CN215079087U - Medial collateral ligament protection tool used in meniscectomy in knee replacement - Google Patents
Medial collateral ligament protection tool used in meniscectomy in knee replacement Download PDFInfo
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- CN215079087U CN215079087U CN202121473731.XU CN202121473731U CN215079087U CN 215079087 U CN215079087 U CN 215079087U CN 202121473731 U CN202121473731 U CN 202121473731U CN 215079087 U CN215079087 U CN 215079087U
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Abstract
A knee joint replacement operation medial collateral ligament protection tool during meniscectomy comprises a protection tool body which is in a long strip shape and is truncated to be in a flat shape, the rear end of the protection tool body is extended to form a handle in an extending mode, the front end of the protection tool body is a shielding portion which is formed by arc bending with radian of 2 pi/9 and used for shielding medial collateral ligament, the total width of the front end of the shielding portion is 22-24 mm, a trapezoidal open slot used for yielding for a meniscus is arranged in the front end of the protection tool body in a manner that the front end is deviated from the central axis of the protection tool body, the trapezoidal open slot extends backwards along the arc of the shielding portion, the depth of the trapezoidal open slot is 20-24 mm, the width of the slot of the trapezoidal open slot is 6-8 mm which is an opening big end, the included angle between oblique edges of two sides of the trapezoidal open slot is 10 degrees, the trapezoidal open slot divides the shielding portion into a femoral isolation portion and a tibial isolation portion, and the width of the femoral isolation portion is 9-12 mm, the width of the tibial isolation part is one half of that of the femoral isolation part.
Description
Technical Field
The utility model relates to the field of medical equipment, in particular to medial collateral ligament protection instrument during excision of knee joint replacement art meniscus.
Background
The Medial Collateral Ligament (MCL) is flat strip-shaped, has the length of 96.40 + -4.49 mm, the width of 12.53 + -2.22 mm and the thickness of 1.82 + -0.36 mm, starts from the medial epicondyle of the femur, ends 7-10cm below the joint surface, and is divided into three layers from the bottom: 1. the medial collateral ligament superficial layer, also called medial collateral ligament anterior bundle, has an oval attachment point on the femur, usually 3.2mm above the medial epicondyle of the femur and 4.8mm behind the medial epicondyle of the femur, and the medial collateral ligament superficial layer extends distally to have two insertion points on the tibia, the insertion point of the proximal end mainly covers the insertion point of the anterior semimembraneous tendon with a layer of soft tissue, is located about 12.2mm below the tibial joint line, and the insertion point of the distal end is wider, is directly attached to the tibia, is about 61.2mm away from the distal end of the tibial joint line, and is just located slightly in front of the medial crest behind the tibia. 2. The posterior oblique ligament, also known as the medial collateral ligament posterior bundle, has many differences in the description of the femoral attachment points, and is generally believed to begin posterior to the medial femoral condyle superficial fibers and fan downward to terminate in the medial tibial posterior half of the condyle below the joint line. 3. The medial collateral ligament, in its deep layer, extends vertically downward from the medial epicondyle inferior semi-periphery of the femur (about 20.72 + -2.52 mm from the horizontal line of the joint), attaches to the middle of the medial meniscal periphery, and terminates at the inferior facet of the medial aspect of the tibial plateau at the midpoint of the articular surface (about 7.32 + -3.23 mm). The medial meniscus is C-shaped, the front end is narrow, the rear end is wide, and the middle part of the outer edge is connected with the joint capsule fibrous layer and the deep layer of the medial collateral ligament.
When excising the meniscus in knee replacement, because the medial collateral ligament is connected closely with inboard meniscus, when the knee was in 90 degrees flexion positions, the medial collateral ligament formed 78 contained angles with the water flat line, and the area of contact with inboard meniscus increased, just very easily accidentally injured the medial collateral ligament when the knee replacement excision was inboard meniscus this moment. While the medial collateral ligament is the most critical structure for maintaining the medial stability of the knee joint, if the medial collateral ligament is damaged, the long-term survival rate of the prosthesis can be affected, and the knee joint replacement operation fails. Currently, there are two main methods commonly used to protect the medial collateral ligament in knee replacement: one is that after the tibial plateau is fully exposed, the medial meniscus is clamped by toothed forceps, the medial collateral ligament is pulled away, and then the meniscus is cut off, but because the medial collateral ligament is tightly connected with the meniscus, the medial collateral ligament is inevitably pulled at the same time in the process of pulling the medial meniscus, so that the boundary between the medial meniscus and the medial collateral ligament is more fuzzy, and the medial collateral ligament is damaged when the meniscus is cut off; the other type is that when the meniscus is cut, the medial collateral ligament is pulled away from the articular surface by an assistant through a draw hook, but the contact area of the existing draw hook and the medial collateral ligament is small, only the surface of the medial collateral ligament can be drawn, on the contrary, the deep layer of the medial collateral ligament is close to the meniscus, so that the contact position of the medial collateral ligament and the meniscus is difficult to clearly expose, and the injury of the medial collateral ligament is easily caused when the meniscus is cut.
Because the gaps formed among the deep layers of the medial meniscus, the joint capsule and the medial collateral ligament are narrow and small, and a common draw hook is difficult to go deep into the gaps between the meniscus and the medial collateral ligament, a tool which can go deep into the gaps among the deep layers of the medial meniscus, the joint capsule and the medial collateral ligament and can fully expose the contact part needs to be designed, and the medial collateral ligament is better protected.
Disclosure of Invention
The utility model aims at prior art's not enough, provide an inboard collateral ligament protection instrument when knee joint replacement art meniscus excision, it can insert in the clearance of the deep formation of inboard meniscus, joint capsule and inboard collateral ligament to separate inboard collateral ligament and keep off in the circular arc of occlusion part inboard, make the upper and lower reason of meniscus and inboard collateral ligament contact department fully expose, thereby play the effect of protection inboard collateral ligament when excision meniscus.
The technical scheme of the utility model is that: a knee joint replacement operation medial collateral ligament protection tool during meniscectomy comprises a protection tool body which is in a long strip shape and is truncated to be in a flat shape, the rear end of the protection tool body is extended to form a handle in an extending mode, the front end of the protection tool body is a shielding portion which is formed by arc bending with radian of 2 pi/9 and used for shielding medial collateral ligament, the total width of the front end of the shielding portion is 22-24 mm, a trapezoidal open slot used for yielding for a meniscus is arranged in the front end of the protection tool body in a manner that the front end is deviated from the central axis of the protection tool body, the trapezoidal open slot extends backwards along the arc of the shielding portion, the depth of the trapezoidal open slot is 20-24 mm, the width of the slot of the trapezoidal open slot is 6-8 mm which is an opening big end, the included angle between oblique edges of two sides of the trapezoidal open slot is 10 degrees, the trapezoidal open slot divides the shielding portion into a femoral isolation portion and a tibial isolation portion, and the width of the femoral isolation portion is 9-12 mm, the width of the tibial isolation part is one half of that of the femoral isolation part.
Furthermore, the shielding part is in a shape that the front end and the wide tail end are gradually reduced, the tail end of the shielding part is connected with the front end of the handle, and the included angle between the inclined edges at the two sides of the shielding part is 10 degrees.
Further, the length of the handle is 200-210 mm, and the width gradually increases from the front end to the rear end and is used for holding.
Furthermore, a hanging hole is formed in the rear end of the handle.
Furthermore, two corners of the outer side of the front end of the shielding part are arc chamfers, and two sides of a notch of the trapezoid opening groove of the shielding part are arc chamfers.
Furthermore, the thickness of the protection tool body is 1-2 mm.
Adopt above-mentioned technical scheme: including being rectangular shape and truncation and personally submitting the protection instrument body of flat shape, the rear end of protection instrument body is extended to stretch and is formed the handle, and the front end of protection instrument body is the arc bending formation that the radian is 2 pi/9 and is used for sheltering from the shielding part of inboard collateral branch ligament, and this shielding part can insert the clearance that inboard meniscus, joint capsule and inboard collateral branch ligament formed, and because the shielding part is the arc bending, then can laminate inboard collateral branch ligament behind the shielding part insertion clearance, makes inboard collateral branch ligament can be separated and keep off in the arc inboard of shielding part. The total width of front end of occlusion part is 22~24mm, the front end sets up one and is used for the trapezoidal open slot that steps down for the meniscus partially in protection instrument body axis, this trapezoidal open slot extends backward along the occlusion part arc, the groove depth of trapezoidal open slot is 20~24mm, the wide 6~8mm of notch of trapezoidal open slot is the opening main aspects, contained angle between the hypotenuse of trapezoidal open slot both sides is 10, the width of trapezoidal open slot reduces gradually, can match the width of the inboard meniscus of different grade type and the junction of inboard collateral branch ligament, the contact department that makes inboard meniscus and inboard collateral ligament can block in trapezoidal open slot. The shielding part is a femur shielding part and a tibia shielding part by the trapezoidal open slot, the width of the femur shielding part is 9-12 mm, the width of the tibia shielding part is one half of the femur shielding part, the femur shielding part is used for being inserted into a gap between a femur condyle and an inner collateral ligament, the tibia shielding part is used for being inserted into a gap between a tibial platform and the inner collateral ligament, the contact area between the shielding part and the deep layer of the inner collateral ligament can be increased, at the moment, the inner collateral ligament is positioned on the arc-shaped inner side of the shielding part and is attached in the concave surface of the arc-shaped shielding part, then, the deep layer of the inner collateral ligament can be pulled away from a bone joint surface by applying force through the handle, so that the contact part of the inner collateral ligament and the inner meniscus is separated, the upper and lower edges of the contact part of the inner collateral ligament and the inner collateral ligament are fully exposed, therefore, an operator can cut the inner collateral ligament without damaging the inner collateral ligament, is convenient for operation, plays a role in protecting the medial collateral ligament, shortens the operation time and reduces postoperative complications.
The shielding part is in a shape that the front end and the wide tail end are gradually reduced, the tail end of the shielding part is connected with the front end of the handle, the included angle between the two side bevel edges of the shielding part is 10 degrees, namely the width of the front end and the rear end of the femoral isolation part is kept consistent, and the width of the front end and the rear end of the tibial isolation part is kept consistent, so that the rear ends of the two isolation parts can be smoothly inserted along the insertion path of the front end, and whether the femoral isolation part and the tibial isolation part of the shielding part are inserted in place or not can be conveniently observed.
The length of handle is 200~210mm, and the width is used for gripping from the front end rear end crescent, can reduce the sheltering from of handle to the operation field of vision, and the application of force is held when making things convenient for the doctor to perform the operation again.
Two angles outside the front end of the shielding part are arc chamfers, two sides of a notch of the trapezoid opening groove of the shielding part are arc chamfers, and ligament or muscle tissues are prevented from being scratched due to the fact that the front end of the shielding part and the trapezoid opening groove are too sharp when the shielding part is inserted.
The thickness of protection instrument body is 1~2mm, guarantees that shielding portion can insert in the narrow and small clearance that forms between inboard meniscus, joint capsule and the MCL deep layer.
The invention is further described with reference to the drawings and the specific embodiments.
Drawings
Fig. 1 is a schematic structural view of the present invention;
FIG. 2 is a schematic view of FIG. 1 taken along line A;
fig. 3 is a schematic view of fig. 2 in the direction B.
Detailed Description
Referring to fig. 1 to 3, a medial collateral ligament protection instrument during knee joint replacement meniscus excision, is including being rectangular shape and truncation personally submitting the protection instrument body of flat shape, the thickness of protection instrument body is 1~2mm, and the protection instrument body of this embodiment adopts 1mm thickness for the best, guarantees that shielding part 2 can insert smoothly in the narrow and small clearance that forms between the deep layer of medial meniscus, joint capsule and medial collateral ligament. The rear end of protection instrument body is straightened and is extended formation handle 1, the length of handle 1 is 200~210mm, and the width is used for gripping from the front end rear end crescent, can reduce sheltering from of handle 1 to the operation field of vision, makes things convenient for the doctor to grip the application of force when performing the operation again, and 1 length of handle of this embodiment adopts 200mm to be the best, can be applicable to most doctor's palm width, the rear end of handle 1 is equipped with hanging hole 6. The front end of protection tool body is that the arc bending that the radian is 2 pi/9 forms the shielding part 2 that is used for sheltering from the inboard collateral ligament, this shielding part 2 is used for inserting inboard meniscus, the clearance that joint capsule and inboard collateral ligament formed, and because shielding part 2 is the arc bending, then can laminate the inboard collateral ligament after the shielding part inserts the clearance, make inboard collateral ligament can be separated and keep off in the arc of shielding part inboard, then inboard collateral ligament laminates in the concave surface of shielding part 2, make things convenient for the application of force to pull inboard collateral ligament from inboard meniscus. The total width of the front end of the shielding part 2 is 22-24 mm, a trapezoidal open slot 3 used for yielding meniscus is arranged at the front end, which is deviated from the central axis of the protection tool body, the trapezoidal open slot 3 extends backwards along the arc of the shielding part 2, the slot depth of the trapezoidal open slot 3 is 20-24 mm, the slot depth of the trapezoidal open slot 3 in the embodiment adopts 22mm as the best, the slot width of the trapezoidal open slot 3 is 6-8 mm as the opening big end, the slot style of the trapezoidal open slot 3 in the embodiment adopts 8mm as the best, the included angle between the inclined sides at two sides of the trapezoidal open slot 3 is 10 degrees, so that the slot width of the trapezoidal open slot 3 is larger than the width of the slot bottom, the slot width and the slot depth of the trapezoidal open slot 3 are designed according to the dead point of the deep layer of the medial collateral ligament at the medial condyle of the femur, the dead point position of the medial condyle of the tibia and the thickness of the contact part of the medial meniscus, and can be adapted to the shape of the medial meniscus with the narrow front end and wide back end when being inserted, the contact position of the inner side meniscus and the inner side collateral ligament can be clamped in the trapezoidal open slot 3, the width of the trapezoidal open slot 3 is gradually reduced, and the width of the connection position of the inner side meniscus and the inner side collateral ligament in different types can be matched. Two angles in the outside of the front end of the shielding part 2 are arc chamfers, and two sides of the notch of the trapezoid opening groove 3 of the shielding part 2 are arc chamfers, so that ligaments or muscle tissues are prevented from being scratched too sharply due to the front end of the shielding part 2 and the trapezoid opening groove 3 when the shielding part is inserted. Trapezoidal open slot 3 divide into thighbone isolation 4, shin bone isolation 5 with occlusion part 2, the width of thighbone isolation 4 is 9~12mm, and thighbone isolation 4's width adopts 10mm to be the best in this embodiment, the width of shin bone isolation 5 is the half of thighbone isolation 4, and this thighbone isolation 4 is arranged in inserting the clearance of thighbone condyle and inboard collateral ligament, and shin bone isolation 5 is arranged in inserting the clearance of tibial plateau and inboard collateral ligament, because the area of contact of thighbone and inboard collateral ligament is greater than the area of contact of shin bone and inboard collateral ligament, consequently the width that sets up thighbone isolation 4 is greater than the width of shin bone isolation 5, can increase the area of contact of occlusion part 2 and the deep layer of inboard collateral ligament, can pull away the inboard collateral ligament from the contact department of inboard meniscus during the assurance operation.
This protection tool not only limits to above-mentioned embodiment, shielding portion 2 can also be the shape that the wide tail end of front end reduces gradually, shielding portion 2's tail end links to each other with handle 1 front end, the contained angle between 2 both sides hypotenuses of shielding portion is 10, the width of 4 front ends of thighbone isolation portion and rear end keeps unanimous promptly, and the width of 5 front ends of shin bone isolation portion and rear end keeps unanimous, make the rear end of two isolation portions insert smoothly along with the insertion path of front end, be convenient for observe simultaneously that thighbone isolation portion 4 and shin bone isolation portion 5 insert to target in place.
Fig. 1-3 show the protection tool for right knee surgery, but the femoral and tibial spacer positions of the protection tool for left knee are reversed from the present embodiment. In this embodiment, taking a protection tool for a right knee as an example, when the protection tool is used, a knee joint of a patient is firstly bent by 90 degrees, a joint cavity is cleaned, redundant osteophytes are cut off, and gaps between a medial meniscus and a medial collateral ligament, a femur and a tibia are exposed; then, a handle 1 of the protection tool is held by hand, the arc-shaped concave surface of the shielding part 2 faces to the inner collateral ligament, the femoral isolation part 4 is inserted into the gap between the inner collateral ligament and the femoral condyle, meanwhile, the tibial isolation part 5 is inserted into the gap between the inner collateral ligament and the tibial plateau, the contact position of the inner meniscus and the inner collateral ligament is clamped in the trapezoidal open slot 3, then, the shielding part 2 is continuously inserted until the contact position of the inner meniscus and the inner collateral ligament is completely clamped in the trapezoidal open slot 3, and the inner collateral ligament is shielded at the arc-shaped inner side of the shielding part 2 and is attached to the concave surface of the arc-shaped shielding part 2; then can pull the deep layer of medial collateral ligament away from the bone articular surface through 1 application of force of handle, make the contact department separation of medial collateral ligament and inboard meniscus from this to fully expose the upper and lower edge of inboard meniscus and medial collateral ligament contact department, the operation doctor cuts inboard meniscus along trapezoidal open slot 3, accomplishes the excision of inboard meniscus back, takes out this protection instrument can.
To sum up, this protection instrument designs shielding plate 2 according to the clearance size and the meniscus thickness that inboard meniscus, joint capsule and the deep formation of inboard collateral ligament, can solve the problem that ordinary drag hook can not go deep into the clearance, and shielding plate 2 and the deep area of contact of inboard collateral ligament are big, the laminating degree is high, can guarantee to obtain fully exposing the lower limb of meniscus and the deep contact department of inboard collateral ligament, can separate the inboard collateral ligament again and keep off in trapezoidal open slot 3 outsides. Therefore, the convenience of an operator for cutting off the medial meniscus can be greatly improved, the operation is convenient, the damage to the medial collateral ligament is avoided, the effect of protecting the medial collateral ligament is achieved, and the postoperative complications are reduced; the protective tool has the advantages of simple structure, easy manufacture, safe and reliable use, and convenience for large-scale popularization and application.
Claims (6)
1. A medial collateral ligament protection instrument during knee replacement operation meniscectomy, its characterized in that: comprises a protection tool body which is in a long strip shape and is truncated to be in a flat shape, the rear end of the protection tool body is extended to form a handle (1), the front end of the protection tool body is a shielding part (2) which is formed by arc bending with radian of 2 pi/9 and is used for shielding medial collateral ligament, the total width of the front end of the shielding part (2) is 22-24 mm, the front end is deviated from the central axis of the protection tool body and is provided with a trapezoidal open slot (3) used for abdicating meniscus, the trapezoidal open slot (3) extends backwards along the arc of the shielding part (2), the depth of the trapezoidal open slot (3) is 20-24 mm, the width of the slot of the trapezoidal open slot (3) is 6-8 mm which is an opening big end, the included angle between the two side bevel edges of the trapezoidal open slot (3) is 10 degrees, the trapezoidal open slot (3) divides the shielding part (2) into a femur isolating part (4) and a tibia isolating part (5), the width of thighbone isolation portion (4) is 9~12mm, the width of shin bone isolation portion (5) is half of thighbone isolation portion (4).
2. The knee replacement meniscectomy medial collateral ligament protection tool of claim 1, wherein: the shielding part (2) is in a shape that the front end and the wide tail end are gradually reduced, the tail end of the shielding part is connected with the front end of the handle (1), and the included angle between the inclined edges at two sides of the shielding part (2) is 10 degrees.
3. The knee replacement meniscectomy medial collateral ligament protection tool of claim 1, wherein: the length of the handle (1) is 200-210 mm, and the width of the handle is gradually increased from the front end to the rear end and is used for holding.
4. The knee replacement meniscectomy medial collateral ligament protection tool of claim 3, wherein: the rear end of the handle (1) is provided with a hanging hole (6).
5. The knee replacement meniscectomy medial collateral ligament protection tool of claim 1, wherein: two corners of the outer side of the front end of the shielding part (2) are arc chamfers, and two sides of a notch of the trapezoidal open slot (3) of the shielding part (2) are arc chamfers.
6. The knee replacement meniscectomy medial collateral ligament protection tool of claim 1, wherein: the thickness of the protection tool body is 1-2 mm.
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| Application Number | Priority Date | Filing Date | Title |
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| CN202121473731.XU CN215079087U (en) | 2021-06-30 | 2021-06-30 | Medial collateral ligament protection tool used in meniscectomy in knee replacement |
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| CN202121473731.XU CN215079087U (en) | 2021-06-30 | 2021-06-30 | Medial collateral ligament protection tool used in meniscectomy in knee replacement |
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Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN114366200A (en) * | 2022-01-28 | 2022-04-19 | 中国人民解放军陆军军医大学第二附属医院 | Femoral neck osteotomy baffle in hip arthroplasty |
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2021
- 2021-06-30 CN CN202121473731.XU patent/CN215079087U/en active Active
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN114366200A (en) * | 2022-01-28 | 2022-04-19 | 中国人民解放军陆军军医大学第二附属医院 | Femoral neck osteotomy baffle in hip arthroplasty |
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