CN106691545A - Cutting tool for infrapatellar fat pad and use method thereof - Google Patents
Cutting tool for infrapatellar fat pad and use method thereof Download PDFInfo
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- CN106691545A CN106691545A CN201710059704.XA CN201710059704A CN106691545A CN 106691545 A CN106691545 A CN 106691545A CN 201710059704 A CN201710059704 A CN 201710059704A CN 106691545 A CN106691545 A CN 106691545A
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- fat pad
- locating rod
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- subpatellar fat
- ligamentum patellae
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- 210000000577 adipose tissue Anatomy 0.000 title claims abstract description 91
- 238000000034 method Methods 0.000 title claims description 11
- 210000004417 patella Anatomy 0.000 claims abstract description 48
- 210000004204 blood vessel Anatomy 0.000 claims abstract description 14
- 230000003028 elevating effect Effects 0.000 claims description 13
- 238000003780 insertion Methods 0.000 claims description 8
- 230000037431 insertion Effects 0.000 claims description 8
- 238000009434 installation Methods 0.000 claims description 6
- 230000009471 action Effects 0.000 claims description 3
- 210000002615 epidermis Anatomy 0.000 claims description 3
- 230000000007 visual effect Effects 0.000 claims description 3
- 238000011883 total knee arthroplasty Methods 0.000 abstract description 5
- 210000003041 ligament Anatomy 0.000 abstract 2
- 230000003247 decreasing effect Effects 0.000 abstract 1
- 210000003127 knee Anatomy 0.000 description 13
- 210000000629 knee joint Anatomy 0.000 description 13
- 238000011160 research Methods 0.000 description 9
- 230000000694 effects Effects 0.000 description 8
- 230000002980 postoperative effect Effects 0.000 description 7
- 230000036770 blood supply Effects 0.000 description 5
- 238000001356 surgical procedure Methods 0.000 description 5
- 210000001367 artery Anatomy 0.000 description 4
- 230000008859 change Effects 0.000 description 4
- 201000010099 disease Diseases 0.000 description 4
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 4
- 230000000302 ischemic effect Effects 0.000 description 4
- 210000004285 patellofemoral joint Anatomy 0.000 description 4
- 230000000717 retained effect Effects 0.000 description 4
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- 210000000988 bone and bone Anatomy 0.000 description 3
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- 238000013150 knee replacement Methods 0.000 description 3
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- 230000009467 reduction Effects 0.000 description 3
- 208000024891 symptom Diseases 0.000 description 3
- 210000001519 tissue Anatomy 0.000 description 3
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- 206010003246 arthritis Diseases 0.000 description 2
- 230000004761 fibrosis Effects 0.000 description 2
- 239000003102 growth factor Substances 0.000 description 2
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- 239000000463 material Substances 0.000 description 2
- 210000005036 nerve Anatomy 0.000 description 2
- 238000002271 resection Methods 0.000 description 2
- 239000000126 substance Substances 0.000 description 2
- 210000002303 tibia Anatomy 0.000 description 2
- 241001421185 Anomis Species 0.000 description 1
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- 208000035965 Postoperative Complications Diseases 0.000 description 1
- 206010048873 Traumatic arthritis Diseases 0.000 description 1
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- 206010053692 Wound complication Diseases 0.000 description 1
- 208000027418 Wounds and injury Diseases 0.000 description 1
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- 238000005299 abrasion Methods 0.000 description 1
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- 238000006073 displacement reaction Methods 0.000 description 1
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B2017/564—Methods for bone or joint treatment
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Heart & Thoracic Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Surgical Instruments (AREA)
Abstract
The invention belongs to the field of operation tools of department of orthopaedics, and particularly relates to a structure of a quantitative cutting tool for an infrapatellar fat pad. The cutting tool for the infrapatellar fat pad comprises a patella fixer, a positioning rod, a patella ligament measuring rod and a cutting tool, wherein the patella fixer comprises a pair of calipers and a patella ligament fixing rod. The cutting tool has the advantages that the excessive infrapatellar fat pad is cut to expose the operation field, the dense blood vessel area of the infrapatellar fat pad is effectively remained, the complication due to simultaneous cutting of the dense blood vessel area caused by excessive cutting of the infrapatellar fat pad is decreased, a joint surgeon can conveniently operate and control, and the total knee arthroplasty operation is favorably performed.
Description
Technical field
Patent of the present invention belongs to bone surgery apparatus field, and in particular to subpatellar fat pad quantifies the structure of resecting tool.
Background technology
According to the year end of China National Bureau of Statistics of China's statistics 2013, the people of China's Mainland total population 1,360,720,000,60 one full year of life and above people
202,430,000 people of mouth, account for the 14.9% of total population, 65 one full year of life and the people of above population 131,610,000, account for the 9.7% of total population.Open within 2013
Begin, China's aging populations quantity will be incremented by with 10,000,000 scale, future will also double breakthrough 400,000,000 for 20 years.According to statistics
As shown by data, China the elderly of more than 60 years old has 51% with knee joint osseous arthritis.In the U.S., more than 9,000,000 people
Gonitis is diagnosed as through clinical symptoms and imaging data.It is a large amount of old plus traumatic arthritis, rheumatoid arthritis etc.
Year, patient underwent the puzzlement of diseases of knee joint.The early stage expectant treatment method of diseases of knee joint mainly have living-pattern preservation,
Physiotherapy, loss of weight, non-steroid anti-inflammatory drug, orthopedics, crutch, closed treating etc.[2].For the old diseases of knee joint of middle and advanced stage
Patient, knee replacements are important treatment means.With deepening continuously for reform and opening-up, the continuous of national comprehensive strength carries
Height, most of tertiary hospitals can carry out artificial full knee joint transposing operation at present for China.At present both at home and abroad for artificial total knee
Whether joint replacement surgery retains subpatellar fat pad is still present larger dispute, and lacks long-term Clinical Follow-up data.
Subpatellar fat pad is located at behind ligamentum patellae, between anterior intercondylar area and facies patellaris femoris bottom, there is pad and lubrication.
Subpatellar fat pad rete vasculosum outside is made up of lateral inferior genicular artery, lateral superior genicular artery descending branch, and inner side is by medial inferior genicular artery liter
Descending branch, the infrapatellar branch composition of rami articulares arteriae descendentis genicularis propped up on branch, descending genicular artery kneecap.The research such as Lin Yujin shows subpatellar fat pad
Other position adipose tissues are different from whole body, are contained within abundant rete vasculosum, this rete vasculosum not only nutrition itself, also to ligamentum patellae
With kneecap Xia Jideng adjacent tissues structure offer blood.The research of Nemschak etc. shows the abundant rete vasculosum in subpatellar fat pad
It is the important blood vessels source of kneecap.The research such as Ushiyama shows rich in nerve and immunocyte in subpatellar fat pad, with product
The effect of raw inflammatory factor and growth factor.Excessive excision subpatellar fat pad can cause knee joint to be given birth in total knee arthroplasty
Material resources change, and cause pain before patella height reduction and ligamentum patellae cripetura, knee, or even cause ligamentum patellae ischemic necrosis and kneecap bone
Folding etc., traces it to its cause closely related with damage subpatellar fat pad blood supply.Therefore protected in artificial full knee joint transposing surgical procedure
It is main academic opinion both domestic and external at present to stay subpatellar fat pad.But there is no a kind of instrument at present can quantify fat under excision kneecap
Fat pad, so as to the instrument in thick blood vessels area is fully retained.
The content of the invention
The technical problems to be solved by the invention are：In view of the shortcomings of the prior art, the first object of the present invention is
A kind of resecting tool that can quantify to cut off subpatellar fat pad is provided；The second object of the present invention is to provide this subpatellar fat pad
The application method of resectoscope, can not destroy the thick blood vessels area of lower section while subpatellar fat pad is cut off.
To realize the first object of the present invention, it is achieved using following technical scheme：
A kind of subpatellar fat pad resecting tool, includes patella fixing device, locating rod, ligamentum patellae analyzing rod and exsector, kneecap
Fixator includes clamp and ligamentum patellae fix bar, and caliper inboard is provided with two latches, two cards are provided with the one side of clamp
Block, is separately installed with the ligamentum patellae fix bar, ligamentum patellae fix bar on fixture block and is socketed with elevating lever, ligamentum patellae fix bar
Side be provided with lifting knob, the elevating lever on the inside of lifting knob connection simultaneously controls it to lift, and is provided with epimere between elevating lever
One connecting rod, the upper surface of connecting rod is provided with chute, and slide bar is connected with chute, and the locating rod is plugged with slide bar, positioning
One sidepiece of bar is provided with slide opening, and after slide opening is plugged into slider head, locating rod is moved left and right on chute, is provided with the middle of locating rod
Both sides can be connected in the ligamentum patellae analyzing rod through the slot for connecting, the other end of locating rod, the side of ligamentum patellae analyzing rod
Balancing pole is connected with face, balance pipe is installed in locating rod, balancing pole is provided with the installation projection of clamping balance pipe, balance pipe
It is connected in installation projection；
The exsector matches and is plugged in slot with slot, and knife face direction and the mutual level of locating rod of exsector set
Put, catch is provided with rear side of exsector, after exsector insertion slot, catch is mutually touched with the upper surface face of locating rod and prevents it
Dropped through locating rod.
Preferably：The lower side surfaces of the ligamentum patellae fix bar are provided with graduation mark.
Preferably：The bottom of the ligamentum patellae analyzing rod is provided with fixing tooth.
In order to realize second above-mentioned purpose, present invention employs following technical scheme：
A kind of application method of subpatellar fat pad resecting tool, including be using step：
1) presetting excision is made film highly
The first-selected height that there is thick blood vessels area according to film making observation subpatellar fat pad, is compared the approximate range of excision；
2）First cut-out subpatellar fat pad
In operation, cut epidermis and be turned to side, allow subpatellar fat pad under the visual field, fat under the kneecap on top is first cut off with knife
Fat pad, is easier when so descending knife.
3）The position of mounting and adjusting resecting tool
The outside of kneecap is clamped with clamp, ligamentum patellae analyzing rod is placed on ligamentum patellae, inserted using fixing tooth and fixed, will be fixed
Projection is installed in position bar one end slide opening insertion slider head, other end balance pipe insertion, and observation ensures that locating rod is horizontal positioned, positioning
Bar, if being viewed as inclining, will can hold clamp and be adjusted, until locating rod and connecting rod with balancing pole to be disposed vertically
Vertical configuration is with balancing pole；
4）Regulation excision height
Fine setting is made according to physical location, rotation and lifting knob adjusts the height of elevating lever, it is ensured that adjustable height is suitable, may be used also
Height comparison is carried out to be slowly put into exsector；
5）Excision subpatellar fat pad
Locating rod is removed, ligamentum patellae analyzing rod is taken away, locating rod is put back to, in exsector slowly being inserted slot, and allows catch to touch
Encounter on the end face of locating rod, pin locating rod and move left and right the action cut, until cutting is completed, will be cut with pliers etc.
The subpatellar fat pad for cutting rear upper end is taken away.
A kind of application method of subpatellar fat pad resecting tool according to claim 4, it is characterised in that：
The thick blood vessels area of subpatellar fat pad described in step 1 is located at outside side in subpatellar fat pad kneecap and opens 4-6mm, under apex patellae
12-15mm, 9-11mm behind ligamentum patellae.
Compared with prior art, the beneficial effects of the invention are as follows：Both unnecessary subpatellar fat pad can have been cut off to appear operation
It is wild, it is also possible to effectively to retain the thick blood vessels area of subpatellar fat pad, reduce because the excision of subpatellar fat pad is excessive, by thick blood vessels
Area cuts off in the lump, and the complication for causing, facilitate joint surgery doctor to manipulate, beneficial to the carrying out of total knee replacement operation.
Brief description of the drawings
Fig. 1 the structural representation of present invention；
Fig. 2 exsectves 4 of the present invention insert the structural representation of slot 13；
Fig. 3 present invention removes the structural representation of ligamentum patellae analyzing rod 3；
The structural representation of Fig. 4 subpatellar fat pad resecting tool operating positions of the present invention.
1st, patella fixing device；2nd, locating rod；3rd, ligamentum patellae analyzing rod；4th, exsector；5th, clamp；6th, ligamentum patellae fix bar；
7th, elevating lever；8th, latch；9th, fixture block；10th, connecting rod；11st, chute；12nd, knob is lifted；13rd, slot；14th, slider head；15th, it is sliding
Hole；16th, balancing pole；17th, balance pipe；The 18th, projection is installed；19th, fixing tooth；20th, graduation mark；21st, catch.
Specific embodiment
Specific embodiment of the invention is made a detailed explanation below according to accompanying drawing.
According to Fig. 1 to Fig. 4, a kind of subpatellar fat pad resecting tool described in the present embodiment includes kneecap and fixes
Device 1, locating rod 2, ligamentum patellae analyzing rod 3 and exsector 4, patella fixing device 1 include clamp 5 and ligamentum patellae fix bar 6, clamp 5
Inner side is provided with two latches 8, and two fixture blocks 9 are provided with the one side of clamp 5, and the ligamentum patellae is separately installed with fixture block 9
Elevating lever 7 is socketed with fix bar 6, ligamentum patellae fix bar 6, the side of ligamentum patellae fix bar 6 is provided with lifting knob 12, lifting
Knob 12 connection on the inside of elevating lever 7 and control it to lift, be provided with a connecting rod 10, connecting rod 10 in epimere between elevating lever 7
Upper surface be provided with chute 11, the slider head 14 that can internally slide is connected with chute 11, be plugged with slider head 14 described
Locating rod 2 a, sidepiece of locating rod 2 is provided with slide opening 15, and after slide opening 15 is plugged into slider head 14, locating rod 2 is on chute 11
Move left and right, slot 13 of the both sides through connection is provided with the middle of locating rod 2, it is tough that the other end of locating rod 2 can be connected to the kneecap
In band analyzing rod 3, balancing pole 16 is connected with the side of ligamentum patellae analyzing rod 3, balance pipe 17 is installed in locating rod 2, balanced
Bar 16 is provided with the installation projection 18 of clamping balance pipe 17, and balance pipe 17 is connected in installation projection 18；
The exsector 4 matches and is plugged in slot 13 with slot 13, and the knife face direction of exsector 4 is mutual with locating rod 2
Horizontally disposed, the rear side of exsector 4 is provided with catch 21, after the insertion slot 13 of exsector 4, the upper surface of catch 21 and locating rod 2
Face is mutually touched prevents it from passing through locating rod 2 to drop, and the lower side surfaces of the ligamentum patellae fix bar 6 are provided with graduation mark 20,
The bottom of the ligamentum patellae analyzing rod 3 is provided with fixing tooth 19.
Operating method
1) presetting excision is made film highly
The first-selected height that there is thick blood vessels area according to film making observation subpatellar fat pad, the thick blood vessels area of subpatellar fat pad is located at
Outside is other in subpatellar fat pad kneecap opens 5mm, and 14mm under apex patellae, 10mm behind ligamentum patellae are compared the approximate range of excision；
2）First cut-out subpatellar fat pad
In operation, cut epidermis and be turned to side, allow subpatellar fat pad under the visual field, fat under the kneecap on top is first cut off with knife
Fat pad, is easier when so descending knife.
3）The position of mounting and adjusting resecting tool
The outside of kneecap is clamped with clamp 5, ligamentum patellae analyzing rod 3 is placed on ligamentum patellae, inserted using fixing tooth 22 and fixed,
One end slide opening 15 of locating rod 2 is inserted into slider head 14, projection 18 is installed in the insertion of other end balance pipe 17, and observation ensures locating rod 2
It is horizontal positioned, locating rod, if being viewed as inclining, will can hold clamp 5 and be adjusted, directly with balancing pole to be disposed vertically
Vertical configuration is to locating rod 2 and connecting rod and balancing pole；
4）Regulation excision height
Fine setting is made according to physical location, rotation and lifting knob adjusts the height of elevating lever, it is ensured that adjustable height is suitable.
Locating rod 2 is first removed, ligamentum patellae analyzing rod 3 is taken away；
5）Excision subpatellar fat pad
Locating rod 2 is removed, ligamentum patellae analyzing rod 3 is taken away, locating rod 2 is put back to, in exsector slowly being inserted slot 13, and gear is allowed
Piece 21 is touched on the end face of locating rod 2, is pinned locating rod 2 and is moved left and right the action cut, until cutting is completed, with pincers
Son etc. takes the subpatellar fat pad of upper end after cutting away.
Operating effect
Rich in nerve and immunocyte in subpatellar fat pad, with the effect for producing inflammatory factor and growth factor.Closed in total knee
Excessive excision subpatellar fat pad can cause knee joint biomethanics to change in section displacement technique, cause patella height reduction and ligamentum patellae
Pain before cripetura, knee, or even cause ligamentum patellae ischemic necrosis and patellar fracture etc., trace it to its cause close with damage subpatellar fat pad blood supply
Cut is closed.We have found that subpatellar fat pad is fully retained can influence operation technique in artificial full knee joint transposing surgical procedure,
Some patientss occur Symptomatic postoperative snap, and few some patientss snap after extracing fat pad under arthroscope disappears,
For the excision of subpatellar fat pad -- whether cut off, cut off it is how many, how to cut off, at present in the world to the research of this respect, still
Lack particulars.
In total knee arthroplasty, excision subpatellar fat pad caused by kneecap tendon ischemic contracture be postoperative patella baja and
One of major reason of kneecap crispatura tendinum.Subpatellar fat pad is cut off in total knee arthroplasty can cause postoperative patella height to drop
It is low, cause kneecap crispatura tendinum and patella baja.Subpatellar fat pad should as far as possible be retained in total knee arthroplasty, and by art
In precise manipulation and correct treatment can reduce damage to subpatellar fat pad and its surrounding tissue, can obtain what is be more satisfied with
Surgical effect.
Research finds, complete resection subpatellar fat pad can cause shin bone outward turning angle in knee stretching process be obviously reduced and
Kneecap is substantially interior to be moved, and kneecap point pressure reduces, when reduction degree is more than knee extension in knee sprung.Therefore they recognize
For subpatellar fat pad has biomechanical function, and the life of kneecap can be influenceed after the symptom excisions that can mitigate pain syndrome before knee
Material resources and motion of knee joint.Subpatellar fat pad should use up in the works in the preoperative to maintaining proximity structure blood supply to play an important role
Amount retains subpatellar fat pad.
Excessive excision subpatellar fat pad can cause ligamentum patellae, kneecap ischemic in TKA arts, and postoperative patellar fracture, ligamentum patellae are short
The complication such as contracting substantially increase therewith.Studied by the angiogram of corpse and found, subpatellar fat pad cuts off completely can cause kneecap
The blood supply blocking of bone the latter half.1~3 year after cutting off subpatellar fat pad in knee replacements, ligamentum patellae length is measured
Substantially shorten 2~3 mm compared with preoperative, account for 5%, it is believed that it is to reduce pole bone under the postoperative kneecaps of TKA to retain subpatellar fat pad
One of key factor of folding.When subpatellar fat pad anatomical structure is with Relationship with Clinical, most authoritative proposition now is needed in TKA arts
Retain subpatellar fat pad as far as possible, to maintain proximity structure blood supply.Excessive excision subpatellar fat pad can cause knee joint biomethanics
Change, cause pain before knee, sometimes ligamentum patellae cripetura, or even cause ligamentum patellae ischemic necrosis and patellar fracture.Think fat under kneecap
Pad has direct protective effect to kneecap tendon, while reparation of the fatty liver cell therein to kneecap tendon has important effect, to low
Position kneecap has large effect.And patella baja can make the mechanical activity of patellofemoral joint that obvious change occurs, so that
Patellofemoral joint is caused to occur abnormal.Pole can clash into tibia sites under being mainly shown as kneecap, due to moving down for kneecap
Can increase the pressure of patellofemoral joint.Research shows to retain the generation that subpatellar fat pad advantageously reduces wound complication.
Wound, abrasion, inflammation etc. cause subpatellar fat pad oedema, hyperplasia, form crowded in shin femoral joint and/or patellofemoral joint
Folder clashes into, and can cause Hoffa diseases, and a series of clinical symptoms occurs, can involve the synovial membrane and tendon of correlation.When fat pad is received
Stimulate to certain factor cause acute and chronic damage to produce aseptic inflammation and cause pain, oedema, bleeding, ooze out, hyperplasia,
Hypertrophy, hardening, the fibr tissue denaturation between fat pad and ligamentum patellae, adhesion, machine, follow the string, make to stretch knee activity and be subject to
Limitation, its abundant nerve endings can be caused goinyalgia by the chemical stimulation of inflammation.Research show subpatellar fat pad fibrosis with
The postoperative knee joint front pain of TKA has significant correlation, and subpatellar fat pad fibrosis can influence knee articulation degree.A lot
Expert thinks fully to appear the carrying out for being more beneficial for TKA operations.Research shows excision subpatellar fat pad compared with fat pad is retained
Do not have too big difference compared with postoperative complications, simply patient occur pain before knee probability it is little higher, it is proposed that if not shadow
Sound operative doctor appears otch can retain subpatellar fat pad, otherwise then give excision.
Current Insall-Salviti indexes are the most frequently used indexes of the assessment postoperative kneecap crispatura tendinums of TKA in clinic, but
Knee joint lateral projection is clapped in the acquisition of Insall-Salviti indexes when needing 30 ° of patient's work to go down on one's knees, but is still lacked in the market
Weary special instrument is used for radiologic technologist, therefore researches and develops a special resecting tool as accurate acquisition Insall-
The powerful guarantee of Salviti indexes.
Apparatus of the invention can contrast quantitative according to preoperative analysis, substantially judge the degree of excision, can be with art
Adjustment resection, to ensure the thick blood vessels area of reservation subpatellar fat pad, it can be ensured that accurately excision seems subpatellar fat pad
It is particularly important, it is to avoid day infectious-related complication generation.Individual difference is different, thus cannot it is single with embodiment as a comparison, but protect
Do not carry out that consumption chemical industry operates in the recovery extent of the ligamentum patellae after staying and art will substantially get well, the probability that ligamentum patellae shortens
It is much smaller.
Claims (5)
1. a kind of subpatellar fat pad resecting tool, it is characterised in that：Include patella fixing device, locating rod, ligamentum patellae analyzing rod
And exsector, patella fixing device include clamp and ligamentum patellae fix bar, caliper inboard is provided with two latches, on the one side of clamp
Two fixture blocks are provided with, are separately installed with fixture block in the ligamentum patellae fix bar, ligamentum patellae fix bar and are socketed with elevating lever,
The side of ligamentum patellae fix bar is provided with lifting knob, and the elevating lever on the inside of lifting knob connection simultaneously controls it to lift, elevating lever it
Between be provided with a connecting rod in epimere, the upper surface of connecting rod is provided with chute, the slider head that can internally slide is connected with chute,
The locating rod is plugged with slider head, a sidepiece of locating rod is provided with slide opening, after slide opening is plugged into slider head 14, locating rod
Moved left and right on chute, slot of the both sides through connection is provided with the middle of locating rod, the other end of locating rod can be connected to described
In ligamentum patellae analyzing rod, balancing pole is connected with the side of ligamentum patellae analyzing rod, balance pipe is installed, on balancing pole in locating rod
The installation projection of clamping balance pipe is provided with, balance pipe is connected in installation projection；
The exsector matches and is plugged in slot with slot, and knife face direction and the mutual level of locating rod of exsector set
Put, catch is provided with rear side of exsector, after exsector insertion slot, catch is mutually touched with the upper surface face of locating rod and prevents it
Dropped through locating rod.
2. a kind of subpatellar fat pad resecting tool according to claim 1, it is characterised in that：The ligamentum patellae fix bar
Lower side surfaces are provided with graduation mark.
3. a kind of subpatellar fat pad resecting tool according to claim 1, it is characterised in that：
The bottom of the ligamentum patellae analyzing rod is provided with fixing tooth.
4. a kind of application method of the subpatellar fat pad resecting tool in use claim 1-3 described in any one, its feature
It is：Including being using step：
1) presetting excision is made film highly
The first-selected height that there is thick blood vessels area according to film making observation subpatellar fat pad, is compared the approximate range of excision；
2）First cut-out subpatellar fat pad
In operation, cut epidermis and be turned to side, allow subpatellar fat pad under the visual field, fat under the kneecap on top is first cut off with knife
Fat pad, is easier when so descending knife；
3）The position of mounting and adjusting resecting tool
The outside of kneecap is clamped with clamp, ligamentum patellae analyzing rod is placed on ligamentum patellae, inserted using fixing tooth and fixed, will be fixed
Projection is installed in position bar one end slide opening insertion slider head, other end balance pipe insertion, and observation ensures that locating rod is horizontal positioned, positioning
Bar, if being viewed as inclining, will can hold clamp and be adjusted, until locating rod and connecting rod with balancing pole to be disposed vertically
Vertical configuration is with balancing pole；
4）Regulation excision height
Fine setting is made according to physical location, rotation and lifting knob adjusts the height of elevating lever, it is ensured that adjustable height is suitable, may be used also
Height comparison is carried out to be slowly put into exsector；
5）Excision subpatellar fat pad
Locating rod is removed, ligamentum patellae analyzing rod is taken away, locating rod is put back to, in exsector slowly being inserted slot, and allows catch to touch
Encounter on the end face of locating rod, pin locating rod and move left and right the action cut, until cutting is completed, will be cut with pliers etc.
The subpatellar fat pad for cutting rear upper end is taken away.
5. the application method of a kind of subpatellar fat pad resecting tool according to claim 4, it is characterised in that：
The thick blood vessels area of subpatellar fat pad described in step 1 is located at outside side in subpatellar fat pad kneecap and opens 4-6mm, under apex patellae
12-15mm, 9-11mm behind ligamentum patellae.
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| WO1997021389A1 (en) * | 1995-12-08 | 1997-06-19 | Wright Medical Technology, Inc. | Distal femoral resection and re-cut instrumentation |
| US5810854A (en) * | 1997-01-24 | 1998-09-22 | Beach; William R. | Method and apparatus for attaching connective tissue to each other or underlying bone |
| US20040153066A1 (en) * | 2003-02-03 | 2004-08-05 | Coon Thomas M. | Apparatus for knee surgery and method of use |
| US20070162142A1 (en) * | 2005-06-15 | 2007-07-12 | Vitruvian Orthopaedics, Llc | Knee surgery method and apparatus |
| CN102551843A (en) * | 2010-09-24 | 2012-07-11 | 德普伊产品公司 | Patella resectioning guide and assembly |
| CN102846347A (en) * | 2011-06-30 | 2013-01-02 | 德普伊产品公司 | Patella drill guide and clamp assembly |
| US20160278938A1 (en) * | 2015-03-25 | 2016-09-29 | E. Marlowe Goble | Knee instruments and methods |
| CN206852644U (en) * | 2017-01-24 | 2018-01-09 | 丽水市人民医院 | A kind of subpatellar fat pad resecting tool |
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2017
- 2017-01-24 CN CN201710059704.XA patent/CN106691545B/en active Active
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO1997021389A1 (en) * | 1995-12-08 | 1997-06-19 | Wright Medical Technology, Inc. | Distal femoral resection and re-cut instrumentation |
| US5810854A (en) * | 1997-01-24 | 1998-09-22 | Beach; William R. | Method and apparatus for attaching connective tissue to each other or underlying bone |
| US20040153066A1 (en) * | 2003-02-03 | 2004-08-05 | Coon Thomas M. | Apparatus for knee surgery and method of use |
| US20070162142A1 (en) * | 2005-06-15 | 2007-07-12 | Vitruvian Orthopaedics, Llc | Knee surgery method and apparatus |
| CN102551843A (en) * | 2010-09-24 | 2012-07-11 | 德普伊产品公司 | Patella resectioning guide and assembly |
| CN102846347A (en) * | 2011-06-30 | 2013-01-02 | 德普伊产品公司 | Patella drill guide and clamp assembly |
| US20160278938A1 (en) * | 2015-03-25 | 2016-09-29 | E. Marlowe Goble | Knee instruments and methods |
| CN206852644U (en) * | 2017-01-24 | 2018-01-09 | 丽水市人民医院 | A kind of subpatellar fat pad resecting tool |
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| CN106691545B (en) | 2023-11-10 |
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