Peculiarities of Total Replacement in Hip Joint Severe Pathology

During the period from 1991 to 2003 the total number of 189 hip replacements in 168 patients aged 17-65 years (mean age 48.7) with severe joint pathology were performed at the traumatology and orthopaedics center of the Military Clinical Hospital named after NN. Burdenko. Six main groups of patients with severe pathologic changes in hip joint and surrounding tissues were detected, i.e. with posttraumatic and gunshot bone defects, dysplastic III- IV stage coxarthrosis, postosteotomic deformities of the extremity, specific inflammatory hip patology metastatic lesions of proximal femur, as well as patients who required single-step bilateral hip replacement. In 18 patients surgical treatment was performed in two steps by authors' technique. «Spotomo» and «Zweymuller» implants, Wagner revision stems and Muller strengthening rings were used most commonly. Excellent and good results were achieved in 157 cases (83.1%), satisfactory in 28 (14.8%). In 4 cases (2.1%) postoperative joint function was unsatisfactory.