Horban D. Complications associated with surgical access to hip arthroplasty. Pathogenesis, diagnostics, prevention and treatment

Having assessed the results of the analysis of problems and complications arising from HJA published in the modern literature, and based on our own experience, we came to an understanding of the need to improve the effectiveness of HJA by studying the pathogenesis, improving the diagnostics, treating and preventing functional disorders and complications associated with surgical accesses, which will allow to restore the functional activity of patients in the shortest possible time and improve their quality of life. It was found that conservative and surgical methods are effective in the treatment of complications associated with surgical access to the HJ. So, at the damage of vessels, it is necessary to perform their ligation urgently, if necessary with the expansion of the surgical access, with the participation of a vascular surgeon; at periprosthetic fractures - intraoperative osteosynthesis; at the luxation of the head of the femoral component of the implant – one-stage removal under anesthesia, or surgical removal with restoration of the stability of the implant; at postoperative neuropathies - complex conservative treatment (medication, exercise therapy, massage, physiotherapy) under the control of electroneuromyography in dynamics. The practical significance of the results obtained is in increasing the effectiveness and improving the results of performing HJA by accelerating the restoration of functional results and preventing complications associated with surgical accesses, based on careful protection of vascular and nervous structures, adequate limb position during surgery, restoration of the integrity of the capsularligamentous, tendon-muscular apparatus of the hip joint.