CN102697542B - Acetabulum installing and adjusting device in total hip arthroplasty - Google Patents
Acetabulum installing and adjusting device in total hip arthroplasty Download PDFInfo
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- CN102697542B CN102697542B CN201210141572.2A CN201210141572A CN102697542B CN 102697542 B CN102697542 B CN 102697542B CN 201210141572 A CN201210141572 A CN 201210141572A CN 102697542 B CN102697542 B CN 102697542B
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Abstract
The invention discloses an acetabulum installing and adjusting device in total hip arthroplasty, comprising a T-shaped rod device and a fixing device, wherein the T-shaped rod device comprises a T-shaped body; three first rods are movably installed on the T-shaped body, and the three first rods and the T-shaped body are vertically installed in a same direction; second rods which are opposite to the three first rods are further installed on the T-shaped body; a leveling instrument is further installed on the T-shaped body; the fixing device comprises a Schanz bolt, and the Schanz bolt is connected with an l-shaped rod through a universal connection piece; and the Schanz bolt is connected with a universal connection rod through another universal connection piece, and the leveling instrument is installed on the universal connection rod. The device can reduce or prevent the dislocation rate after the total hip arthroplasty, can reduce the excessive wear of acetabular components, and can prolong the service life of artificial hip joints in human bodies.
Description
Technical field
The present invention relates to acetabular bone device for installing and adjusting in a kind of replacement of total hip.
Background technology
Patient's hip arthralgia can be alleviated or alleviate to replacement of total hip, improve hip joint function, it is the reliable method of current generally acknowledged treatment hip joint disease in various late period, due to long-term survival rate good after replacement of total hip, make increasing young patient constantly accept total hip replacement hands art, the whole world has more than 100 ten thousand People's Bank of China's replacement of total hip every year, after replacement of total hip, prosthese failure is in vivo relevant with many factors, as the design of prosthese, the material of prosthese, the selection of prosthese, prosthese riding position in vivo, postoperative infection, prothesis dislocation, prosthese wearing and tearing, patient age, the factors such as mobility are relevant.Wherein acetabular component position lay most important, research shows, acetabular component is placed in the 5-25 degree that leans forward, while rolling 30-50 degree position, the position of acetabular component is good, and acetabular component position is within the scope of this time, and prosthese postoperative dislocation rate is only 1.5%, if not when this scope, displacement rate can be up to 6.1%.At present, during total hip replacement, most of operators all adopt free-hand setting acetabular prosthese, conventionally do not have suitable instrument to help operator and in art, determine position during setting acetabular prosthese, guarantee that acetabular component can be placed to desired safety range.During free-hand setting acetabular prosthese, top rake only has 82.7% 5-25 degree scope, and angle of heel only has 85.2% 30-50 degree scope, and top rake and angle of heel all in this safety range person only have 70.5%, therefore author thinks, free-hand setting acetabular is the very insecure method of one.If prosthese is dislocated, its early stage revision rate can be up to 20.8%.If acetabular component position of sound production is bad, not only postoperative prothesis dislocation rate is high, and can reduce range of motion, and can increase and by excessive wear, caused Periprosthetic bone dissolving etc. and can cause prosthetic loosening in late period.Acetabular abduction, as exceeded safety range, can obviously increase the wearing and tearing of acetabular bone polyethylene liner.And these all can reduce artificial hip joint existence time limit and the satisfaction of patient to total hip replacement operation in vivo.
Research is found: angle of heel, the degree of depth and the top rake of patient's acetabular bone exist significant individual variation, according to the shape of acetabular bone self and direction, lay acetabular component, and the ratio of acetabular component riding position outside safety range is still very high.Also there is operator to place in the preoperative position, make patient remain on the lateral position of standard as far as possible, pelvis is as far as possible vertical with ground level, use the fixing pelvis of support, while laying acetabular component in art, adopt artificial hip joint company that measuring stick is provided, regulate the position of acetabular component, determine in the preoperative position, after the fixing pelvis of pelvis fixed mount, although better fixing, but still may there is the activity of certain limit, therefore, position when setting acetabular prosthese be can not determine with whether preoperative put position is consistent, patient is after paving hands drape simultaneously, there is no reliably and accurately reference plane, therefore, still have 27.8% acetabular component to exceed its safety range.In art, adopt C shape arm perspective, because its visual field is less, be difficult to judge exactly angle of heel and the top rake of acetabular bone, although take the photograph sheet side hectare angle in art, can judge than being easier to, top rake is still difficult to determine.Therefore in recent years, in order to reduce the bad problem of acetabular component position of sound production after replacement of total hip, application navigation technology in replacement of total hip, although airmanship effect is better, navigator is expensive, has limited its extensive use.
Summary of the invention
The object of the present invention is to provide acetabular bone device for installing and adjusting in a kind of replacement of total hip.This device can reduce or avoid Dislocation Following Total Implantation of Hip Joint rate, reduces the excessive wear of acetabular component, increases the artificial hip joint existence life-span in vivo.
In order to reach above-mentioned purpose, solution of the present invention is:
Acetabular bone device for installing and adjusting in a kind of replacement of total hip, comprise T shape lever apparatus and fixture, wherein T shape lever apparatus comprises the body of T font, is movably installed with 3 the first bars on the body of described T font, and the body of 3 the first bars and T font is equidirectional at right angle setting; On the body of T font, be also provided with and 3 reciprocal the second bars of the first bar; Level indicator is also installed on the body of T font; Described fixture comprises 1 piece of Schanz screw, on Schanz screw, by universal connecting components, is connected with 1 font bar; On Schanz screw, by another universal connecting components, be connected with universal connection rod, level indicator is installed on universal connection rod.
3 described the first pole lengths equate.
The second described bar is installed on one end of the body of T font.
Described T shape lever apparatus and fixture are 316L type stainless T shape lever apparatus and the stainless fixture of 316L type.
Beneficial effect of the present invention is: this acetabular bone device for installing and adjusting advantage is as follows: when 1) can guarantee to prepare acetabular bone and placing acetabular component in operation, coronalplane and the horizontal plane of pelvis are perpendicular to the ground, and can in operation, recognize well the coronalplane of pelvis, when making in art burr acetabular bone and placing acetabular component, there is a good reference plane, therefore can guarantee that acetabular component is placed in desired safety range; 2) this installation cost low, simple in structure, easy to operate, do not increase operation wound.
Therefore, in replacement of total hip, use device of the present invention, make on the one hand within the angle of heel of acetabular bone in replacement of total hip and top rake be arranged on safety range, reduce or avoid Dislocation Following Total Implantation of Hip Joint rate, increase the satisfaction of patient to whole coxa substitution operation, reduce doctor-patient dispute; Within acetabular component is placed in safety range on the other hand, can reduce the excessive wear of acetabular component, increase the artificial hip joint existence life-span in vivo, postpone or avoid hip revision operation, reduce patient's misery, alleviate family, hospital and burden on society.
Accompanying drawing explanation
Fig. 1 is structural representation of the present invention;
Fig. 2 is the schematic diagram that X-ray film of the present invention is measured acetabular bone angle of heel;
Fig. 3 is the schematic diagram that X-ray film of the present invention is measured acetabulum.
The specific embodiment
Acetabular bone device for installing and adjusting in a kind of replacement of total hip of the present embodiment, as shown in Figure 1, comprise the stainless T shape of 316L type lever apparatus 1 and the stainless fixture 2 of 316L type, wherein T shape lever apparatus 1 comprises the body 3 of T font, on the body 3 of described T font, be movably installed with 4,3 the first bars 4 of 3 the first bars equal in length; And 3 the first bars 4 are equidirectional at right angle setting with the body 3 of T font; The one end that is installed on the body 3 of T font with 3 reciprocal the second bar 5, the second bars 5 of the first bar 4 is also installed on the body 3 of T font; On the body 3 of T font, level indicator 6 is also installed; Described fixture 2 comprises 1 piece of Schanz screw 7, on Schanz screw 7, by universal connecting components, is connected with 1 font bar 8; On Schanz screw 7, by another universal connecting components, be connected with universal connection rod 9, level indicator 6 is installed on universal connection rod 9.
When this device is used:
A. before sterilization, in horizontal position, determine bilateral anterior superior iliac spine and the pubic symphysis leading edge row labels of going forward side by side, then patient is put to lateral position.
B. routine disinfection drape tubercle of iliac crest region, disposes one piece of Schanz screw 7 and determines that it is securely fixed on pelvis, can install universal connecting components and the universal connection rod 9 of level indicator 6 in connection in tubercle of iliac crest.Use the body 3 of T font and 3 the first bars 4 that are flexibly connected with it, determine the coronalplane of pelvis, by the level indicator 6 being arranged on the body 3 of T font, pelvis coronalplane and horizontal plane are adjusted to perpendicular to the ground, now according to 9 level indicator 6 on universal connection rod, adjust the position of universal connecting components and universal connection rod 9, after determining that it is perpendicular to ground, keep universal connection rod 9 in this position and fixedly secure.
C. install on the body 3 of the second bar 5 to T fonts, now the second bar 5 is parallel with pelvis coronalplane and vertical with bilateral anterior superior iliac spine line, according to the second bar 5, adjust 1 font bar 8 on Schanz screw 7 in parallel and fix by universal connecting components, then remove the body 3 of T font and coupled 3 the first bars 4, level indicator 6 and 1 font bar 8.
D. then routine disinfection drape operative region and Schanz screw 7 and universal connection rod 9, Schanz screw 7 and universal connection rod 9 are exposed, get posteriolateral incision, in art, expose acetabular bone, at use reamer for hip arthroplasty,acetabulum, prepare before acetabular bone, again by level indicator 6 is installed on universal connection rod 9, according to level indicator 6, pelvis coronalplane and horizontal plane are adjusted to perpendicular to the groundly, 1 font bar 8 is mounted on the universal connecting components that is arranged in advance 1 font bar 8 on Schanz screw again.
E. the acetabular bone position-measurement device that uses artificial hip joint company to provide, determines after the top rake and angle of heel of acetabular bone, prepares acetabular bone, inserts acetabular component; Matched group, adopts conventional operation method, and free-hand preparation acetabular bone and insert acetabular component does not re-use acetabular bone device for installing and adjusting in art.
Clinical practice: the present embodiment is chosen needs the patient of row total hip replacement 40 examples, according to table of random number, at random 40 routine patients are divided into experimental group and matched group, every group of 20 examples, experimental group is used the acetabular bone device for installing and adjusting of designed, designed in operation, matched group adopts conventional method to perform the operation, do not use acetabular bone device for installing and adjusting, two groups are compared, and carry out statistical analysis.
1) typing standard: the various diseases such as fracture of femoral neck, osteoarthritis, aseptic necrosis of femoral head, hip dysplasia companion osteoarthritis, adults congenital dislocation of hip joint companion osteoarthritis, rheumatoid arthritis and old infectivity need the patient of row total hip replacement, all can be used as object of study.Object of study signing Informed Consent Form with participating in, makes process, safety and the object of experimental subject to this experiment have comprehensive understanding.
2) exclusion standard: pelvis exists deformity, the not obvious person of pelvis bone mark, is not suitable for participating in this research and disallowable.
By the method for the present embodiment, use acetabular bone device for installing and adjusting in replacement of total hip to carry out replacement of total hip, and measure:
Before all operation in patients of the preoperative assessment of a, take the photograph normal bit Anterior and posterior ring of pelvics bit slice, specify pelvis and have or not deformity, whether the anatomic landmark of pelvis is obvious; The body surface symbol of preoperative touch pelvis, whether the body surface symbol of specifying pelvis is obvious, or has obvious deformity etc.
After the postoperative pelycogram surveying of b, all patients take Anterior and posterior ring of pelvics bit slice and the positive bit slice of hip joint, while taking the photograph sheet, first use the body 1 of the T font of T shape lever apparatus 1 in adjusting device and coupled 3 the first bars 4, level indicator 6, allow the coronalplane of pelvis keep parallel to the ground, x-ray bulb is apart from film magazine 110cm.According to taking the photograph X-ray film, measure following index: angle of heel and the top rake of by Anterior and posterior ring of pelvics bit slice and the positive bit slice of hip joint, measuring acetabular component.
When the top rake of the positive bit slice measurement of c employing Anterior and posterior ring of pelvics bit slice and hip joint acetabular component and angle of heel, in order to make measured value more accurate, allow three different doctors measure respectively, get its meansigma methods.The measurement of angle of heel: the lower edge take bilateral teardrop shaped body draws a straight line as putting, then draw a straight line as putting take interior lower edge and the outer upper limb of acetabular component, the included angle A OB of these two lines is acetabular bone angle of heel (as shown in Figure 2).The measurement of top rake: camber line is made in the projection along the outer lower side of acetabular component, interior lower edge and outer upper limb take acetabular component draw a straight line as putting, and make a vertical line at the mid point of this straight line, take the intersection point of this vertical line and camber line as point, as drawing a straight line, point as putting the angle AOP that draws a straight line, is the top rake (as shown in Figure 3) of acetabular component with interior lower edge take acetabular component and outer upper limb with the interior lower edge of acetabular component, conventionally the measured top rake of Anterior and posterior ring of pelvics bit slice, because of the little 4-5 degree of the reason of the x-ray crevice projection angle top rake more measured than the positive bit slice of hip joint.
Statistical analysis: according to top rake and the angle of heel of the acetabular component of measuring, calculate experimental group and the matched group patient acetabular bone angle of heel percentage ratio in safety range, acetabulum is at the percentage ratio of safety range, acetabular bone angle of heel and top rake are all at the percentage ratio of safety range, adopt SAS6.12 statistics analysis software package, by one factor analysis of variance, carry out statistical analysis, during definition P<0.05, difference has significance statistically.
Follow up a case by regular visits to: postoperative 1 first quarter moon, within 3 months, 6 months, follow up a case by regular visits to, determined whether that hip prosthesis dislocation appears in patient, postoperative 6 months by inquiry questionnaire understand patient to operation satisfaction, to suffering from hip, carry out Harris scoring, and to data, adopt SAS6.12 statistics analysis software package, by one factor analysis of variance, carry out statistical analysis, during definition P<0.05, difference has significance statistically.
Use by this device in art, make the installation of acetabular component meet desirable installation requirement, if compared with routine operation, there is statistical significance, illustrate in replacement of total hip, use this device can obviously improve acetabular component position bad, thereby reduce the wearing and tearing of replacement of total hip posterior joint displacement rate and acetabular component, therefore be expected to extend the existence time limit of prosthese at body, make a part of patient extend the hip revision time, even make a part avoid hip joint to turn over operation, produce good Social benefit and economic benefit.
Claims (4)
1. acetabular bone device for installing and adjusting in a replacement of total hip, it is characterized in that: comprise T shape lever apparatus (1) and fixture (2), wherein T shape lever apparatus (1) comprises the body (3) of T font, on the body (3) of described T font, be movably installed with 3 the first bars (4), and 3 the first bars (4) are at right angle setting with the body (3) of T font; On the body (3) of T font, the second bar (5) is also installed, described the second bar (5) is positioned at the opposite side of 3 the first bars (4); On the body (3) of T font, level indicator (6) is also installed; Described fixture (2) comprises 1 piece of Schanz screw (7), and Schanz screw (7) is upper to be connected with 1 font bar (8) by universal connecting components; Schanz screw (7) is upper to be connected with universal connection rod (9) by another universal connecting components, and level indicator (6) is installed on universal connection rod (9).
2. acetabular bone device for installing and adjusting in a kind of replacement of total hip as claimed in claim 1, is characterized in that: described 3 the first bars (4) are equal in length.
3. acetabular bone device for installing and adjusting in a kind of replacement of total hip as claimed in claim 1, is characterized in that: described the second bar (5) is installed on one end of the body (3) of T font.
4. acetabular bone device for installing and adjusting in a kind of replacement of total hip as claimed in claim 1, is characterized in that: described T shape lever apparatus (1) and fixture (2) are respectively the stainless T shape of 316L type lever apparatus (1) and the stainless fixture of 316L type (2).
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201210141572.2A CN102697542B (en) | 2012-07-18 | 2012-07-18 | Acetabulum installing and adjusting device in total hip arthroplasty |
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| Application Number | Priority Date | Filing Date | Title |
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| CN201210141572.2A CN102697542B (en) | 2012-07-18 | 2012-07-18 | Acetabulum installing and adjusting device in total hip arthroplasty |
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| CN102697542A CN102697542A (en) | 2012-10-03 |
| CN102697542B true CN102697542B (en) | 2014-04-23 |
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| CN201210141572.2A Expired - Fee Related CN102697542B (en) | 2012-07-18 | 2012-07-18 | Acetabulum installing and adjusting device in total hip arthroplasty |
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| CN117379235B (en) * | 2023-12-13 | 2024-03-12 | 天津市医疗器械质量监督检验中心 | Hip joint prosthesis movement angle testing device |
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| CN2364854Y (en) * | 1999-03-26 | 2000-02-23 | 严怀宁 | Acetabulum positioning device for all-hip displacement operation |
| CN2553755Y (en) * | 2002-07-19 | 2003-06-04 | 王海涛 | Acetabulum cap locator |
| CN100463650C (en) * | 2007-09-21 | 2009-02-25 | 绍兴市人民医院 | Lower limbs isometric measuring device used for all-hip joint displacement operation |
| US8267938B2 (en) * | 2007-11-01 | 2012-09-18 | Murphy Stephen B | Method and apparatus for determining acetabular component positioning |
| WO2010065378A1 (en) * | 2008-11-25 | 2010-06-10 | A123 Systems, Inc. | Method and design for externally applied laser welding of internal connections in a high power electrochemical cell |
| AU2010323639B2 (en) * | 2009-11-24 | 2014-04-10 | Lexi Co., Ltd. | Preoperative planning program for artificial hip joint replacement surgery and surgery support jig |
| CN202078365U (en) * | 2011-05-26 | 2011-12-21 | 祝桂涛 | Acetabulum reamer guiding device for artificial hip joint replacement |
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