Prostheses will be printed in the University clinic

Doctors of Trauma Department No 2  of the Pirogov Clinic specialise in foot surgery, arthroscopy of knee, shoulder and ankle joints. They also perform neurosurgeries in cases of spine degenerative diseases and endoprosthesis replacement. A new promising focus area of the department is hand surgery. Clinical surgeons are already helping patients suffering from deformity of any degree of complexity: from long-term damage, tendon injuries and plastic surgery to rheumatoid finger deformity, which constrain hand and arm movement  and impedes grasping.

Such deformity is planned to be corrected with 3D printed hand endoprostheses. Now, doctors of the department together with engineers are developing a prosthesis yet unknown in Russia. The project is at the draft stage at the moment and is getting ready to be launched. The clinic is planning to perform the first knuckle straightening surgery using a 3D printed prosthesis for a rheumatoid arthritis patient.

The in-patient hospital on  Kadetskaia Line  has:  two trauma departments, one for adults and one for children, with an operating unit and an intensive care ward; a convalescence and rehabilitation treatment ward; and four doctor’s consulting rooms. A 3D laboratory for printing anatomical models and orthopedic surgical fixators is on the ground floor.

As the head of the trauma department Anton Akulaev said, development of tailor-made surgery with the use of 3D technologies will allow to treat a bigger number of patients with more complex and non-standard joint deformities, who have been rejected by other hospitals, and to perform more revision surgeries.

Last year, the Clinic acquired five 3D printers working with titanium and plastic. The laboratory of computer modelling technology and 3D printing was equipped with the help of St Petersburg University. It lets the Clinic staff create patient-specific  fixators. Such appliances allow to carry out effective preoperative assessment and minimise human factor during surgery. 

 ‘Computer modelling of a certain surgery and necessary offsetting allowed  us to create a custom-made product that will perfectly reproduce all the irregularities of a joint of each patient,’ the head of the department explained. Computer offsetting and high accuracy correction are key elements for creating products to be used in the operating room. This approach makes it possible to  reduce the length of operation twice and consequently minimise the risk of intraoperative injuries and increase endoprosthesis durability.

In April, 2018 after reequipping, the Pirogov Clinic of St Petersburg University on  Kadetskaia Line  acquired three high-tech equipped operating rooms. Each of the leading surgeons of Department No 2 performs from 400 to 500 operations a year.

By the end of the year 2018 there had been performed  more than 1600 joint operations. 300  of them involved neurosurgical manipulations, with 80% carried out through a one-centimetre diameter hole with the use of a camera. Thanks to this method, patients are dismissed from hospital in a 24-hour period. In neurosurgery this method is only used in a small number of hospitals of St Petersburg.

Every week, doctors of Department No 2 install endoprostheses on around ten patients. The day after the operation patients are already capable of moving around being supervised by instructors. Then they can go downstairs to the rehabilitation room. Generally, rehabilitation takes from four to five days.

If a patient needs a conservative treatment, for example, physiotherapy, or if they go through a postoperative recovery, they are sent to the rehabilitation room on the ground floor.

The head of the trauma department Anton Akulaev

Fast track recovery used in the Clinic involves serious postoperative care. That is why there is a staff of administrators always in touch with the patients. They supervise operated patients remotely. They monitor their condition in the first weeks after the operation, remind them to do exercises necessary for successful recovery, and control their daily routine during three months of rehabilitation.

You can get a consultation with a doctor via telephone or email from anywhere of the world. This remote support of patients is necessary for the Clinic that focuses on nonresidents. More than 60% of patients of the trauma department live outside St Petersburg. Many of them come from the Leningrad Region and towns of the North-West of Russia. According to Anton Akulaev, most of the patients choose the Pirogov Clinic for the great number of operations performed there, as it implies the solid experience of the staff. ‘If a doctor performs 400-500 operations a year  with good results, people  know about it and  trust them,’ he emphasised.