ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS

APPLICATION OF SURGICAL TECHNOLOGIES FOR THE TREATMENT OF VICTIMS WITH DEFECTS OF LONG BONES DUE TO MODERN COMBAT TRAUMA. REPORT THREE. BONE TRANSPORT TECHNOLOGIES

Sergiy Guryev, Serhiy Hariyan, Vitalii Kushnir, Oleksandr Tsybulsky — Sun, 28 Jun 2026 00:00:00 +0300

Objective. To provide a full description of the indications for the use of bone transport technology in victims with long bone defects due to combat trauma. Methods. The current state of domestic and international treatment strategies, as well as research achievements regarding bone transport methods (antegrade, retrograde, and antegrade-retrograde) were reviewed. The medical histories of 62 patients with long bone defects who were successfully treated using bone transport technology were studied. Results. It was found out that antegrade bone transport is most often used for the surgical treatment of victims with such defects — 54.84 %. In the general array of victims who were treated with bone transport technology, patients aged 21–50 years prevail — 77.42 %. It should be noted that the use of this technology prevailed in cases of damage to the long bones of the lower limb - 96.78%. It can also be stated that the bone transport technology for the treatment of long bone defects is inherent in conditions of defect sizes from 5 to 15 cm. Conclusions. The use of bone transport technology in the surgical treatment of victims with long bone defects due to combat trauma to achieve a successful clinical and anatomical result requires a clear comprehensive formation of indications based on age, anatomical features, as well as assessment of the defect, the criteria being the age of the victim (up to 50 years) and the defect size of 5 cm or more. Each subtype of bone transport technology has a specific localization of defects for its successful use: antegrade bone transport for defects due to combat trauma of the forearm (100 %) and lower leg (56.82 %), retrograde — thigh (62.5 %), antegrade-retrograde — only on the lower leg.

COMPARATIVE ANALYSIS OF NORMALIZED HIP MUSCLE STRENGTH ACCORDING TO SURGICAL APPROACH IN TOTAL HIP ARTHROPLASTY

Dmytro Sereda, Valentyna Maltseva, Olena Karpinska — Sun, 28 Jun 2026 00:00:00 +0300

Patients who require total hip arthroplasty (THA) experience atrophy and weakness of the thigh muscles, which affects the ability to maintain balance while standing and walking. THA corrects a certain imbalance in muscle function, but the surgical approach used may also affect the recovery of individual groups of thigh muscles. Methods. The results of treatment of 41 patients who underwent unilateral THA with a modified lateral (group I) or direct anterior surgical approach (group II) were analysed. Group I included 23 patients aged 34 to 74 years, 17 (73.9 %) men and 6 (26.1 %) women, and group II included 18 people aged 27 to 75 years, 11 (61.1 %) men and 7 (38.9 %) women. The strength of the muscles of the contralateral and healthy limbs was measured using a device based on the SBA-100L strain gauge before THA, 1 and 3 months after the surgery. To assess muscle strength, the normalized coefficient (NC) was used, as the ratio of muscle strength to body weight. Results. Before THA, according to the NC assessment, no intergroup differences in muscle strength were established in patients (p > 0.05). One month after THA, the strength of the adductor group of the operated limb in group II was g reater ( p = 0 .014) c ompared t o g roup I , a nd t he s trength of the flexors and extensors were significantly greater (p = 0.026) in group I compared to group II. No statistical difference was found for the abductor group of muscles. After 3 months, the abductor muscle strength (p = 0.003) was greater in group II than in group I, and the flexor muscle strength (p = 0.009) was greater in group I than in group II. The adductor and extensor muscle groups did not differ. NC of all muscle groups were significantly lower than the contralateral limb for all patients after 3 months, except for the extensor muscles in group I, where no difference was found. Conclusions. The restoration of thigh muscle strength in patients after total hip arthroplasty had a positive linear dynamics regardless of the surgical approach used during 3 months of observation; however, there is asymmetry in the restoration of the studied muscle groups.

ADVANTAGES AND DISADVANTAGES OF USING MODULAR STEMS IN REVISION HIP ARTHROPLASTY

Sun, 28 Jun 2026 00:00:00 +0300

The increasing number of revision hip surgeries highlights the challenge of selecting the optimal revision femoral component, particularly in cases of bone stock loss. Objective. To determine the advantages and disadvantages of modular revision stems compared to monoblock stems based on literature data and personal clinical observations. Methods. A literature review (37 sources) and a retrospective analysis of 175 revision surgeries performed between 2013 and 2025 were conducted. Patients were divided into two groups: 70 cases utilizing modular stems and 105 using monoblock stems. The study assessed the distribution of bone defects according to the Paprosky classification, complication rates, and functional outcomes using the Harris Hip Score (HHS) at 1-year follow-up. Results. Monoblock stems were predominantly used for Paprosky type I–II femoral defects (79 %), whereas modular stems were preferred for type III–IV defects (66.2 %). The overall complication rate was comparable: 8.8 % in the modular group and 8 % in the monoblock group (P = 0 .834). S ignificant s ubsidence ( > 10 m m) w as m ore f requently observed with monoblock stems. Functional outcomes according to HHS significantly improved in both groups after one year (80.2 ± 3.1 and 83.1 ± 3.3 points, respectively) with no statistically significant difference between them. Conclusions. The clinical outcomes of modular and monoblock stems are equivalent. The choice of implant should be based on the anatomical situation: monoblock stems are effective for moderate defects, while modular stems offer advantages in severe defects (Paprosky type III–IV) to ensure stable fixation and biomechanical restoration.

CORRELATION BETWEEN MRI AND CLINICAL EXAMINATION IN THE EVALUATION OF POSTEROLATERAL CORNER INJURIES OF THE KNEE JOINT

Sun, 28 Jun 2026 00:00:00 +0300

An analysis of the possibilities of MRI diagnostics of posterolateral corner injuries of the knee was performed. Thirty-three patients, 5 women and 28 men with a mean age of (32.9 ± 9.8) years (range 18–59), participated in the study. MRI was performed on average (7.8 ± 3.8) months after injury, with a minimum time of three months and a maximum of 18 months. The purpose of the study was to evaluate the correlation between MRI, clinical examination and diagnostic arthroscopy in posterolateral corner injuries of the knee. A comparative analysis was performed between MRI reports, clinical examination data and diagnostic arthroscopy results for the patients who underwent reconstruction of the posterolateral corner. Thus, we assessed the effectiveness of MRI for the diagnosis of such injuries. The results of the study showed that MRI in standard sequences has a sensitivity of 100 % for anterior cruciate ligament injuries, 86.96 % for posterior cruciate ligament injuries, 57.58 % for lateral collateral ligament injuries, and 24.24 % for hamstring tendon injuries. Conclusion: Posterolateral corner injuries are difficult to visualize and interpret; therefore, MRI imaging should not be used alone for diagnosis. Lateral collateral ligament injuries are described in MRI reports in 57.5 % of cases, and hamstring tendon injuries in only 24.2 %, and these diagnostic percentages cannot be used to guide surgical treatment. Visualization of posterolateral corner damage is possible on coronary oblique views, which are not routinely performed, so clinical diagnosis may be crucial for establishing the diagnosis.

HYPERPLASIA OF THE MEDIOPATELLAR PLICA OF THE KNEE JOINT IN PATIENTS WITH CHRONIC PAIN SYNDROME

Sun, 28 Jun 2026 00:00:00 +0300

The morphology of the mediopatellar plica of the knee joint in patients with knee pain syndrome is of significant importance, as age-related changes of the plica, its hypertrophy, and trauma may increase the risk of damage to the articular cartilage of the femur and lead to chronic pain. The aim. To study the histological features of the mediopatellar plica of the knee joint in patients with pain syndrome and to identify factors influencing its morphology. Methods. A histological study of 12 mediopatella plicae harvested from patients aged (42,3 ± 9,8) years (10 men and 2 women) was performed. The relative density of blood vessels, fibrous tissue, and adipose tissue within the plicae was assessed. The association between plica morphology and factors contributing to pain syndrome was analyzed. Results. Histological study demonstrated that the mediopatellar plica is composed of fibrous connective tissue, vascularized, with severe fibrosis with signs of hyalinosis observed in 41,6 % of cases. A morphological difference was identified between the paracapsular and marginal zones of the plica. The marginal zone lacked adipose tissue and consisted predominantly of dense connective tissue. Age and hyalinosis were found to be significant determinants of plica morphology, whereas trauma, type of occupation, and sex were not significant predictors of morphological changes in the mediopatellar plica. Conclusions. Dense connective tissue with features of fibrosis is more characteristic of the marginal zone of the plica, while the presence of adipose tissue beneath the synovial membrane distinguishes the paracapsular zone. Plica thickness significantly increases in the presence of hyalinosis; however, the relationship between plica morphology and clinical factors requires further investigation.

FLEXION CONTRACTURES OF THE KNEE JOINTS IN CHILDREN WITH CEREBRAL PALSY: PATHOGENESIS, CLINICAL MANIFESTATIONS, ANATOMICAL AND MORPHOLOGICAL CHANGES IN BONES, MUSCLES AND INTRA-ARTICULAR STRUCTURES

Oleksandr Danilov, Oleksandr Shulha, Valeria Gorelik — Sun, 28 Jun 2026 00:00:00 +0300

The main causes of knee contractures are the dominance of the hamstring muscles, particularly the biceps femoris, as well as associated hip joint contractures, which are combined with torsional deformities of the lower limb bones. Femoral deformity involves anteversion of its proximal epimetaphysis, which arose during ontogenesis and due to the action of external rotators, as well as internal rotation resulting from spasticity of the hip adductor muscles. Pathological external torsion of the tibia is a consequence of a compensatory mechanism aimed at restoring the axis of the lower limb, overcoming spasticity of the biceps femoris muscle, and retraction of the anterior cruciate ligament. Objective. To investigate the pathogenesis of flexion contractures of the knee joints, as well as associated anatomical and structural changes in the bones and primary and secondary stabilizers in children with cerebral palsy. Methods. The analyzed data were obtained during the treatment of 40 patients with cerebral palsy, spastic diplegia, and tetraparesis. In all cases, hip joint contractures were noted, and in most patients, knee joint contractures and foot deformities were observed. Clinical and instrumental diagnostic methods were used. Results. The causes of flexion contractures of the knee joints were studied, theoretically substantiated, and investigated. A direct correlation was established between the degree of contracture and degenerative-dystrophic changes in the intra-articular tissues of the joint, as well as between the degree of torsional deformity of the lower limb bones. Conclusions. The pathogenesis of knee joint contractures is multifactorial in nature and depends on structural changes in the bones of the lower extremities and in the primary and secondary stabilizers of the knee joint, which influences the clinical course of the disease and the future choice of treatment strategy.

COMPUTATIONAL ANALYSIS OF THE DEFORMATION OF THE BIOMECHANICAL SYSTEM «BONE – IMPLANT – PROSTHESIS»

Oleksandr Sitenko, Oleksiy Larin, Denis Lavinsky, Kostiantyn Barbin — Sun, 28 Jun 2026 00:00:00 +0300

The prospects of the method of endo-exo-prosthetics of lost limbs, the basis of which is the interaction of the patient with the prosthesis through an implant connected to the stump bone, largely depends on ensuring the durability of the functioning of the stump bone, the implant and their connection. This article presents the method and analysis of deformations in the biomechanical system "bone-implant-prosthesis", an assessment of the mechanical condition of the specified objects of study is given. Purpose. To develop an adequate model of the "bone-implantprosthesis" system and to conduct a computational analysis of deformation in order to predict the strength of the elements. Methods. The finite element method is chosen as the numerical method of analysis. Particular attention is paid to the simulation of contact interaction, taking into account dry friction. The coefficient of friction (adhesion) varied in the calculations, thus simulating different degrees of osseointegration. Results. The obtained distributions of the main characteristics of the deformation process made it possible to find out that under the considered loading conditions, the strength of the bone and implant is preserved. Conclusions. From the point of view of mechanical behavior, both intramedullary and extramedullary implants maintain bone strength and ensure the performance of the prosthesis.

HOW DOES THE DEGREE OF WRIST OSTEOARTHRITIS AFFECT THE OUTCOMES OF SURGICAL TREATMENT OF SCAPHOID NONUNION?

Serhii Tymoshenko — Sun, 28 Jun 2026 00:00:00 +0300

Objective. To evaluate the effectiveness of surgical treatment of scaphoid nonunion using screw fixation with bone grafting in patients with different stages of wrist osteoarthritis. Methods. This single-center study included 81 adult patients with nonunion located in the middle third of the scaphoid. All patients underwent surgical treatment consisting of nonunion resection via a volar approach, iliac crest bone grafting, and fixation with a specialized compression screw. Exclusion criteria were nonunion of the proximal or distal third of the scaphoid, signs of avascular necrosis of bone fragments, and bilateral wrist involvement. Patients were divided into four subgroups: without osteoarthritis and with stage I, II, and III osteoarthritis according to the SNAC classification (SNAC 0, I, II, III), comprising 34, 21, 19, and 7 patients, respectively. Outcomes were assessed at 1 year or longer postoperatively, including union rate, cylindrical grip strength (as a percentage of the contralateral side), DASH score, and wrist flexion–extension range of motion. Results. Bone union was achieved in 88 % of cases overall. The rate of nonunion increased significantly with advancing osteoarthritis stage: 3, 10, 21 and 42 % for SNAC 0, I, II, and III, respectively (p = 0.0021). Most postoperative functional outcomes (range of motion, grip strength, and qDASH scores) demonstrated clinical and subjective improvement in patients with achieved union; however, the magnitude of improvement decreased with increasing osteoarthritis severity, particularly in SNAC III. Among patients who achieved scaphoid union, no statistically significant differences were found in the improvement of strength, range of motion, or disability scores depending on the stage of wrist osteoarthritis.

RESULTS OF BIOMECHANICAL STUDIES OF THE EFFECTIVENESS OF OSTEOSYNTHESIS OF UNSTABLE FRACTURES OF THE CLAVICLE WITH A COMPRESSION ROD

Henrich Hercen, Oleksandr Hapon, Hennadii Bilonozhkin — Sun, 28 Jun 2026 00:00:00 +0300

Objective. To study the effectiveness of osteosynthesis of unstable clavicle fractures of type 15.2AB using a compressive rod based on biomechanical studies. Methods. Biomechanical studies analysed the results of computer experimental studies, as well as finite element method data. In the conditions of modelling o steosynthesis o f u nstable c lavicle f ractures 1 5.2AB, he strength characteristics of the compression rod were taken into account in comparison with the traditional intramedullary Bogdanov rod. Computer modelling analysed studies that used clavicle models created using the finite element method (FEM). These models made it possible to assess the distribution of stresses and deformations in the clavicle and fixing elements under different types of loads. Parameters such as maximum stress in the implant and bone, as well as interfragmentary displacement, were measured. Results. Biomechanical studies of osteosynthesis modelling of unstable clavicle fractures OTA 15.2AB showed the advantages of a compression rod compared to the traditional Bogdanov intramedullary rod in terms of the maximum load required for deformation, implant failure, as well as creating greater stability of clavicle osteosynthesis during its torsion and bending. Thus, the bending stiffness of the compression rod was 1.3-1.4 times higher, and the torsional stiffness was 1.3 times higher (p < 0.05). The load to deformation and destruction of the compressive rod was also 1.3–1.6 times higher (p < 0.05). The maximum displacement of clavicle fragments with the compressive rod was 0.7–0.8 times less compared to the Bogdanov rod. Conclusions. After osteosynthesis of unstable clavicle body fractures 15.2AB with a compressive rod, its strength characteristics have advantages over Bogdanov’s rod in terms of deformation, implant destruction, and higher stability of clavicle fragments during bending and torsion due to a more uniform pressure distribution.

BIOMECHANICAL VALIDATION OF TOPOGRAPHIC PATTERNS OF NEW VERTEBRAL COMPRESSION FRACTURES AFTER VERTEBROPLASTY USING

Sun, 28 Jun 2026 00:00:00 +0300

Despite the high clinical effectiveness of percutaneous vertebroplasty, the occurrence of new osteoporotic vertebral compression fractures after the procedure remains a significant clinical problem. One of the key mechanisms of recurrent fractures is believed to be the redistribution of mechanical loads within the spine caused by changes in geometry and stiffness after vertebral collapse and cement augmentation. Finite element analysis (FEA) is an appropriate tool for quantitative assessment of these biomechanical processes. The purpose. To provide biomechanical validation of topographic patterns of new vertebral fractures by analyzing the stress-strain state of a multisegment spinal model. Methods. Three-dimensional finite element models of the ThV–LV s pine w ere d eveloped, t aking i nto a ccount o steoporotic bone properties, including an intact model and models with compression fractures at different vertebral levels. Additional models simulated post-vertebroplasty conditions with local replacement of cancellous bone by bone cement. Results. The simulations demonstrated that vertebral compression fractures lead to significant redistribution of stresses in adjacent and distant spinal segments, with the location of high-stress zones depending on the level of the primary fracture. Vertebroplasty reduced stress in the treated vertebra but did not eliminate elevated stresses in other spinal segments, where biomechanical conditions favorable for subsequent fractures persisted. Conclusion. These findings confirm that the level of the primary fracture determines the spatial pattern of load redistribution in the spine and may explain the topographic features of new fractures after vertebroplasty. Finite element analysis is an effective method for investigating mechanisms of cascade fractures and for supporting preventive strategies in patients with osteoporosis.

THE ROLE OF NONINVASIVE CEREBRAL OXYGENATION MONITORING IN THE DETECTION OF CEREBRAL AUTOREGULATION IMPAIRMENT AND COGNITIVE DYSFUNCTION DURING ANESTHESIA IN THE BEACH CHAIR POSITION

Kseniia Lyzohub, Mykola Lyzohub — Sun, 28 Jun 2026 00:00:00 +0300

The beach chair position, commonly used in shoulder surgery, is associated with a potential risk of cerebral hypoperfusion due to hydrostatic gradient and anesthesia-induced hypotension. The role of cerebral autoregulation in maintaining adequate cerebral oxygenation under these conditions remains incompletely understood. Objective. Assess t he relationships b etween i ndicators of systemic hemodynamics, cerebral oximetry and cognitive functions in patients in the perioperative period in a beach chair position. Methods. A total of 80 patients were included. Mean arterial pressure (MAP), heart rate, and regional cerebral oxygen saturation were continuously monitored using near-infrared spectroscopy (NIRS). Cerebral autoregulation was assessed using the correlation between MAP and rSO2 (cerebral oximetry index, COx). Cognitive function was evaluated using the Montreal Cognitive Assessment (MoCA). Results. Preserved cerebral autoregulation was observed in 75 patients (93.75 %), who demonstrated no clinically significant decrease in rSO2 after positioning. Five patients (6.25 %) developed marked reductions in MAP and cerebral oxygenation. During surgery, the decrease in rSO2 was significantly greater in these patients compared with the preserved autoregulation group (–15.2 ± 4.6 % vs. –1.07 ± 4.79 %; p < 0.001). Postoperatively, the impaired autoregulation group showed a significant decline in MoCA scores from 28.4 ± 0.5 to 26.4 ± 0.5 points (p = 0.011), whereas cognitive performance remained unchanged in the remaining patients. Conclusions. Cerebral autoregulation remained preserved in most patients undergoing surgery in the beach chair position. Impaired cerebral autoregulation was associated with greater decreases in cerebral oxygenation and postoperative cognitive decline. NIRS monitoring may facilitate early identification of patients at risk of cerebral hypoperfusion and perioperative neurological complications.

Frida Solomonivna Leontievna

Yulia Zadorozhnaya — Sun, 28 Jun 2026 00:00:00 +0300

May 12, 2026 marked the 80th anniversary of the birth and 55 years of work at the State Institution "Institute of Spine and Joint Pathology named after Prof. M. I. Sytenko of the National Academy of Medical Sciences of Ukraine", Head of the Department of Laboratory Diagnostics and Immunology with a Clinical Diagnostic Laboratory, Candidate of Biological Sciences, Senior Researcher Frida Solomonivna Leontieva.

Volodymyr Anatoliyovych Staude

Anna Kushnir — Sun, 28 Jun 2026 00:00:00 +0300

On May 29, 2026, the head of the rehabilitation department of the State Institution "Institute of Spine and Joint Pathology named after Prof. M. I. Sytenko of the National Academy of Medical Sciences of Ukraine", Doctor of Medical Sciences Stauda Volodymyr Anatoliyovych, turned 60 years old.

The impact of vitamin D supplementation on post-operative recovery in fracture patients: a meta-analysis

Sun, 28 Jun 2026 00:00:00 +0300

Fractures remain a major cause of disability, particularly in older adults, despite advances in surgical management. Postoperative complications such as delayed union, persistent pain, and impaired functional recovery continue to challenge orthopaedic outcomes. Vitamin D plays a critical role in bone remodelling, muscle function, and immune regulation, suggesting potential benefits in postoperative recovery. Objective. This meta-analysis aims to evaluate the effect of vitamin D supplementation on postoperative fracture recovery, focusing on structural, functional, and clinical outcomes. Methods. A systematic review and meta-analysis were conducted in accordance with PRISMA 2020 guidelines. Electronic databases including PubMed, Scopus, ProQuest, ScienceDirect, and Google Scholar were searched for studies published between 2000 and 2025. Eligible studies included randomized controlled trials and prospective cohorts involving adult fracture patients receiving vitamin D supplementation. Primary outcomes included bone mineral density (BMD), pain intensity (VAS), functional outcomes (ODI), and biochemical markers. A random-effects model was applied to pool the data. Results. Four studies met the inclusion criteria. Vitamin D supplementation significantly improved serum 25(OH)D levels and supported calcium homeostasis. Pooled analysis demonstrated improvements in BMD and functional outcomes, with reduced pain intensity and disability scores in the intervention groups. However, the magnitude of benefit varied depending on baseline vitamin D status and supplementation regimen. Daily physiological dosing showed more consistent benefits compared to high-dose bolus administration. Clinical improvements were most pronounced in patients with pre-existing vitamin D deficiency. Conclusion: Vitamin D supplementation contributes to improved postoperative fracture recovery by enhancing bone mineralization, reducing pain, and improving functional outcomes, particularly in deficient patients. Routine screening and targeted supplementation with physiological dosing may optimize recovery and should be considered as part of perioperative management in orthopaedic practice.

FEATURES OF MEDICAL REHABILITATION OF PATIENTS WITH PELVIC FRACTURES

Valentin Zhuravlоv — Sun, 28 Jun 2026 00:00:00 +0300

The goal is to develop and test a program for early active rehabilitation of patients after osteosynthesis of unstable fractures using external fixation devices (EFD) with rods with multidirectional threads. Methods. The clinical and radiological examination protocols of 42 patients were studied, who were randomized into two groups: main A (n = 25) and control B (n = 17). In g roup A, rods with a multidirectional thread were used in the EFD and the active early rehabilitation program developed by us was applied. In group B, rods in the EFD had a unidirectional thread; a standard rehabilitation program was prescribed. The control examination was carried out 3 months after surgery. Results. The developed plan of active early postoperative rehabilitation differed from the standard one in the presence of a training program that corrected the level of kinesiophobia and anxiety associated with the expectation of pain; in kinesiotherapy, the following additional methods were used: in the 1st period — extended mobilization of the trunk muscles, ideomotor exercises, dosed load in a vertical position with the use of additional support; in the 2nd — soft manual therapy techniques; in the 3rd - isometric exercises for the muscles of the lumbopelvic zone and the muscles of the pelvic floor. The average period of bed rest was (8.2 ± 3.7) days for group A and (16.9 ± 10.2) days for group B; p < 0.05. Conclusions. The developed technique had the following effectiveness: during the control examination after 3 months. All indicators (pain intensity according to VAS ((3.6 ± 1.8) cm in group A and (4.8 ± 1.8) cm in B), level of kinesiophobia according to Tampa TSK scale ((31.7 ± 9.8) points and 40.6 ± 11.4 respectively), level of anxiety according to PASS-20 questionnaire (21.6 ± 9.4 and (36.2 ± 8.9) points respectively), integral quantitative indicator of the degree of patient participation (full — in 24 and 12 % respectively; moderately limited — 40 and 24 %; significantly limited — 28 and 46 % respectively; nominal — 8 and 18 %), endurance of flexor muscles (112.1 ± 34.8 and (101.9 ± 35.4) s) and extensors of the pelvis and hips (96.4 ± 36.2 and (90.5 ± 36.2) s), the functional assessment of the consequences of pelvic fractures according to the Majeed scale (78.6 ± 4.4 and (76.2 ± 4.81) points) in the main group A was higher than the results of group B.

MOTIVATIONAL FACTORS AND METHODOLOGICAL PRINCIPLES OF FORMING THE GOAL OF SCIENTIFIC RESEARCH

Sun, 28 Jun 2026 00:00:00 +0300

Choosing the goal of scientific research for a scientist (or group of scientists) is a special action, on which the real contribution to the relevant field depends. Objective. In order to understand how to make the right choice, we retrospectively assessed the historical experience of forming the most effective scientific projects at the Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine. Methods. The material for the study was dissertations, monographs and articles of the institute's employees, which are in the library of the institution since the first years of its foundation. Results. During the period of the institute's existence, three most important scientific and practical achievements can be distinguished: obtaining fundamental knowledge about the laws of bone tissue regeneration; substantiation and development of transplantation methods for replacing bone defects; diagnostics and treatment of spinal pathology. Conclusions. The definition of a potentially effective scientific goal occurs in the mind of a person (scientist) who is endowed with a sense of curiosity and is capable of theoretical thinking. The main drivers of the correct choice are the presence of a problem and the level of knowledge and character traits of the individual. The priority option for a scientific and medical institution is the goal of a strategic direction, which involves obtaining fundamental knowledge about the biological processes involved in the pathogenesis of various lesions and diseases. For its implementation, it is necessary to build a complex of separate interconnected theoretical, experimental and applied works, in which the goal and objectives are also determined, but of the second (lower) order.

RESULTS OF RECONSTRUCTION OF THE UPPER CAPSULE OF THE SHOULDER JOINT WITH THE BROAD FASCIA OF THE THIGH IN PATIENTS WITH ROTATOR CUFF ARTHROPATHY

Sergiy Strafun, Sergiy Bohdan, Olexandr Strafun, Ruslan Sergienko — Sun, 28 Jun 2026 00:00:00 +0300

Restoration of the upper capsule (superior capsule reconstruction) of the shoulder joint is one of the options for surgical treatment, which is performed for non-repairable ruptures of the rotator tendons with signs of rotator cuff arthropathy. The aim of the work is to investigate and compare the results of restoration of the upper capsule of the shoulder joint with a wide fascia of the thigh of different thicknesses. Materials and methods. We performed restoration of the upper capsule of the shoulder joint using a graft from the wide fascia of the thigh in 45 patients with rotator cuff arthropathy of the 2nd degree. The patients were divided into 2 groups depending on the characteristics of the surgical intervention: group 1 — restoration of the upper capsule was performed with a graft from the wide fascia of the thigh in 6 layers; group 2 — restoration of the upper capsule was performed with a graft from the wide fascia of the thigh in 8 layers. Results: At 6 months after surgery, the mean functional outcome on the Constant Shoulder Score scale was 20.5 ± 6.9 points in the 6-layer graft group, while the results were better in the 8-layer graft group, at 18.5 ± 16.2 points (p = 0.037). At 12 months after surgery, the mean functional outcome on the Constant Shoulder Score scale was 16.6±5.9 points in the 6-layer graft group, while the results were also better in the 8-layer graft group, at 12.9 ± 9.1 points (p = 0.022). Conclusion: The average short-term results (6–12 months) according to the Constant Shoulder Score and VAS scales of surgical repair of the upper capsule of the shoulder joint in patients of both groups, regardless of the thickness of the wide fascia of the thigh graft, were better than preoperative indicators.