THE TACTIC OF CEMENTLESS TOTAL ENDOPROSTHESIS REPLACEMENT OF HIP JOINT IN PATIENTS WITH INHERENT HIP DISLOCATION

Abstract

Introduction. The total endoprosthesis replacement is a main method of treatment of congenital dislocation of hip. However, significant disorders of joint, resistant muscular contractures create technical complications under operation and force to apply various surgical tactics. Methods. The analysis was implemented concerning results of Crowe total endoprosthesis replacement in 69 patients with one-sided high hip dislocation type IV operated on the basis of traumatological orthopedic department of Saratovskii research institute of traumatology and orthopedics during 2010-2015. The treatment of patients was implemented using original genuine technique including total endoprosthesis replacement of hip joint combined with double V-subtrochanteric osteotomy. Results. The pathological types of implantation in operated hip joint are absent. On the whole, one can notice amelioration of bio-mechanical indices: cycle of step, period of double support, coefficient of rhythm. Among systemic complications of total endoprosthesis replacement one is to mark out phlebothrombosis established in 3 patients (7.1%) that was conditioned by sedentary state of patients. Among specific complications one stated dislocation related to inobservance of restrictive orthopedic regimen in 1 (2.4%) patient. None case of instability of prosthesis and difference in length of extremities in average periods of observation more than on 0.5 cm was established. This is a proof of effectiveness of developed technique of correcting V-subtrochanteric osteotomy. Therefore, the proposed technique of femoral bone osteotomy permitted to ameliorate the results of treatment and to diminish number of complications. The applied technique permits to obtain satisfactory clinical and technical results of surgical treatment of patients with high hip joint dislocation. The osteotomy permitted to eliminate difference in length of bones of patients and at that to ameliorate conditions for union of distal and proximal fragments of femur bone at the expense of larger surface of their contact.