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

LCF in 2025 (December)

  LCF in 2025 ( December)   (Quotes from articles and books published in  December  2025 mentioning the ligamentum capitis femoris)   Sarassa, C., Aristizabal, S., Mejía, R., García, J. J., Quintero, D., & Herrera, A. M. (2025). Intraosseous Tunneling and Ligamentum Teres Ligamentodesis “Teretization” to Enhance Stability in Congenital Hip Dislocation Surgery: Surgical Technique and Mid-Term Outcomes. Journal of Pediatric Orthopaedics , 10-1097.   [i]      journals.lww.com   Kampouridis, P., Svorligkou, G., Spassov, N., & Böhme, M. (2025). Postcranial anatomy of the Late Miocene Eurasian hornless rhinocerotid Chilotherium. PLoS One , 20 (12), e0336590.     [ii]      journals.plos.org   Burdette, T. N., Hsiou, C. L., McDonough, S. P., Pell, S., Ayers, J., Divers, T. J., & Delvescovo, B. Sidewinder syndrome associated with complete rupture of the ligamentum capitis ossis femoris in a horse. Eq...
Post a Comment
Read more

IMPROVING POSTOPERATIVE COMFORT...

  Improving Postoperative Comfort and Increasing the Reliability of Hip Prostheses by Supplementing with Artificial Ligaments: Proof of Concept and Prototype Demonstration S.V. Arkhipov, Independent Researcher, Joensuu, Finland       CONTENT [i]   Abstract [ii]   Introduction [iii]   Materials and Methods [iv]   Results and Discussion [v]   Static Tests [vi]   Dynamic Tests [vii]   Prototype Fabrication and Testing [viii]   Conclusion [ix]   References [x]   Application [i]   Abstract The principle of operation of an experimental total hip endoprosthesis augmented with ligament analogs has been demonstrated in single-leg vertical stances and at the mid-stance phase of the single-support period of gait. The experiments were conducted on a specially designed mechatronic testing rig. The concept of the important role of the ligamentous apparatus is further illustrated by a set of demonstrative mechanical models. The...
Post a Comment
Read more

2008DoddsMK_McCormackD

  Content [i]   Annotation [ii]   Original text [iii]   References [iv]   Source  &  links [v]   Notes [vi]   Authors & Affiliations [vii]   Keywords [i]   Annotation Abstract of the article: Dodds MK et al . Transarticular stabilization of the immature femoral head: assessment of a novel surgical approach to the dislocating pediatric hip in a porcine model (2008). The article describes an experiment of reconstruction of ligamentum capitis femoris (LCF) in pigs with the formation of a femoral tunnel. The text in Russian is available at the following link:  2008DoddsMK_McCormackD . [ii]   Original text Abstract Background: Acetabular dysplasia and hip instability are common in neuromuscular diseases such as spina bifida and cerebral palsy due to deranged muscle function around the hip. Occasionally in developmental dysplasia of the hip, persistent instability may be difficult to manage by standard treatments. It i...
Post a Comment
Read more

NEWS 2026

New publications of our resource   in 2026 The initial phase of collecting data on LCF, accumulated prior to the 20th century, is largely complete. Next, we plan to analyze and synthesize thematic information, adding data from the 20th and 21st centuries. The work will focus primarily on: prevention, diagnosis, arthroscopy, plastic surgery, and endoprosthetics.  January 05, 2026 2018YoussefAO The article describes a method for transposition of the proximal attachment of the LCF in congenital hip dislocation.   2007WengerD_OkaetR The authors demonstrated in the experiment that the strength of the LCF is sufficient to ensure early stability during hip joint reconstruction in children. January 04, 2026 2008 BacheCE _TorodeIP The article describes a method for transposition of the proximal attachment of the LCF in congenital hip dislocation .  2021PaezC_WengerDR The ar ticle analyzes the results of open reconstruction of LCF in dysplasia.   2008DoddsMK...
Post a Comment
Read more

1970MichaelsG_MatlesAL

  Content [i]   Annotation [ii]   Original text [iii]   References [iv]   Source  &  links [v]   Notes [vi]   Authors & Affiliations [vii]   Keywords [i]   Annotation Abstract of the article: Michaels G, Matles AL. The role of the ligamentum teres in congenital dislocation of the hip (1970). The authors proposed an analogy for the role of the ligamentum capitis femoris (LCF) as a “ball and chain control” and noted that it can spontaneously reduce congenital hip dislocation. The text in Russian is available at the following link: 1970MichaelsG_MatlesAL . [ii]   Original text Quote p. 199 Many papers in the literature have implicated the ligamentum teres as a hindrance to the late open reduction of a congenitally dislocated hip. Occasionally the ligamentum teres has been reported to be absent. However, in most cases it is hypertrophied and elongated. Our present knowledge confirms the fact that congenital dislocation of t...
Post a Comment
Read more

1724FabriciusJA

Fragments from the book Fabricius JA. Bibliothecae Graecae volume duodecimum (1724). The author quotes the Byzantine physician Theophilus Protospatharius, who supposedly lived between the 7th and 10th centuries. Selected passages provide views on the normal anatomy of the ligamentum capitis femoris (LCF) and its inherent connective function.   [Grc] θεοφιλος ο Πρωτοσπαθάριος . Περὶ τῆς τοῦ ανθρώπου κατασκευῆς . Βιβλιον Ε . XIII, [p. 892] (see fig.) [Lat] Theophilus Protospatharius. De corporis humani fabrica, Liber quintus, Cap. XIII [p. 892] 1) Dei erga homines amor ex heminae fundo teretem nervum promisit, cartilaginosum vinculum femoris capiti insertum adstringensque, ne facile elabatur:» 2) inde ex heminae oris aliae copulae oriuntur, totum femoris caput in orbem constringentes, non teretes & solae, qualis quae ex fundo porrigitur, sed latae, valenter que heminae oras ad commissurae praesidium ambientes.   Translation [Eng] 1) For the sake ...
Post a Comment
Read more

1883SuttonJB

  According to the author, the ligamentum capitis femoris (LCF) is a tendon of the pectineus muscle, separated from it in consequence of skeletal modifications.   THE LIGAMENTUM TERES By J. B. SUTTON, Demonstrator of Anatomy, Middlesex Hospital. (PLATE VIII.) The round ligament of the coxo-femoral articulation has long been an anatomical puzzle, consequently many diverse notions exist concerning it. Some anatomists ascribe to this hollow band of fibrous tissue very important functions in the mechanism of the hip-joint; others deprive it of all glory, simply assigning to it the menial duty of conveying blood-vessels to the head of the femur. Certain authors content themselves with a brief description of its attachments; others give elaborate and detailed accounts, extending over several pages, of its anatomy and supposed function. My object in the present communication is to show that this singular ligament is nothing more than the tendon of the pectineus muscle, sepa...
Post a Comment
Read more

2012FrederickP_KelmanDC

   Invention (Patent): Frederick P, Belew K, Jasper L, Gatewood J, Gibson L, Masonis J, Cooper M, Kelman DC. Methods and apparatus for FAI surgeries.  US20120283840A1   (2012).   US20120283840A1 US Inventors: Phillip Frederick, Kevin Belew, Lauren Jasper, James Gatewood, Luke Gibson, John Masonis, Michael Cooper, David C. Kelman Current Assignee: Smith and Nephew Inc Worldwide applications 2010 KR JP RU BR CA US CN EP CN WO AU 2014 US 2016 AU 2017 AU Application US13/202,612 events: 2010-02-25 Заявка подана Smith and Nephew Inc 2010-02-25 Приоритет US13/202,612 2012-11-08 Публикация US20120283840A1 2014-12-02 Заявка удовлетворена 2014-12-02 Публикация US8900320B2 Статус: Активный 2031-06-08 Измененный срок действия   Methods and apparatus for FAI surgeries Phillip Frederick, Kevin Belew, Lauren Jasper, James Gatewood, Luke Gibson, John Masonis, Michael Cooper, David C. Kelman   Abstract A partial rim implant for an acetabulum in a pelvic bone comprise...
Post a Comment
Read more

2011HosalkarHS_WengerDR

  Content [i]   Annotation [ii]   Original text [iii]   References [iv]   Source  &  links [v]   Notes [vi]   Authors & Affiliations [vii]   Keywords [i]   Annotation Abstract of the article: Hosalkar HS et al . Isocentric reattachment of ligamentum teres: a porcine study (2011). The article describes a method of isocentric fixation of the proximal end of the ligamentum capitis femoris (LCF) during plastic surgery in an experiment on pigs. The text in Russian is available at the following link: 2011HosalkarHS_WengerDR . [ii]   Original text Abstract Background: Recent reports reveal interest in the mechanical importance of ligamentum teres (LT) in hip dislocation. In the previously established procedure of anteroinferior acetabular LT reattachment in developmental dysplasia of the hip, the LT functions as a check-rein, showing promising results. However, this position of reattachment could potentially limit motion. Th...
Post a Comment
Read more

2008WengerDR_MiyanjiF

  Article: Wenger DR et al. Ligamentum teres maintenance and transfer as a stabilizer in open reduction for pediatric hip dislocation: surgical technique and early clinical results (2008). The article describes a method of open reconstruction of the ligamentum capitis femoris (LCF) for hip dysplasia. The text in Russian is available at the following link: 2008WengerDR_MiyanjiF . Ligamentum teres maintenance and transfer as a stabilizer in open reduction for pediatric hip dislocation: surgical technique and early clinical results   Wenger DR, Mubarak SJ, Henderson PC, Miyanji F   CONTENT [i]   Abstract [ii]   Introduction [iii]   Materials and Methods [iv]   Surgical technique & Results [v]   Discussion & Conclusion [vi]   References [vii]   Application [i]   Abstract Purpose The ligamentum teres has primarily been considered as an obstruction to reduction in children with developmental dislocation of the hip (DDH). In the ea...
Post a Comment
Read more