Traumatology

doi: 10.25005/2074-0581-2020-22-1-91-97
COMPREHENSIVE PREVENTION OF INSTABILITY IN HIP REPLACEMENT FOR HIP FRACTURES AND THEIR CONSEQUENCES IN POSTMENOPAUSAL OSTEOPOROSIS IN MULTIPAROUS WOMEN

A.A. Razzokov, A.S. Ekhsonov

Department of Traumatology, Orthopedics and Military Surgery, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan

Objective: To reduce instability rate after hip replacement (HR) in postmenopausal osteoporosis in multiparous women.

Methods: Analyzed data of HR performed by 126 multiparous women with postmenopausal osteoporosis and hip fractures and their consequences. In the main group (n=65; 51.6%) of patients prevention of instability of endoprosthesis components was carried out using the proposed measures, in the control group (n=61; 48.4%) of patients – with traditional approaches. Clinical and X-ray methods, densitometry, a comprehensive method of assessing hip function by Harris, statistical methods are used in the implementation of the work.

Results: In the main group influenced by proposed approaches in the dynamics have seen a decrease in the frequency of osteoporosis and due to this – an increasing osteopenia. In addition, there was a decrease in the frequency of instability of endoprosthesis components compared to the control group from 14.8% to 4.6% (p<0.005).

Conclusion: Rational operation planning, and its implementation taking into account the peculiarities of the current of osteoporosis, continuous medication and rational post-operative rehabilitation are effective ways to reduce the frequency of instability in hip replacement in considered pathology.

Keywords: Postmenopausal osteoporosis, hip replacement, hip fractures, multiparous women, baseline treatment for osteoporosis.

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References
  1. Kaysinova AS, Lepshokova AB, Menshikova TB, Akhkubekova NK, Cherevashchenko LA, Mallaeva RM. Issledovanie kal’tsiy-fosfornogo obmena pri osteoartroze s soputstvuyushchim osteopenicheskim sindromom u zhenshchin v sostoyanii menopauzy [Investigation of calcium-phosphoric exchange in women with the menopause state suffering from osteoartrosis and concomitant osteopenic syndrome]. Vestnik Avitsenny [Avicenna Bulletin]. 2017;19(4):520-3. Available from: https://doi.org/10.25005/2074-0581- 2017-19-4-520-523.
  2. Zakharov IS. Dvukhmernaya mineral’naya plotnost’ kosti u zhenshchin v razlichnye vozrastnye periody [Two-dimensional bone mineral density in women at different ages]. Vestnik Avitsenny [Avicenna Bulletin]. 2014;3:81-5.
  3. Lesnyak ОМ, Benevolenskaya LI. Osteoporoz v Rosiyskoy Federatsii: problem i perspektivy [Osteoporosis in the Russian Federation: problems and prospects]. Nauchno-practicheskaya revmatologiya. 2010;5:14-8.
  4. Gnetetskiy SF. Sotsial’noe znachenie i resul’taty total’nogoendo protezirovaniya tazobedrenogo sustava v starcheskom vozraste [Social significance and results of total hip joint endoprothestics in old age]. Rossiyskiy meditsinskiy zhurnal. 2013;6:54-7.
  5. Snir N, Kaye ID, Klifto CS. 10-year follow-up wear analysis of first-generation highly crosslinked polyethylene in primary total hip arthroplasty. J Arthroplasty. 2014;29(3):630-3.
  6. Lewis PM, Waddell JP. When is the ideal time to operate on a patient with a fracture ofthe hip?: A review of the available literature. Bone Joint J. 2016;98- B(12):1573-81.
  7. Meding J, Faris, PM, Davis KE. B. Bilateral total hip and knee arthroplasties: average 10-year follow-up. J Arthroplasty. 2017;32(11):3328-32.
  8. Tikhilov RМ, Shubnyakov II, Kovalenko AN. Danye registra endoprotezirovaniya tazobedrenogo sustava RNIITO im. R.R. Vredena za 2007-2012 gody [Register data of hip joint endoprosthestics RNIITO for 2007-2012]. Travmatalogiya i ortopediya Rossii. 2013;3:167-90.
  9. Tkachenko АN, Bakhtin МYu, Zharovskikh OS.Vozmozhnosti prognozirovaniya gnoynykh oslozhneniy pri endoprotezirovanii tazobedrennogo sustava u patsientov starshikh vozrastnykh grupp [Possibilities of predicting purulent complication in hip joint endoprosthetics in patients of older age groups]. Travmatalogiya i ortopediya. 2012;2:48-53.
  10. Vinkler Т, Trampush А, Rents N. Klassifikatsiya i algoritm diagnostiki i lecheniya periproteznoy infektsii tazobedrennogo sustava [Classification and algorithm for the diagnosis and treatment of periprosthetic infection of the hip joint]. Travmatologiya i ortopediya. 2016;1:33-45.
  11. Korshnyak VYu, Rykov АG, Volovik VЕ. Prichiny rasshatyvaniya komponentov endoproteza tazobedrennogo sustava v zavisimosti ot sposobov fiksatsii [Causes of loosening of the components of the hip joint endoprosthesis depending of their fixation]. Zdravokhranenie Dal’nego Vostoka. 2015;2:98- 102.
  12. Ovechkin АМ, Politov МЕ, Panov НV. Ostryy i khronicheskiy posleoperatsionnyy bolevoy sindrom u patsientov, perenyosshikh total’noe endoprotezirovanie sustavov nizhnikh konechnostey [Acute and chronic postoperative pain in patients undergoing total endoprosthesis replacement of the joints of the lower limbs]. Anestiziologiya i reanimatologiya. 2017;3:224-30.
  13. Shilnikov VА, Denisov АО. Algoritmy differentsial’noy diagnostiki bolevogo sindroma posle endoprotezirovaniya tazobedrennogo sustava [Algorithms for the defferential diagnosis of pain after hip joint arthroplasty]. Consilium medicum. Khirurgiya. 2013;2:20-4.
  14. Razzokov AA, Salimov NF, Saidov DM, Nazarov IR. Organizatsiya okazaniya meditsinskoy pomoshchi, osobennosti techeniya, diagnostiki i kompleksnogo lecheniya sistemnogo osteoporoza [Organization of delivery of health care, especially of a current, diagnostics and complex treatment of system osteoporosis]. Zdravookhranenie Tadzhikistana. 2009;1:24-30.
  15. Hadji P. The effect of teriparatide compared with risedronate on reduction of back pain in postmenopausal women with osteoporotic vertebral fractures. Osteoporosis international. 2012;23(8):2141-50.

Authors' information:


Razzokov Abduvali Abdukhamitovich
Doctor of Medical Sciences, Full Professor, Head of the Department of Traumatology, Orthopedics and Military Surgery, Avicenna Tajik State Medical University
Researcher ID: G-2628-2019
ORCID ID: 0000-0001-6429-1116
E-mail: rfiruz@mail.ru

Ekhsonov Abdushokir Safarmatovich
Applicant of the Department of Traumatology, Orthopedics and Military Surgery, Avicenna Tajik State Medical University
Researcher ID: G-4743-2019
ORCID ID: 0000-0002-4592-2629
E-mail: ehsonov28@gmail.com

Information about support in the form of grants, equipment, medications

The authors did not receive financial support from manufacturers of medicines and medical equipment

Conflicts of interest: No conflict

Address for correspondence:


Razzokov Abduvali Abdukhamitovich
Doctor of Medical Sciences, Full Professor, Head of the Department of Traumatology, Orthopedics and Military Surgery, Avicenna Tajik State Medical University

734003, Republic of Tajikistan, Dushanbe, Rudaki Ave., 139

Tel.: +992 (915) 046001

E-mail: rfiruz@mail.ru

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