CN115005986B - Individual intelligent navigation positioning device for single condyle replacement surgery and osteotome - Google Patents
Individual intelligent navigation positioning device for single condyle replacement surgery and osteotome Download PDFInfo
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- CN115005986B CN115005986B CN202210616223.5A CN202210616223A CN115005986B CN 115005986 B CN115005986 B CN 115005986B CN 202210616223 A CN202210616223 A CN 202210616223A CN 115005986 B CN115005986 B CN 115005986B
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- 238000001356 surgical procedure Methods 0.000 title claims abstract description 63
- 210000000988 bone and bone Anatomy 0.000 claims description 51
- 210000002303 tibia Anatomy 0.000 claims description 39
- 210000001264 anterior cruciate ligament Anatomy 0.000 claims description 6
- 238000010146 3D printing Methods 0.000 claims description 5
- 238000005516 engineering process Methods 0.000 claims description 4
- 206010067268 Post procedural infection Diseases 0.000 abstract description 5
- 230000004083 survival effect Effects 0.000 abstract description 5
- 208000004550 Postoperative Pain Diseases 0.000 abstract description 3
- 239000003814 drug Substances 0.000 abstract 1
- 238000000034 method Methods 0.000 description 17
- 230000008569 process Effects 0.000 description 6
- 238000010586 diagram Methods 0.000 description 4
- 210000000629 knee joint Anatomy 0.000 description 4
- 208000002193 Pain Diseases 0.000 description 3
- 230000005499 meniscus Effects 0.000 description 3
- 210000004872 soft tissue Anatomy 0.000 description 3
- 208000027418 Wounds and injury Diseases 0.000 description 2
- 210000000845 cartilage Anatomy 0.000 description 2
- 238000009434 installation Methods 0.000 description 2
- 230000007794 irritation Effects 0.000 description 2
- 210000003127 knee Anatomy 0.000 description 2
- 238000011084 recovery Methods 0.000 description 2
- 235000010893 Bischofia javanica Nutrition 0.000 description 1
- 240000005220 Bischofia javanica Species 0.000 description 1
- 208000003947 Knee Osteoarthritis Diseases 0.000 description 1
- 208000035965 Postoperative Complications Diseases 0.000 description 1
- 208000037099 Prosthesis Failure Diseases 0.000 description 1
- 238000011882 arthroplasty Methods 0.000 description 1
- 210000000544 articulatio talocruralis Anatomy 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 210000004439 collateral ligament Anatomy 0.000 description 1
- 238000004891 communication Methods 0.000 description 1
- 230000006378 damage Effects 0.000 description 1
- 230000007812 deficiency Effects 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 210000003414 extremity Anatomy 0.000 description 1
- 208000015181 infectious disease Diseases 0.000 description 1
- 208000014674 injury Diseases 0.000 description 1
- 238000013150 knee replacement Methods 0.000 description 1
- 238000004519 manufacturing process Methods 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 201000008482 osteoarthritis Diseases 0.000 description 1
- 210000000426 patellar ligament Anatomy 0.000 description 1
- 230000000149 penetrating effect Effects 0.000 description 1
- 230000035479 physiological effects, processes and functions Effects 0.000 description 1
- 210000002967 posterior cruciate ligament Anatomy 0.000 description 1
- 230000002980 postoperative effect Effects 0.000 description 1
- 238000006467 substitution reaction Methods 0.000 description 1
- 210000001694 thigh bone Anatomy 0.000 description 1
- 210000003906 tibiofibular joint Anatomy 0.000 description 1
- 238000011883 total knee arthroplasty Methods 0.000 description 1
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/14—Surgical saws ; Accessories therefor
- A61B17/142—Surgical saws ; Accessories therefor with reciprocating saw blades, e.g. with cutting edges at the distal end of the saw blades
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/14—Surgical saws ; Accessories therefor
- A61B17/15—Guides therefor
- A61B17/154—Guides therefor for preparing bone for knee prosthesis
- A61B17/155—Cutting femur
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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
- A61B17/14—Surgical saws ; Accessories therefor
- A61B17/15—Guides therefor
- A61B17/154—Guides therefor for preparing bone for knee prosthesis
- A61B17/157—Cutting tibia
-
- 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
- A61F2/461—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 knees
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- 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
- A61F2002/4687—Mechanical guides for implantation instruments
-
- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
- Y02A—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE
- Y02A50/00—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE in human health protection, e.g. against extreme weather
- Y02A50/30—Against vector-borne diseases, e.g. mosquito-borne, fly-borne, tick-borne or waterborne diseases whose impact is exacerbated by climate change
Abstract
The invention provides a personalized intelligent navigation and positioning device for a unicondylar replacement surgery and a osteotome, wherein the personalized intelligent navigation and positioning device for the unicondylar replacement surgery comprises a guide plate body, the guide plate body is provided with an osteotomy groove and a through hole with a rectangular cross section, the depth direction of the osteotomy groove is the same as the height direction of the through hole, the length direction of the osteotomy groove is the same as the depth direction of the through hole, the bottom of the osteotomy groove is higher than the top of the through hole, and the osteotomy opening direction of the osteotomy groove faces the top of the guide plate body; the osteotomy opening of the osteotomy slot is directed toward the anterior superior iliac crest in flexion. Can avoid postoperative pain, prosthesis dislocation, loosening, subsidence, poor rotation alignment, postoperative infection and other complications caused by osteotomy of the traditional Chinese medicine root according to self experience, and improves the success rate of the operation and the survival rate of the prosthesis.
Description
Technical Field
The invention relates to the technical field of surgical instruments, in particular to a personalized intelligent navigation positioning device for a unicondylar replacement operation and an osteotome.
Background
Total knee replacement is an effective method for treating end-stage knee osteoarthritis, but in cases where the simple one-sided tibiofemoral compartment regresses severely without any painful discomfort to the contralateral compartment, the student recommends knee unicondylar replacement with the goal of replacing the damaged cartilage surface of the tibiofemoral joint. Compared with high tibial osteotomy and total knee arthroplasty, the unicondylar arthroplasty has the advantages of small wound, quick recovery, low cost, small influence on revision and the like.
Due to deficiencies in early prosthetic processes and designs, unicondylar replacement has not been clinically accepted for a long time. In recent years, the use of unicondylar replacement has achieved good recent results with improvements in surgical techniques, prosthesis design and clear surgical indications. However, unicondylar replacement does not have a uniform standard in terms of prosthesis placement and force lines, and inaccurate placement of the prosthesis is a very important factor affecting prosthesis survival.
Traditional joint replacement mainly relies on the bone cutting baffle to cooperate machinery to accomplish to the line system and cut bone, prosthesis and lay and limb power line control, and its accuracy relies on the experience of operative person to a great extent, need rely on surgeon's experience and feel location anatomical landmarks, has subjective error, consequently, urgently needed a individualized intelligent navigation positioner of unicondylar replacement operation and bone cutter, come accurate definite bone cutting direction, ensured the bone cutting precision.
Disclosure of Invention
The invention provides an individualized intelligent navigation positioning device for a unicondylar replacement operation and an osteotome, which are used for solving the technical problem that the existing individualized intelligent navigation positioning device for the unicondylar replacement operation is difficult to determine the osteotomy direction, and improving the success rate of the operation and the survival rate of prosthesis.
The invention provides a single condyle replacement operation personalized intelligent navigation positioning device, which comprises: the guide plate comprises a guide plate body, wherein the guide plate body is provided with a bone cutting groove and a through hole with a rectangular cross section, the depth direction of the bone cutting groove is the same as the height direction of the through hole, the length direction of the bone cutting groove is the same as the depth direction of the through hole, the groove bottom of the bone cutting groove is higher than the top of the through hole, and the bone cutting opening direction of the bone cutting groove faces the top of the guide plate body;
wherein the osteotomy opening of the osteotomy slot is directed toward the anterior superior iliac crest in flexion.
According to the individualized intelligent navigation and positioning device for the unicondylar replacement surgery, the projection of the first side wall of the through hole in the height direction of the through hole is positioned between the projection areas of the second side wall and the third side wall of the osteotomy groove in the depth direction of the osteotomy groove.
According to the personalized intelligent navigation and positioning device for the unicondylar replacement surgery, which is provided by the invention, one side of the guide plate body, which is connected with the tibia, is a fitting connection side;
the fitting connection side is provided with a first fitting part and a second fitting part at a first height position, and the osteotomy groove is formed between the first fitting part and the second fitting part;
and a third fitting part is arranged at the second height position of the fitting connection side.
According to the personalized intelligent navigation and positioning device for the unicondylar replacement surgery, the length of the first fitting part is larger than that of the second fitting part, and the first fitting part is used for extending to the inner side of an anterior cruciate ligament.
According to the personalized intelligent navigation and positioning device for the unicondylar replacement surgery, the first fitting part, the second fitting part and the third fitting part extend towards the direction perpendicular to the guide plate body.
According to the personalized intelligent navigation and positioning device for the unicondylar replacement surgery, which is provided by the invention, the guide plate body is provided with a first connecting hole and a second connecting hole, and the first connecting hole and the second connecting hole are both suitable for being connected with the tibia through fasteners;
the first connecting hole is vertically formed in the guide plate body, and the second connecting hole is obliquely formed in the guide plate body;
or the first connecting hole is obliquely arranged on the guide plate body, and the second connecting hole is vertically arranged on the guide plate body.
According to the personalized intelligent navigation and positioning device for the unicondylar replacement surgery, the first connecting hole and the second connecting hole are both positioned at the lower side of the through hole along the vertical direction of the guide plate body, and the vertical direction is the same as the depth direction of the osteotomy groove;
the hole center of the first connection hole and the hole center of the second connection hole are located at different height positions.
According to the personalized intelligent navigation and positioning device for the unicondylar replacement surgery, the osteotomy groove points to the anterior-superior iliac crest in the flexion position.
According to the individualized intelligent navigation and positioning device for the unicondylar replacement surgery, which is provided by the invention, the individualized intelligent navigation and positioning device for the unicondylar replacement surgery is an individualized intelligent navigation and positioning device for the unicondylar replacement surgery which is integrally formed by adopting a 3D printing technology.
The invention also provides a using method of the individualized intelligent navigation positioning device for the unicondylar replacement surgery, which comprises the following steps:
fitting the individualized intelligent navigation positioning device for the unicondylar replacement surgery with a fitting surface of a tibial plateau;
after the fitting is finished, fixing the individualized intelligent navigation positioning device for the unicondylar replacement surgery through a fastener;
performing sagittal and coronal osteotomies through the through holes and the osteotomy slots respectively by using a swing saw;
and taking down the fastener and the individualized intelligent navigation positioning device for the unicondylar replacement surgery to complete the osteotomy operation.
The present invention also provides an osteotome comprising: the oscillating saw and the individualized intelligent navigation positioning device for the unicondylar replacement surgery are suitable for being arranged in the osteotomy groove and/or the through hole in a penetrating mode.
The individualized intelligent navigation positioning device and the osteotomy device for the unicondylar replacement surgery assist in accurate osteotomy through the osteotomy groove and the through hole, wherein the osteotomy groove points to the anterior superior iliac crest at the flexion position, so that the osteotomy is more accurate, the prosthesis can be accurately placed after the osteotomy is finished, the prosthesis is prevented from being placed askew or suspended after the osteotomy, if the prosthesis is placed or suspended, the prosthesis is seriously worn in the straightening and flexion processes, the inner soft tissue irritation pain can be caused, the postoperative infection can be caused, the gasket edge load can be increased, the meniscus liner is excessively worn, the bone support is insufficient, the prosthesis is easily subjected to aseptic loosening due to uneven stress, the prosthesis is dislocated and sinks, and therefore, postoperative complications such as postoperative pain, prosthesis dislocation, loosening, sinking, poor rotation alignment, infection and the like caused by the osteotomy performed according to the experience of the surgical root can be avoided, and the survival rate of the prosthesis can be improved.
Drawings
In order to more clearly illustrate the present invention or the technical solutions in the prior art, the drawings used in the embodiments or the description of the prior art will be briefly introduced below, and it is obvious that the drawings in the following description are some embodiments of the present invention, and other drawings can be obtained by those skilled in the art without creative efforts.
FIG. 1 is a schematic structural diagram of a personalized intelligent navigation and positioning device for a unicondylar replacement surgery provided by the present invention;
FIG. 2 is a second schematic structural diagram of the personalized intelligent navigation and positioning device for unicondylar replacement surgery provided by the present invention;
FIG. 3 is one of the schematic structural diagrams of the personalized intelligent navigation and positioning device for the unicondylar replacement surgery provided by the present invention when being connected with the tibia;
FIG. 4 is a second schematic structural view of the personalized intelligent navigation and positioning device for unicondylar replacement surgery provided by the present invention when connected to a tibia;
FIG. 5 is a schematic view of the installation of the personalized intelligent navigation and positioning device for the unicondylar replacement surgery provided by the invention;
FIG. 6 is one of the osteotomy schematics of the personalized intelligent navigation and positioning device for unicondylar replacement surgery provided by the present invention;
FIG. 7 is a second schematic diagram of an osteotomy of the personalized intelligent navigation and positioning device for unicondylar replacement surgery provided by the present invention;
FIG. 8 is a schematic structural view of a tibia after a unicondylar tibial osteotomy procedure using the osteotomy provided by the present invention;
FIG. 9 is a schematic view of the process of installing and cutting bone of the personalized intelligent navigation and positioning device for single condylar replacement surgery provided by the present invention.
Reference numerals:
1. a guide plate body; 2. a osteotomy slot; 3. a through hole; 4. a first fitting section; 5. a second fitting section; 6. a third fitting section; 8. a first connection hole; 9. a second connection hole; 10. a first side wall; 11. a second side wall; 12. a third side wall; 13. a threaded nail; 14. and (5) swinging the saw.
Detailed Description
The embodiments of the present invention will be described in further detail with reference to the drawings and examples. The following examples are intended to illustrate the invention but are not intended to limit the scope of the invention.
In the description of the embodiments of the present invention, it should be noted that the terms "center", "longitudinal", "lateral", "upper", "lower", "front", "rear", "left", "right", "vertical", "horizontal", "top", "bottom", "inner", "outer", and the like indicate orientations or positional relationships based on those shown in the drawings, and are only for convenience in describing the embodiments of the present invention and simplifying the description, but do not indicate or imply that the referred devices or elements must have a specific orientation, be constructed in a specific orientation, and be operated, and thus, should not be construed as limiting the embodiments of the present invention. Furthermore, the terms "first," "second," and "third" are used for descriptive purposes only and are not to be construed as indicating or implying relative importance.
In the description of the embodiments of the present invention, it should be noted that, unless explicitly stated or limited otherwise, the terms "connected" and "connected" are to be interpreted broadly, and may be, for example, fixedly connected, detachably connected, or integrally connected; can be mechanically or electrically connected; may be directly connected or indirectly connected through an intermediate. Specific meanings of the above terms in the embodiments of the present invention can be understood in specific cases by those of ordinary skill in the art.
In embodiments of the invention, unless expressly stated or limited otherwise, a first feature may be "on" or "under" a second feature such that the first and second features are in direct contact, or the first and second features are in indirect contact via an intermediary. Also, a first feature "on," "over," and "above" a second feature may be directly or diagonally above the second feature, or may simply indicate that the first feature is at a higher level than the second feature. A first feature being "under," "below," and "beneath" a second feature may be directly under or obliquely under the first feature, or may simply mean that the first feature is at a lesser elevation than the second feature.
In the description herein, references to the description of the term "one embodiment," "some embodiments," "an example," "a specific example," or "some examples," etc., mean that a particular feature, structure, material, or characteristic described in connection with the embodiment or example is included in at least one embodiment or example of an embodiment of the invention. In this specification, the schematic representations of the terms used above are not necessarily intended to refer to the same embodiment or example. Furthermore, the particular features, structures, materials, or characteristics described may be combined in any suitable manner in any one or more embodiments or examples. Furthermore, various embodiments or examples and features of different embodiments or examples described in this specification can be combined and combined by one skilled in the art without contradiction.
The individualized intelligent navigation and positioning device for the unicondylar replacement surgery is described below with reference to fig. 1-8, and comprises a guide plate body 1, wherein a bone cutting groove 2 and a through hole 3 with a rectangular cross section are arranged on the guide plate body 1, the depth direction of the bone cutting groove 2 is the same as the height direction of the through hole 3, the length direction of the bone cutting groove 2 is the same as the depth direction of the through hole 3, the groove bottom of the bone cutting groove 2 is higher than the top of the through hole 3, and the opening direction of the bone cutting groove 2 faces the top of the guide plate body 1. Wherein the osteotomy opening of the osteotomy notch 2 is directed towards the anterior superior iliac crest in flexion.
In this embodiment, cut bone groove 2 and through-hole 3 and assist and carry out accurate osteotomy, wherein, because cut bone groove 2 points to the anterior superior iliac crest when bucking position (knee is crooked), can make and cut the bone more accurate, after cutting the bone and accomplishing, make the placing that the false body can be accurate, it is askew or unsettled to avoid cutting the back false body, if the false body is askew or unsettled can lead to false body wearing and tearing serious in straightening and bucking in-process, can cause inboard soft tissue irritation pain, cause postoperative infection, still can increase false body edge load and lead to the excessive wearing and tearing of meniscus liner, lead to the bone to support not enough, make its atress uneven and easily take place aseptic becoming flexible, cause false body dislocation and subside, therefore, can avoid the root of operation according to self experience according to cut the bone and cause postoperative pain, false body dislocation, become flexible, sink, rotatory counterpoint is bad and postoperative infection's complications, the success rate of operation and the survival rate of false body have been improved.
Wherein, cut bone groove 2 and cut bone groove for sagittal position, when carrying out the operation of unicondylar shin bone osteotomy, cut bone groove 2 and be located the inboard slope of inboard intercondylar ridge, cut bone groove 2 and can play fine reference mark effect this moment, and because the upside of cutting bone groove 2 forms at the top of baffle body 1 and cuts the bone breach, can be very convenient for utilize pendulum saw 14 to cut.
Knee joint is at bucking and extension in-process, it is inevitable to have the shin bone to revolve for the internal and external of thighbone along with, if cut the bone precision not enough, the false body mounted position has the possibility of placing askew or unsettled, can arouse the amazing pain of inboard soft tissue at bucking and extension in-process, postoperative infection even, simultaneously, the unsettled not only of shin bone false body can increase the excessive wear that gasket edge load leads to the meniscus liner, still can lead to the bone to support not enough, make its atress uneven and easily take place aseptic nature not hard up, cause the false body to dislocate and sink. Cut bone baffle through in this scheme and assist and cut the bone, the assurance that can be accurate cuts the bone direction, cuts the bone and accomplishes and carry out the false body and put the back, can make the interior outward turning of knee joint in bucking and straightening in-process physiology that satisfies that the false body can be better.
The structure of the through hole 3 can make both ends of the through hole 3 be a closed design, as shown in fig. 1, the left side of the through hole 3 is located at a position close to the lower side of the osteotomy groove 2, the right side of the through hole 3 is a closed arrangement, as shown in fig. 1, the left side of the through hole 3 is also a closed arrangement. The right side of the through hole 3 is set to be in a closed state, so that the injury of the medial collateral ligament caused by the improper protection in the operation process can be avoided.
According to the personalized intelligent navigation and positioning device for the unicondylar replacement surgery, the projection of the first side wall 10 of the through hole 3 in the height direction of the through hole 3 is positioned between the projection areas of the second side wall 11 and the third side wall 12 of the osteotomy groove 2 in the depth direction of the osteotomy groove 2. The first side wall 10 of a particular through hole 3 may coincide with the projection of the second side wall 11 of the osteotomy groove 2. In this way, after the oscillating saw 14 cuts through the osteotomy groove 2 and the through hole 3, the cutting position of one side of the oscillating saw is matched, and accurate osteotomy is better ensured.
The side of the guide plate body 1, which is used for being connected with the tibia, is a fitting connection side, a first fitting part 4 and a second fitting part 5 are arranged at the first height position of the fitting connection side, a third fitting part 6 is arranged at the second height position of the fitting connection side, and a bone cutting groove 2 is formed between the first fitting part 4 and the second fitting part 5. As shown in fig. 1 and 2, the shapes of the connection surfaces of the first fitting part 4, the second fitting part 5, and the third fitting part 6 are the same as the shapes of the positions corresponding to the tibia, and the first fitting part 4, the second fitting part 5, and the third fitting part 6 are used for accurately fitting the corresponding tibia regions, so that the guide plate body 1 and the tibia are accurately connected.
It will be appreciated that the osteotomy groove 2 comprises two parts, one part being located on the guide body 1 and the other part being formed by the gap between the first fitting part 4 and the second fitting part 5, which parts are in communication to form the osteotomy groove 2.
The first height position is higher than the second height position along the vertical direction of the fence body 1 (i.e., the depth direction of the osteotomy groove), and in the embodiment of the present invention, the first height position is the top of the fence body 1 in the vertical direction, and the second height position is the middle of the fence body 1 in the vertical direction.
First fitting portion 4 and second fitting portion 5 set up in the top position of the fitting connection side of baffle body 1 to make first fitting portion 4 and second fitting portion 5 can the fitting articulate in the upside region of shin bone, third fitting portion 6 sets up approximately in the middle part region of the fitting connection side of baffle body 1, when carrying out the operation of unicondylar shin bone osteotomy, third fitting portion 6 is located shin bone the place ahead inboard, and third fitting portion 6 has dodged the patellar ligament, more convenient fitting in the art.
The fitting areas (i.e. the connection areas with the tibia) of the first fitting part 4, the second fitting part 5 and the third fitting part 6 are uneven, so that the fitting stability of the guide plate can be enhanced.
According to the personalized intelligent navigation and positioning device for the unicondylar replacement surgery, the length of the first fitting part 4 is larger than that of the second fitting part 5, the first fitting part 4 is used for extending to the inner side of the anterior cruciate ligament, as shown in fig. 4, the first fitting part 4 is positioned on the left side of the guide plate body 1, and the first fitting part 4 can extend to the inner side of the anterior cruciate ligament, so that the anterior cruciate ligament is protected, and the anterior cruciate ligament is prevented from being damaged in the sagittal osteotomy.
As shown in fig. 4, the width of the first fitting portion 4 is much smaller than the width of the second fitting portion 5.
The first fitting part 4, the second fitting part 5 and the third fitting part 6 extend in the direction perpendicular to the guide plate body 1, so that the first fitting part 4, the second fitting part 5 and the third fitting part 6 can be well connected with the tibia in a fitting mode.
According to the personalized intelligent navigation and positioning device for the unicondylar replacement surgery, provided by the invention, the guide plate body 1 is provided with the first connecting hole 8 and the second connecting hole 9, wherein the first connecting hole 8 and the second connecting hole 9 are both suitable for being connected with a tibia through fasteners. It can be understood that the guide plate body 1 is accurately positioned and connected after being connected with the tibia in a fitting mode through the first fitting portion 4, the second fitting portion 5 and the third fitting portion 6 on one hand, and the guide plate body 1 is more firmly fixed through the fasteners matched with the first connecting holes 8 and the second connecting holes 9 on the other hand.
Wherein, first connecting hole 8 sets up perpendicularly on baffle body 1, and second connecting hole 9 slopes to set up on baffle body 1. At this moment, the fastener is perpendicularly squeezed into the shin bone from first connecting hole 8, and the fastener is squeezed into the shin bone from second connecting hole 9 slant to make first connecting hole 8 and second connecting hole 9 mutually noninterfere in space, can strengthen the fixity of baffle body 1 like this, effectively avoid the unicondylar shin bone to cut the not hard up possibility that leads to cutting the bone slope of in-process baffle body 1.
In another embodiment of the invention, the first connecting hole 8 is obliquely arranged on the guide plate body 1, the second connecting hole 9 is vertically arranged on the guide plate body 1, at this time, a fastener is obliquely driven into the tibia from the first connecting hole 8, and the fastener is vertically driven into the tibia from the second connecting hole 9, so that the first connecting hole 8 and the second connecting hole 9 are not interfered with each other in space, thus the fixity of the guide plate body 1 can be enhanced, and the possibility of osteotomy inclination caused by looseness of the guide plate body 1 in the process of osteotomy of the unicondylar tibia can be effectively avoided.
Wherein, along the vertical direction of baffle body 1, first connecting hole 8 and second connecting hole 9 all are located the downside of through-hole 3, wherein, the vertical direction of baffle body 1 is the same with the depth direction who cuts bone groove 2, when carrying out the condyle shin bone osteotomy, pendulum saw 14 can pass in through-hole 3 in order to cut the bone to the shin bone, because the top region of through-hole 3 has utilized first fitting portion 4 and second fitting portion 5 to realize baffle body 1's connection, and the below region of through-hole 3 has utilized first connecting hole 8, the connection of baffle body 1 is realized to second connecting hole 9 cooperation fastener, just so alright make the position of through-hole 3 very stable, the condition of skew appears in the osteotomy position in the art can not appear.
The hole centers of the first connecting hole 8 and the second connecting hole 9 are located at different height positions, and it can be understood that, when the position of the guide plate body 1 is further fixed by using the fasteners, the two fasteners can be fixed in an auxiliary manner at different height positions of the guide plate body 1, so that the guide plate body 1 can be fixed more firmly.
According to the individualized intelligent navigation and positioning device for the unicondylar replacement surgery, which is provided by the invention, the individualized intelligent navigation and positioning device for the unicondylar replacement surgery is an individualized intelligent navigation and positioning device for the unicondylar replacement surgery integrally formed by adopting a 3D printing technology, namely, different individualized intelligent navigation and positioning devices for the unicondylar replacement surgery are manufactured by adopting the 3D printing technology according to the states of shin bones of different patients, so that the first fitting part 4, the second fitting part 5 and the third fitting part 6 can be accurately in fitting connection with the shin bones of the different patients, and the individualized design of the individualized intelligent navigation and positioning device for the unicondylar replacement surgery is realized.
The individualized intelligent navigation positioning device for the unicondylar replacement surgery, provided by the invention, has three fitting areas, can be more accurately placed and attached to the guide plate body 1, realizes accurate osteotomy, avoids repeated osteotomy caused by inaccurate osteotomy, reduces the surgery time, reduces the surgery risk, is beneficial to postoperative recovery of a patient, reduces the revision probability, and simultaneously improves the success rate of the surgery and the survival rate of a prosthesis.
Next, referring to fig. 9, the installation and osteotomy process of the personalized intelligent navigation and positioning device for unicondylar replacement surgery will be described. Specifically, the method comprises the following steps:
step 90: start of
Step 91: and removing cartilage on the fitting surface when the tibial plateau is fitted with the single condyle replacement operation personalized intelligent navigation positioning device.
And step 92: fitting the individualized intelligent navigation and positioning device for the unicondylar replacement surgery with a fitting surface of a tibial plateau (as shown in fig. 3), namely fitting the navigation and positioning device to the anterior-medial side of the tibia.
Step 93: two screw nails 13 are respectively implanted into the first connecting hole 8 and the second connecting hole 9 (as shown in fig. 5), so as to realize the fixation between the navigation positioning device and the tibia, wherein the screw nails 13 can be the above-mentioned fasteners.
Step 94: an osteotomy operation (as shown in fig. 6) is performed with the oscillating saw 14 in the direction of the through-hole 3, i.e., a coronal osteotomy is performed. After the tibia is cut through in the direction of the through hole 3, the cutting is stopped.
Step 95: an osteotomy operation (as shown in fig. 7) is performed along the depth direction of the osteotomy groove 2 by the oscillating saw 14, that is, a sagittal osteotomy is performed. When the oscillating saw 14 cuts the bone to the lowest position of the osteotomy groove 2 along the depth direction of the osteotomy groove 2, the bone cutting is stopped.
Step 96: and (3) removing the two screw nails 13 from the first connecting hole 8 and the second connecting hole 9 respectively, and removing the individualized intelligent navigation and positioning device and the osteotomy part (shown in figure 8) of the unicondylar replacement surgery to complete the osteotomy operation.
Step 97: and (6) ending.
Next, a planning method of the personalized intelligent navigation positioning device for the unicondylar replacement surgery is exemplified.
Firstly, determining a mechanical axis of a tibia (a connecting line from the center of a knee joint to the center of an ankle joint) according to a bone model of a patient, and further determining a cross section, wherein the cross section is vertical to the mechanical axis;
then determining an Akagi line according to a connecting line from the midpoint of the posterior cruciate ligament to the medial edge of the tibial tubercle, and determining a sagittal plane;
secondly, measuring the internal tibial posterior slope of the patient at the position of the dislocation, wherein the internal tibial posterior slope is generally 0-7 degrees;
thirdly, determining the position of the through hole, namely keeping the direction of transverse bone cutting along the through hole consistent with the tibial retroversion angle of the patient, wherein the bone cutting thickness is 2-5mm away from the lowest point of the inner side of the platform;
finally, determining the position of the osteotomy groove, namely, the direction of performing the dislocation osteotomy along the osteotomy groove points to the anterior-iliac upper crest when the knee joint is at the flexion position, and the osteotomy position is 1-2mm away from the medial intercondylar crest; and designing and generating a complete model of the individualized intelligent navigation and positioning device for the unicondylar replacement surgery according to the positions of the through hole and the osteotomy groove, and performing 3D printing on the model to manufacture the individualized intelligent navigation and positioning device for the unicondylar replacement surgery.
In another aspect, the invention provides a method for using a personalized intelligent navigation and positioning device for a unicondylar replacement surgery, comprising the following steps:
fitting the individualized intelligent navigation positioning device for the unicondylar replacement surgery with a fitting surface of a tibial plateau;
after the fitting is finished, fixing the individualized intelligent navigation positioning device for the unicondylar replacement surgery through a fastener;
performing sagittal and coronal osteotomies through the through holes and the osteotomy slots respectively by using an oscillating saw 14;
and taking down the fastener and the individualized intelligent navigation positioning device for the unicondylar replacement surgery to complete the osteotomy operation.
On the other hand, the invention also provides an osteotome, which comprises an oscillating saw 14 and the individualized intelligent navigation and positioning device in the unicondylar replacement surgery in the foregoing embodiment, wherein the oscillating saw 14 is adapted to penetrate through the osteotomy groove 2 and/or the through hole 3, when the unicondylar tibia osteotomy surgery is performed, as shown in fig. 3 and 4, the guide plate body 1 is accurately fixed on the tibia by using the first fitting part 4, the second fitting part 5 and the third fitting part 6, the position of the guide plate body 1 is stabilized by matching the first connecting hole 8 and the second connecting hole 9 with a fastener, and then the oscillating saw 14 is used to perform osteotomy along the osteotomy groove 2 and the through hole 3 in sequence, so that the tibia side osteotomy surgery is completed, and the tibia is shaped as shown in fig. 5 after being osteotomy.
Finally, it should be noted that: the above examples are only intended to illustrate the technical solution of the present invention, but not to limit it; although the present invention has been described in detail with reference to the foregoing embodiments, it will be understood by those of ordinary skill in the art that: the technical solutions described in the foregoing embodiments may still be modified, or some technical features may be equivalently replaced; and such modifications or substitutions do not depart from the spirit and scope of the corresponding technical solutions of the embodiments of the present invention.
Claims (7)
1. The utility model provides a individualized intelligent navigation positioner of unicondylar replacement operation which characterized in that includes: the guide plate comprises a guide plate body (1), wherein the guide plate body (1) is provided with a bone cutting groove (2) and a through hole (3) with a rectangular cross section, the depth direction of the bone cutting groove (2) is the same as the height direction of the through hole (3), the length direction of the bone cutting groove (2) is the same as the depth direction of the through hole (3), the groove bottom of the bone cutting groove (2) is higher than the top of the through hole (3), and the bone cutting opening direction of the bone cutting groove (2) faces the top of the guide plate body (1);
wherein the osteotomy opening of the osteotomy groove (2) points towards the anterior superior iliac crest in flexion;
the projection of the first side wall (10) of the through hole (3) in the height direction of the through hole (3) is positioned between the projection areas of the second side wall (11) and the third side wall (12) of the osteotomy groove (2) in the depth direction of the osteotomy groove (2);
one side of the guide plate body (1) used for being connected with the tibia is a fitting connection side;
the fitting connection side is provided with a first fitting part (4) and a second fitting part (5) at a first height position, and the osteotomy groove (2) is formed between the first fitting part (4) and the second fitting part (5);
the fitting connection side is provided with a third fitting portion (6) at a second height position, wherein the first height position is higher than the second height position.
2. The personalized intelligent navigation and positioning device for the unicondylar replacement surgery according to claim 1, wherein the length of the first fitting part (4) is greater than the length of the second fitting part (5), and the first fitting part (4) is used for extending to the inner side of the anterior cruciate ligament.
3. The personalized smart navigational positioning device of unicondylar replacement surgery according to claim 1, characterized in that the first fitting part (4), the second fitting part (5) and the third fitting part (6) all extend in a direction perpendicular to the guide plate body (1).
4. The personalized intelligent navigation and positioning device for the unicondylar replacement surgery according to claim 1, wherein the guide plate body (1) is provided with a first connecting hole (8) and a second connecting hole (9), and the first connecting hole (8) and the second connecting hole (9) are both suitable for being connected with the tibia through fasteners;
the first connecting hole (8) is vertically arranged on the guide plate body (1), and the second connecting hole (9) is obliquely arranged on the guide plate body (1);
or the first connecting hole (8) is obliquely arranged on the guide plate body (1), and the second connecting hole (9) is vertically arranged on the guide plate body (1).
5. The personalized intelligent navigation and positioning device for the unicondylar replacement surgery according to claim 4, characterized in that the first connecting hole (8) and the second connecting hole (9) are both located at the lower side of the through hole (3) along the vertical direction of the guide plate body (1), which is the same as the depth direction of the osteotomy groove (2);
the hole center of the first connection hole (8) and the hole center of the second connection hole (9) are located at different height positions.
6. The individualized intelligent navigation and positioning device for the unicondylar replacement surgery according to any one of claims 1 to 5, wherein the individualized intelligent navigation and positioning device for the unicondylar replacement surgery is an individualized intelligent navigation and positioning device for the unicondylar replacement surgery which is integrally formed by adopting a 3D printing technology.
7. Osteotomy device, characterized in that it comprises an oscillating saw (14) and a personalized intelligent navigation and positioning device for the unicondylar replacement surgery according to any one of claims 1 to 6, said oscillating saw (14) being suitable for being inserted into said osteotomy groove (2) and/or said through hole (3).
Priority Applications (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202210616223.5A CN115005986B (en) | 2022-05-31 | 2022-05-31 | Individual intelligent navigation positioning device for single condyle replacement surgery and osteotome |
| PCT/CN2023/082702 WO2023231522A1 (en) | 2022-05-31 | 2023-03-21 | Personalized intelligent navigation and positioning apparatus and method for unicompartmental knee arthroplasty |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202210616223.5A CN115005986B (en) | 2022-05-31 | 2022-05-31 | Individual intelligent navigation positioning device for single condyle replacement surgery and osteotome |
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| CN115005986A CN115005986A (en) | 2022-09-06 |
| CN115005986B true CN115005986B (en) | 2023-04-07 |
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| CN202210616223.5A Active CN115005986B (en) | 2022-05-31 | 2022-05-31 | Individual intelligent navigation positioning device for single condyle replacement surgery and osteotome |
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| WO (1) | WO2023231522A1 (en) |
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| CN115005986B (en) * | 2022-05-31 | 2023-04-07 | 北京长木谷医疗科技有限公司 | Individual intelligent navigation positioning device for single condyle replacement surgery and osteotome |
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Also Published As
| Publication number | Publication date |
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| WO2023231522A1 (en) | 2023-12-07 |
| CN115005986A (en) | 2022-09-06 |
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Address after: 100176 2201, 22 / F, building 1, yard 2, Ronghua South Road, Beijing Economic and Technological Development Zone, Daxing District, Beijing Patentee after: Beijing Changmugu Medical Technology Co.,Ltd. Patentee after: Zhang Yiling Address before: 100176 2201, 22 / F, building 1, yard 2, Ronghua South Road, Beijing Economic and Technological Development Zone, Daxing District, Beijing Patentee before: BEIJING CHANGMUGU MEDICAL TECHNOLOGY Co.,Ltd. Patentee before: Zhang Yiling |