This journal is
indexed in Scopus
Year 2016 Vol. 24 No 5
G.P. KOTELNIKOV, Y.V. LARTSEV, D.S. KUDASHEV, S.D. ZUEV-RATNIKOV, I. S. SHORIN
MOSAIC CHONDROPLASTY OF FULL-THICKNESS DEFECTS OF KNEE ARTICULAR SURFACES IN ITS DESTRUCTIVE DYSTROPHIC LESIONS
SBEE HPE "Samara State Medical University",
The Russian Federation
Objectives. The improvement of the operative treatment results of patients with full-thickness destructive and dystrophic defects of the articular cartilage of the knee joint based on a new method of chondroplasty application.
Methods. The patients were divided into two clinical groups according the method of the operative treatment. The patients (n=34, 49%) were enrolled into the first group. They were operated on using Hangody’s mosaic chondroplasty technique (1992). The patients of the second group (n=35, 51%) subjected to a proposed mosaic chondroplasty based on the use of bone spongy autograft taken extra-articularly as a plastic material for defect replacement. Comparative evaluation of operative treatment results of the indicated clinical groups of patients was carried out 3, 6 and 36 months after the operation. Treatment response was assessed according the indicators WOMAC-index, Lequesne index, parameteres of the functional electromyography, stabilometry and podometry that allowed calculating integral indicators Õâi and using it in the mathematical models of the system (clinical and functional status of the lower limb) and analyse them.
Results. Comparative analysis of the mathematical models (clinical and functional status of the knee) demonstrated more expressed clinical remission and functional recovery of the lower limb comparing to the Hangody’s method within 3-6 months after the operation.However, if in those terms a clear trend of reduction of integral indicator Õâi with its striving to the value, corresponded to norm, the reversed increasing of Õâi value identical for both groups was observed later in terms of 36 months after the operation. It testifies the regression of the achieved compensation and is considered to be an unfavorable criterion of prognosis of the pathological process progression.
Conclusion. The proposed method of chondroplasty of the articular cartilage defects of the knee joint provided significantly greater structural and functional recovery of the knee and and may be recommended for clinical use.
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443099, Russian Federation, Samara,
Chapaevskaya st., 89, Samara State Medical University,
department of traumatology, orthopedics and
extreme surgery named after Academician AF Krasnov.
Kudashev Dmitry Sergeevich
Kotelnikov G.P. MD, Academician of RAS, Professor, Head of department of traumatology, orthopedics and extreme surgery named after Academician of RAS Krasnov A.F. SBEE HPE "Samara State Medical University".
Lartsev Y.V. MD, Professor of department of traumatology, orthopedics and extreme surgery named after Academician of RAS Krasnov A.F., Head, department N2 of traumatology-orthopedics SBEE HPE "Samara State Medical University".
Kudashev D.S. PhD, traumatologist-orthopedist SBEE HPE "Samara State Medical University", department N2 of traumatology-orthopedics, Assistant of department of traumatology, orthopedics and extreme surgery named after Academician of RAS Krasnov A.F.
Zuev-Ratnikov S.D. PhD, traumatologist-orthopedist, SBEE HPE "Samara State Medical University", department N2 of traumatology-orthopedics of clinics, Assistant of department of traumatology, orthopedics and extreme surgery named after Academician of RAS Krasnov A.F.
Shorin I.S. Post-graduate student, SBEE HPE "Samara State Medical University", department of traumatology, orthopedics and extreme surgery named after Academician of RAS Krasnov A.F.