Russian Scientific Research Institute of Traumatology and Orthopedics named after R.R. Vreden

The expert council evaluated the appropriateness of using a preparation containing a combination of B-group vitamins in the multimodal treatment of pain associated with osteoarthritis (OA). Theoretical rationale, clinical trial data, and meta-analyses support the consideration of high-dose B vitamin complexes as an effective component of combination therapy for musculoskeletal pain in OA.

Arthroscopic bone marrow stimulation (BMS) is widely used for treating small osteochondral lesions of the talus (OLT). Although its short-term efficacy is well-established, mid- and long-term outcomes remain ambiguous. This study evaluates the 5-year follow-up results of arthroscopic BMS with a focus on pain and functional recovery. We conducted a cohort study at a traumatology and orthopedic department on patients with OLT during 5-year follow-up period. Follow-up evaluations included magnetic resonance imaging (MRI) and computed tomography (CT) scans. Pain levels and functional outcomes were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) score and the Visual Analogue Scale (VAS) at one and five years postoperatively. The study was conducted retrospectively, follow-up time points were determined in accordance with the standard protocol adopted in the clinic. The mean AOFAS score significantly improved from 67.1 ± 9.4 preoperatively to 86.5 ± 12.5 at one year (p < 0.05) and remained consistent at five years (85.7 ± 11.2; p > 0.05). The VAS score showed a marked reduction from 6.4 ± 1.4 preoperatively to 1.6 ± 2.3 at one year (p < 0.05) and 1.9 ± 2.4 at five years (p > 0.05). CT scans confirmed a substantial decrease in lesion size postoperatively, with no significant changes between the one- and five-year evaluations. Arthroscopic BMS demonstrates sustained clinical benefits for OLT, providing significant pain relief and functional improvement over a mid-term period.Level of Evidence:4. The online version contains supplementary material available at 10.1007/s43465-025-01527-x.

Wound infection has a negative impact on the course of the wound healing process, slowing down tissue reparation, reducing the patient's quality of life, and increasing economic costs. Ineffective eradication of the pathogen can lead to chronic inflammation and expansion of the tissue damage area, therefore early detection and treatment of wound infection promotes faster healing, reducing the incidence of adverse effects. Aim. To evaluate the possibility of using the original polymer antimicrobial gel as part of a dressing and its effect on the healing of staphylococcal-infected wounds in vivo. Materials and methods. A polymer composition based on polyvinylpyrrolidone containing dioxidine and gentamicin (RU2822155C1) was applied to medical material. The obtained samples were lyophilized, sterilized, and their antibacterial activity against S. aureus ATCC 29213 was determined. The in vivo study was carried out on 12 rats, to which an infected skin defect was applied. The animals were taken out on the 3rd, 7th, and 10th days of the experiment; wound contamination was monitored, and tissue blocks were removed for histological examination. Results. The dressing with the original gel was characterized by the presence of significant antibacterial properties against S. aureus ATCC 29213, while the activity of the samples was preserved after lyophilization, sterilization, and storage for 1.5 years. During the in vivo experiment, the growth of S. aureus was not recorded in animals of the experimental group as soon as on the third day from the start of the experiment, while in animals of the control group, S. aureus was isolated at all observation periods. Morphological examination showed acceleration of wound cleansing, relief of purulent inflammation, as well as an earlier onset of reparation processes in the wounds of animals of the experimental group. Conclusion. The effectiveness of the developed antimicrobial wound dressings in stopping the acute staphylococcal infectious process, taking into account the traumatization of the wound surface and good biocompatibility, allow us to consider promising further studies of the possibilities of using the studied materials in the treatment of acute infectious process, as well as in the treatment of chronic wounds.

Body temperature is one of the key indicators for diagnosing a variety of surgical and trauma-related conditions. Infrared thermography is one of the most relevant and widely used methods in modern clinical practice. This technique has not yet received general acceptance, and its use is currently underrepresented in the scientific community. The aim of this study was to analyze existing data on the practical significance and role of medical thermography in diagnosing and predicting postoperative complications in trauma patients. An analysis of both Russian and international publications was conducted to explore the potential and future prospects of medical thermography in current trauma practice. In orthopedic and trauma practice, infrared thermography is more commonly used to diagnose chronic musculoskeletal conditions such as scoliosis, osteoporosis, and osteochondrosis. In acute traumatic injuries, it is more commonly used for intraoperative and postoperative monitoring to prevent complications or enable their early detection, as treatment outcomes largely depend on timely and adequate diagnosis and identification of the primary injury. Opinions within the scientific community on the use of medical thermography remain divided. On the one hand, the vast majority of researchers studying the potential of medical thermography consider it a valuable supplement to conventional imaging methods. However, despite its numerous advantages and significant application potential, the technique has yet to be widely adopted. Infrared thermography is a promising diagnostic tool in modern medicine, especially in traumatology. Conducting more studies to explore its capabilities could help raise awareness and promote its integration into trauma care practice.

Hyaline cartilage (HC) is a specialized connective tissue that covers the surfaces of major joints and is characterized by its limited regenerative capacity. Modern therapeutic approaches to HC restoration often do not provide complete regeneration of damaged tissue. Developed tissue engineering methods show promise as effective approaches for restoring various types of HC damage. Due to the rapid evolution of various technologies in research practice, the range of methods available for analysis of TE constructs has expanded, including for the study of tissue engineering of hyaline cartilage (TEHC). Because of the complexity of the HC’s structure, a whole range of methods is needed to assess characteristics of the scaffold, such as structure and strength. It is also important to study the behavior of cells inside the TE construct at all stages of cultivation, including post transplantation into the damaged area. The opacity of the scaffold and the complexity of its architecture often cause issues with the cell visualization and assessment of their viability. Therefore, there is a need to optimize each specific method for each specific scaffold. Despite the active study of TEHC, the results remain unsatisfactory. In this study, we have systematized data on the effectiveness and feasibility of methods to analyze structure, mechanical characteristics, cell interaction with the scaffold, and their ability to form new tissue before and after transplantation.

Background. Replacement of bone defects in the surgical treatment of chronic osteomyelitis is a key step to prevent recurrence of infection and potential fractures at the site of rehabilitation. Bone cement, biodegradable synthetic materials, as well as autologous, allogeneic, and xenogeneic bone tissue have become widespread in surgical practice. Giving these materials antibacterial properties will expand their use in the treatment of bone and joint infections, shorten the treatment time, and improve the patients’ quality of life. The aim of the study — to analyze the mid-term results of the second stage of surgical treatment for chronic osteomyelitis in long bones, depending on the type of used vancomycin-impregnated bone graft material: an original biodegradable mineralized material based on allogeneic bone or a commercially available biocomposite material consisting of β-tricalcium phosphate and hydroxyapatite. Methods. The study included 25 patients who underwent the second stage of surgical treatment for chronic osteomyelitis. After removal of the cement spacer, the defect was replaced in Group 1 (n = 14) with a biocomposite material ReproBone® Granules with the addition of vancomycin, while in Group 2 (n = 11) — with an original mineralized allograft impregnated with vancomycin. Laboratory tests, vancomycin concentration in the drainage fluid, and the presence of infection recurrence within 1-3 years after surgery were evaluated. Results. The groups did not differ in gender, age, and duration of the disease. The volume of the cavity defect was significantly higher in Group 2 (50 ml vs 14 ml; p = 0.0004). The vancomycin concentration in the drainage fluid from the first day after surgery in Group 2 was more than 10 times higher than in Group 1 (p = 0.0300) and remained at a high level until the 5th day. Osteomyelitis recurrence was observed in 14% of patients in Group 1 and was absent in Group 2. Conclusions. Standard approach to the treatment of chronic osteomyelitis using antimicrobial spacers does not ensure complete eradication of microbial pathogens that continue to persist in bone tissue. The original biodegradable mineralized bone graft material based on allogeneic bone creates significantly higher local vancomycin concentrations and demonstrates clinical efficacy in all applications.

BackgroundAngiogenesis and osteogenesis are closely interrelated. The interaction between endothelial and bone-forming cells, such as osteoblasts, is crucial for normal bone development and repair. Juxtacrine and paracrine mechanisms play key roles in cell differentiation towards the osteogenic direction, assuming the direct effect of endothelium on osteogenic differentiation. However, the mechanisms of this interplay have yet to be thoroughly studied.MethodsIsolated endothelial cells (EC) from human umbilical vein and human osteoblasts (OB) from the epiphysis of the femur or tibia were cultured in direct and indirect (separated by membrane) contact in vitro under the osteogenic differentiation conditions. Osteogenic differentiation was verified by RT-PCR, and alizarin red staining. Shotgun proteomics and RNA-sequencing were used to compare both EC and OB under different co-culture conditions to assess the mechanisms of EC-OB interplay. To verify the role of Notch signaling, experiments with Notch modulation in EC were performed by EC lentiviral transduction with further co-cultivation with OB. Additionally, the effect of Notch modulation in EC was assessed by RNA-sequencing.ResultsEC have opposite effects on osteogenic differentiation depending on the co-culture conditions with OB. In direct contact, EC enhance osteogenic differentiation, but in indirect cultures, EC suppress it. Our proteotranscriptomic analysis revealed that the osteosuppressive effect is related to the action of paracrine factors secreted by EC, while the osteoinductive properties of EC are mediated by the Notch signaling pathway, which can be activated only upon a physical contact of EC with OB. Indeed, in the direct co-culture, the knockdown of Notch1 and Notch3 receptors in EC has an inhibitory effect on the OB osteogenic differentiation, whereas activation of Notch by intracellular domain of either Notch1 or Notch3 in EC has an inductive effect on the OB osteogenic differentiation.ConclusionThe data indicate the dual role of the endothelium in regulating osteogenic differentiation and highlight the unique role of the Notch signaling pathway in inducing osteogenic differentiation during cell-to-cell interactions. The findings of the study emphasize the importance of intercellular communication in the regulation of osteoblast differentiation during bone development and maintenance.Graphical