jktoКафедра травматологии и ортопедииDepartment of Traumatology and Orthopaedics2226-2016ПРОФИЛЬ — 2С10/17238/issn2226-2016.2025.3.40-48jkto-49Research ArticleКЛИНИЧЕСКИЙ СЛУЧАЙCLINICAL CASEРеэндопротезирование тазобедренного сустава по поводу рецидивирующих вывихов и разобщений ацетабулярной конструкции при её изначально высоком расположении: клиническое наблюдениеRevision total hip arthroplasty for instability and recurrent dissociation of the acetabular construct after it’s initial placement at the high hip center: a case reporthttps://orcid.org/0000-0002-1039-6921СрогинисП. В.SroginisP. V.

Срогинис Полина Витальевна, к.м.н., врач травматолог-ортопед

ул. Академика Байкова 8,г. Санкт-Петербург, 195427

Polina V. Sroginis, Cand. Sci. (Med.)

str. Academician Baykova house 8, St. Petersburg, 195247

sroginis@bk.ruhttps://orcid.org/0000-0002-1813-3421ЕфимовН. Н.EfimovN. N.

Ефимов Николай Николаевич, к.м.н., врач травматолог-ортопед

ул. Академика Байкова 8,г. Санкт-Петербург, 195427

Nikolai N. Efimov, Cand. Sci. (Med.)

str. Academician Baykova house 8, St. Petersburg, 195247

efimov-n-n@mail.ruhttps://orcid.org/0000-0003-2799-532XЧеркасовМ. А.CherkasovM. Ah.

Черкасов Магомед Ахмедович, к.м.н., врач травматолог-ортопед

ул. Академика Байкова 8,г. Санкт-Петербург, 195427

Magomed Ah. Cherkasov, Cand. Sci. (Med.)

str. Academician Baykova house 8, St. Petersburg, 195247

dr.medik@gmail.comhttps://orcid.org/0000-0001-6435-7939ГончаровМ. Ю.GoncharovM. Yu.

Гончаров Максим Юрьевич, к.м.н., заведующий травматолого-ортопедическим отделением № 5

ул. Академика Байкова 8,г. Санкт-Петербург, 195427

Maxim Yu. Goncharov, Cand. Sci. (Med.)

str. Academician Baykova house 8, St. Petersburg, 195247

goncharov71@list.ruФГБУ национальный медицинский исследовательский центр травматологии и ортопедии имени Р.Р. Вредена, Минздрава РоссииРоссияVreden National Medical Research Center of Traumatology and OrthopedicsRussian Federation202513032026034048Copyright © Срогинис П.В., Ефимов Н.Н., Черкасов М.А., Гончаров М.Ю., 20262026Срогинис П.В., Ефимов Н.Н., Черкасов М.А., Гончаров М.Ю.Sroginis P.V., Efimov N.N., Cherkasov M.A., Goncharov M.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.jkto.moscow/jour/article/view/49Введение

Введение. Эндопротезирование по поводу коксартроза на фоне более тяжелых вариантов дисплазии является сложным вариантом первичного эндопротезирования тазобедренного сустава с повышенным риском различных осложнений, в том числе вывиха головки эндопротеза. При этом возможны различные варианты позиционирования центра ротации.

Цель исследования

Цель исследования. Продемонстрировать ряд тактических и технических сложностей ревизионного эндопротезирования тазобедренного сустава при изначально высоком расположении ацетабулярной системы.

Клинический случай

Клинический случай. Представлена история лечения пациентки, которой при дисплазии с высоким вывихом было выполнено первичное эндопротезирование тазобедренного сустава с установкой антипротрузионного кейджа с большим краниально-латеральным смещением относительно истинной впадины. У пациентки развилась рецидивирующая нестабильность сустава, и дважды происходило разобщение ацетабулярной конструкции после цементирования чашки двойной мобильности в сохраняемый хорошо фиксированный кейдж.

Заключение

Заключение. Первичное эндопротезирование тазобедренного сустава с краниально-латеральным смещением центра ротации сустава может иметь ряд преимуществ в плане снижения травматичности вмешательства, но в случае неудачи приводит к большим сложностям при ревизионном эндопротезировании.

Introduction

Introduction: Total hip arthroplasty for osteoarthritis secondary to more severe types of developmental dysplasia is a complex procedure, associated with an increased risk of failure, including instability. Different positions of the center of rotation have been described.

Purpose

Purpose: To demonstrate tactical and technical challenges of revision hip arthroplasty after initial high placement of the acetabular component.

Case report

Case report: A patient underwent primary hip arthroplsty for dysplasia with a high dislocation, an antiprotrusio cage was placed at the high hip center. Recurrent instability was encountered, and then two revisions with cementation of a dual mobility cup into a retained well-fixed cage resulted in dissociation of the constuct.

Сonclusion

Сonclusion: Proximal and lateral placement of the acetabular component may have an advantage of reducing perioperative morbidity, but if it fails, the following revision is associated with additional difficulties.

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