Restoration and strengthening of soft tissue structures of the musculoskeletal system underlie the principles of regenerative medicine to improve treatment results and prevent possible complications. Influencing various parts of the regenerative process, it is possible to correct the recovery time, the morphological properties of the scar, and, as a result, the clinical results of treatment. We have proposed using a polypropylene mesh (PM) impregnated with a metabolitotropic solution to restore damaged and strengthen weakened structures. The work aimed to study the effect of PM with metabolite impregnation on the regeneration process of soft tissues. A series of morphological and biochemical studies were carried out on laboratory animals. The degree of inducible nitric oxide synthase (iNOS) and endothelial nitric oxide synthase (eNOS) mRNA expression was studied as indicators of tissue ischemia and their trophism in correlation with morphological changes in the zone of mesh implantation. Using a PM with a metabolitotrope increases the expression of eNOS mRNA by 10.8 times, and iNOS mRNA - reduces by 3.6 times. Morphologically coated PM causes a pronounced inflammatory effect, followed by a pronounced proliferation of connective tissue fibers around the mesh elements. Particular attention is drawn to the growth of the microvasculature and the increase in the number of anastomoses - 10.3% of the relative area compared to 8.8% in the group using PM without a metabolite. The metabolitotropic impregnation improves oxygenation and trophism of damaged soft tissues, which helps to stimulate regeneration.

Objectives: The use of infrapatellar fat pad adipose stem cells (IPFP-ASCs) shows an age-independent proliferation and differentiation potential. In addition, the pronounced chondrogenic potential of IPFP-ASCs makes them promising candidates for research for use in other methods of regenerative therapy. The purpose of this study was to ascertain the presence and compare the relative abundance of cells exhibiting an immunohistochemical profile characteristic of adipose-derived mesenchymal stem cells in selected samples of the stromal vascular fraction (SVF) obtained from the IPFP and subcutaneous fat tissue. Methods: A direct immunohistochemical study was carried out in serial paraffin sections of the SVF of the infrapatellar fat pad (IPFP) and subcutaneous tissue, using monoclonal antibodies. The minimum criteria were established by the International Society for Cell Therapy to ensure the identity of mesenchymal stem cells use CD73, CD90, and CD105 as positive markers and CD34, CD31, and CD45 as a negative. Results: According to the results of histological, immunohistochemical, morphometric, and statistical studies, it was found that in the SVF of IPFP and subcutaneous adipose tissue, the relative number of cells with the profile CD105+, CD73+, CD34+, CD31-, CD45- in the standard field of view (x200), the SVF of IPFP was 1.58%, whereas the SVF of subcutaneous adipose tissue was 6.92 %, which was statistically significantly greater by 4.38 times (p < 0.05). Conclusion: The presence of a sufficient number of mesenchymal stromal cells in IPFP in combination with their topographic relationship with the structures of the joint determines the use of the SVF of the IPFP for the treatment of diseases of the knee joint.

In recent years, despite the development of modern methods of diagnosis and treatment of foot injuries in patients with diabetes mellitus, there has been an increase in the number of purulent-necrotic complications with a significant percentage of generalization of the infection. Due to potentially "catastrophic" wound healing, uncontrolled, irrational use of antibiotics, lack of regular blood glucose control, implementation of long and complex surgical interventions leads to the development of complications, including infection. The aim of the study. To substantiate the expediency of using a complex treatment scheme for purulent complications of foot bone fractures in patients with diabetes. Materials and methods. The results of treatment of 25 diabetic patients with foot injuries complicated by a purulent process were analyzed. In order to restore homeostasis disorders, patients received a complex of medical measures, including surgical treatment, infusion therapy, immunotherapy, antibiotic therapy. Patients were under the constant control of an endocrinologist. The results. As a result of complex treatment of patients, the inflammatory process was stopped in 21 (84%) patients, however, in 1 (4%) patient with stage 3 diabetic foot syndrome and in 3 (12%) patients with stage 4 according to the F.W.Wagner classification, the inflammatory process spread on the shin, therefore amputation was performed in this patients. The use of the developed treatment tactics, which included drainage of the wound with the removal of destroyed bone fragments, fixators (pins, screws, plates) in the maximum possible volume is the most effective method of surgical treatment of patients with this form of inflammation and allows you to save the foot, avoid the progression of purulent process and repeated surgical intervention.

Endothelial dysfunction is characterized by a decrease in the bioavailability of the vasodilator – nitric oxide (NO), and an increase in the level of vasoconstrictor substances. This imbalance leads to vasoconstriction, leukocyte attachment and inflammatory reactions in the vascular wall, atherosclerosis and thrombosis. The aim: to evaluate the role of adipose tissue elements in the regulation of parameters of the nitroxidergic system under hypoxia conditions. Materials and methods. The studies were carried out on 30 adult white male Wistar rats. All animals were randomly assigned and divided into groups: a control group (15 rats), type 2 diabetes mellitus (T2DM) was induced in the animals of the second group (15 rats). Isolated fragments of the popliteal arteries (PA) and intrapulmonary artery (IPA) were cleared of perivascular adipose tissue (PVAT-) or left uncleaned (PVAT+) and cut into rings. The simulation of acute hypoxia with further study of medical agents were performed. Results. The PA and IPA with PVAT responded to acute hypoxia with vasoconstriction – an increase in the amplitude of contraction in the first and second phases, and after removing PVAT, they responded with a decrease in the maximum amplitude of contraction by 3.4 times in the 1st phase and an increase in amplitude by 1.8 times in the 2nd phase. Perfusion with Angiolin reduced 2nd phase of HV of the PA and IPA. Adding a combination of Thiotriazoline and L-arginine (1:4) to a solution for perfusion of fragments of arteries of animals with T2DM, causes a significant increase in constrictor reactions in both the 1st and 2nd phases of HV, regardless of presence of perivascular adipose tissue. Conclusions. The presence of PVAT affects the HV of arteries, both in normal and in T2DM. The possibilities of ways of pharmacological modulation of the nitroxidergic system depending on the state of PVAT were determined.

Formulation of the problem Dislocation of the femoral component of the endoprosthesis is one of the most frequent complications of total hip replacement. The best option for the “treatment” of dislocation of the hip endoprosthesis is to prevent the development of primary instability. There are cases in which even with the correct installation of the endoprosthesis components, dislocations arise due to the weakness or defect of the capsular–ligament apparatus. Currently, many methods have been developed to strengthen and restore the posterior structures of the capsule of the hip joint with the help of auto- and allomaterials, which differ in both the fixation technique and the characteristics of the materials themselves. In this paper, we propose a method for restoring and strengthening the posterior structures of the capsule of the hip joint using polypropylene-based graft implants. The purpose of this study is to, with the help of specialized software, build a model of the capsule of the hip joint after capsulotomy and to determine the stiffness capabilities of the defect covered with polypropylene mesh. Results The study was performed using a software package based on the finite-element method. As a result of the performed calculations, pictures of the distribution of the stress–strain state in the “head-capsule” system were obtained. To assess the effectiveness of the method of closing the capsule, from the viewpoint of rigidity, as the main characteristics, the values of the opening of the cut are selected. Conclusions Under the kinematic loading of the model, the smallest values of the opening of the section are obtained when it is closed by a grid. In the case of thread fixation, the values were higher by 8.5%. However, the values of equivalent stresses, both in the capsule and in the head, in the model with the grid turned out to be the largest. These stresses were higher by 23.8% in the capsule and by 60.4% in the head than the same values for the thread fixation model. The obtained results indicate that the model with a grid is more rigid in the considered fixation variants.

Delayed union of fractures is one of the most frequent complications in orthopedic practice, especially in polytrauma patients. With the development of new methods of regenerative medicine, including the use of adipose derived stromal cells as a component of the stromal-vascular fraction (SVF), new possibilities for conservative treatment of this problem have emerged. This article presents a clinical case of conservative treatment of delayed union of a radial bone fracture using local SVF injections. In the fracture space, SVF with PRP creates a pool of cells that could differentiate towards surrounding tissue, releases various inducers of tissue growth and, via an indirect chemotactic effect on receptors, mobilizes the body’s own resources and creates conditions for angiogenesis and trophism in the injured segment. In the patient with delayed consolidation after SFV-therapy, progress in clinical and radiological dynamics was noted with complete healing within 7 months. The positive clinical result provides a basis for further study and implementation in practice.