ЭНДОПРОТЕЗИРОВАНИЕ ТАЗОБЕДРЕННОГО СУСТАВА ПРИ ПЕРЕЛОМАХ ШЕЙКИ БЕДРА И ИХ ПОСЛЕДСТВИЯХ ПРИ ПОСТМЕНОПАУЗАЛЬНОМ ОСТЕОПОРОЗЕ У МНОГОРОЖАВШИХ ЖЕНЩИН

Abstract

Objective: Improving the treatment outcomes for hip fractures and their consequences in postmenopausal osteoporosis in multiparous women by applying hip replacement (HR). Methods: Analyzed data on 126 patients with hip fractures and their consequences against the background of postmenopausal osteoporosis in multiparous women, whom applied HR. Patients are divided into main (65 patients (51.6%), in the comprehensive treatment of which were used drug therapy and other approaches implemented during the study) and control (61 patients (48.4%), treated by traditional methods without targeted diagnosis and treatment of osteoporosis) groups. Clinical and X-ray methods, densitometry, objective methods of assessing the severity of patients’ condition on the Gumanenko scale, point objective method of complex Harris’ hip function assessments, statistical methods were used. Results: Long-term results studied in 111 patients. It was found that excellent results (90-100 points) were noted in 17 (15.3%) of the patients, good (80-89 points) – in 56 (50.5%), satisfactory (70-79 points) – in 30 (27.0%) and unsatisfactory (less than 70 points) – in 8 (7.2%) patients. The frequency of unsatisfactory results with total cement-free HR was 3.7%, with total cement HR – 7.7%, with hybrid – 11.8%, with bipolar HR – 29.6%. In the main group, the frequency of instability of endoprosthesis components under the influence of basic pathogenetic drug therapy of osteoporosis decreased by 3.2 times compared to the control group (4.6% and 14.8%, respectively, p<0,05). Conclusion: A significant correlation between treatment results, on the one hand, and the severity of patients’ condition, the nature of the main pathology, the type of replacement and the tactics of comprehensive treatment of osteoporosis, on the other hand, was obtained. The most favorable results are stated in the implementation of the proposed approaches in the complex treatment of the pathology under consideration. In general, positive outcomes were noted in 92.8% of observations, which gives grounds for their widespread use in clinical practice. Keywords: Postmenopausal osteoporosis, hip replacement, hip fracture, consequences of hip fractures, multiparous women , osteoporosis baseline drug therapy.