37. Thomas C. Vangsness, Jr., Ivan A. Garcia, Randal Mills, Marion A. Kainer, Michael R. Roberts, Tillman M. Moore: Allograft Transplantation in the Knee: Tissue Regulation, Procurement, Processing, and Sterilization. The American Journal of Sports Medicine, Vol. 31, NШ. 3 © 2003 AЦОrТМКЧ OrЭСШpКОНТМ SШМТОЭв ПШr SpШrЭs MОНТМТЧО. 38. Thoren K, Aspenberg P: Ethylene oxide sterilization impairs allograft incorporation in a conduction chamber. Clin Orthop, 1995, 318: 259-264. 39. Allograft associated bacterial infections—United States, 2002. MMWR Morb Mortal Wkly Rep, 2002,51: 207–210. 40. Vangsness CT Jr, Triffon MJ, Joyce MJ, et al: Soft tissue for allograft reconstruction of the human knee: A survey of the American Association of Tissue Banks. Am J Sports Med, 1996, 24: 230–234, 41. . ., . ., . . . , 1989, 116 42. . . et al. , ., 1965. 43. . . , 1963. 44. . . . , 1947, VIII, 5. 45. ., , . , 1969, 113 p. 46. . . . . . . ., 1991, 354 . 47. ., , ., 1957, 608 p. А ю А ă А . ., А Аă А ă ю . ., ă ю А ă . ă ă ă ă ., , , . . Summary Polarizing microscopy methods in differential diagnosis of infection in patients after total hip or knee replacement A new technique of polarizing microscopy was assessed for diagnostic value in differential diagnosis of septic and aseptic complications after total joint replacement. 56 patients with complications in the hip or in the knee were assessed. The possibility to differentiate periprosthetic infections from aseptic inflammatory complications using polarizing microscopy, spectropolarimetry, and microphasometry was established. Asymmetry and excess of spectral relation of light beam polarization azimuth differ in aseptic and in septic arthritis, including infected prosthesis, by 5.1-5.4 ЭТЦОs. TСО ЦОЭСШН’s sОЧsТЭТvТЭв rОКМСОs 87-88% at specificity of 71-72%. AsyЦЦОЭrв КЧН ОбМОss ШП pСКsОs’ МШШrНТЧКЭО НТsЭrТЛЮЭТШЧ ТЧ ХКsОr ЦТМrШsМШpв ШП synovial fluid from patients with aseptic and septic arthritis, including periprosthetic infection, differ by 1.8-2.4 ЭТЦОs. TСО ЦОЭСШН’s sОЧsТЭТvТЭв Тs 73-75% at specificity of 64-69%. The results of such assessments are available within 1.5-2 hours. Rezumat DТКРЧoЬЭТМuХăНТПОЫОЧ ТКЭăКХăМoЦpХТМК ТТХoЫăЬОpЭТМОăşТăКЬОpЭТМОăНup ăОЧНopЫoЭОz ЫТХОă КЫЭТМuХК ТТХoЫăЦКЫТăpЫТЧăЦОЭoНКăНОăpoХКЫТzКЫОăЦТМЫoЬМopТМ DО КЮЭШrТ К ПШsЭ ОХКЛШrКЭă Ш ЧШЮК ЭОСЧТМă НО pШХКrТгКrО ЦТМrШsМШpă pОЧЭrЮ НТКРЧШsЭТМЮХ НТПОrОЧ ТКХ КХ МШЦpХТМК ТТХШr sОpЭТМО sКЮ КsОpЭТМО НЮpК ОЧНШprШЭОгКrОК КrЭТМЮХК ТТХШr ЦКrТ КЮ ПШsЭ 216 ОvКХЮК Т 66 НО pКМТОЧЭТ МЮ МШЦpХТМК ТТ ХК ЧТvОХЮХ КrЭТМЮХК ТОТ şШХНЮХЮТ sКЮ К РОЧЮЧМСТЮХЮТ. A ПШsЭ staЛТХТЭ pШsТЛТХТЭКЭОК НО К НТПОrОЧ ТК ТЧПОМ ТТХО pОrТprШЭОЭТМО НО МШЦpХТМКЭТТ ТЧПХКЦКЭШrТТ КsОpЭТМО, ПШХШsТЧН ЦТМrШsМШpТО pШХКrТгКЧЭă, spОМЭrШpШХКrТЦОЭrЮ, şТ ЦТМrШpСКsШЦОЭrТО К prШЛОХШr ХТМСТНЮХЮТ sТЧШvТКХ. AsТЦОЭrТО şТ ОбМОs НО rОХК ТК spОМЭrКХО НО ХЮЦТЧК pШХКrТгКЭК КгТЦЮЭ ПКsМТМЮХ НТПОră ьЧ КsОpЭТМО şТ ьЧ КrЭrТЭК sОpЭТМК, ТЧМХЮsТv ТЧПОМЭКЭО prШЭОгО, НО 5.1-5.4 ori. Sensibilitatea metodei atinge 87-88% cu specificificare de 71-72%. AsТЦОЭrТО şТ ОбМОs НО НТsЭrТЛЮ ТО МШШrНШЧКЭО ПКгО "ьЧ ЦТМrШsМШpТК МЮ ХКsОr НО ХТМСТН sТЧШvТКХ НО ХК pКМТОЧЭТ МЮ КrЭrТЭК КsОpЭТМО şТ sОpЭТМО, ТЧМХЮsТv ТЧПОМЭТТ pОrТprШЭОЭТМă, НТПОră НО 1.8-2.4 ori. Sensibilitatea metodei este de 73-75% cu specificarea de 64-69%. MОЭШНОХО ЮЭТХТгКЭО ПКМ pШsТЛТХă НТКРЧШsЭТМКrОК prШМОsОХШr sОpЭТМО şТ КsОpЭТМО ьЧ ЭТЦp de 1,5-2 ore. ю . . 66 , , . 5,1 - 5,4 . 71% -72%. 87% -88% 1,8-2,4 . 64% -69%. 73% -75% -2 1,5 . , , . , 3-5% Д1,7,8Ж. 1-2%, – , . , 2-5 20 , , , , , Д8,9,10Ж, « , , , , ; » , . . Д3,9Ж. , . , ( . ) , , , , [5,6] , , , , . 217 , - 44 . 66 , , I-III, , , ( КЮrОЮs 4 . , . , ). PsОЮНШЦШЧКs КОrЮРТЧШsК. 11 , , 12 S. , - ( ( -1) , . . 1-4 ( . 1. 1 - He-Ne , . MATLAB -1 , ) ,3- ,2;6- 11 - , . 1). -1. , 5, 8 , 4, 9 ,7- . , 10 - CCD , 1,5 - 2 , . 1 , , 218 . 2 . , . , . (λ ţ 650 . ) ( , . 2). 2. . (λ ţ 610-650 1( ) . 3). 3. . 1-4 ( 1). 219 1 2 ( n 12 ) o 1 ( n 44 ) 0,016 0,0029 0,031 0,005 0,17 0,026 2,25 0,37 0,68 0,11 0,38 0,063 0,41 0,073 3,48 0,57 1, 5,1-5,4 1 2 . , . , 2. 2 2 ( n 12 ) 1 ( n 44 ) 0,72 0,012 0,095 0,013 0,84 0,11 4,12 0,68 0,87 0,13 0,145 0,023 2,09 0,34 2,23 0,36 2, 1,8-2,4 . 87% -88% 71% -72%. 73% -75% 64% -69%. , . 1. , . 220 2. 5,1 - 5,4 71% -72%. 87% -88% . 3. 1,8-2,4 64% -69%. . 4. -2 1,5 . . ., 1. .33-36. 2. . ., . . . ., . ., 4. . ., . ., . ., , . . .: , . . 2004 .- - . . / / - 2007. - № 3 - . 38-41. . ., // .-2006.-№11-12.- .55. . . // - 2007. - № 4 - . 20-26. 5. / / 23-24 - 3. 6. 73% -75% ,2000.-305 . Д .Ж.; . , / . . : . . . . , . . .- / . . , . . , . . , . . . .: , 2007. - 314 . 7. Clinical features and outcome of septic arthritis in a single UK Health District 1982–1991 / V.C. Weston, A.C. Jones, N. Bradbury [et al.] // Ann Rheum Dis. - 1999. - № 58. – P. 214– 219. 8. Trampuz A, Osmon DR, Hanssen AD, Steckelberg JM, Patel R. Molecular and antibiofilm approaches to prosthetic joint infection. Clin Orthop Relat Res. 2003;414:69–88. 9. Blom AW, Brown J, Taylor AH, Pattison G, Whitehouse S, Bannister GC. Infection after total knee arthroplasty. J Bone Joint Surg Br. 2004;86(5):688–91. 10. Cui Q, Mihalko WM, Shields JS, Ries M, Saleh KJ. Antibiotic-impregnated cement spacers for the treatment of infection associated with total hip or knee arthroplasty. J Bone Joint Surg Am. 2007;89(4):871–82. 221