Oleynik A. Hip joint endoprosthesis in the case of deformations and defects observed in proximal part of femoral bone and acetabulum.

The object: deformities and defects of the proximal part of the femoral bone and acetabulum. The goal: to develop the new complex system of hip joint replacement based on the clinical and biomechanical data and to improve the existing technologies of joint replacement, which will result to the effective treatment of patients with defects and deformities of the proximal part of the femoral bone and acetabulum. Methods: clinical, roentgenological, biomechanical, mathematic modeling using the final-element method, statistic. Based on the roentgenological and anthropometrical research of the femoral bone the significant difference of sizes of medullar channel was revealed. The new phenomenon of direct formation of trabecular bone surrounding the ORTEN cup as a double-level system of implant’s fixation was discovered. The clinical and biomechanical ground of efficacy of new native standard hip endoprosthesis in cases of defects and deformities of the proximal part of the femoral bone and acetabulum was reflected. For the first time based on the complex clinical and roentgen-anthropometrical analysis the criteria of evaluation of hip joint condition were determined. These criteria allow to systematize the defects and deformities of the proximal part of the femoral bone and acetabulum. First time it was determined that the criteria of the grade of defects and deformities of the proximal part of the femoral bone is the quantity of the corner between the axis of the proximal shaft and the axis of diaphysis and also the absence of the spongious bone in the proximal part of the femur. The criteria of the grade of defects and deformities of acetabulum are geometric data which show the difference between the shape of acetabulum and hemisphere. For the first time the clinical confirmation of biomechanical ground of effective using of standard stem of hip endoprosthesis ORTEN as an intramedullar device for fixation was described. Also firstly in case of dysplastic coxarthrosis the reliable relations between the stage of disease and thickness of the acetabular bottom were revealed. Based on the researching of follow-up results of hip replacement surgeries in patients with deformities and defects of the proximal part of the femoral bone and acetabulum the efficacy of developed new construction of native hip endoprostheses ORTEN which allow to achieve the quality of medical service of patients was proved. The results of investigation have been used in the clinical practice of Dnipropetrovsk, Zaporozh’ye, Kharkov municipal clinical regional hospitals and also Sevastopol municipal hospital number 9. The date of scientific work were used in the educational process in chairs of Traumatology and Orthopaedics of Dnepropetrovsk state medical academy, Kharkov state medical university, Vinnitsa national medical university named after N.I. Pirogov and Zaporozh’ye state medical university. Traumatology and orthopaedy.