JP2020014827A - Artificial hip joint replacement appliances - Google Patents

Abstract

To provide artificial hip joint replacement appliances for performing artificial hip joint replacement more efficiently than before.SOLUTION: A canal finder according to the invention includes a tip part, an intermediate part, and a grip part that are connected via bent parts, where cut grooves are formed on the tip part, the intermediate part, and a bent part between the tip part and the intermediate part. A hip joint surgery retractor according to the invention comprises: a first frame including a rod-like member on which a gear groove is formed and a first arm member fixed to the rod-like member; a second frame including a movement member engaged with the gear groove of the first frame and a second arm member fixed to the movement member; and a pair of pawl members attached to respective tips of the first arm member and the second arm member.SELECTED DRAWING: Figure 1

Description

  The present invention relates to a hip replacement device and a hip replacement system using the same. More specifically, the present invention relates to a device used for artificial hip joint replacement, such as a retractor, a canal finder, a rasp holder, and a cup for artificial joint replacement.

  The artificial hip joint replacement operation is an operation for relieving the trouble by replacing the hip joint with an artificial joint when the deformation of the hip joint causes trouble in daily life. General hip arthroplasty is described, for example, in Non-Patent Document 1 below.

  In general hip arthroplasty, the femoral head is cut off, a member called a stem is inserted into the femur and the head is covered, while a hip replacement cup is fixed to the acetabular acetabulum of the pelvis, By disposing the head in the cup, the hip joint can slide smoothly.

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  By the way, at present, hip joint replacement is generally performed, but there are various problems in each of the instruments in the surgery.

  For example, in hip replacement, it is necessary to open the leg near the patient's femur in order to replace the patient's hip, but in the case of hip replacement, various mechanical devices are used, so the retractor itself is not large. There are many cases where the retractor causes interference, and there is a problem in efficient surgery.

  Further, for example, the canal finder used to check the direction of the medullary cavity after resection of the head of the femur has a problem that it is difficult to know in which direction the tip is oriented when used.

  Further, the above-mentioned canal finder is formed on the premise that cutting is performed at the distal end portion, and there is a problem that the cutting posture and the cutting area are limited and the efficiency is not good.

  Further, for example, when a stem is inserted into the femur after resection of the femoral head, as a preliminary operation, a rasp (file) is inserted into the femur, and the stem is inserted in a size large enough to insert the stem. Need to be secured, but are subject to many restrictions from the position of the patient's body.

  Also, for example, when inserting a hip replacement cup into the acetabulum, it is necessary to fix the bone matrix and the cup with bolts (screw), but the bolt fixing holes are not arranged at appropriate positions. There is. Further, there is no locking mechanism between the cup and the bolt, and in a mode in which the bone and the bolt are crimped by tightening the bolt and the cup is indirectly fixed, the fixability of the bone and the bolt may be weak. Such concerns about the fixation of the cup can result in a limitation in surgical efficiency. In order to reduce the burden on the patient as much as possible, it is necessary to reduce these restrictions as much as possible and perform an efficient operation.

  In view of the above problems, an object of the present invention is to provide an artificial hip joint replacement device for performing a more efficient artificial hip joint replacement operation.

  A canal finder according to one aspect for solving the above-described problem has a distal end portion, an intermediate portion, and a grip portion each connected via a bent portion. A cut groove is formed in the bent portion.

  Further, a retractor for hip joint surgery according to another aspect of the present invention for solving the above-described problem has a first frame including a rod-shaped member having a gear groove formed therein, and a first arm member fixed to the rod-shaped member. A moving member engaged with the gear groove of the rod-shaped member in the first frame, a second arm member fixed to the moving member, and a second frame having a first arm member and a second arm member. And a pair of claw members to be attached.

  In addition, a rasp holder according to another aspect of the present invention for solving the above-described problems includes a bent portion having a rasp holding portion formed at a tip, a grip portion connected to the bent portion, and a rounded corner connected to the grip portion. It has a square driving portion.

  Further, an artificial hip joint replacement cup according to another aspect for solving the above-described problem is an artificial hip joint replacement cup fixed to an acetabulum, and a plurality of bolt fixing holes are provided with the center of the cup being symmetrical. The screw groove is formed on the side surface of the bolt fixing hole.

  As described above, according to the present invention, it is possible to provide an artificial hip joint replacement tool for performing a more efficient artificial hip joint replacement.

It is a figure showing the outline of the retractor concerning an embodiment. It is a figure which shows the image of the nail | claw member of the retractor which concerns on embodiment. It is a figure which shows the image of the moving member of the retractor which concerns on embodiment. It is a figure showing the outline of the canal finder concerning an embodiment. It is a figure showing the outline of section shape of the middle part of the canal finder concerning an embodiment. It is a figure showing the outline of the canal finder concerning an embodiment. It is a figure showing the outline in case the return part of the canal finder concerning an embodiment is provided. It is a figure showing the outline of the return part of the canal finder concerning an embodiment. It is a figure showing the outline of the rasp holder concerning an embodiment. It is a figure showing the outline of the state where the rasp holder concerning an embodiment held a rasp. It is a figure showing the outline of the rasp holding part of the rasp holder concerning an embodiment. It is a figure which shows the outline (upper surface) of the bending part of the rasp holder concerning embodiment. It is a figure which shows the outline of the shape of the driving part of the rasp holder concerning embodiment. It is a figure which shows the outline of another example (rasp holder for skilled persons) of the rasp holder which concerns on embodiment. It is a figure showing the outline of the stem concerning an embodiment. It is a figure showing the outline of the cup concerning an embodiment. It is a figure showing the outline of the section of the cup concerning an embodiment.

  Hereinafter, a hip joint replacement tool according to an embodiment of the present invention will be described in detail with reference to the drawings along with a specific flow of surgery. However, the present invention can be implemented in many different forms, and is not limited to only specific examples of the embodiments described below.

(Retractor)
FIG. 1 is a view schematically showing a retractor 1 according to the present embodiment. The retractor 1 includes a first frame 11 having a rod-shaped member 111 in which a gear groove 1111 is formed, a first arm member 112 fixed to the rod-shaped member 111, and a rod-shaped member in the first frame 11. The second frame 12 having the moving member 121 engaged with the gear groove 111 of the second member 111 and the second arm member 122 fixed to the moving member 121, and the first end of the first arm member 112 and the second end of the second arm member 122. And a pair of claw members 131 and 132 to be attached.

  In the main retractor 1, the first frame 11 is a main member serving as a skeleton of the main retractor 1, and includes the bar-shaped member 111 and the first arm member 112 as described above. The first member 112 and the bar-shaped member 111 are connected at substantially right angles. The first member 112 and the bar-shaped member 111 are not limited, but are preferably integrally formed from the viewpoint of securing mechanical strength. The material of the rod-shaped member 111 and the first arm member 112 is not particularly limited, but is preferably a metal such as stainless steel or a resin such as polycarbonate.

  The length of the rod-shaped member 111 in the retractor 1 can be appropriately adjusted depending on the size of the wound, but is preferably, for example, in a range of 10 cm or more and 30 cm or less, and the length of the first arm member 112 is appropriately adjusted. Although possible, it is preferable that the distance be in the range of 10 cm or more and 20 cm or less.

  In the retractor 1, a gear groove 1111 is formed in the rod-shaped member 111. This is a groove in which the moving member 121 is engaged. Although described in detail later, the gear in the moving member 121 is engaged with the gear groove 1111 to enable reliable movement and fixing.

  Further, the first arm member 112 in the main retractor 1 is a rod-shaped member and can hold the claw member 131. The first arm member 112 is preferably linear, but may have a bent portion in part. Note that a claw member may be fixed to the distal end of the first arm member 112 so as to be integrated, but the claw member 131 can be detachably fixed by, for example, a locking mechanism or the like. Is preferred. FIG. 2 shows an image diagram of the claw member. By doing so, it becomes possible to remove, and it is possible to install and retract symmetrically by turning over the upper surface and the lower surface depending on the fixing direction of the claw member. 2A is a view of the claw member viewed from the direction in which the first and second arm members extend, and FIG. 2B is a view of the claw member viewed from the side.

  In the present retractor 1, the cross section of the first arm member 112 is preferably a polygon such as a quadrangle or a hexagon. By doing so, when the claw member 131 is made detachable, it is possible to prevent the claw member 131 from rotating around the first arm member 112.

  Further, in the present retractor 1, the second frame 12 is also a member serving as a main skeleton of the retractor 1 similarly to the first frame 11, and as described above, the rod-shaped member 111 in the first frame 11 is provided. And a second arm member 122 fixed to the moving member 121.

  The moving member 121 of the present retractor 1 is a member that is engaged with the gear groove 1111 and that can move on the rod-shaped member 111 by rotating. With this configuration, the distance between the first arm member and the second arm member can be adjusted and secured to a desired length.

  The moving member 121 of the retractor 1 is not limited as long as it can be engaged with the gear groove 1111. However, it is preferable that the moving member 121 includes a gear and a knob member connected to the gear. By doing so, the gear can be combined with the gear groove, and the movement can be easily performed by rotating the knob member.

  In this case, it is also preferable that the moving member 121 further includes a pawl member capable of controlling release and fixation, and has a so-called ratchet mechanism. By controlling the release and fixation of the pawl member in this manner, the distance between the first arm member and the second arm member can be easily adjusted, while stably fixed in a desired state. it can.

  In the retractor 1 of the present retractor 1, the knob member 14 is detachably attached to the second frame 12, and when the knob member 14 is mounted on the second frame 12, the knob member 14 is rotatable and movable. However, it is also preferable to make it impossible to rotate when removed. By doing so, by removing the knob member 14 after fixing, the unevenness of the knob member 14 can be reduced, and symmetrical installation and retraction can be performed, contributing to an improvement in operation efficiency. it can. FIG. 3 shows an image in this case.

  Further, the second arm member 122 of the retractor 1 is a rod-shaped member like the first arm member 112, and can hold the claw members 131 and 132. Further, the second arm member 122 is disposed with a portion substantially parallel to the first arm member 112. Note that the claw members 131 and 132 may be fixed to the tip of the second arm member 122 so as to be integrated, but the claw members can be detachably fixed by, for example, a locking mechanism. Is also preferred. By doing so, it becomes possible to remove, and depending on the fixing direction of the claw member, symmetrical installation and retraction can be performed.

  In addition, it is preferable that the moving member 121 and the second arm member 122 in the present retractor 1 are formed integrally except for small parts such as gears. In this way, sufficient strength can be secured. As a material for forming the second frame, as in the case of the first frame, a metal such as stainless steel or a resin such as polycarbonate is a preferable example.

  Further, as apparent from the above description, the claw members 131 and 132 of the retractor 1 can be fixed to the first arm member 112 and the second arm member 122. When detachable, an arm member insertion portion into which the tip of the arm member can be inserted, a plate-shaped portion for adjusting the depth and stably holding and securing the wound, and a claw formed with a deep claw, It is provided with. The depth (length) of the plate-like portion can be appropriately adjusted, but is preferably 2 cm or more and 10 cm or less, and its width is preferably 1 cm or more and 5 cm or less. Further, it is preferable that the claw member be a set including a plurality of plate-shaped portions having different depths so that the claw members can be appropriately adjusted in accordance with the size of the patient's body, the size of the wound, and the like.

  Further, as shown in the above figure, the shape of the claw of the claw member may not have a cut, but the cut portion is formed into a comb-like shape and includes a pressing portion and a folded portion. It may be something. By forming the cut portion, it is possible to prevent the body tissue of the patient from being unnecessarily fixed, and to obtain a force for pressing the wound portion of the patient downward by the pressing portion.

  Further, the nail of the nail member is provided with a depressed portion (a portion which is bent toward the wound portion and protrudes) so as not to damage the wound portion of the patient more than necessary. (See, for example, FIG. 3 (c)). By doing so, it is possible to stably expand the wound in accordance with the shape of the wound of the patient, and to reduce the risk of injuring the wound of the patient more than necessary as described above.

(Canal finder)
Further, in the hip replacement, after opening the femur, the femur is exposed, the head of the femur is cut with a bone saw or the like, and preparation is made to insert the stem into the medullary cavity of the femur. The operation of inserting the stem is performed by inserting a canal finder into the femur and confirming the direction of the medullary cavity in the femur and the like.

  FIG. 4 schematically shows the canal finder 2 according to the present embodiment. As shown in the figure, the canal finder 2 has a distal end portion 21, an intermediate portion 22, and a grip portion 23, which are connected via bent portions 24 and 25, respectively.

  Since the canal finder 2 of the present embodiment can confirm the direction in which the medullary cavity has been formed and can cut the bone, it is preferable that the canal finder 2 is formed of a hard member. Although it is preferable to be composed of the above-mentioned metal, it may be composed of a hard plastic.

  As described above, the canal finder 2 of the present embodiment joins a plurality of members as long as the distal end portion 21, the intermediate portion 22, and the grip portion 23 are configured to be connected via the bent portions 24 and 25. Although it may be manufactured by the above, it is preferable that it is constituted by an integral member from the viewpoint of easy manufacturing and the viewpoint of strength.

  In the canal finder 2 of the present embodiment, the distal end portion 21 is a portion used for confirming the central axis of the medullary cavity, and is a rod-shaped portion. In the canal finder 2 according to the present embodiment, it is preferable that the distal end portion 21 becomes thinner as approaching the distal end. This makes it easier to insert into the medullary cavity.

  Further, a shaving groove is formed in the distal end portion 21, the intermediate portion 22, and the bent portion 24 between the distal end portion 21 and the intermediate portion 22. The formation of the shaving groove enables the bone to be cut while being inserted into the medullary cavity and confirming the central axis of the medullary cavity.

  Further, the grip 23 in the canal finder 2 of the present embodiment is a portion for literally enabling the user to stably grip the canal finder. The grip portion 23 is also a rod-shaped member, and the core needs to be formed of a hard member, but it is preferable that its periphery is covered with an elastic member such as rubber. This makes it less slippery and easier to grip.

  Further, the intermediate portion 22 in the canal finder of the present embodiment is disposed between the distal end portion 21 and the grip portion 23 and is used for adjusting the length and the angle, and is connected to each via a bent portion. I have.

  Here, the cross section of the intermediate portion is preferably a rounded polygon, more specifically, a rounded triangle. By doing so, the user can easily confirm which direction and angle the canal finder is currently at. More specifically, by arranging the rounded polygonal ridge line so as to be substantially parallel to the surface along the insertion direction of the canal finder, the direction of extension of this canal finder is always in use during use. Can be easily checked. An image diagram in this case is shown in FIG.

  Further, in the canal finder of the present embodiment, the distal end portion 21, the intermediate portion 22, and the grip portion 23 are zigzagly bent on a plane, and the intermediate portion 3 and the grip portion are more bent than the bending angle A between the distal end portion and the intermediate portion. It is preferable that the bending angle B of 4 is larger. More specifically, the bending angles A and B are preferably obtuse angles, respectively. The bending angle A is preferably 100 degrees or more and 130 degrees or less, and the bending angle B is preferably 110 degrees or more and 140 degrees or less. By doing so, the user can insert the canal finder 2 from above while keeping the tip of the canal finder horizontal (see FIG. 6).

  As described above, a groove for cutting is provided in the bent portion 24 between the distal end portion 21 and the intermediate portion 22 of the canal finder 2 according to the present embodiment.

  Further, in the canal finder 2 according to the present embodiment, a bent portion 24 between the distal end portion 21 and the intermediate portion 22 may be provided with a return portion 27 for cutting. A diagram in this case is shown in FIG. In addition, the return portion 27 is provided at the center portion in this drawing, but may be provided at both corner portions at the ends.

  As shown in the figure, by providing the return portion (projection), the canal finder 2 according to the present embodiment can cut the bone even when the canal finder 2 is pulled. As a result, cutting can be performed not only at the tip but also at the return portion 27, and more cutting postures and cutting areas can be achieved. In addition, it is also preferable that a cutting groove is formed in the return portion 27 from the viewpoint of increasing cutting efficiency.

  Further, it is also preferable that the width of the return portion is smaller than the width of the front end portion, the intermediate portion, and the bent portion. By doing so, there is an advantage that the tip of the return portion can be made sharper and the cutting efficiency can be increased. FIG. 8 shows an image diagram in this case.

  As described above, it is possible to provide a canal finder having a higher cutting function and easily confirming the direction.

(Rasp and rasp holder)
After confirming the direction of the medullary cavity with the canal finder 2, the surgeon inserts the rasp 4 to secure the size of the space for inserting the stem, and cuts the inside of the medullary cavity. FIG. 9 is a diagram schematically illustrating the rasp holder 3 according to the present embodiment, and FIG. 10 is a diagram schematically illustrating the rasp holder 3 holding the rasp 4.

  As shown in these drawings, the rasp holder 3 according to the present embodiment includes a bent portion 31 having a rasp holding portion 311 formed at a tip, and a grip portion 32 connected to the bent portion 31. Further, the rasp holder 3 includes a driving portion 33 connected to the grip portion 32.

  The rasp holding portion 311 of the present rasp holder 3 has a portion to be inserted into an insertion hole formed in the rasp 3, and is configured to stably hold the rasp after being inserted. . Specifically, the rasp holding portion 311 includes a projection 3112 inserted into the insertion hole, and a claw 3111 inserted into the rasp and hooked in the same manner as the projection 3112. By controlling the taking in and out of the 3111, the rasp is hooked or opened to the concave portion in the rasp, and the rasp can be attached and detached. It is preferable that the claw 3111 is controlled by a mechanism provided in the bent portion 31 and the grip portion 32. That is, the rasp holding unit 311 is controlled by the attachment / detachment mechanism 3113 provided in the bending unit 31 and the holding unit 32. An image in this case is shown in FIG. By providing both the projection 3112 and the claw 3111 as in the present rasp holder 3, there is an advantage that the force for stably holding the rasp against operations such as intraoperative turning can be increased.

  Further, it is preferable that the rasp holding portion of the rasp holder 3 is configured so as to be accommodated in the joint portion (in the insertion hole) and not protruded outside when inserted into the rasp.

  The bent portion of the rasp holder is bent when viewed from the side and when viewed from the top. When viewed from the side, this is as described above, but FIG. 12 shows an outline when viewed from the top. Although the drawing shows the right rasp holder, the left rasp holder may be left-right symmetric.

  The present rasp holder is bent not only in the so-called vertical direction (when viewed from the side) but also in the horizontal direction (when viewed from the top). This is because, during surgery, the patient's femur is usually at the same height as the pelvis and the direction of the medullary canal of the femur is also close to the pelvis height. Therefore, when a straight rasp holder is used, the rasp holder is in a state close to the patient's pelvis or the like. This is because there is a risk that the patient's body will be pressed by pushing the patient's body. Can be reduced. The right and left rasp holders are required.

  By the way, in the present rasp holder, in a state where the rasp is held, the axial direction of the grip portion and the insertion axis direction of the rasp are substantially parallel. In order to insert the rasp, the rasp holder may hit the driving portion connected to the rear end portion of the grip portion with a hammer. In this case, by making the axial direction of the driving portion and the insertion axis direction of the rasp substantially parallel, the force on the rasp can be reliably transmitted, and the insertion direction can be stabilized. The shape of the rear end portion is preferably a rounded polygon, particularly a rounded triangle, and the vertices are preferably substantially parallel to the insertion axis direction. FIG. 13 shows an image in this case.

  The fitting portion between the rasp and the rasp holder must be firmly fixed because an impact by a hammer works. Although it can be attached to and detached from the rasp by holding the lever (handle) of the rasp holder, it has a two-stage locking mechanism that fixes the lever itself so that it does not accidentally come off due to the impact of a hammer. This makes it possible to withstand a stronger impact. In order to insert the rasp holder, it is desirable to attach a pneumatic or electric instrument such as a woodpecker, in addition to hitting with a hammer.

  However, as described above, since it is possible to reduce the burden on the patient when the patient is further away from the patient's body, the angle between the axial direction of the grasping portion and the insertion axial direction of the rasp is 140 when the rasp is held. The angle may be in a range of not less than degrees and not more than 160 degrees. FIG. 14 shows an image diagram in this case. By doing so, it becomes possible to further separate the rasp holder from the patient's body, and it is easier to put the rasp in and out by avoiding collision of the iliac and the iliac wing. Note that if the angle range is set, there is a difference between the direction in which force is applied to the gripping member and the direction in which force is applied to the rasp. Therefore, it is preferable that this user is a somewhat skilled operator. The insertion of the rasp holder usually requires the surgeon to move his / her standing position to the patient's head side and insert it toward the patient's foot side. However, if "the angle between the axial direction of the grip portion and the insertion axis direction of the rasp is within the range of 140 degrees or more and 160 degrees or less", the surgeon inserts the patient toward the patient's foot while standing on the patient's foot. It becomes possible to do. Since the operator does not need to move his standing position in the operation of the femur, the operation can be performed efficiently.

(Stem insertion)
After cutting the inside of the femur with the rasp, the stem 5 is inserted into the medullary cavity cut by the rasp. FIG. 15 shows an image diagram in this case.

  As shown in the figure, the stem is provided with a neck and a head, and the orientation and height of the neck, so-called offset, are appropriately selected according to the state of the hip joint of the patient.

(Cup setting)
Next, the cup is fixed to the acetabulum of the hipbone. FIG. 16 shows an outline of the cup. The cup has a hemispherical shape, one at the center, and a plurality of bolt fixing holes (screw holes) formed therearound. In this step, before fixing the cup, a spherical drill with a blade having the same shape as the cup is pressed against the acetabulum to form a recess having the same shape as the cup.

  Then, a cup is inserted into the formed concave portion and fixed in the acetabulum. In addition, the outer surface of the cup is subjected to rough unevenness processing, and displacement in the acetabulum can be prevented by using resistance due to the unevenness.

  Also, a hole is formed at the center of the cup as described above, and when fixing the cup to the acetabular, connect the cup holder to this hole and press it against the acetabulum to insert it into the acetabulum. Secure the cup.

  Then, after removing the rotation axis of the drill, a screw member is inserted into a plurality of peripheral holes, and the cup and the bone are firmly fixed with the screw member. Thereby, the cup can be more reliably fixed to the acetabulum.

  In this case, the positions of the plurality of bolt fixing holes are preferably formed symmetrically from the center, and the respective bolt fixing holes are preferably separated from the point of strength by 1.5 cm or more. . For example, in a cup with an outer diameter of 40 mm and 42 mm, four holes are formed at 90-degree intervals on a circumference having a swing width of 45 degrees from the center of the sphere, or in a cup with an outer diameter of 44 mm and 46 mm, the hole is formed at 45 degrees from the center of the sphere. Six holes are formed at 60-degree intervals on the circumference of the swing width, or, for cups with an outer diameter of 48 mm or more, eight holes are formed at 45-degree intervals on the circumference of the swing width of 45 degrees from the center of the ball. Is preferred. Further, it is preferable that a screw groove is formed on a side surface of each bolt fixing hole. By using the locking mechanism as described above, the cup and the bolt are integrated, and the cup and the bone can be more securely fixed. In addition, although the example of this figure shows the example of eight holes, the number of holes is not limited as long as it has the above function.

  In this case, it is preferable that the center hole is also a locking mechanism so that the locking screw can be fixed. This part has a bone stock (bone mass) and the bone matrix has a sufficient thickness, so that the screw can easily be fixed. In addition, since the screw is located at the center of the axis of the cup, there is little risk that excessive torque will be applied when the screw is tightened and the cup will move. By doing so, in combination with the plurality of bolt fixing holes, for example, 5 holes are provided for cups having an outer diameter of 40 mm and 42 mm, 7 holes are provided for cups having an outer diameter of 44 mm and 46 mm, and 9 holes are provided for a cup having an outer diameter of 48 mm or more. It is formed. FIG. 17 shows an image in this case.

  Then, a receiving member made of resin or ceramic is inserted and fixed inside the cup. Thereby, the installation of the cup can be completed.

(Stem mating)
Then, after installing the cup, the head is put on the neck of the stem, and the head and the receiving member of the cup are fitted together. Thereby, the replacement of the artificial hip joint is completed. In this fitting, it is necessary to confirm the operation sufficiently so as not to easily dislocate.

(suture)
Then, after confirming that the above-described series of flows has been completed, the wound site is sutured to complete the artificial joint replacement.

  As described above, by providing the artificial hip joint replacement tool of the present embodiment and a system in which these are combined, a more efficient artificial hip joint replacement can be performed.

INDUSTRIAL APPLICABILITY The present invention has industrial applicability as a hip replacement device.

Claims (9)

The tip, the middle, and the grip are connected via bent portions, respectively.
A canal finder in which a cut groove is formed in the front end portion, the intermediate portion, and a bent portion between the front end portion and the intermediate portion, and the cross section of the intermediate portion is a rounded polygon. The tip, the middle, and the grip are bent zigzag on the same plane,
The canal finder according to claim 1, wherein a bending angle between the intermediate portion and the grip portion is larger than a bending angle between the distal end portion and the intermediate portion.   The canal finder according to claim 1, wherein a bent portion for cutting is provided at a bent portion between the distal end portion and the intermediate portion. A first frame having a rod-shaped member in which a gear groove is formed, and a first arm member fixed to the rod-shaped member,
A second member having a moving member engaged with the gear groove of the rod-shaped member in the first frame, a second arm member fixed to the moving member,
A retractor for hip joint surgery, comprising: a pair of claw members detachably attached to respective distal ends of the first arm member and the second arm member, and which can be used symmetrically by inverting the upper surface. A bent portion having a rasp holding portion formed at a tip, a grip portion connected to the bent portion, and a rasp holder including a driving portion having a rounded polygon connected to the grip portion,
The rasp holder, wherein the holding of the rasp is controlled by an attachment / detachment mechanism provided in the bent portion and the grip portion.   The rasp holder according to claim 5, wherein the bent portion is bent when viewed from the side and when viewed from the top.   6. The rasp holder according to claim 5, wherein, in a state where the rasp is held, an axial direction of the grip portion is substantially parallel to an insertion axis direction of the rasp.   6. The rasp holder according to claim 5, wherein an angle between an axial direction of the grip portion and an insertion axial direction of the rasp is in a range of 140 degrees or more and 160 degrees or less in a state where the rasp is held. An artificial hip joint replacement cup fixed to an acetabulum, wherein a plurality of bolt fixing holes are formed symmetrically with respect to the center of the cup, and a screw groove is formed on a side surface of the bolt fixing hole. Hip replacement cup.