Orthopedics - Oleksa A.P. 2006

Joint Diseases
Degenerative and Dystrophic Joint Diseases
Treatment of Protrusive Coxarthrosis

In cases of protrusio coxarthrosis (Fig. 331), which result from Otto-Chrobak disease, the femoral HEAD protrudes toward the pelvic cavity. While numerous Treatment modalities exist for such conditions, surgery remains the method of choice.

Under general anesthesia, the hip joint cavity is exposed using an anterolateral or posterolateral approach. The femoral head is dislocated, and cheilotomy is performed on both the femoral head and the margins of the acetabulum. The articular Cartilage of the acetabulum is debrided, and the floor is reconstructed using an autologous bone graft (harvested from the iliac wing or a rib), an appropriately sized cortico-cancellous allograft, or a vitreous-porous ceramic graft. Corundum ceramics feature open pores that account for 75% of their mass.

Various cups of different shapes, thicknesses, and sizes are available, which are implanted into the acetabulum after its floor has been cleared of cartilage. Blood Vessels eventually grow into the cancellous Structure OF THE ceramics, while their smooth, vitreous surface articulates with the reduced femoral head.

If protrusio coxarthrosis is accompanied by severe destructive and degenerative Changes in the femoral head, standard bipolar arthroplasty is performed. The acetabular floor is reinforced with bone grafts, over which the acetabular component of the endoprosthesis is cemented in place.

It should be noted that revision surgeries on an endoprosthetized hip joint, as well as operations for protrusio coxarthrosis, are technically more demanding, harder on the patient, and associated with a higher incidence of complications.



Last update: 10/08/2026

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