Using the Medline database within the period from 1960 to 2004 the authors made a quantitative analysis of publication dynamics with the key words relevant to osteoporosis problem. Their notable increase has been demonstrated to start since the late 1970s. There was a significant disparity between an immense number (thousands per year) of articles on epidemiology, diagnostics, complications of osteoporosis (fractures) and its treatment, and a relatively scanty number (hundreds per year) of publications on the pathogenesis of bone mass loss as a whole and that of osteoporosis in particular. The authors emphasize the presence of informational pressing in the sphere of conservative treatment and prevention of osteoporosis. As for the society on the whole and a certain part of medical community, this pressing is a background of forming parascientific and paramedical knowledge which determine, not quite correctly from etiopathogenetic point of view the main ways of prevention, diagnosticis and treatment of bone mass loss and osteoporosis in particular.

The authors have developed and studied the effectiveness of the programs of complex treatment of patients with slight and moderate neurologic deficit and pain syndromes as a result of vertebral-and-cerebrospinal injury through postmenopausal osteoporosis. The complex approach to treatment of patients with vertebral fractures through postmenopausal osteoporosis of the spine, apart from surgical treatment, should comprise replacement hormonal therapy, the use of bisphosphonates, calcium preparations, as well as the course of rehabilitation measures.

Within the period from 2000 to 2009 thirty patients (35 observations) at the age of 21-69 years were treated in orthopaedic department No 6 for deforming arthrosis of the knee joints, using video-and-arthroscopic technique. Treatment-and-diagnostic arthroscopy with subsequent tibial valgus-producing subcondylic osteotomy was performed in 27 patients, two patients underwent arthroscopy of the knee with subsequent femoral valgus-producing epicondylic osteotomy, and one patient – arthroscopy with subsequent varus-producing subcondylic osteotomy. Long-term results were traced in 29 (96,7%) patients, good results of treatment were observed in 100% of cases.

Roentgen studies have been performed in 340 patients with deforming arthrosis of the knee, hip and ankle joints, the patients’ age was 18-60 years and above. Complex of measurements, characterizing roentgen-and-anatomical changes in the joints, has been analyzed to assess the degree of dystrophic manifestations with scoring the degree of process severity before and after conservative treatment. The results obtained have demonstrated that idiopathic, dysplastic arthorses of I-II stages dominate in all the groups with more stable values for the hip and the ankle. There were no evident signs of x-ray picture worsening after 1-3 years in 92-95% of patients through the treatment performed.

The results of studying the influence of lower limb axis on the results of rehabilitation measures in patients at the age of 30-45 years with the knee posttraumatic osteoarthritis of I-II stages are presented. It has been demonstrated that X- or O-shaped axis of the lower limbs contributes to worsening of the immediate and long-term results of rehabilitation measures.

Podography study has been performed in 40 patients with bilateral coxarthrosis of III stage before treatment and within 6-18 months after endoprosthetic surgery of the hip. Three forms of the adaptive stereotype of feet support reactions for walking without additional supporting means have been singled out. I type: there is no asymmetry of step cycle temporal parameters; the asymmetry of foot loading statically and dynamically doesn’t exceed 10%; the path of pressure general centre on a horizontal plane keeps having a clear typical butterfly-like pattern. II type: the asymmetry of step cycle temporal parameters is not more than 20%; the double-support period of step is increased for both limbs; the asymmetry of foot loading statically and dynamically is increased up to 30%; the path of pressure general centre on a horizontal plane has an asymmetric butterfly-like pattern. III type: the asymmetry of step cycle temporal parameters exceeds 20%; front/back push ratio is less than 1.0; the asymmetry of foot loading statically and dynamically is increased up to 50%; the path of pressure general centre on a horizontal plane has no butterfly-like pattern.

The content of glycosaminoglycans (GAG) and the complexes of proteoglycans (PG) were determined analytically in synovia of patients with osteoarthrosis of different stages by the method of electrophoresis in agarose gel. The amount of GAG in synovia increases at early stages of the disease, and at the late ones it decreases, thereby reflecting the dynamics of changes in articulate cartilage. The amount of GAG, their qualitative composition and PG structural aggregatbility can serve as a diagnostic test for risk of osteoarthrosis occurrence and its development dynamics.

The authors have studied the effect of complex, pathogenetically substantiated conservative treatment, including the use of medicamentous therapy, physiotherapeutic procedures, exercise therapy, on phagocytic activity of peripheral blood neutrophils in patients with lower limb osteoarthroses (I-II Degree).

Biochemical studies of lipoperoxide level and antioxidant activity in 248 patients with uneventful clinical course and 53 patients with clinically, roentgenologically and intraoperatively confirmed endoprosthesis instability after total endoprosthetics of the hip were performed on the basis of the traumatological department of Municipal Clinical Hospital 3. The data obtained have demonstrated the increase of lipoperoxides of all types in patients with deforming osteoarthrosis. The dynamics of lipid peroxidation and antioxidant activity measurements in patients with favorable clinical course was shown to differ from that of patients with subsequent development of endoprosthesis component instability. The substantial increase of lipid peroxidation measaurements through the reduction of antioxidant activity was found in patients with clinically and roentgenographically confirmed hip instability.

The new medical extraarticular technology of gonarthrosis treatment presented is based on trophostimulating effect secondary to microfracturing articular parts in combination with cellular-and-medullary stimulation. Pathogenetical reasons of using microfractures in subchondral zones and grafting cellular-and-tissue substance from tubular bone medullary canal consist in creation of the conditions for coming out the blood clot with growth factors, biologically active substances to wound cavity, as well as the bone marrow with polypotent mesenchymal stromal autocells, that results in reparative chondrogenesis activation.

The article deals with roentgenometric diagnostics of idiopathic and dysplastic gonarthosis using x-ray axial views at the knee flexion angle of 30°. The analysis is presented with measurement estimation depending the severity of the knee osteoarthrosis process. The authors has substantiated the role of diagnostic criteria in the prognostic determination of the disease course in stages in elderly persons, and that of planning the tactics and technology of treatment.

The results of studying the influence of standard treatment on the progression of local morphological changes in patients with posttraumatic osteoarthrosis of I-II stages are presented. It has been revealed, that despite the standard treatment being performed the local morphological changes continue progressing dynamically.

The data on the most common local intra- and postoperative complications after endoprosthetics of the hip are reported. Among 1096 cases of the hip endoprostheses implantations the local complications of slight and medium severity developed in 3,9% of the cases (wound edge necrosis – 0,9%, postoperative wound hematoma – 1,0%, ligature fistula – 0,2%, fractures of the greater trochanter – 0,7%, femoral diaphyseal fractures of the upper third – 0,2%, prosthesis head dislocation – 0,4%, sciatic nerve neuropathy of fibular type – 0,3 %, femoral nerve neuropathy − 0,3%), and those of high severity were observed in 2,8% of the cases (endoprosthesis total aseptic instability – 2,1%, total infected instability – 0,7%). The causes of local intraoperative and early postoperative complications have been analyzed, the measures for their prevention and optimal treatment techniques have been reported.

44 patients were examined after total hip arthroplasty. The examination revealed heterotopic ossification in 16 patients, the absence of pathological process was observed in 28 patients. The markers of bone tissue remodeling were determined in the blood serum of patients. The dynamics of Informative marker activity could be considered as a criterion of heterotopic ossification development estimation.

37 patients (38 joints) with closed intraarticular fractures of proximal tibia have been treated within the period of 2002-2009 using a combined method of treatment, which consists in arthroscopy performing for the purpose to diagnose the degree of damaging the knee soft tissue structures, in correction of tibial fragment position under video control and subsequent application of the Ilizarov fixator different modules. Long-term results were traced in 32 (86.5%) patients, good results of treatment were obtained in 89% of cases.

Paget disease in clinical practice is rare. By its nature the disease represents the disorder of bone remodeling processes. The etiology still has been studied insufficiently. We have generalized the experience of treatment of 33 patients. The most frequent localization of the process is noted in femur and tibia. Clinical picture manifests itself as pain, limb deformity, as well as malignization is possible. The diagnosis is based on the data of roentgenography, CT, MSCT, MRT. Treatment with bisphosphonates (fosamax) and thyrocalcitonin is effective, but prolonged. Surgical treatment is performed if indicated: osteosynthesis, endoprosthetics, amputations.

Surgical treatment has been performed in 178 patients with bone tumors and tumor-like bone diseases within the period of 1997-2007 using cellular carbon of high porosity for the purpose of bone defect plasty. The effectiveness of its use for bone defect filling after tumor removal has been demonstrated.

The techniques of local determination of bone mineral density by the method of double-energy roentgen absorptiomentry have been developed for treatment of orthopaedic-and-traumatological patients. At the expense of low radiation loading bone marrow and viscera repeated examinations of patients’ skeleton have been performed to obtain the quantitative values and characteristic of reparative regenerated bone.

Biochemical methods have been proposed to assess the key ways of metabolism (forming metabolic state) in traumatological patients in the posttraumatic period and in the dynamics of treatment.

A complex approach to treatment of intervertebral disk herniae in patients with lumbar osteochondrosis has been developed. The possibilities of surgical and conservative methods have been assessed comparatively. The principally new system evidences that pain for involvement of spinal cord roots (or spinal nerves) are imaged on the skin. The points, functionally significant and strictly specific for each spinal nerve (root), have been revealed which being pressed are of maximal painfulness for the patient, thereby giving the possibility of orienting oneself with respect to the level and extent of involvement. Preparations have been selected which being injected intracutaneously (or subcutaneously) at the points, conforming to the root involved, produced a persistent focus of contrirritation, thereby blocking pain impulse conduction. As for additional techniques of complex treatment, the following ones were used depending on the disease character: orthesing (external fixation), traction therapy (skeletal traction), psychocorrection and background medicamental therapy.

The article deals with the experimental substantiation of using a new technique of distraction osteogenesis stimulation for filling postresection defects of long bones by the methods of non-free osteoplasty. The introduction of free bony autochips into the zone of connective-tissue interlayer of the distraction regenerated bone being formed according to ―ischemic‖ type stimulates osteogenesis and allows to restore the activity of osteogenesis process.

The article deals with the regularities of forming mental disorders in orthopaedic diseases, which are determined by interaction of somatogenic, psychogenic and social factors. Phenomenological analysis reveals the necessity of dynamic studying psychopathological disorders within the framework of "reaction − state-development" continuum. The author has determined the clinical expression range of some nosological forms of the neurotic sphere − varying from those effaced situationally dependened to deeply personal. Moreover, the author also has distinguished clinical variants of dynamically developing mental disorders in patients with congenital and acquired pathology of the locomotor system.

UNIITO workers’ scientific findings on the problem of compression-distraction osteosynthesis according to Ilizarov have been presented by the authors for 50 years. The clinical debvelopments of this school have allowed to propose new ways and technologies of diagnostics and treatment for patients with the locomotor system pathology. Experimental-and-theoretical studies formed the basis of causing the concept of distraction histogenesis. Bone restoration under lengthening should be considered as а variety of physiological regeneration.

Treatment of intra-articular fractures of the proximal tibia so far remains an urgent problem of trauma due to an increase in the frequency of their occurrence and frequency of unsatisfactory results of treatment.

Complex approach is presented for rehabilitation of a female patient with flexion neurogenic and positional contracture of the knees on account of severe craniocerebral injury, including surgical treatment with the Ilizarov fixator and exercise therapy according to an individual program; this approach allows to recover the knee function and the ability of independent walking.