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Top1. Introduction
Degenerative diseases such as osteoarthritis and coxarthrosis affect about 60% of the elderly population over the age of sixty (60). Osteoarthritis includes mainly joint cartilage of hip joints (Leszczyński & Pawlak-Buś, 2008) whereas coxarthrosis will lead to biomechanical disorders that are caused by incorrect positioning or loading of various joint components. The results may be an impaired hip joint function and/or the wear of a joint cartilage for patients suffering from these degenerative diseases; over a period of time, their ligaments and joint capsules will thicken and become less flexible. In advanced stages of the disease, there is direct contact between the joint forming elements, thereby causing biomechanical disorders (Issa & Sharma, 2006; Marczyński, 2007).
The aetiology of a primary form of the hip coxarthrosis is unknown. What are known are the pre-conditional factors for the development of the osteoarthritis – these include, among others, those patients characterized as having: (i) a cardiac dysfunction in the joint area; (ii) changes in the joint fluid composition; (iii) abnormal nutrition of articular cartilage; (iv) age over 50; (v) female gender; (vi) obesity; and (vii) predisposing genetic factors. Secondary forms of the disease may occur as a result of injuries, diseases of joints and bones, hormonal and metabolic disorders, systemic diseases, nutritional disorders of femoral head, congenital and developmental joint deformations, obesity, lack of physical activity or abnormal forms of physical activity, certain categories of pursued profession, or more simply, the aging process (Ackerman et al., 2017).
A multitude of factors can affect the patient’s clinical condition, complicating the decision on the optimal timing for a surgery. Advancing hip osteoarthritis, for example, can lead to biomechanical and motor dysfunctional disorders, resulting in increased disabilities and social isolation of the patient. Typical symptoms include complaints of increased pain; contractures and muscle atrophy; reduced joint mobility; and abnormal walking that may worsen over time along with the development of the degenerative disease. Often, the radiological image enables the detection of geodesy, osteophytes, sclerosis, narrowing or atrophy of the joint cavity, and the deformation of joint contours (Bennell & Hinman, 2011).
Additionally, a multitude of other criteria may have to be considered in qualifying patients for alloplasty of the hip joint. One such measure is the quality of walking and functional condition of patients waiting for alloplasty (Suetta et al., 2007; Srokowski et al., 2010). Another may be the size of decrease in muscle strength that is assessed using, for example, walking on stairs and muscle functioning tests (Arokoski et al., 2002; 2004). To date, no single functional test exists that includes the determination of impaired biomechanics for all joints’ parameters.
In order to properly diagnose and prepare the patient for the needed surgery, the physician has to first examine the patient’s clinical condition. With many influencing factors to be considered for the diagnosis, the methods used by physicians are often subjective, error-prone, and results largely dependant upon the experience of the investigator (Rodriquez et al., 1996; Guzik et al., 2019). Even so, the central challenge is the lack of uniformity of the patient’s qualifications for the surgery and a lack of a suitable method to facilitate the doctor’s decision on the treatment method. Development and verification of the appropriate method may improve the patient’s classification for the surgery and/or the adjustment of an optimal conservative treatment.
The rest of this paper is organized as follows. Section II discusses materials and methods, more specifically, the form of disease, competence data and evaluation criteria applicable to the AHP (Analytic Hierarchy Process) and the Electre Tri process methods. Section III focuses on statistical results achieved from the application of these proposed methods while section IV offers suggestive insights from the interpretation of the evaluation results. Finally, section V closes the paper with potential limitations and future work in the associated study domain.