
Teplenkii Mihail
National Ilizarov Medical Research Center for traumatology and orthopaedics, Russian FederationTitle: Possibilities of joint preserving surgery in patients with the developing dysplastic coxarthrosis
Abstract
Introduction: The significance of pelvic and femoral osteotomies in the
condition of developed arthrosis is still disputable. Early osteoarthritis and
dis-congruency of the articular surfaces are evaluated by many specialists as
contra-indication for the joint preserving operation. Purpose: Review middle
term results of reconstructive treatment in adolescents and young adults with
dysplastic coxarthrosis
Materials and methods: Treatment outcomes of 35 patients with dysplastic
coxarthrosis were analyzed. Mean age at intervention was 16 years (14-32). The
grade of arthrosis in joints were assessed according to Tonnis: I –
22, II - 10, III - 3. The type of congruence of articulare
surfaces were assessed according to Coleman: I- 12, II-9, III -8, IV – 6.
All subjects underwent extraarticulare hip reconstruction with the Ilizarov
apparatus included pelvic and femoral osteotomies.
Results: Outcomes were followed from 3 to 12 years. Functional outcomes
according to Merle d'Aubigne-Postel were: Pain 4,7±0,1 points. ROM
– 4,1±0,2 points. Walking ability – 4,6±0,1 points. Radiographic findings
according to Severin were: II? - 20, IIb - 11, III – 4. The
congruence of articular surfaces improved in 14 joints, remained unchanged in
20 joints, worsened in one joint. Distribution of joints by type of congruence:
I - 18, II-1, III - 14, IV – 2. The grade of arthrosis
was unchahged in 25 cases, progressed one grade in 3 joints,
reduced in 4 cases. Considering clinical and radiological picture the positive
outcomes made up 82%.
Conclusions: application of reconstructive operations with
Ilizarov frame allows to extend fairly the indications for extra-articular
reconstructive invasions in dysplastic coxarthrosis. Improved congruence of the
articular surfaces in conditions of osteoarthritis in most cases leads to a
slowing of progression.
Biography
Teplenkii Mihail
has graduated Cheliabinsk State Medical Institute and has been working at
Russian Ilizarov Scientific Center “RTO” from 1984.In 2004 he became a Head of
Pediatric Orthopaedic Department and in 2011 – a Head of the Laboratory for
Joint Pathology. He has the highest qualification and the certificate of the
specialist on the specialty “Traumatology and Orthopaedics”.He successfully
presented the dissertation on “Reconstructive and restorative operations using
Ilizarov fixator in children with DDH” for the scientific degree of Doctor of
Medical Sciences. Main trend of his work is the congenital and acquired
pathology of the large joints in children.4 monographs covering hip pathology
were published with co-authors. He published 83 scientific articles and
obtained 47 patents on inventions and useful models. He is a member of ATOP,
ASAMI, AOLF and SICOT.