RESUMEN
Experiments were carried out on 22 albino male Wistar rats to study the morphological peculiarities of osseointegration of titanium grafts with bioactive surface stimulated additionally with bone plastic material "Gamalant-paste-FORTE Plus" containing recombinant human bone morphogenetic protein-2 (rhBMP-2). In 9 rats the implants were placed into femoral bones after local treatment of bone canal with rhBMP-2-containing material. Another 9 animals were implanted but received no treatment, 4 rats formed the group of intact control. Zone of osseointegration was studied 4, 8 and 12 weeks after graft placement using histological and morphometric methods as well as immune histochemistry to demonstrate osteonectin, CD68, MMP-9, and TIMP-1. The study showed that preliminary treatment of bone canal with rhBMP-2-containing material preceding implant placement was accompanied by an additional osteoinductive effect. More intense and outrunning bone formation in the area of osseointegration was observed, together with remodeling and compaction of the contiguous cancellous bone, thus providing the necessary balance between MMP-9 and TIMP-1 with a high level of each factor expression.
Asunto(s)
Proteína Morfogenética Ósea 2/farmacología , Colágeno/farmacología , Hidroxiapatitas/farmacología , Implantes Experimentales , Oseointegración/efectos de los fármacos , Inhibidor Tisular de Metaloproteinasa-1/farmacología , Titanio , Animales , Humanos , Masculino , Ratas , Ratas Wistar , Proteínas Recombinantes/farmacologíaRESUMEN
An analysis of results of treatment of 38 patients with 40 degenerative injuries of the knee joint by arthroscopic arthroplasty shows clinical effectiveness of this method only in cases with light and medium degrees of gravity of the disease. The absence of clinical effects of the complex conservative treatment of patients with osteochondrosis and persistent painful syndrome, mechanical symptoms of disturbances in the joint, recurring synovitis can be considered as indications for arthroscopic operations. The probability of achievement of positive results of arthroscopic treatment is higher in patients with the I-III degrees of injuries of the cartilage and IV degree--with a full thickness defect of the articulation surface as big as 1 cm in diameter in one part of the knee joint and on one of the joining condyles.
Asunto(s)
Artroplastia , Artroscopía , Articulación de la Rodilla/cirugía , Osteocondritis/cirugía , Sinovitis/cirugía , Adulto , Anciano , Cartílago Articular/patología , Cartílago Articular/cirugía , Estudios de Seguimiento , Humanos , Articulación de la Rodilla/patología , Persona de Mediana Edad , Osteocondritis/patología , Recurrencia , Sinovitis/patología , Factores de TiempoRESUMEN
The role of the anterior cruciate ligament is considered in this work from the standpoints of anatomy and biomechanics. The authors are supporters of early and active operative management of acute injuries of the ligament and chronic instability of the knee joint. To improve early diagnostics of injuries of the anterior cruciate ligament the positional anterior drawer test was developed. Positive results of this test were compared with those of well-known tests for the insufficiency of the anterior cruciate ligament and it was recommended for diagnosing the anterior instability of the knee joint.