Hip arthroplasty in patients with complex femoral deformity after surgical treatment of dysplasia

Objective - based on the analysis of remote results of total hip arthroplasty in patients with complex deformities of the femur to compare the effectiveness of operations with standard cases and identify the factors that determine the surgery effectiveness. Material and methods. in Vreden clinic 73 patients with complex deformities of the femur underwent surgical treatment between 2001 and 2013 by various surgical interventions: arthroplasty without femoral osteotomy (23); arthroplasty accompanied by great trochanteric slide osteotomy or Paavilainen technigue (37), arthroplasty with femoral osteotomy below the lesser trochanter (13), including 4 - at the level of deformation, 4 - with double two-stage osteotomy and 5 - with one-stage double osteotomy. all patients were assessed with Harris scale before and after surgery. the results obtained in the course of the study data were processed using statistical methods, including correlation analysis using Pearson's coefficients and Gamma. Results. in assessing the long-term results the Harris hip score improved from a preoperative average of 40.2 (95% Ci 38.2 to 45.6) to 78.4 (95% Ci 76.7 to 83.5). the analysis of various factors influencing on operation efficiency showed that maximum results are achieved with good initial function and a small level of pain (Harris score of 40-45 points), residual femoral deformation should not exceed 5 degrees, the rotation center displacement - no more than 30 mm, the offset increasing - no more than 20 mm and of limb length increasing - no more than 25-30 mm. Conclusion. Hip arthroplasty in patients with coxarthrosis associated with complex femoral deformities is technically challenging, but the using the algorithm presented by authors allows achieve the best possible results.

коксартроз, сложные деформации бедренной кости, эндопротезирование тазобедренного сустава, остеотомия, coxarthrosis, complex femoral deformation, hip arthroplasty, osteotomy