They set the tone

Belarusian trauma and orthopaedic surgeons are proficient in all global treatment standards and are implementing their own unique methods

Traumatology is one of the oldest branches of medicine. It develops every year, and the Belarusian experience is exemplary in this regard. Thus, many methods introduced by our doctors in hip replacement surgery are protected by patents and are used not only in Belarus. Orthopaedic surgeons from Germany, Japan, Kazakhstan, Russia and other countries have come here to master them. Doctors from the USA, Türkiye, and Great Britain have already introduced — with the help of Belarusian colleagues — many approaches in their clinics. What are domestic traumatologists proud of, and what new developments do they offer? We have found out from the director of the Republican Scientific and Practical Centre (RSPC) for Traumatology and Orthopaedics, corresponding member of Belarus’ National Academy of Sciences, Doctor of Medical Sciences, Professor Mikhail Gerasimenko. 

Striding confidently

Significant work is carried out in Belarus regarding joint replacement surgery, as evidenced by the figures. In 2019, approximately 7,500 knee and hip replacements were performed in our country. In the past year, 2024, this figure reached 21,300 surgeries. This represents an almost threefold increase! Moreover, while the waiting time across the country previously averaged from three to six years, the current waiting time for hip replacement, depending on the region, ranges from a few weeks to nine months, and for knee replacement — from one to 12 months. And these timescales are decreasing.
“Understanding the tasks set by the Head of State for the medical service, we have mobilised to the maximum, opened a number of inter-district centres, and trained specialists capable of performing endoprosthetic replacement of large joints,” emphasised Mikhail Gerasimenko. “In Belarus, 245 orthopaedic surgeons are proficient in this technique, which constitutes almost a third of all specialised professionals in our country. Furthermore, one in ten trauma and orthopaedic specialists, including those in polyclinics and paediatric centres, hold a PhD or Doctor of Medical Sciences degree.”
Thanks to the transfer of experience and extensive on-site training, the number of medical institutions performing such operations is gradually expanding. Hip replacement surgery is now performed in 46 clinics, and knee replacement — in 25. A comprehensive patient registry has been created for those in need of replacement surgery. It has become possible to avoid corruption risks in queueing and to establish accounting for joint replacement components through the Endoprosthesis automated information system (AIS), developed in collaboration with specialists from the Republican Scientific and Practical Centre for Medical Technologies. “In addition, we have refined the system for uninterrupted supply of prosthetic implants from abroad and, in parallel, expanded domestic production,” recounted Mikhail Gerasimenko. “A turning point was the creation of the Belarusian knee implant. Now, approximately half of the joints we use are domestically produced. Within a few years, we plan to reach maximum import substitution to ensure national security in this sector.” 

Operating theatre at RSPC for Traumatology and Orthopaedics              Aleksandr Kulevsky 

Shoulder joint replacement, spinal systems and other innovations

In traumatology and orthopaedic departments of the country, 64 new treatment methods were introduced last year alone. One of the most significant innovations is reverse shoulder arthroplasty. This type of surgery is performed at the RSPC for Traumatology and Orthopaedics. It is planned to introduce it in regional hospitals over time. Reverse arthroplasty can help patients not only with diseases of the shoulder joint, but also with severe proximal humerus fractures, when it is impossible to collect and fix bone fragments.
Currently, doctors use imported implants for these operations. Shoulder joint endoprostheses are not yet produced in Belarus and the CIS countries, but the demand for them is high. In order not to depend on imports, the team of the RSPC for Traumatology and Orthopaedics — together with colleagues from Russia’s Samara and with the support of Belarus’ and Russia’s Healthcare Ministries — has decided to launch a project of the Union State dedicated to the development of a domestic reverse shoulder endoprosthesis.
The collaboration between the RSPC for Traumatology and Orthopaedics and the Turner National Medical Research Centre for Children’s Orthopaedics and Trauma Surgery in St. Petersburg has been very fruitful. Together, they have implemented the Spinal Systems — 1 Union State programme and developed a spinal system. Thanks to this development, it has become possible to restore health to a large number of Belarusian and Russian children with severe deformities and injuries of the spine.   
A spinal system is a specific set of components that allows for the creation of an individual configuration tailored to a planned surgery for a specific child at a specific age. This is the unique aspect of the development compared to global counterparts. It is worth noting that the structure is produced in Belarus.
The Belarusian equivalent is at least three times cheaper than the metal structure of a leading global manufacturer. At the same time, it allows for results comparable to those achieved with the best global technologies. Thanks to the operation, a real miracle occurs. Children, who, in many cases, were destined for a wheelchair, recover, attend a regular nursery and school, and can even participate in sports.
Mikhail Gerasimenko revealed that Belarusian and Russian traumatologists decided to go even further: they have devised a programme for children, Spinal Systems — 2, to create new methods for diagnosing and treating patients with neuro-orthopaedic pathology. As a rule, these are children with cerebral palsy.

  

 Aleksandr Kulevsky

Maximum practical focus

The RSPC for Traumatology and Orthopaedics performs all types of surgical interventions for musculoskeletal disorders that are carried out worldwide. Moreover, many types of operations were proposed by the centre’s specialists themselves. These approaches are aimed at extremely effective treatment, minimal invasiveness, and therefore, at the fastest possible patient recovery. “In addition, our scientific developments are as practically oriented as possible,” noted Mikhail Gerasimenko. “As a result, we have achieved 100 percent import substitution of metal structures for spinal surgery. More than 40 percent of metal structures used in fractures of long bones of the limbs are created as a result of the centre’s research programmes and are produced in Belarus.” 
The achievements of Belarusian trauma and orthopaedic surgeons are of interest abroad. In addition to close co-operation with Russian colleagues, specialists from the RSPC for Traumatology and Orthopaedics interact with the CIS countries, share experience with medics from the UK and the USA. Belarusian methods for hip joint reconstructive surgery in children have been implemented and are in demand in Japan and Iran. 

Ilya Shvedko 

TO THE POINT  

The RSPC for Traumatology and Orthopaedics is equipped with a modern 3D printer. The creation of a life-size, three-dimensional model of the affected area from polymer materials allows for detailed visualisation and assessment of changes in bone structures, clarification of the diagnosis, planning of the scope of the upcoming surgery, and its optimisation.  

FACTS

The Presidium of the National Academy of Sciences awarded a prize to a team of trauma and orthopaedic surgeons for the best project in the field of medicine. The team of authors includes Director Mikhail Gerasimenko, as well as the head of the RSPC laboratory, Doctor of Medical Sciences, Professor Oleg Sokolovsky, and the chief physician at Minsk’s 6th city clinical hospital, Candidate of Medical Sciences, Associate Professor Viktor Anosov. They developed and implemented new technologies for leg deformities in children and young people. The specialists had worked on the project for five years. The result is dozens of publications, implementations, patents, instructions for use, presentations at prestigious international forums, monographs, difficult operations. But the main thing is hundreds of cured patients!

NUMBERS

Last year, staff at the RSPC for Traumatology and Orthopaedics travelled to the regions approximately 300 times to provide emergency treatment for injuries to the spine and spinal cord. During these visits, they provided consultations to around 350 patients and performed around 160 surgeries.  

By Yelena Basikirskaya