[Coxarthrosis: clinical aspects, diagnosis and treatment]. / Koksartroz, klinika, diagnostika i lechenie.

Based on a large clinical material the authors analyze the causes of the development of secondary coxarthrosis, suggest new methods of the surgical treatment of the disease, worked out at the Pathology Clinic of Large Joints, Prof. M. I. Sitenko Kharkov Research Institute of Orthopedics and Traumatology, with regard to the shortcomings of the common treatment methods. The term "hyperplastic coxarthrosis" is introduced, the treatment method for that pathology is offered. The problem of further studies and of the design of new methods for the treatment of chronic nonspecific coxitis is under discussion.

[Therapeutic approach in degenerative-dystrophic diseases of the hip joint in relation to the immunologic status]. / Osobennosti lechebnoi taktiki pri degenerativno-distroficheskikh zabolevaniiakh tazobedrennogo sustava s uchetom immunologicheskogo statusa.

In the process of study of the immunological status peculiarities of 202 patients with some degenerative-dystrophic diseases of hip joint has been revealed that the hyperimmune reactions to tissular antigens of the joint components (bone, cartilage, synovial membrane) are more often observed in case of non-specific arthritis, asephic necrosis of the head of the femur and dysplastic coxarthrosis. These were precisely the states with more frequent postoperative complications, provoking the process development, joint ankylosing or formation of ossificates. Preoperative immunocorrection therapy of 20 patients by means of a course of low-dose injections of plasma substitutes (polyglukine, hemodesis or reopolyglukine), individually selected by RIML and lymphocytotoxic test, allowed to arrest the lryperimmune manifestations. After reconstructive-restorative operations there was observed positive clinical and roentgenologic dynamics in the operated joint of the patients.

[Errors in reconstructive-rehabilitative operations on the hip joint]. / Oshibki pri rekonstruktivno-vosstanovitel'nykh operatsiiakh na tazobedrennom sustave.

Based upon the analysis of 1015 case records of patients, aged 16-70, with different hip joint pathology types, carried out during 1985-1990, there were revealed mistakes and complications after reconstructive-restorative operations. In the group of patients with dysplastic coxarthrosis they noted rather frequent (12% of cases) formation of "tectum" in supratrochanteric region that served as the cause of joint instability and development of arthrosis in future. Cartilaginous limbus, not removed at grave forms of dysplastic coxarthrosis, served as the cause of the pain syndrome in 63% of cases. Carrying out of "osteotomy-medicate" only in patients with aseptic necrosis of femoral head was ineffective in 38% of cases. Total removal of necrotization foci in thigh head with subsequent osseous plasty is necessary. In the process of mobilization operation in case of hyperplastic, coxarthrosis, removal of the lower edge of cotyloid cavity is the obligatory step. Thus, the important condition of favourable terminations of reconstructive-restorative operations is the correct selection of indications, carrying out of complete surgical intervention, rigorous observation of the patient control rules in near and distant postoperative period.

[Development of the arthroplasty method in coxarthrosis]. / Evoliutsiia metoda artroplastiki pri koksartroze.

On the basis of analysis of surgical treatment of 753 patients with coxarthrosis during 1970-1987, the authors set forth the stages of arthroplasty development in the USSR, using the experience of the Kharkov research institute of orthopaedics and traumatology named after M. I. Sitenko on the problems of arthrodesis operations, endoprosthetics and biological arthroplasty. In the article are presented the peculiar features of diagnostic and surgical tactics in case of patients with idiopathic and dysplastic coxarthrosis; operation technique for each form is presented in details. The authors have developed a new perosseous access to the hip joint, which made a good showing and permits to preserve the integrity of periarticular muscles and neurovascular formations. Application of the given access made possible the extension of indications for arthroplasty in case of grave forms of coxarthrosis, met earlier in a reserved manner.

[Contraindications regarding total prosthesis of the hip joint]. / Protivopokazaniia k total'nomu protezirovaniiu tazobedrennogo sustava.

The authors have made an analysis of unsatisfactory remote results in 83 (21.5%) out of 387 patients operated for endoprosthezing of the hip joint which resulted from shaking loose the endoprostheses in the bone tissue. A conclusion is made that the following factors may be considered as contraindications to endoprosthesis of the hip joints: coxarthrosis against the background of arthroso-arthritis, neglected stages of protrusive coxarthrites, deforming osteoarthrosis due to the use of corticosteroids, pronounced senile osteoporosis.

[Total endoprosthesis of the hip joint]. / Total'noe éndoprotezirovanie na tazobedrennom sustave.

The authors analyse the results of operations for total endoprosthetics of the hip joint in 22 patients subjected earlier to different surgical interventions on the same joint. The observation period lasted from 6 months to 10 years. Good results were obtained in 86,41%, satisfactory--in 4,5% and unsatisfactory--in 9,09% of cases. The complex preparation of such patients before the operation, specific course of the operation itself and of the postoperative period are described.