Rybinskyi M. Complex treatment of patients with stage I-II gonarthrosis and local cartilage defects of the knee joints based on the use of – platelet-rich plasma. Experimental-clinical study.

Object: cartilaginous defects of the knee joint. Aim: to improve the results of treatment of patients with stage I-II gonarthrosis and local cartilaginous defects of the knee joints by applying intraarticular injections of autologous platelet-rich plasma. Methods: clinical, arthroscopic, X-ray, magnetic resonance imaging, experimental, statistical. For the first time in the experiment, the morphological changes in the process of restoration of the cartilage of the knee joint under the influence of intraarticular injections of the autologous platelet-rich plasma in the early postoperative period of bone-marrow stimulation were analyzed and evaluated, and its pronounced stimulating effect on damage to the subchondral plate was proved. For the first time the possibility of a complete restoration of articular cartilage with its local post-traumatic injuries in the experiment is reflected. On the basis of the performed analysis, the use of a modified histological scale for the evaluation of cartilage tissue regeneration was created and substantiated. The importance of MRI for the study of cartilage regeneration was first demonstrated and the necessity of not only conservative support, but also early non-invasive surgical treatment with local administration of platelet-rich plasma in patients with gonarthrosis stages I-II & with the presence of cartilage defects was proved. The histological scale offered by us allows us to quickly and clearly determine the regenerative potential of recovered cartilage tissue in experimental samples, which will allow it to be introduced into the practice of morphological examination of articular cartilage. For the first time, clinical evaluation of the use in patients with stage II gonarthrosis and local cartilage defects of the knee joint of autologous platelet-rich plasma in the early postoperative period of bone marrow stimulation was developed and performed. The proposed method for the use of platelet-rich plasma for local cartilage defects in the knee joint has proven to be effective and has allowed to improve the quality of patients' treatment, which is followed by the dynamics of pain indicators, symptoms, function and daily activities of the KOOS scale. The results of the study have been introduced into scientific work in National Pirogov Memorial Medical University (Vinnytsya), in the clinical practice of the Vinnytsya Regional Clinical Hospital of the Veterans of the War of the Vinnytsya Regional Council, the City Clinical Hospital of Emergency Medical Care of the Vinnytsya City Council, Vinnitsya Regional Clinical Hospital Named After N.I.Pirogov, Research Institute of Rehabilitation of the Disabled (educational scientific medical complex) of the National Pirogov Memorial Medical University (Vinnytsya). Тraumatology and Orthopaedics