The creation of a multidisciplinary scientific and clinical center of modern evidence-based physical and rehabilitation medicine based on the reconstruction of the complex of buildings and structures of the State Institution "Institute of Spine and Joint Pathology named after Prof. M.I. Sytenko of the National Academy of Medical Sciences of Ukraine", at the address: Kharkiv, G. Skovorody St., 80, with an increase in area, its equipment and facilities at the level of modern world standards of specialized medical and diagnostic care for patients with injuries and diseases of the spine and joints will allow to ensure high standards of treatment and stay in the clinic, as well as provide additional medical operations on the spine and joints, including organ-preserving surgical interventions for oncological bone lesions, by approximately 1,000 annually (+20%), for citizens of Ukraine. Among other things, since the beginning of the full-scale aggression in Ukraine by the Russian Federation, despite hostile shelling and the constant missile threat, the Institute has continued its medical and scientific work. Qualified and specialized medical care is provided to wounded soldiers and civilians. Interruptions in the supply of medicines, food, and periodic power outages do not prevent the institute's employees from fulfilling their professional and moral and ethical duties at the highest level. Moreover, it is planned to increase the volume of assistance to injured military personnel and civilians by expanding rehabilitation measures, introducing new treatment methods, and restoring the working capacity of injured soldiers and civilians with damage to the musculoskeletal system. Thus, against the background of the above-mentioned prospects, the reconstruction of the construction and material base of our institute becomes even more urgent in order to improve and expand qualified specialized medical care, primarily for war victims with damage to the musculoskeletal system.

The Institute is a leading state-level medical research institution of strategic importance for the health of the nation in Ukraine. Under conditions that do not meet modern standards, doctors provide exclusive and highly specialized medical care, in particular, treatment methods developed by the Institute's specialists are used, namely, the improvement of unique methods of minimally invasive surgery of the spine and joint pathology, reconstructive and restorative operations on the spine and joints, organ-preserving technologies for the surgical treatment of oncological lesions of the musculoskeletal system. Today, the administration and staff of the clinic are making every effort to create acceptable conditions for patients to stay in the clinic. However, the specified conditions not only do not meet modern world standards, but also any standards of a medical institution of this level. Most of the wards are 4-6-bed without proper sanitary and hygienic conditions: bathrooms are of a general type, located far from the wards, which is unacceptable for patients with severe pathology and significantly pronounced disorders of the function of support and movement. It should be emphasized separately that the severity of the problem is that the number of beds for patients with bone oncology only meets the need by 50%. Currently, the institute treats about 1,500 patients with bone oncology annually. Currently, the number of cancer patients requiring surgical intervention on bones and joints is growing by 20-25% annually. The problem is significantly exacerbated by the annual increase in patients with other pathologies of the spine and joints who apply to the institute and require surgical treatment, in connection with which the 5 operating rooms currently equipped at the institute are not enough, and it becomes necessary to perform 6-8 operations per day in each of them instead of the 4 operations for which they are designed. This significantly complicates the work of surgeons and nursing staff, and also negatively affects the results of patient treatment. Along with this, the institute is developing quite actively modern minimally invasive surgery, in particular endoscopic operations on the spine and joints. All this also requires separate premises for the creation of specially equipped operating units. At present, such operations are also performed in existing operating rooms, which also complicates and hinders the development of this important area of modern surgery at the institute. The above emphasizes the urgent need for additional premises for the arrangement of additional operating rooms and the creation of conditions for the full and high-quality functioning of the operating unit of the institute. Engineering communications cannot ensure the uninterrupted operation of high-precision medical equipment (their planned operation period has already been exceeded 3 times). The rehabilitation department at the institute is located in the basement next to the swimming pool. Apparatus for developing movements in the joints and other exercise machines are installed in a small room, massage tables in one room with an area of 20 m2. All this also complicates the work of medical personnel and high-quality rehabilitation of patients during conservative and postoperative treatment. The above confirms the urgent need to expand the area of the premises to create a modern rehabilitation center at the institute. There is only 1 elevator in the clinical building, which cannot meet the need for patient transportation. For examination in the biomechanics laboratory, which is located on the third floor in the part of the main building where there is no elevator, patients with injuries and significant limitations in the musculoskeletal system are forced to walk up the stairs, and in some cases, if the patient cannot move independently, such an examination is not possible at all. The premises of the laboratory diagnostics department are located in two different buildings, which significantly complicates coordination and complicates the centralization of clinical diagnostic studies. The institute completely lacks premises suitable for placing a tomograph and conducting CT and NMR diagnostics. Communications have already exceeded their service life several times, in particular, electrical ones, on which the operation of high-precision equipment directly depends. This also applies to operating room equipment. Thus, the technical and operational resource of the clinical building is, as it were, physically exhausted, which creates difficult working conditions for surgeons and worsens the quality and timeliness of providing specialized medical care to patients with pathology of the spine and joints, as well as with oncological lesions of the bones. The creation of a multidisciplinary scientific and clinical center of modern evidence-based physical and rehabilitation medicine based on the reconstruction of the complex of buildings and structures of the State Institution "Institute of Pathology of the Spine and Joints named after Prof. M.I. Sytenko NAMS of Ukraine provides for the following changes: 1) The construction of an additional two floors above the "Workshop" building. As a result of such a reconstruction, it is planned to create a diagnostic center on the 1st-2nd floors, and a modern rehabilitation department for orthopedic and traumatological patients on the 3rd-4th floors using scientifically sound methods and technologies for children and adults: - On the minus first floor, it is planned to create a protective structure for civil defense (shelter), which will accommodate up to 500 people. -On the first floor of the specified building, it is planned to install equipment for radiological diagnostics: a digital X-ray machine, a computer tomograph and an MRI (magnetic resonance tomograph), an ultrasound examination room, a modern densitometer and a diagnostic room for planning and creating modern orthoses and other orthopedic individual products. -On the second floor, it is planned to locate: -functional diagnostics rooms for examining the condition of human organs and systems: cardiovascular system, respiratory system, digestive system, etc.; -electromyography and other methods of examining the nervous system; -biomechanical examination of the musculoskeletal system, analysis of gait function, muscle condition, etc. -Analytical center for diagnostics and planning of treatment and prevention measures. -On the third floor, it is planned to locate a modern rehabilitation department for orthopedic and traumatological patients using scientifically based methods and technologies with a day hospital for adults. -On the fourth floor, a modern rehabilitation department for orthopedic and trauma patients using scientifically based methods and technologies with a day hospital for children is planned. These two floors are planned to be equipped with massage rooms, exercise therapy, physiotherapy, apparatus therapy, and equipped with modern equipment for the effective rehabilitation of victims and patients with musculoskeletal system pathologies, both adults and children. 2) Construction of an additional one floor above the administrative and utility building (non-residential building "B-2"). This will allow all the institution's service services to be concentrated in one building. First of all, the computer center for management and coordination of all diagnostic and treatment work of the institute. The scientific archive will be relocated here. In turn, the main medical building will have the opportunity to deploy additional wards for modern treatment of acute combat trauma and its consequences and complications, the use of methods developed at the institute for optimizing reparative processes, replacing bone defects with bioinert structures, skin grafting, etc. 3) An extension of two floors above the laboratory building. On one of them, it is planned to build a clinical department for the treatment and care of patients with oncological bone lesions using the latest technologies of regenerative medicine. On the third floor of the building, it is planned to locate and equip premises for creating a bone fund for transplantation, and a department of support and movement system transplantology will also be located. 4) An extension of a floor above the building of the experimental and biological clinic. Conditions will be created for experimental and biological research in accordance with "GLP" standards, which will allow the institute to conduct research and clinical trials at a much higher level. 5) Expansion and reconstruction of the operating and anesthesiology block, which will be possible due to the vacated current premises of the laboratory and clinical building. 6) Creation of a single internal connection and significant improvement of the logistics of clinical departments with laboratory and other services of the institute. 7) Improvement of communications and general infrastructure of the institution, which will lead to increased comfort of stay in the clinic for patients and staff. Currently, the creation of a multidisciplinary scientific and clinical center of modern evidence-based physical and rehabilitation medicine based on the reconstruction of the complex of buildings and structures of the State Educational Institution "Institute of Spine and Joint Pathology named after Prof. M.I. Sytenko NAMS of Ukraine" (which will house: blocks of premises of the Department of Laboratory Diagnostics and Immunology, a Biomechanics Laboratory, a CT and NMR Diagnostic Center, a clinical department for the treatment and care of patients with oncological bone lesions, an operating room, a department of transplantology of the musculoskeletal system, a department of transplantology and experimental modeling with an experimental biological clinic) is at the project initiation stage.