The dissertation is devoted to the optimization of surgical treatment of patients with bone tumors using a material based on bioactive glass.
Until recently, the problem of treatment of benign and malignant bone tumors remains relevant. The main method of treatment of benign tumors and tumor-like bone diseases is a surgical one: removal of the tumor followed by filling the bone defect with a graft or implant, and in pathological bone fracture on the background of the tumor, metallic osteosynthesis is additionally used. Taking into account the fact that after osteoplastic surgery using alloplasty and autoplasty there has been observed a high percentage of post-surgery complications and rejection of plastic material, it forced researchers to look for new materials to replace bone defects. Malignant bone tumors are usually treated comprehensively, and surgical treatment is one of the stages of such treatment. Surgical treatment of malignant bone tumors in 90% of cases is provided by endoprosthesis replacement of joints or bones. It is known that the use of endoprostheses and implants without special coatings does not always provide reliable fixation. In most cases, after removal of malignant tumors, cemental endoprosthesis replacement is used, but in some cases, usage of cementless endoprosthesis replacement is possible. Improving the fixation of metal endoprostheses and implants in bone tissue is achieved by covering their surface with osteointegration material. Recently, a variety of biological implants have been proposed: organic, inorganic and synthetic materials to replace bone defects, as well as materials to cover the surface of implants. In this case, each of them has its advantages and disadvantages. The current stage of development of reconstructive surgery poses an urgent task of developing materials that can serve as a supporting structure for the regeneration of damaged bone, at the same time, gradually decomposing and being replaced with the patient`s own tissues, at that stimulating osteogenesis. Materials based on bioactive glass and their modifications have become widespread among the implantation materials. In this regard, conducting an experimental-clinical study to determine the effectiveness of osteoreparative properties of the material based on bioactive glass in plasty of bone defects after having excised bone tumors, and features of tissue structure at the boundary “bone – implant”, formed by using coating materials based on bioactive glass, which are still poorly understood, represents a very important way to improve surgical service. A new modification of the material based on bioactive glass in surgery (osteoplastic surgery, metallic osteosynthesis, endoprosthesis replacement) regarding bone tumors has not yet been used, clinic-roentgenological features of the healing of material based on bioactive glass with bone have not been identified, local and general impact of material based on bioactive glass on the patient's body has not been studied, morphological reconstruction of bone tissue at the site of implantation of material based on bioactive glass has not been studied, timing of recovery of limb function has not been defined in patients with bone tumors after osteoplastic surgery using material based on bioactive glass, endoprosthesis replacement and metallic osteosynthesis using coating of the implant surface with a material based on bioactive glass, no indications and contraindications to the use of material based on bioactive glass in these operations have been developed. There is reason to believe that the use of domestic material based on bioactive glass in osteoplastic surgery after excising bone tumors, and the use of endoprosthesis replacement and metallic osteosynthesis using coating of the implant surface with a material based on bioactive glass may reduce postoperative complications, reduce period, required for medical rehabilitation, and recovery period of limb function in the operated patients.
Purpose of the study: Improving the results of treatment of patients with bone tumors based on the development and justification of surgical technologies for the replacement of bone tissue defects using a material based on bioactive glass and implants and endoprostheses with deposited on their surface material based on bioactive glass.
