Polulyakh D. Endoprosthetics of the hip joint in patients with dysplasia Crowe type III, IV

Work is sanctified to the decision of actual scientific task to the traumatology and orthopaedics on the increasing the effectiveness of total endoprosthetics of the hip joint in patients with dysplasia of Crowe type III, IV. The basis of the work is analysis of endoprosthetics of the hip joint results in 58 patients, there are 7 men and 51 woman (p<0,01) among them. The age of patients with the main (operated by modified method) group (n = 52) ranged from 17 to 61 years, which was on average (43,8 ± 1,3) years. The computer program is worked out for a study and clarification of |X-ray and anatomical features, standardization of the angular definition and linear values of the hip joint; a method of bone plastic arts of the cavity roof; method of the hip joint replacement adjusting; experimental research is executed with the different angels of inclination of acetabular component: 45о, 55о and 35о. A differentiated approach for implementation of endoprosthetics complex with Crowe type III, IV of dysplasia has been developed, which allowed to avoid threatening complications and to improve the condition of the hip joint on the Harris scale from (41,31 ± 2,75) to (85,31 ± 1,40) points at limb shortening < 4 cm and from (41,17 ± 1,96) to (83,67 ± 1,49) points at limb shortening 4 cm. In Crowe III type dysplasia, the limb shortening was on average compensated for (2,72 ± 0,13) cm. with Crowe IV type dysplasia at (4,40 ± 0,34) cm. While the congenital dislocation of the hip of Crowe type IV indemnification of shortening arrived at (5,32 ± 0,35) cm. From the group of patients with type Crowe III, IV, the displacements of the operating methods according to the standard procedure got the following results: one thrombosis of the femoral artery, two neuropathies of the fibular nerve, two cases of early instability of acetabular component. According to the system for the state estimation of the hip joint Harris, only in two cases were a good result that corresponded to the change of the state of the hip joint from (46,0 ± 0,2) to (85,0 ± 0,4) points.