CN112998804B - Bone tunnel preparation device for knee joint ligament reconstruction - Google Patents

Bone tunnel preparation device for knee joint ligament reconstruction Download PDF

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Publication number
CN112998804B
CN112998804B CN202110290761.5A CN202110290761A CN112998804B CN 112998804 B CN112998804 B CN 112998804B CN 202110290761 A CN202110290761 A CN 202110290761A CN 112998804 B CN112998804 B CN 112998804B
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bit
bone tunnel
pilot
pull rope
free end
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CN112998804A (en
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钱洪
包倪荣
袁涛
张雷
江辉
孟嘉
赵建宁
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Eastern Theater General Hospital of PLA
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Eastern Theater General Hospital of PLA
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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
    • A61B17/1615—Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material
    • 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
    • A61B17/1622—Drill handpieces
    • 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
    • A61B17/1622—Drill handpieces
    • A61B17/1624—Drive mechanisms therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—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
    • A61B17/1675—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 knee
    • 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
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • 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
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
    • A61B17/1764—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the knee

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
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  • Orthopedic Medicine & Surgery (AREA)
  • Oral & Maxillofacial Surgery (AREA)
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Abstract

The invention relates to the technical field of medical instruments, in particular to a bone tunnel preparation device for knee joint ligament reconstruction. The bone tunnel preparation device comprises a pilot drill bit, a hole expanding drill bit and a pull rope. The cutting section of the pilot bit is provided with a chute. The connecting section of the pilot bit is connected with a conduit for transmitting torque to the pilot bit. The interior of the pilot drill bit is hollow and is connected with the interior of the guide pipe to form a channel for the pull rope to pass through. And a connecting key matched with the sliding groove is arranged on the inner wall of the reaming bit. The inside of reaming bit is provided with fixing device. The free end of the pull rope and the fixing device form a locking structure. When the locking structure is in the first state, the free end of the pull rope and the fixing device form locking, and axial restraint is formed on the reaming bit; in the second configuration, the free end of the pull cord is separated from the securing device. The device has realized the reverse reaming of bone tunnel preparation, has alleviateed the painful sense of patient's postoperative, has promoted the effect of knee joint function recovery.

Description

Bone tunnel preparation device for knee joint ligament reconstruction
Technical Field
The invention relates to the technical field of medical instruments, in particular to a bone tunnel preparation device for knee joint ligament reconstruction.
Background
The anterior cruciate ligament of the knee joint, also called as the cruciate ligament of the knee joint, is connected between the femur and the tibia and is mainly used for limiting the anterior transition displacement of the tibia, thereby maintaining the stability of the knee joint. Anterior cruciate ligament rupture is a common athletic injury and often requires surgery to reconstruct the anterior cruciate ligament. The traditional treatment method is that semitendinosus muscle tendon and gracilis muscle tendon are taken from the same side of the injured knee of the patient; weaving the two ends of the tendon with a Qiangsheng No. 2 thread respectively, wherein the weaving length is 2cm to form a graft; positioning a tibia dead point on the knee joint by using a point-to-point sighting device; the implant is positioned on the medial surface footprint area of the femoral external condyle through the tibia, the femoral side is fixed by a bone fracture plate, the implant is tensioned by bending 30 degrees, the tibial tunnel is screwed into an extrusion nail for fixation under the backward pushing stress, and the external tendon of the tibial bone way is fixed by a portal bone nail.
However, the positions of the anterior cruciate ligament insertion point obtained after the reconstruction by the traditional treatment method and the physiological anterior cruciate ligament insertion point have certain deviation, and a satisfactory treatment effect is difficult to obtain. Through search, chinese patent document CN106456195B discloses a bone canal preparation device and method for anterior cruciate ligament reconstruction. The bone preparation device comprises a knocking part, a connecting rod and a bone preparation component. The bone preparation component is a columnar body with an oval cross section and a U-shaped longitudinal section and is used for preparing the bone. The open end of the U-shaped section is connected with one end of the connecting rod. The other end of the connecting rod is connected with the knocking part. The knocking part is provided with a knocking plane which is vertical to the extending direction of the connecting rod. The longitudinal axis is coincident with the longitudinal axis of the prepared and constructed ellipse of the bone tunnel. This bone way preparation facilities can rebuild for anterior cruciate ligament and prepare oval-shaped thighbone end bone way, accords with the shape of the material of rebuilding anterior cruciate ligament, more approaches the anatomical form of anterior cruciate ligament, and then has promoted treatment.
With the development of minimally invasive surgery technology, in the field of knee joint reconstruction, compared with the traditional treatment method, reconstruction of anterior cruciate ligaments under a total-internal-method arthroscope gradually becomes mainstream. Rebuilding anterior cruciate ligament by a total internal method is that semitendinosus tendon is taken at the same side of the injured knee of a patient and is fixed on a locking belt loop bone fracture plate after being folded by 4 times; the broken ends are anastomosed by using the strong No. 2 thread and the tendon is woven at the position of 1cm of the two ends to form a graft. When a femoral tunnel and a tibial tunnel are manufactured, a turning drill bit is selected. Firstly, a 3.5mm turnover drill bit is used for drilling through the bone tunnel in an antegrade way, then the drilling diameter of the turnover drill bit is enlarged, and the turnover drill bit reversely drills back to form the bone tunnel with the same diameter as the graft. Therefore, the inner diameter of the bone tunnel is larger than the outer diameter, the caliber communicated with the outside is small, the risk of intra-articular infection is greatly reduced, meanwhile, the surgical wound is smaller, and the effect of recovering the exercise capacity of the postoperative patient is favorably improved.
For example, chinese patent document CN110996817A discloses a control system for a retrograde drilling medical apparatus. A rotary cutting apparatus includes an elongate body and a blade. A blade is located at the distal end of the elongate body, the blade configured to rotate from a first position substantially aligned with the longitudinal axis to a second, flipped position non-parallel to the longitudinal axis. The blade is moved to a first position and a second position by a blade position control system. And holding the large piece in the second position by a cam using a position retention system to hold the cutting edge of the insert in position such that the cutting edge is exposed towards the proximal end of the elongated body for retrograde drilling of the hole. In the reconstruction process of the anterior cruciate ligament of the knee joint, the femoral tunnel and the tibial tunnel are formed in an inverted drilling mode.
The purpose of the back drilling is to fix the tibia and the femur by applying the steel plate with the loop, and the fixing mode is firmer than that of the traditional steel plate with the loop and the extrusion screw. However, in the process of performing the back-off drilling by the rotary cutting device, the blade is used for cutting on one side, the radial force applied to the blade is difficult to balance, the disturbance in the back-off drilling process is too large, the straightness of the bone tunnel is affected, and the operation effect of reconstructing the anterior cruciate ligament is further affected. Even the cutting of the unilateral blade can happen, the blade is broken in a bone tunnel, and therefore the operation process is greatly delayed.
Further, chinese patent document CN203873826U discloses a drill bit capable of adjusting the size of a drilled hole. The drill bit comprises a hollow drill rod, and the front end of the drill rod is an opening end. The core rod is inserted in the hollow drill rod, and the front end of the core rod is hinged with a shear type drill blade. The nut is sealed at the opening end of the hollow drill rod. The plug pin is inserted in the jack at the rear end of the core rod. The adjusting nut is connected to the large-diameter section of the hollow drill rod through threads. The lock nut is in threaded connection with the large-diameter threaded section of the adjusting nut. The lock nut is matched with the adjusting nut to form an adjusting mechanism for pushing the bolt to move in the shifting strip hole in a reciprocating mode. The drill bit can automatically adjust the opening and closing size of the scissor type drill blade according to the requirement to control the drilling size of the drill bit. The multi-shear type drill edge solves the problem that the radial force borne by the blade is difficult to balance to a certain degree. However, the drill has difficulty in ensuring the size of the hole for obtaining the bone tunnel.
In summary, in the process of reconstructing the ligament of the knee joint, how to design a bone tunnel preparation device for realizing reverse reaming of the bone tunnel, thereby alleviating postoperative pain of the patient and improving the effect of recovering the function of the knee joint becomes a technical problem to be solved urgently by those skilled in the art.
Disclosure of Invention
The invention aims to provide a bone tunnel preparation device for realizing reverse reaming of a bone tunnel in the process of reconstructing a knee joint ligament, so that postoperative pain of a patient is relieved, and the effect of restoring the knee joint function is improved.
In order to achieve the purpose, the invention adopts the following scheme: the bone tunnel preparation device for knee joint ligament reconstruction comprises a pilot drill bit, a hole expanding drill bit and a pull rope;
the pilot bit is provided with a cutting section and a connecting section, the cutting section is provided with a sliding chute, the connecting section is connected with a conduit for transmitting torque to the pilot bit, the interior of the pilot bit is hollow, and the interior of the pilot bit is connected with the interior of the conduit to form a channel for a pull rope to pass through;
a connecting key matched with the sliding groove is arranged on the inner wall of the hole expanding drill bit, a fixing device is arranged inside the hole expanding drill bit, the free end of the pull rope and the fixing device form a locking structure, and the locking structure has a first shape and a second shape;
when the reamer bit is in the first state, the free end of the pull rope is locked with the fixing device, and the pull rope applies axial tension to the reamer bit to form axial restraint on the reamer bit;
when in the second configuration, the free end of the pull cord is disengaged from the securing device.
Preferably, the fixing device comprises a pressing plate and a bearing, an outer ring of the bearing is fixedly installed on the inner wall of the reaming bit, the pressing plate is fixedly installed on an inner ring of the bearing, a through hole is formed in the middle of the pressing plate, a protruding block is arranged at the free end of the pull rope, and a groove for the protruding block to penetrate through is formed in the inner wall of the through hole. So set up, the free end of stay cord forms the lock solid through the terminal surface of lug with the clamp plate, and the free end of stay cord and fixing device's installation and dismantlement are convenient for, are favorable to the stay cord to form axial restraint to the reamer bit more, effectively prevent that the reamer bit from taking place to drop with the guide bit at reverse drilling in-process.
The inner wall of the expanding bit is provided with a bearing, and the inner ring of the bearing is provided with a pressing plate. Therefore, the output torque of the power device is transmitted to the pilot drill bit through the guide pipe, and the pilot drill bit drives the expanding drill bit to rotate together in a key connection mode. The outer ring of bearing rotates for the inner circle of bearing, has avoided the stay cord to rotate along with the rotation of reaming bit, has reduced the risk that the stay cord knoed in the pipe, has promoted the stability of device.
Preferably, the projections are evenly distributed on the side wall of the free end of the pull rope along the axis of the pull rope, and the grooves correspond to the projections one to one. Due to the arrangement, on one hand, the friction force between the free end of the pull rope and the end face of the pressing plate is increased, the pull rope and the fixing device are prevented from falling off due to vibration generated in the reverse drilling process, and the locking effect of the fixing device is further improved; on the other hand, due to the arrangement of the plurality of grooves, the locking can be formed only by rotating a small angle after the lug at the free end of the pull rope passes through the groove, the pull rope and the fixing device can be separated only by reversely rotating the corresponding angle when the reaming drill bit is detached, the rapid detachment of the reaming drill bit is facilitated, and the operation efficiency is further improved.
Preferably, the runners are evenly distributed along the axis of the pilot bit on the outer wall of the pilot bit. The connecting key is arranged on the inner wall of the expanding bit, and the structural strength of the expanding bit is further improved. The spout sets up on the outer wall of guide's drill bit, is favorable to guide's drill bit to arrange to cut at the in-process that creeps into, further improves and creeps into efficiency.
Preferably, the bottom of the reamer bit is provided with an observation port, so that medical personnel can observe the connection condition of the free end of the stay cord and the fixing device from the arthroscope conveniently, and the smooth operation can be ensured.
Preferably, the outer wall of the reamer bit is provided with the clamping part, so that the auxiliary clamping tool can conveniently clamp the reamer bit, the reamer bit is installed on the pilot bit, the reamer bit is prevented from accidentally falling into a joint cavity in the installation and disassembly processes, and the installation and disassembly efficiency of the reamer bit is further improved.
Preferably, the reamer head has at least two cutting edges, which are arranged uniformly along the axis of the reamer head in the circumferential direction of the reamer head. So set up, be favorable to balanced reamer bit radial cutting force who receives, greatly reduced reamer bit is at the disconnected sword risk of reverse drilling in-process.
The invention also provides a hole expanding drill bit for reversely drilling the bone tunnel, which comprises a fixing device and a hollow drill body;
the fixing device comprises a pressing plate and a bearing, an outer ring of the bearing is fixedly arranged on the inner wall of the drill body, the pressing plate is fixedly arranged on an inner ring of the bearing, a through hole is formed in the middle of the pressing plate, and a groove is formed in the inner wall of the through hole;
the inner wall of the drill body is provided with a connecting key, and the outer wall of the drill body is provided with at least two cutting edges.
Compared with the prior art, the bone tunnel preparation device for knee joint ligament reconstruction provided by the invention has the following prominent substantive characteristics and remarkable progress:
1. the bone tunnel preparation device for reconstructing the knee joint ligament drills a first bone tunnel on a leg bone by driving a pilot drill bit through a power device under the auxiliary guidance of a sighting device, and then a hole expanding drill bit is installed on the pilot drill bit in a knee joint cavity, wherein the hole expanding drill bit and the pilot drill bit transmit torque in a key connection mode, so that reverse hole expansion of the bone tunnel is realized, postoperative pain of a patient is relieved, and the effect of restoring the knee joint function is improved;
2. the free end of the stay cord in the bone tunnel preparation device for knee joint ligament reconstruction is detachably connected with the fixing device, and the tension force of the stay cord is used for offsetting the axial force generated by the reaming bit in the reverse drilling process, so that the reaming bit is effectively prevented from sliding off from the pilot bit, and the stability of the device is further improved;
3. this a bone tunnel preparation facilities for knee joint ligament is rebuild pours the diameter that the bone tunnel that bores the formation is close to joint intracavity portion and is greater than the diameter of the initiating terminal in bone tunnel, has reduced the interface diameter of bone tunnel with outside intercommunication, greatly reduced the risk of infecting in the joint, the wound of operation is littleer, is favorable to improving the effect that postoperative patient's motion ability resumes.
Drawings
FIG. 1 is a schematic illustration of a bone tunnel for knee ligament reconstruction in an embodiment of the invention;
FIG. 2 is a schematic perspective view of a bone tunnel preparation device for knee ligament reconstruction according to an embodiment of the present invention;
FIG. 3 is an assembled schematic view of the bone tunnel preparation device of FIG. 2 for knee ligament reconstruction;
FIG. 4 is a front view of FIG. 2;
fig. 5 is a cross-sectional view at a-a in fig. 4.
Reference numerals: femur 1, shin bone 2, femoral tunnel 3, shin bone tunnel 4, reamer bit 5, guide bit 6, bearing 7, clamp plate 8, stay cord 9, pipe 10, connecting key 11, spout 12, lug 13, recess 14.
Detailed Description
The following detailed description of embodiments of the invention refers to the accompanying drawings.
As shown in figure 1, the knee joint anterior cruciate ligament is reconstructed under an arthroscope by a total internal method, a femur tunnel 3 is respectively established on a femur 1 of a patient, and a tibia tunnel 4 is respectively established on a tibia 2 of the patient by using the bone tunnel preparation device for knee joint ligament reconstruction in the embodiment of the invention. The reamer bit 5 is attached to the pilot bit 6 in the joint cavity with the aid of an arthroscope. After the reamer bit 5 is fixed, reverse drilling is performed to form the femoral tunnel 3 and the tibial tunnel 4.
2-5, a bone tunnel preparation device for knee ligament reconstruction, which uses a power device to drive a pilot drill bit 6 to drill a first bone tunnel on leg bone under the auxiliary guide of an aiming device. And then the expanding bit 5 is arranged on the pilot bit 6 in the knee joint cavity. Wherein, torque is transmitted between the reaming bit 5 and the pilot bit 6 in a key connection mode, and reverse reaming of the bone tunnel is realized. Thereby relieving the postoperative pain of the patient and improving the effect of restoring the function of the knee joint. The diameter that the bone tunnel that the back-drilling formed is close to joint intracavity portion is greater than the diameter of the initiating terminal in bone tunnel, has reduced the interface diameter of bone tunnel with outside intercommunication, greatly reduced the risk of infection in the joint, the wound of operation is littleer.
As shown in fig. 2 and fig. 3, the bone tunnel preparation device for knee joint ligament reconstruction comprises a pilot drill bit 6, a reamer drill bit 5 and a pull rope 9. The pilot bit 6 has a cutting section and a connecting section. The cutting section is connected with the expanding bit 5 through a key. The cutting section is located inside the reamer bit 5. A conduit 10 for transmitting torque to the pilot bit 6 is connected to the connecting section. The pilot bit 6 is hollow inside. The interior of the pilot bit 6 is connected to the interior of the guide tube 10 to form a passage for the pull cord 9 to pass through. The reamer bit 5 is internally provided with fixing means. The free end of the pull rope 9 is detachably connected with the fixing device.
The free end of the pull cord 9 forms a locking structure with the fixing means. The locking structure has a first configuration and a second configuration. When in the first configuration, the free end of the pull cord 9 forms a lock with the fixing device. The pull rope 9 applies axial tension to the reaming bit 5 to form axial restraint on the reaming bit 5; when in the second configuration, the free end of the pull cord 9 is disengaged from the securing means.
When the hole expanding drill bit 5 performs the back-drilling operation of the bone tunnel, the locking structure is in the first state, the free end of the pull rope 9 is locked with the fixing device, and the pull rope 9 applies axial tension to the hole expanding drill bit 5 to form axial restraint on the hole expanding drill bit 5; when the hole expanding drill bit 5 finishes the back drilling operation of the bone tunnel, the locking structure is in the second shape, and the free end of the pull rope 9 is separated from the fixing device.
As shown in fig. 4 in conjunction with fig. 5, the fixing means comprises a pressure plate 8 and a bearing 7. The outer ring of the bearing 7 is fixedly arranged on the inner wall of the expanding bit 5. The pressure plate 8 is fixedly arranged on the inner ring of the bearing 7. The middle part of the pressure plate 8 is provided with a through hole. The free end of the pull cord 9 is provided with a projection 13. The inner wall of the through hole is provided with a groove 14 for the projection 13 to pass through. So set up, the lock solid is formed through the terminal surface of lug 13 with clamp plate 8 to the free end of stay cord 9, and the installation and the dismantlement of the free end of the stay cord 9 of being convenient for and fixing device are favorable to the stay cord 9 to form axial restraint to reamer bit 5 more, prevent effectively that reamer bit 5 from taking place to drop with guide's drill bit 6 at reverse drilling in-process.
For example, before the reaming bit 5 performs the tibial tunnel drilling operation, the power device is used to drive the pilot bit 6 to drill a first tibial tunnel on the tibia under the auxiliary guide of the aiming device. The pilot bit 6 enters the knee joint cavity through the first tibial tunnel. And the expanding bit 5 is clamped by the auxiliary fixture and is placed in the knee joint cavity, and the expanding bit 5 is arranged on the pilot bit 6. The pull rope 9 is threaded from the channel formed by the connection of the interior of the pilot drill 6 and the interior of the guide tube 10, so that the projection 13 of the free end of the pull rope 9 passes completely through the groove 14 on the pressure plate 8. Then, the control end of the pulling rope 9 performs a rotating operation on the pulling rope 9 along the axis of the pulling rope 9, so that the bottom end face of the projection 13 falls on the end face of the pressing plate 8, and the free end of the pulling rope 9 is locked with the pressing plate 8.
After the free end of the pull rope 9 is locked with the pressing plate 8, a tensioning force is applied to the pull rope 9. And starting the power device, transmitting the output torque of the power device to the expanding bit 5 through the pilot bit 6, and drilling the expanding bit 5 along the axis of the first tibial tunnel towards the starting end of the first tibial tunnel until the preparation of the tibial tunnel is completed.
After the reaming bit 5 finishes the back drilling operation of the tibial tunnel, the reaming bit 5 is kept pulled by the pull rope 9, and the reaming bit 5 retreats into the knee joint cavity along with the pilot bit 6. The expanding bit 5 is held by the auxiliary clamp, and the control end of the pull rope 9 performs reverse rotation operation on the pull rope 9 along the axis of the pull rope 9, so that the lug 13 of the free end of the pull rope 9 completely passes through the groove 14 on the pressure plate 8. The free end of the pull rope 9 enters the interior of the pilot bit 6 again, and the free end of the pull rope 9 is separated from the pressure plate 8. The reamer bit 5 is detached from the pilot bit 6 and removed from the knee joint cavity. The pilot bit 6 exits from the beginning of the first tibial tunnel together with the pull cord 9 along the axis of the tibial tunnel.
The method for performing the femoral tunnel backdrilling operation by using the reamer bit 5 is similar to the step of the tibial tunnel backdrilling operation.
A bearing 7 is mounted on the inner wall of the reamer bit 5, and a pressing plate 8 is provided on the inner ring of the bearing 7. In this way, the output torque of the power device is transmitted to the pilot bit 6 through the guide tube 10, and the pilot bit 6 drives the reamer bit 5 to rotate together in a key connection manner. The outer ring of the bearing 7 rotates relative to the inner ring of the bearing 7, so that the stay cord 9 is prevented from rotating along with the rotation of the reaming bit 5, the knotting risk of the stay cord 9 in the guide pipe 10 is reduced, and the stability of the device is improved.
Among them, the bearing 7 can be a rolling bearing. The bearing 7 may preferably be a micro deep groove ball bearing. The outer diameter of the bearing 7 and the inner diameter of the inner wall of the expanding bit 5 can adopt interference fit, so that when the expanding bit 5 rotates along with the pilot bit 6, the outer ring of the bearing 7 can better rotate along with the expanding bit 5. The inner diameter of the bearing 7 and the outer diameter of the pressure plate 8 can also be in interference fit, so that the inner ring of the bearing 7 and the free end of the pull rope 9 are relatively static, and the outer ring of the bearing 7 rotates relative to the inner ring of the bearing 7.
The inside of the expanding drill bit 5 can be provided with a hook to form a fixing device. The free end of the pull cord 9 may be connected to an annular knot. When the hole expanding drill bit 5 performs reverse drilling operation on a bone tunnel, the annular knot at the free end of the pull rope 9 is hung on the hook to form locking, and the pull rope 9 applies axial tension to the hole expanding drill bit 5 to form axial restraint on the hole expanding drill bit 5; after the hole expanding drill bit 5 completes the back drilling operation of the bone tunnel, the annular knot at the free end of the pull rope 9 is separated from the drag hook, so that the hole expanding drill bit 5 is convenient to detach.
As shown in fig. 4, the projections 13 are evenly distributed along the axis of the pull cord 9 on the side wall of the free end of the pull cord 9. The grooves 14 correspond to the projections 13 one to one. Due to the arrangement, on one hand, the friction force between the free end of the pull rope 9 and the end face of the pressing plate 8 is increased, the pull rope 9 and the fixing device are prevented from falling off due to vibration generated in the reverse drilling process, and the locking effect of the fixing device is further improved; on the other hand, due to the arrangement of the plurality of grooves 14, the locking can be formed only by rotating a small angle after the lug 13 at the free end of the pull rope 9 passes through the groove 14, the pull rope 9 and the fixing device can be separated only by reversely rotating the corresponding angle when the reaming bit 5 is detached, the rapid detachment of the reaming bit 5 is facilitated, and the operation efficiency is further improved.
As shown in fig. 4, 3 projections 13 are evenly distributed along the axis of the pull cord 9 on the side wall of the free end of the pull cord 9. The 3 grooves 14 are evenly distributed on the inner wall of the through hole in the middle of the pressure plate 8.
As shown in fig. 5, the inner wall of the reamer head 5 is provided with a connection key 11. The outer wall of the pilot bit 6 is provided with a chute 12. The connecting key 11 is keyed to the runner 12. The connecting key 11 is arranged on the inner wall of the expanding bit 5, which is beneficial to further improving the structural strength of the expanding bit 5. The sliding groove 12 is arranged on the outer wall of the pilot bit 6, so that the pilot bit 6 can be conveniently arranged and cut in the drilling process, and the drilling efficiency is further improved. As shown in fig. 3, in order to further improve the stability of the reamer head 5, 3 connecting keys 11 are uniformly distributed on the inner wall of the reamer head 5, and 3 sliding grooves 12 are correspondingly arranged on the outer wall of the pilot bit 6. Wherein, the connecting key 11 can be made by integral forging.
The bottom of the reamer bit 5 can be provided with an observation port, so that medical personnel can observe the connection condition of the free end of the stay cord 9 and the fixing device from the arthroscope conveniently, and the smooth operation can be ensured.
Be provided with clamping part on the outer wall of reamer bit 5, the auxiliary clamping tool of being convenient for implements the centre gripping to reamer bit 5 to install reamer bit 5 on guide's drill bit 6, be favorable to preventing reamer bit 5 from dropping in the joint chamber carelessly in installation and dismantlement process, further improve reamer bit 5's installation and the efficiency of dismantling.
The reamer bit 5 has at least two cutting edges. The cutting edges are evenly arranged along the axis of the reamer bit 5 in the circumferential direction of the reamer bit 5. So set up, be favorable to balanced reamer bit 5 radial cutting force who receives, greatly reduced reamer bit 5 is at the disconnected sword risk of reverse drilling in-process. The number of cutting edges can be selected to be an appropriate number according to the size of the prepared bone tunnel. The number of the cutting edges can be selected from 2, 3, 4 and the like. The number of cutting edges may preferably be 3.
The embodiment of the invention also provides a bone tunnel preparation method using the bone tunnel preparation device for knee joint ligament reconstruction, which comprises the following steps:
firstly, driving a pilot drill bit 6 to drill a first bone tunnel on a leg bone downwards under the auxiliary guide of a sighting device by using a power device, and enabling the pilot drill bit 6 to enter a knee joint cavity through the first bone tunnel;
step two, closing the power device, placing the hole expanding drill bit 5 into the knee joint cavity, and installing the hole expanding drill bit 5 on the pilot drill bit 6;
thirdly, the pull rope 9 penetrates through a channel formed by connecting the interior of the pilot drill bit 6 with the interior of the guide pipe 10, and after the free end of the pull rope 9 is locked with the fixing device, tension force is applied to the pull rope 9;
and step four, starting the power device, transmitting the output torque of the power device to the hole expanding drill bit 5 through the pilot drill bit 6, and drilling the hole expanding drill bit 5 along the axis of the first bone tunnel towards the starting end of the first bone tunnel until the preparation of the bone tunnel is completed.
The preparation method of the bone tunnel further comprises the following steps:
and step five, after the preparation of the bone tunnel is completed, the reaming bit 5 retreats into the knee joint cavity along with the pilot bit 6, the free end of the pull rope 9 is separated from the fixing device, the reaming bit 5 is detached from the pilot bit 6, the reaming bit 5 is taken out from the knee joint cavity, and the pilot bit 6 and the pull rope 9 retreat from the starting end of the first bone tunnel along the axis of the bone tunnel.
The invention also provides a reamer bit 5 for reverse drilling of a bone tunnel, which comprises a fixing device and a hollow drill body. The fixing means comprise a pressure plate 8 and a bearing 7. The outer ring of the bearing 7 is fixedly arranged on the inner wall of the drill body. The pressure plate 8 is fixedly arranged on the inner ring of the bearing 7. The middle part of the pressure plate 8 is provided with a through hole. The inner wall of the through hole is provided with a groove 14. The inner wall of the drill body is provided with a connecting key 11. The drill body has at least two cutting edges on its outer wall.
The present invention is not limited to the specific technical solutions described in the above embodiments, and other embodiments may be made in the present invention in addition to the above embodiments. It will be understood by those skilled in the art that various changes, substitutions of equivalents, and alterations can be made without departing from the spirit and scope of the invention.

Claims (7)

1. A bone tunnel preparation device for knee joint ligament reconstruction is characterized by comprising a pilot drill bit, a hole expanding drill bit and a pull rope;
the pilot bit is provided with a cutting section and a connecting section, the cutting section is provided with a sliding chute, the connecting section is connected with a conduit for transmitting torque to the pilot bit, the interior of the pilot bit is hollow, and the interior of the pilot bit is connected with the interior of the conduit to form a channel for a pull rope to pass through;
a connecting key matched with the sliding groove is arranged on the inner wall of the hole expanding drill bit, a fixing device is arranged inside the hole expanding drill bit, the free end of the pull rope and the fixing device form a locking structure, and the locking structure has a first shape and a second shape;
when the reamer bit is in the first state, the free end of the pull rope is locked with the fixing device, and the pull rope applies axial tension to the reamer bit to form axial restraint on the reamer bit;
when in the second configuration, the free end of the pull cord is disengaged from the securing device.
2. The bone tunnel preparation device for knee joint ligament reconstruction according to claim 1, wherein the fixing device comprises a pressing plate and a bearing, an outer ring of the bearing is fixedly installed on an inner wall of the reaming bit, the pressing plate is fixedly installed on an inner ring of the bearing, a through hole is formed in the middle of the pressing plate, a protrusion is arranged at a free end of the pull rope, and a groove for the protrusion to pass through is formed in an inner wall of the through hole.
3. The bone tunnel preparation device for knee ligament reconstruction according to claim 2, wherein the projections are uniformly distributed on the side wall of the free end of the pulling rope along the axis of the pulling rope, and the grooves correspond to the projections one to one.
4. Bone tunnel preparation device for knee ligament reconstruction according to any one of claims 1 to 3, characterized in that the sliding grooves are evenly distributed on the outer wall of the pilot drill along the axis of the pilot drill.
5. The bone tunnel preparation device for knee ligament reconstruction of claim 1, wherein a bottom of the reamer bit is provided with a viewing port.
6. The bone tunnel preparation device for knee ligament reconstruction of claim 1, wherein the reamer bit is provided with a grip on an outer wall thereof.
7. The bone tunnel preparation device for knee ligament reconstruction of claim 1, wherein the reamer bit has at least two cutting edges, the cutting edges being uniformly arranged along an axis of the reamer bit in a circumferential direction of the reamer bit.
CN202110290761.5A 2021-03-18 2021-03-18 Bone tunnel preparation device for knee joint ligament reconstruction Active CN112998804B (en)

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CN110537954A (en) * 2019-08-27 2019-12-06 谢军 Drill bit for total hip joint replacement minimally invasive surgery

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EP1785103B1 (en) * 2005-11-10 2010-09-15 Arthrex, Inc. Apparatus for anterior cruciate ligament (ACL) reconstruction using rotary drill cutter to form retrograde sockets
WO2016149173A1 (en) * 2015-03-14 2016-09-22 University Of Cincinnati Retrograde reamer system and methods for providing bone tunnels in ligament reconstruction surgery
CN204890096U (en) * 2015-08-18 2015-12-23 张为 Can ride articular process enlarger of striding on articular process
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CN106535786A (en) * 2014-05-29 2017-03-22 史密夫和内修有限公司 Retrogade reamer depth tube gage
CN110537954A (en) * 2019-08-27 2019-12-06 谢军 Drill bit for total hip joint replacement minimally invasive surgery

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