FEATURES OF FORMATION OF CONTRACTURES OF A HIP JOINT AT PATIENTS WITH A HIP-LUMBAR SYNDROME

Abstract

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.