Results of acetabular reconstruction with tantalum constructions were analyzed for 56 patients (25 men and 31 women) aged 35 to 70 years. Primary arthroplasty was performed in 30 and revision intervention in 26 patients. In case of primary total hip arthroplasty the following etiologic factors were considered: posttraumatic acetabulum deformity (21 patients), deficit of acetabular walls resulted from dysplasia (4), femoral head protrusion (5). Evaluation of the defect and selection of tantalum construction were made using defect classification by W.G. Paprosky. Results were assessed by Harris scale at terms 3,6 and 12 months after operation and every year thereafter. Excellent, good and satisfactory results were achieved in 96.8% of cases. The most common complication was the dislocation of hip implant head. It developed in 2 patients after revision arthroplasty and in 1 patient after primary total hip arthroplasty.

Experience in treatment of 27 patients with deep periprosthetic infection is presented. In 17 patients infectious process was localized in the zone of hip implant, in 10 patients — in the zone of knee implant. Sanitation without implant removal was performed in 2 cases of early deep infection. Two-step revision arthroplasty was performed in 25 patients with late deep infection. First the implant was removed and spacer was inserted, then spacer was changed for a revision implant. In 12 patients individual articulating spacers with antibiotics were used. No relapse was noted in 23 patients at terms up to 58 months. Thus, two-step revision arthroplasty with application of spacers showed its high efficacy in treatment of patients with late deep periprosthetic infection.

Hip arthroplasty outcomes for 202 patients, aged 40-88 years, with femoral neck pseudarthrosis were analyzed. All patients were divided into 3 groups depending on the type of treatment (surgical or conservative) and terms of the removal of previously implanted metal constructions (before or during surgical procedure). Good and satisfactory results by Harris hip score were achieved in 94.6% of observations. The reasons of postoperative complications were considered for every group of patients. It was stated that in 30 (14.9%) cases the formation of pseudarthrosis resulted from ungrounded use of osteosynthesis in Garden III and IV fractures.

Experience in revision hip arthroplasty with change of femoral stem was analyzed for 165 patients. In 107 operations (64.8%) Wagner SL Revision Stems were used, in the rest of cases - femoral components of other manufacturers. Distribution of patients by femoral defect type by Paprovsky was the following: I type - 27 patients, II type - 75, IIIA type - 59, IIIB and IV type - 4 patients. Good results at use of Wagner SL Revision Stems and stems of other manufacturers were comparable and made up 87.9 and 86.2%, respectively. Achieved data enabled to make conclusion that Wagner SL Revision Stem use is reasonable for patients with hip implant instability in I-IIIA femoral bone deficit, as they are cheaper than the modular revision stems and their design prevents the wear in the area of modular junction.

Rate of extensor mechanism complications after primary and revision knee arthroplasty reaches 12 %. Description and systematization of such complications by literature data is given. Our experience in treatment of 12 patients with such complications after primary knee and in 5 patients after revision knee arthroplasty that made up 1.0 and 13.9% of all interventions, respectively, is presented. Registered complications include para-patellar scars and ossification impingement (4), patellar lateralization (5), patellar dislocation (1), patellar tendon rupture (7). Treatment results in patients after primary arthroplasty are better than after revision intervention - 83.3 and 40% of positive results, respectively. It is shown that high rate (42.9%) of patellar tendon rupture are associated with deep periprosthetic infection. Besides, autoplasty with m. gracilis and m. semitendinosus shows its inefficiency in treatment of such complications.