METHOD OF PRIMARY TOTAL SHOULDER REPLACEMENT IN THE POST-TRAUMATIC DEFORMATIONS OF THE GLENOID SURFACE OF THE BLADE WITH AN INDIVIDUAL ENDOPROSTHESIS Russian patent published in 2019 - IPC A61B17/56 A61F2/40 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely reconstructive surgery in traumatology and orthopedics. A method of primary total shoulder replacement in the post-traumatic deformations of the glenoid surface of the blade with an individual endoprosthesis. Said endoprosthesis represents a single unit of a gloidoid component and an augment made by a three-dimensional model, created using hybrid parametric modeling and topological optimization taking into account the parameters of the bone defect of the glenoid surface of the blade according to computed tomography of the shoulder joint on SLS 3D printer from titanium-aluminum-vanadium (Ti6Al4V) alloy. In said endoprosthesis there is external porous surface for osteointegration, holes for introduction in specified direction of two screws for coracoid process, four screws for acromial process and three screws for blade spin. In implementing the method, an endoprosthesis of a head with a pedicle is used. Method comprises deltectoral approach, release of tendon of subscapular muscle, resection of head of humerus, riming of glenoid surface of blade, is performed by root of beak-like and acromial processes of blade, thereafter, individual endoprosthesis is fixed to the blade with bone screws, wherein two screws are inserted into the coracoid process, four – into the acromial process and three – into the blade root. Cement cup is installed without additional positioning. Thereafter, the bone canal of the humerus is reamed, the templates of the shoulder component of the endoprosthesis are installed to determine the level of immersion of the endoprosthesis leg and the stretch of the soft tissues with the subsequent installation of the endoprosthesis with the head on bone cement, after which the endoprosthesis is brought back and tested for instability, re-fixation of the subscapular muscle, a layer wound suture.

EFFECT: invention provides strong fixation and accurate positioning of the glenoidal component of the endoprosthesis, complete reconstruction of the bone defect area, reduced time of operation due to previously known directions of introduction and sizes of bone screws, restoration of biomechanics of shoulder joint, normal interaction of muscles of rotary cuff.

1 cl, 4 dwg