Background: The accuracy of component positioning in robotic-assisted total knee arthroplasty (RaTKA) is unquestionable. Comparing RaTKA with conventional total knee arthroplasty (TKA), including histological examination of bone tissue following resection using different cutting instruments, remains clinically relevant.

   Objective: To investigate the histological features of bone resection performed with a robotic burr versus an oscillating saw and their impact on mid-term clinical outcomes after total knee arthroplasty.

   Materials and Methods. A comparative prospective two-center study was conducted from 2022 to 2025. Mean age: Group 1 (RaTKA) – 66,4 ± 8,3 years; Group 2 (TKA) – 66,59 ± 8,6 years. Median BMI: Group 1 – 30,28 (Q1 26,65; Q3 34,21) kg/m²; Group 2 – 33,91 (32,23; 36,93) kg/m². Hip-knee-ankle (HKA) angle: Group 1 – 171° (170°; 172°); Group 2 – 170° (170°; 173°). Patient outcomes were assessed using Visual Analog Scale (VAS) and WOMAC scores. Bone tissue microarchitecture was evaluated histologically.

   Results. In the RTKA group, early postoperative stiffness outcomes were superior. Over 1–3 years, functional scores demonstrated a statistically significant difference, with median values differing by 1–2 points. Histological analysis revealed that the extent of morphological bone tissue changes (microfractures, defects, necrosis) was 4,97-fold lower following RTKA compared to the conventional technique.

   Conclusion. Histologically, RaTKA is characterized by a 4,97-fold reduction in bone tissue damage and bone surface roughness (p < 0,05) relative to conventional TKA, without affecting three-year clinical outcomes.

   Introduction. The knee joint is the largest and most structurally and biomechanically complex joint, which makes it the most vulnerable component of the musculoskeletal system. Injuries to the knee joint account for approximately 50% of all joint injuries in the human body. Damage to the capsuloligamentous apparatus of the knee joint is the most common, which determines the relevance of this problem. Timely recognition of the presence and severity of cruciate ligament pathology is essential for determining the optimal treatment strategy, including surgical reconstruction.

   Aim of the study. To assess the feasibility of using diffuse reflectance spectroscopy as a diagnostic method for detecting insufficiency of the knee joint cruciate ligaments.

   Materials and methods. The study objects were explanted cruciate ligaments of the knee joint obtained from patients undergoing elective primary total knee arthroplasty. Tissue harvesting was performed together with bone blocks at the sites of cruciate ligament attachment. In the preoperative period, all patients underwent magnetic resonance imaging with assessment of cruciate ligament status using the ACLOAS scale. Ligament integrity was evaluated prior to harvesting using the AAOS classification. Subsequently, the explants were examined using diffuse reflectance spectroscopy in the near-infrared (800–1050 nm) and mid-infrared (1050–1800 nm) spectral ranges.

   Results. In the near-infrared range at a wavelength of 910 nm, statistically significant differences (p < 0.05) were identified among the measured parameters for all three grades of ligament injury severity according to the AAOS classification. In the mid-infrared range, within 1050–1200 nm, a highly statistically significant difference was observed between the mean values of grade I and grade II ligament injuries according to AAOS (p < 0.0001).

   Conclusion. Data analysis demonstrated that diffuse reflectance spectroscopy is a promising diagnostic tool for differentiating stages of cruciate ligament pathology of the knee joint.

   Background: the high rate of unsatisfactory outcomes following total knee arthroplasty (TKA) necessitates continuous refinement of surgical techniques, including the implementation of minimally invasive approaches and robotic-assisted systems.

   Objective: To evaluate the efficacy of robotic-assisted TKA utilizing the subvastus approach compared with conventional manual TKA.

   Materials and Methods: This prospective randomized controlled trial enrolled 60 patients with stage III knee osteoarthritis (Kellgren-Lawrence grade). The study group (n=31) underwent robotic-assisted TKA via subvastus approach; the control group (n=29) received manual TKA through medial parapatellar approach. Primary outcomes included pain intensity (VAS), functional recovery (KOOS), and knee range of motion assessed up to 12 months postoperatively.

   Results: In the early postoperative period (postoperative days 1, 3, 5, and month 1), the robotic subvastus group demonstrated statistically significant reductions in pain scores (p < 0.05), greater knee range of motion, and superior KOOS functional scores. Analgesic requirements during hospitalization were 32.5 % lower in the study group. By 6 and 12 months, intergroup differences were no longer statistically significant.

   Conclusion: The subvastus approach in robotic-assisted TKA significantly reduces early postoperative pain and accelerates functional rehabilitation compared to conventional manual TKA performed through medial parapatellar approach.

   Introduction. Strategies that can slow or prevent articular cartilage deterioration remain clinically important. Reduced expression of genes encoding major extracellular matrix components, including aggrecan and decorin, is associated with cartilage degeneration.

   Objective: To assess how a hyaluronic-acid–based synovial fluid substitute containing chelated zinc influences the expression of aggrecan, decorin, and transforming growth factor TGF-β1 in a senescent chondrocyte model.

   Methods: Primary chondrocytes were isolated from costal cartilage and cultured. Cellular senescence/inflammaging-associated genotoxic stress was induced by ultraviolet irradiation. Four conditions were compared: (1) untreated control culture; (2) inflammaging model (IM); (3) IM with hyaluronic acid gel (IM+HA); and (4) IM with the hyaluronic acid + chelated zinc preparation Yuventa (IM+Yuventa). Chondrocyte phenotype was confirmed by immunocytochemistry using monoclonal antibodies to type II and type IV collagen, with signal detection by confocal immunofluorescence microscopy. Relative expression of target markers was evaluated from fluorescence intensity.

   Results: IM was accompanied by a pronounced decline in aggrecan expression (5.6-fold vs control; 0.60 %). HA partially increased aggrecan to 1.34 %, whereas Yuventa raised it to 5.88 %. TGF-β1 dropped to 0.12 % under IM and increased comparably with HA and Yuventa (1.47 % and 1.45 %, respectively). Decorin decreased more than 16-fold under IM; Yuventa did not demonstrate a clear advantage over HA alone for this marker.

   Conclusion: Hyaluronic acid supplemented with chelated zinc may partially restore anabolic activity in senescent chondrocytes, primarily by enhancing aggrecan expression.

   Introduction: displaced fractures of the calcaneus are a complex orthopedic problem, the optimal solution of which is a challenge for the surgeon. Such clinical cases are accompanied by a number of basic symptoms, which are caused by posttraumatic arthrosis of the subtalar and calcaneo-cuboid joints, impingement between the external ankle and the calcaneus (due to which there is dislocation and inflammation of the peroneal tendon sheaths), Impingement syndrome between the talus and tibia, due to the change in the normal angle of the talus and the associated impingement of the calf
nerve and not infrequent compression-ischemic neuropathy of the tibial nerve due to changes in the anatomy of the tarsal canal. We would like to present a method of correction of post-traumatic deformity of the calcaneus, which was first used in 1993 and described in detail by Romasch in 2006, thanks to which it is possible to solve the problems associated with impingement syndrome in the anterior ankle joint, due to the inclination of the posterior aspects of the talus, as well as the height and alignment with the axis of the tibia displaced on valgus and deformed as a result of trauma of the calcaneus. It consists in arthrodesis of the subtalar joint with oblique osteotomy of the calcaneus, recreating the primary fracture line, and subsequent repositioning of the fragments allows to obtain the desired anatomical and radiological picture. This distraction arthrodesis technique has the advantages of using “living” bone tissue to provide arthrodesis, instead of an intermediate bone graft, and the ability to correct the position of the hindfoot to a neutral position before fixation.

   Materials and methods: we performed 11 surgical interventions according to the proposed technique in patients with a long-standing posttraumatic deformity of the calcaneus.

   Results: we obtained positive results after the performed surgical interventions, correction of the calcaneal bone height by 1.5 cm and increase of the Belair angle by 25 degrees occurred.

   Introduction: Periprosthetic joint infection (PJI) remains one of the most serious complications following total joint arthroplasty, with an incidence of up to 2 % after primary and 4–6 % after revision procedures. Increasing antimicrobial resistance and the complexity of treatment necessitate continuous refinement of diagnostic and therapeutic strategies.

   Aim. To provide a comprehensive review of current diagnostic methods and treatment approaches for PJI, with a particular focus on recent spacer innovations. This article is the first Russian-language review to systematize up-to-date global data and technological advances in the field.

   Materials and Methods. A systematic search was conducted in PubMed, eLIBRARY, and Google Scholar databases, focusing on publications from the past 10 years. Inclusion criteria followed the PRISMA protocol. Forty-seven articles, including clinical studies, meta-analyses, and reviews, were analyzed.

   Results and discussion. Coagulase-negative staphylococci and Staphylococcus aureus remain the most frequent pathogens, often protected by biofilms. Diagnostic criteria from MSIS and ICM include biomarkers (e. g., alpha-defensin), leukocyte esterase, and synovial fluid analysis. Two-stage revision arthroplasty with antibiotic-loaded cement spacers remains the standard of care. The review highlights novel spacer modifications, including personalized 3D-printed designs, embedded drug reservoirs, and magnetically controlled delivery systems. The potential role of bacteriophage therapy in multidrug-resistant infections is also discussed.

   Conclusion. This review consolidates current knowledge and recent innovations in PJI diagnosis and treatment, addressing a gap in Russian-language literature. The integration of advanced materials, technologies, and diagnostic tools represents a promising direction for improving patient outcomes

   Introduction: Femoroacetabular impingement (FAI) is a mechanical conflict between the acetabular rim and the femoral head-neck junction, leading to damage of hip joint structures and associated clinical symptoms. Hip arthroscopy is a modern and promising treatment for FAI; however, this orthopedic surgical technique is still in active development, with numerous variations in intraoperative approaches.

   Objective. Based on an analysis of domestic and international publications, this study aims to describe current approaches to key stages of arthroscopic FAI correction, identify major challenges, and outline future directions for this technology.

   Materials and Methods. A review of Russian and international scientific publications on the evolution of arthroscopic FAI treatment was conducted. Searches were performed in PubMed, Google Scholar, and e-LIBRARY using the following keywords: hip arthroscopy, femoroacetabular impingement, hip labral tears, CAM deformity correction, arthroscopic hip capsulotomy, hip arthroscopic surgery, femoroacetabular impingement syndrome. The search depth was 60 years. Conference abstracts and case reports were excluded.

   Results and Discussion. The main challenges in hip arthroscopy include selecting the type of capsulotomy for surgical access, choosing a method for labral repair, and preoperative planning with intraoperative execution of CAM deformity correction. Several studies have shown that insufficient or excessive CAM resection, labral debridement, failed labral repair, and capsular defects are the most common causes of poor clinical outcomes and revision arthroscopic procedures.

   Conclusion. The effectiveness of surgical treatment for femoroacetabular impingement (FAI) depends on multiple factors, including the strategy and technique used at different stages of arthroscopic intervention.

   Background. Ankle osteoarthritis remains a challenging problem, but conservative therapy fails to restore function and does not prevent the progression of degenerative changes. There is no consensus on which surgical strategy—arthrodesis, total ankle arthroplasty, or supramalleolar osteotomy – provides the optimal balance between functional outcomes and complication rates.

   Objective. To conduct a comparative meta-analysis of functional outcomes and complication rates associated with different surgical approaches to the treatment of ankle osteoarthritis.

   Materials and Methods. A literature search was performed in PubMed, Scopus, eLibrary, and CyberLeninka databases for the period 2000–2025. Nine comparative studies (2014–2024) evaluating functional outcomes using AOFAS, FAAM, and MOXFQ scales and complication rates were included. Statistical analysis was performed in R using a random-effects model (DerSimonian–Laird) with Hartung–Knapp adjustment.

   Results. Mean differences between methods did not reach statistical significance (p > 0.05). A trend toward higher functional scores was observed following supramalleolar osteotomy (MD = +3.43; 95 % CI [–9.16, 16.02]) and lower scores following arthroplasty (MD = –13.05; 95 % CI [–28.52, 2.43]). Infection risk was higher after total ankle arthroplasty (RR = 2.32; 95% CI [1.06–5.09]), with revision rates nearly twice as high (RR = 1.92; 95 % CI [0.90–4.10]). Nonunion following arthrodesis occurred in 10–12 % of cases.

   Conclusion. All three methods provide comparable functional outcomes. Arthrodesis is reliable but carries nonunion risk. Arthroplasty is associated with higher infection and revision rates. Supramalleolar osteotomy demonstrates the lowest complication rates and may be considered a joint-preserving option.