Background. Acetabular dysplasia creates significant technical difficulties in total hip arthroplasty due to anatomical features and bone tissue deficiency for placement of endoprosthesis components. The use of robot-assisted technologies opens up new opportunities to improve the accuracy of surgical interventions in this pathology. Objective. To conduct a comparative assessment of the effectiveness of robot-assisted and traditional manual methods of total hip arthroplasty in patients with dysplastic coxarthrosis.

Materials and methods. A prospective study of one hundred total hip arthroplasty operations for dysplastic coxarthrosis was conducted from 2023 to 2025. Patients were randomized into two groups of fifty people. The first group was operated on using the traditional manual method, the second - using the robot-assisted MAKO Robot system through a modified anterolateral approach according to Harding. All patients underwent a comprehensive preoperative examination, including pain assessment using the VAS scale, quality of life using the SF-36 questionnaire, and an X-ray examination to determine the degree of dysplasia according to the Crowe classification. Patients in the second group additionally underwent computed tomography using a special protocol for three-dimensional modeling. Control examinations were carried out three, six and twelve months after the operation.

Results. The robot-assisted technique ensured the accuracy of positioning of the endoprosthesis components with a deviation of no more than one millimeter and one degree from the preoperative plan. The period of using crutches was reduced from three months with the manual technique to six weeks with the robot-assisted approach. The duration of hospitalization was reduced from six to three days. One year after the operation, the VAS score was zero in the robot-assisted hip replacement group versus two points in the manual method group. The quality of life according to the SF-36 questionnaire reached ninety-five points versus eighty points, respectively. No complications were registered in either group.

Conclusion: Robot-assisted hip replacement for dysplasia demonstrates significant advantages over traditional methods, including high accuracy of component positioning, shorter rehabilitation period, and improved quality of life for patients. This technology can be considered as a method of choice for the treatment of dysplastic coxarthrosis with the prospect of widespread implementation in clinical practice.

Introduction. The most common complication of total elbow arthroplasty in the mid- to long-term period is aseptic loosening of the prosthetic components. This complication is often accompanied by periprosthetic aseptic loosening due to osteolysis of varying severity. In cases of significant osteolysis, impact bone grafting is performed during revision arthroplasty to fill cavitary defects. In this article, we present a clinical case illustrating this approach.

Objective. To describe a clinical case of revision elbow arthroplasty with impact bone grafting for a pronounced cavitary defect of the humerus.

Discussion. To date, the global experience of employing impact bone grafting in elbow arthroplasty is represented by a limited number of observational series; however, it should be noted that this technique allows for the reconstruction of large cavitary defects in the humerus and restoration of elbow joint function.

Conclusion. The use of bone allografts in conjunction with impact bone grafting techniques is an effective method for revision elbow arthroplasty in the presence of significant bone defects. This approach ensures the stability of the construct and the restoration of the joint's functional capabilities, ultimately enhancing the patient's quality of life.

Introduction. Non-specific inflammatory lesions of the spine with impaired bearing capacity and progressive deformity of the spinal column remain a rather severe pathology leading to patient disability, high risk of repeated surgical interventions in case of incorrectly chosen tactics of treatment.

Purpose of the study. To describe the clinical observation of a patient suffering from nonspecific spondylitis of the lumbar spine who underwent surgical treatment in the scope of anterior spondylodesis with a titanium cylindrical mesh implant using an osteoconductor and bilateral resorbable collagen membrane according to the original patented technique.

Materials and Methods. We presented a case of successful surgical treatment of nonspecific spondylitis of the L2-L3 vertebrae with impaired spinal column support. Surgical treatment was performed according to the patented technology by joint application of titanium grating, osteoconductor and resorbable collagen membrane.

Results. As a result of complex surgical treatment, it was possible to form a bone block in the area of destruction in a shorter period of time in comparison with the classical technique.

Conclusion. Despite the wide list of surgical techniques, the issue of bone block formation in the area of surgery remains rather controversial. The application of the proposed technique allows to create optimal conditions for bone block formation in the operation zone, avoiding the ingrowth of soft tissue elements into the zone of new bone proliferation and thus increasing the efficiency of bone block formation.

Introduction. Total and subtotal defects of the heel bone is a complicated and actual problem in the modern traumatology, and they do not have an unique solution. But the more complicated task is treatment of patients with defects associated with distal neuropathy complicated by chronical infection.

Objective. Asses the efficiency of the heel bone total and subtotal defects restoration using endoprosthesis, which is made based on the 3D CT reconstruction study, in patients with distal neuropathy accompanied by infectious complications and soft tissue defects.

Materials and methods. In 2022–2023, three patients with heel bone osteomyelitis associated with diabetes mellitus and distal neuropathy have been treated by stages; and one patient with total defect of the heel bone and contact osteomyelitis after a motorcycle accident. As a result, all patients had the individual titanium 3D implants set. Follow-up period after treatment completion is more than 1.5 years.

Conclusion. Application of individual 3D implants made of porous titanium in patients with distal neuropathy complicated by an infectious process is the easiest to use method for tissue replacement in place of the developed defects; also it is useful for a single-stage rearfoot restoration and to restore the support ability of extremity; it may be used as an alternative to the previously used treatment methods.

Introduction: Total hip arthroplasty for osteoarthritis secondary to more severe types of developmental dysplasia is a complex procedure, associated with an increased risk of failure, including instability. Different positions of the center of rotation have been described.

Purpose: To demonstrate tactical and technical challenges of revision hip arthroplasty after initial high placement of the acetabular component.

Case report: A patient underwent primary hip arthroplsty for dysplasia with a high dislocation, an antiprotrusio cage was placed at the high hip center. Recurrent instability was encountered, and then two revisions with cementation of a dual mobility cup into a retained well-fixed cage resulted in dissociation of the constuct.

Сonclusion: Proximal and lateral placement of the acetabular component may have an advantage of reducing perioperative morbidity, but if it fails, the following revision is associated with additional difficulties.

Background. Osteoporosis is a serious medical and social problem characterized by progressive bone loss and an increased risk of fractures. For a long time, there have been concerns in clinical practice about the negative impact of antiosteoporotic drugs on fracture healing processes, which has led to an unjustified delay in specific therapy in patients with recent injuries. Consolidation of fractures in osteoporosis occurs under conditions of an imbalance between bone resorption and bone formation, which creates the prerequisites for the formation of inadequate bone callus. The aim of the study is a systematic analysis of modern data on the effect of various groups of antiosteoporotic drugs on the processes of bone fracture consolidation in order to form an evidence base for optimizing therapeutic approaches.

Research methods. A systematic search of scientific literature was conducted in the PubMed, Scopus, Web of Science, EMBASE and Cochrane Library databases for the period 2017–2025. Search queries included combinations of terms related to osteoporosis, fractures, and antiosteoporotic therapy. The analysis included randomized controlled trials, prospective and retrospective cohort studies, meta-analyses, and systematic reviews assessing the efficacy of bisphosphonates, denosumab, teriparatide, and calcium and vitamin D supplements in fracture healing.

Study results. The analysis showed that antiosteoporotic drugs do not have a negative effect on fracture healing when the treatment regimen is selected correctly. Bisphosphonates, especially zoledronic acid, demonstrate a positive effect on bone microarchitecture and reduce the risk of recurrent fractures by 35 % while reducing mortality by 28 % after proximal femur fractures. Denosumab shows comparable efficacy and has advantages in patients with severe cortical bone loss. Teriparatide exhibits differential efficacy depending on the fracture location, accelerating the consolidation of intertrochanteric fractures, but not demonstrating significant advantages in medial femoral neck fractures. Calcium and vitamin D preparations are a necessary component of therapy, but require supplementation with specific antiosteoporotic agents. The effectiveness of therapy varies significantly depending on the type of fracture, patient age and concomitant diseases, which necessitates a personalized approach to treatment.

Introduction. The search for a solution to the problem of knee cartilage restoration has been going on for more than two and a half centuries. Currently known surgical treatment options do not provide a complete guarantee of restoring the anatomical and physiological integrity of the knee joint, so there is still a need to find new, more advanced methods that will achieve maximum results. This paper analyzes data published in the world literature on generally accepted methods of surgical treatment of local cartilage and osteochondage defects of the knee joint, provides epidemiological data, analyzes in detail the possibilities of these methods, and provides an analytical assessment of the advantages and disadvantages leading to a limitation of the use of traditional chondroplasty options.

Materials and Methods. The literature search is based on databases PubMed, Embase, eLybrary and Cochrane Library using the keywords "hyaline cartilage", "chondroplasty", "debridement", "bone-cartilage defect", "mosaic chondroplasty", "subchondral tunneling", "microfracturing", "abrasive chondroplasty", "autogenous chondrocyte transplantation", "new combined methods of chondroplasty". The analysis included papers describing known chondroplasty methods, evaluating their advantages and disadvantages, comparing treatment options for articular cartilage defects, and searching for the relationship between the size of the defect and the preferred method of repair.

Results. Organ-sparing surgery on the cartilage of the knee joint is currently a promising area, however, the range of surgical interventions used is still limited by the area and depth of the cartilaginous or bone-cartilaginous defect. When treating full-layer defects with an area of more than 5 cm2, difficulties arise due to a lack of plastic material and the restructuring of the collagen membrane in the center of a large defect. Isolated use of alloplasty in such cases is not a good alternative to monocondylar endoprosthetics. Our accumulated experience has allowed us to propose two combined techniques for chondroplasty of large-area bone and cartilage defects. Combined bone-cartilage plastic surgery due to the relative simplicity of performing and obtaining a two-layer cartilage structure expands the indications for organ-preserving operations to restore knee cartilage and helps to avoid the lack of remodeling of the collagen membrane in the center of the defect, however, it is necessary to conduct prospective and retrospective studies aimed at a detailed comparison of the new type of chondroplasty with classical ones.

Introduction: pain in the area of the first toe caused by osteoarthritis of the first metatarsophalangeal joint (I MTP) is one of the most common pathologies of the human foot. In this pathology, painfulness is caused by arthritic changes in the joint, movements in the joint become painful, and joint mobility decreases [1]. T he above is a clinical manifestation of hallux rigidus disease. When diagnosing this pathology, radiologic examination reveals narrowing of the articular gap of the first metatarsophalangeal joint and the presence of dorsal osteophytes of I MTP [3]. Patients with hallux rigidus are quite often encountered in the clinical practice of a physician. The etiology of hallux rigidus encompasses a variety of factors, and there are many approaches to the treatment of this disease. To date, the choice of treatment is based on a combined assessment of clinical and radiologic findings. The aim of this article is to review the current knowledge on the treatment of hallux rigidus.

Research objective: to determine the modern principles of conservative and surgical treatment of the first metatarsophalangeal joint disease hallux rigidus.

Materials and methods: A systematic literature search was conducted in relevant databases with the search terms “hallux rigidus”. The depth of the search was 24 years. The number of articles used for this paper was 42. A systematic review of research papers on the treatment of hallux rigidus was conducted according to the preferred reporting elements for systematic reviews and meta-analyses (PRISMA).

Results: There are many treatment options for hallux rigidus in the current literature. Treatment of hallux rigidus can be divided into conservative and surgical treatment. Surgical treatment is usually divided into surgery that preserves the I MTP and surgery that does not preserve the I MTP. Treatment tactics depend on the severity of hallux rigidus, the clinical picture and the patient's complaints. For I-II degrees of first metatarsophalangeal joint damage, methods such as cheillectomy combined with or without Moberg surgery, shortening chevron osteotomy should be used. In the case of III degree hallux rigidus, there is experience with treatment by endoprosthesis of the I MTP, but this method of treatment has insufficient positive results and leads to difficulties in subsequent surgical interventions. This technique requires further observation and more in-depth clinical studies. Therefore, arthrodesis of the first metatarsophalangeal joint remains the "gold standard" for the treatment of patients with advanced hallux rigidus. However, other methods have emerged with comparable clinical results that allow preservation of joint motion, but there are not enough reliable results from long-term studies.

Introduction: Hip preservation techniques for young adults with structural abnormalities (FAI, dysplasia, retroversion) aim to prevent joint degeneration. T his review assesses surgical innovations, outcomes, and unresolved challenges in the field.

Materials and Methods: A literature search across PubMed, Scopus, Web of Science, e-Library.  identified 45 studies. Inclusion criteria: focus on joint preservation surgery, comparative analysis of techniques (PAO, arthroscopy, surgical dislocation), and ≥5-year follow-up. Excluded: case reports, animal studies.

Results: Hip arthroscopy shows favorable short-term outcomes for FAI (mHHS 85.9±12.1), yet 4.2 % require conversion to arthroplasty. Surgical dislocation of the hip allows surgeons who do not have hip arthroscopy to correct pronounced deformity with femoroacetabular impingement, as well as to suture a massive rupture of the acetabulum lip with minimal risk of avascular necrosis but correlates with pseudarthrosis and heterotopic ossification. PAO provides 91.3% (95 % Cl: 87.7–94.8 %) of 10-year survivorship; however, The survival of the hip joint after periacetabular osteotomy was influenced by the presence of correction errors and the initial condition of the hip joint.

The following issues also remain unresolved: standardization of protocols, minimization of complications, individualization of approaches. The integration of digital technologies and biomechanical research will expand the indications for organ-preserving operations.

Introduction: distal humerus fractures (DHU) are a significant problem in traumatology and orthopedics due to the technical complexity of treatment and high frequency of complications. The main method of treating this pathology is surgical, which includes open reduction and internal fixation (ORIF), intramedullary fixation, osteosynthesis with external fixation devices and total elbow arthroplasty (TEP).

The propose: to assess the current state of the issue of surgical treatment of distal humerus fractures, to analyze the results of current studies devoted to this issue.

Materials and methods: the search was conducted in open electronic scientific databases PubMed and databases of the Russian scientific electronic library e-Library using keywords and phrases: surgical treatment, humerus, osteosynthesis, endoprosthetics.

Results: the presented review pays special attention to the description and discussion of both classical and innovative approaches in the surgical treatment of the distal humerus, such as the use of pre-contoured plates with variable angle screw fixation (VALP), which have shown advantages in increasing the stability of fixation and improving functional results, especially in patients with osteoporosis. The prospects for the use of 3D printing to create individual implants, bioresorbable materials, nanotechnology and cellular technologies aimed at accelerating bone regeneration and reducing the risk of complications are considered.

Conclusion: total elbow arthroplasty is an effective alternative for elderly patients with complex fractures. Innovative technologies such as 3D printing of individual implants, bioresorbable materials and cell technologies open up new perspectives in the treatment of patients with POD, but require further clinical trials and cost-effectiveness assessment.