METHOD OF AUTOPLASTY OF OWN LIGAMENT OF WHIRLBONE AFTER ENDOPROSTHESIS REPLACEMENT OF KNEE JOINT Russian patent published in 2009 - IPC A61B17/56 

FIELD: medicine; orthopedy and traumatology.

SUBSTANCE: invention is used at treatment of patients with complications after total endoprosthesis replacement of knee joint in the form of a necrosis or extensive defects of soft tissues on anterior surface of a knee joint, and-or cicatrical degeneration of the is muscular-copular apparatus patella-crural joint, and as with inveterate ruptures of own ligament of a whirlbone. After endoprosthesis replacement of the knee joint exsect cicatrical and necrotic tissues round defect of anterior surface of knee joint and own ligament of a whirlbone. Allocate and cut a medial head of the gastrocnemius muscle below level of its transition into the heel tendon. Form a constrained tendon-muscular autograft, mobilise and turn it on 180°. Form the tunnel on forward surface from donor zone to defect zone under the skin and hypodermic fat. Enter and move proximally through it an autograft, closing defect, and make its bracing. In addition move autograft with overlapping of zone of defect of forward surface of knee joint and own ligament of whirlbone, and fix, sewing the tendon part with tendon of rectus muscle of thigh at the unbent knee joint. Before bracing, the whirlbone is reduced in distal direction as much as possible. Dissect the soft tissues of an anticnemion in a projection of internal head of the gastrocnemius muscle below articulate cleft not less than on 100 mm. Cut the gastrocnemius muscle with a tendon site not less than 50-60 mm. If there is whirlbone lateroposition, make autograft bracing with its medial shift to the tendinous part. If there are lateral superficial defects, straighten the muscular part of autograft cross-section and fix to edges of defects with discharge sutures. If superficial defects are appreciable, dissect own fascia of external surface of autograft crosswise cuts and cover with the punched dermal flap.

EFFECT: method allows reaching restoration of active extension of knee joint as much as possible approached to physiological, raises reliability of bracing of graft.

7 cl, 1 ex