Clinical and pathogenetic role of endogenous and exogenous metals in gonocoxarthrosis, contained in the prosthetic knee and hip joints

Abstract

Topicality. Gonocoxarthrosis is accompanied by microelementoses proceeding with a disorder in the body levels of many essential and toxic metals. After endoprosthesis replacement, the content of such metals as Co, Cr, Ti, and others in the blood changes. They are able to determine the "durability" of the prosthesis transplantants and the further course of osteoarthosis (osteoarthritis) of the knee and hip joints.Objective — to determine levels of metals in blood and hair of patients with gonococcemia, which were part of a joint endoprosthesis (Al, Co, Cr, Fe, Mo, Ni, Ti, V), comparing with the indicators of Co, Cr, Mo, Ni, Ti and V in the soil of areas of patients residence, to evaluate the clinical and pathogenetic significance of endogenous and exogenous microelements in different variants of the disease.Matherial and methods. The study involved 87 patients with gonarthrosis (45% men and 55% women aged on average age 53 years). I, II and III stages of the disease respectively were diagnosed in 28%, 41% and 31% of the observations, polyarthrosis occurred in 53%, osteochondrosis — 92%, spondiloarthrosis of bootastic joints in 71% of clinically symptomatic synovitis 67%. To study the performance of metals in the organism the atomic absorption spectrometer "SolAAr-Mk2-MOZe" with electrographyte atomizer (UK) was used. Assessment of anthropogenic trace element contamination of soil by metals was made by sanitary stations and the regional offices of the State committees for Hydrometeorology, environmental control and environmental safety.Results. If gonocoxarthrosis in the blood serum is accompanied by a significant rise in blood levels of Ti and V, in hair — Al, Fe and Ti, while decreasing in the first object of study Fe, and the second Co, Cr and Mo, and further development of lesions of the hip joints occurs with higher blood levels of Ti and V, in the hair — Ti against the background of oppression of the contents of the Cr. Indicators correlate among themselves, depending on the degree of severity of the disease, affect the severity of degenerative inflammatory changes. The level of Ti in the soil is directly correlated with the concentrations of Fe and Mo in the serum, and the settings in the hair of Al, Co, Cr, Mo, Ni, Ti and V in the hair depending on the content of Co, Cr, Ni and V in the soil, and the integral indexes of the severity of microelements in blood and hair of patients with gonarthrosis has direct dispersion-correlation connections, respectively, with the indices Cr and V in the soil, with Co, Ti and V have an impact on the formation of the epiphyseal osteoporosis, ligamentos, trabecular edema of the femur and of the patella, damage to the anterior cruciate ligament.Conclusions. Gonocoxarthrosis is accompanied by microelementoses of metals contained in endoprothesis of knee and hip joints, which is closely associated with the same level of metals in the soil of the region of patients residence and forces the necessitaty of study of the status of the trace element composition in blood and hair of patients in the process of dynamic observation after joint replacement taking into account the nature of the environmental areas.