ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS

ANALYSIS OF THE STRESS-DEFORMED STATE OF THE FEMUR WITH GUNSHOT FRACTURE WITH VARIOUS METHODS OF ITS FIXATION

2025-09-26T16:13:24+00:00

The standard method for stabilizing diaphyseal gunshot fractures of the femur (GFF) is external fixation using a rod apparatus (ex-fix). Objective. To perform a comparative analysis of the biomechanical effectiveness between conventional ex-fix fixation and a modified «ex-fix + intramedullary spacer» design by assessing the stress-strain state of the femur with a midshaft gunshot fracture. Methods. A finite element model of a midshaft femoral gunshot fracture was developed. Two fixation scenarios were simulated: standard rod-based ex-fix, and a combined system using an intramedullary spacer and an ex-fix rod apparatus. Displacement, stress, strain and safety factor were chosen as the effects studied. Results. Conventional fixation resulted in significant stress concentrations at the fracture site (62.4 MPa) and high deformation levels (215.9), exceeding the strength threshold of cortical bone. This may lead to fragment instability and femoral axis misalignment. Rod exit points showed deformation (121,1), contributing to loosening, inflammation in adjacent soft tissues, and overall instability of the fixation system. In contrast, the addition of an intramedullary spacer redistributed stress more evenly, reduced the mechanical load on bone tissue, and improved structural integrity. The combined «spacer + ex-fix» configuration demonstrated superior performance in minimizing deformation and fragment displacement. Conclusions. Finite element modeling confirmed that the «bone + ex-fix + spacer» system outperforms the traditional «bone + ex-fix» configuration in key parameters: displacement, stress, deformation, and safety margin.

BONE MINERAL DENSITY AND VITAMIN D STATUS IN WAR VETERANS AFTER LOWER LIMB AMPUTATION

2025-09-26T19:51:28+00:00

The study aimed to assess bone mineral density (BMD) and vitamin D status in war veterans after unilateral lower limb amputation (ULLA). Methods. In the case-control study, 64 men aged 20–54 years were examined and divided into two groups: healthy subjects without any diseases or conditions affecting bone metabolism (control group) and men who received ULLA (study group). The analysis was performed depending on the presence and level of amputation. BMD was measured by two energy X-ray absorptiometry, and vitamin D status was assessed by serum dihydroxyvitamin D (25(OH)D) levels. Results. Significantly lower BMD values were found in the femoral neck and the hip of t he a mputated ( p = 0 .00002 a nd p = 0.0002, r espectively), byt not in the contralateral side or lumbar spine in amputees compared with controls. Significantly worse BMD indices were found in the femoral neck and the hip in men with transfemoral amputation compared with those with transtibial amputation at the level of the amputation, but not the contralateral side. BMD of the femoral neck of the amputated side significantly correlated with the duration of the post-amputation period (r = –0.47; p = 0.01). Significantly lower serum level of 25(OH) D was found in amputees compared to controls (25.9 ± 4.8) and (32.0 ± 9.8) ng/ml; p = 0.002). 50 % of the control group and 81.25 % of the study group had low side of 25(OH)D. Conclusions. The results demonstrated BMD changes in subjects after ULLA, a significant relationship between BMD and the duration of the post-amputation period, and a high proportion of vitamin D deficiency and insufficiency, which should be taken into account when planning rehabilitation measures in this category of patients.

DYNAMICS OF BIOCHEMICAL MARKERS OF BONE METABOLISM IN PATIENTS WITH SEGMENTAL BONE DEFECTS TREATED WITH THE MASQUELET TECHNIQUE

2025-09-27T15:29:50+00:00

Segmental bone defects represent a complex clinical challenge in reconstructive orthopedics, etiologically associated with high-energy trauma, oncological resections, and osteomyelitic processes. The two-stage Masquelet technique with induced membrane formation demonstrates high efficacy in reconstructing critical-size bone defects, however, the molecular biochemical mechanisms of reparative osteogenesis during its application remain insufficiently investigated. Objective. To evaluate the dynamics of biochemical markers of bone metabolism in patients with segmental defects of long tubular bones during treatment using the induced membrane (Masquelet) technique in order to determine the metabolic characteristics of osteogenesis and to optimize bone regeneration. Methods. The study included 85 patients aged 18 to 65 years. The experimental group consisted of 44 patients with segmental bone defects, while the control group comprised 41 patients with low-energy fractures. Biochemical markers such as alkaline phosphatase, osteocalcin, β-CrossLaps, calcium, phosphorus, and parathyroid hormone were analyzed. Results. Before treatment, significant abnormalities in bone metabolism markers were observed in the experimental group: elevated alkaline phosphatase (175.45 ± 46.2) U/L, osteocalcin (53.70 ± 12.4) ng/mL, β-CrossLaps (0.949 ± 0.271) ng/mL. Following treatment, 75-92 % of patients demonstrated normalization of biochemical parameters, indicating stimulation of reparative osteogenesis. Conclusions. The Masquelet technique effectively stimulates bone regeneration in segmental defects, as confirmed by the normalization of biochemical markers. Comprehensive biochemical monitoring can serve as a valuable tool for assessing treatment efficacy.

BIOMECHANICAL ANALYSIS OF SHORT-SEGMENT PEDICLE SCREW FIXATION FOR AO TYPE A FRACTURES AT THE THORACOLUMBAR JUNCTION UNDER EXTENSION LOADING

2025-09-27T19:44:20+00:00

Thoracolumbar junction fractures account for up to 60 % of all spinal injuries, with more than 20 % classified as burst fractures. These injuries are characterized by instability and an increased risk of kyphotic deformity. Short-segment transpedicular fixation, which has been gradually gaining favor as the treatment of choice for burst fractures in this region, undoubtedly reduces invasiveness but can lead to fixation failure if there is no intermediate support in the body of the injured vertebra. Objective. To evaluate the stress-strain state of the thoracolumbar spine with a burst fracture at Th_XII under extension loading, considering screw length and the presence of intermediate fixation. Methods. A finite element model of the spine (Th_IX–L_V) with a burst fracture at Th_XII was developed. Four variants of shortsegment transpedicular fixation were analyzed: short or long (bicortical) screws, with or without additional screws in Th_XII. A 350 N load was applied to Th_IX, and stresses were determined at control points using the von Mises criterion. Results. The highest stresses in the connecting rods were observed with long screws without intermediate fixation (337.2 MPa). Introducing intermediate screws decreased the stress in Th_XII from 16.2 to 9.8 MPa. Short screws with Th_XII fixation distributed loads more effectively, reducing peak stresses. Long screws led to overload at the entry points (up to 12.8 MPa in L_I), while their maximum stress reached 95.1 MPa. Conclusions. Intermediate fixation of the injured vertebra reduces stress in both bone structures and the implant, thereby decreasing the risk of correction loss. The most favorable configuration is a combination of short screws with intermediate fixation. Long screws are advisable in cases of osteoporosis, although they increase local stresses — a factor that must be taken into consideration during surgical planning.

HISTOLOGICAL CHANGES IN ADJACENT INTERVERTEBRAL DISCS IN A RAT MODEL OF NUCLEUS PULPOSUS INJURY AND SPINAL NERVE COMPRESSION

2025-09-27T20:18:16+00:00

The prevalence of decompression and stabilization in the thoracic and lumbar spine (LS) is constantly increasing due to the high incidence of degenerative spine diseases among the working-age population. Aim: To analyze histological changes in rats in which the condition of LS was experimentally reproduced as in patients with spinal nerve compression before and after performing decompression and stabilization of the spine. Methods. The study was conducted using 19 white rats, in which the nucleus pulposus in the intervertebral disc was destroyed at the L_V–L_VІ l evel. In Model 1, at the level of the damaged disc, the right spinal nerve was ligated with two double knots of suture material. In Model 2, the L_V and L_VI vertebral bodies were bilaterally fixed with two metal staples, pressing them on the root area. Results. No signs of inflammation were detected in any of the rats. Degenerative changes were recorded in the adjacent cranial and caudal intervertebral discs, but there was no significant difference in the scores between the adjacent intervertebral discs, both in the case of a general assessment and separately for the annulus fibrosus and the nucleus pulposus. The values obtained were ≈ 6.5 and ≈ 5 points, respectively, for the model. The sum of the scores for the annulus fibrosus of the degenerative disc of Model 1 was significantly higher compared to both adjacent discs (p = 0.016; p = 0.026), compared to the corresponding values for the cranial or caudal disc of Model 2, no difference was detected. In both models, Wallerian degeneration was detected in the more distal areas of the nerves. Conclusions: Degenerative changes occur in adjacent discs in a rat model of spinal nerve compression and intervertebral disc nucleus pulposus injury. This provides an opportunity to use this model to study treatments for disc degeneration in patients with neurological complications after spinal decompression and stabilization.

THE EFFECT OF BODY POSITION ON HEMODYNAMIC PARAMETERS AND BISPECTRAL INDEX

2025-09-29T07:46:54+00:00

Surgical interventions routinely have a significant impact on haemodynamic parameters due to a combination of factors: stress, anaesthetics, specific surgical procedures and perioperative position. Monitoring the bispectral index (BIS) helps to adjust anaesthesia to maintain stable haemodynamic status, minimise consciousness and potentially reduce recovery time. Objective. To assess the effect of body position on haemodynamic parameters and bispectral index during upper limb surgery under general anaesthesia with propofol solution. Methods. A prospective randomised study involved 70 patients divided into two groups: I (n = 35) — operated on in a semi-sitting position (SSP); II (n = 35) — anaesthetised in a standard supine position. The average age of patients in group I was (43.06 ± 11.92), in group II — (40.25 ± 10.14) years. General anaesthesia was maintained with a 1% propofol solution depending on BIS monitoring indicators. To control the depth of sedation and adjust the propofol infusion, BIS monitoring COVIDEN was used. Results. Patients were comparable in terms of age, duration of surgery, and blood loss. When comparing haemodynamic values, the following changes were observed: a statistical difference in SBP (p < 0.001), DBP (p < 0.001), SAT (p < 0.001), slight tachycardia was observed compared to group II, but within the reference values (79.22 ± 9.76) beats per minute and (71.34 ± 7.77) beats per minute, respectively (p < 0.001). Reliable statistical values were obtained when calculating the dosage of 1% propofol solution; in group I, the average value was (4.87 ± 0.24) mg/kg/hour, while in group II it was (6.16 ± 0.49) mg/kg/hour (p < 0.001). Episodes of nausea and vomiting were observed in 12 patients in group I and in 5 patients in group II. The average time to spontaneous breathing recovery was longer in group I (p < 0.001), but no significant difference was found in the average time to extubation (p = 0.55). Conclusions. Anaesthesia monitoring using BIS allows to reduce the recovery time after awakening by reducing the total doses of anaesthetics administered. The infusion of anaesthetics depends not only on haemodynamic parameters but also on the perioperative body position.

EVALUATION OF THE EFFICACY OF KINEMATIC Прийнято до друку 30.07.2025 AND MECHANICAL ALIGNMENT IN PRIMARY TOTAL KNEE ARTHROPLASTY DURING THE EARLY POSTOPERATIVE PERIOD

2025-09-29T08:18:00+00:00

Mechanical alignment is widely accepted as a standard technique for total knee arthroplasty (TKA). However, approximately 20 % of patients remain dissatisfied with the outcomes. Recent studies suggest that an alternative method, known as kinematic alignment, could potentially improve functional outcomes and provide more rapid pain relief during the early postoperative period. Objective. To compare early postoperative clinical and functional outcomes of primary total knee arthroplasty performed using either kinematic or mechanical alignment. Methods. We prospectively analyzed the outcomes of 100 patients undergoing primary TKA, with 50 patients receiving mechanical alignment and 50 receiving kinematic alignment. Clinical assessments included pain measurement using the VAS, functional evaluation using the WOMAC, and knee range of motion (ROM). Assessments were conducted preoperatively, at 14 days, and 1.5 months postoperatively. Results. Analysis of key surgical parameters — including operation duration, intraoperative blood loss, and length of hospital stay — revealed no significant differences between the two groups. However, the requirement for additional ligament releases was significantly higher in the mechanical alignment group. According to WOMAC scores, the kinematic alignment group showed consistently better outcomes at all follow-up stages. At postoperative day 14, the kinematic alignment group had significantly better VAS pain scores and greater knee ROM compared to the mechanical alignment group (p < 0.05). However, by 1.5 months after surgery, the differences between the two groups were no longer statistically significant (p > 0.05). Conclusions. Kinematic alignment leads to superior early pain relief and faster functional recovery in the initial postoperative period compared to mechanical alignment. Nevertheless, differences in pain and function between both groups diminish by 1.5 months after surgery. These findings suggest the need for further studies with a longer follow-up (at least one year) to evaluate long-term outcomes and potential complications.

ANALYSIS OF RISK FACTORS AND ASSESSMENT OF PREVENTION OF VENOUS THROMBOEMBOLIC COMPLICATIONS IN PATIENTS WITH HIP JOINT REPLACEMENT

2025-09-29T08:42:21+00:00

The issue of thromboembolic complications prevention is one of great importance, since patients have a high risk of developing postoperative venous thromboembolism. Objective. To analyze risk factors contributing to the development of venous thromboembolic complications in patients with hip pathology undergoing arthroplasty, and to substantiate its prophylactic measures. Methods. Depending on age, all patients were divided into groups: 20–40 years — 13 individuals, 41–60 years — 13 individuals, 61– 80 years — 42 cases. To assess the effectiveness of thromboprophylaxis, two groups of patients diagnosed with stage III–IV idiopathic coxarthrosis aged 41 to 80 years were compared. 100 patients with various pathologies of the hip who underwent surgical treatment with endoprosthetics were involved. Results. Among the identified nosological forms of pathology, idiopathic coxarthrosis was most frequently diagnosed in patients aged 41 to 80 years. Our study demonstrated dynamic changes in the hemostatic system in patients after total hip arthroplasty when using various drugs for the prevention of thromboembolic complications, taking into account the level of antithrombin-III. In patients of the group I who received nadroparin calcium, the fibrinogen content in the blood before the operation was 4.90 (4.50–5.10) g/l, after 7 days — 4.40 (4.30–4.65), after 14 — 3.54 (2.30–3.75) g/l. In group II, thromboprophylaxis was achieved by taking dabigatran etexilate, before the operation, the fibrinogen content in the blood was 4.87 (4.45–5.15) g/l, after 7 days — 4.30 (4.20–4.50), after 14 — 3.62 (2.35–3.80) g/l. Conclusions. In patients with hip pathology, the main risk factors for venous thromboembolic complications before the endoprosthetic surgery and in the early postoperative period are age 41-80 years, obesity, arterial hypertension, as well as chronic venous insufficiency of the lower extremities. Thromboprophylaxis in total hip arthroplasty should be implemented with an individualized approach, considering not only surgical factors but also the early postoperative period.

RESULTS OF RECONSTRUCTION OF THE STRUCTURES OF THE POSTEROLATERAL CORNER IN COMBINATION WITH ANTERIOR CRUCIATE LIGAMENT SURGERY

2025-09-29T10:08:26+00:00

The results of treatment of patients with damage to the structures of the posterolateral corner in combination with anterior cruciate ligament (ACL) surgery are presented. The purpose of the work was to evaluate the results of reconstruction of combined injuries of the anterior cruciate ligament and structures of the posterolateral corner under arthroscopic control based on a comparative analysis of the results and complications. The study group consisted of 26 patients, the comparison group consisted of 27. As part of the examination, the VAS, IKDS, Tegner, Lysholm and KOOS scales were determined in both groups of patients, and the dynamics of osteoarthritis progression according to the Kellgren and Lawrence classification were also assessed. The results of arthroscopically guided reconstruction of the posterolateral corner, combined with ACL reconstruction, were quite promising: the overall IKDS score was: A19, B5, C2, D0. The majority of patients (87.50 %) were very or moderately satisfied with the treatment results. A comparative analysis of functional and radiological results showed that the stability of the knee joint based on the IKDS score was better in the group of patients with arthroscopically guided reconstruction of the posterolateral corner in combination with ACL reconstruction, and this group also had a lower rate of progression of osteoarthritis. Arthroscopic intervention using the original technology using a tendon graft is combined with the minimally invasive arthroscopic technique “allinside” for ACL reconstruction. The results of this work argue for the good stability of anatomical reconstruction by arthroscopic intervention technique, which can be recommended as a valuable alternative method of plastic surgery of the structures of the posterolateral corner of the knee joint. Conclusion. Arthroscopic surgery of the structures of the posterolateral corner of the knee joint in case of combined injury with rupture of the ACL can be recommended as an alternative method compared to open surgery.

PATELLAR TENDINOPATHY AFTER ARTHROSCOPIC MENISCUS RESECTION, WITH «ANTERIOR KNEE PAIN» SYNDROME

2025-09-29T10:25:00+00:00

Patellar tendinopathy is a common problem in patients after arthroscopic interventions, accompanied by chronic pain and limitations in knee joint function. The purpose of the study was to analyze the dynamics of clinical and functional parameters in patients with patellar tendinopathy within 3 months after surgery and standard rehabilitation. Methods. The study involved 196 patients with diagnosed patellar tendinopathy (29.1 %) who underwent arthroscopic meniscus resection. All patients received a standard course of rehabilitation measures. Control was performed after 2 weeks, 6 weeks and 3 months, assessing the level of pain on the VAS scale, functional capacity on the KSS and AKPS scales, as well as quality of life on the SF- 36 scale. Results. It was found that in patients who underwent comprehensive rehabilitation, the level of pain decreased from 6.9 ± 1.0 to (2.2 ± 0.6) points (68.12 % decrease). According to the AKPS scale, functional capabilities increased from 62 ± 4.4 to (64 ± 1.6) points (an increase of 3.2 %). The restoration of motor and psychological functions contributed to a significant improvement in the quality of life: the SF-36 score increased to (78.2 ± 4.6) points, which is 15% more than the initial score and confirms the effectiveness of integrated approaches. Conclusions. Analysis of the results shows that in patients who developed patellar tendinopathy after arthroscopic meniscus resection, even 3 months after surgery, the level of functional ability and quality of life remained lower than before surgery. Overall, physical functioning decreased by 6.7 % (from 75 to 70 points). Role limitations related to physical health decreased from 65 to 22. Psychological indicators also improved: emotional well-being rose from 50 to 75, although it remained below the preoperative level. Social functioning decreased from 88 to 78, a decrease of 11.36 %. Pain levels decreased by 27.3 % (from 55 to 70), but pain sensations remain pronounced. Thus, most indicators failed to reach preoperative levels, although significant progress in recovery and functionality has been observed.

THE EFFECT OF CARBOXYTHERAPY AND ITS COMBINATION WITH DICLOFENAC SODIUM AND CHONDROITIN SULFATE ON TNF-Α AND TGF-Β1 EXPRESSION IN MONOIODOACETATE-INDUCED OSTEOARTHRITIS IN RATS

2025-09-29T10:50:06+00:00

Osteoarthritis remains one of the leading causes of disability worldwide, associated with chronic inflammation and progressive destruction of articular cartilage. Current therapeutic approaches show limited efficacy in restoring damaged tissues, which drives interest in novel adjuvant methods, particularly physiotherapeutic techniques such as carboxytherapy. Objective. To investigate the effects of carbon dioxide monotherapy and its combinations with diclofenac sodium or chondroitin sulfate on the expression of the pro-inflammatory cytokine TNF-α and the regenerative factor TGF-β1 in rats with experimentally induced osteoarthritis. Methods. An osteoarthritis model was induced by intra-articular injection of monoiodoacetic acid. Treatment included CO2 monotherapy or its combination with chondroitin sulfate or diclofenac sodium. On days 14 and 28, serum levels of TNF-α and TGF-β1 were measured using the ELISA method. Statistical analysis was performed using one-way ANOVA followed by Tukey’s post hoc test; 95 % confidence intervals and effect sizes (Cohen’s d) were calculated. Results. All interventions involving CO2 led to a statistically significant reduction in TNF-α levels on days 14 and 28 (ANOVA: F = 2551 and F = 4057, respectively; p < 0.001), with the most pronounced effect observed in the «CO2 + diclofenac» group (a decrease of –54.7 %). Concurrently, an increase in TGF-β1 levels was noted across all treatment groups (ANOVA: F = 1492 and F = 3492; p < 0.001), particularly in the «CO2 + chondroitin» group (+99.4 % compared to the pathology group). Large effect sizes were recorded for key comparisons (Cohen’s d > 0.8), indicating the clinical relevance of the observed changes. Conclusions. The combined application of carboxytherapy with diclofenac sodium or chondroitin sulfate promotes a reduction in inflammatory response and activation of regenerative mechanisms in an osteoarthritis model, supporting the rationale for further preclinical and clinical investigations.

K. F. VEGNER — AN OUTSTANDING SCIENTIST, FOUNDER OF THE NATIONAL ORTHOPEDICS AND TRAUMATOLOGY

2025-09-30T07:26:26+00:00

The main stages of the research achievements of the outstanding scientist orthopedic and traumatologist Professor Karl Fedorovych Wegner are characterized and presented. His significant contribution to the development of a functional method of treating bone fractures and his use of the skeletal traction method for treating a femoral fracture are outlined. Objective. To show the contribution of K. F. Wegner to the formation and development of domestic orthopedics and traumatology, in particular to the technology of treating bone fractures and bone tuberculosis, the organization of narrow-profile orthopedic and traumatological care for victims with industrial injuries, and the development of the concept of «emergency surgery». Methods. An information search was conducted in electronic databases, archives, and the library 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». Results. Karl Fedorovych also revealed in detail the concept of what a bone fracture is, analyzed the mechanisms of its occurrence. The works of K. F. Wegner are analyzed, the professor's contribution to the formation of domestic orthopedics and traumatology is highlighted. The phenomenon of elitist thinking of Karl Fedorovych Wegner, which became the foundation of the collective medical experience of the Kharkiv School of Orthopedists and Traumatologists, of which he is the founder, is characterized in a multi-vector manner. Conclusion. It s proven that Professor Wegner is the founder of the modern system of providing medical care to patients with occupational injuries of the musculoskeletal system. Special attention is paid to the methods of treating bone tuberculosis introduced by him.

RISK FACTORS FOR RECURRENT VERTEBRAL COMPRESSION FRACTURES AFTER PERCUTANEOUS VERTEBROPLASTY IN OSTEOPOROTIC PATIENTS: A SYSTEMATIC REVIEW AND META-ANALYSIS

2025-09-29T11:11:38+00:00

Recurrent vertebral compression fractures (rVCFs) after percutaneous vertebroplasty (PVP) impair quality of life in osteoporotic patients, yet their risk factors remain debated, necessitating a systematic evaluation. Objective. To synthesize clinical data and quantitatively assess the impact of demographic, morphometric, and technical factors on rVCF incidence postPVP. Methods. A search was conducted in PubMed, Scopus, Medline, and Google Scholar (2010–2024) using MeSH terms: «vertebroplasty», «compression fractures», «osteoporosis», «risk factors», «recurrence». Twenty cohort studies (7,923 patients) were included. Continuous variables were pooled using the Sidik–Jonkman random-effects model (Cohen’s d), and categorical variables using the Paule–Mandel model (odds ratio, OR). Heterogeneity was assessed with I² and prediction intervals; sensitivity analyses were performed. Evidence certainty was evaluated using GRADE. Results. Significant risk factors for rVCFs included absence of anti-osteoporotic therapy (AOT) (OR = 1.97, I² = 40 %), cement leakage (OR = 1.92, I² = 68 %), and low bone mineral density (BMD) (d = –0.55, I² = 72 %), with moderate GRADE certainty. Female sex (OR = 1.30, I² = 39 %) and older age (d = 0.24, I² = 62 %) showed weaker associations with low certainty. Cement volume, body mass index, kyphotic angle, its correction, vertebral height restoration, and thoracolumbar junction involvement were not associated with rVCFs. Conclusions. The most significant rVCF risk factors are absence of AOT, cement leakage, and low BMD, nearly doubling the risk. Female sex increases risk by approximately one-third, and older age has a minor effect. These findings highlight the importance of AOT and technical precision in PVP to prevent rVCFs.

NONSTEROIDAL ANTI-INFLAMMATORY DRUGS IN THE MANAGEMENT OF DEGENERATIVE SPINAL DISORDERS: EFFICACY, SAFETY, AND FUTURE PERSPECTIVES

2025-09-29T11:31:49+00:00

Objective. To analyze the current literature on the pathogenetically justified use of nonsteroidal anti-inflammatory drugs (NSAIDs) in patients with degenerative spinal diseases, considering the growing use of this drug class in recent years during the perioperative period of spinal surgery as well as in conservative treatment, and to identify potential risks and prospects for optimizing therapy. Methods. A literature review was conducted using electronic databases such as PubMed, covering the past 10 years. Results. Relevant studies were selected that highlight the pathogenesis of degenerative spinal disorders (DSD), the role of inflammatory mediators, the mechanisms of NSAID action, and their impact on pain and inflammation. The key role of inflammatory processes in intervertebral disc degeneration was emphasized, with increased expression of cytokines IL-1β, TNF-α, and IL-6. This cascade promotes extracellular matrix degradation, triggers neurovascular ingrowth, and enhances nociceptive sensitization. Comparative clinical trials demonstrate that NSAIDs with varying degrees of cyclooxygenase isoform selectivity reduce pain scores and improve functional outcomes, though they differ in tolerability profiles. For chronic use, special attention is required regarding gastrointestinal and cardiovascular risk assessment, minimal effective dosing, and the use of protective co-medications. Conclusion. Accumulating experimental evidence suggests that NSAIDs should be regarded not only as symptomatic analgesics but also as potential modulators of the inflammatory microenvironment of the intervertebral disc. This opens perspectives for their combination with biological agents or antioxidants to slow down the degenerative process. Future research should focus on developing personalized treatment protocols integrating pharmacological, physical, and rehabilitative interventions with consideration of inflammatory biomarkers.

Mykola Ivanovych Berezka

2025-09-30T07:55:57+00:00

September 1 marked the 70th anniversary of the famous scientist, Doctor of Medical Sciences, Professor of the Department of Emergency and Urgent Medical Care, Orthopedics, Traumatology and Prosthetics of the Kharkiv National Medical University, Mykola Ivanovych Berezka

Alexander Ivanovich Korolkov

2025-09-30T08:07:23+00:00

On August 15, Korolkov Oleksandr Ivanovich, a well-known pediatric orthopedist and traumatologist, scientist, lecturer, teacher, and renowned specialist in the field of orthopedics and traumatology, turned 60.