JP5866306B2 - 肩置換術用器具 - Google Patents
肩置換術用器具 Download PDFInfo
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- JP5866306B2 JP5866306B2 JP2012557610A JP2012557610A JP5866306B2 JP 5866306 B2 JP5866306 B2 JP 5866306B2 JP 2012557610 A JP2012557610 A JP 2012557610A JP 2012557610 A JP2012557610 A JP 2012557610A JP 5866306 B2 JP5866306 B2 JP 5866306B2
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- scapula
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- 210000001991 scapula Anatomy 0.000 claims description 122
- 241001653121 Glenoides Species 0.000 claims description 94
- 238000011882 arthroplasty Methods 0.000 claims description 20
- 238000000034 method Methods 0.000 claims description 20
- 238000005259 measurement Methods 0.000 claims description 19
- 238000005553 drilling Methods 0.000 claims description 7
- 238000001356 surgical procedure Methods 0.000 claims description 5
- 230000008569 process Effects 0.000 claims description 2
- 238000002591 computed tomography Methods 0.000 description 9
- 230000008901 benefit Effects 0.000 description 8
- 238000004458 analytical method Methods 0.000 description 5
- 238000010586 diagram Methods 0.000 description 5
- 238000003384 imaging method Methods 0.000 description 4
- 210000000323 shoulder joint Anatomy 0.000 description 4
- 210000003484 anatomy Anatomy 0.000 description 2
- 238000013459 approach Methods 0.000 description 2
- 238000010420 art technique Methods 0.000 description 2
- 206010003246 arthritis Diseases 0.000 description 2
- 230000000694 effects Effects 0.000 description 2
- 230000003628 erosive effect Effects 0.000 description 2
- 230000006870 function Effects 0.000 description 2
- 210000004095 humeral head Anatomy 0.000 description 2
- 239000007943 implant Substances 0.000 description 2
- 230000001939 inductive effect Effects 0.000 description 2
- 238000003780 insertion Methods 0.000 description 2
- 230000037431 insertion Effects 0.000 description 2
- 239000000463 material Substances 0.000 description 2
- 239000002184 metal Substances 0.000 description 2
- 238000007619 statistical method Methods 0.000 description 2
- 239000004698 Polyethylene Substances 0.000 description 1
- 230000004075 alteration Effects 0.000 description 1
- 230000015572 biosynthetic process Effects 0.000 description 1
- 210000000988 bone and bone Anatomy 0.000 description 1
- 238000010276 construction Methods 0.000 description 1
- 238000007796 conventional method Methods 0.000 description 1
- 230000007547 defect Effects 0.000 description 1
- 238000013461 design Methods 0.000 description 1
- 238000011161 development Methods 0.000 description 1
- 230000003292 diminished effect Effects 0.000 description 1
- 210000002758 humerus Anatomy 0.000 description 1
- 230000008407 joint function Effects 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- -1 polyethylene Polymers 0.000 description 1
- 229920000573 polyethylene Polymers 0.000 description 1
- 210000000513 rotator cuff Anatomy 0.000 description 1
- 239000007787 solid Substances 0.000 description 1
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1613—Component parts
- A61B17/1615—Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material
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- A—HUMAN NECESSITIES
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1796—Guides or aligning means for drills, mills, pins or wires for holes for sutures or flexible wires
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- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1662—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body
- A61B17/1684—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body for the shoulder
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- A—HUMAN NECESSITIES
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1697—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans specially adapted for wire insertion
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- A—HUMAN NECESSITIES
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- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
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- A—HUMAN NECESSITIES
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
- A61B17/1778—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the shoulder
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
- A61B17/8625—Shanks, i.e. parts contacting bone tissue
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- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/90—Guides therefor
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4657—Measuring instruments used for implanting artificial joints
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/8897—Guide wires or guide pins
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/2812—Surgical forceps with a single pivotal connection
- A61B17/2833—Locking means
- A61B2017/2837—Locking means with a locking ratchet
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/06—Measuring instruments not otherwise provided for
- A61B2090/062—Measuring instruments not otherwise provided for penetration depth
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
- A61F2/4612—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of shoulders
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4657—Measuring instruments used for implanting artificial joints
- A61F2002/4662—Measuring instruments used for implanting artificial joints for measuring penetration depth
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4657—Measuring instruments used for implanting artificial joints
- A61F2002/4668—Measuring instruments used for implanting artificial joints for measuring angles
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Veterinary Medicine (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Public Health (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Dentistry (AREA)
- Transplantation (AREA)
- Neurology (AREA)
- Biophysics (AREA)
- Physical Education & Sports Medicine (AREA)
- Cardiology (AREA)
- Vascular Medicine (AREA)
- Prostheses (AREA)
- Surgical Instruments (AREA)
- Length-Measuring Instruments Using Mechanical Means (AREA)
Description
図5は、上から見た場合の肩甲骨平面50、肩甲骨頸部平面51および関節窩平面52の略図を示す。表1は、この表示で見た関節窩の後傾の統計値を示す。
図6は、前方位置から見た場合の肩甲骨平面60、肩甲骨頸部平面61および関節窩平面62の略図を示す。表2は、この表示で見た関節窩の上方傾斜の統計値を示す。
図7は、肩甲骨平面に垂直な平面中で外側横方向から見た場合の肩甲骨平面70、肩甲骨頸部平面71および関節窩平面72の略図を示す。表3は、この表示で見た関節窩の回転の統計値を示す。
図8は、垂直な肩甲骨平面中で外側横方向から見た場合の肩甲骨平面80、肩甲骨頸部平面81および関節窩平面82の略図を示す。表4は、この表示におけるオフセット位置の統計値を示す。
図9は、肩甲骨頸部平面中で外側横方向から見た場合の肩甲骨平面90、肩甲骨頸部平面91および関節窩平面92の略図を示す。表5は、この表示におけるオフセット位置の統計値を示す。
11 関節窩表面
20 肩甲骨頸部の前方
21 肩甲骨の外側縁に沿った点
30 肩甲骨頸部の後方
40 棘上筋窩の最深部
50 肩甲骨平面
51 肩甲骨頸部平面
52 関節窩平面
60 肩甲骨平面
61 肩甲骨頸部平面
62 関節窩平面
70 肩甲骨平面
71 肩甲骨頸部平面
72 関節窩平面
73 上方−下方軸
74 上方−下方軸
80 肩甲骨平面
81 肩甲骨頸部平面
82 関節窩平面
83 外側関節窩縁上の点の下側2/3の幾何学的中心
90 肩甲骨平面
91 肩甲骨頸部平面
92 関節窩平面
100 本用具
101 アーム部分
102 グリップ部分
103 ハンドル部分
104 ラッチ手段
105 ガイド
120 取り付け点
121 第2のキーワイヤーガイド
130 軸
131 軸
140 キーワイヤー
141 鋭い末端
142 拡大直径
160 組み合わせたドリルおよびキーワイヤー
161 点領域
162 ドリルビット領域
Claims (13)
- 肩甲骨内にドリル開けする工程中にキーワイヤーを誘導するためのガイドと、
アームのペアであって、一緒にヒンジ連結されてアーム間の相対的回転が可能であり、アームの一方の末端はハンドル部分で、アームの他方の末端はグリップ部分でそれぞれ終結する、アームのペアと、前記ガイド中に位置付けられているキーワイヤーが肩甲骨頸部と事前に決定された幾何学的関係で位置付けられるように、前記肩甲骨頸部と係合するように構成されたグリップ部分と、
を備え、ここで、前記事前に決定された幾何学的関係は、前記ガイドによって誘導されたキーワイヤーと前記肩甲骨頸部との間に0°〜5°の範囲の後傾をもたらすことで、キーワイヤーが関節窩人工装具を肩甲骨頸部に対して所要の位置で配置するように利用できる関係である、
肩関節形成術中に関節窩人工装具を配置するためのキーワイヤーを誘導するための外科装置。 - 前記事前に決定された幾何学的関係が、前記ガイドによって誘導されたキーワイヤーと前記肩甲骨頸部との間に約2.1°の後傾をもたらす、請求項1に記載の外科装置。
- 前記事前に決定された幾何学的関係が、前記ガイドによって誘導されたキーワイヤーと前記肩甲骨頸部との間に0.4°〜3.8°の範囲の後傾をもたらす、請求項1に記載の外科装置。
- 前記事前に決定された幾何学的関係が、前記ガイドによって誘導されたキーワイヤーと前記肩甲骨頸部との間に約1.9°の上方傾斜をもたらす、請求項1に記載の外科装置。
- 前記事前に決定された幾何学的関係が、前記ガイドによって誘導されたキーワイヤーと前記肩甲骨頸部との間に0.3°〜3.5°の範囲の上方傾斜をもたらす、請求項1に記載の外科装置。
- 前記事前に決定された幾何学的関係が、前記ガイドによって誘導されたキーワイヤーと前記肩甲骨頸部との間に0°〜5°の範囲の上方傾斜をもたらす、請求項1に記載の外科装置。
- 前記事前に決定された幾何学的関係が、前記ガイドによって誘導されたキーワイヤーと前記肩甲骨頸部との間に0mmのオフセットをもたらす、請求項1に記載の外科装置。
- 前記事前に決定された幾何学的関係が、前記ガイドによって誘導されたキーワイヤーと前記肩甲骨頸部との間に−0.2mm〜0.8mmの範囲のオフセットをもたらす、請求項1に記載の外科装置。
- 前記事前に決定された幾何学的関係が、前記ガイドによって誘導されたキーワイヤーと前記肩甲骨頸部との間に0mm〜1.5mmの範囲のオフセットをもたらす、請求項1に記載の外科装置。
- キーワイヤーを誘導するための第2のガイドをさらに備える、請求項1から9のいずれかに記載の外科装置。
- 取り外し可能に連結された2つの部分を備える、請求項1から10のいずれかに記載の外科装置。
- 少なくとも1つのガイドが、前記事前に決定された幾何学的関係を変動させるために調節可能である、請求項1から11のいずれかに記載の外科装置。
- 請求項1から12のいずれかに記載の外科装置と、拡張直径部分および測定指標を備える、肩関節形成術において使用するためのキーワイヤーとを含み、ここで、前記測定指標は、前記キーワイヤーの軸に沿った拡張直径部分からの距離の指標をもたらす、キット。
Applications Claiming Priority (5)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
EP10305265.0 | 2010-03-17 | ||
EP10305265 | 2010-03-17 | ||
GB1014694.2 | 2010-09-06 | ||
GB1014694.2A GB2479017B (en) | 2010-03-17 | 2010-09-06 | Shoulder replacement apparatus |
PCT/GB2011/050521 WO2011114153A1 (en) | 2010-03-17 | 2011-03-16 | Shoulder replacement apparatus |
Publications (2)
Publication Number | Publication Date |
---|---|
JP2013521917A JP2013521917A (ja) | 2013-06-13 |
JP5866306B2 true JP5866306B2 (ja) | 2016-02-17 |
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Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
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JP2012557610A Active JP5866306B2 (ja) | 2010-03-17 | 2011-03-16 | 肩置換術用器具 |
Country Status (11)
Country | Link |
---|---|
US (1) | US9592065B2 (ja) |
EP (1) | EP2547269B1 (ja) |
JP (1) | JP5866306B2 (ja) |
CN (1) | CN102821703B (ja) |
AU (1) | AU2011228836B2 (ja) |
BR (1) | BR112012023391B1 (ja) |
CA (1) | CA2793346C (ja) |
GB (3) | GB2479694B (ja) |
IL (1) | IL222094A (ja) |
RU (3) | RU2682501C2 (ja) |
WO (1) | WO2011114153A1 (ja) |
Families Citing this family (8)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
GB201320745D0 (en) * | 2013-11-25 | 2014-01-08 | Darwood Alastair | A method and apparatus for the intraoperative production of a surgical guide |
US9681960B2 (en) | 2014-05-16 | 2017-06-20 | Howmedica Osteonics Corp. | Guides for fracture system |
US10575968B2 (en) | 2014-05-16 | 2020-03-03 | Howmedica Osteonics Corp. | Guides for fracture system |
CN104000641B (zh) * | 2014-06-13 | 2016-08-17 | 赵金忠 | 一种微创条件下的肩关节植骨装置 |
CN106264652B (zh) * | 2015-06-09 | 2019-04-16 | 北京纳通科技集团有限公司 | 截骨工具 |
WO2019245862A1 (en) | 2018-06-19 | 2019-12-26 | Tornier, Inc. | Visualization of intraoperatively modified surgical plans |
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EP2547269A1 (en) | 2013-01-23 |
CN102821703A (zh) | 2012-12-12 |
GB2479694B (en) | 2012-02-08 |
GB2479695B (en) | 2012-02-08 |
BR112012023391A2 (pt) | 2016-11-29 |
RU2015146304A (ru) | 2019-01-11 |
RU2682501C2 (ru) | 2019-03-19 |
AU2011228836A1 (en) | 2012-10-18 |
GB2479695A (en) | 2011-10-19 |
AU2011228836B2 (en) | 2015-10-15 |
RU2693363C2 (ru) | 2019-07-02 |
RU2015146304A3 (ja) | 2019-05-13 |
US9592065B2 (en) | 2017-03-14 |
RU2015146370A (ru) | 2019-01-11 |
RU2015146370A3 (ja) | 2019-01-23 |
GB201014694D0 (en) | 2010-10-20 |
CA2793346A1 (en) | 2011-09-22 |
EP2547269B1 (en) | 2016-09-28 |
GB201114224D0 (en) | 2011-10-05 |
GB2479017A (en) | 2011-09-28 |
GB2479017B (en) | 2012-02-08 |
JP2013521917A (ja) | 2013-06-13 |
CN102821703B (zh) | 2016-01-20 |
BR112012023391B1 (pt) | 2020-05-26 |
RU2569531C2 (ru) | 2015-11-27 |
CA2793346C (en) | 2019-10-22 |
RU2012144023A (ru) | 2014-04-27 |
IL222094A (en) | 2017-08-31 |
US20130023999A1 (en) | 2013-01-24 |
WO2011114153A1 (en) | 2011-09-22 |
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