Algorithm of selection of acetabular component of hip joint endoprothesis in patients with femoral head aseptic necrosis.
DOI:
https://doi.org/10.26641/2307-0404.2015.1.40235Ключевые слова:
femoral head aseptic necrosis, roentgenmorphometry, acetabulum, algorithmАннотация
The article represents a comparative roentgenmorphometric analysis of hip joint deformation development in femoral head aseptic necrosis (FHAN) that was done to identify criteria which determine the selection of the acetabular component of the total hip joint endoprosthesis. There were analysed 234 hip joint radiograms of patients with FHAN performed in anterior-posterior plane. Radiograms were subdivided into 3 groups concerning staging of the process: stage II – 18 radiograms, stage III – 84 radiograms, stage IV – 132 radiograms. Analyzing the acetabular retraction (AR) following indices were assessed: sphericity coefficient α (α = r/d), proportionality coefficient β (β = n/r), compliance coefficient γ (γ = h/r), where r – radius of the acetabulum, n – thickness of the acetabular bottom, h – height of the “Napoleon’s hat”. In addition, there was assessed presense of the major trabecular structures of the supra-acetabular area (A,B,C). Score assessment system, based on the identified indices of changing tendencies in FHAN was offered. There were determined the first level criteria, characterizing the acetabular and supra-acetabular area state. Besides, individual factors of the patient (sex, age) which substantially determine endoprosthesis stability in the remote postoperative period were related to second level criteria. Basing on the assessment of the first and second level criteria algorithm of choice of the total hip endoprosthesis component was developed. Thus, developed system of choice of total hip endoprosthesis component which consider peculiarities of the acetabular deformation formed in the late stages of FHAN assesses the ability of the supra-acetabular area to perceive loading. In addition algorithm takes into consideration individual factors of the patient (sex, age) by the moment of implantation, which determine total hip endoprosthesis stability in the latest postoperative period and consequently the risk for aseptic instability development.Библиографические ссылки
Bansal Alok. [Aseptic instability of the total hip endoprosthesis. Diagnosis and treatment]: dis. …kand. med. nauk: 14.01.21 / Bansal Alok. – Harkіv, 2000;183s. Ukrainian. 2. Gajko GV, Pіdgaєc'kij VM, Sulima OM, Chkalov OV. [Prerequisities for development of the total hip endoprosthesis aseptic instability (biomechanical and mathematic modeling)]. Ortopedija, travmatologija i protezirovanie. 2009;1:10-17. Ukrainian. 3. Mihajlova NM, Malova MI. [Femoral head asep¬tic necrosis in adults]. M.: Medicina. 1982;136. Russian. 4. [Possible complications in total hip replacement]: Ukr. naukovo-prk. konf. [«Endoprotezuvannja suglobіv (pokazannja, tehnіka, pomilki)»], Dnіpropetrovs'k (11-12 veresnja 1997). Kiїv-Dnіpropetrovs'k, 1997;33-35. Ukrainian. 5. Sherepo NK, Sherepo KM. [Total hip endop¬rosthesis aseptic instability as the major problem of the total hip replacement]. Vest. travmatol. i ortoped. im. N.N.Priorova. 2007;1:43–47. Ukrainian. 6. Bombelli R. Radiological Pattern of the Normal Hip Joint and its Biomechanical Meaning. In: Draenert K., Rutt A. Morphologie und Function der Hufte. Histo-Morph Bewengungsapp. 1981;1:113-38. 7. Lieberman JR, Kay RM, Hamlet N, Kabo JM. Deformation patterns and frictional torgue in modular acetabular components. Presented at the annual meeting of the American Academy of Orthopaedic Surgeons, New Orleans. 1994;210-9. 8. Effenberger H, Ramsauer T, Dorn U. Factors in¬fluencing the revision rate of Zweymueller acetabular cup. Int. Orthop. 2004;28:155-8. 9. Effenberger H, Bohm G, Huber M, et al. Experi¬mental study of bone-implant contact area with a para¬bolic acetabular component (Hofer-Imhof). Arch. Orthop. Trauma Surg. 2000;120:160-5. 10. Fritsche A, Bialek K, Mittelmeier W. Experimen¬tal investigations of the insertion and deformation be¬havior of press-fit and threaded acetabular cups for total hip replacement. J Orthop. Sci. 2008;13:240–7. doi 10.1007/s00776-008-1212-z. 11. Garino JR, Steinberg ME. Total hip arthroplasty in patients with avascular necrosis of the femoral head: 2- to 10-year follow-up. Clin. Orthop. 1997;334:108-15. 12. Engh CH, Zettl-Schaffer KF, Kukita Y, et al. His¬to¬logical and radiografic assesment of well-functioning porous-coated acetabular components. J. Bone Joint Surg. Am. 1993;75:814-24. 13. Springer BD, Griffin WL, Fehring TK, et al. In¬complete seating of press-fit porous-coated acetabular components: the fate of zone 2 lucencies. The Journal of Arthroplasty. 2008;23(6)(Suppl. 1):120-6. 14. Piston RW, Engh CA, De Carvalho PI, Suthers KJ. Osteonecrosis of the femoral head threated with total hip arthroplasty without cement. Bone Joint Surg. Am 1994;76A:202-14. 15. Parvizi J, Morrey MA, Breen CJ, Cabanela ME. The outcome of uncemented total hip arthroplasty for avascular necrosis in patients under 50 years of age. Trans¬actions of Mid-America Orthopaedic Association, 18th Annual Meeting, Scottsdale AZ, April 26-29. 2000;110-7. 16. Xenakis TA, Beris AE, Malizos KK, et al. Total hip arthroplasty for for avascular necrosis and dege¬nerative osteoarthritis of the hip. Clin. Orthop. Relat. Res. 1997;12:683-8. 17. Phillips AM, Pankaj P, Howie CR, et al. 3D non-linear analysis of the acetabular construct following impaction grafting. Computer Methods in Biomechanics and Biomedical Engineering. 2006;9:125-33. 18. Stulberg BN, Singer R, Goldner J, et al. Unce¬mented total hip arthroplasty in osteonecrosis. A 2- to 10-year evaluation. Clin. Orthop. 1997;334:116-23. 19. Witzel U. Distriburion of stress in a hemispherical RM cup and its bony bed. In: Bergmann EG Hip-join surgery, the RM cup. Einhorn-Presse Verlag. Reinbek. 1998;29-41. 20. Witzel U, Rieger W, Effenberger H. Three-di¬mensional stress analysis of threaded cups – a finite ele¬ment analysis. International Orthopaedics (SICOT). 2008;32:195–201. doi10.1007/s00264-006-0308-3.
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