CN107693065B - Knee joint gap retractor - Google Patents
Knee joint gap retractor Download PDFInfo
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- CN107693065B CN107693065B CN201711083446.5A CN201711083446A CN107693065B CN 107693065 B CN107693065 B CN 107693065B CN 201711083446 A CN201711083446 A CN 201711083446A CN 107693065 B CN107693065 B CN 107693065B
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- 210000000629 knee joint Anatomy 0.000 title claims abstract description 105
- 230000005540 biological transmission Effects 0.000 claims abstract description 46
- 210000002303 tibia Anatomy 0.000 claims abstract description 9
- 210000000689 upper leg Anatomy 0.000 claims abstract description 9
- 230000007246 mechanism Effects 0.000 claims description 14
- 241000469816 Varus Species 0.000 claims description 7
- 230000006835 compression Effects 0.000 claims description 7
- 238000007906 compression Methods 0.000 claims description 7
- 241001227561 Valgus Species 0.000 claims description 5
- 210000003041 ligament Anatomy 0.000 abstract description 18
- 238000012546 transfer Methods 0.000 abstract description 10
- 210000003127 knee Anatomy 0.000 description 8
- 210000004872 soft tissue Anatomy 0.000 description 7
- 238000000034 method Methods 0.000 description 5
- 125000006850 spacer group Chemical group 0.000 description 5
- 238000010276 construction Methods 0.000 description 2
- 238000004519 manufacturing process Methods 0.000 description 2
- 230000000399 orthopedic effect Effects 0.000 description 2
- 230000008569 process Effects 0.000 description 2
- 238000001356 surgical procedure Methods 0.000 description 2
- 230000009471 action Effects 0.000 description 1
- 230000006978 adaptation Effects 0.000 description 1
- 238000011882 arthroplasty Methods 0.000 description 1
- 239000012620 biological material Substances 0.000 description 1
- 230000007547 defect Effects 0.000 description 1
- 238000013461 design Methods 0.000 description 1
- 201000010099 disease Diseases 0.000 description 1
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 1
- 230000009977 dual effect Effects 0.000 description 1
- 230000005489 elastic deformation Effects 0.000 description 1
- 210000003141 lower extremity Anatomy 0.000 description 1
- 238000005259 measurement Methods 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 230000035790 physiological processes and functions Effects 0.000 description 1
- 238000012545 processing Methods 0.000 description 1
- 230000007480 spreading Effects 0.000 description 1
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
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/025—Joint distractors
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
- A61B5/107—Measuring physical dimensions, e.g. size of the entire body or parts thereof
- A61B5/1072—Measuring physical dimensions, e.g. size of the entire body or parts thereof measuring distances on the body, e.g. measuring length, height or thickness
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/22—Ergometry; Measuring muscular strength or the force of a muscular blow
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/025—Joint distractors
- A61B2017/0268—Joint distractors for the knee
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Veterinary Medicine (AREA)
- Public Health (AREA)
- General Health & Medical Sciences (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Engineering & Computer Science (AREA)
- Surgery (AREA)
- Animal Behavior & Ethology (AREA)
- Molecular Biology (AREA)
- Medical Informatics (AREA)
- Transplantation (AREA)
- Physics & Mathematics (AREA)
- Biophysics (AREA)
- Pathology (AREA)
- Physical Education & Sports Medicine (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Orthopedics, Nursing, And Contraception (AREA)
- Dentistry (AREA)
- Cardiology (AREA)
- Vascular Medicine (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
Abstract
The present application provides a knee joint space retractor comprising: a base; a column extending vertically from the base and fixedly secured thereto; a first handle fixedly coupled or formed as one body with the base; a second handle above the first handle and slidable along the post; a first distracting component for contacting an osteotomy face of a distal femur of a patient; and a second distracting component for contacting an osteotomy face of a proximal tibia of a patient and detachably coupled to the second handle; wherein, still include: a force transmission member that is provided above the second handle and is slidable along the column, and the first spreader member is detachably coupled to the force transmission member; and a spring extending along the post between the base and the force transfer member. The utility model discloses a utilize the spring can realize measuring ligament pulling force and knee joint to prop up the clearance in real time, and more accurate force value shows, and the doctor has direct hand to ligament pulling force size to feel, simple operation, struts the mode simple, high-efficient.
Description
Technical Field
The present application relates to medical devices for orthopedic surgery, and more particularly to a knee joint space retractor for use in knee joint replacement surgery.
Background
Artificial knee joint replacement is an orthopedic operation that replaces a diseased knee joint of a human body with an artificial biological material and restores normal physiological functions of the knee joint. In operation, a physician needs to perform a characteristic osteotomy and soft tissue balancing procedure on the patient's knee to match the artificial knee prosthesis and restore optimal stable morphology of the knee.
After osteotomy of the proximal tibia and distal femur, the knee joint is typically tested for gap and ligament tension in the straightened and flexed positions using a gap pad or prosthetic trial. The doctor adjusts the knee joint gap and the ligament tension according to the disease of the knee joint of the patient so as to help rebuild the normal joint surface and obtain the correct lower limb force line, restore the balance of the knee joint ligament and ensure the stability of the artificial joint. In general, a physician uses a knee joint space retractor to directly determine knee joint distraction space and ligament tension to aid in assessing knee joint osteotomy mass and performing soft tissue balancing procedures.
Retractors that perform similar functions as currently used in knee arthroplasty are largely divided into two types: active and passive. Active retractors detect ligament tension or measure knee distraction gap by means of electrical signals. Because of the introduction of a power source, the active retractor belongs to a class II instrument in medical instruments, has moderate risks, and needs to be strictly managed to ensure the safety and the effectiveness of the active retractor, so the production cost of the active retractor is generally higher. The passive retractor adopts a mechanical energy mode to prop open knee joint gaps, belongs to class I instruments, can ensure the safety and effectiveness of the passive retractor by conventional management and control, and has relatively low production cost and higher stability.
However, the existing passive retractors generally only comprise part of functions of expanding knee joint gaps, obtaining ligament tension, judging the varus-valgus angle of the knee joint and the like, which are required to be realized in knee joint replacement, and have the defects of complex operation, no consideration of physiological structures of the knee joint in instrument design, no direct instrument function aiming at unilateral knee joint or acquired data and the like, and the risks of delaying operation time, influencing doctor judgment and the like are easily caused. In addition, designing multiple instrument gauges due to the need to match the needs of the left and right knees also increases processing costs, transportation costs, and management costs.
Thus, there is a need for a multi-functional, easy to use, accurate indication knee joint space retractor.
Disclosure of Invention
It is an object of the present application to overcome at least one or more of the problems of existing knee joint space retractors, and to provide an improved knee joint space retractor that provides more functionality and is easy to use.
To this end, according to an aspect of the present application, there is provided a knee joint space retractor comprising:
a base;
a post extending vertically from the base and fixedly secured thereto;
a first handle fixedly coupled or formed as one body with the base;
a second handle above the first handle and slidable along the post;
a first distracting member for contacting an osteotomy face of a distal femur of a patient; and
a second distracting member for contacting an osteotomy face of the proximal tibia of the patient and detachably coupled to the second handle;
wherein the knee joint space retractor further comprises:
a force transmission member that is above the second handle and is slidable along the column, and to which the first spreader member is detachably coupled; and
a spring extending along the post between the base and the force transfer member.
Preferably, the knee joint space retractor further comprises a first parallel transmission mechanism including at least one pair of links including a first link and a second link of equal length, the first link and the second link being hinged at a midpoint, and one end of the first link and one end of the second link on the same side being hinged on the first handle and the second handle, respectively, and the other end of the first link and the other end of the second link on the other side being slidably hinged in a chute of the second handle and a chute of the first handle, respectively, and a torsion spring or a leaf spring being provided at the midpoint to urge the first handle and the second handle apart.
Preferably, the knee joint space retractor further comprises a second parallel transmission mechanism including at least one pair of links including a third link and a fourth link of equal length, the third link and the fourth link being hinged at a midpoint, and one end of the third link and one end of the fourth link on the same side being hinged to the second handle and the force transmission member, respectively, and the other end of the third link and the other end of the fourth link on the other side being slidably hinged within a chute of the force transmission member and a chute of the second handle, respectively, and a torsion spring or a leaf spring being provided at the midpoint to urge the second handle and the force transmission member apart.
Preferably, the knee joint space retractor further comprises a distraction space gauge disposed on the force transmission member or the second handle.
Preferably, the knee joint space retractor further comprises a space locking member arranged to lock a space between the second handle and the force transmitting member.
Preferably, the knee joint space retractor further comprises a distraction force gauge disposed on the post.
Preferably, the first spreader part is rotatable or lockable relative to the force transmission part and/or the second spreader part is rotatable or lockable relative to the second handle.
Preferably, the first spreader part is detachably coupled to the force transmission part by a first connection rod, and the second spreader part is detachably coupled to the second handle by a second connection rod, the first and second connection rods being configured to be capable of being respectively reversed after being detached from the force transmission part and the second handle, and then being respectively inserted back into the force transmission part and the second handle.
Preferably, the knee joint gap retractor further comprises an varus angle indicator fixedly coupled with the force transmission member to indicate the valgus angle of the first or second distraction member, the valgus angle indicator being provided on the first or second connecting rod and correspondingly provided with an indication portion on the first or second distraction member.
Preferably, the spring is pre-stressed between the force transmitting member and the base, and the pre-stress is greater than the total weight of the member supported by the spring when the knee joint space retractor is in an initial state.
Preferably, the knee clearance retractor includes a handle locking member configured to limit the second handle from moving away relative to the first handle.
Preferably, the handle lock member comprises a ratchet bar hinged to the first handle and a pawl provided on the second handle, and the ratchet bar is held in engagement with the pawl by a biasing force applied by a torsion spring or a leaf spring at the hinge.
The present application provides significant benefits over current knee joint space retractors in at least one or more of the following respects. For example, the ligament tension and knee joint distraction gap can be measured in real time by using the spring, and the larger spring travel and more accurate force value display are realized; the doctor has direct hand feeling on the ligament pulling force; the operation is convenient, the opening mode is simple and efficient; the left knee joint and the right knee joint can be operated by a set of machines.
Drawings
Exemplary embodiments of the present application will be described in detail below with reference to the attached drawings, and it should be understood that the embodiments described below are only for the purpose of explaining the present application and are not limiting the scope of the present application, wherein:
fig. 1 is a perspective view illustrating a knee joint space retractor according to an embodiment of the present application;
FIG. 2 is an elevation view of the knee joint space retractor of FIG. 1;
FIG. 3 is a cross-sectional view of the knee joint space retractor of FIG. 1;
FIG. 4 is another perspective view showing the knee joint space retractor of FIG. 1 with the first and second distracting members removed;
fig. 5 is a sectional view taken along line A-A of fig. 3, in which the internal structures of the first and second spreader components are shown.
Detailed Description
Preferred embodiments of the present application are described in detail below with reference to examples. However, those skilled in the art will appreciate that these exemplary embodiments are not meant to be limiting in any way. Furthermore, embodiments of the present application and features of the embodiments may be combined with each other without conflict. In the drawings, other components are omitted for brevity, but this does not indicate that the knee joint space retractor of the present application may not include other components.
Referring to fig. 1, 2 and 3, wherein fig. 1 shows a perspective view of a knee joint space retractor in accordance with an embodiment of the present application, fig. 2 and 3 are front and cross-sectional views, respectively, of the knee joint space retractor shown in fig. 1. As shown in fig. 1 and 2, the knee joint space retractor mainly includes a base 10, a column 11, a first handle 12, a second handle 13, a force transmission member 20, a first distraction member 41, and a second distraction member 42. The post 11 may extend vertically upward from the base 10 and be fixedly secured to the base 10. The first handle 12 may be fixedly coupled with the base 10 or formed as one piece (i.e., as a unitary piece). The second handle 13 is located above the first handle 12 and is slidable along the post 11. The first distracting member 41 is adapted to contact an osteotomy surface of a distal femur of a patient, and the second distracting member 42 is adapted to contact an osteotomy surface of a proximal tibia of a patient. Additionally, the knee joint space retractor of the present application can further include a force transmitting member 20 and a spring 30. The force transmission member 20 is located above the second handle 12 and is slidable along the post 11. The spring 30 may extend along the post 11 between the base 10 and the force transmitting member 20. The first spreader part 41 may be detachably coupled with the force transmission part 20 through a first connection rod 47, and the second spreader part 42 may be detachably coupled with the second handle 13 through a second connection rod 48. As shown in fig. 4, knee joint space retractor 1 is shown with first distracting member 41 and second distracting member 42 removed.
According to one embodiment, the spring 30 is preferably a cylindrical helical compression spring of simple construction because its load versus deformation curve is nearly straight and its stiffness is relatively stable. The spring 30 shown in fig. 1-3 may extend upwardly from the base 10 around the post 11, but may also extend inside or on one side of the post 11. In addition, other types of springs, such as helical tension springs, coil springs, and the like, may also be employed. Of course, in the case of other types of springs, the mechanism associated with the springs may need to be adjusted accordingly, such adjustment being well known and not described in detail herein.
The knee clearance retractor of the present application also includes a handle lock 50 to limit the distance the second handle 13 is moved away from the first handle 12. According to one embodiment, the handle lock 50 may include a ratchet bar 51 provided on the first handle 12 and a pawl 52 provided on the second handle 13. As shown in fig. 2 and 3, the handle lock member 50 is shown in an inoperable state in which the ratchet bar 51 is biased out of engagement with the pawl 52. In the operating state, pawl 52 engages the ratchet teeth on ratchet bar 51, allowing only pawl 52 to move downward, but preventing pawl 52 from moving upward. Torsion springs or leaf springs may be provided at the hinge of the handle lock member 50 to the first handle 12 to urge the ratchet bar 51 and pawl 52 into engagement.
In addition, to ensure that the first handle 12 and the second handle 13 remain parallel when the first handle 12 and the second handle 13 are held by the doctor's hand, to facilitate parallel transfer of force, and to provide for equal transfer of hand grip to the spring 30, the knee joint spacer retractor 1 of the present application may further comprise a first parallel transfer mechanism comprising at least one pair of links including a first link 14 and a second link 15. As shown in fig. 1 and 2, the first link 14 and the second link 15 are hinged at a midpoint 18 (visible in fig. 3), and the lengths of the first link 14 and the second link 15 are equal. The right end of the first link 14 and the right end of the second link 15 are respectively hinged on the first handle 12 and the second handle 13, and the left end of the first link 14 and the left end of the second link 15 are respectively slidably hinged in a chute 17 of the second handle 13 and a chute 16 of the first handle 12. In fig. 1, a pair of links provided in the middle of the first handle 12 and the second handle 13 is shown, however, a pair of links may be provided on either side of the first handle 12 and the second handle 13. The connection between the left and right ends of the first link 14 and the second link 15 may be exchanged.
Similarly, to facilitate parallel transfer of forces during compression of spring 30 and to equivalently transfer the pressure of spring 30 to first and second distracting members 41, 42, knee joint spacer retractor 1 of the present application may further include a second parallel transfer mechanism including at least one pair of links including third and fourth links 24, 25. As shown in fig. 1 and 2, the third link 24 and the fourth link 25 are hinged at a midpoint 28, and the lengths of the third link 24 and the fourth link 25 are equal. The left end of the third link 24 and the left end of the fourth link 25 are hinged to the second handle 13 and the force transmission member 20, respectively, and the right end of the third link 24 and the right end of the fourth link 25 are slidably hinged to the slide groove 27 of the force transmission member 20 and the slide groove 26 of the second handle 13, respectively. In fig. 1 and 2, two pairs of links provided on both sides of the second handle 13 and the force transmission portion 20 are shown, however, a pair of links may be provided in the middle of the second handle 13 and the force transmission member 20. The connection between the left and right ends of the third link 24 and the fourth link 15 may be exchanged.
According to an embodiment, at either end of one or more of the first link 14, the second link 15, the third link 24 and the fourth link 25, a stopper may be provided to limit the degree of compression and/or the degree of extension of the first parallel transmission mechanism and/or the second parallel transmission mechanism. For example, a stopper 21 provided on the first link 14 and a stopper 22 provided on the fourth link 25.
According to one embodiment, to maintain first distracting member 41 and second distracting member 42 in contact when the knee joint space retractor is in the initial state, it is desirable that second handle 13 and force transmitting member 20 be as close together as possible. For this purpose, a torsion spring or leaf spring 19 may be provided at the midpoint 18 of the first link 14 and the second link 15 of the first parallel transmission mechanism to tend to separate the first handle 12 and the second handle 13. As shown in fig. 3, the torsion spring or leaf spring 19 applies a torsion force to the first link 14 and the second link 15 such that the ends of the first link 14 and the second link 15 hinged to the first handle 12 or the second handle 13 tend to be closed together, thereby tending to move the second handle 13 upward. Alternatively, a torsion spring or leaf spring (not shown) may be provided at the midpoint 28 of the third link 24 and the fourth link 25 of the second parallel transmission mechanism to urge the second handle 13 and the force transmitting member 20 toward each other. In the knee joint space retractor, one or a plurality of torsion springs or spring pieces are arranged, but the elasticity of the torsion springs or the spring pieces has no influence on the indication of the expanding force in the expanding state.
According to one embodiment, to allow the knee joint space retractor to display the space indication directly, an opening space indication scale 23 may be provided on the force transmission member 20 or the second handle 13 to indicate the space between the knee joints being opened by the first opening member 41 and the second opening member 42. It should be noted that the indication of the opening gap indication scale 23 takes into account the own thicknesses of the first and second opening members 41 and 42. Therefore, the doctor can directly judge whether the knee joint gap reaches the expected size through the indication of the opening gap.
According to an embodiment, a gap locking member 29 is also provided on the force transmission member 20 or the second handle 13. As shown in fig. 1, when the distraction gap gauge 23 is provided on the second handle 13, the gap locking member 29 may be a lock bolt provided on the force transmission member 20. The locking bolt may be rotated when required to secure the distraction gap gauge 23. Of course, the distraction gap gauge 23 may also be provided on the force transmission member 20, and the gap locking member 29 may be provided on the second handle 13.
When the knee joint space retractor distracts the osteotomy surfaces of the distal femur and proximal tibia of the knee joint, the force applied by the doctor's hand holding the first handle 12 and the second handle 13 is transferred to the first distracting member 41 and the second distracting member 42 via the spring 30. When the equilibrium state is reached, the grip force, the spring force and the ligament pulling force are equal in magnitude. According to one embodiment, to display the force value, a spreader force indicator scale 32 is provided on the post 11. As shown in fig. 1, a spreader force indicator scale 32 is provided at the upper end of the post 11. In the initial state, the springs 30 are subjected to a certain pre-compression upon assembly, taking into account the stability of the knee joint space retractor. The magnitude of this pre-stress is reflected on the spreader force indicator scale 32. Preferably, the pre-pressure is greater than the total weight of the components supported by the springs 30 in the initial state.
As previously described, the first and second spreader members 41 and 42 are detachably coupled to the force transmission member 20 and the second handle 13, respectively. According to an embodiment, the first spreader part 41 is hinged with the first connecting rod 47 by means of a shaft 48. As shown in fig. 4 and 5, the shaft 45 of the first opening part 41 is received in the hole of the first connecting rod 47 and may be fixed by the locking bolt 44. When the locking bolt 44 is unscrewed, the first distracting member 41 may be rotated relative to the first connecting rod 47 (i.e., relative to the force transmitting member 20) so that the varus of the knee joint may be indicated. To this end, according to one embodiment, the knee joint space retractor of the present application further includes an varus angle indicator 43. The inside-out angle indicator 43 may be provided on the first connecting rod 47 as shown in fig. 5, for example, by being mounted on one side of the first connecting rod 47 by means of a plug-in. Accordingly, at the sides of the first spreader component 41, there are provided indication portions 49, 46, which indication portions 49, 46 are adjacent to the inside-out angle indicator 43, such that when the first spreader component 41 and the second spreader component 42 remain parallel, the zero graduations of the inside-out angle indicator 39 are aligned with the indication portions 49, 46 (only shown in fig. 5 as being aligned with the indication portion 49). With the rotation of the first spreader part 41, the indication portions 49, 46 indicate the corresponding inside-out angle indication on the inside-out angle indicator 43. Of course, in the case where the second spreader part 42 is pivotally hinged to the second connecting rod 48, the inside-out angle indicator 43 may be provided on the second connecting rod 48. In this case, an indication portion (not shown in the drawings) may be provided on the second spreader component 42 accordingly.
According to an embodiment, the second spreader component 42 and the second connecting rod 48 may be two components coupled together or may be integrally formed. The first and second connecting rods 47, 48 are configured to be able to be reversed and reinserted back into the force transfer member 20 and the second handle 13, respectively, after being detached from the force transfer member 20 and the second handle 12, respectively, such that the knee joint space retractor 1 is converted from an original measurable left knee joint to a now measurable right knee joint, for example. Accordingly, the first and second connection rods 47 and 48 are configured such that the first and second distracting members 41 and 42 are biased to one side of a plane defined by the post 11 and the force transmission member 20, the second handle 13 and/or the first handle 12. For example, as shown in fig. 1, when a physician holds the knee joint space retractor of the present application with his hand, first and second distracting members 41, 42 are directed anteriorly and offset to the right of the plane defined by post 11 and force transmitting member 20, second handle 13 and/or first handle 12, at which point the left knee joint may be measured. After the first and second connection rods 47 and 48 are disassembled, reversed and inserted back, the first and second distracting members 41 and 42 are directed forward but are biased to the left side of the above-mentioned plane when the doctor holds it, at which time the right knee joint can be measured.
The specific construction of a knee joint space retractor in accordance with embodiments of the present application is described above with reference to fig. 1-5, and the operation of a knee joint space retractor utilizing the present application is illustrated below with reference also to fig. 1-5.
In the initial state of the knee joint space retractor, the spring 30 is compressed by the pre-pressure and the second handle 13 is pressed against the force transmitting member 20 by, for example, a torsion spring or a leaf spring 19.
The doctor can insert the first and second distraction members 41, 42 into the knee joint where the initial osteotomy has been completed by holding the first and second handles 12, 13 such that the first distraction member 41 corresponds to the osteotomy face of the distal femur and the second distraction member 42 corresponds to the osteotomy face of the proximal tibia.
Then, the doctor can hold the first handle 12 and the second handle 13 hard, so that the holding force of the hand is transferred to the spring 30, and further the first opening member 41 and the second opening member 42 are driven to overcome the tension of the ligaments, so as to open the gap of the knee joint. At this time, according to an embodiment, the first handle 12 and the second handle 13 can be ensured to move in parallel toward each other all the time by the first parallel transmission mechanism, and the first spreader part 41 and the second spreader part 42 can be ensured to move in parallel away from each other all the time by the second parallel transmission mechanism. Thus, the knee joint space retractor of the present application can ensure that the first handle and the second handle are always in parallel constraint by the dual parallel transmission mechanism, and that the second handle and the force transmission member are always in parallel constraint. Specifically, the grip force of the doctor is transferred to the spring 30 by the handle, and then the force is transferred to the first spreader part 41 by the simultaneous action of the post 11 and the spring 30, so that the spreading force caused by the spring 30 directly acts on the osteotomy surfaces of the femur and the tibia, that is, the force applied by hand grip is reacted on the osteotomy surfaces of the femur and the tibia to spread the knee joint gap. When the balance state is reached, the holding force, the spring expanding force and the ligament pulling force are equal. At this time, the knee joint gap is indicated on the distraction gap indication scale 23, and the distraction force is indicated on the distraction force indication scale 32.
It should be noted that the handle lock 50 also operates in real time when the doctor holds the first handle 12 and the second handle 13 hard so that the first handle 12 and the second handle 13 do not get away from each other. Specifically, the pawl 52 on the second handle 13 is held in engagement with the ratchet bar 51 on the first handle 12 by the torsion or spring tab during gripping of the handles.
As the first handle 12 and the second handle 13 are continuously held with force, the expanding gap and the expanding force are gradually increased, when the expanding gap reaches the expected value, the gap locking component 29 can be screwed as required, so that the positions of the first expanding component 41 and the second expanding component 42 are kept fixed, and at the moment, the tension of the knee joint ligament can be read from the expanding force indication scale 32. In the embodiment in which the varus angle indicator is provided, the varus condition of the knee joint may be read from the valgus angle indicator 43. Based on the varus-valgus angle readings, the physician may perform a soft tissue balancing procedure. After the soft tissue balancing operation is completed by the doctor, the first opening member 41 can be fixed by the locking bolt 44 according to the requirement, so that the first opening member 41 loses the rotational freedom degree and maintains the parallel relation with the second opening member 42. Of course, if no varus determination is required, the locking bolt 44 may be tightened before the measurement begins.
So far, doctor can assist to accomplish soft tissue balancing operation or judge whether the osteotomy amount meets the operation requirement according to the opening gap, the opening force and the inside-out angle.
Subsequently, the gap locking member 29 is unscrewed, and then the handle locking member 50 is released, so that the knee joint gap retractor 1 can be restored to the original state.
When the other side knee joint operation is required, the first opening part 41 and the second opening part 42 can be directly pulled out from the force transmission part 20 and the second handle 13 respectively, and then respectively inserted back after being respectively reversed, so that the functions of gap opening and soft tissue balancing for the other side knee joint operation can be satisfied.
Furthermore, if first distracting member 41 is replaced with a spacer, the knee joint spacer retractor of the present application can assist in determining the thickness of the spacer. In addition, if the first distracting member 41 is used with an osteotomy plate positioning guide, a posterior reference osteotomy positioning may be performed.
The knee joint clearance retractor of the application adopts the cylindrical helical compression spring with simple structure, realizes that the process of expanding the clearance is completed by a hand-held mode, and ensures that a doctor has direct hand feeling on the magnitude of ligament tension. In addition, by utilizing the characteristics that the spring load and the deformation relation curve thereof are approximately linear and the rigidity value is stable, the elastic deformation of the spring is equal to the ligament pulling force after the knee joint is pulled out of the gap, and the pulling force caused by the compression deformation of the spring and the ligament pulling force of the knee joint are equivalent and opposite after the retractor is pulled out of the knee joint gap, so that the ligament pulling force and the knee joint pulling gap can be measured in real time, and the travel of the handheld part of a doctor and the travel of the spring are 1:1, a larger spring travel and a more accurate force value display. In the knee joint gap retractor, one of the expansion parts inserted into the knee joint gap keeps one degree of rotation freedom, so that the condition of the eversion of the knee joint can be displayed, and an effective basis is provided for a doctor to perform knee joint soft tissue balancing operation. In addition, the locking/releasing process of the knee joint space retractor is easy to operate, time is saved, and the knee joint space retractor is simple in structure and good in reliability.
The present application is described in detail above in connection with specific embodiments. It will be apparent that the embodiments described above and shown in the drawings are to be understood as illustrative and not limiting of the present application. It will be apparent to those skilled in the art that various modifications or adaptations can be made thereto without departing from the spirit of the present application.
Claims (12)
1. A knee joint space retractor comprising:
a base (10);
-a column (11) extending vertically from the base (10) and firmly fixed to the base (10);
a first handle (12) fixedly coupled or formed as one piece with the base (10);
a second handle (13) located above the first handle (12) and slidable along the column (11);
a first distracting member (41) for contacting an osteotomy face of a distal femur of a patient; and
a second distracting member (42) for contacting an osteotomy face of the proximal tibia of the patient and detachably coupled to the second handle (13);
characterized in that the knee joint space retractor further comprises:
a force transmission member (20) that is above the second handle (13) and is slidable along the column (11), and the first spreader member (41) is detachably coupled with the force transmission member (20);
a spring (30) extending along the post (11) between the base (10) and the force transmission member (20), and being a cylindrical helical compression spring; and
the first parallel transmission mechanism comprises at least one pair of connecting rods, the at least one pair of connecting rods comprise a first connecting rod (14) and a second connecting rod (15) which are equal in length, the first connecting rod (14) and the second connecting rod (15) are hinged at the middle point, one end of the first connecting rod (14) and one end of the second connecting rod (15) on the same side are hinged on the first handle (12) and the second handle (13) respectively, and the other end of the first connecting rod (14) and the other end of the second connecting rod (15) on the other side are hinged in a sliding groove of the second handle (13) and a sliding groove of the first handle (12) respectively in a sliding way.
2. Knee joint space retractor according to claim 1, wherein a torsion spring or leaf spring (19) is provided at the midpoint of the first (14) and second (15) links to tend to separate the first (12) and second (13) handles.
3. Knee joint space retractor according to claim 1, further comprising a second parallel transmission mechanism comprising at least one pair of links comprising a third link (24) and a fourth link (25) of equal length, the third link (24) and the fourth link (25) being hinged at a midpoint, and one end of the third link (24) and one end of the fourth link (25) on the same side being hinged on the second handle (13) and the force transmission member (20), respectively, the other end of the third link (24) and the other end of the fourth link (25) on the other side being slidably hinged in a chute of the force transmission member (20) and a chute of the second handle (13), respectively, and a torsion spring or leaf spring being provided at the midpoint of the third link (24) and the fourth link (25) to urge the second handle (13) and the force transmission member (20) apart.
4. The knee joint gap retractor according to claim 1, further comprising a distraction gap gauge (23) disposed on the force transmission member (20) or the second handle (13).
5. The knee joint gap retractor according to claim 4, further comprising a gap locking member (29) arranged to lock a gap between the second handle (13) and the force transmitting member (20).
6. The knee joint space retractor according to claim 1, further comprising a distraction force gauge (32) disposed on the post (11).
7. Knee joint space retractor according to claim 1, wherein the first distracting member is rotatable or lockable relative to the force transmission member (20) and/or the second distracting member is rotatable or lockable relative to the second handle (13).
8. The knee joint space retractor according to claim 7, wherein the first distracting member (41) is detachably coupled to the force transmitting member (20) by a first connecting rod (47), the second distracting member (42) is detachably coupled to the second handle (13) by a second connecting rod (48), the first connecting rod (47) and the second connecting rod (48) being configured to be capable of being respectively reversed after being detached from the force transmitting member (20) and the second handle (13) and then being respectively inserted back into the force transmitting member (20) and the second handle (13).
9. The knee joint gap retractor according to claim 8, further comprising an varus angle indicator (43) fixedly coupled with the force transmitting member (20) to indicate a valgus angle of the first (41) or second (42) distracting member, the valgus angle indicator (43) being provided on the first (47) or second (48) connecting rod and an indication portion being provided on the first (41) or second (42) distracting member, respectively.
10. The knee joint space retractor according to claim 1, wherein the spring (30) is pre-stressed between the force transmitting member (20) and the base (10) and the pre-stress is greater than the total weight of the members supported by the spring (30) when the knee joint space retractor is in an initial state.
11. The knee joint gap retractor of claim 1, including a handle lock member (50) configured to limit the second handle (13) from moving away relative to the first handle (12).
12. The knee joint space retractor according to claim 11, wherein the handle locking member (50) includes a ratchet bar (51) hinged to the first handle (12) and a pawl (52) provided on the second handle (13), and wherein the ratchet bar (51) is held in engagement with the pawl (52) at the hinge by a biasing force exerted by a torsion or spring plate.
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| CN201711083446.5A CN107693065B (en) | 2017-11-07 | 2017-11-07 | Knee joint gap retractor |
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| CN201711083446.5A CN107693065B (en) | 2017-11-07 | 2017-11-07 | Knee joint gap retractor |
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| US11344352B2 (en) * | 2019-03-29 | 2022-05-31 | Depuy Ireland Unlimited Company | Methods of operating a surgical instrument and performing a surgical procedure to balance a patient's knee |
| CN111568449A (en) * | 2020-06-02 | 2020-08-25 | 北京爱康宜诚医疗器材有限公司 | Joint soft tissue balance measuring device |
| CN111743599A (en) * | 2020-08-04 | 2020-10-09 | 北京爱康宜诚医疗器材有限公司 | Osteotomy device |
| CN112006691B (en) * | 2020-08-07 | 2024-01-23 | 徐卫东 | Knee joint replacement flexion-extension gap measurement balancing device |
| CN111839467A (en) * | 2020-08-14 | 2020-10-30 | 北京力达康科技有限公司 | Knee joint stretches and bends clearance range finding balancer |
| CN114587556B (en) * | 2022-03-28 | 2023-03-10 | 中南大学湘雅医院 | Fixed support for tibial osteotomy |
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