In the dissertation work on the results of complex research the actual problem of
orthopedics is solved. The study was based on examination and treatment of 134 patients aged 42 to 80 years (mean age 57.5 ± 1.7 years), of whom men - 53, women - 81.
Objective topographic and anatomical characteristics of the cartilage defect and adequate
choice of personalized surgical treatment provides a comprehensive radiographic, CT, MRI,
arthroscopic examination. To increase the informativeness of the MRI study, color mapping of
the obtained tomograms of the knee joint (CS) was used, which allowed to detail the fine
structure of cartilage and its post-traumatic defects. Note that the cartilage defect (DC) is not
always detected by X-ray examination of the CS, even in 5 projections.
Arthroscopic debridement as an independent method of treatment was performed in 32
patients (1 group). In 28 patients (group 2) he was followed by bone marrow stimulation by
microfractures, which were performed with an awl in a spiral to the center of the DH. Bone
and cartilage autotransplantation was performed in 34 patients (group 3). In 40 patients (group
4) after arthroscopic debridement performed mini-arthroplasty DH with a metal implant
developed in accordance with the study of CS simulation of the kinematic chain "femur - miniimplant - tibia". Arthroscopic approaches were used: lower anterior-medial and anterior-lateral,
medial and lateral parapatellar.
In all 134 patients before surgery, as well as 1 - 1.5 months, 3 months, 6 months and 12
months after arthroscopic interventions studied the biochemical parameters of blood serum:
inorganic phosphorus, alkaline phosphatase, total and ionized calcium, interleukins 1L - 1B,
1L - 6, 1L - 1RA.
The use of arthroscopic debridement, bone marrow stimulation (microfractures), bone
and cartilage autotransplantation and mini-endoprosthetics (microendo-filling) in the treatment
of post-traumatic defects of articular cartilage and CS does not cause significant ).
Proven informativeness of the scale of MRI-assessment of joint surface injury repair
according to MOCART (2007). For clinically informative MRI monitoring of repair of joint
surface damage, it is advisable to use the Jones C.W. et.al. (2007).
After 12 months of treatment, the following results were obtained (score on the
LISHOLM scale) for arthroscopic debridement: excellent - 15.00% of observations, good -
50.00% of observations, satisfactory - 15.63%, unsatisfactory - 9.37%; with bone marrow
stimulation (microfractures) - 59.68%, 25.81%, 8.06%, and 6.45%, respectively, with bone and
cartilage autotransplantation - 29.4%, 38.2%, 11.8%, 20.6%, with mini-endoprosthesis -
55.00%, 30.00%, 10.00% and 5.00% respectively.
