Introduction Growing knowledge and understanding of the biomechanics and kinematics of the knee are prompting the search for new surgical techniques and new ACL grafts. Purpose Evaluation of the medium-term results of primary arthroscopic reconstruction of the anterior cruciate ligament of the knee using peroneus longus tendon autograft and comparing the results with the control group of patients who underwent primary arthroscopic reconstruction of the anterior cruciate ligament using patellar tendon autograft with two bone blocks. Materials and methods 108 patients were operated on in 2017-2018. They were divided into two groups. 55 patients underwent reconstruction of ACL using peroneus longus ligament autograft – group 1 (study group). 53 patients underwent reconstruction of ACL using patella tendon autograft – group 2 (control group). Evaluation of the knee joint function was based on clinical examination, medical history, results of functional tests, MRI results, on the data of instrumental diagnostic methods (CT‑1000) after the surgical treatment, patient responses when filling out scales before surgery and two years after the surgery (Tegner Lysholm, IKDC). Additionally, the patients of the study group underwent a study on a plantograph before surgery and 24 months after it. Postoperative evaluation was also performed using the AOFAS scale. Results In group 1, the average score on the Tegner Lysholm scale before surgery was 69.2 ± 10.7 points, after surgery – 92.2 ± 10.4 points; on the IKDC scale before surgery – 68.2 ± 10.6 %, after surgery – 90.1 ± 9.5 %. KT-1000 – 3.7 ± 1.4 mm, AOSAF – 95.3 ± 7.5 %. An autograft rupture within 2 years after the surgery was detected in 4 out of 50 patients, which amounted to 8 %. Measurements on the PKS-01 plantograph 24 months after the operation did not reveal changes in the arch of the foot. In group 2, the average score on the Tegner Lysholm scale before surgery was 70.2 ± 11.6 points, after surgery it was 94.3 ± 8.7 points. The mean value on the IKDC scale before surgery was 68.6 ± 8.7 %, after surgery it was 91.5 ± 8.2 %. KT-1000 – 3.4 ± 1.2 mm. Autograft rupture within 2 years after the surgery was detected in 3 out of 50 patients, which amounted to 6 %. Conclusion The results of the operations performed in the two groups can be assessed as good, no statistically significant differences were found, which indicates that the peroneus longus tendon autograft is an alternative option for primary ACL repair.

Composite materials with bioresorption properties are promising for use in traumatological and orthopedic practice as a material of various fixing implants for osteosynthesis and for replacement of bone defects. This article reviews the preparation methods, physicochemical and biological properties of biodegradable composites based on polyesters and calcium phosphate fillers, and the design and manufacture of implants based on these composites.

Fractures of bones of the forearm are the most frequent damage of the bones of the upper limb. A high percentage of unsatisfactory results of the treatment necessitates research on the development of effective methods of medical rehabilitation. Purpose. To evaluate the effectiveness of tape kinesiology and hand trainers in the medical rehabilitation of patients with fractures of the forearm bones. Material and methods. 68 patients (22 men and 46 women) aged of 19-85 years with isolated fractures of the forearm bones were examined. In 65 patients, bone osteosynthesis was performed, external fixation devices were used in 3 patients. All patients were divided into three groups. All patients were divided into three groups. The 21 cases from the control group received standard medical rehabilitation. In 23 patients from the comparison group the standard medical rehabilitation was supplemented by standard kinesiology with standard medical rehabilitation. In 24 patients from the main group hand trainers were used against the background of standard medical rehabilitation and kinesiology. The effectiveness of the treatment was assessed on the basis of the VAS scale, the DASH and SF-36 questionnaires, the Green and O’Brien scoring scheme. Results. The complex application of tape kinesiology and hand trainers in comparison with standard medical rehabilitation and the use of tape kinesiology allows increase the amplitude of movements by 29,1% and 11,0%, rotational movements by 24,11% and 9,12%, to improve the DASH 46,8% and 19,6%; reduce the severity of the pain syndrome by 45,5% and 22,7%, diminish the number of patients with edema by 1,8 and 1,5 times, respectively. In the long-term period surpasses the effectiveness of using kinesiotherapy by the amplitude of movement by 7,9%, rotational movements by 13,4%, DASH by 8,9%, and quality of life by 11,7%. Conclusion. The comprehensive application of tape kinesiology and hand trainers allows significantly reduce the severity of the pain syndrome, contributes both to the cupping of the edema and the most complete restoration of the functions of the wrist joint, as well to the improvement of the quality of life of patients.

The ongoing reform of the national health care impacted significantly on the health care financing system to the population. Especially these changes were reflected in the financing of public health organizations of the Federal Fund of CHI and from budgets of different levels. The article analyzed the financial aspects of providing public health care system in recent years and estimates prospects for the further reform of the Russian health care.

Study Design Comparison outcome treatment of pain syndromes in lumbar degenerative disk disease (DDD) in application two combined minimally invasive methods of treatment in intervertebral disk (IVD) herniations. Objectives To estimate and compare the treatment effectiveness of laser IVD vaporization in combination with dynamic stabilization by percutaneous interspinous implant In-Space. Background Data The method of laser vaporization is based on impact of laser radiation on IVD tissue. The impact of laser radiation impulse lead to the creation of vaporization defect of few square millimeter area and reduction of the intradiscal pressure. The reduction of pressure out of disk causing pain syndrome occurs indirectly. The reduction of disk volume and pressure in it can lead to instability in spinal motion segment and redistribution of loads to facet joints, accelerate development of spondyloarthrosis and lead to appearance of facet syndrom. Height reduction in the posterior column of the lumbar spine accelerate spinal canal stenosis. Pain syndrome recurrences more frequently occur in previous laser vaporization signs of segmental instability. Materials and Methods There were selected patients who were operated (71 females and 55 males) at the age of 28 to 46 with protrusions of IVD and presence of signs of spondyloarthrosis. There were two groups of patients: the first group consisted of 109 patients and underwent laser vaporization of IVD by laser Nd-YAG Dornier; the second group consisted of 17 patients with laser vaporization in combination with percutaneous interspinous stabilization by In-Space (Synthes) implant. In the first group, pathology located on the levels L3-L4 (18 cases), L4-L5 (52 cases) and L5-S1 (39 cases), in the second group on the levels L3-L4 (3 cases), L4-L5 (10 cases), and L5-S1 (4 cases). Relatively less quantity of patients with the level L5-S1 in the second group is caused by selection and limited opportunities of interspinous fixation on this level owing to anatomical peculiarity. Laser vaporization operation of IVD was performed under local anesthesia in the standard regime and takes 25 minutes in the average. The second stage in the second group to the interspinous space from lateral puncture was inserted interspinal stabilizer with 15 minutes duration under local or intravenous anesthesia. All manipulations were performed under X-ray control. Results As a result of treatment, it is managed to gain significant improvement quality of patients life estimated by ODI (23%, from 9.5 to 31%) in discharge for all patients. The results of treatment showed the outcomes as follows: in first group outcomes according to Mac Nab scale areexcellent 59 (54.1%) patients, good 42 (38.5%), satisfactory 8 (7.37%). According to Nurick scale, excellent 61 (64.3%) patients, improvement 19 (17.4%), without dynamic 17 (15.6%), worsening 3 (2.7%). Three patients in the postoperative follow-up had herniation recurrence. In the second group, outcomes according to Mac Nab are as follows: excellent 14 (82.3%), good 3 (17.7%). According to Nurick, excellent 12 (70.5%), improvement 5 (29.5%). Discussion The application of percutaneous dynamic interspinous stabilization in combination with laser vaporization of IVD allowed to improve treatment results of patients with lumbar DDD pain syndrome. The combination of these methods allow to decrease intradiscal pressure, to gain long-term deception of disk, reduction of disk protrusion, and to prevent or eliminate development of segmental instability. The installed implant extend interspinous space, perform expanding of ligaments and restoring foraminal height, reloading of facet joints and occurs restoration of congruence its articulation surfaces. Thus, it is restores natural topographic and anatomic relations in the spinal motion segment by saving its mobility which is confirmed by follow-up X-ray films and clinically neurological results in the long-term follow-up. Conclusion Performing percutaneous dynamic interspinous stabilization after laser vaporization of IVD is an effective method of treatment of pain syndrome in comparison with isolated application of laser vaporization. I confirm having declared any potential conflict of interest for all authors listed on this abstract Yes Disclosure of Interest None declared

The use of ultrasound (US) scanning to assess the muscular function during the reinnervation is a new concept in medicine. The US signs of muscle denervation were thoroughly described in the article. The US muscle monitoring was performed by the complete and partial radial nerve injury in various follow-up periods. Absolute and relative indications for surgery were determined. The comparative characteristics of structural muscular changes, together with the US test for the assessment of the treatment efficacy and nerval and muscular recovery were suggested.

Basic difficulties of the adequate and precise electrophysiological examination of radial nerve injuries are traditionally conditioned by the impossibility to separate the muscle, isolated from the muscles, innervated by the ulnar or medial nerves. The phenomenon of flexor motor units potentials propagation by the stimulating electroneuromyography and M-flow registration from extensor muscles has been described in literature. To prevent the false interpretation of the examination results, 98 patients with radial nerve injuries were examined using the original program of separate assessment of motor and sensor fibers.

The influence of different exposure regimes of low-intensity extremely high-frequency electromagnetic radiation on the growth rate of solid Ehrlich carcinoma in mice has been studied. It was shown that, at an optimum repetition factor of exposure (20 min daily for five consecutive days after the tumor inoculation), there is a clearly pronounced frequency dependence of the antitumor effect. The analysis of experimental data indicates that the mechanisms of antitumor effects of the radiation may be related to the modification of the immune status of the organism. The results obtained show that extremely high-frequency electromagnetic radiation at a proper selection of exposure regimes can result in distinct and stable antitumor effects.

Mossbauer spectroscopy analysis of the changes in a erythrocytes hemoglobin physical and chemical state in human blood as a result of low-intensity intravenous laser irradiation has been performed. This research has shown, that the method of an intravenous laser irradiation of blood is not structurally destructive for hemoglobin. The mechanism of the structurally-chemical transformations in hemoglobin as a result of such influence was discovered.

Using animal models of inflammatory processes, physical parameters and exposure regimens of extremely high-frequency electromagnetic radiation were optimized. High efficacy of the irradiation was shown when applied for treatment of local inflammatory processes, tumor growth and repair of skin injuries. The results obtained have underlain a development of prototype of extremely high-frequency generator for medical application.