Arthro-medullary shunting is a unique technology presented on the Russian market that has completed the full cycle of medical trials, allowing patients to preserve their natural joint without replacement with a prosthesis. This elegant, fast, and effective method for managing disorders of the knee and ankle joints has been proven in hundreds of patients.

Restoration of joint mobility is achieved through the permanent delivery of the patient's own fat lubricant into the joint from the medullary canal of the long bone. A grease gun inside the joint! The fat mixes with the synovial fluid, improving its lubricating capability three times over and reducing friction in the joint. The lost functions of the joint are restored. The patient becomes a healthy person within a few days while preserving their own joint. The effect of the surgery lasts for years.

A 67-year-old female patient presented with knee pain and clicking sounds when walking. X-rays and tomography results showed that the woman's knee joint was not damaged severely enough to require joint replacement. The doctors decided to use an innovative surgical method. "The essence of the surgery is to use a titanium tube inserted into the femur to create a connection between the femoral medullary canal and the joint cavity. Through this tube, fat and bioactive bone marrow cells will be delivered. In this way, the joint regenerates and is lubricated by natural fat," explained Andrey Komkov, Head of the Department of Orthopedics and Traumatology No. 3. Minimally invasively, through a single puncture, an arthro-medullary shunt 7.5 cm long is introduced into the joint. It will function for 5 to 7 years. This low-trauma surgery significantly increases the chances of avoiding joint replacement.

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As Artem Litvinenko, an Orthopedic Trauma Surgeon at the Day Hospital of Vladivostok Polyclinic No. 9, told a correspondent from the VladMedicina.ru portal, the technique is quite simple yet highly effective. Its key feature is that it utilizes the body's own resources to treat the affected joint, which rules out allergic reactions and tissue rejection.
"During this procedure, a hollow arthro-medullary shunt made of a biocompatible and non-oxidizing titanium alloy is inserted into the affected joint through a microscopic puncture under video endoscopic guidance, connecting the medullary cavity with the joint cavity," Artem Nikolaevich explains. "As a result, the body's constantly produced bone fat drips into the cavity of the damaged joint and significantly reduces cartilage friction—a mechanism that earned the method the nickname 'grease gun' in the West."
This method offers several obvious benefits and advantages. First, the lower the friction, the less damage occurs, with lubricating properties improving on average twofold compared even to a healthy joint. Second, the antioxidant properties of bone fat provide complete nourishment to the articular cartilage, not only preventing its degeneration but also promoting regeneration. Third, they relieve intraosseous pressure, which subsequently eliminates the patient's pain.
"I started practicing this technique when I encountered a patient who had undergone arthro-medullary shunting seven years prior at a leading central clinic," the doctor notes. "She is a responsible individual and had X-rays taken every year. I reviewed them all, and they showed no changes over time—meaning the disease had completely stopped progressing."

The arthro-medullary shunting procedure is performed as follows: on the day of the surgery, the pre-examined patient abstains from food and drink and arrives at the operating block of Polyclinic No. 9. A nurse settles the patient into a ward, and they are taken to the operating room later that day based on the surgical schedule. The intervention itself is minimally invasive, performed without an incision or opening the joint under spinal anesthesia, and lasts about 30 minutes. By evening, the patient is discharged to go home. A dressing change is scheduled for the next day, and three small sutures are removed after 7–10 days. According to the orthopedic trauma surgeon, the technique provides a long-term beneficial effect for patients with knee osteoarthritis (gonarthrosis) who do not respond to conservative treatment. It also helps delay joint replacement or avoid it completely, for instance, in cases of severe osteoporosis or other serious concomitant diseases. Furthermore, this minimally invasive intervention significantly reduces surgery and rehabilitation costs for both the patient and the healthcare facility compared to total joint replacement (arthroplasty). Patients who have already received arthro-medullary shunts initially could not believe that their pain completely disappeared the very next day after the procedure, allowing them to return to the active daily life they had not dared to dream of for many years. Patients report feeling young and healthy again. This wonderful technique is not a myth, but today's objective reality, which is available at Vladivostok Polyclinic No. 9.

Due to high physical stress and injuries from professional sports, his knee joint had worn out. Specialists at our Center offered him an innovative treatment method: arthro-medullary shunting. This technique relies on using the patient's own intraosseous marrow content as a lubricant to treat the affected joint. This allows to:

• Significantly reduce pain
• Preserve the natural joint
• Delay joint replacement surgery
• Stimulate the healing of damaged areas of the articular cartilage

Today, Evgeny feels well and shares his feedback on the surgery.

Orthopedic trauma surgeons at the M.A. Podgorbunsky Kuzbass Clinical Emergency Hospital have mastered an innovative surgical method: arthro-medullary shunting. They successfully applied it to help a 67-year-old female patient with a knee joint pathology, who presented with knee pain and clicking sounds when walking.
"The essence of the surgery is to use a titanium tube inserted into the femur to create a connection between the femoral medullary canal and the joint cavity. Through this tube, fat and bioactive bone marrow cells will be delivered. In this way, the joint regenerates and is lubricated by natural fat," explained Andrey Komkov, Head of the Department of Orthopedics and Traumatology No. 3.
Minimally invasively, through a single puncture, an arthro-medullary shunt 7.5 cm long is introduced into the joint. It will function for 5 to 7 years. This low-trauma surgery significantly increases the chances of avoiding joint replacement.

The progressive development of degenerative-dystrophic diseases makes joint replacement surgery necessary, which ultimately leads to the loss of natural joints. In order to preserve the affected knee and ankle joints, as well as to improve and prolong their function, an arthro-medullary implant (shunt) has been developed to lubricate the damaged articulations. Evgeny Ivanovich Belousov discusses this unique surgical treatment method for degenerative and post-traumatic joint diseases.
Dr. Belousov is a member of the Russian Arthroscopic Society and the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS). He is proficient in all types of orthopedic trauma surgeries and is a Board-Certified Specialist. He successfully performs arthroscopy of the knee, shoulder, elbow, and ankle joints. His expertise includes ACL reconstruction, meniscus repair, chondroplasty, and surgical procedures for shoulder instability and rotator cuff tears.