Bondar V. Trabecular-bionic endoprosthetic systems in the treatment of degenerative-dystrophic diseases of the hip joint (experimental-clinical study).

Object: total hip arthroplasty using trabecular-bionic stem Physiohip in case of various forms of coxarthrosis. Aim: to improve the results of treatment of patients with various forms of coxarthrosis using the total hip arthroplasty method using trabecular bionic stem based on clarification of indications, improvement of the surgical procedure and rules of the postoperative period. Methods: clinical, X-ray, magnetic resonance imaging, experimental, mathematical modeling, biomechanical, statistical. The hydro-damping role of the spongy tissue of the proximal femur, which consists in the distribution of the external load on the femur, is illuminated. For the first time it has been proved that the trabecular-bionic stem Physiohip integrated in the proximal femoral area provides a physiological distribution of external loading. For the first time, based on biomechanical studies, it has been proved that the characteristics of the Implant-Bone model with the trabecular-bionic stem Physiohip predominate over the characteristics of the model "femur bone - standard endoprosthesis" with compression – 2.3 times, with torsion – 1.6 times and at bending – in 1.7 times. Based on the results of the clinical study, the indications for the operation of total hip joint replacement with use a trabecular-bionic stem Physiohip are formulated. For osteointegration experiments in the zone of "endoprosthesis-bone" an analogue of spongy bone tissue is proposed as a composite material form an epoxy resin with the inclusion of small spherical grains of foam. It is proved that the modulus of elasticity 57.1 – 79.4 MPa and the sufficient adhesion of this material on the surface of the implant allows the use of this analogue for the modeling of spongy bone. At the stage of preoperative planning, the main causes of the development of early aseptic instability of the implant Physiohip are for On the basis of theoretical, experimental and clinical researches a new method of operations total hip joint replacement using a trabecular-bionic stem Physiohip (the patent of Ukraine № 75843 dated December 10, 2012) has been developed. A rehabilitation program for patients after total hip joint replacement using a trabecular-bionic stem Physiohip has been developed. Improved surgical technique of endoprosthetics and rehabilitation program promotes positive long-term treatment outcomes in degenerative-degenerative diseases of the hip joint. The results of the study have been introduced into the clinical practice in Kyiv City Clinical Hospital № 12 Kyivsky City Council, Ivano-Frankivsk regional clinical hospital, LLC "ORTOKLINIKA" (Ternopil city) and in the educational process of the departments of traumatology and orthopedics of I. Horbachevsky Ternopil National Medical University, Ivano-Frankivsk National Medical University. Тraumatology and Orthopaedics.