Introduction The use of ceramic materials is a promising approach to bone defect repair. Various orthobiological agents are used to improve their properties and enhance their regenerative potential. The aim of this study was to determine the efficacy of platelet-rich plasma in repairing bone defects with yttria-doped zirconia ceramic implants. Materials and Methods Bioceramic samples were zirconium dioxide. The ceramic implants measured 0.15 × 0.15 × 1.00 cm. Male Chinchilla rabbits were used in the experiment: Group 1 ( n = 10) included animals that underwent bilateral metaphyseal bone defect filling with implantation of ceramic augments; Group 2 ( n = 10) included animals that underwent bone defect repair without implantation. Platelet-rich plasma (PRP) was injected into the bone defect in the right femur of rabbits in both groups; PRP was not injected into the defect in the left femur. Blood samples were collected preoperatively and at the end of the experiment, four and eight weeks after surgery. Key blood parameters, including C-reactive protein, and platelet-derived growth factor (PDGF) in PRP were determined. To assess the effect of PRP on the dynamics of osteogenesis, a comparative histological analysis of the tissue structure in the simulated bone defect area was conducted. Results No significant differences were found between the groups in key parameters of leukocytes, erythrocytes, and platelets, or C-reactive protein levels, either preoperatively or eight weeks after surgery. The concentration of PDGF in the injected PRP did not differ significantly between the groups. Histological analysis showed that injection of PRP increased the number of regenerating bone trabeculae and reduced the number and size of fibrotic foci and osteochondral callus in both groups. Discussion Autologous PRP has previously been shown to be a simple and effective way to enhance bone regeneration due to the release of multiple growth factors by platelets, which regulate key biological processes, including angiogenesis, inflammation resolution, and tissue regeneration. Our study aimed to investigate whether platelet-rich plasma enhances the osteogenic potential of zirconia ceramic implants in bone defect repair. Our results confirm that PRP, with a platelet concentration of 800 × 10 9 /L to 1200 × 10 9 /L, a white blood cell count of 4–7 %, and a red blood cell count of no more than 1 % of the baseline blood count, may be a useful tool for bone regeneration. Conclusion The use of PRP is effective in compensating bone defects using zirconia ceramic implants. However, further rigorous clinical studies are needed to integrate PRP-based methods into evidence-based medical practice.

Background Plantar fasciitis is one of the main causes of heel pain, which is one of the most prevalent complaints in foot and ankle clinics. Surgery may be necessary if conservative therapies have failed. The appropriate surgical technique has been debated, open plantar fasciotomy and percutaneous plantar fasciotomy are the two common surgical techniques. The aim of the study is to compare the outcomes of open release versus percutaneous midsole release of the plantar fascia in this study to treat recalcitrant heel pain. Methods A prospective study was conducted on 54 patients who had unresponsive plantar fasciitis following conservative treatment for at least six months. 20 patients in the 54 enrolled cases had open plantar fascia release, whereas the remaining 34 patients had percutaneous mid-sole plantar fascia release. All patients' surgical outcomes were evaluated using the Foot and Ankle Disability Index (FADI) both before and after the procedure and a follow-up period of one year was used to assess the functional results. Results The percutaneous plantar fasciotomy group's mean foot and ankle disability index score improved statistically significantly from 39 ± 6 preoperatively to 101 ± 3 postoperatively, compared to 38 ± 5 preopera tively and 98 ± 2 postoperatively for the open plantar fasciotomy group at the final follow-up. Two patients in the percutaneous group experienced numbness at the site of surgery, compared to seven in the open group. By the time of the last follow-up, there had been no recurrence of pain. Discussion We performed a percutaneous release of the mid-sole plantar fascia with a minimum incision and little dissection. We could thus access the plantar fascia effectively while preserving the surrounding tissues and maintaining optimal cosmetic results. Open plantar fascia release is the most conventional technique. However, disadvantages of the surgery include large wound, longer postoperative recovery time, and potential postoperative occurrence of complex regional pain syndrome. Conclusion Both open and percutaneous plantar fascia releases resulted in a considerable improvement in the patients' limb function and pain symptoms. The long-term curative results of the two surgical treatments were identical. Due to fewer postoperative problems, percutaneous plantar fascia release is a superior procedure.

Introduction Bariatric surgery is the most effective treatment of morbid obesity, which is common in patients with hip osteoarthritis. However, the extent to which weight loss after bariatric surgery affects the outcomes and complication rates of total hip arthroplasty (THA) has not been adequately explored. The aim of the study was to determine the impact of bariatric surgery on the results of THA and functional restoration of the lower limbs facilitating a lower risk of postoperative complications. Material and methods A retrospective-prospective cohort, single-center, controlled study included patients with hip osteoarthritis grades 3–4 as described by I. Kellgren and I. Lawrence in 1957. Patients were referred for THA, had a history of morbid obesity (body mass index > 40 kg/m 2 ) and underwent bariatric surgery. The parameters assessed included body mass index, pain, functional status of patients measured with the Harris hip score and complication rate. Results The findings suggested a significant statistical difference ( p < 0.001) in pain intensity on the first day after surgery measured in patients of the study group and the comparison group with (6.3 ± 2.3) and (7.4 ± 2.3) scores, respectively. The modified Harris Hip Score measured at 12 months of surgery reached the maximum with (90.2 ± 10.3) scores in the study group and (86.5 ± 11.6) scores in the comparison group, with a statistically significant difference in the measurements, p = 0.021. The Kaplan – Meier estimator showed a five-year survival rate of THA being 94.6 % (5.4 % complications) in the study group and 77.2 % (22.8 % complications) in the comparison group. Conclusion The bariatric surgery used in patients with morbid obesity and grade 3–4 hip osteoarthritis prior to THA facilitated a statistically significant risk of postoperative complications reduced to 17.4 % and the five-year survival rate of THA increased to 94.6 %.

Introduction Revision foot surgery has increased in recent decades with the increasing surgical procedures. Nonunion is common after arthrodesis and osteotomies. From an economic perspective, revision surgery can be associated with greater length of disability imposing an additional financial burden on healthcare facilities. Impaired bone metabolism is one of the key factors leading to the risk of nonunion and a revision surgery. The aim of the study was to determine the impact of metabolism bone abnormalities on the incidence of nonunion in revision foot and ankle surgery. Material and methods A prospective study with retrospective control was conducted to compare two groups of patients aged 45 to 70 years who required revision foot surgery. The retrospective control group ( n = 36) consisted of patients who had no bone metabolism assessment prior to revision foot surgery. The prospective group ( n = 42) consisted of patients who underwent bone metabolism assessment preoperatively and subsequent correction if needed. Revision surgery was produced in the hindfoot and midfoot due to failed arthrodesis of the corresponding joints. AP and lateral weight-bearing radiographs of the foot, the Salzmann view and a CT scan of the feet were produced preoperatively. Results The mean period from the initial consultation to surgical treatment was longer in the prospective group than in controls: (16.0 ± 4.0) weeks and (8.0 ± 1.7) weeks, respectively. There were no significant differences in the mean period of consolidation/ankylosis measuring (10.0 ± 2.2) weeks in controls and (8.0 ± 1.5) weeks in the prospective group. A statistically significant difference was found in the frequency of non-unions between the two groups showing 14 % ( n = 5) in controls and 2.4 % ( n = 1) in the prospective group. Discussion The findings demonstrated clinical effectiveness of a comprehensive approach to revision foot surgery including optimization of biological factors for bone union. Protocol for preoperative assessment and correction of bone metabolism can significantly improve outcomes of revision procedures reducing the risk of recurrent nonunions and the need for revisions. Conclusion The time from initial consultation to revision surgery was longer in the prospective group of patients with no statistically significant differences in the time to bone consolidation. The nonunion rate was higher in the control group with no diagnosis and correction of bone metabolism diagnostics performed, highlighting the importance in reducing the rate of revision foot and ankle surgeries.

Introduction Foot drop syndrome due to peroneal nerve neuropathy significantly impairs limb support and patient quality of life. The aim of this study was to evaluate the clinical effectiveness of the Bridle procedure compared to ankle arthrodesis and isolated tendon transfer. Materials and methods A retrospective analysis of 27 patients was performed, divided into a main group (n = 14, Bridle technique) and a control group (n = 13, arthrodesis or tendon transfer). Functional outcomes were assessed using the AOFAS and VAS scales, along with rehabilitation duration, orthotic use, and complication rates. The mean follow-up period was 2.3 years. Results The main group showed significantly better outcomes: AOFAS score improved from 38 to 82, VAS score decreased from 6.8 to 2.1, and the need for orthotic devices was reduced. In the control group, improvements were less pronounced (AOFAS: 37→65; VAS: 6.7→3.9). The complication rate was 14.3 % in the Bridle group versus 38.5 % in the control group. Discussion The Bridle technique restores active dorsiflexion while preserving ankle mobility. Its functional and rehabilitation advantages make it preferable in cases of isolated peroneal nerve injury without severe deformities. Conclusion The Bridle procedure is an effective joint-preserving surgical method for treating foot drop, providing superior clinical outcomes compared to alternative interventions.

Introduction Post-surgical dysphagia is one complication particularly common in early postoperative period after Anterior cervical spine surgery (ACSS). However, the pathophysiology of dysphagia after surgery has not been well understood. This study aimed to analyse the frequency and risk factors for developing dysphagia following ACSS and find an effective program to prevent and treat. Materials and methods A prospective observational study was conducted on 50 patients undergoing ACSS from April 2021 to Oct 2022 at the Department of Orthopedics, Guru Gobind Singh Medical College and Hospital, Punjab (India). Patients were in the age group of 27 to 60 years. The indications for cervical surgeries were traumatic, degenerative, infective and neoplastic involving C2 to C7 vertebra with signs of neural compression unresponsive to conservative treatment. Data on patient age, gender, duration of surgery, intraoperative blood loss, segment operated and the number of segments operated were collected. Follow up time was 24 weeks. Results Incidence of dysphagia was 20 % (10/50) within first week which reduced to zero at completion of six months of follow-up. Dysphagia was present in 2 % (1/50) patients in age group 21–40 years and 18 % (9/50) patients in age group of 41–60 years. 14.6 % (6/41) males and 44 % (4/9) of females had dysphagia. Prevalence of dysphagia in patients with one affected segment was 9.5 % (4/42), two segments was 80 % (4/5) and three segments was 50 % (1/2). Mean duration of surgery in patients with post-operative dysphagia was 115 mins. Mean blood loss in patients with post-operative dysphagia was 171.40 mL Mean Et (endotracheal) tube cuff pressure in patients with post-operative dysphagia was 24.70 cm H 2 O. Within the first week of surgery, there were 10 cases out of which one was mild, six were moderate and three were severe. Conclusion Despite the fact that some inconsistency is there in the literature regarding risk factors it can be safely concluded from our study that incidence of post-operative dysphagia can be reduced by decreasing blood loss during surgery, reducing surgery time and optimizing Endotracheal tube cuff pressure during surgery.

Introduction Titanium has been successfully employed as artificial implants in orthopedic surgery for decades. Surgical intervention, specifically the implantation of medical devices, carries a risk of implant-associated infection (IAI), the causative agents of which are staphylococci in more than half of the cases.The objective was to evaluate the antibacterial, antibiofilm activity and cytocompatibility of a multicomponent coating with magnesium and silver oxides on the surface of 3D titanium samples.Material and methods The MgO-AgO-MgO complex The MgO-AgO-MgO complex was applied to 3D samples of medical titanium. Elemental analysis was performed using a TM 4000 Plus scanning electron microscope. The samples were incubated with bacteria for 24 hours to identify antibacterial activity against S. aureus. S. aureus biofilms were formed by immersing the test samples in a nutrient medium with bacteria. After a 24-hour incubation, the samples were washed, placed in an ultrasonic washer, and then sonication fluid was seeded using the sector seeding method. The cytocompatibility of the coating was assessed on a culture of eukaryotic cells of the Vero line.Results Elemental analysis and mapping confirmed the uniform distribution of oxides on the surface of 3D titanium samples. The coating was characterized by antibacterial activity against S. aureus for three days. The MgO-AgO-MgO complex effectively prevented S. aureus adhesion and microbial film formation, while the control samples showed biofilm formation by staphylococci. However, cytocompatibility analysis of the 3D samples showed no viable cells after 72 h of incubation in a medium with an extract from coated titanium samples.Discussion Despite a decrease in antibacterial properties on day 4, the MgO-AgO-MgO complex prevented microbial adhesion to the surface of the samples which ensured protection of the implant from the formation of microbial biofilm. The cytotoxicity of the complex was caused by significant activation of lipid peroxidation reactions, which resulted in suppression of the viability of eukaryotic cells.Conclusion The MgO-AgO-MgO coating prevents primary interaction between the pathogen and the abiotic surface, which is one of the main factors in preventing the development of IAI and the relapses after revision surgeries with implant replacement. However, the high level of cytotoxicity requires further modification of the coating application technique and its composition.

Introduction High risk of infectious complications in gunshot wounds remains a pressing issue in military medicine. Analysis of the structure of sanitary losses shows that limb injuries account for 55 % to 81.4 %, with about 35 % of them accompanied by bone fractures. Performing operations for the final stabilization of these fractures under the conditions of primary microbial contamination is associated with a high risk of infectious complications. However, the use of antibacterial coatings on internal implants significantly reduces the risk of such complications.The purpose of the work, based on the analysis of Russian and foreign literary sources, is to determine the effectiveness of using antibacterial coatings on titanium implants for gunshot fractures.Materials and methods The search for scientific publications was carried out in the search engines eLibrary, PubMed and Connected Papers using the keywords: antibacterial coatings, gunshot fractures, implant-associated infection, internal osteosynthesis, infectious complications, antibacterial coating, gunshot fractures, infectious complications, peri-implant infection. The sources were selected based on the hypothesis of the possibility of using antibacterial coatings in clinical practice. The search depth was from 2009 to 2025.Results and discussion The existing systems for delivering antibacterial drugs to the surgical intervention area demonstrate high clinical efficacy in the prevention of peri-implant infection. To date, the most studied agents for creating coatings are metal ions, polymers, as well as composites containing antibacterial / antiseptic drugs. The most effective are multifunctional and intelligent coatings that have a combined effect on microbial biofilms due to their pronounced anti-adhesive and biocidal properties. There is a shortage of research on the use of multifunctional coatings in traumatological and orthopedic practice. There are no publications in the world literature devoted to the use of antibacterial coatings in the treatment of gunshot fractures and their consequences.Conclusion The use of polymer and multifunctional antibacterial coatings, hydrogels, as well as oxides of silver, iodine and zinc demonstrate high efficiency in the prevention of infectious complications after internal osteosynthesis, and, in our opinion, can be considered for use in clinical practice in the treatment of gunshot fractures of limb bones.

Introduction The relevance of studying the treatment of proximal humeral fractures in children stems from the high incidence of fractures in this anatomical region and the absence of a standardized treatment approach. This highlights the need for further research to develop treatment protocols that account for the unique characteristics of the pediatric body and the specific features of these fracture types.Objective of the study was to analyze and compare the outcomes of treating children with extra-articular proximal humeral fractures using double-nail versus single-nail modifications of intramedullary osteosynthesis with elastic nails.Materials and Methods Patients were divided into two groups. The study group (n = 39) patients underwent surgical treatment with a single elastic rod while patients in the control group (n = 32) received treatment using a double-nail modification of osteosynthesis. Treatment efficacy was analyzed in both inpatient and outpatient settings with clinical, radiological, and sociological assessment methods.Results Postoperative parameters (duration of pain syndrome, hospitalization period, return to school, and fracture consolidation time) were comparable in both groups, indicating similar efficacy of the treatment methods in these studied parameters. Statistically significant differences were observed only in operative time, directly linked to the specific surgical techniques employed in each group. The proposed method in the main study group allowed for faster surgery and did not significantly affect other key parameters of anatomical and functional recovery. Patients in both groups were satisfied with the treatment outcomes.Discussion Unlike the conventional two-nail configuration, the single-rod approach significantly reduces operative time, thereby lowering the risks associated with anesthesia, and slightly reduces the duration of pain syndrome. The study had limitations, including a short follow-up period (no more than 12 months post-injury and 1 month post-implant removal) and a lack of differentiation between fracture configurations (metaphyseal vs. epiphyseal fractures).Conclusion The single elastic nail osteosynthesis method provides functional recovery of the injured segment and restoration of the child’s overall activity comparable to the double-nail technique. Fracture consolidation occurs with correct fragment alignment within standard timeframes.

Introduction The technique of multiapical deformity correction with orthopaedic hexapods can be accepted as "standard." This requires several software calculations a and lengths changes in the 12–18 struts. The "spring" technique was designed to address these disadvantages.Purpose To analyze the treatment results of patients with lower leg multiapical deformities corrected by "standard" and "spring" techniquesMethods The data of patient group 1 (standard technique, n = 17) and patient group 2 (spring technique, n = 17), were used. Correction accuracy, duration of correction, and fixation periods were compared. In patients requiring lengthening, fixation and osteosynthesis indices were additionally analyzed. Quality of life and segment function were assessed using the LEFS questionnaire.Results There was no statistically significant difference between the groups when comparing each of the parameters studied. When comparing LEFS parameters before external fixation (EF) and 2–3 months after frame removal, a statistically significant difference was observed in patients within each of the first and second groups.Discussion The correction accuracy in each group was 94.4 %, which, along with the absence of a significant difference in the duration of treatment and data from the LEFS questionnaire, indicates equal clinical effectiveness of both methods. It was noted that treatment with various modifications of circular external fixators is equally uncomfortable for patients. At the same time, the need for only one calculation in a hexapod software instead of 2–3, the ability to change the length of 6 struts instead of 12–18, as well as simpler assembly and less cumbersome construct if there is small (less than 10–12 cm) distance between the rings are advantages of a "spring" technique.Conclusion Based on the analysis of the criteria used for evaluation, it can be concluded that the “spring” technique for correcting lower leg multiapical deformities is as effective as the “standard” technique. The advantages of the "spring" technique are associated with the greater convenience of its use: both for the orthopedic surgeon and the patient.