Peculiarities of the hip joint endoprosthesis in patients with severe forms of the hip depression dysplasia and coxarthrosis on background of spondyloepiphysar dysplasia
Objective. To determine the approach for implantation of a hip joint endoprosthesis bowl in patients, suffering coxarthrosis on background of spondyloepiphysar dysplasia.
Маterials and methods. For determination of peculiarities in distribution of loadings in biomechanical system “аcetabular component - osseous tissue” a definitely-еlemental model was elaborated and mathematical modelling was accomplished, and, taking into account its results, a hip joint endoprosthesis was performed in 25 patients, suffering severe forms of the hip depression dysplasia and coxarthrosis on background of spondyloepiphysar dysplasia.
Results. In all the patients, suffering coxarthrosis on background of spondyloepiphysar dysplasia, in whom individualized technique for implantation of acetabular component of a hip joint endoprosthesis was applied, including the technique of medial shift of the endoprosthesis bowl, it was possible to avoid aseptic migration of the implant during 9 yrs of follow-up.
Conclusion. For secure fixation of acetabular component of a hip joint endoprosthesis a critical aspect is a preservation of osseous tissue in region of the hip depression perimeter, but not the osseous tissues integrity in its bottom, what makes possible to achieve a stable fixation of the implant, using its dosed medialization, even in patients, having severe forms of the hip depression dysplasia.
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