Burlaka V. Custom made endoprosthetic replacement in the treatment of tumors of the distal radius (experimental and clinical study).

Object: custom made endoprosthetic replacement of the distal radius after tumor resection. Purpose: to justify and develop the methodic of custom made endoprosthetic replacement for surgical treatment patients with tumors of the distal radius. Methods: clinical, radiological, patent information research, mathematical modeling using the finite element method, experiment on animals, histomorphological. The possibility of the custom made endoprosthetic arthroplasty for replacement of bone-joint defects of the distal radius after tumor resection was proved. For the first time proved that bones with oval and triangular cross-section can withstand more loading and effectively interact with endoprostheses with combined type of connection (intramedullary and extracortical) because they have ribs of stiffness. Use additional extracortical fixing of the implant can evenly distribute the loading in the area of implant attachment and significantly decrease loading in the area of implant - intramedullary stem transition. For the first time in animal experiments was determined that structural disorders of the articular cartilage in the contact with different coatings of implants less manifested in contact with polished alumooksid ceramic coating. First developed and clinically tested new custom made endoprostheses of the distal radius. Designs of these implantes were allowed excellent oncological and satisfactory functional results. Developed individual endoprosthesis of the distal radius (patents of Ukraine for useful model number 29221 and number 62018) allow to substitution of the same bone-joint defect after wide resection of the tumor. This in clinical applications allow to maximal preserve of the functions of the wrist joint, to reduce of postoperative immobilization and early functional restorate of the wrist joint and upper extremity in general. The proposed combined type of fixation of the prostheses is provide its strength and durability connection with bone and minimal risk of aseptic loosening of the implant. Using polished ceramic coating on the articular surface of the endoprosthesis is reduces the possibility and degree of degenerative changes in the proximal carpal bones. This allow to restore adequate limb loading with full painless function of the wrist joint and restore full ability work capacity for long term. The results of studies were introduced into clinical practice of the State institution "Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine", of departmets of public institutions of the Kharkiv public health "Regional clinical hospital - center of emergency medical help and catastrophe medicine", "Kharkiv regional traumatology hospital", public institution of the L'viv regional Soviet "West-Ukrainian specialized medical center", in educational process of chair of the traumatology and orthopaedics of Kharkiv National Medical University Ukrainian Ministry of Health, Public higher education institution " Uzhhorod National University" Ukrainian Ministry of Health and education. Traumatology and Orthopaedics.