The dissertation is dedicated to the improvement of effectiveness of total uncemented arthroplasty in patients with osteoarthrosis of the hip joint. In thesis, were presented principals of preoperative planning, on the base of examination of 168 patients with osteoarthrosis of the hip joint, among which 125 patients in 139 cases were done total uncemented hip replacement. The algorithm of differentiated selection of prosthesis in form, type of fixation and the character of functional covering in patients with atrophic, normotrophic and hypertrophic types of osteoarthrosis was developed. In work were used: clinical, x-ray, cultural, hystomorphological, mathematical modeling and analysis of final elements, statistical methods of research. For the selection of hip prothesis are very important determined x-ray, roentgenometry peculiarities in patients with different kinds of osteoarthrosis. Authentic correlation was established between types of osteoarthrosis of hip joint and bony-like reconstruction of hip joint, by Index Spotorno-Romagnoli, Index Barnett-Nordin, type of cannel by Index Noble. The system of clinical-x-ray scoring of arthroplasty results was worked out and long-term results of total uncemented hip replacement in patients with osteoarthrosis of hip joint were analyzed for own rating. Dependence of long-term results of total uncemented hip replacement from sex and Body Mass Index patients, term of functioning the endoprosthesis was defined by correlation analysis. It is established that reliable reasons of instability of acetabular component were his vertical position, a lack of bone tissue covering and existence of bony-like rebuilding of acetabular. A reliable reason of the instability of femoral component was his varus position in the cannal of femoral bone, a lack of place of contact surface with bone tissue (<70 %), incorrectly selected fixation method (by Index Spotorno-Romagnoly), discrepancy of component's form with form of bony-medullary cannel of thigh-bone (by Index Noble). It is defined the dependence of elastic-strain state of acetabulum and hip bone tissue from the endoprosthesis's form of components with the form of uncemented fixation. Peculiarities of clonogenic activity of marrow's stroma in patients with different kinds of osteoarthrosis of hip joint were discovered. The activity level is low at atrophic type, and high at hypertrophic type. By the way, it is proved at in vitro conditions that the most effective at low clonogenic activity of marrow's stroma is titanic, porous covering, at high clonogenic activity - titanic covering with superficial layer of hydroxyapatite. In experiment with rabbits was established that among studied samples with different types of functional covering, proposed titanic and titanic-hydroxyapatite covering characterizes the largest strength coupling with bone tissue, it doesn't case the occurrence of metabolism and resorption, which proves the possibility of its using in clinical practice. Designed algorithm of differentiated selection of endoprosthesis for its form, type of fixation and the character of functional covering in patients with different kinds of hip joint osteoarthrosis give us the opportunity to avoid mistakes even on the stage of preoperative planning. And introduction of total cementless hip prothesis in clinical practice "ІТО-Моtor Sіch", will allow us to give specialized medical help to bigger amount of patients who need it.
