Features of total hip arthroplasty in the treatment of secondary coxarthrosis of different genesis in older children

Abstract

Total hip arthoplasty (THA) in school children with secondary hip arthritis is the least studied treatment in orthopedic surgery. The need for THA arises much less often in children than in adults, but is a pressing problem. Indications for joint replacement at the age of 12–17 years include secondary hip arthritis of various etiologies such as dysplastic (congenital and paralytic), posttraumatic, infectious allergic (juvenile rheumatoid arthritis and Bechterew’s disease), postinfectious (osteomyelitis and tuberculosis of the joints hip joint) associated with severe pain, joint contractures, and decreases in motor activity. The aim of this study was to evaluate the effectiveness of THA in adolescents with stage 3 hip arthritis. A two-stage method of surgical treatment in cases of limb shortening of >4 cm is proposed. We present the results of the treatment in 45 patients. The proposed surgical technique achieved satisfactory results in 68% of the cases. The method allowed the restoration of hip joint function and limb length in all patients. Based on these results, we recommend the use of this method in the treatment of severe forms of secondary coxarthrosis as a result of dysplastic, paralytic, postinfection, systemic autoimmune, and posttraumatic processes.