CN106725744A - A kind of subpatellar fat pad resectoscope and its application method - Google Patents
A kind of subpatellar fat pad resectoscope and its application method Download PDFInfo
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- CN106725744A CN106725744A CN201710059703.5A CN201710059703A CN106725744A CN 106725744 A CN106725744 A CN 106725744A CN 201710059703 A CN201710059703 A CN 201710059703A CN 106725744 A CN106725744 A CN 106725744A
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- 210000000577 adipose tissue Anatomy 0.000 title claims abstract description 89
- 238000000034 method Methods 0.000 title claims description 11
- 210000004417 patella Anatomy 0.000 claims abstract description 42
- 210000004204 blood vessel Anatomy 0.000 claims abstract description 16
- 238000003780 insertion Methods 0.000 claims description 6
- 230000037431 insertion Effects 0.000 claims description 6
- 230000009471 action Effects 0.000 claims description 3
- 210000002615 epidermis Anatomy 0.000 claims description 3
- 238000012216 screening Methods 0.000 claims description 3
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- 238000004804 winding Methods 0.000 claims description 3
- 238000001356 surgical procedure Methods 0.000 abstract description 7
- 230000009286 beneficial effect Effects 0.000 abstract description 4
- 210000000988 bone and bone Anatomy 0.000 abstract description 4
- 238000013150 knee replacement Methods 0.000 abstract description 4
- 210000003127 knee Anatomy 0.000 description 13
- 210000000629 knee joint Anatomy 0.000 description 13
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- 230000000302 ischemic effect Effects 0.000 description 4
- 210000004285 patellofemoral joint Anatomy 0.000 description 4
- 230000000717 retained effect Effects 0.000 description 4
- 210000002435 tendon Anatomy 0.000 description 4
- 238000011883 total knee arthroplasty Methods 0.000 description 4
- 206010061218 Inflammation Diseases 0.000 description 3
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- 206010052428 Wound Diseases 0.000 description 1
- 206010053692 Wound complication Diseases 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
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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
- A61B2017/32006—Surgical cutting instruments with a cutting strip, band or chain, e.g. like a chainsaw
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Abstract
The invention belongs to bone surgery apparatus field, and in particular to subpatellar fat pad quantifies the structure of resecting tool.A kind of subpatellar fat pad resectoscope, include patella fixing device, locating rod, ligamentum patellae analyzing rod and exsector, patella fixing device includes clamp and ligamentum patellae fix bar, both unnecessary subpatellar fat pad can have been cut off to appear operating field, it is also possible to effectively retain the thick blood vessels area of subpatellar fat pad, had been reduced because the excision of subpatellar fat pad is excessive, thick blood vessels area is cut 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.
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 resectoscope 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 and cuts
Except the application method of device, the thick blood vessels area of lower section can not be destroyed 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 resectoscope, includes patella fixing device, locating rod, ligamentum patellae analyzing rod and exsector, and kneecap is solid
Determining device includes clamp and ligamentum patellae fix bar, and the rear end of clamp is provided with spanner, and clamp are provided with two latches, the front end face of latch
On be provided with fixture block, the ligamentum patellae fix bar is separately installed with fixture block, a connecting rod is provided between ligamentum patellae fix bar, even
The edge surface of extension bar is provided with chute of the both sides through connection, and the locating rod is plugged with chute, and locating rod is moved in chute
Dynamic, positioning boom end is provided with tightening knob, and tightening knob is on another side end face of the connecting rod, and locating rod is provided with two
Through the slot of connection, on side of the slot in locating rod, the other end of locating rod can be connected to the ligamentum patellae and determine for side
In bar, the exsector matches and is plugged in slot with slot, and catch, exsector insertion slot are provided with rear side of exsector
Afterwards, catch is mutually touched with the side of locating rod；
The lower side of the ligamentum patellae analyzing rod is provided with the draw-in groove being mutually matched with locating rod, and one end of locating rod is connected to
In draw-in groove, the end face of locating rod is provided with fixing hole, and the lateral surface of ligamentum patellae analyzing rod is provided with and consolidating that fixing hole matches
Determine nut；
Link slot is equipped with the relative medial surface of described two ligamentum patellae fix bars, the connecting rod is connected in link slot simultaneously
Can move up and down, the side of link slot is connected to lifting groove, and lifting groove is arranged at the outer surface of ligamentum patellae fix bar
On, the surface of ligamentum patellae fix bar is provided with the swinging arms being connected with connecting rod.
Preferably：The ligamentum patellae fix bar of the link slot side is provided with graduation mark.
Preferably：The interlude of the locating rod is provided with and draws high interior bar, draws high interior bar and is socketed in locating rod.
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 resectoscope, 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）Resectoscope to predetermined excision height is installed
In operation, cut epidermis and be turned to side, allow subpatellar fat pad under the visual field, then the outer of kneecap is clamped with clamp
Side, ligamentum patellae analyzing rod is placed on ligamentum patellae, is inserted using fixing tooth and fixed, and is compared with graduation mark according to screening height,
The level height of connecting rod is adjusted using swinging arms, when ligamentum patellae analyzing rod and connecting rod are parallel to each other, by locating rod
The other end insertion ligamentum patellae analyzing rod in, while observe ensure locating rod be horizontal positioned, rotate fixing nut be fixed；
3）Actually it is adjusted to accurate excision height
Fine setting, rotatable clamp are made according to physical location, moreover it is possible to swinging arms of outwarding winding, adjust the height of connecting rod, unclamp tight
Gu knob adjusts the horizontal level of locating rod, when ligamentum patellae analyzing rod and connecting rod are parallel to each other, the positioning of ligamentum patellae analyzing rod
Complete, ensure that locating rod is on the height of subpatellar fat pad thick blood vessels area upper end 8-12mm after adjustment.
4）Remove ligamentum patellae analyzing rod
After entering the horizontal level determination of exsector, fixing nut is unclamped, be pulled along drawing high interior bar, by ligamentum patellae analyzing rod from calmly
Removed on the bar of position, remove ligamentum patellae analyzing rod；
5）Excision subpatellar fat pad
In exsector slowly being inserted slot, and catch is allowed to touch on the end face of locating rod, the rear end for pinning catch pushes away forward
The dynamic action cut, until cutting is completed, is taken away the subpatellar fat pad of upper end after cutting with pliers etc..
The thick blood vessels area of subpatellar fat pad described in step 1 and step 3 is located at outside side in subpatellar fat pad kneecap and opens
4-6mm, 12-15mm under apex patellae, 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
Operating field, it is also possible to effectively retain the thick blood vessels area of subpatellar fat pad, is reduced because the excision of subpatellar fat pad is excessive, will be intensive
Area vasculosa cuts off in the lump, and the complication for causing, facilitate joint surgery doctor to manipulate, beneficial to entering for total knee replacement operation
OK.
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；
The structural representation of Fig. 3 movements of locating rod 2 of the present invention；
The structural representation of Fig. 4 subpatellar fat pad resectoscope 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, spanner；8th, latch；9th, fixture block；10th, connecting rod；11st, chute；12nd, tightening knob；13rd, slot；14th, draw-in groove；15th, fixing hole；
16th, fixing nut；17th, link slot；18 lifting grooves；19th, swinging arms；20th, graduation mark；21st, interior bar is drawn high；22nd, fixing tooth；
23rd, 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 resectoscope described in the present embodiment includes patella fixing device
1st, 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
Rear end is provided with spanner 7, and clamp 5 are provided with two latches 8, and fixture block 9 is provided with the front end face of latch 8, are respectively mounted on fixture block 9
There is the ligamentum patellae fix bar 6, a connecting rod 10 is provided between ligamentum patellae fix bar 6, the edge surface of connecting rod 10 is provided with two
Side is plugged with the locating rod 2 through the chute 11 of connection on chute 11, locating rod 2 is moved in chute 11, catch 23 with it is fixed
The side of position bar 2 is mutually touched, and the end of locating rod 2 is provided with tightening knob 12, and tightening knob 12 is in the another of the connecting rod 10
On one side end face, locating rod 2 is provided with slot 13 of the both sides through connection, and slot 13 is located on the side of locating rod 2, locating rod
2 other end can be connected in the ligamentum patellae analyzing rod 3, and the exsector 4 and slot 13 match and be plugged on slot 13
Interior, the rear side of exsector 4 is provided with catch 23, and after the insertion slot 13 of exsector 4, catch 23 is mutually touched with the side of locating rod 2
Touch,；
The lower side of the ligamentum patellae analyzing rod 3 is provided with the draw-in groove 14 being mutually matched with locating rod 2, one end of locating rod 2
It is connected in draw-in groove 14, the end face of locating rod 2 is provided with fixing hole 15, and the lateral surface of ligamentum patellae analyzing rod 3 is provided with and fixation
The fixing nut 16 that hole 15 matches；
Link slot 17 is equipped with the relative medial surface of described two ligamentum patellae fix bars 6, the connecting rod 10 is connected to connection
Groove 17 is interior and can move up and down, and the side of link slot 17 is connected to lifting groove 18, and lifting groove 18 is arranged at ligamentum patellae and consolidates
On the outer surface of fixed pole 6, the surface of ligamentum patellae fix bar 6 is provided with the swinging arms 19 being connected with connecting rod 10.
The ligamentum patellae fix bar 6 of the side of the link slot 17 is provided with graduation mark 20.
The interlude of the locating rod 2 is provided with and draws high interior bar 21, draws high interior bar 21 and is socketed in locating rod 2.
The bottom of the ligamentum patellae analyzing rod 3 is provided with fixing tooth 22.
A kind of the step of application method of subpatellar fat pad resectoscope is：
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, 14mm under apex patellae, 10mm behind ligamentum patellae.
, compared the approximate range of excision；
2）Resectoscope to predetermined excision height is installed
In operation, cut epidermis and be turned to side, allow subpatellar fat pad under the visual field, then the outer of kneecap is clamped with clamp 5
Side, ligamentum patellae analyzing rod 3 is placed on ligamentum patellae, is inserted using fixing tooth 22 and fixed, according to screening height and graduation mark 20
Compare, the level height of connecting rod is adjusted using swinging arms 19, when ligamentum patellae analyzing rod 3 and connecting rod 10 are parallel to each other
Wait, by the other end insertion ligamentum patellae analyzing rod 3 of locating rod 2, while observe ensureing that locating rod is horizontal positioned, rotate and fix
Nut 16 is fixed；
3）Actually it is adjusted to accurate excision height
Fine setting, the deviation in the adjustment angle of rotatable clamp 5 are made according to physical location, moreover it is possible to swinging arms 19 of outwarding winding, adjusted
The height of connecting rod 10, unclamps the horizontal level that tightening knob 12 adjusts locating rod 2, when ligamentum patellae analyzing rod 3 and connecting rod 10
It is parallel to each other, the positioning of ligamentum patellae analyzing rod 3 is completed, ensures that locating rod 2 is in subpatellar fat pad thick blood vessels area after adjustment
Hold on the height of 8-12mm.
4）Remove ligamentum patellae analyzing rod
After entering the horizontal level determination of exsector 4, fixing nut 16 is unclamped, be pulled along drawing high interior bar 21, ligamentum patellae is determined
Bar 3 is removed from locating rod 2, removes ligamentum patellae analyzing rod 3；
5）Excision subpatellar fat pad
In exsector slowly being inserted slot 13, and allow catch 23 to touch on the end face of locating rod 2, pin the rear end of catch 23
The action cut is promoted forward, until cutting is completed, is taken away the subpatellar fat pad of upper end after cutting with pliers etc..
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
Control is within 2%.
Claims (6)
1. a kind of subpatellar fat pad resectoscope, it is characterised in that：Include patella fixing device, locating rod, ligamentum patellae analyzing rod and
Exsector, patella fixing device includes clamp and ligamentum patellae fix bar, and the rear end of clamp is provided with spanner, and clamp are provided with two cards
Tooth, is provided with fixture block on the front end face of latch, the ligamentum patellae fix bar is separately installed with fixture block, between ligamentum patellae fix bar
A connecting rod is provided with, the edge surface of connecting rod is provided with chute of the both sides through connection, the locating rod is plugged with chute, fixed
Position bar is moved in chute, and positioning boom end is provided with tightening knob, and tightening knob is on another side end face of the connecting rod,
Locating rod is provided with slot of the both sides through connection, and slot is on the side of locating rod, and the other end of locating rod can be connected to
In the ligamentum patellae analyzing rod, the exsector matches and is plugged in slot with slot, and catch is provided with rear side of exsector,
After exsector insertion slot, catch is mutually touched with the side of locating rod；
The lower side of the ligamentum patellae analyzing rod is provided with the draw-in groove being mutually matched with locating rod, and one end of locating rod is connected to
In draw-in groove, the end face of locating rod is provided with fixing hole, and the lateral surface of ligamentum patellae analyzing rod is provided with and consolidating that fixing hole matches
Determine nut；
Link slot is equipped with the relative medial surface of described two ligamentum patellae fix bars, the connecting rod is connected in link slot simultaneously
Can move up and down, the side of link slot is connected to lifting groove, and lifting groove is arranged at the outer surface of ligamentum patellae fix bar
On, the surface of ligamentum patellae fix bar is provided with the swinging arms being connected with connecting rod.
2. a kind of subpatellar fat pad resectoscope according to claim 1, it is characterised in that：The link slot side it is described
Ligamentum patellae fix bar is provided with graduation mark.
3. a kind of subpatellar fat pad resectoscope according to claim 1, it is characterised in that：On the interlude of the locating rod
It is provided with and draws high interior bar, draws high interior bar and be socketed in locating rod.
4. a kind of subpatellar fat pad resectoscope according to claim 1, it is characterised in that：The bottom of the ligamentum patellae analyzing rod
Portion is provided with fixing tooth.
5. a kind of application method of the subpatellar fat pad resectoscope in use claim 1-4 described in any one, its feature exists
In：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）Resectoscope to predetermined excision height is installed
In operation, cut epidermis and be turned to side, allow subpatellar fat pad under the visual field, then the outer of kneecap is clamped with clamp
Side, ligamentum patellae analyzing rod is placed on ligamentum patellae, is inserted using fixing tooth and fixed, and is compared with graduation mark according to screening height,
The level height of connecting rod is adjusted using swinging arms, when ligamentum patellae analyzing rod and connecting rod are parallel to each other, by locating rod
The other end insertion ligamentum patellae analyzing rod in, while observe ensure locating rod be horizontal positioned, rotate fixing nut be fixed；
3）Actually it is adjusted to accurate excision height
Fine setting, rotatable clamp are made according to physical location, moreover it is possible to swinging arms of outwarding winding, adjust the height of connecting rod, unclamp tight
Gu knob adjusts the horizontal level of locating rod, when ligamentum patellae analyzing rod and connecting rod are parallel to each other, the positioning of ligamentum patellae analyzing rod
Complete, ensure that locating rod is on the height of subpatellar fat pad thick blood vessels area upper end 8-12mm after adjustment；
4）Remove ligamentum patellae analyzing rod
After entering the horizontal level determination of exsector, fixing nut is unclamped, be pulled along drawing high interior bar, by ligamentum patellae analyzing rod from calmly
Removed on the bar of position, remove ligamentum patellae analyzing rod；
5）Excision subpatellar fat pad
Exsector is slowly inserted slot, and allows catch to touch on the end face of locating rod, the rear end for pinning catch promotes forward
The action cut, until cutting is completed, is taken away the subpatellar fat pad of upper end after cutting with pliers etc..
6. the application method of a kind of subpatellar fat pad resectoscope according to claim 5, it is characterised in that：
The thick blood vessels area of subpatellar fat pad described in step 1 and step 3 is located at outside side in subpatellar fat pad kneecap and opens 4-
6mm, 12-15mm under apex patellae, 9-11mm behind ligamentum patellae.
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| CN201710059703.5A CN106725744B (en) | 2017-01-24 | 2017-01-24 | Subcarpler fat pad resectoscope and use method thereof |
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| Application Number | Priority Date | Filing Date | Title |
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| CN201710059703.5A CN106725744B (en) | 2017-01-24 | 2017-01-24 | Subcarpler fat pad resectoscope and use method thereof |
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| US5342368A (en) * | 1992-07-08 | 1994-08-30 | Petersen Thomas D | Intramedullary universal proximal tibial resector guide |
| US5667512A (en) * | 1996-05-03 | 1997-09-16 | Metagen, Llc | Patellar resection guide |
| US20030212403A1 (en) * | 2002-05-10 | 2003-11-13 | Swanson Todd V. | Method and apparatus for minimally invasive knee arthroplasty |
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| US20160278938A1 (en) * | 2015-03-25 | 2016-09-29 | E. Marlowe Goble | Knee instruments and methods |
| CN206852645U (en) * | 2017-01-24 | 2018-01-09 | 丽水市人民医院 | A kind of subpatellar fat pad resectoscope |
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|---|---|---|---|---|
| US5342368A (en) * | 1992-07-08 | 1994-08-30 | Petersen Thomas D | Intramedullary universal proximal tibial resector guide |
| US5667512A (en) * | 1996-05-03 | 1997-09-16 | Metagen, Llc | Patellar resection guide |
| US20030212403A1 (en) * | 2002-05-10 | 2003-11-13 | Swanson Todd V. | Method and apparatus for minimally invasive knee arthroplasty |
| US20040102785A1 (en) * | 2002-11-27 | 2004-05-27 | Hodorek Robert A. | Method and apparatus for achieving correct limb alignment in unicondylar knee arthroplasty |
| CA2449336A1 (en) * | 2002-11-27 | 2004-05-27 | Robert A. Hodorek | Method and apparatus for achieving correct limb alignment in unicondylar knee arthroplasty |
| US20160278938A1 (en) * | 2015-03-25 | 2016-09-29 | E. Marlowe Goble | Knee instruments and methods |
| CN206852645U (en) * | 2017-01-24 | 2018-01-09 | 丽水市人民医院 | A kind of subpatellar fat pad resectoscope |
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| CN106725744B (en) | 2023-11-10 |
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