MODERN TRENDS IN THE DEVELOPMENTS OF HIP AND KNEE ARTHROPLASTY

摘要

Total hip (THA) and knee (TKA) arthroplasty is an effective surgical treatment for late-stage osteoarthritis. Objective. Highlight the most significant technological developments in the design of implants and assistive technologies for hip and knee arthroplasty. Results. The development of hip and knee arthroplasty is associated with the desire to improve treatment outcomes, reduce complications and increase the survival of implants. The emphasis is placed on some of the most interesting, in our opinion, trends in this area. It has been shown that metal-to-metal friction steam implants are used to replace the articular surface of the hip joint, but the method is the best option only for active men with a large hip joint. New approaches involve the use of friction pairs «ceramic – ceramic» or «metal – polyethylene». The creation of smaller femoral components of endoprostheses (mini-legs) for THA is aimed at preserving bone tissue and achieving physiological load. Dual mobility endoprostheses are increasingly preferred for primary THA. The creation of implants with a porous surface (in particular, with the use of additive technologies) is promising to increase their osteointegration and antibacterial properties. The latest direction is the creation of robotic support systems for joint replacement operations, which will improve the accuracy of implant positioning, reduce blood loss, improve functional results, as well as achieve after TKA balance of ligaments and joint space by accurately determining its size and accuracy resection of the femur. However, high-evidence clinical trials are needed to find convincing longterm results for this approach to become standard in hip and knee arthroplasty. Conclusions. Robotic surgery is one of the most interesting developments in hip and knee surgery. The growth in the use of this technology has shown convincing long-term results.