Development of endoprosthesis of larger joints

10 years ago at the Institute of Traumatology and Orthopedics of AMS Ukraine on the basis of clinical departments of orthopedy and traumatology for adults and joint diseases in adults, the Republican Centre of joint endoprosthetics was organized that became clinical training base for all the orthopedists of Ukraine, and established close contacts with specialists of USA, Switzerland, Austria, Poland, Russia, countries of Baltic etc.

For 10 years there were performed 3412 joint endoprosthetics out of which the number of operations on the hip joint was 2807, on the knee joint - 534, on the elbow joint - 12.

During that period there were 208 revision endoprosthetics, out of which in 157 patients the primary endoprosthetics was performed at the Institute of Traumatology and Orthopedics, and in 51 patients - at the other orthopedic departments.

Since 1996 the Centre began to make total endoprosthetics of knee joints, since 2001- elbow and shoulder joints. The amelioration of the work of the Centre of Endoprosthetics was achieved by tenders on centralized

purchase of total endoprostheses and instrumentation for their implantation since 2002 by MPH of Ukraine.

It should be marked for comparison that if at the start of the Centre of endoprosthetics foundation, 150-250 endoprostheses were implanted average yearly, in 2004 there were 530, and in 2005 - 640.

It should be separately pick out the very complicated department of endoprosthetics development - it is revision endoprosthetics. With every year the number of revision endoprosthetics is increased, and they need significant material expenses connected with the acquirement of revision or individual endoprostheses, materials for bone plasty etc.

As our observations have shown, the first problems with the implanted endoprostheses arise average 7-8 years later after the operation. So, out of 3412 endoprosthetics that were made at the Centre of revision endoprosthetics, the revision endoprosthetics were subjected to 157 patients, that put together 4,6 %.

To perform the revision endoprosthetics, it is necessary to organize 3-4 regional centres in Ukraine where the necessary implants, materials for bone plasty should be concentrated, and to train highly qualified specialists.

Gayko G.V., Gerasimenko S.I., Polulyakh M.V., Torchinsky  Institute of Traumatology and Orthopaedics of AMS Ukraine, Kyiv

 

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