Репозиторий Университета

© 2020, The Author(s). Background: Currently, no data is available regarding the association between professional experience or limb dominance and the prevalence of asymptomatic knee joint lesions in adult professional male soccer players. Hypothesis: The prevalence of the accumulated changes increases with training experience. This is especially true for the dominant leg, which is involved in a large proportion of the athletes’ movements. Study Design: Level 2 cross-sectional cohort study Methods: MRI was used to assess the condition of 94 knee joints in 47 adult professional male soccer players (mean age 25.7 ± 4.6 years, BMI 22.8 ± 1.4). Previous surgery on joints was an exclusion criterion. No football player had knee injuries (including fresh bruises) for at least 3 months before the examination. All the scans were performed using a 1.5T MRI scanner and a slice thickness of 3 mm. The images were blindly analyzed by two experienced radiologists. We analyzed all the three compartments of the knee joint. We consider a chondral lesion already from grade I in modified Noyes and Stabler classification system. To assess the influence of soccer training experience, all players were divided into two groups: group 1 formed from players with less than 20 years of experience and group 2 with more than 20 years of experience. Results: One hundred percent of the soccer players had at least one chondral and meniscal lesion. In both legs, the posterior horn of the medial meniscus (95.6%) was the most frequent site of injury. Most of the injuries were classified as grade II injuries (73.3% for the dominant and 75.6% for the non-dominant leg). Experience and age of the athletes significantly increased the probability of subcortical bone lesions. They were significantly positively correlated with the grades of patellar lesions and lesions of the patellar surface of the femur and significantly negatively correlated with the grades of lesions of posterior horn of lateral meniscus and anterior horn of medial meniscus. No statistically significant differences in the prevalence and grades of cartilage and meniscal lesions in the dominant and non-dominant limb were observed. Conclusion: Soccer practice is associated with the increased prevalence of asymptomatic chondral and meniscal lesions. The probability of subcortical bone lesions significantly increases with training experience and age. These factors are also positively correlated with the grades of patellar lesions and lesions of the patellar surface of the femur. The prevalence and grade of asymptomatic chondral and meniscal lesions is independent of leg dominance.

© 2019, SICOT aisbl. Background: Rupture of the anterior cruciate ligament (ACL) is one of the most common sports injuries of the knee joint. Today, we have a large number of approaches to arthroscopic reconstruction of the anterior cruciate ligament that lead to successful outcomes and allow the patients to return to a significant level of activity post-operatively. Nevertheless, the return to competitions rate stays relatively low. The functional state is thought to be dependent on rotational and anteroposterior stability of the knee. These data encourage search for methods of additional stabilization of the knee joint, one of them being extra-articular tenodesis, or reconstruction of anterolateral ligament of the knee. The aim of the study: To evaluate medium-term results of combined simultaneous arthroscopic reconstruction of anterior cruciate ligament and anterolateral ligament of the knee joint in sportsmen and to access the probability of return to competitions. Materials and methods: The surgeries were performed in 2014–2015 in 50 patients who fulfilled the entry criteria: 20 patients (including 10 professional sportsmen) underwent arthroscopic ACL reconstruction together with reconstruction of anterolateral ligament—group 1 (main group), and 30 patients (including 10 professional sportsmen) underwent arthroscopic ACL reconstruction—group 2 (control group). Results: Group 1: All patients of group 1 were able to return to the pre-operative sports level in two years after the surgery. The mean Tegner Lysholm score was 72.6 ± 6.45 (hereinafter, SE—standard error) before the surgery and 97.4 ± 1.18 after the surgery. The mean IKDC score was 63.1 ± 4.8% before the surgery and 96.3 ± 1.8% after the surgery. Group 2: 20 of 30 patients (66.7%) returned to the pre-operative level of activity and returned to competitions (if they were professional sportsmen) in a year after the surgery. Five of ten patients (50%) (professional sportsmen) returned to competitions. Fifteen of 20 patients (75%) (amateur sportsmen) also returned to competitions. The mean pre-operative Tegner Lysholm score was 69.6 ± 3.5, and the mean post-operative score was 92.1 ± 3.9. The mean pre-operative IKDC score was 73.4 ± 3.2%, and the mean post-operative score was 90.3 ± 3.7%. Conclusion: The results of the study show that more patients with higher functional demands and more professional sportsmen returned to sports. Despite the results of our and other foreign studies, a need remains for studies that will compare outcomes of ALL reconstruction with the same surgical technique in homogenous groups of patients.

© 2018, SICOT aisbl. Objective: To investigate the effect of knee arthroscopic synovectomy (AS) on the disease activity, quality-of-life (QoL), and the functional status of patients with rheumatoid arthritis (RA). Materials and methods: A retrospective analysis was conducted on the outcomes of AS performed on 138 RA patients; pre-surgery assessments were done using Disease Activity score (DAS 28) and Routine Assessment of Patient Index Data З (RAPID-3) on а multidimensional health-assessment questionnaire for disease activity, EuroQol-5D (EQ-5D) and the Short-Form Medical Outcomes Study (SF-36) for quality of life, and the Health Assessment Questionnaire (HAQ) for functional status. The pain response to SA was measured by а visual analogue score (VAS) and the Knee Society Score (KSS). Results: All parameters assessed in the study showed significant positive changes: the activity of the disease decreased, and patients’ functional status and QoL improved. Conclusion: AS is effective treatment for recurrent synovitis of the knee in RA patients. This technique improves the functional status of patients and their quality of life and reduces the activity of the disease.

© 2018 Pirogov Russian National Research Medical University. All Rights Reserved.  Rivaroxaban is a safer and more effective alternative to warfarin. However, there are reports of some cases of major hemorrhagic complications associated with rivaroxaban that significantly impair the patients' quality of life and can lead to a fatality. Personalized therapy, including pharmacogenetic testing, may help prevent such adverse events. This study aimed to investigate how ABCB1 3435C>T (rs1045642) and CYP3A5 6986A>G (rs776746) gene polymorphisms, when carried by a patient taking rivaroxaban to prevent thrombosis after total hip or knee replacement surgery, affect prothrombin time (PT). Sixty-five patients participated in the study. Their genotypes were identified by PCR in real time. To learn PT peculiar to each patient, we collected venous blood on the 5 th day of their anticoagulation therapy, 1 hour before they took rivaroxaban and 3 hours after. Having calculated %∆PT, we divided the patients into 2 groups: 1) %∆PT ≤ 0 (n = 7; 10.8%); 2) %∆PT > 0 (n = 58; 89.2%). Regarding the distribution of rs1045642 polymorphism, we determined the difference between the groups to be statistically significant (χ 2 = 6.64; p = 0.027). As for rs776746 polymorphism, the difference was insignificant (χ 2 = 0.101; p = 1.0). We discovered that rs1045642 polymorphism has a significant effect on PT variance in patients taking rivaroxaban to prevent thrombosis after total hip or knee replacement surgery.

© 2018 Russian Electronic Journal of Radiology. All Rights Reserved. Purpose. The purpose of this study was to determine possibilities of functional computed tomography for diagnostics of the knee endoprosthesis loosening. Materials and methods. A total of 12 patients with suspected knee endoprosthesis loosening were observed. We performed dynamic computed tomography on the Toshiba Aquilion One 640. On MIP images in the three planes of the joint in the static position, we marked up to 5 lines. Every line connected the point in prosthesis component with the point in the periprosthetic cortical bone. After that, the computer analysed the functional research reconstruction and showed the length of the same lines at each stage of knee flexion. If the length of at least one of the lines changes by more than 1.1 mm, we can confirm loosening of the endoprosthesis component. Results. According to data of dynamic computed tomography, in 2 patients we identified loosening of the tibial components, 1 patient – the loosening of the femoral component and 1 patient – the loosening of both components. In 8 patients knee implants were stable. In 10 patients we performed total revision knee arthroplasty. Computed tomography data were fully confirmed by intraoperative examinations. 4 patients were operated because of components loosening, 6 patients were operated because of patellofemoral in-congruence. 2 patients were treated conservatively with good results. Conclusion. The dynamic computed tomography of the knee after total arthroplasty showed high efficiency in diagnostics of the knee endoprosthesis loosening.

© 2018 Russian Electronic Journal of Radiology.All right reserved. Purpose: Complications after hip/knee/other joint arthroplasty develop in approximately 1-1.5% of young people and in 2.5-3% of elderly patients. Despite the meager chance of developing negative consequences, they can affect anyone, especially those who did not follow the rigorous rehabilitation program. Complications after endoprosthetics of hip/knee/other joints results from incorrect postoperative care and physical activity after discharge from the hospital. The second reason is technical approach of the surgeon. And third is an inadequate preoperative examination. The aim of the article is to have a detailed description of short term, midterm and long-term complications after joint replacement surgeries and of the methods (clinical and radiological) to avoid those complications with all the required parameters.

© 2018 Russian Electronic Journal of Radiology. All rights reserved. Purpose. Purpose of the study is to have a detailed examination and investigation of the patient with all the required parameters. Material and methods. Revision knee replacement prosthesis making a difference in treatment outcome. Results. The result after the sleeve operation was uneventful and the patient had no complaints or pain even after a year of surgery. Conclusion. Long term complications are comparatively less when a proper prosthesis is selected for the particular patient operation.