RU180998U1 - An individual resection unit for performing femoral filings during knee replacement - Google Patents

An individual resection unit for performing femoral filings during knee replacement Download PDF

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Publication number
RU180998U1
RU180998U1 RU2018111817U RU2018111817U RU180998U1 RU 180998 U1 RU180998 U1 RU 180998U1 RU 2018111817 U RU2018111817 U RU 2018111817U RU 2018111817 U RU2018111817 U RU 2018111817U RU 180998 U1 RU180998 U1 RU 180998U1
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Russia
Prior art keywords
sawdust
plastic frame
made
linear
holes
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RU2018111817U
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Russian (ru)
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Александр Леонидович Печкуров
Анастасия Викторовна Филиппова
Вадим Сергеевич Клименко
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Анастасия Викторовна Филиппова
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10Computer-aided planning, simulation or modelling of surgical operations
    • GPHYSICS
    • G06COMPUTING; CALCULATING; COUNTING
    • G06TIMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T19/00Manipulating 3D models or images for computer graphics
    • G06T19/20Editing of 3D images, e.g. changing shapes or colours, aligning objects or positioning parts

Abstract

The utility model relates to medical equipment and can be used for the preparation of sawdust in the distal femur during knee replacement. The objective of the utility model is to reduce the time and simplify the technique of filing sawdust, reduce the risk of displacement of sawdust during installation and the risk of instability of the knee joint. The technical result - the ability to perform all 5 sawdust of the femur without changing tools, reducing the risk of displacement of sawdust during installation, eliminating the use of a standard resection block, increasing the strength of fixation of the metal insert with a slot. This is achieved by the fact that in the utility model, unlike the prototype, the metal insert with a linear slot is equipped with a handle, additionally 3 through holes for installing metal bushings, as well as 4 linear slots for alternately installing a metal insert with a linear slot and equipped with a handle in them .

Description

The utility model relates to medical equipment and can be used for the preparation of sawdust in the distal femur during knee replacement.

It is known the use of an individual resection block for performing sawdust of the femur in knee replacement arthroplasty, made of collapsible and consisting of a plastic frame printed on a 3D printer. Three linear slots are made in the plastic frame, one of which is for distal filing of the femoral condyles, two for the front filing, and 12 through holes, 7 of which are made in the distal part of the plastic frame, and 5 in the proximal part, one of which - large through hole. The location of the linear slots, through holes correspond to the obtained 3D modeling results based on computed tomography of the femur.

(https://www.medacta.com/EN/myknee).

A plastic frame is installed on the condyles of the femur, through 2 through holes made in the distal part of the plastic frame, holes are drilled and pins are drawn. Through 2 through holes made in the proximal part of the plastic frame, holes are drilled. A distal filing of the femoral condyles is performed through a linear slot, and a front filing is performed through the remaining linear cuts (https://www.youtube.com/watch?v=7IGXrtmCfl8). Then the plastic frame and 2 pins are removed. In the prepared drilled holes, a plastic or metal standard resection block is installed, fix it with two pins, through which 2 oblique and rear sawdusts are doped. After the plastic or metal standard resection block with two pins is removed.

The disadvantages of the analogue are:

the inability to complete all 5 sawdust of the femur without changing tools, which leads to the duration of the sawdust;

the need for alternately using an individual plastic frame and a standard resection block to perform thigh sawdust is a risk of displacement during installation;

ingress of plastic chips during sawdust through linear plastic slots, which is a risk of wound infection;

the duration of the filing due to the presence of secondary stages.

As a prototype for the closest technical nature, we have chosen an individual resection unit for performing femoral sawdust during knee replacement, made of collapsible and consisting of a plastic frame printed on a 3D printer, a metal insert with a linear slot and four metal bushings. In the distal part of the plastic frame, a linear slot is made for installing a metal insert with a linear slot used for distal filing of the femoral condyles, and 4 through holes are made for installing metal bushings in the plastic frame, two of which are made in the distal part of the plastic frame, and 2 - in the proximal. The inner surface of the plastic skeleton is a copy of the outer surface of the bone, and the location of the linear slots and through holes made in the plastic skeleton corresponds to the obtained 3D modeling result based on computed tomography of the femur (http://synthes.vo.llnwd.net/o16 / LLNWMB8 / INT% 20Mobile / Synthes% 20International / Product% 20Support% 20Material / legacy_DePuy_PDFs / DPEM-ORT-0912-0235-1_9075-96-000_LR.pdf).

The device selected as a prototype works as follows: a plastic frame is put on the femoral condyles, 4 metal bushings are installed in 4 through holes. A metal insert is installed in the linear slot. Through two metal bushings installed in two through holes made in the distal part of the plastic frame, 2 pins are drawn. Through metal sleeves installed in two through holes made in the proximal part of the plastic frame, holes are drilled in the condyles of the femur. A resection of the distal condyles of the femur is performed through a metal insert. Then 2 pins, drawn through two metal bushings installed in two through holes made in the distal part of the plastic frame, remove and remove the plastic frame with a metal insert and 4 bushings. A standard resection block is installed in the drilled two holes in the condyles of the femur, fixed with two pins, and through the slots in it, the front, back and two oblique sawdust of the posterior condyles of the femur are made. Then the standard resection block and two pins are removed.

The disadvantages of the prototype are:

the inability to complete all 5 sawdust of the femur without changing tools, which leads to the duration of the sawdust;

the need for the alternate use of an individual plastic frame and a standard resection block for performing thigh sawdust, which is the risk of their displacement during installation;

the risk of displacement of the metal insert with a slot due to its insufficiently strong fixation.

The objective of the utility model is:

reduction in the execution time of sawdust femur;

simplification of the technique for performing thigh sawdust;

reduced risk of knee instability.

The technical result achieved using the claimed utility model:

the ability to perform all 5 sawdust of the femur without changing tools.

reducing the risk of displacement of sawdust during their installation;

the exclusion of the use of a standard resection unit;

increasing the fixation strength of the metal insert with a slot.

The technical result is achieved by the fact that an individual resection unit for performing thigh sawdust during knee joint replacement is made collapsible and consists of a plastic frame printed on a 3D printer, a metal insert with a linear slot and equipped with a handle, as well as seven metal bushings, while the distal part of the plastic frame has a linear slot for installing a metal insert with a linear slot and equipped with a handle used to perform the distal saw the condyles of the femur, in the proximal part there are 4 linear slots for alternately installing a metal insert with a linear slot and equipped with a handle, one of the 4 linear slots is made for the front sawdust, two for oblique sawdust, one for the rear sawdust, in the plastic frame there are also 7 through holes for installing metal bushings, 2 of which are made in the side of the plastic frame, and 3 in its distal part, one of which is made between two with through holes located at the same level above the level of their location, the remaining 2 through holes are made in the proximal part of the reservoir frame. The inner surface of the plastic skeleton is a copy of the outer surface of the bone, and the location of the linear slot and through holes made in the plastic skeleton corresponds to the obtained 3D modeling result based on computed tomography of the femur.

Distinctive essential features and a causal relationship between them and the achieved result.

The metal insert with a linear slot is equipped with a handle.

The presence of a handle will allow to hold and control the location of the metal insert in the linear slot of the plastic frame during the execution of the sawdust, thereby eliminating the likelihood of displacement during the sawdust and, as a consequence, the error in the sawdust.

Additionally, 3 through holes for installing metal sleeves were made, 2 through holes were made in the side of the plastic frame, and one in the distal part of the plastic frame between two existing through holes above the level of their location, which allows stable fixation of the massive plastic frame, which, in in turn, eliminates its displacement during the execution of successive five sawdust.

In addition, 4 linear slots were made for alternately installing a metal insert with a linear slot and equipped with a handle in them (one of the 4 linear slots above was made for front sawdust, two for oblique sawdust, one for rear sawdust), eliminating the need to change and the use of standard tools at the time of preparation of the femoral sawdust, and also allow, in addition to the distal sawdust, to alternately perform another 4 sawdust (front, 2 oblique and posterior sawdust) and prepare the distal Thigh bones are required to install the femoral component of the knee endoprosthesis.

Errors and line offsets that could occur when changing tools are eliminated due to the fact that the plastic frame with linear slots is statically fixed to the condyles of the femur and only the metal insert with a linear slot and equipped with a handle is moved, the blade.

The essence of the utility model is illustrated in FIG. 1-10, which depict a General view of the claimed utility model, where:

1 - plastic frame;

2 - through hole No. 1, made in the distal part of the plastic frame;

3 - through hole No. 2, made in the distal part of the plastic frame;

4 - through hole No. 3, made in the distal part of the plastic frame;

5 - through hole No. 4, made in the side of the plastic frame;

6 - through hole No. 5, made in the side of the plastic frame;

7 through hole No. 6, made in the proximal part of the plastic frame;

8 - through hole No. 7, made in the proximal part of the plastic frame;

9 - metal sleeve;

10 - linear slot No. 1 for performing posterior filing of the femoral condyles;

11 - metal insert with a linear slot and equipped with a handle;

12 - oscillatory saw with a blade;

13 - linear slot No. 2 for the first oblique filing of the condyles of the femur;

14 - linear slot No. 3 for the second oblique filing of the femoral condyles;

15 is a linear slot No. 4 for performing anterior filing of the femoral condyles;

16 - linear slot No. 5 for performing distal filing of the femoral condyles.

The proposed utility model can be used as follows. On the condyles of the femur put a plastic frame (1) in the through holes (2-8) set 7 metal bushings (9) (Fig. 1). Through the through holes (4, 5, 6) with inserted metal bushings (9), three pins are passed and thereby fix the plastic frame (Fig. 2). Through holes (2, 3, 7, 8) with four metal bushings (9) inserted, drill holes are drilled with a drill (Fig. 3), then four metal bushings (9) inserted into the through holes (2, 3, 7, 8). Then, in a linear slot No. 1 (10), a metal insert with a linear slot and equipped with a handle (11) and an oscillating saw with a blade 1.27 (12) is installed with a rear sawdust (Fig. 4), after which, similarly, in a linear slot No. 2 (13) install a metal insert with a linear slot and equipped with a handle (11) and perform the first oblique sawdust (Fig. 5), also in a linear slot No. 3 (14) install a metal insert with a linear slot and equipped with a handle (11) and perform the second oblique sawdust (Fig. 6). In the linear slot No. 4 (15), a metal insert with a linear slot and equipped with a handle (11) is installed and the front sawdust is made (Fig. 7). In the last linear slot No. 5 (16), a metal insert with a linear slot and equipped with a handle (11) is installed and distal filing is performed (Fig. 8). Then, a metal insert with a linear slot and equipped with a handle (11), three pins and a plastic frame (1) are removed with metal sleeves (9) (Figs. 9, 10).

We give a clinical example.

Example 1. Patient O., 69 years old. Diagnosis: Deforming arthrosis of the left knee joint 3 tbsp. with multi-plane deformation and violation of the biological axis of the limb. Based on the data of computed tomography of the femur, the patient performed 3D modeling. As a result of the obtained 3D modeling data, the patient selected the femoral left component of the Aesculap F6 knee joint prosthesis (Fig. 11). Given the location of the component of the knee endoprosthesis, the coordinates of the osteotomy planes of the distal, anterior, first oblique, second oblique, posterior fillets of the femoral condyles are obtained (Fig. 12) and the location of 7 pins. After that, a plastic frame was virtually created, taking into account the location of 5 osteotomy planes and 7 pins. Then, a plastic frame was made on a 3D printer (Fig. 13).

A surgical procedure was performed, during which, after subperiosteal excision of the femoral condyles, a plastic frame (1) was put on the condyles of the femur, 7 metal bushings (9) were installed in the through holes (2-8). Through the through holes (4, 5, 6) with the inserted metal bushings (9), three pins are drawn and thereby the plastic frame is fixed. Through holes (2, 3, 7, 8) with four metal bushings (9) inserted, drill holes are drilled with a drill, then four metal bushings (9) inserted into the through holes (2, 3, 7, 8) are removed. Then, in a linear slot No. 1 (10), a metal insert with a linear slot and equipped with a handle (11) and an oscillator saw (12) with a 1.27 blade is mounted with a rear sawdust, after which a metal insert is installed in a linear slot No. 2 (13) an insert with a linear slot and provided with a handle (11) and the first oblique sawdust is made, also a linear insert with a linear slot and equipped with a handle (11) and a second oblique is installed in the linear slot No. 3 (14). In the linear slot No. 4 (15), a metal insert with a linear slot and equipped with a handle (11) is installed and the front sawdust is made (Fig. 14). In the last linear slot No. 5 (16), a metal insert with a linear slot and equipped with a handle (11) is installed and a distal sawdust is made. Through the holes (2, 3, 7, 8), the expected and obtained results are checked and compared using the navigation system. Then the metal insert with a linear slot and equipped with a handle, three pins and a plastic frame with metal sleeves were removed (Fig. 15). Thanks to the correctly executed sawdust, the component of the knee joint endoprosthesis is set to a predetermined position (Figs. 16, 17).

An individual resection block for performing femoral sawdust during knee replacement implants reduced the time of surgical treatment by 30 minutes, by eliminating secondary instruments and standard resection blocks and alterations during surgery.

Thus, the claimed utility model, unlike the prototype, allows all 5 sawdust of the femur to be performed without changing tools, reduces the risk of displacement of the sawdust of the femur during installation, eliminates the use of a standard resection block, increases the fixation strength of the metal insert with a slot, which, in in turn, it shortens the time and simplifies the technique of performing sawdust of the femur, and also reduces the risk of instability of the knee joint.

Claims (1)

  1. An individual resection unit for performing femoral sawdust for knee replacement, made of collapsible and consisting of a plastic frame printed on a 3D printer, a metal insert with a linear slot and four metal bushings, while a linear slot was made in the distal part of the plastic frame for installing a metal inserts with a linear slot used to perform distal filing of the femoral condyles, and to install metal bushings in plastics There are 4 through holes in the frame, two of which are made in the distal part of the plastic frame, and 2 in the proximal, the inner surface of the plastic frame being a copy of the outer surface of the bone, and the location of the linear slot and through holes made in the plastic frame corresponds to the result 3D modeling based on computed tomography of the femur, characterized in that in the plastic frame 4 additional linear sections are made in its proximal part cutters for alternately installing a metal insert with a linear slot in them, one of the 4 above linear cuts is made for front sawdust, two for oblique sawdust, one for rear sawdust, in the plastic frame there are also 3 additional through holes for installing metal bushings, 2 of which are made in the side of the plastic frame, and one in the distal part of the plastic frame between two existing through holes above the level of their location, while metallic Skye insert with a linear slit is provided with a handle.
RU2018111817U 2018-04-02 2018-04-02 An individual resection unit for performing femoral filings during knee replacement RU180998U1 (en)

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Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
RU2465855C1 (en) * 2011-10-05 2012-11-10 Федеральное государственное бюджетное учреждение "Саратовский научно-исследовательский институт травматологии и ортопедии" Министерства здравоохранения и социального развития Российской Федерации (ФГБУ "СарНИИТО" Минздравсоцразвития России) Method for bone defect replacement in tibial and femoral condyles in total knee replacement
US20170151019A1 (en) * 2014-02-28 2017-06-01 Blue Belt Technologies, Inc. System and methods for positioning bone cut guide
US20170178413A1 (en) * 2011-12-09 2017-06-22 Brainlab Ag Method for determining contact position parameters of a joint connecting two bones
US20170258526A1 (en) * 2016-03-12 2017-09-14 Philipp K. Lang Devices and methods for surgery

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
RU2465855C1 (en) * 2011-10-05 2012-11-10 Федеральное государственное бюджетное учреждение "Саратовский научно-исследовательский институт травматологии и ортопедии" Министерства здравоохранения и социального развития Российской Федерации (ФГБУ "СарНИИТО" Минздравсоцразвития России) Method for bone defect replacement in tibial and femoral condyles in total knee replacement
US20170178413A1 (en) * 2011-12-09 2017-06-22 Brainlab Ag Method for determining contact position parameters of a joint connecting two bones
US20170151019A1 (en) * 2014-02-28 2017-06-01 Blue Belt Technologies, Inc. System and methods for positioning bone cut guide
US20170258526A1 (en) * 2016-03-12 2017-09-14 Philipp K. Lang Devices and methods for surgery

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
Cutting guide system with the Sigma High Perfomence Instruments System, Surgical technique, True match personalized solution, DePuy International Ltd. and Ortopeadics, INC., 11.2013. *

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