TWM642133U - Adjustable Osteotomy Correction Positioner - Google Patents

Abstract

The invention provides an adjustable osteotomy correction positioner, which includes a positioning piece, a first guiding and fixing piece, a connecting piece and a second guiding and fixing piece. The positioning part has two spoon arms with adjustable width, and the two spoon arms can be placed between the femur and the tibia of the human body; the first guiding and fixing part can be sleeved on the positioning part for fixing on the tibia, the first guiding and The part is provided with a first cutting guide groove, the connecting part has a first connecting part and a second connecting part, there is an included angle corresponding to the sagittal plane between the first connecting part and the second connecting part, and the first connecting part can connect In the positioning part, the second guiding and fixing part can be sleeved on the connecting part to be fixed on the femur. The connecting part is provided with a second cutting guide groove, so that this creation is suitable for the problem of femur and tibial inclination, so as to achieve knee joint Balance in the sagittal plane.

Description

Adjustable Osteotomy Correction Positioner

The invention relates to an appliance for osteotomy correction surgery, especially an adjustable osteotomy correction positioner.

Currently, the tools used in total knee arthroplasty (Total Knee Arthroplasty, TKA) have provided a lot of help to the surgeon performing the operation, but the steps in the operation are complicated, and the conditions of the osteotomy required by the patient are also inconsistent. Therefore, it still relies heavily on the practical experience of doctors.

When the patient has the problem of tilting of the femur and tibia, the existing tools cannot meet the needs of surgery, especially the balance of the sagittal plane (Sagittal plane) and the coronal plane (Coronal plane) of the knee joint cannot be achieved equally. It is not conducive to the simultaneous treatment of femoral osteotomy and tibial osteotomy.

In order to solve the above problems, this creation provides an adjustable osteotomy correction positioner. When the femur and tibia are tilted, this creation can achieve the balance of the sagittal and coronal planes of the knee joint.

One embodiment of the present invention provides an adjustable osteotomy correction positioner, which includes a positioning element, a first guiding and fixing element, a connecting element and a second guiding and fixing element. The positioning part has a base, two symmetrically shaped spoon arms extend from one side of the base and a body is provided on the other side, the base has a chute, one of the spoon arms is slidably set in the chute, and the two spoon arms can be opposed Between the femur and the tibia of the human body, two spoon arms support a medial posterior femoral condyle and a lateral posterior femoral condyle corresponding to the femur, wherein each spoon arm is roughly cross-shaped, and each spoon arm is along The radius of curvature in the X-axis direction is the same as the radius of curvature along the Y-axis direction; the first guiding and fixing member has a first set groove and a first fixing part, the first set groove can be sleeved on the body, and the second set groove A fixing part is used to fix the tibia, and a first cutting guide groove is provided between the first fixing part and the first sheathing groove, which is used to guide a cutting tool to trim a tibial plateau of the tibia; the connecting part has A first connecting portion and a second connecting portion away from each other, there is an included angle corresponding to the sagittal plane between the first connecting portion and the second connecting portion, the first connecting portion can be connected to the positioning member, and the second guide The guide fixing part has a second set groove and a second fixing part, the second set groove can be sleeved on the second connecting part, and the second fixing part is used to fix the femur, the second fixing part and the second set A second cutting guide groove is arranged between the grooves for guiding the cutting tool to trim the articular surface of the femur.

Therefore, the adjustable osteotomy correction locator of this creation has a simple structure and is easy for doctors to operate. When the femur and tibia are tilted, it is fixed on the tibia by the first guide and fixer of this creation, and the second guide and fixer is fixed on the femur , and the balance between the sagittal and coronal planes of the knee joint can be achieved, which is conducive to the osteotomy.

In addition, one of the two spoon arms of this creation is slid on the chute, so that the two spoon arms can adjust the width between the two spoon arms according to the width of the femur, so that the two spoon arms can resist and fit more stably On the spherical surface of the posterior femoral condyle.

Furthermore, there is a pivot between the first connecting part and the second connecting part of the connecting part of this creation, so that the first connecting part and the second connecting part are relatively pivoted, so that this creation can respond to different knee joints. Regardless of the tightness, the positioning piece can be successfully placed in the gap between the tibia and the femur and floated on the spherical surface of the posterior condyle of the femur to form a positioning.

When tibial or femoral osteotomy needs to adjust the inclination of the anterior and posterior sagittal plane of the knee joint, the first cutting guide slot or the second cutting guide slot at different angles can be used to achieve the balance of the sagittal plane osteotomy plane .

For ease of explanation, the central idea expressed in the above-mentioned creation content column of this creation is expressed with specific embodiments. Various objects in the embodiments are drawn according to proportions, sizes, deformations or displacements suitable for illustration, rather than drawn according to the proportions of actual components, which are described first.

The thinking logic of artificial knee joint reconstruction and replacement surgery currently has two major systems - mechanical axis positioning or motion axis positioning. Which system to choose is related to the subsequent osteotomy method and the balance of soft tissue around the joint.

This creation is a surgical workpiece developed based on the thinking logic of KA (kinematic alignment) so-called motion axis positioning. The starting point of the creation is to use a pair of parallel spoon-shaped structures with the same curvature to conform to the spherical surface of the spherical structure of the posterior femoral condyle of the knee joint to achieve effective positioning of the movement axis. From this positioning, the effective articular surface of the femur and the osteotomy workpiece of the proximal tibial joint platform parallel to the axis of motion are derived, so that the entire total knee arthroplasty procedure can completely rely on a single reference axis to achieve the requirements of perfect natural balance.

The derived workpiece, in addition to the positioning key assembly, provides X, Y, Z three-axis adjustable positive and negative six-vector adjustment flexibility, which is sufficient to meet the needs of bone deformation and osteotomy reconstruction of various degrees of severity, and from the beginning to the end , without using any soft tissue adjustment surgery, it is easy and reasonable to achieve the result of three-axis balance.

Please refer to Fig. 1 to Fig. 7, the invention provides an adjustable osteotomy correction positioner 100, which includes a positioning part 10, a first guide fixing part 20, a connecting part 30 and a second guide Fixture 40. Among them, the adjustable osteotomy correction positioner 100 can be used as a tool for femur 1 osteotomy and tibia 2 osteotomy at the same time when the knee is operated on, especially when the femur 1 and tibia 2 have tilt problems, it can be used in this creation to achieve Sagittal and coronal balance of the knee joint for surgeons to perform total knee arthroplasty in a simple and precise manner.

The positioning member 10 has a base 11 , two symmetrical spoon arms 12 extend from one side of the base 11 and an elongated body 13 is provided on the other side, the elongated body 13 is convenient for the operator to hold. As shown in Figures 1 to 5, in this creative embodiment, the shape of the two spoon arms 12 is symmetrical and spaced apart, and the two spoon arms 12 can be placed between the femur 1 and the tibia 2 of the human body, so that The two spoon arms 12 support the spherical structure of the medial posterior femoral condyle 1a and the lateral posterior femoral condyle 1b corresponding to the femur 1, that is, the curved part of the two spoon arms 12 can correspond to the medial posterior femoral condyle 1a and the lateral femoral The corresponding curvature of the spherical surface of the posterior condyle 1b.

Among them, in this creative embodiment, the base 11 has a chute 111, and one of the spoon arms 12 is slid on the chute 111, so that the two spoon arms 12 can adjust the distance between the two spoon arms 12 according to the width of the femur 1. The width allows the two spoon arms 12 to more stably be placed between the femur 1 and the tibia 2 .

In addition, in this creative embodiment, each spoon arm 12 is roughly in the shape of a cross, and the radius of curvature of each spoon arm 12 along the X-axis direction is the same as the curvature radius along the Y-axis direction, so that the two spoon arms 12 can be compliant It rests on the spherical surface of the medial posterior femoral condyle 1a and the lateral posterior femoral condyle 1b of the approximately spherical femur 1 (also indirectly reflects the spherical center of the spherical structure of the medial posterior femoral condyle 1a and the lateral posterior femoral condyle 1b) ), so that the two spoon arms 12 can more stably be placed between the femur 1 and the tibia 2 .

The first guiding and fixing member 20 has a first sleeve groove 21 and a first fixing portion 22 , and a first cutting guide groove 23 is disposed between the first fixing portion 22 and the first sleeve groove 21 . The first setting groove 21 can be sleeved on the body part 13 , the first fixing part 22 is used to fix the tibia 2 , and the first cutting guide groove 23 is used to guide the cutting tool to trim the tibial plateau 2 a. In this creative embodiment, the number of the first sleeved grooves 21 is two and has different heights, so as to adjust the height of the sleeved slots 21 on the positioning member 10 . In addition, the first guiding and fixing part 20 further includes a first plug part 24, the first plug part 24 has a first cutting guide groove 23, and the first guiding and fixing part 20 has a first setting groove 25, the first The plug 24 is detachably slid in the first setting groove 25 . Further, the first plug piece 24 and the first setting groove 25 are concave-convex fit, that is, the outer edge of the first plug piece 24 has a first protrusion 241 of a predetermined shape, and the inner edge of the first setting groove 25 has a The first concave portion 251 of the protruding block enables the first plug member 24 to be stably disposed in the first disposing groove 25 .

The first fixing part 22 has a plurality of perforations 221 for a plurality of bone screws 3 to lock the first guiding and fixing part 20 to the appropriate position of the tibia 2. As far as the present invention is concerned, the perforations 221 are respectively arranged on two At the side, the height position of each perforation 221 on each side is different, so the operator can adjust the position of the first guiding and fixing member 20 relative to the tibia 2 according to the operation situation, so as to facilitate the operator to pass the cutting tool through the first A cutting guide groove 23 trims the tibial plateau 2a. Wherein, the first cutting guide groove 23 is inclined, and its angle can be positive (extension) negative (flexion) 3 degrees, 5 degrees, 7 degrees and 9 degrees. In other embodiments, the first cutting guide groove 23 can also be straight, that is, not inclined, so that the angle is 0 degrees, so that the operator can select the first plug with a specific angle specification according to the surgical requirements. The first cutting guide groove 23 of 24 is used to trim the tibial plateau 2a so as to achieve the balance of the sagittal plane osteotomy.

The connector 30 has a first connecting portion 31 and a second connecting portion 32 away from each other, and there is an included angle A corresponding to the sagittal plane between the first connecting portion 31 and the second connecting portion 32, and the first connecting portion 31 can be connected to the positioning member 10 . In this inventive embodiment, the first connecting portion 31 has a socket 311 for being laterally sleeved on the base portion 11 of the positioning member 10 .

There is a pivot 33 between the first connecting portion 31 and the second connecting portion 32 , so that the first connecting portion 31 and the second connecting portion 32 can be pivoted relative to each other. In addition, in this creative embodiment, a spacer 50 is further included, which can be arranged on the second connecting part 32 and is located between the femur 1 and the connecting part 30, so as to fill up the femur 1 when the cartilage of the femur 1 wears out. The distance between it and the connecting piece 30 makes the osteotomy of the femur 1 appear parallel. The second connecting portion 32 is generally in an inverted T shape. Two wings 321 are disposed on both sides of the second connecting portion 32 , and there are two spacers 50 for hanging on the two wings 321 respectively. It should be noted that, since the degree of cartilage wear of the medial posterior femoral condyle 1a and lateral posterior femoral condyle 1b of femur 1 varies from person to person, the X-ray interpretation estimation before the operation and the visual inspection during the operation should be based on the degree of wear. A spacer 50 of predetermined thickness is selected. And when the cartilage of the medial posterior femoral condyle 1a is worn out, then the pad 50 is arranged on the wing plate 321 on one side, so that the pad 50 is added between the femur 1 and the connector 30 when the femur 1 is osteotomized, and then Restore the original appearance of femur 1 without degeneration and wear, and then perform osteotomy of femur 1. Similarly, if the cartilage at the posterior femoral condyle 1b on the outer side of the femur is worn out, correspondingly add the corresponding spacer 50 on the wing plate 321 on the other side according to the foregoing; When both the posterior femoral condyle 1a and the lateral posterior femoral condyle 1b are worn out, corresponding gaskets 50 are added to the two wing plates 321 to make the osteotomy surface of the femur 1 appear parallel. And when two spacers 50 are used, their thicknesses may be the same or different, depending on the degree of wear of the cartilage. Therefore, in this creative embodiment, as shown in FIG. 3 , the spacer 50a is thinner and suitable for those with a low degree of cartilage wear. And in Fig. 7 (another embodiment for this creation), the size of pad 50b is thicker and is suitable for those with high degree of cartilage wear.

The second guide fixing part 40, which is substantially the same member as the first guide fixing part 20, has a second sleeve groove 41 and a second fixing part 42, and the second fixing part 42 and the second sleeve A second cutting guide groove 43 is defined between the grooves 41 . The second sleeve groove 41 can be sleeved on the second connecting part 32, the second fixing part 42 is used to fix the femur 1, and the second cutting guide groove 43 is used to guide the cutting tool to carry out the articular surface of the femur 1. Trimming. In the present invention, the number of the second sleeve slots 41 is two, for adjusting the position of the sleeve on the connecting member 30 . In addition, the second guide and fixer 40 further includes a second plug 44, the second plug 44 has a second cutting guide groove 43, and the second guide and fixer 40 has a second setting groove 45, the second The plug 44 is detachably slid in the second installation groove 45 . Further, the second plug piece 44 and the second setting groove 45 are concave-convex fit, that is, the outer edge of the second plug piece 44 has a second protrusion 441 of a predetermined shape, and the inner edge of the second setting groove 45 has a The second recess 451 of the protruding block enables the second plug 44 to be stably disposed in the second disposing groove 45 .

The second fixing part 42 has a plurality of perforations 421 for a plurality of bone screws 3 to lock the second guiding and fixing part 40 to the appropriate position of the femur 1. As far as the present invention is concerned, the perforations 421 are respectively arranged on the two sides. The position of each perforation 421 on each side from the second sleeve groove 41 is different, so the operator can adjust the position of the second guiding and fixing member 40 relative to the femur 1 according to the operation situation, so as to facilitate the operation Or use the cutting tool to trim the articular surface of the femur 1 through the second cutting guide groove 43 . Wherein, the second cutting guide groove 43 is inclined, and its angle can be positive (extension) negative (flexion) 3 degrees, 5 degrees, 7 degrees and 9 degrees. In other embodiments, the second cutting guide groove 43 can also be straight, that is, not inclined, so that the angle is 0 degrees, so that the operator can select a second plug with a specific angle specification according to the surgical requirements. The second cutting guide groove 43 of 44 is used to trim the articular surface of the femur 1 so as to achieve the balance of the sagittal plane osteotomy.

As shown in Figure 3 to Figure 6 (and cooperate with Figure 2), it is to illustrate the operation mode of the embodiment of the invention. Taking the left foot as an example, the skin and flesh tissue at the knee joint of the patient is cut open, and the two spoon arms 12 of the positioning member 10 are placed between the tibia 2 and the femur 1 along the Y-axis direction (as shown in FIG. 3 ). The two spoon arms 12 can maintain contact between the tibial plateau 2a and the medial posterior femoral condyle 1a and the lateral posterior femoral condyle 1b of the femur 1, and as the two spoon arms 12 are parallel or have a height difference in the horizontal direction, this The positioning member 10 will naturally position a reference axis L according to the positions of the two spoon arms 12 when they are clamped, (as shown in FIG. 4 ).

Next, install the first guiding and fixing part 20 and the connecting part 30 on the positioning part 10 respectively, and then also install the second guiding and fixing part 40 on the connecting part 30, and make the first guiding and fixing part 20 correspond to the tibia 2 , the second guiding and fixing member 40 corresponds to the femur 1 . Next, fix the first fixation part 22 of the first guiding and fixing part 20 to the tibia 2 with the bone screw 3 (as shown in Fig. 3 and Fig. 4 ), and fix the second fixing part 22 of the second guiding and fixing part 40 with the bone screw 3 42 is fixed on the femur 1 (as shown in Fig. 3 and Fig. 6), so that the first guide and fixer 20 corresponds to the second guide and fixer 40 and is fixed at the proper position of the knee joint, so that this creation can not be used during the operation. Will be displaced by external force.

After the aforementioned reference axis L is positioned, the reference axis L is nearly parallel to the movement axis of the medial posterior femoral condyle 1a and the lateral posterior femoral condyle 1b relative to the tibial plateau 2a. The articular surface between tibia 2 and femur 1 was repaired. That is to say, the operator can guide the cutting tool through the first cutting guide groove 23 of the first guiding fixture 20 to the tibial plateau 2a, and through the second cutting guide groove 43 of the second guiding fixture 40 The cutting tool is guided so that the articular surface of the femur 1 can be trimmed. Since the first cutting guide groove 23 and the second cutting guide groove 43 can be preset with a specific inclination, the first plug 24 and the second plug 44 with different inclinations can be selected according to the operation requirements for smooth operation. .

In particular, since the human knee is bent and straightened at different angles, the tightness of the inside and outside of the knee joint, and the upper and lower sides are different. Between the femur 1 and the tibia 2, in this creative embodiment, the connecting member 30 is centered around the pivot 33, so that the relative folding ability of the first connecting part 31 and the second connecting part 32 can be adjusted. The included angle A between them, so as to correspond to the patient's knee joint, for the first guide and fixer 20 and the second guide and fixer 40 to correspond to the required positions.

Therefore, this creation is suitable for the situation where femur 1 and tibia 2 are tilted, so that femur 1 osteotomy and tibia 2 osteotomy can be processed simultaneously, and through this creation, the knee joint can be achieved in the coronal plane (X axis) and sagittal plane (Y axis). axis) in perfect balance.

In this creation, the spacer 50 is hung on the connector 30, so that the gasket 50 is located between the connector 30 and the femur 1, so that the distance between the femur 1 and the connector 30 can be filled during the osteotomy operation. In this way, the original joint line position of the articular surface of the medial and lateral knee condyles can be reconstructed without additional soft tissue procedure.

The above-mentioned embodiments are only used to illustrate the creation, and are not intended to limit the scope of the creation. All modifications or changes that do not violate the spirit of this creation belong to the scope of protection intended by this creation.

100: Adjustable osteotomy correction positioner 10: Positioning parts 11: Base 111: Chute 12: spoon arm 13: Body 20: The first guiding fixture 21: The first set of grooves 22: The first fixed part 221: perforation 23: The first cutting guide groove 24: The first plug 241: The first bump 25: First setting slot 251: the first recess 30: connector 31: The first connecting part 311: socket 32: The second connecting part 321: wing plate 33: Pivot 40: The second guiding fixture 41: The second set of slots 42: The second fixed part 421: perforation 43: The second cutting guide groove 44: Second plug 441: second bump 45: Second setting slot 451: the second recess 50: Gasket 50a: Gasket 50b: Gasket 1: femur 1a: Medial posterior femoral condyle 1b: Lateral posterior femoral condyle 2: Tibia 2a: tibial plateau 3: Bone screw A: Angle L: reference axis

Figure 1 is a schematic diagram of the appearance of the adjustable osteotomy correction locator of this invention. Fig. 2 is a structural exploded schematic diagram of the adjustable osteotomy correction locator of the present invention. Figure 3 is a schematic diagram of the adjustable osteotomy correction locator of this creation on the sagittal plane, showing that the two spoon arms of the locator are placed between the femur and the tibia, and the curved surface of the scoop is obedient to the spherical surface of the spherical structure of the posterior femoral condyle superior. Fig. 4 is a schematic diagram of the front view of the adjustable osteotomy correction locator fixed on the tibia with the first guiding and fixing member. Fig. 5 is a schematic diagram of the front view of the adjustable osteotomy correction locator fixed on the tibia with the first guide and fixture, showing that the two spoon arms can adjust the width between the two spoon arms according to the width of the femur. Fig. 6 is a schematic view of the adjustable osteotomy correction locator fixed on the femur by the second guiding and fixing member. Fig. 7 is another embodiment of the adjustable osteotomy correction locator of the present invention.

100: Adjustable osteotomy correction positioner

10: Positioning parts

11: base

111: Chute

12: spoon arm

13: Body

20: The first guiding fixture

21: The first set of grooves

22: The first fixed part

221: perforation

23: The first cutting guide groove

24: The first plug

241: The first bump

25: First setting slot

251: the first recess

30: connector

31: The first connecting part

311: socket

32: The second connecting part

321: wing plate

33: Pivot

40: The second guiding fixture

41: The second set of slots

42: The second fixed part

421: perforation

43: The second cutting guide groove

44: Second plug

441: second bump

45: Second setting slot

451: the second recess

50: Gasket

Claims (10)

An adjustable osteotomy correction positioner, comprising: A positioning part, which has a base, two spoon arms with symmetrical shapes extend from one side of the base, and a body is provided on the other side, the base has a chute, and one of the spoon arms is slidably arranged on the chute , the two spoon arms can be placed between the femur and the tibia of the human body, and the two spoon arms support a medial posterior femoral condyle and a lateral posterior femoral condyle corresponding to the femur, wherein each of the spoons The arms are generally cross-shaped, and the radius of curvature of each spoon arm along the X-axis direction is the same as the curvature radius along the Y-axis direction; A first guiding and fixing part, which has a first set groove and a first fixing part, the first set groove can be sleeved on the body part, and the first fixing part is used to fix the tibia, A first cutting and guiding groove is provided between the first fixing part and the first sleeve groove for guiding a cutting tool to trim a tibial plateau of the tibia; A connecting part has a first connecting part and a second connecting part far away from each other, there is an included angle corresponding to the sagittal plane between the first connecting part and the second connecting part, and the first connecting part can connected to the locator; and A second guiding and fixing part, which has a second sleeve groove and a second fixing part, the second sleeve groove can be sleeved on the second connecting part, and the second fixing part is used to be fixed on the For the femur, a second cutting and guiding groove is provided between the second fixing portion and the second sheathing groove for guiding the cutting tool to trim the articular surface of the femur. The adjustable osteotomy correction positioner according to claim 1, wherein there is a pivot between the first connecting part and the second connecting part, so that the first connecting part and the second connecting part can be opposite Create a pivot relationship. The adjustable osteotomy correction positioner as described in claim 2 further includes a spacer, which can be arranged on the second connecting part and between the femur and the connecting part. The adjustable osteotomy correction positioner as described in Claim 3, wherein a wing plate is provided on both sides of the second connecting part, and the number of the spacers is two, which are used to hang on the two wing plates respectively. The adjustable osteotomy correction positioner as described in Claim 4, wherein the first connecting portion has a socket for being laterally sleeved on the base of the positioning member. The adjustable osteotomy correction positioner according to claim 5, wherein the number of the first sleeve and the second sleeve is two. The adjustable osteotomy correction positioner as described in claim 5, wherein, the first guiding and fixing part has a first plug, the second guiding and fixing has a second plug, and the first plug It has the first cutting and guiding groove, the second plug has the second cutting and guiding groove, and the first guiding and fixing part has a first setting groove, and the second guiding and fixing part has a second setting and The first plug is detachably slid in the first setting groove, and the second plug is detachably slid in the second setting groove. The adjustable osteotomy correction positioner according to claim 7, wherein, the first plug is concave-convex fit with the first setting groove, and the second plug is concave-convex fit with the second setting groove. The adjustable osteotomy correction positioner according to claim 8, wherein the first cutting guide groove and the second cutting guide groove are respectively inclined. The adjustable osteotomy correction positioner according to claim 9, wherein, the first fixing part and the second fixing part respectively have a plurality of perforations for a plurality of bone screws to connect the first guiding and fixing part with the The second guiding and fixing parts are respectively locked in proper positions of the femur and the tibia.

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