METHOD OF REVERSE SHOULDER ARTHROPLASTY IN PATIENTS WITH POST-TRAUMATIC BONE DEFICIENCY OF PROXIMAL HUMERUS USING PERSONALIZED 3D AUGMENT OF PROXIMAL HUMERUS Russian patent published in 2024 - IPC A61B17/72 A61F2/40 

FIELD: medicine; traumatology; orthopedics.

SUBSTANCE: invention can be used for the treatment of patients with post-traumatic arthrosis of the shoulder joint and false joints of the proximal humerus or other types of bone mass deficiency of the proximal humerus. Before performing surgical treatment, an assessment is made of radiographs of the shoulder joint, computed tomography of the shoulder joint with a slice thickness of not more than 0.6 mm, performed not later than 2 weeks before surgery. The results are analyzed and transmitted to the designer. After the shape of the product is approved by the attending physician, an electronic 3D model of the augment is printed based on the Ti-6A1-4V alloy. The resulting 3D model of the augment is sterilized. Next, the patient is hospitalized for surgical treatment. An anterolateral incision is used to access the shoulder joint layer by layer. Excision of scar-modified paraarticular tissues and articular labrum is performed. A reverse shoulder arthroplasty system is used. Guides for resection blocks are installed. Resection of the altered bone tissue is performed according to preoperative planning. According to the standard technique, the articular surface of the scapula is treated and the glenoid base is implanted, fixed with bone screws. Next, the canal of the humerus is processed with rasps. A personalized 3D augment is installed on the diaphysis of the humerus using a press-fit method. Next, a polyethylene plug is inserted into the canal of the humerus, then bone cement is inserted. Next, through a personalized augment, the humeral component of the endoprosthesis is inserted into the canal of the humerus so that 5–6 centimeters of the leg are immersed in the bone, and the remaining part is completely covered with the augment. After fitting, a cup of the endoprosthesis with a polyethylene insert fixed to it is installed on the stem, the prosthesis is adjusted and movements are checked. The wound is sutured in layers, drainage is provided.

EFFECT: method ensures reliable fixation of the endoprosthesis stem in case of deficiency of the bone base in its potential bed, longer service life of the implant, lower risk of early aseptic loosening of the stem due to the fact that the porous structure of the personalized 3D augment and its tight fit on the sawdust of the humerus create optimal conditions for osseointegration, potential consolidation at the implant-bone interface.

1 cl, 5 dwg, 1 ex