Due to the growing scale of arthroplasty and the widening of indications for knee joint replacement, the durability of joint functioning has become a critical issue. Untimely diagnosis and inadequate treatment of patients with endoprosthesis component loosening leads to major bone defects. This problem arises from repeated joint interventions, large bone defects and duration of revision surgeries, that is fraught with catastrophic consequences for patients – revision prosthesis removal or even limb amputation. The project aims to improve the treatment for patients with instability of components after knee joint arthroplasty. The aim of the study is to analyze the results of revision knee arthroplasty and identify the causes of mistakes and complications of revision arthroplasty with the intention of prevention. Materials and methods. A retrospective analysis of 50 revision knee arthroplasties performed at the Centre for Arthroplasty of the State Institution “Institute of Traumatology and Orthopedics of the National Academy of Medical Sciences of Ukraine” was conducted. Clinical and radiological findings were evaluated for all patients. All revision prostheses used in this study were of the semi-constrained type. Cementation technique was used for all implants. In the revision of the septic complication group, a full cementation technique with antibiotics according to a sensitivity profile were used, while in the aseptic complication group, a surface cementation technique with antibiotics according to sensitivities were used. Results. The authors of the project have analyzed the results of treatment of 50 revision arthroplasty procedures performed between 2013 and 2022 for instability of the endoprosthesis components. The structure of complications has been examined and the causes of failure in revision knee arthroplasty have been identified. This study has shown promise in preventing complications and developing personalized approaches to revision arthroplasty. Conclusions. The analysis of revision knee arthroplasty failure has shown the prevalence of septic complications (56.0 %). In the case of septic complications after revision arthroplasty, Staphylococcus aureus prevailed (57.1 %), gram (-) microorganisms were causative agents in other cases. Factors resulting in aseptic complications included those associated with the surgical intervention (81.8 %), the patient (45.4 %) and the combination thereof (72.7 %). Significant causes of the femoral revision component loosening were residual valgus deformity, medial instability in the frontal plane; significant causes of the tibial component loosening were residual varus deformity and lateral instability in the frontal plane.

Background/Objectives: Spinal excitability may undergo adaptive modulation in response to training load, sport-specific demands, and fatigue. While high-impact sports are known to influence reflex responsiveness, the extent to which these changes differ from athletes in lower-impact disciplines remains unclear. This study aimed to investigate post-exercise changes in Hmax/Mmax ratio among trained runners with varied sport backgrounds, and to identify emergent physiological profiles that may reflect differential spinal adaptation to fatigue. Methods: Twenty-two trained athletes underwent unilateral H-reflex testing before and after treadmill running performed to voluntary exhaustion. Amplitudes of the H-reflex and M-wave were recorded, and Hmax/Mmax ratios were analyzed. Based on a physiologically relevant threshold commonly used to distinguish normal from suppressed reflex amplitudes, participants were post hoc classified into three groups: Group A (pre- and post-test ratios above threshold), Group B (pre above, post below), and Group C (both below). A two-way repeated-measures ANOVA was used to assess between-group effects. Results: Significant differences were found across groups and conditions (p < 0.001). Group A maintained reflex ratios above the threshold, indicating stable excitability. Group B showed the greatest suppression (approximately 66%), transitioning from normal to subthreshold values. Group C remained consistently below-threshold. A significant interaction (p < 0.0001) confirmed that reflex modulation varied by physiological profile. A small but statistically significant reduction in H-reflex latency was also observed; however, this change remained within normal physiological variability. Conclusions: Postexercise H-reflex modulation revealed heterogeneous neuromuscular responses among athletes. These findings may contribute to understanding how sport-specific demands and fatigue shape spinal excitability and may help identify individuals with adaptive or potentially pathological profiles relevant to sports diagnostics.

Aim. To evaluate the impact of complex regional pain syndrome (CRPS) on outcomes following primary and revision total knee arthroplasty (TKA). The study assesses the incidence, clinical manifestations, and functional consequences of CRPS, while evaluating current diagnostic and treatment approaches and the need for standardization. Materials and methods. A systematic scientific review was conducted, covering literature from PubMed, Scopus, and Web of Science published between 2015 and 2025. Inclusion criteria focused on studies of adult patients undergoing TKA who developed CRPS diagnosed by IASP or Budapest criteria. The analysis targeted incidence, clinical manifestations, risk factors, diagnostic approaches, treatment efficacy, and impact on rehabilitation outcomes. Results. CRPS remains a significant complication of TKA, with a reported incidence of approximately 0.2–2.0 % after primary procedures and 2–5 % following revision surgery. Clinical presentation is characterized by refractory pain, vasomotor dysfunction, and restricted range of motion, leading to significantly lower WOMAC and SF-36 scores and prolonged rehabilitation compared to uncomplicated TKA. Diagnosis remains challenging due to the lack of standardized early-detection protocols and symptom overlap with other complications, and underutilization of international diagnostic criteria. While multimodal management (pharmacotherapy, physiotherapy, and interventional techniques) is effective, its success is highly dependent on early initiation. High-quality evidence regarding CRPS in the specific context of revision TKA remains limited. Conclusions. CRPS adversely affects functional outcomes after TKA, with higher prevalence observed in revision cases. The absence of standardized preventive measures and optimized therapeutic regimens highlights an urgent need for personalized rehabilitation strategies and the implementation of international diagnostic criteria in routine clinical practice. Further research is needed to establish precise diagnostic criteria, effective prevention strategies, and personalized therapeutic and rehabilitation approaches.

Traumatic muscle injuries often lead to prolonged functional impairments due to oxidative stress, metabolic disturbances, and structural damage. This study investigates the therapeutic potential of chronic administration of C₆₀ fullerene aqueous (C₆₀FAS) solutions in enhancing muscle recovery post-injury. Rats with experimentally induced gastrocnemius muscle trauma received C₆₀FAS orally at a daily dose of 1 mg/kg body weight. Functional assessments included measurements of maximal force generation and time to peak contraction. Biochemical analyses evaluated lactate, superoxide dismutase (SOD), and catalase (CAT) levels, while histological examinations assessed muscle fiber integrity and collagen deposition. Results demonstrated significant improvements in muscle function, with a 35–40% increase in maximal force and a 27–38% acceleration in contraction time. Biochemical analysis revealed a 25% decrease in lactate concentration, potentially indicating improved metabolic function. This change is in line with normalized SOD and CAT activities, suggesting enhanced redox balance following treatment. Histological analyses revealed preserved myofibrillar architecture and reduced fibrosis in treated muscles. These findings suggest that C₆₀ fullerene facilitates muscle recovery through antioxidant protection, metabolic support, and structural preservation, highlighting its potential as a therapeutic agent for muscle injuries.

Neurogenic atrophy is the most severe type of muscle atrophy. It can be caused by injury or disease of the nerve that connects to the muscle. Damage to the sciatic nerve (nervus ischiadicus) initiates molecular processes that lead to the transformation of muscle dysfunction into an atrophic state. Oxidative stress is one of the key factors that initiates skeletal muscle atrophy. Therefore, this study evaluates the effects of oral administration of water-soluble C₆₀ fullerenes (daily dose: 1 mg/kg), as powerful antioxidants, on the contraction dynamics of the rat musculus soleus on days 15, 30, and 45 following neurogenic atrophy induced by transection of the nervus ischiadicus. Using biophysical (tensometric), biochemical, and histological analyses, we evaluated the biomechanical parameters of musculus soleus contraction (time of onset of muscle force response, integrated muscle power, maximum and minimum contraction forces), blood biochemical markers (concentrations of C-reactive protein, lactate, creatinine, and reduced glutathione, as well as superoxide dismutase and catalase activities), as well as histological and morphometric indicators of muscle damage in rats on days 15, 30, and 45 after injury induction. It was found that the use of water-soluble C₆₀ fullerenes improves the contractile activity of the musculus soleus after neurogenic atrophy and has a time-dependent nature. Specifically, by day 45 of the experiment, the maximum therapeutic effect reached 23–35 ± 2% for the biomechanical parameters of muscle contraction, and the biochemical blood parameters have nearly approached the control values. Finally, histological analysis confirmed a significant reduction in signs of destruction in muscle fibers and the level of fibrosis in the musculus soleus. These findings suggest the potential application of water-soluble C₆₀ fullerenes in the treatment of pathological conditions of the muscular system arising from peripheral nerve injury.

У роботі розроблено тривимірну скінченно-елементну модель системи «великогомілкова кістка – ревізійний колінний імплантат» для оцінювання напруженого стану губчастої кісткової тканини. Досліджено вплив діаметра та довжини ніжки протеза в межах повного факторного експерименту. Побудовано регресійну модель для прогнозування максимальних еквівалентних напружень і показано можливість скорочення обчислювальних витрат під час інженерного підбору параметрів імплантатів.