WO2022143423A1 - Plaque de guidage tibial pour arthroplastie totale du genou et sa méthode d'utilisation - Google Patents

Plaque de guidage tibial pour arthroplastie totale du genou et sa méthode d'utilisation Download PDF

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Publication number
WO2022143423A1
WO2022143423A1 PCT/CN2021/140940 CN2021140940W WO2022143423A1 WO 2022143423 A1 WO2022143423 A1 WO 2022143423A1 CN 2021140940 W CN2021140940 W CN 2021140940W WO 2022143423 A1 WO2022143423 A1 WO 2022143423A1
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WO
WIPO (PCT)
Prior art keywords
tibial
guide plate
total knee
osteotomy
replacement surgery
Prior art date
Application number
PCT/CN2021/140940
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English (en)
Chinese (zh)
Inventor
张逸凌
刘星宇
Original Assignee
北京长木谷医疗科技有限公司
张逸凌
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Publication date
Application filed by 北京长木谷医疗科技有限公司, 张逸凌 filed Critical 北京长木谷医疗科技有限公司
Publication of WO2022143423A1 publication Critical patent/WO2022143423A1/fr

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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
    • A61B17/16—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

Definitions

  • the present application relates to the technical field of medical devices, and in particular, to a tibial bone guide for total knee replacement surgery and a method of using the same.
  • TKA total knee arthroplasty
  • the deviation of lower extremity alignment is only judged by knee X-ray or CT before surgery, which affects the angle judgment and may lead to surgical errors.
  • most of the traditional osteotomy positioning is achieved by TKA holding instruments. There are many surgical instruments, heavy weight, and complicated assembly methods, which cannot guarantee the accuracy of positioning.
  • the present application provides a tibial guide plate for total knee arthroplasty and a method of using the same, which are used to solve the defect of low accuracy of osteotomy positioning in total knee arthroplasty in the related art, realize the accuracy of tibial guide plate osteotomy location, and improve Success rate of total knee replacement surgery.
  • the present application provides a tibial guide plate for total knee replacement surgery, including a tibial guide plate body.
  • the tibial osteotomy groove penetrates one end of the tibial guide plate body, and the tibial osteotomy groove is configured to be able to be inserted with a sickle blade that can verify the amount of tibial osteotomy; the second side of the tibial guide plate body
  • One end of the tibial guide plate body is provided with a force wire rod insertion hole configured to be capable of inserting a force wire rod.
  • the first side of the tibial guide plate body is further provided with a positioning hole, and the positioning hole is set so that a positioning pin can be inserted.
  • a tibial guide plate for total knee replacement surgery provided by the present application, two positioning holes are provided, and the axes of the two positioning holes are parallel.
  • the tibial guide plate body is provided with an observation port, and the observation port penetrates one end of the tibial bone guide plate body.
  • the observation port is provided on the third side of the tibial bone guide plate body.
  • the axis of the insertion rod of the force line is perpendicular to the tibial osteotomy surface.
  • the tibial bone guide plate for total knee replacement surgery is an integral molding structure.
  • the tibial bone guide plate for total knee replacement surgery is made by 3D printing.
  • the material of the tibial bone guide plate for total knee replacement surgery is medical resin or medical metal.
  • the wire rod inserted into the wire rod insertion hole is configured to verify whether it is parallel to the tibial wire, so that the position of the tibial guide can be determined based on the verification result. Correction.
  • the present application also provides a method for using a tibial guide plate for total knee replacement surgery, comprising the steps of: assembling the tibial guide plate body with the tibia, so that the fitting groove is aligned with the anterior and medial tibia, so that the tibial osteotomy groove is aligned with the tibia. Align the tibial osteotomy surface; insert the force line rod into the force line rod socket, observe and correct until the force line rod is parallel to the tibial force line; insert the sickle blade into the tibial osteotomy slot to verify and determine the tibial osteotomy; Osteotomy of the tibia with osteotomy instruments.
  • the present application provides a tibial guide plate for total knee replacement surgery and a method of using the same.
  • a fitting groove By setting a fitting groove, the alignment and fitting with the anterior and medial sides of the tibia is realized, so as to ensure the accurate positioning and assembly of the tibial guide plate and the tibia.
  • the tibial osteotomy surface is aligned, and the sickle blade is inserted into the tibial osteotomy groove to achieve accurate verification of the tibial osteotomy volume, ensure the accurate positioning of the tibial osteotomy, and improve the safety and success rate of the operation.
  • the structure is simple and the operation is simple. Convenient and accurate positioning.
  • FIG. 1 is a rear view of a tibial guide for total knee replacement surgery provided by an embodiment of the present application
  • FIG. 2 is a front view of a tibial guide for total knee replacement surgery provided by an embodiment of the present application
  • FIG. 3 is a side view of a tibial guide plate for total knee replacement surgery provided by an embodiment of the present application
  • FIG. 4 is a top view of a tibial guide for total knee replacement surgery provided by an embodiment of the present application
  • FIG. 5 is a top view of the assembly effect of the tibial guide for total knee replacement surgery and the tibia provided by the embodiment of the present application;
  • FIG. 6 is a front view of the assembly effect of the tibial guide for total knee replacement surgery and the tibia provided by the embodiment of the present application;
  • FIG. 7 is a side view of the assembly effect of the tibial guide for total knee replacement surgery and the tibia provided by the embodiment of the present application;
  • FIG. 8 is a flowchart of a method of using a tibial guide for total knee replacement surgery provided by an embodiment of the present application
  • FIG. 9 is a schematic diagram of operation 1 of a method for using a tibial guide for total knee replacement surgery provided by an embodiment of the present application;
  • FIG. 10 is a schematic diagram of operation 2 of the method for using the tibial guide for total knee replacement surgery provided by the embodiment of the present application;
  • FIG. 11 is a schematic diagram of operation 3 of the method for using the tibial guide for total knee replacement surgery provided by the embodiment of the present application;
  • FIG. 12 is a schematic diagram of operation four of the method for using the tibial guide for total knee replacement surgery provided by the embodiment of the present application;
  • Fig. 13 is the schematic diagram of operation five of the using method of the tibial guide plate for total knee replacement surgery provided by the embodiment of the present application;
  • FIG. 14 is a schematic diagram of operation six of the method for using the tibial guide for total knee replacement surgery provided by the embodiment of the present application;
  • Fig. 15 shows the tibia after osteotomy using the method of using the tibial guide for total knee replacement provided in the embodiment of the present application.
  • tibial guide plate body 110, tibial osteotomy groove; 111, sickle blade; 120, fitting groove; 130, positioning hole; 131, positioning pin; 140, observation port; 160, force wire rod fixing plate; 170, Force line rod jack; 171, force line rod; 200, tibia; 300, osteotomy instrument.
  • connection and “connected” should be understood in a broad sense, for example, it may be a fixed connection or a detachable connection, Or integral connection; it can be mechanical connection or electrical connection; it can be directly connected or indirectly connected through an intermediate medium.
  • connection should be understood in a broad sense, for example, it may be a fixed connection or a detachable connection, Or integral connection; it can be mechanical connection or electrical connection; it can be directly connected or indirectly connected through an intermediate medium.
  • the first feature "on” or “under” the second feature may be in direct contact with the first and second features, or the first and second features pass through the middle indirect contact with the media.
  • a first feature being “above”, “over” and “above” a second feature may mean that the first feature is directly above or obliquely above the second feature, or simply means that the first feature is level higher than the second feature.
  • the first feature being “below”, “below” and “below” the second feature may mean that the first feature is directly below or obliquely below the second feature, or simply means that the first feature has a lower level than the second feature.
  • a tibial guide plate for total knee replacement surgery including a tibial guide plate body 100 .
  • Aligned tibial osteotomy groove 110, the tibial osteotomy groove 110 runs through one end of the tibial guide plate body 100, and the tibial osteotomy groove 110 is set to be able to insert a sickle blade 111 for verifying the tibial osteotomy amount;
  • the second side is provided with a fitting groove 120; one end of the tibial guide plate body 100 is provided with a wire rod fixing plate 160 parallel to the tibial osteotomy groove 110, and one end of the wire rod fixing plate 160 away from the tibial guide plate body 100 is provided with
  • the wire rod insertion hole 170 is provided to be capable of inserting the power wire rod 171 .
  • the left side of the tibial guide plate body 100 is provided with a tibial osteotomy groove 110, and the tibial osteotomy groove 110 runs through the tibial bone guide plate body 100 from front to back to cut the tibial bone.
  • the alignment of the bone surfaces facilitates inserting the sickle blade 111 into the tibial osteotomy slot 110, and verifies the tibial osteotomy volume, improves the measurement accuracy, and provides accurate osteotomy volume data for osteotomy.
  • the anterior side of the tibial guide plate body 100 is the inner side that fits with the tibia 200, and there is a fitting groove 120 to achieve anastomosis and assembly with the anterior and inner side of the tibia, ensuring the stability of fitting, improving the accuracy of assembly and positioning, and improving the success of the operation. Rate.
  • One end of the tibial guide plate body 100 is provided with a force line rod fixing plate 160 parallel to the tibial osteotomy groove 110, and one end of the force line rod fixing plate 160 away from the tibial guide plate body 100 is provided with a force line rod for inserting the force line rod 171. Jack 170.
  • One end of the force wire rod fixing plate 160 is fixedly connected to the anterior side of the tibial guide plate body 100 , and the other end extends laterally parallel to the tibial osteotomy groove 110 .
  • the end of the force line rod fixing plate 160 away from the tibial guide plate body 100 is provided with a force line rod insertion hole 170, and a force line rod insertion hole 170 can be inserted into a force line rod 171 to simulate the recovery of the tibial force line after osteotomy using the tibial guide plate. , it is easy to adjust the lower limb force line.
  • the first side of the tibial guide plate body 100 is further provided with a positioning hole 130 .
  • the positioning hole 130 is disposed on the front side of the tibial guide plate body 100 to provide a positioning and installation basis for the osteotomy instrument 300 to ensure the installation and positioning accuracy of the osteotomy instrument 300 .
  • two positioning holes 130 are provided, and the axes of the two positioning holes 130 are parallel. It can be understood that, in order to ensure the fixing strength and positioning accuracy, preferably two positioning holes 130 are provided, and the two positioning holes 130 are provided in the middle of the tibial guide plate body 100, and are arranged at intervals on both sides to ensure the stability of the positioning. .
  • the axes of the two positioning holes 130 are parallel. It should be noted that the distance between the two positioning holes 130 is smaller than the diameter of the tibia 200 .
  • a positioning pin 131 can be inserted into the positioning hole 130, and the positioning pin 131 is used for connecting and positioning with the anterior side of the tibia. It can be understood that the positioning nails 131 can be inserted into the positioning holes 130. After the fitting groove 120 is aligned with the anterior and medial tibia, the two positioning nails 131 are respectively inserted into the two positioning holes 130, and are respectively connected to the two positioning holes 130. Tibial burr hole positioning connection. That is to say, providing two one-positioning holes 130 and passing through two positioning pins 131 can ensure accurate positioning and reduce the number of pin holes for the tibia 200 at the same time.
  • the tibial guide plate body 100 is provided with an observation port 140 , and the observation port 140 penetrates one end of the tibial guide plate body 100 .
  • the observation port 140 penetrates through the tibial guide plate body 100 from right to left, so as to observe the fitting condition of the fitting groove 120 and the bone surface.
  • the observation port 140 is provided on the third side of the tibial guide plate body 100 , that is, on a different side from the tibial osteotomy groove 110 , that is, the tibial guide plate body 100 , so that the fitting condition of the fitting groove 120 and the bone surface can be observed in an all-round way.
  • the axis of the force wire rod insertion hole 170 is perpendicular to the tibial osteotomy surface.
  • the tibial bone guide plate for total knee replacement surgery is an integral molding structure. Ensure the strength of the overall structure, facilitate integrated processing and molding, and improve production efficiency.
  • the tibial bone guide plate for total knee replacement surgery is made by 3D printing. It is understandable that the tibial guide is prepared by 3D printing, taking into account any slight deformity or osteophyte through preoperative design and rehearsal, and the size, position and rotation of the tibial guide can be determined in advance, which is beneficial to adjust the lower limb alignment so that It is close to the neutral line of force, which makes the position of the tibial guide plate more accurate, and completely fits the contour of the tibia 200, realizing individualized and precise design.
  • the material of the tibial bone guide plate for total knee replacement surgery is medical resin or medical metal.
  • medical resins polyethylene, polyetheretherketone, polyacetic acid, etc.
  • titanium, titanium alloys, and stainless steels can be used as medical metals.
  • the wire rod inserted into the wire rod insertion hole is configured to verify whether it is parallel to the tibial wire, so that the position of the tibial guide can be determined based on the verification result. Correction.
  • the position of the tibial guide plate can be adjusted and readjusted so that the two lines are parallel, so that the osteotomy position can be accurately determined.
  • the present application also provides a method for using a tibial bone guide for total knee replacement surgery, comprising the following steps:
  • the tibial guide plate body 100 is assembled with the tibia 200, so that the fitting groove 120 is aligned with the anterior and medial tibia, and the tibial osteotomy groove 110 is aligned with the tibial osteotomy surface.
  • tibial osteotomy groove 110 is arranged on the front side of the tibial guide plate body 100, and a fitting groove 120 is arranged on the rear side of the tibial guide plate body 100 to complete the preparation of the individualized tibial guide plate;
  • S101 curettage the tibia 200 corresponding to the fitting position S102, assemble the tibial guide plate body 100 with the tibia 200, so that the fitting groove 120 is aligned with the anterior and inner side of the tibia, and ensure that the tibial osteotomy groove 110 is aligned with the tibial osteotomy surface;
  • S103 the force Insert the wire rod 171 into the wire rod insertion hole 170, observe and correct until the wire rod 171 is parallel
  • it may include: S104 , inserting two positioning pins 131 into the positioning holes 130 respectively, and connecting and positioning with the tibia 200 .
  • inserting the sickle blade into the tibial osteotomy groove, and verifying the osteotomy amount of the tibia comprises: inserting the sickle blade into the tibia In the osteotomy groove, based on the position of the sickle blade, the amount of osteotomy of the tibia is verified; after inserting the positioning pin into the positioning hole of the tibial guide plate, the tibial guide plate is removed, and the remaining positioning pin is left.
  • S105 insert the sickle blade 111 into the tibial osteotomy groove 110 to verify and determine the osteotomy amount of the tibia 200; insert the sickle blade 111 into the tibial osteotomy groove 110 to verify and determine the osteotomy amount of the tibia 200; Osteotomy is performed on the tibia 200 by the osteotomy instrument 300; S106, the tibial guide plate 100 is removed along the screw channel of the positioning nails 131 (larger than the diameter of the positioning nails), and the two positioning nails 131 remain connected to the tibia 200. The role of the positioning mark.
  • performing an osteotomy on the tibia with an osteotomy instrument includes: installing and registering the osteotomy instrument with the positioning pin; Osteotomy.
  • the osteotomy it can be determined based on the distance between the straight line where the lower end surface of the osteotomy groove 110 is located and the straight line where the dot 130 is located, wherein the straight line where the lower end surface of the 110 is located is parallel to the straight line where the positioning hole 130 is located. .
  • S107 may be included, setting the osteotomy instrument 300 on the two positioning pins 131 correspondingly (the osteotomy instrument may be provided with a screw channel matching the diameter of the positioning pins), and performing the osteotomy on the tibia 200 according to the amount of osteotomy. Osteotomy; S108 , after the osteotomy, the osteotomy instrument 300 and the two positioning pins 131 are sequentially removed to complete the operation.
  • the present application provides a tibial guide plate for total knee replacement surgery and a method of using the same.
  • a fitting groove By setting a fitting groove, the alignment and fitting with the anterior and medial sides of the tibia is realized, so as to ensure the accurate positioning and assembly of the tibial guide plate and the tibia.
  • the tibial osteotomy surface is aligned, and the sickle blade is inserted into the tibial osteotomy groove to achieve accurate verification of the tibial osteotomy volume, ensure the accurate positioning of the tibial osteotomy, and improve the safety and success rate of the operation.
  • the structure is simple and the operation is simple. Convenient and accurate positioning.

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Abstract

Une plaque de guidage tibial pour arthroplastie totale du genou et sa méthode d'utilisation. La plaque de guidage tibial pour arthroplastie totale du genou comprend un corps (100) de plaque de guidage tibial ; un premier côté du corps (100) de plaque de guidage tibial est pourvu d'une fente d'ostéotomie tibiale (110), la fente d'ostéotomie tibiale (110) passant à travers une extrémité du corps (100) de plaque de guidage tibial, et une lame de faucille (111) étant insérée dans la fente d'ostéotomie tibiale (110) ; un second côté du corps (100) de plaque de guidage tibial est pourvu d'une fente d'ajustement (120) ; une extrémité du corps de plaque de guidage tibial (100) est pourvue d'une plaque de fixation (160) de tige de ligne de force parallèle à la fente d'ostéotomie tibiale (110), et l'extrémité de la plaque de fixation (160) de tige de ligne de force à distance du corps (100) de plaque de guidage tibial est pourvue d'un trou d'insertion (170) de tige de ligne de force conçu pour permettre l'insertion d'une tige de ligne de force (171). La mise à disposition de la fente d'ajustement (120) permet d'ajuster l'alignement avec un côté interne avant d'un tibia (200), assurant ainsi un positionnement et un assemblage précis de la plaque de guidage tibial et du tibia (200) et l'alignement entre la fente d'ostéotomie tibiale (110) et une surface d'ostéotomie tibiale. La lame de faucille (111) est insérée dans la fente d'ostéotomie tibiale (110), de façon à effectuer une vérification précise de la quantité d'ostéotomie du tibia, à garantir un positionnement exact de l'ostéotomie durant une chirurgie, et d'améliorer la sécurité et le taux de réussite de la chirurgie. Par conséquent, la présente invention présente une structure simple, est pratique à utiliser, et assure un positionnement exact.
PCT/CN2021/140940 2020-12-31 2021-12-23 Plaque de guidage tibial pour arthroplastie totale du genou et sa méthode d'utilisation WO2022143423A1 (fr)

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CN202011635832.2A CN112842455B (zh) 2020-12-31 2020-12-31 全膝关节置换手术用胫骨导板及其使用方法
CN202011635832.2 2020-12-31

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CN112842455B (zh) * 2020-12-31 2022-05-17 北京长木谷医疗科技有限公司 全膝关节置换手术用胫骨导板及其使用方法
CN113729909B (zh) * 2021-08-24 2023-03-03 北京长木谷医疗科技有限公司 膝关节置钉导板
CN113729846B (zh) * 2021-08-24 2023-04-07 北京长木谷医疗科技有限公司 膝关节截骨导板
CN113983888B (zh) * 2021-10-20 2023-09-26 北京长木谷医疗科技股份有限公司 膝关节手术用导板精度验证装置及其验证方法
CN113995466B (zh) * 2021-10-28 2023-05-12 北京长木谷医疗科技有限公司 胫骨截骨器及胫骨截骨导板组件
CN115624366A (zh) * 2022-09-21 2023-01-20 北京长木谷医疗科技有限公司 用于膝关节置换术的定位工具的检测系统、方法及装置

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CN104840231A (zh) * 2015-05-25 2015-08-19 北京爱康宜诚医疗器材股份有限公司 截骨板和胫骨截骨方法
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