Bolhovitin P. The reconstruction of cruciate ligaments in the system of surgical treatment of knee instability

Українська версія

Thesis for the degree of Candidate of Sciences (CSc)

State registration number

0405U002242

Applicant for

Specialization

  • 14.01.21 - Травматологія та ортопедія

13-05-2005

Specialized Academic Board

Д64.607.01

Essay

3. The object of research – unstable knee of human being. The purpose – to build an informational-conceptual model “restoration of cruciate ligaments”; create on its base new methods of the plasty of cruciate ligaments with their following approbation and clinical implementation with the examples of different kinds of knee instability. Methods – theoretical methods of research – system ap-proach as a methodology of scientific perception and con-ceptual modeling as a way of realization of system concep-tions; empirical investigation (technical realization of new conception, clinical observations) are used as the verifiers; clinical, rontgenological and informational methods; the results of treatment are studied by means of questionnaire testing with following statistical treatment of obtained re-sults. Novelty – the systematic informational-conceptual model of the restoration of cruciate ligaments was built, it brings new quality in the imagination of this pathology and it is a base for further investigation; the concept of double-shred plastic reconstruction of cruciate ligaments was for-mulated and theoretically substantiated; the principle of variable tension of grafts bundles of cruciate ligaments was substantiated and verified, it provides optimal conditions for their function. The principle of variable tension of ligaments bundles took on special significance and new meaning, due to the sequence of tension that did not took into considera-tion earlier; methodological and technological basis for the restoration of cruciate ligaments in the conditions of unsta-ble knee was worked out. New findings, which were ob-tained, can be characterized as a new knowledge about known event, as a definite stage of cognitive activity. Results – new, biomechanically substantiated methods of double-shred plastic reconstruction of cruciate ligaments, combined with the principle of sequence of bundles tension offered by author, substantially improved the results of surgical treat-ment of patients with chronicle knee instability, resulted in shortening of treatment terms, improvement of its results and decreasing of victims’ disability. New principle of au-thor, as a new knowledge about double-shred plastic recon-struction of cruciate ligaments taking into consideration individual peculiarities of their formation (depending upon the peculiarities of damages and instability) has different functions, inherent in new knowledge, namely: informa-tional – new concept about the peculiarities of the restora-tion of cruciate ligaments in different clinical conditions was obtained; descriptive – the peculiarities of different types of plastic restoration of cruciate ligaments were described, anatomy-functional criteria of the fixation of plastic material and methods of grafts forming (tension) were presented; forecasting – causes of possible complications were revealed, it allows to forecast the results of treatment; design – theo-retical summarizing, which was obtained, gave grounds for the working out of two new methods of surgical operations; applied – new methods of the restoration of cruciate liga-ments were worked out and used on the basis of new concep-tion, it allows to improve the quality of treatment of patients with knee instability, obtain more favorable outcomes, de-crease the risk of intraoperative and postoperative complica-tions, reduce the probability of postoperative recurrence of knee instability. The methods of surgical operations that were offered can be widely used in practical health service. The results were applied in clinical practice at Sytenko Insti-tute of Spine and Joint Pathology AMS of Ukraine, city clinical hospital #11 in Odessa, road clinical hospital in Kharkov, central district hospital in Balakleya of Kharkov area, into educational course of chair of traumatology, or-thopedics and combustiology of Kharkov Medial Academy of Postgraduate Education. Traumatology and orthopedics.

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