Patent RU-2711608-C1 (RU)
Title: Method for manufacturing articulating reinforced cement antibacterial knee joint spacer
Inventor: Bova Sergej Ivanovich
IPC: A61F2/38
Filed: 2018-12-24
Granted: 2020-01-17
Abstract: FIELD: medicine.SUBSTANCE: invention refers to medicine, namely to traumatology and orthopedics, purulent surgery. Method of producing articulating reinforced cement antibacterial tibial component of a spacer consists in the fact that from bone cement with antibiotics intraoperatively producing a tibial component of a spacer, consisting of two aligning elements, one of them is an intraoperative solid mushroom figure, reinforced in a vertical and horizontal portion of a curved Kirschner pins of 1.8 mm in diameter, second element is an insert repeating the shape of the articular bone element. Ratio of the area of the reinforced horizontal part of the tibial element of the spacer to the total area of the horizontal part of the tibial element of the spacer shall be not less than 1/2, provided that the horizontal part of the reinforcing element itself shall be immersed into the bone cement massif at least 3 mm from above and from below. When the cement reaches the application phase, the prepared reinforcing wire is provided with a predefined shape and with the maximum bent knee joint. Vertical part of the tibial element of the spacer is inserted into the intramedullary canal of the tibia during the bone cement hardening phase, which allows cement to be moderately integrated into bone tissue and to fill shinbone defects caused by debridement. Perpendicular ratio of the plane of the horizontal portion of the tibial of the spacer to the shin axis is imparted. Form and volume of plateau are formed. Bone cement excess is removed. Further, on the horizontal part of the tibial element of the spacer, at least 20 depressions with a diameter and depth of 2 mm are formed at a distance of at least 5 mm from the edge of the horizontal portion of the tibial element of the spacer for subsequent connection with the spacer cement insert. After bone cement polymerisation, the knee joint is bent, the height of free space between the installed components of the spacer is evaluated, from the bone cement dose with addition of the required antibiotic an oval spacer insert is formed. In the phase of bone cement application, the formed insert of the spacer is laid on the horizontal part of the shin-bone element of the spacer; at that, the cement is integrated into the previously formed cavities. Knee joint is unbent, then bent again 2 times, which gives to the articulating surface of the insert the maximum correspondence of the surface of the femoral component and the required height is formed, which does not limit movements in the joint. Extraction of excess cement is removed, knee joint is unbent and held in stretched state until bone cement is heated, after which moderate compression is performed until complete polymerisation of cement.EFFECT: invention provides treating a deep periprosthetic knee joint infection, improving the patient's life quality during the second stage of re-prosthesis repair, reducing the frequency of possible intra- and postoperative complications associated with instability of the knee joint spacer and its mechanical destruction.1 cl, 8 dwg, 2 ex