METHOD OF KNEE ARTHRODESIS IN CONDITIONS OF PERIPROSTHETIC INFECTION AND PRESENCE OF BONE DEFECTS Russian patent published in 2025 - IPC A61B17/72 A61F2/38 

FIELD: medical science.

SUBSTANCE: invention refers to medicine, namely to traumatology and orthopaedics, and can be used for knee arthrodesis in conditions of periprosthetic infection and presence of bone defects. Method includes installation of intramedullary rod in femoral and tibial bones and bone grafting. Individual blocked intramedullary nail is inserted, and bone defects are repaired with a titanium cage. Operation is preceded with computed topogram of lower extremities. Individual parameters of the patient’s extremity are determined, which are used to make a blocked intramedullary nail, a titanium cage is selected, proportionate to the length of the bone defect. Simulating resection of non-viable ends of bones is carried out before blood "dew". Surgical approach is performed in the femoral bone above a greater trochanter in a sagittal plane, through which a locked nail is inserted into a femoral canal. Titanium cage resting on an end of the femoral bone is put on a distal end of the nail extending from the femoral canal. Titanium cage is positioned in relation to a tibial defect bed to ensure a maximum contact area of the implant edges with the bone tissue. Space between the cage and the intramedullary nail is filled with a ground cortical spongy autograft. At the level of a distal tibial metadiaphysis, the nail is locked with two screws in a mutually perpendicular direction. Compression is performed until the titanium cage is immersed into the ends of the femoral and tibial bones, followed by proximal blocking of the nail with two screws. In the postoperative period, if observing the signs of fibrous or bone-fibrous ankylosis, the proximal screw blocking the nail in the femur is removed.

EFFECT: method provides arthrodesis of knee joint with creation of conditions for formation of stability for transfer of cyclic loads and bone fusion with achievement of ankylosis without considerable shortening of extremity due to removal of endoprosthesis components and installation of cement spacer with antibiotic, forming a hole at the level of a distal tibial metadiaphysis before inserting the intramedullary nail to reduce intracanal pressure and prevent systemic complications, as well as blocking titanium cage and intramedullary nail fixation.

1 cl, 9 dwg, 1 ex