SMALL ACCESS SURGERY FOR TOTAL ENDOPROSTHETICS IN PATIENTS WITH DYSPLASTIC COXARTHRITIS

Authors:

Abstract:

The most promising treatment of dysplastic coxarthrosis is total arthroplasty using mini- and non-invasive surgical access techniques. For a comparative assessment of the effectiveness of total hip arthroplasty using classical and modified surgical approaches, we analyzed the course of the disease in 55 patients with dysplastic coxarthrosis types 1 and 2 according to Hartofilakidis, divided into two groups: control – 25 patients and main – 30 patients. All patients underwent total hip arthroplasty. The results of the treatment were evaluated 6 months and 1 year after the intervention using clinical and radiological methods. Patients were evaluated for disease activity according to the DAS28 index and performed a complete blood count, study of the immune status by determining the serum concentration of C-reactive protein. A comparative analysis of the identified parameters shows that patients of the main group have a significantly more pronounced tendency to a decrease in the content of C-reactive protein at all stages of the postoperative period. When screening for chronic pain syndrome, there was a definite relationship between access technique and disease activity. The use of the proposed minimally invasive surgical approach for total hip arthroplasty in patients with dysplastic coxarthrosis is effective and can significantly reduce the intensity of pain and improve the results of arthroplasty in general.

Keywords:

dysplastic coxarthrosis arthroplasty surgical approach protein disease activity

References:

1. Zhdan VM, Shylkina LM, Babanina MY, Oliynichenko YO, Martynyuk DI. Osteoartroz u poyednanni z metabolichnym syndromom u zahalnolikarskiy praktytsi. Visnyk problem biolohiyi i medytsyny. 2020;1(155):34–39. DOI 10.29254/2077-4214-2020-1-155-34-39 [in Ukrainian]
2. Akhmedov SS, Khamraev BU.Total endoprosthetics method of choice for degenerative-dystrophic diseases of the hip joint. OSF Preprints. Scientific Journal of research medicine (SJRM). 2022;1(2):44–50. doi:10.3129/osf.io/rfz7d.
3. Baghoolizadeh M, Schwarzkopf R, Lawrence D. Surgical Techniques & Technologies Award: Conversion Total Hip Arthroplasty: Is it a Primary or Revision Hip Arthroplasty. J. Arthroplasty. 2016;31:16–21. DOI:10.1016/j.arth.2015.06.024.
4. Curtis JR, Weinblatt ME, Shadick NA, Brahe CH, Ostergaard M, Hetland ML. et al. Validation of the adjusted multi-biomarker disease activity score as a prognostic test for radiographic progression in rheumatoid arthritis: a combined analysis of multiple studies. Arthritis Res Ther. 2021;23(1). https://doi.org/10.1186/s13075-020-02389-4
5. Hradetzky E, Ohlmeier C, Brinkmann C, Schild M, Galetzka W, Schmedt N, et al. Epidemiology and routine care treatment of patients with hip or knee osteoarthritis and chronic lower back pain: real-world evidence from Germany. J Public Health (Berl.). 2022. https://doi.org/10.1007/s10389–022-01700-8
6. Huang Y, Zeng Z, Xu LY, Li Y, Peng JP, Shen C, Zheng G, Chen XD. What factors are associated with postoperative ischiofemoral impingement after bernese periacetabular osteotomy in developmental Dysplasia of the Hip? Clin Orthop Relat Res. 2022;1;480(9):1694–1703. doi: 10.1097/CORR.0000000000002199.
7. James SL, Abate D, Abate KH, Abay SM, Abbafati C, Abbasi N, et al. Global, regional and national incidence, prevalence and years lived with disability for 354 diseases and injuries for 195 countries and territories1990–2017: a systematic analysis for the Global Burden of Disease Study. Lancet. 2018;392 (10159):1789–1858.10.1016/S0140-6736(18)32279-7
8. Liu R, Liang J, Wang K, Dang X, Bai C. Sciatic nerve course in adult patients with unilateral developmental dysplasia of the hip: implications for hip surgery. BMC Surg. 2015;15(1):1. DOI: 10.1186/1471-2482-15-14.
9. Mercurio M, Galasso O, Familiari F, Iannò B, Bruno CF, Castioni D, Gasparini G. Trend of perioperative crp (c-reactive protein) levels in non-infected total knee arthroplasty. Orthop Rev (Pavia). 2022;14(4):36589. doi: 10.52965/001c.36589.
10. Rivera F, Comba LC, Bardelli A. Direct anterior approach hip arthroplasty: How to reduce complications – A 10-years single center experience and literature review. World J Orthop. 2022; 13(4):388–399. DOI: https://dx.doi.org/10.5312/wjo.v13.i4.388
11. Schwarz EM, Parvizi J, Gehrke T, Aiyer A, Battenberg A, Brown SA, et al. 2018 International Consensus Meeting on Musculoskeletal Infection: Research Priorities from the General Assembly Questions. J Orthop Res. 2019;37(5):997–1006. doi: 10.1002/jor.24293.
12. Shohat N, Bauer T, Buttaro M, Budhiparama N, Cashman J, Della Valle CJ, et al. Hip and knee section, what is the definition of a periprosthetic joint infection (PJI) of the knee and the hip? Can the same criteria be used for both joints?: Proceedings of international consensus on orthopedic infections. J Arthroplasty. 2019;34(2):325–327. DOI: 10.1016/j.arth.2018.09.045.
13. Strafun S, Fishchenko O, Moskovko G, Karpinska O. Clinical study of walking parameters in patients with coxarthrosis according to GAITRite system. TRAUMA. 2021;19(6):54–60. https://doi.org/10.22141/1608-1706.6.19.2018.152221
14. Yang Y, Zou C, Fang Y, Shakya S. Clinical efficacy and its influencing factors of surgical treatment for T-shaped associated with posterior wall acetabular fractures using combined surgical approaches. BMC Surg. 2022;22(1):65. doi: 10.1186/s12893-022-01467-5.
15. Yu D, Jordan KP, Bedson J, Englund M, Blyth F, Turkiewicz A, et al. Population trends in the incidence and initial management of osteoarthritis: age-period-cohort analysis of the Clinical Practice Research datalink,1992–2013.Rheumatology.2017;56 (11):1902–1917. doi: 10.1093/rheumatology/kex270

Publication:

«World of Medicine and Biology» Vol. 18 No. 82 (2022) , с. 128-132
УДК 616.728.3-089.77

DOI:

https://doi.org/10.26724/2079-8334-2022-4-82-128-132