In experiments on Wistar rats, a simulated defect in the flat bones of the skull was filled with a collagen sponge of animal origin impregnated with BMP-2 or pure sponge; in control rats, the defect was left open. During follow-up, X-ray density of the collagen sponge in the experimental groups differed significantly. The results attest to the absence of spontaneous remodeling of the bone tissue under conditions modeled focal defect. Moreover, stimulation of reparative processes by the collagen matrix did not lead to positive dynamics. Saturation of the collagen sponge with BMP-2 in a concentration of 0.05 mg/ml allowed increasing Xray density of the bone starting from week 4.

The analysis of literature on treatment of chronic instability of the shoulder joint shows that results of treatment are not always satisfactory, and the subject has been studied insufficiently. The volume of diagnostics does not include the actions directed to studying of condition of the capsule of the shoulder joint. In our opinion, the lack of information on condition can be one of the reasons of unsatisfactory results as it does not allow planning the actions directed to improvement of condition of the capsule of the shoulder joint in the preoperative period. In this connection, we made the decision to survey the joint capsule by means of ultrasonic diagnostics. Objective – to estimate and define the dependence of condition of the capsule in surgical treatment of chronic instability of the shoulder joint. Patients and methods . The retrospective analysis included 37 patients with chronic instability of the shoulder joint treated with various joint plasty techniques, without presurgical ultrasonic examination of the shoulder joint. Also the results of presurgical diagnostics with inclusion of ultrasonic sonography and treatment of 22 patients with such pathology of the upper extremity were analyzed. Results. Some cases of chronic instability of the shoulder joint are related to thinning of its capsule. After diagnosis of the capsule thinning, we carried out its strengthening according to our original technique. Conclusion. The high relevance of the problem of chronic instability of the shoulder joint is an incentive to further studying of the reasons of its emergence, and existence of the diagnosed thinning of the capsule is the indication to its strengthening.

Supramolecular structure formation of poly(3-hydroxybutyrate) ultrathin fibers prepared by electrospinning and the influence of low concentrations of silicon and TiO2 nanoparticles on the structure, physicomechanical and sorption properties, and resistance to thermal destruction and thermoand photo-oxidative destruction of non-woven fibrous material based on these fibers were studied. It was found that nanoparticles promoted the formation of thinner fibers with enhanced physicomechanical parameters and a structure that was more resistant to thermal and thermo- and photo-oxidative destruction and had a positive effect on the growth dynamics of mesenchymal stem cells.

Creation of implants for the restoration of ligaments and tendons in their complete/massive injury is an urgent task. The efficacy of the restoration of completely resected Achilles tendons after implantation of a new material consisting of absorbable pledged threads Dar-Vin USP 5/0 and conductive nonofibrous scaffolds of polyhydroxybutyrate placed around the threads into the zone of defect was studied in Wistar rats. Either nanofibrous implant (experiment) or pledged threads (control 1) were placed into the zone of completely resected Achilles tendon (control 1), or the postresection wound was sutured without placement of any material (control 2). It was stated that from 2nd to 13th week after implantation of nanofibrous implant the animals from the experimental group used their hind paws in full volume. In control groups 1 and 2 the animals moved with difficulties. In the experimental group of animals in 6 and 13 weeks after implantation a soft tissue regenerate connecting the calcanean tuber and gastrocnemius muscle was present with the absence of gastrocnemius muscle contracture as compared with the control groups. Histologic examination showed the similarity of the regenerate on nanofibrous implant with the native Achilles tendon. Thus, the suggested implant ensured functional and morphologic restoration of totally resected Achilles tendon in rats and can be considered as a perspective prototype of new materials initiating effective regeneration of ligaments and tendons in their massive injuries.

Значительное количество последствий заболеваний или несчастных случаев, приводящих к повреждению костной системы, требуют обязательного восстановления ее целостности.Для восполнения дефектов наряду с металлоконструкциями наиболее оптимальными костнозамещающими субстанциями являются различные пластические материалы.К настоящему времени в течение последних 17 лет удачным, эффективным костнопластическим материа-лом зарекомендовали себя деминерализованные костные аллоимплантаты (ДКИ), технология изготовления которых включает в себя процессы деминерализации, лиофилизации и радиационной стерилизации дозой поглощения 20-25 кГр.Более 10 лет выпускаются ДКИ на основе донорских тканей -костей свода черепа.Данный материал нашел свое применение при проведении ревизионного эндопротезирования тазобедренного сустава, осложненного разрушением вертлужной впадины, хирургии позвоночника и дефектов костей лицевого черепа.Перспективным и эффективным материалом оказались лиофилизированные губчатые аллоимплантаты, которые могут быть деминерализованными или нет, в виде блоков.Кроме блоков в качестве носителя применяются костные чипсы.Что касается научно-практических перспектив, то в «тканевом банке ЦИТО» начаты исследования по созданию семейства биокомпозиционных костнопластических материалов, в состав которых войдут рекомбинантные костные морфогенетические белки, антиоксиданты, антибиотики и т

The authors offer an original method of treatment for the progressive form of initial stage of idiopathic posttraumatic coxarthrosis and avascular necrosis of the femoral head by means of double minimally invasive proximal femoral osteotomy and revascularization. 349 patients with incipient coxarthrosis were examined. At the comparative analysis of the results of treatment the following data is obtained. In check group unsatisfactory results at the conservative treatment in 3–4 years are received in 39–86 % of cases. In main group at the surgical treatment unsatisfactory results are received only in 6,5–9,6 % of cases. Therefore use of the offered method of treatment allows to stop processes of destruction of the joint for a long time in young and middle age and to postpone an expensive surgery at this age like total endoprosthesis replacement. Minimally invasive technique of proximal femoral osteotomy and revascularization also gives an excellent cosmetic result.

Over the period from 1997 to 2006, 580 patients (14 to 45 years old) with back pain and gonalgia complaints were examined, including 292 female and 288 male patients. Hip joint pathologies in the so-called incipient stage were found in 192 (33,7%) patients, with progressive disease being detected in 128 (66,3%) cases. When choosing a medical examination plan it is very important to take into consideration the patient’s complaints, his/her occupation, case record, sex, age and genetic predisposition. It is also important to check whether the patient received conservative treatment and what was the treatment response. Radiation examination includes X-ray of joints, MRI and computer-assisted tomography. A comprehensive and consistent examination of patients allows diagnosing progressive coxarthrosis at an early stage.

In treatment of 88 patients with different posttraumatic abnormalities of osseous regeneration autotransplantation of marrow in conjunction with crystalline chymotrypsin dissolved in was applied. Analysis of results showed effectiveness of proposed method in delayed union by 100% cases, in ununited fractures by 91,7%, in hypertrophic pseudoartrosis by 91.7%, in hypotrophic pseudoartrosis by 76,6%, and in pseudoartrosis in combination with marginal bone defect by 66,7%. Rigid fixation of fragments is indispensable condition of beneficial effects achievement.

Modern technology of total hip replacement in case fractures of proximal parts of hip (femur) which detected at senile age, fulfilled in 420 cases with minimum share of complications. This technology gives highly favorable results, allows to restore painless movements and supporting functions of lower extremities and ensure possibility of self attendance.