Sekundarna osteoartroza kuka lečena ugradnjom totalne bescementne endoproteze sa Fitmore® stemom – prikaz bolesnika

  • Ivan Golubović Clinical Center Niš, Clinic for Orthopaedic Surgery and Traumatology, Niš, Serbia
  • Zoran Baščarević Institute of Orthopaedic Surgery “Banjica”, Belgrade, Serbia
  • Predrag Stojiljković Clinical Center Niš, Clinic for Orthopaedic Surgery and Traumatology, Niš, Serbia
  • Zoran Radovanović University of Niš, Faculty of Medicine, Niš, Serbia
  • Ivana Golubović University of Niš, Faculty of Medicine, Niš, Serbia
  • Milan Radojković University of Niš, Faculty of Medicine, Niš, Serbia
  • Dušan Djordjević Military Hospital, Niš, Serbia
  • Aleksandar Mitić University of Niš, Faculty of Medicine, Niš, Serbia
  • Svetlana Milijić University of Niš, Faculty of Medicine, Niš, Serbia
  • Zoran Golubović Clinical Center Niš, Clinic for Orthopaedic Surgery and Traumatology, Niš, Serbia
DOI: https://doi.org/10.2298/VSP151223198G
Ključne reči: ostheoarthritis, hip||, ||kuk, osteoartritis, hip prosthesis||, proteza, orthopedic procedures||, ||ortopedske procedure, treatment outcome||, ||lečenje, ishod,

Sažetak


Uvod. Razvojni poremećaj kuka sa subluksacijom predstavlja nedovoljnu pokrivenost glave butne kosti koja se nalazi u displastičnom acetabulumu. Nepokrivenost glave butne kosti acetabulumom može biti jedva primetna do nepokrivensti jedne polovine glave. Postoji povećanje kolodijafizarnog ugla i ugla anteverzije, Wiberov ugao je manji od 15 stepeni, Shenton-Menardov luk je prekinut. Vrlo rano dolazi do degenerativnih promena u zglobu kuka što je praćeno bolovima, ograničenjem pokreta u kuku i skraćenjem noge. Prikaz bolesnika. U radu je prikazana bolesnica stara 53 godine, koja je kao dete lečena neoperativno zbog razvojnog poremećaja kuka. Nakon trudnoće i porođaja javili su se bolovi u desnom zglobu kuka. Urađen je klinički i radiološki pregled pri čemu je dijagnostikovana subluksacija desnog zgloba kuka sa znacima degenerativne osteoartroze. Lečenje je započeto neoperativno, medikamentoznom terapijom i balneo-fizikalnim procedurama. Nakon konzervativnog lečenja zbog stalnih bolova i ograničenja pokreta u kuku, odlučeno je da se lečenje nastavi ugradnjom endoproteze zgloba kuka. U preoperativnoj pripremi urađen je antero-posteriorni rendgenski snimak kuka sa gornjom trećinom butne kosti, koji omogućava precizno planiranje ugradnje komponenti endoproteze. Ugrađena je bescementna endoproteza zgloba kuka sa Fitmore® stemom. Rani postoperativni tok protekao je uredno. Dobijen je dobar klinički rezultat lečenja. Nakon sprovedene rahabilitacije bolesnica se vratila svojim radnim i životnim aktivnostima. Zaključak. Primena bescementne endoproteze zgloba kuka sa Fitmore stemom u lečenju sekundarne osteoartroze kuka, predstavlja dobar izbor u lečenju mlađih bolesnika sa dobrim kvalitetom koštanog tkiva. Buduća klinička i radiološka praćenja primene ove vrste stema uz komparativne studije, su neophodna da bi se pokazale njegove prednosti u odnosu na klasični bescementni dugi stem.

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Objavljeno
2017/09/19
Broj časopisa
Vol. 74 Br. 8 (2017)
Rubrika
Prikaz bolesnika