METHOD FOR TWO-STAGE TREATMENT OF GONARTHROSIS WITH THE PRESENCE OF A DEFECT OF THE TIBIAL CONDYLE Russian patent published in 2021 - IPC A61B17/56 A61B17/66 A61B17/68 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to traumatology and orthopedics, and can be used to treat patients with gonarthrosis complicated by a defect of the medial or lateral condyle of the tibia. At the first stage, the spokes are carried out and the external fixation device is applied to the shin. In this case, the device consists of three ring supports and one arc per ¾ of the ring. The spokes are fixed to the supports of the apparatus and stretched, the distal and intermediate supports of the apparatus are connected with threaded rods. With the help of a chisel, osteotomy of the metaphysis of the tibia and head osteotomy of the fibula are performed. The proximal support is fixed to the intermediate support by hinged nodes. In the presence of a defect of the tibial condyle with a height of up to 10 mm, a simultaneous correction of the height of the altered condyle is performed by turning the proximal support on hinges and increasing the angle between the osteotomized fragments. In the presence of a defect with a height of more than 10 mm, a single-step correction of the height of the altered condyle is performed by the apparatus in increments of 1 mm per day, the proximal support is rotated on hinges and the angle between the osteotomized fragments is increased. In both cases, hypercorrection of the height of the altered condyle is set by rotating the fragments by a value of 1-3 degrees more than is necessary to restore the required height, the position of the bones is fixed with an external fixation device. After the formation of the regenerate in the osteotomy area, the device is dismantled. At the second stage of treatment, total knee endoprosthesis replacement is performed using a knee endoprosthesis and cement fixation, with the support of the endoprosthesis component on the bonesaw-line of the restored condyle.

EFFECT: method provides restoration of the height and shape of the altered condyle of the tibia and the formation of a stable bed for an endoprosthesis that increases the stability and survival of the knee joint endoprosthesis by replacing the defect with newly formed bone tissue without the use of additional transplants or implants.

1 cl, 3 dwg, 1 ex