Pre-Surgery Planning of Lower Limbs Major Joints Arthroplasty

Knee and hip joints endoprosthetics are the main surgical method of arthrosis treatment. The epidemiological incidence rate of the disease is growing steadily every year, affecting younger and younger people. Despite the proven tactics of joint endoprosthetics, an important issue is quality planning of surgery.

The aim of this research is to develop a device and a method that would contribute to solving the existing challenges of pre-surgery planning of hip endoprosthetics in patients with related pathologies, which have caused compensatory deformation, and making long vertebrarium-pelvis-lower limbs scout images with the patient lying on his back with an axial load in a computer tomography.

Analog X-ray photographs of the pelvis made on film, digital DICOM images, and special planning programs are used for planning. However, according to numerous studies, the disease of the hip joint is not an independently isolated pathology. In most cases, this pathology is accompanied by changes in the lumbar spine. Often, patients prepared for endoprosthetics have a congenital deformity of tarsus or hip segment, which, during the knee, joint endoprosthetics surgery causes difficulties with the installation of an intramedullary guide.

The results after total knee arthroplasty according to the method modified at the Department showed a reduction of the WOMAC index slightly more than twice down to 37.26 ± 7.92. The number of revision surgeries after endoprosthetics decreased from 5 (5.7%) to 1 (1.1%) for the hip joint, and from 7 (4.3%) to 2 (1.3%) for the knee joint, respectively.

To form a proper guide entry point, it is necessary to assess the segment at the stage of surgery planning and examination of patients, which can be done using the proposed method. To remove the complications during the pre-surgery planning of hip joint endoprosthetics in patients with related pathologies, a device and methods have been developed for obtaining long topograms of the vertebrarium-pelvis-lower limbs complex with the patient lying on his back with the axial load in computer tomography.