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Introduction. Healing of finger flexor tendons after reconstructive operations takes place under the conditions of scary changes in fibro-osseous canals. Determining factor for the functional outcome is the intensity of commissural process around the flexor tendon. The problem of conventional treatment is the impossibility to ensure the ingrowth of fibrous tissue into the scar zone with simultaneous formation of smooth canal wall.Patients and methods. Eighty six patients with 94 finger flexor tendon injuries along the fibroosseous canals were operated on. Eighteen operations with primary delayed deep flexor tendon suture, 8 operations with repeated suture and 7 operations of tendon tenolysis after primary suture were supplemented with the proposed method of temporary isolation of the reconstructed tendon within a dissected polymeric tube. The tube isolates the tendon from blood clots, forms the smooth canal wall.Results.Finger function was assessed in 6 and 12 months. After operations supplemented by temporary isolation of the tendon within the polymeric tubes excellent and good results were achieved at shorter terms, no tenolysis was required and one-step tenoplasty could be performed instead of two-step reconstruction.

The lubricity of medical and tribological preparations based on blood serum and intended for injection into joints is studied. It is found that the lubricity of the blood serum of osteoarthritis patients improves after the use of Doxycycline, a semisynthetic antibiotic from the tetracycline group. The induction method is used to measure the magnetic susceptibility of preparations based on blood serum and synovia sampled from joints with various pathologies. It is shown that all of the preparations are diamagnetics. The atomic-force microscopy method is used to find variations in the structure of patients’ blood serum resulting from the biochemical bonding of Doxycycline with blood proteins. Increase in the imaginary part of the magnetic susceptibility, which characterizes the absorption of the magnetic energy by the sample, is caused by growth of the magnetic moment in the fluid; the moment is directed oppositely to the electromagnetic field of the joint. It initiates the transformation of the lubricating film structure, reduces friction in the joint, and acts as a biophysical ground for methods of transfusion chondroprotection that favor the improvement of the tribological state of joints.

Analysis of the development of ideas concerning the bioelectrical fields of living organisms shows that approaches to the modeling of the electromagnetic field of synovial joints in experiments in vitro have not yet been developed. The current work considers the biophysical and biochemical processes of the formation and circulation of synovia in joints, which are controlled by their natural electromagnetic field. The basic conditions are determined of the adequacy of the effect on friction and lubrication of a natural biofield in a synovial joint and of an external electromagnetic field in a friction pair that imitates a joint. Examples of the modeling of the electromagnetic field of the joint in experiments in vitro are given, demonstrating the pronounced effect of the external field on the lubricity of synovia.

Comparison of biochemical composition and biophysical properties showed the pathogenetic expediency of blood serum use as a corrector of synovial environment in joints affected by osteoarthritis. For serum modification the patients were preliminary given a single dose of drug only. Then patient's blood was collected in the period of its maximum saturation by preparation. Serum obtained was applied in patients with knee joint osteoarthritis of 2-3 stages using three intra-articular injections. The evaluation of treatment results 5-6 months after treatment completion showed a significantly better and more stable therapeutic effect in test group as compared with patients from control group. Positive effect was stipulated by pain decrease, normalization of articular tissue trophicity, depression of local inflammation and cartilage lubrication improvement.

The paper discusses a methodology for correcting the tribological state of synovial osteoarthritic joints by means of blood dialysis. The concept of medicinal and immunological modification of lubricating fluids based on blood serum is substantiated. The concept is based on the fundamental capacity of living tissues, as frictional materials, to regenerate defects on the friction surfaces of cartilage during metabolism.

The paper presents a review of current trends in biotribiology. The authors discuss the extent of the achievements in this field at the turn of the 21st century. This period is distinguished by the discovery of liquid-crystalline and quasi-electret states revealed by AFM in the articular lubricating fluid; new boundary lubrication mechanisms, which are realized by organic super-lubricants at the nanolevel; and methods for in vitro study of friction in joints using electromagnetic fields able to simulate the natural articular biofield. A relationship is traced between biotribology and the chief directions in contemporary orthopedics, namely: 1) articular chondroprotection exercised via local therapeutic methods based on tribomonitoring of pharmaceutic substances; 2) injection of drugs based on blood serum; 3) development of a new generation of articular endoprostheses able to simulate the biophysical properties of synovial joints. It is shown that progress in modern biotribology has provided scientific substantiatiation of orthopedic treatment procedures. The ideas advanced by I.V. Kragelskii in resolving various engineering problems have proven fruitful in biotribology, which deals with living tissues and biological fluids.

A concept is advanced and a structural diagram is shown of the synovial joint as an “intelligent” friction unit possessing the properties of a cybernetic system. The joint demonstrates a record-low friction coefficient and compensation of cartilage wear as a triboengineering material maintaining human locomotor activity for many years. It is provided with a feedback system with the sympathetic center controlling the lubricating conditions of the movable joint of the articular bone ends, the lubricating fluid composition, and the elimination of debris from the articular capsule. The main reason why the joint fails is insufficient lubrication due to disruption of the exchange between the bloodstream and the joint synovial shell inducing a deficit of the lubricating synovial fluid. The disruption of the exchange is compensated by injecting synovial fluid substitutes. The paper shows the results of tribological studies and clinical trials providing evidence that the patient’s blood serum can be used as an absolutely compatible lubricating fluid to restore the functions of the articular synovial medium.

Lubricating capacity of drugs injected into articular cavity were tested using a pendulum tribometer. The findings indicate that friction coefficient for a pair simulating metallopolymeric articular endoprosthesis is changed under the effect of electromagnetic field after lubrication. Regularities of these changes depend on the nature and mechanism of action of drugs. A method for rapid evaluation of the lubricating characteristics of drugs is proposed for optimizing their therapeutic effect on joints.

Main medicinal preparations (MPs) administered by injections into a joint cavity are studied by means of electret-thermal analysis and tribometry. In the latter case, the MPs are used as lubricants in a friction pair (a model of an artificial joint) exposed to an electromagnetic field simulating the biological field. Changes in the thermally stimulated current spectra from the MPs exposed to the electromagnetic field and those in the friction coefficient of the pair provide a deeper insight into the physicochemical mechanisms of MP action. Comprehensive tests of MPs involving electret-thermal and tribological analyses may be of great practical significance for optimizing local treatment of diseased joints.