CN106236289A - Femoral rotation osteotomy automatic backlash static organ in a kind of total knee arthroplasty - Google Patents

Femoral rotation osteotomy automatic backlash static organ in a kind of total knee arthroplasty Download PDF

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Publication number
CN106236289A
CN106236289A CN201610605412.7A CN201610605412A CN106236289A CN 106236289 A CN106236289 A CN 106236289A CN 201610605412 A CN201610605412 A CN 201610605412A CN 106236289 A CN106236289 A CN 106236289A
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China
Prior art keywords
base plate
movable panel
osteotomy
static organ
femoral rotation
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Pending
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CN201610605412.7A
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Chinese (zh)
Inventor
李国东
昝鹏飞
范琳
杨东
范鳌元
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Shanghai Tenth Peoples Hospital
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Shanghai Tenth Peoples Hospital
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Priority to CN201610605412.7A priority Critical patent/CN106236289A/en
Publication of CN106236289A publication Critical patent/CN106236289A/en
Pending legal-status Critical Current

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Abstract

The present invention relates to femoral rotation osteotomy automatic backlash static organ in a kind of total knee arthroplasty, described femoral rotation osteotomy automatic backlash static organ includes benchmark base plate, retractor device, telescopic arm, movable panel, scriber;Described scriber is fixed on benchmark base plate;Described scriber includes jointing plate, connecting plate, marking groove;Described marking groove is parallel with the plane at benchmark base plate place.Its advantage shows: be fitted on tibial plateau Osteotomy by the benchmark base plate of knee joint static organ, with the screwdriver tool that assembles by space distraction, according to theory of mechanics, movable panel proximal end plane can swing with interior outside soft tissue tension, outside soft tissue tension absolute equilibrium in final guarantee, according to the scriber assembled, femur ankle far end cutting face is carried out marking again, determine femur outward turning angle accurately, to femoral rotation osteotomy with absolute accuracy, it is greatly saved again operating time.

Description

Femoral rotation osteotomy automatic backlash static organ in a kind of total knee arthroplasty
Technical field
The present invention relates to technical field of medical instruments, specifically, be that in a kind of total knee arthroplasty, femoral rotation cuts Bone automatic backlash static organ.
Background technology
Knee joint is mainly made up of femur, tibia and patella, and joint capsule is attached to the periphery of each bone articular cartilage, joint capsule Surrounding have ligament to reinforce, the joint capsule at knee joint, ligament, muscle, tendon, nerve, blood vessel etc. constitute soft group of knee joint Knit.
Along with the arrival of aging society, pathologic changes of knee joint has become as the common disease of one affecting life of elderly person quality Sick.Total knee arthroplasty is a kind of effective ways for the treatment of pathologic changes of knee joint in late period.
Total knee arthroplasty (Total KneeReplacement, TKA) refers to that the full knee joint applying artificial material to make closes Structure implants the human body autologous joint with replacement disease damage, thus obtains knee joint function.
In total knee arthroplasty (Total KneeReplacement, TKA), the levels of precision of osteotomy concerns performs the operation Success or failure, for the most vital step of determination of femoral rotation in art.Traditionally, according to femur and tibial rotation The feature of para-position.Prior art use femur Measurement die the rotation of femur is positioned at outward turning 3 °.This instrument is used to exist Complete knee joint art (Total KneeReplacement, TKA) suffers from the drawback that deficiency.
But, owing to the outward turning angle on the femur Measurement die that producer provides is given, usually stock with patient own The outward turning situation of bone is not inconsistent, the most this way being manually set femur outward turning angle, it is likely that to follow-up osteotomy and soft group Knit balance and bring huge difficulty.
Further, since the difference that the femur of each patient is grown, so bring the biggest error to osteotomy, in some instances it may even be possible to The possibility of failure is brought to operation.In order to improve this shortcoming, at present in operation, surgical staff generally uses knee sprung When 90 °, assistant's both hands are embraced distal femur and are maintained flexing position and interior outside soft tissue tension, the tibial plateau terminated with osteotomy For reference plane, condyle of femur coronalplane is rule to determine outward turning angle, even if so, because ensureing by application Saper The absolute equilibrium of outside soft tissue in the knee joint that assistant maintains, i.e. interior outside equalization of strain, condyle of femur coronalplane is drawn Line is the most accurate, a lot of error to osteotomy band.
In sum, need how one ensures interior outside soft tissue tension absolute equilibrium badly, precisely determine that femoral rotation cuts The automatic backlash static organ that the position of bone is put.And yet there are no report about this femoral rotation osteotomy automatic backlash static organ.
Summary of the invention
It is an object of the invention to for deficiency of the prior art, it is provided that how one ensures that interior outside soft tissue tension is exhausted To balance, precisely determine the automatic backlash static organ of femoral rotation osteotomy site.
For achieving the above object, the present invention adopts the technical scheme that:
Femoral rotation osteotomy automatic backlash static organ in a kind of total knee arthroplasty, described femoral rotation osteotomy is automatic Gap static organ includes benchmark base plate, retractor device, telescopic arm, movable panel, scriber;Described scriber is fixed on benchmark On base plate;Described scriber includes jointing plate, connecting plate, marking groove;Described marking groove is flat with the plane at benchmark base plate place OK;Described movable panel inner surface central authorities are provided with contiguous block;Described retractor device includes regulating bolt, housing, slide block, partially Heart wheel, elastomeric element, rotary shaft;Described shell side is provided with screw thread mouth;Described screw thread mouth connects and has regulation bolt;Described regulation Bolt includes screw rod and nut, and screw rod is provided with external screw thread and is connected with the female thread on screw thread mouth;The outside of described regulation bolt Being provided with screw tool bore, on screw tool bore, coupling has the screwdriver of correspondence;The inner side of described regulation bolt is provided with slide block;Described slide block It is provided with wedge-shaped slot;Described wedge-shaped slot is equipped with eccentric;Described eccentric is provided with rotary shaft;The two of described rotary shaft End is connected to telescopic arm;The other end of described telescopic arm is provided with circular hole;Described circular hole is corresponding with through hole on contiguous block, and In circular hole and through hole, it is equipped with bearing pin connects movable panel.
Further, described benchmark base plate and movable panel be shaped as the shape of a hoof.
Further, described benchmark base plate is fitted on tibial plateau.
Further, described base plate is additionally provided with support chip.
Further, described wedge-shaped slot is set to V-arrangement.
Further, in use, the distance between movable panel to benchmark base plate is 8-to described movable panel 18mm。
Further, described elastomeric element is spring.
Further, described scriber and benchmark base plate unitary design.
Further, described telescopic arm is two.
Further, described scriber is positioned at outside screw tool bore.
The invention has the advantages that:
1, femoral rotation osteotomy automatic backlash static organ in a kind of total knee arthroplasty of the present invention, balances based on gap Principle (gap balance), is fitted in the benchmark base plate of knee joint static organ on tibial plateau Osteotomy, with the spiral shell assembled Silk the Knife tool is by space distraction, and according to theory of mechanics, movable panel proximal end plane can swing with interior outside soft tissue tension, Outside soft tissue tension absolute equilibrium in final guarantee, then according to the scriber assembled, is rule in femur ankle far end cutting face Labelling, in the case of the soft tissue tension absolute equilibrium of interior outside, is determined the outward turning angle of femur.So based on gap Condyle osteotomy before and after the femur of equilibrium principle (gapbalance), have modified largely because cutting according to anatomic landmark position rotating Bone line and the personal error that causes, determine femur outward turning angle, accurately to femoral rotation osteotomy with absolute accuracy, again It is greatly saved operating time;
2, benchmark base plate and movable panel shape are designed as the shape of a hoof, and this design is to set according to human body knee joint physiological structure Meter, be conducive to inserting;
3, the datum level of benchmark base plate is set up with tibial plateau face and is connected, and provides location to depend on for femoral rotation osteotomy According to;
4, being provided with retractor device, its retractor device effect is to realize telescopic arm in height to regulate, thus controls movable top Plate in height can regulate, and movable panel can be strutted suitable position by surgical staff;
5, in retractor device, it is connected with the screw-threaded coupling of housing by regulation bolt, can be to counter lock in retractor device Fixed, i.e. realize after movable panel struts suitable position, the movable panel under this height to be locked;
6, movable panel is connected on telescopic arm by bearing pin, with knee joint both sides under movable panel use state Tension force contacts, because human body knee joint both sides Tensity size is different, when interior outside tension contact is to movable panel, movable top Plate can rotate around bearing pin, is automatically adjusted effective arm of force distance, it is achieved outside equalization of strain in knee joint;
7, movable panel is in use, and the distance between its movable panel to benchmark base plate is 8-18mm, this distance Scope is according to clinical experience, under knee sprung gap, femoral rotation osteotomy need clearance distance and design;
8, scriber and benchmark base plate unitary design, surgical staff regulates movable panel by screwdriver and struts After Ju Li, carry out ruling by marking groove;
9, arranging the mode of marking groove, compared with in prior art by the way of pedicle screw punches, its line is more Fast, precisely;
10, wedge-shaped slot is set to V-arrangement, and the wedge-shaped slot that V-type is arranged more can trigger the rotation of eccentric so that whole device control Make highly sensitive.
Accompanying drawing explanation
Accompanying drawing 1 be the present invention a kind of total knee arthroplasty in femoral rotation osteotomy automatic backlash balancer structure signal Figure.
Base plate, movable panel and retractor device main apparent direction schematic diagram on the basis of accompanying drawing 2.
Accompanying drawing 3 is movable panel cross section structure schematic diagram.
Base plate, movable panel and retractor device cross-sectional view on the basis of accompanying drawing 4.
Base plate, movable panel and retractor device structural representation on the basis of accompanying drawing 5.
Base plate each modular construction schematic diagram on the basis of accompanying drawing 6.
Detailed description of the invention
The detailed description of the invention provided the present invention below in conjunction with the accompanying drawings elaborates.
The reference and the ingredient that relate in accompanying drawing are as follows:
1. benchmark base plate 2. retractor device
21. housings 22. regulate bolt
221. screw rod 222. nuts
223. screw tool bore 23. screw thread mouths
24. slide block 25. wedge-shaped slots
26. elastomeric element 27. eccentrics
28. rotary shaft 3. telescopic arms
31. circular hole 4. bearing pins
5. movable panel 51. contiguous block
52. through hole 6. scribers
61. jointing plate 62. connecting plates
63. marking groove 64. shape holes
7. support chip
Refer to femoral rotation osteotomy automatic backlash in a kind of total knee arthroplasty that Fig. 1 and Fig. 2, Fig. 1 are the present invention Balancer structure schematic diagram.Base plate 1, movable panel 5 and retractor device 2 main apparent direction schematic diagram on the basis of Fig. 2.A kind of full knee joint Femoral rotation osteotomy automatic backlash static organ in joint replacement, described femoral rotation osteotomy automatic backlash static organ includes base Quasi-base plate 1, retractor device 2, telescopic arm 3, movable panel 5, scriber 6;Described scriber 6 is fixed on benchmark base plate 1;Institute State scriber 6 and include jointing plate 61, connecting plate 62, marking groove 63, connecting plate 62;Described marking groove 63 and benchmark base plate 1 institute Plane parallel.
Refer to Fig. 3, Fig. 3 is movable panel 5 cross section structure schematic diagram.Described movable panel 5 inner surface central authorities are provided with Contiguous block 51;Described contiguous block 51 is provided with through hole 52.
Refer to Fig. 4, base plate 1, movable panel 5 and retractor device 2 cross-sectional view on the basis of Fig. 4.Fig. 5 is base Quasi-base plate 1, movable panel 5 and retractor device 2 structural representation.Described benchmark base plate 1 is provided with retractor device 2;Described Retractor device 2 includes regulating bolt 22, housing 21, slide block 24, eccentric 27, elastomeric element 26, rotary shaft 28;Described shell side It is provided with screw thread mouth 23;Described screw thread mouth 23 connects and has regulation bolt 22;Described regulation bolt 22 includes screw rod 221 and nut 222, screw rod 221 is provided with external screw thread and is connected with the female thread on screw thread mouth 23;The outside of described regulation bolt 22 is provided with screw Tool bore 223, on screw tool bore 223, coupling has the screwdriver of correspondence;The inner side of described regulation bolt 22 is provided with slide block 24;Described cunning Block 24 is provided with wedge-shaped slot 25;Being equipped with eccentric 27 in described wedge-shaped slot 25, described eccentric 27 is provided with rotary shaft 28; The two ends of described rotary shaft 28 are connected to telescopic arm 3;
Refer to Fig. 6. base plate 1 each modular construction schematic diagram on the basis of Fig. 6.Described telescopic arm 3 is two;Described flexible The other end of arm 3 is provided with circular hole 31;Described circular hole 31 connects movable panel 5 by bearing pin 4;It is additionally provided with support chip on described base plate 7, the quantity of support chip 7 is preferably two.
It should be understood that described benchmark base plate 1 and movable panel 5 be shaped as the shape of a hoof, the design of this shape be by Being designed according to knee joint physiological structure, beneficially benchmark base plate 1 and movable panel 5 is preferably embedded in knee joint.Its In, benchmark base plate 1 is fitted on tibial plateau, and benchmark base plate 1 is normative with reference to tibial plateau, and benchmark base plate 1 passes through Tibial plateau sets up benchmark, provides basis on location for femoral rotation osteotomy, cuts stock size precisely, and error is little.
Described retractor device 2 includes regulating bolt 22, housing 21, slide block 24, eccentric 27, elastomeric element 26, rotating Axle 28, telescopic arm 3, before not using, elastomeric element 26 one end is connected on housing 21, and the other end is connected on slide block 24, bullet Property parts 26 before not using in compressive state.And the elastic force under elastomeric element 26 compressive state passes to regulation through slide block 24 On bolt 22, the screw rod 221 on regulation bolt 22 is provided with external screw thread, and this external screw thread is by the internal thread locking on housing 21 Connect, by the way of screw-threaded coupling, so balance the elastic force of elastomeric element 26 under compressive state.During use, pass through screwdriver Inserting in screw tool bore 223, release regulation bolt 22 and be connected with the screw-threaded coupling on housing 21, now, elastomeric element 26 is without phase The equilibrant answered, the elastomeric element 26 of compression promotes slide block 24 to move, because being provided with wedge-shaped slot 25, and wedge-shaped slot 25 on slide block 24 In be equipped with eccentric 27, when slide block 24 moves, eccentric 27 promotes eccentric because the height and position of wedge-shaped slot 25 is different 27 rotate, and eccentric 27 rotates and rotary shaft 28 can be driven along with eccentric 27 synchronous axial system, and rotary shaft 28 is with eccentric 27 turns During Dong, its height is change, and the telescopic arm 3 that is so connected in rotary shaft 28 achieves rising and lower by function, And on telescopic arm 3 connect have movable panel 5, i.e. achieve movable panel 5 rise and lower by function, therefore, pass through screwdriver Just can control the movable panel 5 distance in knee joint free clearance, after movable panel 5 reaches to strut suitable position, logical Cross screwdriver precession so that regulation bolt 22 is connected with housing 21 screw-threaded coupling, balances the elastic force of elastomeric element 26, secures The position of movable panel 5.Therefore, this design, designs ingenious, by screwdriver control realization movable panel 5 knee joint certainly By the distance strutted in gap, and movable panel 5 can be kept again fixing under desired location.
Wedge-shaped slot 25 is set to V-arrangement, and the wedge-shaped slot 25 that V-type is arranged more can trigger the rotation of eccentric 27 so that whole dress Putting control highly sensitive, as long as i.e. screwdriver releases screw-threaded coupling connection, once slide block 24 is at the elastic force of elasticity of compression parts 26 Promoting lower movement, the rotation of the most attainable eccentric 27, eccentric 27 rotates, thus realizes movable panel 5 in knee joint certainly Move with in gap.
Movable panel 5 inner surface central authorities are provided with contiguous block 51;Described contiguous block 51 is provided with through hole 52, and through hole 52 is with flexible The circular hole 31 of arm 3 is corresponding, loads bearing pin 4 in circular hole 31 and through hole 52, and such movable panel 5 two ends can rotate around bearing pin 4, In use, movable panel 5 is respectively placed in inside and outside kneed, from human physiological structure, inside and outside knee joint Side soft tissue is different, and the Tensity size of the both sides of its correspondence is different, and during femur osteotomy, outside in needing to set up Osteotomy of ruling on the basis of equalization of strain is the most accurate, the movable panel 5 designed by the present invention, the soft tissue in interior outside Tension force act on movable panel 5 two ends, in movable panel 5 two ends outside tension force rotate equilibrium establishment voluntarily around bearing pin 4.From And maintain the balance of outside tension force in knee joint.It addition, contiguous block 51 position is designed as required, because contiguous block 51 is real Matter is the strong point, and the interior outside tension force of different patient's soft tissues is different, and interior outside tension force is different, according to mechanics principle, sets up flat The position of the strong point required for weighing apparatus is different.
In use, the distance between movable panel 5 to benchmark base plate 1 is 8-18mm to described movable panel 5, preferably This distance is 13mm, and this distance range is according to clinical experience, little in knee sprung gap, between femoral rotation osteotomy needs Stand-off distance from and design.
Described elastomeric element 26 mainly provides elastic force effect, and its elastomeric element 26 can need to select, and can be bullet Spring realizes, easy for installation, and material easily obtains, low cost.
Described scriber 6 is positioned at outside screw tool bore 223, and the jointing plate 61 on scriber 6 is provided with a shape hole 64, door Shape hole 64 just to screw tool bore 223, effect is that convenient screwdriver inserts through door shape hole 64;Described scriber 6 and benchmark base plate 1 Unitary design, surgical staff by screwdriver regulate movable panel 5 strut distance after, by marking groove 63 carry out draw Line, easy to operate, improve work efficiency.By the way of marking groove 63 is set, pass through pedicle screw in prior art The mode of punching is compared, and its line is more quick, precisely.
Femoral rotation osteotomy automatic backlash static organ in a kind of total knee arthroplasty of the present invention, former based on gap balance Reason (gap balance), is fitted in the benchmark base plate 1 of knee joint static organ on tibial plateau Osteotomy, with the spiral shell assembled Silk the Knife tool is by space distraction, and according to theory of mechanics, movable panel 5 proximal end plane can be put with about the soft tissue tension of interior outside Dynamic, outside soft tissue tension absolute equilibrium in final guarantee, then according to the scriber 6 assembled, femur ankle far end cutting face is carried out Marking, in the case of the soft tissue tension absolute equilibrium of interior outside, is determined the outward turning angle of femur.So based on Condyle osteotomy before and after the femur of gap equilibrium principle (gapbalance), have modified largely because of according to the rotation of anatomic landmark location The personal error turning osteotomy line and cause, determines femur outward turning angle accurately, to femoral rotation osteotomy with absolute accurate Property, it is greatly saved again operating time;Benchmark base plate 1 and movable panel 5 shape are designed as the shape of a hoof, and this design is according to human body The design of knee joint physiological structure, be conducive to inserting;The datum level of benchmark base plate 1 is set up with tibial plateau face and is connected, for Femoral rotation osteotomy provides basis on location;Being provided with retractor device 2, the effect of its retractor device 2 is to realize telescopic arm 3 in height to adjust Joint, thus control movable panel 5 and in height can regulate, movable panel 5 can be strutted suitable position by surgical staff;Stretching In compression apparatus 2, it is connected with the screw-threaded coupling of housing 21 by regulation bolt 22, balance locking in retractor device 2 i.e. can be realized After movable panel 5 struts suitable position, the movable panel 5 under this height can be locked;Movable panel 5 is by bearing pin 4 even Being connected on telescopic arm 3, under movable panel 5 use state, the tension force with knee joint both sides contacts, because of human body knee joint both sides Tensity size is different, and when interior outside tension contact to movable panel 5, movable panel 5 can rotate around bearing pin 4, automatically adjust Save effective arm of force distance, it is achieved outside equalization of strain in knee joint;Movable panel 5 in use, its movable panel 5 to Distance between benchmark base plate 1 is 8-18mm, and this distance range is according to clinical experience, under knee sprung gap, femur Rotary osteotomy need clearance distance and design;Scriber 6 and benchmark base plate 1 unitary design, surgical staff is passed through Screwdriver regulate movable panel 5 strut distance after, carry out ruling by marking groove 63;The mode of marking groove 63 is set, Compared with in prior art by the way of pedicle screw punches, its line is more quick, precisely;Wedge-shaped slot 25 is set to V-arrangement, The wedge-shaped slot 25 that V-type is arranged more can trigger the rotation of eccentric 27 so that whole device controls highly sensitive.
The above is only the preferred embodiment of the present invention, it is noted that for the ordinary skill people of the art Member, on the premise of without departing from the inventive method, it is also possible to makes some improvement and supplements, and these improve and supplement and also should be regarded as Protection scope of the present invention.

Claims (10)

1. femoral rotation osteotomy automatic backlash static organ in a total knee arthroplasty, it is characterised in that described femur rotation Turn osteotomy automatic backlash static organ and include benchmark base plate, retractor device, telescopic arm, movable panel, scriber;Described scriber It is fixed on benchmark base plate;Described scriber includes jointing plate, connecting plate, marking groove;Described marking groove and benchmark base plate institute Plane parallel;Described movable panel inner surface central authorities are provided with contiguous block;Described retractor device includes regulating bolt, shell Body, slide block, eccentric, elastomeric element, rotary shaft;Described shell side is provided with screw thread mouth;Described screw thread mouth connects and has regulation spiral shell Bolt;Described regulation bolt includes screw rod and nut, and screw rod is provided with external screw thread and is connected with the female thread on screw thread mouth;Described regulation The outside of bolt is provided with screw tool bore, and on screw tool bore, coupling has the screwdriver of correspondence;The inner side of described regulation bolt is provided with cunning Block;Described slide block is provided with wedge-shaped slot;Described wedge-shaped slot is equipped with eccentric;Described eccentric is provided with rotary shaft;Institute The two ends stating rotary shaft are connected to telescopic arm;The other end of described telescopic arm is provided with circular hole;On described circular hole and contiguous block Through hole is corresponding, and is equipped with bearing pin connection movable panel in circular hole and through hole.
Femoral rotation osteotomy automatic backlash static organ the most according to claim 1, it is characterised in that described benchmark base plate With movable panel be shaped as the shape of a hoof.
Femoral rotation osteotomy automatic backlash static organ the most according to claim 1, it is characterised in that described benchmark base plate It is fitted on tibial plateau.
Femoral rotation osteotomy automatic backlash static organ the most according to claim 1, it is characterised in that also set on described base plate There is support chip.
Femoral rotation osteotomy automatic backlash static organ the most according to claim 1, it is characterised in that described wedge-shaped slot is arranged For V-arrangement.
Femoral rotation osteotomy automatic backlash static organ the most according to claim 1, it is characterised in that described movable panel exists During use, the distance between movable panel to benchmark base plate is 8-18mm.
Femoral rotation osteotomy automatic backlash static organ the most according to claim 1, it is characterised in that described elastomeric element For spring.
Femoral rotation osteotomy automatic backlash static organ the most according to claim 1, it is characterised in that described scriber and base Quasi-base plate unitary design.
Femoral rotation osteotomy automatic backlash static organ the most according to claim 1, it is characterised in that described telescopic arm is Two.
Femoral rotation osteotomy automatic backlash static organ the most according to claim 1, it is characterised in that described scriber It is positioned at outside screw tool bore.
CN201610605412.7A 2016-07-28 2016-07-28 Femoral rotation osteotomy automatic backlash static organ in a kind of total knee arthroplasty Pending CN106236289A (en)

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CN110522524A (en) * 2019-10-08 2019-12-03 胡日鹤 90 degree of side-lying position operation fixed frames of medical standard and sterile sets used
CN115462866A (en) * 2022-11-02 2022-12-13 北京壹点灵动科技有限公司 Knee joint parameter-based adjustment method and device, processor and electronic equipment

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