Use of Additive Technologies in Surgical Treatment of Chronic Posterior Dislocations of the Shoulder.

The aim of the study was to evaluate the efficiency of additive technologies in surgical treatment of patients with osteochondral defects of the humeral head articular surface against the background of chronic posterior dislocation of the shoulder by means of comparing clinical and radiological results with the McLaughlin procedure. Materials and Methods: A prospective randomized comparative group clinical study was conducted, which included 20 patients who in 2019-2021 underwent surgical treatment of chronic posterior dislocation of the shoulder in the Traumatological and Orthopedic Department of the Institute of Traumatology and Orthopedics of the Privolzhsky Research Medical University (Nizhny Novgorod, Russia). Depending on the type of surgery, all patients were divided into 2 groups: group 1 (n=10) was subject to McLaughlin procedure, whereas group 2 (n=10) - to reconstruction of the humeral head using a customized implant based on additive technologies (3D printing). To assess postoperative results, 6 months after the surgery all patients underwent the following procedures: X-ray imaging of the shoulder joint in two projections, CT scanning, and angulometry as well as provided their responses in line with the following questionnaires: Visual Analog Scale (VAS), Disabilities of the Arm, Shoulder and Hand (DASH), American Shoulder and Elbow Surgeons Shoulder Score (ASES), Constant Shoulder Score (CSS), Shoulder Rating Questionnaire (SRQ), and the Hospital for Special Surgery Shoulder Surgery Expectations Survey (Survey of patient, SP). Results: Both the McLaughlin procedure and the reconstruction of the humeral head using a customized implant made using additive 3D printing technologies increased the range of motion in the shoulder joint, mitigated the pain syndrome and improved the patients' quality of life. During the postoperative period, there were no infectious complications in both groups. The total bed-day in group 1 was 7 [5; 9] days; in group 2, it was 8 [6; 9] days. There was no recurrence of dislocation or progression of osteoarthritis of the shoulder joint in patients in both groups during 6 months after the surgery. The ASES, SP, SRQ, CSS, DASH, and VAS questionnaires assessment for both groups showed a statistically significant improvement for all indicators in the postoperative period. There were no statistically significant differences found between the groups as to the results of angulometry and answering the questionnaires. Conclusion: Customized implants made using additive technologies can shorten the surgery duration by 1.3 times, whereas the volume of intraoperative blood loss - by at least 1.5 times compared to the McLaughlin procedure.

[Comparative efficiency of a course of multi-factor physiotherapeutic treatment and a complex of instrumental physiotherapy technics for medical rehabilitation of patients with stable angina pectoris].

Examination of comparable groups of patients with angina of efforts has demonstrated identical clinical efficiency of multi-factor therapeutic modalities and methods of instrumental physiotherapy for medical rehabilitation of patients with stable angina of effort. The results of this study suggest the possibility to avoid polypragmasia when prescribing physiotherapeutic treatment.

[The scope and algorithm of instrumental physiotherapy programs at the hospital stage of rehabilitation of patients with stable angina pectoris].

Optimization of the list of physiotherapeutic methods for rehabilitation of patients with stable angina of effort provided a basis for the rationale and the development of an algorithm of instrumental physiotherapy programs. The algorithm permits to avoid negative effect of environmental physical factors on the human body.

[Biofeedback-wave rehabilitation therapy in combined treatment of patients with stable angina pectoris]. / Informatsionno-volnovoi metod fizioterapii v kompleksnom lechenii bol'nykh stabil'noi stenokardiei.

160 patients with stable stress angina pectoris (SSAP) received combined treatment. One of the modalities was information-wave impact generated by devices Azor-IR, Chrono-DMW (microwaves), Chrono-EHF. The impact from Azor-IR proved most effective as it reduced the amount of medication without loss of therapeutic activity.