Syndrome faset joints of the lumbar spine of the total hip joint arthroplasty (literature review)

To date, the treatment and rehabilitation of patients with trauma and orthopedic profiles (backgrounds), suffering from coxarthrosis with concomitant syndrome of intervertebral joints, is an important medical, social and economic problem [1]. The first scientific work that highlighted the study of pain after total hip arthroplasty, was published in the 1970s. Experts and specialists tried to explain the pain syndrome, occurring during the instability of the prosthetic components and / or infectious processes [22]. By the results of (Krapcheva I. V. 2016.) the pain syndrome after primary total hip replacement is noted in one third of patients thus 42,7% out of 1286 patients from his research. The « lumbar-sacral System, part of the spine - hip joints» is a complex combination of physiological functions and a large number of anatomical structures, and this unified system is very sensitive to changes in any part of it [22,26]. According to foreign reports on arthroplasty, 17-20% of patients undergoing surgery for total hip replacement, have persistent pain, and 32- 35% under observations from a period of 1 to 10 years without instability and infectious process of the components have a new sensation in the form of mild pain or discomfort in the region of the hip joint [8]. With the increasing number of primary operations of hip replacement surgery around the world, this issue is gradually becoming more actual with a more detailed work. In the world of medical literature there is no consensus on adequate classification and diagnosis of the pain syndrome arising after hip replacement surgery.Avoyan T. K. in 1998 in his works on the basis of existing literature described the syndrome of the intervertebral joints as the combination of symptoms and signs that arise as a results of irritations of the tissues of the intervertebral joints. Where the main symptoms are lumbar joint and ligament pain, pseudo radicular sclerodermal pain, muscle tone destructions. And also he identified the various types of syndromes, such as dystrophic-destructive, disarticulations and disarticulation-dystrophic. For verification of the pain syndrome many experts recommend the use of conventional diagnostic methods (xRay, CT, MRI) In recent years operative treatment in volume of total hip replacement has become one of the main methods of treatment of patients with coxarthrosis and is considered one of the most revolutionary achievements of orthopedic surgery at the effectiveness of reducing pain [38]. However, the treatment of patients suffering coxofemoral syndrome is a difficult and unsolved medical and social problem. The combination of these pathological processes exacerbates the problem. Hip replacement is currently the most dynamically developing area of orthopedics.It is important to determine the precise point where conservative treatment is ineffective or where conservative treatment is no longer applicable.Results of operative treatment largely depend on the initial state of the hip joints and lumbar spine. In this connection it is necessary for a thorough evaluation of patients with this pathology to determine the tactics and order of treatment of the lumbar spine and hip joint.