Driving electrochemical corrosion of implanted CoCrMo metal via oscillatory electric fields without mechanical wear

Decades of research have been dedicated to understanding the corrosion mechanisms of metal based implanted prosthetics utilized in modern surgical procedures. Focused primarily on mechanically driven wear, current fretting and crevice corrosion investigations have yet to precisely replicate the complex chemical composition of corrosion products recovered from patients’ periprosthetic tissue. This work specifically targets the creation of corrosion products at the metal on metal junction utilized in modular hip prosthetics. Moreover, this manuscript serves as an initial investigation into the potential interaction between implanted CoCrMo metal alloy and low amplitude electrical oscillation, similar in magnitude to those which may develop from ambient electromagnetic radiation. It is believed that introduction of such an electrical oscillation may be able to initiate electrochemical reactions between the metal and surrounding fluid, forming the precursor to secondary wear particles, without mechanically eroding the metal’s natural passivation layer. Here, we show that a low magnitude electrical oscillation (≤ 200 mV) in the megahertz frequency (106 Hz) range is capable of initiating corrosion on implanted CoCrMo without the addition of mechanical wear. Specifically, a 50 MHz, 200 mVpp sine wave generates corrosion products comprising of Cr, P, Ca, O, and C, which is consistent with previous literature on the analysis of failed hip prosthetics. These findings demonstrate that mechanical wear may not be required to initiate the production of chemically complex corrosion products.

Medical and social expertise of patients after amputation of the lower limbs on the background of atherosclerosis

Rationale. Up to 200 reconstructive operations on the aorta and arteries of the lower extremities are performed annually in the Kabardino-Balkar Republic for obliterating arterial diseases, the main of which is atherosclerosis. After performing reconstructive operations on the arteries of the lower extremities, 4045% of patients developed a relapse of ischemia during the next 35 years due to the progression of the underlying disease, 80% of them undergo high-level amputations of the extremities. Carrying out medical and social expertise in the early stages after amputation is an important link in the rehabilitation of this contingent of patients. Purpose. assessment of medical and social expertise and quality of life of patients who have undergone amputation of the lower extremities against the background of obliterating arterial diseases. Materials and methods. The object of the study was 87 patients who had undergone amputation of the lower extremities, who were hospitalized in the vascular department of the Republican Clinical Hospital of Nalchik from 2015 to 2019. Results: The following results were obtained during the examination of patients at the Medical and social expertise bureau in Nalchik: The third group of disability was assigned to 14 patients; The second group of disability was assigned to 68 patients; The first group of disability was assigned to 5 patients. In this case, the objective data of the state of hemodynamics in the lower extremities were assessed. When assessing the quality of life of disabled people using the SF-36 questionnaire, the following results were obtained: after amputation of the lower limb, the indicators of physical health sharply decreased, and the indicator of social role also significantly decreases, not reaching half the value of the scale (38 points). Conclusion. It is necessary to carry out a medical and social examination of patients after amputation of the lower limbs by the visiting commission of the Main Bureau of Medical and Social Expertise in the postoperative period in the hospital, while up to a period of 6 months (before hip prosthetics) for group 1 of disability patients , considering that these patients during this period need constant outside care. It is necessary to create, on the basis of rehabilitation centers, orthopedic workshops for the manufacture of good quality limb prostheses, and train patients in the use of prostheses by specialists of rehabilitation centers. After teaching the patient to use a prosthesis in a rehabilitation center, undergo a medical and social examination to obtain an appropriate group of disabilities.

Physiotherapeutic support of patients with dysplastic coxarthrosis after total hip prosthetics

Today, the main method of surgical treatment of dysplastic coxarthrosis among adults is total hip prosthetics. Distant positive results according to foreign authors are 76–89%. One method of rehabilitation is physiotherapeutic treatment. The absence of standardized physiotherapeutic treatment protocols leads to a sharp reduction in the prescription of this type of rehabilitation measures. The aim of the study is to assess the long-term results of hip joint endoprosthetics among patients with dysplastic coxarthrosis using the developed physiotherapeutic treatment technique. Research materials and methods. For the period from 2010 to 2014, 205 patients were performed an operation with dysplastic coxarthrosis 1, 2, 3 degrees of Crowe. In the pre- and postoperative periods, patients of the main group were prescribed physiotherapeutic treatment according to the developed methodology. Evaluation of the results was carried out 12 months after surgical treatment using clinical and radiological methods, questionnaires using the Harris scale, SF-36. The obtained data were processed using statistical methods: Student coefficient, Pearson coefficient, correlation method. Results. When analyzing distant results, the average Harris score in the main group 85.82 (84.93–86.71) was significantly higher than in the comparison group 83.01 (82.02–84.00). The average score of the SF-36 questionnaire in the main group was significantly higher than in the comparison group (p < 0.001). Mental health indicators of patients were not significantly different from those of the postoperative period and were at a high level. Conclusions. Prescription of physiotherapeutic treatment promotes rapid healing of postoperative wounds and improves results of surgical treatment.

Physiotherapeutic support of patients with dysplastic coxarthrosis after total hip prosthetics

Today, the main method of surgical treatment of dysplastic coxarthrosis among adults is total hip prosthetics. Distant positive results according to foreign authors are 76–89%. One method of rehabilitation is physiotherapeutic treatment. The absence of standardized physiotherapeutic treatment protocols leads to a sharp reduction in the prescription of this type of rehabilitation measures. The aim of the study is to assess the long-term results of hip joint endoprosthetics among patients with dysplastic coxarthrosis using the developed physiotherapeutic treatment technique. Research materials and methods. For the period from 2010 to 2014, 205 patients were performed an operation with dysplastic coxarthrosis 1, 2, 3 degrees of Crowe. In the pre- and postoperative periods, patients of the main group were prescribed physiotherapeutic treatment according to the developed methodology. Evaluation of the results was carried out 12 months after surgical treatment using clinical and radiological methods, questionnaires using the Harris scale, SF-36. The obtained data were processed using statistical methods: Student coefficient, Pearson coefficient, correlation method. Results. When analyzing distant results, the average Harris score in the main group 85.82 (84.93–86.71) was significantly higher than in the comparison group 83.01 (82.02–84.00). The average score of the SF-36 questionnaire in the main group was significantly higher than in the comparison group (p < 0.001). Mental health indicators of patients were not significantly different from those of the postoperative period and were at a high level. Conclusions. Prescription of physiotherapeutic treatment promotes rapid healing of postoperative wounds and improves results of surgical treatment.