Introduction Three-phalanx finger flexor tendon injuries in the fibrous-osseous canals of the fingers represent a complex orthopedic problem requiring multifaceted treatment. The functional outcome of flexor tendon reconstruction depends on the surgical strategy, timely provision of necessary rehabilitation support, and patient compliance. Failure to adopt a comprehensive approach to treating patients with this injury often leads to poor clinical and functional outcomes.

The purpose was to determine key surgical and rehabilitation factors that have impact on the outcomes of primary reconstruction of the flexor tendons of the three-phalangeal fingers in the second zone.

Materials and Methods We analyzed the postoperative results of 100 patients who underwent primary reconstruction of the deep flexor tendon of one three-phalangeal finger after damage to both flexor tendons in zone 2 according to the Verdan classification. These included finger function using the Strickland criteria and the Boyes – Lister scale, and clinical and functional assessment of the limb using the validated DASH and MHQ scales. The impact of patient morphological characteristics, anatomical topography of the injury, surgical strategy, and rehabilitation protocol on postoperative outcome was assessed.

Results A statistically significant improvement in function was found according to the Strickland criterion with a surgical incision size not exceeding 1.5 phalanx lengths (p < 0.05). Functional results with the use of a four-thread 3/0 intrasegmental suture and a six-thread 3/0 suture according to the Strickland criterion and the Boyes Lister scale were statistically significantly better (p < 0.05). Poor results according to the Strickland criterion were observed statistically significantly more often in the absence of rehabilitation than with any type of rehabilitation (p < 0.05). Suture ruptured more frequently without rehabilitation (p < 0.001) than if rehabilitation with a hand therapist was provided.

Discussion The obtained results both differ from the published ones in the literature and confirm some parameters. The use of fouror six-thread 3/0 tendon suture configurations and a rehabilitation protocol with a specialist improves functional outcomes in the treatment of flexor tendon injuries of the triphalangeal fingers and reduces the risk of suture rupture. Combined flexor tendon and digital nerve injuries do not show functionally significant differences compared to isolated tendon injuries.

Conclusion A retrospective cohort analysis identified key surgical and rehabilitation factors that influence the outcomes of primary zone 2 flexor tendon reconstruction of the three-phalangeal fingers: the configuration and caliber of the intra-articular suture, the size of the surgical incision, and the availability and type of rehabilitation provided. These factors significantly had a significant impact on the clinical and functional outcomes of treatment.

Introduction With advances in the study of bone reparative regeneration there are no methods for early detection of impaired consolidation. Methods for stimulating consolidation processes remain an unresolved question. The development of accessible criteria for assessing impaired fracture consolidation and medications for skeletal muscle tissue repair are challenges of orthopedic trauma care.

The objective was to measure microcirculation in patients with uncomplicated fractures to the long bones of the lower limb, impaired consolidation processes, and stimulation of reparative regeneration.

Material and methods The study included 100 young patients with long bone fractures: group 1 (n = 40) with uncomplicated fractures; group 2 (n = 40) with delayed consolidation; group 3 (n = 20) with established delayed consolidation treated with a bioregulator (peptides from the cerebral cortex). The control group (n = 40) consisted of healthy individuals matched for gender and age. Diagnosis, treatment and rehabilitation were produced according to clinical guidelines. Microcirculation index (MI), shunt index (SI), neurogenic (NT) and myogenic (MT) vascular tone, the amplitude of the endothelial, neurogenic, myogenic and respiratory oscillation ranges were measured using laser Doppler flowmetry on the first, second, fifth, tenth and 90th days after the injury. Statistical processing of the findings was performed using the IBM SPSS Statistics Version 25.0 software package.

Results Patients with normal consolidation showed a progressive increase in PM and active oscillation amplitudes in both limbs, a decrease in NT and MT after two days. Patients with delayed consolidation demonstrated a consistently low perfusion index and increased NT and MT in the injured limb (p < 0.05). Patients treated with the neuropeptide drug showed significantly decreased NT and MT in the injured limb, reaching levels comparable to those in normal consolidation (p < 0.05) after 90 days.

Discussion Long-term hypoperfusion, elevated NT and MT in the injured limb, precapillary spasm, and less efficient blood flow redistribution in patients with impaired consolidation were associated with persistent sympathetic activation, which led to persistent vasoconstriction and perfusion restriction, creating unfavorable conditions for angiogenesis and migration of progenitor cells to the area of regenerative bone formation. The mechanism of action of the peptide bioregulator could be explained by activated neuropeptides and neurotrophic factors, optimization of the balance of excitatory and inhibitory amino acids, and GABAergic effects, which ultimately led to the creation of more favorable local conditions for the completion of osteogenesis.

Conclusion Microcirculation in patients with normal bone reparative processes demonstrated early activation of all regulatory mechanisms, decreased HT and MT as early as the fifth day on the injured side, and rapid restoration of perfusion in the healthy limb. Normalized microcirculation was recorded after ten days of surgery. Prolonged hypoperfusion, prolonged precapillary spasm, and less effective blood flow redistribution, high HT and MT were observed in patients with impaired fracture consolidation. Neuropeptide bioregulator had a significant effect on the regulation of microcirculation at the fracture site through reduced HT, MT, and PSH and could be recommended for stimulating reparative regeneration in patients with impaired fracture healing.

Introduction Histological data on the effect of intramuscular administration of branched-chain amino acids (BCAA) on muscle recovery are lacking.

The purpose of the work was a histomorphometric assessment of the effect of intramuscular administration of BCAA in a dosage for injections on the regeneration of the anterior tibial muscle (ATM) after its closed partial crushing in rats.

Materials and methods Compression of the ATM was performed for one minute in 48 male Wistar rats. After 24 hours, animals of series 1 received a single injection of saline into the ATM, while animals of series 2 received BCAA. Euthanasia was performed after 7, 14, 28, and 42 days. In paraffin section images, the volumetric densities of muscle fibers (MF) (V_Vm), microvessels (V_Vmv), and endomysium (V_Vе) were determined; MF diameters were measured, the numerical densities of MF (Na_m), microvessels (Na_mv), and intramuscular nuclei (Na_n) were determined, and the vascularization (kv as Na_mv/Na_m) and nucleation (kn as Na_n/ Na_m) coefficients were calculated. Ten intact rats were a control group.

Results After seven days, VVm in both series decreased by 36–37 %; in the rest of the periods, the indicator was significantly higher in series 2, but remained below normal in both groups. Within 28 days, the MF diameter was higher in series 2. After seven, 14 and 28 days, the indicator exceeded the values of series 1 by 17 % (p = 0.026), 11 % (p = 0.012) and 5 % (p = 0.048); after 28 days in series 1 and 2 it was 79 % and 84 % of the norm. The kn indicator in series 2 was lower than normal only after seven days of experiment, and in series 1 after seven, 14 and 42 days by 24 % (p = 0.002), 24 % (p = 0.004) and 10 % (p = 0.034), that indicates less active myogenesis. The kv indicator after 14 and 28 days was higher in series 2 by 10 % (p = 0.045) and 32 % (p = 0.014). On the 42^nd day in series 2, the MF diameter decreased against the increase in their Nam and was 47 % lower than the norm (p = 0.0006) and 30 % lower than in series 1 (p = 0.0023).

Discussion The findings obtained suggest that a BCAA injection has a positive effect on the MF regeneration and microvessels, and was more active than in series 1.

Conclusion A single BCAA injection has a myogenic stimulating effect. Further studies on side effects and long-term outcomes are needed.

Introduction Chondromalacia patellae is a leading cause of anterior knee pain and is considered an early form of degenerative patellofemoral cartilage disease. The limited regenerative potential of the hyaline cartilage and the variable effectiveness of conservative treatments motivate the search for biological technologies capable of providing structure-modifying effects. A promising approach is the use of autologous stromal vascular fraction (SVF) of adipose tissue that has anti-inflammatory and regenerative potential.

The purpose of the work is to conduct a comparative assessment of clinical and instrumental studies of the results of standard and modified SVF therapy technologies in the treatment of patients with chondromalacia patella.

Materials and Methods A non-randomized, retrospective, multicenter cohort study was performed. It included 41 patients with Outerbridge grades I–III chondromalacia patellae. Patients were divided into two groups according to treatment protocol provided: standard SVF (n = 20) and modified SVF (n = 21). Assessments were performed before treatment and after one, six, and 12 months. VAS, KOOS-PS, and quantitative parameters of cartilage defect based on MRI data (linear dimensions, area, volume) were analyzed. Differences were considered statistically significant at p < 0.05.

Results In both groups, a significant reduction in pain and improvement in function were noted after 12 months (p < 0.001). In the standard SVF group, the defect area decreased by 27.4 % and volume by 44.6 %; in the modified SVF group, by 40.2 % and 53.8 %, respectively (p < 0.001). Intergroup comparison revealed a more pronounced decrease in defect width with the modified technique (p = 0.007). One month after treatment, the modified SVF group showed a more pronounced reduction in pain and improvement in function (p < 0.01), while the differences leveled out at six and 12 months.

Discussion The modified SVF therapy technique resulted in earlier pain reduction and improved function compared to the standard technique. These differences leveled over the long term, confirming the high efficacy of SVF therapy regardless of the protocol variant. Comparable morphological results based on MRI data indicate that the structural effect was maintained with the modified technique. Limitations of the study include the non-randomized design and a moderate sample size.

Conclusion SVF therapy demonstrates significant clinical and structural benefits in chondromalacia patellae. The modified technology provides a more rapid onset of clinical effect with comparable long-term morphological changes based on MRI data, suggesting it as a promising option for optimizing cell therapy.

Introduction Knee osteoarthritis (OA) is a progressive disease causing pain and dysfunction in postmenopausal women.

Purpose This study aimed to evaluate the therapeutic efficacy of a combination of glucosamine-chondroitin, chitosan, and phytoestrogen with paracetamol compared to paracetamol alone in postmenopausal women with knee osteoarthritis.

Materials and Methods A double-blind randomized controlled trial was conducted on 60 postmenopausal women with Kellgren – Lawrence grade II–III knee osteoarthritis. A total of 60 patients were included in this study and divided into treatment and control groups with a 1:1 ratio. The mean age of patients was 59.77 years (± 2.99) while the control group had a mean age of 60.4 years (± 3.21), there was no significant difference (p = 0.43). Patients were randomly assigned into two groups: the treatment group (n = 30), which received glucosamine-chondroitin, chitosan, and phytoestrogen in combination with paracetamol, and the control group (n = 30), which received paracetamol alone. The levels of soluble interleukin-6 receptor (sIL-6R), interleukin-10 (IL-10), cartilage oligomeric matrix protein (COMP), as well as Visual Analog Scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were measured at baseline and after two weeks of treatment.

Results After the pharmacological intervention, the treatment group showed significant reductions in WOMAC score, COMP, and sIL-6R compared to the control group (p < 0.01). Both groups had increased IL-10 levels following treatment, but the increase was greater in the control group.

Discussion The combination therapy demonstrated improvement in joint function and a reduction in inflammatory and cartilage degeneration markers. These findings support the anti-inflammatory and chondroprotective potential of natural compounds in the management of knee osteoarthritis.

Conclusion The combination of glucosamine-chondroitin, chitosan, phytoestrogen, and paracetamol demonstrated superior short-term effects in reducing inflammatory and cartilage degeneration biomarkers and improving clinical symptoms in postmenopausal women with grade II-III knee osteoarthritis compared with paracetamol alone.

Introduction Special questionnaires recommended by SOSORT are used to study the quality of life (QoL) of children and adolescents undergoing brace treatment for scoliosis. One of them is the Brace Questionnaire (BrQ) which has undergone the stage of linguistic and cultural adaptation and validation in the Russian language.

Aim To reveal groups of patients with scoliosis requiring special attention during brace treatment using the BrQ which was validated in Russia.

Methods 405 patients that wore braces were surveyed with the automated BrQ. Changes in the domains and the overall quality of life score were statistically analyzed based on gender, age, duration of brace wear, and daily brace wear time. In 325 individuals, changes were tracked based on the magnitude of the main scoliotic curve.

Results Boys showed statistically significantly higher scores in the "Vitality" (p = 0.05) and "Bodily Pain" (p = 0.03) domains. A main trend was identified: a decrease in domain scores and the overall QoL score with increasing age, duration of brace wear, and magnitude of the main curve. Statistically significant differences in various domains were found between the study groups for these parameters. The dependence of scores on the daily brace wear time was their growth.

Discussion The identified trends in changes of domain scores and the overall QoL score in regard to increase in age, duration of brace wear, daily wear time, and the magnitude of the main curve are consistent with scientific literature data.

Conclusion Determination of the significance of differences revealed groups of patients requiring special attention during brace treatment for scoliosis. These are girls who have a lower QoL level in the "Emotional Functioning" and "Social Functioning" domains; middle and senior school-age children who show a decrease in the "General Health Perception", "Bodily Pain", "Self-Esteem and Esthetics", and "Social Functioning" domains. These are patients who wore a brace for 4 years or more: the "General Health Perception", "Emotional Functioning", and "Self-Esteem and Esthetics" domains decrease; and for the "Bodily Pain" domain, pain increased already after 2–3 years of brace use. A special group of patients are those who at the initial stage of brace wear had the lowest Quality of Life (QoL) scores. High grades of scoliosis significantly reduce the scores in the domains such as "General Health Perception", "Vitality", and "School Activity", while the "Social Activity" domain score is reduced with a curve more than 50º.

Introduction Cerebral palsy (CP) is the most common neurological disorder in children, associated with movement disorders. The maximum age for reconstructive surgery is twelve years, but the optimal age for maintaining the results of multi-level orthopedic interventions is considered to be the second half of the adolescence period. Analysis of established orthopedic impairments and their impact on gait, as well as their characteristics depending on previous interventions, is of interest for determining the optimal conditions for reconstructive surgery on the lower extremities in adolescents.

The purpose of this study was to evaluate the kinematic and kinetic gait parameters of adolescents with cerebral palsy (GMFCS I–III) before orthopedic surgery using a cross-sectional comparative analysis. The null hypothesis was the absence of differences in gait parameters between patients with previous orthopedic surgery and those who did not undergo it.

Materials and methods This retrospective study included 102 adolescents aged 13–17 years with cerebral palsy, divided into two groups: Group A (GMFCS I–II, n = 63) and Group B (GMFCS III, n = 39). Three subgroups were identified in each group based on surgical history. All patients underwent computer video gait analysis. The gait analysis presents the parameters as medians with a percentile distribution level of 25 %–75 %. The unpaired Wilcoxon test (p ≤ 0.05) was used for comparison. The relationship between the parameters was assessed using Spearman's rank correlation. The chi-square test for binary samples was used to compare the incidence of the crouch gait pattern.

Results Gait characteristics revealed a predominance of horizontal movement disorders (due to torsional deformities) in previously unoperated GMFCS I–II patients, while the prevalence of crouch gait increased in the remaining subgroups. An increase in decompensated crouch gait patterns was observed in the subgroups of patients who underwent early triceps surae interventions. A significant difference was found between groups 1A and 2A in the incidence of decompensated crouch gait (chi-square test, p = 0.002). No significant differences were found between the other subgroups.

Discussion The systemic nature of motor impairments in children with cerebral palsy and the resulting orthopedic disorders, necessitate not only the assessment and monitoring of individual orthopedic impairments of the lower extremity locomotor chains but also the consideration of integrated movement indices (GPS), as well as kinematic and kinetic data in their interrelationships.

Conclusion In patients with GMFCS levels I–II and no previous orthopedic interventions, indications for surgical treatment are determined by joint contractures and torsional deformities of the lower extremity segments. In patients with GMFCS level III, the crouch gait pattern, which remains compensated, predominates in adolescence. In the group of patients with triceps surae lengthening performed at an early age, the development of compensated and decompensated types of crouch gait with high-energy movements was observed. This should be taken into account both when choosing a surgical treatment strategy and during subsequent rehabilitation measures and orthotics. In adolescents with previous multilevel interventions, torsional deformities, recurrent contractures, and the development of knee flexion remained indications for surgical treatment. However, the spatiotemporal and strength characteristics of movements remained relatively high.

Introduction Total elbow arthroplasty (TEA) is increasingly used for the treatment of advanced elbow conditions with the rate of adverse events after surgery being high.

The objective was to analyze the spectrum and causes of complications following TEA depending on the biomechanical implant design and evaluate the effect of humeral trochlear resection on hand grip strength.

Material and methods A retrospective non-randomized cohort study of 622 primary and revision TEA procedures was performed between 2002 and 2025. Depending on the biomechanical principle of implant fixation, patients were stratified into two groups to include constrained implants (ESI, n = 404) and semi-constrained implants (Zimmer Coonrad – Morrey, Conmet, Treza, Logeeks, n = 218). Clinical and radiological data, intraoperative findings during revisions, and instrumented dynamometry results (n = 80) were analyzed preoperatively and at 6 weeks of surgery. Statistical analysis was performed using non-parametric tests (Mann – Whitney U, Wilcoxon, Chi-square).

Results The overall complication rate was 7.0 % (44/622). Aseptic loosening of TEA was more common for constrained implants (4.5 %, 18/404) due to stress concentration at the bone-cement interface. Mechanical failure of the hinge joint/polyethylene wear (3.2 %, 7/218) was the leading cause of revision in the semi-constrained group. Resection of the humeral trochlea had no clinically significant effect on hand and pinch grip strength (p > 0.05).

Discussion Existing TEA constructs exhibit a predictable complication profile directly related to their biomechanical design. Optimizing outcomes is associated with advanced surgical techniques and a transition to new-generation implants considering the complex three-dimensional kinematics of the joint and providing balanced load transfer with a reinforced, wear-resistant hinge system.

Conclusion The complication profile after TEA was implant dependent. Constrained systems could predispose to aseptic loosening, and semi-constrained systems can be associated with fatigue wear of the hinge. Trochlear resection did not compromise the hand strength. Future implant developments should focus on optimization of controlled varus-valgus laxity (5–7°), reinforcing the hinge coupling mechanism, considering the anatomical torsion of the distal humerus.

Introduction Pes planovalgus is a progressive, collapsing deformity of the foot, stage IV (subtype IV B according to the Myerson classification), associated with ankle joint involvement. This pathology remains one of the most complex and disabling in foot and ankle surgery. Surgical correction of the hindfoot associated with ankle osteoarthritis suggests careful planning and may include isolated arthrodesis procedures and strategies to be followed by total ankle arthroplasty.

The objective was to evaluate the clinical and functional results of surgical correction of pes planovalgus deformity in patients with concomitant ankle osteoarthritis.

Material and methods This retrospective, single-center study included data from 13 surgically treated patients with stage IVB flatfoot deformity and concomitant ankle osteoarthritis. All patients underwent surgery to correct the hindfoot deformity, using various arthrodesis procedures depending on the clinical situation. Clinical and functional outcomes were assessed using the Visual Analogue Scale (VAS), the AOFAS scale, and the FAOS questionnaire before and after surgery. The minimum follow-up period was 12 months. Statistical analysis was performed using the Wilcoxon signed-rank test with exact two-tailed p values calculated.

Results Postoperatively the median VAS score decreased from 8 [7; 8] to 2 [2; 3.5] scores (p = 0.000244). The median FAOS score increased from 22 [16.5; 42] to 86 [69; 89.5] (p = 0.001709). The median AOFAS score improved from 40 [32.5; 42.5] to 88 [80; 90] (p = 0.000977).

Discussion The findings are consistent with those reported in international literature and demonstrate the high efficacy of hindfoot arthrodesis in this condition. Significant improvement in the functional parameters suggests the appropriateness of the surgical approach. In some cases, hindfoot arthrodesis can be considered as the first step prior to the total ankle arthroplasty.

Conclusion Surgical correction of pes planovalgus deformity through hindfoot arthrodesis provides a statistically significant reduction in pain and improved functional status in patients with concomitant ankle osteoarthritis.

Introduction The use of transcutaneous implants for the attachment of limb prostheses is a rapidly developing modern technology for restoring function of lost limbs, particularly relevant for lower limb prosthesis applications. The primary challenge in developing this technology is the need to significantly improve implant survival, which depends on its design and the presence of biocoatings.

The purpose of the work is to experimentally evaluate the survival rate of original Press-Fit-type percutaneous implants produced without coating the surface of the osseointegrated part and with an applied zinc-containing calcium phosphate coating during one-stage osseointegration.

Materials and Methods The study was performed on 10 mongrel male dogs aged 1.5 to 2 years and weighing 19.2 ± 1.3 kg. Animals in Group 1 (n = 5) received an uncoated implant, while animals in Group 2 (n = 5) received an implant coated with a zinc-containing calcium phosphate. Osseointegration was assessed using a combination of clinical, radiographic, and laboratory studies. Quantitative analysis of the results was performed using statistical methods.

Results Twenty-six weeks after implantation, all animals had implant stability. A single bone-implantation unit with a continuous and sufficiently dense compact plate was formed. Animals in Group 1 demonstrated organotypic bone remodeling and compaction of periosteal layers. By that time, animals in Group 2 featured completion of organotypic remodeling around the implant that indicated signs of more pronounced osteogenesis in the implant-bone system. The zinc-containing calcium phosphate coating promoted the formation of denser and more mineralized structures on the implant surface and prevented calcium efflux from the compact plate of the bone stump.

Discussion The studies conducted and clinical observations demonstrated the absence of significant local or systemic disorders in the experimental animals during the implant osseointegration period, indicating good tolerability. The zinc-containing calcium phosphate coating provided excellent biocompatibility and stimulated osteogenesis. The obtained results are consistent with data presented in the domestic and international scientific literature and expand the evidence base of the effectiveness of Press-Fit titanium SLM implants with zinc-containing calcium phosphate coating for osseointegration prosthetics.

Conclusion The data obtained during the experiment show fairly good results of osseointegration of Press-Fit implants without coating the surface of the osseointegrated part and with an applied zinc-containing calcium phosphate coating. They did not show pronounced restrictions on their use. However, from the point of view of minimizing the the risks, preference should be given to product with a zinc-containing calcium phosphate coating of the osseointegrated part.

Introduction Treatment of patients with post-osteomyelitic defects is one of the most challenging areas in traumatology and orthopedics.

Purpose To substantiate, on an experimental model, the potential of a partially bioresorbable material Rekost used to compensate for osteomyelitic cavities in combination with an antibiotic.

Materials and methods The study was performed on nine male Soviet Chinchilla rabbits (16–18 months old, 4.3–4.5 kg of weight), in which osteomyelitis was modeled in the proximal metaphysis of the tibia by producing a trepanation hole and installing an Osteolite™ containing a Staphylococcus aureus culture. The animals were divided into three groups. Animals in group 1 were withdrawn from the experiment after 21 days of osteomyelitis modeling. In groups 2 and 3, the second stage included sequestronecrectomy and substitution of the bone defect thus formed with Rekost material (OOO AikonLabGmbh, Nizhny Novgorod, RZN 2014/1646 dated 03.07.2014, for indefinite) impregnated with an antibiotic in group 3. After 21 days of implantation, the animals were withdrawn from the experiment. Clinical, radiological, biochemical and histological methods were used.

Results In Group 1, signs of osteomyelitis were recorded: necrotic fragments of bone trabeculae, inflammatory infiltrate, osteoclastic resorption and osteogenesis, bone marrow fibrosis, and pronounced CD15 expression. In groups 2 and 3, three weeks after implantation, a network of newly formed bone trabeculae at the bone-material interface was noted, and bone trabeculae were observed in the implant cavities. In the epiphysis of group 2, a HOES score of ≥ 6 points corresponded to active chronic osteomyelitis. In group 3, a median HOES score of 2 points indicated a remission of chronic osteomyelitis, and CD15 marker expression was less pronounced than in group 2. C-reactive protein levels continued to increase in Group 2 and significantly decreased in Group 3.

Discussion Bioresorbable implants, impregnated with antibiotics, provide gradual replacement of the material with bone tissue, eliminate the need for repeated surgeries, reduce the risk of chronic infection, and are biocompatible.

Conclusion In an in vivo experimental model, minimal degradation of the Rekost material was observed three weeks after implantation, manifested by highly frequent foreign-body-type giant multinucleated cells. Early data on the osteoplastic properties of the Rekost material and its ability to suppress infection and inflammation in combination with an antibiotic suggest the potential for further experimental studies of this product to be used in the treatment of patients with chronic osteomyelitis.

Introduction The first stage of two-step surgery to replace infected hip suggests the intraoperative fabrication of an articulating cement spacer. A critical step is manual holding the metal reinforcement in the mold for 8–12 minutes while the bone cement cures, which increasing the overall surgical time. Optimizing this stage is essential.

The objective was to evaluate the effectiveness of the first stage of hip revision in 2-stage surgery optimized with a new device for fixing reinforcement in the manufacture of a cemented spacer for the hip joint.

Material and methods A new device (RU Patent No. 232924 U1), made of medical-grade AISI304 stainless steel, which is reusable and sterilizable, allows for the fixation of reinforcement used to manufacture hip articulating spacers in a clamp and their positioning over the center of a mold cell sized to fit the acetabulum (diameters 46–62 mm in 2 mm increments). With the cell filled with cement, the reinforcement was inserted to the specified depth and secured with the device. After 8–12 minutes, to allow polymerization completed, the construct was removed for cementation of the femoral component. A retrospective analysis of 85 patients with infectious coxitis surgically treated between 2023 and 2026 was conducted: the spacer was made by manual retention of reinforcement in the control group (n = 51) and the spacer was made using a new fixation device in the study group (n = 34). Total operative time (min), the frequency of spacer revisions, and early complications were assessed. The groups were comparable for key parameters.

Results Operating time was reduced by 13.7 minutes in the study group ((84.5 ± 8.9) min versus (98.2 ± 12.5) min, p = 0.008). The frequency of intraoperative spacer adjustments decreased fivefold (6 % versus 29 %, p = 0.012). No dislocations were recorded early post-op in either group. No significant differences in the accuracy of radiographic parameters (offset, neck-to-shaft angle) were found.

Discussion There are no publications reporting similar devices for the fabrication of the acetabular component of the hip articulating spacers. Patients with an underlying infectious process (tuberculous or purulent coxitis) and frequent comorbidities (HIV, hepatitis) may benefit with even a relatively small reduction in surgical time improving the prognosis. The lack of need for spacer modification preserves the integrity of the femoral head surface and ensures a more uniform distribution of the antibiotic in the cement.

Conclusion The device offered can be recommended for clinical implementation reducing surgical time by an average of 14 minutes and the frequency of spacer modifications.