RU1814886C - Method for fixation of prosthesis of craciate ligament of knee joint - Google Patents

Abstract

Usage: the invention relates to medicine, in particular to orthopedics and herbs2, and can be used in the surgical treatment of injuries of the ligamentous apparatus of the knee joint. An object of the invention is to securely fix the ends of an implant by preventing displacement of its ends. This goal is achieved by using a pin formed from the cortical part of the bone at the site of the passage for the ligament prosthesis having a feeding leg from the periosteum, pyramidal in shape, with a base 10 mm by 10 mm, 25 mm high, with the apex facing the medullary canal ..

Description

The invention relates to medicine, in particular to orthopedics and traumatology, and can be used in the surgical treatment of damage to the ligamentous apparatus of the knee joint.

The aim of the invention is to ensure reliable fixation of the implant by preventing the displacement of its ends.

The method is carried out as follows.

Under potentiated anesthesia, an incision is made in the skin and subcutaneous tissue in the area of the external epicondyle of the femur, preserving the periosteum as much as possible, a bone wedge with a base of 10 x 10 mm and a height of 25 mm with a pyramidal shape with the apex facing the bone marrow is formed with a narrow chisel.

channel. The wedge with the feeding flap is folded to the side, and through the obtained hole, a canal is drilled at a pre-calculated angle in the femoral and tibia bones through the joint cavity under the control of an arthroscope previously inserted into the joint cavity through one of the standard approaches. After determining the required length of the prosthesis, the latter is carried out through the channel using a conductor and fixed at the entrance with a pyramidal bone wedge on the feeding leg in the form of a spacer. The wound is sutured in layers. Postoperative management of the patient has no significant differences. Joint development begins on the 3rd day. Similarly, the ends of the prostheses are fixed on the tibia and the internal epicondyle of the femur.

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Example. Patient G. 22 lay. Diagnosis: closed rupture of the cruciate ligament of the knee joint, anterior instability, an injury a year ago. Under general anesthesia, an arthroscope was punctured into the joint cavity. Arthroscopy revealed complete rupture of the anterior cruciate ligament. In the area of the external epicondyle of the femur, an incision was made in the skin and subcutaneous tissue 3 cm long; With a narrow chisel, preserving the periosteum in the zone of passage of the supply vessel, a bone wedge with a base of 10 x 10 mm and a height of 25 mm and an apex facing the bone marrow canal is formed in a pyramidal shape. The wedge with the feeding flap is thrown to the side. Through the obtained hole, a canal was drilled with a drill under the control of an arthroscope through the femur into the joint cavity, the intercondylar elevation and metaphysis of the tibia. An additional incision of the skin and subcutaneous tissue with a length of 3 cm was made at the exit site of the drill from the tibia. Using the same bit, a similar wedge was formed with preservation of the feeding part of the periosteum, which was folded to the side. The necessary length of the prosthesis (lavsan tape) was determined. The latter, with the help of a conductor, is drawn through the received channel. The ends of the prosthesis are fixed with bone wedges on the feeding leg in the form of a spacer. At

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power of passive flexion. and the extensor movements in the joint, the fixation of the prosthesis was checked, stitches were put on the wound in layers. Rehabilitation began from the 3rd day and was completed by the time the sutures were removed on the 14th day. The function of the limb is complete. On control radiographs after 3 and 6 months restoration of bone structure.

Claims (1)

SUMMARY OF THE INVENTION A method for fixing a cruciate ligament prosthesis by forming channels in the articular ends of the femur and tibia, passing an implant through them, and then fixing its ends in the external parts of the canals, characterized in that. in order to ensure reliable fixation of the implant by preventing displacement of its ends, a graft is formed in the place of the planned outlet of the canal from the cortical part of the bone with a base of 10 x 10 mm, 25 mm high, pyramidal in shape, with the apex facing the bone marrow canal, the periosteum, then through the formed defect in the cortical layer a channel is formed under the control of an arthroscope, after the implant is passed through the channel, its ends are fixed by introducing the formed bone graft ata into the outer opening of the channel.