Traumatology and Orthopedics of RussiaTraumatology and Orthopedics of RussiaТравматология и ортопедия России2311-29052542-0933Vreden National Medical Research Center of Traumatology and Orthopedics23710.21823/2311-2905-2012--2-5-15MODERN TRENDS IN TRAUMATOLOGY AND ORTHOPEDICSСОВРЕМЕННЫЕ ТЕНДЕНЦИИ В ТРАВМАТОЛОГИИ И ОРТОПЕДИИMODERN TRENDS IN ORTHOPEDICS: THE KNEE ARTHROPLASTYСОВРЕМЕННЫЕ ТЕНДЕНЦИИ В ОРТОПЕДИИ: АРТРОПЛАСТИКА КОЛЕННОГО СУСТАВАTikhilovR. M.ТихиловТ. Р.
Russian Federation
rmtihilov@rniito.ruKornilovN. N.КорниловН. Н.
Russian Federation
drkornilov@hotmail.comKulyabaT. A.КулябаТ. А.
Russian Federation
taraskulyaba@hotmail.comSaraevA. V.СараевА. В.
Russian Federation
saraefff@mail.ruIgnatenkoV. L.ИгнатенкоВ. Л.
Russian Federation
v_ignatenko@mail.ruThe Vreden Russian Research Institute of Traumatology and Orthopedics, St.-PetersburgФГБУ «Российский научно-исследовательский институт травматологии и ортопедии им. Р.Р. Вредена» Минздравсоцразвития России3006201218251501112016https://journal.rniito.org/jour/article/view/237

Using PubMed the authors analyzed publications dedicated to knee arthroplasty that were published in 2011. The modern trends of knee joint replacement include improvement of implants and instruments; partial knee replacement as alternative to TKA; reducing of surgical trauma due to less-invasive approaches; achieving of deep flexion after TKA; using of computer navigation and individual cutting blocks to make surgery more precise; optimization of rehabilitation process in pre-, intra-and postoperative period; including multimodal pain control; development of complex strategies for prevention of intra- and postoperative complications. In this review the attention was attracted to the most discussed in 2011 subjects: development of new designs and materials of knee implants; navigation, robotics and individualized resection blocks; partial knee replacement; infection, blood loss and venous thromboembolism after TKA; influence of different factors on arthroplasty outcomes, especially components and leg alignment, patella resurfacing, PCL retention or substitution, uncemented fixation, mobility of PE insert, severe pre-op deformities or stiffness, previous intra-articular fractures and tibia or femur osteotomies, soft tissue deficit etc.

Используя поисковую систему PubMed, были проанализированы работы, посвящённые различным аспектам артропластики коленного сустава, опубликованные за 11 месяцев 2011 года более чем в 80 зарубежных медицинских журналах. Современные тренды развития технологий эндопротезирования, кроме непрерывного совершенствования используемых конструкций и инструментов, включают в себя внедрение методик изолированного замещения одного или нескольких отделов коленного сустава как альтернативу тотальной артропластике, уменьшение хирургической агрессии за счёт использования менее инвазивных доступов, использование компьютерных навигационных технологий и индивидуально изготовленных резекторных блоков для повышения пространственной точности ориентации компонентов имплантата и количественного контроля сбалансированности сустава в пределах всей амплитуды движений, достижение максимально возможного сгибания в суставе, оптимизацию протоколов ранней реабилитации для ускорения восстановления функции сустава и как следствие более быстрому возвращению пациента к повседневной активности, мультимодальную направленность послеоперационной аналгезии, разработку комплексных стратегий по предупреждению интра- и послеоперационных осложнений, в частности кровопотери, хирургической инфекции, тромбоэмболии и т.д. В обзоре подробно освещены разделы, вызвавшие наибольший интерес исследователей, такие как материалы и дизайн имплантатов, результаты артропластики, инфекционные осложнения, использование навигации, робототехники и индивидуальных резекторных блоков, кровопотеря и тромбоэмболические осложнения.

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