WO2024122933A1 - Dispositif et procédé d'insertion d'une plaque de base glénoïde - Google Patents

Dispositif et procédé d'insertion d'une plaque de base glénoïde Download PDF

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Publication number
WO2024122933A1
WO2024122933A1 PCT/KR2023/018715 KR2023018715W WO2024122933A1 WO 2024122933 A1 WO2024122933 A1 WO 2024122933A1 KR 2023018715 W KR2023018715 W KR 2023018715W WO 2024122933 A1 WO2024122933 A1 WO 2024122933A1
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Prior art keywords
glenoid
base plate
reaming guide
reaming
sizer
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PCT/KR2023/018715
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English (en)
Korean (ko)
Inventor
김정성
김재원
정성욱
이상길
허연범
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주식회사 코렌텍
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Priority claimed from KR1020220170678A external-priority patent/KR20240085620A/ko
Application filed by 주식회사 코렌텍 filed Critical 주식회사 코렌텍
Publication of WO2024122933A1 publication Critical patent/WO2024122933A1/fr

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  • the present invention relates to a device and a method for inserting a glenoid base plate, and more specifically, to a dial checker, at least a portion of which faces the surface of the bone and is at least temporarily fixed to the bone, and which is disposed on one side of the dial checker and attaches to the bone.
  • a device for inserting the glenoid base plate of an artificial shoulder joint that can accurately determine the amount and direction of bone defect in the glenoid bone, including an augment sizer that checks the direction and amount of the defect from the central part, and a glenoid along the first axis
  • a defect measurement step to confirm a reaming guide insertion step to insert a reaming guide that guides the cutting range of the glenoid fossa into the glenoid fossa to form a horizontal plane perpendicular to the first axis, and a reaming guide insertion step to insert the reaming guide into the glenoid fossa to form a horizontal plane perpendicular to the first axis.
  • the present invention relates to a method of inserting a glenoid base plate of an artificial shoulder joint, which includes a second reaming step to form a vertical horizontal plane.
  • An artificial shoulder joint is a type of artificial prosthesis that replaces the human shoulder joint when it does not function properly. It mainly consists of a stem implanted in the humerus, a glenoid base plate connected to the scapula (scapula), and the stem. It consists of an artificial bone head and an insert that implement rotational movement between the condyle and the base plate.
  • the artificial bone head may be coupled to the stem side like a human shoulder joint, or conversely, it may be coupled to the glenoid base plate side. Accordingly, the insert is coupled to the glenoid base plate and stem, respectively.
  • the scapula 91 has an overall inverted triangular structure with the infrascapular fossa 913 (subscapular fossa), which is the front of the body facing anterior, and the posterior scapula.
  • the infraspinal fossa (not shown, infraspinatus fossa), which is the rear of the body facing the body, the coracoid process (917, beak process) protruding forward from the upper side, the acromion (919, acromion) protruding backward from the upper side, and the above It faces laterally between the coracoid process (917) and the acromion (919) and includes a glenoid (911, glenoid) that contacts the humeral head and implements joint movement.
  • the glenoid base plate (8) When total shoulder replacement surgery is performed, the glenoid base plate (8) is generally coupled to the glenoid (911) to replace the function of the glenoid (911). At this time, fixing means such as screws are used to firmly couple the glenoid base plate (8) to the glenoid (911).
  • the invention shown in the above patent document discloses a glenoid base plate used in an artificial shoulder joint.
  • the lower surface 81 in the direction in which the hollow stem extends is formed flat, as can be seen in FIG. 2.
  • This conventional base plate has the disadvantage of not being able to be seated or inserted stably when a bone defect occurs in the glenoid region.
  • a portion where the defect does not occur (R1) is used to secure the glenoid base plate, as shown in FIG. ) must be cut.
  • a partially reinforced (fully wedged) glenoid base plate (B), as shown in Figure 5, can be used.
  • the base plate (B) constitutes an artificial shoulder joint together with other surgical instruments such as glenospheres and inserts, and accommodates a fixation means such as a screw so that the fixation means engages with the bone or is inserted into the bone and is placed on the glenoid fossa 911.
  • a base plate (B) includes a base (B1) seated on the glenoid (911), an augmentation (B3) that reinforces the glenoid base plate on one side of the base, and extending at a predetermined angle on one side of the base (B1). It includes a formed stem (B5), and the augmentation (B3) provided on one side can compensate for bone defects and minimize the amount of fracture.
  • the augmentation B3 may include a plate B31 extending substantially flatly perpendicular to the central axis of the stem and a wedge B33 extending from one end of the plate.
  • the plate extends from one end of the base through the central axis to a point spaced apart by a first length from the central axis, and the wedge is formed to gradually decrease in thickness as it extends from one end of the plate in the first direction (A1). , the thickness extends uniformly in the second direction (A2) perpendicular to the first direction (A1).
  • the contact surface formed by the plate B31 and the wedge B33 extends flat along the first surface B31a on the plate formed at one end of the base, passes through the central axis of the stem, and is spaced a first length D1 from the central axis. It is formed to form a convex curve from the point where it approaches the base (B1).
  • the first length D1 is formed to be smaller than the distance r from the central axis corresponding to the radius of the stem to the outer peripheral surface of the stem.
  • a contact surface In order to insert the partially reinforced glenoid base plate (B) into the glenoid (911), a contact surface must be formed in the glenoid to contact the plate (B31) and the wedge (B33), respectively. At this time, the contact surface in contact with the plate (B31) must be cut to a flat surface, and the surface in contact with the wedge (B33) must be formed as a curved surface, but there is a problem in that it is difficult to form a flat and curved surface in the glenoid.
  • a partially reinforced (half wedged) glenoid base plate (C) as shown in Figure 7 may be used.
  • the base plate (C) constitutes an artificial shoulder joint together with other surgical instruments such as glenospheres and inserts, and accommodates a fixation means such as a screw so that the fixation means engages with the bone or is inserted into the bone and is placed on the glenoid fossa 911. can be fixed to
  • a base plate (B) includes a base (C1) seated on the glenoid (911), an augment (C3) that reinforces the glenoid base plate on one side of the base, and an extension at a predetermined angle on one side of the base (C1).
  • the glenoid base plate (C) In order to insert the partially reinforced glenoid base plate (C) into the glenoid 911, two or more surfaces must be formed on the glenoid, and the glenoid is cut (reamed) to form a surface approximately perpendicular to the insertion direction of the base plate. ), the glenoid is secondarily cut to form a surface with a predetermined angle to the insertion direction of the base plate. At this time, there is a problem that the cutting direction is not clearly guided during the secondary cutting process of the glenoid, and the size of the glenoid defect is not properly measured, so there is a problem that the shape of the glenoid and the base plate do not match accurately after cutting (reaming).
  • a surgical instrument capable of cutting the glenoid, a reaming guide for accurate cutting when cutting the glenoid, and an accurate size and insertion direction of the implant are required.
  • a guiding method is required.
  • the present invention was devised to solve the above problems,
  • the object of the present invention is to provide a dial checker that is at least temporarily fixed to the bone while at least part of it faces the surface of the bone, and an ugg disposed on one side of the dial checker to check the direction and amount of the defect from the central part of the bone.
  • the aim is to provide a defect measuring device that can accurately determine the amount and direction of bone defect in the joint fossa by including a sizer.
  • the dial checker includes a rod extending in a first axis direction and a disk extending at least radially from one side of the rod, and the augmentation sizer is coaxially aligned with the dial checker and is aligned with the first axis.
  • the augmentation sizer includes a rotor that has a substantially flat contact surface on one surface and can rotate about the first axis on the disk, and a leg extending from one side of the rotor, By allowing the endpoint of the leg to contact the bone and at the same time the contact surface of the rotor to contact one surface of the disc, a defect measuring device is provided that can accurately determine the amount of bone defect.
  • the object of the present invention is that the disc includes an indicator displayed on one side that does not face the bone to enable the direction to be determined, and the direction in which the leg of the augmentation sizer faces is indicated by the indicator so that the surgeon can see the exact bone with the naked eye.
  • the goal is to provide a defect measuring device that can determine the direction of the defect.
  • the purpose of the present invention is to provide a defect measuring device that can more easily determine the direction of the defect along with an augmentation sizer, including a disk body whose outer peripheral surface alternately protrudes and recesses.
  • the object of the present invention is that the disc further includes at least one alignment hole formed penetrating the disc, and the alignment hole is a long hole extending up and down, so that the insertion position of the defect measuring device is determined based on the landmark marked on the glenoid.
  • the goal is to provide a defect measurement device that can be aligned.
  • the purpose of the present invention is to provide a defect measuring device in which the disc includes at least one spike protruding on one surface facing the bone, thereby increasing the fixing force to the glenoid.
  • An object of the present invention further includes a sizer handle for accommodating at least a portion of the rod and the augment sizer, wherein the sizer handle includes a through hole for penetrating and receiving the rod, and an accommodating space therein to form an accommodating space for the augment sizer.
  • the purpose is to provide a defect measuring device that allows for easy work by including an accommodating portion that accommodates a portion, an augment sizer, and a sizer handle so that they can rotate around a first axis.
  • the purpose of the present invention is to allow the dial checker to have a hollow hole to penetrate and accommodate a guide pin inserted into the bone and extending in the first axis direction, so that the amount and direction of the defect can be confirmed without removing the guide pin inserted into the glenoid. It provides a device for measuring defects.
  • the object of the present invention is to determine the insertion position of the reaming guide by at least temporarily engaging a reaming guide that is inserted into the bone and guides the cutting of the bone, and the direction in which a portion of the reaming guide faces when the reaming guide is inserted into the bone.
  • a reaming guide holder that aligns the insertion position of the reaming guide and inserts it into the glenoid fossa, including an insertion position determining part that determines and a fastening part that is at least temporarily fastened to the reaming guide.
  • An object of the present invention is to include a body at least partially extending in a first axis direction, an alignment portion for aligning the insertion position of the reaming guide on one side of the body, and the alignment portion having a corresponding indicator on one side radially.
  • a reaming guide holder capable of aligning the insertion position of the reaming guide according to the direction of the bone defect by being displayed or formed as.
  • the object of the present invention is to include a disk formed to have a predetermined thickness, a plurality of receiving grooves recessed into the outer peripheral surface of the disk, and a corresponding indicator corresponding to the number of the receiving grooves is a portion where the receiving grooves are formed. It provides a reaming guide holder that can align the insertion direction of the reaming guide by rotating the reaming guide holder in the correct direction by displaying it in correspondence with .
  • An object of the present invention further includes an alignment leg extending from one side of the body, the alignment leg having a leg that is divided into two while forming a gap in the middle, and a bent portion that is bent and extended from one end of the leg to ream the gap.
  • the aim is to provide a reaming guide holder that can temporarily fasten to the reaming guide and guide the insertion of the reaming guide by accommodating part of the guide.
  • An object of the present invention is to provide a reaming guide holder that further includes a fixing leg that prevents the reaming guide from rotating with respect to the reaming guide holder, and the fixing leg extends from one side of the body and forms a pin at an end.
  • An object of the present invention further includes a screw driver coaxially aligned with the insertion position determining portion and the fastening portion, wherein the screw driver protrudes beyond one end of the fastening portion when the screw driver moves forward and is accommodated within the fastening portion when the screw driver moves backward. It provides a reaming guide holder that allows multiple operations with one surgical instrument, including a tip.
  • An object of the present invention is a base plate holder that is temporarily fastened to a partially reinforced glenoid base plate to determine an insertion position of the base plate and is inserted into a bone, comprising: a body at least partially extending in a first axis direction; A base plate that aligns the insertion position of a partially reinforced base plate and inserts it into the glenoid, including an insertion end at least partially inserted into the base plate on one side and an alignment portion provided on the other side of the body to align the insertion position of the base plate.
  • a holder is provided.
  • the purpose of the present invention is to accurately align the base plate holder by ensuring that the alignment portion includes a disk formed to have a predetermined thickness, a plurality of receiving grooves recessed into the outer peripheral surface of the disk, and a corresponding indicator displayed or formed radially on one surface of the disk.
  • the alignment portion includes a disk formed to have a predetermined thickness, a plurality of receiving grooves recessed into the outer peripheral surface of the disk, and a corresponding indicator displayed or formed radially on one surface of the disk.
  • the purpose of the present invention is to provide a base plate holder in which a number of corresponding indicators corresponding to the number of receiving grooves is displayed corresponding to the portion where the receiving grooves are formed.
  • the purpose of the present invention is to ensure that the base plate is installed correctly by having the insertion end include an insertion protrusion that protrudes from the insertion end and is inserted into the base plate, and an insertion indicator displayed to indicate the fastening direction of the base plate and the base plate holder.
  • the aim is to provide a base plate holder that can be fastened by a method.
  • An object of the present invention further includes a fastening auxiliary part that assists fastening between a base plate and a base plate holder, wherein the fastening auxiliary part includes an auxiliary protrusion inserted into the base plate together with the insertion protrusion, and a rotating body at least a portion of which is exposed to the outside of the body. , to provide a base plate holder with increased fastening force with the base plate by including a connecting rod that connects the rotating body and the auxiliary protrusion and transmits rotational force to the auxiliary protrusion.
  • the purpose of the present invention includes a defect measurement step of confirming the direction and amount of defect of the defective portion of the joint fossa with respect to the first surface, and the defect measurement step is performed between augments provided to measure the depth of the defect.
  • the augmentation sizer placement step of measuring the distance in the first axis direction from the center of the glenoid to the lowest point of the glenoid defect
  • the defect direction checking step of measuring the direction in which the lowest point was formed based on the center of the glenoid fossa.
  • the goal is to provide a glenoid base plate insertion method that can accurately determine the amount and direction of bone defect in the glenoid bone.
  • the purpose of the present invention is to measure the distance in the first axis direction from the first surface to the lowest point of the glenoid defect through an augment sizer provided to measure the depth of the defect. It provides a glenoid base plate insertion method that can determine the amount and direction of bone defect in the defect area with a single surgical instrument, including a placement step and a defect direction checking step of measuring the direction in which the lowest point is formed based on the central part of the glenoid fossa. .
  • the defect measuring step includes a dial checker placement step of disposing a dial checker indicating a direction based on the central portion of the glenoid fossa on the glenoid before the augment sizer placement step, and the defect direction.
  • the direction in which the part of the augmentation sizer in contact with the lowest point faces on the dial checker is determined as the direction in which the lowest point is formed, so that the surgeon can quickly and clearly recognize in what direction from the center of the glenoid the lowest point of the glenoid fossa is formed. It provides a base plate insertion method.
  • the purpose of the present invention is to place the augment sizer in such a way that a portion of the augment sizer is in contact with the lowest point and at the same time, one surface of the augment sizer is in contact with one surface of the dial checker. It provides a glenoid base plate insertion method that allows the use of an appropriate augment sizer according to the amount of bone defect by placing it on the bone defect.
  • the object of the present invention further includes a reaming guide insertion step of inserting a reaming guide for guiding cutting of the glenoid fossa into the glenoid fossa, wherein the reaming guide insertion step includes a reaming guide fastening step of fastening the reaming guide to the reaming guide holder, and the reaming guide insertion step of inserting the reaming guide into the glenoid fossa.
  • Cutting of the joint fossa including a reference indicator fastening step of connecting a reference indicator to one side of the guide holder, and a direction alignment step of aligning the insertion position of the reaming guide fastened to the reaming guide holder by moving the reference indicator to a first position.
  • the goal is to provide a glenoid base plate insertion method that can clearly guide the.
  • the dial checker includes an indicator displayed or formed on one side so as to be able to determine the direction, and in the step of fastening the reference indicator, the reaming guide guides the reference indicator in the direction indicated by the indicator identified in the step of checking the defect direction. It provides a glenoid base plate insertion method that allows the reaming guide to be inserted into the glenoid fossa in the direction of the measured glenoid bone defect by inserting it into the holder.
  • the purpose of the present invention is to perform the direction alignment step by aligning the reference indicator and the reaming guide holder around the first axis so that one end of the reference indicator is directed downward while the reaming guide holder accommodating the reference indicator is located on the first axis.
  • By rotating it provides a glenoid base plate insertion method in which the surgeon aligns the insertion position of the reaming guide according to accurate standards without having to guess the direction of the defect.
  • An object of the present invention further includes a base plate insertion step of inserting a partially reinforced base plate into the glenoid, wherein the base plate insertion step includes a base plate fastening step of fastening the partially reinforced base plate to a base plate holder, A reference indicator fastening step of connecting a reference indicator to one side of the base plate holder, an alignment insertion step of aligning the insertion position of the base plate fastened to the base plate holder and inserting the base plate by moving the reference indicator to a first position.
  • the aim is to provide a glenoid base plate insertion method that can simply and accurately insert a partially reinforced base plate into the glenoid.
  • the present invention is implemented by an embodiment having the following configuration.
  • the present invention provides a dial checker that is at least temporarily fixed to the bone while at least a portion faces the surface of the bone, and is disposed on one side of the dial checker to direct the defected portion from the center of the bone. and an augment sizer that checks the amount of defects.
  • the dial checker includes a rod extending in a first axis direction and a disk extending at least radially from one side of the rod, and the augmentation sizer is coaxially aligned with the dial checker. It is characterized by being provided so that one end can contact the lowest point of the bone while rotating about one axis.
  • the augment sizer includes a rotor that has a substantially flat contact surface on one surface and is capable of rotating about the first axis on the disk, and a leg extending from one side of the rotor. It is characterized in that the end point of the leg touches the bone and at the same time, the contact surface of the rotor contacts one surface of the disc.
  • the disc includes an indicator displayed on one side that does not face the bone to help determine the direction, and the direction in which the leg of the augmentation sizer faces is indicated by the indicator. Do it as
  • the disk is characterized in that it includes a disk body whose outer peripheral surface is alternately protruded and recessed.
  • the disk further includes at least one alignment hole formed penetrating the disk, and the alignment hole is characterized as a long hole extending up and down.
  • the disc is characterized in that it further includes at least one spike protruding on one surface facing the bone.
  • the present invention further includes a sizer handle accommodating at least a portion of the rod and the augmentation sizer, wherein the sizer handle has a through hole for penetrating and accommodating the rod, and forms an accommodating space therein. It is characterized in that the augment sizer and the sizer handle, including a receiving portion that accommodates a part of the augment sizer, are provided so that they can rotate about the first axis.
  • the dial checker is characterized by having a hollow hole to accommodate a guide pin inserted into the bone and extending in the first axis direction.
  • the present invention is at least temporarily engaged with a reaming guide that is inserted into the bone and guides the cutting of the bone to determine the insertion position of the reaming guide, and when the reaming guide is inserted into the bone, It is characterized by comprising an insertion position determining part that determines the direction in which a portion of the reaming guide faces, and a fastening part that is at least temporarily fastened to the reaming guide.
  • the insertion position determination unit includes a body at least partially extending in the first axis direction, an alignment unit for aligning the insertion position of the reaming guide on one side of the body, and the alignment unit is on one side. It is characterized in that the corresponding indicator is displayed or formed radially.
  • the alignment unit includes a disk formed to have a predetermined thickness, a plurality of receiving grooves recessed into the outer peripheral surface of the disk, and a number of corresponding indicators corresponding to the number of the receiving grooves are accommodated. It is characterized in that it is displayed corresponding to the portion where the groove is formed.
  • it further includes an alignment leg extending from one side of the body,
  • the alignment leg is characterized in that it has a leg that is divided into two while forming a gap in the middle, and a bent portion that is bent and extended from one end of the leg to accommodate a part of the reaming guide in the gap.
  • the reaming guide further includes a fixing leg that prevents the reaming guide from rotating with respect to the reaming guide holder, and the fixing leg extends from one side of the body and forms a pin at the end. .
  • it further includes a screw driver coaxially aligned with the insertion position determining part and the fastening part, wherein the screw driver protrudes beyond one end of the fastening part when the screw driver moves forward, and when the screw driver moves forward, the screw driver protrudes beyond one end of the fastening part. It is characterized by including a tip accommodated within the fastening portion.
  • the present invention is a base plate holder that is temporarily fastened to a partially reinforced glenoid base plate to determine the insertion position of the base plate and inserted into the bone, at least a portion of which is oriented in the first axis direction. It is characterized by comprising an extending body, an insertion end at least partially inserted into the base plate on one side of the body, and an alignment portion provided on the other side of the body to align the insertion position of the base plate.
  • the alignment portion includes a disk formed to have a predetermined thickness, a plurality of receiving grooves recessed into the outer peripheral surface of the disk, and a corresponding indicator displayed or formed radially on one surface of the disk.
  • a number of corresponding indicators corresponding to the number of the receiving grooves is displayed in correspondence with the portion where the receiving grooves are formed.
  • the insertion end includes an insertion protrusion that protrudes from the insertion end and is inserted into the base plate, and an insertion indicator displayed to indicate the fastening direction of the base plate and the base plate holder. It is characterized by
  • the present invention further includes a fastening auxiliary part that assists fastening between the base plate and the base plate holder, and the fastening auxiliary part has an auxiliary protrusion inserted into the base plate together with the insertion protrusion, at least a portion of which is outside the body. It is characterized by comprising an exposed rotating body and a connecting rod that connects the rotating body and the auxiliary protrusion to transmit rotational force to the auxiliary protrusion.
  • the present invention includes a defect measurement step of confirming the direction and amount of defect of the defective portion of the glenoid with respect to the first surface, and the defect measurement step is provided to measure the depth of the defect.
  • Augment sizer placement step of measuring the distance in the first axis direction from the central part of the glenoid to the lowest point of the glenoid defect using the augment sizer, measuring the direction in which the lowest point was formed based on the central part of the glenoid fossa. It is characterized by including a direction checking step.
  • the defect measuring step includes a dial checker placement step of placing a dial checker indicating a direction based on the central portion of the glenoid fossa on the glenoid before the augmentation sizer placement step; ,
  • the defect direction checking step is characterized in that the direction in which the portion of the augmentation sizer in contact with the lowest point faces on the dial checker is determined as the direction in which the lowest point was formed.
  • a portion of the augmentation sizer is in contact with the lowest point, and at the same time, one surface of the augmentation sizer is in contact with one surface of the dial checker. characterized in that it is disposed on the dial checker.
  • a reaming guide insertion step of inserting a reaming guide for guiding cutting of the glenoid fossa into the glenoid fossa wherein the reaming guide insertion step includes fastening the reaming guide to the reaming guide holder.
  • the dial checker includes an indicator displayed or formed on one side so as to be able to determine the direction, and the reference indicator fastening step indicates that the reference indicator is indicated by an indicator confirmed in the defect direction checking step. It is characterized by inserting it into the reaming guide holder in one direction.
  • the direction alignment step is performed by aligning the reference indicator and the reaming guide holder so that one end of the reference indicator is directed downward, with the reaming guide holder accommodating the reference indicator located on the first axis. It is characterized by rotating around one axis.
  • the present invention further includes a base plate insertion step of inserting the partially reinforced base plate into the glenoid, and the base plate insertion step includes fastening the partially reinforced base plate to the base plate holder.
  • the present invention can achieve the following effects by combining the above-mentioned embodiment with the configuration, combination, and use relationship described below.
  • the present invention relates to a dial checker that is at least temporarily fixed to the bone while at least part of it faces the surface of the bone, and an augment that is disposed on one side of the dial checker and checks the direction and amount of the defect from the central part of the bone.
  • an augment that is disposed on one side of the dial checker and checks the direction and amount of the defect from the central part of the bone.
  • the dial checker includes a rod extending in a first axis direction and a disk extending at least radially from one side of the rod, and the augmentation sizer is coaxially aligned with the dial checker and rotates about the first axis.
  • the augmentation sizer includes a rotor having a substantially flat contact surface on one surface and rotatable about the first axis on the disk, a leg extending from one side of the rotor, and the leg
  • the exact amount of bone defect can be determined by having the endpoint of the rotor contact the bone and at the same time the contact surface of the rotor contact one surface of the disc.
  • the disc includes an indicator displayed on one side that does not face the bone to enable the direction to be determined, and the direction in which the leg of the augmentation sizer faces is indicated by the indicator so that the surgeon can accurately determine the bone defect with the naked eye. You can figure out the direction.
  • the disc includes a disc body whose outer peripheral surface is alternately protruded and recessed, so that the direction of the defect can be more easily determined with the augmentation sizer.
  • the disc further includes at least one alignment hole formed penetrating the disc, and the alignment hole is a long hole extending up and down to align the insertion position of the defect measuring device based on a landmark displayed on the glenoid. This is possible.
  • the disc includes at least one spike protruding on one surface facing the bone, thereby increasing the fixing force to the glenoid fossa.
  • the present invention further includes a sizer handle for accommodating at least a portion of the rod and the augmentation sizer, wherein the sizer handle includes a through hole for penetrating and receiving the rod, and a portion of the augmentation sizer while forming a receiving space therein.
  • the augmentation sizer and the sizer handle including a receiving part that accommodates, are provided so that they can rotate around the first axis.
  • the dial checker has a hollow hole to accommodate a guide pin inserted into the bone and extending in the first axis direction, so that the amount and direction of the defect can be confirmed without removing the guide pin inserted into the glenoid.
  • the present invention is at least temporarily engaged with a reaming guide that is inserted into the bone and guides the cutting of the bone to determine the insertion position of the reaming guide, and determines the direction in which a portion of the reaming guide faces when the reaming guide is inserted into the bone. Aligning the insertion position of the reaming guide, including an insertion position determining part and a fastening part that is at least temporarily fastened to the reaming guide, allows the reaming guide to be inserted into the glenoid fossa.
  • the insertion position determination unit includes a body at least partially extending in the first axis direction, an alignment unit for aligning the insertion position of the reaming guide on one side of the body, and the alignment unit has a corresponding indicator radially on one side. By marking or forming it, it is possible to align the insertion position of the reaming guide according to the direction of the bone defect.
  • the alignment portion includes a disk formed to have a predetermined thickness, a plurality of receiving grooves recessed into the outer peripheral surface of the disk, and a number of corresponding indicators corresponding to the number of the receiving grooves is placed on the portion where the receiving grooves are formed.
  • the present invention further includes an alignment leg extending from one side of the body, wherein the alignment leg is divided into two legs forming a gap in the middle, and has a bent portion bent and extended from one end of the leg, and a reaming guide in the gap.
  • the present invention further includes a fixing leg that prevents the reaming guide from rotating with respect to the reaming guide holder, and the fixing leg extends from one side of the body and has the effect of providing a reaming guide holder forming a pin at the end. .
  • the present invention further includes a screw driver coaxially aligned with the insertion position determination part and the fastening part, wherein the screw driver protrudes beyond one end of the fastening part when the screw driver moves forward and is accommodated in the fastening part when the screw driver moves backward.
  • a screw driver coaxially aligned with the insertion position determination part and the fastening part, wherein the screw driver protrudes beyond one end of the fastening part when the screw driver moves forward and is accommodated in the fastening part when the screw driver moves backward.
  • the present invention is a base plate holder that is temporarily fastened to a partially reinforced glenoid base plate to determine the insertion position of the base plate and is inserted into the bone, comprising: a body at least partially extending in a first axis direction; one side of the body; A base plate holder that aligns the insertion position of the partially reinforced base plate and inserts it into the glenoid, including an insertion end at least partially inserted into the base plate and an alignment portion provided on the other side of the body to align the insertion position of the base plate.
  • the alignment portion includes a disk formed to have a predetermined thickness, a plurality of receiving grooves recessed into the outer peripheral surface of the disk, and a corresponding indicator displayed or formed radially on one surface of the disk to accurately orient the base plate holder. You can align the insertion direction of the base plate by rotating it.
  • the present invention has the effect of providing a base plate holder in which a number of corresponding indicators corresponding to the number of receiving grooves is displayed in correspondence with the portion where the receiving grooves are formed.
  • the present invention provides a correct method of inserting the base plate by ensuring that the insertion end includes an insertion protrusion that protrudes from the insertion end and is inserted into the base plate, and an insertion indicator displayed to indicate the fastening direction of the base plate and the base plate holder. It can be concluded with
  • the present invention further includes a fastening auxiliary part that assists fastening between a base plate and a base plate holder, wherein the fastening auxiliary part includes an auxiliary protrusion inserted into the base plate together with the insertion protrusion, a rotating body at least a portion of which is exposed to the outside of the body, By including a connecting rod that connects the rotating body and the auxiliary protrusion and transmits rotational force to the auxiliary protrusion, the fastening force with the base plate is increased.
  • the present invention includes a defect measurement step of confirming the direction and amount of defect of the defective portion of the joint fossa based on the first surface, and the defect measurement step includes an augmentation sizer provided to measure the depth of the defect. It includes an augment sizer placement step of measuring the distance in the first axis direction from the central part of the glenoid to the lowest point of the glenoid defect, and a defect direction checking step of measuring the direction in which the lowest point is formed based on the central part of the glenoid. Only then can the amount and direction of bone defect in the joint fossa be accurately identified.
  • the defect measuring step includes arranging an augment sizer to measure the distance in the first axis direction from the first surface to the lowest point of the glenoid defect through an augment sizer provided to measure the depth of the defect.
  • the defect measurement step includes a dial checker placement step of placing a dial checker indicating a direction based on the central portion of the glenoid fossa on the glenoid before the augment sizer placement step, and checking the defect direction.
  • the direction in which the part of the augmentation sizer in contact with the lowest point faces on the dial checker is determined as the direction in which the lowest point is formed, so that the surgeon can quickly and clearly recognize in what direction from the center of the glenoid the lowest point of the glenoid fossa is formed.
  • the augmentation sizer arrangement step includes placing the augmentation sizer in which a portion of the augmentation sizer is in contact with the lowest point and at the same time, one surface of the augmentation sizer is in contact with one surface of the dial checker. By placing it in , it is possible to use an appropriate augment sizer depending on the amount of bone defect.
  • the present invention further includes a reaming guide insertion step of inserting a reaming guide for guiding cutting of the glenoid fossa into the glenoid fossa, wherein the reaming guide insertion step includes a reaming guide fastening step of fastening the reaming guide to a reaming guide holder, the reaming guide Cutting of the joint fossa, including a reference indicator fastening step of connecting the reference indicator to one side of the holder, and a direction alignment step of aligning the insertion position of the reaming guide fastened to the reaming guide holder by moving the reference indicator to the first position.
  • the reaming guide insertion step includes a reaming guide fastening step of fastening the reaming guide to a reaming guide holder, the reaming guide Cutting of the joint fossa, including a reference indicator fastening step of connecting the reference indicator to one side of the holder, and
  • the dial checker includes an indicator displayed or formed on one side so as to be able to determine the direction, and in the step of fastening the reference indicator, the reaming guide holder moves the reference indicator in the direction indicated by the indicator identified in the step of checking the defect direction. By inserting it into the glenoid, the reaming guide can be inserted into the glenoid in the direction of the glenoid bone defect measured.
  • the direction alignment step is performed by rotating the reference indicator and the reaming guide holder about the first axis so that one end of the reference indicator is directed downward while the reaming guide holder in which the reference indicator is accommodated is located on the first axis.
  • the present invention further includes a base plate insertion step of inserting the base plate into the glenoid, wherein the base plate insertion step includes a base plate fastening step of fastening the partially reinforced base plate to the base plate holder, and one of the base plate holders.
  • a part including a reference indicator fastening step of connecting a reference indicator to the side, an alignment insertion step of aligning the insertion position of the base plate fastened to the base plate holder by moving the reference indicator to the first position and inserting the base plate.
  • the reinforced base plate can be inserted into the glenoid simply and accurately.
  • Figure 1 is a perspective view showing the glenoid base plate being inserted into the scapula.
  • Figure 2 is a view showing a glenoid base plate according to the prior art.
  • Figures 3 and 4 are diagrams illustrating seating the glenoid base plate according to the prior art into the glenoid where a bone defect has occurred.
  • Figure 5 is a perspective view of a partially reinforced (fully wedged) glenoid base plate (B).
  • Figure 6 is a cross-sectional view of the partially reinforced glenoid base plate (B)
  • Figure 7 is a perspective view of a partially reinforced (half wedged) glenoid base plate (C).
  • Figure 8 is a view showing landmarks displayed in the shape of a cross on the glenoid according to an embodiment of the present invention.
  • FIGS. 9 and 10 are diagrams showing the insertion of the guide pin 110 into the glenoid fossa according to an embodiment of the present invention.
  • Figure 11 is a perspective view of the guide handle 200 according to an embodiment of the present invention.
  • Figure 12 is a perspective view of a defect measuring instrument 300 according to an embodiment of the present invention.
  • Figure 13 is an exploded perspective view of the defect measuring instrument 300 according to an embodiment of the present invention.
  • Figure 14 is a view showing that the augmentation sizer 330 according to an embodiment of the present invention is in contact with the lowest point (L) of the glenoid fossa.
  • Figure 15 is a view showing a state in which the dial checker 310 according to an embodiment of the present invention is at least temporarily fixed on the glenoid.
  • Figure 16 is a view showing the size checker 370 according to an embodiment of the present invention approaching the glenoid fossa (G) and contacting the lowest point (L).
  • Figure 17 is an exploded perspective view of the size checker 370 and the sizer handle 350 according to an embodiment of the present invention.
  • Figure 18 is an exploded perspective view of the reaming guide 400 according to an embodiment of the present invention.
  • Figure 19 is a cross-sectional view of the reaming guide 400 according to an embodiment of the present invention.
  • Figure 20 is a view showing the reaming guide 400 inserted into the glenoid
  • Figure 21 is a view showing inserting the reaming guide 500 into the glenoid while the reference indicator (guide handle, 200) is fastened to the reaming guide holder 600 according to a preferred embodiment of the present invention.
  • Figure 22 is an exploded perspective view of the reaming guide holder 600 and the reaming guide 500 according to an embodiment of the present invention.
  • Figure 23 is a cross-sectional view of the reaming guide 500 according to an embodiment of the present invention.
  • Figure 24 is a view showing the reaming guide 500 inserted into the glenoid
  • Figure 25 is a perspective view of the reaming guide 500 according to an embodiment of the present invention.
  • Figure 26 is a perspective view of the reaming guide 500 according to another embodiment of the present invention.
  • Figure 27 is a view showing the screw driver 700 being fastened to the reaming guide 500 according to an embodiment of the present invention.
  • Figure 28 is an exploded perspective view of the screw driver 700 and the reaming guide 500
  • Figure 29 is a perspective view of the reaming guide holder 800 and the reaming guide 500 according to another embodiment of the present invention.
  • Figure 30 is an exploded perspective view of the reaming guide holder 800
  • Figure 31 shows that the screw driver 850 of the reaming guide holder 800 moves forward and backward within the fastening part 830 so that the tip 853 of the screw driver 850 is hidden or exposed within the fastening end 833.
  • Figure 32 is an exploded perspective view of the reaming guide holder 900 and the reaming guide 500 according to another embodiment of the present invention.
  • Figure 33 is a view showing inserting the partially reinforced base plate (B) into the glenoid while the reference indicator (guide handle, 200) is fastened to the base plate holder 1200 according to an embodiment of the present invention.
  • 34 is an enlarged view of a portion of the base plate holder 1200.
  • Figure 35 is a flow chart of the glenoid base plate insertion method (S) according to an embodiment of the present invention.
  • Figure 36 is a flow chart of the defect measurement step (S40) according to an embodiment of the present invention.
  • Figure 37 is a flow chart of the reaming guide insertion step (S50) according to an embodiment of the present invention.
  • Figure 38 is a flow chart of the base plate insertion step (S80) according to an embodiment of the present invention.
  • the base plates (B, C) refer to the glenoid base plate that is partially reinforced (full wedged, half wedged) as described above, and an augmentation to compensate for the bone defect of the glenoid is formed in a portion.
  • landmarks may be displayed in the shape of a cross on the glenoid (G) along the anterior and posterior and superior and inferior directions.
  • the guide pin 110 is inserted into the central part of the landmark.
  • the center guide 120 can be used to insert the guide pin 110, and the guide handle 200 After supporting the center guide 120, the guide pin 110 may be inserted through the hole formed in the center guide 120.
  • the guide pin 110 has a pin 111 extending in one direction and a sharply formed end 113, and the end 113 is inserted into the center of the glenoid fossa (G).
  • the direction in which the guide pin 110 is inserted may be defined as the first axis.
  • the guide handle 200 is a device that assists in supporting or manipulating the center guide 120 and/or other surgical instruments, and the end is received and fastened to a groove or receiving portion of another surgical instrument. As a result, the surgeon can manipulate and move the surgical instrument coupled to the guide handle 200.
  • the guide handle 200 may have substantially the same configuration as the reference indicator described later.
  • the guide handle 200 may include a body 210 extending to one side and a receiving portion 230 accommodated in a surgical instrument.
  • the body 210 is preferably extended to a predetermined length so that it is easy for the surgeon to hold, and the end opposite to the receiving portion 230 is formed flat to facilitate impacting.
  • the body 210 is formed with a long hole 210a penetrating from one side to the other side along an extending axis, and landmarks displayed on the glenoid can be confirmed through the long hole 210a.
  • the receiving portion 230 is configured to be accommodated in a groove of a surgical instrument, etc. at one end of the body 210 and then fastened.
  • the receiving portion 230 may be formed with a smaller diameter than the body 210 .
  • the receiving portion 230 has an overall cylindrical shape, but has a substantially circular shape, and a protrusion 231a protruding to one side is provided at the tip portion 231, which constitutes the endpoint of the receiving portion with the gap 233 interposed therebetween.
  • the gap 233 is formed along an axis along which the body extends from the distal end 231, so that the gap 233 between the distal ends 231 can be reduced and then increased by an external force.
  • a protruding step 235 may be formed along the outer circumferential surface at a predetermined distance away from the distal end, and a portion of the step 235 may be provided with a protrusion 235a protruding toward the other side.
  • the protrusion 231a formed on the tip 231 and the protrusion 235a formed on the step 235 may protrude in opposite directions.
  • the glenoid fossa (G) may be primarily reamed by a first reamer (not shown).
  • the first reamer is a surgical instrument that extends flatly perpendicular to the first axis along the guide pin 110 inserted into the glenoid (G) or reams the first surface, which is a concave curved surface centered on the first axis.
  • the first surface is extended flatly perpendicular to the first axis (X1) or is a concave curved surface centered on the first axis. forms.
  • a recess (H) with a larger diameter than the guide pin may be formed in the glenoid.
  • the surgeon may form a recess by reaming the glenoid while approaching the glenoid along the first axis so that the boss cutter on which the stopper is seated or the boss cutter provided integrally with the stopper can accommodate the guide pin 110.
  • the defect measuring device 300 is an instrument that measures the amount of bone defect in the glenoid fossa and in what direction the defect is located, preferably based on the reamed first surface or the center portion of the glenoid fossa. You can check the direction and amount of the defect. When a portion of the glenoid fossa is missing, a lowest point (L) may exist in a predetermined direction based on the center of the glenoid even after reaming to form the first surface on the glenoid. The defect measuring device 300 can check the amount of bone defect in the glenoid fossa and the direction of the defected part based on the lowest point (L).
  • the dial checker 310 is a component that can indicate the direction of another component seated or overlapping on the dial checker, and is at least temporarily fixed to the glenoid (G) so that the direction of a portion of the augment sizer, which will be described later, is clearly known. make it possible
  • the dial checker 310 has a hollow 310a to penetrate and receive the guide pin 110, approaches the curved surface of the glenoid G, and is aligned as described later. A portion may be temporarily fixed while facing the glenoid fossa.
  • the disk 313 is a configuration that substantially has a direction.
  • 'having a direction' means that it is not a rotating body with the first axis as the rotation axis, and has the shape of a rotating body with the first axis as the rotation axis. This means that even if it has a symmetrical shape with respect to the first axis, the direction in which at least part of the structure faces is substantially distinct. That is, the actual direction of the disk 313 can be determined according to rotation about the first axis, and a predetermined insertion position can be determined or recognized.
  • the disk 313 enables recognition and/or confirmation of the direction of components seated or overlapping on the disk.
  • the disk 313 may include a disk body 3131, an indicator 3133, a spike 3135, and an alignment hole 3137.
  • the disk body 3131 is a portion that extends radially at least in part with respect to the rod 311, and may have a curved or flat surface in which one side is substantially flat and the other side is convex.
  • the disc body 3131 may have a flat surface when the first surface of the glenoid (G) or bone is reamed to a flat surface, and when the first surface is reamed to a concave curved surface, the other surface may have a convex curved surface.
  • the disk body 3131 may have a flat surface on the rod 311 side and a convex curved or flat surface on the insertion portion 315 side.
  • the convex curved surface of the disk body 3131 may protrude around the first axis, which is the extension direction of the rod.
  • the curvature of the convex surface of the disc body 3131 may also vary. Accordingly, a plurality of dial checkers 310 including disk bodies 3131 having different curvatures may be prepared.
  • the outer peripheral surface of the disk body 3131 may be alternately protruded and recessed to facilitate direction confirmation.
  • the disk body 3131 may be formed radially with 12 protrusions having a central angle of 30 degrees with respect to the center. In other embodiments, fewer than 12 or more than 12 protrusions, such as 8 or 16, may be formed radially. It is enough for the outer peripheral surface of the disk body 3131 to be configured so that it is easy to check the direction in which the components on the disk 313 are facing.
  • grooves extending radially from the center are formed on the disk body 3131. A configuration formed in can also be adopted.
  • the indicator 3133 is displayed on one side of the disk body 3133 to determine the direction.
  • the indicator 3133 is preferably displayed on the lateral side of the glenoid, that is, on one side of the disc body 3133 that does not face the glenoid, so that the surgeon can easily read it.
  • the indicators 3133 may be numbers from 1 to 12 and may be displayed on 12 protrusions.
  • the indicator 3133 may use letters indicating directions such as N, S, E, W, etc., and the central angle of a certain part, for example, the superior part from the center of the glenoid, is set to 0 degrees. The central angle may be displayed for each part.
  • the spikes 3135 are provided so that the dial checker 310 can be temporarily fixed on the first surface of the glenoid, and at least one spike 3135 is provided on one surface facing the glenoid of the disc body 3133.
  • a protrusion may be formed on the top.
  • the alignment hole 3137 is at least one through hole penetrating the disk body 3131, and may preferably be a long hole extending up and down.
  • the alignment of the disk 313 or dial checker 310 can be checked through the alignment hole 3137. After the surgeon approaches the dial checker 310 to the glenoid, the surgeon can align the dial checker 310 by aligning the alignment hole 3137 with a cross-shaped landmark displayed on the glenoid. In one embodiment, the insertion position of the dial checker 310 can be aligned so that the landmark displayed in the superior-inferior direction is at the center of the alignment hole 3137.
  • the insertion part 315 is a part inserted into the recess H of the glenoid and, together with the spike 3135, can assist in temporarily fixing the dial checker.
  • the insertion portion 315 extends a predetermined length from the disk 313 toward the glenoid, and has a hollow extension to accommodate the guide pin.
  • the augmentation sizer 330 is configured to measure the depth and direction of the defect. It is coaxially aligned with the dial checker 310 and rotates about the first axis while rotating about the first axis or the central part of the glenoid. Makes it possible to recognize the direction of the lowest point.
  • the augmentation sizer 330 has a through hole 330a that penetrates and accommodates the rod 311 so that it can rotate about the first axis, and can rotate on the disk 313.
  • the augmentation sizer 330 may include a rotor 331, legs 333, and a receiving head 335.
  • the rotor 331 is configured to rotate about the rod 311, that is, the first axis, on the disk 313, has a substantially flat contact surface on one surface, and is in contact with the disk body 3131 in a preferred embodiment. can do. As the rotor 331 rotates on the disk, the disk body 3131 faces the glenoid on one side and the rotor 331 on the other side.
  • the leg 333 extends from one side of the rotor 331 to the glenoid side, and in a preferred embodiment, the endpoint 333a of the leg may reach the lowest point. Since the amount of bone defect in the glenoid fossa varies depending on the patient, the distance from the lowest point (L) to the first surface or the distance from the lowest point (L) to the rotor may vary, so a plurality of augmentation sizers with different leg lengths may be provided. there is. The surgeon can rotate the augmentation sizer 330 on the dial checker 310 to check whether the endpoint 333a of the leg reaches the lowest point L.
  • the depth of the lowest point (L) that is, the distance along the first axis direction from the first surface as a curved or flat surface formed in the glenoid fossa to the lowest point (L), can be measured according to the leg length of the augmentation sizer.
  • the receiving head 335 is a part accommodated in the sizer handle 350, and may have a shape corresponding to the receiving space of the sizer handle, which will be described later.
  • the receiving head 335 extends a predetermined length from the rotor 331 to one side, and a portion of the outer peripheral surface may have a curved surface and the other portion may have a flat surface.
  • the central portion of the receiving head 335 may have an extended through hole 330a to accommodate the rod 311.
  • the direction of the defect which is the direction in which the lowest point is formed based on the central part of the glenoid
  • the dial checker 310 may be fixed at least temporarily after approaching the glenoid at a predetermined insertion position, that is, in the direction in which the alignment hole 3137 and the landmark are aligned as described above.
  • the augmentation sizer 330 rotates so that the endpoint 333a of the leg comes into contact with the lowest point L. At this time, the direction the leg 333 is facing can be recognized by the indicator 3133.
  • the sizer handle 350 is configured to easily rotate the augment sizer 330 on the dial checker 310, and accommodates at least a portion of the augment sizer 330 to create an augment sizer ( 330) and the sizer handle 350 may rotate together about the first axis. That is, the sizer handle 350 has a through hole 330a that penetrates and accommodates the rod 311 of the dial checker and can rotate around the rod 311.
  • the sizer handle 350 may include a handle 351, a receiving portion 353, and a receiving cap 355.
  • the handle 351 is hollow and extends to one side, and extends to a length that is easy for the surgeon to grip.
  • the receiving portion 353 can accommodate the receiving head 335 of the augmentation sizer while forming a receiving space 353a therein.
  • the receiving space 353a for accommodating the receiving head 335 of the augmentation sizer 330 is preferably formed so that the augmentation sizer 330 does not rotate independently of the sizer handle 350.
  • the accommodating cap 355 is configured to open and close the accommodating space 353a while slidingly moving to at least one side with respect to the accommodating portion 353.
  • the receiving cap 355 can move forward or backward by sliding in the direction of the first axis. In the forward state, the receiving space is closed to fix the augment sizer 330, and in the backward state, the augment sizer 330 is moved. ) can be removed or replaced.
  • the surgeon When the dial checker 310 is temporarily fixed on the glenoid according to a predetermined insertion position, the surgeon first inserts the receiving head 335 into the receiving space 353a and advances the receiving cap 355 to form the augmentation sizer 330. ) is fixed to the sizer handle 350 and then approached to the glenoid in the first axis direction. At this time, the rod 311 of the dial checker is received through the sizer handle 350 and the augmentation sizer 330. Thereafter, while rotating the augment sizer 330, it is checked whether the end point (333a) of the leg touches the lowest point (L), and at this time, one side of the augment sizer 330 and the rotor 331 is connected to the disk 313.
  • the defect measuring device 300 may further include a size checker 370.
  • the size checker 370 may be provided to check the amount of bone defect in the glenoid fossa, and similarly to the augmentation sizer 330, it can check the amount of bone defect in the glenoid fossa.
  • the size checker is placed on the glenoid so that a portion of the size checker 370 contacts the lowest point (L) of the glenoid and the glenoid, thereby confirming the amount of bone defect in the glenoid.
  • the size checker 370 may be coaxially aligned with the guide pin 110 and may have a through hole for receiving the guide pin 110 so that it can rotate about the first axis.
  • the size checker 370 may include a rotor 371, a first leg 373, a second leg 375, and a receiving head 377.
  • the rotor 371 is configured to rotate based on the guide pin 110, and one surface may be formed to be substantially flat.
  • the first leg 373 is configured to extend from one side of the rotor 371 to the glenoid side.
  • the endpoint 273a of the first leg can reach an outer part of the curved surface formed on the glenoid. there is.
  • the second leg 375 extends from the other side of the rotor 371 to the glenoid side, and in a preferred embodiment, the endpoint 375a of the second leg can reach the lowest point (L) of the glenoid. Since the amount of bone defect in the glenoid fossa varies depending on the patient, the distance from the lowest point (L) to the center of the glenoid or the distance from the lowest point (L) to the rotor may vary, so a plurality of size checkers with different leg lengths may be provided. .
  • the surgeon rotates the size checker 370 on the glenoid so that the endpoint (373a) of the first leg touches the outer part of the curved surface (F1) formed on the glenoid, and the endpoint (375a) of the second leg touches the lowest point (L). You can check whether it reaches.
  • a size checker with a desirable leg length is used. It can be recognized. Therefore, the depth of the lowest point (L), that is, the amount of bone defect in the glenoid fossa, can be measured according to the leg length of the size checker.
  • the receiving head 377 is a part accommodated in the sizer handle 350, and may have a shape corresponding to the receiving space of the sizer handle described above. In one embodiment, the receiving head 377 extends a predetermined length from the rotor 371 to one side, and a portion of the outer peripheral surface may have a curved surface and the other portion may have a flat surface. The central portion of the receiving head 377 may have an extended through hole to accommodate the guide pin 110.
  • the reaming guide 400 is configured to guide reaming the second surface of the glenoid (G), and provides a guide for reaming the second surface suitable for the amount and direction of bone defect of the glenoid (G).
  • the amount of defect of the glenoid (G) may correspond to the distance in the first axis direction from the first surface to the lowest point (L), and the second surface may be reamed at an angle corresponding to the amount of defect.
  • a plurality of reaming guides 400 may be provided according to the amount of glenoid defect measured or confirmed by the defect measuring device 300.
  • the reaming guide 400 can be inserted into the glenoid fossa (G) along the first axis, and at least a portion extends in the direction of a second axis that is not parallel to the first axis to guide reaming of the second surface perpendicular to the second axis.
  • the reaming guide 400 includes a stem 410 extending in the first axis direction, a guide rod 430 extending in the second axis direction, and a fixing part 450 that at least temporarily fixes the reaming guide on the glenoid. can do.
  • the stem 410 has a hollow portion 410a and extends in the direction of the first axis
  • the central portion of the glenoid has a recess (H) formed by a boss cutter (220) centered on the guide pin (110), and at least part or all of the stem (410) is to be inserted into the recess (H).
  • a hollow 410a is formed on the inner peripheral surface of the stem 410, and the hollow 410a may be a cylindrical hole.
  • Parts of the reaming guide holders 600 and 800 and the screw driver 700 which will be described later, can be accommodated in the reaming guide 400 through the hollow.
  • the stem 410 may have a thread 410b formed on the inner peripheral surface of the glenoid side.
  • the head of a screw 480 which will be described later, is fastened to the thread 410b formed on the inner peripheral surface, or a part of the reaming guide holder 600, 800. can be concluded.
  • the guide rod 430 is configured to extend in the direction of the second axis ( You can.
  • the second axis which is the direction in which the guide rod 430 extends, has a predetermined angle r with the first axis.
  • the angle (r) formed by the second axis and the first axis may be 5 degrees to 40 degrees.
  • the angle formed by the second axis with the first axis may be 5 degrees, 10 degrees, 15 degrees, 20 degrees, 25 degrees, 30 degrees, 35 degrees, or 40 degrees.
  • the guide rod 430 may have an end surface facing a hollow 410a formed on the inner peripheral surface of the stem, and the hollow formed by the end surface and the inner peripheral surface of the stem may be a cylindrical hole.
  • the end surface 431 extends from the inner peripheral surface of the stem and may be a part of the inner peripheral surface of the stem that substantially forms a hollow area. While the guide rod 430 extends along the second axis, at least a portion of the end surface 431 may extend along the first axis. Accordingly, a portion of the reaming guide holders 600 and 800 and/or the screw driver 700 may be accommodated in the hollow 410a.
  • the fixing part 450 is configured to at least temporarily fix the reaming guide to the glenoid on one side of the stem or guide rod. It is preferable that the fixing part 450 extends along a direction other than the second axis direction, which is the direction in which the guide rod 430 extends. A portion of the fixing portion 450 may contact the first surface of the glenoid, or at least a portion may be inserted into the first surface, thereby preventing the reaming guide 400 from rotating within the recess (H). there is.
  • the fixing part 450 has a branch 451 extending to one side from the stem or guide rod, and is provided with a spike 453 extending from the branch 451 to the glenoid side, so that the end of the spike is connected to the first surface of the glenoid or It can be touched or inserted into the surrounding area of the joint fossa to increase friction.
  • the fixing portion 450 may have a slot 455 formed to receive a part of another mechanism.
  • the slot 455 may have a portion of a branch formed through a hole.
  • the slot 455 may be a groove formed on a branch.
  • the branch 451 may extend in a direction opposite to the guide rod 430. That is, the branch 451 may extend perpendicular to the stem 410 while extending in a direction opposite to the second axis based on the first axis.
  • a reaming guide lacking the fixing portion 450 may be used.
  • the reaming guide 400 is at least partially accommodated through the stem 410, and a portion may further include a screw 480 inserted into the glenoid fossa.
  • the screw 480 has a thread formed on a portion extending to one side, and a thread is formed on the outer peripheral surface of the head portion so that it can be fastened to a portion of the inner peripheral surface of the stem.
  • the head of the screw 480 may be screwed with a thread 410b formed on the inner peripheral surface of the stem.
  • the screw 480 is not excluded from being provided integrally with the reaming guide 400.
  • the screw 480 has a groove 481 extending to at least one side on the surface of the head, so that the screw 480 can be rotated using a mechanism.
  • the reaming guide 500 is configured to guide the formation of a second surface as a horizontal surface perpendicular to the first axis on the curved surface of the glenoid (G), and is suitable for forming a second surface as a horizontal surface perpendicular to the first axis on the curved surface of the glenoid (G), depending on the amount and direction of bone defect in the glenoid (G).
  • the amount of defect in the glenoid (G) may correspond to the distance along the first axis direction from the center of the glenoid to the lowest point (L), and the horizontal plane is based on the direction from the center of the glenoid to the lowest point (L). Can be reamed.
  • a plurality of reaming guides 500 may be provided according to the amount of glenoid defect measured or confirmed by the defect measuring device 300.
  • the reaming guide 500 can be inserted into the glenoid fossa (G) along the first axis and guides reaming on the second surface as a horizontal plane perpendicular to the first axis.
  • the reaming guide 500 may include a stem 510 extending in the first axis direction, a limit guide 530 protruding from the stem, and a fixing part 550 that at least temporarily fixes the reaming guide on the glenoid. You can.
  • the stem 510 has a hollow portion 510a and extends in the direction of the first axis
  • the central portion of the glenoid has a recess (H) formed by a boss cutter (220) centered on the guide pin (110), and at least part or all of the stem (510) is to be inserted into the recess (H).
  • the stem 510 has a hollow 510a formed on the inner peripheral surface, and the hollow 510a may be a cylindrical hole. Parts of the reaming guide holders 600 and 800 and the screw driver 700, which will be described later, can be accommodated in the reaming guide 500 through the hollow.
  • the stem 510 may have a thread 510b formed on the inner peripheral surface of the glenoid side.
  • the head of a screw 580 which will be described later, is fastened to the thread 510b formed on the inner peripheral surface, or a part of the reaming guide holder 600, 800. can be concluded.
  • the stem 510 can be divided into an upper part 510c and a lower part 510d by a limit guide 530, which will be described later. At least a portion of the upper part 510c is accommodated in the reaming guide holder 600 to at least temporarily fix the reaming guide 500 to the glenoid or to guide the glenoid chamfering device 1100, which will be described later, and the lower part 510d At least a portion may be inserted into the recess (H) formed in the glenoid fossa.
  • the stem 510 includes a first plane 511 extending substantially flat along the first axis, and a second plane 512 opposing the first plane and extending substantially flat along the first axis. do.
  • the stem 510 extends between the first plane and the opposing second plane and further includes a first connection surface 513 and a second connection surface 515, at least partially formed as a curved surface.
  • the first plane 511 and the second plane 512 face each other on both sides of the stem 510 and extend in parallel. As at least a portion of the first plane 511 and the second plane 512 extends flat, a portion of the stem may be guided into the alignment leg 613 of the reaming guide 600, which will be described later.
  • the first connection surface 513 and the second connection surface 515 extend between the opposing first and second planes and connect the first and second planes.
  • the first connection surface 513 may be a curved surface that is convex outward and extends along the first axis direction.
  • a portion of the second connection surface 515 located on the side where the limit guide 530, which will be described later, is formed may be formed as a curved surface that is partially convex outward and extends along the first axis direction, and the other portion may be formed as a flat surface.
  • the second connection surface 515 includes a guide surface 515a and a curved portion 515b.
  • the guide surface 515a may be formed at least partially as a flat plane for interaction with the chamfering mechanism 1100 described later at the upper part 510c, which is the upper part of the limit guide, including a portion of the limit guide 530.
  • the curved portion 515b may extend outward from the lower portion 510d as a convex curved surface.
  • the limit guide 530 protrudes from a predetermined height of the stem 510 and is provided to guide the cutting range of the joint fossa. As shown in FIGS. 24 and 25, the limit guide 530 may be formed to protrude in a direction symmetrical about the first axis at a predetermined height of the stem. Additionally, the limit guide protrudes from one edge of the first and second planes. In one embodiment, the limit guide may be formed to protrude from an edge of one connection surface 515 at a predetermined height of the first and second planes.
  • the stem 510 can be divided into an upper part 510c and a lower part 510d by the limit guide 530, and as described above, the connection surface 515 on the side where the limit guide is formed is substantially flat on the upper side. It may form a guide surface 515a and have a curved portion 515b on the lower side. That is, the limit guide 530 may extend on both sides along the guide surface 515a.
  • the fixing unit 550 is configured to at least temporarily fix the reaming guide to the glenoid on the guide surface or one lower side of the guide surface. A portion of the fixing portion 550 may contact the first surface of the glenoid, or at least a portion may be inserted into the first surface, thereby preventing the reaming guide 500 from rotating within the recess (H). You can.
  • the fixing part 550 has a branch 551 extending from the stem 510 to one side, and is provided with a spike 553 extending from the branch 551 to the glenoid side, so that the end of the spike is connected to the first surface of the glenoid or It can be touched or inserted into the surrounding area of the joint fossa to increase friction.
  • the fixing portion 550 may have a slot 555 formed to receive a part of another mechanism.
  • the slot 555 may have a portion of a branch formed through a hole.
  • the slot 555 may be a groove formed on a branch.
  • the branch 551 may extend from the surface on which the guide surface 515a is formed. That is, the branch 551 may extend perpendicular to the stem 510 while extending from the guide surface 515a.
  • the reaming guide 500 without the fixing part 550 may be used.
  • the reaming guide 500 is at least partially accommodated through the stem 510, and a portion may further include a screw 580 inserted into the glenoid fossa.
  • the screw 580 has a thread formed on a portion extending to one side, and a thread is formed on the outer peripheral surface of the head portion so that it can be fastened to a portion of the inner peripheral surface of the stem.
  • the head of the screw 580 may be screwed with a thread 510b formed on the inner peripheral surface of the stem.
  • the screw 580 is not excluded from being provided integrally with the reaming guide 500.
  • the screw 580 has a groove 581 extending to at least one side on the surface of the head, so that the screw 580 can be rotated using a mechanism.
  • the reaming guide holder 600 holds the reaming guide 500 and aligns the direction while approaching the reaming guides 400 and 500 to the glenoid. This is a configuration that can be inserted.
  • the reaming guide holder 600 approaches the glenoid with the reaming guides 400 and 500 fastened, and the insertion position of the reaming guides 400 and 500 can be determined for second surface reaming as an accurate horizontal plane.
  • the reaming guide holder 600 may include an insertion position determination part 610 that determines the insertion position of the reaming guides 400 and 500, and a fastening part 630 that is at least partially fastened to the reaming guide.
  • the insertion position determination unit 610 can determine the insertion position of the reaming guides 400 and 500. In one embodiment, the insertion position determination unit 610 may determine which direction the guide rod 430 faces when the reaming guide 400 is inserted into the glenoid. In one embodiment, the insertion position determination unit 610 may determine which direction the guide surface 515a faces when the reaming guide 500 is inserted into the glenoid fossa. As described above, the reaming guides 400 and 500 are inserted into the glenoid along the first axis, but if the direction of the reaming guide 500 is not determined, one end of the guide surface 515a or the guide rod 430 is aligned with the first axis. It can be pointed in any direction within a 360-degree range.
  • the insertion position determination unit 610 can determine the insertion position of the reaming guides 400 and 500 along the defect direction recognized by the defect measuring device 300 described above.
  • the insertion position of the reaming guide may be determined so that the second axis and the lowest point (L) are on the same plane as shown in FIG. 20. That is, the first axis (X1), the second axis (X2), and the lowest point (L) may be located on the same plane.
  • the insertion position of the reaming guide may be determined so that the guide surface 515a faces in the opposite direction to the lowest point L, as shown in FIG. 24.
  • the insertion position may be determined so that the limit guides 530 protruding on both sides of the stem are symmetrical with respect to the line from the glenoid center or recess to the lowest point (L).
  • the insertion position determination unit 610 can approach the glenoid (G) with at least a portion of it at least temporarily fastened to the reaming guides 400 and 500, and rotates about the first axis to connect the reaming guides 400 and 500. You can adjust or specify the insertion position.
  • the insertion position determination unit 610 includes a body 611 at least partially extending in the first axis direction, an alignment leg 613 extending from one side of the body 611, and connecting the body 611 and the alignment portion 617. It includes a connecting portion 615 that connects the body 611 and an alignment portion 617 provided on the other side of the body 611.
  • the body 611 extends to at least one side to form the outer shape of the insertion position determining part 610, and may have a hollow interior to accommodate a fastening part 630, which will be described later.
  • the body 611 preferably extends in the first axis direction.
  • the alignment leg 613 is provided to accommodate at least a portion of the reaming guide in the gap 613a and align the direction of the reaming guide.
  • the alignment leg 613 includes a leg 6131 that is divided into two while forming a gap 613a in the middle, and a bent portion 6133 that is bent and extended from one end of the leg 6131.
  • the pair of bent portions 6133 are parallel and accommodate a portion of the reaming guide in the gap 613a between the bent portions 6133.
  • the upper portion 510c of the stem may occupy the gap formed by the alignment leg 613.
  • the first plane 511 and the second plane 512 opposing each other are accommodated between the alignment legs 613 to grip the stem 510 to align the direction of the reaming guide 500.
  • the gap 613a may be occupied by the guide rod 430.
  • a reaming guide lacking the fixing portions 450 and 550 as described above may be used with the reaming guide holder 600 having the alignment leg 613 in one embodiment.
  • the connecting portion 615 connects the body 611 and the alignment portion 617 formed at the other end of the body, and may form a predetermined space therein for smooth rotation of the fastening portion 630, which will be described later.
  • the alignment portion 617 is formed to align the insertion positions of the reaming guides 400 and 500. The surgeon checks the alignment portion 617 and rotates the insertion position determination portion 610 about the first axis. You can do it.
  • the alignment unit 617 may include a disk 6171, a receiving groove 6173, and a corresponding indicator 6175.
  • the disk 6171 is provided in the shape of a plate with a predetermined thickness, and the surface opposite to the joint, that is, the lateral surface, is formed to be substantially flat, so that impacting, etc. can be easily performed.
  • the disk 6171 may be a circular plate or a polygonal plate with a plurality of receiving grooves 6173 formed on the outer peripheral surface.
  • the receiving groove 6173 is a groove provided to accommodate one end of the reference indicator, and is formed recessed into the outer peripheral surface of the disk 6171, so that the reference indicator and the reaming guide holder 600 can be substantially perpendicular.
  • the receiving groove 6173 receives the reference indicator and then determines the insertion position of the reaming guides 400 and 500 together with the reference indicator.
  • the reference indicator may have substantially the same configuration as the guide handle 200.
  • a protruding groove 6173a is formed on one side of the receiving groove 6173 to prevent rotation or falling off, and the protrusion 231a of the guide handle 200 can be accommodated as a reference indicator.
  • the corresponding indicator 6175 is an indicator marked or formed on one side of the disk 6171, and is displayed corresponding to the indicator 3133 formed on one side of the disk body 3131 described above. That is, a corresponding indicator such as the indicator 3133 displayed on the disk checker 310 to determine the direction of the lowest point (L) is displayed radially.
  • the corresponding indicator 6175 may be displayed to correspond to the portion where the receiving groove 6173 is formed, and the number corresponding to the number of receiving grooves 6173 formed on the outer peripheral surface of the disk may be displayed. That is, when 12 corresponding indicators 6175 are displayed at an angle of 30 degrees on one side of the disk 6171, a receiving groove 6173 is formed on the outer peripheral surface corresponding to the portion where the corresponding indicators 6175 are displayed.
  • the surgeon can check the direction of the defect through the defect measuring device 300.
  • the augmentation sizer 330 is placed toward the lowest point on the dial checker 310, it is possible to check which direction the lowest point (L) is by checking the indicator 3133 where the legs 333 overlap.
  • the insertion position determination unit 610 according to an embodiment of the present invention inserts the reference indicator into the receiving groove 6173 marked with the corresponding indicator 6175 corresponding to the indicator 3133 and then moves the reference indicator to the first position.
  • the insertion position of the reaming guide fastened to the reaming guide holder is provided to be aligned.
  • the guide surface 515a of the reaming guide fastened to the reaming guide holder 600 is The direction and lowest point (L) are located in the opposite direction from the center of the glenoid.
  • the guide rod 430 of the reaming guide fastened to the reaming guide holder 600 The extended second axis (X2) and the lowest point (L) of the glenoid are located on the same plane.
  • the surgeon fastens the reference indicator (guide handle, 200) to the receiving groove 6173 marked with the corresponding indicator 6175 corresponding to the direction of the lowest point (L), and then directs the reference indicator in the inferior direction. Move or rotate to position 1. Through this, the insertion positions of the reaming guides 400 and 500 can be aligned. At this time, movement to the first position occurs when the reaming guide holder (600, 800) in which the reference indicator or guide handle 200 is accommodated is located on the first axis, and one end of the reference indicator or guide handle 200 is lower (inferior). ) direction, the reference indicator or guide handle 200 and the reaming guide holders 600 and 800 may be rotated around the first axis.
  • indicators 3133 from 1 to 12 may be displayed on the disk 313 of the dial checker, and 12 or an indicator corresponding to the superior direction is a landmark indicated in the superior direction of the glenoid fossa.
  • the dial checker 310 is arranged so that it corresponds to .
  • the direction of the lowest point (L) is confirmed by a predetermined number or an indicator corresponding to the direction.
  • Corresponding indicators 6175 from 1 to 12 may also be displayed on the disk 617 of the reaming guide holder 600.
  • the fastening part 630 is fastened with at least a part of the reaming guide 500, and preferably, one end of the fastening part 630 is fastened with the threads 410b and 510b formed on the inner peripheral surface of the stems 410 and 510 to achieve reaming.
  • the guides 400 and 500 may be at least temporarily fastened to the reaming guide holder 600.
  • the fastening part 630 may be coaxially aligned with the insertion position determining part 610.
  • the fastening part 630 has a rod 631 extending to one side, and the rod 631 may be at least partially surrounded by the body 611.
  • the fastening end 633 provided at one end of the glenoid side of the rod 631 is inserted into the stem and mediates fastening with the reaming guide 500, and a thread is formed on the outer peripheral surface of the fastening end 633.
  • a rotating body 635 capable of rotating the fastening part 630 is formed on the other side of the rod 631.
  • the rod 631 and the fastening end 633 may protrude toward the end through the gap 613a between the alignment legs 613. In one embodiment, the fastening end 633 may extend further toward the glenoid than the alignment leg 613.
  • the screw driver 700 is configured to rotate the screws 480 and 580 in the reaming guides 400 and 500 to insert the screws into the glenoid fossa, and the driver 710 and the holder are coaxially aligned. It may include (730).
  • the driver 710 includes a rod 711 extending along the first axis, a tip 713 that is inserted into the groove 581 formed on the head surface of the above-described screw at one end of the rod to transmit a rotational force, and a circuit that rotates the driver. Includes total (715).
  • the holder 730 constitutes the outer shell of the driver 710 and may have a plurality of through holes to facilitate cleaning.
  • a reaming guide holder 800 according to another embodiment of the present invention is shown.
  • the insertion position determining part 810, the fastening part 830, and the screw driver 850 are coaxially aligned, so that the reaming guides 400, 500 are approached to the glenoid side and the screw is used as a single device. You can rotate it to at least temporarily fix it.
  • the insertion position determination unit 810 has the same function as the insertion position determination unit 610 described above, and substantially the same configuration is replaced with the description of the insertion position determination unit 610.
  • the insertion position determination unit 810 includes a body 811 at least partially extending in the first axis direction, an alignment leg 813 extending from one side of the body 811, and an alignment portion provided on the other side of the body 811. Includes (815).
  • the alignment unit 815 may include a disk 8151, a receiving groove 8153, and a corresponding indicator 8155, and the fastening portion 830 or the screw driver 850 can be turned on one side of the disk 8151. It is the same as the above description except that the rotating body provided so as to be formed is formed.
  • the fastening part 830 is coaxially aligned with the insertion position determining part 810, and includes a rod 831 extending to one side, a fastening end 833 provided on one end of the rod 831, and a fastening end 833 on the other side of the rod 831. It includes a rotating body 835 provided.
  • the fastening part 830 may have a hollow 830a to accommodate the screw driver 850.
  • the screw driver 850 includes a rod 851 extending along the first axis, a tip 853 that is inserted into the groove 581 formed on the head surface of the above-described screw at one end of the rod to transmit rotational force, and a screw driver that rotates. It includes a rotating body 855.
  • the screw driver 850 is coaxially aligned with the insertion position determining part 810 and the fastening part 830, and is slidably provided within the fastening part 830, so that one end can be exposed or hidden at the end near the glenoid.
  • the tip 853 protrudes beyond the fastening end 833 when the screw driver 850 moves forward, and is accommodated in the hollow 830a of the fastening part 830 when the screw driver 850 moves backward.
  • the reaming guide holder 800 in which the insertion position determination part 810, the fastening part 830, and the screw driver 850 are coaxially aligned, has a fixing leg (described later) instead of the alignment leg 813. 913) can be provided.
  • a reaming guide holder 900 according to another embodiment of the present invention may be provided.
  • the reaming guide holder 900 includes an insertion position determination part 910 and a fastening part 930 and can perform a substantially similar function to the reaming guide holder 600, but instead of the alignment leg 613, it has a fixing leg ( There is a difference in that 913) is formed, and the configuration that is substantially the same as that of the reaming guide holder 600 according to an embodiment of the present invention will be replaced by the above description.
  • the insertion position determination part 910 includes a body 911 at least partially extending in the first axis direction, a fixing leg 913 extending from one side of the body, a connection part 915 connecting the body and the alignment part, and a body 911 extending on the other side of the body. It includes an alignment unit 917 that is provided.
  • the fixing leg 913 is configured to prevent the reaming guide 500 from rotating with respect to the reaming guide holder 900, and at least a portion of the fixing leg 913 may extend toward the reaming guide 500 from one end of the glenoid side of the body 911. .
  • the fixing leg 913 allows the reaming guides 400 and 500 to determine or designate an insertion position without rotating.
  • the pin 913a formed at the end of the fixing leg can be accommodated in the slots 455 and 555 of the fixing part.
  • the alignment portion 917 may include a disk 9171, a receiving groove 9173, and a corresponding indicator 9175, and a protruding groove 9173a is formed on one side of the receiving groove 9173 to prevent rotation or falling off. can be formed.
  • the fastening part 930 includes a rod 931 extending to one side, a fastening end 933 provided at one end of the joint fossa side of the rod, and a rotating body 935 capable of rotating the fastening part 930 on the other side of the rod. It can be included.
  • the second surface of the glenoid may be guided by a second reamer (not shown).
  • the reaming guide 400 can be at least temporarily fixed to the glenoid fossa for insertion of a partially reinforced (half wedged) base plate (C), and a second reamer is provided along the guide rod 430.
  • the second surface perpendicular to the second axis having a predetermined angle with the first axis can be reamed.
  • the reaming guide 500 can be at least temporarily fixed to the glenoid fossa for insertion of a partially reinforced (full wedged) base plate (B), and the jerimer is positioned according to the guidance of the reaming guide 500.
  • a second surface is formed as a horizontal plane perpendicular to the first axis (X1), and the cutting range can be guided by the limit guide 530.
  • the base plate holder 1200 is a device for inserting a partially reinforced glenoid base plate (B, C) into the glenoid, and is at least temporarily fastened to the base plate (B, C). Then, determine the insertion position of the base plates (B, C) and insert the base plate into the glenoid recess (H). At this time, it is preferable that the base plate holder 1200 approaches the glenoid along the first axis while being fastened to the base plate.
  • the base plate holder 1200 can determine which direction the augmentation faces when the base plates (B, C) are inserted into the glenoid fossa.
  • the plate B31 corresponds to the second surface as the horizontal surface of the joint fossa formed according to the cutting range limitation of the reaming guide 500
  • the wedge B33 corresponds to the first surface as the curved surface of the joint fossa. It must correspond to the chamfered portion of the base plate, and the augmentation (C3) of the base plate must correspond to the second surface of the glenoid formed according to the cutting angle guidance of the reaming guide 400, so the insertion position of the augment when inserted into the glenoid This must be decided.
  • the base plate holder 1200 determines the insertion position of the base plates (B, C) according to the defect direction recognized by the defect measuring device 300 described above and/or the insertion position determined by the reaming guide holder 600. You can.
  • the base plate holder 1200 can rotate about the first axis to adjust or designate the insertion position of the base plate.
  • the base plate holder 1200 includes a body 1210 at least partially extending in the first axis direction, a fastening auxiliary part 1230 that assists fastening between the base plate and the base plate holder, and a base plate ( It includes an insertion end 1250 that is at least partially inserted into B) and an alignment portion 1270 provided on the other side of the body 1210.
  • the body 1210 preferably extends along the first axis (X1) and surrounds at least a portion of the fastening auxiliary part 1230.
  • a plurality of through holes or long holes may be formed in the body 1210.
  • the fastening auxiliary part 1230 assists fastening between the base plates (B, C) and the base plate holder 1200, and can prevent the base plates (B, C) from falling off from the base plate holder 1200.
  • the fastening auxiliary part 1230 is inserted into the base plates (B, C) together with a connecting rod 1231 that transmits rotational force, a rotating body 1233 that can be rotated by the surgeon, and an insertion protrusion 1251 to be described later. Includes auxiliary protrusions (1235).
  • the connecting rod 1231 connects the rotating body 1233 and the auxiliary protrusion 1235 to transmit rotational force to the auxiliary protrusion 1235, and the auxiliary protrusion 1235 moves forward or backward by the rotational force to connect the base plates (B, C). ) can be inserted into the through hole or insertion hole formed in the.
  • a screw thread 1235a may be formed on the outer peripheral surface of the auxiliary protrusion 1235.
  • the insertion end 1250 is a part that is substantially fastened to the base plates (B, C) and is formed at one end of the glenoid side of the body.
  • the insertion end 1250 may include an insertion protrusion 1251 and an insertion indicator 1253.
  • the insertion protrusion 1251 is a protrusion that protrudes from the insertion end 1250 toward the glenoid and can be inserted into the hollow of the base plates (B, C). Accordingly, the insertion protrusion 1251 may be fastened to the base plates (B, C) on the first axis (X1), which is the central axis of the base plate.
  • the insertion indicator 1253 is displayed on the insertion end 1250 or the body 1210 to indicate the fastening direction of the base plate and the base plate holder 1200. Since the partially reinforced base plates (B, C) do not have a symmetrical shape because the augments are formed in only a portion, the base plates and the base plate holder 1200 must be fastened in a predetermined manner so that the augments are connected to the second joint of the glenoid. It can correspond to the side.
  • the base plate is configured so that the auxiliary protrusion 1235 is engaged with the through hole of the portion where the plate B31 is formed among the augmentations of the base plate, and the insertion protrusion 1251 is engaged with the through hole formed in the center of the base plate. (B) and/or the approach direction of the base plate holder 1200 may be indicated. In another embodiment, the base plate (C) and the auxiliary protrusion 1235 are engaged with the through hole of the augmented portion of the base plate (C), and the insertion protrusion 1251 is engaged with the through hole formed in the center of the base plate. /Or the approach direction of the base plate holder 1200 may be indicated.
  • the insertion indicator 1253 displays the cross-sectional shape of the partially reinforced base plates (B, C), and the augmentation portion is displayed on the side of the auxiliary protrusion 1235 so that the surgeon uses the insertion indicator 1253.
  • the partially reinforced base plates (B, C) can be fastened in the specified direction.
  • the alignment unit 1270 is formed to align the insertion position of the base plate (B), and the surgeon can check the alignment unit 1270 and rotate the base plate holder 1200 about the first axis.
  • the alignment unit 1270 may include a disk 1271, a receiving groove 1273, and a corresponding indicator 1275.
  • the disk 1271 is provided in the shape of a plate with a predetermined thickness, and the surface opposite to the joint, that is, the lateral surface, is formed to be substantially flat, so that impacting, etc. can be easily performed.
  • the disk 1271 may be a circular plate or a polygonal plate with a plurality of receiving grooves 1273 formed on the outer peripheral surface.
  • the receiving groove 1273 is a groove provided to accommodate one end of the reference indicator, and is formed recessed into the outer peripheral surface of the disk 1271, so that the reference indicator and the base plate holder 1200 can be substantially perpendicular.
  • the receiving groove 1273 receives the reference indicator and then determines the insertion position of the base plates (B, C) together with the reference indicator.
  • the reference indicator may have substantially the same configuration as the guide handle 200.
  • a protruding groove 1273a is formed on one side of the receiving groove 1273 to prevent rotation or falling off, and the protrusion 231a of the guide handle 200 can be accommodated as a reference indicator.
  • the corresponding indicator 1275 is an indicator displayed or formed on one side of the disk 1271, and is displayed corresponding to the indicator 3133 formed on one side of the disk body 3131 described above. That is, a corresponding indicator such as the indicator 3133 displayed on the disk checker 310 to determine the direction of the lowest point (L) is displayed radially.
  • the corresponding indicator 1275 may be displayed to correspond to the portion where the receiving groove 1273 is formed, and the number corresponding to the number of receiving grooves 1273 formed on the outer peripheral surface of the disk may be displayed. That is, when 12 corresponding indicators 1275 are displayed at an angle of 30 degrees on one side of the disk 1271, a receiving groove 1273 is formed on the outer peripheral surface corresponding to the portion where the corresponding indicators 6175 are displayed.
  • the corresponding indicator 1275 of the base plate holder 1200 may be substantially the same as the corresponding indicator 6175 of the reaming guide holder 600, and the alignment portion 1270 of the base plate holder 1200 is the reaming guide holder. It may be substantially the same as the alignment portion 617 of 600.
  • the surgeon can check the direction of the defect through the defect measuring device 300.
  • the augmentation sizer 330 is placed toward the lowest point on the dial checker 310, it is possible to check which direction the lowest point (L) is by checking the indicator 3133 where the legs 333 overlap.
  • the surgeon fastens the reference indicator (guide handle, 200) to the receiving groove 1273 marked with the corresponding indicator 1275 corresponding to the direction of the lowest point (L), and then Move or rotate to the first position so that it is facing downward. Through this, the insertion positions of the base plates (B, C) can be aligned and inserted into the glenoid.
  • the device for inserting a glenoid base plate according to an embodiment of the present invention and the process of inserting a partially reinforced base plate into the glenoid through the device have been described.
  • the glenoid base plate insertion method (S) according to an embodiment of the present invention will be described.
  • the glenoid base plate insertion method (S) extends flatly perpendicular to the first axis on the glenoid to insert the partially reinforced base plates (B, C) into the glenoid (G), or This is the process of forming the first surface, which is a concave curved surface, and the second surface, which is a horizontal surface, around one axis, and then aligning the insertion position of the base plate and inserting it into the glenoid fossa. If a part of the glenoid fossa is missing, the missing part is replaced with part of the base plate. Compensation can be made through the augment formed in .
  • the glenoid base plate insertion method (S) includes a guide pin insertion step (S10), a first reaming step (S20), a post drill step (S30), a dial checking step (S40), a reaming guide insertion step (S50), and a second reaming step. It may include a step (S60) and a base plate insertion step (S80).
  • the guide pin insertion step (S10) is a process of inserting the guide pin 110 into the glenoid (G).
  • the guide pin can be inserted along the first axis (X1), and the guide pin 110 is a center guide. It can be inserted into the glenoid fossa under the guidance of (120).
  • a guide pin 110 can be inserted into the central portion of the glenoid where each landmark intersects. .
  • a landmark other than a cross may be displayed to indicate the center of the glenoid, but it is preferable to include landmarks in the superior and inferior directions.
  • the center guide 120 used to insert the guide pin may have a shape suitable for being supported on the glenoid.
  • the first reaming step (S20) is a process of reaming the first surface that extends flatly perpendicular to the first axis along the guide pin or is a concave curved surface centered on the first axis.
  • the surgeon When reaming so that the first surface extends flatly perpendicular to the first axis, the surgeon operates the first reamer while approaching the glenoid fossa along the first axis so that the first reamer can accommodate the guide pin, ) forms a first side perpendicular to the
  • the first reaming step may be performed after measuring the amount of bone defect in the glenoid fossa by attaching the size checker 370 to the defect measuring device 300.
  • the surgeon rotates the size checker 370 on the glenoid so that the endpoint (373a) of the first leg touches the outer part of the curved surface (F1) formed on the glenoid, and the endpoint (375a) of the second leg touches the lowest point (L). You can check whether it reaches.
  • the endpoint (375a) of the second leg touches the lowest point (L) and the endpoint (373a) of the first leg touches the outer part of the curved surface formed on the glenoid
  • a size checker with a desirable leg length is used. It can be recognized. Therefore, the depth of the lowest point (L), that is, the amount of bone defect in the glenoid fossa, can be measured according to the leg length of the size checker.
  • the surgeon operates the first reamer while approaching the glenoid fossa along the first axis so that the first reamer can accommodate the guide pin to form a first surface as a concave curved surface centered on the first axis (X1).
  • the post drill step (S30) is a process of forming a recess (H) with a cross-section larger than the guide pin based on the center portion of the glenoid into which the guide pin is inserted.
  • a reaming guide and a base are installed in the recess (H). At least a portion of the plate may be inserted.
  • the post drill step (S30) may be performed by a boss cutter on which a stopper is mounted, or a boss cutter provided integrally with the stopper.
  • the post drill step (S30) causes at least a portion of the boss cutter having a predetermined diameter to protrude to one side of the stopper with one side convexly protruding, and then the boss cutter is inserted into the glenoid fossa along the first axis to accommodate the guide pin 110.
  • the glenoid can be reamed while approaching.
  • the defect measurement step (S40) is a process of confirming the direction and amount of defects of the defect with respect to the first side, and can be performed by the defect measurement device 300.
  • the direction of the defect can be confirmed through an indicator, and the insertion position of the reaming guides (400, 500) is determined to correspond to the indicator, and the reaming guide insertion step (S50) and the second reaming described later are performed.
  • Step (S60) can be performed to accurately ream the second side.
  • the defect measurement step includes a dial checker placement step (S41), an augmentation sizer placement step (S43), and a defect direction checking step (S45).
  • the dial checker placement step (S41) is a process of placing a dial checker indicating the direction based on the central part of the glenoid fossa on the glenoid fossa.
  • the dial checker 310 described above is placed on the glenoid, and the surgeon approaches the glenoid with the dial checker 310 and then aligns the cross-shaped landmark marked on the glenoid with the alignment hole 3137 to place the dial checker 310 on the glenoid. ) can be sorted.
  • the insertion position of the dial checker 310 can be aligned so that the landmark displayed in the superior-inferior direction on the glenoid is at the center of the alignment hole 3137.
  • the dial checker 310 may be at least temporarily fixed to the glenoid by a spike 3135 protruding from one surface of the disc body 3133 facing the glenoid.
  • the augment sizer placement step (S43) measures the distance in the first axis direction from the first surface to the lowest point (L) of the glenoid defect through the augment sizer 330 provided to measure the depth of the defect. It's a process. A portion of the augmentation sizer 330 is in contact with the lowest point (L), and at the same time, one surface of the augmentation sizer 330 is in contact with one surface of the dial checker 310. It can be placed on the dial checker. As described above, since the depth of the lowest point (L) may be different depending on the amount of glenoid defect for each patient, a plurality of augmentation sizers 330 having different leg 333 lengths may be provided.
  • the ment sizer placement step (S43) can be performed. The surgeon can rotate the augment sizer 330 on the dial checker 310 to check whether the endpoint 333a of the leg touches the lowest point L. When the contact surface of the rotor 331 comes into contact with one surface of the disk body 3131, it can be recognized that an augment sizer having a desirable leg length has been used.
  • the defect direction checking step (S45) is a process of measuring the direction in which the lowest point is formed based on the central part of the glenoid fossa.
  • the direction in which the lowest point is formed is determined through the direction measured by the dial checker, and the direction in which the part of the augmentation sizer in contact with the lowest point (L) faces on the dial checker is the direction in which the lowest point is formed. direction can be determined.
  • the endpoint (333a) of the leg is in contact with the lowest point (L) and the contact surface of the rotor (331) is in contact with one surface of the disk body (3131)
  • the direction in which the leg (333) faces is recognized by the indicator (3133).
  • the direction of the defect can be determined. Afterwards, the guide pin 110 can be removed.
  • the reaming guide insertion step (S50) includes a reaming guide 400 that guides reaming of a second surface perpendicular to a second axis that is not parallel to the first axis, or a horizontal surface perpendicular to the first axis. This is a process of inserting the reaming guide (500), which guides two-sided reaming, into the glenoid fossa.
  • the reaming guides (400, 500) whose insertion positions are aligned may be inserted into the recess (H).
  • the reaming guide insertion step (S50) may be performed by the reaming guide holder 600 and the screw driver 700, or the reaming guide holder 800 accommodating the screw driver 850 therein.
  • the reaming guide insertion step (S50) includes a reaming guide fastening step (S51), a reference indicator fastening step (S53), a direction alignment step (S55), a reaming guide fixing step (S57), and a screw insertion step (S59).
  • the reaming guide fastening step (S51) is a process of fastening the reaming guides (400, 500) to the reaming guide holder (600). At least a portion of the reaming guide holder 600 may be accommodated in the hollow 410a, 510a of the stem of the reaming guide.
  • An appropriate reaming guide (400, 500) from among a plurality of reaming guides may be selected and used according to the amount of glenoid bone defect measured in the augmentation sizer placement step (S43).
  • the fastening end 633 rotates to form a thread formed on the outer peripheral surface of the fastening end 633 and the inner peripheral surface of the stem.
  • the formed threads 410b and 510b are fastened through screw coupling.
  • the direction in which the guide rod 530 faces when fastening the reaming guide may be guided by the fixing leg 913 or the alignment legs 613 and 813.
  • the pin 913a formed at the end of the fixing leg can be accommodated in the slot 455 of the fixing part of the reaming guide to guide the fastening of the reaming guide, and the gap 613a formed by the alignment leg 613
  • the guide rod 530 is accommodated therebetween to guide fastening of the reaming guide.
  • the direction in which the guide surface 515a faces when the reaming guide is fastened may be guided by the alignment legs 613 and 813 or the fixing leg 913.
  • the pin 913a formed at the end of the fixing leg is accommodated in the slot 555 of the fixing part of the reaming guide to guide the fastening of the reaming guide, and the gap formed by the alignment legs 613 and 813 (
  • the upper part 510c of the stem is accommodated between 613a and 813a so that fastening of the reaming guide can be guided.
  • the reference indicator fastening step (S53) is a process of connecting a reference indicator to one side of the reaming guide holder.
  • the reference indicator may be substantially the same as the guide handle 200.
  • the reference indicator and the reaming guide holder can form a predetermined angle.
  • the reference indicator and the reaming guide holder may form a right angle.
  • an angle other than a right angle may be formed depending on whether the first axis X1 is tilted.
  • the reference indicator is inserted into the receiving groove (6173) where the corresponding indicator (6175) corresponding to the indicator (3133) confirmed in the defect direction checking step (S45) is displayed. That is, the reference indicator can be inserted into the reaming guide holder in the direction indicated by the indicator confirmed in the defect direction checking step (S45), and the reference indicator can be inserted into the reaming guide holder in the defect direction confirmed in the defect direction checking step (S45). .
  • the direction alignment step (S55) is a process of aligning the insertion position of the reaming guide fastened to the reaming guide holder by moving the reference indicator to the first position.
  • the reaming guide fastened to the reaming guide holder 600 is moved by moving the reference indicator inserted in the receiving groove 6173 to the first position with one end facing downward.
  • the direction in which the guide surface 515a faces is positioned so that the lowest point (L) of the glenoid fossa is in the opposite direction.
  • the second axis (L) is a process of aligning the insertion position of the reaming guide fastened to the reaming guide holder by moving the reference indicator to the first position.
  • the direction in which the guide surface 515a faces is positioned so that the lowest point (L) of the glenoid fossa is in the opposite direction.
  • the second axis (L) of the glenoid fossa) is in the opposite direction.
  • the reference indicator or guide handle 200 and the reaming guide holders 600 and 800 may be rotated around the first axis.
  • the reaming guide fixing step (S57) is a process of approaching the reaming guide to the glenoid along the first axis (X1) and fixing the reaming guide on the glenoid according to the aligned insertion position.
  • the surgeon approaches the aligned reaming guide holder 600 and the reaming guides 400 and 500 to the glenoid along the first axis and inserts and fixes a part of the reaming guide into the glenoid.
  • the stem 510 of the reaming guide is inserted into the glenoid recess (H) and fixed at least temporarily.
  • the screw insertion step (S59) is a process of inserting the screws (480, 580) into the glenoid by rotating the screws in the reaming guides (400, 500).
  • the screw insertion step (S59) may be performed by the screw driver 700 or the screw driver 850 accommodated in the reaming guide holder 800.
  • the screws in the reaming guides 400 and 500 can be rotated using a screw driver 700 to insert them into the glenoid and at least temporarily fix them.
  • the screw driver 850 is advanced so that the tip 853 is exposed to the glenoid side rather than the fastening end 833, and then the screws 480 and 580 can be rotated to insert it into the glenoid and at least temporarily fix it.
  • the second reaming step (S60) is a process of reaming the second surface perpendicular to at least a portion of the reaming guide.
  • the reaming guide 400 When the reaming guide 400 according to one embodiment is inserted into the glenoid for insertion of the partially reinforced (half wedged) base plate (C), the second surface perpendicular to the second axis may be reamed.
  • a line segment from the center of the axis and glenoid to the lowest point (L) may form a right angle, and the lowest point (L) may be included in the second surface.
  • the second surface which is a plane perpendicular to the first axis, is preferably reamed.
  • the rotation range of the second reamer may be limited by the limit guide 530, and the second reamer cuts the portion on the glenoid excluding the portion toward which the guide surface faces. That is, the second reamer faces the direction in which the first plane 511, the first connection surface 513 without a guide surface, and the second plane 512 face the center or recess (H) of the glenoid fossa. It is cut flatly perpendicular to the first axis (X1). Accordingly, a second surface as a horizontal surface of the joint condyle faces the plate B31 of the base plate B having the above-described portion reinforced. At this time, the lowest point (L) may be included in the second side.
  • the glenoid base plate insertion method (S) may further include a chamfer forming step of forming a chamfer between the first and second surfaces of the glenoid.
  • the glenoid base plate insertion method (S) may further include a chamfering step of chamfering the curved surface that was not reamed in the second reaming step.
  • the base plate insertion step (S80) is a process of inserting the partially reinforced base plates (B, C) into the glenoid fossa.
  • the base plates (B, C) can be fastened to the base plate holder 1200 and inserted into the glenoid.
  • the base plate insertion step (S80) includes a base plate fastening step (S81), a reference indicator fastening step (S83), and an alignment insertion step (S85).
  • the base plate fastening step (S81) is a process of fastening the partially reinforced base plate to the base plate holder.
  • the insertion protrusion 1251 of the base plate holder 1200 is inserted into the hollow formed in the center of the base plate, and the auxiliary This is a process in which the protrusion 1235 is inserted into a hole formed in a portion other than the center of the base plates (B, C) and fastened at least temporarily.
  • the base plate may be fastened in the direction according to the insertion indicator 1253.
  • the insertion indicator 1253 is a base plate ( B, C) and/or the approach direction of the base plate holder 1200.
  • the reference indicator fastening step (S83) is a process of connecting a reference indicator to one side of the base plate holder, and can be performed similarly to the reference indicator fastening step (S53) described in the reaming guide insertion step described above.
  • the reference indicator may be substantially the same as the guide handle 200.
  • the reference indicator and the base plate holder can form a predetermined angle.
  • the reference indicator and the base plate holder may form a right angle.
  • an angle other than a right angle may be formed depending on whether the first axis (X1) is tilted.
  • the reference indicator is inserted into the receiving groove (1273) where the corresponding indicator (1275) corresponding to the indicator (3133) confirmed in the defect direction checking step (S45) is displayed.
  • the corresponding indicator 1275 which is the same as the corresponding indicator 6173 in the reference indicator fastening step (S53) described above, can be inserted into the receiving groove 1273 displayed.
  • the alignment and insertion step (S85) is a process of aligning the insertion position of the base plate fastened to the base plate holder and inserting the base plate by moving the reference indicator to the first position.
  • the base fastened to the base plate holder 1200 is moved by moving the reference indicator inserted into the receiving groove 1273 to the first position with one end facing downward.
  • the augmentation of the plate is positioned to be complementary to the second surface, and by inserting the base plate into the glenoid, the base plate is inserted and fixed at the correct position and angle.
  • movement to the first position occurs when the base plate holder 1200, which accommodates the reference indicator or guide handle 200, is located on the first axis, and one end of the reference indicator or guide handle 200 is moved to the lower side. It may include rotating the reference indicator or guide handle 200 and the base plate holder 1200 about a first axis so that they face in the (inferior) direction. Accordingly, the augmentation of the base plates (B, C) can be seated on the glenoid.

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Abstract

La présente invention concerne un dispositif et un procédé d'insertion d'une plaque de base glénoïde, et plus spécifiquement, un dispositif et un procédé d'insertion d'une plaque de base glénoïde d'une articulation scapulaire artificielle. Le dispositif est caractérisé en ce qu'il comprend : un vérificateur de molette, dont au moins une partie est au moins temporairement fixée à un os tout en faisant face à la surface de l'os ; et un calibreur d'augmentation qui est disposé sur un côté du vérificateur de molette et vérifie la direction d'une partie perdue à partir du centre de l'os et la quantité de perte, la quantité et la direction de la perte osseuse dans la glénoïde pouvant être déterminées avec précision. Le procédé est caractérisé en ce qu'il comprend : une étape d'insertion de broche de guidage pour insérer une broche de guidage dans la glénoïde le long d'un premier axe ; une première étape d'alésage pour aléser une surface incurvée ayant une certaine courbure le long de la broche de guidage ; une étape de mesure de perte pour vérifier la direction d'une partie perdue et la quantité de perte dans la glénoïde par rapport à la surface incurvée formée pendant la première étape d'alésage ; une étape d'insertion de guide d'alésage pour insérer, dans la glénoïde, un guide d'alésage pour guider la plage de coupe de la glénoïde afin de former un plan horizontal perpendiculaire au premier axe ; et une seconde étape d'alésage pour former le plan horizontal perpendiculaire au premier axe en fonction du guidage du guide d'alésage.
PCT/KR2023/018715 2022-12-08 2023-11-20 Dispositif et procédé d'insertion d'une plaque de base glénoïde WO2024122933A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
KR10-2022-0170678 2022-12-08
KR1020220170678A KR20240085620A (ko) 2022-12-08 관절와 베이스플레이트 삽입용 기구 및 그 방법

Publications (1)

Publication Number Publication Date
WO2024122933A1 true WO2024122933A1 (fr) 2024-06-13

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Application Number Title Priority Date Filing Date
PCT/KR2023/018715 WO2024122933A1 (fr) 2022-12-08 2023-11-20 Dispositif et procédé d'insertion d'une plaque de base glénoïde

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WO (1) WO2024122933A1 (fr)

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20060074353A1 (en) * 2004-09-27 2006-04-06 Deffenbaugh Daren L Glenoid instrumentation and associated method
US8187282B2 (en) * 2003-03-10 2012-05-29 Tornier Sas Ancillary tool for positioning a glenoid implant
JP2016503328A (ja) * 2012-12-05 2016-02-04 スミス アンド ネフュー インコーポレーテッド 整形外科的ガイドシステムおよび方法
US20180303618A1 (en) * 2015-04-24 2018-10-25 Biomet Manufacturing, Llc Patient-specific augmented glenoid systems and methods
US20210077279A1 (en) * 2019-09-12 2021-03-18 Arthrex, Inc. Defect gauge instrument for preparation of surgical sites

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8187282B2 (en) * 2003-03-10 2012-05-29 Tornier Sas Ancillary tool for positioning a glenoid implant
US20060074353A1 (en) * 2004-09-27 2006-04-06 Deffenbaugh Daren L Glenoid instrumentation and associated method
JP2016503328A (ja) * 2012-12-05 2016-02-04 スミス アンド ネフュー インコーポレーテッド 整形外科的ガイドシステムおよび方法
US20180303618A1 (en) * 2015-04-24 2018-10-25 Biomet Manufacturing, Llc Patient-specific augmented glenoid systems and methods
US20210077279A1 (en) * 2019-09-12 2021-03-18 Arthrex, Inc. Defect gauge instrument for preparation of surgical sites

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