WO2020010479A1 - 一种下开口式后交叉韧带保护器 - Google Patents

一种下开口式后交叉韧带保护器 Download PDF

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WO2020010479A1
WO2020010479A1 PCT/CN2018/000298 CN2018000298W WO2020010479A1 WO 2020010479 A1 WO2020010479 A1 WO 2020010479A1 CN 2018000298 W CN2018000298 W CN 2018000298W WO 2020010479 A1 WO2020010479 A1 WO 2020010479A1
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cruciate ligament
posterior cruciate
main body
smooth surface
opening
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PCT/CN2018/000298
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English (en)
French (fr)
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孔杰
张鹏
杜建春
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孔杰
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    • 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
    • A61B17/14—Surgical saws ; Accessories therefor
    • A61B17/15—Guides therefor
    • A61B17/154—Guides therefor for preparing bone for knee prosthesis
    • A61B17/158—Cutting patella
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/1657—Bone breaking devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/1662—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body
    • A61B17/1675—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body for the knee
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A61B17/1732—Guides or aligning means for drills, mills, pins or wires for bone breaking devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
    • A61B17/1764—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the knee
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B2017/564—Methods for bone or joint treatment

Definitions

  • the invention relates to the technical field of orthopaedic medical instruments, and in particular to a lower-opening posterior cruciate ligament protector for total knee arthroplasty.
  • the knee joint is one of the most important joints in the human body.
  • Total knee arthroplasty is the main method for the treatment of severe knee degenerative arthritis in the middle and late stages. Because it can effectively relieve knee pain and reconstruct joint function and mobility, it has been widely used. Clinical application.
  • the purpose of total knee arthroplasty is to restore normal knee joint movement, retain normal knee joint range and stability, and maintain a good proprioception of the knee joint.
  • the complete preservation of the posterior cruciate ligament during surgery plays a vital role in the stability of the knee joint, the recovery of the knee proprioception, and the walking gait.
  • the posterior cruciate ligament is a very important anterior-posterior and rotationally stable structure in the knee joint cavity. It is in the shape of a round cable with thick ends and an elongated middle. The surface is covered with a synovial membrane. The average length of the posterior cruciate ligament is 34-38mm and the average width is 10-13mm.
  • the posterior cruciate ligament femoral attachment area is located on the outer side of the femoral medial malleolus, and is semicircular in shape, with a width of 19-21 mm. It walks downward and rearward, ending at the posterior bone of the tibial medial and lateral malleolus articular surface, which is irregular.
  • the posterior cruciate ligament has the physiological functions of restricting tibia backward, knee extension, rotation, and lateral movement of the knee joint.
  • the position and size of the bone mass at the bottom dead center of the posterior cruciate ligament can only be determined by visual inspection or using a long steel nail, which is not only time-consuming Effortless and poorly protected posterior cruciate ligament.
  • electric pendulum saw for tibial plate osteotomy partial avulsion or complete avulsion of the posterior cruciate ligament's tibial lateral bottom dead point can easily occur, causing the posterior cruciate ligament to relax, which in turn affects postoperative efficacy and knee prosthesis Service life, leading to failed surgery.
  • Chinese patent document CN105708529A discloses a posterior cruciate ligament protection device for total knee arthroplasty, which includes a handle, an auxiliary plate fixedly connected at one end of the handle, the inner surface of the auxiliary plate is curved, and the end of the auxiliary plate away from the handle A fixed guard is fixedly connected, a groove structure is provided on the inner surface of the fixed guard, and a cutting edge is provided at the end of the fixed guard far from the auxiliary board; the posterior cruciate ligament protection device of the patent document first bends the knee joint when in use.
  • the posterior cruciate ligament protection device in the above patent document needs to insert the fixed shield into the bone first, and then use the lever principle to hold the handle backwards to push the tibial platform forward; however, the ligament muscles at the joint position Large, it is very difficult to insert the fixed shield into the bone near the posterior cruciate ligament, which results in poor practical application effect.
  • the applicant has designed a posterior cruciate ligament protector that is easy to operate and has good protection effects. However, in actual application, it has been found that the bottom of the insertion end is a flat-shaped setting, which will squeeze the posterior cruciate ligament. If it is not handled properly, it will still After the cruciate ligament was injured, the applicant further improved the protocol.
  • the technical problem to be solved by the present invention is to overcome the prior art that the posterior cruciate ligament protection device has a flat plate shape at the bottom of the insertion end in actual application, and will be squeezed into contact with the posterior cruciate ligament.
  • the present invention provides a lower-opening posterior cruciate ligament protector, including:
  • the main body has an insertion end, a hand-held end, and a first smooth surface; the first smooth surface extends to be in contact with the insertion end; a lower opening for accommodating the posterior cruciate ligament is provided below the middle of the insertion end;
  • the protection member is slidably connected to the main body through a guide connection structure, and has a second smooth surface.
  • the second smooth surface is in close contact with the first smooth surface and approaches A part of the insertion end of the second smooth surface is recessed in a direction away from the first smooth surface to form a receiving space that is open at one end.
  • the main body includes:
  • the lower body is flat and the bottom is the insertion end
  • the upper body is fixedly connected with the lower body.
  • the insertion end has two spline teeth, and the two spline teeth are respectively located on both sides of the bottom of the flat lower body, the middle portion is the lower opening, and the lower opening is a semicircular arc. And forms a stepped platform between the teeth.
  • the bottom of the teeth is inclined.
  • the protection member includes:
  • the semi-cylindrical body has the second smooth surface extending in the axial direction, the upper part is solid, and the lower part forms the accommodating space with both side and bottom surfaces open.
  • the upper body is semi-cylindrical.
  • the upper body and the protection member are slidably connected, the upper body and the protection member are bonded to form a cylindrical shape.
  • an end of the protective member near the handheld end forms a hammering surface; when the hammering surface is flush with the handheld end, an end of the protective member near the insertion end protrudes beyond The insertion end sets the distance.
  • the protective member portion forming the bottom surface of the accommodating space is formed in a blade shape.
  • the guide connection structure includes:
  • At least two guide grooves are provided on the main body and the side openings are opposite;
  • At least two guide plates are provided on the protection member and can be slid into the two guide grooves respectively.
  • the lower open type posterior cruciate ligament protector of the present invention comprises a main body and a protective member, both of which are slidingly connected through a guide connection structure, the main body has a first smooth surface, and the protective member has a second smooth surface; the protective member is slidingly connected to the main body When the second smooth surface is in close contact with the first smooth surface, the portion of the second smooth surface near the insertion end is recessed away from the first smooth surface to form an open space at one end; using the lower opening rear cross of the present invention
  • first hold the main body insert the insertion end into the appropriate position between the femur and tibia, and then use the principle of lever to move the main body backward to push the tibia forward to the upper end of the tibia to expose; then, pass the protective member through the guide
  • the connection structure is connected to the main body, and the protective member is hammered downward to insert the protective member into the bone, and then part of the bone connected with the posterior cruciate ligament enters the interior of the accommodation
  • the tibial plate is subjected to osteotomy.
  • the pendulum saw is osteotomy, it cannot continue to move forward when it touches the protective member, thereby protecting the posterior cruciate ligament.
  • the lower open posterior cruciate ligament protector of the present invention is inserted by the main body during operation, and the upper end of the tibia is pushed backwards to expose.
  • the operation steps of the posterior cruciate ligament protector disclosed in the reference document are opposite.
  • the protector of the present invention operates Easier, very convenient and efficient application in surgery;
  • the lower part of the insertion end is provided with a lower opening for receiving the posterior cruciate ligament.
  • the lower opening position reserves space for the posterior cruciate ligament, so as not to compress the posterior cruciate ligament excessively. Good protection of the posterior cruciate ligament.
  • the main body includes a lower body and an upper body, wherein the lower body is flat and the bottom is an insertion end; the flat lower body is more convenient for insertion between the tibia and femur Gap.
  • the lower open type posterior cruciate ligament protector of the present invention has two insert teeth at the insertion end, and the two insert teeth are respectively located on both sides of the bottom of the flat lower body; the lower open type cruciate ligament protector of the present invention is used At this time, two teeth are inserted on both sides of the tibia, and the flat lower body is in contact with the back of the tibia, which can more effectively push the tibia forward and expose the upper end of the tibia. Further, the bottom surface of the setting teeth is inclined, which is more convenient for the insertion operation of the setting teeth. The position of the stepped platform can catch the back of the tibia, apply force to the tibia, and avoid compressing the posterior cruciate ligament.
  • the lower open rear cruciate ligament protector of the present invention is a semi-cylindrical body, the upper part is solid, and the lower part forms a receiving space that is open on the side and the bottom.
  • the lower open posterior cruciate ligament protector of the present invention the upper body is semi-cylindrical, and when the main body is slidably connected with the protector, the upper body and the protector fit together to form a cylindrical shape; this structure is provided when the protector is inserted into the tibia When all the internal operations are completed, the upper body and the protective member form a cylindrical structure, which facilitates the overall operation of the entire posterior cruciate ligament protection device, which drives the tibial movement, and can also protect the posterior cruciate ligament from damage during exercise.
  • the lower open rear cruciate ligament protector of the present invention the end of the protective member near the handheld end forms a hammering surface, and when the hammering surface is flush with the handheld end, the end of the protective member near the insertion end protrudes from the insertion end by a set distance.
  • the advantage of this arrangement is that when using the lower open posterior cruciate ligament protector of the present invention, the hammering surface of the protective member being hammered downward is flush with the hand-held end of the main body, and it can be known that the lower end of the protective member extends into the tibial bone Quality depth, there is no need to measure the insertion depth separately.
  • the lower-opening posterior cruciate ligament protector of the present invention forms a protective member portion that is open on the bottom surface of the accommodation space, and has a blade shape, which is sharper and more smoothly inserted into the bone.
  • the guide connection structure includes a guide groove and a guide plate, which are fixedly disposed on the main body and the protective member, respectively. This structural design enables the protective member to be inserted downwardly. In the middle, keep a proper distance from the subject at all times, and just incorporate the posterior cruciate ligament and part of the bone into the accommodation space for protection.
  • FIG. 1 is a schematic diagram of the overall structure of a posterior cruciate ligament protector in Embodiment 1 of the present invention.
  • FIG. 2 is another perspective view of FIG. 1.
  • FIG. 3 is a perspective view of the main body in FIG. 1.
  • FIG. 4 is a perspective view of the protective member in FIG. 1.
  • FIG. 5 is a schematic diagram of the overall structure of a lower-opening posterior cruciate ligament protector with a preferred structure.
  • FIG. 6 is a perspective view of a main body in Embodiment 2.
  • FIG. 6 is a perspective view of a main body in Embodiment 2.
  • This embodiment provides a posterior cruciate ligament protector, as shown in FIGS. 1-4, including: a main body 1 having an insertion end 11, a handheld end 12, and a first smooth surface 10; the first smooth surface 10 extends to It is in contact with the insertion end 11; a protective member 2 is slidably connected to the main body 1 through a guide connection structure, and has a second smooth surface 20; when the protective member 2 is slidably connected to the main body 1, the second The smooth surface 20 is in close contact with the first smooth surface 10, and a portion of the second smooth surface 20 that is close to the insertion end 11 is recessed away from the first smooth surface 10 to form a receiving space 30 that is open at one end. .
  • the lower-opening posterior cruciate ligament protector of this embodiment When using the lower-opening posterior cruciate ligament protector of this embodiment, first hold the main body 1 and insert the insertion end 11 into an appropriate position between the femur and the tibia, and then use the principle of the lever to move the main body 1 backwards and forward the tibia Push to the upper end of the tibia to expose; then, connect the protective member 2 to the main body 1 through the guide connection structure, and hammer the protective member 2 downward to insert the protective member 2 into the bone, and then let the part of the bone connected with the posterior cruciate ligament enter Provide protection to the interior of the accommodating space 30, and then perform an osteotomy operation on the tibial plateau.
  • the lower open posterior cruciate ligament protector of this embodiment is inserted first by the main body during operation, and the upper end of the tibial bone is pushed backwards.
  • the operation steps of the posterior cruciate ligament protector disclosed in the prior art are opposite. Protector operation is easier, and it is very convenient and efficient to apply in surgery.
  • the main body 1 includes: a lower main body 13, which is flat, and the bottom is the insertion end 11; and an upper main body 14 is fixedly connected to the lower main body 13.
  • the flat lower body 13 is more convenient to be inserted into the gap between the tibia and the femur.
  • the insertion end 11 has two insert teeth 15, and the two insert teeth 15 are respectively located on both sides of the bottom of the flat lower body 14.
  • two teeth 15 are inserted on both sides of the tibia, and the flat lower body 13 is in contact with the posterior side of the tibia, which can more effectively push the tibia forward and make the tibia The top is exposed.
  • the bottom surface of the inserting teeth 15 is set to be inclined, which is more convenient for inserting the inserting teeth.
  • the protection member 2 includes: a semi-cylindrical body 21 having the second smooth surface 20 extending in the axial direction, the upper part being solid, and the lower part forming the accommodating space 30 having both sides and bottom surfaces open.
  • the upper part is solid to withstand hammering.
  • the upper body 14 is semi-cylindrical. When the main body 1 and the protection member 2 are slidably connected, the upper body 14 and the protection member 2 are bonded to form a cylindrical shape. With this structure, when the insertion of the protective member 2 into the tibia is completed, the upper body 14 and the protective member 2 form a cylindrical structure, which is convenient for the overall operation of the entire posterior cruciate ligament protection device, which drives the tibial movement and can also protect during exercise The posterior cruciate ligament is not damaged.
  • an end of the protection member 2 near the handheld end 12 forms a hammering surface 22; when the hammering surface 22 is flush with the handheld end 12, the protection member 2 is close to the One end of the insertion end 11 protrudes from the insertion end 11 by a set distance.
  • the advantage of this arrangement is that when using the lower-opening posterior cruciate ligament protector of this embodiment, the hammering surface 22 of the protective member 2 is hammered downward to be flush with the handheld end 12 of the main body 1, and the The depth of the lower end of the bone into the tibial bone does not need to be measured separately. Further, a portion of the protection member 2 forming an opening on the bottom surface of the accommodating space 30 may be provided in a blade shape.
  • the guide connection structure includes: at least two guide grooves 41 provided on the main body 1 with opposite side openings; at least two guide plates 42 provided on the protection member 2 and can be respectively Slide into the two guide grooves 41.
  • This structural design enables the protective member to maintain a proper distance from the main body at all times during the downward insertion process, and the posterior cruciate ligament and part of the bone are incorporated into the accommodation space for protection.
  • the use method of the lower open posterior cruciate ligament protector of the present invention is as follows: First, hold the main body 1 and insert the insertion end 11 into an appropriate position between the femur and the tibia, so that the two insert teeth 15 are located on both sides of the tibia, and then use the principle of leverage , Push the main body 1 backward, so that the lower main body 13 is against the tibia, and push the tibia forward to the upper end of the tibia to expose; then, connect the protective member 2 to the main body 1 through the guide connection structure, and hammer the protective member 2 downward
  • the hammering surface 22 allows the protective member 2 to be inserted into the bone, and then the part of the bone connected with the posterior cruciate ligament enters the accommodation space 30 to provide protection.
  • the tibial plate is subjected to osteotomy operation, and the saw blade is used for osteotomy
  • the protection member 2 is touched, it cannot continue to move forward, thereby protecting the posterior cruciate ligament.
  • This embodiment provides an improved posterior cruciate ligament protector, which is an improvement on the first embodiment. The difference is that, as shown in FIG. 6, a lower portion for receiving the posterior cruciate ligament is provided below the middle of the insertion end 11. Opening 16.
  • the advantage of such a setting is that when the main body is inserted downward, the position of the lower opening 16 reserves a space for the posterior cruciate ligament, so as not to compress the posterior cruciate ligament excessively, thereby better protecting the posterior cruciate ligament.
  • the insertion end 11 has two insert teeth 15, and the two insert teeth 15 are respectively located on both sides of the bottom of the flat lower body 14, and the middle portion is the lower opening 16, and the lower opening 16 It has a semi-circular arc shape, and a stepped platform 17 is formed between the teeth and the teeth 15.
  • the 17 position of the step platform can jam the back end of the tibia, apply force to the tibia, and avoid compressing the posterior cruciate ligament.

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Abstract

一种下开口式后交叉韧带保护器，包括主体（1）和保护件（2），二者通过导向连接结构滑动连接，主体（1）具有第一平滑面（10），保护件（2）具有第二平滑面（20）；保护件（2）与主体（1）滑动连接时，第二平滑面（20）与第一平滑面（10）贴合接触，第二平滑面（20）的靠近插入端（11）的部分向着远离第一平滑面（10）的方向凹陷，形成一端开口的容纳空间（30）。主体（1）插入端（11）中部下方设有用于容置后交叉韧带的下开口（16），用于在主体（1）插入到胫骨和股骨之间的位置时，为后交叉韧带预留空间；下开口式后交叉韧带保护器，与第一代产品相比，能够更好地保护后交叉韧带不受损伤。

Description

一种下开口式后交叉韧带保护器 技术领域
本发明涉及骨科医疗器械技术领域，具体涉及一种用于全膝关节置换术的下开口式后交叉韧带保护器。
背景技术
膝关节是人体最重要的关节之一，全膝关节置换术是治疗中晚期严重膝关节退变性关节炎的主要手段，由于可以有效缓解膝关节疼痛，重建关节功能和活动度，因而得到了广泛的临床应用。全膝关节置换术的目的是恢复正常膝关节的运动，保留正常的膝关节活动范围和稳定性，保持膝关节良好的本体感觉。而在手术时后交叉韧带的完整保留对于膝关节的稳定性及术后膝关节本体感觉的恢复和行走步态起着至关重要的作用。
后交叉韧带是膝关节腔内非常重要的前后向和旋转稳定结构。它呈两端粗大、中间细长的圆索条形，表面被覆一层滑膜，后交叉韧带平均长度为34-38mm，平均宽度为10-13mm。后交叉韧带股骨的附着区位于股骨内踝的外侧面骨质，形状为半环形，宽度为19-21mm，向下后方向行走，止于胫骨内外踝关节面的后部骨质，呈不规则的四边形，内外侧宽度为10-12mm，并向后延伸至胫骨平台的下方约1cm处，其前方紧邻内外侧半月板后角的止点处。后交叉韧带具有限制胫骨后移、膝关节后伸、旋转和膝关节侧方活动的生理功能。
在现有的全膝关节置换术中，由于没有专用的手术器械或装置保护后交叉韧带，只能通过目测或使用长钢钉来确定后交叉韧带下止点骨块的位置和大小，不仅费时费力，而且后交叉韧带保护效果欠佳。在使用电动摆锯片进行胫骨平台截骨时，极易发生后交叉韧带胫骨侧下止点骨块部分撕脱或完全撕脱，引起后交叉韧带松弛，进而影响术后疗效和膝关节假体使 用寿命，导致手术失败。
中国专利文献CN105708529A公开了一种用于全膝关节置换术的后交叉韧带保护装置，包括手柄，在手柄一端固定连接的辅助板，辅助板的内表面为弧形，在辅助板远离手柄的一端固定连接有固定护板，固定护板的内表面设置有凹槽结构，在固定护板远离辅助板的一端设置有刃口；该专利文献的后交叉韧带保护装置，在使用时首先曲膝关节至90-110°，去除前交叉韧带，显露出后交叉韧带位于胫骨平台后侧的止点，然后将辅助板包裹在股骨的滑车沟和后交叉韧带前方，将固定护板完全包绕在后交叉韧带的胫骨侧止点周围的骨质处，并垂直于胫骨平台通过刃口将固定护板锤击打入胫骨平台骨质内，直至限位凸起与胫骨平台接触。然后利用杠杆原理，手握手柄向后用力，进而带动辅助板将胫骨平台相对股骨向前推出，使胫骨平台充分显露并利用摆锯片对胫骨平台进行截骨，由于有固定护板对后交叉韧带下止点进行保护，可以防止摆锯片截骨时对后交叉韧带造成损伤，完整保留了后交叉韧带胫骨平台止点骨质，防止手术中后交叉韧带胫骨侧下止点撕脱骨折。
然而，上述专利文献中的后交叉韧带保护装置，需要先将固定护板插入骨质，再利用杠杆原理手握手柄向后用力，推动胫骨平台向前推出；然而，骨关节位置韧带肌肉作用力大，先将固定护板插入靠近后交叉韧带位置的骨质内部的操作十分困难，导致实际应用效果差。
申请人设计了一种操作方便、保护效果好的后交叉韧带保护器，然而在实际应用中发现，插入端底部为平板形的设置，会与后交叉韧带挤压接触，如果操作不当，仍会损伤后交叉韧带，因而申请人对方案进行了进一步改进。
发明内容
因此，本发明要解决的技术问题在于克服现有技术中的后交叉韧带保护装置在实际应用插入端底部为平板形的设置，会与后交叉韧带挤压接触， 如果操作不当，仍会损伤后交叉韧带的技术缺陷，从而提供一种操作方便、保护效果好的下开口式后交叉韧带保护器。
为此，本发明提供一种下开口式后交叉韧带保护器，包括：
主体，具有插入端、手持端、以及第一平滑面；所述第一平滑面延伸至与所述插入端相接；；所述插入端中部下方设有用于容置后交叉韧带的下开口；
保护件，通过导向连接结构与所述主体滑动连接，具有第二平滑面；所述保护件与所述主体滑动连接时，所述第二平滑面与所述第一平滑面贴合接触，靠近所述插入端的部分所述第二平滑面向着远离所述第一平滑面的方向凹陷，形成一端开口的容纳空间。
作为一种优选方案，所述主体包括：
下部主体，扁平状，底部为所述插入端；
上部主体，与所述下部主体固定连接。
作为一种优选方案，所述插入端具有两个插齿，两个所述插齿分别位于扁平状的所述下部主体的底部两侧，中部为所述下开口，所述下开口为半圆弧形，并与所述插齿之间形成阶梯台。
作为一种优选方案，所述插齿的底部为斜面形。
作为一种优选方案，所述保护件包括：
半圆柱体，具有沿轴向延伸的所述第二平滑面，上部实心，下部形成侧面、底面均开口的所述容纳空间。
作为一种优选方案，所述上部主体为半圆柱形，所述主体和所述保护件滑动连接时，所述上部主体和所述保护件贴合形成圆柱形。
作为一种优选方案，所述保护件的靠近所述手持端的一端形成锤击面；所述锤击面与所述手持端平齐时，所述保护件的靠近所述插入端的一端突出于所述插入端设定距离。
作为一种优选方案，形成所述容纳空间的底面开口的所述保护件部分，成刀刃口形。
作为一种优选方案，所述导向连接结构包括：
导向凹槽，至少为两个，设置在所述主体上，且侧面开口相对；
导向板，至少为两个，设置在所述保护件上，能够分别滑动插入两个所述导向凹槽内。
本发明提供的技术方案，具有以下优点：
1.本发明的下开口式后交叉韧带保护器，包括主体和保护件，二者通过导向连接结构滑动连接，主体具有第一平滑面，保护件具有第二平滑面；保护件与主体滑动连接时，第二平滑面与第一平滑面贴合接触，第二平滑面的靠近插入端的部分向着远离第一平滑面的方向凹陷，形成一端开口的容纳空间；使用本发明的下开口式后交叉韧带保护器时，首先手持主体，将插入端插入股骨和胫骨之间的合适位置，然后利用杠杆原理，向后掰动主体，将胫骨向前推至胫骨上端露出；接着，将保护件通过导向连接结构连接至主体，向下锤击保护件，使保护件插入骨质内部，进而使连接有后交叉韧带的部分骨质进入到容纳空间内部给予保护，此时再对胫骨平台进行截骨操作，摆锯片截骨到接触保护件时便不能继续向前，从而起到保护后交叉韧带的作用。本发明的下开口式后交叉韧带保护器，操作时是主体先插入，向后掰动推动胫骨上端外露，与对比文件中公开的后交叉韧带保护装置的操作步骤相反，本发明的保护器操作更加容易，在手术中应用十分方便、高效；
插入端的中部下方设置有用于容置后交叉韧带的下开口，在主体插入股骨和胫骨之间的位置时，下开口位置为后交叉韧带预留空间，不至于过分压迫后交叉韧带，从而能够更好地保护后交叉韧带。
2.本发明的下开口式后交叉韧带保护器，主体包括下部主体和上部主体，其中下部主体为扁平状，底部为插入端；扁平状的下部主体，更有利于插入至胫骨和股骨之间的缝隙。
3.本发明的下开口式后交叉韧带保护器，插入端具有两个插齿，两个插齿分别位于扁平状的下部主体的底部两侧；使用本发明的下开口式后交叉韧带保护器时，两个插齿插至胫骨两侧，扁平状的下部主体与胫骨后侧接触，能够更有效地将胫骨向前推出，使胫骨上端外露。进一步的，设置 插齿的底面为斜面形，更加便于插齿的插入操作。阶梯台位置可以卡住胫骨后端，对胫骨施力，避免压迫后交叉韧带。
4.本发明的下开口式后交叉韧带保护器，保护件的形状为半圆柱体，上部实心，下部形成侧面、底面均开口的容纳空间，上部实心有利于承受锤击。
5.本发明的下开口式后交叉韧带保护器，上部主体为半圆柱形，主体与保护件滑动连接时，上部主体和保护件贴合形成圆柱形；这种结构设置，当保护件插入胫骨内部的操作全部完成时，上部主体与保护件形成圆柱体结构，便于整体操作整个后交叉韧带保护装置，带动胫骨运动，在运动时也可保护后交叉韧带不受损伤。
6.本发明的下开口式后交叉韧带保护器，保护件的靠近手持端的一端形成锤击面，锤击面与手持端平齐时，保护件的靠近插入端的一端突出于插入端设定距离；这样设置的好处在于，当使用本发明的下开口式后交叉韧带保护器时，向下锤击保护件的锤击面与主体的手持端平齐，即可知保护件的下端伸入胫骨骨质的深度，无需再单独测量插入深度。
7.本发明的下开口式后交叉韧带保护器，形成容纳空间的底面开口的保护件部分，成刀刃口形，刀刃口形更加锋利，插入骨质内部更加顺利。
8.本发明的下开口式后交叉韧带保护器，导向连接结构包括导向凹槽和导向板，分别固定设置在主体和保护件上，这种结构设计，能够使保护件在向下插入的过程中，时刻保持与主体的恰当距离，正好将后交叉韧带及部分骨质纳入容纳空间内部予以保护。
附图说明
为了更清楚地说明现有技术或本发明具体实施方式中的技术方案，下面对现有技术或具体实施方式描述中所使用的附图作简单介绍。
图1是本发明实施例1中后交叉韧带保护器的整体结构示意图。
图2是图1的另一立体视图。
图3是图1中主体的立体图。
图4是图1中保护件的立体图。
图5是一种优选结构的下开口式后交叉韧带保护器的整体结构示意图。
图6是实施例2中主体的立体图。
附图标记：1、主体；10、第一平滑面；11、插入端；12、手持端；13、下部主体；14、上部主体；15、插齿；16、下开口；17、阶梯台；2、保护件；20、第二平滑面；21、半圆柱体；22、锤击面；30、容纳空间；41、导向凹槽；42、导向板。
具体实施方式
下面结合说明书附图1-5对本发明的技术方案进行详细描述。
实施例
本实施例提供一种后交叉韧带保护器，如图1-4所示，包括：主体1，具有插入端11、手持端12、以及第一平滑面10；所述第一平滑面10延伸至与所述插入端11相接；保护件2，通过导向连接结构与所述主体1滑动连接，具有第二平滑面20；所述保护件2与所述主体1滑动连接时，所述第二平滑面20与所述第一平滑面10贴合接触，靠近所述插入端11的部分所述第二平滑面20向着远离所述第一平滑面10的方向凹陷，形成一端开口的容纳空间30。
使用本实施例的下开口式后交叉韧带保护器时，首先手持主体1，将插入端11插入股骨和胫骨之间的合适位置，然后利用杠杆原理，向后掰动主体1，将胫骨向前推至胫骨上端露出；接着，将保护件2通过导向连接结构连接至主体1，向下锤击保护件2，使保护件2插入骨质内部，进而使连接有后交叉韧带的部分骨质进入到容纳空间30内部给予保护，此时再对胫骨平台进行截骨操作，摆锯片截骨到接触保护件2时便不能继续向前，从而起到保护后交叉韧带的作用。本实施例的下开口式后交叉韧带保护器，操作时是主体先插入，向后掰动推动胫骨上端外露，与现有技术中公开的后交叉韧带保护装置的操作步骤相反，本实施例的保护器操作更加容易，在手术中应用十分方便、高效。
如图3所示，所述主体1包括：下部主体13，扁平状，底部为所述插入端11；上部主体14，与所述下部主体13固定连接。扁平状的下部主体13，更有利于插入至胫骨和股骨之间的缝隙。
所述插入端11具有两个插齿15，两个所述插齿15分别位于扁平状的所述下部主体14的底部两侧。使用本实施例的下开口式后交叉韧带保护器时，两个插齿15插至胫骨两侧，扁平状的下部主体13与胫骨后侧接触，能够更有效地将胫骨向前推出，使胫骨上端外露。进一步的，设置插齿15的底面为斜面形，更加便于插齿的插入操作。
如图4所示，所述保护件2包括：半圆柱体21，具有沿轴向延伸的所述第二平滑面20，上部实心，下部形成侧面、底面均开口的所述容纳空间30。上部实心有利于承受锤击。
所述上部主体14为半圆柱形，所述主体1和所述保护件2滑动连接时，所述上部主体14和所述保护件2贴合形成圆柱形。这种结构设置，当保护件2插入胫骨内部的操作全部完成时，上部主体14与保护件2形成圆柱体结构，便于整体操作整个后交叉韧带保护装置，带动胫骨运动，在运动时也可保护后交叉韧带不受损伤。
如图5所示，所述保护件2的靠近所述手持端12的一端形成锤击面22；所述锤击面22与所述手持端12平齐时，所述保护件2的靠近所述插入端11的一端突出于所述插入端11设定距离。这样设置的好处在于，当使用本实施例的下开口式后交叉韧带保护器时，向下锤击保护件2的锤击面22与主体1的手持端12平齐，即可知保护件2的下端伸入胫骨骨质的深度，无需再单独测量插入深度。进一步的，可设置形成所述容纳空间30的底面开口的所述保护件2部分，成刀刃口形。
所述导向连接结构包括：导向凹槽41，至少为两个，设置在所述主体1上，且侧面开口相对；导向板42，至少为两个，设置在所述保护件2上，能够分别滑动插入两个所述导向凹槽41内。这种结构设计，能够使保护件在向下插入的过程中，时刻保持与主体的恰当距离，正好将后交叉韧带及部分骨质纳入容纳空间内部予以保护。
本发明下开口式后交叉韧带保护器的使用方法如下：首先手持主体1，将插入端11插入股骨和胫骨之间的合适位置，使两个插齿15分别位于胫骨两侧，然后利用杠杆原理，向后掰动主体1，使下部主体13抵住胫骨，并将胫骨向前推至胫骨上端露出；接着，将保护件2通过导向连接结构连接至主体1，向下锤击保护件2的锤击面22，使保护件2插入骨质内部，进而使连接有后交叉韧带的部分骨质进入到容纳空间30内部给予保护，此时再对胫骨平台进行截骨操作，摆锯片截骨到接触保护件2时便不能继续向前，从而起到保护后交叉韧带的作用。
实施例2
本实施例提供一种改进的后交叉韧带保护器，其是在实施例1基础上的改进，区别在于，如图6所示：插入端11的中部下方设有用于容置后交叉韧带的下开口16。
这样设置的好处在于，当使用主体向下插入时，下开口16位置为后交叉韧带预留空间，不至于过分压迫后交叉韧带，从而能够更好地保护后交叉韧带。
具体的，所述插入端11具有两个插齿15，两个所述插齿15分别位于扁平状的所述下部主体14的底部两侧，中部为所述下开口16，所述下开口16为半圆弧形，并与所述插齿15之间形成阶梯台17。阶梯台17位置可以卡住胫骨后端，对胫骨施力，避免压迫后交叉韧带。
显然，上述实施例仅仅是为清楚地说明所作的举例，而并非对实施方式的限定。对于所属领域的普通技术人员来说，在上述说明的基础上还可以做出其它不同形式的变化或变动。这里无需也无法对所有的实施方式予以穷举。而由此所引伸出的显而易见的变化或变动仍处于本发明创造的保护范围之中。

Claims (9)

  1. 一种下开口式后交叉韧带保护器，其特征在于：包括：
    主体(1)，具有插入端(11)、手持端(12)、以及第一平滑面(10)；所述第一平滑面(10)延伸至与所述插入端(11)相接；所述插入端(11)中部下方设有用于容置后交叉韧带的下开口(16)；
    保护件(2)，通过导向连接结构与所述主体(1)滑动连接，具有第二平滑面(20)；所述保护件(2)与所述主体(1)滑动连接时，所述第二平滑面(20)与所述第一平滑面(10)贴合接触，靠近所述插入端(11)的部分所述第二平滑面(20)向着远离所述第一平滑面(10)的方向凹陷，形成一端开口的容纳空间(30)。
  2. 根据权利要求1所述的下开口式后交叉韧带保护器，其特征在于：所述主体(1)包括：
    下部主体(13)，扁平状，底部为所述插入端(11)；
    上部主体(14)，与所述下部主体(13)固定连接。
  3. 根据权利要求2所述的下开口式后交叉韧带保护器，其特征在于：所述插入端(11)具有两个插齿(15)，两个所述插齿(15)分别位于扁平状的所述下部主体(14)的底部两侧，中部为所述下开口(16)，所述下开口(16)为半圆弧形，并与所述插齿(15)之间形成阶梯台(17)。
  4. 根据权利要求3所述的下开口式后交叉韧带保护器，其特征在于：所述插齿(15)的底部为斜面形。
  5. 根据权利要求2-4中任一项所述的下开口式后交叉韧带保护器，其特征在于：所述保护件(2)包括：
    半圆柱体(21)，具有沿轴向延伸的所述第二平滑面(20)，上部实心，下部形成侧面、底面均开口的所述容纳空间(30)。
  6. 根据权利要求5所述的下开口式后交叉韧带保护器，其特征在于：所述上部主体(14)为半圆柱形，所述主体(1)和所述保护件(2)滑动连接时，所述上部主体(14)和所述保护件(2)贴合形成圆柱形。
  7. 根据权利要求5所述的下开口式后交叉韧带保护器，其特征在于： 所述保护件(2)的靠近所述手持端(12)的一端形成锤击面(22)；所述锤击面(22)与所述手持端(12)平齐时，所述保护件(2)的靠近所述插入端(11)的一端突出于所述插入端(11)设定距离。
  8. 根据权利要求5所述的下开口式后交叉韧带保护器，其特征在于：形成所述容纳空间(30)的底面开口的所述保护件(2)部分，成刀刃口形。
  9. 根据权利要求1所述的下开口式后交叉韧带保护器，其特征在于：所述导向连接结构包括：
    导向凹槽(41)，至少为两个，设置在所述主体(1)上，且侧面开口相对；
    导向板(42)，至少为两个，设置在所述保护件(2)上，能够分别滑动插入两个所述导向凹槽(41)内。
PCT/CN2018/000298 2018-07-09 2018-08-14 一种下开口式后交叉韧带保护器 WO2020010479A1 (zh)

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Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20070055256A1 (en) * 2005-08-22 2007-03-08 Galindo Sergio L Intraosseous fixation device for reconstructing the knee posterior cruciate ligament
CN205379349U (zh) * 2016-01-20 2016-07-13 首都医科大学附属北京朝阳医院 用于全膝关节置换术的后交叉韧带保护装置
CN205514729U (zh) * 2016-03-22 2016-08-31 北京积水潭医院 一种用于后交叉韧带保留型膝关节置换术的骨撬
CN206372095U (zh) * 2016-07-19 2017-08-04 北京积水潭医院 一种保护后交叉韧带止点的骨刀
CN206434421U (zh) * 2016-09-21 2017-08-25 北京积水潭医院 后交叉韧带止点保护器
CN108852457A (zh) * 2018-07-09 2018-11-23 孔杰 一种后交叉韧带保护器

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20070055256A1 (en) * 2005-08-22 2007-03-08 Galindo Sergio L Intraosseous fixation device for reconstructing the knee posterior cruciate ligament
CN205379349U (zh) * 2016-01-20 2016-07-13 首都医科大学附属北京朝阳医院 用于全膝关节置换术的后交叉韧带保护装置
CN205514729U (zh) * 2016-03-22 2016-08-31 北京积水潭医院 一种用于后交叉韧带保留型膝关节置换术的骨撬
CN206372095U (zh) * 2016-07-19 2017-08-04 北京积水潭医院 一种保护后交叉韧带止点的骨刀
CN206434421U (zh) * 2016-09-21 2017-08-25 北京积水潭医院 后交叉韧带止点保护器
CN108852457A (zh) * 2018-07-09 2018-11-23 孔杰 一种后交叉韧带保护器

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