urmjУральский медицинский журналUral Medical Journal2949-4389Ural State Medical University10.52420/umj.23.5.114WAHVXRurmj-1611Research ArticleЛитературные обзоры | Literature reviewsLiterature reviewsВлияние позвоночно-тазовой подвижности на технологию и исходы тотального эндопротезирования тазобедренного суставаThe Effect of Vertebral-Pelvic Mobility on the Technology and Outcomes of Total Hip Replacementhttps://orcid.org/0000-0003-1583-473XГлазуновС. Ю.GlazunovS. Yu.

Станислав Юрьевич Глазунов — аспирант кафедры травматологии и ортопедии с курсом ИДПО

Уфа

Stanislav Yu. Glazunov - Postgraduate Student of the Department of Traumatology and Orthopedics with an IDPO Course

Ufa

vkomissiya@inbox.ruБашкирский государственный медицинский университетРоссияBashkir State Medical UniversityRussian Federation202418102024235114–124Copyright © Глазунов С.Ю., 20242024Глазунов С.Ю.Glazunov S.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.umjusmu.ru/jour/article/view/1611

Введение. Тотальное эндопротезирование тазобедренного сустава (ТЭТБС) является одним из наиболее часто проводимых оперативных вмешательств среди пациентов с заболеваниями тазобедренного сустава. Несмотря на высокую частоту и эффективность ТЭТБС, нестабильность является основной причиной выполнения повторных оперативных вмешательств, которые оказывают значительное влияние на качество жизни пациентов.Цель исследования. Анализ литературных данных, посвященных позвоночно-тазовым взаимодействиям, разработка рекомендаций по устранению патологий позвоночника и таза на основе проанализированных данных. В статье подробно рассматриваются классификации нарушений позвоночно-тазового взаимодействия, а также описываются методы их коррекции, которые необходимо учитывать при выполнении ТЭТБС.Материалы и методы. Проведен поиск публикаций в электронных базах данных PubMed и eLibrary.ru по следующим поисковым терминам: «позвоночно-тазовая подвижность, тотальное эндопротезирование тазобедренного сустава, артропластика тазобедренного сустава», “vertebral-pelvic mobility, total hip replacement, hip arthroplasty”. Временной интервал поиска не ограничивался. В настоящее исследование включались статьи, опубликованные на русском и английском языках.Результаты и обсуждение. Ориентацию тазового компонента следует планировать в соответствии с оценкой движений тазобедренного сустава, чтобы расположить тазовую часть эндопротеза в соответствии с новой безопасной зоной и комбинированным сагиттальным индексом. Однако хирург должен учитывать, что послеоперационная подвижность таза и позвоночника может отличаться от предоперационной из-за контрактуры сустава или физиологического старения позвоночника. В настоящее время еще не определено, как часто эти изменения приводят к выходу тазового компонента эндопротеза за пределы своей позиции и пространственного расположения, увеличивая риск вывиха.Заключение. Правильное понимание взаимосвязи тазобедренного сустава и позвоночника, а также влияние их взаимодействий на позиционирование вертлужного компонента является определяющим моментом в снижении риска вывихов. «Безопасная зона» Левиннека по-прежнему может использоваться в качестве ориентира для большинства пациентов, однако пациенты с нарушениями спинально-тазовой подвижности должны быть четко идентифицированы.

Introduction. Total hip arthroplasty (THA) is one of the most commonly used surgical interventions among patients with diseases of the hip joint. Despite the high frequency and effectiveness of THA, instability is the main reason for repeated surgical interventions, which have a significant impact on the quality of life of patients.Purpose. Analysis of literature data on spinal-pelvic interactions, development of recommendations for eliminating pathologies of the spine and pelvis based on the analyzed data.Materials and methods. The author searched for publications in the electronic databases PubMed and eLibrary. ru using the following search terms: “spinopelvic mobility, total hip replacement, hip arthroplasty, vertebral-pelvic mobility, total hip replacement, hip arthroplasty”.Results and discussion. The orientation of the pelvic component should be planned according to hip motion assessment to position the pelvic portion of the endoprosthesis according to the new safe zone and combined sagittal index. However, the surgeon must take into account that postoperative mobility of the pelvis and spine may differ from preoperative mobility due to joint contracture or physiological aging of the spine. To date, it has not yet been determined how often these changes lead to the pelvic component of the endoprosthesis moving beyond its position and spatial location, increasing the risk of dislocation.Conclusion. A proper understanding of the relationship between the hip joint and the spine, and the impact of their interactions on the positioning of the acetabular component, is critical to reducing the risk of dislocation.

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The authors declare that there are no conflicts of interest present.