Puzyrov I. The role of the breaches immunity in pathogenesis of gonarthrosis and forecasting of his current

The present thesis focuses on the state of immunological reactivity and non-specific resistance of the patients suffering from gonarthrosis. Its goal is to find mechanisms of immunological disorders in the pathogenesis of gonarthrosis, to elaborate immunological criteria of prognostication and to evaluate the degree of joint lesions. Techniques applied are clinical and X-ray as well as immunological, immunoenzymatic and statistical ones. The novelty of the study lies in defining the role of immunological disorders caused by severe mechanical trauma in the pathogenesis of gonarthrosis. The mechanism of using immunological disorders in the reaction of systematic inflammatory response of the body of the patients suffering from gonarthrosis has been determined. Consideration has been given to the immunity mechanism, changing in relation to the transformation of generative and distrophic process into inflammatory one in knee joints. The role of hyperactive state of immunological reactivity and cytokines hasbeen given special attention. Significance of more informative immunological indices as criteria of prognostication and the evaluation of severity of gonarthrosis have been proved. On the basis of the elaborated hyperactive mechanism of inflammatory affection of knee joints the use of immunomodulation which is aimed at eliminating disbalance between the quantity of lymphocytes and phagocytes (macro- and microphags), separate subpopulations of lymphocytes and also changes of cytokine ratio has been grounded. The results of the study have been applied in practice at Departments of Donetsk Regional Traumatological Hospital, in the Clinics of Traumatology and Orthopaedics at Donetsk State Medical University named after M.Gorky, at the Institute of Urgent and Restorative Surgery named after V.K.Gusak (the NAS of Ukraine). They have been applied in the course of lectures and practical classes at Donetsk and Lugansk State Medical Universities. Recommendations for the use of the results of the study at the Departments of Pathophysiology, Traumatology and Orthopaedics at medical institutions as well as in the treatment and diagnostics process at traumatological, orthopaedic and rheumatological departments are presented.