METHOD OF HIP REPLACEMENT WITH APPLICATION OF DIRECT ANTERIOR APPROACH Russian patent published in 2024 - IPC A61B17/00 A61B17/74 A61F2/36 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to traumatology and orthopaedics, and can be used for hip replacement with application of direct anterior approach. Method involves making a skin incision for length of 8–10 cm parallel to the direction of the inguinal fold, which is made 3 fingers distal from the anterior superior iliac spine, lateral to the line drawn from the anterior superior iliac spine in the distal direction and the corresponding projection of the intermuscular space between the fascia lata tensioner and the sartorius muscle. After opening the space between the fascia lata tensioner and the sartorius muscle, the rectus femoris muscle is retracted medially, followed by coagulation of the ascending branch of the lateral artery enveloping the hip. Deep leaf of the own hip fascia is dissected and a capsule of the hip joint is exposed on which an anterior L-shaped capsulotomy is performed. Osteotomy of a femoral neck is performed. Femoral head is removed by means of a screwed-in corkscrew. Capsule is released including an upper and an inferior capsulotomy. Acetabular cavity is prepared. Cotyloid component is inserted, during which the femur is displaced posteriorly with the help of a posterior retractor. Further, a femoral medullary canal is prepared and an endoprosthesis leg is inserted, during which the femoral bone is exposed while pulling the bone hook in an anterior and lateral direction. Thereafter, the proximal femur is fixed in an elevated position with the retractor placed at the level of the capsule release. Operated limb is placed under the contralateral limb in a reduced position with external rotation. Thereafter, a medullary canal of the proximal femur is opened. Bed for an endoprosthesis leg is formed. Test femoral component is installed, and when the results of the assessment tests and the length of the extremities are achieved, an implant is installed. For the purpose of the lower capsulotomy, the operated extremity of the patient is placed over the contralateral extremity to provide external rotation. For the upper capsulotomy, the operated extremity is placed in a neutral position, while the bone hook is used to elevate the hip by bringing the instrument into the medullary canal behind the calcar part of the femur after osteotomy. Acetabular cavity is prepared with the help of cutters. Endoprosthesis stem bed is formed with rasps and two offset adapters to the planned implant size. Medullary canal of the proximal femur is opened with a box chisel.

EFFECT: method provides less severity of pain syndrome and, as a result, reduces the need for prescription of opioid analgesics due to short incision length, absence of damage to fascia lata and muscle straining fascia lata and muscles of deltoid group of hip.

6 cl, 9 dwg, 3 ex