limit or prevent the achievement of the desired level of functional independence, allow individualization of rehabilitation intervention to bring this level to the maximum possible.

scholarly journals Hip function and health-related quality of life in intramedullary and extramedullary internal fixation of trochanteric fractures

2020 ◽  
Vol 148 (7-8) ◽  
pp. 451-454
Author(s):  
Milan Mitkovic ◽  
Sasa Milenkovic ◽  
Ivan Micic ◽  
Igor Kostic ◽  
Predrag Stojiljkovic ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Internal Fixation ◽  
Harris Hip Score ◽  
Health Related Quality ◽  
Trochanteric Fractures ◽  
Component Score ◽  
Related Quality ◽  
Health Related ◽  
Hip Function

Introduction/Objective. There are extramedullary and intramedullary methods of trochanteric fractures? internal fixation with implants having a lag screw. The objective of this study was to examine the difference in impact of these fixation types on final hip function and health-related quality of life. Method. There were 75 patients treated for a trochanteric fracture, using self-dynamisable internal fixator (SIF group), as an extramedullary method, or gamma nail (GN group), as an intramedullary method. These patients were called for the evaluation of Harris Hip Score (HHS) and SF-12 questionnaire at least two years after surgery. The SF-12 questionnaire has dual expression ? physical component score (PCS) and mental component score (MCS). Results. There were no significant differences between the SIF group and the GN group regarding HHS, PCS, and MCS. Positive correlation was confirmed between HHS, PCS, and MCS, with the strongest relation between HHS and PCS. Negative correlation was confirmed between age and HHS. Conclusion. There was no difference in final hip function and health-related quality of life between SIF and GN methods in trochanteric fractures treatment (p > 0.05). These parameters of outcome were confirmed to have positive interrelation (p < 0.05). Both submuscular presence of extramedullary implant with dimensions of SIF and the need for bone reaming in cephalomedullary fixation were considered not to have significant impact in HHS and SF-12 scores after trochanteric fractures treatment by internal fixation.

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