Pushkash I. Diagnosis of dysplastic syndrome sagittal deviation condyles of the femur

Object: dysplastic syndrome of sagittal deviation of the condyles of the femur. Objective: To increase the effectiveness of treatment of patients with dysplasia of the knee joint on the basis of clinical and radiological, morphological studies and mathematical modeling methods in the syndrome of the sagittal deviation of the condyles of the femur. Methods: clinical, histological, mathematical modeling using the finite element method, statistical. First radiometric, sonographic, MRI studies of the knee joints in patients with joints diseases caused by hereditary predisposition were performed that allowed us to obtain new data about the diagnosis of the knee joints diseases, particularly syndrome sagittal deviation of the condyles of the femur. First histological examination of the damaged meniscus in patients with dysplastic syndrome sagittal deviation femoral condyle was carried out. The new data on damages of the integrity of the collagen framework for different types of meniscal tears were obtained. Formation of a number of pathological disorders affecting not only the meniscus adjacent to the tear portions, but spaced from it was proved. For all types of meniscal tears adjacent to the site of injury collagen fibers were fragmented, with impaired macromolecular organization of collagen, changes of collagen types and chondroitinsulphates. The most expressed disturbances were shown in the case of degenerative meniscus tears and tears of "watering can handle." A mathematical model of the stress-strain state of the system "the knee - the femur - hip" was developed. The use of this system in the case of dysplastic syndrome of sagittal deviation allows to estimate the effect of the load leading to dystrophic changes in the meniscus. A strong correlation between the stress-strain state of the investigated biomechanical system and shape parameters of the femur at the knee joint was found. As a result of a comprehensive exam of patients with the syndrome of the sagittal deviation targeted concept based on the idea that changes in the menisci and articular cartilage caused by the load abnormality was created. First diagnostic criteria for patients with dysplastic syndrome of the sagittal deviation of femoral condyle which must be considered in clinical practice at the arthroplasty of knee and hip joints were developed. The diagnostic algorithm using informative clinical X-ray parameters, the application of which allows identify dysplastic syndrome of the sagittal deviation of the femur condyles was created. Based on the X-ray researches some diagnostic and prognostic criteria for patients with joints diseases were justified and developed. Radiometric data were introduced into clinical medicine and used to improve the efficiency of diagnosis of dysplastic changes in the knee joint. Results of the study are introduced into clinical practice in district hospitals in Vynohradiv, Tichev, Khust, Smoliv, Kovel MTMO, department of orthopaedics of the Transcarpathian regional clinical hospital named Novak, Municipal establishments "Rivne Regional Hospital" Rivne regional council, as well as in the educational process of the department of general surgery, traumatology and orthopedics, operative surgery and forensic medicine public higher education institution "Uzhgorod National University" of Ministry of Education and Science of Ukraine. Traumatology and orthopaedics.