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Abstract
Introduction Total hip replacement is a gold standard for dysplastic coxarthritis treatment. Deformations in the bony structures that form the hip joint and develop directly due to the pathology and after surgical interventions, as well shortened or lengthened soft tissues, scars, the necessity of bringing the femoral head down result in a significant number of postoperative complications. This study aimed to develop an algorithm of medication therapy for such patients in the postoperative period, based on pathogenic mechanisms that would enable to reduce complications. Objective To study long-term results of treatment in patients with coxarthritis in stages 3-4 and dysplastic hip type 1, 2, 3 (Crowe) according to clinical, EMG and X-ray studies, as well as dual energy X-ray absorptiometry (DEXA) and modified Harris scale scores after total hip replacement and administration of medication therapy. Materials and methods The study was performed in 258 patients with dysplastic coxarthritis in stage 3-4 and DHD types 1, 2, 3 (Crowe) after total hip replacement surgery who were divided into two groups according to the medication therapy administered. Patients of the main group received vitamins, anticholinesterase drugs, NSAIDs, antibiotics, anticoagulants, inhibitors of osteoclasts, and calcium supplements. The comparison group patients were administered NSAIDs, antibiotics, anticoagulants, and calcium supplements. The study was conducted 2 years after their operative treatment with clinical and radiological, EMG and densitometric methods. Results It was found that the use of anticholinesterase drugs and vitamins improves axonal conduction and neuromuscular transmission of the sciatic nerve in patients with dysplastic coxarthritis. Inhibitors of osteoclasts, calcium and vitamin D3 improve the indices of bone mineral density. Conclusions Administration of the drug complex developed improves functional results in patients with dysplastic coxarthritis after total hip replacement.
Highlights
Total hip replacement is a gold standard for dysplastic coxarthritis treatment
This study aimed to develop an algorithm of medication therapy for such patients in the postoperative period, based on pathogenic mechanisms that would enable to reduce complications
Materials and methods The study was performed in 258 patients with dysplastic coxarthritis in stage 3-4 and DHD types 1, 2, 3 (Crowe) after total hip replacement surgery who were divided into two groups according to the medication therapy administered
Summary
Данное исследование направлено на разработку алгоритма медикаментозного ведения пациентов в послеоперационном периоде, основанного на патогенетических механизмах, позволяющего снизить процент возникающих осложнений. Изучение отдаленных результатов лечения больных с диспластическим коксартрозом 3-4 стадии и 1, 2, 3 степени по Crowe по данным клинико-лабораторного, электронейромиографического и рентгенологического исследований, а также двухэнергетической рентгеновской абсорбциометрии (DEXA) после тотального эндопротезирования тазобедренного сустава и модифицированной шкалы Харриса после назначения разработанного медикаментозного комплекса. Исследование выполнено у 258 больных с диспластическим коксартрозом 3–4 стадии и 1, 2, 3 степени по Crowe после тотального эндопротезирования тазобедренного сустава, которые были разделены на 2 группы в зависимости от получаемой терапии: пациенты основной группы получали витамины группы В, антихолинэстеразные препараты, НПВС, антибиотики, антикоагулянты, ингибиторы остеокластов, препараты кальция, а в группе сравнения – НПВС, антибиотики, антикоагулянты, препараты кальция. Применение разработанного медикаментозного комплекса позволяет улучшить функциональные результаты у пациентов с диспластическим коксартрозом после тотального эндопротезирования.
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