KR102622418B1 - Tibial Template and Handle for Minimally Invasive Total Knee Arthroplasty - Google Patents

Abstract

A surgical instrument for measuring tibia size for minimally invasive total knee replacement surgery is disclosed. The minimally invasive tibia size measuring surgical instrument for total knee arthroplasty according to the present invention is used to minimize the incision range during total knee arthroplasty, which involves excising the joint surface of a severely worn joint and replacing it with an artificial knee joint. It is a surgical instrument with a shape or structure suitable for minimally invasive surgery (MIS surgery), and has a flat contact surface on the lower surface that contacts the flat bone resection surface of the proximal tibia, and a central attachment portion formed in the center of the front. It includes a handle consisting of a tibia template and a gripping part that provides a gripping surface that can be gripped by hand, a straight middle support part coaxially coupled to one end of the gripping part, and a template holding part connected to the tip of the middle support part. In the tibia template, a first side fastening part and a second side fastening part each having side fastening holes are formed in a symmetrical structure on both sides of the central fastening part, and the tip of the template holding part is inserted into the side fastening hole and attached to the handle. A fixation protrusion of a rectangular cross-section is formed for attaching the tibia template, and the template holding part having the fixation protrusion at the tip is characterized in that it is formed in a bent structure biased to one side with respect to the longitudinal center line (CL) of the handle.

Description

Surgical instrument for measuring tibia size for minimally invasive total knee replacement surgery {Tibial Template and Handle for Minimally Invasive Total Knee Arthroplasty}

The present invention relates to a surgical instrument for measuring the size of the tibia for total knee joint replacement surgery. In particular, in total knee replacement surgery, in which the joint surface of a severely worn joint is excised and replaced with an artificial knee joint, the surgery is performed with a minimum incision range. This relates to a surgical instrument for measuring tibia size for minimally invasive total knee joint replacement surgery, which is suitable for minimally invasive surgery (MIS surgery).

The knee joint or knee joint is made up of three bones that surround the knee: the femur (also known as the “thigh bone”), the tibia (also called the “tibia”), and the patella (also called the “kneecap”). ) refers to the joint formed by the back being adjacent to each other. The knee joint is present in both left and right legs, and together with the hip joint (coxa), it is the most essential joint that enables the human body to walk upright.

Due to the nature of the knee joint, it is used frequently, so there is a lot of potential for damage. In particular, function may deteriorate or be lost due to wear and tear or aging of bone tissue, and inflammation and pain may occur due to damage to bones and ligaments due to gradual damage or degenerative changes in cartilage. This is called degenerative arthritis.

To treat degenerative arthritis, conservative treatments such as lifestyle improvement, drug treatment, and physical therapy are generally performed. However, these treatment methods only slow down the progression of degenerative arthritis or temporarily relieve pain and are not a fundamental solution. In particular, there are cases where degenerative arthritis has worsened so much that it is no longer possible to respond with medication or physical therapy.

Total knee replacement surgery is performed on patients whose degenerative arthritis has worsened so much that pain continues despite medication or physical therapy and who have difficulty walking. Total knee replacement is a surgery that removes the joint surface of a severely worn joint and replaces it with an artificial knee joint. The artificial knee joint used at this time generally consists of a femoral element, a tibial element, and a bearing element.

The femur component is transplanted to the site where the articular surface of the severely worn femur joint is excised, and the tibia component is transplanted to the site where the articular surface of the upper tibia adjacent to the femur joint is excised. Additionally, the bearing component is located between the femoral component and the tibial component and serves as a type of cartilage to allow the joint surface to move smoothly.

Among the elements constituting these artificial knee joints, the tibial element is fixed to a bone resection surface made by flattening the proximal portion of the tibia. To this end, as a preliminary work to fix the tibial element to the bone resection surface, a groove to be combined with the tibial element is first formed through drilling on the bone resection surface at the planned location. At this time, the tool used for more stable and accurate drilling is a drilling guide member.

This drilling guide member (hereinafter referred to as 'tibia template') is seated and fixed in a pre-planned exact position on the bone resection surface of the proximal tibia to guide drilling. Here, it is important to accurately position the tibia template in the planned position on the bone resection surface. A tibial template handle is known as a dedicated tool used to position the tibia template in the planned position on the bone resection surface.

The following patent document 1 (Japanese Patent Application Publication No. 2013-013732) and Patent Document 2 (Japanese Patent Application Publication No. 2002-291760) show a tibia template handle according to the prior art. Although the conventional template handles disclosed in these patent documents are somewhat different in their attachment structure to the tibia template, they are basically composed of a straight type with an overall shape of a straight structure.

To perform total knee arthroplasty using such a straight type conventional tibial template handle, as shown in the example of FIG. 1, the incision area of the knee is widened sufficiently on both sides to first secure a space for the tibial template to safely enter. Using the tibial template handle, the tibial template should be pushed between the femur and tibia from the front of the incision site (see arrow direction in Figure 1).

At this time, considering the shape and size of the tibia template, the incision range (approximately 7 to 9 cm) must be sufficiently large to allow safe and stable entry of the tibia template without interference with the skin or soft tissue at the incision site.

However, if the incision is large, it inevitably causes a lot of damage to normal tissue, and cosmetic problems such as large scars remain after surgery. In particular, in the process of opening the incision site to both sides to secure space for stable entry of the tibia template without interference with skin or soft tissue, abduction of the patella is accompanied as shown in Figure 1, so there is a risk of damage to the patella or tissues associated with it. There are concerns.

Japanese Patent Publication No. 2013-013732 (publication date 2013.01.24.) Japanese Patent Publication No. 2002-291760 (published on October 8, 2002)

The technical problem to be solved by the present invention is to have a unique shape or structure suitable for pushing the tibial template from the side (inside the knee) rather than from the front of the incision site during total knee replacement surgery, thereby enabling surgery to be performed with a minimum incision range. The purpose is to provide a tibia size measuring surgical instrument for minimally invasive total knee joint replacement surgery that is suitable for minimally invasive surgery (MIS surgery).

According to an embodiment of the present invention as a means of solving the problem,

As a surgical instrument used in total knee replacement surgery,

A tibia template having a flat contact surface on the lower surface that contacts the flat bone resection surface of the proximal tibia and a central attachment portion formed in the front center portion; and

It includes a handle consisting of a gripping part that provides a gripping surface that can be gripped by hand, a straight middle support part coaxially coupled to one end of the gripping part, and a template holding part connected to the tip of the middle support part,

In the tibia template, a first side connection part and a second side connection part each having side connection holes are formed in a left-right symmetrical structure on both sides of the central connection part,

At the tip of the template holding part, a binding protrusion of a square cross-section is formed which is inserted into the side binding hole and attaches the tibia template to the handle,

Measurement of tibia size for minimally invasive total knee replacement surgery, characterized in that the template holding portion, which has a binding protrusion at the tip, is formed in a bending structure that is biased to one side with respect to the longitudinal center line (CL) of the handle. Provides surgical instruments.

In an embodiment of the present invention, the tibia template includes a plate-shaped body portion having a shape corresponding to the outer shape of the bone resection surface, a circular central opening formed in the center of the body portion, and central openings on both sides of the central opening. A V-shaped drilling slot consisting of a slit-shaped side opening formed in a symmetrical structure so as to communicate, a through bolt formed around the drilling slot and fixing the body part to the bone cutting surface, and a fixing pin are respectively penetrated and fixed thereto. The central coupling portion having holes and pin holes, a central coupling hole having a circular cross-sectional shape, and a central coupling slit formed on both sides of the central coupling hole, and a square cross-section corresponding to the cross-sectional shape of the coupling protrusion. It may include the first side coupling portion and the second side coupling portion, each having a side coupling hole and a side open coupling groove formed on one side of the side coupling hole.

At this time, the side open fastening groove may be formed with an arc-shaped fastening surface concave in the direction of the side fastening hole that is closely coupled to the structure in which the tip lock tip of the lock part installed in the template holding part engages.

Additionally, a rod mounting bar having at least one rod coupling hole into which an alignment rod is inserted may be formed in the intermediate support portion.

In addition, the template holding portion constituting the handle includes an outward portion bent at an angle of 100 to 140 degrees in a direction away from the center line (CL) at the tip of the intermediate support portion, and an angle of 80 to 100 degrees from the distal end of the outward portion toward the center line. It may be composed of an inward-facing portion bent at an angle, and the binding protrusion of a rectangular cross-section may be formed on the front end surface of the inward-facing portion.

The handle applied to the embodiment of the present invention is also installed on the template holding unit and binds the tibia template to the template holding unit with the binding protrusion inserted into the side binding hole, or releases the restraint. It may further include a lock unit that operates to separate the tibia template from the template holding unit.

At this time, the lock unit includes an input lever pivotably mounted on a first hinge point (H1) of the template holding part formed adjacent to the intermediate support part, and an input lever formed adjacent to the binding protrusion and spaced a predetermined distance from the first hinge point. A lock lever pivotably mounted on the second hinge point (H2) of the template holding portion, and an arc-shaped or horse-shaped elastic linkage connected to each of the input lever and the lock lever in a hinge structure to interlock the input lever and the lock lever. It may be a composition including a link.

Here, a tip lock tip is formed at the tip of the lock lever in a structure that is in close contact with the concave fastening surface of the side open fastening groove formed on one side of the side fastening hole at a position for restraining the tibial template, thereby restraining the tibial template. , the tip lock tip may be bent in the direction of the fastening protrusion.

In addition, the template holding part may be composed of a pair of L-shaped plates arranged at a predetermined interval so that a mounting space is formed between them, and a portion of the mounting space formed by the pair of L-shaped plates spaced apart from each other may be formed. The lock portion may be installed so that it protrudes to the outside of the mounting space.

According to an embodiment of the present invention, a pair of side fasteners are formed on both sides of the front of the tibia template, and a handle can be fastened to one of them, and a part of the handle that clamps and handles the tibia template has a unique bent structure. By being formed, the tibial template can be pushed into the surgical site from the side (inside the knee) rather than from the front of the incision site during total knee arthroplasty.

Accordingly, compared to the existing method in which the skin tissue in the center of the front of the knee is incised up and down, the incision area is spread as much as possible to both sides, and the tibial template is pushed into the surgical site from the front, smooth surgery is possible even with a small incision range. In other words, it has the advantage of being a structure suitable for implementing minimally invasive surgery (MIS surgery), which involves performing surgery with a minimum incision.

In addition, during total knee arthroplasty, due to the unique configuration that allows the tibial template to be pushed into the surgical site from the side (inside the knee) rather than from the front of the incision site, the existing anterior insertion method (spreading the incision site to both sides and inserting the tibial template from the front) Unlike the insertion method, there is no need to abduct the patella or abduction of the patella can be minimized, thereby minimizing damage to the patella or its associated tissues.

Figure 1 is a diagram showing the incision state of the knee when performing total knee arthroplasty using a straight type conventional tibial template handle.
Figure 2 is an exploded perspective view showing the tibia template and handle of the tibia size measuring surgical instrument for minimally invasive total knee replacement surgery according to an embodiment of the present invention.
Figure 3 is a plan view of the combined state of the present invention showing a state in which the tibia template and the handle shown in Figure 2 are coupled to each other.
Figure 4 is a plan view of the tibia template shown in Figure 2;
Figure 5 is an enlarged view of the main portion of the present invention showing part 'A' of Figure 4.
Figure 6 is a plan view of the handle shown in Figure 2;
Figure 7 is a right side view of the handle shown in Figure 2.
FIG. 8 is a view illustrating only the lock portion configuration in FIG. 6 separately extracted.
Figures 9a and 9b are diagrams showing the operating state of the present invention attaching the tibia template to the handle.
Figure 10 is a diagram showing the state of use of the tibia size measuring surgical instrument for minimally invasive total knee replacement surgery according to an embodiment of the present invention.

Hereinafter, preferred embodiments of the present invention will be described in detail with reference to the accompanying drawings.

The terms used in the specification are merely used to describe specific embodiments and are not intended to limit the present invention. Singular expressions include plural expressions unless the context clearly dictates otherwise.

In this specification, terms such as “include” or “have” are intended to indicate the presence of features, numbers, steps, operations, components, parts, or combinations thereof described in the specification, but are not intended to indicate the presence of one or more other features or It should be understood that this does not exclude in advance the possibility of the presence or addition of numbers, steps, operations, components, parts, or combinations thereof.

Additionally, terms such as first, second, etc. may be used to describe various components, but the components should not be limited by the terms. The above terms are used only for the purpose of distinguishing one component from another.

In the description with reference to the accompanying drawings, identical components will be assigned the same drawing reference numerals, and overlapping descriptions thereof will be omitted. Also, in describing the present invention, if it is determined that a detailed description of related known technologies may unnecessarily obscure the gist of the present invention, the detailed description will be omitted.

Figure 2 is an exploded perspective view showing the tibia template and handle of the tibia size measuring surgical instrument for minimally invasive total knee replacement surgery according to an embodiment of the present invention, and Figure 3 is a tibia template shown in Figure 2 and This is a plan view of the combined state of the present invention showing the handles being connected to each other.

Referring to Figures 2 and 3, the present invention is a tibia size measuring surgical instrument (1) for total knee arthroplasty used in surgery to replace a knee joint with an artificial knee joint, including a tibia template (10) and a device for handling the same. It may consist of a handle 20. The tibia template 10 has a flat contact surface (symbol omitted) on its lower surface that contacts the flat bone resection surface of the proximal tibia, and the handle 20 has a grip part 22 that provides a grip surface that the operator can grip with his hand. ) can be configured.

The tibia template 10 is composed of a first side fastening portion 18R and a second side fastening portion 18L, each having a side fastening hole 180, formed in a symmetrical structure on both sides of the central fastening portion 16. The handle 20 has a coupling protrusion 28 inserted into one of the side coupling holes 180 included in each of the first side coupling portion 18R and the second side coupling portion 18L, and each side coupling hole. (180) The lock portion 30 may be configured to have a lock tip 360 that is fastened to the side open fastening groove 182 formed on one side.

The lock portion 30 may be installed on the template holding portion 26 of the handle 20. The attachment protrusion 28 (a component that is inserted into one of the side attachment holes of the first side attachment portion or the second side attachment portion to attach the tibia template to the handle) is formed at the tip of the template holding portion 26, The template holding portion 26 having the protrusion 28 at its tip may be formed in a bent structure that is biased to one side with respect to the longitudinal center line CL of the handle 20.

According to an embodiment of the present invention configured as described above, a pair of side fasteners (18R, 18L) are formed on both sides of the front of the tibia template 10, so that the handle 20 can be fastened to one of them, and the tibia A part of the handle 20 that clamps and handles the template 10 is formed in a unique banded structure, so that during total knee arthroplasty, the tibia template 10 is pushed to the surgical site from the side (inside the knee) rather than from the front of the incision site. You can put it in.

Accordingly, compared to the existing method in which the skin tissue in the center of the front of the knee is incised up and down, the incision area is spread as much as possible to both sides, and the tibial template is pushed into the surgical site from the front, smooth surgery is possible even with a small incision range. In other words, it has the advantage of being a structure suitable for implementing minimally invasive surgery (MIS surgery), which involves performing surgery with a minimum incision.

In addition, during total knee arthroplasty, due to the unique configuration that allows the tibial template (10) to be pushed into the surgical site from the side (inside the knee) rather than from the front of the incision site, the existing anterior insertion method (opening the incision site to both sides to insert it from the front) Unlike the method of inserting a tibial template, there is no need to abduct the patella or abduction of the patella can be minimized, thereby minimizing damage to the patella or its associated tissues.

The configuration of the tibia size measuring surgical instrument for minimally invasive total knee replacement surgery according to an embodiment of the present invention will be examined in more detail for each component with reference to the drawings.

First, let's take a closer look at the configuration of the tibia template with reference to FIGS. 4 and 5.

Figure 4 is a plan view of the tibia template shown in Figure 2. And Figure 5 is an enlarged view of the main part of the present invention showing part 'A' of Figure 4.

Referring to Figures 4 and 5, the tibia template 10 applied to the surgical instrument according to an embodiment of the present invention includes a plate-shaped body portion 12 having a shape corresponding to the outer shape of the bone resection surface of the tibia; It consists of a circular central opening 140 formed in the center of the body portion 12 and a slit-shaped side opening 142 formed in a symmetrical structure on both sides of the central opening 140 to communicate with the central opening 140. It includes a V-shaped drilling slot (14).

In addition, a plurality of bolt holes 13 and pins into which penetrating bolts and fixing pins are inserted to firmly fix the body portion 12 in a state in which the body portion 12 is accurately placed in the planned position and direction of the flat bone resection surface of the proximal tibia Contains holes 15. Here, a plurality of bolt holes 13 and pin holes 15 are formed in an appropriate arrangement around the drilling slot 14, but their positions or numbers are not limited to those shown in the drawing.

A central fastening portion 16 may be formed in the center of the front side of the tibia template 10 (the side facing the front of the knee). Additionally, a first side coupling portion 18R and a second side coupling portion 18L may be formed on both sides of the central coupling portion 16 to be symmetrical about the central coupling portion 16. At this time, an existing straight type handle (tibia template handle) may be coupled to the central attachment portion 16, and the handle 20 applied to the present invention may be coupled to one of the two side attachment portions.

That is, the tibia template 10 applied to the tibia size measuring surgical instrument 1 for minimally invasive total knee artificial knee replacement surgery according to an embodiment of the present invention has a conventional straight type handle and a banding of the present invention to be described later. It can be configured in a compatible form so that all types of handles 20 can be used, and accordingly, the tibia template can be handled by selecting an appropriate handle according to the patient's body structure or surgical environment.

The central attachment portion 16 of the tibia template 10 has a central attachment hole 160 formed at a certain depth from the front center of the tibia template 10 to the rear side of the tibia template 10 (the side facing the rear of the knee). Includes. In addition, it may be configured to include a pair of central binding slits 162 on both sides of the central binding hole 160, that is, a pair formed to be symmetrical about the central binding hole 160.

Considering the structure of the coupling part of the existing straight type handle 20, the central coupling hole 160 may have a circular cross-sectional shape to be compatible with it, and the central coupling slit 162 has an opening on the front and has a flat shape. (see FIG. 2 or FIG. 4) may be formed overall in the shape of an L-shaped groove or hole. Of course, the plane shape is not limited to the L-shape, and although not shown, a T-shape or dovetail shape can also be applied.

As shown in FIG. 4, the first side coupling portion 18R and the second side coupling portion 18L have the same configuration except that the direction of formation of the side open coupling groove 182 included in each is opposite. Therefore, in order to omit unnecessary redundant description of the same configuration, the description of the configuration of the first side coupling portion 18R will be replaced with a description of the configuration of the second side coupling portion 18L referring to FIG. 5. do.

In FIG. 4, reference numeral 19 indicates a coupling hole into which a drilling guide member (not shown) is coupled.

Referring to FIG. 5, the second side coupling portion 18L formed on one side of the central coupling portion 16 described above has a cross-sectional shape (preferably) corresponding to the cross-sectional shape of the coupling protrusion 28 at the tip of the handle 20, which will be described later. Specifically, it includes a side fastening hole 180 having a square cross-sectional shape. In addition, it is provided with a side open fastening groove 182 formed on one side of the side fastening hole 180 (the side farthest from the central fastening part 16).

An arc-shaped binding surface 183 may be formed in the side open binding groove 182. The arc-shaped fastening surface 183 may be concavely recessed in the direction of the side fastening hole 180, and the template holding part 26 of the handle 20, which will be described later, is attached to this fastening surface 183. As a result, the tip lock tip 360 of the lock part 30 installed on the template holding part 26 is closely coupled in an engaging structure, so that a firm bond between the handle 20 and the tibia template 10 can be realized. there is.

Next, let's take a closer look at the handle configuration with reference to the drawings.

Figure 6 is a top view of the handle shown in Figure 2, and Figure 7 is a right side view of the handle shown in Figure 2.

Referring to Figures 6 and 7, the handle 20 includes a gripping part 22 that provides a gripping surface that can be gripped by hand, and a straight middle support part 24 coaxially coupled to one end of the gripping part 22. ) includes. In addition, a template holding part 26 is connected to the tip of the intermediate support part 24 and is installed on this template holding part 26 to restrain the tibial template 10 described above so that it can be completely attached to the template holding part 26. It is provided with a lock portion 30 that releases such a restrained state.

The distal end of the template holding portion 26 is provided with a binding protrusion 28 of a rectangular cross-section that is inserted into the side binding hole 180 of the tibia template 10 described above and attaches the tibia template 10 to the handle 20. It can be. In particular, this template holding portion 26, which has a binding protrusion 28 at the tip, has a structure that is bent to one side with respect to the longitudinal center line (CL) of the handle 20, as shown in FIG. 6. can be formed.

The middle support portion 24 has a rod mounting bar 25 having at least one rod coupling hole 250 for coupling an alignment rod that allows the direction or height of the handle 20 to be adjusted to the planned direction and height. Can be formed, and the template holding portion 26 is a pair of L-shaped shapes arranged at a predetermined interval so that a mounting space (S, see FIGS. 2 and 7) for mounting the lock portion 30 is formed therebetween. It may be composed of a mold plate 261.

When the lock part 30 is mounted in the mounting space S, a part of the lock part 30 (each part of the lock lever 36, the input lever 32, and the elastic interlocking link 34, which will be described later) The lock portion 30 may be installed in the mounting space S in a structure that protrudes outward from the mounting space S. Accordingly, the main configuration of the lock portion 30 is located within the mounting space S. It can be safely protected by a pair of L-shaped plates 261.

Specifically, the template holding portion 26 includes an outward portion 262 bent at an angle of 100 to 140 degrees (θ1 in the drawing) in a direction away from the center line CL at the tip of the intermediate support portion 24, and the outward portion ( 262) may be composed of an inward portion 264 bent at an angle of 80 to 100 degrees (θ2 in the drawing) toward the center line. At this time, the binding protrusion 28 of a rectangular cross-section may be formed on the front end surface of the inward-facing portion 264.

The lock unit 30 may be installed in the template holding unit 26 configured as above. More specifically, the lock portion 30 is installed on the template holding portion 26 and restrains the tibia template 10 with the fastening protrusion 28 inserted into the side fastening hole 180 to secure the template holding portion. The tibia template 10 can be separated from the template holding portion 26 by locking it to (26) or releasing its restraint.

FIG. 8 is a diagram illustrating only the lock portion configuration in FIG. 6 separately extracted.

Referring to FIG. 8 and the preceding FIG. 6, the lock unit 30 may be composed of an input lever 32, a lock lever 36, and an elastic interlocking link 34. The input lever 32 may be provided with an input plate 320 at one end of which a force for operating the lock unit 30 is input with a larger area than other parts, and is formed adjacent to the middle support part 24. One side of the input lever 32 may be pivotably coupled to the first hinge point H1 of the template holding portion 26.

Approximately the central portion of the lock lever 36 is capable of pivoting at the second hinge point (H2) of the template holding portion (26), which is formed adjacent to the binding protrusion (28) and is spaced a predetermined distance from the first hinge point (H1). It can be combined into a hinge structure. In addition, the lock lever 36 and the input lever 32 can be interlockably connected with an arc-shaped or horse-shaped elastic interlocking link 34 connected to each of the input lever 32 and the lock lever 36 in a hinge structure. there is.

Here, the tip of the lock lever 36 is in close contact with the concave fastening surface 183 of the side open fastening groove 182 formed on one side of the above-described side fastening hole 180 at a position for restraining the tibia template 10. A tip lock tip 360 is formed that binds the tibia template 10 by forming a structure, and the tip lock tip 360 is located at the tip of the template holding unit 26 as shown in the drawings (FIGS. 6 and 8). It may be bent to face the binding protrusion 28.

Figures 9a and 9b are diagrams showing the operating state of the present invention, showing how the tibia template is attached to the handle by manipulating the lock unit configured as above.

In attaching the tibia template 10 to the handle 20, first, as shown in FIG. 9A, the attachment protrusion 28 at the tip of the handle 20 is connected to the first side attachment portion 18R or the second side attachment portion 18L. Insert it into one of the side attachment holes (180). Figure 9a shows the tibial template 10 being attached by coupling the attachment protrusion 28 to the second side attachment portion 18L. However, the handle 20 is turned over and attached to the first side attachment portion 18l. The protrusions 28 may also be combined.

In the state shown in FIG. 9A, when the input panel 320 at one end of the input lever 32 is pressed in the direction of the arrow as shown in FIG. 9B, the input lever 32 moves to the first hinge point (H1) by the force (F in the drawing). ) is rotated clockwise (CW) by a predetermined angle in the drawing. The above rotational force of the input lever 32 centered on the first hinge point H1 is transmitted to the lock lever 36 through the elastic linkage 34, and as a result, the lock lever 36 moves to the second hinge point. It rotates by a predetermined angle in the counterclockwise direction (CCW) in the drawing around (H2).

As a result, the tip lock tip 360 of the lock lever 36 is strongly adhered to the fastening surface 183 of the side open fastening groove 182, thereby realizing a firm bond between the handle 20 and the tibia template 10. It can be.

In more detail, as the clockwise rotation of the input lever 32 is centered on the first hinge point H1, the elastic link 34 is connected to the input lever 32 and the lock lever 36 in a hinge structure. The both ends (340, 342) are elastically displaced in the direction of approaching each other, causing the overall shrinkage, and as a resistance to this, the elastic interlocking link (34) generates a restoring force (elastic restoring force) to return to its original state.

This restoring force is caused by the force F, where the distal end of the input lever 32 (the part connected to the elastic link and the hinge structure) is approximately the longitudinal center line of the outward portion 262 passing through the center of the first hinge point H1 ( Until it exceeds A1), it acts as a force to return the input lever 32 by resisting the force F, but from the moment it crosses the A1 line, the input lever 32 moves in the opposite direction in which the force F is applied. It acts as a pressing force.

That is, when the input lever 32 is rotated by more than a predetermined angle clockwise in the drawing due to the force applied to the input panel 320, the restoring force of the elastic connection link 34 structurally acts as a force to press the input lever 32. Therefore, even if you remove your hand (force F is removed) from that position (the position where the restoring force of the elastic connection link acts as a force to press the input lever), the locking state (the state in which the lock tip restrains the tibia template) remains. It can be maintained.

Although not shown, separation between the handle 20 and the tibia template 10 is quickly realized through the operation of lifting the input lever 32 (operating the input lever 32 counterclockwise in the drawing), contrary to the above. It can be.

According to the embodiment of the present invention discussed above, a pair of side fasteners are formed on both sides of the front of the tibia template, and a handle can be fastened to one of them, and a part of the handle that clamps and handles the tibia template has a unique banding. By forming the structure, the tibia template can be pushed into the surgical site from the side (inside the knee) as shown in the usage diagram of FIG. 10, rather than from the front of the incision site during total knee replacement surgery.

For reference, Figure 10 is a diagram showing the use of a surgical instrument according to the present invention during total knee replacement surgery for the left knee (a handle is attached to the first side attachment portion of the tibia template and pushed into the surgical site). , In the case of the right knee, the handle can be reversed and used as shown in Figure 10 (turn the handle over and connect it to the second side attachment portion of the tibia template to enter the surgical site).

According to this, compared to the existing method in which the skin tissue in the front center of the knee is incised up and down, the incision area is spread as much as possible to both sides, and the tibial template is pushed into the surgical site from the front, smooth surgery is possible even with a small incision range. In other words, the present invention has the advantage of being a structure suitable for minimally invasive surgery (MIS surgery), which involves performing surgery with a minimum incision range.

Moreover, due to the unique configuration of the present invention that allows the tibial template to be pushed into the surgical site from the side (inside the knee) rather than from the front of the incision site during total knee arthroplasty, unlike the existing anterior insertion method, there is no need to abduct the patella. Since there is no or abduction of the patella can be minimized, damage to the patella or tissue associated with it can be minimized.

In the above detailed description of the present invention, only special embodiments thereof have been described. However, it should be understood that the present invention is not limited to the particular form mentioned in the detailed description, but rather is understood to include all modifications, equivalents and substitutes within the spirit and scope of the present invention as defined by the appended claims. It has to be.

1: Surgical instrument
10: tibia template 12: body part
14: Drilling slot 16: Central fastening part
18R: first side fastening portion 18L: second side fastening portion
20: handle 22: gripping portion
24: middle support 25: rod mounting bar
26: template holding portion 28: binding protrusion
30: lock part 32: input lever
34: elastic interlocking link 36: lock lever
160: central binding hole 162: central binding slit
180: side fastening hole 182: side open fastening groove
183: binding surface 261: L-shaped plate
262: extrovert 264: introvert
360: Tip lock tip H1, H2: Hinge point

Claims (9)

As a surgical instrument used in total knee replacement surgery,
A tibia template having a flat contact surface on the lower surface that contacts the flat bone resection surface of the proximal tibia and a central attachment portion formed in the front center portion; and
It includes a handle consisting of a gripping part that provides a gripping surface that can be gripped by hand, a straight middle support part coaxially coupled to one end of the gripping part, and a template holding part connected to the tip of the middle support part,
In the tibia template, a first side connection part and a second side connection part each having side connection holes are formed in a left-right symmetrical structure on both sides of the central connection part,
At the tip of the template holding part, a binding protrusion of a square cross-section is formed which is inserted into the side binding hole and attaches the tibia template to the handle,
Measurement of tibia size for minimally invasive total knee replacement surgery, characterized in that the template holding portion, which has a binding protrusion at the tip, is formed in a bending structure that is biased to one side with respect to the longitudinal center line (CL) of the handle. surgical instruments.
According to claim 1,
The tibia template is,
A plate-shaped body portion of a shape corresponding to the outer shape of the bone resection surface,
a V-shaped drilling slot consisting of a circular central opening formed in the center of the body and slit-shaped side openings formed symmetrically on both sides of the central opening to communicate with the central opening;
Bolt holes and pin holes formed around the drilling slot and through which a through bolt and a fixing pin for fixing the body part to the bone cutting surface are respectively penetrated and fixed;
The central coupling portion having a central coupling hole having a circular cross-sectional shape and central coupling slits formed on both sides of the central coupling hole,
Characterized by comprising a first side coupling portion and a second side coupling portion each having a side coupling hole of a square cross-section corresponding to the cross-sectional shape of the coupling protrusion and a side open coupling groove formed on one side of the side coupling hole. Surgical instrument for measuring tibia size for minimally invasive total knee replacement surgery.
According to claim 2,
Minimally invasive total knee arthroplasty, characterized in that in the side open fastening groove, an arc-shaped fastening surface for engaging the tip lock tip of the lock portion installed in the template holding part is formed concavely in the direction of the side fastening hole. Surgical instrument for measuring tibia size for procedures.
According to claim 1,
A tibia size measuring surgical instrument for minimally invasive total knee arthroplasty, characterized in that the middle support portion is formed with a rod mounting bar having at least one rod coupling hole into which an alignment rod is inserted.
According to claim 1,
The template holding part,
An outward portion bent at an angle of 100 to 140 degrees in a direction away from the center line (CL) at the tip of the intermediate support portion,
It consists of an inward portion bent at an angle of 80 to 100 degrees from the tip of the outward portion toward the center line.
A tibia size measuring surgical instrument for minimally invasive total knee replacement surgery, characterized in that the tie protrusion of a square cross-section is formed on the distal end surface of the inward portion.
According to claim 1,
The handle is,
It is installed on the template holding part, and the tibial template is restrained with the binding protrusion inserted into the side binding hole and fastened to the template holding unit, or the restraint is released so that the tibial template can be separated from the template holding unit. A tibia size measuring surgical instrument for minimally invasive total knee joint replacement surgery, further comprising an actuated locking unit.
According to claim 6,
The lock part is,
an input lever pivotably mounted on a first hinge point (H1) of a template holding portion formed adjacent to the intermediate support portion;
a lock lever formed adjacent to the binding protrusion and pivotably mounted on a second hinge point (H2) of the template holding portion spaced a predetermined distance from the first hinge point;
Measurement of tibia size for minimally invasive total knee arthroplasty, characterized in that it includes an arc-shaped or horse-shaped elastic interlocking link connected to each of the input lever and the lock lever in a hinge structure in order to interlock the input lever and the lock lever. surgical instruments.
According to claim 7,
At the tip of the lock lever, a tip lock tip is formed that is in close contact with the concave coupling surface of the side open coupling groove formed on one side of the side coupling hole at a position for constraining the tibia template, thereby constraining the tibia template. A tibia size measuring surgical instrument for minimally invasive total knee replacement surgery, characterized in that the distal lock tip is bent in the direction of the attachment protrusion.
According to claim 6,
The template holding part is composed of a pair of L-shaped plates arranged at a predetermined interval so that a mounting space is formed between them,
A tibia size measuring surgical instrument for minimally invasive total knee arthroplasty, characterized in that the lock portion is installed in the mounting space formed by the pair of spaced apart L-shaped plates so that a portion protrudes outside the mounting space. .

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