FIELD: medicine.
SUBSTANCE: invention relates to medicine, namely to traumatology and orthopaedics, and can be used in revision hip replacement in the presence of massive unlimited bone defects in the cotyloid cavity as a result of osteolytic process or mechanical bone wear during loosening of the acetabular or infectious endoprosthesis cotyloid component. Method involves computer tomography, determining the shape and size of a bone defect of the cotyloid cavity, designing and manufacturing of titanium powder by 3D printing of an individual design in the form of a mesh anatomical pre-bent plate for bone defect augmentation, as well as a plastic fitting pattern. Surgical approach to the endoprosthesis is performed, a bone defect of the hip bone is isolated in the cotyloid cavity. Cotyloid cavity is de-folded with fibrous membrane removed to bleeding bone, bone surface is prepared for individual mesh by fitting the plastic template, implantation of the manufactured individual net with fixation by screws along the edge of the structure adjacent to the bone at distance of 1 cm, impaction of the crushed bone allograft and cement-based installation of the polyethylene cavity of the endoprosthesis. Design is designed individually for a specific defect. Screws are directed towards the most pronounced bone mass specified during design. First screw is drawn along the top of the defect, two further along the edges. Rest screws are made by means of guide sleeves on the plate surface around each hole along the edge adjoining the bone.
EFFECT: method provides optimization of operative intervention and reduction of total length of operation due to individual designing of the shape and planning of direction and size of fixing screws.
1 cl, 7 dwg
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Authors
Dates
2020-09-25—Published
2019-11-27—Filed