Authors
Pronskih A.A.1, Lukinov V.L.1, Pimanchev O.V.2, Pavlov V.V.1
1 Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan, Novosibirsk
2 Pirogov National Medical and Surgical Center, Moscow
Abstract
Rationale: Тotal Hip replacement in patients with the consequences of acetabulum fractures is associated with a high risk of various complications. The percentage of unsatisfactory outcomes reaches 26%.
Objective: search for statistically reliable predictors of complications after total hip replacement in patients with the consequences of acetabulum injuries.
Materials and methods. A restrospective single–center controlled study was conducted — an analysis of 235 case histories of patients with the consequences of acetabulum fractures who underwent total hip arthroplasty for post-traumatic arthritis in the in the period from 2014 to 2022. In total, various complications occurred in 32 patients (13.6%) in 38 cases (16%). To identify significant predictors, an analysis of the logistic regression model of complications with ROC analysis, determination of sensitivity and specificity indicators was carried out.
Results: Some significant predictors of the development of all types of complications were identified — vertical displacement of the hip rotation center, the level of hip joint function was determined on the Harris Hip Score scale before total endoprosthesis surgery, the correctness of earlier treatment. The formula of an automatic multifactorial optimal model of the development of complications for the threshold value of the probability of complications = 18%, with sensitivity indicators — 62.5% and specificity — 80.8% is derived. Predictors of the development of all types of complications, both mechanical and neurological, were analyzed separately.
Conclusion. Predictors of complications can be divided into preoperative (previous transverse fractures and fractures of the posterior edge or posterior column of the acetabulum, the correctness of previous treatment), and indicators of the difference between the mechanical parameters of the operated and healthy hip joints, such as the hip rotation center and femoral offset, depending on total hip arthroplasty.
Keywords: аcetabulum fracture, post-traumatic hip arthritis, hip arthroplasty, aseptic loosening, recurrent dislocation.
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