CN106691545B - Subcarpler fat pad cutting tool and using method thereof - Google Patents
Subcarpler fat pad cutting tool and using method thereof Download PDFInfo
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- CN106691545B CN106691545B CN201710059704.XA CN201710059704A CN106691545B CN 106691545 B CN106691545 B CN 106691545B CN 201710059704 A CN201710059704 A CN 201710059704A CN 106691545 B CN106691545 B CN 106691545B
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- 210000000577 adipose tissue Anatomy 0.000 title claims abstract description 70
- 238000000034 method Methods 0.000 title description 7
- 210000004417 patella Anatomy 0.000 claims abstract description 82
- 210000003041 ligament Anatomy 0.000 claims abstract description 31
- 238000000926 separation method Methods 0.000 claims description 6
- 230000000149 penetrating effect Effects 0.000 claims 1
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- 230000000399 orthopedic effect Effects 0.000 abstract description 3
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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
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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
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
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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
- A61B17/56—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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- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
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Abstract
The invention belongs to the field of orthopedic surgical tools, and particularly relates to a structure of a quantitative excision tool for a fat pad below a patella. The utility model provides a fat pad excision instrument under patella, including patella fixer, locating lever, patella ligament survey pole and excision sword, the patella fixer includes calliper and patella ligament dead lever, both can excision unnecessary fat pad under the patella in order to show the operation field, also can effectively remain the dense vascular area of fat pad under the patella, reduce because of the excision of fat pad under the patella is too much, excision the dense vascular area in the lump, and the complication that causes, make things convenient for joint surgeon to control, do benefit to the going on of full knee joint replacement operation.
Description
Technical Field
The invention belongs to the field of orthopedic surgical tools, and particularly relates to a structure of a quantitative excision tool for a fat pad below a patella.
Background
The statistics of the 2013 year end by the national statistical office of China shows that the population of China is 136072, the population of China is 20243 ten thousand, 14.9% of the population, and the population of China is 13161 ten thousand, 9.7% of the population. Beginning in 2013, the number of the aging population in China is increased in 1000 ten thousand scale, and the future 20 years are doubled by 4 hundred million. According to the statistical data, 51% of the elderly people over 60 years old in China have knee osteoarthritis. In the united states, over 900 tens of thousands of people are diagnosed with gonarthritis via clinical symptoms and imaging data. In addition to traumatic arthritis, rheumatoid arthritis, etc., a large number of elderly patients experience knee joint disease. Early-stage conservative treatment methods for knee joint diseases mainly include lifestyle changes, physical therapy, weight loss, nonsteroidal anti-inflammatory drugs, orthopedic shoes, walking sticks, closed treatment, etc. [2]. Knee arthroplasty is an important treatment for elderly knee joint disease patients in the middle and late stages. With the continuous deep development of reform, the comprehensive strength of the country is continuously improved, and most three-level hospitals in China can perform artificial total knee joint replacement operation. At present, whether the patellar fat pad is reserved in the artificial total knee replacement operation at home and abroad is still in great debate, and long-term clinical follow-up data is lacking.
The patellar inferior fat pad is positioned behind the patellar ligament, between the intercondylar anterior region and the lower portion of the patellar surface of the femur, and has the functions of pad and lubrication. The external side of the blood vessel network of the patellar fat pad is composed of an external artery below the knee and an external artery below the knee, and the internal side is composed of an internal artery ascending branch below the knee, a descending branch of an upper patellar branch of an artery below the knee and a lower patellar branch of a joint branch of the artery below the knee. Lin Yujin it is shown that the fat pad under the patella is different from fat tissue at other parts of the whole body, and contains rich blood vessel network, which not only nourishes itself, but also provides blood for adjacent tissue structures such as patella ligament, patella inferior pole, etc. Studies by nemschk et al indicate that the rich vascular network in the infrapatellar fat pad is an important vascular source for the patella. Research by Ushiyama and the like shows that the infrapatellite pad is rich in nerves and immune cells and has the function of producing inflammatory factors and growth factors. Excessive excision of the infrapatellite pad in total knee replacement can cause biomechanical changes of the knee joint, resulting in reduced patella height, shortened patellar ligament, anterior knee pain, even ischemic necrosis of the patellar ligament, fracture of the patella, and the like, the reason of which is closely related to injury of blood supply of the infrapatellite pad. Therefore, preserving the fat pad below the patella during the artificial total knee replacement operation is currently the main academic claim at home and abroad. However, there is no tool currently available to quantitatively resect the infrapatellar fat pad, thereby completely preserving the dense vascular region.
Disclosure of Invention
The technical problems to be solved by the invention are as follows: in view of the shortcomings of the prior art, a first object of the present invention is to provide a resecting tool that can quantitatively resect a infrapatellar fat pad; a second object of the present invention is to provide a method of using such a infrapatellar fat pad resector that can resect the infrapatellar fat pad without damaging the underlying dense vascular region.
In order to achieve the first object of the present invention, the following technical solutions are adopted:
the utility model provides a fat pad excision instrument under patella, including patella fixer, locating lever, patella ligament survey pole and excision sword, patella fixer includes calliper and patella ligament dead lever, and the calliper inboard is equipped with two latch, is provided with two fixture blocks on one side of calliper, installs respectively on the fixture block the patella ligament dead lever, has all cup jointed the lifter in the patella ligament dead lever, and one side of patella ligament dead lever is equipped with the lift knob, and the lifter of inboard is connected to the lift knob and control it and goes up and down, is equipped with a connecting rod between the lifter in the upper segment, is equipped with the spout on the upper surface of connecting rod, is connected with the slide bar on the spout, peg graft on the slide bar the locating lever, be equipped with the slide hole on one lateral part of locating lever, behind the slide hole grafting to the slider head, the locating lever moves about on the spout, is equipped with the slot that both sides run through the intercommunication in the middle of locating lever, and the other end of locating lever can block in the ligament survey pole, the joint has the balancing lever on the side of patella ligament survey pole, installs the balancing hole on the balancing lever, is equipped with the balancing lug and installs the balancing lug in the balancing lug that the balancing lug in the joint of balancing hole;
the utility model discloses a cutting knife, including the locating lever, the cutting knife, the locating lever, the cutting knife is connected in the slot with slot phase-match, and the knife face direction of cutting knife and the mutual level setting of locating lever are equipped with the separation blade, and the rear side of cutting knife inserts the slot after, and the separation blade touches each other with the up end face of locating lever and prevents that it from passing the locating lever and drop.
As a preferable scheme: scale marks are arranged on the lateral surface of the lower part of the patellar ligament fixing rod.
As a preferable scheme: the bottom of the patellar ligament measuring rod is provided with fixed teeth.
In order to achieve the second object, the present invention adopts the following technical scheme:
the using method of the patellar fat pad excision tool comprises the following using steps:
1) Film shooting preset cutting height
Firstly, observing the height of a dense blood vessel region of the fat pad under the patella according to a film, and comparing the height with the approximate range of cutting;
2) First resecting part of the patellar fat pad
In the operation, the epidermis is cut and turned to one side, so that the patellar fat pad is exposed to the visual field, and the patellar fat pad at the upper part is firstly resected by a knife, so that the knife is easy to lower.
3) Mounting and adjusting the position of the cutting tool
Clamping the outer side of the patella by using a caliper, placing a patella ligament measuring rod on the patella ligament, inserting and fixing by using a fixed tooth, inserting a sliding hole at one end of a positioning rod into a sliding block head, inserting a balance hole at the other end into a mounting lug, observing to ensure that the positioning rod is horizontally placed, and if the positioning rod is inclined, holding the caliper for adjustment until the positioning rod is vertical to the connecting rod and the balance rod;
4) Adjusting the cutting height
The fine adjustment is carried out according to the actual position, the lifting knob is rotated, the height of the lifting rod is adjusted, the proper lifting height is ensured, and the cutter can be slowly placed into the cutter for height comparison;
5) Resecting the fat pad under the patella
The positioning rod is taken down, the patellar ligament measuring rod is taken away, the positioning rod is put back, the resectoscope is slowly inserted into the slot, the baffle plate touches the end face of the positioning rod, the positioning rod is pressed to move left and right to perform cutting action until the cutting is completed, and the patellar fat pad at the upper end after the cutting is taken away by pliers and the like.
The method of using a fat pad removal device according to claim 4, wherein:
in the step 1, the dense vascular region of the patellar fat pad is positioned at the inner side and the outer side of the patella of the patellar fat pad by 4-6mm, the patellar tip is 12-15mm, and the posterior surface of the patellar ligament is 9-11mm.
Compared with the prior art, the invention has the beneficial effects that: the device can cut off redundant infrapatellite pad to expose the operation field, can also effectively reserve the dense vascular area of the infrapatellite pad, reduces complications caused by cutting off the dense vascular area together due to excessive cutting off of the infrapatellite pad, is convenient for a joint surgeon to operate and control, and is beneficial to the whole knee joint replacement operation.
Drawings
FIG. 1 is a schematic diagram of the structure of the present invention;
FIG. 2 is a schematic view of the structure of the excision blade 4 of the present invention inserted into the slot 13;
fig. 3 is a schematic view of the structure of the patellar ligament measurement rod 3 of the present invention;
fig. 4 is a schematic view of the structure of the operation position of the fat pad removal tool according to the present invention.
1. A patella fixator; 2. a positioning rod; 3. a patellar ligament measurement rod; 4. a cutting blade; 5. a caliper; 6. a patellar ligament fixation rod; 7. a lifting rod; 8. latch teeth; 9. a clamping block; 10. a connecting rod; 11. a chute; 12. lifting buttons; 13. a slot; 14. a slider head; 15. a slide hole; 16. a balance bar; 17. a balance hole; 18. mounting the protruding blocks; 19. a fixed tooth; 20. Scale marks; 21. a baffle.
Description of the embodiments
The following describes the embodiments of the present invention in detail with reference to the drawings.
According to fig. 1 to 4, the patellar fat pad resecting tool of the present embodiment comprises a patella fixer 1, a positioning rod 2, a patella ligament measuring rod 3 and a resecting knife 4, wherein the patella fixer 1 comprises a caliper 5 and a patella ligament fixing rod 6, two clamping teeth 8 are arranged on the inner side of the caliper 5, two clamping blocks 9 are arranged on one side surface of the caliper 5, the patella ligament fixing rod 6 is respectively installed on the clamping blocks 9, a lifting rod 7 is sleeved in the patella ligament fixing rod 6, one side of the patella ligament fixing rod 6 is provided with a lifting knob 12, the lifting knob 12 is connected with the lifting rod 7 on the inner side and controls the lifting of the patella ligament fixing rod, a connecting rod 10 is arranged at the upper section of the lifting rod 7, a sliding groove 11 is arranged on the upper surface of the connecting rod 10, a sliding block head 14 capable of sliding inside is connected with the sliding rod, the sliding rod 2 is inserted into the sliding block head 14, a sliding hole 15 is arranged on one side part of the positioning rod 2, after the sliding hole 15 is inserted into the sliding block head 14, the positioning rod 2 moves on the left side and right side of the sliding block 11, the middle of the positioning rod 2 is provided with a balancing lug 17 which is connected with a balancing lug 17, the balancing lug 17 is arranged on the inner side surface of the patella measuring rod 3, and the balancing lug 17 is connected with the balancing lug 17;
the utility model discloses a patella ligament measuring rod, including slot 13, excision sword 4, the excision sword 4 is with slot 13 assorted and peg graft in slot 13, and the face direction of excision sword 4 sets up with locating lever 2 level each other, and the rear side of excision sword 4 is equipped with separation blade 21, and after excision sword 4 inserted slot 13, separation blade 21 and the up end face of locating lever 2 touch each other prevent that it from passing locating lever 2 and dropping, be equipped with scale mark 20 on the lower part lateral surface of patella ligament dead lever 6, the bottom of patella ligament measuring rod 3 is equipped with fixed tooth 19.
Method of operation
1) Film shooting preset cutting height
Firstly observing the height of a dense blood tube region of the patellar fat pad according to a radiograph, wherein the dense blood tube region of the patellar fat pad is positioned at the inner side and the outer side of a patella of the patellar fat pad and is opened by 5mm, the patellar tip is 14mm below, and the distance behind a patellar ligament is 10mm, and comparing the two regions to the approximate range of cutting;
2) First resecting part of the patellar fat pad
In the operation, the epidermis is cut and turned to one side, so that the patellar fat pad is exposed to the visual field, and the patellar fat pad at the upper part is firstly resected by a knife, so that the knife is easy to lower.
3) Mounting and adjusting the position of the cutting tool
Clamping the outer side of the patella by using a caliper 5, placing the patella ligament measuring rod 3 on the patella ligament, inserting and fixing by using a fixed tooth 22, inserting a sliding hole 15 at one end of a positioning rod 2 into a sliding block head 14, inserting a balance hole 17 at the other end into a mounting lug 18, observing to ensure that the positioning rod 2 is horizontally placed, and if the positioning rod is inclined, holding the caliper 5 for adjustment until the positioning rod 2 is vertical to a connecting rod and the balance rod;
4) Adjusting the cutting height
And fine adjustment is performed according to the actual position, the lifting knob is rotated, the height of the lifting rod is adjusted, and the proper lifting height is ensured.
Firstly, the positioning rod 2 is taken down, and the patellar ligament measuring rod 3 is taken off;
5) Resecting the fat pad under the patella
The positioning rod 2 is taken down, the patellar ligament measuring rod 3 is taken away, the positioning rod 2 is replaced, the resectoscope is slowly inserted into the slot 13, the baffle piece 21 touches the end face of the positioning rod 2, the positioning rod 2 is pressed to move left and right to perform cutting until the cutting is completed, and the patellar fat pad at the upper end after the cutting is taken away by pliers and the like.
Effect of operation
The infrapatellar fat pad is rich in nerve and immune cells, and has the function of producing inflammatory factors and growth factors. Excessive excision of the infrapatellite pad in total knee replacement can cause biomechanical changes of the knee joint, resulting in reduced patella height, shortened patellar ligament, anterior knee pain, even ischemic necrosis of the patellar ligament, fracture of the patella, and the like, the reason of which is closely related to injury of blood supply of the infrapatellite pad. During the artificial total knee replacement operation, we find that the complete retention of the fat pad under the patella can affect the operation, and that part of patients can have symptomatic postoperative ringing, and that few patients have the ringing disappeared after the fat pad is removed under the arthroscope, so that the detailed information is not yet available in the international research on the excision of the fat pad under the patella, whether, how much and how to be excised.
In total knee arthroplasty, ischemic contracture of the patellar tendon caused by excision of the subpatellar fat pad is one of the important reasons for postoperation low-position patella and patellar tendon contracture. Resecting the infrapatellar fat pad during total knee replacement can result in a decrease in post-operative patella height, resulting in shortening of the patellar tendon and lower patella. The fat pad below the patella should be kept as much as possible in the total knee arthroplasty, and the damage to the fat pad below the patella and the surrounding tissues thereof can be reduced by the accurate operation and correct treatment in the operation, so that more satisfactory operation effect can be obtained.
It has been found that total removal of the infrapatellar fat pad results in a significant decrease in the angle of tibial supination and significant inward movement of the patella during extension of the knee, with reduced pressure at the patella point, to a greater extent when the knee is flexed than when the knee is extended. They therefore believe that the fat pad has biomechanical functions that can alleviate the symptoms of the pre-knee pain syndrome, the biomechanics of the patella and knee joint kinematics can be affected after resection. The infrapatellar fat pad plays an important role in maintaining blood supply of adjacent structures, and should be kept as much as possible in the preoperative plan.
Excessive excision of the subpatellar fat pad in TKA surgery can lead to complications such as patellar ligament, patellar ischemia, postoperative patellar fracture, patellar ligament shortening, and the like, which are obviously increased. It was found by angiographic studies on cadavers that complete resection of the infrapatellar fat pad resulted in blockage of blood supply to the inferior half of the patella. 1-3 years after the patellar fat pad is resected in the knee joint replacement operation, the measured patellar ligament length is obviously shortened by 2-3 mm compared with the length before operation, which accounts for about 5%, and the preservation of the patellar fat pad is considered to be one of the important factors for reducing the patellar lower pole fracture after the TKA operation. In the clinical relationship between the anatomical structure of the infrapatellar fat pad, it is most authoritative to maintain the infrapatellar fat pad as much as possible in TKA surgery to maintain blood supply to the adjacent structure. Excessive removal of the infrapatelectasis can cause biomechanical changes in the knee joint, leading to pain in the front of the knee, sometimes shortening of the patellar ligament, and even ischemic necrosis of the patellar ligament and fracture of the patella. The infrapatellar fat pad is considered to have a direct protective effect on the patellar tendon, and meanwhile, fatty liver cells in the infrapatellar fat pad have an important effect on the repair of the patellar tendon and have a great influence on the occurrence of low-level patella. The mechanical movement of the patellofemoral joint is obviously changed by the low-position patella, so that the patellofemoral joint is abnormal. The patellar inferior pole can collide with the tibia, and the pressure of the patellofemoral joint can be increased due to the downward movement of the patella. Studies have shown that preserving the fat pad below the patella is beneficial in reducing the occurrence of wound complications.
Trauma, abrasion, inflammation and the like cause the infrapatellar fat pad to edema and hyperplasia, form pinch or impact on the tibiofemoral joint and/or the patellofemoral joint, can cause Hoffa disease, and present a series of clinical symptoms, and can involve related synovial membranes and tendons. When the fat pad is stimulated by a certain factor, acute and chronic injuries can generate aseptic inflammation to cause pain, edema, hemorrhage, exudation, hyperplasia, hypertrophy and hardening, and fibrous tissue between the fat pad and the patellar ligament is denatured, adhered, mechanized and lose elasticity, so that the knee extension activity is limited, and the knee pain can be caused by the chemical stimulation of the rich nerve endings caused by the inflammation. Studies have shown that infrapatellar fat pad fibrosis has a significant correlation with pain in front of the knee after TKA surgery, and infrapatellar fat pad fibrosis affects knee joint mobility. Many specialists consider adequate exposure to be more beneficial for TKA surgery. Studies have shown that there is no significant difference in postoperative complications from the removal of the infrapatellar fat pad compared to the retention of the fat pad, except that the patient has a slightly higher probability of pain in front of the knee, suggesting that the infrapatellar fat pad can be retained without affecting the surgeon's exposure to the incision, and vice versa.
At present, the Insall-Salviti index is the most commonly used index for evaluating the patellar tendon shortening after TKA operation in clinic, but the acquisition of the Insall-Salviti index requires a patient to take a knee joint lateral slice when bending a knee by 30 degrees, however, no special tool is available for a radiologist in the market at present, so that the research and development of a special excision tool becomes a powerful guarantee for accurately acquiring the Insall-Salviti index.
The device can be used for judging the degree of excision according to preoperative analysis, comparison and quantification, and the excision amount can be regulated in the operation, so that the dense vascular area of the fat pad below the patella is kept, the accurate excision of the fat pad below the patella is ensured to be particularly important, and the occurrence of complications in the future is avoided. The individual differences are different, so that the example cannot be used as a comparison, but the recovery degree of the preserved patellar ligament is obviously better than that of the patellar ligament which is not subjected to quantitative working operation in operation, and the probability of shortening the patellar ligament is much smaller.
Claims (1)
1. A fat pad excision instrument under patella, characterized in that: the patella fixer comprises a caliper and a patella ligament fixing rod, wherein two clamping teeth are arranged on the inner side of the caliper, two clamping blocks are arranged on one side surface of the caliper, the patella ligament fixing rod is respectively installed on the clamping blocks, lifting rods are sleeved in the patella ligament fixing rod, lifting buttons are arranged on one side of the patella ligament fixing rod, the lifting buttons are connected with the lifting rods on the inner side and control the lifting of the lifting rods, a connecting rod is arranged at the upper section between the lifting rods, a sliding chute is arranged on the upper surface of the connecting rod, a sliding block head capable of sliding in the sliding chute is connected with the sliding block head, the positioning rod is inserted on the sliding block head, a sliding hole is formed in one side part of the positioning rod, the positioning rod moves left and right on the sliding chute, a slot with two sides penetrating through the patella is formed in the middle of the positioning rod, the other end of the positioning rod can be connected in the patella sleeved mode in the patella ligament measuring rod, a balancing rod is connected on the side surface of the patella balancing rod in a clamped mode, a balancing hole is installed on the balancing rod, a mounting lug is arranged on the balancing rod, and a balancing hole is clamped in the balancing lug; the utility model discloses a patella ligament measuring rod, including the slot, the excision sword is in slot phase-match and grafting in the slot, and the face direction of excision sword and the mutual level setting of locating lever are equipped with the separation blade, and the rear side of excision sword inserts the slot back, and the separation blade touches each other with the up end face of locating lever and prevents that it from passing the locating lever and drop, be equipped with the scale mark on the lower part lateral surface of patella ligament dead lever, the bottom of patella ligament measuring rod is equipped with the fixed tooth.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201710059704.XA CN106691545B (en) | 2017-01-24 | 2017-01-24 | Subcarpler fat pad cutting tool and using method thereof |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201710059704.XA CN106691545B (en) | 2017-01-24 | 2017-01-24 | Subcarpler fat pad cutting tool and using method thereof |
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| CN106691545A CN106691545A (en) | 2017-05-24 |
| CN106691545B true CN106691545B (en) | 2023-11-10 |
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Citations (5)
| 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 |
| 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 |
| CN206852644U (en) * | 2017-01-24 | 2018-01-09 | 丽水市人民医院 | A kind of subpatellar fat pad resecting tool |
Family Cites Families (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| 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 |
| EP3581120B1 (en) * | 2015-03-25 | 2021-11-10 | Marlowe E. Goble | Knee instruments |
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2017
- 2017-01-24 CN CN201710059704.XA patent/CN106691545B/en active Active
Patent Citations (5)
| 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 |
| 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 |
| 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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| CN106691545A (en) | 2017-05-24 |
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