PERSONALIZED HIP COMPONENT OF ENDOPROSTHESIS FOR PATIENTS WITH PRONOUNCED BONE DEFECTS AND LOCAL DEFECTS OF BONE TISSUE QUALITY OF FEMUR FOR PERFORMING ONE-STAGE OR SECOND STAGE OF TWO-STAGE REVISION HIP REPLACEMENT, METHOD OF ITS MANUFACTURING AND METHOD OF IMPLANTATION Russian patent published in 2024 - IPC A61F2/36 A61F2/32 

FIELD: medicine.

SUBSTANCE: personalized femoral component of the endoprosthesis for patients with pronounced bone defects and local defects of femoral bone tissue quality for performing one-stage or second stage of two-stage revision hip replacement consists of eurocone, neck, implant body with hole for implantation of impactor and leg. Personalized femoral component of the endoprosthesis is made monolithic using computed tomography of the affected femur with possibility of 3D modelling and using 3D printing techniques from titanium alloy Rematitan CL. Leg is cone-shaped. Body is made tetrahedral. Neck is cylindrical. Cone-shaped leg has a polished surface for cement fixation, located on the area for the zone with pronounced bone tissue defects and osteoporosis, while the rest of the cone-shaped leg and the body have a porous surface for cement-free fixation. Method for manufacturing a personalized hip component of the endoprosthesis for patients with pronounced bone defects and local defects of the quality of the femoral bone tissue for performing a one-stage or second stage of a two-stage revision hip replacement consists in the following: radiographs of the affected hip joint of the patient and femur are evaluated, computed tomography of the pelvis and femur is performed with a section thickness of 0.6 mm, constructing 3D model of the pelvis and femur with all defects while removing artifacts and metal objects. Method includes preoperative planning of parameters of individual 3D femoral component of endoprosthesis, place of its installation, its size and shape, length of sections of surfaces polished for cement fixation at cone-shaped leg and porous coating for cementless fixation, body and the rest of the leg of the femoral component in accordance with areas of lost bone structures in the area of the defect and areas of intact bone tissue. Femoral component is 3D printed on the basis of metal powder consisting of titanium alloy Rematitan CL. Powder is melted by fibre-optic laser with power of 200 W or more in sealed chamber filled with inert gas. Method for implantation of a personalized femoral component of the endoprosthesis for patients with evident bone defects and local defects of the quality of the femoral bone tissue for performing a one-stage or second stage of a two-stage revision hip replacement made according to the method of p. 2 consists in the fact that after a skin incision, an endoprosthesis or a spacer of the hip joint is approached, non-viable tissues are excised, the endoprosthesis or spacer is dislocated, and the endoprosthesis or spacer is removed. That is followed by wound sanitation with the help of antiseptic solutions. Thereafter, an acetabular component is implanted according to the preoperative planning. Then, the medullary canal is treated and prepared for implantation of the femoral component and implantation of a cone-shaped leg, made with a polished surface for cement fixation, located on an area for a zone with pronounced bone tissue defects and osteoporosis zones, and press-fit fixation of the rest of the cone-shaped leg and the body, made with a porous surface for cementless fixation, intended for osteointegration. After polymerization of the bone cement and fitting, a standard type endoprosthesis head is installed, the femoral component of the endoprosthesis is repositioned, joint stability and range of motion are checked.

EFFECT: inventions provide the creation of the femoral component of the hip joint endoprosthesis, which provides the possibility of individual selection of the size of the component, selection of a suitable value of the neck-shaft angle, offset and anteversion of the neck, as well as adjustment of length of sections of its surface, intended for various methods of fixation, method of its manufacture and installation.

5 cl, 16 dwg, 2 ex