Clinico-diagnostic peculiarities of dysplastic coxarthrosis of III-IV degree

Abstract

CIinicodiagnostic researches included. 73 patients with dysplastic coxarthrosis who were examined and treated in orthopedic ward of Scientific Center of Reconstructive and. Restorative Surgery SB RAMS during 2001-2010 years. The aim. of the research is to specify clinic-radiologic criteria of hip joint with dysplastic changes at the arthrosis of III-IV degree. The diagnosis was set on the basis of clinicodiagnostic criteria. The main signs that characterize dysplastic joint were: anteversion of femoral neck; deflection of acetabulum anterior from sagittal plane; disorder of center of the head in horizontal plane; change of cervical-diaphyseal angle and. the angulation of acetabulum (more than 60°). Acetabulum becomes shallow and. head's embedding into it is Iess than 1/3 (1/2 as a norm). Main clinical manifestations of all examined patients were bending-adduction and rotation contractures of hip joints, shortening of extremities concerned with pathoIogic process, stabIe pain syndrome, gross Iimping with disorder of support function of extremity and Iocomotor act of waIking. In aII 73 patients we reveaIed. different disorders of anatomic interreIations of components of hip joint that are typicaI for grave forms of dyspIastic coxarthrosis. Ensuring of stabiIity of an impIant is extremeIy important at totaI hip joint repIacement. Prediction of measures of postoperative compIications prevention that allow to determine right tactics of operative treatment is the first to reaIize. If the indices of dyspIasia (ratio between thickness of acetabuIum's bottom and its depth) at dyspIastic coxarthrosis of III-IV degree is Iess than 0,6, it's possibIe to predict appearance of instabiIity of hip component of an impIant. VaIues of these indices can be used for forming impIant bed at the pIacing of impIant cup without additionaI ways of fixation.

Keywords

• coxarthrosis
• endoprosthesis replacement
• radiodiagnosis
• clinic