Features of hip arthroplasty for fractures of the femoral neck

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Abstract

Biomechanic conception of implant choice for primary total hip replacement in osteoporotic femur neck fractures is presented. Criterion for the choice is a localization of load-bearing surface of dense structure in acetabulum roof zone, i.e. sursile. Absolute indications to total hip replacement, use of bipolar and unipolar hemiprostheses are determined depending on the direction and deviation degree of sursile from horizontal axis of pelvis. Based on suggested conception the retrospective analysis of joint replacement results in 58 patients has been performed. The causes of protrusion and loosing of implants were studied.

About the authors

A. F. Lazarev

Central Institute of Traumatology and Orthopedics. N.N. Priorova

Email: info@eco-vector.com
Russian Federation, Moscow

A. O. Ragozin

Central Institute of Traumatology and Orthopedics. N.N. Priorova

Email: info@eco-vector.com
Russian Federation, Moscow

E. I. Solod

Central Institute of Traumatology and Orthopedics. N.N. Priorova

Email: info@eco-vector.com
Russian Federation, Moscow

M. G. Kakabadze

Central Institute of Traumatology and Orthopedics. N.N. Priorova

Author for correspondence.
Email: info@eco-vector.com
Russian Federation, Moscow

References

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Supplementary files

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2. Fig. 1. Protrusion of the head of the Moore-CITO endoprosthesis into the acetabulum during 5 years.

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3. Fig. 2. Protrusion of the bipolar head into the acetabulum for 2 years.

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4. Fig. 3. Patient A., 86 years old. In 1992, endoprosthesis of the right hip joint was performed with a Moore-CITO prosthesis, in 1994, endoprosthesis of the left hip joint was performed with a total endoprosthesis with fixation on bone cement. a — 2 years after arthroplasty of the right, b — immediately after arthroplasty of the left hip joint; c — there are no changes in the hemiprosthesis 4 years after the installation, there is a “falling through” of the Bi-metris cement stem 2 years after the operation; d — the position of the hemiprosthesis did not change 8 years after the operation, the position of the cemented endoprosthesis stabilized after 6 years.

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5. Fig. 4. Sursil - loadable surface (1), bundles of bone beams forming a "Gothic arch" (2), position of the resultant force vector (R).

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6. Fig. 5. Distribution of force vectors with a horizontal location of the sursil. And — a vector of force of the taking away muscles of a hip; I - force vector of the iliac muscle; Ra and Pi are the vertical components, (Qa and Qi are the horizontal components, R is the resultant force, R1 is the reaction force of the support.

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7. Fig. 6. Distribution of force vectors in the medial position of the sursil: the balance of forces shifts towards the abductor muscles.

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8. Fig. 7. Distribution of force vectors in the lateral position of the sursil: the balance of forces shifts towards the iliac muscle.

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