METHOD OF REPLACING AN ELBOW JOINT DEFECT WITH AN INDIVIDUAL 3D IMPLANT Russian patent published in 2023 - IPC A61B17/56 A61F2/38 

FIELD: medicine; traumatology; orthopedics; oncology.

SUBSTANCE: group of inventions can be used when replacing the lotus joint with restoring its functions. On the inner contour of the annular element of the individual 3D implant there are liners made of ultra-high molecular weight polyethylene. The outer part of the annular element of the elbow component has a smooth polished articulation surface. On the other side of the shoulder component of the body there is a leg and a detachable element with holes, including two bushings, between which the ring element with the sleeve of the elbow component is fixed. When assembling the endoprosthesis, the hole of the annular element of the elbow component is aligned with the detachable element of the shoulder component and fixed with an axle and a lock in the form of plugs. The defect replacement method includes a skin incision along the outer surface of the lower third of the left shoulder with the transition to the anterior surface of the elbow joint. Soft tissues are bred. The biceps and brachialis muscles are retracted and the affected tumor of the humerus is exposed. From the places of attachment to the humerus, the brachioradialis muscle, the long radial extensor of the wrist, the short radial extensor of the wrist, the extensor of the fingers, the extensor of the little finger, the ulnar extensor of the wrist are cut off. The capsule of the elbow joint is dissected and the olecranon of the ulna is exposed. The block of the humerus is isolated and dislocated from the trochlear notch of the ulna, the bone is resected along the required length, the preparation is mobilized and removed. After resection, a plastic fitting template is installed to determine the boundaries of the resection of sections of the bone tissue of the ulna. A seat for the ulnar stem of the endoprosthesis is prepared, the stem of an individual 3D implant is installed in the humerus on cement. The body template of an individual 3D implant is placed on the shoulder stem and tightened with a screw. The shoulder and elbow components are aligned using the axis template, the operability of the connection and the level of resection are checked. The templates are removed and a sleeve is installed in the hole of the shoulder leg. The shoulder body of an individual 3D implant is placed and fixed with a cap screw to the shoulder stem and a bump stop is installed. The leg of the ulnar component in the ulna is installed and secured with a screw. The sleeve is placed in the elbow component. A plug with an insert is placed in the hinge joint of the shoulder housing of an individual 3D implant and two bushings are installed. The elbow component and the shoulder body of an individual 3D implant are aligned using an axis. The second liner is installed and the second plug is tightened and tried for movement. A prolene mesh is fixed around the individual 3D implant, to which the severed muscles are fixed, after which the joint capsule is sutured.

EFFECT: group of inventions provides a range of motion close to the range of motion of a healthy elbow, with long-term survival of the implant, as well as adequate support for the remaining bones of the forearm, due to the use of an individual 3D implant in the method.

2 cl, 12 dwg, 1 ex