RU110958U1 - DEVICE FOR TUNNELIZATION AND MICROFRACTURING OF SUBHONDRAL BONE - Google Patents

Abstract

 A device for tunneling and microfracturing the subchondral bone, which is a device for perforating the subchondral bone, characterized in that the proposed device contains a Kirchner needle with focus and marks, a spring and a cannula with a handle, while the spoke is inside the cannula, the spring is put on the spoke between the cannula and focus, and the length of the Kirschner needle corresponds to the length of the cannula.

Description

The utility model relates to medicine, namely to traumatology and orthopedics.

Analog 1. Through osteoperforation is performed using a drill with a diameter of 6 mm and using a spoke, in addition, a subchondral osteoperforation of the patella with a number of tunnels with at least three tunnels through the frontal plane through mutually oblique directions is made with a knitting needle (Makushin VD; Chegurov OK; Kazantsev V .I .; Kamshilov BV A method for the treatment of deforming arthrosis of the knee joint. Patent of the Russian Federation No. 2193363, according to the application No. 2000126047/14 of 16.10.2000; Date of publication: 11.27.2002).

Analog 2: Known Universal conductor for knitting needles and drills (Oster B. P. Universal conductor for knitting needles and drill // V. R. Oster / Orthopedics, traumatology and prosthetics. - 1976. - No. 5. - P.64-65). The jig contains a bracket with heads in which coaxial threaded holes are drilled. The heads are provided with lower slots. Coaxial threaded bushings are screwed into the holes of the heads: guide and receiving. There is a set of bushings with longitudinal axial channels for spokes and drills of various diameters. Each sleeve has a knurled head at one end, and a groove for a U-shaped pin at the other (outer diameter). When holding knitting needles, the bracket with the sleeves covers the limb, while the end of each sleeve corresponds to the point of insertion of the spoke, and the end of the other (receiving) to the point of exit. After holding the spokes, the bushings are turned out, and the bracket is removed from the spokes through the slots in the heads. When drilling bones with detached soft tissues (for example, through both tibia bones in the syndesmosis region), tips with spikes and holes for the studs are put on the free ends of the bushings. The spikes are pressed into the bone and firmly fix the jig, regardless of whether the oblique or transverse channel is supposed to be drilled.

Analogue 3. Known drill-pin (Sivash K.M., Borodkin B.C. Spoke-drill // K.M. Sivash / Orthopedics, traumatology and prosthetics. - 1974. - No. 5. - P. 82-83.

Criticism of analogues:

1. The needle is used in open form, which does not protect paraarticular tissue from damage during rotation of the tool;

2. The spoke does not have a graduation, which creates certain difficulties in determining the depth of its penetration into the bone;

3. The universal conductor for knitting needles and drills is massive and not intended for insertion into the joint cavity;

4. The needles are not additionally supported by the handle or cannula, which increases the invasiveness of the procedure, as the inevitable vibration and “play” during rotation will cause damage to adjacent bone sections and an unplanned opening of the hole.

Prototype. To perform the endoscopic microfracturing operation with relatively large defects in the cartilage (more than 2 cm ² ), the “Device for perforating the subchondral bone” is used (Dr. med. Sciences, professor, academician of the National Academy of Sciences of Belarus E. D. Beloenko, Dr. Medical sciences O. L. Eismont. Surgical treatment technology for isolated injuries of the cartilage of the knee joint (instructions for use) Institution developed by the State Institution “Belarusian Research Institute of Traumatology and Orthopedics Minsk 2007”, contains a pointed rod, platform, central threaded hole and spikes. After determining the area of the cartilage defect, a platform of the desired size is selected and fixed on the pointed end of the rod by screwing. Next, the selected platform is installed parallel to the machined surface so that the spikes are perpendicular to the latter. Osteoperforation is performed to a predetermined depth until the appearance of blood and droplets of fat from bone tissue.

The disadvantages of the prototype:

1. The diameter of the selected platform may exceed the diameter of the hole on the skin and in the capsule, which will complicate the introduction of the instrument into the joint cavity and injure the synovial membrane;

2. When fixing the instrument on the articular surface, the spikes can injure intact cartilage.

The purpose of the utility model: Creating a design that allows you to drill the subchondral bone without causing injury to the soft tissues of the joint, under the control of the depth of insertion of the tool and easily remove the knitting needles from the bone.

The essence of the proposed utility model: The device proposed as a utility model is depicted in figure 1 and figure 2, where

- Cannula (figure 1, position 1)

- pen (Fig. 1, item 2)

- knitting needle (figure 1, position 3; figure 2, position 3)

- labels (figure 1, position 4; figure 2, position 4)

- emphasis (figure 1, position 5; figure 2, position 5)

- spring (figure 1, position 6; figure 2, position 6).

A device for tunneling and microfracturing of the subchondral bone consists of a cannula (figure 1, position 1) with a handle (figure 1, position 2). Inside the cannula there is a spoke (figure 1, position 3; figure 2, position 3) with marks (figure 1, position 4; figure 2, position 4) and a stop (figure 1, position 5 ; figure 2, item 5). Between the cannula (Fig. 1, Pos. 1) and the focus (Fig. 1, Pos. 5; Fig. 2, Pos. 5) on the spoke (Fig. 1, Pos. 3; Fig. 2, Pos. 3) is worn spring (figure 1, pos.6; figure 2, pos.6). The distance between the marks is 1 mm. The length of the marks is 4 cm. The distance between the blunt end of the spoke and the stop is 1.5 cm. The length of the spring is 3 cm.

Features of utility model distinctive from prototype

1. The needle is passed through the soft tissue in a closed form, i.e. when the needle is in the cannula, which protects the paraarticular tissue from damage during rotation of the tool, and according to the prototype, the device is used in open form. The entire needle is in the cannula since the length of the Kirschner needle corresponds to the length of the cannula, which eliminates vibration and “play” during rotation and does not damage adjacent sections of the bone;

2. The needle is provided with tags, which facilitates the determination of the depth of its penetration into the bone; and in the known device there are no marks on the spoke. The presence of labels does not allow injuring paraarticular tissue during the introduction of the instrument;

3. The cannula is provided with a handle, but the known device does not have a handle.

4. The presence of a spring. The needle is inserted into the cannula, then the spring is put on the needle at the end that is fixed to the drill. The presence of a spring facilitates the "return" of the spoke after drilling a portion of the bone and prevents the "dip" of the spoke to a greater depth than planned;

An example of a specific implementation:

The proposed device for tunneling and microfracturing of the subchondral bone is used as follows: First, the spoke is fixed to the electric drill from the side of the marks. Then put a spring on the knitting needle (Fig. 1, pos. 6; Fig. 2, pos. 6) and insert the sharp end of the knitting needle into the cannula (Fig. 1, pos. 1), holding it by the handle (Fig. 1, pos. 2). The free end of the cannula is inserted into the joint cavity and attached to the damaged area of the bone. It is drilled, the depth of which (from 4-5 mm to 1.5 cm) is controlled by the marks on the spoke. After drilling, the pressure on the drill is weakened and the spoke, under the action of the spring, leaves the bone. After the completion of the manipulation, the tool is removed from the joint and disconnected from the drill.

The technical result of the proposed utility model: Improving the blood supply to the subchondral bone and creating the conditions for filling the defect in the articular cartilage with regenerate.

Drilling of the subchondral bone without causing injury to the soft tissues of the joint, under the control of the depth of insertion of the instrument and easy extraction of the spokes from the bone. At the free end, the device does not contain additional elements that can damage healthy cartilage.

Information taken into account:

- Makushin V.D .; Chegurov O.K .; Kazantsev V.I .; Kamshilov B.V. A method for the treatment of deforming arthrosis of the knee joint. (RF patent No. 2193363, by application No.2000126047 / 14 dated 10.16.2000; Date of publication: 11.27.2002);

- Oster V.R. Universal conductor for knitting needles and drills // V.R.Oster / Orthopedics, traumatology and prosthetics. - 1976. - No. 5. - S.64-65.

- Sivash K.M., Borodkin B.C. Spoke drill // K.M.Sivash / Orthopedics, traumatology and prosthetics. - 1974. - No. 5. - S. 82-83.

- Dr. honey. Sciences, prof., Acad. NAS of Belarus E.D. Beloenko, Dr. med. Sciences O.L. Eismont. The technology of surgical treatment of isolated injuries of the cartilage of the knee joint (instructions for use) Institution developer: State Institution “Belarusian Research Institute of Traumatology and Orthopedics” Minsk 2007 - prototype.

Claims (1)

A device for tunneling and microfracturing the subchondral bone, which is a device for perforating the subchondral bone, characterized in that the proposed device contains a Kirchner needle with focus and marks, a spring and a cannula with a handle, while the spoke is inside the cannula, the spring is put on the spoke between the cannula and emphasis, and the length of the Kirschner needle corresponds to the length of the cannula.