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Orthopedy

Marked tendency to "rejuvenation" of various etiology arthritises-arthroses and high disability rate among working age patients makes us to search for new ways in complex treatment of musculosceletal system diseases.

Arthrosis is a disease of joints and joint-forming structures predominantly of dystrophic-degenerative character.
Arthrosis makes 73-75% of musculosceletal system diseases. First radiologic arthrosis signs manifest at age of 55-65. Disease clinical signs after 50 are observed in 22% of females and in 15% of males. At first place large support joints suffer. Disease start has little symptoms: pain sensation develops by the end of a day, after physical load. Joints contours do not change. Disease progression leads to visible articular deformation, joint contours changing, restricted mobility and difficult mobility in joint, pronounced pain syndrome, and disability.

Disease may develop at any age.

 

Fig.1. X-ray picture. Х-like leg angulation in knee joints arthropathy deformans.

 

Disease pathogenetic causes are various: hereditary joint pathology, traumas, excessive physical load, metabolic diseases, overweight, hypodynamia, synovial membrane inflammatory diseases, endocrine diseases, genetic predisposition, degenerative-dystrophic changes of joint tissues and structures due to aging.

Among arthrosis causes 74% make age degenerative-dystrophic changes of articular tissues.
During body aging articular tissue supportive-amortization function weakens due to fibrous carcass changing, regeneration processes slowing, slowing in chondrocytes and chondroblasts proliferation, which produce all cartilage matrix elements, primary glycosaminoglycanes that form proteoglycanes – natural softeners. At that restoration of new cartilage damages slows down, cartilage becomes thinner, decreases its elasticity, cartilage becomes fragile, and its surface becomes rough.

Normally cartilage tissue metabolism is maintained through diffusion of nutrients, microelements, oxygen, etc. from synovial fluid during periodic pressure and load release on joint cartilage during movement. In arthrosis the synovial membrane becomes involved, which inflammation leads to secretion disturbances of synovial fluid by superficial cells that are the principal source of nutrients inflow and natural joint lubrication.

Due to its certain viscosity synovial fluid covers articular surfaces, protecting cartilage from rubbing off, promoting new micro-lesions regeneration, softens pressure and shocks during running, jumps, and sudden heavy loads lifting. It is interesting that during changes in rubbing force synovial fluid content also changes, which is associated with hydration degree of its structural proteins – proteoglycans having a globular structure. Such proteoglycan structure provides them with ability to restore primary form after mechanical load, provide for soft sliding and shock absorption.

At present important place in complex approach to arthrosis patients treatment is synovial fluid volume replenishing, and its function restoration. With such goal intra-articular fluid substitutes are used. Injectable implant NUBIPLANTтм is the closest to synovial fluid by the structure, hydrophilic properties, physical-chemical, and flow characteristics.

Application method for injectable implant – intra-articular fluid substitute

Its application method adds up to the usual adopted procedure of intra-articular injection, demanding certain doctor’s qualification and not demanding any additional technical facilities. The volume of applied material depends on articulate cavity volume and may be 0.5 to10.0 ml. The necessary implant volume shall be injected as single injection with observing aseptic rules. Clinical effect is preserved for 4 - 12 months depending on joint functional condition. If needed, additional implant volume may be injected, as well as it is possible to enter a single injection into several joints. Treatment may be completed in out-patient conditions. Immediately after injection implant improves rubbing surfaces sliding in affected joint, decreases pain, gradually restores articular mobility.

 

Fig.2. Injection scheme of injectable implant into knee joint cavity.

 

Implant action mechanism
replenishes (replaces) synovial fluid volume.
increases synovial fluid viscosity.
protects articular cartilage from mechanical damages.
prevents articular inflammations.
promotes metabolism normalization in joint.
stimulates articular cartilage regeneration.
prevents commissures formation.
does not resorb.

 

 

 

Indications for use:

- synovial fluid replacement;
- synovial fluid replenishing;
- in articular reconstructive surgeries;
-in reconstructive-restorative surgeries on joint-tendon apparatus;
-in tenogenic contractures;
-in arthrogenic contractures;
-in osteoarthroses of various etiology.

Contraindications:
- acute joints inflammatory diseases;
- worsening of chronic joints inflammatory diseases;
- skin inflammations at planned injection site.






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