Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
  • A61B17/14—Surgical saws ; Accessories therefor
  • A61B17/15—Guides therefor
  • A61B17/154—Guides therefor for preparing bone for knee prosthesis
  • A61B17/155—Cutting femur
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
  • A61B17/14—Surgical saws ; Accessories therefor
  • A61B17/142—Surgical saws ; Accessories therefor with reciprocating saw blades, e.g. with cutting edges at the distal end of the saw blades
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
  • A61B2017/00526—Methods of manufacturing
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
  • A61B2017/00831—Material properties
  • A61B2017/0088—Material properties ceramic

Definitions

• the invention relates to a saw block made of a plastic body with slot-like recesses for guiding a saw blade on opposite guide surfaces.
• a saw block also called a cutting template, is fixed to the femur or tibia.
• the distal bone cut is normally performed.
• Another femoral saw block performs four to five additional incisions (anterior, posterior, oblique anterior, posterior oblique, and eventual femoral notching) to accommodate the femur to the geometry of the femoral implant.
• the tibia is also cut by a saw block.
• a distal, obliquely posterior and posterior saw cut is usually performed on the femur.
• the tibia requires a horizontal and sagittal incision.
• the saw slots have a height of 1 mm to 1.5 mm.
• New additive manufacturing processes enable the creation of patient-specific saw blocks made of various plastics. Furthermore, plastic parts are increasingly being used in the instrument systems of the knee systems as an alternative to metallic instruments.
• the saw blocks made of plastic or metal can not sufficiently withstand the friction generated by the oscillating saw blade. This leads to a material abrasion. This abrasion is not or can only be removed from the wound inadequately intraoperatively. This attrition can in turn become the cause of infections and / or too lead to allergic reactions of the patient. For this reason, the abrasion should always be reduced or avoided. In particular, when a CrCoMo-free or a ceramic femoral component is used in a potential allergic or metal-sensitive patient and an implant reaction is to be avoided.
• the invention has for its object to improve a saw block according to the preamble of claim 1 as follows: a) reduction of metal abrasion compared to the previous metal solutions b) reduction of plastic abrasion
• this object is achieved by a saw block according to the features of claim 1.
• Ceramic elements are arranged, which form the guide surfaces for the saw blade, resulting in no metal abrasion or hardly plastic abrasion, so that the risk of allergies or allergic reactions of patients and the risk of infection is much lower.
• the ceramic elements are used in the body, pressed, clickable or clickable, plugged or inserted. It makes sense to any kind of attachment in the body.
• the ceramic elements are rods, in particular with a rectangular, round or triangular cross-section, or platelets.
• the main body of the saw block may be formed in one or more parts.
• the base body is formed in one piece and has receiving bores, wherein the ceramic elements can be inserted from the outside into the receiving bores. This is particularly advantageous when the ceramic elements are rods.
• Such a saw block will be described below with reference to figures.
• the base body is designed in several parts consisting of sub-modules and is / are arranged in one or more sub-module / sub-modules receiving bores, wherein the ceramic elements can be inserted or inserted into the receiving bores.
• the base body is in two parts, that is formed of two sub-modules formed.
• a sub-module has a protruding guide pin and another sub-module to a guide pin fitting guide hole and is in the mounted state of the saw block of the guide pin in the guide hole and are in the sub-modules receiving holes for Recording the ceramic elements arranged.
• the mounting holes in the two Submodules are arranged in alignment with each other, so that the ceramic elements can be formed as rods and then preferably can be inserted.
• sub-modules are locked together, in particular by clips.
• the saw block consisting of several submodules is easier to handle.
• the ceramic elements must be inserted.
• the saw block is produced by means of additive manufacturing processes. This can be done individually for each patient, for example.
• a saw blade according to the invention for use in a saw block according to the invention is characterized in that ceramic contact elements projecting from the saw blade are arranged, which slide along the guide surfaces in the saw block during sawing.
• the contact elements may preferably be a ceramic coating or round, rectangular or elongated ceramic nubs.
• the ceramic elements according to the invention also called ceramic guide plates / rails / inserts, for oscillating saw blades (metal or ceramic) as a fixed or modular insert (single or multiple product) in "patient-specific cutting blocks", once cut blocks or plastic cutting blocks for the uni and bicondylar femoral / tibial surgery can reduce wear on existing metal and plastic solutions
• the ceramic or ceramic guide plates / shims / inserts can be placed in the same position during manufacture as well as immediately prior to surgery "Customized cutting blocks”, single-use blocks or plastic cutting blocks for femoral and / or tibial surgery are manually inserted (pushed, inserted, inserted, clicked or clicked in.) Depending on the design, these can be disposed of or disassembled and sterilized and reused after surgery.
• the saw block according to the invention consists of plastic with inserted ceramic elements, wherein only the guide or support for the oscillating saw blade made of ceramic and the base body consists of plastic.
• the shape of the basic body can be produced as a disposable item and / or via additive manufacturing in a patient-specific manner (based on X-ray, CT or MRI data sets).
• the ceramic elements or ceramic guide plates / rail / inserts can be used during production or intraoperatively - shortly before use, in the main body or its sub-modules (pressed, inserted, inserted, on or clicked).
• the ceramic elements or flat ceramic pads for the saw blade can be used for all femur and tibial bone incisions in uni- and bicondylar knee operations.
• the invention will be further explained with reference to figures.
• FIGS. 1 and 2 show a saw block 1 according to the invention, also called a cutting template, which is fixed to the tibia on the femur or in another embodiment of the basic body and serves as a guide for a saw blade (see FIGS. 11 to 13).
• the saw block consists of a base body 2 a plastic.
• lateral tabs 1 1 with through holes 13 may be arranged with which the base body 2 and the saw block 1 can be fixed by screws on the femur or tibia.
• FIG. 1 shows the saw block 1 from above, ie the side facing away from the bone and FIG. 2 from below, ie the bone-facing side.
• the base body 2 consists of two sub-modules 7a and 7b, which are interconnected by clips 10.
• a sub-module 7a facing the sub-module 7b guide pin 8 is arranged, which engages in connecting the two sub-modules 7a, 7b in a guide hole 9 in the sub-module 7b.
• 2 ceramic elements 5 are arranged in the saw block 1 or base body, which form the guide surfaces for the saw blade 4. In an embodiment according to the invention, these ceramic elements 5 are ceramic rods 5a with a round cross section.
• FIG. 4 shows the contact surface facing the submodule 7a with the locating bores 6.
• FIG. 4 shows by way of example in each case two opposite receiving bores 6, so that the two guide surfaces of a slot-like recess are formed by a total of four rods.
• Figure 4 also shows a guide surface, which is formed from only one rod 5a. The guide surface opposite this rod, however, is formed by two rods 5a.
• FIG. 5 shows the two submodules 7a. 7b (see FIGS. 1 to 4) prior to assembly with rods 5a inserted into the submodule 7b. Since all mounting holes 6 are aligned with each other, the sub-modules 7a, 7b can be easily plugged together with the inserted rods 5a.
• FIG. 6 shows a view of the contact surface of the submodule 7b with the inserted rods 5a. Good to see is one of the two centering pins 14. In this figure, the guide surfaces can be seen, which are formed by the rods 5a.
• FIG. 7 shows a rod 5a with a circular cross section which, like all ceramic elements, consists of a ceramic. Preferred ceramics are sintered ceramics, for example aluminum oxide or aluminum nitride. Figure 7 also shows other possible cross sections for bars such as squares 5b and triangles 5c. According to the invention, it is also possible to use ceramic plates as ceramic elements 5, which may, for example, have a rectangular 5d or circular cross-section 5e. FIG. 7 shows these embodiments.
• FIG 8 shows the same saw block as shown in Figures 1 to 6, but this has a slightly different way of connection by clips 10.
• hook-shaped clips 10 are attached to the sub-module 7b in this embodiment, which engage in corresponding pockets 15 in the sub-module 7b so that the hook-shaped end of the clip 10 engages in an extension of the pocket 15 and hooks there.
• Each clip 10 consists of two individual clips 10a and 10b.
• the hook-shaped ends of the individual clips 10a, 10b are arranged at 90 ° relative to the hook-shaped ends of the clips 10 and thus extend perpendicular to the bone-facing side of the saw block or the base body 2.
• For connecting the two sub-modules 7a, 7b engage the individual clips 10a, 10b in corresponding pockets 15 in the sub-module 7b, wherein the hook-shaped ends of the individual clips 10a, 10b in extensions of the pockets 15 engage so that they get caught there. Since each clip 10 consists of two individual clips 10a, 10b, a secure connection of the two sub-modules 7a, 7b results. An inadvertent release of the two sub-modules 7a, 7b from each other is almost impossible.
• FIG. 9 shows a section through a saw block according to the invention, which consists of two sub-modules, with inserted ceramic elements 5, wherein these ceramic elements 5d are formed plate-shaped and have a rectangular cross-section. This can be clearly seen in FIG. With the embodiment of the ceramic elements used, their number can also vary.
• a one-piece or one-piece base body 2 is shown, the receiving holes 6, wherein the ceramic elements 5 are inserted from the outside into the mounting holes 6.
• the ceramic elements 5 are formed in the embodiment shown here as platelets.
• the receiving holes 6 have a rectangular cross-section.
• the saw block according to FIG. 10 is identical to the saw block of FIG. 9 with respect to the receiving bores 6 and ceramic elements 5.
• saw blades 4 according to the invention are shown, which can be used with the saw blocks 1 according to the invention for use.
• the saw blade 4 protruding ceramic contact elements 12, which slide along the guide surfaces in the saw block during sawing.
• the abrasion is minimized by the saw blade.
• Figure 1 1 shows a side of a saw blade 4, on which a rectangular ceramic contact element 12 is arranged. This contact element 12 slides during sawing along the guide surfaces in the saw block.
• FIG. 12 shows a side of a saw blade 4 on which two rectangular ceramic contact elements 12 are arranged. This contact elements 12 slides during sawing along the guide surfaces in the saw block.
• FIG. 13 shows a side of a saw blade 4 on which round ceramic abutment elements 12, which are also referred to as nubs, are arranged. This contact elements 12 slides during sawing along the guide surfaces in the saw block.

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• Health & Medical Sciences (AREA)
• Surgery (AREA)
• Life Sciences & Earth Sciences (AREA)
• Biomedical Technology (AREA)
• Public Health (AREA)
• Oral & Maxillofacial Surgery (AREA)
• Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
• Veterinary Medicine (AREA)
• Dentistry (AREA)
• Engineering & Computer Science (AREA)
• General Health & Medical Sciences (AREA)
• Heart & Thoracic Surgery (AREA)
• Medical Informatics (AREA)
• Molecular Biology (AREA)
• Animal Behavior & Ethology (AREA)
• Orthopedic Medicine & Surgery (AREA)
• Physical Education & Sports Medicine (AREA)
• Transplantation (AREA)
• Surgical Instruments (AREA)
• Processing Of Stones Or Stones Resemblance Materials (AREA)
• Prostheses (AREA)

Priority Applications (7)

Applications Claiming Priority (2)

Publications (1)

Family

ID=55453153

Family Applications (1)

Country Status (10)

Cited By (3)

Families Citing this family (2)

Citations (4)

Family Cites Families (4)

• 2016
  • 2016-03-01 CN CN201680017596.3A patent/CN107427306A/zh active Pending
  • 2016-03-01 DE DE102016203351.4A patent/DE102016203351A1/de active Pending
  • 2016-03-01 KR KR1020177028530A patent/KR20170134473A/ko unknown
  • 2016-03-01 RU RU2017135547A patent/RU2017135547A/ru unknown
  • 2016-03-01 BR BR112017018928A patent/BR112017018928A2/pt not_active Application Discontinuation
  • 2016-03-01 AU AU2016231338A patent/AU2016231338A1/en not_active Abandoned
  • 2016-03-01 JP JP2017564799A patent/JP2018507090A/ja active Pending
  • 2016-03-01 EP EP16707712.2A patent/EP3264999A1/de not_active Withdrawn
  • 2016-03-01 WO PCT/EP2016/054308 patent/WO2016142213A1/de active Application Filing
  • 2016-03-03 TW TW105106459A patent/TW201641083A/zh unknown

Patent Citations (4)

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