Total Hip Arthroplasty in Patients With Post-Traumatic Bone Defects and Acetabular Deformities
- Authors: Pronskikh A.A.1, Romanova S.V.1, Lukinov V.L.1, Bazlov V.A.1, Mamuladze T.Z.1, Korytkin A.A.1, Pavlov V.V.1
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Affiliations:
- Novosibirsk Research Institute of Traumatology and Orthopedics n.a. Ya.L. Tsivyan
- Issue: Vol 28, No 4 (2022)
- Pages: 66-78
- Section: СLINICAL STUDIES
- URL: https://journals.rcsi.science/2311-2905/article/view/124764
- DOI: https://doi.org/10.17816/2311-2905-2001
- ID: 124764
Cite item
Abstract
Backround. Total hip replacement in cases of traumatic changes of the acetabulum refers to cases of difficult primary arthroplasty and requires detailed preoperative planning and accurate restoration of anatomical relationships in the operated joint.
The aim of the study was to evaluate the structure of pathological changes in the acetabulum in patients with posttraumatic hip arthrosis, to develop a method for their detailed description and to determine the tactics of choosing the type of acetabulum implant.
Methods. The results of treatment of 194 patients with the consequences of acetabulum fractures who underwent total hip arthroplasty in the period from 2014 to 2022 were analyzed. The study was conducted in two stages, at the first stage, the structure of pathological changes, such as defect, deformation, changes in the center of rotation and offset (relatively healthy contralateral joint), was analyzed. A method was developed for choosing the tactics of implantation of the acetabulum component, based on a detailed description of the defect and deformation of the acetabulum. The second stage analyzed the results of treatment of patients for whom planning and surgical treatment was carried out in the period from 2020 to 2022 using the proposed method.
Results. During the first stage of the study, it was revealed that the magnitude of the change in the indicators of the displacement of the rotation center and offset changes by more than 8 mm. statistically significantly increases the likelihood of complications by 17.9%. The restoration of the rotation and offset center reduces the number of complications by 22.3%. The proposed method makes it possible to statistically reliably restore anatomical relationships in the operated hip joint and reduce the number of complications by 10%.
Conclusion. The proposed method allows us to qualitatively and quantitatively describe pathological changes in the bone tissue of the acetabulum. Depending on the degree of displacement of the center of rotation, the walls of the acetabulum and the nature of the defect of the supporting bone tissue, the surgeon can determine the tactics of surgical treatment.
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##article.viewOnOriginalSite##About the authors
Aleksandr A. Pronskikh
Novosibirsk Research Institute of Traumatology and Orthopedics n.a. Ya.L. Tsivyan
Email: proal_88@mail.ru
ORCID iD: 0000-0003-1197-556X
Cand. Sci. (Med.)
Russian Federation, NovosibirskSvetlana V. Romanova
Novosibirsk Research Institute of Traumatology and Orthopedics n.a. Ya.L. Tsivyan
Author for correspondence.
Email: s.romanova0319@gmail.com
ORCID iD: 0000-0002-7014-2763
Russian Federation, Novosibirsk
Vitaliy L. Lukinov
Novosibirsk Research Institute of Traumatology and Orthopedics n.a. Ya.L. Tsivyan
Email: Vitaliy.L.lukinov@sci-boost.com
ORCID iD: 0000-0002-3411-508X
Cand. Sci. (Phys.-Mat.)
Russian Federation, NovosibirskVyacheslav A. Bazlov
Novosibirsk Research Institute of Traumatology and Orthopedics n.a. Ya.L. Tsivyan
Email: sbazlov@yandex.ru
ORCID iD: 0000-0001-8982-5516
Russian Federation, Novosibirsk
Tariel Z. Mamuladze
Novosibirsk Research Institute of Traumatology and Orthopedics n.a. Ya.L. Tsivyan
Email: gromadina@inbox.ru
ORCID iD: 0000-0001-8891-535X
Russian Federation, Novosibirsk
Andrey A. Korytkin
Novosibirsk Research Institute of Traumatology and Orthopedics n.a. Ya.L. Tsivyan
Email: andrey.korytkin@gmail.com
ORCID iD: 0000-0001-9231-5891
Cand. Sci. (Med.)
Russian Federation, NovosibirskVitaliy V. Pavlov
Novosibirsk Research Institute of Traumatology and Orthopedics n.a. Ya.L. Tsivyan
Email: pavlovdoc@mail.ru
ORCID iD: 0000-0002-8997-7330
Dr. Sci. (Med.)
Russian Federation, NovosibirskReferences
- Sloan M., Premkumar A., Sheth N.P. Future Demand for Total Joint Arthroplasty Drives Renewed Interest in Arthroplasty Fellowship. HSS J. 2020;16(Suppl 2):210-215. doi: 10.1007/s11420-019-09678-y.
- Zahar A., Papik K., Lakatos J., Cross M.B. Total hip arthroplasty with acetabular reconstruction using a bulk autograft for patients with developmental dysplasia of the hip results in high loosening rates at mid-term follow-up. Int Orthop. 2014;38(5):947-951. doi: 10.1007/s00264-014-2280-7.
- Morales De Cano J.J., Guillamet L., Perez Pons A. Acetabular reconstruction in paprosky type III defects. Acta Ortop Bras. 2019;27(1):59-63. doi: 10.1590/1413-785220192701187313.
- Tsybin A.V., Lubchak V.V., Sivkov V.S., Shilnikov V.A., Malygin R.V., Shubnyakov M.I. [Rationale for the use of the original classification of posttraumatic acetabular deformities in primary total hip replacement]. Genij Ortopedii [Orthopaedic Genius]. 2021;(5):508-513. (In Russian). doi: 10.18019/1028-4427-2021-27-5-508-513.
- Meinberg E.G., Agel J., Roberts C.S., Karam M.D., Kellam J.F. Fracture and Dislocation Classification Compendium-2018. J Orthop Trauma. 2018;32 Suppl 1: S1-S170. doi: 10.1097/BOT.0000000000001063.
- Burgess A.R., Eastridge B.J., Young J.W., Ellison T.S., Ellison P.S. Jr, Poka A. et al. Pelvic ring disruptions: effective classification system and treatment protocols. J Trauma. 1990;30(7):848-856.
- Tile M. Pelvic ring fractures: should they be fixed? J Bone Joint Surg Br. 1988;70(1):1-12. doi: 10.1302/0301-620X.70B1.3276697.
- D’Antonio J.A., Capello W.N., Borden L.S., Bargar W.L., Bierbaum B.F., Boettcher W.G. et al. Classification and management of acetabular abnormalities in total hip arthroplasty. Clin Orthop Relat Res. 1989;(243):126-137.
- Bettin D., Katthagen B.D. [The German Society of Orthopedics and Traumatology classification of bone defects in total hip endoprostheses revision operations]. Z Orthop Ihre Grenzgeb. 1997;135(4):281-284. (In German). doi: 10.1055/s-2008-1039389.
- Saleh K.J., Holtzman J., Gafni ASaleh L., Jaroszynski G., Wong P., Woodgate I. et al. Development, test reliability and validation of a classification for revision hip arthroplasty. J Orthop Res. 2001;19(1):50-56. doi: 10.1016/S0736-0266(00)00021-8.
- Paprosky W.G., Perona P.G., Lawrence J.M. Acetabular defect classification and surgical reconstruction in revision arthroplasty. A 6-year follow-up evaluation. J Arthroplasty. 1994;9(1):33-44. doi: 10.1016/0883-5403(94)90135-x.
- Ahmad A.Q., Schwarzkopf R. Clinical evaluation and surgical options in acetabular reconstruction: A literature review. J Orthop. 2015;12(Suppl 2):S238-243. doi: 10.1016/j.jor.2015.10.011.
- Knafo Y., Houfani F., Zaharia B., Egrise F., Clerc-Urmès I., Mainard D. Value of 3D Preoperative Planning for Primary Total Hip Arthroplasty Based on Biplanar Weightbearing Radiographs. Biomed Res Int. 2019;2019:1932191. doi: 10.1155/2019/1932191.
- Mainard D., Barbier O., Knafo Y., Belleville R., Mainard-Simard L., Gross J.B. Accuracy and reproducibility of preoperative three-dimensional planning for total hip arthroplasty using biplanar low-dose radiographs: A pilot study. Orthop Traumatol Surg Res. 2017; 103(4):531-536. doi: 10.1016/j.otsr.2017.03.001.
- Milyukov A.Y. [Classification of damages of cotyloid cavity]. Meditsina i obrazovanie v Sibiri [Medicine and Education in Siberia]. 2012;(2). (In Russian). Available from: https://mos.ngmu.ru/article/text_full.php?id=680.
- Gudz A.I., Denisov A.O., Lasunskiу S.A., Shubnyakov I.I., Shilnikov V.A., Sorokin E.P. et al.[Management of complex acetabulum fractures and their consequences]. Khirurgiya. Zurnal im. N.I. Pirogova. [Pirogov Russian Journal of Surgery] 2017;(2):70-76. (In Russian). doi: 10.17116/hirurgia2017270-76.
- Tikhilov R.M., Shapovalov V. M, Artjuh V.A., Sivkov V.S. [Hip arthroplasty features after acetabular fracture]. Travmatologiya i ortopediya Rossii [Traumatology and Orthopedics of Russia]. 2005;(3):30-35. (In Russian).
- Martynenko D.V., Voloshin V.P., Sherman l.A., Shevyrev K.V., Oshkukov S.A., Stepanov E.V. [Assessment of Acetabulum Deformity During Preoperative Planning for Hip arthroplasty]. Travmatologiya i ortopediya Rossii [Traumatology and Orthopedics of Russia]. 2019;25(3):153-164. (In Russian). doi: 10.21823/2311-2905-2019-25-3-153-164.
- Tikhilov R.M., Shubnyakov I.I., Chiladze I.T., Pliev D.G., Shorustamov M.T., Artyukh V.A. et al. [Choice of surgical approach for acetabular component’s implantation using current classification for arthritis following acetabular fracture]. Travmatologiya i ortopediya Rossii [Traumatology and Orthopedics of Russia]. 2011;(2): 37-43. (In Russian).
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