Pustovoit K. Role of dysplastic deformities of the knee osseous components in gonarthrosis formation, prognosis of its development.

Object: dysplastic deformities of the knee joint osseous components, dysplastic syndromes and gonarthrosis. Purpose: to ground the role of dysplastic deformities of the osseous components (especially distal femoral) in gonarthrosis development and elaborate its prognostic model. Methods: conceptual modeling, graphoanalytical and mathematical modeling, radiometric and statistic methods. Conceptual model of arthrotic changes in joint connected with structural changes resulting from altered stress according to moderate and instant scenarios has been designed and grounded for the first time. Mathematical models of knee joint (at flection and extension) under dysplastic deformities of the knee joint osseous components in face (forward) and profile (side) projections have been designed for the first time and stressed dynamic characteristics of knee osseous models have been presented with the mathematical odds. New knowledge on internal tensions distribution in the knee joint at flexion and extension at dysplastic deformities has been obtained. First retrospective radiometric analysis of knee osseous deformities at different dysplastic syndromes has been carried out in the patients of different age at all stages of gonarthrosis development. A new radiometric diagnostic criterion has been developed - a knee joint pathology index (patent for a useful model of Ukraine № 70946), which joins parameters concerning highness of patella elevation and shape of femoral processes. For the first time characteristics of knee dysplastic deformities in the patients of different age at all stages of gonarthrosis have been obtained with the elaborated radiometric diagnostic criteria and results of their analysis. New knowledge about anatomic structure peculiarities of the knee, namely, mathematical dependence of arthrosis stage on anatomic parameters of the knee joint has been revealed. The role of each knee osseous structure in dysplastic gonarthrosis formation has been determined that facilitates diagnostic search of this pathology in different age groups at all stages of gonarthrosis. The developed mathematical models of the knee joint (at flextion and extension) in sagittal and frontal images with different shapes of femoral processus and different highness of patella elevation may be used or added in the further research of the stressedly-deformed state of the knee joint. Application of radiometric parameters of the knee and prognostic model of dysplastic gonarthrosis diagnosis will improve diagnosis, timely treatment and its early prevention with general preciseness to predict arthrosis stage about 97 %. Application of the pathology index in radiodiagnosis of dysplastic knee deformities allows to choose right planning tactics for such surgical treatment. The results of the research have been introduced into clinical practice of SE "Sytenko Institute of Spine and Joint Pathology, AMS of Ukraine", CHCE "Kharkiv Regional Clinical Traumatology Hospital" and into the academic process of Traumatology and Orthopedics department of Kharkiv Medical Academy of Postgraduate Education, Ministry of Health of Ukraine. Traumatology and Orthopedics.