Art of Medicine Volume-1 International Medical Scientific Journal Issue-3 10.5281/zenodo.5634147 9 Art of Medicine Volume-1 International Medical Scientific Journal Issue-3 10.5281/zenodo.5634147 10 Art of Medicine International Medical Scientific journal Founder and Publisher Pascual Izquierdo-Egea Published science may 2021 year. Issued Quarterly. Internet address: http://artofmedicineimsj.us E-mail: info@artofmedicineimsj.us 11931 Barlow Pl Philadelphia, PA 19116, USA +1 (929) 266-0862 Art of Medicine Volume-1 International Medical Scientific Journal Issue-3 10.5281/zenodo.5634147 11 COMPARATIVE ANALYSIS OF SEPARATE RESULTS OF ARTHROPLASTY FOR ASEPTIC NECROSIS OF THE FEMORAL HEAD Akramov Vohid Rustamovich Bukhara State Medical Institute, Bukhara, Uzbekistan Abstract. Objective: Improving the results of arthroplasty in aseptic necrosis of the femoral head (ANFH). Materials and Methods: We studied the quality of life of patients according to the scale developed by us; we examined patients before and after treatment in 172 patients. The patients were of working age from 20 to 65 years old. In this system, 6 clinical parameters were used on a 5-point scale, the clinical result was assessed by the analysis of the sum of points. Results: Analysis of the results of surgical treatment of patients with ANFH showed the prevalence of the proportion of good results in patients of the main group in 45 (82.6%) cases versus the control group - 40 (73%) and a decrease in unsatisfactory results to 1 (1%) case in patients of the main group against the control - 2 (3%). Keywords: separate results, endoprosthetics, aseptic necrosis of the femoral head. Introduction. Aseptic necrosis of the femoral head is one of the most pressing problems of modern orthopedics, which leads to severe pain syndromes, limited joint function, significant economic costs and increased mortality [1, 2, 8, 9, 10, 12]. Clinical and radiological signs of degenerative-dystrophic diseases of large joints are found in 55 - 65% of cases in people over 60 years old and in about 80% of people over 75 years old. Many authors have proven that early diagnosis, complex and specific treatment of ANFH, depending on the stage of the disease, are the key to successful treatment and reduce complications [3, 4, 5, 6, 7, 11]. As studies of recent years show, ANFH is a polietiologic disease, with a large role playing, general and local factors of them: trauma, alcohol intoxication and those taking steroid drug therapy [13, 15, 16, 17, 18, 19, 21]. The authors describe in patients who have suffered fractures of the femoral neck and traumatic dislocation of the femoral head in the near and long-term, ANFH Art of Medicine Volume-1 International Medical Scientific Journal Issue-3 10.5281/zenodo.5634147 12 develops. These patients have obstruction of the blood vessels feeding the femoral head, which leads to degenerative-dystrophic changes characteristic of ANFH [14, 20, 22, 23, 24, 25, 26]. Materials and methods. We studied the quality of life of patients according to the scale developed by us; we examined patients before and after treatment in 172 patients. The patients were of working age from 20 to 65 years old. In this system, 6 clinical parameters were used on a 5-point scale, the clinical result was assessed by the analysis of the sum of points. Results. According to our assessment of the quality of life, good results were in the range from 15 to 22 points, satisfactory - from 8 to 14; unsatisfactory was assessed by the sum from 0 to 7 points. Summarizing the scores obtained, we evaluated the effectiveness of the treatment and presented them as a percentage, which reflected the difference between the post-treatment increase in the score. We took the initial state of the patient as 100%. After surgery, an increase in the score of up to 30% of the initial patient scores before surgery was noted (Table 1). Table 1 Criteria for assessing the quality of life of patients with ANFH Pain Function Emotion al percepti on Necessity of means of rehabilitatio n and support, (orthoses, cane) Ability to walk / perform an action with the upper limb Gait disorder / ability to lift and carry weights Poin ts No no restrictio ns enthusias m No no restriction s Norm 5 transient weak transient weak transient weak transient weak transient weak transient weak 4 weak restrictio n in precise moveme nts Satisfacti on brace limited minimal cosmetic disturbance s 3 transient transient transient transient transient transient 2 Art of Medicine Volume-1 International Medical Scientific Journal Issue-3 10.5281/zenodo.5634147 13 moderate moderate moderate moderate moderate moderate moderate partial incapacit y acceptabl e one cane or crutch a housewife maximum cosmetic, minimum physical difficulties 1 significa nt complete inability unaccept able two canes or crutches need for outside help absent 0 To study the results of treatment, comparative immediate results of treatment were carried out in patients with ANFH before and after 1 month. after surgical treatment. Comparative results of treatment in patients with ANFH before and 1 month after surgical treatment (table 2). Table 2 Criteria for assessing the quality of life of patients with ANFH Criteria for evaluation Before treatment (n = 110) patients After treatment, one month later (n = 110) patients The main Control The main Control Pain 1 1,0 2,5 2,0 Function 1,5 1,5 2,5 2,0 Emotional perception 1,5 1 1,5 1,5 The need for rehabilitation and support (orthoses, cane) 1,0 1,0 2,5 2,5 The ability to walk / perform an action with the lower limb 1,5 1,5 2,5 2,0 Gait disorder / ability to lift and carry weights 1,5 1 2,5 2 Points total 8 7 14 12 Art of Medicine Volume-1 International Medical Scientific Journal Issue-3 10.5281/zenodo.5634147 14 From table 2 it can be seen that before the operation, that in ANFH patients before the operation, pain was noted - in the main group, 1 points, in the control group, 1 points. After the operation, one month later, it became 2.5 points in the main and 2 points in the control. Before the operation, the patients had impaired mobility function of varying severity after the operation, the dysfunction recovered before the operation in the main group, 1.5 points and the control group were also 1.5 points. After the operation, one month later, it became 2.5 points in the main group and 2 points in the control group. Before the operation, the patients had emotional perception in the main group, it was 1.5 and the control group was also 1.0 points. After the operation, one month later, it became 1.5 points in the main group and 1.5 points in the control group. Before the operation, the patients had a need for means of rehabilitation and support, (orthoses, canes) in the main group, 1.5 points were noted, and in the control group, they were also 1.0 points. After the operation, one month later, it became 2.5 points in the main group and 2.5 points in the control group. Before the operation, the patients had an insignificant ability to walk, to perform the action with the upper limb before the operation in the main group, 1.5 points were noted and in the control group, also 1.5 points. After the operation, one month later, it became 2.5 points in the main group and 2 points in the control group. Before the operation in patients, the ability to lift and carry weights before the operation in the main group was 1.5 and the control group was also 1.0 points. After the operation, one month later, it became 2.5 points in the main group and 2 points in the control group. The average score before treatment in the main group was 8, in the control group. After the treatment, it became the main group of 14, and in the control group - 12 points. The presence of persistent pain was the main indication for surgery in both groups; after surgical treatment, pain decreased most in the main group compared to the control group, which shows a good efficacy of surgical treatment of hip joint. Art of Medicine Volume-1 International Medical Scientific Journal Issue-3 10.5281/zenodo.5634147 15 We present the comparative results of treatment in patients with ANFH after treatment at 3.6 months and one, two years (table 3). Table 3 Comparative results of treatment in patients with ANFH after surgical treatment Criteria for evaluation 3 months 6 months 1 year 2 year The main Cont rol The main Cont rol The main Cont rol The main Cont rol Pain 3 2,5 3,5 3 4 3 4,0 4,0 Function 3 2,5 4 3,0 4,0 3 4 4,0 Emotional perception 3 3 3 3 3 4,0 4 3 The need for rehabilitation and support (orthoses, cane) 3,0 3 3,5 3,0 4 4 4 4 The ability to walk / perform an action with the lower limb 2,5 2 3 3 3 2,5 3,0 3,0 Gait disorder / ability to lift and carry weights 2,5 2 3 2,0 3 2,5 3,0 3,0 Points total 17 15 20 17 21 19 22 21 Table 3 shows that in patients after surgery, pain was noted in the main group: after 3 months - 3, 6 months - 3.5, 1 year - 4 and 2 years - 4 points. In the control group: after 3 months - 2.5, 6 months - 3.0, 1 year - 3 and 2 years - 4 points. After the operation, dysfunction was observed in the main group: after 3 months - 3, 6 months - 3.5, 1 year - 4 and 2 years - 4 points. In the control group: after 3 months - 2.5, 6 months - 3.0, 1 year - 3 and 2 years - 4 points. After the operation, the patients had emotional perception in the main group: after 3 months - 3, 6 months - 3.0, 1 year - 3 and 2 years - 4 points. In the control group: after 3 months - 3.0, 6 months - 3.0, 1 year - 4 and 2 years - 3 points. Art of Medicine Volume-1 International Medical Scientific Journal Issue-3 10.5281/zenodo.5634147 16 After the operation, the patients noted the need for rehabilitation means and support (orthoses, canes) in the main group: after 3 months - 3.6 months - 3.5, 1 year - 4 and 2 years - 4 points. In the control group: after 3 months - 3.0, 6 months - 3.0, 1 year - 4 and 2 years - 4 points. After the operation, the patients had the ability to walk, perform an action with the upper limb, emotional perception in the main group: after 3 months - 2.5, 6 months - 3.0, 1 year - 3 and 2 years - 3 points. In the control group: after 3 months - 2.0, 6 months - 3.0, 1 year - 2.5 and 2 years - 3 points. After the operation, the patients had a gait disorder, the ability to lift and carry weights in the main group: after 3 months - 2.5, 6 months - 3.0, 1 year - 3 and 2 years - 3 points. In the control group: after 3 months - 2.0, 6 months - 2.0, 1 year - 2.5 and 2 years - 3 points. The average score before treatment in the main group: after 3 months - 17, 6 months - 20.0, 1 year - 21 and 2 years - 22 points. In the control group: after 3 months - 15.0, 6 months - 17, 1 year - 19 and 2 years - 21 points. From these data, we can say that in patients in the postoperative period after 6 and 12 months, there is an improvement in the results of treatment: a decrease in pain, deformity and an increase in the amplitude of joint movement and an improvement in limb function (Table 4). Table 4 Results according to the scale developed by us Scale score Основная группа Контрольная группа Количество больных Good 45 (82,6%) 40 (73%) 85 (77%) Satisfactory 9 (16,4%) 13 (24%) 22 (20%) Unsatisfactory 1 (1%) 2 (3%) 3 (3%) Total 55 (100%) 55 (100%) 110 (100%) Table 4 shows that in patients with ANFH, good results were obtained in the main group in 45 (82.6%), in the control group in 40 (73%). Satisfactory in the main group in 9 (16.4%), in the control group in 13 (24%). Unsatisfactory in the main Art of Medicine Volume-1 International Medical Scientific Journal Issue-3 10.5281/zenodo.5634147 17 group in 1 (1%), in the control group in 2 (3%). Compared to the main and control groups, the results of treatment after arthroplasty in the main group are good results 82.6%, in the control group 73%, these data show the effectiveness of surgical treatment in the main group. Conclusion. The use of the developed method of hip arthroplasty in ANFH against the background of severe osteoporosis promoted good integration of the prosthesis with the bone, leading to an improvement in the functional capacity of the joint and lengthening the life of the endoprosthesis. Analysis of the results of surgical treatment of patients with ANFH showed the prevalence of the proportion of good results in patients of the main group in 45 (82.6%) cases versus the control group - 40 (73%) and a decrease in unsatisfactory results to 1 (1%) case in patients of the main group against the control - 2 (3%). References: 1. Akramov V.R. Features of hip arthroplasty in case of anatomical disorders of the acetabulum // "Bulletin of the association of doctors of Uzbekistan" Uzbekistan, Tashkent № 3 - 2011, Pages 94-97. [in Russian] 2. Akramov V.R. 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