CN102525692B - Implantation angle collimator for acetabulum prostheses - Google Patents

Implantation angle collimator for acetabulum prostheses Download PDF

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Publication number
CN102525692B
CN102525692B CN201210024761.1A CN201210024761A CN102525692B CN 102525692 B CN102525692 B CN 102525692B CN 201210024761 A CN201210024761 A CN 201210024761A CN 102525692 B CN102525692 B CN 102525692B
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angle
angled trapezium
bevel protractor
acetabulum
implantation
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CN102525692A (en
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翁文杰
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2/4609Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of acetabular cups
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof

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  • Health & Medical Sciences (AREA)
  • Transplantation (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

The invention relates to an implantation angle collimator for acetabulum prostheses, which comprise a right angle trapezoid body with an acute angle of alpha, a first bevel protractor with an included angle of beta, a second bevel protractor with an included angle of gamma, a gradienter and a guide rod. The alpha is larger than 75 degrees and smaller than 80 degrees, the beta is larger than 40 degrees and smaller than 45 degrees, and the beta plus the gamma is equal to 90 degrees. An inclined waist face of the right angle trapezoid body is arranged at the top, a right angle face opposite to the inclined waist face is positioned at the bottom, another two right angle faces are positioned on the left side and the right side, the gradienter is positioned on the inclined waist face, the bottom of the right angle trapezoid body is arranged on the guide rod, slide grooves are respectively arranged on the front lateral side and the rear lateral side of the right angle trapezoid body, and one sides of the first bevel protractor and the second bevel protractor are positioned in the slide grooves on the front lateral side and the rear lateral side and can move along the slide grooves. The implantation angle collimator resolves the problems that an operator is low in implantation location accuracy and large in error relying on experience and according to topography signs. The implantation angle collimator is simple in operation, economic and practical, widely applied to the medical field and capable of meeting clinical requirements well.

Description

Implantation angle collimator for acetabulum prostheses
Technical field
The present invention relates to a kind of bone surgical operation appliances, relate in particular to a kind of implantation angle collimator for acetabulum prostheses.
Background technology
Hip joint is one of maximum, the most stable joint of human body, is typical ball mortar joint.Hip joint had both had good intrinsic stability, also had activeness flexibly.Along with the development of the related disciplines such as orthopaedics and tranmstology, materialogy and anesthesiology, artificial total hip arthroplasty (total hip arthroplasty, THA) has become the standard treatments of multiple hip joint disease and has proved that long-term efficacy is good at present.Research show the success or not of total hip replacement and acetabular bone implant angle closely related.Acetabular component implant angle is indicating complication such as there will be hip pain, dislocation of hip joint or subluxation, hip joint shakiness, polyethylene liner wearing and tearing acceleration and prosthetic loosening extremely.Therefore studying and how acetabular component being placed in to ideal position is important clinical problem.
Normal adult acetabular bone is positioned at pelvis hipbone lateral surface central authorities, is the dark recess of hemispherical, and diameter 30 ~ 50 mm, are comprised of body of ilium, body of ischium and body of pubis, with femoral head associated section, towards front, outer, below.The HAC of thick approximately 2 mm of acetabular bone surface coverage, is semilune and distributes.There are two important angles in acetabular bone: angle of splay and top rake.Angle of splay is the angle between health longitudinal axis and acetabular bone central shaft.Acetabulum is the angle that acetabular bone opening surface and sagittal plane form.
Dislocation is one of postoperative modal complication of THA, and the incidence rate of first Dislocation Following Total Implantation of Hip Joint is 1%~3%, and the displacement rate after revision procedure can be up to 5%~20%; Generally believe dislocation be mainly divided into position dislocation due to the dislocation that suffering limb activity surpasses due to safety range, hip joint surrounding soft tissue imbalance causes, prosthese position of sound production is bad, soft tissue is uneven and prosthese position is bad a dislocation causing simultaneously.Research shows that the bad and dislocation in acetabular component position exists directly related relation between risk.
Acetabulum, angle of splay are that in replacement of total hip, acetabular component is settled most important position phase parameter.Angle of splay, top rake have three kinds of different concepts at present, and its angle can and directly be observed to assess to measure by anatomy, iconography and be obtained in operation, is: dissect angle of splay, top rake; Radiation angle of splay, top rake; Operation angle of splay, top rake.
In the anatomical research of Normal Hip, between acetabular bone face and horizontal plane, angle is considered to the inclination angle of acetabular bone, and this angle equals the angle between acetabular bone axle and the longitudinal axis, namely dissects angle of splay (Anatomical inclination).When projecting from cephlad-caudal, acetabular bone axle and coronalplane formed angle on horizontal plane is dissection top rake, and this is equivalent to acetabular bone along limbs longitudinal axis inward turning gained, (Anatomical anteversion).The angle of splay of anatomy definition and top rake be often appointment be real angle of splay and top rake.
Acetabular component angle can by postoperative hip joint anteroposterior position X sheet not thoroughly the mark of X line measure, inclination angle is exactly the angle between acetabular component cup face and trunnion axis, namely acetabular bone axle and long axis of body project the angle forming on coronalplane, radiate angle of splay (Radiographic inclination); Radiation top rake (Radiographic anteversion) is the angle between acetabular bone axle and coronalplane on iconography namely.
Operation top rake (Operative anteversion) is the angle after acetabular bone axle projects sagittal plane and between the limbs longitudinal axis.Angle between acetabular bone axle and sagittal plane, the angle of splay of performing the operation (Operative inclination).
The acetabular component position phase parameter safety range of relatively more consistent approval is 10-15 ° of top rake of acetabular component radiation, operation angle of splay 40-45 ° at present.In a word, angle of splay is excessive, and femoral head top is contained few, joint instability, and interior receipts, inward turning are limited, and the interior time receiving easily dislocates; Angle of splay is too small, large to the containing of femoral head top, there will be flexing, abduction limited, and along with the flexing of lower limb, mortar cup forward leaning angle amount of decrease increases, the variation that retreats by leaning forward of mortar cup, and inward turning is also limited, as continue flexing, and be prone to the collision at neck of femur and mortar cup edge, cause dislocation.And top rake can make angle of splay alternation when hip in the wrong is movable slower, guaranteed that acetabular bone covers preferably to femoral head, but when excessive, stretched afterwards limitedly, easily the shock between a generation mortar, causes anterior dislocation.When too small, flexing is limited, easily backward dislocation.We according to clinical research think operation angle of splay 42 °, during 12 ° of top rakes of radiation, acetabular component is best to capital covering, contacts extensivelyr with capital, stress distribution is even, joint is stable, displacement rate is minimum.
In whole coxa substitution operation at present, acetabular component method for implantation is mainly divided into the lower implantation of Traditional Man implantation, acetabular bone local form anchoring approach and navigation.
The acetabular component guide post location that Traditional Man implantation provides according to apparatus business, setting patient is standard lateral position or dorsal position, with operation angle of splay 40-45 °, 10-15 ° of direction of radiation top rake implanted, patient can be according to limbus of acetabulum form and clinical experience adjustment simultaneously, advantage is easy to operate, and shortcoming is that acetabular bone angle is not accurate enough sometimes, and inaccurate reason is not enough with doctor's operating experience, patient posture is uncertain relevant.There is certain inclination at anteroposterior position in human pelvis, is called the inclination angle of pelvis, i.e. angle between the line of cape and pubis upper limb and horizontal plane.The top rake that the variation at pelvic inclination angle can cause mortar cup changes thereupon, finds out that thus Traditional Man implantation accuracy is not high, is not a very reliable method.
Acetabular bone local form anchoring approach is to be used as reference according to the local operational anatomical landmarks of acetabular bone, carries out the method for mortar cup implantation.Conventional acetabular bone local form anchoring approach mainly contains two kinds: transverse acetabular ligament Directional Method and Periacetabular bone labelling Directional Method.Transverse acetabular ligament Directional Method: when directed, the lower edge of mortar cup should be in transverse ligament level, the degree of depth is not less than transverse ligament, and the trend of transverse ligament represents the natural forward leaning angle of this patient's acetabular bone, can determine thus position, angle of splay and the top rake of acetabular component; Periacetabular bone labelling Directional Method: art midpelvis has three bone marks, the minimum point of acetabular bone-ischial tuberosity inter-drain, peels off and can appear along ischium in art; Second point is positioned at the outside of superior ramus of pubis, the intersection of iliopubic eminence and pubic branch, and this point, apart from mortar edge approximately 5 mm, can be looked at straight in art; Get the peak of limbus of acetabulum.By 3 formation planes, just can determine direction and the position of acetabular component.
Traditional Man method for implantation and acetabular bone local form anchoring approach depend on patient's clinical experience and local anatomic landmark more, exist certain error, and along with scientific and technical development, airmanship is widely used.There are some researches show that the mortar cup implanted by airmanship relies on rich experiences than doctor and the registration implanted according to topography sign many, and do not need preoperative, postoperative perspective, reduce amount of radiation, time and energy.
Navigation is lower implants: pass through machinery guidance, obtain acetabular bone stereochemical structure image, guiding mortar cup is implanted, and with the comparison of Traditional Man implantation, airmanship can obtain mortar cup more accurately and implant, the reference plane that simultaneously can come homogenize pelvic planes to implant as mortar cup by anterior superior iliac spine and pubic tubercle.Although navigation is lower, implant can accurate implanting prosthetic, also must recognize the lower Shortcomings part of implanting of navigation: somewhat expensive, and complicated operation, has very high professionally, and incorrect navigation information can add the risk of major operation, even causes operative failure; The lower system of implanting of navigation is at present comparatively expensive, and domestic only have hospital few in number to be equipped with.
Summary of the invention
The object of the present invention is to provide a kind of implantation angle collimator for acetabulum prostheses of simple, economical and practical, registration.
Technical scheme of the present invention is as follows:
A kind of implantation angle collimator for acetabulum prostheses, comprise that acute angle is the right-angled trapezium body of α, the first bevel protractor that angle is β, the second bevel protractor, level indicator and the guide post that angle is γ, 75 °≤α≤80 ° wherein, 40 °≤β≤45 °, and β+γ=90 °; The oblique girdle plane of described right-angled trapezium body is positioned at top, the right angle face relative with oblique girdle plane is positioned at bottom, two other right angle face is positioned at the arranged on left and right sides of oblique girdle plane, level indicator is placed on oblique girdle plane, the bottom of right-angled trapezium body is placed on guide post, the forward and backward side of right-angled trapezium body is respectively equipped with chute, and the first bevel protractor and the second bevel protractor are arranged in the chute of forward and backward side and can move along chute.
According to clinical research think operation angle of splay 42 °, during 12 ° of top rakes of radiation, acetabular component is best to capital covering, contacts extensivelyr with capital, stress distribution is even, joint is stable, displacement rate is minimum;
As improvement, described α is 78 °, and β is 42 °.
During use, for the level indicator on oblique girdle plane is not moved, as improvement, the first groove is set on the oblique girdle plane of right-angled trapezium body, level indicator is placed in the first groove.
Easy to operate in order to use, it is more accurate to locate, and described chute is located at the bottom of forward and backward side, and the chute on two sides is parallel.
As improvement, level indicator is connected with right-angled trapezium body, during use, level indicator and right-angled trapezium body are not easy to be offset, and improve the accuracy of location.
As improvement, guide post is connected with right-angled trapezium body; During location, avoided guide post and right-angled trapezium body to move and caused locating inaccuracy.
In order to increase the accuracy of location, reduce the slip of guide post and right-angled trapezium body, the bottom of right-angled trapezium body is provided with the second groove, and guide post is located in the second groove.
To be convenient to grasp right-angled trapezium body in order using, right-angled trapezium body to be made as to hollow structure.
α of the present invention, β, γ occurrence be, described α value is 90 ° and deducts radiation top rake required in operation, and β is the operation angle of splay in operation, and γ is 90 ° of operation angle of splays that deduct in operation; Radiation top rake in operation is 12 °, operation angle of splay while being 42 °, and α is 78 °, and β is 42 °, and γ is 48 °.
The present invention first describes each face of right-angled trapezium body: when the present invention supposes to perform the operation, need the acetabular bone of displacement to be placed on left side, the oblique girdle plane of right-angled trapezium body is positioned at top, the right angle face relative with oblique girdle plane is positioned at bottom, becoming the right angle face at α angle with oblique girdle plane is " left surface ", and another right angle face being connected with oblique girdle plane is " right flank ".
Using method of the present invention is: before use, first level indicator is placed in the first groove on right-angled trapezium body oblique girdle plane, the first bevel protractor is placed in the chute of trailing flank, and the second bevel protractor is placed in the chute of leading flank, during placement, the summit of bevel protractor is positioned at the left side of right-angled trapezium body; The second groove of right-angled trapezium body bottom is placed on guide post.During operation, patient is standard dorsal position, preoperative first by level indicator by operation table leveling, make pelvis on a fixing plane; When in art, acetabular bone is polished, acetabular bone guide-localization file is enclosed within to the left end of guide post in the pointing instrumentation of having assembled, while aiming at location, guide post is parallel with acetabular bone axle, it is vertical with operation table that the second bevel protractor does not insert a side of chute, due to β+γ=90 °, it is just in time parallel with long axis of body and vertical with pelvis sagittal plane that the first degree chi does not insert a side of chute, and β is now operation angle of splay; During level indicator reveal competence on right-angled trapezium body inclined trough surface, because the face of operation table is equivalent to coronalplane, now the face of operation table and the angle of guide post are 90 °-α of radiation top rake; Now operation technique personnel guide-localization can be filed to perform the operation angle of splay be β, radiation top rake be that 90 °-α carries out acetabular bone polishing, the fine setting that whole process leads according to situation in art, after polishing, the mortar cup that again leading, and complete when acetabular implant cup is implanted.
Adopt this device in art, acetabular bone polishing and the implantation of mortar cup to be positioned, solved operation technique person by virtue of experience and the problem that positional accuracy is not high, error is larger of implanting according to topography sign; Compare with the lower navigation system of implanting of navigation, it is simple to operate that the present invention has, economic and practical, can be widely used in medical field, can better meet clinical demand.
Accompanying drawing explanation
Fig. 1 is the structural representation of right-angled trapezium body;
Fig. 2 is the axonometric chart of Fig. 1;
Fig. 3 is β bevel protractor structural representation;
Fig. 4 is γ bevel protractor structural representation;
Fig. 5 is using state figure of the present invention.
Wherein: A is acetabular bone, 1 is right-angled trapezium body, and 2 is the first groove, and 3-1 is the first chute; 3-2 is the second chute, and 4 is the second groove, and 5 is the first bevel protractor, and 6 is the second bevel protractor, and 7 is level indicator, and 8 is guide post, and 9 is guide-localization file.
The specific embodiment
Below in conjunction with accompanying drawing, further illustrate the present invention.
Referring to Fig. 1 to Fig. 5, the second bevel protractor 6, level indicator 7 and guide post 8 that the first bevel protractor 5, the angle that right-angled trapezium body 1, the angle that the present invention includes acute angle and be α is β is γ, for the ease of grasping and be set to hollow structure right-angled trapezium body 1; During operation, suppose to need the acetabular bone of displacement to be placed on left side, the oblique girdle plane of right-angled trapezium body 1 is positioned at top, and the right angle face relative with oblique girdle plane is positioned at bottom, the right angle face that becomes α angle with oblique girdle plane is left surface, and another right angle face being connected with oblique girdle plane is placed on right flank; Oblique girdle plane is provided with the first groove 2, and level indicator 7 is placed in the first groove 2, and the shape of the shape of the first groove 2 and level indicator 7 matches, and preferred the first groove 2 is rectangular channel, and level indicator can be connected with right-angled trapezium body by conventional connector; The bottom of right-angled trapezium body is provided with for placing shape and the guide post 8 of the second groove 4, the second grooves 4 of guide post 8 and matches, and guide post 8 also can adopt conventional connector to be connected with right-angled trapezium body; The forward and backward side of right-angled trapezium body 1 is respectively equipped with the first chute 3-1 and the second chute 3-2, the first chute 3-1 is parallel with the second chute 3-2, the first bevel protractor 5 is placed in the second chute 3-2 of trailing flank, the second bevel protractor 6 is placed in the first chute 3-1 that is located at leading flank, and two bevel protractors all can move along chute.
The said connector of the present invention can be screw, fixation clamp etc., and the number of required connector is determined according to practical situation.
Wherein the angular relationship of α, β, γ need meet: 75 °≤α≤80 °, 40 °≤β≤45 °, β+γ=90 °, preferred α is 78 °, β is 42 °, described α value is 90 ° and deducts radiation top rake required in operation, and β is the operation angle of splay in operation, and γ is 90 ° of operation angle of splays that deduct in operation; Radiation top rake in operation is 12 °, operation angle of splay while being 42 °, and γ is 48 °.
Using method of the present invention is: before use, first level indicator is placed in the first groove on right-angled trapezium body oblique girdle plane, the first bevel protractor is placed in the chute of trailing flank, and the second bevel protractor is placed in the chute of leading flank, during placement, the summit of bevel protractor is positioned at the left side of right-angled trapezium body; The second groove of right-angled trapezium body bottom is placed on guide post.During operation, patient is standard dorsal position, preoperative first by level indicator by operation table leveling, make pelvis on a fixing plane; When in art, acetabular bone A polishes, acetabular bone guide-localization file is enclosed within to the left end of guide post in the position finder of having assembled, while aiming at location, guide post is parallel with acetabular bone axle, it is vertical with operation table that the second bevel protractor does not insert a side of chute, due to β+γ=90 °, the side that the first degree chi does not insert chute is parallel with long axis of body and vertical with pelvis sagittal plane (angle of splay of performing the operation refers to the angle between acetabular bone axle and sagittal plane) just in time, and β is now operation angle of splay; During level indicator reveal competence on right-angled trapezium body inclined trough surface, because the face of operation table is equivalent to coronalplane, now the face of operation table and the angle of guide post are 90 °-α of radiation top rake; Now operation technique personnel guide-localization can be filed to perform the operation angle of splay be β, radiation top rake be that 90 °-α carries out acetabular bone polishing, the fine setting that whole process leads according to situation in art, after polishing, the mortar cup that again leading, and complete when acetabular implant cup is implanted.

Claims (7)

1. an implantation angle collimator for acetabulum prostheses, it is characterized in that comprising that acute angle is the right-angled trapezium body of α, the first bevel protractor that angle is β, the second bevel protractor, level indicator and the guide post that angle is γ, 75 °≤α≤80 ° wherein, 40 °≤β≤45 °, and β+γ=90 °; The oblique girdle plane of described right-angled trapezium body is positioned at top, the right angle face relative with oblique girdle plane is positioned at bottom, two other right angle face is positioned at the arranged on left and right sides of oblique girdle plane, level indicator is placed on oblique girdle plane, the bottom of right-angled trapezium body is placed on guide post, the forward and backward side of right-angled trapezium body is respectively equipped with chute, and the chute on two sides is parallel, and the first bevel protractor and the second bevel protractor are arranged in the chute of forward and backward side and can move along chute.
2. implantation angle collimator for acetabulum prostheses according to claim 1, is characterized in that described α is 78 °, and β is 42 °.
3. implantation angle collimator for acetabulum prostheses according to claim 1, is characterized in that described oblique girdle plane is provided with the first groove, and level indicator is located in the first groove.
4. implantation angle collimator for acetabulum prostheses according to claim 1, is characterized in that described chute is located at the bottom of forward and backward side.
5. implantation angle collimator for acetabulum prostheses according to claim 4, is characterized in that described guide post is connected with right-angled trapezium body.
6. implantation angle collimator for acetabulum prostheses according to claim 3, is characterized in that the bottom of right-angled trapezium body is provided with the second groove, and guide post is located in the second groove.
7. implantation angle collimator for acetabulum prostheses according to claim 1, is characterized in that described right-angled trapezium body is hollow structure.
CN201210024761.1A 2012-02-06 2012-02-06 Implantation angle collimator for acetabulum prostheses Expired - Fee Related CN102525692B (en)

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CN107149490A (en) * 2017-05-18 2017-09-12 汤向阳 A kind of complete positioner of artificial full hip-joint replacement

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US6395005B1 (en) * 2000-04-14 2002-05-28 Howmedica Osteonics Corp. Acetabular alignment apparatus and method
CN2553755Y (en) * 2002-07-19 2003-06-04 王海涛 Acetabulum cap locator
CN201542755U (en) * 2009-11-30 2010-08-11 张全金 Acetabular angle positioning device
CN201642304U (en) * 2010-05-13 2010-11-24 张建平 Vertebral pedicle nail implanted angle guider

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GB0907650D0 (en) * 2009-05-05 2009-07-22 Depuy Int Ltd Alignment guide
US9295566B2 (en) * 2010-05-04 2016-03-29 Depuy International Limited Alignment guide

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN2364854Y (en) * 1999-03-26 2000-02-23 严怀宁 Acetabulum positioning device for all-hip displacement operation
US6395005B1 (en) * 2000-04-14 2002-05-28 Howmedica Osteonics Corp. Acetabular alignment apparatus and method
CN2553755Y (en) * 2002-07-19 2003-06-04 王海涛 Acetabulum cap locator
CN201542755U (en) * 2009-11-30 2010-08-11 张全金 Acetabular angle positioning device
CN201642304U (en) * 2010-05-13 2010-11-24 张建平 Vertebral pedicle nail implanted angle guider

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