METHOD FOR SURGICAL TREATMENT OF CHRONIC INSTABILITY OF A REVERSE ENDOPROSTHESIS OF THE SHOULDER JOINT Russian patent published in 2022 - IPC A61B17/00 A61B17/56 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to traumatology and orthopedics, and can be used for surgical treatment of chronic instability of a reverse shoulder joint endoprosthesis. In the preoperative period, the spatial visualization of the affected structures and the state of the endoprosthesis components are determined by the method for multilayer spiral computed tomography, the pain syndrome, the range of motion of the shoulder joint and the functional state of the deltoid muscle are assessed. Surgical intervention is performed in the patient's position sitting on the operating table with an angle between the patient's body and hips of 90° and with a roller in the popliteal region by performing an incision of the skin and subcutaneous tissue 5.0-5.9 cm long from the edge of the acromion linearly along the outer surface of the shoulder distally to the level of the projection of the large tubercle, access the deltoid muscle. The anterior and middle bundles of the deltoid muscle are bluntly bred and the components of the installed endoprosthesis are visualized. The endoprosthesis is dislocated and the endoprosthesis liner is replaced when it is worn out. Three anchor fixators with threads are implanted along the circumference of the glenoid cavity and with the location of the anchor fixators along the dial at 12, 4 and 8 o'clock. Two anchor fixators with threads are implanted into the region of the anterior and posterior surfaces of the proximal humerus. A mesh implant made in the form of a tube made of polypropylene with hole sizes sufficient for integration and ingrowth of connective tissue is pulled onto the proximal part of the shoulder joint and the glenosphere, while the strength and elastic characteristics of the placed mesh implant ensure the absence of biomechanical disturbances and limitation of range of motion in the shoulder joint. The endoprosthesis components are repositioned into an anatomically correct position. The proximal end of the mesh endoprosthesis is pulled up to the glenoid cavity of the scapula and stitched with anchor threads, the distal end of the mesh implant is pulled with tension to the proximal humerus and fixed with anchor threads. Perform layer-by-layer suturing of the wound.

EFFECT: method ensures the preservation of the patient's motor activity in the early postoperative period, minimally invasive surgical access, restoration of the shape and anatomical function of the structures of the shoulder joint and reduction of the hospital stay due to the reduction of surgical aggression and tissue injury.

1 cl, 3 ex