Skip to main content

1992NeverovVA_ShilnikovVA


Our translation of the patent for invention: NeverovVA, ShilnikovVA. Method for plastic surgery on the femoral head in applying hip joint endoprosthesis SU1743595 (1992). The original in Russian is available at the link: 1992НеверовВА_ШильниковВА.

 

SU1743595A1 USSR
Inventors: Valentin Aleksandrovich Neverov, Viktor Aleksandrovich Shilnikov
Worldwide applications 1990 SU
Application SU904822620A events:
1990-05-03 Application filed by Ленинградский Государственный Институт Для Дальнейшего Усовершенствования Врачей
1990-05-03 Priority to SU904822620A
1992-06-30 Application granted
1992-06-30 Publication of SU1743595A
Status:  Expired – Lifetime 

 

Method for plastic surgery on the femoral head in applying hip joint endoprosthesis

Valentin Aleksandrovich Neverov , Viktor Aleksandrovich Shilnikov

 

Abstract

Use: in medicine, namely in orthopedics for hip joint endoprosthetics. The purpose of the invention is to ensure the biomechanics of the joint by preserving the fat pad of the acetabulum. The essence of the invention: a channel is formed in the head, a tape is passed around the transverse ligament of the acetabulum, then through the head channel, and its ends are fixed in the natural attachment site by wedging using quick-hardening plastic.

 

Description

The proposed method relates to medicine, namely to surgical methods of treating the musculoskeletal system.

A known method of surgery on the femoral head ligament consists of strengthening the cut end of the ligament to the iliac muscle through an opening in the center of the bottom of the glenoid cavity. Another method consists of cutting the ligament from the head and applying tendon sutures according to Cuneo, then fixing the threads to the greater trochanter through a drilled channel in the head.

The disadvantage of these methods is that they cannot be used for endoprosthetic replacement of the femoral head. A method for forming a femoral head ligament during endoprosthetics is known, which consists in that the endoprosthesis is fixed in the acetabulum and in the femur with an artificial ligament, for example, a lavsan tape, passed through a channel in the head, neck of the endoprosthesis and in the proximal end of the femur and fixed on one side in the acetabulum, and on the other side - in the subtrochanteric region. In this case, one end of the ligament with a dumbbell-shaped stop is placed in the cavity of the small pelvis through an opening made in the fossa of the glenoid cavity.

The disadvantage of the known method is that it does not ensure the restoration of the biomechanics of the joint, since one end of the artificial ligament is attached to the bottom of the acetabulum, which does not correspond to the normal anatomy of the hip joint, and the other - through the channel of the endoprosthesis head, made in an arbitrarily chosen place, and not in accordance with the place of attachment of the natural ligament to a specific replaced femoral head. Thus, this method can only perform the fixing function of the ligament, but is not capable of restoring the biomechanics of the joint.

In addition, when forming a hole in the glenoid fossa, the fat pad, which contains a large number of vessels, is damaged, and the body itself, being covered with a synovial membrane, under normal conditions helps supply the joint with synovial fluid. Therefore, this method increases the trauma of the operation, helps reduce the sliding of rubbing surfaces, disrupts the supply of articular cartilage with a nutrient medium and creates conditions for the penetration of infection into the pelvic cavity in the case of a purulent complication.

The purpose of the invention is to restore the biomechanics of the joint by preserving the fat pad of the acetabulum.

This goal is achieved by preserving the fat pad, and the connection of the head and the acetabulum is made with an artificial ligament, passed around the transverse natural ligament, which is then fixed to the head of the endoprosthesis at the site of their natural connection, by wedging using a quick-hardening polymer, from which the endoprosthesis is made. The proposed attachment points of the artificial ligament, corresponding to their natural attachment site, with preservation of the fat pad of the acetabulum, ensure restoration of the biomechanics of the joint, a reduction in the trauma of the operation and an increase in the reliability of the fixing function of the artificial ligament of the hip and thereby achieving the purpose of the invention.

Example. Patient N., 61 years old, was admitted on 2.2.90 with the diagnosis: pseudoarthrosis of the neck of the right femur. The patient underwent endoprosthetic replacement of the right hip joint according to Vorontsov with the formation of an artificial ligament of the femoral head, which consisted of the following.

Using one of the known approaches to the hip joint, an incision was made in the soft tissues, the joint capsule was opened. Using scissors, the ligament was cut at the place of its attachment to the head of the femur. Then the head was dislocated from the acetabulum, the femoral neck was resected at the level of its base. A head made of quick-hardening plastic was welded onto a titanium-acrylic blank (the stem of the endoprosthesis) made the day before. A cast of the removed head of the femur was used as a mold. On the head of the endoprosthesis made in this way, a fossa is clearly visible - the place of attachment of the ligament of the head of the femur, through which a channel with a diameter of 5 mm was made using an electric drill so that its external opening came out on the upper surface of the neck of the endoprosthesis at the place of its transition to the head. From the side of the external opening, the channel is drilled in the form of a cone with the base outward. The stem of the endoprosthesis is inserted into the medullary canal of the femur. In the lower part of the acetabulum, through its notch under the transverse ligament, a lavsan tape is passed using a clamp, the ends of which are brought together in the form of a loop around the transverse ligament. The lavsan tape-ligament is passed through the channel into the head of the endoprosthesis with a wire guide. The head of the endoprosthesis is reduced to the acetabulum. In the adducted position of the limb, the ends of the lavsan tape are stretched and spread apart, and a plastic wedge is inserted between them; to the surface of which a quick-hardening plastic of a doughy consistency (acryloxide) is preliminarily applied. After polymerization of acryloxide and strong fixation of the femoral head ligament in the tension position, the remaining ends of the lavsan tape are excised, the joint capsule is sutured (Drainage). Layered wound suture, aseptic dressing. Limb immobilization was not used. On the second day, physiotherapy exercises were started, on the fourth day, sitting in bed with lowered legs is allowed. The stitches were removed on the 12th day and from this time on, walking with crutches with dosed support on the operated limb is allowed. Two months after the operation, he walks with a cane, has practically no complaints, and takes care of himself completely.

Claims

A method for plastic surgery of the femoral head ligament during joint endoprosthetics by forming a channel in the head, passing a tape through the head with fixation to the acetabulum, characterized in that, in order to ensure the biomechanics of the joint by preserving the fat body of the acetabulum, the tape is passed around the transverse ligament of the acetabulum, its ends are fixed in the natural attachment site by wedging using quick-hardening plastic.

Non-Patent Citations

Ортопедия, травматология, протезирование, 1989, № 12, с. 57-58.


 

External links

Неверов ВА, Шильников ВА. Способ пластики связки головки бедренной кости при эндопротезировании тазобедренного сустава. SU1743595, от 3 мая 1990. Бюл. № 24, 30.06.1992. patents.su

Neverov VA, Shilnikov VA. Method for plastic surgery on the femoral head in applying hip joint endoprosthesis (Способ пластики связки головки бедренной кости при эндопротезировании тазобедренного сустава) SU1743595А1 May 3, 1990. 1992. patents.google.comEN , patents.googleRU


Authors & Affiliations

Valentin Aleksandrovich Neverov – traumatologist-orthopedist, PhD (1990), Saint Petersburg, Russia. rosturner.ru

Viktor Aleksandrovich Shilnikov – traumatologist-orthopedist, PhD, Saint Petersburg, Russia. rniito.ru


Keywords

ligamentum capitis femoris, ligamentum teres, ligament of head of femur, endoprosthesis, prosthesis, invention, unipolar, subtotal


                                                                    

NB! Fair practice / use: copied for the purposes of criticism, review, comment, research and private study in accordance with Copyright Laws of the US: 17 U.S.C. §107; Copyright Law of the EU: Dir. 2001/29/EC, art.5/3a,d; Copyright Law of the RU: ГК РФ ст.1274/1.1-2,7


ENDOPROSTHESES AND IMPLANTS


Labels:

Comments

Post a Comment

Popular posts from this blog

Test catalog of the LCF pathology

  Test catalog of the ligamentum capitis femoris pathology By Sergey V. Arkhipov, MD, PhD     CONTENT [i]   Abstract [ii]   Introduction [iii]   Testing in the supine position [iv]   Testing in a standing position [v]   Gait study [vi]   References [vii]   Application [i]   Abstract A description of tests for the detection and differential diagnosis of ligamentum capitis femoris (LCF) pathology is presented. [ii]   Introduction One of the first studies devoted to the diagnosis of LCF injury demonstrated a variety of symptoms: groin pain, hip stiffness, sometimes long-standing minimal clinical findings, or signs similar to osteoarthritis (1997GrayA_VillarRN). More than a decade later, researchers concluded: "Unfortunately, there is no specific test for detecting LCF tears." The signs known at that time were nonspecific and were also observed in other intra-articular pathologies of the hip joint (2010CerezalL_Pérez-CarroL). The a...
Post a Comment
Read more

Who, When, and Where Wrote the Book of Genesis?

  Who, When, and Where Wrote the Book of Genesis?  A Medical Hypothesis By Sergey V. Arkhipov, MD, PhD & Lyudmila N. Arkhipova, BSN     CONTENT [i]   Abstract [ii]   Introduction [iii]   Egyptian physician [iv]   Asian diviner [v]   Conclusion [vi]   References [vii]   Application [i]   Abstract The Book of Genesis is an example of an ancient literary text that contains important medical insights. We propose that it was written in northern Egypt in the late 17th century BCE, approximately ten years after the Minoan eruption. The protograph likely emerged from the collaboration between an Asiatic seer, who rose to the rank of an Egyptian official, and an Egyptian physician-encyclopedist. By refining its dating and authorship, this hypothesis positions Genesis as a credible source of medical and historical data, thereby enhancing its value for interdisciplinary research. [ii]   Introduction According to Rabbinic Judais...
Post a Comment
Read more

Catalog. LCF of Extinct Species

Discussion of the LCF and morphological signs of its existence in extinct species.   Funston, G. F. (2024). Osteology of the two-fingered oviraptorid Oksoko avarsan (Theropoda: Oviraptorosauria). Zoological Journal of the Linnean Society, zlae011. [ academic.oup.com ] Hafed, A. B., Koretsky, I. A., Nance, J. R., Koper, L., & Rahmat, S. J. (2024). New Neogene fossil phocid postcranial material from the Atlantic (USA). Historical Biology, 1-20. [ tandfonline.com ] Kuznetsov, A. N., & Sennikov, A. G. (2000). On the function of a perforated acetabulum in archosaurs and birds. PALEONTOLOGICAL JOURNAL C/C OF PALEONTOLOGICHESKII ZHURNAL, 34(4), 439-448. [ researchgate.net ] Romer, A. S. (1922). The locomotor apparatus of certain primitive and mammal-like reptiles. Bulletin of the AMNH; v. 46, article 10. [ digitallibrary.amnh.org  ,  digitallibrary.amnh.org(PDF) ]    Słowiak, J., Brusatte, S. L., & Szczygielski, T. (2024). Reassessment of the enigmati...
Post a Comment
Read more

18th Century

  18th Century Catalog of archived publications of the specified period        1700-1709 1705PetitJL  The author writes about anatomy, role, and damage of the LCF in hip dislocation.  1705RuyschF  The author  describes the anatomical preparation containing the LCF, notes its areas of attachment, geometric and mechanical properties.  1706PolluxJ   The author refers to LCF as "νεῦρον" and also points out the synonym "ἰσχίον". 1709PetitJL   The author discusses the anatomy, role and damage of the LCF in hip dislocation, and also mentions the principle of treatment.  1710-1719 1715MunnicksJ   The author describes the attachment, shape, role of the LCF, and discusses subluxation of the hip. 1717HermannD  The author indicates the distal area of attachment of the LCF and uses a rare synonym. 1720-1729 1720RuyschF  The author draws attention to the well-developed blood supply of the acetabular fossa, as well as the ...
Post a Comment
Read more

1836-1840PartridgeR

  «Prof. Partridge in his lectures on anatomy at King's College was accustomed to compare the Ligamentum Teres, in its function, to the leathern straps by which the body of a carriage is suspended on springs » ( 1874SavoryWS ). Perhaps Nikolai Pirogov listened to these lectures ( 1859PirogoffN ).   The analogy that Richard Partridge used could have arisen after reading the monograph Bell J. The Principles of Surgery (1801) . In it, the author depicted a cart and a pelvis resting on the head of one and two femurs. However, there is no mention of ligamentum capitis femoris (LCF) in the chart descriptions. References Savory WS. On the use of the ligamentum teres of the hip joint. J Anat Physiol. 1874;8(2)291-6.    [ ncbi.nlm.nih.gov  ,    archive.org ] Pirogoff N. Anatome topographica sectionibus per corpus humanum congelatum triplici directione ductus illustrate. Petropoli: Typis Jacobi Trey, 1859.   [ books.google  ,   archive.org ] ...
Post a Comment
Read more

Key Role of the LCF

  In the experiments conducted on the pelvis-femur-muscle-ligaments model, we found that when the contralateral pelvic drop occurs, the ligament of the head of femur become maximally tense; simultaneously, there is relaxation and lengthening of the gluteus medius muscle; the pelvis spontaneously rotates towards the stance limb (forward), and the load on the hip joint decreases. Thanks to the functioning of the ligament of the head of femur the walking is smooth, rhythmic, and energy-efficient. Track Music:  Blue Dot Sessions , Vittoro (CC BY-NC 4.0 DEED / fragment)  "Take care of the ligament of the head of femur for yourself and your neighbor!" .                                                                       . keywords: ligamentum capitis femoris, ligament of head of femur, ligamentum te...
Post a Comment
Read more

2025ChenJH_AcklandD

  The article by Chen JH, Al’Khafaji I, Ernstbrunner L, O’Donnell J, Ackland D. Joint contact behavior in the native, ligamentum teres deficient and surgically reconstructed hip: A biomechanics study on the anatomically normal hip (2025). The authors experimentally demonstrated the role of the ligamentum capitis femoris (LCF) in unloading the upper sector of the acetabulum and the femoral head. The text in Russian is available at the following link: 2025ChenJH_AcklandD . Joint contact behavior in the native, ligamentum teres deficient and surgically reconstructed hip: A biomechanics study on the anatomically normal hip By  Chen JH, Al’Khafaji I, Ernstbrunner L, O’Donnell J, Ackland D.     CONTENT [i]   Abstract [ii]   Introduction [iii]   Materials and methods [iv]   Results [v]   Discussion and Conclusion [vi]   References [vii]   Application [i]   Abstract Background The ligamentum teres is known to contribute to hip joint st...
Post a Comment
Read more

MYTHS AND MISCONCEPTIONS

  MYTHS AND MISCONCEPTIONS ( Erroneous and folkloric beliefs, folk and traditional stories...)  LCF in English Bibles   The first written mention of the LCF in humans is found in the  ancient Hebrew book – Bereshit (Genesis). In English translations of the Bible, LCF is denoted by various terms, often not explicitly referring to the «ligament».  The Shortest Comments on Genesis, Chap. XXXII-XXXIII  In the selected excerpt, the symptoms, mechanism, and differential diagnostic test for the injury to LCF are provided, along with details about the circumstances, time, and place of the biblical trauma.  1609-1583bcProtoBereshit  Hypothesis: in the work of fiction, an unknown physician-encyclopedist for the first time pointed out damage to the LCF as a cause of gait disturbance.  922-722bcElohist  A variant of the oldest description of damage to the LCF and the cause of lameness in Hebrew, dating from 922-722 BC.  8cent.bcHomer   The...
Post a Comment
Read more

2012KomistekRD

    Invention (Patent Application Publication): Komistek RD. Maintaining proper mechanics THA.  US20120221115A1  (2012).   US20120221115A1 US Inventor: Richard D. Komistek Current Assignee: DePuy Ireland ULC Worldwide applications 2011 US 2012 AU CN EP WO EP EP CN EP JP 2013 ZA 2015 US 2016 AU JP US 2018 US AU Application US13/034,226 events: 2011-02-24 Priority to US13/034,226 2011-02-24 Application filed by Individual 2012-08-30 Publication of US20120221115A1 2015-05-05 Publication of US9023112B2 2015-05-05 Application granted Status: Active 2031-02-24 Anticipated expiration   Maintaining proper mechanics THA Richard D. Komistek   Abstract A prosthetic hip joint comprising: (a) a femoral component including a femoral head; and, (b) an acetabular component including an acetabular cup and an acetabular cup insert, the acetabular cup insert sized to receive the femoral head, where the femoral head is sized to have a spherical center that matches a sph...
Post a Comment
Read more

Congenital Hip Dislocation. Pathogenesis

  An original view on the pathogenesis of congenital hip dysplasia, congenital dislocation and subluxation of the hip. One example of the importance of ligamentum capitis femoris (LCF) and the influence of a mechanical factor on living systems is a group of diseases of the hip joint such as congenital hip dysplasia, congenital subluxation and congenital hip dislocation. The last of these pathological conditions is an extreme degree of severity of the previous two. Common to these pathological conditions is the presence of connective tissue dysplasia syndrome of varying severity. It is based on a decrease in the strength and elasticity of connective tissue structures. The consequence of this is that a standard load, for example, on ligaments causes their plastic deformation: thinning, elongation, and in some cases, rupture. This occurs due to both mechanical and biological processes (for more details, see the  Law of Bioinduction ). If, in connective tissue dysplasia syndr...
Post a Comment
Read more