Our experience of total hip arthroplasty in adolescents with consequences of acute hematogenous osteomyelitis

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription Access

Abstract

BACKGROUND: Currently, the number of adolescents with terminal stages of coxarthrosis of various origins who underwent total hip joint arthroplasty has increased, as the use of modern implant models with a long service life has narrowed the age limit and expanded the indications for this intervention.

AIM: This study aimed to assess the effectiveness of total hip arthroplasty in adolescents with stage 3 coxarthrosis caused by acute hematogenous osteomyelitis.

MATERIALS AND METHODS: The study analyzed preoperative data and postoperative clinical, radiological, and functional examination data of 40 patients aged 13–18 (15 ± 1.2) years with stage 3 coxarthrosis caused by acute hematogenous osteomyelitis. The study group was composed of 21 (52.5%) boys and 19 (47.5%) girls. The control group consisted of 32 patients with stage 3 post-traumatic coxarthrosis, aged 12–18 (15.4 ± 1.7) years, of which 14 (43.75%) were girls and 18 (56.25%) were boys.

RESULTS: The long-term functional results were evaluated using the Harris hip score (14). The average Harris hip scores before and after arthroplasty were 44.87 ± 5.65 and 80 ± 7.61 (p < 0.05), respectively. In the comparison group, the mean Harris hip scores before and after surgery were 33.73 ± 4.28 and 89.47 ± 5.60 points, respectively (p < 0.05). The postoperative follow-up duration was 5 ± 3 M ± SD (95% confidence interval) years. No complications were observed in the early and late postoperative periods.

CONCLUSIONS: In adolescents, total hip arthroplasty is an effective surgical treatment for complications of acute hematogenous osteomyelitis. It quickly provides attainable, stable, and favorable outcomes, which improve the quality of life and social adaptation of adolescents.

About the authors

Khisrav D. Imomov

H.Turner National Medical Research Center for Сhildren's Orthopedics and Trauma Surgery

Author for correspondence.
Email: Kh.Imomov90@mail.ru
ORCID iD: 0000-0001-5025-7689
SPIN-code: 3671-9450

MD, PhD student

Russian Federation, Saint Petersburg

Vladimir E. Baskov

H.Turner National Medical Research Center for Сhildren's Orthopedics and Trauma Surgery

Email: dr.baskov@mail.ru
ORCID iD: 0000-0003-0647-412X
SPIN-code: 1071-4570

MD, PhD

Russian Federation, Saint Petersburg

Valentin A. Neverov

H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery; North-Western State Medical University named after I.I. Mechnikov

Email: 5507974@mail.ru
ORCID iD: 0000-0002-7244-5522
SPIN-code: 2325-0152

MD, PhD, D.Sc., Professor

Russian Federation, Saint Petersburg; Saint Petersburg

Pavel I. Bortulev

H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery

Email: pavel.bortulev@yandex.ru
ORCID iD: 0000-0003-4931-2817
SPIN-code: 9903-6861

MD, PhD

Russian Federation, Saint Petersburg

References

  1. Akzhigitov GN. Gematogennyy osteomiyelit. Moscow: Meditsina; 1998. (In Russ.)
  2. Katko VA. Gematogennyy osteomiyelit u detey. Minsk: BGMU; 2007. (In Russ.)
  3. Choi IH, Pizzutillo PD, Bowen JR, et al. Sequelae and reconstruction after septic arthritis of the hip in infants. J Bone Jt Surg. 1990;72-A(8):1150–1165.
  4. Savintsev AM. Khirurgicheskoye lecheniye ortopedicheskikh posledstviy gnoynykh zabolevaniy tazobedrennogo sustava [dissertation]. Saint Petersburg; 2004. (In Russ.)
  5. Skvortcov AP. Khirurgicheskoye lecheniye posledstviy gematogennogo osteomiyelita oblasti sustavov nizhnikh konechnostey u detey [abstract dissertation]. Kazan; 2008. (In Russ.)
  6. Andrianov VL, Savelyev VI, Bystryy KN, Terekhov SG. Artroplastika s primeneniyem demineralizirovannykh kostno-khryashchevykh allokolpachkov (perdvaritelnoye soobshcheniye). Patologiya tazobedrennogo sustava. 1983. P. 20–24. (In Russ.)
  7. Daniyelyan OA. Deformatsiya sustavov nizhnikh konechnostey u detey i podrostkov pri posledstviyakh gematogennogo osteomiyelita: Klinika, diagnostika, lecheniye [abstract dissertation]. Saint Peterburg; 1996. (In Russ.)
  8. Linnik SA. Osteomiyelit taza. osteoartrit tazobedrennogo sustava i ikh ortopedicheskiye posledstviya. Khirurgicheskoye lecheniye. Saint Petersburg: MAPO; 2007. P. 332–334. (In Russ.)
  9. Garkavenko YuE. Ortopedicheskiye posledstviya gematogennogo osteomiyelita dlinnykh trubchatykh kostey u detey: klinika. diagnostika. lecheniye [abstract dissertation]. Saint Petersburg, 2011. (In Russ.)
  10. Teplenkiy MP, Oleynikov EA, Bunov VS. Khirurgicheskoye lecheniye detey s posledstviyami septicheskogo koksita. Travmatologiya i ortopediya Rossii. 2017;23(3):43–52. (In Russ.). doi: 10.21823/2311-2905-2017-23-3-43-52
  11. Baindurashvili AG, Krasnov AI, Deyneko AN. Khirurgicheskoye lecheniye detey s displaziyey tazobedrennogo sustava. Saint Petersburg: SpetsLit; 2011. (In Russ.)
  12. Baskov VE, Neverov VA, Bortulev PI, et al. Osobennosti totalnogo endoprotezirovaniya tazobedrennogo sustava u detey posle artroplastiki demineralizovannymi kostno-khryashchevymi allokolpachkami. travmatologiya. Ortopediya i vosstanovitelnaya khirurgiya detskogo vozrasta. 2017;5(1):13–20. doi: 10.17816/PTORS5113-20. (In Russ.)
  13. Kotlyarov RS. Totalnoyeendoprotezirovaniye tazobedrennogo sustava u podrostkov [abstract dissertation]. Moscow; 2011. (In Russ.)
  14. Neverov VA, Kamosko MM, Baskov VE. Endoprotezirovaniye tazobedrennogo sustava u detey i podrostkov. Vestnik khirurgii im. II Grekova. 2011;(6):107–112. (In Russ.)
  15. Launay F, Jouve JL, Guillaume JM, et al. Total hip arthroplasty without cement in children and adolescents: 17 cases. Rev Chir Orthop Reparatrice Appar Mot. 2002;88(5):460–466.
  16. Hannouche D, Devriese F, Delambre J, et al. Ceramic-on-ceramic THA implants in patients younger than 20 years. Clin Orthop Relat Res. 2016;474(2):520–527. doi: 10.1007/s11999-015-4546-9
  17. Metcalfe D, Peterson N, Wilkinson JM, Perry DC. Temporal trends and survivorship of total hip arthroplasty in very young patients. Bone Joint J. 2018;100-B(10):1320–1329. doi: 10.1302/0301-620x.100b10.bjj-2017-1441.r2
  18. Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty: an end result study using a new method of result evaluation. J Bone Joint Surg. 1969;51-B:737–755.
  19. Abeltsev VP. Desyatiletniy opyt endoprotezirovaniya tazobedrennogo sustava pri displasticheskom koksartroze. Vestnik travmatologii i ortopedii im. NN Priorova. 2002;(1):54–57. (In Russ.)
  20. Tikhilov RM, Shapovalov VM, editors. Rukovodstvo po endoprotezirovaniyu tazobedrennogo sustava. Saint Petersburg: RNIITO im. RR Vredena; 2008. (In Russ.)
  21. Paavilainen T. Total hip replacement for developmental dysplasia of the hip. Acta Orthop Scand. 1997;68(1):77–84.
  22. Li W, Fang X, Zhang C, et al. Comparison of efficacy and complications between two types of staging arthroplasty in treating chronic septic hip arthritis: A retrospective clinical study. Exp Ther Med. 2019;15(5). doi: 10.3892/etm.2019.7430
  23. Bessette BJ, Fassier F, Tanzer M, et al. Total hip arthroplasty in patients younger than 21 years: a minimum, 10-year follow-up. Can J Surg. 2003;46(4):257–262.
  24. Bortuleva OV, Baskov VE, Bortulev PI, et al. Effektivnost reabilitatsii detey posle totalnogo endoprotezirovaniya tazobedrennogo sustava. Vestnik vosstanovitelnoy meditsiny. 2018;(3):101–107. (In Russ.)
  25. Torchia ME, Klassen RA, Bianco AJ. Total hip arthroplasty with cement in patients less than twenty years old. Long-term results. J Bone Joint Surg. 1996;78-A:995–1003. doi: 10.2106/00004623-199607000-00003
  26. Restrepo C, Lettich T, Roberts N, et al. Uncemented total hip arthroplasty in patients less than twenty-years. Acta Orthop. Belg. 2008;74(5):615-622.
  27. Tihilov RM, Shubnjakov II, Mjasoedov AA, et al. Jendoprotezirovanie tazobedrennogo sustava pri kostnyh ankilozah razlichnoj jetiologii, prichiny i rezul’taty. Sovremennye problemy nauki i obrazovanija. 2018;(2). doi: 10.17513/spno.27426

Supplementary files

Supplementary Files
Action
1. JATS XML
Download
2. Fig. 1. Dynamics of indicator changes in the Harris hip score before (a) and after (b) surgery in patients of the main and control groups.

Download (125KB)
Indexing metadata
3. Fig. 2. Dynamic of changes in the magnitude of affected limb shortening before (a) and after (b) surgery in patients of the main and control groups

Download (135KB)
Indexing metadata

Copyright (c) 2021 Imomov K.D., Baskov V.E., Neverov V.A., Bortulev P.I.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
 


Согласие на обработку персональных данных

 

Используя сайт https://journals.rcsi.science, я (далее – «Пользователь» или «Субъект персональных данных») даю согласие на обработку персональных данных на этом сайте (текст Согласия) и на обработку персональных данных с помощью сервиса «Яндекс.Метрика» (текст Согласия).