Profilaksa DVT kod velikih ortopedskih operacija - Depol ...

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2 st INTERNATIONAL CONFERENCE ON REGENERATIVE ORTHOPAEDICS
ARTHROPLASTY BY DEMINERALIZED OSTEOCHONDRAL
ALLOGRAFTS AS AN ALTERNATIVE TO EARLY TOTAL HIP
ARTHROPLASTY IN CHILDREN WITH THE SEQUELAE OF
OSTEOMYELITIS
Yury Garkavenko, The Turner Scientific and Research Institute for Children’s Orthopedics, Saint-Petersburg –
Pushkin, Russian Federation
Alexandr Pozdeev, The Turner Scientific and Research Institute for Children’s Orthopedics, Saint-Petersburg –
Pushkin, Russian Federation
In the period from one to 26 years, the results were studied of the hip arthroplasty by demineralized osteochondral
allografts in 52 patients with sequelae of osteomyelitis of the hip operated at the The Turner Research Institute
for Children’s Orthopedics.
The initial state of the affected hip with destructive hip dislocation was in 56 per cent of patients, in one third of
patients was an ankylosis of the joint in a vicious position, and in 13% of patients was severe flexion-adduction
contracture on the background of coxarthrosis, requiring joint stabilization and restoration of function.
If indicated, the hip arthroplasty with the use of one or two demineralized osteochondral allografts was supplemented
by shortening osteotomy of the femur in its lower third.
The study has shown that in more than a half of the patients, namely in 27 (52%), flexion in the operated hip exceeded
80°, reaching 100° or more in 7 (13.5%) patients.
In the late followup, in all 16 patients with initial ankylosis of the hip the range of motion in at least two planes
has preserved. However, only in four patients (25%) of them the flexion did not exceed 45°, while in the remaining
cases (75%) it exceeded 60°, reaching 100° or more in 9 (56.2%) patients.
Despite the increase in number of patients during later followup with limited range of motion in the operated hip,
the preservation of a sufficient range of flexion beyond 80º was observed in patients even 10-15 years (33.3%), and
even 16-20 years (66, 6%) after performed arthroplasty.
The results presented here provide a basis to consider the arthroplasty with the use of demineralized osteochondral
allografts as an alternative to the early total hip arthroplasty in children with destructive changes in the proximal
femur.
Poster