CN111658244A - 一种膝关节置换可调节抱髁器装置 - Google Patents

一种膝关节置换可调节抱髁器装置 Download PDF

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CN111658244A
CN111658244A CN202010625169.1A CN202010625169A CN111658244A CN 111658244 A CN111658244 A CN 111658244A CN 202010625169 A CN202010625169 A CN 202010625169A CN 111658244 A CN111658244 A CN 111658244A
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徐志宏
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    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
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Abstract

本发明公开了一种膝关节置换可调节抱髁器装置,它包含假体尺寸读数框、立板、后踝切骨量限位器、可调节弹簧夹和后踝靠板,所述立板的一侧中部设置有假体尺寸读数框,所述立板的一侧两端对称设置有限位器座,所述限位器座内可滑动地垂直设置有后踝切骨量限位器,所述后踝切骨量限位器的下端延伸出限位器座与后踝靠板固定连接,且后踝靠板与后踝切骨量限位器垂直;所述限位器座的外侧面设置有与后踝切骨量限位器相配合的可调节弹簧夹。本发明整体设计巧妙,可以使手术的操作过程变得更为简单、方便、准确可靠,有效的避免传统方法的弊端,减少返工的机会,减少过度依赖手术经验的弊端,减少软组织松解弊端,使得手术效果更加可靠。

Description

一种膝关节置换可调节抱髁器装置
技术领域
本发明涉及医疗器械技术领域,尤其是一种定位装置,具体涉及一种膝关节置换可调节抱髁器装置。
背景技术
膝关节置换目前被广泛应用于临床,为关节外科成熟手术技术,对于缓解老年患者膝关节疼痛畸形有着绝对的手术疗效。但是手术同时也带来了诸多风险,由于手术创伤相对较大,手术后的感染、出血、肺栓塞等也带来了很多问题。在膝关节假体飞速发展的今天,膝关节手术的疗效最关键的仍然为手术技术,手术中假体的安装位置影响因素很多,与手术医生的经验息息相关,包括力线还有股骨假体与胫骨假体的旋转对线,屈伸活动不同角度的关节稳定性等,随着手术技术的逐步普及,关节置换术后的稳定性越来越受到重视,其中股骨假体的旋转对线与屈伸间隙平衡至关重要,然而几乎所有医生的股骨侧切骨大部分依赖于工具或者手术经验,往往在截骨完成以后才可以进行假体稳定性测试,这对于此前的截骨错误已经难以避免。只能重新修正或者放弃修正,带来不稳定的风险以及远期患者的不满意度及假体磨损高风险。
目前解决的两个办法,一个是采用间隙平衡技术,首先在0°位置获得矩形间隙,再在90°位置确定伸屈间隙的一致,但是无法保证其余角度的稳定性;另一个采用测量切骨法,只是参考解剖标志进行切骨,但这对于一部分发育异常的病例存在难以矫正的内外侧间隙平衡。无论哪种方案,都只能在切骨完成以后才可以进行试模测试,但是很可能已经无法获得最佳的股骨假体位置。精确的后髁切骨量为手术成功的关键,然而不同公司的四合一切骨板往往各不相同,有前参考有后参考,有外旋度数差异,由于伸直间隙内外侧平衡之前经过的侧副韧带松解导致的屈伸活动时候内侧间隙的不一致,以及胫骨骨骼发育的不同导致的后髁切骨量变化,简单按照传统的抱髁板进行切骨往往会发生错误,此时需要进行后髁矫正,但是目前缺乏精确的内外后髁测量厚度的工具。
发明内容
(一)解决的技术问题
本发明的目的在于提供一种膝关节置换可调节抱髁器装置,以解决上述背景技术中提出的简单按照传统的抱髁板进行切骨往往会发生错误,此时需要进行后髁矫正,但是目前缺乏精确的内外后髁测量厚度的工具的问题。
(二)技术方案
为实现上述目的,本发明提供如下技术方案:一种膝关节置换可调节抱髁器装置,它包含假体尺寸读数框、立板、后踝切骨量限位器、可调节弹簧夹和后踝靠板,所述立板的一侧中部设置有假体尺寸读数框,所述立板的一侧两端对称设置有限位器座,所述限位器座内可滑动地垂直设置有后踝切骨量限位器,所述后踝切骨量限位器的下端延伸出限位器座与后踝靠板固定连接,且后踝靠板与后踝切骨量限位器垂直;所述限位器座的外侧面设置有与后踝切骨量限位器相配合的可调节弹簧夹。
作为本发明的进一步改进,所述的假体尺寸读数框为上端开口的圆柱设计,其内部同轴设置有笔针适配孔。
作为本发明的进一步改进,所述的后踝切骨量限位器的一侧均匀设置有齿槽,且后踝切骨量限位器上设置有读数指示器。
作为本发明的进一步改进,所述的可调节弹簧夹是横截面为十字型的棱柱结构,通过扭力弹簧安装在限位器座的外侧面,可调节弹簧夹的一侧设置有与后踝切骨量限位器的齿槽相配合的齿牙。
作为本发明的进一步改进,所述的限位器座的表面设置有与刻度指示器相对应的刻度线层。
作为本发明的进一步改进,所述的立板上设置有四合一切骨板定位孔。
(三)有益效果
与现有技术相比,采用上述技术方案后,本发明有益效果为:
1、本发明的核心技术为中采用了分开的内外后髁骨量确定切骨板位置,相比传统的仅仅通过后髁线内外旋角度确定切骨位置更为可靠,在伸屈间隙确定后可以精确的判断需要切骨的骨量;
2、本发明采用可调节弹簧夹定位,保证定位的准确性,保证后髁精确的切骨量;
3、本发明的笔针适配孔可以个体化定制,根据不同公司的抱髁器笔针适配,插入后即可测量假体大小;
4、本发明简便可行,避免传统方法依赖后髁线进行旋转及切骨厚度判断的弊端,有助于精准化膝关节置换手术技术,便于大规模推广使用;
5、本发明可以适配不同公司四合一切骨板,只要在抱髁器上留取不同的固定孔即可,整体结构设计巧妙、安装方便。
附图说明
图1是本发明所提供的实施例的结构示意图;
图2是图1沿着Y轴旋转180°后的俯视图;
图3是图1的左视图;
图4是图1的I部放大结构示意图;
图5是图1的II部放大结构示意图;
图6是本发明所提供的实施例的操作流程图;
附图标记说明:
1、假体尺寸读数框;2、立板;3、四合一切骨板定位孔;4、后踝切骨量限位器;5、限位器座;6、可调节弹簧夹;7、后踝靠板;8、扭力弹簧;9、齿牙;10、笔针适配孔;11、读数指示器;12、刻度线层。
具体实施方式
下面将结合本发明实施例中的附图,对本发明实施例中的技术方案进行清楚、完整地描述,显然,所描述的实施例仅仅是本发明一部分实施例,而不是全部的实施例。基于本发明中的实施例,本领域普通技术人员在没有做出创造性劳动前提下所获得的所有其他实施例,都属于本发明保护的范围。
请参阅图1-图5,本发明提供的一种实施例:一种膝关节置换可调节抱髁器装置,它包含假体尺寸读数框1、立板2、四合一切骨板定位孔3、后踝切骨量限位器4、限位器座5、可调节弹簧夹6、后踝靠板7、扭力弹簧8、齿牙9、笔针适配孔10、读数指示器11和刻度线层12,其中,
立板2上设置有四合一切骨板定位孔3,可以适配不同公司四合一切骨板,只要在抱髁器上留取不同的固定孔即可;立板2的一侧中部设置有假体尺寸读数框1,假体尺寸读数框1为上端开口的圆柱设计,其内部同轴设置有笔针适配孔10,笔针适配孔10可以个体化定制,根据不同公司的抱髁器笔针适配,插入后即可测量假体大小;立板2的一侧两端对称设置有限位器座5,限位器座5的表面设置有与刻度线层12,限位器座5内可滑动地垂直设置有后踝切骨量限位器4,后踝切骨量限位器4的一侧均匀设置有齿槽,且后踝切骨量限位器4上设置有与刻度线层12相对应的读数指示器11,本实施例中,读数指示器11为一个箭头标志,箭头标志指向刻度线层12时,方便读数;后踝切骨量限位器4的下端延伸出限位器座5与后踝靠板7固定连接,且后踝靠板7 与后踝切骨量限位器4垂直;限位器座5的外侧面设置有与后踝切骨量限位器4相配合的可调节弹簧夹6,可调节弹簧夹6通过扭力弹簧8安装在限位器座5的外侧面,可调节弹簧夹6的一侧设置有与后踝切骨量限位器4的齿槽相配合的齿牙9,可调节弹簧夹6可活动,限位器座5固定不可活动,可调节弹簧夹6、扭力弹簧8及限位器座5形成类似弹力夹的结构,拨动可调节弹簧夹6,即可按压扭力弹簧8,使得齿牙9被抬起,后踝切骨量限位器4可上下移动,位置调节完毕后松开可调节弹簧夹6,使得齿牙9与后踝切骨量限位器 4侧面的齿槽相卡合,通过读数指示器11得出刻度线层12上的读数即可得知后踝切骨量数据。可调节弹簧夹6是横截面为十字型的棱柱结构,操作时可达到增加摩擦力,防滑的目的,便于使用。
请参阅图6,本实施例的操作步骤为:
Step1、在膝关节无屈伸畸形情况下,在完成股骨远端切骨与胫骨近端常规切骨及软组织松解处理以后,通过测量工具测量伸直位内外侧间隙A与B,可以根据内外侧韧带的紧张度进行判断,松解后使得A与B的差异值在 1mm-2mm以内;
Step2、屈曲位再采用间隙测量器分别测出内外侧厚度C与D;
Step3、通过精确计算出内外侧后髁需要切骨的厚度A-C与B-D,此时,直接通过膝关节置换可调节抱髁器装置控制精确到1mm甚至0.5mm的后髁切骨量,确定切骨厚度后,将膝关节置换可调节抱髁器装置的后髁靠板紧贴于后髁面上,此时可以在四合一切骨板定位孔钻孔;
Step4、通过四合一切骨板定位孔安放四合一切骨板,并完成四合一切骨,与传统方法单纯通过内外旋角度确定后髁切骨量不同,这样在进行四合一切骨板安装后不需要判断具体厚度而确保获得相等的屈伸间隙;
Step5、经过前面四步处理后,再次测量屈曲间隙验证是否也为A与B。
综上所述,本发明整体设计巧妙,可以使手术的操作过程变得更为简单、方便、准确可靠,有效的避免传统方法的弊端,减少返工的机会,减少过度依赖手术经验的弊端,减少软组织松解弊端,使得手术效果更加可靠。
对于本领域技术人员而言,显然本发明不限于上述示范性实施例的细节,而且在不背离本发明的精神或基本特征的情况下,能够以其他的具体形式实现本发明。因此,无论从哪一点来看,均应将实施例看作是示范性的,而且是非限制性的,本发明的范围由所附权利要求而不是上述说明限定,因此旨在将落在权利要求的等同要件的含义和范围内的所有变化囊括在本发明内。
此外,应当理解,虽然本说明书按照实施方式加以描述,但并非每个实施方式仅包含一个独立的技术方案,说明书的这种叙述方式仅仅是为清楚起见,本领域技术人员应当将说明书作为一个整体,各实施例中的技术方案也可以经适当组合,形成本领域技术人员可以理解的其他实施方式。

Claims (7)

1.一种膝关节置换可调节抱髁器装置,其特征在于,它包含假体尺寸读数框、立板、后踝切骨量限位器、可调节弹簧夹和后踝靠板,所述立板的一侧中部设置有假体尺寸读数框,所述立板的一侧两端对称设置有限位器座,所述限位器座内可滑动地垂直设置有后踝切骨量限位器,所述后踝切骨量限位器的下端延伸出限位器座与后踝靠板固定连接,且后踝靠板与后踝切骨量限位器垂直;所述限位器座的外侧面设置有与后踝切骨量限位器相配合的可调节弹簧夹。
2.根据权利要求1所述的一种膝关节置换可调节抱髁器装置,其特征在于,所述的假体尺寸读数框为上端开口的圆柱设计,其内部同轴设置有笔针适配孔。
3.根据权利要求1所述的一种膝关节置换可调节抱髁器装置,其特征在于,所述的后踝切骨量限位器的一侧均匀设置有齿槽,且后踝切骨量限位器上设置有读数指示器。
4.根据权利要求1所述的一种膝关节置换可调节抱髁器装置,其特征在于,所述的可调节弹簧夹是横截面为十字型的棱柱结构,通过扭力弹簧安装在限位器座的外侧面,可调节弹簧夹的一侧设置有与后踝切骨量限位器的齿槽相配合的齿牙。
5.根据权利要求1所述的一种膝关节置换可调节抱髁器装置,其特征在于,所述的限位器座的表面设置有与刻度指示器相对应的刻度线层。
6.根据权利要求1所述的一种膝关节置换可调节抱髁器装置,其特征在于,所述的立板上设置有四合一切骨板定位孔。
7.一种膝关节置换可调节抱髁器装置,其特征在于,它的操作步骤为:
Step1、在膝关节无屈伸畸形情况下,在完成股骨远端切骨与胫骨近端常规切骨及软组织松解处理以后,通过测量工具测量伸直位内外侧间隙A与B,可以根据内外侧韧带的紧张度进行判断,松解后使得A与B的差异值在1mm-2mm以内;
Step2、屈曲位再采用间隙测量器分别测出内外侧厚度C与D;
Step3、通过精确计算出内外侧后髁需要切骨的厚度A-C与B-D,此时,直接通过膝关节置换可调节抱髁器装置控制精确到1mm甚至0.5mm的后髁切骨量,确定切骨厚度后,将膝关节置换可调节抱髁器装置的后髁靠板紧贴于后髁面上,此时可以在四合一切骨板定位孔钻孔;
Step4、通过四合一切骨板定位孔安放四合一切骨板,并完成四合一切骨,进行四合一切骨板安装后不需要判断具体厚度而确保获得相等的屈伸间隙;
Step5、经过前面四步处理后,再次测量屈曲间隙验证是否也为A与B。
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Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6024746A (en) * 1995-05-31 2000-02-15 Lawrence Katz Method and apparatus for locating bone cuts at the distal condylar femur region to receive a femoral prothesis and to coordinate tibial and patellar resection and replacement with femoral resection and replacement
US20030187452A1 (en) * 2002-03-29 2003-10-02 Smith Bryan J. Instruments and methods for flexion gap adjustment
CN210811346U (zh) * 2019-09-27 2020-06-23 大理白族自治州人民医院 一种全膝关节置换手术股骨前髁可调节截骨装置

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6024746A (en) * 1995-05-31 2000-02-15 Lawrence Katz Method and apparatus for locating bone cuts at the distal condylar femur region to receive a femoral prothesis and to coordinate tibial and patellar resection and replacement with femoral resection and replacement
US20030187452A1 (en) * 2002-03-29 2003-10-02 Smith Bryan J. Instruments and methods for flexion gap adjustment
CN210811346U (zh) * 2019-09-27 2020-06-23 大理白族自治州人民医院 一种全膝关节置换手术股骨前髁可调节截骨装置

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