V.N. TsIbulkina, I.Ph. Akhtyamov, T.A. Kilmetov

Kazan State Medical University, 49 Butlerov Str., Kazan, Russian Federation, 420012

Tsibulkina V.N. ― D. Med. Sc., Professor, Head of the Department of clinical immunology and allergology, tel. (843) 231-20-87, e-mail: [email protected]

Akhtyamov I.Ph. ― D. Med. Sc., Professor, Head of the Department of traumatology, orthopedics, and surgery of extreme situations, tel. (843) 269-50-15, e-mail: [email protected]

Kilmetov T.A. ― postgraduate student of the Department of traumatology, orthopedics, and surgery of extreme situations, tel. (843) 269-50-15, e-mail: [email protected] 

Pyoinflammatory complications after endoprosthesis replacement of large joints are caused not only by operative invasion itself, but also by the state of anti-infectious immunity that was present in patient prior to operation. Comorbid diseases can contribute to changes in immunological reactivity by decreasing antibacterial resistance. The most important mechanisms in development of transient immunological deficiency in postoperative period are disorders of neutrophilic phagocytosis, decrease in opsonic activity of blood serum and evident disimmune globulinemia. Clinical and laboratory control allows to diagnose and to purposefully stimulate immunity, increasing phagocytic activity of neutrophils and macrophages, restoring balance of regulatory cells and increasing concentrations of immunoglobulins in blood serum. Immunotherapy together with antibacterial and anti-inflammatory treatment is a rational approach to cure infectious complications after joints replacement.

Key words: joint replacement, infectious complications, immunological insufficiency, immunotropic therapy.

REFERENCES

1. Tkachenko A.N., Bakhtin M.Yu., Zharovskikh O.S. et al. Features of forecasting of purulent complications of hip replacement in patients of older age groups. Travmatologiya i ortopediya Rossii, 2012, 2, pp. 48-53 (in Russ.).
2. Zheleznikova G.F. Infection and immunity: the strategy on both sides. Meditsinskaya immunologiya, 2006, vol. 8, no. 5-6, pp. 597-614 (in Russ.).
3. Pal’tsev M.A., Cherepakhina N.E., Shonfel’d E. et al. Postinfectious clinical and immunological syndrome: Etiopathogenesis basics and strategy immunogenodiagnostiki. Vestnik Rossiyskoy AMN, 2009, 10, pp. 25-31 (in Russ.).
4. Simonova A.V., Lebedeva I.S. Innovative methods of diagnosis and treatment of secondary immunodeficiencies. Lechashchiy vrach, 2012, 4, pp. 16-19 (in Russ.).
5. Bozhkova S.A., Tikhilov R.M., Krasnova M.V., Rukina A.N. Orthopedic implant-associated infection: the leading pathogens, local resistance and recommendations on antibiotic therapy. Travmatologiya i ortopediya Rossii, 2013, 4, pp. 5-14 (in Russ.).
6. Bekhalo V.A., Sysolyatina E.V., Nagurskaya E.V. Regulation of the innate immune response in the focus of chronic inflammation. Immunologiya, 2009, 3, pp. 184-187 (in Russ.).
7. Vasil’eva G.I., Ivanova I.A., Tyukavkina S.Yu. Cooperative interaction of mono- and polynuclear phagocytes mediated mono- and neutrophilokine. Immunologiya, 2000, 5, pp. 11-16 (in Russ.).
8. Dobrotina N.A., Prokhorova M.V., Kazatskaya Zh.A. Influence polyoxidonium native and immunomodulators on immunological reactions in vitro. Immunologiya, 2005, 3, pp. 152-155 (in Russ.).
9. Immunoterapiya: rukovodstv, pod red. R.M. Khaitova, R.I. Ataullakhanova [Immunotherapy: manual. Ed. by R.M. Haitov, R.I. Ataullahanov]. Moscow: GEOTAR-Media, 2011. 672 p.
10. Pobel A.N., Klyatskiy Yu.P., Peleshchuk I.L. et al. Treatment of inflammatory complications of joint replacement tazobodrennogo joint. Suchani medichni tekhnologii, 2011, 2, pp. 55-58 (in Russ.).
11. Pavlov V.V., Sadovoy M.A., Prokhorenko V.M. Modern aspects of diagnosis and surgical treatment of patients with periprosthetic infection of the hip joint. Travmatologiya i ortopediya Rossii, 2015, 1, pp. 116-123 (in Russ.).
12. Sereda A.P., Kavalerskiy G.M., Murylev V.Yu. Rukin Ya.A. Diagnosis of periprosthetic infection. Travmatologiya i ortopediya Rossii, 2014, 4, pp. 115-121 (in Russ.).