JP3372608B2 - Bone shape correction spacer - Google Patents

Description

Description: BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a method for treating patellofemoral arthropathy which occurs in, for example, a patellofemoral joint. In addition, the present invention relates to a bone shape correcting spacer capable of adjusting an eccentric position of a ligament in order to treat valgus and varus deformations associated with arthrosis. 2. Description of the Related Art There is a source disease on the patellofemoral joint surface of a human body, which causes secondary deformation of the joint, for example, deformation of the subarticular cartilage bone layer or proliferative change of bone. In cases such as local occurrence and deformation, such a case is called patellofemoral arthropathy. In such patellofemoral arthropathy, for example, as shown in FIG. In some cases, deformation occurs, causing the patella P and the femur Q to slide over a large area, and this has caused pain and adversely affected operations such as walking. For such a case, conventionally, as shown in FIG. 4 (b), an incision is made in the bone from the upper part of the rough part of the tibia L to a position almost directly below the front part, and the tibia T and the rough tibia are formed. By filling the gap M formed between the ligaments with the autogenous bone pieces K collected from the iliac bone, the rough tibia L supporting the ligament N and the ligament N
Is moved forward to bring the patella P and the femur Q into sliding contact with a small area. [0004] According to this method, the autogenous bone piece K is fused with the tibia T at an early stage, but bone resorption tends to occur in the direction in which the load is applied, and the correction effect is weakened.
In children and in cases where both joints are treated, extensive removal of the gluteus and iliac muscles is necessary to obtain a sufficient amount of bone, which results in prolonged surgery, increased bleeding, and postoperative rest. There were many problems due to autologous bone grafting, such as prolonged time. . [0005] Therefore, instead of the above autologous bone fragment K, FIG.
As shown in FIG. 6, a ceramic bone shape correcting spacer (hereinafter, abbreviated as a spacer) 10 having a tapered shape in a direction of a lower end 11 has been used for the treatment. However, the conventional spacer 10 has the following problems. That is, when incising the inside of the above-described rough surface of the tibia L in order to mount the conventional spacer 10, the periosteum J on both the left and right sides must be incised as shown in FIG. Cannot be covered with periosteum J, postoperatively, subcutaneous hematoma may occur, pain may remain, and bone union may be difficult. Further, the patella P and the femur Q
In addition to sliding in a large area, the ligament N is biased to the left or right as shown in FIG. 8, and if the ligament N is stabilized in that state, valgus deformation or varus deformation occurs, and in some cases, walking Failure to do so. In such a case, even if the spacer 10 is used, since the tibial rough surface L only moves uniformly to the front side, there is a problem that the above-described bias cannot be eliminated. In order to solve the above problems, the spacer of the present invention has a tapered shape in both the lower end and the tip. An embodiment of the present invention will be described below with reference to the drawings. FIGS. 1 and 2 show a spacer 1 of the present embodiment made of a ceramic material having no harm to the living body such as alumina, zirconia, and apatite. This spacer 1 has a block shape and tapers in the direction of a lower end 8 and a tip 9. It has a shape. Further, a through hole 3 penetrating both sides is formed in the left and right side surfaces 2, 2.
Is formed with three quadrangular pyramid-shaped projections 4, and furthermore, the rear upper shoulder 5 is hollowed toward the center, and a hollow surface 6 is formed. It has a unique shape. [0012] Next, a description will be given of a method of mounting the spacer 1 to the affected area, firstly, the tibial tuberosity L positioned in front side of the articular surface T ₁ of the tibia T, as shown in FIG. 3 (a)
As shown by the dotted line in the figure, the inner side of the tibia is incised from the upper end leaving either the left or right end, and the tibial rough surface L is slightly pushed forward to open the door, and the narrowest anterior lower part 7 is opened. Then, the spacer 1 is pushed in. At this time, the tip of a dedicated driving rod (not shown) is pressed against the recessed surface 6 of the rear shoulder 5 of the spacer 1 and driven from behind by a hammer. Also, the side surfaces 2 and 2 of the spacer 1
As described above, a total of six projections 4 on the left and right are formed at separate positions as described above, but these projections 4 bite into the bone and serve as stoppers during the initial fixation period. The side surfaces 2 and 2 of the spacer 1 are not limited to the protrusions 4 but may be a plurality of concave holes or grooves or beads made of an aggregate of small ceramic particles in order to increase the fixability to the tibia T. A surface or the like may be formed. The through-hole 3 is pre-filled with autogenous bone fragments from the iliac bone and the like, whereby the autogenous bone fragments and the tibia are fused at an early stage so that the spacer 1 is not displaced or the like. After the spacer 1 is filled, autogenous bone fragments from the iliac bone and the like are filled into the space S formed by cutting the upper side of the recessed surface 6, that is, the upper rear shoulder 5 of the spacer 1, thereby forming the largest gap. This part can be fused at an early stage. According to the spacer 1 configured as described above, at the time of incision for inserting the spacer, one of the left and right ends is left without being incised. There is no need to make an incision. As a result, no subcutaneous hematoma or pain remains after the operation, and bone fusion is also good. Further, since the spacer 1 has a tapered shape in the direction of the distal end 9, not only does the ligament N move forward as shown in FIG. The ligament N is returned to its original position, so that the patella P can be corrected to an appropriate position, and the varus deformity knee and varus deformity knee can be eliminated. The material of the spacer 1 is as follows.
The material is not limited to the above-mentioned ceramic material, and may be made of a metal material having no harm to the living body such as pure titanium or a titanium alloy, or any other suitable material among various materials having no harm to the living body, such as a titanium mesh. Although this embodiment shows an example of application to the patellofemoral joint, the spacer of the present invention is not limited to this region, but can be applied to other regions as appropriate. As described above, the spacer of the present invention comprises:
Since it is tapered in both directions, the lower end and the tip, it is possible to open the incised part of the bone with the left or right periosteum open to open the door and to install it in the bone, so that after surgery, subcutaneous hematoma There is no pain and no pain remains, and bone fusion is also good. Furthermore, since the tapered shape is formed in the direction of the distal end, the ligament deviated to the left or right can be returned to the original position, and the varus deformity knee and varus deformity knee can be eliminated.

BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a perspective view of a spacer according to an embodiment of the present invention. FIG. 2 shows the spacer of FIG. 1, (a) is a front view,
(B) is a side view, and (c) is a top view. FIG. 3 shows a state in which the spacer of FIG. 1 is mounted on the inner side of the rough surface of the tibia, (a) is a top view of the tibia before mounting,
(B) is a top view of the tibia after mounting. 4A and 4B show a state in which an autologous bone fragment or a conventional spacer is mounted on the inner side of a rough surface of a tibia, FIG. 4A is a side view of a patellofemoral joint before mounting, and FIG. FIG. FIG. 5 is a perspective view of a conventional spacer. 6 shows the spacer of FIG. 4, (a) is a front view,
(B) is a side view, and (c) is a top view. 7A and 7B show a state in which the spacer of FIG. 5 is mounted on the inner side of the rough surface of the tibia, and FIG. 7A is a horizontal cross-sectional view of the tibia before mounting.
(B) is a horizontal sectional view of the tibia after the attachment. FIG. 8 is a perspective view of the patellofemoral joint with the spacer of FIG. 5 attached to the medial side of the rough tibia. [EXPLANATION OF SYMBOLS] T: the tibia T _1: articular surface L: the tibial tuberosity N: ligament M, S: void K: autologous bone pieces J: periosteum P: patellofemoral Q: femur 1, 10: Spacer 2: side 3 : Through hole 4: Projection 5: Rear upper shoulder 6: Gouge surface 7: Lower front 8,11: Lower end 9: Tip

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Claims (1)

(57) [Claim 1] A block-shaped spacer made of a material having no harm to a living body, wherein the spacer has a tapered shape in both directions of a lower end and a tip. .