Osadchuk T. Corrective osteotomy in the surgical treatment of patients with osteoarthritis of the knee

The dissertation is devoted to improve the effectiveness of surgical treatment of patients with osteoarthrosis of the knee joint. The paper based on a comprehensive survey of 118 patients with osteoarthritis of the knee joint and presents a differentiated approach to the selection of optimal methods of surgical interventions and developed clinical ? diagnostic algorithm of patients. The features of metabolic disorders articular cartilage depending on the stage of disease were indicated. Biochemical markers of progression of osteoarthrosis are the increase the concentration of glucose-amino-glycans and growth of content of free hydroxyproline accompanied by increased activity of collagenasum. There was defined the dynamics of gait biomechanics in patients with osteoarthritis of the knee joint. Characteristic biomechanical properties of gonarthrosis is to reduce the resistance of the front shock, increase power characteristics of midshock period and increase the reference time of the affected limb compared with the normal and with intact limb. The features of osteoarthrosis of the knee joint in patients with structural and functional disorders of the bone tissue were identified. The severity of gonyarthrosis is backward proportional to densitometric parameters Stiffness, T-score and Z-score, reducing the values of these indexes are reliable when disease switches from the second to the third stages. The most informative parameter that reflects the severity of osteoarthrosis is the densitometric index of stiffness. There was developed the clinical ? diagnostic algorithm of surgical treatment of osteoarthritis of the knee joint, the criteria and system prediction of clinical course of gonarthrosis providing a differentiated approach to treatment, to determine the optimal method of surgical intervention of patients with knee osteoarthritis particularly in the later stages of the disease. Results of surgical treatment, traced in terms of 2 to 10 years (average 4,3 ± 2,6 years). Good results were obtained in 59 patients (55.14%), satisfactory ? in 47 patients (43.92%), and unsatisfactory ? in 1 (0.93%).