JP2010179033A - Apparatus and method of measuring tension for artificial joint replacement - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an apparatus of measuring tension for artificial joint replacement which enables easier and accurate determination of a tensile force attributed to a soft tissue between bones of a joint site and the interosseous distance, and easier quick determination of the relationship between the tensile force and the interosseous distance without variations due to operators. <P>SOLUTION: An interosseous distance detection means detects the interosseous distance altered by an interosseous distance alteration means 11. An interosseous tensile force detection means detects a tensile force caused by the soft issue between bones as a result of the alteration of the interosseous distance. A memory means 48 stores distance data as values of the interosseous distance and tensile force data as values of the tensile force corresponding to a detection timing. A display control means 50 makes a control so that the distance data and the tensile force data are shown on a display 14 based on the contents of memory in the memory means 48. <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

  The present invention relates to an artificial joint that is used in artificial joint replacement and measures the tension generated by soft tissue between the bones of the joint site to which the artificial hip joint is applied and the distance between the bones when the tension is generated. The present invention relates to a tension measuring device for replacement surgery, and a tension measuring method for artificial joint replacement surgery that is an operation method of the tension measuring device for artificial joint replacement.

  2. Description of the Related Art Conventionally, artificial joint replacement, which is an operation for replacing a joint with an artificial joint, is performed on a patient with an abnormality in the joint, such as a hip replacement. In such artificial joint replacement, the placement of the artificial joint is examined by using a trial member to examine the placement of the bone component of the appropriate size in the appropriate state when installing the bone component constituting the artificial joint. Work is done. In this work, the operator examines the arrangement of the artificial joint while the trial member arranged at the joint site to which the artificial joint is applied is replaced many times, and the soft tissue between the bones of the joint site is examined. Determination of the tension state and confirmation of dislocation are performed by (a connective tissue such as a fibrous tissue, a fat tissue, and a blood vessel excluding bone tissue). If an appropriately sized bone component is not selected and soft tissue tension is insufficient, the performance of the prosthesis is impaired and dislocation is likely to occur. On the other hand, when the tension of the soft tissue is excessive, problems such as early wear of the artificial joint, generation of pain, and limitation of the range of motion of the joint may occur. For this reason, in artificial joint replacement, it is important that the tension generated by the soft tissue between the bones of the joint site to which the artificial joint is applied is appropriately set. In artificial hip joint replacement, the above-described tension force and the distance between bones when this tension force is generated are often determined through examination by the operator as described above.

  However, as described above, when examining the tension and the distance between the bones while replacing the trial member many times, a lot of work time is required, which is desirable from the viewpoint of further minimizing the invasiveness. That's not true. In addition, since the surgeon evaluates the tension state of the soft tissue based on the feel by the operation of the hand, it is necessary for the surgeon to have experience in the field in order to know the accurate feel. For this reason, there is a problem that variations in evaluation by the operator are likely to increase, and inaccuracies associated therewith tend to be caused. On the other hand, in Patent Document 1, the tension generated by the soft tissue between the bones to which the artificial joint is applied (between the femur and the pelvis) and the distance between the bones when the tension is generated. As a tension measuring device for artificial joint replacement that can measure the above, a balancing device used in hip replacement is disclosed.

  The device disclosed in Patent Document 1 includes a frame provided with a first arm, and a second arm that can move relative to the first arm by a drive mechanism including a rack and a pinion. Each of the first arm and the second arm is provided with a fork-like portion, and these fork-like portions are inserted between a trial member that engages with the femur and a trial member that engages with the acetabulum of the pelvis. . Further, the device of Patent Document 1 includes a force applicator provided with a torque wrench that is connected to the frame and is operated by a handle operation by an operator. In the apparatus of Patent Document 1, the surgeon operates the force applicator with the fork-like portion inserted between the trial members as described above, and the second arm is relative to the first arm. By moving, the distance between the femur and the pelvis is changed, and the tension generated by the soft tissue is changed between the bones. Moreover, in the apparatus of patent document 1, it is comprised so that the distance between the changed bones can be grasped | ascertained by the distance indicator which consists of the scale provided in the flame | frame, and the parameter | index provided in the 2nd arm. And it is comprised so that the tension | tensile_strength which has arisen by the soft tissue between bones can be grasped | ascertained by the force indicator which consists of the scale board provided in the torque wrench and the pointer.

JP 2006-81905 A

  By using the device disclosed in Patent Document 1, the surgeon can determine the tension generated by the soft tissue between the bones of the hip joint to which the artificial hip joint is applied, and the distance between the bones when this tension is generated. Can be grasped quantitatively. For this reason, it can suppress that the inaccuracy accompanying the dispersion | variation in evaluation by an operator arises. However, it is necessary to read the scale provided on the frame in order to grasp the tension force caused by the soft tissue, and it is necessary to read the scale plate of the torque wrench to grasp the distance between the bones. For this reason, during the artificial joint replacement, a complicated operation of reading the above-described tension, the distance between the bones, and the fine scales is required. In addition, when the surgeon further operates the apparatus of Patent Document 1 to change the distance between the bones, the measurement results regarding the tension and the distance between the bones can be obtained sporadically at each measurement timing. become. For this reason, there is a problem that it is difficult for the surgeon to grasp the relationship between the tension and the distance between the bones during the operation. Note that it is possible to grasp the relationship between tension and the distance between bones while recording the measurement results at each measurement timing as needed, but in this case, a complicated and time-consuming recording operation is required. .

  In view of the above circumstances, the present invention can suppress the inaccuracy caused by the variation in evaluation by the operator, and the tension between soft tissue between the bones of the joint site and the distance between the bones. It is an object of the present invention to provide a tension measuring device for artificial joint replacement that can easily and accurately grasp the relationship between the tension force and the distance between the bones. And It is another object of the present invention to provide an artificial joint replacement tension measuring method which is an operation method of the artificial joint replacement tension measuring apparatus.

  The tension measuring device for artificial joint replacement according to the first invention for achieving the above object is used in artificial joint replacement, and the tension generated by the soft tissue between the bones of the joint site to which the artificial joint is applied The present invention relates to a tension measuring device for artificial joint replacement that measures the distance between bones when tension is generated. And the tension measuring device for artificial joint replacement according to the first aspect of the present invention is changed by the interosseous distance changing means, at least a part of which is arranged between the bones, and changing the distance between the bones, and the interosseous distance changing means. An inter-bone distance detecting means for detecting the distance between the bones, and an inter-bone tension force for detecting a tension force generated by the soft tissue between the bones by changing the distance between the bones by the inter-bone distance changing means. Detection means, distance data that is the value of the distance between the bones detected by the interosseous distance detection means, and tension data that is the value of the tensions detected by the interosseous tension detection means, And storage means for storing in correspondence with the detection timing, and display control means for controlling the distance data and the tension data to be displayed on a display based on the contents stored in the storage means. It is characterized by.

  According to the present invention, the distance between the bones of the joint site to which the artificial joint is applied is changed by the inter-bone distance changing means, and the distance between the bones and the tension force caused by the soft tissue between the bones are detected. The detected distance data and tension data are stored correspondingly at the detection timing and displayed on the display based on the stored contents. For this reason, the surgeon can quantitatively grasp the data on the tension force and the distance between the bones (tension force data and distance data) between the bones of the joint site, resulting in variations in evaluation by the operator. Incurring the accompanying inaccuracy will be suppressed. Then, the surgeon confirms the display on the display without requiring a complicated operation of reading a fine scale or the like about the tension force and the distance between the bones as in the case of using the device disclosed in Patent Document 1. It is possible to easily and accurately grasp the tension force caused by the soft tissue between the bones of the joint site and the distance between the bones. Also, when the surgeon operates the interosseous distance changing means to sequentially change the interosseous distance, the measurement results for the tension and interosseous distance are displayed automatically and continuously. Will be displayed. Therefore, the surgeon can easily and quickly grasp the relationship between the tension and the distance between the bones during the operation. Further, as in the case of using the apparatus disclosed in Patent Document 1, there is also a troublesome and time-consuming recording operation of grasping the relationship between the tension force and the distance between the bones while recording the measurement results at each measurement timing as needed. It becomes absolutely unnecessary.

  Therefore, according to the present invention, it is possible to suppress the inaccuracy caused by the variation in evaluation by the operator, and it is possible to easily reduce the tension force caused by the soft tissue between the bones of the joint site and the distance between the bones. It is possible to provide a tension measuring device for artificial joint replacement that can be accurately grasped and can easily and quickly grasp the relationship between the tension force and the distance between bones.

  The tension measuring device for artificial joint replacement according to the second invention is the tension measuring device for artificial joint replacement according to the first invention, wherein the display control means corresponds to one of the vertical axis and the horizontal axis corresponding to the distance data. The distance data and the tension data are displayed on the display as a two-dimensional graph in a state where the other of the vertical axis and the horizontal axis corresponds to the tension data corresponding to the distance data and the detection timing. It is characterized by controlling as follows.

  According to the present invention, the distance data corresponds to one of the vertical axis and the horizontal axis, and the tension data corresponding to the distance data is a two-dimensional graph corresponding to the other of the vertical axis and the horizontal axis. Data appears on the display. For this reason, the surgeon can easily and clearly grasp the state of the continuous change of the tension force due to the change in the distance between the bones, and more easily and accurately grasp the relationship between the distance between the bones and the tension force. can do.

  A tension measuring device for artificial joint replacement according to a third aspect of the present invention is the tension measuring device for artificial joint replacement according to the first or second aspect of the present invention, based on the signal input by operating the input means. The apparatus further includes determination data generating means for generating determination data for the operator to determine the state when the distance data and the tension data are detected, and the storage means stores the determination data and The distance data and the tension data are stored in correspondence with the determination data, and the display control means determines whether the distance data and the tension data are based on the contents stored in the storage means. Control is performed so that the data is displayed on the display in a state of being distinguished according to the data.

  According to the present invention, when the operator wants to check the data while changing and comparing the distance data and the tension data, the operator or other operator operates the input means. Thereby, determination data for the surgeon to determine the state when the distance data and the tension data are detected is generated and stored together with the distance data and the tension data. Then, the distance data and the tension data are displayed on the display in a state of being distinguished corresponding to the determination data. For this reason, the surgeon can easily and accurately grasp the effect of changing the state when detecting the distance data and the tension data by checking the display.

  A tension measuring device for artificial joint replacement according to a fourth aspect of the present invention is the tension measuring device for artificial joint replacement of the third aspect, wherein the determination data includes a bone and a bone facing each other at a joint site to which the artificial joint is applied. It is data for a surgeon to determine a bone posture state when the distance data and the tension data are detected in a bone posture state in a relative positional relationship.

  According to the present invention, when the surgeon wants to check the data while changing and comparing the posture state of the bone when the distance data and the tension data are detected, for example, when the joint is extended or bent When it is desired to check the data while changing to the changed state, the operator or the like operates the input means. Thereby, determination data for the surgeon to determine the state of the posture of the bone when the distance data and the tension data are detected is generated and stored together with the distance data and the tension data. Then, the distance data and the tension data are displayed on the display in a state of being distinguished corresponding to the state of the bone posture. For this reason, the surgeon checks the display to compare the effects of changing the posture of the bone when detecting distance data and tension data to an extended or bent joint. However, it can be grasped easily and accurately.

  The tension measuring device for artificial joint replacement according to the fifth invention is the strain measuring device for artificial joint replacement according to any one of the first to fourth inventions, wherein the interosseous distance changing means has a relative displacement with respect to each other. A pair of displacement members that are connected to each other and have distal end portions disposed between the bones, and the inter-bone distance detection means detects a relative position of the other member with respect to one member of the pair of displacement members. A relative position detection sensor; and an interosseous distance calculation unit that calculates a distance between bones based on a detection result of the relative position detection sensor, wherein the interosseous tension detection unit is connected to the pair of displacement members. Based on a detection result of the relative position maintaining mechanism that is provided and that can maintain the relative position, a load detection sensor that detects a load acting on the relative position maintenance mechanism from the pair of displacement members, and a detection result of the load detection sensor And interosseous tension calculating means for calculating a serial tension, and having a.

  According to this invention, the relative position of the other member with respect to one member of the pair of displacement members in the interosseous distance changing means is detected, and distance data is obtained by calculation based on the detection result. For this reason, distance data which is a value of a distance between bones can be easily detected by detecting a relative position in a pair of displacement members as a physical quantity correlated with distance data. The relative position is maintained by a relative position maintaining mechanism provided on the pair of displacement members, and a load acting on the relative position maintaining mechanism is detected from the pair of displacement members at this time, and an operation based on the detection result is performed. This will give you tension data. For this reason, by detecting the load acting on the relative position maintaining mechanism as a physical quantity that correlates with the tension data, the tension data that is the value of the tension can be easily detected.

  The tension measuring device for artificial joint replacement according to a sixth aspect of the present invention is the tension measuring device for artificial joint replacement of the fifth aspect, wherein the pair of displacement members is such that the other member swings with respect to one member. The relative position detection sensor is provided as a pair of lever members connected to each other in the middle so that relative displacement is possible, and the relative position detection sensor is a relative angle in the swing direction of the other member with respect to one member of the pair of lever members. Is detected as the relative position, and the relative position maintaining mechanism can maintain the relative angle.

  According to the present invention, the pair of displacement members are provided as a pair of lever members that are coupled and oscillated at midway portions, and the relative position is detected as the predetermined relative angle between the pair of lever members. Further, the relative position maintaining mechanism maintains the relative angle, and a load acting on the relative position maintaining mechanism is detected. For this reason, distance data and tension force data can be easily detected with a simple configuration using a pair of lever members that are swingably connected.

  A tension measuring device for artificial joint replacement according to a seventh aspect of the present invention is the tension measuring device for artificial joint replacement according to any one of the first to sixth aspects of the present invention, wherein the opposing bones and bones in the joint site to which the artificial joint is applied And a pair of members disposed so as to engage with each other, and attached to a trial member used in the placement of the artificial joint, and the interosseous distance changing means The adapter member is further provided, and a plurality of adapter members having different attachment angles with respect to the trial member are provided as the adapter member.

  According to the present invention, an adapter member that is attached to a trial member that is used in an operation for positioning an artificial joint that examines the arrangement of an appropriately sized bone component in an appropriate state when installing the bone component constituting the artificial joint. Is attached to the interosseous distance changing means. A plurality of adapter members having different attachment angles with respect to the trial member are provided. For this reason, the operator can collect distance data and tension data by simply replacing the adapter members having different attachment angles in the examination of the placement of the artificial joint. This makes it easier to examine the arrangement, shape, and size of bone components that appropriately correspond to the state of the joint site to which the artificial joint is applied during alignment.

  An artificial joint replacement tension measuring device according to an eighth aspect of the present invention is the artificial joint replacement tension measuring device according to the third aspect of the present invention, which is related to one of bones facing each other in a joint site to which the artificial joint is applied. An adapter member that is attached to a trial member that is disposed so as to be engaged with each other or that is engaged with each other and that is attached to a trial member that is used in the placement of the artificial joint, and that is attached to the interosseous distance changing means. A plurality of adapter members having different attachment angles with respect to the trial member are provided as the adapter member, and the determination data includes the attachment angle of the adapter member attached to the trial member among the plurality of adapter members. The surgeon determines the state of the attachment angle when the distance data and the tension data are detected. Characterized in that it is a data for constant.

  According to this invention, similarly to the seventh invention, the operator can collect distance data and tension data by simply replacing adapter members having different attachment angles with respect to the trial member when examining the positioning of the artificial joint. it can. This makes it easier to examine the arrangement, shape, and size of bone components that appropriately correspond to the state of the joint site to which the artificial joint is applied during alignment. And according to the present invention, when the surgeon wants to check the data while changing and comparing the mounting angle state of the adapter member when the distance data and the tension data are detected, the surgeon etc. inputs Operate the means. As a result, determination data for the operator to determine the state of the attachment angle of the adapter member when the distance data and the tension data are detected is generated and stored together with the distance data and the tension data. And distance data and tension data are displayed on a display in the state distinguished according to the state of the attachment angle of an adapter member. For this reason, the operator can easily and accurately grasp the effect of changing the mounting angle state of the adapter member when detecting the distance data and the tension data by checking the display. it can.

  A tension measuring device for artificial joint replacement according to a ninth aspect of the invention is the tension measuring device for artificial joint replacement according to any one of the first to eighth aspects of the invention, which is used in artificial hip joint replacement, and an artificial hip joint is applied. It is characterized by measuring the tension force generated by the soft tissue between the pelvis and the femur at the joint site and the distance between the pelvis and the femur when the tension force is generated.

  According to the present invention, it is possible to suppress the inaccuracy caused by the variation in evaluation by the operator, and the tension force caused by the soft tissue between the pelvis and the femur at the hip joint part and between these bones. To provide a tension measuring device for artificial hip joint replacement that can easily and accurately grasp the distance, and can easily and quickly grasp the relationship between the tension force and the distance between the bones. Can do.

  Further, the tension measuring method for artificial joint replacement according to the tenth aspect of the invention for achieving the above-mentioned object is characterized in that, in the artificial joint replacement, the tension generated by the soft tissue between the bones of the joint site to which the artificial joint is applied, and A tension measuring method for artificial joint replacement which measures a distance between bones when the tension is generated, and is configured as an operating method of the tension measuring device for artificial joint replacement of the first invention. And the tension measuring method for artificial joint replacement according to the tenth aspect of the present invention includes an interosseous distance changing means arrangement step in which at least a part of an interosseous distance changing means capable of changing the distance between bones is arranged between the bones, The inter-bone distance detecting step for detecting the distance between the bones changed by the inter-bone distance changing means, and the tension generated by the soft tissue between the bones by changing the distance between the bones by the inter-bone distance changing means. Interosseous tension detecting step for detecting force, distance data which is a distance value between the bones detected in the interosseous distance detecting step, and values of the tensioning force detected in the interosseous tension detecting step Is stored in correspondence with the detection timing, and the distance data and the tension data are displayed on the display based on the contents stored in the storage step. Characterized in that it and a display control step of controlling the.

  According to this invention, the tension measuring method for artificial joint replacement which is the operating method of the tension measuring device for artificial joint replacement of the first invention is configured. Therefore, according to the present invention, the distance between the bones of the joint part to which the artificial joint is applied is changed by the interbone distance changing means, and the distance between the bones and the tension force caused by the soft tissue between the bones are detected. . The detected distance data and tension data are stored correspondingly at the detection timing and displayed on the display based on the stored contents. For this reason, the surgeon can quantitatively grasp the data of the tension force and the distance between the bones of the soft tissue between the bones of the joint part, which may cause inaccuracy due to the variation in evaluation by the surgeon. Will be suppressed. Then, the operator can easily and accurately grasp the tension force caused by the soft tissue between the bones of the joint site and the distance between the bones only by confirming the display on the display. Also, when the surgeon operates the interosseous distance changing means to sequentially change the interosseous distance, the measurement results for the tension and interosseous distance are displayed automatically and continuously. Will be displayed. Therefore, the surgeon can easily and quickly grasp the relationship between the tension and the distance between the bones during the operation.

  Therefore, according to the invention of the tension measuring method for artificial joint replacement surgery, it is possible to suppress inaccuracy caused by variations in evaluation by the operator and to suppress the tension force caused by the soft tissue between the bones of the joint site. And the distance between the bones can be grasped easily and accurately, and the relationship between the tension force and the distance between the bones can be grasped easily and quickly.

  According to the present invention, it is possible to suppress the inaccuracy caused by the variation in evaluation by the operator, and to easily and accurately determine the tension force caused by the soft tissue between the bones of the joint site and the distance between the bones. In addition, the relationship between the tension and the distance between bones can be easily and quickly grasped.

BRIEF DESCRIPTION OF THE DRAWINGS It is the schematic explaining the outline of the whole structure of the tension measuring apparatus for artificial joint replacement surgery concerning one embodiment of this invention. It is sectional drawing which shows an artificial hip joint, and is a figure shown with a part of cross section of a femur and a pelvis. It is a perspective view of the interosseous distance change device in the tension measuring apparatus for artificial joint replacement shown in FIG. It is a rear view of the interosseous distance change device shown in FIG. It is the figure which showed the state of the interosseous distance change device shown in FIG. 3 currently operated by the operator in artificial hip joint replacement with a pelvis, a femur, etc. It is a perspective view shown with a shell member about the shell adapter in the tension measuring apparatus for artificial joint replacement shown in FIG. It is a front view shown with a trial stem member about the neck adapter in the tension measuring apparatus for artificial joint replacement shown in FIG. FIG. 8 is a front view showing a plurality of neck adapters shown in FIG. 7. It is the figure which showed the structure of the control apparatus and the arithmetic unit about the tension measuring apparatus for artificial joint replacement shown in FIG. 1 with the functional block diagram. 10 shows an example of an image displayed on a display screen in the tension measuring device for artificial joint replacement shown in FIG. 9. 10 shows an example of an image displayed on a display screen in the tension measuring device for artificial joint replacement shown in FIG. 9. 10 shows an example of an image displayed on a display screen in the tension measuring device for artificial joint replacement shown in FIG. 9. It is a flowchart which shows the operating method of the tension measuring apparatus for artificial joint replacement shown in FIG.

  Hereinafter, embodiments for carrying out the present invention will be described with reference to the drawings. The present invention relates to an artificial joint that is used in artificial joint replacement and measures the tension generated by the soft tissue between the bones of the joint site to which the artificial joint is applied and the distance between the bones when the tension is generated. The present invention can be widely applied as a tension measuring device for replacement surgery and a tension measuring method for artificial joint replacement surgery that is an operation method of the tension measuring device for artificial joint replacement surgery. In the following description, the case where the present invention is applied to an artificial hip joint replacement will be described as an example. However, the present invention is not limited to this example, and an artificial joint replacement other than an artificial hip joint replacement (for example, an artificial knee joint replacement). The present invention can also be applied to, for example, artificial elbow joint replacement.

  FIG. 1 is a schematic diagram for explaining the outline of the overall configuration of a tension measuring device 1 for artificial joint replacement according to an embodiment of the present invention (hereinafter also simply referred to as “tension measuring device 1”). The tension measuring device 1 shown in FIG. 1 is used in hip replacement. On the other hand, FIG. 2 is a cross-sectional view showing an artificial hip joint, and is a view showing a part of a cross section of the femur 100 and the pelvis 101. In the hip replacement, the hip prosthesis shown in FIG. 2 is applied to the hip joint site.

  Here, the artificial hip joint will be described. The hip prosthesis includes a stem member 102, a shell member 103, a liner member 104, and a bone head ball member 105 as bone components. The stem member 102 is formed in a rod shape in which one end side is implanted in the medullary cavity portion 100 a of the femur 100. Then, the head ball member 105 formed in a ball shape is attached to the other end side of the stem member 102. On the other hand, the shell member 103 formed in a hemispherical shell shape is disposed on the acetabulum 101a of the pelvis 101, and the liner member 104 formed in a hemispherical shell shape having a smaller diameter than the shell member 103 is disposed inside the shell member 103. Is done. And the artificial hip joint is comprised by arrange | positioning so that the head ball member 105 may slidably contact with the inner surface of the liner member 104.

  In artificial hip joint replacement, an operation is performed to replace the hip joint with the above-mentioned artificial hip joint. At this time, when the operator installs the bone component (102, 103, 104, 105), the bone component of an appropriate size is used. First of all, an artificial joint placement operation is performed using a trial member to examine the placement of the joint in an appropriate state. In this alignment work, the tension generated by soft tissue (connective tissue such as fibrous tissue, adipose tissue, blood vessel other than bone tissue) between the pelvis 101 and the femur 100 at the joint site to which the artificial hip joint is applied. Need to be determined appropriately (in FIG. 2, illustration of soft tissue is omitted). For this reason, it is necessary to determine the distance between the pelvis 101 and the femur 100 that causes an appropriate tension, and the length dimension of the neck portion 102a of the stem member 102, which is a dimension that defines the distance, is particularly large. It becomes important. Then, the surgeon uses the tension measuring device 1 shown in FIG. 1, whereby the tension force caused by the soft tissue between the pelvis 101 and the femur 100 and the pelvis 101 and the femur 100 when the tension force is generated. Based on the measurement result, the stem member 102 having an appropriate length of the neck portion 102a and the bone head ball member 105 having an appropriate inner taper are determined.

  Next, the tension measuring device 1 will be described in detail. As shown in FIG. 1, the tension measuring apparatus 1 is an interosseous distance changer (interosseous distance changing means) 11, a control unit 12, a calculation unit 13, a display 14, and a pointing device such as a keyboard or a mouse. The input means 15, the relative position detection sensor 24, the relative position maintaining mechanism 28, the load cell 33, the shell adapter 35, and the neck adapter 36 are configured. FIG. 3 shows a perspective view of the interosseous distance changer 11, and FIG. 4 shows a rear view of the interosseous distance changer 1 viewed from the side opposite to FIG. As shown in FIGS. 3 and 4, the interosseous distance changer 11 includes a pair of lever members 21 and a connecting shaft 34.

  The pair of lever members 21 is provided as a pair of elongated members (22, 23) that are formed to have curved portions and are connected in a line-symmetric arrangement. The pair of lever members 21 are connected to each other so that the other member 23 swings with respect to the one member 22 so as to be able to be displaced relative to each other. And the connection shaft 34 is arrange | positioned in those middle parts to which the one member 22 and the other member 23 are connected. The connecting shaft 34 passes through a hole (not shown) formed in the other member 23 in a rotatable state, and is fixed to the one member 22 at both ends thereof. For this reason, one member 22 and the other member 23 are configured to be able to swing with respect to the connecting shaft 34.

  FIG. 5 is a view showing a state of the interosseous distance changing device 11 operated by the operator in the hip replacement, together with the pelvis 101, the femur 100, and the like. In FIG. 5, illustration of the soft tissue is omitted. As shown in FIG. 5, when measuring the distance between the pelvis 101 and the femur 100, the pair of lever members 21 have their tip portions, that is, the tip portion 22 a of one member 22 and the other portion. The distal end portion 23 a of the member 23 is disposed between the pelvis 101 and the femur 100. In the present embodiment, the pair of lever members 21 are coupled to each other so as to be capable of relative displacement, and the pair of displacement members are disposed between the bones (100, 101) at the distal end portions (22a, 23a). Is configured. Then, the interosseous distance changer 11 has a part (22a, 23a) arranged between the bones (100, 101) and can change the distance between the bones (100, 101). It constitutes a change means.

  The relative position detection sensor 24 shown in FIGS. 3 and 4 includes a large-diameter spar gear 25, a small-diameter pinion gear 26, and a potentiometer 27. The spur gear 25 is disposed around the swing center position of the pair of lever members 21 that is the position where the coupling shaft 34 is disposed, and is fixed to an end portion of the coupling shaft 34 protruding from one member 22. . The pinion gear 26 is arranged so that its axial direction is parallel to the axial direction of the spur gear 25 (that is, the axial direction of the connecting shaft 34) and meshes with the spur gear 25. The shaft of the pinion gear 26 is attached to a potentiometer 27 at the end opposite to the side that meshes with the spur gear 25. The potentiometer 27 is configured as a rotary potentiometer that detects the rotation angle of the shaft of the pinion gear 26, and is attached to one member 22. As described above, the relative position detection sensor 24 includes the spur gear 25 fixed to the connecting shaft 34, the pinion gear 26 that meshes with the spur gear 25, and the potentiometer 27 that detects the rotation angle of the pinion gear 26. The member 21 is configured to be able to detect a relative angle in the swing direction of the other member 23 with respect to the one member 22. In the present embodiment, the above relative angle is detected as the relative position of the other member 23 with respect to the one member 22 in the pair of displacement members 21.

  The relative position maintaining mechanism 28 shown in FIGS. 3 and 4 is provided on the pair of lever members 21 and includes a handle 29, a screw shaft 30, and mounting members (31, 32). . The mounting member 31 is swingably attached to one member 22, and the mounting member 32 is swingably attached to the other member 23. The screw shaft 30 has one end passing through the attachment member 32 and the other end connected to the load cell 33 attached to the attachment member 31. In addition, a handle 29 that is rotatably held with respect to the attachment member 32 is screwed and attached to an end portion on one end side that penetrates the attachment member 32 of the screw shaft 30 at its center position. For example, the operator rotates the handle 29 with the other hand while holding the interosseous distance changing device 11 with one hand, so that the handle 29 rotates with respect to the screw shaft 30. Thereby, the relative position of one member 22 and the other member 23 which were connected via the screw shaft 30 and the load cell 33 between the attachment members (31, 32) is changed. When the rotation operation of the handle 29 is stopped, the relative position of the other member 23 with respect to the one member 22 is achieved by the relative position maintaining mechanism 28 including the handle 29, the screw shaft 30 and the attachment members (31, 32). The above-mentioned relative angle is maintained.

  The load cell 33 shown in FIGS. 3 and 4 is configured as a strain gauge type load cell, for example, and is attached to the attachment member 31. As described above, the end of the screw shaft 30 opposite to the side on which the handle 29 is attached is connected to the load cell 33, and the one member 22 and the other member are rotated as the handle 29 rotates. The load cell 33 is configured to detect a load acting on the screw shaft 30 when the relative position to the screw shaft 30 is changed. That is, in the present embodiment, the load cell 33 constitutes a load detection sensor that detects a load acting on the relative position maintaining mechanism 28 from the pair of lever members 21.

  FIG. 6 is a perspective view showing the shell adapter 35 together with the shell member 103. FIG. 6 also shows a perspective view of a T wrench 107 that is a surgical instrument for attaching the shell adapter 35 to the shell member 103 and is provided with a socket portion 107a and a handle portion 107b. The shell adapter 35 shown in FIGS. 1, 5 and 6 is provided as a block-like member, and is used to measure the distance between the femur 100 and the pelvis 101, and the distal end portions (22a, 23a) is placed between the shell member 103 and the tip portion 22a when inserted between the bones (100, 101). The shell adapter 35 is provided with a screw part 35a at one end and a fitting part 35b at the other end. The screw portion 35a is formed as a male screw portion, and is screwed in the direction indicated by the broken arrow in FIG. 6 with respect to the female screw portion formed as a screw hole in the inner central portion of the hemispherical shell member 103. It is formed to be compatible. The fitting portion 35b is formed as a hemispherical portion, and a fitting hole 22b (see FIG. 3) having a hemispherical inner surface opened at the tip portion 22a of one member 22 of the pair of lever members 21. ) Can be fitted.

  When the shell adapter 35 is disposed between the shell member 103 and the distal end portion 22a, the shell member 103 is first attached to the mortar lid 101a. Then, the screw portion 35b is fitted to the above-mentioned female screw portion of the shell member 103 in a state where the fitting portion 35b of the shell adapter 35 is fitted in the hole of the socket portion 107a of the T wrench 107 in the direction indicated by the broken arrow in FIG. Adapted. In this state, when the operator rotates the handle portion 107 b of the T wrench 107, the screw portion 35 a is screwed with the female screw portion of the shell member 103, and the shell adapter 35 is attached to the shell member 103. . And the front-end | tip part (22a, 23a) of a pair of lever member 21 is inserted between bones (100, 101), and the front-end | tip part 22a of one member 22 is fitted to the fitting part 35b in the fitting hole 22b. Are arranged as follows. Thereby, the shell adapter 35 is attached to the interosseous distance changing device 11, and the pelvis 101 is biased by the pair of lever members 21 via the shell adapter 35 and the shell member 103 in accordance with the swinging motion of the pair of lever members 21. Will be.

  FIG. 7 is a front view showing the neck adapter 36 together with the trial stem member 106. The trial stem member 106 is disposed so as to engage with one of the femur 100 and the pelvis 101 facing each other at the hip joint portion to which the artificial hip joint is applied, and is used for positioning the artificial hip joint. Trial member. The trial stem member 106 is inserted into the medullary cavity portion 100a of the femur 100 as shown in FIG. The trial stem member 106 is provided with a mounting protrusion 106b that is formed so as to protrude from the main body 106a that is a portion to be embedded in the medullary cavity 100a and to which the neck adapter 36 is attached. .

  The neck adapter 36 shown in FIGS. 1, 5, and 7 is provided as a block-shaped member, and is used to measure the distance between the femur 100 and the pelvis 101, and the distal end portions (22 a, 22 a, 23a) is placed between the trial stem member 106 and the tip portion 23a when inserted between the bones (100, 101). The neck adapter 36 constitutes an adapter member in the present embodiment that is attached to the trial stem member 106 and attached to the interosseous distance changer 11. The neck adapter 36 is provided with a fitting portion 37, a mounting hole portion 38 and a protrusion 39.

  The fitting portion 37 of the neck adapter 36 is formed as a columnar end portion whose edge portion is chamfered, and has a circular cross section formed in an opening at the tip end portion 23 a of the other member 23 of the pair of lever members 21. It is formed so that it can be fitted in a hole (not shown). The attachment hole 38 is provided as a hole opened at the end of the neck adapter 36 opposite to the fitting portion, and the attachment projection 106b of the trial stem member 106 is in the direction indicated by the broken arrow in FIG. It is formed so that it can be fitted. Thus, the neck adapter 36 is attached to the trial stem member 106 by fitting the attachment hole 38 with the attachment protrusion 106b. The center line direction of the mounting hole 38, which is the fitting direction of the mounting hole 38 and the mounting projection 106b, is inclined with respect to the cylindrical center line direction of the fitting part 37. An attachment angle with respect to the trial stem member 106 is defined. Further, a projection 39 is provided at the end of the neck adapter 36 where the attachment hole 38 is opened. The projection 39 is formed so as to be able to fit into a hole 106c formed at an end portion of the trial stem member 106 where the mounting projection 106b of the main body 106a projects. By fitting the hole 39c formed at the end of the mounting projection 106b with the projection 39, it is possible to prevent the rotational deviation about the mounting projection 106b of the neck adapter 36 with respect to the trial stem member 106 (see FIG. It is configured to prevent rotation.

  When placing the neck adapter 36 between the trial stem member 106 and the distal end portion 23a, the trial stem member 106 is first inserted into the medullary cavity 100a of the femur 100 (see FIG. 5). Next, the neck adapter 36 is attached to the trial stem member 106 so that the attachment hole 38 and the attachment protrusion 106b are fitted, and the protrusion 39 and the hole at the end of the main body 106a are fitted. . And the front-end | tip part (22a, 23a) of a pair of lever member 21 is inserted between bones (100, 101), and the front-end | tip part 23a of the other member 23 is a fitting part in the hole (not shown) of the circular cross section. 37 to be fitted. As a result, the neck dapter 36 is attached to the interosseous distance changing device 11, and the femur 100 is urged by the pair of lever members 21 via the neck adapter 36 and the trial stem member 106 in accordance with the swinging motion of the pair of lever members 21. Will be.

  Further, in the tension measuring device 1, as shown in FIGS. 8A to 8C, as the neck adapter 36, the above-described attachment angle with respect to the trial stem member 106 (attachment in the direction of the center line L1 of the fitting portion 37). A plurality (three in this embodiment) of neck adapters (36a, 36b, 36c) having different center line L2 directions of the hole portions 38 are provided. As an attachment angle that is an angle (a sharp angle) formed by the center line L1 of the fitting portion 37 and the center line L2 of the attachment hole portion 38, the attachment angle of the neck adapter 36a shown in FIG. FIG. 8B shows a case where the attachment angle of the neck adapter 36b shown in FIG. 8B is set to β °, and the attachment angle of the neck adapter 36c shown in FIG. 8C is set to γ °. When using the tension measuring device 1, the operator can select any one of the plurality of neck adapters 36 (36 a to 36 c) and attach it to the trial stem member 106, and the trial stem member 106 as appropriate. The attached neck adapter 36 can be removed and replaced with another neck adapter 36. The specific values and combinations of the mounting angles (α °, β °, γ °) and the number of neck adapters 36 can be arbitrarily set.

  Next, the arithmetic device 13 and the control device 12 will be described. The arithmetic device 13 and the control device 12 are used in a state where the interosseous distance changer 11 is arranged as shown in FIG. In the state shown in FIG. 5, the neck adapter 36 is attached to the trial stem member 106 arranged on the femur 100, and the shell adapter 35 is attached to the shell member 103 arranged on the acetabulum 101a. The distal end portions (22a, 23a) of the interbone distance changer 11 are disposed between the bones (100, 101), the distal end portion 22a is attached to the shell adapter 35, and the distal end portion 23a is attached to the neck adapter 36. ing. In this state, the arithmetic device 13 and the control device 12 that are powered on operate.

  As shown in FIG. 1, the arithmetic device 13 includes an LED (Light Emitting Diode) display unit 40, an arithmetic circuit 41, an interface circuit (I / F circuit) 42, and the like. The potentiometer 27 and the load cell 33 are connected. In the control device 13, a detection result as a voltage signal detected by the potentiometer 27 and the load cell 33 is input, and the detection result is converted from an analog signal to a digital signal in the interface circuit 42, and will be described later in the arithmetic circuit 41. Arithmetic processing is performed. In addition, the calculation result processed by the calculation circuit 41 is displayed in real time when a predetermined LED is lit (emitted) on the LED display unit 40. FIG. 9 is a functional block diagram illustrating the configuration of the control device 12 and the arithmetic device 13 in the tension measuring device 1. As shown in FIG. 9, in the calculation device 13, an interosseous distance calculation unit (interosseous distance calculation unit) 46 and an interosseous tension calculation unit (interosseous tension calculation unit) are included in the calculation circuit 41. 47 is built.

  9 is based on the detection result of the potentiometer 27 of the relative position detection sensor 24, and the bone (when the tension force is generated by the soft tissue between the femur 100 and the pelvis 101). 100, 101) is calculated (a distance indicated by a double-ended arrow in FIG. 5, hereinafter simply referred to as “distance D between bones”). In the present embodiment, the distance D between the bones is opposed to the hemispherical center position of the acetabulum 101 a having a hemispheric inner surface (the center position of the spherical shell of the hemispherical shell-shaped shell member 103) and the pelvis 101 of the femur 100. As an example, a distance calculated by the interosseous distance calculation unit 46 is calculated as the distance between the center position of the end portion (the center position of the end portion to which the neck adapter 36 of the main body portion 106b of the trial stem member 106 is attached). Yes. The distance D between the bones is not limited to the above exemplified distance, and can be set with various changes. For example, the center position of a sphere having the surface of the fitting portion 35b formed as a hemispherical portion in the shell adapter 35 as a part of the sphere surface, and the center position of the end of the femur 100 facing the pelvis 101 May be set as the distance D between the bones.

  In the interosseous distance calculation unit 46, based on the rotation angle of the pinion gear 26 shaft detected by the potentiometer 27, the number of teeth of each of the pinion gear 26 and the spur gear 25, the radial dimension of the pitch circle, and the center position of the connecting shaft 34. The distance D between the bones is calculated using values such as the distance between the center of the tip and the tip (22a, 23a), the thickness of the tip (22a, 23a), and the dimensions of the shell adapter 35 and the neck adapter 36. The During the operation of the calculation device 13, the inter-bone distance calculation unit 46 always calculates the above-mentioned distance D between bones. Therefore, when the interosseous distance changer 11 is operated by the operator and the pair of lever members 21 swings to change the gap between the distal end portion 22a and the distal end portion 23a, the interosseous distance changer The distance D between the bones changed in 11 is always detected. The relative position detection sensor 24 and the interosseous distance calculation unit 46 constitute the interosseous distance detection means of this embodiment that detects the interosseous distance D changed by the interosseous distance changer 11. The distance D between the bones is detected by this inter-bone distance detecting means, and the measurement result of the distance D between the bones is obtained.

  The interosseous tension calculation unit 47 shown in FIG. 9 calculates the tension (hereinafter also simply referred to as “tensioning force”) generated by the soft tissue between the femur 100 and the pelvis 101 based on the detection result of the load cell 33. To do. In the interosseous tension calculating unit 47, based on the load acting on the relative position maintaining mechanism 28 detected by the load cell 33, the respective swing center positions of the attachment member 31 and the attachment member 32 and the center position of the connecting shaft 34 are obtained. The tension force is calculated using a value such as a distance dimension specified by the relationship between the center position of the tip portion (22a, 23a). During the operation of the calculation device 13, the interosseous tension calculation unit 47 always calculates the tension described above. For this reason, when the interosseous distance changing device 11 is operated by the operator and the interosseous distance D is changed, the tension force changed thereby is always detected. In the present embodiment, the bone (100, 101) is obtained by changing the distance D between the bones by the interbone distance changer 11 by the relative position maintaining mechanism 28, the load cell 33, and the interosseous tension calculating unit 47. The interosseous tension detecting means of this embodiment is configured to detect the tension generated by the soft tissue between them. The tension force is detected by the interosseous tension detection means, and the measurement result of the tension is obtained.

  The control device 12 can be configured using, for example, a general-purpose personal computer, and includes a CPU (Central Processing Unit) 43, a memory 44, an interface circuit (I / F circuit) 45, etc., as shown in FIG. And is connected to the arithmetic device 13, the display 14, and the input means 15. In the control device 12, the calculation result signal about the distance D between the bones and the tension force processed by the calculation device 13 and the signal input by operating the input means 15 are input via the interface circuit 45. It is stored in the memory 44 and processed by the CPU 43. Then, a video signal as a processing result in the CPU 43 is output to the display 14 via the interface circuit 45, and a predetermined image is displayed on the screen of the display. The memory 44 stores a program for performing processing as the control device 12 that controls display on the display 14, and is read and executed by the CPU 43. Then, as shown in FIG. 9, in the control device 12, a storage unit (storage unit) 48 and a determination data generation unit (determination data generation unit) are generated by the CPU 43, the memory 44, and the program stored in the memory 44. Means) 49 and a display control unit (display control means) 50 are constructed.

  The storage unit 48 shown in FIG. And this memory | storage part 48 is the value of the tension | tensile_strength detected by the distance data which is the value of the distance D between the bones detected by the above-mentioned interosseous distance detection means, and the above-mentioned interosseous tension detecting means. The tension data is stored in correspondence with the detection timing.

  The display control unit 50 shown in FIG. 9 is configured by the CPU 43 that reads and executes a predetermined program, and the content stored in the storage unit 48 (distance data, tension data, and the like stored in association with the detection timing). Based on this, the distance data and the tension data are controlled to be displayed on the display 14. FIG. 10 shows an example of an image displayed on the screen of the display 14 based on the control of the display control unit 50. As shown in the image example of FIG. 10, the display control unit 50 associates the distance data and the tension with the horizontal axis corresponding to the distance data and the vertical axis corresponding to the tension data corresponding to the detection timing corresponding to the distance data. The force data is controlled to be displayed on the display 14 as a two-dimensional graph. In FIG. 10, illustration of specific numerical values on the vertical axis and the horizontal axis is omitted. As illustrated in FIG. 10, in the tension measuring device 1, the distance data and the tension data measured by the interosseous distance change device 11, the interosseous distance detecting unit, and the interosseous tension detecting unit are used as the control unit 12. Based on the control, it is displayed on the screen of the display 14 as an image showing their correlation.

  The determination data generation unit 49 shown in FIG. 9 is based on a signal input by operating the input unit 15 (by performing a keyboard operation, a mouse operation, or the like) by an operator or another operator. Determination data for the surgeon to determine the state when the data and the tension data are detected is generated. This determination data is stored in the storage unit 48. And the memory | storage part 48 memorize | stores distance data and tension data corresponding to the determination data. Further, the display control unit 50 performs control so that the distance data and the tension data are displayed on the display 14 in a state of being distinguished corresponding to the determination data based on the contents stored in the storage unit 48.

  The image example of FIG. 10 shows an example in the case where an operator or the like (operator or other worker) is not operating the input means 15 for generating determination data. On the other hand, in the image examples of FIGS. 11 and 12, determination data is generated by operating the input means 15 by an operator or the like, and distance data and tension data are distinguished in accordance with the determination data. The example displayed on the display 14 in the state is shown. FIG. 11 shows that when the surgeon arbitrarily changes the state when the distance data and the tension data are detected into three patterns, the distance data and the tension are distinguished according to the determination data of each state. An example of an image in which force data is displayed is shown. In the example of FIG. 11, determination data corresponding to three states (state A, state B, and state C) are generated based on the operation of the input unit 15 by an operator or the like, and distance data and tension for each state. Line images showing the correlation with force data are displayed separately by changing the line type. That is, the distance data and tension data corresponding to the state A are indicated by solid lines, the distance data and tension data corresponding to the state B are indicated by alternate long and short dash lines, and the distance data and tension data corresponding to the state C are indicated by broken lines. Yes. In addition, the data corresponding to each state may be distinguished and displayed by changing the color of the line.

  In the image example of FIG. 11 described above, the operator can arbitrarily assume what state corresponds to each state (A, B, C). For example, the determination data is the bone posture that is the relative positional relationship between the femur 100 and the pelvis 101 facing each other at the hip joint portion to which the artificial hip joint is applied, and when the distance data and the tension data are detected. It is also possible to set the posture state as data for the surgeon to determine. Specifically, a state in which the orientation of the femur 100 facing the pelvis 101 is changed (for example, a state where the legs are straightened or bent at various hip joints), or the femur 100 is changed to the pelvis 101. In contrast, it is possible to set various determination data corresponding to a state in which the angle in various rotation directions is changed and arranged at a twisted position.

  FIG. 12 shows that the determination data is the state of the mounting angle of the neck adapter 36 attached to the trial stem member 106 among the plurality of neck adapters 36 (36a, 36b, 36c), and the distance data and the tension data are detected. It is an example of an image in case it is the data for an operator to determine the state of the attachment angle when it is done. In this case, the determination data generator 49 and the input means 15 of the control device 12 can perform an input operation in which an operator or the like selects the attachment angle (α °, β °, γ °) of the neck adapter 36, The determination data is generated based on the input operation. Therefore, the surgeon performs an input operation for selecting an attachment angle (any one of α °, β °, and γ °) of the neck adapter 36 (any one of 36a to 36c) attached to the trial stem member 106. Will do. When the surgeon replaces the neck adapter 36 attached to the trial stem member 106 with another neck adapter 36 having a different attachment angle, the above-described input operation for selecting the attachment angle is performed again by the operator or the like. In the example of FIG. 12, determination data corresponding to the mounting angle selected and operated based on the operation of the input means 15 by an operator or the like is generated, and the distance data and the tension force data for each mounting angle state. A line image showing the correlation is displayed by changing the type of the line. That is, the distance data and tension data corresponding to the mounting angle of α ° are solid lines, the distance data and tension data corresponding to the mounting angle of β ° are dashed lines, the distance data corresponding to the mounting angle of γ ° and The tension data is displayed in broken lines.

  Next, an operation method (hereinafter also simply referred to as “tension measurement method”) of the tension measurement device 1 which is a tension measurement method for artificial joint replacement according to an embodiment of the present invention will be described. This tension measurement method is used in artificial hip joint replacement, and when the tension force described above and the tension force generated by the soft tissue are generated between the femur 100 and the pelvis 101 at the hip joint portion to which the artificial hip joint is applied. Is used as a method of measuring the distance D between bones. FIG. 13 is a flowchart showing a tension measuring method. As shown in FIG. 13, the tension measuring method includes an interosseous distance changing means arranging step S101, an interosseous distance detecting step S102, an interosseous tension detecting step S103, a storing step S104, a display control step S105, It is configured with.

  When the tension measuring method is performed, that is, when the tension measuring device 1 is operated, first, the trial stem member 106 is disposed on the femur 100 and the shell member 103 is disposed on the acetabulum 101 a of the pelvis 101. The Next, the neck adapter 36 having an attachment angle desired by the operator is attached to the trial stem member 106, and the shell adapter 35 is attached to the shell member 103. Then, in the interosseous distance changing means arrangement step S101, the distal end portions (22a, 23a) of the pair of lever members 21 in the interosseous distance changer 11 capable of changing the interosseous distance D are located between the interosseous (100, 101). Be placed. At this time, the fitting portion 35b of the shell adapter 35 is attached to the fitting hole 22b of the tip portion 22a, and the fitting portion 37 of the neck adapter 36 is attached to a hole having a circular cross section in the tip portion 23a.

  When the interosseous distance changing means arranging step S101 is completed, the interosseous distance detecting means configured by the relative position detection sensor 24 and the interosseous distance calculating unit 46 of the arithmetic unit 13 as described above in the interosseous distance detecting step S102. By the operation of, the inter-bone distance D changed by the inter-bone distance changer 11 is detected. In the interosseous tension detecting step S103, as described above, the interosseous tension detecting means including the relative position maintaining mechanism 28, the load cell 33, and the interosseous tension calculating unit 47 of the arithmetic unit 13 is operated. The tension D generated by the soft tissue is detected between the bones (100, 101) by changing the distance D between the bones by the interbone distance changer 11.

  When the distance D between the bones is detected in the inter-bone distance detection step S102 and the tension force is detected in the inter-bone tension detection step S103, the storage step S104 is subsequently performed by the operation of the control device 12. In the storage step S104, distance data that is the value of the distance D between the bones and tension data that is the value of the tension are stored in correspondence with each other at the detection timing. In addition, when the determination data generation part 49 act | operates with operation of the input means 15 by an operator etc., distance data and tension | tensile_strength data are memorize | stored corresponding to determination data. Further, the display control step S105 is performed by the operation of the control device 12. In the display control step S015, control for displaying the distance data and the tension data on the screen of the display 14 as in the image example of FIG. 10 is performed based on the contents stored in the storage step S104. . At this time, when the determination data generating unit 49 is operated, the distance data and the tension data are distinguished from each other in accordance with the determination data on the screen of the display 14 as shown in FIG. It will be displayed as an example of the image.

  When the above steps S102 to S105 are performed, it is determined in the control device 12 whether or not an ending operation for ending the operation of the tension measuring device 1 is performed by the operator or the like (step S106). If the end operation has not been performed (S106, No), the processing from step S102 to step S105 is repeated. On the other hand, if the end operation has been performed (S106, Yes), the tension measuring method that is the operating method of the tension measuring device 1 is ended. Note that the processing from step S102 to step S105 is repeatedly performed every predetermined calculation cycle time or control cycle time.

  According to the tension measuring device 1 described above and the tension measuring method which is the operating method thereof, the distance D between the bones (100, 101) of the hip joint part to which the artificial hip joint is applied is changed by the interosseous distance changer 11, and this The distance D between the bones and the tension force due to the soft tissue between the bones (100, 101) are detected. The detected distance data and tension data are correspondingly stored at the detection timing and displayed on the display 14 based on the stored contents. For this reason, the surgeon can quantitatively grasp the tension force and distance data between bones (tension force data and distance data) between the bones (100, 101) of the joint part, and the evaluation by the surgeon. Incurring inaccuracies associated with variations will be suppressed. Then, the operator can easily and accurately grasp the tension force caused by the soft tissue between the bones (100, 101) and the distance D between the bones only by confirming the display on the display 14. Further, when the surgeon operates the interosseous distance changer 11 to sequentially change the interosseous distance D, the measurement results for the tension and interosseous distance D are automatically and continuously measured. It will be displayed on the display 14. For this reason, the surgeon can easily and quickly grasp the relationship between the tension and the distance D between the bones during the operation.

  Therefore, according to the present embodiment, it is possible to suppress the inaccuracy caused by the variation in the evaluation by the operator, and the tension force caused by the soft tissue between the bones (100, 101) of the hip joint part and the bone distance The distance D can be easily and accurately grasped, and the relationship between the tension force and the distance D between the bones can be grasped easily and quickly.

  Further, according to the tension measuring device 1, the distance data and the tension data are displayed on the display 14 as a two-dimensional graph in which the distance data corresponds to the horizontal axis and the tension data corresponding to the distance data corresponds to the vertical axis. Is done. Therefore, the surgeon can easily and clearly grasp the state of the continuous change in the tension force accompanying the change in the distance D between the bones, and the relationship between the distance D between the bones and the tension force can be more easily and accurately. Can grasp.

  Further, according to the tension measuring device 1, the operator or the like operates the input means 15 when it is desired to check the data while changing and comparing the state when the surgeon detects the distance data and the tension force data. . Thereby, determination data for the surgeon to determine the state when the distance data and the tension data are detected is generated and stored together with the distance data and the tension data. Then, the distance data and the tension data are displayed on the display 14 in a state of being distinguished corresponding to the determination data. For this reason, the operator can grasp | ascertain easily and correctly, confirming the display 14, comparing the influence by changing the state at the time of detecting distance data and tension power data.

  Further, according to the tension measuring device 1, when the operator wants to check the data while changing and comparing the posture state of the bone when the distance data and the tension force data are detected, for example, the joint is extended. The operator or the like operates the input means 15 when the user wants to check the data while comparing it with a bent state or a bent state. Thereby, determination data for the surgeon to determine the state of the posture of the bone when the distance data and the tension data are detected is generated and stored together with the distance data and the tension data. Then, the distance data and the tension data are displayed on the display 14 in a state of being distinguished in accordance with the state of the bone posture. For this reason, the surgeon checks the display 14 to compare the effects of changing the posture of the bone when detecting the distance data and the tension data to an extended or bent state. It can be easily and accurately grasped.

  Further, according to the tension measuring device 1, the relative position of the other member 23 with respect to the one member 22 of the pair of displacement members 21 in the interosseous distance changer 11 is detected, and distance data is obtained by calculation based on the detection result. Will be. For this reason, distance data which is a value of distance D between bones can be easily detected by detecting a relative position in a pair of displacement members 21 as a physical quantity correlated with distance data. In addition, the relative position maintaining mechanism 28 provided in the pair of displacement members 21 maintains the above relative position. At this time, the load acting on the relative position maintaining mechanism 28 from the pair of displacement members 21 is detected. Tension data is obtained by calculation based on the above. For this reason, by detecting the load acting on the relative position maintaining mechanism 28 as a physical quantity that correlates with the tension data, the tension data that is the value of the tension can be easily detected.

  In addition, according to the tension measuring device 1, the pair of displacement members 21 are provided as a pair of lever members 21 that are connected to each other at the midway portions and swing, and a relative position is detected as a predetermined relative angle in the pair of lever members 21. The The relative angle is maintained by the relative position maintaining mechanism 28, and a load acting on the relative position maintaining mechanism 28 is detected. For this reason, distance data and tension force data can be easily detected with a simple configuration using a pair of lever members 21 that are swingably connected.

  Further, according to the tension measuring device 1, an artificial hip joint that considers arranging an appropriately sized bone component (especially the stem member 102) in an appropriate state when installing the bone components (102 to 105) constituting the artificial hip joint. The neck adapter 36 attached to the trial stem member 106 used in the alignment operation is attached to the interosseous distance changer 11. A plurality of neck adapters having different attachment angles with respect to the trial stem member 106 are provided. For this reason, the operator can easily replace the neck adapter 36 having a different attachment angle and collect distance data and tension data when examining the placement of the artificial hip joint. This makes it easier to examine the arrangement, shape, and size of the bone component (particularly the stem member 102) that appropriately corresponds to the state of the hip joint portion to which the artificial hip joint is applied during alignment.

  Further, according to the tension measuring device 1, when the operator wants to check the data while changing and comparing the state of the attachment angle of the neck adapter 36 when the distance data and the tension data are detected, the operator And the like operate the input means 15. Thereby, determination data for the operator to determine the state of the attachment angle of the neck adapter 36 when the distance data and the tension data are detected is generated and stored together with the distance data and the tension data. Then, the distance data and the tension data are displayed on the display 14 in a state of being distinguished corresponding to the state of the attachment angle of the neck adapter 36. Therefore, the operator can easily and accurately grasp the effect by changing the state of the attachment angle of the neck adapter 36 when detecting the distance data and the tension data by checking the display 14. be able to.

  Although the embodiments of the present invention have been described above, the present invention is not limited to the above-described embodiments, and various modifications can be made as long as they are described in the claims. For example, the following modifications may be made.

(1) In this embodiment, the tension measuring device for artificial joint replacement and the tension measuring method for artificial joint replacement used in the hip replacement are described as examples. However, this need not be the case. The present invention can also be applied to artificial joint replacement other than replacement.

(2) In this embodiment, the case where the distance data and the tension data are displayed on the display as a two-dimensional graph in which the horizontal axis represents the distance data and the vertical axis represents the tension data is described as an example. It does not have to be. For example, the tension data may be displayed on the horizontal axis and the distance data may be displayed on the vertical axis as a two-dimensional graph. Alternatively, distance data and tension data may be displayed as time-series data with the vertical axis corresponding to the vertical axis and the horizontal axis representing the time axis. Further, the distance data and the tension data may be displayed in parallel as different graphs.

(3) In the present embodiment, the case where the determination data corresponds to the state of the posture of the bone and the state of the attachment angle of the adapter member has been described as an example. However, this need not be the case. Various states other than the above may be selected or set.

(4) In the present embodiment, the case where the trial member is disposed so as to engage with one of the opposing bones and bones in the joint part to which the artificial joint is applied has been described as an example. It does not have to be. That is, the present invention can be applied even when a pair of trial members are arranged so that both of the opposing bones and bones in the joint site to which the artificial joint is applied are engaged.

(5) In the present embodiment, the case where the interosseous distance changing means is an interosseous distance changer that is directly operated by an operator's hand has been described as an example, but this need not be the case. The interosseous distance changing means may be appropriately provided with devices such as a cylinder, a rod, and a pump, and may be configured as an actuator that operates by fluid pressure such as hydraulic pressure or water pressure. That is, an interosseous distance changing unit that changes the distance between the bones by operating an actuator that operates by fluid pressure may be used.

(6) Although the present embodiment has been described by taking the example of the interosseous distance changing means having, as an example, a pair of displacement members that are pivotably connected to each other in the middle part, this need not be the case. For example, it may be an interosseous distance changing means connected so that relative displacement is possible so that a pair of displacement members approaches or separates along a linear direction.

  The present invention relates to an artificial joint that is used in artificial joint replacement and measures the tension generated by soft tissue between the bones of the joint site to which the artificial hip joint is applied and the distance between the bones when the tension is generated. The present invention can be widely applied as a tension measuring device for replacement surgery and a tension measuring method for artificial joint replacement which is an operation method of the tension measuring device for artificial joint replacement.

1 Tension measuring device for artificial joint replacement 11 Interosseous distance changer (interosseous distance changing means)
14 Display 24 Relative position detection sensor (interosseous distance detection means)
28 Relative position maintenance mechanism (interosseous tension detecting means)
33 load cell (load detection sensor, interosseous tension detection means)
46 Interosseous distance calculation unit (interosseous distance detection means)
47 Interosseous tension calculating unit (interosseous tension detecting means)
48 storage unit (storage means)
50 Display control unit (display control means)

Claims (10)

Used for artificial joint replacement, which measures the tension generated by soft tissue between the bones of the joint site to which the artificial joint is applied and the distance between the bones when the tension is generated A tension measuring device,
An interosseous distance changing means that is arranged at least partially between the bones and can change the distance between the bones;
An inter-bone distance detecting means for detecting a distance between the bones changed by the inter-bone distance changing means;
The interosseous tension detecting means for detecting the tension generated by the soft tissue between the bones by changing the interosseous distance by the interosseous distance changing means,
Corresponding distance data that is the value of the distance between the bones detected by the interosseous distance detection means and the tension data that is the value of the tensions detected by the interosseous tension detection means at the detection timing Storage means for storing and,
Display control means for controlling the distance data and the tension data to be displayed on a display based on the contents stored in the storage means;
A tension measuring device for artificial joint replacement, characterized by comprising: The tension measuring device for artificial joint replacement according to claim 1,
The display control means associates one of the vertical axis and the horizontal axis with the distance data, and associates the other of the vertical axis and the horizontal axis with the tension data whose detection timing corresponds to the distance data. The tension measuring device for artificial joint replacement, wherein the distance data and the tension force data are controlled to be displayed as a two-dimensional graph on a display. The tension measuring device for artificial joint replacement according to claim 1 or 2,
Determination data generating means for generating determination data for the surgeon to determine a state when the distance data and the tension data are detected based on a signal input by operating the input means. In addition,
The storage means stores the determination data, and stores the distance data and the tension data in association with the determination data.
The display control unit performs control so that the distance data and the tension data are displayed on the display in a state of being distinguished corresponding to the determination data based on the contents stored in the storage unit. A tension measuring device for artificial joint replacement. The tension measuring device for artificial joint replacement according to claim 3,
The bone when the determination data is a bone posture state that is a relative positional relationship between bones facing each other in a joint part to which the artificial joint is applied, and the distance data and the tension data are detected A tension measuring device for artificial joint replacement, characterized in that it is data for the operator to determine the state of the posture. The tension measuring device for artificial joint replacement according to any one of claims 1 to 4,
The interosseous distance changing means has a pair of displacement members that are connected to each other so as to be capable of relative displacement and whose distal end portion is disposed between the bones.
The inter-bone distance detecting means calculates a distance between bones based on a relative position detection sensor that detects a relative position of the other member with respect to one member of the pair of displacement members, and a detection result of the relative position detection sensor. An interosseous distance calculating means to perform,
The interosseous tension detecting means includes a relative position maintaining mechanism that is provided on the pair of displacement members and can maintain the relative position, and a load that detects a load acting on the relative position maintaining mechanism from the pair of displacement members. A tension measuring device for artificial joint replacement, comprising: a detection sensor; and an interosseous tension calculation means for calculating the tension based on a detection result of the load detection sensor. The tension measuring device for artificial joint replacement according to claim 5,
The pair of displacement members are provided as a pair of lever members that are coupled with each other so that relative displacement is possible by swinging the other member with respect to one member,
The relative position detection sensor detects a relative angle in the swing direction of the other member with respect to one member of the pair of lever members as the relative position,
The relative position maintaining mechanism is capable of maintaining the relative angle, and is a tension measuring device for artificial joint replacement. The tension measuring device for artificial joint replacement according to any one of claims 1 to 6,
The artificial joint is arranged to be engaged with one of the opposing bones or bones at a joint site to which the artificial joint is applied, or a pair of both are arranged to engage with each other, and used when the artificial joint is aligned. And an adapter member attached to the interosseous distance changing means.
A tension measuring device for artificial joint replacement, wherein a plurality of adapter members having different attachment angles with respect to the trial member are provided as the adapter members. The tension measuring device for artificial joint replacement according to claim 3,
The artificial joint is arranged to be engaged with one of the opposing bones or bones at a joint site to which the artificial joint is applied, or a pair of both are arranged to engage with each other, and used when the artificial joint is aligned. And an adapter member attached to the interosseous distance changing means.
As the adapter member, a plurality of adapter members having different mounting angles with respect to the trial member are provided,
The determination data is a state of the attachment angle of the adapter member attached to the trial member among the plurality of adapter members, and the attachment angle when the distance data and the tension data are detected. A tension measuring device for artificial joint replacement, characterized in that it is data for the surgeon to determine the state of the joint. The tension measuring device for artificial joint replacement according to any one of claims 1 to 8,
Tension force generated by the soft tissue between the pelvis and the femur at the joint site to which the hip joint is applied and the distance between the pelvis and the femur when the tension force is used A tension measuring device for artificial joint replacement, characterized by measuring Tension measurement for artificial joint replacement, which measures the tension generated by the soft tissue between the bones of the joint site to which the artificial joint is applied and the distance between the bones when the tension occurs. A method,
An interosseous distance changing means arrangement step in which at least a part of the interosseous distance changing means capable of changing the distance between the bones is arranged between the bones;
An interosseous distance detection step for detecting the interosseous distance changed by the interosseous distance changing means;
An interosseous tension detecting step for detecting the tension generated by the soft tissue between the bones by changing the interosseous distance by the interosseous distance changing means;
Corresponding distance data, which is the value of the distance between the bones detected in the inter-bone distance detecting step, and tension data, which is the value of the tension, detected in the inter-bone tension detecting step, at the detection timing A storage step for storing and
A display control step for controlling the distance data and the tension data to be displayed on a display based on the contents stored in the storage step;
A tension measuring method for artificial joint replacement, characterized by comprising:

Images