COMPLEX TREATMENT OF COXARTHROSIS IN ADOLESCENTS WITH JUVENILE RHEUMATOID ARTHRITIS
https://doi.org/10.15690/vsp.v11i2.219
Abstract
The results of surgical treatment of 34 patients with coxarthrosis due to juvenile rheumatoid arthritis (JRA) are shown in this article. The operations with endoprosthetics methodic were performed in the department of traumatology and orthopaedics of the Scientific Centre of Children Health RAMS since 2008 till 2012. The aim of the study was to evaluate the efficacy of surgical treatment and influence of this procedure on patients life quality. The main presenting complaints were pain and motion limitations in hip joints, differences in extremities length, limping, support disability and lower extremity dysfunction, which makes movement without additional support impossible in 90% of all cases. The indications to the total endoprosthetic hip joint replacement (TEHJR) in adolescents with
juvenile arthritis are represented. The special features of TEHJR in young patients with JRA. The assessment of X-ray pictures during the follow-up examinations showed adequate positioning of endoprosthesis components. One year after the surgical operation the mean level of points according to specialized questionnaire HHS was 88 (87; 89) points (Me [25;75]) (comparing with 55 [51; 58] before the operation, [p < 0,001]), and according to the questionnaire СHAQ — 0,4 (0,3; 0,5) points (comparing with 2,6 [2,3; 2,8] before the operation, [p < 0,001]). This facts confirm the efficacy of the performed treatment and significant improvement in functioning of operated joints and patients life quality. The marked correction of the lower limbs deformations and the normal or near-normal physiological functioning were achieved.
juvenile arthritis are represented. The special features of TEHJR in young patients with JRA. The assessment of X-ray pictures during the follow-up examinations showed adequate positioning of endoprosthesis components. One year after the surgical operation the mean level of points according to specialized questionnaire HHS was 88 (87; 89) points (Me [25;75]) (comparing with 55 [51; 58] before the operation, [p < 0,001]), and according to the questionnaire СHAQ — 0,4 (0,3; 0,5) points (comparing with 2,6 [2,3; 2,8] before the operation, [p < 0,001]). This facts confirm the efficacy of the performed treatment and significant improvement in functioning of operated joints and patients life quality. The marked correction of the lower limbs deformations and the normal or near-normal physiological functioning were achieved.
About the Authors
O. A. Malakhov
Scientific Centre of Children Health RAMS, Moscow
Russian Federation
Oleg Alekseevich Malakhov, professor, PhD, Head of Traumatological and Orthopedic Department of SCCH of RAMS
Russian Federation
Oleg Alekseevich Malakhov, professor, PhD, Head of Traumatological and Orthopedic Department of SCCH of RAMS
E. I. Alekseeva
Scientific Centre of Children Health RAMS, Moscow;
I.M. Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
S. J. Morev
Scientific Centre of Children Health RAMS, Moscow
Russian Federation
Russian Federation
O. O. Malakhov
Scientific Centre of Children Health RAMS, Moscow
Russian Federation
Russian Federation
S. I. Valieva
Scientific Centre of Children Health RAMS, Moscow
Russian Federation
Russian Federation
T. M. Bzarova
Scientific Centre of Children Health RAMS, Moscow
Russian Federation
Russian Federation
R. V. Denisova
Scientific Centre of Children Health RAMS, Moscow
Russian Federation
Russian Federation
T. V. Sleptsova
Scientific Centre of Children Health RAMS, Moscow
Russian Federation
Russian Federation
E. V. Mitenko
Scientific Centre of Children Health RAMS, Moscow
Russian Federation
Russian Federation
K. B. Isaeva
Scientific Centre of Children Health RAMS, Moscow
Russian Federation
Russian Federation
L. A. Semenova
Scientific Research Institute of Rheumatology RAMS, Moscow
Russian Federation
Russian Federation
E. I. Zelenkovich
Scientific Centre of Children Health RAMS, Moscow
Russian Federation
Russian Federation
G. V. Kurilenko
Scientific Centre of Children Health RAMS, Moscow
Russian Federation
Russian Federation
M. I. Travina
Scientific Centre of Children Health RAMS, Moscow
Russian Federation
Russian Federation
A. V. Anikin
Scientific Centre of Children Health RAMS, Moscow
Russian Federation
Russian Federation
G. A. Bekdzhanyan
Scientific Centre of Children Health RAMS, Moscow
Russian Federation
Russian Federation
References
1. Алексеева Е. И., Литвицкий П. Ф. Ревматоидный артрит. Этиология, патогенез. Клиника. Алгоритм диагностики и лечения. М.: Веди. 2007. 359 с.
2. Cassidy J., Petty R. Textbook of paediatric rheumatology, 5th ed. Elsevier Saunders. 2005.
3. Насонов Е. Л. Кинические рекомендации. Ревматология.
4. М.: ГЭОТАР-Медиа. 2005. С. 25–71, 120–140.
5. Алексеева Е. И. Ревматические болезни и их влияние на качество жизни детей и их семей. Качество жизни. Медицина.
6. ; 1: 14–17.
7. Денисова Р. В., Алексеева Е. И., Альбицкий В. Ю. и соавт. Качество жизни больных ювенильным артритом в условиях лечения химерными моноклональными антителами к ФНО _. Вопросы современной педиатрии. 2009; 8 (3): 18–26.
8. Verstappen S. M., Hoes J. N., Ter Borg E. J. et al. Joint surgery in the Ultecht Rheumatoid Arthritis Cogort: the effect of treatment strategy. Ann. Rheum. Dis. 2006; 65: 1506.
9. Yano K., Ikari K., Inoue E. et al. Effect of total knee arthroplasty on disease activity in patients with established rheumatoid arthritis: 3-year follow-up results of combined medical therapy and surgical intervention. Mod. Rheumatol. 2010.
10. Снетков A. И., Нуждин В. И., Котов В. Л. Тотальное эндопротезирование тазобедренного сустава у подростков. Пособие для врачей. Москва. 2004.
11. Harris W. H. Traumatic arthritis of the hip after dislocation and acetabular fractures: Treatment by mold arthroplasty. J. Bone Jt. Surg. 1969; 51(A–P): 737–755.
12. Ruperto N., Ravelli A., Pistorio A. et al. Cross Dcultural adaptation and psychometric evaluation of the Childhood Health Questionnaire (CHAQ) and the Chilghood Health Questionnaire (CHQ).
Review
For citations:
Malakhov O.A., Alekseeva E.I., Morev S.J., Malakhov O.O., Valieva S.I., Bzarova T.M., Denisova R.V., Sleptsova T.V., Mitenko E.V., Isaeva K.B., Semenova L.A., Zelenkovich E.I., Kurilenko G.V., Travina M.I., Anikin A.V., Bekdzhanyan G.A. COMPLEX TREATMENT OF COXARTHROSIS IN ADOLESCENTS WITH JUVENILE RHEUMATOID ARTHRITIS. Current Pediatrics. 2012;11(2):98-105. (In Russ.) https://doi.org/10.15690/vsp.v11i2.219
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