Introduction Elevated concentrations of serum calprotectin and lactoferrin were observed to make prediction about microvascular changes in patients with bone fractures.

The aim of the present study was to assess the diagnostic value of serum calprotectin and lactoferrin in the development of inflammatory response in patients with bone fractures.

Material and Methods Seventy patients were included in the study between October 2021 and January 2022; of these, 40 had bone fractures and 30 were healthy participants (control group). Calprotectin and lactoferrin were measured by immunosorbent assay.

Results 12 patients (30 %) had open bone fractures while 28 (70 %) had closed bone fractures. The study revealed that levels of serum calprotectin significantly increased in patients with bone fractures as compared to healthy subjects, while lactoferrin exhibited a borderline but not significant increase (P = 0.06). Patients with open bone fractures had higher levels of serum calprotectin compared to those with closed fractures (P = 0.05). The correlation matrix exhibited that there was a strong positive correlation between calprotectin and lactoferrin in patients with bone fractures.

Discussion Calprotectin is classified as a potent pro-inflammatory marker that has been noted to be elevated in  chronic inflammation such as irritable bowel syndrome (IBS), atherosclerotic lesions, different types of arthritis, and immunological rejection. The present study may only confirm an increase in calprotectin in patients with bone fractures. Recently published studies indicate the potential new role of calprotectin in bone healing and fracture risk.

Conclusion High serum calprotectin and lactoferrin indicate a strong inflammatory status in bone fracture patients, especially in those with open fractures.

Introduction Due to substantial rates of dissatisfaction in patients with mechanical alignment in total knee replacement, surgeons began searching for alternative techniques to improve functional outcome. In the recent decade, kinematic alignment that is not based on the mechanical axis of the femur has become the most popular alternative to mechanical alignment. Kinematic alignment technique development has led to creation of a personalized alignment technique.

Purpose To compare postoperative implant positions in full-length standing lower-leg radiographs between kinematic alignment and mechanical alignment groups of patients.

Materials and methods A prospective, single-center, randomized, controlled study was performed in 139 patients with grade 3–4 knee osteoarthritis (Kellgren – Lawrence). We collected data from 76 cases of mechanical alignment (66 women and 10 men) and 83 cases of personalized alignment group (60 women and 23 men). There were no patients with significant post-traumatic or other deformities of the lower limb which can alter the results in the study. All measurements were done on digital full-length standing X-rays of the lower legs with special MediCAD software.

Results The positions of the implant components in mechanical and personalized alignments did not differ significantly in many parameters after operations, despite the fact that the alignment was based on completely different principles. There were no differences between the average values of the angles after operations with mechanical and anatomical axes of the femur in both study groups (the difference was 0.1° at p = 0.595). The only difference in the groups was the position of the tibial component in relation to the horizontal surface in the standing position: in personalized alignment, the angle was 0.9°, and in mechanical alignment it was 2.4° valgus (p < 0.001).

Discussion The absence of significant difference in the postoperative leg alignment and implant position except in the joint line orientation between the groups demonstrates possibility to achieve good leg alignment with both techniques. In the personalized alignment group, the joint line orientation in the coronal plane was found nearly parallel to the ground which can result in a more balanced weight distribution compared to mechanical alignment.

Conclusion In patients who receive total knee replacement with the personalized technique, the postoperative lower limb alignment was found within the safe boundaries of 3° from the mechanical axis while the joint line orientation in the coronal plane was significantly closer to be parallel with the ground compared with mechanical alignment group.

Introduction Opening- and closing wedge osteotomies are the two most commonly used variants of high tibial osteotomy in medial gonarthrosis associated with varus deformity.

Purpose Based on a retrospective analysis of the results of surgical treatment of patients with medial gonarthrosis associated with varus deformity of the proximal tibia, to evaluate functional and radiological outcomes of high tibial osteotomy performed with two different surgical techniques.

Material and methods The study included 37 patients (26 men and 11 women) aged 20 to 54 years (42.84 ± 9.1) with meadial gonarthrosis associated with varus deformity in the frontal plane. The first group included 23 patients with 25 operated limbs who underwent open wedge osteotomy (OWO), the second group included 14 patients who underwent closed wedge osteotomy (CWO).

Results Comparison of MPTA, LDTA, aPPTA and MAD in both groups after surgery did not show a statistically significant difference (p > 0.05), but in the closing wedge group, the recorded values had an extremely wide range. The results on the Lisholm-Tegner scale after surgery compared between the two groups showed a statistically significant difference (p = 0.05), this parameter showed that the opening-wedge osteotomy was more effective.

Discussion Opening wedge osteotomy is a more predictable surgical procedure compared to closing wedge osteotomy. In opening wedge osteotomy, there are significantly fewer cases with excessive or insufficient correction of reference angles and lines than after closing wedge osteotomy.

Conclusion Absence of specific surgical complications in the studied patients demonstrates the safety of  both surgical techniques. The study showed an extremely wide range of MPTA and LDTA values in the closed wedge osteotomy group, which were beyond the preoperative planning. The CWO group had the highest number of patients who underwent hypercorrection of the mechanical limb axis, which was beyond the reference values. It is possible to use a small allograft or not to use it at all in OWO, which makes it a more manageable technology for correcting limb bone deformity.

Introduction Bone defect management remains one of the challenging problems of regenerative medicine, for the solution of which the most promising trend is the use of tissue-engineered implants based on composite scaffolds that stimulate osteogenesis. One of the main tasks of tissue engineering is the development of a scaffold that mimics three-dimensional architecture for osteogenic progenitor cells inside the scaffold, with the possibility of cell interaction with appropriate chemical and physical stimuli of natural bone.

The purpose of the work is to evaluate the possibility of using composite scaffolds based on glassy carbon in tissue engineering.

Materials and Methods This study describes a reproducible method of obtaining three-dimensional porous glass-carbon-based scaffolds with surfaces modified with pyrocarbon (CF-C) and pyrocarbon and hydroxyapatite (CF-C-HAP) and investigates the porosity, strength characteristics, cytotoxicity, and osteoinductivity of the composite scaffolds obtained. Osteogenic differentiation of cultured human mesenchymal stem cells (MSCs) was evaluated on CF-C and CF-C-HAP scaffolds using common osteogenic markers such as: alkaline phosphatase (ALP) activity, alizarin red staining and quantitative real-time PCR (qPCR).

Results In vitro studies showed the biocompatibility of the developed scaffolds. The ability of CF-C-HAP to  induce MSC differentiation in osteogenic direction and to produce calcium-containing matrix was established.

Discussion The scaffolds based on glassy carbon foam with pyrocarbon and hydroxyapatite coatings have a  three-dimensional structure with open porosity, along with the strength comparable to the strength of the replaced tissue, and imitate the structure of trabecular bone. However, the strength of glassy carbon foam without coating is characterized by low compressive strength. All the studied materials demonstrated adhesive and proliferative activity of MSCs, high cell adhesion and absence of cytotoxicity. Determination of  the  mRNA expression level by real-time PCR showed that after 14 days, cells cultured on  CS-C-HAP showed expression of the VDR, BMP7, IGFR1, SPP1 genes, what demonstrates osteogenic potential. The results of our studies on phosphatase activity and alizarin red staining demonstrated that the CF-C‑HAP scaffold stimulates osteoblast differentiation in vitro in the osteogenic direction, as well as intracellular mineralization processes.

Conclusion Composite CF-C-HAP scaffolds based on glassy carbon foam support cell proliferation and differentiation and may be promising for use in bone tissue engineering.

Introduction Growth zone injuries are quite common and account for 15–30 % of all skeletal bone injuries in children. Complications occur in 2–14 % of patients. An adequate experimental animal model is needed to develop new methods for treating growth zone injuries. The purpose of the work is to identify patterns in the dynamics of histomorphometric characteristics of the metaepiphyseal cartilage of the distal femur of lambs during the period of their intensive growth.

Materials and methods The metaepiphyseal cartilage of the distal femur of 12 lambs (aged 3.5 and 5.5 months, 5  males and  7  females) previously participating in an experiment on the effect of  osteosynthesis pins on  the  structural reorganization of the metaepiphyseal cartilage was studied. Histological, immunohistochemical, and histomorphometric studies were performed.

Results The zonal structure of the metaepiphyseal plate along with an increased proportion of PAS-positive structures in the outer layer of the border zone and in the calcified cartilage zone were determined. Masson staining revealed fuchsinophilic areas of the border zone matrix in the metaepiphyseal cartilage of animals aged 5.5 months, as well as an increase in the proportion of fuchsinophilic areas of the calcified cartilage zone compared to animals aged 3.5 months, which indicated increased mineralization. CD34 expression at 3.5 months was detected in the outer layer of the border zone, at 5.5 months the depth of vascular invasion increased, but did not reach the proliferating cartilage zone. A decrease in the thickness of the metaepiphyseal cartilage at the age of 5.5 months by an average of 18.2 % is due to a decrease in the thickness of the border zone by 1.9 times, while the thickness of the proliferating cartilage zone increased by 1.2 times.

Discussion The changes observed in the main substance of the metaepiphyseal cartilage indicated that  the  processes of matrix calcification are more intense in lambs by the age of 5.5 months. The  depth of  vascular penetration from the diaphysis is more pronounced than from the epiphysis. Fractures in the growth zone during the period of intensive growth can be caused by the predominance of the border zone and by the proliferating cartilage zone.

Conclusion Histomorphometric changes in the metaepiphyseal plate of the distal femur of lambs during the period of their intensive growth were characterized by a decrease in its thickness due to a marked decrease in the thickness of the reserve zone, while the thickness of the proliferating cartilage statistically significantly increased. The depth of vascular invasion in the border zone increased, but did not reach the proliferating cartilage zone, changes in the tinctorial characteristics of the ground substance indicated the activation of matrix calcification processes from the subchondral bone of the epiphysis and endomorphic ossification from the diaphysis.

Introduction Pediatric limb reconstruction associated with impaired osteogenesis and fragile bone suggests the use of combined techniques with telescopic intramedullary rods left in situ.

The objective was to test the hypothesis that transphyseal telescopic rods applied simultaneously with  an  external fixation device for pediatric femur or tibia lengthening associated with weak and brittle bone in  Ollier disease and osteogenesis imperfecta does not lead to the rod blocking during fixation, does not prevent distraction bone regeneration, lengthening and deformity correction.

Material and methods The study involved four male patients with Ollier disease and a female patient with osteogenesis imperfecta who underwent limb lengthening and/or deformity correction using a combined technique. Ilizarov apparatus was used as an external fixator, and a telescopic titanium rod was placed simultaneously with external fixator. With the bone consolidated, the Ilizarov apparatus was removed and the telescopic rod left in place.

Results The length gain and deformity correction intended were achieved in all patients. No loss of fixation of the threaded rod was observed in the femur and tibia epiphyses, or greater trochanter apophysis during distraction. There was no blocking of the rod telescopes during distraction. The external fixation index was 11.6 days/cm for polysegmental lengthening, 22.6 days/cm to 28.8 days/cm with monosegmental femoral lengthening.

Discussion Limb lengthening with a telescopic rod has the advantages of additional reinforcement through the segment with no risk of intramedullary construct migration as compared with combined lengthening techniques using flexible intramedullary nailing. There were no problems with formation of the distraction regenerate and longer period of external fixation, which can be seen with other techniques.

Conclusion Outcomes in this series indicated the possibility of limb lengthening and simultaneous osteosynthesis using external fixator and a telescopic titanium rod in patients with pathological osteogenesis. No loss of fixation of the threaded parts of the intramedullary rod, no blocking of the sliding parts of the rod were observed during limb lengthening.

Introduction The most common approach to the treatment of osteomyelitic cavities (Cierny – Mader type  III) is a two-stage approach proposed by Masquelet, the main shortcoming of which is the need to  perform a  second surgical intervention which results in a longer rehabilitation period, increased economic costs  and  additional emotional distress of the patient. In electronic databases, we found 17 publications devoted to the use of partially bioresorbable materials for filling in uncomplicated bone defects. The experience of treatment of chronic osteomyelitis (Cierny – Mader type III) using such materials has not been described.

Purpose Demonstration of the first use of a partially bioresorbable osteosubstituting material in a one‑stage treatment of a patient with a long-term osteomyelitic process after failures of conventional surgical treatment methods.

Materials and methods We present a case of a 54-year old patient with a diagnosis of chronic post-traumatic osteomyelitis of the right leg, fistulous form, associated with contracture of the right ankle joint, 2-cm shortening of the right lower limb. A one-stage treatment technique was used using a partially bioresorbable osteosubstituting material for the first time in combination with antibacterial drugs, preselected in accordance with the patient's microbial cultures.

Results The study evaluated the use of a partially bioresorbable material impregnated with antibacterial drugs in the treatment of a patient with osteomyelitic cavity Cierny – Mader type III that achieved stable arrest of purulent and inflammatory process.

Discussion The mandatory two-stage Masquelet approach increases the surgical aggression, requires collection of an autologous bone graft, thus the risk of possible complications becomes higher. The obvious advantages of bioresorbable materials impregnated with antibacterial drugs to fill in bone defects are: no need to collect an autograft, a reduction in the number of surgical interventions to one, the possibility of gradual natural degradation of the implant from the patient's body due to bioresorption. Conclusion The study demonstrates the potential use of partially bioresorbable materials in a one-stage technology for treating patients with Cierny – Mader type III osteomyelitic cavities.

Introduction Neuropathic arthropathy, or Charcot arthropathy, is characterized by rapid progressive bone destruction due to impaired nociceptive and proprioceptive innervation of the affected limb. In recent years, there have been publications on the use of 3D modeling and 3D printing of porous titanium implants for filling large bone defects in the foot, but we found only two descriptions of clinical cases of 3D porous titanium implants in patients with Charcot arthropathy.

The aim of the work is to demonstrate and analyze the results of performing resection calcaneotibial arthrodesis with  defect plasty using a customized 3D implant made of porous titanium in a patient with manifestation of Charcot arthropathy as a complication of tertiary syphilis.

Materials and methods A 50-year-old woman, with a history of syphilis for 26 years, noted the signs of inflammation in the ankle joint during increased loading two months after total knee arthroplasty on the left joint. The examination revealed total destruction of the talus. The diagnosis was Charcot neuroosteoarthropathy of the foot, active stage. After 2.5 months of unloading, based on the results of a CT study of the left ankle joint and 3D modeling, a 3D porous titanium customized implant was fabricated; resection calcaneotibial arthrodesis with autograft harvesting from the tibial canal and plastic surgery of the defect with a 3D implant and fixation with the Ilizarov apparatus were performed. Five months after the operation, consolidation was determined based on the results of control radiographs, and the Ilizarov apparatus was dismantled.

Discussion The proposed method of surgical treatment for total destruction of the talus and the resulting defect-diastasis allows for reconstructive intervention with immediate compensation of shortening, regardless of the shape and size of the defect, to avoid secondary shortening of the limb while maintaining its ability to support, thereby preventing the occurrence of secondary overload changes in the adjacent joints.

Conclusion The initial results in this clinical case seem encouraging, but additional research is required to clarify the indications and patient selection criteria for this treatment method.

Introduction Trauma and extreme physical activity may result in common patterns of forearm dislocation, which account for 10 to 25 % of all elbow injuries in the adult population. Good long-term results of eliminating joint dislocation with the use of conservative treatment have been much described, but 8 % of patients experience symptoms of chronic instability. We present a case of successful arthroscopic treatment of ligamentous stabilizers of the elbow joint using an effective combination of implants for its posterolateral instability. We found no publications on such an experience in the Russian literature.

The purpose of the work is to present a clinical case of an effective combination of arthroscopic and minimally invasive surgery methods for reconstruction of the ligamentous apparatus in chronic posterolateral instability of the elbow joint.

Material and methods Patient N., 31 years old, suffered chronic posterolateral rotational instability of the left elbow joint after dislocation of the forearm bones for more than 10 years. The operative technique was based on the principles of minimally invasive reconstructive plastic surgery and meets the objectives of  gentle treatment of soft tissues, allowing visualization of the lesion and avoiding the contact with neuro‑vascular structures. Baseline clinical tests (O'Driscoll, Regan/Lapner, Pollock), questionnaires (VAS, DASH, MEPS, SF‑36), and MRI, 1.5 Tesla MRI scans of dynamic stabilizer disruption are reflected. Evaluation was performed at two control points (45 and 180 days).

Results The assessment was carried out at two control points. First follow-up (45 days): flexion/extension 50/175º, pronation/supination 90/90º, VAS 2, DASH 24.2, MEPS 80 points, respectively. Second follow‑up (180  days): VAS 1, DASH 9.2, MEPS 95 points, comparative ranges of motion corresponded to  a  healthy joint. An  MRI study confirmed the progress of the autotenograft and tendon ligamentization in  the  area of reinsertion, the absence of inflammatory changes and no heterotopic ossification.

Discussion Improvements in elbow surgery and technical progress are focused on minimally invasive interventions, while arthroscopy of the elbow joint is still technically difficult due to a limited space. And yet, this is an effective treatment method, as a result of which specialists can avoid a wide range of complications (14.7 %), and patients start rehabilitation faster and, as a result, recover faster than with open surgical approaches with a higher percentage of risks (52 %).

Conclusion The combination of the above techniques avoids conflict with neurovascular structures, provides visual control of the implantation of anchors and, as a result, reduces the overall risk of complications in the treatment of a rare group of patients with instability of the elbow joint.

Introduction Upper limb injuries sustained by children and adults with electric meat grinders in motion are mutilating. These injuries may lead to physical disability and severe psychological consequences not only for the injured subjects, but also for their family members.

Aim Based on current medical literature, to analyze the issues of incidence, etiopathogenesis, clinical symptoms, surgical treatment, rehabilitation, prevention of injuries to the upper limbs sustained with electric meat grinders and to illustrate the material with authors’ own clinical cases.

Material and methods The search for scientific publications was carried out in the electronic databases and libraries PubMed, eLIBRARY, CyberLeninka. The search depth was 47 years. In total, 49 scientific articles were analyzed and studied: 9 domestic sources (18.36 %) and 40 foreign ones (81.64 %).

Results and discussion Epidemiological data show that the incidence of injuries sustained by individuals while contacting with electric meat grinders in motion is 1.4 % to 11.1 % of open injuries to the upper limbs,. The main cause of this type of injury in children is the lack of control by adults, and in adults it is failure to comply with safety measures. The main mechanisms of trauma are traction and rotation. The right hand is most often injured, namely its fingers II, III and IV. Injuries are characterized by traumatic amputations, ruptures and crushing of hand segments. The most important goals of surgical treatment is excision of non-viable tissue, arrest of bleeding, shaping stumps of finger phalanges and metacarpal bones and / or osteosynthesis of  broken bones, suturing of vessels and nerves, the maximum possible closure of  the  soft tissue wound with preserved skin flaps. As preventive measures, it is proposed to inform the population on safety measures by operating electric meat grinders. There should be careful supervision by adults over young children if they are in places where food is prepared. Services of professional butchers are highly recommended.

Conclusion Based on data from 49 scientific articles, information was obtained on the frequency of occurrence, causes, mechanisms, clinical features, surgical treatment, rehabilitation and prevention of severe hand injuries sustained by individuals contacting with operation electric meat grinders.

Introduction Scaphoid nonunion can result in progressive scaphoid nonunion advanced collapse (SNAC) and  have an impact on the quality of life in younger patients. The social significance of the pathological condition induces original research and literature analysis.

The objective was to identify methods for preventing scaphoid nonunion and improving treatment outcomes for SNAC patients based on the literature on etiology, diagnosis and treatment of the disease.

Material and methods The original literature search was conducted on key resources including Scientific Electronic Library (www.elibrary.ru) and the National Library of Medicine (www.pubmed.org) and using the  keywords: scaphoid nonunion, scaphoid, bone grafting, scaphoid nonunion, vascularized bone graft. The  search yielded 355 results. Literature searches included both Russian and English studies published between 1984 and 2024. Inclusion criteria included original articles, systematic reviews, meta-analyses relevant to the search topic. Non-inclusion criteria included a case report, case/control, and articles available only on a fee-paying basis. There were 67 articles identified.

Results and discussion The topography of the scaphoid is associated with a high incidence of avascular necrosis, delayed healing and fracture nonunion. Clinical testing and imaging are essential for diagnosis of scaphoid fractures in the acute period of injury, and fracture instability would be important for surgical indications. There is a classification of scaphoid nonunions that is practical for the choice of a surgical treatment (osteosynthesis with compression screws, debridement and bone grafts or “salvage” operations). Scaphoid nonunions treated with the Ilizarov method employing no open approaches or grafts was reported in  a few publications. Treatment of SNAC patients is traditionally based on the stage of the disease: 1 —  scaphoid reconstruction, resection of the styloid process of the radius; 2–3 — 4-corner arthrodesis or the proximal row carpectomy. Meta-analyses highlight the need for the research into the effectiveness of  various treatments. Arthroscopic techniques are common in wrist surgery improving diagnostic capabilities and minimally invasive interventions.

Conclusion Timely healing of a scaphoid fracture is essential for preventing carpal instability and SNAC. The choice of SNAC treatment is associated with the stage of the disease and functional needs of the patient.

Introduction Repair of bone defects in the hand is still a challenge despite advancements in hand surgery and improved surgical techniques. However, the main difficulty still lies in restoring the function of the injured segment when the defect affects functionally significant joints including the proximal interphalangeal and metacarpophalangeal joints of the fingers. Loss of mobility in the joints significantly impairs the physical capabilities of patients and the quality of life. A reconstructive intervention is primarily aimed at restoration of the useful range of motion of the involved finger with minimal risks of postoperative complications.

The objective was to evaluate the possibilities with finger function restoration and the effectiveness of the techniques used to repair defects in the fingers joints based on literature analysis.

Material and methods The original literature search was conducted on key resources including Scientific Electronic Library (www.elibrary.ru) and the National Library of Medicine (www.pubmed.org), Elseiver, Google Scholar (2008 to 2024) and using keywords: finger joint defects, bone loss, intra-articular injuries of the fingers, arthroplasty, small joint replacement, reconstruction of finger joints, joint restoration, metacarpophalangeal joint, proximal interphalangeal joint, bone graft, joint transplantation, joint transfer, microsurgery, vascular bone joint transfer. Sixty articles by foreign authors and 11 publications of Russian researchers were selected for analysis.

Results and discussion With the variety of surgical techniques, there is no universal method for replacing defects in the finger joints. Along with the high rate of postoperative complications, the lack of an optimal method requires careful preoperative planning. Reconstructive interventions should be considered as a method of choice and an alternative to arthrodesis in young, physically active patients. Limited postoperative range of motion in the reconstructed joint is a challenge in the treatment of patients with this pathology. The choice of surgical strategy relies on the patient’s compliance for a complex and lengthy rehabilitation in achievement of a functionally satisfying result.

Conclusion Reconstructive interventions for repair of a bone defect in the joint are practical for increasing the useful range of motion of the involved finger and improving the physical capabilities of the hand.

Introduction The management of infected non-unions continues to be a herculean task for the orthopaedic surgeon due to the emergence of microbial resistance, failure of fixation, frequent re-fractures and resurgence of previously treated infection.

The aim of the paper was to structure the approach to the management of patients with infected femoral non‑union based on the literature review and surgeons’ experience.

Material and methods A detailed literature review, including current updates on the management of fracture‑resistant infections (FRI) and non-union of the femur was conducted. Search words and phrases used for navigation in the international medical literature platforms were: osteomyelitis, non-union, diagnostic solutions, local antibiotics, biomechanical stability.

Results and Discussion The principles of surgical management of infected non-union of the femur remain the  same: (a) adequate soft tissue sampling; (b) thorough debridement; (c) fracture stabilization; (d) dead space and defect management; (e) delivery of local antibiotics and (f) soft tissue coverage. The goal of surgery is to get rid of infection. There is no place for empirical treatment of suspected infection. Therapy should be initiated based upon microbial cultures of deep tissue specimens. While selecting the type of hardware for non-union of the femur, one often encounters a dilemma concerning the most appropriate surgical tool for stabilization. Internal fixation with bone grafting would depend on the size of the gap; commonly defects < 6 cm are treated with this modality. External fixation becomes indispensable in certain scenarios such as poor local skin and soft tissue conditions, associated limb length discrepancy > 2 cm, large defect gaps ≥ 6 cm, concomitant deformity, small fragments or osteopenic bone.

Conclusion Based on this review of current concepts, the authors conclude that there is no ideal or universal approach for management of infected non-union of the femur, and the approach may vary depending on the technical expertise available and the institutional practices. Irrespective of the modality used, the golden rules of fixation remain the same, alignment, preservation of biology, contact of fragments, stability and early restoration of function.

Introduction The widespread use of bone cement in the treatment of patients with orthopedic infections can be associated with limited elution of antibiotics with use of local spacers.

The objective was to determine problems of elution of antibiotics from bone cement and ways to solve them based on literature data.

Material and methods The original literature search was conducted on key resources including Scientific Electronic Library (www.elibrary.ru) and the National Library of Medicine (www.pubmed.org) (1994 to 2024) and using keywords: bone cement, PMMA, polymethylmethacrylate, antibiotic elution, bone cement, antibiotic elution, additive manufacturing, porous constructions, lattice structures. The sources were included based on the hypothesis that preformed implants based on a lattice structure could be used in combinations with bone cement.

Results and discussion The elution of antibiotics from bone cement can be improved through examination of the cement type, the porosity, the implant/spacer shape, the type of antibiotics, quantities and  combinations administered that pose a difficult scientific problem in the absence of an acceptable solution along with the variety of publications. However, research in this area has not led to any complete solution.

Conclusion A paradigm has been developed for improving the elution of antibiotics from polymethyl methacrylate (PMMA) to include working with the cement: its composition, geometry and pyrogenicity. Solutions offered for improving the elution of antibiotics from PMMA are often impracticable and can deteriorate the performance properties of cement. Another approach can involve a research aimed at studying the effectiveness of spacers with a preformed base and bone cement coating, without or with minimal interference with the properties specified by the manufacturer.

Introduction Osteoarthritis (OA) is a common polyetiological disease of the musculoskeletal system, leading to disability. The condition can prevent a person from work, affect mental health, increasing mortality and affecting health care resources around the world as a current and future disease burden. OA had been considered an aseptic disease in the past and now the microbiological factor is viewed as one of the significant etiological aspects of the condition.

The objective was to summarize the literature data on the role of microorganisms in the etiology and pathogenesis of osteoarthritis, including concomitant HIV infection.

Material and methods The original literature search (2010 to 2023) was conducted on key resources including Scientific Electronic Library (www.elibrary.ru) and the National Library of Medicine (www.pubmed.org). Literature searches included both Russian and English studies reporting the effect of microbiological factors on the development of arthropathy.

Results and discussion New, more advanced microbiological diagnostic methods have been used. There has been evidence of a variety of microorganisms including pathogenic and opportunistic pathogens in the absence of  clinical and radiological signs of arthritis. This changes ideas about the etiology and  pathogenesis of degenerative processes in the articular cartilage and necessitates a revision of treatment protocols for some joint diseases. Multicenter comprehensive studies of the microbiome of joint formations, blood and intestines are needed.

Conclusions The presence of pathogenic microflora in the joint structures is evident in a significant number of  observations. There is evidence of a local infectious process in the local cellular elements of osteochondral tissue in patients with previously diagnosed aseptic osteoarthritis. Intestinal microbiomes and the urogenital tract are most common sources of infection. A local influence of the immunodeficiency virus on the development of osteonecrotic processes in joint formations can be suggested in HIV patients.