卷 21, 编号 2 (2015)

The objective - to evaluate long-term results and survival rates of «Universal» condylar knee prosthesis. Material and methods. There were a total of 121 total knee joint replacements in the set with 107 patients aged 71.3 years on average (52-86 years). A total of 115 knees diagnosed with osteoarthritis of the 3-4th degree were indicated for the surgery, and there were 6 patients with the diagnosis of rheumatoid arthritis. Functional outcomes were evaluated using the Knee Society Score (KSS), Results. The assessment of the knee state on a scale KSS average clinical section KSS (knee score) was 48.2, and functional (function score) - 46,8 points. After surgery, the indices increased to 87.4 points and 85.8 points, respectively. One complication was described during the surgery, namely - the fracture of the medial tibia condyle (0.8%). In the early post-surgery period, peroneal nerve paresis was observed in two patients (1.6%). In the postoperative period, disorders of the wound healing were observed in 6 patients (4.9%), which were healed successfully in a conservative way. In the late post-surgery period, there were infectious complications in the knee joint in 4 knee joints (3.3%). Aseptic loosening was observed in 4 cases out of 117 endoprostheses (3.4%). It always concerned the loosening of tibial component. The loosening of the femoral component was not observed. In the period from the implantation until June 2014, which is 16-22 years after the implantation, there are 16 patients in total surviving, who had a total of 21 implanted endoprostheses. Among them there are no signs of a loosening only in 4 patients (19%); there was an apparent radiolucent line up until 2 mm with a sclerotic rim under the tibial component. All the patients were without clinical symptoms for the loosening. Six female patients (28.5%) state troubles in the area of the femoro-patellar joint, where there is a lateralization of the patella, apparent on the X-ray images. Two patients (1.6%) experienced a periprosthetic femur fracture during the period of observation. It was possible to resolve this state by the distal femoral nail osteosynthesis. Upon assessing the results via the Kaplan-Meier curve method, the survival index was 98.7% after 7 years, 94.3% - after 22 years and 91.8% - after 22 years. Conclusion. The result of this study had showed the reliability of «Universal» prosthesis which can be recommended for the treatment of patients with degenerative knee disea;

Objective. To assess the impact of anemia on the incidence of myocardial infarction and delirium in the early postoperative period in patients with hip fractures who underwent total hip replacement. Materials and methods. A retrospective study of 303 patients with hip fractures who underwent total hip replacement was performed. Patients were divided into two groups according to the level of hemoglobin (Hb) on the 2nd postoperative day: Group 1 (n = 116) with Hb levels above 100 g/L and Group 2 (n = 187) with Hb levels below 100 g/L. Results and conclusion. Transfusion in Group 1 was performed more often intraoperatively or in the early postoperative hours (67 vs. 35 patients; p <0.001). Hb levels on the 2nd day were significantly higher in Group 1 (108 [104; 117] vs. 87 [80; 92] g/L; p <0.001). Moderate and severe anemia in the early postoperative period was noted in 53.5% and 4.3% of the patients of Group 2, respectively. The incidence of myocardial infarction and delirium was higher in Group 2 than in Group 1 (6.4% vs. 0%; p = 0,013 and 7.5% vs 0.8%; p = 0.021, respectively). The study has shown that moderate and severe anemia in the early postoperative period is associated with an increase in the incidence of myocardial infarction and delirium.

Tendon ruptures of the pectoralis major muscle are considered a rare type of injury, but there is a tendency for a greater frequency of occurrence in such cases, which is associated with an increased interest in sport and fitness among the population. Despite the seeming simplicity of diagnosis, many complete ruptures remain unrecognized and many patients do not seek medical help or being treated for bruises, sprains and partial damage, although in fact there a complete ruptures of the pectoralis major muscle or it’s tendon. Currently there is no consensus on diagnostic tactics, surgical approach, the optimal method of fixation, indications for use of plastic material; disputable tactics of chronic ruptures and rehabilitation program in the treatment of tendon ruptures of the pectoralis major muscle.