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Results of hip arthroplasty using Paavilainen technique in patients with congenitally dislocated hip
- Authors: Tikhilov R.M.1,2, Mazurenko A.V.3, Shubnyakov I.I.2, Denisov A.O.2, Bliznyukov V.V.2, Bilyk S.S.2
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Affiliations:
- Mechnikov North-Western State Medical University
- Vreden Russian Research Institute of Traumatology and Orthopedics
- Cheboksary Federal Centre Of Traumatology, Orthopedics and Arthroplasty
- Issue: Vol 20, No 1 (2014)
- Pages: 5-15
- Section: Clinical studies
- URL: https://journal.rniito.org/jour/article/view/38
- DOI: https://doi.org/10.21823/2311-2905-2014-0-1-5-15
- ID: 38
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Abstract
The purpose of the study was to analyze the medium- and long-term results of hip arthroplasty using Paavilainen technique in patients with the congenitally dislocated hip. Methods: From 2001 to 2012 180 operations were carried out were using the Paavilainen technique in 140 patients with high dislocation of the hip (Crowe IV). All patients were clinically evaluated using the Harris Hip Score (HHS), VAS and radiography. Statistical analysis was performed using the Pearson correlation coefficients, multiple regression analysis and classification trees analysis. Results: The average Harris score improved from preoperative 41.6 (40,3-43,5) to 79.3 (77,9-82,7) at final follow-up, and the difference was significant. Early complications were 9% (the most frequent were fractures of the proximal femur), later - 16.7% (pseudoarthrosis of the greater trochanter, 13.9%; disclocations-1,1%, aseptic loosening of the components - 1.7%), reoperation performed in 8.3% of cases. Such factors as age and limb length has statistically significant effect on functional outcomes. Established predictive model allows to get the best possible functional outcome in such patients with severe dysplasia. Conclusions: Total Hip arthroplasty using the Paavilainen technique is an effective method of surgical treatment in patients with the congenitally dislocated hip, but it is technically difficult operation with a high incidence of complications in comparison with standard primary total hip replacement.
About the authors
R. M. Tikhilov
Mechnikov North-Western State Medical University; Vreden Russian Research Institute of Traumatology and Orthopedics
Author for correspondence.
Email: info@rniito.org
Russian Federation
A. V. Mazurenko
Cheboksary Federal Centre Of Traumatology, Orthopedics and Arthroplasty
Email: amazourenko.home@inbox.ru
Russian Federation
I. I. Shubnyakov
Vreden Russian Research Institute of Traumatology and Orthopedics
Email: shubnyakov@mail.ru
Russian Federation
A. O. Denisov
Vreden Russian Research Institute of Traumatology and Orthopedics
Email: med-03@yandex.ru
Russian Federation
V. V. Bliznyukov
Vreden Russian Research Institute of Traumatology and Orthopedics
Email: vadim-ortoped@yandex.ru
Russian Federation
S. S. Bilyk
Vreden Russian Research Institute of Traumatology and Orthopedics
Email: ssbilyk@rniito.ru
Russian Federation
References
- Ахтямов И.Ф., Туренков С.В., Преснов П.В., Кузьмин И.И., Коваленко А.Н. Хирургическое лечение остаточных дефектов развития элементов тазобедренного сустава у взрослых. Казанский медицинский журнал. 2004; 85(5): 352-356
- Мазуренко А.В., Тихилов Р.М., Шубняков И.И., Николаев Н.С., Плиев Д.Г., Близнюков В.В. Оценка возможности восстановления длины конечности у пациентов с тяжелой степенью дисплазии тазобедренного сустава при различных вариантах хирургической техники эндопротезирования. Травматология и ортопедия России. 2010;(3):16-20
- Мазуренко А.В., Тихилов Р.М., Шубняков И.И., Плиев Д.Г., Денисов А.О. Оптимальный вариант эндопротезирования тазобедренного сустава у пациентов с тяжелой степенью дисплазии. В кн.: Материалы международной научно-практической конференции «Многопрофильная клиника XXI века. Современные технологии в эндовидеохирургии». СПб., 2013. с. 163-165.
- Сергеев С.В., Жмотова Е.А., Кимельфельд И.М. и др. Эволюция коксартроза в свете экспертизы трудоспособности. Вестн. травматологии и ортопедии им. Н.Н. Приорова. 1996;(2): 3-10
- Тихилов Р.М. Шаповалов В.М. (ред.) Руководство по эндопротезированию тазобедренного сустава. СПб.: РНИИТО им. Р.Р. Вредена, 2008 . 324 с
- Тихилов Р.М., Шубняков И.И., Коваленко А.Н., Черный А.Ж., Муравьева Ю.В., Гончаров М.Ю. Данные регистра эндопротезирования тазобедренного сустава РНИИТО им. Р.Р. Вредена за 2007-2012 годы. Травматология и ортопедия России.-2013;(3):167-190
- Тихилов Р.М., Шубняков И.И., Мазуренко А.В., Митряйкин В.И., Саченков О.А., Кузин А.К., Денисов А.О., Плиев Д.Г., Бояров А.А., Коваленко А.Н. Экспериментальное обоснование установки ацетабулярного компонента с недопокрытием при эндопротезировании пациентов с тяжелой степенью дисплазии. Травматология и ортопедия России. 2013;(4):42-51
- Угнивенко В.И. Диагностика и лечение диспластического коксартроза в амбулаторных условиях. Режим доступа: http://www.rusmedserv.com/ orthopaedics/diagcox.htm
- Шубняков И.И., Тихилов Р.М., Гончаров М.Ю., Карпухин А.С., Мазуренко А.В., Плиев Д.Г., Близнюков В.В. Достоинства и недостатки современных пар трения эндопротезов тазобедренного сустава (обзор литературы). Травматология и ортопедия России. 2010;(3):147-158
- Carrlson A., Bjorkman A., Ringsberg K., Schewelov T. Untreated congenital and posttraumatic high dislocation of the hip treated by replacement in adult age. Acta Orthop. Scand. 2003;74(4):389-396.
- Eskelinen A., Helenius I., Remes V., Ylinen P., Talloroth K., Paavilainen T. Cementless total hip arthroplasty in patients with high congenital hip dislocation. J. Bone Joint Sur. Am. 2006;88(1):80-91.
- Eskelinen A., Remes V., Ylinen P., Helenius I., Tallroth K., Paavilainen T. Cementless total hip arthroplasty in patients with severely dysplastic hips and a previous Schanz osteotomy of the femur. 2009;80(3):263-269.
- Hartofilakidis G., Stamos K., Karachalios T. Treatment of high dislocation of the hip in adults with total hip arthroplasty. Operative technique and long-term clinical results. J. Bone Joint Surg. Am. 1998;80(4):510-517.
- Holinka J., Pfeiffer M., Hofstaetter J.G., Lass R., Kotz R.I., Giurea A. Total hip replacement in congenital high hip dislocation following iliofemoralmonotube distraction. Int. Orthop. 2010;35(5):639-645.
- Koulouvaris P., Stafylas K., Sculco T., Xenakis T. Distal femoral shortening in total hip arthroplasty for complex primary hip reconstruction. A new surgical technique. J. Arthroplasty. 2008;23(7):992-998.
- Lai K.A., Liu J., Liu T.K. Use of iliofemoral distraction in reducing high congenital dislocation of the hip before total hip arthroplasty. J. Arthoplasty. 1996;11(5):588-593.
- Martell J.M., Pierson R.H. 3rd, Jacobs J.J., Rosenberg A.G., Maley M., Galante J.O. Primary total hip reconstruction with a titanium fiber-coated prosthesis inserted without cement. J. Bone Joint Surg. Am. 1993;75(4):554-571.
- Muratli K.S., Karatosun V., Uzun B., Celik S. Subtrochanteric shortening in total hip arthroplasty: biomechanical comparison of four techniques. J. Arthroplasty. 2013 Oct 3. pii: S0883-5403(13)00648-7. doi: 10.1016/j.arth.2013.09.004.
- Oinuma K., Tamaki T., Miura Y., Kaneyama R., Shiratsuchi H. total hip arthroplasty with subtrochanteric shortening osteotomy for crowe grade 4 dysplasia using the direct anterior approach. J. Arthroplasty. 2013 Aug 30. pii: S0883-5403(13)00556-1
- Paavilainen T., Hoikka V., Solonen K.A. Cementless total replacement for severely dysplastic or dislocated hips. J. Bone Joint Surg. Br. 1990;72(2):205-211
- Paavilainen T., Hoikka V., Paavolainen P. Cementless total hip arthroplasty for congenitally dislocated or dysplastic hips. Technique for replacement with a straight femoral component. Clin. Orthop. 1993;297:71-81.
- Paavilainen T. Total hip replacement for developmental dysplasia of the hip. Acta Orthop. Scand. 1997;68:77-84.
- Park M.S., Kim K.H., Jeong W.C. Transverse subtrochanteric shortening osteotomy in primary total hip arthroplasty for patients with severe hip developmental dysplasia. J. Arthroplasty. 2007;22(7):1031-1036.
- Sanchez-Sotelo J., Berry D.J., Trousdale R.T., Cabanela M.E. Surgical treatment of developmental dysplasia of the hip in adults: II. Arthroplasty options. J. Am. Acad. Orthop. Surg. 2002; 10(5):334-344.
- The Norwegian Arthroplasty Register. Report 2010. 214 p. Available from: http://nrlweb.ihelse.net/eng/ Report_2010.pdf.
- Thorup B., Mechlenburg I., Seballe K. Total hip replacement in the congenitally dislocated hip using the Paavilainen technique: 19 hips followed for 1.5-10 years. Acta Orthop. 2009;80(3):259-262.
- Xenakis T. Reconstruction of congenitally dislocated hips in adults by an arthroplasty. Eur. Instr. Course Lect. 2001: 5:183-193.
- Vukasinovic Z., Bascarevic Z. Diseases of the infant hip. In: Vukasinovic Z. Special orthopaedics. Belgrade: "Banjica"; 2004. P. 237-273.
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