Email this article Total hip arthroplasty in children who have undergone arthroplasty with demineralized bone-cartilage allocups
- Authors: Baskov V.E.1, Neverov V.A.1, Bortulev P.I.1, Krasnov A.I.1, Barsukov D.B.1, Pozdnikin I.Y.1, Krasnogorskiy I.N.1, Bortuleva O.V.1
-
Affiliations:
- The Turner Scientific and Research Institute for Children’s Orthopedics
- Issue: Vol 5, No 1 (2017)
- Pages: 13-20
- Section: Articles
- URL: https://journals.rcsi.science/turner/article/view/6152
- DOI: https://doi.org/10.17816/PTORS5113-20
- ID: 6152
Cite item
Abstract
Introduction. Treating children with degenerative dystrophic diseases of the hip joint has become one of the most acute problems in contemporary orthopedics. Until recently, we performed arthroplasty by demineralized bone-cartilage allocups (DBCA) in the Clinic of the Hip Joint Pathology of the Turner Scientific and Research Institute for Children’s Orthopedics for patients showing clinical and radiological signs of irreversible destruction of the hip joint; we carried out this procedure to preserve the function of the lower limb. However, over the last 8 years, we have changed our protocol for children older than 12 years of age and have replaced DBCA with total hip replacement. In a number of cases, total hip replacement was performed after a previous intervention involving arthroplasty with DBCA.
Objective. To determine the technical peculiarities of total hip replacement after a previous intervention involving arthroplasty with DBCA.
Material and methods. We analyzed the results of treatment involving various types of hip pathology in 13 children (100%) aged between 15 and 16 years [8 girls (61.5%) and 5 boys (38.5%)]. The medical histories of all 13 children (100%) showed repeated operations on the hip joint, ultimately resulting in arthroplasty with DBCA. All 13 children (100%) underwent a total hip replacement. Upon hip replacement, all 13 patients (100%) showed a pronounced thinning and hardening of the edges and the bottom of the acetabulum, which created some difficulties in the process of acetabular component implantation. The transformation of DBCA was not evident in any of the 13 cases (100%).
Results. During the observation period of 3–5 years following total hip arthroplasty, all 13 cases (100%) showed recovery in the range of motion and absence of pain. An important criterion for evaluating the quality of care was the complete social and domestic adaptation of all 13 children (100%) during the period from 6 to 9 months following total hip replacement surgery.
Conclusions. The main feature of the implementation of total hip replacement, following a previous intervention involving arthroplasty with DBCA, was a pronounced deficit of the pelvic bone in the joint component. This significantly complicated the subsequent implantation of the acetabular prosthesis component, and in some cases required the use of a cemented acetabular component. Our experience suggests that patients under 11 years of age who show clinical and radiological signs of coxarthrosis can be treated with arthroplasty with DBCA in order to save the lost function of the hip joint and maintain the function of the periarticular muscles.
Full Text
##article.viewOnOriginalSite##About the authors
Vladimir E. Baskov
The Turner Scientific and Research Institute for Children’s Orthopedics
Author for correspondence.
Email: dr.baskov@mail.ru
MD, PhD, head of the department of hip pathology
Russian FederationValentin A. Neverov
The Turner Scientific and Research Institute for Children’s Orthopedics
Email: 5507974@mail.ru
MD, PhD, professor, leading research associate of the department of hip pathology
Russian FederationPavel I. Bortulev
The Turner Scientific and Research Institute for Children’s Orthopedics
Email: pavel.bortulev@yandex.ru
MD, research associate of the department of hip pathology
Russian FederationAndrey I. Krasnov
The Turner Scientific and Research Institute for Children’s Orthopedics
Email: pavel.bortulev@yandex.ru
MD, PhD, orthopedic and trauma surgeon
Russian FederationDmitry B. Barsukov
The Turner Scientific and Research Institute for Children’s Orthopedics
Email: dbbarsukov@gmail.com
MD, PhD, senior research associate of the department of hip pathology
Russian FederationIvan Y. Pozdnikin
The Turner Scientific and Research Institute for Children’s Orthopedics
Email: pozdnikin@gmail.com
MD, PhD, research associate of the department of hip pathology
Russian FederationIvan N. Krasnogorskiy
The Turner Scientific and Research Institute for Children’s Orthopedics
Email: pozdnikin@gmail.com
MD, PhD, senior research
associate histologist of the scientific and morphological
laboratory
Oksana V. Bortuleva
The Turner Scientific and Research Institute for Children’s Orthopedics
Email: pozdnikin@gmail.com
MD, PhD student of the department of hip pathology
Russian FederationReferences
- Поздникин Ю.И., Камоско М.М., Поздникин И.Ю. Профилактика и лечение деформирующего пре- и коксартроза у детей и подростков с врожденной патологией тазобедренного сустава: пособие для врачей. – СПб., 2005. – С. 31. [Pozdnikin YuI, Kamosko MM, Pozdnikin IYu. Profilaktika i lechenie deformiruyushchego pre- i koksartroza u detei i podrostkov s vrozhdennoi patologiei tazobedrennogo sustava: posobie dlya vrachei. Saint Petersburg; 2005. P. 31. (In Russ.)]
- Малахов О.А., Кралина С.Е. Врожденный вывих бедра (клиника, диагностика, консервативное лечение). – М.: Медицина, 2006. [Malakhov OA, Kralina SE. Vrozhdennyi vyvikh bedra (klinika, diagnostika, konservativnoe lechenie). Moscow: Meditsina; 2006. (In Russ.)]
- Неверов В.А., Камоско М.М., Басков В.Е. Эндопротезирование тазобедренного сустава у детей и подростков // Вестник хирургии им. Н.Н. Приорова. – 2011. – Т. 170. – № 6. – С. 107. [Neverov VA, Kamosko MM, Baskov VE. Endoprotezirovanie tazobedrennogo sustava u detei i podrostkov. Vestnik khirurgii im. N.N. Priorova. 2011;170(6):107 (In Russ.)]
- Котляров Р.С. Тотальное эндопротезирование тазобедренного сустава у подростков: Автореф. дис. … канд. мед. наук. – М., 2011 [Kotlyarov RS. Total’noe endoprotezirovanie tazobedrennogo sustava u podrostkov. [dissertation] Moscow; 2011 (In Russ.)]
- Басков В.Е. Ортопедо-хирургическое лечение детей с диспластическим маргинальным вывихом бедра: Автореф. дис. ... канд. мед. наук. – СПб., 2009. [Baskov VE. Ortopedo-khirurgicheskoe lechenie detei s displasticheskim marginal’nym vyvikhom bedra. [dissertation] Saint Petersburg; 2009. (In Russ.)]
- Танькут В.А., Хвисюк А.Н., Гращенкова Т.М., и др. Артропластика тазобедренного сустава (обзор литературы) // Ортопедия, травматология и протезирование. – 1989. – № 8. – С. 60–63 [Tan’kut VA, Khvisyuk AN, Grashchenkova TM, et al. Artroplastika tazobedrennogo sustava (obzor literatury). Ortopediya, travmatologiya i protezirovanie. 1989;(8):60-63 (In Russ.)]
- Buckwalter JA, Mankin HJ. Articular cartilage. Part II. Degeneration and osteoarthrosis, repair, regeneration and transplantation. J Bone Joint Surg Am. 1997;79(4):612-632. doi: 10.2106/00004623-199704000-00022.
- Андрианов В.Л., Савельев В.И., Быстрый К.Н., Терехов С.Г. Артропластика с применением деминерализированных костно-хрящевых аллоколпачков (пердварительное сообщение) // Патология тазобедренного сустава. – 1983. – С. 20–24. [Andrianov VL, Savel’ev VI, Bystryi KN, Terekhov SG. Artroplastika s primeneniem demineralizirovannykh kostno-khryashchevykh allokolpachkov (perdvaritel’noe soobshchenie). In: Patologiya tazobedrennogo sustava. 1983. P. 20-24. (In Russ.)]
- Савельев В.И. Деминерализованная кость как особая разновидность костно-пластического материала // Заготовка и пересадка костной ткани в эксперименте и клинике. – 1983. – С. 3–12. [Savel’ev VI. Deminerlizovannaya kost’ kak osobaya raznovidnost’ kostno-plasticheskogo materiala. In: Zagotovka i peresadka kostnoi tkani v eksperimente i klinike. 1983. P. 3-12 (In Russ.)]
- Тихоненков Е.С., Терехов С.Г., Райе И.А. Восстановление функции тазобедренного сустава у детей после артропластики // Восстановительное лечение детей с заболеваниями опорно-двигательного аппарата. – 1984. – С. 35–37 [Tikhonenkov ES, Terekhov SG, Raie IA. Vosstanovlenie funktsii tazobedrennogo sustava u detei posle artroplastiki. In Vosstanovitel’noe lechenie detei s zabolevaniyami oporno-dvigatel’nogo apparta. 1984. P. 35-37 (In Russ.)]
- Терехов С.Г. Артропластика тазобедренного сустава у детей и подростков деминерализированными костно-хрящевыми аллоколпачками: Дис. … канд. мед. наук. – Л., 1985 [Terekhov SG. Artroplastika tazobedrennogo sustava u detei i podrostkov demineralizirovannymi kostno-khryashchevymi allokolpachkami. [dissertation] Leningrad; 1985. (In Russ.)]
- Дейнеко А.Н., Краснов А.И., Барсуков Д.Б. Артропластика с применением деминерализированных костно-хрящевых аллоколпачков у детей с врожденным вывихом бедра (обзор четырех случаев) // Травматология и ортопедия России. – 2006. – Т. 42. – № 4. – С. 69–72 [ Deineko AN, Krasnov AI, Barsukov DB. Artroplastika s primeneniem demineralizirovannykh kostno-khryashchevykh allokolpachkov u detei s vrozhdennym vyvikhom bedra (obzor chetyrekh sluchaev). Travmatologiya i ortopediya Rossii. 2006;42(4):69-72. (In Russ.)]
- Камоско М.М., Басков В.Е., Барсуков Д.Б., и др. Транспозиция вертлужной впадины путем тройной остеотомии таза при лечении детей с дисплазией тазобедренного сустава // Травматология и ортопедия России. – 2014. – Т. 73. – № 3. – С. 76–85. [Kamosko MM, Baskov VE, Barsukov DB, et al. Transposition of the acetabulum after triple pelvic osteotomy in the treatment of children with hip dysplasia. Traumatology and Orthopedics of Russii. 2014;73(3):76-85. (In Russ.)]. doi: 10.21823/2311-2905-2014-0-3-76-85.
- Баиндурашвили А.Г., Краснов А.И., Дейнеко А.Н. Хирургическое лечение детей с дисплазией тазобедренного сустава. – СПб.: СпецЛит, 2011 [Baindurashvili AG, Krasnov AI, Deineko AN. Khirurgicheskoe lechenie detei s displaziei tazobedrennogo sustava. Saint Petersburg: SpetsLit; 2011. (In Russ.)]
Supplementary files
