JP6416644B2 - Surgical instrument for total knee arthroplasty - Google Patents

Description

  The present invention relates to a surgical instrument for artificial knee joint replacement used in artificial knee joint replacement.

  Conventionally, artificial knee joint replacement, which is an operation for replacing a knee joint with an artificial knee joint, has been performed on a patient with an abnormality in the knee joint. In total knee arthroplasty, an implant is placed on each of the proximal end of the patient's tibia and the distal end of the femur. When the implant is placed on the tibia, first, a part of the proximal end of the tibia is excised with an excision instrument such as a bone saw. Thereby, the installation surface of an implant is formed in the edge part of the proximal side of a tibia.

  When a part of the proximal end of the tibia is excised with the excision instrument as described above, a surgical instrument for artificial knee joint replacement including an excision guide part for guiding the excision direction of the excision instrument is used. . As such a surgical instrument for artificial knee joint replacement, one disclosed in Non-Patent Document 1 is known.

  The surgical instrument for artificial knee joint replacement disclosed in Non-Patent Document 1 is provided with a vertical rod portion arranged so as to extend along the vertical direction of the human body. And the ankle joint fixing | fixed part fixed to an ankle joint is provided in the one end side of the rod part of an up-down direction. Further, the above-described resection guide portion is provided on the other end side of the vertical rod portion. Furthermore, the rod part of the front-back direction arrange | positioned so that it may extend along the front-back direction of a human body is provided in the other end side of the rod part of an up-down direction.

  In addition, a through hole into which a long spike pin and a short spike pin are fitted is formed in the rod portion in the front-rear direction. Each spike pin fitted to the rod part in the front-rear direction is driven by a hammer so that it is inserted into the proximal end of the tibia and fixed to the tibia.

Smith & Nephew, Inc., “JOURNEY II BCS Bi-Cruciate Stabilized Knee System”, [online], [searched January 20, 2015], Internet <URL: http://www.smith-nephew.com/ global / assets / pdf / products / surgical / journeyii_st_rev.pdf>

  In artificial knee joint replacement, when using the surgical instrument for artificial knee joint replacement disclosed in Non-Patent Document 1, an operator first fixes the ankle joint fixing portion to the ankle joint. The operator then inserts and fixes the long spike pin into the proximal end of the tibia with the long spike pin penetrating the rod portion in the front-rear direction.

  Next, the operator adjusts the position of the vertical rod portion so that the vertical rod portion is disposed substantially parallel to the bone axis direction of the patient's tibia. At this time, the surgeon swings the vertical rod portion while partially destroying the portion of the tibia where the long spike pin is inserted, and adjusts the position of the rod portion relative to the tibia. When the surgeon adjusts the position of the vertical rod part relative to the tibia to a desired position, the short spike pin is inserted into the proximal end of the tibia with the short spike pin penetrating the rod part in the anteroposterior direction. Insert into and fix. When the two spike pins are fixed to the tibia, the operator then inserts the pin into the tibia and fixes the pin while the other pin different from the spike pin is passed through the resection guide portion. In this state, the resection instrument is used, and while the resection direction of the resection instrument is guided by the resection guide part, a part of the proximal end of the tibia is resectioned to form the implant installation surface.

  As described above, when using the surgical instrument for artificial knee joint replacement disclosed in Non-Patent Document 1, the operator breaks the rod portion in the vertical direction while partially destroying the portion where the long spike pin is inserted in the tibia. The position of the rod portion with respect to the tibia is adjusted. On the other hand, it is desirable that the range in which the tibia is broken by the long spike pin is suppressed as small as possible. For this reason, the adjustment range of the position of the vertical rod portion with respect to the tibia is greatly limited, and the adjustment range is narrowed. Therefore, there is a problem that it is difficult to adjust the position of the rod portion in the vertical direction. In particular, there is a problem that it is difficult to adjust the position by swinging the rod portion in the vertical direction along the longitudinal direction of the human body.

  In addition, when the cortical bone or cancellous bone in the patient's tibia is hard, it is difficult to destroy the portion of the tibia where the long spike pin is inserted. In this case, it is difficult to change and adjust the position of the rod portion in the vertical direction with respect to the ankle joint fixing portion. Therefore, also in this case, the adjustment range of the position of the vertical rod portion with respect to the tibia is greatly limited, and the adjustment range becomes narrow. For this reason, also in this case, there is a problem that it is difficult to adjust the position of the rod portion in the vertical direction.

  Further, when the surgical instrument for artificial knee joint replacement disclosed in Non-Patent Document 1 is used, if a short spike pin is inserted into the tibia and fixed, the position of the vertical rod portion relative to the tibia is defined. . For this reason, the surgeon can adjust the position of the vertical rod portion with respect to the tibia only in a state where only the long spike pin is inserted into the tibia. Therefore, the operator must adjust the position of the vertical rod portion in all directions relative to the tibia with only the long spike pin inserted into the tibia.

  More specifically, first, the operator performs a position adjustment operation in which only the long spike pin is inserted into the tibia and the position of the rod is adjusted by swinging the rod portion in the vertical direction along the longitudinal direction of the human body. There must be. In addition, the operator adjusts the position by swinging the rod part in the vertical direction along the horizontal plane perpendicular to the human body axis with only the long spike pin inserted into the tibia. Must also be done. In addition, if necessary, the surgeon must also perform a position adjustment operation of adjusting the position by swinging the rod portion in the vertical direction along the horizontal direction of the human body. In this way, the operator must adjust the position of the vertical rod part in all directions relative to the tibia with only the long spike pin inserted into the tibia. There is a problem that adjustment work is difficult.

  The present invention has been made in view of the above circumstances, and the purpose thereof is to expand the adjustment range of the position of the rod portion arranged to extend along the vertical direction of the human body with respect to the tibia. It is an object of the present invention to provide a surgical instrument for artificial knee joint replacement that can easily adjust the position of a rod portion.

  (1) A surgical instrument for an artificial knee joint replacement according to an aspect of the present invention for achieving the above object is a surgical instrument for an artificial knee joint replacement used in an artificial knee joint replacement, A main body portion having an upper and lower rod portion arranged so as to extend along a direction, an ankle joint fixing portion attached to the main body portion on one end side of the upper and lower rod portion and fixed to an ankle joint, and the upper and lower rod portion A resection guide portion that is attached to the main body portion on the other end side and guides the resecting direction of the resecting device when a portion of the proximal end of the tibia is resected by the resecting device, and the upper and lower rod portions A front and rear rod portion that is attached to the main body portion on the other end side of the body and is arranged to extend along the front and rear direction of the human body, and a proximal end portion of the tibia in a state of being inserted into the front and rear rod portion. Inserted and fixed to the tibia A first pin and a second pin, wherein the first pin and the second pin are respectively inserted into a first hole and a second hole provided side by side along a longitudinal direction of the front and rear rod portions, Each of the first hole and the second hole is provided as a through-hole penetrating the front / rear rod part, and is provided as a long hole extending along the longitudinal direction of the front / rear rod part. At least one of the hole and the second hole is provided as a cross-sectional area changing hole provided with a narrowed portion in which the cross-sectional area of the hole decreases in the through direction of the hole.

  According to this configuration, the front and rear rod portions are provided with the first hole and the second hole into which the first pin and the second pin are inserted, respectively, as long holes that extend along the longitudinal direction of the front and rear rod portion. . Furthermore, at least one of the first hole and the second hole is provided as a cross-sectional area changing hole provided with a portion where the cross-sectional area of the hole is reduced and narrowed in the penetration direction of the hole. For this reason, the adjustment range of the position of the upper and lower rod portions with respect to the tibia can be expanded, and the adjustment operation of the position of the upper and lower rod portions can be easily performed.

  The above effect will be described in more detail. First, the operator inserts and fixes the pin into the proximal end of the tibia with one of the first pin and the second pin inserted into the cross-sectional area change hole. In this state, the surgeon adjusts the position of the upper and lower rod portions so that the upper and lower rod portions are arranged substantially parallel to the bone axis direction of the patient's tibia. At this time, the surgeon swings the vertical rod portion by changing the relative position of the pin inside the cross-sectional area change hole without destroying the tibia with the pin inserted into the tibia, and the vertical rod portion The position relative to the tibia can be easily adjusted. In addition, since it is not necessary to destroy the tibia with the pin inserted into the tibia, even if the cortical bone or the cancellous bone in the patient's tibia is hard, the operator can By changing the position, the upper and lower rod portions can be swung, and the position of the upper and lower rod portions with respect to the tibia can be easily adjusted.

  Therefore, according to said structure, the adjustment range of the position with respect to the tibia of an up-and-down rod part is not restrict | limited largely, The adjustment range can be expanded compared with the conventional case. For this reason, it is possible to easily adjust the position of the upper and lower rod portions. Moreover, according to said structure, both the 1st hole and the 2nd hole are provided as a long hole extended and opened along the longitudinal direction of the front-back rod part. For this reason, it becomes easier to adjust the position by swinging the upper and lower rod portions along the front-rear direction of the human body.

  According to the above configuration, the cross-sectional area change hole into which one of the first pin and the second pin is inserted is provided with a narrowed portion in which the cross-sectional area of the hole is reduced in the through direction of the hole, and It is provided as a long hole that extends along the longitudinal direction of the rod portion and opens. Therefore, in a state where only one of the first pin and the second pin is fixed to the tibia, the operator can adjust the positions of the upper and lower rod portions in all directions with respect to the tibia. More specifically, the operator can perform a position adjustment operation of adjusting the position by swinging the upper and lower rod portions along the front-rear direction of the human body. Further, the operator can also perform a position adjustment operation of adjusting the position by swinging the upper and lower rod portions along a horizontal plane perpendicular to the body axis of the human body. Furthermore, the operator can also perform a position adjustment operation of adjusting the position by swinging the upper and lower rod portions along the left and right direction of the human body.

  With only one of the first pin and the second pin fixed to the tibia, the surgeon swings the upper and lower rods so as to rotate at least along a horizontal plane perpendicular to the human body axis. Perform the position adjustment to be adjusted. Then, with this position adjustment operation completed, the operator inserts the other of the first pin and the second pin into the anteroposterior rod portion, and inserts the other pin into the proximal end of the tibia. Fix it. Both the first hole and the second hole are provided as elongated holes that extend along the longitudinal direction of the front and rear rod portions. For this reason, even in a state where both the first pin and the second pin are fixed to the tibia, the operator can perform the position adjustment operation by swinging the upper and lower rod portions along the front-rear direction of the human body. . Therefore, the surgeon adjusts the position of the upper and lower rod portions in different directions with respect to the tibia, in a state where only one of the first pin and the second pin is fixed to the tibia and when both the first pin and the second pin are It can be performed separately in the state fixed to the tibia. Therefore, the adjustment work of the position of the upper and lower rod portions can be performed more easily.

  When both the first pin and the second pin are fixed to the tibia and the adjustment work of all the positions of the upper and lower rod portions with respect to the tibia is completed, the surgeon attaches another pin different from the first pin and the second pin. The pin is inserted into the tibia and fixed while being penetrated through the resection guide part. In this state, the cutting instrument is used, and a part of the proximal end of the tibia is cut while the cutting direction of the cutting tool is guided by the cutting guide part.

  As described above, according to the above configuration, the adjustment range of the position of the upper and lower rod portions arranged to extend in the vertical direction of the human body relative to the tibia can be expanded, and the position adjustment operation of the upper and lower rod portions It is possible to provide a surgical instrument for artificial knee joint replacement that can be easily performed.

(2) It is preferable that the cross-sectional area changing hole is provided as a hole having a shape that continuously increases after the cross-sectional area of the hole once continuously decreases in the penetration direction of the hole.

  According to this configuration, the cross-sectional area changing hole continuously increases after the hole cross-sectional area once decreases continuously. For this reason, the front and rear rod portions can be swung more smoothly around the portion having a small cross-sectional area in the cross-sectional area change hole with respect to the first pin or the second pin inserted into the cross-sectional area change hole. . Thereby, the adjustment operation | work of the position of an up-and-down rod part can be performed still more easily.

(3) The cross-sectional area change hole once continuously decreases in the hole width direction, which is a direction perpendicular to both the hole penetration direction and the longitudinal direction of the front and rear rod portions in the hole penetration direction. It is preferable that the hole is provided as a continuously increasing shape.

  According to this configuration, the sectional area changing hole is configured to continuously increase after the dimension in the hole width direction once decreases continuously. For this reason, with respect to the first pin or the second pin inserted into the cross-sectional area change hole, the front and rear rod portions are smoother along the left-right direction of the human body around the small cross-sectional area of the cross-sectional area change hole. Can be swung. As a result, the position adjusting operation performed by swinging the upper and lower rod portions along the horizontal direction of the human body can be performed more easily.

  According to the present invention, the adjustment range of the position of the upper and lower rod parts arranged so as to extend along the vertical direction of the human body relative to the tibia can be expanded, and the adjustment work of the position of the upper and lower rod parts can be easily performed. A surgical instrument for artificial knee joint replacement can be provided.

It is a figure which shows the surgical instrument for artificial knee joint replacement surgery which concerns on one embodiment of this invention. It is a figure which shows typically the usage type of the surgical instrument for artificial knee joint replacement, Comprising: It is a perspective view which shows the surgical instrument for artificial knee joint replacement with a patient's tibia. It is a figure which shows typically the usage type of the surgical instrument for artificial knee joint replacement, Comprising: It is a front view which shows the surgical instrument for artificial knee joint replacement with a patient's tibia. It is a figure which shows typically the usage type of the surgical instrument for artificial knee joint replacement, Comprising: It is a side view which shows the surgical instrument for artificial knee joint replacement with a patient's tibia. It is a figure which shows typically the usage form of the surgical instrument for artificial knee joint replacement, Comprising: It is a top view which shows the surgical instrument for artificial knee joint replacement with a patient's tibia. It is a figure which expands and shows a part of FIG. It is a figure which expands and shows a part of FIG. It is a top view of the surgical instrument for artificial knee joint replacement. It is sectional drawing which shows the cross section of the front-back rod part of the surgical instrument for artificial knee joint replacement seen from the AA arrow direction of FIG. It is sectional drawing which shows the cross section of the front-back rod part of the surgical instrument for artificial knee joint replacement seen from the BB arrow direction of FIG. It is sectional drawing of the front-back rod part and the 1st pin in the state in which the 1st pin was inserted in the front-back rod part in the surgical instrument for artificial knee joint replacement surgery. It is sectional drawing of the front-back rod part and the 2nd pin in the state in which the 2nd pin was inserted in the front-back rod part in the surgical instrument for artificial knee joint replacement. It is a schematic diagram for demonstrating the usage type of the surgical instrument for artificial knee joint replacement, Comprising: It is a side view which shows the surgical instrument for artificial knee joint replacement with a patient's tibia. It is a schematic diagram for demonstrating the usage type of the surgical instrument for artificial knee joint replacement, Comprising: It is a side view which shows the surgical instrument for artificial knee joint replacement with a patient's tibia.

  Hereinafter, modes for carrying out the present invention will be described. The present invention can be widely applied as a surgical instrument for artificial knee joint replacement used in artificial knee joint replacement for replacing a patient's knee joint with an artificial knee joint.

[Summary of Surgical Instruments for Knee Arthroplasty and Knee Arthroplasty]
FIG. 1 is a view showing a surgical instrument 1 for artificial knee joint replacement according to an embodiment of the present invention (hereinafter also simply referred to as “surgical instrument 1”). The surgical instrument 1 is used in artificial knee joint replacement. Artificial knee joint replacement is an operation in which a knee joint is replaced with an artificial knee joint for a patient who has an abnormality in the knee joint.

  In total knee arthroplasty, a portion of the proximal end of the patient's tibia and a distal end of the femur are respectively excised to form a placement surface for the implant. The artificial knee joint includes a tibial implant (not shown) and a femoral implant (not shown). Then, the tibial implant is installed on the installation surface (not shown) of the proximal end of the tibia, and the femoral implant is installed on the installation surface (not shown) of the distal end of the femur. Is done. This replaces the patient's knee joint with an artificial knee joint. The “proximal side” is a side closer to the trunk, and the “distal side” is a side farther from the trunk.

  As described above, in artificial knee joint replacement, a tibial implant placement surface is formed at the proximal end of the tibia. When the placement surface of the implant is formed at the proximal end of the tibia, a part of the proximal end of the tibia is excised with a cutting tool (not shown) such as a bone saw. When the proximal end portion of the tibia is excised with the excision instrument, the surgical instrument 1 for artificial knee joint replacement including the excision guide part for guiding the excision direction of the excision instrument is used. Hereinafter, the surgical instrument 1 for artificial knee joint replacement will be described in detail.

  FIG. 2 is a perspective view schematically showing a usage pattern of the surgical instrument 1 and showing the surgical instrument 1 together with the patient's tibia 100. FIG. 3 is a diagram schematically showing a usage pattern of the surgical instrument 1, and is a front view showing the surgical instrument 1 together with the patient's tibia 100. FIG. 4 is a diagram schematically showing a usage pattern of the surgical instrument 1, and is a side view showing the surgical instrument 1 together with the patient's tibia 100. FIG. 5 is a diagram schematically showing a usage pattern of the surgical instrument 1, and is a plan view showing the surgical instrument 1 together with the patient's tibia 100. 2 to 5, only the tibia 100 is schematically shown as an element of the patient's human body, and illustrations of other soft tissues such as other bones and muscles of the patient's human body are omitted. .

  In each figure described below, the direction indicated by the arrow described as “upper” corresponds to the upper side or the upper side of the patient's human body, and the direction indicated by the arrow described as “lower” is the patient's human body. The direction indicated by the arrow labeled “Right” corresponds to the right or right side of the patient's human body, and the direction indicated by the arrow labeled “Left” corresponds to the patient's human body. The direction indicated by the arrow marked “front” corresponds to the front or front of the patient's human body, and the direction indicated by the arrow marked “rear” corresponds to the patient's human body. Corresponds to the rear or rear. That is, the up-down direction, the left-right direction, and the front-rear direction shown in each drawing described below correspond to the up-down direction, the left-right direction, and the front-rear direction based on the human body of the patient.

  As shown in FIGS. 1 to 5, the surgical instrument 1 includes a main body part 11, an ankle joint fixing part 12, a resection guide part 13, a front / rear rod part 14, a first pin 15, a second pin 16, and the like. Has been.

[Main unit]
As shown in FIGS. 1 to 5, the main body 11 includes an upper and lower rod portion 17, a shaft connecting portion 18, a front and rear rod support portion 20, and the like.

  The upper and lower rod portions 17 are disposed so as to extend along the vertical direction of the human body in a state where the surgical instrument 1 is disposed along the tibia 100. The upper / lower rod portion 17 includes a first rod 17a, a second rod 17b, a third rod 17c, and the like. The first rod 17a, the second rod 17b, and the third rod 17c are all provided as linearly extending members and are arranged along the vertical direction of the human body.

  The first rod 17a and the second rod 17b are coaxially connected in series. The first rod 17a is provided, for example, as a rectangular tube member, and the second rod 17b is provided, for example, as a round bar member having a substantially circular cross section. And the 2nd rod 17b is comprised so that the part by the side of the one end part may be inserted with respect to the inner side of the 1st rod 17a, and a position can be changed along an axial direction with respect to the 1st rod 17a. . That is, the part comprised by the 1st rod 17a and the 2nd rod 17b in the up-and-down rod part 17 is comprised by the axial direction so that expansion-contraction is possible.

  With the above configuration, the upper and lower rod portions 17 are configured to be capable of changing the length in the axial direction. That is, the vertical rod portion 17 is configured to be adjustable in length in the vertical direction of the human body in a state where the vertical rod portion 17 is disposed along the tibia 100. A positioning portion 17d is provided at a connecting portion of the upper and lower rod portions 17 between the first rod 17a and the second rod 17b. The positioning portion 17d is provided as a mechanism for positioning the axial position of the second rod 17b with respect to the first rod 17a at a position desired by the operator. For example, the positioning part 17d is provided with an engaging part for engaging the first rod 17a and the second rod 17b based on the spring force and a pressing operation part for releasing the engagement based on the spring force. It is configured. The upper and lower rod parts 17 are configured such that the operator can change the position of the second rod 17b with respect to the first rod 17a stepwise by operating the positioning part 17d.

  The third rod 17c is provided as a rod-shaped member having a substantially rectangular cross section. Further, the third rod 17c is provided with a slit-like opening penetrating in a direction perpendicular to the axial direction at an intermediate portion in the axial direction. The third rod 17c is connected to the second rod 17b via a rod connecting portion 17e described later.

  The third rod 17c is connected to the second rod 17b via the rod connecting portion 17e in a state where the axial direction of the third rod 17c and the axial direction of the second rod 17b are set in parallel. ing. That is, the third rod 17c is not coaxially connected to the second rod 17b, but is connected by the rod connecting portion 17e in a state where the axial direction is offset and extends in parallel.

  As described above, the rod connecting portion 17e connects the third rod 17c to the second rod 17b with the axial direction being offset and extending in parallel. Further, a resection guide portion 13 to be described later is attached to the rod connecting portion 17e. And the mechanism which adjusts the position of the cutting guide part 13 with respect to the 2nd rod 17b in the axial direction of the 3rd rod 17c continuously is provided in the rod connection part 17e. For example, the rod connecting portion 17e includes a rotation operation portion that is rotated by an operator, and a linear displacement portion that continuously displaces linearly along the axial direction of the rotation axis in accordance with the rotation operation of the rotation operation portion. And are provided. For example, the rotation operation unit is attached to the second rod 17 b so as to be rotatable, and the linear displacement unit is attached to the resection guide unit 13.

  And the surgical instrument 1 is comprised so that the position in the up-down direction of the human body of the 3rd rod 17c with respect to the 2nd rod 17b can be changed in a stepless manner, when an operator operates the rod connection part 17e. Thereby, after the operator adjusts the position along the vertical direction of the human body with respect to the first rod 17a of the second rod 17b, the surgical instrument 1 further moves the human body up and down with respect to the second rod 17b of the third rod 17c. It is configured so that the position along the direction can be finely adjusted.

  The shaft connecting portion 18 is provided as a mechanism for connecting the upper and lower rod portions 17 and an ankle joint fixing portion 12 described later. The ankle joint fixing portion 12 is provided with a shaft 21. The shaft connecting portion 18 connects the first rod 17a and the shaft 21 to connect the vertical rod portion 17 and the ankle joint fixing portion 12.

  The shaft connecting portion 18 connects the shaft 21 to the end portion of the first rod 17a so that the axial direction of the shaft 21 is orthogonal to the axial direction of the first rod 17a. The shaft connecting portion 18 is an end portion of the first rod 17a opposite to the side connected to the second rod 17b (the lower end portion when the first rod 17a is disposed along the vertical direction of the human body). The shaft 21 is connected to the first rod 17a.

  Further, the shaft connecting portion 18 is provided with a through hole through which the shaft 21 penetrates slidably in the axial direction. The surgical instrument 1 is configured such that the position of the upper and lower rod portions 17 relative to the ankle joint fixing portion 12 in the axial direction of the shaft 21 can be changed by changing the position of the shaft coupling portion 18 with respect to the shaft 21. Accordingly, the surgical instrument 1 is configured to be able to adjust the position of the upper and lower rod portions 17 in the front-rear direction of the human body with respect to the ankle joint fixing portion 12 in a state of being disposed along the tibia 100.

  The shaft connecting portion 18 is also provided with a mechanism for positioning the position of the first rod 17a in the direction parallel to the axial direction of the shaft 21 with respect to the shaft 21 at a position desired by the operator. For example, the shaft connecting portion 18 is provided with an engaging portion for engaging the shaft 21 and the first rod 17a based on the spring force, and a pressing operation portion for releasing the engagement based on the spring force. Yes. And the surgical instrument 1 is comprised so that the position in the front-back direction of the human body of the upper-and-lower rod part 17 with respect to the ankle joint fixing | fixed part 12 can be changed in steps, when an operator operates the shaft connection part 18. FIG.

  The front / rear rod support portion 20 is provided as a mechanism that connects the upper / lower rod portion 17 and a front / rear rod portion 14 described later, and supports the front / rear rod portion 14 with respect to the upper / lower rod portion 17. Further, the front / rear rod support portion 20 includes a rectangular tube-shaped block member. The front / rear rod support portion 20 is attached to the end portion of the third rod 17c. The front / rear rod support portion 20 is the end of the third rod 17c opposite to the side connected to the second rod 17b (the upper end when the third rod 17c is disposed along the vertical direction of the human body). The front / rear rod portion 14 is connected to the third rod 17c.

  The front / rear rod support portion 20 is provided with a through hole into which the front / rear rod portion 14 is slidably inserted in the axial direction. Then, the front / rear rod support part 20 connects the front / rear rod part 14 to the third rod part 17c so that the axial direction of the front / rear rod part 14 inserted into the through hole is orthogonal to the axial direction of the third rod 17c. It is slidably connected to the end of the. Then, by changing the position of the front / rear rod part 14 with respect to the front / rear rod support part 20, the position of the front / rear rod part 14 with respect to the upper / lower rod part 17 in the direction orthogonal to the axial direction of the third rod 17c is changed. .

  The front / rear rod support portion 20 is provided with a mechanism for continuously adjusting the position of the front / rear rod portion 14 relative to the third rod 17c. For example, the front / rear rod support portion 20 is provided with a rotary screw portion that is rotated by an operator and is screwed so as to be displaceable with respect to the above-described rectangular tube-like block member. The distal end portion of the rotating screw portion is configured to be able to position the front and rear rod portion 14 with respect to the block-shaped member by contacting the front and rear rod portion 14 inside the block-shaped member. Then, the surgical instrument 1 allows the surgeon to operate the rotary screw part, thereby stepping the position of the front / rear rod part 14 along the front / rear direction of the human body to the position desired by the operator. It is configured so that it can be adjusted to.

[Ankle joint fixing part]
The ankle joint fixing portion 12 shown in FIGS. 1 to 5 is provided as a mechanism that is attached to the main body portion 11 at one end side of the upper and lower rod portions 17 and fixed to the ankle joint. The ankle joint fixing part 12 includes a shaft 21, a pair of clamp parts (22a, 22b), a frame part 23, and the like.

  The shaft 21 has, for example, a round bar-like portion with a substantially circular cross section, and is provided as a member extending linearly. The shaft 21 is disposed such that the axial direction thereof extends along the front-rear direction of the human body when the surgical instrument 1 is disposed along the tibia 100. And as above-mentioned, the shaft 21 is the end part of the 1st rod 17a of the upper-and-lower rod part 17 (the lower end part when the 1st rod 17a is arrange | positioned along the up-down direction of a human body) via the shaft connection part 18. ). Thereby, the ankle joint fixing part 12 is attached to the main body part 11 on one end side of the upper and lower rod part 17 (lower end side when the upper and lower rod part 17 is arranged along the vertical direction of the human body).

  The pair of clamp portions (22a, 22b) is a mechanism for fixing the ankle joint fixing portion 12 to the ankle joint by clamping (fixing) the ankle joint toward the frame portion 23 from the outside. Is provided. The frame portion 23 has a pair of arm-shaped portions, and is provided as a structure having a shape in which the pair of arm-shaped portions are obliquely intersected and integrated. And the frame part 23 is comprised so that a pair of clamp part (22a, 22b) and the shaft 21 may be connected. The shaft 21 is attached to the central portion of the frame portion 23 at its end. Each of the pair of clamp portions (22a, 22b) is attached to each end portion of the pair of arm-shaped portions.

  The frame portion 23 is disposed from the front side to the left and right sides with respect to the ankle joint. A pair of clamp part (22a, 22b) is arrange | positioned from the left-right side to the back side with respect to an ankle joint. And a pair of clamp part (22a, 22b) and the frame part 23 are arrange | positioned so that the circumference | surroundings of an ankle joint may be enclosed except the area | region between a pair of clamp parts (22a, 22b) in the back of an ankle joint. Thereby, a pair of clamp part (22a, 22b) and the frame part 23 are comprised so that an ankle joint may be inserted | pinched from the circumference and fixed.

  Each of the pair of clamp parts (22a, 22b) is attached to the frame part 23 in a cantilevered manner so as to be swingable. Further, a torsion spring that urges each of the pair of clamp portions (22a, 22b) toward the frame portion 23 side is provided at a connection portion between the pair of clamp portions (22a, 22b) and the frame 23. .

  When the operator fixes the ankle joint fixing portion 12 to the ankle joint, the operator temporarily opens the pair of clamp portions (22a, 22b) with respect to the frame portion 23 against the spring force of the torsion spring. Rocks. Then, the surgeon releases the force applied against the spring force of the torsion spring while surrounding the ankle joint with the pair of clamp parts (22a, 22b) and the frame part 23. Accordingly, the pair of clamp portions (22a, 22b) swings so as to sandwich the ankle joint toward the frame portion 23 by the spring force of the torsion spring, and the pair of clamp portions (22a, 22b) and the frame portion 23 are moved. Fixed to the ankle joint. In the drawing, the soft tissue around the tibia 100 is not shown, but the ankle joint fixing unit 12 is fixed to the ankle joint from the outside of the soft tissue.

[Resection guide]
FIG. 6 is an enlarged view of a part of FIG. FIG. 7 is an enlarged view of a part of FIG. The excision guide part 13 shown in FIGS. 1 to 7 is a mechanism for guiding the excision direction of the excision instrument when a part of the proximal end of the tibia 100 is excised by an excision instrument (not shown) such as a bone saw. It is provided as.

  The excision guide part 13 is provided with an attaching part 13a, a slit forming part 13b, and the like. The excision guide part 13 is attached and fixed to the rod connecting part 17e of the upper and lower rod parts 17 in an attachment part 13a provided in a block shape. Thereby, the resection guide part 13 is attached to the main body part 11 on the other end side of the upper and lower rod part 17 (upper end side when the upper and lower rod part 17 is arranged along the vertical direction of the human body).

  The slit forming portion 13b is provided integrally with the attachment portion 13a, and is provided as a plate-like portion that gently curves and extends from the attachment portion 13a. In the state where the surgical instrument 1 is disposed along the tibia 100, the attachment portion 13a is disposed in front of the tibia 100. And the slit formation part 13b is arrange | positioned so that it may curve gently and may extend along the circumference | surroundings of the tibia 100 toward the one side of the left-right direction from the front of the tibia 100.

  The slit forming portion 13b is formed with a slit-shaped guide groove 13c that guides the excision direction of the excision instrument when part of the proximal end of the tibia 100 is excised with the excision instrument described above. ing. In a state where the adjustment of the position of the surgical instrument 1 with respect to the tibia 100 is completed, a resecting instrument is inserted along the guide groove 13c, and a part of the proximal end of the tibia 100 is resected by the resecting instrument. A part of the proximal end of the tibia 100 is excised, so that an installation surface of the tibia implant is formed on the tibia 100.

  In addition, the excision guide portion 13 is provided with a plurality of pin holes 13d. Each pin hole 13d is provided as a through hole. Then, another pin (not shown) different from the first pin 15 and the second pin 16 described later is inserted into the pin hole 13d. The other pins inserted into the pin holes 13d are further inserted into the tibia 100 and fixed to the tibia 100. Thus, the resection guide part 13 is fixed to the tibia 100 by being inserted and fixed to the tibia 100 with the other pins penetrating the plurality of pin holes 13d. In the state where the resection guide part 13 is fixed to the tibia 100, the above resecting instrument is used, and a part of the proximal end of the tibia 100 is resectioned.

[Front and rear rod, first pin, second pin]
FIG. 8 is a plan view of the surgical instrument 1. FIG. 9 is a cross-sectional view showing a cross section of the front / rear rod portion 14 of the surgical instrument 1 as viewed from the direction of arrows AA in FIG. FIG. 10 is a cross-sectional view showing a cross section of the front / rear rod portion 14 of the surgical instrument 1 as seen from the direction of arrows BB in FIG. The front / rear rod portion 14 shown in FIGS. 1 to 10 has, for example, a rectangular bar-like portion having a substantially rectangular cross section, and is provided as a member extending linearly. The front / rear rod part 14 is attached to the front / rear rod support part 20 in a state of being inserted into the through hole of the front / rear rod support part 20. Thus, the front / rear rod portion 14 is attached to the main body portion 11 on the other end side of the upper / lower rod portion 17 (upper end side when the upper / lower rod portion 17 is arranged along the vertical direction of the human body).

  Further, the front / rear rod part 14 is inserted into the through-hole of the front / rear rod support part 20 and supported by the front / rear rod support part 20, so that the axial direction of the front / rear rod part 14 is relative to the axial direction of the third rod 17c. Are attached to the main body 11 in an orthogonal state. Thereby, the front-rear rod part 14 is disposed such that the axial direction extends along the front-rear direction of the human body when the surgical instrument 1 is disposed along the tibia 100.

  The first pin 15 and the second pin 16 shown in FIGS. 1 to 7 are respectively inserted into the proximal end of the tibia 100 while being inserted into the anteroposterior rod portion 14 and fixed to the tibia 100. It is provided as a member. Each of the first pin 15 and the second pin 16 has a round bar portion having a substantially circular cross section, and is provided as a member extending linearly. Each distal end portion of the first pin 15 and the second pin 16 is formed as a cut-away portion inserted into the tibia 100. The first pin 15 and the second pin 16 inserted into the anteroposterior rod portion 14 are located above and below the human body relative to the proximal end of the tibia 100 in a state where the surgical instrument 1 is disposed along the tibia 100. It is inserted and fixed downward along the direction.

  Further, the front and rear rod portion 14 is provided with a first hole 24 and a second hole 25. The first pin 15 and the second pin 16 are inserted into the first hole 24 and the second hole 25, respectively. That is, the first pin 15 is inserted into the first hole 24, and the second pin 16 is inserted into the second hole 25. The first hole 24 and the second hole 25 are provided side by side along the longitudinal direction of the front and rear rod portion 14. The longitudinal direction of the anteroposterior rod portion 14 is an axial direction in which the anteroposterior rod portion 14 extends linearly, and in a state in which the surgical instrument 1 is disposed along the tibia 100, the longitudinal direction is the direction extending along the anteroposterior direction of the human body.

  Further, both the first hole 24 and the second hole 25 are provided as through holes that penetrate the front and rear rod portions 14. The first pin 15 and the second pin 16 inserted into the first hole 24 and the second hole 25 respectively penetrate the first hole 24 and the second hole 25 provided as through holes, and the tibia 100. Note that the direction in which the first hole 24 and the second hole 25 penetrate the front / rear rod portion 14 is a direction that extends along the vertical direction of the human body when the surgical instrument 1 is disposed along the tibia 100.

  Further, both the first hole 24 and the second hole 25 are provided as long holes that extend along the longitudinal direction of the front / rear rod portion 14. And at least any one of the 1st hole 24 and the 2nd hole 25 is provided as a cross-sectional area change hole provided with the part which the cross-sectional area of the hole decreased and narrowed in the penetration direction of a hole. In this embodiment, as well shown in FIG. 9, the first hole 24 is provided as the cross-sectional area change hole. Thus, the first hole 24 is a cross-sectional area that is a portion where the cross-sectional area of the hole is reduced and narrowed in the vertical direction of the human body, which is the penetration direction of the hole, in a state where the surgical instrument 1 is disposed along the tibia 100. It is provided as a cross-sectional area change hole provided with a reduced portion 24a. As shown in FIG. 10, the second hole 25 is provided as a hole that penetrates the front and rear rod portions 14 with a constant cross-sectional area without changing the cross-sectional area of the hole in the penetration direction of the hole.

  Further, as shown in FIG. 9, the first hole 24, which is a cross-sectional area changing hole, is continuously formed after the cross-sectional area of the hole once continuously decreases and passes through the cross-sectional area decreasing portion 24a in the hole penetrating direction. It is provided as a hole of increasing shape. Further, in the first hole 24, the dimension in the hole width direction, which is a direction perpendicular to both the hole penetration direction and the longitudinal direction of the front and rear rod portion 14, in the hole penetration direction once decreases continuously. It is provided as a hole having a shape that continuously increases after passing through the cross-sectional area decreasing portion 24a. In the state where the surgical instrument 1 is arranged along the tibia 100, the penetration direction of the first hole 24 corresponds to the vertical direction of the human body, the longitudinal direction of the front / rear rod portion 14 corresponds to the front / rear direction of the human body, The hole width direction of one hole 24 corresponds to the left-right direction of the human body. Therefore, in the state where the surgical instrument 1 is disposed along the tibia 100, the first hole 24 is a state in which the dimension in the left-right direction of the human body increases continuously after once decreasing continuously in the vertical direction of the human body. It becomes.

  FIG. 11 is a cross-sectional view of the front / rear rod portion 14 and the first pin 15 in a state where the first pin 15 is inserted into the first hole 24 of the front / rear rod portion 14 in the surgical instrument 1. FIG. 12 is a cross-sectional view of the front / rear rod portion 14 and the second pin 16 in a state where the second pin 16 is inserted into the second hole 25 of the front / rear rod portion 14 in the surgical instrument 1. 11 corresponds to the cross section of the front / rear rod portion 14 shown in FIG. The cross section of the front / rear rod portion 14 shown in FIG. 12 corresponds to the cross section of the front / rear rod portion 14 shown in FIG.

  As shown in FIG. 11, the dimension of the first hole 24 in the hole width direction is set to be slightly larger than the diameter of the first pin 15 in the cross-sectional area decreasing portion 24 a. And the dimension in the hole width direction of the 1st hole 24 is set so that it leaves | separates from the cross-sectional area reduction part 24a and goes to the opening side of the 1st hole 24. As shown in FIG. On the other hand, as shown in FIG. 12, the dimension of the second hole 25 in the hole width direction is constant without changing in the hole penetration direction, and is set to a dimension slightly larger than the diameter of the second pin 16. Yes. In the second hole 25 as well, the hole width direction is defined similarly to the first hole 24. That is, the hole width direction of the second hole 25 is defined as a direction perpendicular to both the penetrating direction of the second hole 25 and the longitudinal direction of the front and rear rod portion 14.

  In a state where the first pin 15 is inserted into the first hole 24, the first pin 15 is disposed in a loosely fitted state inside the first hole 24 (see FIGS. 2, 5, and 11). For this reason, with respect to the 1st pin 15 of the state inserted in the 1st hole 24 and inserted in the tibia 100, the front-back rod part 14 rock | fluctuates and is arrange | positioned so that relative displacement is possible. In particular, the first hole 24 is provided as a long hole extending along the longitudinal direction of the anteroposterior rod portion 14 (the anteroposterior direction of the human body when the surgical instrument 1 is disposed along the tibia 100). The portion 14 can be relatively displaced by swinging relatively greatly along the front-rear direction of the human body with respect to the first pin 15 fixed to the tibia 100.

  Further, as described above, the first hole 24 has a dimension in the hole width direction that increases from the cross-sectional area decreasing portion 24a toward the opening side of the hole. For this reason, the front / rear rod portion 14 swings relative to the first pin 15 inserted into the first hole 24 and fixed to the tibia 100 so as to tilt along the left-right direction of the human body and is relatively displaced. It is also possible. Furthermore, the front / rear rod portion 14 can swing relative to the first pin 15 fixed to the tibia 100 so as to rotate along a horizontal plane perpendicular to the body axis of the human body.

  When the second pin 16 is inserted into the second hole 25, the second pin 16 is disposed in a loosely fitted state inside the second hole 25 (see FIGS. 2, 5, and 12). . For this reason, with respect to the 2nd pin 16 of the state inserted in the 2nd hole 25 and inserted in the tibia 100, the front-back rod part 14 rock | fluctuates and is arrange | positioned so that relative displacement is possible.

  The second hole 25 is provided as a long hole extending along the longitudinal direction of the front / rear rod portion 14 (the front / rear direction of the human body when the surgical instrument 1 is disposed along the tibia 100). The part 14 can be relatively displaced by swinging relatively large along the front-rear direction of the human body with respect to the second pin 16 fixed to the tibia 100. However, the dimension of the second hole 25 in the hole width direction is set to a constant dimension that is slightly larger than the diameter of the second pin 16. Therefore, the relative displacement of the front and rear rod portion 14 by swinging along the direction other than the front and rear direction of the human body with respect to the second pin 16 fixed to the tibia 100 is restricted.

[Usage of surgical instruments for knee replacement]
FIGS. 13 and 14 are schematic views for explaining a usage pattern of the surgical instrument 1 and are side views showing the surgical instrument 1 together with the patient's tibia 100. In FIG. 13 and FIG. 14, only the tibia 100 is schematically shown as the elements of the patient's human body, and the illustration of other soft tissues such as other bones and muscles of the patient's human body is omitted. .

  When the surgical instrument 1 is used in artificial knee joint replacement, first, the ankle joint fixing portion 12 is fixed to the patient's ankle joint (see FIG. 13). That is, the surgeon operates the pair of clamp portions (22a, 22b), and the ankle joint fixing portion 12 is fixed to the patient's ankle joint.

  When the ankle joint fixing portion 12 is fixed to the ankle joint, the operator adjusts the position of the upper and lower rod portions 17 so that the upper and lower rod portions 17 are arranged substantially parallel to the bone axis direction of the patient's tibia 100. The At this time, first, the positioning part 17d and the rod connecting part 17e of the upper and lower rod parts 17 are operated by the operator as described above, so that the operator can place the resection guide part 13 at a desired position. The length of the upper and lower rod portions 17 along the direction is adjusted.

  When the length of the vertical rod portion 17 along the vertical direction of the human body is adjusted, the first pin 15 is then inserted into the first hole 24 of the anteroposterior rod portion 14, and the first pin 15 is further connected to the tibia 100. It is inserted into the proximal end and fixed (see FIG. 14). When the first pin 15 is inserted into the first hole 24 and is fixed to the tibia 100, the surgeon is placed in the tibia 100 with the first pin 15 being placed loosely inside the first hole 24. On the other hand, the position of the upper / lower rod part 17 is adjusted such that the upper / lower rod part 17 is swung, and the upper / lower rod part 17 is arranged substantially parallel to the bone axis direction of the tibia 100.

  More specifically, the operator performs a position adjustment operation of adjusting the position by swinging the upper and lower rod portions 17 along a horizontal plane perpendicular to the body axis of the patient's human body. Furthermore, the surgeon also performs a position adjustment operation for adjusting the position by swinging the upper and lower rod portions 17 along the left-right direction of the patient's human body as necessary. When the surgeon swings the upper and lower rod portions 17 with respect to the tibia 100, the front and rear rod portions 14 swing with respect to the first pin 15.

  When the above position adjustment operation is completed, the second pin 16 is inserted into the second hole 25 of the anteroposterior rod portion 14, and the second pin 16 is inserted into the proximal end of the tibia 100 and fixed. (See FIGS. 2-7). When the first pin 15 inserted into the first hole 24 and the second pin 16 inserted into the second hole 25 are fixed to the tibia 100, the surgeon moves the upper and lower rod portions 17 in that state. The final adjustment of the position of the upper and lower rod portions 17 is performed so that the position of the upper and lower rod portions 17 is arranged substantially parallel to the bone axis direction of the tibia 100 at a position desired by the operator.

  More specifically, the operator swings the upper and lower rod portions 17 in the front-rear direction of the human body with respect to the tibia 100, and the upper and lower rod portions 17 are substantially parallel to the bone axis direction of the tibia 100 at the operator's desired position. The final adjustment of the position of the upper and lower rod portions 17 is performed so that When the surgeon swings the upper and lower rod part 17 along the front-rear direction of the human body with respect to the tibia 100, the front-rear rod part 14 moves forward and backward with respect to the first pin 15 and the second pin 16. It will swing along the direction.

  When both the first pin 15 and the second pin 16 are fixed to the tibia 100 and the adjustment work of all positions of the upper and lower rod portions 17 with respect to the tibia 100 is completed, the operator further moves the resection guide portion 13 to the tibia. 100 fixed. More specifically, the surgeon allows other pins (not shown) different from the first pin 15 and the second pin 16 to penetrate through a plurality of desired pin holes 13 d in the resection guide portion 13. Then, with these pins penetrating through the resection guide part 13, these pins are further inserted into the tibia 100 and fixed. In this state, a resecting instrument (not shown) is used, and a part of the proximal end of the tibia 100 is resected while the resecting direction of the resecting instrument is guided by the resecting guide portion 13.

[Operational effects of this embodiment]
According to the present embodiment, the operator first inserts the first pin 15 into the first hole 24 that is a cross-sectional area change hole, and inserts the first pin 15 into the proximal end of the tibia 100. Insert into and fix. In this state, the surgeon adjusts the position of the upper and lower rod portions 17 so that the upper and lower rod portions 17 are disposed substantially parallel to the bone axis direction of the patient's tibia 100. At this time, the surgeon changes the relative position of the first pin 15 inside the first hole 24 which is a cross-sectional area change hole without destroying the tibia 100 with the first pin 15 inserted into the tibia 100. The position of the vertical rod portion 17 relative to the tibia 100 can be easily adjusted by swinging the vertical rod portion 17. Further, since it is not necessary to destroy the tibia 100 with the first pin 15 inserted into the tibia 100, even if the cortical bone or cancellous bone in the patient's tibia 100 is hard, the operator has a cross-sectional area change hole. By changing the relative position of the first pin 15 inside the first hole 24, the vertical rod portion 17 can be swung, and the position of the vertical rod portion 17 with respect to the tibia 100 can be easily adjusted.

  Therefore, according to this embodiment, the adjustment range of the position of the upper and lower rod portions 17 with respect to the tibia 100 is not greatly limited, and the adjustment range can be expanded as compared with the conventional case. For this reason, it is possible to easily adjust the position of the upper and lower rod portions 17. Moreover, according to this embodiment, both the 1st hole 24 and the 2nd hole 25 are provided as an elongate hole extended and opened along the longitudinal direction of the front-back rod part 14. As shown in FIG. This makes it easier to adjust the position by swinging the upper and lower rod portions 17 along the longitudinal direction of the human body.

  In addition, according to the present embodiment, the first hole 24 that is the cross-sectional area changing hole into which the first pin 15 is inserted is provided with a portion that is narrowed by reducing the cross-sectional area of the hole in the through-direction of the hole, It is provided as a long hole that extends along the longitudinal direction of the front and rear rod portion 14 and opens. Therefore, in a state where only the first pin 15 is fixed to the tibia 100, the operator can adjust the positions of the upper and lower rod portions 17 in all directions with respect to the tibia 100. More specifically, the operator can perform a position adjustment operation of adjusting the position by swinging the upper and lower rod portions 14 along the front-rear direction of the human body. The surgeon can also perform a position adjustment operation of adjusting the position by swinging the upper and lower rod portions 14 along a horizontal plane perpendicular to the body axis of the human body. Furthermore, the operator can also perform a position adjustment operation of adjusting the position by swinging the upper and lower rod portions 14 along the left and right direction of the human body.

  The position where the operator adjusts the position by swinging the upper and lower rod portions 17 along at least a horizontal plane perpendicular to the body axis of the human body in a state where only the first pin 15 is fixed to the tibia 100. Perform adjustment work. Then, with this position adjustment operation completed, the surgeon inserts the second pin 16 into the anteroposterior rod portion 14, and further inserts and fixes the second pin 16 into the proximal end of the tibia 100. Both the first hole 24 and the second hole 25 are provided as long holes that extend along the longitudinal direction of the front and rear rod portion 14. For this reason, even in a state where both the first pin 15 and the second pin 16 are fixed to the tibia 100, the surgeon swings the upper and lower rod portions 17 along the front-rear direction of the human body and performs the position adjustment work. It can be carried out. Therefore, the surgeon performs the adjustment work of the positions of the upper and lower rod portions 17 in different directions with respect to the tibia 100, in a state where only the first pin 15 is fixed to the tibia 100, and both the first pin 15 and the second pin 16 are fixed. In the state fixed to the tibia 100, it can carry out separately. Therefore, it is possible to further easily adjust the position of the upper and lower rod portions 17.

  As described above, according to the present embodiment, the adjustment range of the position of the upper and lower rod parts 17 arranged so as to extend along the vertical direction of the human body with respect to the tibia 100 can be expanded. It is possible to provide the surgical instrument 1 for artificial knee joint replacement which can easily perform the adjustment operation.

  Further, according to the present embodiment, the first hole 24 that is a cross-sectional area changing hole continuously increases after the cross-sectional area of the hole once decreases continuously. For this reason, with respect to the first pin 15 inserted in the first hole 24 which is a cross-sectional area changing hole, the front and rear rod portion 14 is centered on a portion having a small cross-sectional area (cross-sectional area decreasing portion 24a) in the first hole 24. As a result, it can be swung more smoothly. Thereby, the adjustment operation | work of the position of the up-and-down rod part 17 can be performed still more easily.

  Further, according to the present embodiment, the first hole 24 that is a cross-sectional area changing hole is configured to continuously increase after the dimension in the hole width direction once decreases continuously. For this reason, with respect to the first pin 15 inserted in the first hole 24 which is a cross-sectional area changing hole, the front and rear rod portion 14 is centered on a portion having a small cross-sectional area (cross-sectional area decreasing portion 24a) in the first hole 24. As described above, it can be more smoothly swung along the horizontal direction of the human body. As a result, the position adjustment operation performed by swinging the upper and lower rod portions 17 along the horizontal direction of the human body can be performed more easily.

[Modification]
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 are possible as long as they are described in the claims. For example, the following modifications may be made.

(1) In the above-described embodiment, an example in which the upper and lower rod portions are configured to include the first to third rods has been described, but this need not be the case. A form in which the upper and lower rod portions are configured to include one, two, or four or more rods may be implemented.

(2) In the above-described embodiment, an example in which only the first hole is provided as a cross-sectional area change hole provided with a narrowed portion in which the cross-sectional area of the hole decreases in the penetration direction of the hole is taken as an example. Although explained, this need not be the case. A mode in which only the second hole is provided as a cross-sectional area change hole provided with a portion where the cross-sectional area of the hole decreases and narrows in the penetration direction of the hole may be implemented. In addition, a mode in which both the first hole and the second hole are provided as cross-sectional area changing holes in which the cross-sectional area of the hole is reduced and narrowed in the penetration direction of the hole is implemented. Also good.

(3) In the above-described embodiment, taking the form in which the cross-sectional area changing hole is provided as a hole having a shape that continuously increases after the cross-sectional area of the hole once decreases continuously in the penetration direction of the hole. Although explained, this need not be the case. The cross-sectional area changing hole may be in any form provided with a narrowed portion in which the cross-sectional area of the hole is reduced in the through direction of the hole. For example, a mode in which the cross-sectional area changing hole is provided as a hole having a shape that increases stepwise after the cross-sectional area of the hole decreases stepwise in the penetration direction of the hole may be implemented.

  The present invention can be widely applied as a surgical instrument for artificial knee joint replacement used in artificial knee joint replacement.

DESCRIPTION OF SYMBOLS 1 Surgical instrument for artificial knee joint replacement 11 Main body part 12 Ankle joint fixing part 13 Resection guide part 14 Front and rear rod part 15 First pin 16 Second pin 17 Upper and lower rod part 24 First hole 25 Second hole

Claims (3)

A surgical instrument for artificial knee joint replacement used in artificial knee joint replacement,
A main body having an upper and lower rod portion arranged so as to extend along the vertical direction of the human body;
An ankle joint fixing part attached to the main body part at one end side of the upper and lower rod parts and fixed to the ankle joint;
An excision guide part that is attached to the main body part at the other end of the upper and lower rod parts and guides the excision direction of the excision instrument when a part of the proximal end of the tibia is excised by the excision instrument;
A front and rear rod part that is attached to the main body part on the other end side of the upper and lower rod parts and arranged to extend along the front and rear direction of the human body,
A first pin and a second pin that are inserted into the proximal end of the tibia in a state of being inserted into the anteroposterior rod portion and fixed to the tibia;
The first pin and the second pin are respectively inserted into a first hole and a second hole provided side by side along the longitudinal direction of the front and rear rod portion,
Each of the first hole and the second hole is provided as a through hole penetrating the front and rear rod part, and is provided as a long hole that extends and opens along the longitudinal direction of the front and rear rod part,
At least one of the first hole and the second hole is provided as a cross-sectional area changing hole provided with a narrowed portion in which the cross-sectional area of the hole decreases in the through direction of the hole. A surgical instrument for artificial knee joint replacement. The surgical instrument for artificial knee joint replacement according to claim 1,
The artificial knee joint replacement surgery characterized in that the cross-sectional area changing hole is provided as a hole having a shape that continuously increases after the cross-sectional area of the hole once decreases continuously in the hole penetrating direction. Instruments. A surgical instrument for artificial knee joint replacement according to claim 2,
The cross-sectional area changing hole is continuous after the dimension in the hole width direction, which is a direction perpendicular to both the penetration direction of the hole and the longitudinal direction of the front and rear rod portions, continuously decreases in the penetration direction of the hole. Surgical instrument for artificial knee joint replacement, characterized in that it is provided as a hole having an increasing shape.

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