Studying of factors for development of complications after primary total endoprosthesis of a hip joint in patients, suffering rheumatoid arthritis
Objective. To reveal correlational links between microbial contamination and regeneratory potential of the bone tissue and to determine their mutual impact on development of complications after primary total endoprosthesis (TEP) of the hip joint in patients, suffering rheumatoid arthritis (RA).
Materials and methods. Results of microbiological investigations of operative material were compared with results of cloning of stromal stem cells from the bone marrow. In the investigation 85 patients, suffering rheumatoid arthritis and affection of a hip joint Stage II Phase III and Stage III in accordance to classification of Sklyarenko, were analyzed. The data were obtained in accordance to actual procedures on 147 specimen of operative material from the patients, in whom a hip joint primary TEP was performed.
Results. Cultures of microorganisms were obtained from operative material in 29.2% patients with RA, in whom a hip joint TEP was performed.
Among 59 strains of microorganisms obtained staphylococci and coryneform bacilli have prevailed– accordingly in 54.2 and 22.2% specimen. In 5.1% of the cultures identified there were Streptococcus spp., in 22.0% – Corynebacterium spp., in 13.5% – nonspore–forming anaerobes, and in 5.1% – gram–negative microorganisms.
Conclusion. In the complex investigation, studying impact of microbial contamination of tissues in operated hip joints on activity of regenerative processes after TEP in patients with RA, there was established the osteogenic potential inhibition by 30.4% at average, or almost in 2 times, what may be regarded as one of mechanisms of occurrence of possible complications and a motive for certain prophylactic measures implementation.
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