Bondarenko S. Hip replacement at reactive arthritis afteractions.

Object: acetabulum replacement at the appearance of afteractions of hip reactive arthritises. The purpose: to improve the results of hip replacement at the appearance of afteractions of hip reactive arthritis by means of biomechanically reasoning the techniques for making the plasty of acetabulum imperfections or defects. Methods of study: clinical, roentgenological, mathematical model approach, statistical. Scientific novelty: new knowledge has been acquired as to a stress-strain state of acetabulum when retaining a subchondral layer, its changes at the presense of various imperfections types of acetabulum walls that are caused by the afteractions of hip reactive arthritises, and feasibility of its renewal by applying various plasty versions.The stress-strain state of acetabulum when carrying out hip replacement retaining thereat a subchondral layer and without any defects present has been determined to correspond to that in its normal condition. It has been proved that a general level of acetabulum stresses is substantially increased and that there appeared additional regions of concentrated stresses that are localized on the walls and at the portions of the acetabulum imperfections, when carrying out hip replacement at the presense of various bone defects that are caused by afteractions of hip reactive arthritises. It has been first determined that when conducting modeling of the proposed plasty versions of different acetabulum imperfection types which are caused by the afteractions of hip reactive arthritises, a stress level in acetabulum during hip replacement is substantially decreased and is close to the stress level that is the case when carrying out hip replacement without any imperfections present and with concurrent retaining of the subchondral layer. There have been developed and clinically tested the biomechanically grounded plasty techniques accompaning hip replacement for different types of acetabulum imperfections that are caused by afteractions of reactive arthritises. The analysis conducted as for the results of application of the developed techniques in the course of hip replacement to make a plasty of various acetabulum imperfection types in patients suffering from afteractions of hip reactive arthritises confirmed their efficiency and feasibility of their use at clinical practice to improve results of conducting hip replacement in patients having this heavy pathology of hip joint. The results of the studies have been introduced into the clinical practice of State institution Sytenko Institute of Spine and Joint Pathology of the Ukrainian Academy of Medical Sciences, Scientific Research Institute of Traumatology and Orthopedics of M. Horkyi Donetsk National Medical University, orthopedics department of Poltava Regional Clinical Hospital, casualty ward of Specialized Medical Unit