The effect of therapeutic and diagnostic arthroscopy on the condition of the synovial environment of the ankle joint in patients with the initial stages of posttraumatic crusarthrosis

Purpose of the study: to compare the cytological composition of synovial fluid in patients with the initial stages of posttraumatic crusarthrosis after therapeutic and diagnostic arthroscopy and conservative therapy, to evaluate the results of treatment using the AOFAS questionnaire.Materials and methods. From 2013 to 2017, 2 groups of patients after osteosynthesis for ankle fractures were examined on the basis of the N.N. Burdenko Center for Traumatology and Orthopedics of the GVKG. The main group underwent removal of metal structures and arthroscopy 6-12 months after osteosynthesis. The control group was treated conservatively after removal of the metal structure. All patients underwent cytological examination of the synovial fluid of the ankle joint. The effectiveness of treatment was evaluated on the AOFAS scale.Results. In all patients, the cytosis values were increased by five times before treatment. In both groups, 3 months after treatment, the number of cell elements in one µl decreased. In the control group, the number of cells in one µl exceeded the norm after 6 and 12 months. In the main group, after 1 year, cytosis decreased too normal. According to the results of synovial fluid analyses, all patients had an excess of the number of macrophages, neutrophils, histocytes, and lymphocytes before the start of treatment. For 3 months after treatment, inflammation decreased in all patients. In the control group, the growth of macrophages and neutrophils was noted, with the preservation of the inflammatory process for the entire duration of the study. After LDA, the number of neutrophils and macrophages decreased until the end of the study. According to AOFAS, good indicators were recorded in two groups 3 months after treatment, which changed to unsatisfactory after 12 months. Patients after LDA maintained a good result until the end of the study. Conclusions. LDA in combination with the removal of metalwork after ankle fractures reduces inflammation in the ankle joint, which reduces pain, slows down the development of DOA, and maintains a good AOFAS result (p function show_eabstract() { $('#eabstract1').hide(); $('#eabstract2').show(); $('#eabstract_expand').hide(); }