Hip arthroplasty in patients with complex femoral deformity after surgical treatment of dysplasia

Близнюков, В.; Тихилов, М.; Шубняков, И. И.; Denisov, Oleksiy; Шильников, А.; Черный, Ж.; Билык, С. С.

doi:10.21823/2311-2905-2014-0-4-5-15

Cited by 2 publications

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References 19 publications

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“…Поэтому в англоязычной литературе в последние десятиле-тия фигурирует термин developmental dysplastic hip, который применяется как к развивающемуся, так и к взрослому тазобедренному суставу [5]. Следует отметить, что оперативные вмешатель-ства на элементах тазобедренного сустава в дет-ском и подростковом возрасте хотя и улучшают долговременный прогноз функционирования собственного сустава, но приводят к его новой по сути ятрогенной деформации [6,7]. Совокуп-ность изменений вертлужной впадины (ВВ) и проксимального отдела бедренной кости при диспластическом коксартрозе, сопутствующие компенсаторные изменения окружающих мягких тканей и всех звеньев биомеханической цепочки скелета требуют от оперирующего хирурга тща-тельного выполнения предоперационного плани-рования эндопротезирования тазобедренного…”

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An integral analysis of the acetabular parameters for the pathomorphological evaluation of dysplastic hip arthritis.

Oleynik¹,

Zub²

2018

Morphologia

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integral analysis of the acetabular parameters for the pathomorphological evaluation of dysplastic hip arthritis. ABSTRACT. Background. Despite the successes in the hip arthroplasty the incidence of complications in cases of dysplastic hip arthritis remains higher then after other forms of hip arthritis. Objective. To pick up the anthropometric criteria of dysplastic acetabulum that determine the correct implantation of the hip implant's cup. Methods. X-ray anthropometric analysis was carried out for 194 dysplastic acetabula, which were divided into 4 groups according to classification by Eftekhar N.S. The same parameters of 70 normal acetabula are studied. Results. Petal diagrams with 4 axes were constructed to visualize the changes in the shape of the dysplastic acetabulum. On each axis of the diagram one of next parameters was deposited: the acetabular width and depth, the thickness of acetabular bottom and the index of the acetabulum, which is calculated as the ratio of depth to width. The indices of the normal acetabular parameters were taken as 1, and the dysplastic indices were expressed as fractions of 1. Variations in the shape of the acetabulum according to Eftekkar's classification are described. An algorithm of action for the implantation of the endoprosthetic cup is proposed for each type of deformation. Also the sketches of preoperative planning for each type of the deformation are presented. Discussion. The ratio of the depth of the acetabulum and the thickness of its bottom is the most significant for the correct implantation of the cup. This indicator enables to surgeon to make the decision about resection of the acetabular bottom during the preparing of the implant's bed. The acetabular width becomes the determining criterion for the dicision on requarment for bone grafting of acetabular roof only for types C and D by Eftekhar. Conclusion. The proposed technique allows to visualize the acetabular deformation from the position of hip replacement in cases of dysplastic hip arthritis. Also this one is suitable for other nosological forms of hip arthritis.

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Section: Introductionunclassified

An integral analysis of the acetabular parameters for the pathomorphological evaluation of dysplastic hip arthritis.

Oleynik¹,

Zub²

2018

Morphologia

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“…При том, что в целом десятилетняя выживаемость после первичного ТЭП ТБС весьма впечатляющая -95-97%*. Для определенных групп пациентов (очень молодые пациенты, пациенты с парами трения металл-металл, пациенты со сложной патологией, выраженной коморбидностью и прочие) эти показатели могут быть существенно хуже и снижаться до 70-80% в те же сроки [5,13,14,15,16,17,18,19,20], а результаты ревизий, и тем более повторных ревизий, вообще в отчетах регистров либо не представлены, либо отражены очень поверхностно [12,21,22]. ТРАВМАТОЛОГИЯ В свою очередь, исследования, посвященные оценке эффективности ревизионных операций, указывают на невозможность достичь такого же уровня успеха, как при первичном эндопротезировании [23,24,25].…”

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What Has Changed in the Structure of Revision Hip Arthroplasty?

Shubnyakov

Шубняков²,

Тихилов³

et al. 2019

Traumatology and Orthopedics of Russia

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The key aspects of the study: 1) what has changed in the structure of revisions in recent years? 2) what is the spectrum of reasons for revision after primary hip arthroplasty and re-revision? 3) what are the demographic features of patients’ population undergoing the revision? Materials and methods. The authors conducted a retrospective evaluation of 2415 hip revision cases during the period of time from 2014 until 2018. Separately the authors assessed revisions after primary surgeries and re-revisions as well as the group of early revisions. Results. In the period from 2014 until 2018 the overall share of revisions was 16,6% from all total hip arthroplasties, at the same time the authors reported the absolute 1.7 times increase in number of revisions as well as increased share of revisions in the total structure of hip arthroplasty from 12,5% to 18,9% without significant variances in the number of primary procedures. The share of early revisions increased from 32.9% in 2013 to 56.7% while the number of early revisions amounted to 37.4% of all primary revisions. Gender composition in primary and revision hip arthroplasty varied insignificantly. Mean age at the moment of hip revision was 59.2% (95% CI from 58.7 to 59.7; Me 60 years) which is slightly less than in primary replacement — 60.2 years (95% CI from 58.9 to 61.1; Me 62 years), but such variances had a high statistical significance, р0.001. The main reasons for primary revisions were aseptic loosening of prosthesis components (50.3%), infection (27.6%), polyethylene wear and osteolysis (9.0%) as well as dislocations (6,2%). Re-revisions structure featured prevalence of infection (69.0%), aseptic loosening (20.8%) and dislocations (7,8%). Mean period of time after primary hip arthroplasty to revision was 7.9 years (95% CI from 7.7 to 8.2; Me 7.3), to first re-revision — 2.9 (95% CI from 2.6 to 3.2; Me 1.2), to second re-revision — 2.2 (95% CI from 1.8 to 2.7; Me 1.1), to third — 2,2 (95% CI from 1.7 to 2.8; Me 1.1), to fourth — 1.0 (95% CI from 0.6 to 1.3; Me 0.6), remaining cases demonstrated rather high heterogeneity. Conclusion. In the result of the present study the authors observed increased number of all revision hip arthroplasties, especially the share of early revisions within first five years from the moment of previous surgery. The most often reason for revision after primary hip arthroplasty was aseptic loosening of one or both components of prosthesis. Infection was the absolute leader in the group of re-revisions constituting over half of all reasons for secondary intervention.

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Hip arthroplasty in patients with complex femoral deformity after surgical treatment of dysplasia

Abstract: т р а в м а т о л о г и я и о р т о п е д и я р о с с и и 2014-4 (74)

Cited by 2 publications

References 19 publications

An integral analysis of the acetabular parameters for the pathomorphological evaluation of dysplastic hip arthritis.

An integral analysis of the acetabular parameters for the pathomorphological evaluation of dysplastic hip arthritis.

What Has Changed in the Structure of Revision Hip Arthroplasty?

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