METHOD OF TREATING PROGRESSIVE AND TUMOUR-LIKE FORMS OF SYNOVIAL CHONDROMATOSIS WITH GONARTHROSIS WITH DISSEMINATED DAMAGE INVOLVING COLLATERAL LIGAMENTS OF PATIENT'S KNEE JOINT Russian patent published in 2025 - IPC A61B17/56 

FIELD: medical science.

SUBSTANCE: invention refers to medicine, namely to traumatology and orthopaedics, and can be used for treating progressive and tumour-like forms of synovial chondromatosis accompanied by gonarthrosis accompanied by disseminated injury involving collateral ligaments of knee of a patient. With the patient in the prone position, an incision is made in the skin and subcutaneous fat from a posterior approach to a knee joint according to Trickey; using a Z-shaped incision, skin and subcutaneous fat layer are dissected. Fascia is dissected; a common peroneal nerve, then a tibial nerve, is separated and held in a traction suture. Popliteal vascular bundle is visualised, which is separated and brought to the lateral or medial side. Posterior capsule of the joint is approached, and the posterior capsule is excised together with free-lying or adhered surrounding tissues with the new growth. Synovial membrane is excised; collateral ligaments are resected; menisci, posterior and anterior cruciate ligaments, head of gastrocnemius muscle, soleus muscle are resected. Wound is washed with an antiseptic solution, a haemostasis is performed, a silicone drain tube is placed, the wound is closed in layers, and an aseptic dressing is applied. Elastic compression is performed. Extremity is fixed in an orthosis. Patient is erected on the second day. For 1-1.5 months, the patient wears the orthosis on the affected knee joint, moves with the help of crutches. Rehabilitation course is carried out with restoration of range of motions in affected knee joint to flexion 60°, extension 180°. Second stage of the surgical management follows 2 months later. Skin incision 14-15 cm long is performed in a patient lying on his/her back under spinal anaesthesia. Subcutaneous fat, fascia, muscles and joint capsule are incised. Anterior synovcapsulectomy is performed with removing chondromic bodies; menisci, an anterior cruciate ligament, collateral ligaments are resected; a fat body is resected. Incisional wound is washed. Joint ends and bone-marrow canals of femoral and tibial bones are treated. Knee joint replacement is performed with a revision coupled endoprosthesis. Silicone drain tube is placed. Wound is closed in layers, and an aseptic dressing is applied. Extremity is fixed. Rehabilitation measures are prescribed on 1st-2nd postoperative day. For 1-1.5 months, the patient wears an orthosis on the affected knee joint and moves with the help of crutches. In the late postoperative period, the patient is shown a rehabilitation course with the range of motions recovered in the involved knee joint.

EFFECT: method provides functional and motor recovery, higher rehabilitation potential, as well as higher quality of life ensured by preserving the anatomic position of the patient’s knee joint after the surgical management.

2 cl, 3 ex