CN111528980B - A femur positioning device for unicondylar replacement of knee joint fixation platform - Google Patents

Abstract

The application provides a femur positioning device for knee joint fixing platform unicondylar replacement operation, which is characterized by comprising a femur drilling guide, a positioning calibrator and a unicondylar prosthesis. According to the tibia plateau prosthesis, a proper positioning calibrator is selected, the cambered surface of a concave base in the positioning calibrator is tightly attached to the outer side (or inner side) wall of the tibia plateau prosthesis after osteotomy, and the hollow cylindrical groove of the gate-type limiting frame clamps the two guide holes of the femur drilling guide to complete femur positioning operation. The device is showing the interference that "shelter from" effect of patella placed the femur drilling director when reducing the art and using, can also carry out the accurate location of femur side prosthesis position direction, prevents that the femur prosthesis from taking place bad condition such as internal, external rotation, internal, eversion, and operation labour saving and time saving, the step is simple, and the repeatability is strong moreover, and the precision is high.

Description

Translated fromChinese

一种膝关节固定平台单髁置换术的股骨定位装置A femur positioning device for unicondylar replacement of knee joint fixation platform

技术领域technical field

本申请涉及医疗器械技术领域，特别涉及膝关节微创单髁关节置换手术操作和精准股骨假体定位手术技术领域，具体是一种膝关节固定平台单髁置换术的股骨定位装置。This application relates to the technical field of medical devices, in particular to the technical field of minimally invasive unicondylar arthroplasty of the knee joint and the technical field of precise femoral prosthesis positioning surgery, and specifically a femoral positioning device for unicondylar knee arthroplasty on a fixed platform.

背景技术Background technique

膝关节单髁置换术已广泛用于治疗膝关节单间室骨性关节炎，其相对于全膝置换能更多的保留骨量，更接近生理的膝关节运动功能，更好的本体感觉和膝关节活动度以及患者更快的恢复。和活动平台单髁置换相比，固定平台单髁关节置换可用于膝关节内、外侧间室骨关节炎的治疗，而不用担心垫片滑脱等并发症的发生。但膝外侧单髁关节置换的手术技术难度较大，对于术者经验的要求较高，同时影响股骨侧假体定位的不确定因素较多，尚缺乏统一的参考标准，目前固定平台单髁置换的股骨侧截骨及定位主要依靠手动操作，实现高精准度的股骨假体力线及位置具有一定的难度，术者的经验非常重要，尤其对于初学者而言，更是巨大的挑战。若存在显著的股骨假体位置不佳，将影响单髁假体的长期生存率。Unicompartmental knee arthroplasty has been widely used in the treatment of unicompartmental osteoarthritis of the knee joint. Compared with total knee arthroplasty, it can preserve more bone mass, have a more physiological knee motion function, and better proprioception and knee arthroplasty. joint mobility and faster recovery for patients. Compared with unicondylar arthroplasty with movable platform, unicondylar arthroplasty with fixed platform can be used for the treatment of osteoarthritis in the inner and outer compartments of the knee joint without worrying about the occurrence of complications such as spacer slippage. However, the surgical technique of lateral unicompartmental knee arthroplasty is difficult and requires high experience of the surgeon. At the same time, there are many uncertain factors affecting the positioning of the femoral prosthesis, and there is still a lack of unified reference standards. Currently, unicondylar arthroplasty with a fixed platform The osteotomy and positioning of the femoral side mainly rely on manual operation, and it is difficult to achieve high-precision alignment and position of the femoral prosthesis. The experience of the surgeon is very important, especially for beginners, it is a huge challenge. The presence of significant femoral component malposition will affect the long-term survival of unicompartmental components.

申请内容application content

本申请的目的在于，克服现有的技术的不足，提供一种膝关节固定平台单髁置换术的股骨定位装置，主要用于微创小切口下完成膝关节固定平台单髁置换术并实现股骨假体的精准定位。The purpose of this application is to overcome the deficiencies of the existing technology and provide a femur positioning device for unicondylar replacement of the knee joint fixation platform, which is mainly used to complete the unicondylar replacement of the knee joint fixation platform and realize femoral Precise positioning of the prosthesis.

为实现上述目标，本申请提供了如下技术方案：In order to achieve the above goals, the application provides the following technical solutions:

一种膝关节固定平台单髁置换术的股骨定位装置，其特征在于，包括股骨钻孔导向器1、定位校准器2、单髁假体3；A femur positioning device for unicondylar replacement of a knee joint fixation platform, characterized in that it includes afemoral drilling guide 1, apositioning calibrator 2, and aunicondylar prosthesis 3;

所述股骨钻孔导向器1包括上钻孔导向孔11、下钻孔导向孔(12)、定位钉定位孔13；股骨钻孔导向器1采用不规则形设计为上窄下宽结构，股骨钻孔导向器1的底座为弧形结构，术前股骨钻孔导向器1底座弧形面与股骨面贴合；上钻孔导向孔11、下钻孔导向孔12为空心圆柱体结构，两者与股骨钻孔导向器1弧形面固定连接，用于术中股骨钻孔导向；Describedfemoral drilling guide 1 comprises upperdrilling guide hole 11, lower drilling guide hole (12), positioningpin positioning hole 13; The base of thedrilling guide 1 is an arc structure, and the arc surface of the base of thefemoral drilling guide 1 before the operation fits the femoral surface; the upperdrilling guide hole 11 and the lowerdrilling guide hole 12 are hollow cylinder structures, and the two The latter is fixedly connected with the curved surface of thefemoral drilling guide 1, and is used for guiding the femoral drilling during the operation;

所述定位校准器2包括：门型限位框21、左右两侧垫块22、凹形底座23、手柄24：门型限位框21位于左侧垫块22上部，门型限位框(21)下端与左侧垫块22固定连接，门型限位框21的框体内部尺寸和间距与上钻孔导向孔11、下钻孔导向孔12外径尺寸和间距相同；Describedpositioning calibrator 2 comprises: doortype limit frame 21, left andright side pads 22,concave base 23, handle 24: doortype limit frame 21 is positioned atleft side pad 22 tops, door type limit frame ( 21) The lower end is fixedly connected to theleft pad 22, and the internal size and spacing of the frame body of the door-shaped limitingframe 21 are the same as the outer diameter size and spacing of the upperdrilling guide hole 11 and the lowerdrilling guide hole 12;

垫块22厚度高于凹形底座23，呈为长方体条状结构，位于凹形底座23上方，与凹形底座23固定连接；Thepad 22 is thicker than theconcave base 23, and is a rectangular parallelepiped strip structure, located above theconcave base 23, and fixedly connected with theconcave base 23;

凹形底座23为板状结构，两端为弧形；Theconcave base 23 is a plate-shaped structure with arc-shaped ends;

左侧垫块22与手柄24连接，手柄24呈外展状态；Thepad 22 on the left side is connected with thehandle 24, and thehandle 24 is in an outstretched state;

所述单髁假体3包括：上假体31、胫骨平台假体32；为现有技术，是使用过程中被试用的对象。Theunicompartmental prosthesis 3 includes: anupper prosthesis 31 and atibial plateau prosthesis 32; it is the prior art and is the object to be tried during use.

一种膝关节固定平台单髁置换术的股骨定位装置，其特征在于：A femur positioning device for knee joint fixation platform unicondylar replacement, characterized in that:

根据胫骨平台假体32选用合适的定位校准器2，使凹形底座23高度h1与胫骨平台假体32高度h2相同，通过定位校准器2中凹形底座23弧面紧贴截骨后的胫骨平台假体32外侧(或内侧)壁，且门型限位框21的框体卡住股骨钻孔导向器1的两个导向孔(上钻孔导向孔11、下钻孔导向孔12)后完成股骨定位操作。Select asuitable positioning calibrator 2 according to thetibial plateau prosthesis 32, so that the height h1 of theconcave base 23 is the same as the height h2 of thetibial plateau prosthesis 32, and the arc surface of theconcave base 23 in thepositioning calibrator 2 is close to the tibia afterosteotomy Platform prosthesis 32 lateral (or medial) wall, and the frame body of door-shaped limit frame 21 blocks after two guide holes (upperdrilling guide hole 11, lower drilling guide hole 12) offemoral drilling guide 1 Complete the femur positioning operation.

有益效果：Beneficial effect:

本申请设计的一种膝关节固定平台单髁置换术的股骨定位装置，既可以方便在微创小切口下进行股骨假体大小的测量选择，无需过度牵拉髌骨，显著降低术中使用时髌骨的“遮挡”效应对股骨钻孔导向器放置的干扰。还可以进行股骨侧假体位置方向的精准定位，防止股骨假体发生内、外旋，内、外翻等不佳情况。仅需一人一步操作即可完成，不仅省时省力，步骤简化，而且可重复性强，精准度高。This application designs a femoral positioning device for unicompartmental knee arthroplasty, which can facilitate the measurement and selection of the size of the femoral prosthesis under a minimally invasive small incision, without excessive stretching of the patella, and significantly reduces the time of use of the patella during surgery. Interfering with the placement of the femoral drill guide by the "shadowing" effect of the It can also accurately locate the position and direction of the femoral prosthesis to prevent internal and external rotation, varus and valgus of the femoral prosthesis. It only needs one person to complete the operation in one step, which not only saves time and effort, simplifies the steps, but also has strong repeatability and high precision.

附图说明Description of drawings

图1为股骨钻孔导向器示意图；Fig. 1 is the schematic diagram of femoral drilling guide;

图2定位校准器示意图；Fig. 2 schematic diagram of positioning calibrator;

图3单踝假体示意图；Figure 3 Schematic diagram of single ankle prosthesis;

图4股骨钻孔导向器安装示意图；Figure 4 is a schematic diagram of installation of the femoral drill guide;

图5手术中定位校准器与股骨钻孔导向器位置关系图；Figure 5 is a positional relationship diagram between the positioning calibrator and the femoral drilling guide during the operation;

附图标记说明Explanation of reference signs

股骨钻孔导向器1、定位校准器2、单髁假体3；Femoral drill guide 1,positioning calibrator 2,unicompartmental prosthesis 3;

股骨钻孔导向器1包括：上钻孔导向孔11、下钻孔导向孔12、定位钉定位孔13；定位校准器2包括：门型限位框21、垫块22、凹形底座23、手柄24；单髁假体3包括：上假体31、胫骨平台假体32；髌骨4、股骨踝5。Thefemoral drilling guide 1 comprises: upperdrilling guide hole 11, lowerdrilling guide hole 12, positioningpin positioning hole 13;positioning calibrator 2 comprises: door-shaped limit frame 21,cushion block 22,concave base 23,Handle 24;unicondylar prosthesis 3 includes:upper prosthesis 31,tibial plateau prosthesis 32; patella 4,femoral condyle 5.

具体实施方式：Detailed ways:

一种膝关节固定平台单髁置换术的股骨定位装置，包括股骨钻孔导向器1、定位校准器2、单髁假体3；所述股骨钻孔导向器1包括上钻孔导向孔11、下钻孔导向孔12、定位钉定位孔13；所述定位校准器2包括：门型限位框21、垫块22、凹形底座23、手柄24；单髁假体3包括：上假体31、胫骨平台假体32。A femur positioning device for knee joint fixation platform unicondylar replacement, comprising afemoral drilling guide 1, apositioning calibrator 2, aunicondylar prosthesis 3; thefemoral drilling guide 1 includes an upperdrilling guide hole 11,Drilling guide holes 12, positioningnail positioning holes 13; thepositioning calibrator 2 includes: door-shaped limit frame 21,spacer 22,concave base 23,handle 24;unicondylar prosthesis 3 includes:upper prosthesis 31.Tibial plateau prosthesis 32.

如图1所示，所述股骨钻孔导向器1采用不规则形设计为上窄下宽结构；如图4所示，髌骨位于股骨钻孔导向器1上部窄体旁，这种上窄下宽结构结构用于减少术中髌骨4对股骨钻孔导向器1的“遮挡”效应，防止髌骨4对股骨钻孔导向器1放置位置的干扰；股骨钻孔导向器1的底座为弧形结构，术前股骨钻孔导向器1底座弧形面与股骨面贴合；上钻孔导向孔11、下钻孔导向孔12为空心圆柱体结构，两者与股骨钻孔导向器1弧形面固定连接，用于术中股骨钻孔导向；定位钉定位孔13位于股骨钻孔导向器1弧形面上，为空心圆结构，用于术中定位钉定位。As shown in Fig. 1, describedfemoral drilling guide 1 adopts irregular design to be narrow at the top and wide at the bottom; The wide structure is used to reduce the "shielding" effect of the patella 4 on thefemoral drill guide 1 during operation, and prevent the interference of the patella 4 on the placement position of thefemoral drill guide 1; the base of thefemoral drill guide 1 is an arc-shaped structure , the arc-shaped surface of the base of thefemoral drill guide 1 fits the femoral surface before operation; the upperdrill guide hole 11 and the lowerdrill guide hole 12 are hollow cylinder structures, both of which are in contact with the arc-shaped surface of thefemoral drill guide 1 The fixed connection is used for the guidance of the femoral drilling during the operation; the positioningnail positioning hole 13 is located on the arc surface of thefemoral drilling guide 1, which is a hollow circle structure, and is used for positioning the positioning nail during the operation.

如图2所示，门型限位框21位于垫块22上部，门型限位框21下端与垫块22固定连接，门型限位框21的框体尺寸和间距与上钻孔导向孔11、下钻孔导向孔12外径尺寸和间距相同；垫块22为长方体结构，位于凹形底座23上方，与凹形底座23固定连接，垫块22厚度恰好等于胫骨假体的厚度，不仅可以测试评估假体试模的伸屈间隙平衡情况，更重要的是可以在准备股骨侧钻孔时恢复侧副韧带正常的张力，股骨和胫骨也回到正常的相对位置；凹形底座23为板状结构，两端为弧形，底部固定与手柄24平台上，凹形底座23高度为h1，术中凹型底座23弧面紧贴截骨后的胫骨平台假体32外侧(或内侧)壁；手柄24为手持定位校准器2的把手，便于术中医生手持。As shown in Figure 2, the door-shaped limitingframe 21 is located at the top of thespacer 22, and the lower end of the door-shaped limitingframe 21 is fixedly connected with thespacer 22. 11. The outer diameter and spacing of the lowerdrilling guide holes 12 are the same; thepad 22 is a cuboid structure, located above theconcave base 23, and is fixedly connected with theconcave base 23. The thickness of thepad 22 is just equal to the thickness of the tibial prosthesis. It is possible to test and evaluate the balance of the extension and flexion gap of the prosthesis trial model, and more importantly, the normal tension of the collateral ligament can be restored when preparing the femoral lateral drilling, and the femur and the tibia also get back to the normal relative position; theconcave base 23 is Plate-shaped structure, both ends are arc-shaped, the bottom is fixed on the platform of thehandle 24, the height of theconcave base 23 is h1, and the arc surface of theconcave base 23 is close to the lateral (or medial) wall of thetibial plateau prosthesis 32 after osteotomy ; Thehandle 24 is the handle of thehandheld positioning calibrator 2, which is convenient for the doctor to hold during the operation.

单髁假体3为现有技术装置，包括：上假体31、胫骨平台假体32；所述胫骨平台假体32为半圆形板块结构，胫骨平台假体32高度为h2；Theunicondylar prosthesis 3 is a prior art device, comprising: anupper prosthesis 31, atibial plateau prosthesis 32; thetibial plateau prosthesis 32 is a semicircular plate structure, and thetibial plateau prosthesis 32 has a height of h2;

如图5所示，一种膝关节固定平台单髁置换术的股骨定位装置使用原理：As shown in Figure 5, the principle of use of a femoral positioning device for unicompartmental knee arthroplasty:

通过定位校准器2中凹形底座23弧面紧贴截骨后的胫骨平台假体32外侧(或内侧)壁，且门型限位框21内部框体卡住股骨钻孔导向器1的两个导向孔(上钻孔导向孔11、下钻孔导向孔12)完成股骨定位操作。The arc surface ofconcave base 23 in thepositioning calibrator 2 is close to thetibial plateau prosthesis 32 lateral (or medial) wall after osteotomy, and the inner frame of the door-shaped limit frame 21 blocks the two sides of thefemoral drilling guide 1. A guide hole (upperdrilling guide hole 11, lower drilling guide hole 12) completes the femoral positioning operation.

实施例1：Example 1:

一种膝关节固定平台单髁置换术的股骨定位装置使用步骤为：A femur positioning device for knee joint fixation platform unicompartmental replacement uses steps as follows:

s1：以腿完全伸直标记的股骨假体上缘为参照，选取合适型号的股骨钻孔导向器1，并将股骨钻孔导向器1底座与股骨5端贴合，并安装胫骨平台假体32；s1: With the upper edge of the femoral prosthesis marked when the leg is fully extended as a reference, select the appropriate model of thefemoral drill guide 1, fit the base of thefemoral drill guide 1 to the end of thefemur 5, and install thetibial plateau prosthesis 32;

s2：选择与胫骨平台假体32匹配的定位校准器2，使胫骨平台假体32高度h2与凹形底座23高度h1相同；s2: Select thepositioning calibrator 2 that matches thetibial plateau prosthesis 32, so that the height h2 of thetibial plateau prosthesis 32 is the same as the height h1 of theconcave base 23;

s3：定位校准器2中凹形底座23弧面紧贴截骨后的胫骨平台假体32外侧(或内侧)壁；s3: The arc surface of theconcave base 23 in thepositioning calibrator 2 is close to the lateral (or medial) wall of thetibial plateau prosthesis 32 after the osteotomy;

s4：门型限位框21内矿体卡住股骨钻孔导向器1的两个导向孔(上钻孔导向孔11、下钻孔导向孔12)；s4: The ore body in the door-shaped limitingframe 21 is stuck in the two guide holes of the femoral drill guide 1 (the upperdrill guide hole 11 and the lower drill guide hole 12);

s5：完成股骨定位操作，进行股骨钻孔。s5: The femoral positioning operation is completed, and the femoral drilling is performed.

Claims (2)

Translated fromChinese

1.一种膝关节固定平台单髁置换术的股骨定位装置，其特征在于，包括股骨钻孔导向器(1)、定位校准器(2)、单髁假体(3)；1. a femur positioning device for knee joint fixation platform unicondylar replacement, is characterized in that, comprises femoral drilling guide (1), positioning calibrator (2), unicondylar prosthesis (3);所述股骨钻孔导向器(1)包括上钻孔导向孔(11)、下钻孔导向孔(12)、定位钉定位孔(13)；股骨钻孔导向器(1)采用不规则形设计为上窄下宽结构，股骨钻孔导向器(1)的底座为弧形结构，术前股骨钻孔导向器(1)底座弧形面与股骨面贴合；上钻孔导向孔(11)、下钻孔导向孔(12)为空心圆柱体结构，两者与股骨钻孔导向器(1)弧形面固定连接，用于术中股骨钻孔导向；The femoral drill guide (1) includes an upper drill guide hole (11), a lower drill guide hole (12), and a positioning nail positioning hole (13); the femoral drill guide (1) adopts an irregular design The structure is narrow at the top and wide at the bottom. The base of the femoral drilling guide (1) is an arc-shaped structure. , The lower drilling guide hole (12) is a hollow cylinder structure, both of which are fixedly connected with the curved surface of the femoral drilling guide (1), and are used for femoral drilling guidance during the operation;所述定位校准器(2)包括：门型限位框(21)、左右两侧垫块(22)、凹形底座(23)、手柄(24)；门型限位框(21)位于左侧垫块(22)上部，门型限位框(21)下端与左侧垫块(22)固定连接，门型限位框(21)的框体内部尺寸和间距与上钻孔导向孔(11)、下钻孔导向孔(12)外径尺寸和间距相同；The positioning calibrator (2) includes: a door-shaped limiting frame (21), pads (22) on the left and right sides, a concave base (23), and a handle (24); the door-shaped limiting frame (21) is located on the left The top of the side spacer (22), the lower end of the door-type spacer frame (21) is fixedly connected with the left side spacer (22), and the frame internal size and spacing of the door-type spacer frame (21) are the same as those of the upper drilling guide hole ( 11), the outer diameter size and spacing of the lower drilling guide hole (12) are the same;垫块(22)厚度高于凹形底座(23)，呈长方体条状结构，位于凹形底座(23)上方，与凹形底座(23)固定连接；The spacer (22) has a thickness higher than that of the concave base (23), has a rectangular parallelepiped strip structure, is located above the concave base (23), and is fixedly connected with the concave base (23);凹形底座(23)为板状结构，两端为弧形；The concave base (23) is a plate-like structure with arc-shaped ends;左侧垫块(22)与手柄(24)连接，手柄(24)呈外展状态；The left pad (22) is connected with the handle (24), and the handle (24) is in an abducted state;所述单髁假体(3)包括：上假体(31)、胫骨平台假体(32)。The unicompartmental prosthesis (3) comprises: an upper prosthesis (31) and a tibial plateau prosthesis (32).2.根据权利要求1所述的一种膝关节固定平台单髁置换术的股骨定位装置，其特征在于：2. the femur positioning device of a kind of knee joint fixation platform unicondylar replacement according to claim 1, is characterized in that:根据胫骨平台假体(32)选用合适的定位校准器(2)，使凹形底座(23)高度h1与胫骨平台假体(32)高度h2相同，通过定位校准器(2)中凹形底座(23)弧面紧贴截骨后的胫骨平台假体(32)外侧壁或内侧壁，且门型限位框(21)的框体卡住股骨钻孔导向器(1)的上钻孔导向孔(11)与下钻孔导向孔(12)后完成股骨定位操作。Select a suitable positioning calibrator (2) according to the tibial plateau prosthesis (32), so that the height h1 of the concave base (23) is the same as the height h2 of the tibial plateau prosthesis (32), and the concave base in the positioning calibrator (2) (23) The arc surface is close to the lateral wall or medial wall of the tibial plateau prosthesis (32) after osteotomy, and the frame body of the door-shaped limiting frame (21) is stuck on the upper drilling hole of the femoral drilling guide (1) The femur positioning operation is completed after the pilot hole (11) and the lower drilling pilot hole (12).

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