of the human body. right now we are printing with this the strips that you see on the screen, that is, here is one end plate. three acetabular cups of the hip joint and one augmentation to the er endoprosthesis of the knee joint. a friend of these products will last 26 hours. approximately together with the implants, the printer prints special test samples for batch quality checks, the batch number is printed on top, they are torn on a tearing machine and we determine the strength and, in the same way, test whether the strength of the manufactured products corresponds to, let's say, a specific batch with the requirements that we we put these products in front of and here they produced 200 implants, although the capacities are much higher, on average, they take somewhere around 900-1000 prostheses , this one printer can print a year. but among thousands of printed samples, there will not be the same ones, because

each product is unique, each implant is unique, what makes it unique by the fact that it is designed for the patient, that is, it is suitable only for this patient and only for his specific defect for his anatomical features, such individual endoprostheses accurately repeat the bones and this is extremely important, for example, in maxillofacial surgery, because in addition to the health of the patient, his appearance will also be restored . our jaw plate is individual, and we can make different products for what facial surgery is for, such as half-jaw plates, jaws, eye orbits of various types, etc. but the demand for production has changed. they say that before they received orders mostly for small implants for scheduled operations, now there is a need for large bone fragments for those wounded as a result of shelling. earlier

there were several a year, but now they have increased a little, the fate is replacement by osteosarcoma, if i remember correctly, but just. by the way, such similar prostheses can now be used to replace defects of tubular bones, which are obtained mainly from explosive injuries . ukrainian-made titanium endoprostheses have a number of advantages compared to with foreign ones, we get about 1.5-2 times cheaper than if we print it abroad, why 1.5-2 because, well , at the prices, it can be 20 dashes 50% cheaper there. but if we also take into account customs clearance and delivery a-a plus the terms we have somewhere, well, twice as fast, for sure, we can deliver the product here in ukraine, er, than if it is brought from abroad, the war pushed the company to a new direction in the production of printing prostheses for animals or four

paws rarely become victims of russian aggression, these are the implants that we made for a-a dogs for one dog that was injured. if i remember correctly, in mariupol from the hostilities, that is, she has such limb prostheses, which titanium rods are inserted into the bone a from the outside, these boots are worn on them. she can use them as paws and walk fully. that is , two paws were simultaneously prosthetics. it was performed for the first time in ukraine in may during and after prosthetics for the patient. she feels good and has already gotten used to the new

iron paws . mr. oleksandr, the history of all this is very interesting. i am very glad that we ukrainians have finally learned how to create these implants and we do not need to go anywhere abroad for such treatment and replacement, let's say so certain uh, organs, so what will we need, and in general, this story is very telling and very necessary, because now there is also a war in our country. i understand that you started creating all this long before the war, it is absolutely true, uh, such technologies we began to use for patients with loose endoprostheses, a loose endoprosthesis causes a large defect in bone tissue around and it is the individual 3d printed implant that will be able to help the patient eh without such an operation, people are

left with an invalid well, namely, the promising self would be a promising and interesting direction for us. it was onco-orthopedics. the fact is that, uh, in some cases, this technology allows you to save the limb in general. oleksandr well, i understand that this, as we saw in our story, is the work of not one person, but a whole company of people and this requires a lot of technology, and this story was interesting about the dog mozart, and a little later we will learn about another story of a person who also lives with a ukrainian-made titanium implant. but first, it is worth saying that the production begins a long time ago before printing implants, it begins with the design of a model, and for this, a computer tomography is performed on the patient in the hospital, the images are sent to the bioengineers to the designers, and they, in turn

, create a 3d model of the future implant. it can take from three weeks to a month and a half to receive a ready-made titanium implant depending on the complexity of the case so how are the future implants designed and who does it we will also now i would like to introduce one more person who will be in touch with us, this is a bioengineer svitlana burburska ms. svitlana i also welcome you today on our air i congratulate you ms. svitlana so how long do i want to ask you how long is the process of creating these projects by you exactly how what will it be called correctly , it will be called a model, is it some kind of special scheme, what is it in the final version, we get exactly the model, but what is the reason for such a long design, because in addition

to the implant itself, we design, roughly speaking, the operation together with the surgeon. that is, we analyze these ct data that we have, create a 3d model based on them, and then we print this 3d model on a plastic printer and the surgeon can get acquainted with it live , that is, he can hold it in his hands and see the defect that is inside of a person because the model comes out one by one, well one to the same scale , accordingly, he can evaluate this defect and he communicates with the engineer and we decide what exactly we will do, we take into account the anatomy of the individual patient access to the surgical room, which doctor will go, we take into account , among other things, what tools he will use, we then print our pre-created model on a plastic 3d printer again, then everything is tried on if the doctor wants to make what certificates we make them and thus several interests happens until

we get the final good result , sometimes in addition to the implant itself. we also design, for example, tools that help to correctly perform the resection, correctly direct the drills, and everything else. and this all helps to make the operation er, well, first of all, effective, and secondly, faster, because the doctor is already going to the operation. he understands how, step by step, he will use, what he will do, and besides, he has already done it all in his office, roughly speaking, in the office on plastic ms. svitlana's prototypes. please tell me, this is the design directly. how long does your work take? well , three weeks. this is the minimum due to the fact that we make corrections together with the doctor, but we will try to speed it up. now there is a shortage of people who have the knowledge and

experience in this field, so we will develop in this direction so that more of our ukrainian specialists are available, and in this way , we will most likely be able to speed up the design and, accordingly, production, including mrs. svitlana, you are talking about the fact that there are not enough people , why are there not enough people because they do not train for such a profession, or do you need to study on your own , go somewhere abroad, what is the matter? i understand that they are just starting such specialties appear why, because this technology is really new, as already mentioned, the first implant was placed only in 2018, and accordingly, the engineer gains experience primarily during work and communication with surgeons, because each end, well, in each bone is a specific anatomy and a specific surgery, tools and everything else, therefore, the entire complex. well, it is unlikely that you can learn this at a university, it is more likely that you need to study in specialized laboratories in schools where there

are already people with experience in this work. oleksandr, i want to ask you if it is possible to make any predictions in advance as to whether this implant will take root, eh, implants are living because they are made of medical titanium, eh, preparation of the patient is very important for this, as i already said, if we are talking about gunshot wounds. the first question is the fight against infection, special tests, special analyzes give an answer to whether the patient is ready for such and such an operation. and in general, how much time should pass after the operation in order to understand that everything is fine and how long does the recovery period last directly a-and each time it is decided individually a-and the main thing is the

main period is before the stitches are removed. if there is no suppuration during the first two weeks, this is already a good prognosis sometimes there are rarely so-called late suppurations that can occur several months after the operation, but fortunately they are quite rare and when we talk about individual 3d printed endoprostheses, we are talking about the fact that this prosthesis is made that is, it is not some kind of blank, but this prosthesis is made directly for each person according to their needs, taking into account what their body constitution is, what their weight is . all defects what kind of bone tissue does he have and all bone irregularities are completely repeated by an individual implant in this case this technology is unique and

has no analogues and precisely because it is an implant personalized individual repeats the geometry of the bone, that's exactly why we have such good results, such hope for the future for such patients, oleksandr, can you say how many patients have already been operated on and helped so far in ukraine, it's hard to say, but at least our laboratory, which is engaged in the design of such implants, only as far as the hip joint is concerned, more than 250 implants have already been designed, i understand . the first is to replace the titanium implant, yes, and i know

that it was half of the pelvis and the second femur , did you have such operations, correct, absolutely true, yes, and it made it possible to do without amputation in both cases. that is, you can say that you not only save people's lives, but also improve yes, this is exactly what we are talking about, because with another technology for replacing large bone defects, a small defect can be filled with the allu bone or the allo bone with special fabulous plastic materials, but if we are talking about replacing the great the defect is more than 25 cm, only a titanium individual implant can help the patient. it is clear and i would like now that we add another person to our list. she used to live

an ordinary life and did sports. had a rare oncological disease, osteosarcoma, and the doctors offered the young girl a complete leg amputation, but she was lucky because her case was taken care of by our guest orthopedic surgeon, traumatologist, and oncologist oleksandr galuzinsky, we will learn the story of the girl just now, because yevgenia is in touch with us now. and mrs. yevgenia. good afternoon. greetings, mrs. yevgenia. i would like to hear exactly your story, and we have before and after photos, which we will ask our directors to show on the screen. please, where did it all start and how did you find out about your illness, what did the doctors suggest, and that's how i lived a normal life, went to work, played sports. if everything was okay, but eh

, these small pains began to appear, you know... e in legs, well, it happens there when something pinched in the back, or there, for example, well, i don’t know, i pulled it during sports, for example, i started to smear something there, well , i treated myself there, but if the pain was constantly growing, well, it grew little by little and already there in three months it was already well, it was just unbearable pain that even i was even prescribed morphine. i even injected morphine and it did not help. that is, there is no pain for 30 minutes, and then it grows more and grows and er, i er, all this time, while this pain appeared there, i am constantly well i went there and tried to get a diagnosis from different doctors, but there they prescribed me massages or

ointments, well, if it wasn’t so serious. yes, and when i was sent to oncologists, because all the tests were normal, and everyone is already throwing up their hands and saying that something is wrong it's strange, yes, we already did the first vfc because there was some kind of freckle in the bone on the x-ray, and after that the biopsy showed that if it wasn't for oncology, everyone was so happy except for me, because if i had it, it wouldn't matter there was pain already for this in the two months when i passed there i continued to go about my business after the first biopsy, uh, if this tumor had just grown enormously in two months, my entire femur was already affected, and

only the knee and hip joints were not affected. we started to make up ideas. several consiliums, the doctors said that such a lesion is better. well, there are no such technologies to be able to order me an implant in any country in any country. for all patients a-a therefore, either an amputation or some such temporary solution for a year er-e well, we don’t like amputation, a young woman there, i was 30 years old at the time and had a complete amputation almost to the buttock the news is that we started with my doctor to figure out what we can do. my doctor is a surgeon, an oncologist, a black

doctor . helped me save my leg and now i walk almost as well, you can’t say how before the disease yes er sometimes i can move around the house without a cane and so er if i go somewhere for a walk because i have to go somewhere on business my two legs, and i am very happy that everything turned out like this, mrs. evgeniyu. how long did the operation last and how long was your recovery after it? the operation lasted more than 6 hours, of which i was conscious for about 4 hours because i had to control this the process is also a-a how the patient is recovering somewhere

it was six months ago, i walked on crutches, and then i gradually got used to walking with the help of one crutch, then i switched to a cane for almost a year, i think i recovered . thank you, evgenia. thank you for what you told me. i want to ask ms. svitlana about my story. please tell me , were you involved in the design of a prosthesis for ms. yevgenia, including me ? is it difficult? anyway, well, how can you evaluate? this is exactly the case yevgeny, it is difficult, or can you say medium easy? yes, no, it is

a difficult case. why? light, but so that it was just as strong. and that's why we used truss structures, that is, beams. this is an engineering approach in order to reduce weight and even increase the strength of the structure in some cases. by god, we managed to do it, we saved both hip and knee joints, that is, all her ligaments are preserved in evga, and in this way it provides additional stabilization of this prosthesis, because if, for example, we used an alternative, for example, a mega protest, then such things are investigated very quickly and you need them. well, even after that, it is true that the ligaments loosen . it is because of the fact that the soft tissues that hold the joint are removed. that is why it was a complicated operation. before that, they went for a long time to

prepare and were actually very worried that everything it turned out well. thank god it happened, mr. oleksandr. well, here i understand that it is very important . here is the joint work of the doctor and the designer, yes, absolutely right. the surgeon must understand in advance what he will do during the operation, and we have performed this several times. the operation well, as if the operation before the operation, that is, we engineers printed a bone from plastic, we gathered with the surgical team with volodymyr serhiyovich chorny posanko and performed this operation in laboratory conditions, and after we made sure that everything was ready with us, that everyone the navigation systems are working. we started to perform the actual operation on a patient-by-patient basis. and what does an operation in a laboratory mean? can you tell us a little more about this

process? the fact is that 3d printing is unique in that it is possible to print a bone based on computer tomography from the plastic we can look at the tumor we can look at the bone effects and we can do with surgical instruments the operation before the operation this is actually also very interesting so i understand and mr. oleksandr, i want to ask you to ask what is the most expensive in this whole process and how much is it in general. this operation is expensive now in ukraine. if you compare it with the cost of similar operations in the usa or europe, the difference is of course not even times and tens of times, that is, a similar operation in western european countries can cost tens or even

hundreds of thousands of dollars or euros. our implant is designed by our engineers and printed in our country can be much cheaper. 2-3 thousand euros, two two-three thousand euros, this is only the cost of the implant itself. and if we talk about the complete cycle, which we talked about today, and the design, all the examinations are directly operative, already the intervention of recovery so that our people, our viewers can simply know e how much money do you need to spend in general, and maybe you have some preferential categories of people, for example, military personnel or people who have been injured and are in a combat zone in order to help military personnel and to help the wounded during military er military operations and we attract charitable funds that

help financially, including a-a now there is an american er fund that collects funds for carrying out similar operational interventions, as for the cost of the full, well, it is very expensive in this of course it implant because uh in most um um uh hospital facilities there are more military examinations of such patients and treatment in the plan according to documents fortunately and free of charge i want to thank you today's guests who joined to our broadcast because the topic is extremely interesting and i hope that in our country there will be more such operations and, nevertheless, it will not only be possible to do them with the help of religious organizations and charitable organizations, but also with the help of the fact that there will be state support, because now it is very necessary . thank you that were with us today because

modern technologies are already available in our country and patients with bone defects do not need to be sent abroad. and all this treatment can be carried out in our country and we should know this and be aware of this, so i was with you iryna koval and the health program take care of yourself the goal will be in 25 two 20 minutes 10 i want to drive this scumbag out of our land 5 3 2 fire wild creatures

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