Olinichenko G. Justification of surgical treatment of aseptic necrosis of femoral head at the early stage in adults.

Object: Aseptic necrosis of the femoral head in adults. Objective: To substantiate, to develop and test methods of surgical treatment of avascular necrosis of the femoral head in the early stages of its development in adults to improve patient outcomes.Methods: The clinical, radiological, mathematical modeling with a finite element method, MRI studies, the experimental (on anatomical specimens) and statistical. For the first time experimentally determined trends in the strength characteristics of the proximal femur in the process of forming a tunnel in the neck and head, depending on the direction of drilling. Determined by the dynamics of intraosseous pressure in the proximal femur metaepiphysis during surgical treatment of early stage avascular necrosis of the femoral head. With the help of the finite element method for three-dimensional model of the proximal femur determined the change of the stress-strain state of bone tissue in the presence of focal aseptic necrosis. For the first time a mathematically justified optimum access to the site of avascular necrosis. For the first time a mathematically defined rational diameter tunnel to the center of avascular necrosis. For the first time a mathematically proved the need for plastic bone defect in the femoral head. Defined by comparing the effectiveness of treatment less traumatic fenestratic osteotomy and intertrochanteric osteotomy for the classic early stages of aseptic necrosis of the femoral head. The results of the thesis introduced into clinical practice Orthopaedic arthrology and replacement of the State Institution "Institute for Spine and Joint Pathology of Professor M.I. Sitenko Academy of Medical Sciences of Ukraine," Research Institute of Traumatology and Orthopedics of Donetsk National Medical University, Gorky MOH, departments and operational arthrology Orthopedics BB "Sevastopol City Hospital № 9", the orthopedic department of City Clinical Hospital № 6 SMP Simferopol, Orthopedics KP "Regional Hospital - Centre for Emergency Medicine and Emergency Medicine" Cherkassy Regional Council. Traumatology and orthopaedy.