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Khirurgii

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Year 2021 Vol. 29 No 1

TRAUMATOLOGY AND ORTHOPEDICS

N.L. ANKIN 1, 2, T.M. PETRYK 1, 2, V.V. ROIENKO 1, V.O. LADYKA 1, 2

FEATURES OF HIP JOINT ARTHROPLASTY IN PATIENTS AFTER OSTEOSYNTHESIS OF THE ACETABULAR FRACTURES

Kiev Regional Clinical Hospital 1,
P.L. Shupyk National Medical Academy of Postgraduate Education 2, Kiev,
Ukraine

Objective. To analyze the late complications after osteosynthesis of the acetabular fractures that led to reoperations; to determine the features of surgical intervention and the choice of the acetabular component during endoprosthetics in these patients.
Methods. From 2009 to 2015, the results of endoprosthetics in patients (n=35) who underwent primary osteosynthesis of the acetabulum and subsequently hip arthroplasty were evaluated at the Orthopedic and Trauma Center of Kiev Regional Clinical Hospital. To assess damage volume, the Letournel-Judet classification was used. 5 years after the endoprosthetics to evaluate functional outcomes the the Harris Hip Scale (HHS) and radiographic method have been used.
Results. The initial preoperative assessment in 35 patients using Harris Hip Scale showed results: 64 (58-71) Ìå (LQ; UQ) points. A year after endoprosthetics when examining 33 (94.3%) patients the Harris scale improved the results to 81 (74-88) points (p0-1<0.001). 5 years after arthroplasty the Harris scale was 85 (77-92) points (p0-5<0.001). After 5 years in 31 (88.6%) patients a radiographic evaluation showed stable integration of the acetabular component without any signs of attenuation in 1-3 zones according to the De Lee and Charnley classification.
Conclusion. The most effective way to treat the recent acetabular fractures with fragment displacement is considered to be the early osteosynthesis with anatomical reposition of fragments, which with the development of degenerative changes in the operated joint, makes it possible to perform endoprosthetics using a full-fledged bone mass for immersion of the acetabular component. Careful planning of the operation, preliminary removal of metal fixators, which can affect the placement of the acetabular component, as well as increase the risk of postoperative complications, allows achieving good results.

Keywords: hip joint, àcetabular fractures, primary total hip replacement, osteosynthesis of the àcetabular fractures, classification of Letournel-Judet, De Lee and Charnley classification
p. 46-52 of the original issue
References
  1. Letournel E, Judet R (eds). Fractures of the acetabulum. Springer Science & Business Media; 2012. 524 ð.
  2. Matta JM. Fractures of the acetabulum: accuracy of reduction and clinical results in patients managed operatively within three weeks after the injury. J Bone Joint Surg Am. 1996 Nov;78(11):1632-45. https://insights.ovid.com/jbjs/199611000/00004623-199611000-00002
  3. Matta JM. The anterior approach for total hip replacement: background and operative technique. In: MIS Techniques in Orthopedics. Springer, New York, NY; 2006. p. 121-40. doi: 10.1007/978-0-387-29300-4_8
  4. Carroll EA, Huber FG, Goldman AT, Virkus WW, Pagenkopf E, Lorich DG, Helfet DL. Treatment of acetabular fractures in an older population. J Orthop Trauma. 2010 Oct;24(10):637-44. doi: 10.1097/BOT.0b013e3181ceb685
  5. Tile M, Helfet DL, Kellam JF, Vrahas M. Fractures of the pelvis and acetabulum: principles and methods of management. Thieme; 2015. doi: 10.1055/b-003-121618
  6. Judet R, Judet J, Letournel E. Fractures of the acetabulum: classification and surgical approaches for open reduction. Preliminary report. J Bone Joint Surg Am. 1964 Dec;46:1615-46.
  7. Rogers JC, Irrgang JJ. Measures of adult lower extremity function: The American Academy of Orthopedic Surgeons Lower Limb Questionnaire, The Activities of Daily Living Scale of the Knee Outcome Survey (ADLS), Foot Function Index (FFI), Functional Assessment System (FAS), Harris Hip Score (HHS), Index of Severity for Hip Osteoarthritis (ISH), Index of Severity for Knee Osteoarthritis (ISK), Knee Injury and Osteoarthritis Outcome Score (KOOS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC™). Arthritis & Rheumatism (Arthritis Care & Research). 2003 Oct 15;49(5S):S67-S84. doi: 10.1002/art.11401
  8. DeLee JG, Charnley J. Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res. 1976 Nov-Dec;(121):20-32.
  9. Berger RA, Jacobs JJ, Quigley LR, Rosenberg AG, Galante JO. Primary cementless acetabular reconstruction in patients younger than 50 years old. 7- to 11-year results. Clin Orthop Relat Res. 1997 Nov;(344):216-26.
  10. Berry DJ, Halasy M. Uncemented acetabular components for arthritis after acetabular fracture. Clin Orthop Relat Res. 2002 Dec;(405):164-67. doi: 10.1097/00003086-200212000-00020
  11. Sierra RJ, Mabry TM, Sems SA, Berry DJ. Acetabular fractures: the role of total hip replacement. Bone Joint J. 2013 Nov;95-B(11 Suppl A):11-16. doi: 10.1302/0301-620X.95B11.32897
  12. Stibolt RD Jr, Patel HA, Huntley SR, Lehtonen EJ, Shah AB, Naranje SM. Total hip arthroplasty for posttraumatic osteoarthritis following acetabular fracture: A systematic review of characteristics, outcomes, and complications. Chin J Traumatol. 2018 Jun;21(3):176-81. doi: 10.1016/j.cjtee.2018.02.004
  13. Bellabarba C, Berger RA, Bentley CD, Quigley LR, Jacobs JJ, Rosenberg AG, Sheinkop MB, Galante JO. Cementless acetabular reconstruction after acetabular fracture. J Bone Joint Surg Am. 2001 Jun;83(6):868-76. doi: 10.2106/00004623-200106000-00008
  14. Ranawat A, Zelken J, Helfet D, Buly R. Total hip arthroplasty for posttraumatic arthritis after acetabular fracture. J Arthroplasty. 2009 Aug;24(5):759-67. doi: 10.1016/j.arth.2008.04.004
  15. Tile M, Helfet D, Kellam J (eds). Fractures of the pelvis and acetabulum. 3rd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2003. 850 p.
  16. Danilyak VV. Comment to the article “Classifications of acetabular defects: do they provide an objective evidence for complexity of revision hip joint arthroplasty? (Critical literature review and own cases)”. Traumatology and Orthopedics of Russia. 2019;25(2):166-69. doi: 10.21823/2311-2905-2019-25-2-166-169 (In Russ.)
Address for correspondence:
04107, Ukraine, Kiev,
Baggoutovskaya Str., 1,
Kiev Clinical Hospital,
the Department of Orthopedics and Traumatology No2 of P.L. Shupyk of the National Medical Academy of Postgraduate Education
tel. +3 8096 258 37 05,
e-mail: ladika084@gmail.com,
Ladyka Victoria A.
Information about the authors:
Ankin Mykola L., MD, PhD, Professor, Acting General Director, Kiev Clinical Hospital, Head of the Department of Orthopedics and Traumatology No2, P.L. Shupyk of the National Medical Academy of Postgraduate Education, Kiev Ukraine.
https://orcid.org/0000-0001-9795-0931
Petryk Taras M., PhD, Head of the Orthopedics And Traumatology Center, Kiev Clinical Hospital, Associate Professor of the Department of Orthopedics and Traumatology No2, P.L. Shupyk of the National Medical Academy of Postgraduate Education, Kiev Ukraine.
https://orcid.org/0000-0002-5319-3921
Roienko Vadym V., Traumatic Surgeon of the Orthopedics and Traumatology Center, Kiev Clinical Hospital, Kiev, Ukraine.
https://orcid.org/0000-0002-1220-4049
Ladyka Victoria A., Assistant of the Department of Orthopedics and Traumatology No2, P.L. Shupyk of the National Medical Academy of Postgraduate Education, Traumatic Surgeon of the Orthopedics and Traumatology Center, Kiev Clinical Hospital, Kiev Ukraine.
https://orcid.org/0000-0002-3796-428X
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