INFLUENCE OF CONCOMITANT FACTORS OF DISEASE AND CONSERVATIVE TREATMENT ON THE RESULTS OF TOTAL HIP ARTHROPLASTY IN PATIENTS WITH RHEUMATOID ARTHRITIS

Герасименко С.І., Полулях M.B., Бабко А.М., Герасименко А.С.

Summary. Relevance. The defeat of the hip joint in rheumatoid arthritis (RA) is accompanied by the formation of contractures and the development of discordant deformities of the lower extremities. Analysis of data from domestic and foreign literature shows that the effect of disease factors such as activity, duration, morpho-cortical index, as well as the effect of anti-inflammatory therapy on improving hip joint repair in RA patients is not given enough attention. Objective. Using statistical methods to determine the effect of individual disease factors and anti-inflammatory therapy on the efficacy of hip joint recovery after arthroplasty. Material and methods. An analysis of the orthopedic treatment of 160 patients with RA with lesions of the hip joints, who underwent 203 total replacements, was carried out. The analysis of the degree of connection of significant factors was carried out using the methods of parametric statistics, namely, Pearson’s pairwise linear correlation and canonical correlation. Results. Patients need total hip arthroplasty, beginning with stage II stage 2. Correlation analysis of 99 patients showed that in the postoperative period, there was an increase in movements, an increased angle of flexion in the hip joint in patients with I (in 9% of patients the full range of movements in the arc flexion / extension) and II degree of activity were achieved (almost 70% of patients had movements from 10 to 35°), however, Pearson’s linear paired correlation is absent (r<0.3) and only in patients with an increase in flexion (p=0.008) is it missing reliably. The greatest increase in movements was observed in patients with a disease duration of 15 years and older and in those who took hormonal or basic therapy (40% of patients) compared with patients who did not take either of these types of drugs, or took them in combination (30% and 10% respectively). Findings. The canonical correlation of the simultaneous effects of activity, disease duration, anti-inflammatory hormonal and basic therapy showed the influence of these factors on the growth of movements in the hip joint of weak and medium strength in the postoperative period (R from 0.3 to 0.7) and the absence of such influence 1 year after operations (R<0.3). The increase in movements is strongly associated with the Harris scale in the preoperative period, the relationship of medium strength was found with the duration of the disease. In the postoperative period, a strong connection with the growth of movements in the sagittal and frontal planes and a weak connection with the duration of the disease and therapy.