WO2024122934A1 - Device for inserting glenoid base plate, and method therefor - Google Patents

Abstract

The present invention relates to a device for inserting a glenoid base plate, and a method therefor, and, more specifically, to: a device for inserting a glenoid base plate of an artificial shoulder joint, the device comprising a stem, which has a hollow portion and extends in the direction of a first axis, and a guide rod, which extends in the direction of a second axis that forms a predetermined angle with the first axis, at least a portion of the stem being inserted into the glenoid and the guide rod guiding the cutting direction of the glenoid; and a method for inserting a glenoid base plate of an artificial shoulder joint, comprising: a guide pin insertion step of inserting a guide pin into the glenoid; a first reaming step of reaming a first surface perpendicular to the first axis along the guide pin; a defect measurement step of checking the direction and defective amount of a defective portion with respect to the first surface; a reaming guide insertion step of inserting, into the glenoid, a reaming guide for guiding reaming of a second surface perpendicular to a second axis, which is not parallel to the first axis; and a second reaming step of reaming the second surface perpendicularly to at least a portion of the reaming guide.

Description

Device and method for inserting glenoid base plate

The present invention relates to a device and method for inserting a glenoid base plate, and more specifically, to a stem having a hollow body extending in the direction of a first axis, and a guide rod extending in the direction of a second axis having a predetermined angle with the first axis. It includes a device for inserting a glenoid base plate of an artificial shoulder joint in which at least a portion of the stem is inserted into the glenoid and the guide rod guides the cutting direction of the glenoid, a guide pin insertion step of inserting a guide pin into the glenoid, and a guide pin. A first reaming step of reaming the first surface perpendicular to the first axis, a defect measurement step of confirming the direction and defect amount of the defective part based on the first surface, and a defective part measurement step that is not parallel to the first axis. A reaming guide insertion step of inserting a reaming guide for guiding reaming of a second surface perpendicular to two axes into the glenoid fossa, and a second reaming step of reaming a second surface perpendicular to at least a portion of the reaming guide. This is about the method of inserting the glenoid base plate of an artificial shoulder joint.

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.

Referring to FIG. 1 to describe the scapula in more detail, 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.

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).

US Patent Registration US 9132016 (registered on September 15, 2015) “Implantable shoulder prostheses”

The invention shown in the above patent document discloses a glenoid base plate used in an artificial shoulder joint.

However, in a typical base plate such as the prior art, 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. When attempting to insert and fix a normal base plate that does not compensate for the bone defect in the glenoid portion (911) of the scapula where a bone defect occurs, a portion where the defect does not occur (R1) is used to secure the glenoid base plate, as shown in FIG. ) must be cut. On the other hand, when the base plate is seated on the glenoid without bone cutting, there is a problem in that the base plate cannot be seated on the scapula 91 or the glenoid 911 in the area where the bone defect occurs (R2), as shown in FIG. 4.

For this purpose, a partially reinforced (Half wedged) glenoid base plate (B) can be used as shown in Figure 5. 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. can be fixed to Such 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 base plate (B) may form a chamfer (B7) between one surface of the base (B1) and one surface of the augment (B3).

In order to insert the partially reinforced glenoid base plate (B) 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).

Therefore, a surgical instrument capable of inserting the partially reinforced glenoid base plate as described above into the glenoid is required, as well as a method for accurately guiding the size and insertion direction of the reaming guide and implant when cutting the glenoid.

The present invention was devised to solve the above problems,

An object of the present invention includes a stem having a hollow body extending in a first axis direction, a guide rod extending in a second axis direction having a predetermined angle with the first axis, and at least a portion of the stem is inserted into the glenoid fossa. The aim is to provide a reaming guide that can accurately guide cutting when cutting the non-extruded second side of the glenoid fossa for insertion of a partially reinforced base plate by allowing the guide rod to guide the cutting direction of the glenoid fossa.

The object of the present invention is that the guide rod has an end surface facing a hollow 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 is a cylindrical hole at least partially extending in the first axis direction. By doing so, it provides a reaming guide that can smoothly accommodate surgical instruments inside.

The purpose of the present invention is to provide a reaming guide in which the stem has threads on at least one side of the inner peripheral surface and can be stably fastened to a surgical instrument.

The object of the present invention further includes a fixing part on one side of the stem or guide rod for at least temporarily fixing the reaming guide on the glenoid, and the fixing part includes a branch extending from the stem or guide rod to one side, and a branch extending from the branch to the glenoid side. The aim is to provide a reaming guide that includes an extending spike and increases fixation force when the reaming guide is temporarily fixed to the glenoid.

The purpose of the present invention is to provide a reaming guide in which the fixing part includes a slot through which a portion of the branch is formed so that a surgeon can easily hold the insertion position of the reaming guide.

An object of the present invention further includes a screw that penetrates the stem and is inserted into the glenoid, wherein the screw has a groove extending to at least one side on the surface of the head and a screw thread is formed on the outer peripheral surface of the head to perform glenoid reaming. The aim is to provide a reaming guide that can be strongly fixed to the glenoid fossa.

An object of the present invention is to include an insertion rod extending in a first axis direction, a guide plate surrounding at least a portion of the insertion rod, the guide plate having guide holes on both sides of the insertion rod, and the guide hole being used for surgery. To provide a chamfer reaming guide that can accurately form a chamfer between a substantially flat first surface and an inclined second surface of the glenoid fossa by penetrating and receiving the instrument in a direction forming a predetermined angle with the first axis.

The purpose of the present invention is to form an opening in the guide plate in the direction of a second axis forming a predetermined angle with the first axis, which is the extension direction of the insertion rod, and to accommodate the surgical instrument through the guide hole in the direction of the third axis, The angle formed by the third axis and the first axis is smaller than the angle formed by the first axis and the second axis, thereby providing a chamfer reaming guide that can form a gentle chamfer between the first surface and the inclined second surface. will be.

The purpose of the present invention is to provide a chamfered reaming guide that is easy to fasten to the reaming guide, wherein the guide plate includes a pin extending to one side at a portion spaced a predetermined distance away from the insert rod.

The purpose of the present invention is to use a reaming guide according to any one of the plurality of claims 1 to 6, wherein the guide rod extends from the stem at different angles, and the guide hole guides the surgical instrument in a direction forming a predetermined angle with different first axes. To provide a surgical instrument set including the chamfer reaming guide according to any one of the plurality of items 7 to 9 that penetrates and receives.

The purpose of the present invention is to include a guide pin insertion step of inserting a guide pin into the glenoid, a first reaming step of reaming the first surface perpendicular to the first axis along the guide pin, the direction of the defective portion with respect to the first surface, and A defect measurement step of confirming the amount of the defect, a reaming guide insertion step of inserting a reaming guide for guiding reaming of a second surface perpendicular to a second axis that is not parallel to the first axis into the glenoid fossa, and at least part of the reaming guide. Insertion of a glenoid base plate that can accurately perform cutting of the slanted second surface of the glenoid fossa for insertion of a partially reinforced base plate through a reaming guide inserted into the glenoid fossa, including a second reaming step of reaming the second surface perpendicular to the glenoid fossa. It provides a method.

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. .

An object of the present invention is that 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 checking step determines the direction in which the lowest point was formed through the direction measured by a dial checker, providing a glenoid base plate insertion method that allows the surgeon to quickly and clearly recognize in which direction the lowest point of the glenoid is formed from the center of the glenoid. .

The purpose of the present invention is to determine the direction in which the part of the augmentation sizer in contact with the lowest point faces on the dial checker as the direction in which the lowest point is formed, so that the defect direction checking step determines the direction in which the lowest point is formed, so that the glenoid base can easily guide the glenoid cutting direction and base plate insertion position. A plate insertion method is provided.

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 purpose of the present invention is to include the reaming guide insertion step, a reaming guide fastening step of fastening the reaming guide to the reaming guide holder, a reference indicator fastening step of connecting a reference indicator to one side of the reaming guide holder, and the reference indicator being connected to a first A direction alignment step of aligning the insertion position of the reaming guide fastened to the reaming guide holder by moving it to a position, and approaching the reaming guide to the glenoid along the first axis and fixing the reaming guide on the glenoid according to the aligned insertion position. The aim is to provide a glenoid base plate insertion method that can clearly guide cutting of the slanted second surface of the glenoid fossa, including the reaming guide fixation step.

The object of the present invention further includes a post drill step of forming a recess having a cross section larger than the guide pin in the first axis direction in the glenoid fossa, wherein at least a portion of the boss cutter having a predetermined diameter is formed on one side. It provides a method of inserting a glenoid base plate that forms a recess (H) within the glenoid by protruding to one side of the flat stopper and then reaming the glenoid along the guide pin.

The object of the present invention further includes a chamfer forming step of forming a chamfer between the first and second surfaces of the glenoid, and the chamfer forming step includes a chamfer reaming step of fastening the chamfer reaming guide to the reaming guide in the first axis direction. A guide fastening step, a chamfer reaming step of reaming a portion between the first surface and the second surface through a reamer at least partially penetrating a chamfer reaming guide in the third axis direction, the substantially flat first surface of the glenoid and the slope The aim is to provide a method of inserting a glenoid base plate that can accurately form a chamfer between the second surfaces.

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.

In order to achieve the above-described object, the present invention is implemented by an embodiment having the following configuration.

According to one embodiment of the present invention, the present invention includes a stem having a hollow body extending in a first axis direction, a guide rod extending in a second axis direction having a predetermined angle with the first axis, and at least one of the stems. A portion is inserted into the glenoid and the guide rod guides the cutting direction of the glenoid.

According to one embodiment of the present invention, the guide rod has an end surface facing a hollow formed on the inner peripheral surface of the stem, and at least a portion of the hollow formed by the end surface and the inner peripheral surface of the stem extends in the first axis direction. It is characterized by being a cylindrical hole.

According to one embodiment of the present invention, the stem is characterized by having a screw thread on at least one side of the inner peripheral surface.

According to one embodiment of the present invention, it further includes a fixing part for at least temporarily fixing the reaming guide on the glenoid on one side of the stem or guide rod, wherein the fixing part includes a branch extending to one side from the stem or guide rod, It is characterized by comprising a spike extending from the branch to the glenoid side.

According to one embodiment of the present invention, the fixing part is characterized in that it includes a slot through which a portion of the branch is formed.

According to one embodiment of the present invention, it further includes a screw that penetrates the stem and is inserted into the glenoid, wherein the screw has a groove extending to at least one side on the surface of the head and a screw thread is formed on the outer peripheral surface of the head. It is characterized by

According to one embodiment of the present invention, the present invention includes an insertion rod extending in a first axis direction, a guide plate surrounding at least a portion of the insertion rod, and the guide plate has guide holes on both sides of the insertion rod. The guide hole is characterized in that the surgical instrument is penetrated and received in a direction forming a predetermined angle with the first axis.

According to one embodiment of the present invention, the guide plate forms an opening in a second axis direction forming a predetermined angle with the first axis, which is the extension direction of the insertion rod, and the guide hole guides the surgical instrument in the third axis direction. Penetration is received, but the angle formed by the third axis and the first axis is characterized in that it is smaller than the angle formed by the first axis and the second axis.

According to one embodiment of the present invention, the guide plate is characterized by including a pin extending to one side at a portion spaced a predetermined distance away from the insertion rod.

According to one embodiment of the present invention, the present invention is a reaming guide according to any one of a plurality of claims 1 to 6, wherein the guide rod extends from the stem at different angles, and the guide hole is used to use different surgical instruments. It is characterized in that it includes a chamfer reaming guide according to any one of a plurality of claims 7 to 9 that penetrates and receives in a direction forming a predetermined angle with the first axis.

According to one embodiment of the present invention, the present invention includes a guide pin insertion step of inserting a guide pin into the glenoid, a first reaming step of reaming a first surface perpendicular to the first axis along the guide pin, and a first reaming step of reaming a first surface perpendicular to the first axis along the guide pin. A defect measurement step of checking the direction and amount of the defect, a reaming guide insertion step of inserting a reaming guide for guiding reaming of a second surface perpendicular to a second axis that is not parallel to the first axis into the glenoid fossa, and a second reaming step of reaming the second surface perpendicular to at least a portion of the reaming guide.

According to one embodiment of the present invention, the defect measuring step includes measuring 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 is characterized by comprising an augmentation sizer placement step and a defect direction checking step of measuring the direction in which the lowest point is formed based on the central portion of the glenoid fossa.

According to one embodiment of the present invention, 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 by determining the direction in which the lowest point was formed through the direction measured by a dial checker.

According to one embodiment of the present invention, 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 is formed.

According to one embodiment of the present invention, in the augmentation sizer arrangement step, 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.

According to one embodiment of the present invention, the reaming guide insertion step includes a reaming guide fastening step of fastening the reaming guide to the reaming guide holder, a reference indicator fastening step of connecting a reference indicator to one side of the reaming guide holder, and the reference A direction alignment step of aligning the insertion position of the reaming guide fastened to the reaming guide holder by moving the indicator to the first position, and approaching the reaming guide to the glenoid fossa along the first axis and adjusting the reaming guide according to the aligned insertion position. It is characterized by comprising a reaming guide fixation step for fixing on the glenoid.

According to one embodiment of the present invention, it further includes a post drill step of forming a recess having a cross section larger than the guide pin in the first axis direction in the glenoid fossa, wherein the post drill step is performed by using a boss cutter having a predetermined diameter. It is characterized by reaming the glenoid fossa along the guide pin so that at least a portion protrudes to one side of the stopper, where one side is flat.

According to one embodiment of the present invention, it further includes a chamfer forming step of forming a chamfer between the first surface and the second surface of the glenoid, and the chamfer forming step includes attaching the chamfer reaming guide to the reaming guide in the first axis direction. It is characterized by including a chamfer reaming guide fastening step, and a chamfer reaming step of reaming a portion between the first and second surfaces through a reamer that at least partially penetrates the chamfer reaming guide in the third axis direction.

According to one embodiment of the present invention, it 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. A fastening step, a reference indicator fastening step of connecting a reference indicator to one side of the base plate holder, aligning the insertion position of the base plate fastened to the base plate holder by moving the reference indicator to a first position and inserting the base plate. It is characterized in that it includes an alignment insertion step.

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 includes a stem that is hollow and extends in a first axis direction, and a guide rod that extends in a second axis direction at a predetermined angle with the first axis, wherein at least a portion of the stem is inserted into the glenoid and the guide rod. By guiding the cutting direction of the glenoid fossa, a reaming guide is provided that can accurately guide the cutting when cutting the non-escaped second side of the glenoid fossa for the insertion of a partially reinforced base plate.

In the present invention, the guide rod has an end surface facing a hollow 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 is at least partially a cylindrical hole extending in the first axis direction, thereby providing an internal It is effective in providing a reaming guide that can smoothly accommodate surgical instruments.

In the present invention, the stem has threads on at least one side of the inner peripheral surface, thereby achieving the effect of enabling stable fastening with a surgical instrument.

The present invention further includes a fixing part for at least temporarily fixing the reaming guide on the glenoid on one side of the stem or guide rod, and the fixing part includes a branch extending to one side from the stem or guide rod, and extending from the branch to the glenoid side. When the reaming guide, including spikes, is temporarily fixed to the glenoid, it has the effect of providing a reaming guide with increased fixation force.

In the present invention, the fixing part includes a slot through which a portion of the branch is formed, resulting in the effect of allowing the surgeon to easily position the reaming guide for insertion.

The present invention further includes a screw that penetrates the stem and is inserted into the glenoid, wherein the screw has a groove extending to at least one side on the surface of the head and a screw thread is formed on the outer peripheral surface of the head to be inserted into the glenoid when reaming the glenoid. A reaming guide that can be strongly fixed can be provided.

The present invention includes an insertion rod extending in a first axis direction, a guide plate surrounding at least a portion of the insertion rod, the guide plate has guide holes on both sides of the insertion rod, and the guide hole is used for surgical instruments. By allowing penetrating reception in a direction forming a predetermined angle with the first axis, a chamfer can be accurately formed between the substantially flat first surface and the sloping second surface of the glenoid fossa.

In the present invention, the guide plate forms an opening in a second axis direction forming a predetermined angle with the first axis, which is the extension direction of the insertion rod, and the guide hole receives the surgical instrument through the third axis direction, The angle formed by the third axis and the first axis is made smaller than the angle formed by the first axis and the second axis, providing the effect of forming a gentle chamfer between the first surface and the inclined second surface.

In the present invention, the guide plate includes a pin extending to one side at a predetermined distance from the insert rod, providing the effect of facilitating fastening to the reaming guide.

The present invention relates to a plurality of reaming guides according to any one of claims 1 to 6, wherein the guide rod extends from the stem at different angles, and the guide hole accommodates the surgical instrument in a direction forming a predetermined angle with a different first axis. A set of surgical instruments including the chamfer reaming guide according to any one of the plurality of claims 7 to 9 is provided.

The present invention includes a guide pin insertion step of inserting a guide pin into the glenoid, a first reaming step of reaming a first surface perpendicular to the first axis along the guide pin, and the direction and amount of defect of the defective portion based on the first surface. A defect measurement step for checking, a reaming guide insertion step for inserting a reaming guide for guiding second surface reaming perpendicular to a second axis that is not parallel to the first axis into the glenoid fossa, and perpendicular to at least a portion of the reaming guide. A glenoid base plate insertion method that can accurately perform cutting of the slanted second surface of the glenoid fossa for insertion of a partially reinforced base plate through a reaming guide inserted into the glenoid fossa, including a second reaming step of reaming the second surface. It has an effect.

In the present invention, the defect measuring step includes an augment sizer arrangement step of measuring 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. , including the 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 amount and direction of bone defect in the defect area can be determined with a single surgical instrument.

In the present invention, 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 the defect direction checking step. By determining the direction in which the lowest point was formed through the direction measured by a dial checker, the surgeon can quickly and clearly recognize in which direction the lowest point of the glenoid fossa was formed from the center of the glenoid fossa.

The present invention has the advantage of simple guidance of the glenoid cutting direction and base plate insertion position by determining the direction in which the part of the augmentation sizer in contact with the lowest point faces on the dial checker as the direction in which the lowest point is formed in the defect direction checking step.

In the present invention, the augmentation sizer arrangement step includes placing an augmentation sizer in which a portion of the augmentation sizer is in contact with the lowest point and one surface of the augmentation sizer is in contact with one surface of the dial checker on the dial checker. By placing it, an appropriate augment sizer can be used depending on the amount of bone defect.

The present invention includes the reaming guide insertion step, a reaming guide fastening step of fastening the reaming guide to the reaming guide holder, a reference indicator fastening step of connecting a reference indicator to one side of the reaming guide holder, and moving the reference indicator to a first position. A direction alignment step of aligning the insertion position of the reaming guide fastened to the reaming guide holder by moving it, and reaming of approaching the reaming guide to the glenoid along the first axis and fixing the reaming guide on the glenoid according to the aligned insertion position. It has the effect of clearly guiding the cutting of the slanted second side of the glenoid fossa, including the guide fixation step.

The present invention further includes a post drill step of forming a recess having a cross-section larger than the guide pin in the first axis direction in the glenoid fossa, wherein at least a portion of the boss cutter having a predetermined diameter has a flat surface. This has the effect of providing a method of inserting a glenoid base plate that forms a recess (H) within the glenoid by protruding to one side of the stopper and then reaming the glenoid along the guide pin.

The present invention further includes a chamfer forming step of forming a chamfer between the first and second surfaces of the glenoid, and the chamfer forming step includes fastening the chamfer reaming guide to the reaming guide in the first axis direction. Step, a chamfer reaming step of reaming the portion between the first surface and the second surface through a reamer at least partially penetrating a chamfer reaming guide in the third axis direction, comprising a substantially flat first surface of the glenoid and a second non-deviated surface. A chamfer can be accurately formed between faces.

The present invention further includes a base plate insertion step of inserting the 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 the base plate holder, the base plate It includes a reference indicator fastening step of connecting a reference indicator to one side of the holder, and 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 a first position and inserting the base plate. This has the effect of providing a glenoid base plate insertion method that can simply and accurately insert a partially reinforced base plate into the glenoid.

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 glenoid base plate (B)

Figure 6 is a view showing landmarks displayed in the shape of a cross on the glenoid according to an embodiment of the present invention.

7 and 8 are views showing the guide pin 110 inserted into the glenoid fossa according to an embodiment of the present invention.

Figure 9 is a perspective view of a center guide according to an embodiment of the present invention.

Figure 10 is a rear perspective view of the center guide according to an embodiment of the present invention.

Figure 11 is a perspective view of a guide handle inserted into the center guide according to another embodiment of the present invention.

Figure 12 is a perspective view of the guide handle 200 according to an embodiment of the present invention.

Figure 13 is a view showing the first reamer 310 approaching the glenoid (G) along the guide pin according to an embodiment of the present invention.

Figure 14 is a perspective view of the first reamer 310 according to an embodiment of the present invention.

Figure 15 is a view showing a structure in which the boss cutter 320 and the stopper 330 are fastened to form a recess (H) along the guide pin 110 according to an embodiment of the present invention.

Figure 16 is an exploded perspective view of the boss cutter 320 and the stopper 330.

Figure 17 is a perspective view of a defect measuring instrument 400 according to an embodiment of the present invention.

Figure 18 is an exploded perspective view of the defect measuring instrument 400 according to an embodiment of the present invention.

Figure 19 is a view of the defect measuring device 400 from one side when the defect measuring device 400 approaches the glenoid (G) according to an embodiment of the present invention.

Figure 20 is a view showing the augmentation sizer 430 in contact with the lowest point (L) of the glenoid fossa according to an embodiment of the present invention.

Figure 21 is a view showing a state in which the dial checker 410 according to an embodiment of the present invention is at least temporarily fixed on the glenoid.

Figure 22 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 23 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 24 is a cross-sectional view of the reaming guide 500 according to an embodiment of the present invention.

Figure 25 is a view showing the reaming guide inserted into the glenoid

Figure 26 is a view showing the screw driver 700 being fastened to the reaming guide 500 according to an embodiment of the present invention.

Figure 27 is an exploded perspective view of the screw driver 700 and the reaming guide 500

Figure 28 is a perspective view of the reaming guide holder 800 and the reaming guide 500 according to another embodiment of the present invention.

Figure 29 is an exploded perspective view of the reaming guide holder 800

Figure 30 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. a drawing

31 and 32 are diagrams showing the second reamer 900 approaching the reaming guide 500 according to an embodiment of the present invention.

Figure 33 is a view showing that the chamfer reaming guide 1000 and the chamfer reamer 1010 form a chamfer between the first and second surfaces according to an embodiment of the present invention.

Figure 34 is an exploded perspective view of the chamfer reaming guide 1000 and the chamfer reamer 1010.

Figure 35 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.

36 is an enlarged view of a portion of the base plate holder 1200.

Figure 37 is a flow chart of the glenoid base plate insertion method (S) according to an embodiment of the present invention.

Figure 38 is a flow chart of the defect measurement step (S40) according to an embodiment of the present invention.

Figure 39 is a flow chart of the reaming guide insertion step (S50) according to an embodiment of the present invention.

Figure 40 is a flow chart of the chamfer forming step (S70) according to an embodiment of the present invention.

Figure 41 is a flow chart of the base plate insertion step (S80) according to an embodiment of the present invention.

Hereinafter, the device and method for inserting a glenoid base plate according to the present invention will be described in detail with reference to the attached drawings. It should be noted that like elements in the drawings are represented by like symbols wherever possible. Additionally, detailed descriptions of well-known functions and configurations that may unnecessarily obscure the gist of the present invention are omitted. Unless otherwise specified, all terms in this specification have the same general meaning as understood by a person skilled in the art to which the present invention pertains, and if there is a conflict with the meaning of the terms used in this specification, this specification Follow the definitions used in the specification. Throughout the specification, when it is said that a part "includes" a certain element, this does not mean excluding other elements, unless specifically stated to the contrary, but also means that other elements may also be included, and as stated in the specification, Terms such as “~unit” described mean a unit that processes at least one function or operation. In addition, when certain components are said to be "connected," this is not limited to the components being directly contacted and fastened to each other, but also includes being connected through other components, and even if not connected, a certain amount of force or energy can be transmitted. It may mean that it is arranged so that Terms such as "1st~" and "2nd~" may be used to indicate the same or substantially the same configuration in a different order, and may be used to indicate the same or substantially the same configuration as the configuration without "1st", "2nd", etc. It can be interpreted as a composition. Hereinafter, the present invention will be described in detail by explaining preferred embodiments of the present invention with reference to the accompanying drawings.

First, the devices for inserting the glenoid base plate according to the present invention will be described with reference to FIGS. 6 to 36. Here, the base plate (B) refers to a glenoid base plate that is partially reinforced (wedged) as described above, and an augmentation to compensate for bone defects in the glenoid is formed in a portion. As shown in FIG. 6, landmarks may be displayed in the shape of a cross on the glenoid fossa (G) along the anterior and posterior and superior and inferior directions. As shown in FIGS. 7 and 8, 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.

Referring to Figures 9 and 10, the center guide 120 according to an embodiment of the present invention is provided with a central portion 121 that penetrates and accommodates the guide pin 110 and a portion of the guide handle 200. It may include a plurality of receiving portions 123. In one embodiment, the receiving portion 123 may be provided on the upper, lower, left, and right sides with respect to the central portion 121. A through hole 121a is formed in the central portion 121 to allow the guide pin 110 to penetrate the center guide, and the receiving portion 123 is accommodated in a shape corresponding to or complementary to the end shape of the guide handle 200. A groove 123a is formed. To enable the surgeon to easily insert the guide handle 200, one side of the receiving portion 123 where the receiving groove 123a is formed may form a predetermined angle with one side of the central portion 121.

The central portion 121 and the receiving portion 123 may form a single contact surface 125 in contact with the glenoid (G). The contact surface may be formed substantially flat, and a spike 123b may be formed on the joint surface to at least temporarily fix the center guide 120 on the glenoid. In a preferred embodiment, the spike 123b is formed on the receiving portion side.

The center guide 120 may further include a loss compensation unit 127. The loss compensation part 127 is a part extending from the end of one receiving part 123 toward the glenoid side, and one end of the loss compensation part 127 can support a portion of the defective glenoid by touching the defective glenoid. Since the amount of bone defect in the glenoid fossa may vary depending on the patient, a plurality of center guides 120 with different lengths of the defect compensation portion 127 extending toward the glenoid may be prepared.

Figure 11 shows a center guide according to another embodiment of the present invention. In another embodiment, the central portion 121 may have a through hole 121b formed by slanting downward. At this time, one end of the through hole 121b on the contact surface 125 may be formed in the center without being deviated downward. Accordingly, the guide pin 110 can be inserted into the glenoid from the bottom to the top. At this time, the inclination angle of the first axis is preferably around 10 degrees, and it is preferable to have an inclination of 10 degrees.

In one embodiment, the center guide 120 may have at least one indicating portion 129 instead of the receiving portion 123. The indicating part 129 can indicate in which direction the defect compensation part 127 is formed based on the central part 121, and in addition, the length of the defect compensation part and the degree of inclination of the through hole are determined by the indicating part ( 129) or may be indicated.

Referring to FIG. 12, 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. In a preferred embodiment, the protrusion 231a formed on the tip 231 and the protrusion 235a formed on the step 235 may protrude in opposite directions.

Referring to Figures 13 and 14, the first reamer 310 is a surgical instrument that reams the first surface perpendicular to the first axis along the guide pin 110 inserted into the glenoid (G). In one embodiment of the present invention, the first reamer 310 is capable of flatly reaming at least a portion of the glenoid fossa (G) perpendicular to the first axis, and includes a body 311 extending to one side, the body 311 It includes a shell 313 provided to surround at least a portion of the and a cutting portion 315 that substantially cuts the glenoid fossa.

The body 311 extends to one side, has a predetermined length to facilitate the surgeon's grip, and preferably has a hollow hole to accommodate the guide pin 110 for cutting the glenoid along the guide pin 110. The outer shell 313 may surround at least a portion of the body and may have a plurality of through holes 313a to facilitate cleaning. The cutting part 315 includes a blade 3151, at least a portion of which extends radially to cut bone, a rim 3153 connecting the blades on the outside of the cutting part 315, and a receiving hole 3155 for receiving a guide pin. ) may include. The surgeon approaches the glenoid so that the reamer 310 penetrates and accommodates the guide pin 110, and then rotates the reamer to ream and/or form a first surface perpendicular to the first axis, which is the insertion axis of the guide pin. . The first surface may be substantially flat.

Referring to Figures 15 and 16, in order to seat the stem (B5) portion of the base plate within the glenoid, a recess with a larger diameter than the guide pin may be formed in the glenoid. After fastening the boss cutter (320) and stopper (330) for post reaming, the glenoid can be reamed along the guide pin (110), and a surgical instrument consisting of the boss cutter (320) and stopper (330) can be used. It may be possible.

The boss cutter 320 is configured to form a recess (H) centered on the first axis into which the guide pin is inserted into the glenoid, and has a hollow body 321 extending to one side to accommodate the guide pin, a boss It may include a cutting portion 323 that reams the bone when the cutter rotates to form a recess (H) with a larger diameter than the guide pin, and a seating portion 325 that protrudes outward for seating the stopper. The stopper 330 is configured to be seated or fastened to the boss cutter to adjust the approach distance of the boss cutter. When the boss cutter rotates and approaches the glenoid, when one surface of the stopper touches the first surface of the glenoid, the boss cutter (320) ) to stop the rotation. The stopper 331 includes a tube 331 that has a hollow portion 331a so that it can be seated on the seating portion 325 while penetrating at least a portion of the boss cutter. One side of the tube is formed to be substantially flat, and includes a boss cutter. When 320 approaches the glenoid, it includes an blocking surface 333 at least partially in contact with the first surface of the glenoid. When the stopper 330 is seated on the boss cutter 320, a part of the boss cutter 320, including the cutting part 323, protrudes to one side of the stopper, which has a flat surface, and the boss cutter 320 has a guide pin ( 110) is approached to the glenoid to receive penetration and then rotated to form a recess (H) in the glenoid. The rotation of the boss cutter 320 may be stopped when the blocking surface 333, which is a flat surface of the stopper, contacts the first surface of the glenoid fossa.

Referring to FIGS. 17 to 21, the defect measuring device 400 is an instrument that measures the amount of bone defect in the glenoid fossa and in what direction the defect is located. Preferably, the direction of the defect is based on the reamed first surface. You can check the amount of defect. When part of the glenoid fossa is missing, the lowest point (L) may exist in a predetermined direction based on the center of the glenoid even after reaming to form the first surface. The defect measuring device 400 can check the amount of bone defect in the joint fossa and the direction of the defected part based on the lowest point (L). The insertion position, which is the direction in which the augment of the base plate will be inserted, can be determined based on the amount and direction of the defect measured by the defect measuring device 400. In one embodiment of the present invention, the defect measuring device 400 can check the amount of defect based on how much the lowest point (L) is indented, and the direction in which the lowest point (L) is formed based on the central part of the glenoid fossa ( direction of the defect) can be confirmed, and the direction of the defect is clearly indicated so that a second surface with an inclination to the glenoid can be formed in the correct direction. The defect measuring device 400 may include a dial checker 410, an augmentation sizer 430, and a sizer handle 450.

The dial checker 410 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 410 has a hollow 410a to penetrate and receive the guide pin 110, approaches the first surface of the glenoid fossa G, and is aligned as described later. It can be temporarily fixed. The dial checker 410 may include a rod 411 extending to at least one side, a disk 413 extending at least radially from one side of the rod, and an insertion portion 415 inserted into a recess (H) formed in the glenoid. You can.

The rod 411 preferably extends in the first axis direction to penetrate and accommodate the guide pin 110.

The disk 413 is a configuration that substantially has a direction. Here, '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 413 can be determined according to rotation about the first axis, and a predetermined insertion position can be determined or recognized. The disk 413 allows recognition and/or confirmation of the direction of components seated or overlapping on the disk. The disk 413 may include a disk body 4131, an indicator 4133, a spike 4135, and an alignment hole 4137.

The disk body 4131 is a portion that extends radially at least in part with respect to the rod 411, and may have a plate shape with substantially flat upper and lower surfaces. In one embodiment, the outer peripheral surface of the disk body 4131 may be alternately protruded and recessed to facilitate confirmation of direction. In a preferred embodiment, the disk body 4131 may be formed radially with 12 protrusions having a central angle of 30 degrees based on 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 4131 to be configured so that it is easy to check the direction in which the components on the disk 413 are facing. In addition to the alternately protruding and recessed shapes, grooves extending radially from the center are formed on the disk body 4131. A configuration formed in can also be adopted.

The indicator 4133 is displayed on one side of the disk body 4133 to determine the direction. The indicator 4133 is preferably displayed on the lateral side of the glenoid, that is, on one side of the disc body 4133 that does not face the glenoid, so that the surgeon can easily read it. In one preferred embodiment, the indicators 4133 may be numbers from 1 to 12 and may be displayed on 12 protrusions. In another embodiment, the indicator 4133 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 4135 are provided so that the dial checker 410 can be temporarily fixed on the first surface of the glenoid, and at least one spike 4135 is provided on one surface facing the glenoid of the disc body 4133. A protrusion may be formed on the top.

The alignment hole 4137 is at least one through hole penetrating the disk body 4131, and may preferably be a long hole extending up and down. The alignment of the disk 413 or dial checker 410 can be checked through the alignment hole 4137. After the surgeon approaches the dial checker 410 to the glenoid, the surgeon can align the dial checker 410 by aligning the alignment hole 4137 with a cross-shaped landmark displayed on the glenoid. In one embodiment, the insertion position of the dial checker 410 can be aligned so that the landmark displayed in the superior-inferior direction is at the center of the alignment hole 4137.

The insertion portion 415 is a portion inserted into the recess H of the glenoid and, together with the spike 4135, can assist in temporarily fixing the dial checker. The insertion portion 415 extends a predetermined length from the disk 413 toward the glenoid, and has a hollow extension to accommodate the guide pin.

The augmentation sizer 430 is configured to measure the depth and direction of the defect. It is coaxially aligned with the dial checker 410 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 430 has a through hole 430a that penetrates and accommodates the rod 411 so that it can rotate about the first axis, and can rotate on the disk 413. The augmentation sizer 430 may include a rotor 431, legs 433, and a receiving head 435.

The rotor 431 is configured to rotate relative to the rod 411 on the disk 413, has a substantially flat contact surface on one surface, and can contact the disk body 4131 in a preferred embodiment. As the rotor 431 rotates on the disk, the disk body 4131 faces the glenoid on one side and the rotor 431 on the other side.

The leg 433 extends from one side of the rotor 431 to the glenoid side, and in a preferred embodiment, the endpoint 433a 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 430 on the dial checker 410 to check whether the endpoint 433a of the leg reaches the lowest point L. When the endpoint (433a) of the leg touches the lowest point (L) and the contact surface of the rotor (431) contacts one surface of the disk body (4131), it can be recognized that an augmentation sizer with a desirable leg length has been used. . Therefore, the depth of the lowest point (L), that is, the distance in the first axis direction from the first surface to the lowest point (L), can be measured according to the leg length of the augmentation sizer.

The receiving head 435 is a part accommodated in the sizer handle 450, and may have a shape corresponding to the receiving space of the sizer handle, which will be described later. In one embodiment, the receiving head 435 extends a predetermined length from the rotor 431 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 435 may have an extended through hole 430a to accommodate the rod 411.

Through the interaction of the augmentation sizer 430 and the dial checker 410, the direction of the defect, which is the direction in which the lowest point is formed based on the central part of the glenoid, can be measured. The dial checker 410 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 4137 and the landmark are aligned as described above. Afterwards, the augmentation sizer 430 rotates so that the endpoint 433a of the leg comes into contact with the lowest point L. At this time, the direction the leg 433 is facing can be recognized by the indicator 4133.

The sizer handle 450 is configured to easily rotate the augment sizer 430 on the dial checker 410, and accommodates at least a portion of the augment sizer 430 to create an augment sizer ( 430) and the sizer handle 450 may rotate together around the first axis. That is, the sizer handle 450 has a through hole 430a that penetrates and accommodates the rod 411 of the dial checker and can rotate around the rod 411. The sizer handle 450 may include a handle 451, a receiving portion 453, and a receiving cap 455.

The handle 451 is hollow and extends to one side, and extends to a length that is easy for the surgeon to grip.

The receiving portion 453 can accommodate the receiving head 435 of the augmentation sizer while forming a receiving space 453a therein. The receiving space 453a for accommodating the receiving head 435 of the augmentation sizer 430 is preferably formed so that the augmentation sizer 430 does not rotate independently of the sizer handle 450.

The accommodating cap 455 is configured to open and close the accommodating space 453a while slidingly moving to at least one side with respect to the accommodating portion 453. The receiving cap 455 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 430, and in the backward state, the augment sizer 430 is moved. ) can be removed or replaced.

When the dial checker 410 is temporarily fixed on the glenoid according to a predetermined insertion position, the surgeon first inserts the receiving head 435 into the receiving space 453a and advances the receiving cap 455 to form the augment sizer 430. ) is fixed to the sizer handle 450 and then approached to the glenoid in the first axis direction. At this time, the rod 411 of the dial checker is received through the sizer handle 450 and the augmentation sizer 430. Afterwards, while rotating the augment sizer 430, it is checked whether the end point (433a) of the leg touches the lowest point (L). At this time, one side of the augment sizer (430) and the rotor (431) is connected to the disk (413). , Check whether it is in contact with one surface of the disk body (4131). If there is no contact, remove the sizer handle 450 from the dial checker 410, replace the augment sizer 430, fasten the augment sizer 430 with an appropriate leg length, and check the amount and direction of the defect. Confirm.

22 to 27, the reaming guide 500 according to an embodiment of the present invention is used through the reaming guide holder 600 and the screw driver 700, or the reaming guide holder 800 according to another embodiment. Explain insertion and fixation into the glenoid (G).

The reaming guide 500 is configured to guide reaming of 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 500 may be provided according to the amount of glenoid defect measured or confirmed by the defect measuring device 400. The reaming guide 500 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 500 includes a stem 510 extending in the first axis direction, a guide rod 530 extending in the second axis direction, and a fixing part 550 that at least temporarily fixes the reaming guide on the glenoid. can do.

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). You can. Referring to FIG. 24, 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 guide rod 530 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 530 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 530 may have an end surface facing a hollow 510a 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. That is, the end surface 531 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. While the guide rod 530 extends along the second axis, at least a portion of the end surface 531 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 510a.

The fixing part 550 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 550 extends along a direction other than the second axis direction, which is the direction in which the guide rod 530 extends. 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). there is.

The fixing part 550 has a branch 551 extending to one side from the stem or guide rod, 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. In a preferred embodiment, 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. In a preferred embodiment, the branch 551 may extend in a direction opposite to the guide rod 530. That is, the branch 551 may extend perpendicular to the stem 510 while extending in a direction opposite to the second axis based on the first axis. In another embodiment, a reaming guide lacking the fixing portion 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. In one embodiment, 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.

Referring again to FIGS. 22 and 23, the reaming guide holder 600 according to an embodiment of the present invention can approach and insert the reaming guide 500 into the glenoid while holding the reaming guide 500 and aligning the direction. It is a configuration that can be done. The reaming guide holder 600 approaches the glenoid with the reaming guide 500 fastened, and the insertion position of the reaming guide 500 can be determined for accurate second surface reaming. The reaming guide holder 600 may include an insertion position determination part 610 that determines the insertion position of the reaming guide 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 guide 500, that is, which direction the guide rod 530 faces when the reaming guide 500 is inserted into the glenoid. As described above, the reaming guide 500 is 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 rod 530 is positioned in all directions within a 360-degree range based on the first axis. can be directed to Since the guide rod 530 guides the second surface reaming, the direction of the guide rod 530 must be determined when inserted into the glenoid, and can be determined or guided by the insertion position determination unit 610. The insertion position determination unit 610 can determine the insertion position of the reaming guide 500 along the defect direction recognized by the defect measuring device 400 described above. In detail, 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. 25. 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 determination unit 610 can approach the glenoid (G) with at least a portion of it at least temporarily fastened to the reaming guide 500, and rotates about the first axis to determine the insertion position of the reaming guide 500. It can be adjusted or specified. The insertion position determination unit 610 includes a body 611 at least partially extending in the first axis direction, a fixing leg 613 extending from one side of the body 611, and connecting the body 611 and the alignment unit 617. It includes a connecting portion 615 that is connected to 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 fixing leg 613 is configured to prevent the reaming guide 500 from rotating with respect to the reaming guide holder 600, and at least a portion of the fixing leg 613 may extend toward the reaming guide 500 from one end of the glenoid side of the body 611. . In addition to fastening the fastening portion 630 and the reaming guide 500, which will be described later, the fixing leg 613 allows the reaming guide 500 to determine or designate an insertion position without rotating. The pin 613a formed at the end of the fixing leg can be accommodated in the slot 555 of the fixing part.

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 position of the reaming guide 500, allowing the surgeon to check the alignment portion 617 and rotate the insertion position determination portion 610 about the first axis. there is. 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 guide 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 displayed or formed on one side of the disk 6171, and is displayed corresponding to the indicator 4133 formed on one side of the disk body 4131 described above. That is, a corresponding indicator such as the indicator 4133 displayed on the disk checker 410 to identify 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 400. In detail, after the augmentation sizer 430 is placed toward the lowest point on the dial checker 410, it is possible to check which direction the lowest point (L) is by checking the indicator 4133 where the legs 433 overlap. The insertion position determination unit 610 according to an embodiment of the present invention inserts the reference indicator into the receiving groove 6173 where the corresponding indicator 6175 corresponding to the indicator 4133 is displayed 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. In a preferred embodiment, when the reference indicator inserted in the receiving groove 6173 is moved to the first position with one end facing downward, the guide rod 530 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 position of the reaming guide 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.

In one embodiment, an indicator 4133 from 1 to 12 may be displayed on the disc 413 of the dial checker, and the indicator corresponding to 12 or superior may correspond to a landmark displayed in the superior direction of the glenoid fossa. Place the dial checker (410). 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 fixing leg 613 may extend toward the glenoid side in a direction corresponding to 12 or superior.

The fastening part 630 is fastened with at least a portion of the reaming guide 500, and preferably, one end of the fastening part 630 is fastened with the screw thread 510b formed on the inner peripheral surface of the stem 510 to secure the reaming guide 500. Can 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.

Referring to Figures 26 and 27, the screw driver 700 is configured to rotate the screw 580 in the reaming guide 500 to insert the screw 580 into the glenoid, and includes a driver 710 and a holder (710) that are coaxially aligned. 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.

28 to 30, a reaming guide holder 800 according to another embodiment of the present invention is shown. The reaming guide holder 800 has an insertion position determining part 810, a fastening part 830, and a screw driver 850 aligned coaxially, so that the reaming guide 500 approaches the glenoid side using a single device and turns the screw to at least It can be temporarily fixed.

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 leg 813 is provided to accommodate at least a portion of the reaming guide in the gap 813a and align the direction of the reaming guide. The alignment leg 813 includes a leg 8131 that is divided into two while forming a gap 813a in the middle, and a bent portion 8133 that is bent and extended from one end of the leg 8131. The pair of bent portions 8133 are parallel and accommodate a portion of the reaming guide in the gap 813a between the bent portions 8133. In a preferred embodiment, the gap formed by the alignment leg 813 may be occupied by the guide rod 530. The alignment leg 813 accommodates the guide rod 530 therebetween, and holds the guide rod 530 to align the direction of the reaming guide 500. A reaming guide lacking the fixing portion 550 as described above may be used with the reaming guide holder 800 having the alignment leg 813 in one embodiment.

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 rod 831 and the fastening end 833 may protrude toward the end through the gap 813a between the alignment legs 813. In one embodiment, the fastening end 833 may extend further toward the glenoid than the alignment leg 813.

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.

In another embodiment not shown, 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 is provided with a fixing leg 613 instead of the alignment leg 813. can be provided. Additionally, in an embodiment in which the screw driver 700 is not coaxially aligned but is used as a separate mechanism, the reaming guide holder 600 may be provided with an alignment leg 813 instead of the fixing leg 613.

Referring to FIGS. 31 and 32, the second reamer 900 is a surgical instrument that reams the second surface perpendicular to the second axis along the reaming guide 500 inserted into the glenoid (G). The second reamer 900 can ream the glenoid while accommodating the guide rod 530. In one embodiment of the present invention, the second reamer 900 is capable of flatly reaming at least a portion of the glenoid fossa (G) perpendicular to the second axis, and includes a body 910 extending to one side, the body 910 It includes a shell 930 provided to surround at least a portion of the and a cutting portion 950 that substantially cuts the glenoid fossa.

The body 910 extends to one side, has a predetermined length to facilitate the surgeon's grip, and preferably has a hollow hole to accommodate the guide rod 530 for cutting the glenoid along the reaming guide or guide rod. The outer shell 930 may surround at least a portion of the body and may have a plurality of through holes 930a to facilitate cleaning. The cutting part 950 includes a blade 951, at least a portion of which extends radially to cut bone, a rim 953 connecting the blades on the outside of the cutting part 950, and a receiving hole 955 for accommodating a guide rod. ) may include. The receiving hole 955 preferably has a larger diameter than the receiving hole 3153 formed in the first reamer. The surgeon approaches the glenoid so that the second reamer 900 penetrates and accommodates the guide rod 530, and then rotates the second reamer to ream the second surface perpendicular to the second axis, which is the extension axis of the guide rod. can be formed. The second surface may be substantially flat.

Referring to Figures 33 and 34, the chamfer reaming guide 1000 is a mechanism that guides the insertion of the chamfer reamer 1100 so as to form a chamfer of the base plate (B) whose portion is reinforced through reaming. The chamfer reaming guide 1000 is at least temporarily engaged with the reaming guide 500 inserted into the glenoid and guides the chamfer reamer 1100 to form a chamfer by cutting between the first and second surfaces of the glenoid. The chamfer reaming guide 1000 includes an insertion rod 1010 extending in the first axis direction, a guide plate 1030 surrounding at least a portion of the insertion rod, a receiving groove 1050 for receiving the guide handle 200, and the It may include a neck 1070 connecting the insertion rod, the guide plate, and the receiving groove.

The insertion rod 1010 extends in the direction of the first axis (X1) and is inserted into the stem 510 of the reaming guide 500.

The guide plate 1030 may surround at least a portion of the insertion rod 1010 and penetrate and receive a chamfer reamer 1100, which is a surgical tool for forming a chamfer between the first and second surfaces. The guide plate 1030 may have the shape of a plate extending around the insertion rod.

The guide plate 1030 can accommodate the chamfer reamer 1100 by forming guide holes 1031 on both sides of the insertion rod. Referring to FIG. 33, the guide hole 1031 penetrates and accommodates the chamfer reamer 1100 in the third axis (X3) direction. At this time, it is preferable that the angle formed by the third axis (X3) and the first axis (X1) is smaller than the angle formed by the first axis (X1) and the second axis (X2). The chamfer reamer 1100 is inserted along the third axis and reams between the first and second surfaces, thereby forming a gentle chamfer between the first and second surfaces. A seating protrusion 1031a is formed within the guide hole 1031 to limit the receiving depth of the chamfer reamer 1100. That is, the chamfer reamer 1100 protrudes from the other surface of the guide plate only to a predetermined extent to enable reaming of the glenoid. In a preferred embodiment, the angle formed by the third axis (X3) and the first axis (X1) may be half of the angle formed by the first axis (X1) and the second axis (X2). Since a plurality of reaming guides may be provided at different angles of the second axis, a plurality of chamfer reaming guides 1000 that guide the chamfer reamer 1100 in the third axis (X3) direction may also be provided.

The guide plate 1030 forms an opening 1034 in the direction of a second axis forming a predetermined angle with the first axis, which is the direction in which the insertion rod extends. The width of the opening 1034 formed by the guide plate 1030 may be substantially the same as or slightly wider than the width of the guide rod 530. The guide rod 530 is accommodated in this opening 1034 and can be substantially held by the guide plate 1030.

The guide plate 1030 may have a pin 1035 extending to one side at a predetermined distance away from the insertion rod 1010. The pin 1035 may extend from one side of the guide plate 1030 to the glenoid side to be accommodated in the slot 555 of the reaming guide.

The receiving groove 1050 is a groove formed to accommodate the guide handle 200, and the surgeon can insert the guide handle 200 into the receiving groove 1050 and operate it.

The neck 1070 is configured to connect the insertion rod, the guide plate, and the receiving groove, and the insertion rod 1010 is inserted into the reaming guide 500 or the guide rod 530 is received into the opening 1034 of the guide plate. It is desirable that it is formed so as not to interfere with the mechanism.

The chamfer reamer 1100 is a device that forms a chamfer between the first and second surfaces and cuts the glenoid between the first and second surfaces. The chamfer reamer 1100 includes a rod 1110 extending to one side, and a cutting portion 1130 that cuts the glenoid through rotation at one end of the rod. The rod 1110 preferably extends in the third axis direction.

Referring to Figures 35 and 36, the base plate holder 1200 is a device for inserting a partially reinforced glenoid base plate (B) into the glenoid, and after being at least temporarily fastened to the base plate (B), the base plate ( Determine the insertion position of B) and insert the base plate into the recess (H) of the glenoid (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 augment faces when the base plate (B) is inserted into the glenoid. Since the augmentation B3 of the base plate must correspond to the second surface of the glenoid, the insertion position of the augment must be determined when inserted into the glenoid. The base plate holder 1200 can determine the insertion position of the base plate (B) according to the defect direction recognized by the defect measuring device 400 described above and/or the insertion position determined by the reaming guide holder 600. . Similar to what was described above, the insertion position of the base plate (B) may be determined so that the highest point of the augment and the lowest point (L) formed along the second surface correspond to each other. 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 plate (B) and the base plate holder 1200, and can prevent the base plate (B) from falling off from the base plate holder 1200. The fastening auxiliary part 1230 includes a connecting rod 1231 that transmits rotational force, a rotating body 1233 that can be rotated by the surgeon, and an auxiliary protrusion inserted into the base plate (B) along with an insertion protrusion 1251 to be described later. Includes (1235).

At least a portion of the rotating body 1233 is exposed to the outside of the body 1210 so that the surgeon can rotate the rotating body to generate rotational force. 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 the base plate (B). It can be inserted into the formed through hole or insertion hole. In a preferred embodiment, 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 plate (B) 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 plate (B). Therefore, the insertion protrusion 1251 can be fastened to the base plate (B) 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 plate (B) does not have a symmetrical shape because the augment is formed in a portion, the base plate and the base plate holder 1200 must be fastened in a predetermined manner to ensure that the augment is on the second surface of the glenoid. can be responded to. In a preferred embodiment of the present invention, the base plate (B) and the auxiliary protrusion 1235 are engaged with the through hole of the augmented portion of the base plate, 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. In one embodiment, the insertion indicator 1253 displays the cross-sectional shape of the partially reinforced base plate (B), and the augmentation portion is displayed on the side of the auxiliary protrusion 1235 so that the surgeon can look at the insertion indicator 1253 and insert the portion of the base plate (B). This reinforced base plate (B) can be fastened in a 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 plate (B) 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 4133 formed on one side of the disk body 4131 described above. That is, a corresponding indicator such as the indicator 4133 displayed on the disk checker 410 to identify 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. That is, 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 400. In detail, after the augmentation sizer 430 is placed toward the lowest point on the dial checker 410, it is possible to check which direction the lowest point (L) is by checking the indicator 4133 where the legs 433 overlap. Similar to the alignment of the reaming guide holder 600, 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 position of the base plate (B) can be aligned and inserted into the glenoid.

Above, 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. Hereinafter, the glenoid base plate insertion method (S) according to an embodiment of the present invention will be described.

Referring to Figure 37, the glenoid base plate insertion method (S) involves forming a first and second surfaces on the glenoid to insert a partially reinforced base plate (B) into the glenoid (G), and then inserting the base plate into the glenoid (G). This is the process of aligning the insertion position and inserting it into the glenoid fossa. If a portion of the glenoid fossa is missing, the missing portion can be compensated for through an augment formed in a portion of the base plate. 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), a chamfer forming step (S70), and a base plate inserting 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). After marking cross-shaped landmarks along the anterior and posterior and superior and inferior directions on the glenoid, 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 perpendicular to the first axis along the guide pin, and can be performed by the first reamer 310. The surgeon operates the first reamer 310 while approaching the glenoid fossa along the first axis so that the first reamer 310 can accommodate the guide pin to form a first surface perpendicular to 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 the boss cutter 320 on which the stopper 330 is mounted or the boss cutter 320 provided integrally with the stopper 330. 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 a flat surface, and then the boss cutter 320 is inserted into the glenoid fossa along the first axis to accommodate the guide pin 110. The glenoid can be reamed while approaching.

Referring to FIG. 38, 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 400. In the defect measurement step (S40), the direction of the defect can be confirmed through an indicator, and the insertion position of the reaming guide 500 is determined to correspond to the indicator, and the reaming guide insertion step (S50) and the second reaming step (S50) to be described later ( S60) can be performed to accurately ream the second side. In the defect measurement step (S40), the amount of defect can be confirmed based on how much the lowest point (L) is indented, and the direction in which the lowest point (L) was formed (defect direction) can be confirmed based on the central part of the glenoid fossa. 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 410 described above is placed on the glenoid, and the surgeon approaches the glenoid with the dial checker 410 and then aligns the cross-shaped landmark marked on the glenoid with the alignment hole 4137 to place the dial checker 410 on the glenoid. ) can be sorted. In a preferred embodiment, the insertion position of the dial checker 410 can be aligned so that the landmark displayed in the superior-inferior direction on the glenoid is at the center of the alignment hole 4137. In the dial checker arrangement step (S41), the dial checker 410 may be at least temporarily fixed to the glenoid by a spike 4135 protruding from one surface of the disc body 4133 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 430 provided to measure the depth of the defect. It's a process. A portion of the augmentation sizer 430 is in contact with the lowest point (L), and at the same time, one surface of the augmentation sizer 430 is in contact with one surface of the dial checker 410. It can be placed on the dial checker. As described above, since the depth of the lowest point (L) may vary depending on the amount of glenoid defect depending on the patient, a plurality of augmentation sizers 430 having different leg 433 lengths may be provided. If the leg's endpoint (433a) touches the lowest point and one side of the augment sizer (430) touches one side of the dial checker (410) are not performed at the same time, replace the augment sizer (430) with a suitable augment sizer (430). The ment sizer placement step (S43) can be performed. The surgeon can rotate the augment sizer 430 on the dial checker 410 to check whether the endpoint 433a of the leg touches the lowest point L. When the contact surface of the rotor 431 comes into contact with one surface of the disk body 4131, 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. In the defect direction checking step (S45), 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. When the endpoint (433a) of the leg is in contact with the lowest point (L) and the contact surface of the rotor (431) is in contact with one surface of the disk body (4131), the direction in which the leg (433) faces is recognized by the indicator (4133). The direction of the defect can be determined. Afterwards, the guide pin 110 can be removed.

Referring to Figure 39, the reaming guide insertion step (S50) is a process of inserting a reaming guide that guides reaming of the second surface perpendicular to the second axis, which is not parallel to the first axis, into the glenoid fossa. At this time, the second axis (X2) may be located on the same plane as the lowest point (L) of the glenoid fossa. Additionally, the first axis (X1), the second axis (X2), and the lowest point (L) may be located on the same plane. The reaming guide 500, whose insertion position is aligned, may be inserted into the recess (H) through the reaming guide insertion step (S50). 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 guide 500 to the reaming guide holder 600. At least a portion of the reaming guide holder 600 may be accommodated in the hollow 510a of the stem of the reaming guide. A suitable reaming guide 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 (S430). In one embodiment, when the surgeon rotates the rotating body 635 after the fastening end 633 of the fastening part is accommodated in the hollow, 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 thread 510b is fastened through screw coupling. At this time, when the reaming guide is fastened, the direction in which the guide rod 530 faces may be guided by the fixing leg 613 or the alignment leg 813. As described above, the pin 613a 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 813a formed by the alignment leg 813 The guide rod 530 is accommodated therebetween to guide fastening of the reaming guide.

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. By fastening the reference indicator to the receiving groove 6173 of the reaming guide holder, the reference indicator and the reaming guide holder can form a predetermined angle. In one embodiment of the present invention, the reference indicator and the reaming guide holder may form a right angle. In another embodiment, an angle other than a right angle may be formed depending on whether the first axis X1 is tilted. In the reference indicator fastening step (S53), the reference indicator is inserted into the receiving groove (6173) where the corresponding indicator (6175) corresponding to the indicator (4133) confirmed in the defect direction checking step (S45) is displayed.

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. In a preferred embodiment as shown in FIG. 22, the reaming guide holder 600 is fastened to the reaming guide holder 600 by moving the reference indicator inserted into the receiving groove 6173 to the first position with one end facing downward. The second axis (X2), along which the guide rod 530 of the guide extends, and the lowest point (L) of the glenoid fossa are positioned on the same plane. 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.

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. In the direction alignment step (S55), the surgeon approaches the aligned reaming guide holder 600 and reaming guide 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 screw 580 into the glenoid by rotating the screw 580 in the reaming guide 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. After the reaming guide holder 600 is removed, the screw 580 in the reaming guide 500 can be rotated using a screw driver 700 to insert it into the glenoid and at least temporarily fix it. In another embodiment, a screw driver ( 850) can be advanced so that the tip 853 is exposed to the glenoid side rather than the fastening end 833, and then the screw 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 second reaming step (S60) may be performed by the second reamer (900). In the second reaming step (S60), the second reamer 900 reams the glenoid while receiving the guide rod 530. Since the guide rod 530 of the reaming guide 500, which is inserted and temporarily fixed in the glenoid fossa, extends toward the second axis, the second surface perpendicular to the second axis is reamed by the second reamer. In a preferred embodiment shown in FIG. 25, a line segment from the second axis and the center of the glenoid to the lowest point (L) may form a right angle, and the lowest point (L) may be included in the second surface.

Referring to Figure 40, the chamfer forming step (S70) is a process of forming a chamfer between the first and second surfaces of the glenoid, and can be performed by the chamfer reaming guide 1000 and the chamfer reamer 1100. . The chamfer forming step (S70) may include a chamfer reaming guide fastening step (S71) and a chamfer reaming step (S73).

The chamfer reaming guide fastening step (S71) is a process of fastening the chamfer reaming guide to the reaming guide in the first axis direction, in which the insertion rod 1010 of the chamfer reaming guide is inserted into the stem 510 of the reaming guide along the first axis. It is accepted. At this time, the pin 1035 extending to one side at a predetermined distance from the insertion rod 1010 can be accommodated in the slot 555 of the reaming guide, and the guide rod 530 is connected to the opening formed in the guide plate 1030 ( 1034) and fastening can be guided.

The chamfer reaming step (S73) is a process of reaming a portion between the first and second surfaces through a reamer that at least partially penetrates the chamfer reaming guide in the third axis direction. The chamfer reamer 1100 is received through the chamfer reaming guide through the guide hole 1031 formed in the guide plate 1030, and the protrusion depth is limited by the seating jaw 1031a, so that reaming can be performed. A suitable chamfer reaming guide among the plurality of chamfer reaming guides 1000 that guide the chamfer reamer 1100 in the third axis (X3) direction may be used. In one embodiment, a chamfer reaming guide may be used so that the angle formed by the third axis (X3) and the first axis (X1) is half of the angle formed by the second axis (X2) and the first axis (X1). Afterwards, the reaming guide 500 can be removed.

Referring to Figure 41, the base plate insertion step (S80) is a process of inserting a partially reinforced base plate (B) into the glenoid fossa. In the base plate insertion step (S80), as shown in FIGS. 36 and 37, the base plate (B) 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, in which the insertion protrusion 1251 of the base plate holder 1200 is inserted into the hollow formed in the center of the base plate (B). This is a process in which the auxiliary protrusion 1235 is inserted into a hole formed in a part other than the center of the base plate (B) and fastened at least temporarily. When fastening the base plate, the base plate may be fastened in the direction according to the insertion indicator 1253. In one embodiment, the insertion indicator 1253 is a base plate ( B) and/or indicates 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. By fastening the reference indicator to the receiving groove 1273 of the base plate holder, the reference indicator and the base plate holder can form a predetermined angle. In one embodiment of the present invention, the reference indicator and the base plate holder may form a right angle. In another embodiment, an angle other than a right angle may be formed depending on whether the first axis X1 is tilted. In the reference indicator fastening step (S83), the reference indicator is inserted into the receiving groove (1273) where the corresponding indicator (1275) corresponding to the indicator (4133) confirmed in the defect direction checking step (S45) is displayed. Alternatively, 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. In a preferred embodiment as shown in FIG. 36, the base fastened to the base plate holder 1200 is moved by moving the reference indicator inserted in the receiving groove 1273 to the first position with one end facing downward. The augmentation of the plate corresponds 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. As described above, 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 plate (B) can be correspondingly seated on the second surface.

The above detailed description is illustrative of the present invention. Additionally, the foregoing is intended to illustrate preferred embodiments of the present invention, and the present invention can be used in various other combinations, modifications, and environments. That is, changes or modifications can be made within the scope of the inventive concept disclosed in this specification, a scope equivalent to the written disclosure, and/or within the scope of technology or knowledge in the art. The above-described embodiments illustrate the best state for implementing the technical idea of the present invention, and various changes required for specific application fields and uses of the present invention are also possible. Accordingly, the detailed description of the invention above is not intended to limit the invention to the disclosed embodiments. Additionally, the appended claims should be construed to include other embodiments as well.

Claims (19)

1. It includes a stem that is hollow and extends in the direction of a first axis, and a guide rod that extends in the direction of a second axis at a predetermined angle with the first axis,

   A reaming guide in which at least a portion of the stem is inserted into the glenoid and the guide rod guides the cutting direction of the glenoid.
2. The method of claim 1, wherein the guide rod has an end surface facing a hollow formed on the inner peripheral surface of the stem,

   A reaming guide, wherein at least a portion of the hollow formed by the end surface and the inner peripheral surface of the stem is a cylindrical hole extending in the first axis direction.
3. The reaming guide according to claim 2, wherein the stem has a screw thread on at least one side of the inner peripheral surface.
4. The method of claim 2, further comprising a fixing part on one side of the stem or guide rod for at least temporarily fixing the reaming guide on the glenoid,

   The fixing part is a reaming guide characterized in that it includes a branch extending to one side from the stem or guide rod, and a spike extending from the branch to the glenoid side.
5. The reaming guide according to claim 4, wherein the fixing part includes a slot formed through a portion of the branch or a groove formed on the branch.
6. The method of claim 2, further comprising a screw penetrated through the stem and inserted into the glenoid fossa,

   The screw is a reaming guide characterized in that a groove extending to at least one side is formed on the surface of the head and a screw thread is formed on the outer peripheral surface of the head.
7. It includes an insertion rod extending in a first axis direction and a guide plate surrounding at least a portion of the insertion rod,

   The guide plate is a chamfer reaming guide that has guide holes on both sides of the insertion rod, and the guide holes accommodate surgical instruments in a direction forming a predetermined angle with the first axis.
8. The method of claim 7, wherein the guide plate forms an opening in a direction of a second axis forming a predetermined angle with a first axis extending in the direction of the insertion rod,

   The guide hole accommodates the surgical instrument in the third axis direction, and the angle formed by the third axis and the first axis is smaller than the angle formed by the first axis and the second axis.
9. The chamfer reaming guide according to claim 8, wherein the guide plate includes a pin extending to one side at a portion spaced a predetermined distance from the insertion rod.
10. A plurality of reaming guides according to any one of claims 1 to 6 in which guide rods extend from the stem at different angles, and a plurality of guide holes in which surgical instruments are penetrated and received in directions forming predetermined angles with different first axes. An instrument set including the chamfer reaming guide of any one of claims 7 to 9.
11. A guide pin insertion step of inserting a guide pin into the glenoid, a first reaming step of reaming the first surface perpendicular to the first axis along the guide pin, and checking the direction and amount of the defect based on the first surface. A defect measurement step, a reaming guide insertion step of inserting a reaming guide for guiding second surface reaming perpendicular to a second axis that is not parallel to the first axis into the glenoid fossa, and a second reaming guide perpendicular to at least a portion of the reaming guide. A method of inserting a glenoid base plate including a second reaming step of reaming the surface.
12. The method of claim 11, wherein the defect measuring step measures the distance in the first axis direction from the first surface to the lowest point of the glenoid defect between the augments using an augment sizer provided to measure the depth of the defect. A glenoid base plate insertion method comprising a low placement step and a defect direction checking step of measuring the direction in which the lowest point is formed based on the central portion of the glenoid fossa.
13. The method of claim 12, wherein 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, wherein the defect The direction checking step is a glenoid base plate insertion method characterized in that the direction in which the lowest point is formed is determined through the direction measured by a dial checker.
14. The method of claim 13, wherein the defect direction checking step determines the direction in which the portion of the augmentation sizer in contact with the lowest point faces on the dial checker as the direction in which the lowest point is formed.
15. The method of claim 14, wherein the augmentation sizer arrangement step includes forming the augmentation sizer such that a portion of the augmentation sizer is in contact with the lowest point and one surface of the augmentation sizer is in contact with one surface of the dial checker. A method of inserting a glenoid base plate, characterized in that it is placed on a checker.
16. The method of claim 13, wherein the reaming guide insertion step,

    A reaming guide fastening step of fastening the reaming guide to the reaming guide holder, a reference indicator fastening step of connecting a reference indicator to one side of the reaming guide holder, and a reaming guide fastened to the reaming guide holder by moving the reference indicator to the first position. A direction alignment step of aligning the insertion position of the guide, and a reaming guide fixing step of approaching the reaming guide to the glenoid along the first axis and fixing the reaming guide on the glenoid according to the aligned insertion position. How to insert a glenoid base plate.
17. The method of claim 11, further comprising a post drill step of forming a recess having a cross-section larger than the guide pin in the glenoid fossa in a first axis direction,

    The post drill step is a glenoid base plate insertion method characterized in that at least a portion of the boss cutter having a predetermined diameter protrudes to one side of the stopper with a flat surface and then reams the glenoid along the guide pin.
18. The method of claim 11, further comprising a chamfer forming step of forming a chamfer between the first and second surfaces of the glenoid fossa,

    The chamfer forming step includes a chamfer reaming guide fastening step of fastening a chamfer reaming guide to the reaming guide in a first axis direction, and a chamfer reaming guide fastening step of fastening the chamfer reaming guide to the reaming guide in a first axis direction, and forming a chamfer reaming guide through a reamer at least partially penetrating the chamfer reaming guide in a third axis direction. A glenoid base plate insertion method comprising a chamfer reaming step of reaming the portion between the surfaces.
19. The method of claim 11, further comprising a base plate insertion step of inserting the partially reinforced base plate into the glenoid fossa,

    The base plate insertion step includes a base plate fastening step of fastening the partially reinforced base plate to the base plate holder, a reference indicator fastening step of connecting a reference indicator to one side of the base plate holder, and moving the reference indicator to a first position. A glenoid base plate insertion method comprising an alignment insertion step of aligning the insertion position of the base plate fastened to the base plate holder by moving and inserting the base plate.

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