Summary. A retrospective analysis of case histories and radiographs of 138 patients with hip-lumbar syndrome who underwent hip joint replacement in the clinic of orthopedics and adult traumatology at the ITO NAMS of Ukraine was carried out. It has been determined that the variant of vertical posture, acting on the morphogenesis of coxarthrosis, determines the rate of its progression. It was determined that in the presence of hip-lumbar syndrome, a moderate form of CA progression most often occurs, regardless of the type of lordosis. The slow rate of progression of coxarthrosis is characteristic of hyper- and normolordosis. Hypolordosis is statistically significant (p < 0,05) characterized by a faster course of the pathological process in the hip joint than other types of lordosis. The studies will contribute to the further development of the clinical diagnostic and therapeutic algorithm for patients with hip-lumbar syndrome.
Resume. With significant destructive changes in the hip joints, endoprosthesis is the main method of surgical treatment of coxarthrosis. However, according to the Swedish and Canadian registries, 17-20% of patients have pain after arthroplasty. The cause of residual pain may be a concomitant lesion of the spine, and the study of issues related to the clinical features of the hip-lumbar syndrome are relevant from a scientific and practical point of view. The purpose of the study: to analyze the clinical and radiological picture of patients with coxarthrosis with concomitant pathology of the spine, to investigate the dependence of the severity of flexion contracture of the hip, variable parameters (pelvic angle RT and lumbar lordosis GLL) from constant angle and angle; to study the features of the clinical course of hip-lumbar syndrome. Materials and methods. An analysis of the results of examination of 150 patients with stage III-IV idiopathic coxarthrosis who under-went hip arthroplasty in the clinic of orthopedics and traumatology of adults of the State Institution "ITO NAMS of Ukraine" was performed. Hip pain and functional impairment were assessed according Harris and Womac scales also before hip arthroplasty and 3 months after surgery. Results. Analysis of the obtained data shows that with an increase in the angle of inclination of the pelvis and flexion contracture, the values of the parameters of the angle of pelvic deviation increase, which causes a statistically significant increase in the angle of lumbar lordosis. The correlation coefficients between the parameters PI-PT and PI-GLL were 0.65±0.15 and 0.74±0.11, respectively. Conclusions. Pain in patients with small contracture of the hip joint is associated with neuro-dystrophic syndrome in osteochondrosis of the lumbar spine, in patients with larger contracture - with spondyloarthritis. In the vertical position of the sacrum - GLL - the smallest, least pro-nounced and flexion contracture of the hip joint. On the contrary, in the horizontal position of the sacrum in patients with hyperlordosis and significant, more than 10 ° contracture in the hip joints.
The authors of the article analyzed the experience of domestic and foreign experts in the effectiveness of the use of HA preparations in the treatment of osteoarthritis of major ligaments. Background and Objective. To analyze the literature sources in order to determine the effectiveness of the use of HA preparations in the treatment of osteoarthritis of major ligaments. Materials and methods. Articles in specialized scientific journals and collections, Internet resource. Results. The analysis of literature sources determined the important role of HA preparations in the supplying and functioning of the articular cartilage. Researchers are inclined to believe that the ideal HA preparation should be as close as possible to the physiological HA of the synovial fluid of the joint. The developed domestic drug Arthro-Patch fully corresponds to these parameters. Conclusions. The use of modern injectable HA preparations is advisable at stages 1–3 of OA. Anti-inflammatory effect of HA preparations makes it possible to reduce the dose and time of administration of non-steroidal anti-inflammatory drugs and, as a consequence, reduce the risk of developing many adverse side effects of NSAIDs. The high level of safety of HA preparations, the absence of serious side effects during their long-term use determine their widespread use in the clinical practice of modern orthopedists.
The authors of the article analyzed the experience of domestic and foreign experts in the effectiveness of the use of HA preparations in the treatment of osteoarthritis of major joints. Background and Objective. To analyze the literature sources in order to determine the effectiveness of the use of HA preparations in the treatment of osteoarthritis of major ligaments. Materials and methods. Articles in specialized scientific journals and collections, Internet resource.Results. The analysis of literature sources determined the important role of HA preparations in the supplying and functioning of the articular cartilage. Researchers are inclined to believe that the ideal HA preparation should be as close as possible to the physiological HA of the synovial fluid of the joint. The developed domestic drug Artro-Patch fully corresponds to these parameters. Conclusions. The use of modern injectable HA preparations is advisable at stages 1–3 of OA. Anti-inflammatory effect of HA preparations makes it possible to reduce the dose and time of administration of non-steroidal anti-inflammatory drugs and, as a consequence, reduce the risk of developing many adverse side effects of NSAIDs. The high level of safety of HA preparations, the absence of serious side effects during their long-term use determine their widespread use in the clinical practice of modern orthopedists.
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