CN107072677A - 可调节的关节盂针插入引导件 - Google Patents
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Abstract
一种用于使引导针与关节盂对准的系统和方法,其包括用于使该引导针相对于解剖结构定向的引导针插入引导件和轴线对准装置。该引导针插入引导件包括基板以及联接到该基板并从该基板延伸的可移动的针定向装置。该轴线对准装置具有多个通孔,每个通孔均限定不同的对准轴线。该引导针与通孔中的一个配合以将该引导针定位于患者特定的对准轴线,当与通孔中的一个配合时,该引导针随后被接收在该引导针插入引导件内,以将该引导针插入引导件沿患者特定的对准轴线相对于基板定位,并且将该引导针插入引导件沿患者特定的对准轴线固定到该基板。
Description
要求优先权
本申请要求于2014年9月29日提交的标题为“可调节的关节盂针插入引导件(ADJUSTABLE GLENOID PIN INSERTION GUIDE)”的美国专利申请No.14/499,965的权益,在此要求其优先权,并且将其通过引用全部并入本文。
技术领域
本公开内容涉及一种可调节的关节盂针(glenoid pin)插入引导件。
背景技术
本章节提供了并非必然是现有技术的与本公开内容相关的背景信息。
实施解剖或反置式关节成形术通常需要在关节盂中放置引导针或导丝。然而,通常需要相当多的手术技巧以正确地暴露出关节盂并且移除环绕该关节盂的软组织,以便在实施解剖或反置式关节成形术之前将处于正确方位中的引导针精确地定位在关节盂上。因此,所需要的是一种可在实施解剖或反置式关节成形术之前相对于关节盂精确而快速地定向引导针的器械或系统。
发明内容
本章节提供了对于本发明内容的总体概述,并且并不是对其全部范围或其所有特征的全面公开。
在示例1中,可提供一种用于将引导针与解剖结构对准的系统。该系统可包括可被用于将引导针相对于解剖结构定向的引导针插入引导件。该引导针插入引导件可包括基板以及可被联接到基板并可从基板延伸的针定向装置。该针定向装置可相对于基板移动。该系统可还包括轴线对准装置。该轴线对准装置可以是一种平面构件,该平面构件可包括第一表面和第二表面且可具有可在第一表面和第二表面之间延伸的多个通孔。通孔中的每一个均可限定不同的对准轴线。通孔之一可被构造成将引导针以患者特定的对准轴线定位。引导针插入引导件可被构造成当引导针与通孔之一配合时,接收该引导针,以将引导针插入引导件沿可与基板相关的患者特定的对准轴线定位。引导针插入引导件可被构造成被沿患者特定的对准轴线固定到该基板。
在示例2中,示例1所述的轴线对准装置可任选地包括坐标系。
在示例3中,前述示例中的任一个所述的一个通孔可被构造成使引导针与可位于患者特定坐标处的患者特定的对准轴线对准。
在示例4中,前述示例中的任一个所述的基板可任选地包括用于使基板与在解剖结构上可见的位置对准的对准装置。此外,该对准装置可被构造成使基板相对于轴线对准装置定位。
在示例5中,前述示例中的任一个所述的基板可被成形成包括顶点并且该对准装置可由该顶点限定。
在示例6中,前述示例中的任一个所述的针定向装置可以是中空的。
在示例7中,前述示例中的任一个所述的针定向装置可任选地包括可与基板以可移动的方式配合的球根状部分。该球根状部分可允许针定向装置相对于基板铰接并且可锁定到适当位置中。
在示例8中,前述示例中的任一个可任选地包括铰孔装置。
在示例9中,前述示例中的任一个所述的引导针插入引导件和对准轴线装置中的每一个都是可重复使用的。
在示例10中,前述示例中的任一个所述的引导针插入引导件和对准轴线装置可由钛或手术用钢形成。
在示例11中,前述示例中的任一个所述的引导针插入引导件的基板可包括可限定患者特定的轮廓的表面。
在示例12中,前述示例中的任一个所述的引导针插入引导件可被构造成被沿患者特定的对准轴线固定到基板。
在示例13中,前述示例中的任一个所述的通孔可被呈坐标阵列布置。
在示例14中,前述示例中的任一个所述的每个通孔都可通过预定角度量限定不同的对准轴线。
在示例15中,示例14所述的预定角度量可由坐标系限定。
在示例16中,可提供一种用于将引导针与关节盂对准的系统。该系统可包括可用于将引导针相对于关节盂定向的引导针插入引导件。引导针插入引导件可包括可具有上表面和关节盂接合表面的基板。针定向装置可联接到基板的上表面并且可从基板的上表面延伸。针定向装置可相对于基板移动。该系统可进一步包括轴线对准装置。该轴线对准装置可以是一种平面构件,该平面构件可包括第一表面和第二表面且可具有可呈坐标阵列布置且可在第一表面和第二表面之间延伸的多个通孔。通孔中的每一个可限定不同的对准轴线。通孔中的一个可被构造成使引导针定位于可由该阵列的患者特定的坐标限定的患者特定的对准轴线。引导针插入引导件可被构造成在引导针与一个通孔配合时,接收引导针,以将引导针插入引导件沿患者特定的对准轴线相对于基板定位。引导针插入引导件可被构造成被沿患者特定的对准轴线固定到基板。
在示例17中,可提供一种将引导针与关节盂对准的方法。该方法可包括相对于关节盂确定用于引导针的患者特定的对准轴线。该方法也可包括提供可由平面构件限定的轴线对准装置,该平面构件可包括第一表面和第二表面并且可具有可被呈坐标阵列布置且可在第一表面和第二表面之间延伸的多个通孔。通孔中的每一个可限定不同的对准轴线。该方法也可包括确定多个通孔中的可限定可与患者特定的对准轴线对应的对准轴线的一个通孔的坐标位置。该方法也可包括使引导针与这一个通孔配合以沿患者特定的对准轴线定向该引导针。该方法还包括将引导针插入引导件放置在引导针上。该引导针插入引导件可包括可具有基板和针定向装置,该基板可具有上表面和关节盂接合表面,该针定向装置可联接到基板的上表面并且可从基板的上表面延伸。针定向装置可相对于基板移动,使得当将引导针插入引导件放置在引导针上时,针定向装置可被沿患者特定的对准轴线定位。该方法也可包括将沿患者特定的对准轴线相对于基板定位的针定向装置固定住。该方法也可包括将引导针连同引导针插入装置一起从轴线对准装置上移除。该方法也可包括使基板的关节盂接合表面与关节盂接触。该方法也可包括将引导针沿患者特定的对准轴线固定到关节盂。
在示例18中,示例17可任选地包括使基板与在关节盂上可见的位置对准。
在示例19中,示例17或18中的任一个所述的基板可包括对准装置。基板可被成形成包括顶点,并且对准装置可由该顶点限定。
在示例20中,示例17到19中的任一个可任选地包括在利用引导针的同时对关节盂进行铰孔。
在示例21中,示例17到20中的任一个可任选地包括对引导针插入引导件和对准轴线装置中的每个进行消毒,使得每一个都是可重复使用的。
在示例22中,示例17到21中的任一个所述的针定向装置可以是中空的,并且可任选地包括可与基板以可移动的方式配合的球根状部分。该球根状部分可允许针定向装置相对于基板铰接并且锁定到适当位置中。
在示例23中,示例17到22中的任一个所述的引导针插入引导件和对准轴线装置都可由钛或手术用钢形成。
在示例24中,示例17到23中的任一个所述的确定坐标位置可包括从坐标阵列选择坐标位置。
其它适用领域将通过本文中提供的描述而变得是明显的。发明内容中的描述和具体示例仅出于说明的目的,且并不旨在限制本公开内容的范围。
附图说明
本文中所描述的附图仅出于示出选定实施例而非所有可能的实施方式的目的,并且并不旨在限制本公开内容的范围。
图1是一种用于反置式肩部关节成形术的现有技术植入物的分解视图;
图2是图1的现有技术植入物的环境视图;
图3是用于解剖肩部关节成形术的现有技术植入物的透视图;
图4A是示出了一种在反置式肩部关节成形术中铰孔过程中使用的引导针的环境视图;
图4B是示出了一种在反置式肩部关节成形术中铰孔之后的引导针的环境视图;
图5是根据本公开内容的原理的引导针插入引导件的透视图;
图6是图5中所示的引导针插入引导件的侧视透视图;
图7是图5中所示的引导针插入引导件的另一透视图;
图8是图5中所示的引导针插入引导件的顶部透视图;
图9是根据本公开内容的原理的与轴线对准装置相关的引导针插入引导件的透视图;
图10是图9中所示的与轴线对准装置相关的引导针插入引导件的顶部透视图;
图11是图9中所示的与轴线对准装置相关的引导针插入引导件的侧视透视图;
图12是图9中所示的与轴线对准装置相关的引导针插入引导件的另一侧视透视图;
图13是图9中所示的与轴线对准装置相关的引导针插入引导件的另一侧视透视图;
图14是根据本公开内容的原理的被相对于关节盂定位的引导针插入引导件的透视图;以及
图15是被相对于图14的关节盂定位的引导针插入引导件的侧视透视图。
遍及附图的若干视图,相应的附图标记表示相应的部件。
具体实施方式
现在将参照附图更充分地描述示例实施例。
本教导主要提供可被构造成患者特定的可重复使用的手术器械。手术器械例如可包括对准引导件、钻孔引导件以及用于在肩关节置换、肩部表面重建术以及涉及肩关节或肩关节的多种骨骼的其它手术中使用的其它工具,这多种骨骼包括肩胛骨的关节盂表面或关节盂腔、肱骨头以及相邻的肩部骨骼。本教导可应用到解剖肩部置换以及反置式肩部置换。这些器械可与常规的植入部件一起使用或与使用根据本教导的计算机辅助图像方法制备的患者特定的植入部件和/或骨移植物一起使用。用于使用对患者的解剖结构进行的医疗扫描(例如MRI、CT、超声、X射线、PET等)、患者特定的假体部件以及患者特定的引导件、模板和其它器械来获取患者的解剖结构的三维图像的计算机建模可被使用多种可购买到的CAD程序和/或可例如通过加拿大蒙特利尔的对象研究系统或ORS获得的软件进行制备。
在患者特定时,通常可基于通过包括例如X射线、MRI、CT、PET、超声波的医学图像扫描或其它医学扫描所产生的患者的三维解剖图像的计算机建模设计和制造器械以及任何相关的患者特定的植入物和骨移植物。非常小的缺陷不需要被结合在三维接合表面中。患者特定的器械可包括定制的引导形态,例如可用于支撑或引导其它器械(例如钻孔引导件、铰孔器、刀具、切割引导件和切割块)或用于插入引导针、克氏针或根据外科医生认可的术前计划的其它紧固件的引导钻孔或插管引导柱或插管引导延伸部或接收器。
在多种实施例中,本教导的器械可还包括用于在对应的患者特定的插入点以及相对于为该特定患者选定的解剖或反置轴线的方位处接收和引导工具(例如,钻或针或导丝)的患者特定的一个或多个管状引导件。这些器械可包括用于引导与手术相关的患者特定的或无需定制的植入物的植入的引导或定向形态和特征。如果使用的话,该器械的多种特征的几何结构、形状和方位以及多种患者特定的植入物和骨移植物可在该手术的术前计划阶段期间结合对于患者解剖结构的计算机辅助建模予以确定。在术前计划阶段期间,可对患者特定的器械、定制、半定制或非定制的植入物及其它非定制的工具进行选择并且患者特定的部件可被针对特定患者利用来自与外科手术相关的外科医生或其他专业人员的输入进行制造。
参照图1-2,示出了一种现有技术的反置式肩部植入物10。该反置式肩部植入物10包括肱骨干12、肱骨盘(humeral tray)14、肱骨支承件(humeral bearing)16、盂球(glenosphere)18以及具有板部22和中心凸起部24的基板20。肱骨干12被植入在肱骨26中并且具有经由莫氏锥度连接件联接到从肱骨盘14的板32延伸的凸形锥体30的近端28。盂球18可以是模块化的并且包括与支承件16铰接的头部34以及偏置的双锥度部件36。双锥度部件36具有联接到头部34的相应锥形开口40的第一锥形部38以及联接到关节盂基板20的中心凸起部24的第二锥形部42。中心螺钉44穿过基板20进入到患者肩胛骨的关节盂表面46中。外围螺钉48被用于将基板20锁定在关节盂表面46中。
参照图3,示出了一种现有技术解剖肩部植入物50。该解剖肩部植入物50包括肱骨干52、盂球54以及带有外围钉58和可移除的或不可移除的中心钉60的支承件56。
图4A示出了使用引导针62以在使用铰孔装置64的反置式肩部关节成形术中对关节盂表面46的铰孔进行引导。图4B示出了通过使用铰孔装置64穿过关节盂表面46形成的孔66的引导针62。引导针62用于引导反置式植入物10或解剖植入物50的放置,如上所讨论的那样。可在接收引导针62之前,在关节盂表面46中预钻出孔(未示出),或者引导针62可以是克氏针,该克氏针在插入到关节盂表面46中之前被与关节盂表面46对准。下文中将更为详细地描述这些过程中的每一个。
参照图5-8,示出了一种示例性患者特定的引导针插入引导件68。患者特定的引导针插入引导件68被构造成在插入到关节盂46的过程中引导该引导针62,并根据外科医生的决定来提供用于反置式及解剖肩部关节成形术的植入物对准方位。引导针插入引导件68包括基板70,该基板70具有参照关节盂表面46而言的平面状的上(或外)表面72和平面状的下(或内)解剖结构接合表面74。尽管下表面74被示为是平面状的,但应该理解的是,下表面74是患者特定的并不在本发明的范围之外,使得下表面74具有三维轮廓以对应于关节盂46的患者特定轮廓,使得下表面74仅置靠在关节盂46上的一个位置中。换句话说,下表面74可被形成轮廓,使得下表面74是关节盂46的负表面。如所示,上唇部(labrum)可被完全地移除,使得下表面74仅参照和反映关节盂腔的骨骼表面或关节盂表面46。
基板70可以是泪滴形的,使得基板70的顶点76限定对准装置78。对准装置78可用于通过使顶点76指向关节盂46的解剖参照点,而将基板70相对于关节盂表面46定位在合适的方位中。例如,对准装置78可用于为基板70定向,使得顶点76指向诸如关节盂46的上顶点之类的视觉标记。基板70可由诸如钛、手术用钢之类的材料以及诸如聚乙烯之类的聚合材料制成。此外,将会了解到的是,基板70可以具有所需的任何形状,只要限定可指向患者解剖结构的诸如关节盂46的上顶点之类的视觉标记的对准装置78即可。
针定向装置或引导管80联接到基板70并从基板70向外延伸。针定向装置80包括具有近端84和远端86的圆柱形引导件82。近端84限定与基板70配合的球根状部分88。在这方面,基板70包括被成形以接收该球根状部分88的孔隙90,并且允许针定向装置80相对于基板70以类似于操纵杆的方式移动或铰接。球根状部分88可以与圆柱形引导件82是一体的,或可被单独地制成并通过焊接、钎接等结合到圆柱形引导件82。无论如何,圆柱形引导件82和球根状部分均优选地由与基板70相同的材料形成。即,诸如钛、手术用钢之类的材料以及诸如聚乙烯之类的聚合材料。圆柱形引导件82为中空的,并且限定用于接收引导针62的细长通道92。
为了允许球根状部分88相对于基板70铰接,基板70包括形成在其中的从端部91延伸到孔隙90的缝隙89,使得基板70的相反两端93和95彼此面对。此外,耳部97分别从相反两端93和95延伸,每个耳部97包括用于接收定位螺钉71的孔隙99。由此,当将要相对于基板70固定住球根状部分88时,螺钉71可与孔隙99接合以将相反两端93和95紧密地拉在一起,以便夹持住处于预期方位的球根状部分88。
如上所讨论的那样,针定向装置80可相对于基板70移动。这允许引导针62在插入到关节盂46中之前相对于关节盂46在任意所需的轴线方向中定向。优选地,根据针对患者作出的术前计划来确定和设计(即,用于解剖和反置式关节成形术的)所需的轴线方向,以限定引导针62的患者特定的解剖对准轴线和插入点。为了帮助将针定向装置80相对于基板70定向于用于解剖或反置式关节成形术的正确的轴线方向,本公开内容提供了轴线对准装置94。
如在图9-13中最佳所示,轴线对准装置94是平面构件96。平面构件96包括第一表面98、第二表面100以及将第一表面98和第二表面100相连的多个侧表面102。平面构件96还包括从第一表面98以不同角度穿过平面构件96穿到第二表面100的多个通孔104。此外,尽管通孔104仅被示出为被定位在平面构件96的单一象限106中,但是应该明白的是,平面构件96的整体均可设置有通孔104,每个通孔104均限定穿过平面构件96的不同轴线角。应该明白的是,仅为了便于说明,基板70并未被示出为包括图9-13中的耳部97。
轴线对准装置94可包括坐标系108。坐标系108有助于组织每个通孔104的轴线角。在所示实施例中,坐标系108包括处于x方向和y方向中的每一个中的坐标0、2、4、6、8、10。在对应于坐标(0,0-第一个零对应于x轴而第二个零对应于y轴)的通孔104处,该轴线角可以是九十度,使得当使用该通孔104进行对准时,针定向装置80将垂直于基板70延伸。在对应于坐标(0,2)的通孔104处,通孔104的轴线角可以是在y方向中倾斜2度。在另一示例中,在对应于坐标(4,6)的通孔104处,通孔104将限定首先已经从正常位置在x方向中倾斜4度,并且随后在y方向中倾斜4度的角度。
剩余象限106可包括限定了在负x方向和y方向中相对于第一表面98倾斜的角度的通孔(未示出)。以这种方式,轴线对准装置94为相对于基板70正确地定向该针定向装置提供了相对于第一表面98的全范围的轴线角。尽管上述坐标系108对应于在x方向和y方向中的每一个中的2度增量的轴线对准变化,但是应该明白的是,任何增量变化(例如,小于1度、1度、2度、3度等的增量)可由坐标系108限定。此外,尽管数字用于识别多种坐标,但应该明白的是,也可使用字母、符号或字母、符号和数字的任何组合。例如,x轴可使用数字而y轴使用字母来标识每个通孔104。
如上所述,针定向装置80将要相对于基部70定向的优选轴线角可在术前确定,使得该优选轴线角是患者特定的。该特定轴线角可随后被分配轴线对准装置94上的合适坐标,该特定轴线角为引导针62提供了与患者特定方位尽可能接近的方位。作为选择,多个轴线对准装置94可设置有不同的角增量,并且可选择合适的角增量以最佳地配合该患者特定的方位。
一旦已经为引导针62的插入制备了关节盂表面46,外科医生就可将轴线对准装置94平放在桌上。引导针62(例如,斯坦曼氏针、引导针或克氏针)可随后被在预定坐标处插入到通孔104中。该引导针插入引导件68包括基板70并且针定向装置80可随后被放置在搁置在预定通孔104中的引导针62上,使得基板70的下表面74平坦地置靠在轴线对准装置94的第一表面98上。在基板70置靠在第一表面98上的情况下,顶点76应该总是沿正y方向指向,并且与位于与所选定的坐标通孔104相同的列中的通孔104对准。因为针定向装置80可相对于基板70移动,因此,该过程将会将针定向装置80相对于基板70定向于合适的轴线角。针定向装置80可随后被如上所述使用定位螺钉71相对于基板70固定住,使得保持在针定向装置80和基板70之间的合适的轴线角。随后,可将引导针插入引导件68从引导针62上移除并转移到患者。
一旦将引导针插入引导件68转移到患者,就将基板70放置在关节盂表面46上,优选地尽可能接近关节盂表面46的中心。在这方面,已确定的是,外科医生能够精确地确定关节盂表面46的中心。为了确保基板70在关节盂表面46上的适当对准,对准装置78的顶点76被指向患者的解剖结构的诸如关节盂46的上顶点之类的可见标记。随后,在已将针定向装置80由于与轴线对准装置94的配合而导致已与基板70正确地轴线对准的情况下,引导针62可被插入穿过针定向装置80的细长通道92并且在用于解剖或反置式关节成形术的正确轴线方位处被插入到关节盂表面46中(例如,在引导针62是克氏针的情况下)。可随后从引导针62移除引导针插入引导件68,从而将引导针62维持成插入到关节盂表面46中。作为选择,可穿过对准的针定向装置80放置钻,以沿所需的患者特定的轴线预钻出随后将接收引导针62的孔(未示出)。无论如何,在适当放置引导针62之后,外科医生可随后进行选定的解剖或反置式关节成形手术。
应该明白的是,针对患者的术前计划可包括用于解剖或反置式关节成形术中的每一个的坐标。以这种方式,一旦已经制备好用于手术的关节盂46,外科医生就可在术中确定用于实施的正确程序。此外,应该明白的是,术中确定的坐标可以在术中加以改变。也就是说,如果外科医生确定了待将引导针62插入到关节盂46所处的轴线角将是不适合的,则外科医生可通过选择多个通孔104中的具有与术前预先选择的通孔104不同的轴线角的一个通孔,来选择用于引导针62的不同的轴线角。例如,如果外科医生在术中确定了设计好的轴线角应在x方向中转移2度,则当相对于基板70定向针定向装置80时,外科医生可选择轴线对准装置94上的那个通孔104。作为选择,外科医生可选择在每个坐标通孔104之间具有较少角度差的另一轴线对准装置94。
最后,应该明白的是,引导针插入引导件68和轴线对准装置94是可重复使用的。具体来说,引导针插入引导件68和轴线对准装置94中的每一个均可由允许对这些装置进行消毒且使其是可重复使用的诸如钛或手术用钢之类的材料形成。然而,如上所述,应该明白的是,如果需要的话,基板70的下表面74可包括患者特定的表面。
已经出于说明和描述的目的提供了对这些实施例的前述描述。并非旨在是穷举的或限制本公开内容。具体实施例的各个元件或特征通常并不限于该具体实施例,但是,在适用的情况下,可以互换并且可在选定实施例中使用,即使并未具体地示出或描述,也是如此。这也可以多种方式予以改变。这种改变并不被视为是对本公开内容的背离,并且所有的这种修改均旨在被包括在本公开内容的范围内。
Claims (23)
1.一种用于将引导针与解剖结构对准的系统,所述系统包括:
引导针插入引导件,所述引导针插入引导件用于将所述引导针相对于所述解剖结构定向,所述引导针插入引导件包括基板以及联接到所述基板并从所述基板延伸的针定向装置,所述针定向装置能够相对于所述基板移动;以及
轴线对准装置,所述轴线对准装置包括第一表面和第二表面且具有在所述第一表面和所述第二表面之间延伸的多个通孔,所述通孔中的每一个限定不同的对准轴线,
其中,所述通孔之一被构造成将所述引导针定位于与患者特定的对准轴线大致对准的方位,并且
其中,所述引导针插入引导件被构造成在所述引导针与所述通孔之一配合时,接收所述引导针,以将所述引导针插入引导件沿所述患者特定的对准轴线相对于所述基板定位。
2.根据权利要求1所述的系统,其中,所述轴线对准装置包括坐标系。
3.根据前述权利要求中的任一项所述的系统,其中,被构造成使所述引导针与患者特定的对准轴线对准的所述一个通孔位于患者特定的坐标处。
4.根据前述权利要求中的任一项所述的系统,其中,所述基板包括用于使所述基板与在解剖结构上可见的位置对准且用于使所述基板与所述轴线对准装置对准的对准装置。
5.根据前述权利要求中的任一项所述的系统,其中,所述基板被成形成包括顶点,并且所述对准装置由所述顶点限定。
6.根据前述权利要求中的任一项所述的系统,其中,所述针定向装置是中空的。
7.根据前述权利要求中的任一项所述的系统,其中,所述针定向装置包括与所述基板以可移动的方式配合的球根状部分,并且所述球根状部分允许所述针定向装置相对于所述基板铰接并且锁定到适当位置中。
8.根据前述权利要求中的任一项所述的系统,其中,所述系统进一步包括铰孔装置。
9.根据前述权利要求中的任一项所述的系统,其中,所述引导针插入引导件和所述对准轴线装置中的每一个都是能够重复使用的。
10.根据前述权利要求中的任一项所述的系统,其中,所述引导针插入引导件和所述对准轴线装置由钛或手术用钢形成。
11.根据前述权利要求中的任一项所述的系统,其中,所述引导针插入引导件的所述基板包括限定患者特定的轮廓的表面。
12.根据前述权利要求中的任一项所述的系统,其中,所述引导针插入引导件被构造成被沿所述患者特定的对准轴线固定到所述基板。
13.根据前述权利要求中的任一项所述的系统,其中,所述通孔被呈坐标阵列布置。
14.根据前述权利要求中的任一项所述的系统,其中,每个通孔都通过预定的角度量限定不同的对准轴线。
15.根据权利要求14所述的系统,其中,所述预定的角度量由坐标系所限定。
16.一种用于将引导针与关节盂对准的方法,包括:
相对于所述关节盂确定用于所述引导针的患者特定的对准轴线;
提供由包括第一表面和第二表面且具有多个通孔的构件限定的轴线对准装置,所述多个通孔呈坐标阵列布置且在所述第一表面和所述第二表面之间延伸,所述通孔中的每一个限定不同的对准轴线;
确定所述通孔中的限定与所述患者特定的对准轴线最为接近地对应的对准轴线的一个的坐标位置;
使所述引导针与所述一个通孔配合以沿所述患者特定的对准轴线定向所述引导针;
将引导针插入引导件放置在所述引导针上,所述引导针插入引导件包括基板和针定向装置,所述基板具有上表面和关节盂接合表面,所述针定向装置联接到所述基板的上表面并且从所述基板的上表面延伸,所述针定向装置能够相对于所述基板移动,使得当将所述引导针插入引导件放置在所述引导针上时,所述针定向装置被沿所述患者特定的对准轴线定位;
将沿所述患者特定的对准轴线相对于所述基板定位的所述针定向装置固定住;
将所述引导针连同所述引导针插入装置一起从所述轴线对准装置上移除;
使所述基板的所述关节盂接合表面与所述关节盂接触;以及
将所述引导针沿所述患者特定的对准轴线固定到所述关节盂。
17.根据权利要求16所述的方法,其中,所述方法进一步包括使所述基板与在所述关节盂上可见的位置对准。
18.根据权利要求16或17中的任一项所述的方法,其中,所述基板包括对准装置,并且所述基板被成形成包括顶点,并且所述对准装置由所述顶点限定。
19.根据权利要求16到18中的任一项所述的方法,其中,所述方法进一步包括在利用所述引导针的同时对所述关节盂进行铰孔。
20.根据权利要求16到19中的任一项所述的方法,其中,所述方法进一步包括对所述引导针插入引导件和所述对准轴线装置中的每一个进行消毒,使得每一个都是能够重复使用的。
21.根据权利要求16到20中的任一项所述的方法,其中,所述针定向装置是中空的,并且包括与所述基板以可移动的方式配合的球根状部分,所述球根状部分允许所述针定向装置相对于所述基板铰接并且锁定到适当位置中。
22.根据权利要求16到21中的任一项所述的方法,其中,所述引导针插入引导件和所述对准轴线装置由钛或手术用钢形成。
23.根据权利要求16到22中的任一项所述的方法,其中,确定所述坐标位置包括从所述坐标阵列选择所述坐标位置。
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- 2015-09-28 AU AU2015324145A patent/AU2015324145B2/en active Active
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CA2961949A1 (en) | 2016-04-07 |
EP3200703B1 (en) | 2020-01-08 |
AU2015324145B2 (en) | 2019-05-02 |
EP3200703A1 (en) | 2017-08-09 |
JP2017529937A (ja) | 2017-10-12 |
AU2015324145A1 (en) | 2017-05-18 |
CN107072677B (zh) | 2019-06-28 |
US20180078267A1 (en) | 2018-03-22 |
US20160089163A1 (en) | 2016-03-31 |
JP6491328B2 (ja) | 2019-03-27 |
US9826994B2 (en) | 2017-11-28 |
CA2961949C (en) | 2020-02-18 |
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