KR20050103776A - Lineup copulative device for copulating femur cutter with tibia cutter and knee joint surgery method using lineup copulative device thereof - Google Patents

Abstract

Disclosed is an alignment connecting apparatus capable of finely following the determined extension intervals and aligning the alignment of the femoral osteotomy and the tibial osteotomy in three dimensions. The disclosed invention has a guide groove is formed in the center of the front surface and the through hole is formed with a fixing pin is inserted into the guide groove side and the fixing portion is indicated by the indicator line; A support part slidably coupled to the guide groove of the fixing part, the support part including a slider having a standard corresponding to the determined extension interval and a step part inserted into the osteotomy groove of the femoral osteotomy; It characterized in that it comprises a fixing means for fixing the support to the fixing portion.

Description

Alignment linkage device for linking the alignment of femoral fractures and tibial fractures in artificial knee arthroplasty LINEUP COPULATIVE DEVICE THEREOF}

The present invention relates to an alignment linkage device for linking the alignment of femoral fractures and tibial osteotomy in an artificial knee replacement surgery, and to a surgical method for replacing an artificial knee joint using the device. More specifically, the present invention relates to an alignment linkage device of the femoral fractures and tibias, which can finely follow the determined extension intervals and can three-dimensionally link the alignment of the femoral fractures and the tibial fractures. It relates to a surgical method for replacing the artificial knee joint using.

Artificial knee arthroplasty is widely used to replace knee joints that have been damaged or modified by congenital malformations, trauma, disease, or degenerative arthritis. Accurate osteotomy of the injured knee joint is very important to prevent postoperative side effects and to prolong the life of the substituted knee joint.

1 is a view showing an ideal osteotomy of the extension intervals, as shown in order to ideally fracture the extension intervals of the femur (11) and the upper osteotomy of the tibia (12) to maintain the parallel to each other The tibia and the tibia should be aligned with the mechanical axis.

Looking at the conventional knee replacement surgery, the conventional replacement surgery is the osteotomy after mounting the femur osteotomy 21 to the lower end of the femur (11) using an alignment device not shown as shown in Figure 2 (a) 21-1) independently of the lower end of the femur (11), and using the alignment device not shown as shown in Figure 2 (b) to mount the tibia osteotomy 22 on the top of the tibia 12 After the top of the tibia (12) through the osteotomy groove (22-1) independently. That is, in the conventional replacement surgery, the femur 11 and the tibia 22 are independently mounted on the femur 11 and the tibia 22, and then the femur 11 and the tibia 21 with respect to each other. It will be osteotomy independently. However, in this conventional replacement surgery to align the femur (11) and the tibia 21 by aligning independently, the femur (11) and the tibia (21) during the actual operation is not aligned with the mechanical axis in the lower femur fracture There is a problem that the osteotomy of the upper tibial and the tibia does not form a parallel so that the interval between the temples cannot be accurately corrected.

In order to compensate for this, the applicant has applied for an alignment linkage device 30 for linking the alignment of the femur osteotomy and the tibial osteotomy, and has been registered as Korean Patent No. 399489. As shown in FIG. 3, the alignment linkage device includes an upper latch 31 and a lower pin groove 32 integrally formed by the side plate 33, and the pin P is inserted into the fixing portion. A plurality of pin grooves 34 are formed at regular intervals.

The artificial knee replacement surgery using the alignment device according to the patent will be briefly described with reference to FIGS. 4 and 5. The replacement surgery is to mount the femur osteotomy 21 to the lower end of the femur 11 through the pin, and then the clasp 31 of the alignment linkage device 30 to the osteotomy groove 21- of the femur osteotomy 21. 1) and insert the pin (P) into the pin groove of the alignment connection device 30 is put in the tibia (12). Thereafter, the alignment linkage device 30 is separated from the femur osteotomy 21 and the pin P, and the tibia osteotomy 22 is mounted to the tibia 12 through the pin P embedded in the tibia. Then, the femur 11 and the tibia 12 are mounted in parallel with the femur 11 at the lower end of the femur 11 and the top of the tibia 12 as shown in FIG. 5. Therefore, the lower femoral osteotomy and the tibia lower osteotomy to be fractured can be parallel to each other.

For reference, the extension interval is the interval between the osteotomy groove 21-1 of the femoral osteotomy 21 and the osteotomy groove 22-1 of the tibia osteotomy 22 in FIG. In other words, the extension interval is the sum of the cutting length at the top of the femur and the cutting length at the bottom of the tibia, and in a typical operation, the cutting length at the top of the femur is 8 mm, and the cutting length at the top of the tibia is determined by the operator according to the condition of the patient. . On the other hand, in the surgery, the position of the osteotomy groove 22-1 of the tibial osteotomy 22 is inserted into the pin groove 34 of the alignment linkage device 30, the position of the pin (P) that is lodged in the tibia 12 Since the reference point of the extension interval is determined to be the position of the pin groove 33 of the alignment connection device in which the pin (P) is inserted. For example, if the operator determines the extension interval to 20 mm according to the degree of injury of the patient's knee, the cut length of the lower femur is 8 mm and the cut length of the upper tibia is 12 mm. When selecting any one of the pin groove 33 corresponding to the cutting length of the upper tibia 12mm and inserting the pin (P) in the pin groove 33 finally the osteotomy groove 21-1 of the femur osteotomy and The interval between the osteotomy grooves 22-1 of the tibia osteotomy is 20 mm.

As described above, the patent uses the alignment linkage device 30 so that the alignment of the femoral osteotomy 21 and the tibial osteotomy 22 is not performed independently of each other, but is performed in interconnection. Tibia 12 and the upper osteotomy is to be made parallel.

However, there is a problem that the alignment linkage device 30 according to the patent cannot finely follow the determined extension interval. As described above, the reference point of the extension interval is the position of the pin groove 33 of the alignment linkage device into which the pin P is inserted, but the pin groove 33 is formed to be spaced so that the extension of the extension interval cannot be followed finely and continuously. For example, if the operator decides the extension interval as 19.5mm (cut length at the bottom of the femur: 8mm, cut length at the top of the tibia: 11.5mm), but there is no pin groove corresponding to the extension, the reference point for the required extension interval is There is a problem that can not be determined. Therefore, there is a need for an alignment linkage device capable of finely following the determined extension interval.

In addition, the alignment linkage device 30 according to the patent has a problem that the relaxed ligament length cannot be accurately compensated when the ligaments of the knee joint are relaxed. For example, if the operator decides the extension interval to 20 mm (cut length at the bottom of femur: 8 mm, the cut length at the bottom of tibia: 12 mm), but the ligament is 0.5 mm relaxed, the extension interval is 19.5 mm (cut length at bottom of femur). : 8mm, cutting length at the top of tibia: 11.5mm), and the femur and tibia were osteotomized and finally the artificial knee joint (femur substitute: 8mm, tibia substitute: 12mm) of 20mm dimension was inserted to extend the ligament. Compensating the relaxed ligament length by zooming, the device has a problem that the pin groove 33 is formed to be spaced apart as described above can not accurately compensate for the relaxed ligament length. Therefore, there is a need for an alignment linkage device that can easily compensate for the loosened ligament length when the ligaments of the knee joint are relaxed.

In addition, according to the alignment linkage device 30 according to the patent, the three-dimensional alignment of the lower femur and the tibial lower osteotomy to be osteotomy was not made. That is, the device was able to maintain parallel alignment of the femur 11 and the tibia 12 on the coronal axis, but the parallel alignment of the femur 11 and the tibia 12 with respect to the saggital axis and the femur 11 with respect to the transverse axis. And there is a problem that can not maintain the rotation of the tibia 12. For reference, the parallel alignment on the coronal axis refers to mechanical axial alignment of the femur and tibia when the knee is viewed from the front, and the parallel alignment on the saggital axis refers to the femur and tibia when the knee is viewed from the side. The mechanical axial alignment of the means, the transverse axial rotational synchronization refers to the rotational synchronization of the tibia relative to the femur when viewed from the top surface. Here, the alignment linkage device 30 may align the tibia parallel to the femur with respect to the mechanical axis on the coronal axis, as shown in FIG. 5, but flatten the tibia with respect to the mechanical axis on the saggital axis. The tibia could not be tilted on the saggital axis, and the tibia could not be synchronized with the rotation of the femur on the transverse axis. Accordingly, there is a need for an alignment linkage device capable of aligning and aligning the alignment of the femur osteotomy and the tibia osteotomy in three dimensions.

An object of the present invention has been made to solve the above problems, an object of the present invention is to provide an alignment linkage device that can finely follow the determined extension intervals. Another object of the present invention is to provide an alignment linkage device capable of three-dimensional alignment of the femur osteotomy and the tibial osteotomy. Another object of the present invention to provide a surgical method for replacing the artificial knee joint using the alignment device.

An object of the present invention is a guide groove is formed in the center of the front and the side of the guide groove is formed with a through hole into which the fixing pin is inserted and the indicator line is indicated; A support part slidably coupled to the guide groove of the fixing part, the support part including a slider having a standard corresponding to the determined extension interval and a step part inserted into the osteotomy groove of the femoral osteotomy; It is achieved by providing an alignment linkage device of the femoral osteotomy and tibial osteotomy, characterized in that it comprises a fixing means for fixing the support to the fixing portion.

In addition, the object is to determine the extension interval in accordance with the degree of injury of the knee joint of the patient; Adjusting the slider of the alignment linkage device according to the determined extension interval and then fixing the slider to the fixing unit through a fixing unit; Mounting a femoral fracture at the bottom of the femur and putting a selective anti-rotation pin at the center of rotation of the upper tibia; Inserting the steps of the alignment linkage into the osteotomy groove of the femoral osteotomy and simultaneously inserting the first and second selective rotation prevention holes of the alignment linkage into the selective rotation prevention pins embedded in the tibia; Adjusting the inclination of the inclination identification pin and the tibia shaft after inserting the inclination identification pin into the inclination identification groove formed on the bottom of the fixing unit of the alignment connection device; Inserting the fixing pin into the through-holes formed at both sides of the fixing unit of the alignment linkage device, and driving the fixation pin into the tibia; Separating the selective rotation preventing pin and the alignment connecting device from the tibia and the femur osteotomy respectively; Mounting a tibial cutter to the tibia through a fixation pin embedded in the tibia; Cutting the lower femur through the femoral osteotomy mounted on the femur, bending the femur in a bent state with respect to the tibia, and inserting the separated alignment linkage into the fixation pin embedded in the tibia again; Positioning the cutting block sizing device on the femur, with the guide seated on the upper surface of the step of the alignment connector and the bent part seated on the first anterior bone of the pre-cut osteotomy; Adjusting a cutting block size determining device to determine a size of the cutting block; Cutting the second half of the femur, the posterior chamber, the anterior chamber and the anterior bone with the determined cutting block; It is achieved by providing a method for arthroplasty of the knee joint, comprising the step of displacing the artificial knee joint between the femur and the tibia after cutting the upper tibia through the tibial osteotomy.

The present invention will be described in detail with reference to the accompanying drawings. 7 is a perspective view of an alignment linkage device according to the present invention, FIG. 8 is an exploded perspective view of the alignment linkage device according to the present invention, and FIG. 9 is a cross-sectional view taken along line AA ′ of FIG. 7. For convenience, the same reference numerals are given to the same components as in the prior art.

7 to 9, the alignment connection device 100 according to the present invention includes a fixing part 110, a supporting part 120, and a fixing means 130.

The fixing part 110 includes a guide groove 111 formed in the front center. The slider 121 of the support part 120 to be described later is coupled to the guide groove 111 so as to be slidable. A pair of through holes 112 are formed at both sides of the guide groove 111, and the fixing pins 113 are inserted into the through holes 112, and then are pinched on the tibia 12. In addition, on both sides of the front surface of the fixing part 110, a leader line 114 indicating a standard displayed on the slider 121 is displayed. Preferably, in order to identify whether the inclination of the saggital axis is inclined on the bottom of the fixing part 110, it is preferable that the inclination identification groove 115 into which the inclination identification pin 116 is inserted is formed to have a predetermined length. In addition, it is preferable that the extension gap preview groove 117 for previewing the extension gap is formed above the through hole 112 of the fixing part 110. In addition, a portion of the rear of the fixing portion is preferably in the form of a predetermined round 118 to be in close contact with the front projection of the tibia.

The support portion 120 is slidingly coupled to the guide groove 111 of the fixed portion and the upper portion is configured to be inserted into the osteotomy groove 21-1 of the femur osteotomy. Specifically, the support part 120 is configured to include a slider 121 which is slidingly coupled to the guide groove 111 of the fixing part and a step portion 122 inserted into the osteotomy groove of the femur osteotomy. In addition, on the front of the slider, a standard 123 corresponding to the determined extension interval is displayed.

Preferably, the contact surface of the slider 121 and the guide groove 111 is tapered inwardly, but is not limited thereto. Further, the first selective rotation preventing hole 124 is formed on the upper side of the slider 121, the second selective corresponding to the first selective rotation preventing hole 124 on the upper side of the guide groove 111 of the fixing portion The anti-rotation hole 119 is formed. Here, the first and second selective rotation prevention holes (124, 119) is provided as a long hole in the longitudinal direction, the upper end of the second selective rotation prevention holes 119 is formed as an open end as shown. The first and second selective rotation prevention holes 124 and 119 are provided to be inserted into the selective rotation prevention pin 125 in a state of being stuck in the center of rotation of the upper tibia as described below. The diameter of the selective rotation prevention pin 125 is formed to be substantially the same as the width of the first and second selective rotation prevention holes (124, 119).

On the other hand, as shown in Figure 9 is formed on the rear of the slider 121 in the height direction of the long groove 126 is formed in the fixing portion 110, the projection pin 140 guided in the long groove 126 in the rear Can be press-fitted. The push-in protruding pin 140 may prevent the slider 126 and the fixing part 110 from being separated from each other.

The fixing means 130 is preferably a fixing bolt inserted into the screw hole 127 of the slider 121.

The operation of the alignment device according to the present invention configured as described above will be described together with a description of a method for arthroplasty of the knee joint.

In the method of arthroplasty of the artificial knee joint using the alignment device according to the present invention, first, after adjusting the slider 121 to be suitable for the extension interval determined by the operator, the fixing part 110 is fixed through the fixing bolt 130. ). That is, as shown in FIG. 7, when the operator determines the extension interval to 20 mm (cut length at the bottom of the femur: 8 mm, cut length at the top of the tibia: 12 mm) according to the patient's condition, the leader line of the fixing part is defined as The slider 130 is fixed to the fixing part 110 through the fixing bolt 130 to indicate the scale 12. Then, the length from the actual extension interval preview groove 117 to the step portion 122 becomes 20 mm, the extension interval. That is, the scale described in the slider 121 represents the cutting length of the upper tibia that is to be fractured, and the extension interval is the length of the step portion 122 in the preview groove 117. However, the present invention is not limited thereto, and the scale itself described in the slider 121 may be designed to exhibit extension intervals that are the sum of the cutting length at the lower end of the femur and the cutting length at the top of the tibia.

When the slider 121 is fixed according to the extension interval, the femoral osteotomy 21 is mounted on the lower end of the femur 11 through the pin 23 as shown in FIG. 10, and the selective rotation prevention pin 125 is tibially supported. (12) Drive to the center of rotation at the top. Thereafter, the step portion 122 of the alignment connecting device 100 is in the osteotomy groove 21-1 of the femoral osteotomy, and the first and second selective rotation prevention holes 124 and 119 are selectively rotated in the tibia. Inserted into the prevention pin 125, respectively. At this time, the diameter of the selective rotation prevention pin 125 is substantially the same as the width of the first and second selective rotation prevention holes (124, 119) and the selective rotation prevention pin 125 is embedded in the center of rotation of the upper tibia Because of this alignment alignment device is to be aligned while maintaining the state of rotation synchronized on the transverse axis with respect to the femur fracture osteotomy 21.

Thereafter, the inclination identification pin 116 is inserted into the inclination identification groove 115 formed on the bottom of the fixing part, and then the degree of coincidence between the inclination identification pin 116 and the tibia shaft is determined. If the inclination identification pin 116 and the tibia shaft are inclined at a predetermined angle (that is, if misalignment occurs on the sagittal axis), the tibia 12 is moved to coincide with the inclination identification pin 116. At this time, since the selective rotation prevention pin 125 embedded in the tibia can move up and down within the selective rotation prevention groove 124 as the hinge point of the rotation center of the tibia, the alignment linkage device sagittal with respect to the femoral osteotomy 21. Alignment can also be maintained parallel to the axis.

On the other hand, the parallel alignment on the coronal axis may also be made by moving the tibia to the left and right finely based on the inclination identification pin 116.

As such, when alignment with respect to three axes (coroanl axis, sagittal axis, transverse axis) is made, the fixing pin 113 is inserted into the through-holes 112 formed on both sides of the fixing part while maintaining the state. ). Since the alignment linkage device 100 has a three-axis alignment, the fixing pin 113 embedded in the tibia is also in a three-axis alignment. After fixing the pin 113 in the tibia, the selective rotation prevention pin 125 and the alignment connecting device 100 are separated from the tibia 12 and the femur osteotomy 21, respectively. Then, only two fixing pins 113 remain in the tibia. Thereafter, the tibial cutter 22 is mounted through the fixing pin 113 remaining in the tibia. Then, as shown in FIG. 5, the femur 11 is fitted with the femoral osteotomy 21, and the tibia 12 is fitted with only the tibial osteotomy 22. Although not shown, the three-dimensional shape of FIG. 5 is aligned in three dimensions. In addition, the position of the osteotomy 22-1 of the tibial osteotomy is in a position corresponding to the position of the preview groove 117 of the alignment device.

As described above, the alignment linkage device according to the present invention has the following effects.

First, it is possible to provide an alignment linkage device capable of finely following the determined extension interval. That is, in the conventional alignment linkage device, since the extension of the extension was followed by the spaced pin groove, it was impossible to follow the extension of the extension extension. There is an effect that the interval can be linearly and continuously followed.

Second, when the ligaments of the knee joint are relaxed, the loosened ligaments can be easily compensated for. As described above, the alignment linkage device according to the present invention has an effect that the extension of the extension can be easily performed by changing the extension of the extension as much as the length of the ligament to be compensated.

Third, it is possible to provide an alignment linkage device capable of linking the alignment of the femur osteotomy and the tibia osteotomy in three dimensions. That is, the present invention can achieve rotational synchronization on the transverse axis by the selective anti-rotation pin, and because of the parallel alignment on the sagittal axis and the fine parallel alignment on the coronal axis by the inclination identification pin, The effect is that the alignment can be linked in three dimensions.

On the other hand, after the femoral osteotomy 21 and the tibial osteotomy 22 are mounted on the femur 11 and the tibia, respectively, as described above, filed by the alignment linkage device 100 and the present applicant according to the present invention. By using a cutting block size determination apparatus according to the PCT application number PCT / KR2004 / 000703 to the operation to replace the artificial knee joint, it will be described below. However, the cutting block size determination device and the peripheral description thereof are described in detail in the PCT application number PCT / KR2004 / 000703, please refer to this.

After the femoral osteotomy 21 and the tibial osteotomy 22 are mounted to the femur 11 and the tibia 12, respectively, after cutting the lower femur through the femur fracture 21, as shown in FIG. 11. After bending the femur 11 in a bent state with respect to the tibia 12, the removed alignment linkage device 100 was inserted into the fixing pin 113 embedded in the tibia again, and according to the PCT application No. PCT / KR2004 / 000703 The cutting block size determining device 200 is located in advance on the femur 11 in which the first anterior bone 11-1 has been fractured to determine the cutting block size.

Here, the cutting block size determination device 200 is a first anterior bone (11-1) in which the guide 201 is seated on the upper surface of the step portion 122 of the alignment connecting device and the bent portion 202 is pre-cut out ) As described above, when the cutting block size determining device 200 is positioned on the femur 11, the scale of the cutting block is determined by determining the scale of the body 204 indicated by the indicator line of the slider 203, as shown in FIG. With the cutting block 300 of the determined size, the second half 11-2 of the femur 11, the rear chamber 11-3, the front chamber 11-4, and the anterior bone 11-5 are fractured. .

Then, the tibial 12 is cut through the tibia osteotomy 22 and then the artificial knee joint is replaced between the cut femur and the tibia.

As described above, according to the alignment linkage device of the present invention, it is possible to finely follow the determined extension intervals, to easily compensate for the relaxed ligament length, and to align the femoral osteotomy and the tibial osteotomy in three dimensions. It is possible to provide an alignment linkage device that can be synchronized and linked. In addition, according to the artificial knee arthroplasty using the alignment device, there is an effect that can prevent side effects after surgery and extend the life of the substituted artificial knee joint.

1 is a view showing an ideal osteotomy of the temple interval,

Figure 2 (a) is a view for explaining the mounting of the femur osteotomy at the bottom of the femur by using the alignment device in a conventional manner,

Figure 2 (b) is a view for explaining the mounting of the tibial osteotomy on the top of the tibia by using an alignment device in a conventional manner,

3 is a perspective view of a conventional alignment linkage device,

4 and 5 are views for explaining the replacement of the knee joint using the conventional alignment linkage device shown in FIG.

6 is a view for explaining the coronal axis, saggital axis, transverse axis and mechanical axis (mechanical axis),

7 is a perspective view of the coupling device in accordance with the present invention in combination;

8 is an exploded perspective view of the alignment linkage device according to the present invention;

FIG. 9 is a cross-sectional view taken along line AA ′ of FIG. 7;

10 is a view showing a state in which the alignment connection device according to the invention is mounted,

11 is a view illustrating a state in which the alignment linkage device and the cutting block size determination device according to the present invention are mounted on the tibia and the femur, respectively.

12 is a view showing a state in which the cutting block is mounted on the femur.

* Description of the symbols for the main parts of the drawings *

11: femur 12: tibia

21: Femoral fractures 22: Tibia fractures

100: alignment linkage 110: fixed portion

120: support 130: fixing means

200: cutting block size determination device

300: cutting block

Claims (7)

A guide groove is formed at the center of the front surface and a through hole into which the fixing pin is inserted at the side of the guide groove, the fixing portion having a leader line; A support part slidably coupled to the guide groove of the fixing part, the support part including a slider having a standard corresponding to the determined extension interval and a step part inserted into the osteotomy groove of the femoral osteotomy; Alignment linkage device of the femoral osteotomy and tibia fracture characterized in that it comprises a fixing means for fixing the support to the fixing portion. The method of claim 1, The first selective rotation prevention hole is formed on the upper side of the slider is inserted into the selective rotation prevention pin, the upper femoral bone characterized in that the second selective rotation prevention hole corresponding to the first selective rotation prevention hole formed on the upper side of the guide groove Alignment linkage device of osteotomy and tibia osteotomy. The method of claim 2, The diameter of the selective rotation prevention pin alignment linkage device of the femoral fractures and tibial bone fracture, characterized in that substantially the same as the width of the first and second selective rotation prevention holes. The method of claim 1, Alignment linkage device of the femoral fractures and tibial osteotomy, characterized in that the inclined identification groove into which the inclination identification pin is inserted to a predetermined length to identify whether the inclination of the saggital axis in the bottom of the fixing portion. The method of claim 1, The rear side of the slide is formed in the longitudinal groove in the height direction alignment device of the femur fracture and tibial bone fracture, characterized in that the protruding pin guided to the fixed groove is pressed in the rear. The method of claim 1, Alignment linkage device of the femoral fracture and tibial bone fracture, characterized in that the extension interval preview groove that can preview the extension interval in the through-hole of the fixing portion. Determining an extension interval according to the degree of injury of the knee joint of the patient; Adjusting the slider of the alignment linkage device according to the determined extension interval and then fixing the slider to the fixing unit through a fixing unit; Mounting a femoral fracture at the bottom of the femur and putting a selective anti-rotation pin at the center of rotation of the upper tibia; Inserting the steps of the alignment linkage into the osteotomy groove of the femoral osteotomy and simultaneously inserting the first and second selective rotation prevention holes of the alignment linkage into the selective rotation prevention pins embedded in the tibia; Adjusting the inclination of the inclination identification pin and the tibia shaft after inserting the inclination identification pin into the inclination identification groove formed on the bottom of the fixing unit of the alignment connection device; Inserting the fixing pin into the through-holes formed at both sides of the fixing unit of the alignment linkage device, and driving the fixation pin into the tibia; Separating the selective rotation preventing pin and the alignment connecting device from the tibia and the femur osteotomy respectively; Mounting a tibial cutter to the tibia through a fixation pin embedded in the tibia; Cutting the lower femur through the femoral osteotomy mounted on the femur, bending the femur in a bent state with respect to the tibia, and inserting the separated alignment linkage into the fixation pin embedded in the tibia again; Positioning the cutting block sizing device on the femur, with the guide seated on the upper surface of the step of the alignment connector and the bent part seated on the first anterior bone of the pre-cut osteotomy; Adjusting a cutting block size determining device to determine a size of the cutting block; Cutting the second half of the femur, the posterior chamber, the anterior chamber and the anterior bone with the determined cutting block; Method of replacing the artificial knee joint surgery comprising the step of replacing the artificial knee joint between the femur and tibia after cutting the upper tibia through the tibial osteotomy.