METHOD OF SHOULDER JOINT ENDOPROSTHETICS FOR TOTAL SHOULDER DEFECTS Russian patent published in 2023 - IPC A61F2/40 A61B17/56 

FIELD: medicine; oncology; traumatology and orthopedics; reconstructive plastic surgery.

SUBSTANCE: invention relates to performing replacement of total scapular defects. Three-dimensional modeling is performed, created using hybrid parametric modeling and topological optimization, taking into account the parameters of the bone defect of the glenoid surface of the scapula according to computed tomography of the shoulder joint, and the 3D implant is made using the technology of layer-by-layer fusion of fine metal powder — DMLS from Ti64ELI material, containing a perforated frame in in the form of the body of the scapula with the acromial and coracoid processes, its medial edge with the lateral edge is connected by two transverse bars, and the frame has a seat for the installation of the glenoid. To install the implant, a skin incision is made along the outer edge of the right scapula to the projection of the acromioclavicular joint, along the anterior surface of the shoulder joint to the projection of the palpable coracoid process, soft tissues are bred in the projection of the shoulder joint, the scapular muscles are cut off from their attachment sites, the muscles attached to the coracoid process, the ligaments of the acromioclavicular joint are dissected, the capsule of the shoulder joint is dissected along the anterior and posterior surfaces and the articular process of the scapula is exposed, then the scapula is isolated and the incision is continued from the lower angle to the articular process, the preparation is mobilized and removed, after which a metal implant of the right scapula is installed and install the overlay of the glenoid on a cement base, set the head of the shoulder joint into the joint and try for movement, after which the joint capsule is sutured and the acromion is sutured through the perforation to the clavicle with cerclage sutures, then the muscles and muscles are sutured to the coracoid process and to the shoulder blade at the back.

EFFECT: proposed method makes it possible to design the endoprosthesis in such a way that, after its installation and fixation, the geometric parameters correspond as much as possible to the shape and symmetry of a healthy scapula.

2 cl, 7 dwg