Prevention of Dislocation of the Femoral Component of Endoprosthesis after Total Hip Arthroplasty in Patients with Rheumatoid Arthritis

S.I. Herasymenko, M.V. Poluliakh, I.V. Roi, A.S. Herasymenko, Yu.H. Pavlova, T.V. Zamorskyi, A.P. Kudrin

Abstract


Rheumatoid arthritis is considered as autoimmune disease of the body, which is based on progressive systemic lesions of connective tissue with a predominance of joint damage that leads to their destruction. In patients with rheumatoid arthritis, the incidence of the hip joint lesions ranges from 29 to 50 %, and bilateral pathology is often observed. Hip replacement is effective, and in the later stages of the disease it is the only way to fully restore the lost limb function in patients with rheumatoid arthritis. According to various authors, the incidence of dislocations of femoral component after total hip arthroplasty ranged from 0.11 to 10 %. After initial dislocation and closed reduction, redislocation is possible in 16–59 % of patients. Objective: to improve the results of hip replacement in patients with rheumatoid arthritis by reducing postoperative complications. Materials and methods. The study is based on the analysis of hip replacement outcomes in patients with rheumatoid arthritis, complicated by dislocation of the femoral component of endoprosthesis in 23 patients treated in the Kyiv institute of traumatology and orthopedics within 2005–2014 years. There were 18 female and 5 male patients. The age of patients ranged from 46 to 92 years. Results. Analysis of the past medical history has shown that the main cause of complications was unawareness patients or motor disorders. Since 2013, there were lectures for all patients with rheumatoid arthritis, in whom the hip replacement was planned to be applied; the purpose of these lectures was to inform patients about possible complications and preoperative preparations, after that the number of the causes of dislocation of the hip endoprosthesis reduced. The number of dislocation decreased by 61 % (P < 0.05) compared with 2005–2013.


Keywords


rheumatoid arthritis; hip joint; endoprosthesis; dislocation

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DOI: https://doi.org/10.22141/1608-1706.6.16.2015.79700

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