CN218009915U - A internal fixation device that is used for total knee joint replacement postoperative Rorabeck II type fracture treatment - Google Patents
A internal fixation device that is used for total knee joint replacement postoperative Rorabeck II type fracture treatment Download PDFInfo
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- CN218009915U CN218009915U CN202221399935.8U CN202221399935U CN218009915U CN 218009915 U CN218009915 U CN 218009915U CN 202221399935 U CN202221399935 U CN 202221399935U CN 218009915 U CN218009915 U CN 218009915U
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- fracture
- rorabeck
- fixation device
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- internal fixation
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- 206010017076 Fracture Diseases 0.000 title claims abstract description 72
- 208000010392 Bone Fractures Diseases 0.000 title claims abstract description 71
- 210000000629 knee joint Anatomy 0.000 title abstract description 17
- 230000002980 postoperative effect Effects 0.000 title abstract description 6
- 210000000988 bone and bone Anatomy 0.000 claims abstract description 25
- 238000013150 knee replacement Methods 0.000 claims description 14
- 239000011248 coating agent Substances 0.000 claims description 11
- 238000000576 coating method Methods 0.000 claims description 11
- 239000011148 porous material Substances 0.000 claims description 6
- 238000011883 total knee arthroplasty Methods 0.000 claims description 3
- 230000007423 decrease Effects 0.000 claims 1
- 230000035876 healing Effects 0.000 abstract description 6
- 238000013461 design Methods 0.000 abstract description 4
- 238000009434 installation Methods 0.000 abstract description 4
- 206010058031 Joint adhesion Diseases 0.000 abstract description 3
- 208000035965 Postoperative Complications Diseases 0.000 abstract description 3
- 208000027418 Wounds and injury Diseases 0.000 abstract description 3
- 230000036770 blood supply Effects 0.000 abstract description 3
- 210000004872 soft tissue Anatomy 0.000 abstract description 3
- 230000009977 dual effect Effects 0.000 abstract 1
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- 230000000694 effects Effects 0.000 description 5
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- 210000003127 knee Anatomy 0.000 description 5
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- 210000000689 upper leg Anatomy 0.000 description 4
- 208000001132 Osteoporosis Diseases 0.000 description 3
- 230000006378 damage Effects 0.000 description 3
- 239000003814 drug Substances 0.000 description 3
- 238000000034 method Methods 0.000 description 3
- 210000001694 thigh bone Anatomy 0.000 description 3
- 206010016454 Femur fracture Diseases 0.000 description 2
- 238000013459 approach Methods 0.000 description 2
- 230000003247 decreasing effect Effects 0.000 description 2
- 238000006073 displacement reaction Methods 0.000 description 2
- 210000003205 muscle Anatomy 0.000 description 2
- 201000008482 osteoarthritis Diseases 0.000 description 2
- 238000001356 surgical procedure Methods 0.000 description 2
- 208000003947 Knee Osteoarthritis Diseases 0.000 description 1
- 208000037099 Prosthesis Failure Diseases 0.000 description 1
- 208000007536 Thrombosis Diseases 0.000 description 1
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- 230000007774 longterm Effects 0.000 description 1
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- 210000003314 quadriceps muscle Anatomy 0.000 description 1
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- 206010043827 tibia fracture Diseases 0.000 description 1
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Abstract
The utility model discloses an internal fixation device that is used for total knee joint replacement postoperative Rorabeck II type fracture treatment, it contains: the main nail is provided with a plurality of first through holes at intervals at the near end, and the first through holes are matched with the bone screws to play a role in fixing; the far end of the main nail is provided with a spindle structure, a plurality of second through holes are arranged on the spindle structure in a crossed mode, and the second through holes are matched with the bone screws to achieve the function of cross fixing. The internal fixing device of the utility model effectively increases the anti-rotation capability and improves the fracture healing capability through the dual fixing design of the intramedullary oversleeve and the far and near end bone screws; the sleeve and spindle structure is adopted to realize that no extra skin incision is added, the operation is simple and easy to expose, the large-range soft tissue stripping is not needed, the operation wound is reduced, and the blood supply at the fracture end is protected; and the knee joint cavity does not need to be exposed during installation and use, thereby avoiding invasive operation in the joint and reducing postoperative complications such as knee joint adhesion stiffness and the like.
Description
Technical Field
The utility model belongs to the field of medical equipment, concretely relates to internal fixation device that is used for total knee replacement postoperative Rorabeck II type fracture treatment.
Background
As the population ages, the incidence of degenerative diseases of the bone joints is also increasing, with the number of elderly suffering from knee osteoarthritis being particularly high. Total Knee Arthroplasty (TKA) has been shown to be an effective treatment for end stage osteoarthritis of the elderly knee. When the total knee joint replacement operation is received, the patient can relieve pain and improve the joint mobility, and finally the life quality is improved. Although the surgical technique is mature, the condition that the fracture around the knee joint of the patient occurs after the patient receives total knee joint replacement is common due to the objective condition that the old patient has osteoporosis and poor bone quality. Once a fracture around the knee prosthesis occurs, it is a great damage to the patient himself and the knee function.
The fracture around the prosthesis after total knee replacement is classified according to the fracture occurrence parts, including distal femur fracture, proximal tibia fracture and patellar fracture, wherein the distal femur fracture is the most common, and the incidence rate is about 0.3-5.5%. The fracture around the distal femoral prosthesis can be divided into three types according to the stability of the prosthesis and the quality of the femoral bone of a patient, and the Rorabeck I-type fracture is a displacement-free fracture (displacement of the fracture end) with stable prosthesis (no prosthesis loosening) and good bone mass; the Rorabeck II type fracture is a displacement fracture with or without good bone mass, and the prosthesis is stable; a Rorabeck type III fracture is a loosening or destruction of the prosthesis, regardless of whether the fracture piece has displaced. The type II of the medicine is the most common clinical medicine. The treatment principles of the fracture around the type I and type III distal femoral prostheses basically reach a consensus, the type I fracture is mainly treated conservatively, the type III fracture needs the revision of the whole knee joint, and the treatment of only the type II fracture still has a larger controversy at present.
At present, the main clinical treatment method for the peripheral fracture of the Rorabeck II type distal femoral prosthesis mainly comprises a locking steel plate and a retrograde intramedullary nail, and the fracture healing rate after the treatment by adopting the locking steel plate and the retrograde intramedullary nail is respectively 87 percent and 84 percent and the complication rate is respectively 35 percent and 53 percent, which are not ideal in curative effect. Moreover, the efficacy of the locking plate is limited by the surgical approach, such as the difficulty in resolving the medial condyle fracture with the lateral locking plate. There are also studies that suggest that the locking plate is too firmly fixed, resulting in reduced micromotion between fractures, thereby increasing the risk of non-union of the fracture. In addition, current retrograde intramedullary nail systems have limitations including susceptibility to prosthesis type limitations (e.g., the intercondylar box of posterior stabilized knee prostheses is closed or small and a retrograde intramedullary nail cannot be inserted), poor distal fracture fixation, or severe osteoporosis.
SUMMERY OF THE UTILITY MODEL
The utility model aims at solving the effective treatment problem of the fracture of the Rorabeck II type, providing an internal fixation device, improving the clinical curative effect of the fracture around the distal prosthesis of the Rorabeck II type thighbone.
In order to achieve the above object, the utility model provides an internal fixation device for total knee replacement postoperative Rorabeck II type fracture treatment, it contains: the proximal end of the main nail is provided with a plurality of first through holes at intervals, and the first through holes are matched with the bone screws to play a role in fixing; the far end of the main nail is provided with a spindle structure, a plurality of second through holes are arranged on the spindle structure in a crossed mode, and the second through holes are matched with the bone screws to achieve the function of cross fixing.
Optionally, the fixing device is further provided with a sleeve, which is sleeved on the main nail and located between the first through hole and the spindle structure, and the inner diameter of the sleeve is matched with the outer diameter of the main nail to prevent the main nail from moving or rotating radially.
Optionally, the sleeve is frusto-conical, the outer diameter of the sleeve decreasing progressively from the distal end of the staple to the proximal end thereof.
Optionally, the outer surface of the sleeve is provided with a coating with a porous structure, and the pore size is 100-200 μm.
Optionally, the coating has pores interconnected with each other, and has a porosity of 55-65%.
Optionally, the coating has a thickness of 0.8mm to 1.2mm.
Optionally, the distal end of the spindle structure is flat.
Optionally, the spindle structure is provided with at least 2 second through holes.
Optionally, the spindle structure is provided with 4 second through holes, and the second through holes intersect with each other two by two.
Optionally, the proximal end of the main nail is provided with 2 second through holes.
The utility model has the advantages that:
1) The intramedullary is internally provided with the oversleeve and the double fixing design of the far-end and near-end bone screws, so that the anti-rotation capacity is effectively increased, and the fracture healing capacity is improved;
2) The original operation incision can be utilized, the skin incision is not additionally increased, the pain of a patient can be effectively reduced, and the visual effect after recovery is more beautiful;
3) The operation is simple and easy to expose, the large-scale soft tissue stripping is not needed, the operation wound is reduced, and the blood supply at the fracture end is protected;
4) The knee joint cavity does not need to be exposed, invasive operation in the joint is avoided, and postoperative complications such as knee joint adhesion stiffness are reduced.
Drawings
Fig. 1 is a schematic structural view of the internal fixation device for treating Rorabeck type II fracture after total knee joint replacement operation of the present invention.
Detailed Description
The technical solution of the present invention will be described clearly and completely with reference to the accompanying drawings, and obviously, the described embodiments are some, but not all embodiments of the present invention. Based on the embodiments in the present invention, all other embodiments obtained by a person skilled in the art without creative work belong to the protection scope of the present invention.
In the description of the present invention, it should be noted that the terms "upper", "lower", "left", "right", "vertical", "horizontal", "inner", "outer", and the like indicate orientations or positional relationships based on the orientations or positional relationships shown in the drawings, and are only for convenience of description and simplification of description, but do not indicate or imply that the device or element referred to must have a specific orientation, be constructed and operated in a specific orientation, and thus, should not be construed as limiting 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 present invention, it should be noted that, in medicine, the far-near end is defined as the side relatively close to the heart as the near end, and the side far from the heart, i.e., closer to the extremity, as the far end. All relevant descriptions herein are to be read in this light. The fracture far end is the fracture broken end at the side where the fracture line is far and is closer to the extremity of the limb, the far end of the internal fixing device is the side close to the extremity of the limb, and the directions of the two are consistent.
In the description of the present invention, it is to be noted that, unless otherwise explicitly specified or limited, the terms "mounted," "connected," and "connected" are to be construed broadly, and may be, for example, fixedly connected, detachably connected, or integrally connected; may be a mechanical connection; they may be connected directly or indirectly through intervening media, or they may be interconnected between two elements. The specific meaning of the above terms in the present invention can be understood in specific cases to those skilled in the art. For the Rorabeck type II fracture, the femoral prosthesis is stable with the fracture line at the proximal end of the prosthesis, so that the distal end of the fracture still retains a certain amount of bone mass. For the treatment of the Rorabeck II fracture after total knee joint replacement, the healing rate of the methods of locking the steel plate and retrograde intramedullary nail is generally not ideal, and the complication rate is high. The efficacy of the locking steel plate is limited by the surgical approach and the like, and the retrograde intramedullary nail is limited by the prosthesis type and the like.
The utility model discloses hope to use former operation incision as far as possible, not additionally increase the skin incision, designed on the basis of retrograde intramedullary nail structure the utility model discloses a fixing device, the pain of hindering that can the minimize patient. The whole structure is designed mainly for mounting and fixing the fractured end, the fractured end can be exposed through the middle cut of the knee in the original knee joint replacement operation, and then mounting and fixing are carried out, and the installation can be carried out without additionally arranging a cut on the inner side or the outer side of the thigh like a steel plate. The ordinary intramedullary nail of the advantage of this aspect of incision also has, but ordinary intramedullary nail need follow the articular cavity and put into, and the utility model discloses need not open the articular cavity, directly put into from the fracture end, can avoid postoperative complications such as knee joint adhesion rigidity.
As shown in fig. 1, the utility model discloses an internal fixation device for treatment of Rorabeck II type fracture after total knee replacement surgery contains: the main nail 10, the proximal end of the main nail 10 is provided with a plurality of first through holes 11 at intervals, and the first through holes 11 are matched with the bone screws 2 to fix the proximal femur of the fracture line; the distal end of the main nail 10 is provided with a spindle structure 12. The spindle-shaped structure of the spindle structure 12 is designed based on the observation of the fracture end shape of the femoral side of the fracture around the knee joint prosthesis by the inventor and years of clinical practice experiments, on one hand, the maximum contact between the spindle-shaped structure and the distal residual bone can be realized, and the fixing effect is improved, on the other hand, the spindle-shaped structure is beneficial to the mounting operation in the operation, and the blocking of the femoral prosthesis can be avoided as much as possible during the mounting. The spindle structure 12 is further provided with a plurality of second through holes 13 in a crossed manner, the second through holes 13 are matched with the bone screws 2 to form crossed fixation on the distal ends of the thighbones, the difference of residual bone mass inside and outside the distal ends of the thighbones of different patients is mainly considered, operation is convenient, and the fixation effect is improved.
In some embodiments, the fixing device further comprises a sleeve 14, which is sleeved on the main nail 10 and located between the first through hole 11 and the spindle structure 12. On the premise of not increasing the difficulty of surgical exposure, the intramedullary sleeve 14 can realize the radial stability of the main nail 10, and the main nail 10 is prevented from moving or rotating in the radial direction. The inner diameter of the sleeve 14 is identical to the outer diameter of the main nail 10, and the main nail 10 is inserted into the sleeve 14, and the position of the main nail 10 in the femoral medullary cavity can be ensured by using the height fit of the shape and the size of the sleeve 14 and the main nail. Meanwhile, the old people are considered to have abnormal shapes of femoral medullary cavities caused by osteoporosis, such as expansion, the sleeve is placed to play a certain shrinkage effect, otherwise, the main nail can swing in the expanded medullary cavity and cannot be well clamped with the cortex of the bone.
Since the distal medullary cavity of the femur is shaped like a trumpet, with a narrow proximal end and a wide distal end, in order to increase the fit between the sleeve and the distal medullary cavity of the femur, in some embodiments, the sleeve 14 is frusto-conical, with the outer diameter of the sleeve 14 decreasing from the distal end of the nail 10 to the proximal end thereof.
In some embodiments, the outer surface of the sleeve 14 is provided with a porous coating (not shown), and the pore size is 100-200 μm. The aim of the coating in designing the porous structure is to increase the friction coefficient with the bone and improve the initial stability on one hand, and on the other hand, the coating is expected to grow into the porous structure so as to realize biological fixation and increase the long-term stability.
In some embodiments, the coating has pores that are interconnected, and has a porosity of 55-65%, in this case 60%.
In some embodiments, the coating has a thickness of 0.8mm to 1.2mm, in this case 1mm.
In some embodiments, the distal end of the spindle structure 12 is flat. The tip of the distal end of the spindle structure is shaved off so that the end is flattened, i.e., "flat" as described herein. This pure flat structural design is based on femoral prosthesis's influence, and the distal end is flat a bit (pure flat), cuts the tip and just can put into the bone more in comparatively thick part in the middle of the back spindle structure, increases the contact with the bone, improves stability.
In some embodiments, the spindle structure 12 is provided with at least 2 second through holes 13.
In some embodiments, the spindle structure 12 is provided with 4 second through holes 13, which intersect each other two by two.
In some embodiments, 2 second through holes 13 are provided at the proximal end of the main nail 10.
The utility model provides an installation application method that is used for total knee replacement postoperative Rorabeck II type fracture treatment's internal fixation device as follows:
1. the incision of the original knee joint replacement operation is extended to the near end by 1-10 cm, no additional incision is added, and the wound of a patient is reduced;
2. separating subcutaneous tissues, entering into gaps between rectus femoris and medial femoral muscles, and splitting femoral intermediate muscles to expose fracture broken ends;
3. after blood clots at the fracture end are cleared, the fracture proximal end is lifted upwards to expose the fracture proximal end, a taper drill is used for polishing a femoral medullary cavity at the fracture proximal end, and the sleeve 14 is implanted;
4. the femoral part at the far end of the fracture is opened by a rough electric drill, the diameter of the opening is consistent with that of the spindle structure 12 of the main nail, and after the main nail is placed in the sleeve 14, the fracture is reset, so that the spindle structure 12 is inserted into the opening at the far end;
5. after adjusting the two ends of the fracture to rotate and align, four fixed bone screws at the spindle part at the far end are arranged;
6. and (4) checking the alignment condition of the fracture end in a perspective way, after the alignment is confirmed to be good, properly pressurizing the fracture end, and placing two bone screws at the near end of the main nail until the installation is finished.
In summary, the internal fixation device of the utility model not only has the natural advantages of intramedullary nail, such as less soft tissue stripping, less blood supply damage around fracture, and is helpful for fracture healing; moreover, the sleeve and spindle structure designed by the utility model can be installed at the fracture end without cutting the joint cavity, which is very convenient and can avoid complications such as rigid hanging adhesion caused by opening the joint; and the design of the first through hole at the near end of the main nail and the second through hole on the spindle structure is combined, and the bone screw is matched, so that the anti-rotation performance can be effectively improved, and the fracture healing capability can be improved.
While the invention has been described in detail with reference to the preferred embodiments thereof, it should be understood that the above description should not be taken as limiting the invention. Numerous modifications and alterations to the present invention will become apparent to those skilled in the art upon reading the foregoing description. Accordingly, the scope of the invention should be limited only by the attached claims.
Claims (10)
1. An internal fixation device for treatment of a Rorabeck type II fracture after total knee arthroplasty, the fixation device comprising: the proximal end of the main nail is provided with a plurality of first through holes at intervals, and the first through holes are matched with the bone screws to play a role in fixing; the far end of the main nail is provided with a spindle structure, a plurality of second through holes are arranged on the spindle structure in a crossed mode, and the second through holes are matched with the bone screws to achieve the function of cross fixing.
2. The internal fixation device for use in the treatment of a post-total knee replacement Rorabeck type II fracture according to claim 1, further comprising a sleeve fitted over said main nail between said first through hole and said spindle structure, wherein said sleeve has an inner diameter matching an outer diameter of said main nail.
3. The internal fixation device for post-total knee replacement Rorabeck type II fracture treatment of claim 2, wherein the cuff has a frusto-conical shape with an outer diameter that decreases from the distal end of the staple to the proximal end of the staple.
4. The internal fixation device for treatment of a Rorabeck type II fracture after total knee replacement as claimed in claim 2, wherein the outer surface of the cuff is provided with a coating having a porous structure with a pore size of 100-200 μm.
5. The internal fixation device for use in the treatment of a Rorabeck type II fracture after total knee replacement according to claim 4, wherein said coating has pores communicating with each other and has a porosity of 55-65%.
6. The internal fixation device for use in the treatment of a post-total knee replacement Rorabeck type II fracture according to claim 4, wherein the coating has a thickness of 0.8mm to 1.2mm.
7. The internal fixation device for use in treatment of a Rorabeck type II fracture after total knee replacement as recited in claim 1, wherein the distal end of said spindle structure is flat.
8. The internal fixation device for use in treatment of a Rorabeck type II fracture after total knee replacement as recited in claim 1, wherein said spindle structure is provided with at least 2 second through holes.
9. The internal fixation device for use in treatment of a Rorabeck type II fracture after total knee replacement as recited in claim 1, wherein said spindle structure is provided with 4 second through holes, crossing each other.
10. The internal fixation device for post-total knee replacement Rorabeck type II fracture treatment according to claim 1, wherein 2 second through holes are provided at the proximal end of the main nail.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202221399935.8U CN218009915U (en) | 2022-06-06 | 2022-06-06 | A internal fixation device that is used for total knee joint replacement postoperative Rorabeck II type fracture treatment |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202221399935.8U CN218009915U (en) | 2022-06-06 | 2022-06-06 | A internal fixation device that is used for total knee joint replacement postoperative Rorabeck II type fracture treatment |
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| Publication Number | Publication Date |
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| CN218009915U true CN218009915U (en) | 2022-12-13 |
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| CN202221399935.8U Expired - Fee Related CN218009915U (en) | 2022-06-06 | 2022-06-06 | A internal fixation device that is used for total knee joint replacement postoperative Rorabeck II type fracture treatment |
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| CN (1) | CN218009915U (en) |
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- 2022-06-06 CN CN202221399935.8U patent/CN218009915U/en not_active Expired - Fee Related
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Granted publication date: 20221213 |