WO2020240889A1 - 骨切除器具 - Google Patents
骨切除器具 Download PDFInfo
- Publication number
- WO2020240889A1 WO2020240889A1 PCT/JP2019/044681 JP2019044681W WO2020240889A1 WO 2020240889 A1 WO2020240889 A1 WO 2020240889A1 JP 2019044681 W JP2019044681 W JP 2019044681W WO 2020240889 A1 WO2020240889 A1 WO 2020240889A1
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- WIPO (PCT)
- Prior art keywords
- tip
- saw blade
- blade
- guide
- guide plate
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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
-
- 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
- A61B17/1604—Chisels; Rongeurs; Punches; Stamps
-
- 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
- A61B17/1659—Surgical rasps, files, planes, or scrapers
-
- 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
- A61B17/1728—Guides or aligning means for drills, mills, pins or wires for holes for bone plates or plate screws
-
- 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
- A61B17/32—Surgical cutting instruments
- A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
- A61B17/32002—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes with continuously rotating, oscillating or reciprocating cutting instruments
Definitions
- the present invention relates to an osteotomy device for excising a part of bone.
- total knee arthroplasty has been widely performed as a treatment method for knee osteoarthritis.
- an osteotomy instrument for performing bone excision for example, a blade for bone cutting disclosed in Patent Documents 1 and 2 below is provided.
- the present invention has been made in view of such a problem, and an object of the present invention is to provide an osteotomy device capable of performing additional excision easily and with high accuracy on the excised surface of the bone.
- the osteotomy instrument is an osteotomy instrument for cutting bone, and has a tip saw blade, and the bone that the tip saw blade comes into contact with by vibrating at high speed.
- a guide that has a substantially flat blade body and a substantially flat tip guide portion that is located on the upper surface side of the blade body and is relatively slidably connected to the blade body in the front-rear direction.
- the tip guide portion protrudes toward the tip side of the blade body from the tip saw blade to cover the tip saw blade, and the protrusion guide position guides the cutting position in the thickness direction by the tip saw blade.
- the tip guide portion is provided with a guide plate that is slidable with and from a retracted position retracted from the tip saw blade.
- the guide plate according to the present invention has a tip saw blade and is used by being attached to a substantially flat blade body that cuts the bone with which the tip saw blade contacts by vibrating at high speed.
- the tip is provided with a substantially flat tip guide portion and a slide rail portion that sandwiches the blade body from the upper surface side, and the tip guide portion projects toward the tip side of the blade body from the tip saw blade.
- the protruding guide position that covers the saw blade and guides the cutting position in the thickness direction by the tip saw blade and the retracted position where the tip guide portion is retracted from the tip saw blade are relative to the blade body in the front-rear direction.
- the tip guide portion is formed with an opening window for visually recognizing the tip saw blade from above when the tip guide portion is located at the protruding guide position. It is characterized by being.
- the osteotomy device According to the osteotomy device according to the present invention, it is possible to easily and highly accurately perform additional excision of a small size on the excised surface of the bone.
- FIG. 1 is a perspective view of the osteotomy device according to the embodiment of the present invention as viewed from above.
- FIG. 2 is a perspective view of the osteotomy device according to the embodiment of the present invention as viewed from below.
- FIG. 3 is a perspective view of the blade body according to the embodiment of the present invention as viewed from above.
- FIG. 4 is a perspective view of the blade body according to the embodiment of the present invention as viewed from below.
- FIG. 5 is a perspective view of the guide plate according to the embodiment of the present invention as viewed from above.
- FIG. 6 is a perspective view of the guide plate according to the embodiment of the present invention as viewed from below.
- FIG. 7 is a perspective view of the osteotomy device according to the embodiment of the present invention as viewed from above.
- FIG. 8 is a perspective view showing a usage state of the osteotomy device according to the embodiment of the present invention.
- FIG. 9 is a side view showing a usage state of the osteotomy device according to the embodiment of the present invention.
- FIG. 10 is a perspective view showing a usage state of the osteotomy device according to the embodiment of the present invention.
- FIG. 11 is a perspective view of the blade body according to the modified example of the embodiment of the present invention as viewed from above.
- FIG. 12 is a perspective view of the guide plate according to the modified example of the embodiment of the present invention as viewed from above.
- the osteotomy device 1 is used in the artificial knee joint replacement technique when the excised surface of the bone to be replaced is excised with an additional predetermined thickness (1 mm in the present embodiment).
- the osteotomy instrument 1 is an instrument used by setting it on the bone saw handpiece 6 which is a high-speed electric vibration instrument (10,000 rpm).
- the osteotomy instrument 1 includes a blade body 10 and a guide plate 20 located on the upper surface side of the blade body 10 and for guiding a cutting position in the thickness direction by the blade body 10.
- the blade body 10 has a substantially strip-shaped flat plate shape, and has a tip saw blade 12 formed on the tip edge in the longitudinal direction thereof and a slide connecting ridge 13 formed on the upper surface thereof, which is a connecting portion with the guide plate 20.
- a joint portion 18 formed at the rear end portion (hand side portion) and which is a connecting portion with the handpiece 6 is provided.
- the tip edge of the blade body 10 has an arc shape that is convex toward the tip side, and the tip saw blade 12 is formed in an arc shape.
- the blade body 10 vibrates at high speed in the width direction, that is, in the extending direction of the tip saw blade 12, the bone at the portion where the tip saw blade 12 contacts is cut.
- the slide-connected ridge 13 extends upward from the rear end of the tip saw blade 12 of the blade body 10 to the hand side at the center in the width direction.
- the width of the slide connecting ridge 13 is about half the width of the blade body 10.
- the thickness of the slide connecting ridge 13 is the same as the thickness of the tip saw blade 12 (1 mm), and in the slide connecting ridge 13 portion, the thickness of the blade body 10 is twice (2 mm) the thickness of the tip saw blade 12. Is.
- the both side edges of the slide connecting ridge 13 are formed with notches that incline in a direction that narrows downward, and the side edges of the slide connecting ridge 13 are the slide rail portion 29 of the guide plate 20 described later.
- the slide connecting ridge 13 is slidably sandwiched between the slide rail portion 29 by being fitted into the slide rail portion 29.
- the joint portion 18 is a portion fixed to the handpiece 6.
- the thickness of the joint portion 18 is 1.5 mm, which is thicker than the portion of the tip saw blade 12 and thinner than the portion of the slide connecting ridge 13.
- a thick plate portion 19 having the same thickness (2 mm) as the portion of the slide connecting ridge 13 is installed between the slide connecting ridge 13 and the joint portion 18.
- the thick plate portion 19 is installed over the entire width direction of the blade main body 10.
- the elongated plate-shaped blade body 10 Since the elongated plate-shaped blade body 10 is driven by the handpiece 6 during cutting and vibrates at high speed in the width direction, if the blade body 10 is thin and has low flexural rigidity, it bends at high speed vibration and the tip portion moves in the vertical direction. As a result, the cutting system is reduced. On the other hand, if the entire blade body 10 is thickened in order to increase the bending rigidity, the blade body 10 becomes heavy and stable high-speed vibration becomes difficult.
- a thick slide connecting ridge 13 and a thick plate portion 19 are installed near the center of the blade body 10 in the longitudinal direction to increase the bending rigidity of the blade body 10. It is possible to prevent the occurrence of bending and realize high-precision cutting while suppressing the overall weight.
- Fastening holes 15 and 16 are formed at two predetermined locations in the longitudinal direction in the portion of the slide connecting ridge 13 at the center of the blade body 10 in the width direction.
- the slide positions of the guide plate 20 and the blade body 10 are fixed by using the fastening holes 15 and 16.
- the fastening holes 15 and 16 do not penetrate the blade main body 10, and are formed only at the portion of the slide connecting ridge 13 at a depth of 1 mm.
- the first fastening hole 15 is a hole for fixing the tip of the guide plate 20 to a protruding guide position where the tip of the guide plate 20 projects forward from the tip edge of the blade body 10 to guide the guide plate 20, and the second fastening hole 16 is a hole of the guide plate 20.
- This is a hole for fixing the tip to a retracted position where the tip of the blade body 10 retracts from the tip edge and does not guide.
- 1 and 2 show a state in which the slide position of the osteotomy device 1 is fixed to the protruding guide position
- FIG. 7 shows a state in which the protruding guide position is fixed to the retracted position.
- the guide plate 20 has a substantially strip-shaped flat plate having a width substantially the same as that of the blade body 10, and the length in the longitudinal direction is about three-fifths of the blade body 10.
- the guide plate 20 includes a tip guide portion 21 installed at the tip portion thereof, a rotary fastener 27 installed on the upper surface thereof, and a slide rail portion 29 installed on the lower surface thereof extending in the longitudinal direction. I have.
- the tip guide portion 21 is a rectangular flat plate portion that occupies about a quarter of the area on the tip side of the guide plate 20, and includes a rectangular opening window 22 located at the center.
- the two sides of the opening window 22 extending in the width direction, the front end side and the rear end side, both have an arc shape convex toward the front end side.
- the tip saw blade 12 By forming the opening window 22 at the tip of the guide plate 20, the tip saw blade 12 can be observed from above the blade body 10 through the opening window 22, and the bone cut by the tip saw blade 12 can be observed.
- the powder can be discharged from the opening window 22.
- the outer peripheral edge of the tip guide portion 21 has R surfaces 24 and 25, and the tip edge R surface 24 is formed on the tip portion and the outer edge R surface 25 is formed on both side portions. In this way, by setting the outer periphery of the tip guide portion 21 to the R surfaces 24 and 25, the outer edge of the tip guide portion 21 that vibrates at high speed in the width direction during cutting comes into contact with the bone, and the bone is scraped or due to friction. It is possible to prevent the smooth high-speed vibration from being hindered.
- an inner edge R surface 23 is formed on the inner side surface of the opening window 22.
- the inner edge R surface 23 of the opening window 22 vibrates at least in the width direction
- the rotary fastener 27 is installed on the upper surface of the guide plate 20 and includes a horizontal and widthwise parallel rotary shaft 27b and a cylindrical protrusion 27a that is rotatable around the rotary shaft 27b.
- the cylindrical protrusion 27a is rotatable between a fastening position protruding from the fastener hole 28 formed in the guide plate 20 toward the lower surface side of the guide plate 20 and a retracting position retracted upward from the fastening position.
- the blade body 10 and the guide plate 20 are relatively non-slidingly fixed, and the cylindrical protrusion in the retracted position.
- the 27a comes out of the first fastening hole 15 or the second fastening hole 16
- the blade body 10 and the guide plate 20 become slidable.
- the slide rail portion 29 is installed extending in the longitudinal direction on both edges of the lower surface of the guide plate 20, and both side edges of the slide connecting ridge 13 are slidably sandwiched by the slide rail portion 29.
- the slide rail portion 29 extends from the hand side end portion of the tip guide portion 21 to the installation location of the rotary fastener 27 near the rear end of the guide plate 20.
- the portion of the tip guide portion 21 has substantially the same width as the blade body 10, but the width of the portion from the tip guide portion 21 to the rear end side is narrower, and the slide connecting protrusion of the blade body 10 It is slightly wider than 13.
- the configuration of the osteotomy instrument 1 has been described above. Next, the usage mode of the osteotomy instrument 1 will be described by taking an example of adjusting the excision plane of the bone by cutting an additional 1 mm.
- the osteotomy device 1 is used by fixing the joint portion 18 to the connecting portion of the handpiece 6, and the blade body 10 vibrates at high speed in the width direction by driving the handpiece 6.
- FIG. 8 shows the state at the start of excision with the osteotomy instrument 1.
- FIG. 9 (a) also shows a state at the start of excision with the osteotomy device 1, and
- FIG. 9 (b) shows a state in which about 70% of the excised surface is additionally excised.
- FIG. 10 shows a state in which the guide plate 20 is fixed in the retracted position and the remaining cut surface is cut in a state where the guide is not performed.
- the osteotomy instrument is provided so that the tip guide portion 21 of the guide plate 20 protrudes toward the tip side from the tip of the blade body 10. Fix the slide position of 1.
- the fixing of the slide position is realized by inserting and fixing the cylindrical protrusion 27a of the rotary fastener 27 into the first fastening hole 15.
- the osteotomy instrument 1 fixed at the protruding guide position has the lower surface of the tip guide portion 21 in parallel with the excision surface of the bone 5, and the tip saw blade 12 of the blade body 10 is the upper end of the bone 5. It is set at the excision start position so that it contacts the side surface of the bone.
- the operator advances the work while pressing the lower surface of the tip guide portion 21 of the guide plate 20 so as to always contact the cut surface of the bone 5 in parallel, so that the tip saw blade 12 always has the initial cut surface.
- the position in the thickness direction is guided so as to be located in the region from 1 mm below to 1 mm below, and the excised surface of the bone 5 is additionally excised from the end by a thickness corresponding to the thickness (1 mm) of the tip saw blade 12 (1 mm). (See FIG. 9B).
- the excised bone 5 chips are sequentially gathered and solidified while colliding with the left and right inner edges at high speed inside the opening window 22, and are sequentially discharged to the outside while forming a dumpling shape.
- a new cut surface that is one step lower than the original cut surface is formed in the region newly cut by the tip saw blade 12 in this way.
- the step between the original cut surface and the new cut surface corresponds to the thickness of the tip saw blade 12, and is about 1 mm in the present embodiment.
- the guide plate 20 cannot be pressed, and if the new cut surface that is one step lower becomes a certain size, the blade body can be used without guidance by the guide plate 20.
- the remaining original cut surface can be cut and removed (see FIG. 10).
- the remaining original cut surface is cut with a thickness of 1 mm without the guidance of the guide plate 20. can do.
- the remaining portion of the original excision surface can be cut by the tip saw blade 12 of the blade body 10 without guidance by the guide plate 20 by the osteotomy instrument 1 whose slide position is fixed to the retracted position.
- the slide position of the guide plate 20 is fixed to the protruding guide position, and the tip guide portion 21 is used. Accurate additional cutting can be performed by cutting with the tip saw blade 12 of the blade body 10 while guiding.
- cutting can be performed while checking the state of the tip saw blade 12, and the chips of the cut bone 5 are external from the opening window 22. It is also possible to prevent chips from accumulating and hindering cutting.
- FIG. 11 shows a modified example of the blade body 10.
- the blade body 10 vibrates at high speed in the width direction to cut the bone that the tip saw blade 12 contacts, but the blade body 10'according to the present modification is the tip portion.
- the tip saw blade 12'formed on the tip side surface and both side edges is provided, and the blade body 10' is vibrated at high speed in the front-rear direction to cut the bone that the tip saw blade 12'contacts. To do.
- the guide plate 20 can be applied to the blade body 10'with such a configuration, and has the same effect as that of the above embodiment.
- FIG. 12 shows a modified example of the guide plate.
- the guide plate 20'according to the present modification is different from the above embodiment in that the shape of the opening window 22'is substantially square. Of course, the shape of the opening window may be circular or oval.
- the guide plate 20'according to the present modification also has the same effect as that of the above embodiment.
- the present invention is not limited to the above-described embodiments, and various modifications can be made without departing from the gist of the present invention. ..
- the shape, size, material, and the like of the member forming the osteotomy instrument can be changed as appropriate.
- osteotomy instrument according to the present embodiment can be widely applied not only to artificial joint replacement but also to the case where all or part of the excised surface of the bone is additionally excised.
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Abstract
Description
10 ブレード本体
12 先端ノコギリ刃
13 スライド連結凸条
15 第一留め穴
16 第二留め穴
18 ジョイント部
19 厚板部
20 ガイドプレート
21 先端ガイド部
22 開口窓
23 内側縁R面
24 先端縁R面
25 外側縁R面
27 回動留め具
27a 円筒突起
27b 回動軸
28 留め具用穴
29 スライドレール部
5 骨
6 ハンドピース
Claims (7)
- 骨を切削するための骨切除器具において、
先端ノコギリ刃を有し、高速振動することで、前記先端ノコギリ刃が接触する前記骨を切削する略平板状のブレード本体と、
略平板状の先端ガイド部を有し、前記ブレード本体の上面側に位置して、前記ブレード本体と前後方向に相対的にスライド自在に連結されるガイドプレートであって、前記先端ガイド部が前記ブレード本体の前記先端ノコギリ刃よりも先端側に突出して前記先端ノコギリ刃を覆い、前記先端ノコギリ刃による厚み方向の切削位置を案内する突出ガイド位置と、前記先端ガイド部が先端ノコギリ刃よりも後退した後退位置との間でスライド自在なガイドプレートと、
を備えることを特徴とする骨切除器具。 - 前記先端ガイド部には、前記先端ガイド部が前記突出ガイド位置に位置する際に、上方から前記先端ノコギリ刃を視認するための開口窓が形成されていることを特徴とする請求項1記載の骨切除器具。
- 前記先端ガイド部の前記開口窓の内側の側面がR面であること特徴とする請求項2記載の骨切除器具。
- 前記先端ガイド部の外側の側面がR面であることを特徴とする請求項1乃至3何れか1項記載の骨切除器具。
- 前記ブレード本体は、その上面に前後方向に延在して突出したスライド連結凸条を有し、
前記ガイドプレートは、前記スライド連結凸条を上面側から挟持する、その下面に設置されたスライドレール部を有することを特徴とする請求項1乃至4何れか1項記載の骨切除器具。 - 前記ガイドプレートは、前記ガイドプレートのスライド位置を前記突出ガイド位置又は前記後退位置に固定するための留め具をさらに有することを特徴とする請求項1乃至5何れか1項記載の骨切除器具。
- 先端ノコギリ刃を有し、高速振動することで、前記先端ノコギリ刃が接触する前記骨を切削する略平板状のブレード本体に装着されて使用されるガイドプレートにおいて、
略平板状の先端ガイド部と、
前記ブレード本体を上面側から挟持するスライドレール部と、
を備え、
前記先端ガイド部が前記ブレード本体の前記先端ノコギリ刃よりも先端側に突出して前記先端ノコギリ刃を覆い、前記先端ノコギリ刃による厚み方向の切削位置を案内する突出ガイド位置と、前記先端ガイド部が先端ノコギリ刃よりも後退した後退位置との間で、前記ブレード本体と前後方向に相対的にスライド自在に連結されると共に、
前記前記先端ガイド部には、前記先端ガイド部が前記突出ガイド位置に位置する際に、上方から前記先端ノコギリ刃を視認するための開口窓が形成されていることを特徴とするガイドプレート。
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GB2114497.7A GB2597858B (en) | 2019-05-27 | 2019-11-14 | Bone Resection Device |
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JP2019-098176 | 2019-05-27 | ||
JP2019098176A JP2020191987A (ja) | 2019-05-27 | 2019-05-27 | 骨切除器具 |
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JP2020191987A (ja) * | 2019-05-27 | 2020-12-03 | 株式会社ミヤタニ | 骨切除器具 |
EP3993937A4 (en) * | 2019-10-18 | 2023-07-05 | Milwaukee Electric Tool Corporation | BLADE FOR A POWER TOOL |
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- 2019-11-14 WO PCT/JP2019/044681 patent/WO2020240889A1/ja active Application Filing
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Also Published As
Publication number | Publication date |
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GB2597858B (en) | 2023-05-03 |
JP2020191987A (ja) | 2020-12-03 |
US20200375609A1 (en) | 2020-12-03 |
GB2597858A (en) | 2022-02-09 |
US10966730B2 (en) | 2021-04-06 |
GB202114497D0 (en) | 2021-11-24 |
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