Clinical and morphological features of coxarthrosis with cystic rearrangement and the quality of secondary fixation of cementless total endoprostheses

Abstract

Clinical and roentgenologic as well as pathomorphologic peculiarities of III-IV stage of coxarthrosis were studied in 254 patients who underwent surgery at the CITO department of joint replacement. Coxarthrosis with cystic alteration of the articular bone structure has been diagnosed in 56% of patients. Cystic alteration was more often detected in middle (II), the most common degree of articular dysplasia. In the absence of dysplasia or in its marginal degrees the noncystic type of coxarthrosis prevailed. It was shown that in patients with cystic coxarthrosis the progress of pathologic process was faster and such patients more often had concomitant diseases characterized by microcirculatory disturbance. Pathomorphologic examination also showed more marked changes of microcirculatory channel in cystic coxarthrosis bone structure. In 47 patients the comparison of roentgenologic indices of the quality of secondary implant fixation and peculiarities of coxarthrosis ( either with or without cystic alteration) performed 3 to 4 years after uncemented total hip replacement by ESI implant demonstrated reliably better quality and longer fixation of bone tissue to the structured surface of the implant in noncystic type of coxarthrosis.