CN112914672A - Split type acetabulum file system, control method and application - Google Patents
Split type acetabulum file system, control method and application Download PDFInfo
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- CN112914672A CN112914672A CN202110215632.XA CN202110215632A CN112914672A CN 112914672 A CN112914672 A CN 112914672A CN 202110215632 A CN202110215632 A CN 202110215632A CN 112914672 A CN112914672 A CN 112914672A
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- 210000000588 acetabulum Anatomy 0.000 title claims abstract description 32
- 238000000034 method Methods 0.000 title claims abstract description 10
- 210000000988 bone and bone Anatomy 0.000 claims abstract description 35
- 238000011541 total hip replacement Methods 0.000 claims description 12
- 238000012544 monitoring process Methods 0.000 abstract description 5
- 238000001356 surgical procedure Methods 0.000 description 8
- 238000009434 installation Methods 0.000 description 7
- 210000001624 hip Anatomy 0.000 description 4
- 210000004872 soft tissue Anatomy 0.000 description 4
- 230000007547 defect Effects 0.000 description 3
- 230000035876 healing Effects 0.000 description 3
- 238000011540 hip replacement Methods 0.000 description 3
- 238000006073 displacement reaction Methods 0.000 description 2
- 210000004013 groin Anatomy 0.000 description 2
- 230000009545 invasion Effects 0.000 description 2
- 210000003205 muscle Anatomy 0.000 description 2
- 238000002360 preparation method Methods 0.000 description 2
- 208000002260 Keloid Diseases 0.000 description 1
- 206010023330 Keloid scar Diseases 0.000 description 1
- 208000026137 Soft tissue injury Diseases 0.000 description 1
- 238000013459 approach Methods 0.000 description 1
- 230000006378 damage Effects 0.000 description 1
- 238000010586 diagram Methods 0.000 description 1
- 238000002674 endoscopic surgery Methods 0.000 description 1
- 238000005516 engineering process Methods 0.000 description 1
- 238000002513 implantation Methods 0.000 description 1
- 210000001117 keloid Anatomy 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 230000003387 muscular Effects 0.000 description 1
- 238000011017 operating method Methods 0.000 description 1
- 230000008092 positive effect Effects 0.000 description 1
- 231100000241 scar Toxicity 0.000 description 1
- 230000000451 tissue damage Effects 0.000 description 1
- 231100000827 tissue damage Toxicity 0.000 description 1
- 238000009966 trimming Methods 0.000 description 1
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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
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1613—Component parts
- A61B17/1631—Special drive shafts, e.g. flexible shafts
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1659—Surgical rasps, files, planes, or scrapers
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1662—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body
- A61B17/1664—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body for the hip
- A61B17/1666—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body for the hip for the acetabulum
-
- 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
- A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
- A61F2/4609—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of acetabular cups
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Engineering & Computer Science (AREA)
- Animal Behavior & Ethology (AREA)
- Veterinary Medicine (AREA)
- Molecular Biology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Medical Informatics (AREA)
- Dentistry (AREA)
- Transplantation (AREA)
- Physical Education & Sports Medicine (AREA)
- Cardiology (AREA)
- Vascular Medicine (AREA)
- Surgical Instruments (AREA)
- Prostheses (AREA)
Abstract
The invention belongs to the technical field of medical appliances, and discloses a split type acetabulum file system, a control method and application, wherein the middle of the plane end of a hemispherical planing file is provided with an inner hexagonal or quincunx clamping groove, and the spherical surface of the hemispherical planing file is uniformly provided with a plurality of protruding arc-shaped planing blades; the plane end of the acetabulum file body is connected with a connecting rod, and one end of the connecting rod is integrally provided with a hexagonal or quincunx connector matched with the clamping groove. According to the invention, the contact part of the acetabular bone file body and the connecting rod is arranged to be in a hexagonal shape or a quincunx shape, so that when a power device or a handle enables the whole device to apply force to the acetabular bone side through the connecting rod, the phenomenon that the rotating speed of the connecting rod is inconsistent with that of the acetabular bone file or the phenomenon that the connecting rod idles does not occur, and smooth acetabular bone file grinding operation is realized in a minimally invasive incision and under the monitoring of an endoscope; if the acetabular files of different models need to be replaced, the power system and the connecting rod can be moved to the far end only by canceling the force to the acetabular side, and the operation is convenient.
Description
Technical Field
The invention belongs to the technical field of medical appliances, and particularly relates to a split type acetabular bone file system, a control method and application.
Background
Total hip replacement surgery is one of the most successful and widely used surgeries in bone surgery since the 20 th century. The total number of patients who undergo the surgery is about 70 ten thousand per year in china. Minimally invasive and rapid healing are important targets for total hip replacement surgery for clinicians in recent years, and therefore a direct anterior total hip replacement surgical approach (DAA-THA) has emerged that can significantly reduce soft tissue damage. A10-12 cm longitudinal incision is used in the traditional direct anterior total hip replacement, the incision at the junction of the proximal end of the longitudinal incision and the skin fold of the groin is easy to split, poor healing and large scar at the later stage often occur, keloid is easy to form, and when the longitudinal incision is adopted for operation, the operation on the femoral side is difficult. Incision complications can be reduced by adopting the dermatoglyph bikini incision (BKN-DAA), but the incision of about 10cm is also required by a skilled doctor. Bikini incisions are less suitable for patients with large body mass indices and strong muscles than longitudinal incisions. The skin fold bikini incision in the groin area is closer to the near end than the longitudinal incision, and is easier to expose and operate on the femoral side than the longitudinal incision, but the skin fold bikini incision is often in the same horizontal position with the acetabulum, so that the operation in the ideal direction of the acetabulum side is difficult to be performed by using a conventional connected straight handle tool and a conventional crank tool, and the conditions of an abduction angle and an over-large anteversion angle of the acetabulum prosthesis installation and soft tissue injury around the incision are easy to occur.
In order to solve the problems, the applicant of the patent innovatively designs an Endo-anterior total hip replacement surgery (Endo-anterior total hip replacement) under an endoscope, and the surgery adopts a transverse incision of 5-6 cm at a proximal skin fold and a distal selective percutaneous puncture incision. Acetabular side preparation, acetabular prosthesis installation and femoral side loosening are accomplished in a transverse incision with endoscopic monitoring assistance. Clinical observations show that the surgical method can solve a series of problems of poor healing, difficult operation, unsatisfactory prosthesis installation and the like. However, the length of the transverse incision at the skin fold of the hip is very short, the traditional integrated straight handle and crank acetabular file tool cannot be used, the assembly operation of the assembled acetabular file using the threaded interface in the incision is complicated and difficult to complete, and even if the assembled acetabular file can be successfully installed, the acetabular file and the like can be displaced due to repeated screwing, so that the operation accuracy is affected. Therefore, designing a split type acetabular bone file which can be assembled quickly and stably in an operative incision without large-scale screwing is one of the key technical problems of the art.
Through the above analysis, the problems and defects of the prior art are as follows: under the endoscope, the minimally invasive anterior full hip replacement is originally designed to reduce soft tissue invasion to the maximum extent, realize ideal prosthesis implantation and reduce the operation difficulty; the operation mode needs to adopt a transverse incision of 5-6 cm at a proximal skin fold and a distal selective percutaneous puncture incision, and the operations of acetabular lateral preparation, acetabular prosthesis installation, femoral lateral loosening and the like are completed under the assistance of endoscope monitoring in the transverse incision.
Currently, there are two basic types of acetabular files used in hip replacement surgery worldwide, and the problem and drawbacks of these two types of tools are summarized as follows:
1 an integrated straight handle or crank tool which cannot be used in a short cut of a minimally invasive anterior total hip replacement hip under an endoscope;
2. the assembly type tool with the threaded interface is complex in installation and operation, and repeated screwing can also cause displacement of an acetabular file and the like, so that the accuracy of the operation is influenced.
The difficulty in solving the above problems and defects is:
1. if an integrated straight handle or crank tool is used, the hip incision of the minimally invasive anterior total hip replacement under an endoscope needs to be enlarged to about 10cm, and even the soft tissues such as muscles need to be stripped, thus the principle of the operation is violated;
2. in the full hip replacement operation of way before wicresoft under the scope, the acetabular bone file and the connecting rod assembly of split type putting into are accomplished under the endoscope field of vision, endoscopic surgery itself just has higher requirement to the hand eye coordination ability, under the endoscope field of vision, in narrow and small operation space, the installation operation of screw thread interface instrument is difficult to accomplish, even successfully install, in order to avoid twisting the instrument displacement that causes many times, the instrument angle probably needs to be adjusted repeatedly, use the clear instrument angle of X line perspective in the art even, in addition because often need replace the acetabular bone file of different models many times in the operation, the interface of helicitic texture can lead to the continuous stack of complicated operating procedure, finally lead to operation time to increase or medical personnel and patient receive unnecessary ray damage.
The significance of solving the problems and the defects is as follows: the split type acetabular bone file capable of being rapidly and stably assembled in an operative incision without being greatly screwed is designed to solve the problems, and is one of important preconditions and key technologies for successfully completing minimally invasive anterior total hip replacement under an endoscope and obtaining good prosthesis installation angle and stability on the premise of not enlarging the incision and minimizing soft tissue invasion.
Disclosure of Invention
Aiming at the problems in the prior art, the invention provides a split type acetabular bone file system, a control method and application.
The invention is realized in this way, a split type acetabular bone file system, which is provided with:
an acetabular file body;
the acetabulum file body is a hemispherical planing file, an inner hexagonal or quincunx clamping groove is formed in the middle of the plane end of the hemispherical planing file, and a plurality of protruding arc-shaped planing blades are uniformly distributed on the spherical surface of the hemispherical planing file;
the plane end of the acetabular bone file body is connected with a connecting rod, and one end of the connecting rod is integrally provided with a hexagonal or quincunx connector matched with the clamping groove.
Further, the acetabular bone file body comprises a plurality of hemispherical planing files with different diameter models.
Furthermore, the other end of the connecting rod is integrally provided with a triangular columnar structure connected with a power system or a handle.
Another object of the present invention is to provide a control method of the split acetabular file system, the control method comprising:
(1) firstly, selecting an acetabulum file body with a smaller diameter, and putting the acetabulum file body in place;
(2) completing the assembly of the power system/handle and the connecting rod: inserting the triangular columnar end of the connecting rod into a handle or a chuck of a power system, and screwing and fixing;
(3) completing the assembly of the connecting rod and the acetabulum side body: the connecting rod penetrates through the far-end puncture incision, and the connecting rod is inserted into the acetabular bone file buckle under the endoscope to be tightly pushed, so that the assembly is completed in one step;
(4) change the acetabular bone file of different models until the planned acetabular bone degree of depth before the art of file grinding to the major diameter step by step, when carrying out this operation, only need cancel to the power system of acetabular bone side be about to the distal end removal with the connecting rod, can take the connecting rod out in the acetabular bone file bayonet socket, and then used repeatedly (1) and (3).
It is another object of the present invention to provide a device for endoscopic minimally invasive total hip replacement using the split acetabular file system.
By combining all the technical schemes, the invention has the advantages and positive effects that: according to the invention, the contact part of the acetabular file body and the connecting rod is arranged to be in a hexagonal shape or a plum blossom shape, so that a tool does not need to be twisted under the view field of an endoscope in the minimally invasive total hip replacement under an endoscope, and the stable assembly of the acetabular file body and the connecting rod can be completed by inserting the connecting rod by aligning the buckling position; in addition, when the power device applies force to the acetabulum side integrally through the connecting rod, the phenomenon that the rotating speed of the connecting rod is inconsistent with that of the acetabulum file or the connecting rod idles can not occur, so that smooth acetabulum file grinding operation can be realized in a minimally invasive incision under the monitoring of an endoscope; if need change the acetabular bone file of different models, only need to cancel the power that is to acetabular bone side and be about to driving system and connecting rod to the distal end removal, can take the connecting rod out in the acetabular bone file bayonet socket for the replacement convenient operation of different models acetabular bone files in the operation further shortens long time of performing the operation, increases the operation security.
Drawings
In order to more clearly illustrate the technical solutions of the embodiments of the present application, the drawings needed to be used in the embodiments of the present application will be briefly described below, and it is obvious that the drawings described below are only some embodiments of the present application, and it is obvious for those skilled in the art that other drawings can be obtained from the drawings without creative efforts.
Fig. 1 is a schematic structural diagram of a connecting rod provided in an embodiment of the present invention.
In the figure: a. the connector is a connecting rod with an inner hexagon; b. the connector is a quincunx connecting rod; c. the cross section of the triangular columnar structure; d. the cross section of the inner hexagonal connector; e. the cross section of the quincunx connector.
Fig. 2 is a schematic structural view of the connection between the connecting rod and the handle according to the embodiment of the present invention.
FIG. 3 is a schematic structural view of an acetabular file body provided by the embodiment of the invention.
In the figure: 1. acetabular file bottoms (internal hex interface); 2. the surface of the acetabular file (which is hemispherical, and the protruding parts are all arc-shaped planing blades); 3. acetabular file bottoms (quincunx interface); 4. the acetabulum file is seen from the side; 5. the acetabulum file is seen from the side (the section shows the inside); 6. acetabular file stereogram (section shows inside, hexagonal interface); 7. acetabular file perspective (socket head); 8. acetabular file stereogram (section shows inside, plum blossom shape interface); 9. acetabulum file perspective view (plum blossom interface).
FIG. 4 is a schematic view of different types of acetabular file bodies provided by embodiments of the invention.
Detailed Description
In order to make the objects, technical solutions and advantages of the present invention more apparent, the present invention is further described in detail with reference to the following embodiments. It should be understood that the specific embodiments described herein are merely illustrative of the invention and are not intended to limit the invention.
In view of the problems of the prior art, the present invention provides a split acetabular file system, which will be described in detail with reference to the accompanying drawings.
As shown in fig. 1 to 3, the split acetabular file system provided by the embodiment of the invention comprises: the acetabulum file comprises an acetabulum file body, a set of hemispherical planing files (see figures 3 and 4) with different models (different diameters), wherein the middle of a hemispherical plane end is provided with a hollow inner hexagonal or quincunx buckle (see figures 3, 1 and 3), and the surface of a hemispherical spherical surface is provided with a plurality of protruding arc-shaped planing blades (see figures 3, 2 and 4) which are uniformly distributed; a connecting rod (see figure 1) is connected to the plane end of the acetabular file body, the connecting rod is of a long straight cylindrical structure, the connecting end of the connecting rod and the acetabular file body is of a hexagonal or quincunx cylindrical structure matched with the hollow inner hexagonal or quincunx buckle, and the other end of the connecting rod is of a triangular cylindrical structure used for being connected with a power system or a handle; and a handle with a hand-tight or self-tightening chuck (see fig. 2) (alternatively to the power system, the power system may use a general medical operation power system, such as sindbis power system of the johnson corporation in usa, but still needs to have a hand-tight or self-tightening chuck).
When the invention is used:
firstly, an acetabulum file body with a smaller diameter is selected according to an operation plan, and is placed in place through a minimally invasive transverse incision at the position of hip skin fold.
Secondly, completing the assembly of the power system/handle and the connecting rod: inserting the triangular columnar end of the connecting rod into a handle or a chuck of a power system, and screwing and fixing;
and thirdly, finishing the assembly of the connecting rod and the acetabulum side body: the connecting rod penetrates through the far-end puncture incision and reaches the acetabulum through the muscular space, and the connecting rod is inserted into the acetabulum file buckle under the endoscope to be tightly pushed, so that the assembly is completed in one step.
Because the contact part of the acetabular bone file and the connecting rod is in a hexagonal shape or a quincunx shape, when the power system/handle is held by hand and the connecting rod is used for applying force to the acetabular bone side as a whole and the power system file grinding or manual trimming is started, the phenomenon that the rotating speed of the connecting rod and the acetabular bone file is inconsistent or idles can not occur, and therefore smooth operation of the acetabular bone file grinding can be realized in a minimally invasive incision and under the monitoring of an endoscope.
And fourthly, in the operation, the acetabulum files of different models are generally replaced to a large diameter step by step until the acetabulum files reach the planned acetabulum depth before the operation, and when the operation is executed, the connecting rod can be pulled out from the bayonet of the acetabulum files only by withdrawing the force to the acetabulum side to move the power system and the connecting rod to the far end, so that the steps of the first step and the third step are repeatedly used.
In the description of the present invention, "a plurality" means two or more unless otherwise specified; the terms "upper", "lower", "left", "right", "inner", "outer", "front", "rear", "head", "tail", and the like, indicate orientations or positional relationships based on the orientations or positional relationships shown in the drawings, are only for convenience in describing and simplifying the description, and do not indicate or imply that the device or element referred to must have a particular orientation, be constructed in a particular orientation, and be operated, and thus, should not be construed as limiting the invention. Furthermore, the terms "first," "second," "third," and the like are used for descriptive purposes only and are not to be construed as indicating or implying relative importance.
The above description is only for the purpose of illustrating the present invention and the appended claims are not to be construed as limiting the scope of the invention, which is intended to cover all modifications, equivalents and improvements that are within the spirit and scope of the invention as defined by the appended claims.
Claims (5)
1. The utility model provides a split type acetabular bone file system which characterized in that split type acetabular bone file system is provided with:
an acetabular file body;
the acetabulum file body is a hemispherical planing file, an inner hexagonal or quincunx clamping groove is formed in the middle of the plane end of the hemispherical planing file, and a plurality of protruding arc-shaped planing blades are uniformly distributed on the spherical surface of the hemispherical planing file;
the plane end of the acetabular bone file body is connected with a connecting rod, and one end of the connecting rod is integrally provided with a hexagonal or quincunx connector matched with the clamping groove.
2. The split acetabular rasp system of claim 1, wherein the acetabular rasp body includes a plurality of different diameter versions of the hemispherical rasp file.
3. The split acetabular rasp system of claim 1, wherein the other end of the connecting rod is integrally provided with a triangular prism-shaped structure connected to a power system or a handle.
4. A control method of the split acetabular file system according to any one of claims 1 to 3, wherein the control method comprises:
(1) firstly, selecting an acetabulum file body with a smaller diameter, and putting the acetabulum file body in place;
(2) completing the assembly of the power system/handle and the connecting rod: inserting the triangular columnar end of the connecting rod into a handle or a chuck of a power system, and screwing and fixing;
(3) completing the assembly of the connecting rod and the acetabulum side body: the connecting rod penetrates through the far-end puncture incision, and the connecting rod is inserted into the acetabular bone file buckle under the endoscope to be tightly pushed, so that the assembly is completed in one step;
(4) change the acetabular bone file of different models until the planned acetabular bone degree of depth before the art of file grinding to the major diameter step by step, when carrying out this operation, only need cancel to the power system of acetabular bone side be about to the distal end removal with the connecting rod, can take the connecting rod out in the acetabular bone file bayonet socket, and then used repeatedly (1) and (3).
5. A device for endoscopic minimally invasive total hip replacement, which is characterized in that the split type acetabular file system of any one of claims 1-3 is used.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202110215632.XA CN112914672A (en) | 2021-02-26 | 2021-02-26 | Split type acetabulum file system, control method and application |
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| Application Number | Priority Date | Filing Date | Title |
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| CN202110215632.XA CN112914672A (en) | 2021-02-26 | 2021-02-26 | Split type acetabulum file system, control method and application |
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Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN113561188A (en) * | 2021-09-26 | 2021-10-29 | 北京爱康宜诚医疗器材有限公司 | Robot control method, device, computer readable storage medium and processor |
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| CN214857164U (en) * | 2021-02-26 | 2021-11-26 | 福建省立医院 | Split type acetabular bone file device for minimally invasive total hip joint replacement under endoscope |
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| CN2337963Y (en) * | 1998-03-05 | 1999-09-15 | 陈汉文 | Acetabulum file |
| US7220264B1 (en) * | 2003-03-12 | 2007-05-22 | Biomet Manufacturing Corp. | Minimally invasive reamer |
| US20110213371A1 (en) * | 2009-12-31 | 2011-09-01 | Anthony Sarah M | Reciprocating rasps for use in an orthopaedic surgical procedure |
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Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
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| CN113561188A (en) * | 2021-09-26 | 2021-10-29 | 北京爱康宜诚医疗器材有限公司 | Robot control method, device, computer readable storage medium and processor |
| CN113561188B (en) * | 2021-09-26 | 2021-12-07 | 北京壹点灵动科技有限公司 | Robot control method, device, computer readable storage medium and processor |
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