Features of total hip arthroplasty in the treatment of secondary coxarthrosis of different genesis in older children

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Abstract


Endoprosthetics of older children with secondary coxarthrosis are the least studied part of orthopedics and traumatology. The need for endoprosthetics in children´s practice arises much less often than in adults, but is an actual problem. Indications for joint replacement are the presence of secondary osteoarthritis of the hip joint of various etiology – dysplastic (congenital and paralytic), posttraumatic, infectious-allergic (juvenile rheumatoid arthritis, Bechterew´s disease), postinfection (osteomyelitis and tuberculosis of the joints hip joint), accompanied by severe pain syndrome. The presence of contractures, a decrease in motor activity, at the age of 12-17 years. The aim of the study was to evaluate the effectiveness of the endoprosthetics method in patients with adolescents with coxarthrosis of stage 3. A two-stage method of surgical treatment in cases of limb shortening more than 4 cm is proposed. The authors cite results of treatment of 45 patients. The proposed tactics allowed to get good results in 68%. The method allowed to restore the function of the hip joint, the length of the limbs in all patients. The achieved results make it possible to recommend the use of this method in a complex of restorative treatment in severe forms of secondary coxarthrosis as a result of dysplastic, paralytic, postinfection, systemic autoimmune and post-traumatic processes.


Sergey V. Khrypov

Author for correspondence.
khrypov-s@yandex.ru
St Petersburg State Pediatric Medical University, Ministry of Healthcare of the Russian Federation
Russian Federation, Saint Petersburg

MD, PhD, Associate Professor, Department of Surgical Diseases of Childhood

Diana A. Krasavina

krasa-diana@yandex.ru
St Petersburg State Pediatric Medical University, Ministry of Healthcare of the Russian Federation
Russian Federation, Saint Petersburg

MD, PhD, Associate Professor, Department of Surgical Diseases of Childhood

Alexander G. Veselov

drveselov@bk.ru
St Petersburg State Pediatric Medical University, Ministry of Healthcare of the Russian Federation
Russian Federation, Saint Petersburg

MD, PhD, Assistant Professor, Department of Surgical Diseases of Childhood

Igor A. Komolkin

igor_komolkin@mail.ru
St Petersburg State Pediatric Medical University, Ministry of Healthcare of the Russian Federation
Russian Federation, Saint Petersburg

MD, PhD, Assistant Professor, Department of Surgical Diseases of Childhood

Ardan P. Aphanasiev

ardan_afanasiev@mail.ru
St Petersburg State Pediatric Medical University, Ministry of Healthcare of the Russian Federation
Russian Federation, Saint Petersburg

MD, PhD, Assistant Professor, Department of Surgical Diseases of Childhood

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