METHOD FOR CHOOSING TREATMENT TACTICS FOR PATIENTS WITH INSTABILITY OF LARGE JOINT COMPONENTS Russian patent published in 2021 - IPC A61B17/56 G01N33/49 G01N33/68 G01N33/53 

FIELD: medicine, traumatology and orthopedics in particular.

SUBSTANCE: invention relates to medicine, namely to traumatology and orthopedics, and can be used to choose the tactics of treatment of patients with instability of the components of endoprostheses of large joints. A laboratory study of biological fluid samples is conducted and the indications for performing a one-/two-stage revision surgical intervention is determined, based on the results obtained. Blood is used as a biological fluid. The laboratory study includes an immunological analysis of peripheral blood with the determination of the absolute content of natural killers CD16+CD56+ by flow cytometry, IgM and IgG by immunoturbidimetric method, the content of TNFα by enzyme immunoassay. The set of the above parameters is estimated by calculating the coefficient P=1/(1+exp (Z)), for which the auxiliary variable Z is calculated by the formula: Z=13.086 – 0.024· (СD16+СD56+) – 0.546·IgM + 0.022·IgG + 1.581·TNFα,

where: CD16+CD56+ is the absolute content of natural killer, cells/mcl; IgM the level of serum immunoglobulin, class M, pg/ml; IgG-the level of serum immunoglobulin, class G, pg/ml; TNFα the level of TNFα serum in the blood, pg/ml. At 0≤P<0.5, a two-stage revision endoprosthesis is performed with the installation of an antibacterial joint spacer. At 0.5≤P<1, one-stage revision endoprosthesis.

EFFECT: method makes it possible to make a rational choice of indications for a one-/ two-stage revision surgical intervention based on the assessment of the state of the patient's immunoreactivity after primary endoprosthesis without the use of invasive diagnostic procedures such as diagnostic arthroscopy, puncture of the knee joint area, due to the combination of such techniques as, on the one hand, the use of a complex of clinical and laboratory parameters obtained by blood analysis, on the other hand, the use of a correction factor formed on the basis of individually defined constant values for each parameter, focused specifically on the pathology of large joints.

1 cl, 2 ex