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Subject:
hip reconstruction ; total hip replacement ; dysplastic hip osteoarthritis ; Alloclassic endoprosthesis ; center of rotation of the hip
Abstract:
Dysplastic osteoarthritis of the hip is a special form of secondary degenerative joint disease. Due to the progressive nature of the degenerative changes an effective method of surgical treatment of dysplastic osteoarthritis of the hip is the total hip arthroplasty, which enables to improve the anatomical and biomechanics of the hip. The aim of the study was to assess the possibility of reconstruction of the hip in dysplastic osteoarthritis with use of total hip arthroplasty with appliance of Alloclassic endoprosthesis and the impact of this reconstruction on the radiological and clinical outcome. Hip reconstruction method was based on possibly anatomical location of the cup of the endoprosthesis in the acetabulum or near the its roof in cases of large subluxation or hip dislocation. The study was retrospective. The material was divided into 2 groups. The determinant of a division was obtained at the time of the total hip arthroplasty by the location the cup implant in the acetabulum. In Group I in the place of the acetabulum, and in Group II in the area of the roof, or a little above. An analysis of the reconstruction of the hip joints were made with reference to a group of normal hip joints. Radiological assessment was done on the basis of the developed own methodology, which was based on the measurement of selected sections on radiographs of the pelvis and the calculation of ; the factors to evaluate the location of the center of rotation and the proximal femur before and after reconstruction. Clinically the hips have been studied using a 100 point scale Harris Hip Score before and after total hip arthroplasty. Analysis of the results of radiological assessment showed that distalization and medialization the center of rotation of the hip and lateralization and dystalisation of proximal femoral segment in Group I resulted in the outcome close to a group of healthy hips, while in Group II the results were intermediate between the initial state and normative. Clinical results have shown significant improvement in functional status of hip joints after total hip arthroplasty but in the Group I the results were better compared to the Group II. It was found that the location of the center of rotation after reconstruction had a significant effect on clinical outcome, while correlation of the results of proximal femur location assessment with the clinical outcome of the trial was poor. To summarize the analysis of the outcomes in a material, it should be noted that the method of reconstruction of the hip joints in dysplastic osteoarthritis with appliance of Alloclassic endoprosthesis allowed to reconstruct the hip with a good functional results.