Year 2012 Vol. 20 No 2

TRAUMATOLOGY AND ORTHOPEDICS

S.V. BLINOV 1, S.N. KOLESOV 2, M.N. KUDYKIN 1, E.E. MALYSHEV 2, N.L. MURAVINA 2, E.S. MALYSHEV 1

EARLY DIAGNOSTICS OF POSTTRAUMATIC KNEE JOINT OSTEOARTHRITIS AFTER OPERATIVE TREATMENT OF FRACTURES OF THE TIBIA CONDYLES

SBEE HPE “Nizhny Novgorod State Medical Academy” 1,
FBSE “Nizhny Novgorod research institute of traumatology and orthopedics” 2,
The Russian Federation

Objectives. To design the method of early diagnostics of the knee joint posttraumatic osteoarthritis based on radiothermometry application.
Methods. Knee joint radiothermometry was applied in 34 patients in the postoperative period at the fractures of the tibia condyles. The research was conducted starting with the 8th week after the operative treatment and every 4 weeks in terms up to 6 months. Control temperature measuring was carried out 1 year afterwards. Control group included 36 healthy volunteers in whom there were no injures, diseases and operations in the knee joint regions in the anamnesis.
Results. While studying temperature readings in dynamics, one revealed statistically significant differences in the temperature reaction of the tissues in patients with a normal course of processes of the bone tissue consolidation and pathological reactions linked with the posttraumatic osteoarthritis development. Tendency to the gradual temperature reduction on the side of the injury in all sections is observed in case of a normal course. In case of the posttraumatic osteoarthritis development the temperature in all sections of the injured joint tends to reduce only in the early period of observation. Temperature increase is further observed which remains up to the end of the period of observation, despite the temperature of the uninjured joint increases in comparison with the control group. One year after the operative intervention the development of the postoperative osteoarthritis was observed in 5 patients making up 14,7%. On studying temperature reaction of the tissues, thermoasymmetry was registered in them due to high temperature readings on the side of the injury in all sections of the knee joint including the projection points of the joint split. Several variants of relationship of the tissue temperature reactions in dynamics characterizing the postoperative osteoarthritis development were revealed.
Conclusions. The suggested method provides an additional diagnostic criterion which permits to assume the development of the postoperative osteoarthritis at the before X-ray stage of the disease.

Keywords: knee joint, condyle fracture, osteoarthritis, radiothermometry, thermoasymmetry, abyssal temperature
p. 64 – 73 of the original issue
References

1. Kallaev NO, Zubov VV, Kallaev TN. Operativnoe lechenie vnutrisustavnykh perelomov kolennogo sustava [Operative treatment of the intraarticular fractures of knee joint]. Vestn Travmatol i Ortopedii im NÈ Priorova. 2006;(3):47–51.
2. Putiatov SM, Shestakov DIu, Golubev VG. Lechenie perelomov plato bol'shebertsovoi kosti metodom chreskostnogo osteosinteza po Ilizarovu [Treatment of tibial plateau fractures by transosseous osteosynthesis (Ilizarov technique)]. Vestn Travmatol i Ortopedii im NI Priorova. 2002;(4):17–23.
3. Gilev IaKh, Pronskikh AA, Miliukov AIu. Sovremennye tekhnologii lecheniia perelomov kolennogo sustava [Current therapeutic technologies of knee fractures]. Politravma. 2007;(2):28–34
4. Manek NJ, Lane NE. Osteoarthritis: current concepts in diagnosis and management. Am Fam Physician. 2000 Mar 15;61(6):1795–804.
5. Kosinskaia NS. Degenerativno-distroficheskie porazheniia kostno-sustavnogo apparata [Degenerative and dystrophic lesions of the locomotor apparatus]. Leningrad, RF: Medgiz; 1961. 196 p.
6. Kellgren JH, Lawrence JS, Radiological assessment of osteoarthrosis. Ann Rheum Dis. 1957 Dec;16(4):494–502.
7. Hinton R, Moody RL, Davis AW, Thomas SF. Osteoarthritis: Diagnosis and Therapeutic Considerations. Am Fam Physician. 2002 Mar 1;65(5):841–48.
8. Zabavskaia O, Agabalaeva A, Akhmedzhanov F, Sakharova O, Malygina M, Kliukvin I. Vozmozhnosti MRT v diagnostike povrezhdenii khriashcha i miagkikh tkanei kolennogo sustava [MRI capabilities in the diagnosis of cartilage and soft-tissue knee injuries]. Vrach. 2009;(2):75–78.
9. von Engelhardt LV, Kraft CN, Pennekamp PH, Schild HH, Schmitz A, von Falkenhausen M. The evaluation of articular cartilage lesions of the knee with a 3-tesla magnet. Arthroscopy. 2007 May;23(5):496–502.
10. Rakhmilevich AB, Chantsev AV, Raspopova EA. Vozmozhnosti artrofonografii v diagnostike i kontrole lecheniia rannikh stadii osteoartroza [Arthrophonography in the diagnosis and monitoring of early stages of osteoarthritis treatment]. Vrach-aspirant. 2010;43(6):45–49.
11. Kanakov VA, Kisliakov AG, Peliushenko S.A. Kontaktnaia radiotermometriia millimetrovogo diapazona dlin voln [Contact radiothermometry of millimeter wave]. Teplovidenie v Meditsine, Promyshlennosti i Ekologii: tez dokl konf. «TeMP 96» v ramkakh Mezhdunar konf. «Prikladnaia optika – 96». Saint-Petersburg, RF; 1996. p. 26–28
12. Kolesov SN, Volovik MG, Priluchnyi MA. Meditsinskoe teploradiovidenie: sovremennyi metodologicheskii podkhod: monografiia [Medical thermoradiovision: contemporary methodological approach. Nizhny Novgorod, RF: FGU NNIITO Rosmedtekhnologii; 2008. 184 p.

Address for correspondence:
603001, Rossiiskaia Federatsiia, g. Nizhnii Novgorod, ul. Nizhne-Volzhskaia nab. 1/1, GBOU VPO Nizhegorodskaia gosudarstvennaia meditsinskaia akademiia”, kafedra khirurgii FPKV (kurs travmatologii i ortopedii),
e-mail: serg512@bk.ru,
Blinov Sergei Valer'evich
Information about the authors:
Blinov S., an assistant of the surgery chair of the specialists retraining faculty (the course of traumatology and orthopedics) of SBEE HPE "Nizhny Novgorod State Medical Academy."
Kolesov S.N., doctor of medical sciences, professor, a leading researcher, a head of the heat-radiovision group of FSBE "Nizhny Novgorod institute of traumatology and orthopedics."
Kudykin M.N., doctor of medical sciences, an assistant of the surgery chair of the specialists retraining faculty of SBEE HPE "Nizhny Novgorod State Medical Academy."
Malyshev E.E., candidate of medical sciences, associate professor of the traumatology, orthopedics and field surgery named after M.V.Kolokoltsev of SBEE HPE "Nizhny Novgorod State Medical Academy."
Muravina N.L., doctor of functional diagnostics of department the heatradiovision of FSBE "Nizhny Novgorod Institute of traumatology and orthopedics."
Malyshev E.S., doctor of medical sciences, professor of the surgery chair of the specialists retraining faculty (the course of traumatology and orthopedics) of SBEE HPE "Nizhny Novgorod State Medical Academy."
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