Early outcomes of using custom-made augments in revision total hip arthroplasty.

INTRODUCTION: The continuing high demand for revision total hip arthroplasty (RTHA) requires not only additional economic costs, but also the search for new, effective methods to manage the reconstruction of acetabular bone loss. This study focuses on the assessment of the clinical and radiographic outcomes after RTHA using custom-made augments (CMA) in the short-term follow-up period. MATERIALS AND METHODS: We retrospectively analyzed the results of using CMAs in 19 patients (20 hips). The average follow-up period was 41.3 months. All surgery was performed on defect types III and IV as per the Gross and Saleh classification. RESULTS: There was a statistically significant difference when comparing the Oxford Hip Score before RTHA of 15.0 (Std. deviation-5.9) and after RTHA of 36.3 (Std. deviation-6.3) (p = 0.01). All implants were radiologically stable. CMA has demonstrated a good ability to restore position of hip centre of rotation (HCOR). In the postoperative period, two patients (2 hips) had dislocations. Only one of two patients underwent re-revision due to dislocation. CONCLUSION: Treatment of uncontained loss of bone stock in RTHA using CMA shows promising clinical and radiographic results at short-term follow-up period; however, dislocation rate is 10% in this study.

[The Willebrand factor in the diagnosis of hemostatic disorders in patients with rheumatoid arthritis]. / Faktor Villebranda v diagnostike narushenii gemostaza u bol'nykh revmatoidnym artritom.

Studies of coagulation hemostasis in 108 patients with rheumatoid arthritis have revealed that high blood coagulation is characteristic of this disease, and a number of coagulation parameters (antithrombin III, fibrinogen, fibrinolytic activity, ethanol test) point to intravascular microthrombi formation (disseminated intravascular coagulation). Along with hemostasis investigations, Willebrand's factor levels were measured in the blood plasma of 44 patients. Enhancement of the inflammatory process activity was found to be associated with elevation of this factor level and augmentation of the blood coagulation activity. These results permit considering Willebrand's factor as one of the diagnostic criteria of thrombophilic conditions in patients with rheumatoid arthritis.