Introduction Rotator cuff tears is still a complex and unresolved problem, which solution requires a comprehensive approach and choosing the optimal way of treatment. Frequently, the results of surgical treatment do not satisfy both patient and surgeon. Objective Improve the results of treatment of patients with rotator cuff ruptures of the shoulder. Material and methods Results of arthroscopic treatment of rotator cuff tears in 15 patients (mean age, 54 ± 4 years) with combined technique are presented. None of the cases had severe muscle atrophy of the rotator cuff (supra- and infraspinatus muscles), according to Goutallier classification less than 3 grade. All patients underwent shoulder arthroscopy with rotator cuff repair by single or double row stitching and subacromial balloon InSpace implantation. Results The mean score according UCLA scale before the operation was 16 ± 2 (13–18), the mean score 12 months after the operation was 30 ± 3 (26–35); in most cases good and excellent results were obtained. Conclusion Preliminary results characterize the proposed method as a relatively easy, law-traumatic and effective procedure for pain relief and shoulder function recovery in this group of patients.

Purpose To improve technique of cortical fixation of quadrupled semitendinosus autograft in anterior cruciate ligament (ACL) reconstruction providing a tight contact of the tendon and bone inside the tunnels. Material and methods Application of the technique offered earlier for preparation and placement of quadrupled semitendinosus autograft in ACL reconstruction for a maximal tendon-bone contact is reviewed. The technique uses cortical buttons for semitendinosus graft fixation. Proximal and distal ends of the graft are corrugated at placement, thus increasing the diameter and providing additional fixation inside the bone tunnels. The modified technique employs same corrugated sutures with an easier placement practice. Potential fixation tightness in the tunnels is assessed by an increase in the diameter at both ends of the prepared graft while tightening corrugated sutures. Six semitendinosus tendons of 3 cadavers were used for testing. Results Diameters of the proximal and distal ends of the graft prepared with modified technique increased by 1.33 ± 0.52 mm and 1.5 ± 0.55 mm, respectively, at tightening the corrugated sutures. The ends of the corrugated sutures were tightened with a force of 50 N with a tension of 80 N applied to the graft. Elastic deformation was observed at 364.83 ± 69.16 N during the tensile test for the graft prepared with earlier technique and cortical fixation thread with the focus on the strength of transverse threads. The modified technique ensured a reliable construct being comparable with that provided by all-inside technique (760 N) by removing the weak link. Tendon graft preparation time reduced by 30 %. Conclusion Modification of the earlier described technique for preparation and placement of quadrupled semitendinosus autograft facilitated tight contact of the tendon and bone inside the tunnels, easier placement practice and improved strength characteristics of the prepared graft.

Introduction Anterior cruciate ligament (ACL) rupture is a relatively common injury to the knee joint in individuals of active working age. As such, ACL injuries result in knee instability with concomitant injuries to the articular components aggravating functional performance. The ACL injury affects a person’s ability to work and go in for sports. Material and methods Outcomes of 192 patients with ACL injury treated with hamstring tendon grafts using the semitendinosus and/or gracilis tendons were reviewed. Results The Lysholm knee score was used to assess the results of ACL reconstruction. Excellent and good results were observed in most of the cases (n = 173; 90.1 %) and 16 (8.3 %) patients had fair results. Three (1.6 %) patients had poor outcomes and two of those underwent revision arthroscopy due to infection. Conclusion ACL reconstruction with semitendinosus and gracilis tendon is an effective and less traumatic technique for restoring knee stability after ACL rupture. Such factors as femoral and tibial tunnels provided at isometric points of the native hamstring ligament insertion site, adequate autograft diameter depending on patient characteristics and proper implementation of ACL rehabilitation program play a role in successful treatment.

Introduction Healing of the digital flexor tendon following zone II delayed repair is associated with tenogenic contractures. Objective Develop and test a new technology of tendon repair in scarry fibro-osseous canals in clinic. Material and methods Medical reports and clinical findings of 11 patients with flexor tendon injures to 13 fingers occurred 4 to 6 weeks were reviewed. Two-stage tendon plasty was secured for the patients. With the possibility of suturing in scarry obliterated canal treatment was produced according to the technique developed. Split sterile bioinert polymeric tubes were used for temporary tendon isolation. Results An experience of delayed repair of 13 deep digital flexor tendons and temporary isolation with a split polymeric tube in zone II is reported. Motor rehabilitation of patients could be initiated after 3 postoperative days with the repaired tendon being unloaded with the tube. There was no tube reaction, tendon repair failures or other complications observed with the use of new technology. Discussion Polymeric tube can prevent adhesion in the tunnel, protect the repaired site during early motion stress. Conclusion The new technology can be an alternative to a two-stage flexor tendon reconstruction facilitating good function recovery and ability to return to work after 2.5−3.5 months.

Objective Present and evaluate results from the first use of a Russian titanium telescopic rod in children with osteogenesis imperfecta. Material and methods A study group included 7 patients with osteogenesis imperfecta types III and IV who underwent femoral and tibial deformity correction with a combined use of titanium telescopic rod and reduced Ilizarov frame. The follow-up period was 6–12 months. Results The desired correction was achieved and maintained in all the cases at 6 to 12 months. The mean length of external fixation was 30.2 ± 7.5 days. No complications related to external fixation were observed. Telescoping was present in all cases. No secondary bone displacement, telescopic rod migration were noted. Conclusion Titanium telescopic rod applied in combined technology of long bone deformity correction in children with severe osteogenesis imperfecta showed high reproducibility of the technique, the possibility of desired correction and no problems related to rod migration. Telescoping of the rod occurred in all cases with no episodes of blocking. The correction achieved persisted throughout the whole period of observation.

The problem of treating patients diagnosed with congenital pseudarthrosis is due to severe and unpredictable course of this disease, difficulties in choosing surgical techniques, and frequent relapses of the process. Purpose Compare the results of treatment of patients with congenital pseudoarthrosisof the tibia (CPT) using non-free Ilizarov bone plasty and a combination of grafting according to Masquelet technique with Ilizarov bone transport. Materials and methods The outcomes of 13 patients with CPT aged 1.5 to 35 years who had been treated since 2009 were analyzed. The main group (n = 6) included patients treated using a combination of the Ilizarov and Masquelet methods. In the control group (n = 7), patients were treated only with Ilizarov transosseous osteosynthesis. Histological examination of the periosteum and tissues of the resected pseudarthrosis area was performed. In the index group, fragments of a biomembrane formed around a cement spacer temporarily bridged the diastasis after resection of pseudarthrosis were studied by light and electron scanning microscopy. Results and discussion Patients of the analyzed groups had a comparable duration of treatment. In the main group, bone fusion was observed in 83 % of cases, while no relapse was detected in the long-term follow-up. The obtained treatment result was achieved due to good vascularization of the biological membrane formed on the spacer surface, which provides trophic effect at the stages of defect management in the area of resected pseudarthrosis. The presence of poorly differentiated osteogenic cells in it promoted active osteogenesis. In patients of the control group, fusion was achieved in all cases, but relapses in the long-term occurred in 71 % of cases. Conclusion The basis of the methodological principles in treating patients with CPT is the use of additional options for osteoplastic interventions and materials in the pseudarthrosis zone. Fixation of a segment without stimulation of bone regeneration does not bring the desired effect. The complex use of non-free Ilizarov bone grafting according to Ilizarov and Masquelet technology achieves bone fusion of the congenital pseudoarthrosis and disease-free course of the conditions.

Background Total shoulder arthroplasty (TSA) is a well-established procedure for treatment of severe pathologies of the shoulder joint. However, it is a radical procedure that may result in adverse outcomes and complications. The goal was to identify causes of poor functional outcomes and complications after total shoulder replacement and search ways to prevent them. Material and methods Outcomes of 168 patients were reviewed. Reverse shoulder arthroplasty and cemented humeral fixation was employed for the majority of patients (n = 125; 74.4 %). Minimal follow-up was at least one year with an average term of 3 to 5 years. Clinical, biomechanical examinations, radiography, magnetic resonance imaging, computed tomography, electromyography, DEXA, VAS, ASES, UCLA, statistical analysis were employed in the study. Results Positive results of TSA were observed in 83.3 % of the cases and 16.7 % had poor outcomes. Patients developed implant dislocation in 9.5 %, infection in 3 %, early instability of shoulder component in 1.2 %, intraoperative fracture of the humerus shaft in 1.8 % and injury to vascular and nerve bundle in 1.2 % of the cases. Causes of poor outcomes were identified and ways of prevention presented. The best recovery was observed with anatomic shoulder replacement, integrity and functionality of the rotator cuff, absence of fatty degeneration verified with magnetic resonance imaging in sagittal plane. Clear understanding of the exact nature of osseous changes using computed tomography allows adequate positioning of implant components. Preoperative deltoid evaluation is important for posttraumatic cases as well as BMD measurements are vital for severe osteoporosis patients with application of reverse shoulder arthroplasty. Conclusion Preoperative planning and assessment of risk factors are important in preventing complications and improving outcomes of total shoulder replacement. The target audience is trauma and orthopaedic surgeons.

Purpose To assess osseointegration of implants made of various osteoconductive materials in an animal experiment by management of a long-bone diaphysis defect complicated with chronic osteomyelitis. Materials and methods Experimental studies were conducted on 24 healthy outbred adult rabbits for six weeks. Diaphyseal defects were managed with allo-, ceramic, and carbon implants. Results and discussion With carbon material, an adhesive interaction between the implant and the maternal bone tissue was of intercalation type. Osteointegration was evidenced by the presence of microfragments of an implant in bone tissue extracted for morphological study from the peri-implant zone, with areas of numerous osteoid islets. With a ceramic implant in the defect, no signs of remodeling and osteointegration in the implant extracted for morphological examination of bone tissue were detected. In the experiment with allograft, the area of implantation was isolated by a fibrous capsule, in which individual osteo-osteoid areas were seen without typical bone structure formation, and complete bone fusion was not achieved. Conclusion Morphological data on the regeneration processes prove the advantages of a carbon nanostructured implant relative to the other osteoplastic materials used in this animal experiment.

Introduction A comparative morphological study of implants made of copper (Cu), 12X18H9T medical steel, 12X18H9T steel coated with hafnium nitride and titanium nitride (HfN + TiN), 12X18H9T steel coated with zirconium nitride and titanium nitride (ZrN + TiN) having an effect on parenchymal organs and the heart is presented. Materials and methods Results of implantations were reviewed in four groups of rats including two control (12X18H9T and Cu) and two experimental (HfN + TiN and ZrN + TiN) groups. The study is the latest research on the implants’ effect on vital organs of experimental animals. Results Analysis of the results showed that histological changes in the organs were the least in the 12X18H9T medical steel and the steel coated with HfN + TiN groups throughout the experiment and histological characteristics of the internal organs appeared to be normal in all animals at the end of the study. Marked pathological changes were observed in the copper group and the group of steel implants coated with TiN + ZrN despite the current widespread use of the latter in dentistry. Conclusion Implants made of copper and steel coated with ZrN + TiN were shown to have a negative impact on the animal body at both local and systemic levels. The findings indicated to the safe use of implants made of 12X18H9T medical steel and steel coated with HfN + TiN alloy.

Objective To review long-term results of congenital vertical talus treated with classical techniques and a minimally invasive treatment approach offered by M. Dobbs. Material and methods Review of 30 pediatric cases (54 feet) with severe congenital convex pes valgus was performed over the period of 11 years. Patient ages ranged from 1 month to 13 years at the start of treatment. The 54 primary operations performed included triple arthrodesis (n = 2), open talus reduction according to S.J. Kumar, K.R. Cowell, D.L. Ramsey (n = 5), Coleman open reduction of the talus and screw fixation (n = 6), serial casting and percutaneous fixation of the talonavicular joint with a Kirschner wire and a percutaneous Achilles tendon tenotomy (n = 41). Reduction of the talus was produced under vision and followed by capsuloplasty of 23 feet. C-arm was used for closed correction in the rest of the cases. Results A minimally invasive Dobbs approach that consisted in serial casting, minimal surgery followed by bracing was shown to provide favorable outcomes in 21 patients (41 feet) treated at early childhood. Recurrent deformity with the oblique talus developed in 3 cases (4 feet) during growth of an average 6.1 years despite satisfactory primary correction and required further interventions. However, open reduction has become a rare procedure in the patient cohort with introduction of Dobbs practice at our hospital. There are more reports of successful primary treatment with Dobbs method in the national literature with no long-term follow-ups available in our country. Conclusions Kumar and Coleman operative interventions are reserved for unrecognized or recurrent cases following Dobbs manipulations. Triple arthrodesis as a definitive procedure can be used in a late detection of the condition or poor outcomes.

Purpose Study the parameters of the hip joint in the short- and long-term postoperative periods in patients with severe types of cerebral palsy, accompanied by pathology of the hip joint, who underwent multilevel interventions, including its reconstruction. Study hip joints at stages depending on the interval between operations (between surgery on the first and second joints in bilateral CP), age of patients as well as an assessment of the intact jointdevelopment in unilateral dislocations. Materials and methods This study included 124 children with spastic types of cerebral palsy who underwent surgical orthopedic reconstructive treatment at the RISC for RTO in the period between 2012 and 2016. Their mean age at the start of treatment was 7.01 ± 2.47 years (range: 3 to 13 years). Coxometry indices were evaluated depending on the interval between operations (between surgery on the first and second joints in bilateral CP), patient's age, and the development of intact joint in unilateral CP was also studied. Results Multilevel interventions, including VDO and operations that restore limb weight-bearing are favorable for the development of the hip joint if the initial Reimers index is more than 40 % in both unilateral and bilateral hip dislocation. In unilateral dislocation (Reimers’ index more than 40 %) and contralateral adduction or adduction flexion contracture combined with torsion of the segment and the difference in limb length that impede postural management, even with the Reimers’ index less than 40 %, surgical treatment with VDO on the contralateral extremity provides a favorable development of the second hip joint. In unilateral VDO performance, on the contralateral limb, it is necessary to perform adductotomy in adduction contracture of the joint (without dislocation) to prevent lateralization and degradation of the situation towards subluxation. Failure to perform this element of the operation increases the risk to 11.8 % (with an age of younger than 8 years old) and to 14.3 % (8 year or older) of the progression of the migration index of more than 7 % per year or the development of hip subluxation. Moreover, by performing unilateral DVO in patients over 8 years of age, there is a risk of an increase in the Reimer’s index of the contralateral joint by more than 7 % per year, even if simultaneous bilateral adductotomy is performed. Conclusion In hip dysplasia requiring reconstructive intervention in children with severe cerebral palsy, hip joint surgery should be combined with restoration of bilateral muscle balance, especially adductors, as well as with elimination of contractures of the knee and ankle joints, foot deformities to create favorable conditions for postural management in early and late postoperative period.

Introduction Subjective questionnaires have been developed and applied in orthopaedics and traumatology to access clinical outcomes, the patients’ functional status and health related quality of life. The aim of the study was translation of the questionnaire into the Russian language, validation and cultural adaptation of the original International Knee Documentation Committee (IKDC) 2000 subjective knee form. Methods The IKDC 2000 was translated into Russian by two orthopaedic surgeons and back into English by a professional translator. IKDC 2000 final Russian version was available with revised translations. 100 patients (64 male and 36 female) with different pathologies of the knee joint completed the approved Russian version of IKDC 2000 and Oxford Knee Score (OKS). A subsample of 29 patients was asked to complete the IKDC 2000 subjective knee form again after 7–10 days for testretest reliability. Cronbach’s α coefficient was used to measure internal consistency. Results Patients’ mean age was 38 ± 1.08 years (range, 11 – 76 years). The median IKDC 2000 score was 83.4 (interquartile range 61.0 – 91.1; range 12.6 – 100). There was a strong positive correlation observed between the IKDC 2000 Russian version and OKS measuring 0.89; p less 0.05. Cronbach α was 0.93 for the IKDC 2000 Russian version; intraclass correlation coefficient (ICC) was 0.82 (0.95 %, 0.56–0.93; p less 0.0001), no ceiling and floor effects revealed. Conclusion The IKDC 2000 Russian version exhibited high internal consistency, test-retest reliability and validity with no floor and ceiling effects noted. The questionnaire can be used for subjective evaluation of outcomes of patients with different pathologies of the knee joint including injuries to meniscus, ligaments and articular cartilage.

Introduction Results of bacteriological study of the pathological material taken from sinus exits and surgical wounds in 105 patients with implantassociated spinal infection (IAI) who were surgically treated at the bone infection clinic of the RISC for RTO in the period from 2011 to 2017 were analyzed. Purpose Identify the main pathogens of the IAI of the spine. Materials and methods Patients were divided into three groups: group 1 had fistulous forms of peri-implant infection: paravertebral and epidural abscesses and phlegmon (n = 18, subgroup 1); suppuration of soft tissues around metal structures (n = 20, subgroup 2); spondylitis / discitis / osteomyelitis (n = 26, subgroup 3), infectious complications associated with postoperative liquorrhea (n = 5, subgroup 4); group 2 suffered peri-implant infection that developed due to postoperative instability of the metal structure (n = 26); group 3 had infection that developed after implantation of the systems for chronic electrical stimulation (n = 10). Identification of the isolated bacterial cultures was carried out both by the traditional method and by using panels for gram-positive (PBBCS 20) and gram-negative microorganisms (NBC 44) on the WalkAway-40 Plus bacteriological analyzer (Siemens). Results and discussion According to the analysis of the bacteriological results, gram-positive microorganisms (65.7 %) significantly prevailed among the pathogens of implant-associated spinal infection, of which the major ones were staphylococci (52.9 %). Isolation of S. aureus was 34.8 %. Among the methicillin-resistant strains, S. epidermidis was dominant. Among gram-negative microorganisms, both non-fermentative (16.8 %) and enterobacteria (20.9 %) were found. Most frequently identified non-fermenting bacteria were P. aeruginosa and A. baumannii. Enterobacteria were mainly represented by strains of K. pneumoniae and E. coli. Mixed cultures, consisting of two or more microorganisms, were significant. Conclusion Difficulties in the treatment of IAI of the spine require the development of methods for predicting these complications and measures to reduce them. Microbiological monitoring is an integral part of infection control in hospitals, where patients with IAI of the spine are treated. Timely identification of infection pathogens enables to choose correct antibiotic therapy and arrest the infection process in a short time.

Introduction A good alternative to bone autograft fusion is the utilization of implants produced from non-biological materials. Such implants can reduce the duration of surgery as well as tissue morbidity, while meeting the mechanical strength and osteoconductivity requirements. According to the study results,carbon is a promising material for interbody fusion because of its biocompatibility and osseointegration, as well as an elastic modulus that is close to bone tissue. Methods From 2015 to 2017 a randomized multicenter study was conducted. Three centers took part in the study: the National Medical Research Center of Traumatology and Orthopedics named after N.N. Priorov; Novosibirsk Research Institute for Traumatology and Orthopedics named after Ya.L. Tsivyan; Saint-Petersburg National Phtisiopulmonology Research Institute. One hundred thirteen patients with vertebral body fractures were included in the study and underwent surgical treatment using posterior interbody fusion. In 75 patients (66.37 %, group I) carbon-carbon implants were used, and in 38 patients (group II) – titanium cages. Patient examination was conducted using one protocol, preoperative examination methods and at 6, 12, and 24 month follow-ups, and included VAS score, SF-36 questionnaire, and ASIA scale, as well as CT examination and fusion progress assessment according to G. Tan’s classification. Results The 2-year study showed statistically significant differences between index (carbon implants) and control (titanium cages) groups. Although bone fusion progressed very slowly in the study group (in 86 % of cases no bone fusion was observed at first follow-up 6 months after surgery), the VAS and SF-36 scores were comparable in study and control groups. Discussion Carbon implants are characterized not only by high mechanical strength but also by a significant ability to osteoconductivity that allow for effective bone-carbon fusion due to their porous structure and an elastic modulus of 20–30 GPa, that is comparable to that of bone tissue. These characteristics were confirmed by radiological data (absence of implant subsidence in 38 out of 58 patients (65.51 %) at 24 month follow-up. Titanium implants with an elastic modulus of 80 GPa had a subsidence rate of 100 %.

Introduction Scoliosis is one of the most common and severe deformities of the human spine, ranking first among all orthopedic pathology in children. Idiopathic scoliosis accounts for 70–90 % of all scoliotic deformities. Purpose The article presents the technique of orthosis and the results of using a functionally correcting Cheneau brace in complex rehabilitation of patients with idiopathic scoliosis. Materials and methods Orthotic application in 300 children (over 3 years old) and adolescents (up to 18 years old) with idiopathic scoliosis within the period from October 2013 to October 2017 was analyzed. Patients were divided into three groups depending on the Cobb angle and the features of orthosis: the first group was 100 subjects with the angle of 18°–35°, the second group had the angle of 36°–45° and included 150 patients, and the third one was 50 individuals with the angle of 46° or more. Clinical and radiological methods of examination were used in the study. A functionally correcting brace of the Cheneau type was used for fixation based on the technique of the Center. Results Correction of deformity was achieved in all children (300), and more than one half (53.3 %) had a complete correction. In the group with spinal deformity of 18°–35° according to Cobb, deliberate hypercorrection of -5° was achieved (in 15 patients for three years, and in 5 children also in the fourth year of treatment). Conclusion The use of functional correcting brace of the Cheneau type in the complex rehabilitation of children and adolescents with idiopathic scoliosis provides good outcomes in most patients of all three groups. The best results of treatment were obtained in the first group of patients. Orthosis application should be performed according to the treatment technology, be individual, taking into account the peculiarities of the spinal deformity and the prospects of its progression, age, as well as growth potential of the spine; systematic exercise therapy, including Schroth gymnastics, is necessary.

The purpose of the study was to evaluate specific features of spine sagittal balance in patients with coxarthrosis of different etiology before and after total hip replacement (THR). Materials and methods Clinical and radiographic evaluation was performed for 46 patients admitted for primary THR. The patients were diagnosed with dysplastic (n = 14), degenerative (n = 26) and posttraumatic (n = 6) coxarthrosis and evaluated preoperatively, on the 7th day postsurgery and at a long-term follow-up. Spinopelvic parameters of sagittal balance, stages of osteoarthritis and cranial displacement of femoral heads according to Crowe were assessed. Clinical evaluation included physical examination, hip function with the Harris Hip Score (HHS), range of motion in the involved hip, relative limb shortening, neurological status, Oswestry questionnaire (ODI) and spinal pain syndrome using the Wong-Baker Faces Pain Rating Scale (2011). A statistical software package of Microsoft Office Excel 2016 was applied for data analysis. Statistical analysis of variance was used to calculate the arithmetic mean (M), error of the arithmetic mean (± m), the Pearson correlation coefficient r and estimate using the Chaddock scale. The Student’s t-test was used to confirm significant differences in the means identifying a significance level. Results and discussion Comparative analysis of spinopelvic parameters showed decreased PT and SS with increased LL in patients with dysplastic coxarthrosis. No considerable changes of spinopelvic parameters were revealed in patients with degenerative coxarthrosis. Marked limitations in ROM were seen in patients with dysplastic coxarthrosis. A moderate correlation between ROM of the involved hip and spinopelvic parameters was observed in dysplastic coxarthrosis. No correlation was detected between spinopelvic balance and spinal pain syndrome. Conclusion No significant differences in spinopelvic parameters were noted in patients with hip-spine syndrome associated with degeneration. Dysplastic changes can be a predisposing factor for spinopelvic imbalance in THR. Correlation analysis showed that combined joint contracture was involved into the biomechanical aspect of spinopelvic imbalance in dysplastic coxarthrosis. As reported by other researchers, total hip replacement with good functional outcome was not shown to result in significant changes in spinopelvic alignment.

Total hip arthroplasty is acknowledged to be a highly effective procedure for treating patients with severe arthritis of the hip joint and it can greatly improve patients’ quality of life. However, an increasing number of primary and revision hip arthroplasties is associated with a higher rate of postoperative complications. Terminological confusion at formulating diagnosis for some pathological conditions related to the hip arthroplasty encouraged the authors explore the problem of the semiotics to create a “unified language of communication” for specialists. PubMed and e-library resources were used to search articles containing arthroplasty related terms that were systematized and arranged in a working classification.

This review analyzes and assesses the existing methods and approaches to prediction and control of the course of distraction osteogenesis (DO). The analysis of the literature revealed few works that recommended specific predictors or methods for prognosis of the course of distraction osteogenesis at the stages of limb lengthening. The authors identified some diagnostic criteria for assessing the distraction regenerate as potential criteria for predicting its development and maturation. It was found that all available predictors and potential diagnostic criteria for assessing the state of the distraction regenerate in clinical practice are used to further correct the distraction regime (respectively, at the stage of distraction) and to determine the timing of the removal of the apparatus, as well as prognosis of recurrence, fracture, and deformity of the regenerate in the non-apparatus period. It was shown that all known diagnostic methods can be applied for the assessment and prediction of the DO course: radiological, physiological, ultrasound diagnostics, laboratory tests. It is stated that a quantitative assessment of the informative value of most of the known predictors of DO disorders is necessary from the point of view of the evidence-based medicine. Difficulties and problems of the development and application of prognostic tests for assessing DO are described. The directions to the development of this topic are proposed. Predicting the DO course is an essential element for monitoring the tissue repair of the segment under lengthening. Prediction and subsequent prophylaxis of DO disorders is a promising solution for optimizing and improving the quality of treatment of patients with orthopedic diseases by using the Ilizarov method of transosseous distraction osteosynthesis.

The article deals with the pin-site infection in transosseous osteosynthesis. Domestic and foreign literature was analyzed; infectious complications were classified and their risk factors, prevention and treatment are discussed.

The paper discusses the etiology, pathogenesis, pathomorphology and pathophysiology of osteoarthritis of large joints from the perspective of evidencebased medicine. The processes occurring in the tissues of the joints during the development of the pathological process at various stages are described in detail; the features of diagnosis and treatment in sports medicine are described in detail. The characteristic of drugs used to treat osteoarthritis is described, with a description of the positive effect and negative effect on particular organs and systems. A preparation Alflutop was comprehensively analysed regarding its effectiveness in terms of safety and impact on the development of the pathological process. It was shown that Alflutop is a drug of choice in the treatment of joint destruction.

Modern oral medications used to prevent venous thromboembolism (VTE) have gained widespread use with major orthopaedic and trauma procedures. There are no accurate multicenter data on the frequency of usage of different prophylactic medications in our country but discussions of the colleagues at specialized web forums make us suspect that factor Xa and dabigatran etexilate inhibitors are in the top three next to low molecular weight heparins. Marketing and promotion strategies of pharmaceutical companies are likely to be of immense importance in that with the contribution of clinical research studies for pharmaceutical drugs. However, preferences of European and American orthopaedic surgeons for the choice of drugs are completely different from those of Russian surgeons. Vitamin K antagonists, acetylsalicylic acid, low molecular weight heparins are commonly used for antithrombotic therapy abroad. Different approaches of Russian and foreign orthopaedic surgeons to the choice of drugs can be explained by a different use of a high-quality evidence base. In our opinion, a collision component can be involved in the endpoints of clinical trials that will be discussed in the present critical review.

Analytical review of scientific theses

The article is devoted to the memory of Professor Oleg V. Beydik. His career and professional development described.

Surgical resection of giant cell tumor of the left ulna diaphysis is presented. Circular resection and same-stage autoplasty with a vascularized left-side fibula fragment was performed. In the late postoperative period, there was no recurrence of the tumor. Full function of the left upper limb was achieved.