This work examines a biomechanical system consisting of the hip endoprosthesis and bones of the pelvic region of a person under a load corresponding to the equilibrium of a person in double-supported state. An assessment of the strength of a customised endoprosthesis has been carried out based on the analysis of the stress-strain state of the finite element model of the "skeleton-hip prosthesis" system when tightening the screws and when the system is subjected the person's weight; dangerous areas of the pelvic bone with high level of stresses have been identified. As recommendations, optimization of the location and number of screws used in order to create a more uniform stress distribution is proposed.
The article contains a biomechanical assessment of the performance of a customized endoprosthesis of the hip joint. Finite-element models of the hip bone and the implant in the projected and actual positions are prepared. The article provides the results of the static structural analysis for a patient in the two-leg standing position in the post-operative period. The results are compared for various implant positions. As a recommendation, it is proposed to optimize the location and the number of screws for a more uniform stress distribution.
Tumors of the nasal cavity and paranasal sinuses present a challenge to treat them. A combination of surgery and radiation therapy can improve treatment outcomes in 49-56% of patients with locally advanced nasal cavity and paranasal sinus cancer. The midface reconstruction poses a formidable challenge to the reconstructive surgeon due to the region’s complex skeletal and soft-tissue anatomy. The rehabilitation program including the reconstruction of the resected orbital walls using the porous and mesh implants from titanium nickelid (TiNi) was developed at the Cancer Research institute jointly with the Research Institute of Medical Materials. The technique was proven effective, allowing the natural position of the eye and visual function to be preserved in 90% of patients. A long period of reparative processes and risk of developing inflammation in the implant area, as well as the need to decrease length of surgery, contributed to the development of a novel approach to repairing the midface bone structures using the implant based on the microporous wire and TiNi mesh. Eighteen patients with nasal cavity and paranasal sinus cancer were treated using the combined thin implants. The novel technique allowed the time of the implant installation to be reduced to 5-10 minutes. The structure of the implant contributed to prevention of inflammatory processes in 97% of cases. Thus, the natural position of the eyeball and visual function were preserved in 100% of patients. The use of the TiNi implants in reconstructive surgery for patients with nasal cavity and paranasal sinus cancer led to reduced time of surgery and rehabilitation, increased level of social adaptation of patients and improved cosmetic and functional results.
At the Cancer Research Institute together with the Research Institute of Medical Materials and Tomsk State University, various types of implants from titanium nickelid (TiNi) were developed for the reconstruction of skull bone defects. Between 2000 and 2015, a total of 43 patients with malignant and benign calvarial and skull base tumors were treated. All patients underwent surgery alone or in combination with other treatment modalities. Fifty surgeries with primary reconstruction of calvarial and skull base defects using individually fabricated TiNi implants were performed. Our techniques for the reconstruction of postoperative skull bone defects appeared to be highly effective: restoration of supporting structures was achieved in 100% of cases, stability in 96% of patients, integrity and barrier function in 90% of cases. The TiNi implants have high mechanical strength and biocompatibility. No cases of fragmentation and rejection of the implants were registered.
Хирургическое вмешательство считается основным методом лечения злокачественных новообразований слюнных желез. Сложное устройство этой анатомической области, выраженность опухолевого процесса, близкое расположение ветвей лицевого нерва часто приводят к развитию осложнений в послеоперационном периоде. В статье описана методика устранения пареза мимической мускулатуры, обусловленного хирургической травмой лицевого нерва. Она включает курсы физиотерапии с применением магнитолазера и СКЭНАР-терапии по методике, разработанной в Научно-исследовательском институте онкологии Томского национального исследовательского медицинского центра РАН. Приведен клинический пример, иллюстрирующий особенности методики.
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