Closure of the hip joint capsule defect with a propylene mesh. Clinical and biomechanical research

Authors

  • Sergey Maslennikov Zaporizhzhia State Medical University. Ukraine, Ukraine
  • Sergey Panchenko SHEI «Pridneprovskaya State Academy of Civil Engineering and Architecture», Dnipro. Ukraine, Ukraine
  • Maksim Golovakha Zaporizhzhia State Medical University. Ukraine, Ukraine https://orcid.org/0000-0003-2835-9333

DOI:

https://doi.org/10.15674/0030-598720184107-114

Keywords:

endoprosthesis, hip joint, modeling, biomechanics, polypropylene

Abstract

Dislocation of the femoral component of the endoprosthesis is one of the most common complications after hip total arthroplasty. The best way of prevention is to prevent the development of primary instability. Even with the proper positioning of endoprosthesis components, there are dislocations associated with the weakness or defect of the capsular-connective structures of the joint. Today, a lot of ways have been developed to strengthen and restore the posterior structures of the capsule of the hip joint with the help of auto and allomaterials, differing in the method of fixation and physical and chemical characteristics.
The paper proposes a method of restoring and strengthening the posterior structures of the capsule using polypropylene mesh implants. Objective: to construct a model of the hip
joint capsule after capsulotomy with the help of the specialized software program and to determine the hardness of the defect closed with a polypropylene mesh. Methods: the study was made in a software complex based on the finite element method. A calculation model was constructed consisting of capsule and endoprosthesis femoral head. Two methods of sewing the dissected capsule were studied: seam thread and polypropylene mesh. In the control model, the capsule was not fixed. Results: pictures of the distribution of stress-strain state in the system «endoprosthesis – joint capsule» were obtained. Conclusions: under
the conditions of the kinematic loading of the model, the smallest sizes of the capsule cut opening are in case of its closure with the mesh. In the case of thread, they were 8.5 % higher. The values of equivalent stresses in the model with the mesh were the largest: in the capsule of the joint by 23.8 %, the endoprosthesis head — by 60.4 % compared with the thread fixation. The obtained results indicate that the mesh model is more rigid.

Author Biography

Maksim Golovakha, Zaporizhzhia State Medical University. Ukraine

MD, Prof. in Traumatology and Orthopaedics

References

  1. Sanchez-Sotelo, J., & Berry, D. J. (2001). Epidemiology of instability after total hip replacement. Orthopedic Clinics of North America, 32 (4), 543–552. doi:https://doi.org/10.1016/s0030-5898(05)70225-x
  2. Kwon, M. S., Kuskowski, M., Mulhall, K. J., Macaulay, W., Brown, T. E., & Saleh, K. J. (2006). Does surgical approach affect total hip arthroplasty dislocation rates? Clinical Orthopaedics and Related Research, 447, 34–38. doi:https://doi.org/10.1097/01.blo.0000218746.84494.df
  3. Browne, J. A., & Pagnano, M. W. (2011). Surgical technique: a simple soft-tissue-only repair of the capsule and external rotators in posterior-approach THA. Clinical Orthopaedics and Related Research, 470 (2), 511–515. doi:https://doi.org/10.1007/s11999-011-2113-6
  4. Singh, B., Brown, T. D., Callaghan, J. J., & Yack, H. J. (2013). Abdomen-thigh contact during forward reaching tasks in obese individuals. Journal of Applied Biomechanics, 29 (5), 517–524. doi:https://doi.org/10.1123/jab.29.5.517
  5. Kim, Y. S., Kwon, S. Y., Sun, D. H., Han, S. K., & Maloney, W. J. (2008). Modified posterior approach to total hip arthroplasty to enhance joint stability. Clinical Orthopaedics and Related Research, 466(2), 294-299. doi:https://doi.org/10.1007/s11999-007-0056-8
  6. Yamaguchi, T., Naito, M., Asayama, I., Kambe, T., Fujisawa, M., & Ishiko, T. (2003). The effect of posterolateral reconstruction on range of motion and muscle strength in total hip arthroplasty. The Journal of Arthroplasty, 18 (3), 347–351. doi:https://doi.org/10.1054/arth.2003.50060
  7. Menschikova, T. I., Chegurov, O. K., & Menshikov, I. N. (2017). The use of the ultrasound method for assessing the structural condition of the hip joint in patients with different stages of coxarthrosis. International Journal of Applied and Fundamental Research, 1–1, 42–46. (in Russian)
  8. Tsikandylakis, G., Mohaddes, M., Cnudde, P., Eskelinen, A., Kаrrholm, J., & Rolfson, O. (2018). Head size in primary total hip arthroplasty. EFORT Open Reviews, 21, 3(5), 225–231. doi: https://doi.org/10.1302/2058-5241.3.170061.
  9. Chizhov, D. V. (2016). Polypropylene materials in surgery of hernia of the abdominal wall (experimental and clinical study) (Doctoral dissertation). (in Russian)
  10. Rathi, P., Pereira, G. C., Giordani, M., & Di Cesare, P. E. (2013). The pros and cons of using larger femoral heads in total hip arthroplasty. The American Journal of Orthopedics, 42 (8), E53–59.
  11. Elkins, J. M. (2013). Biomechanics of failure modalities in total hip arthroplasty. doi:https://doi.org/10.17077/etd.addybua3

How to Cite

Maslennikov, S., Panchenko, S., & Golovakha, M. (2023). Closure of the hip joint capsule defect with a propylene mesh. Clinical and biomechanical research. ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS, (4), 107–114. https://doi.org/10.15674/0030-598720184107-114

Issue

Section

ORIGINAL ARTICLES