Auxiliary device and method for determining rotational force line of femoral prosthesis in total knee arthroplasty
By combining auxiliary devices and methods for measuring osteotomy technology and gap balance technology, the accuracy of the rotation force line determination of femoral prosthesis in total knee arthroplasty is solved, achieving higher surgical accuracy and patient recovery effect.
Patent Information
- Application Number
- CN202411257428.4
- Authority / Receiving Office
- CN · China
- Patent Type
- Applications(China)
- Current Assignee / Owner
- Filing Date
- 2024-09-09
- Publication Date
- 2025-01-07
AI Technical Summary
In total knee arthroplasty, it is difficult for the prior art to accurately determine the rotational force line of the femoral prosthesis, resulting in imbalance in the flexion gap and soft tissue errors, affecting the surgical accuracy and patient recovery effect.
Provide an auxiliary device and method including a distal femur external rotation angle adjustment device and a buckling gap angle measurement device. By combining measurement osteotomy technology and gap balance technology, it assists in determining the rotation force line of the femur prosthesis and adjusting the rotation angle to ensure soft tissue. Balance, reduce soft tissue loosening.
It improves the accuracy and efficiency of the surgery, reduces the patient's trauma and recovery time, improves the postoperative effect, and ensures the safety and treatment effect of the surgery.
Smart Images
Figure CN119257800A_ABST
Abstract
Description
Technical Field
[0001] The present invention relates to the field of medical devices, and in particular to an auxiliary device and method for determining the rotational force line of a femoral prosthesis in total knee replacement surgery. Background Art
[0002] Total knee arthroplasty (TKA) is the main method for treating end-stage knee joint lesions. The most commonly used osteotomy techniques in TKA are measured osteotomy technique and gap balancing technique. The measured osteotomy technique uses a line parallel to the knee flexion-extension axis to determine the distal femoral external rotation osteotomy. Currently, the commonly used technique is an osteotomy with an external rotation of 3° relative to the line connecting the posterior femoral condyle. The gap balancing technique focuses on the balance of soft tissue in the flexion gap. The osteotomy of the posterior femoral condyle is determined based on the osteotomy surface of the tibial plateau at 90° knee flexion and the soft tissue tension on both sides of the knee joint to ensure the balance of soft tissue in the flexion gap.
[0003] The measured osteotomy technique for posterior femoral condyle osteotomy will result in flexion gap imbalance and require soft tissue release, which will affect the soft tissue balance of the extension gap during the release process. Although the gap balance technique for posterior femoral condyle osteotomy is easy to achieve flexion gap balance, it is greatly affected by the tension of the soft tissues on both sides of the knee joint. If the soft tissue on one side of the knee joint is contracted, the rotational force line error of the femoral prosthesis will increase, and the accuracy is insufficient. Summary of the invention
[0004] In order to solve some of the problems existing in the above-mentioned prior art, the present invention provides an auxiliary device and method for determining the rotational force line of a femoral prosthesis in total knee replacement surgery, so as to solve the deficiencies existing in the prior art.
[0005] To achieve the above-mentioned purpose, the present invention provides an auxiliary device for determining the rotational force line of a femoral prosthesis during total knee replacement surgery, comprising an auxiliary device body, wherein the auxiliary device body comprises a distal femoral external rotation angle adjustment device and a flexion gap angle measuring device, and the distal femoral external rotation angle adjustment device and the flexion gap angle measuring device are both provided with multiple models; the distal femoral external rotation angle adjustment device is arranged in an H-shape as a whole, and a positioning pin mounting hole a and a positioning pin mounting hole c are arranged at one end of the distal femoral external rotation angle adjustment device, and a positioning pin mounting hole b and a positioning pin mounting hole d are arranged at the other corresponding end of the distal femoral external rotation angle adjustment device; the flexion gap angle measuring device comprises a flexion gap measuring head, and a handle is also installed on the flexion gap measuring head.
[0006] The beneficial effects of the present invention are: assisting doctors in determining the rotational force line of the femoral prosthesis and installing the femoral prosthesis during surgery, improving surgical accuracy and efficiency, and reducing errors; adjusting the rotation angle without the need for soft tissue release of the flexion gap, reducing patient trauma, shortening patient recovery time, and improving patient postoperative effects.
[0007] As a further improvement of the present invention, in order to provide accurate information reference, help doctors use auxiliary devices accurately, and ensure the safety of subsequent operations; the upper parts of the positioning pin mounting hole b and the positioning pin mounting hole d are engraved with angle markings; an upper arrow mark and a lower arrow mark are also engraved between the positioning pin mounting hole c and the positioning pin mounting hole b.
[0008] As a further improvement of the present invention, in order to improve the accuracy of the distal femoral external rotation angle adjustment device in assisting in determining the rotational force line; the angle between the line connecting the positioning pin mounting hole a and the positioning pin mounting hole b and the line connecting the positioning pin mounting hole c and the positioning pin mounting hole d is α; the position of the positioning pin mounting hole c can be adjusted in the direction indicated by the upper arrow mark, and the position of the positioning pin mounting hole d can be adjusted in the direction indicated by the lower arrow mark, and the increase and decrease of the angle α can be achieved by adjusting the positions of the positioning pin mounting hole c and the positioning pin mounting hole d; the angle α is an integer value, and α∈[1,3°]; the angle mark content engraved on the distal femoral external rotation angle adjustment device is consistent with the corresponding angle α.
[0009] As a further improvement of the present invention, in order to enable the flexion gap angle measuring device to better cooperate with surgical treatment and improve the surgical effect; the upper and lower surfaces of the flexion gap measuring head are at different angles, and are used to measure the angle β between the lower edge of the distal femoral osteotomy guide and the tibial plateau osteotomy surface when the knee joint is flexed at 90°, and the angle β is an integer value, β∈[0,3°]; a measuring head specification mark is engraved on the handle, and the content of the measuring head specification mark is consistent with the corresponding angle β and the thickness in the middle position of the flexion gap measuring head.
[0010] As a further improvement of the present invention, in order to check the adjusted flexion gap of the posterior femoral condyle osteotomy and ensure that the knee flexion gap is rectangular, soft tissue release of the flexion gap can be avoided and patient trauma can be reduced; when the angle β between the lower edge of the distal femoral osteotomy guide and the tibial plateau osteotomy surface at the knee flexion 90° position is 0, the upper end face and the lower end face of the flexion gap measuring head are parallel, and the flexion gap measuring head is a rectangular block as a whole.
[0011] The present invention also provides an auxiliary method for determining the rotational force line of a femoral prosthesis in total knee replacement surgery, wherein a method combining a measurement osteotomy technique and a gap balancing technique is used to assist in determining the rotational force line of a femoral prosthesis in total knee replacement surgery, and the auxiliary method comprises the following steps: Step 1: During the operation, the distal femoral osteotomy guide is installed using conventional measurement osteotomy technology. After installation, the patient's knee joint is flexed 90° and the area between the patient's tibial plateau osteotomy surface and the distal femoral osteotomy guide is observed; Step 2: Use a flexion gap angle measuring device to measure the angle between the patient's tibial plateau osteotomy surface and the distal femoral osteotomy guide, and adjust the external rotation osteotomy angle by rotating the distal femoral osteotomy guide according to the measurement results. After the adjustment is completed, remove the distal femoral osteotomy guide to determine the positions of nail holes a and b; Step 3: inserting positioning pins into the positions of nail holes a and b determined by the original external rotation, and selecting a distal femoral external rotation angle adjustment device with the same angle according to the angle measured by the flexion gap angle measurement device; Step 4: Insert the selected distal femoral external rotation angle adjustment device into the originally inserted positioning pin through the positioning pin installation hole a and the positioning pin installation hole b, and then insert the positioning pin into the positioning pin installation hole c and the positioning pin installation hole d to determine the positions of the pin hole c and the pin hole d; Step 5: Remove the distal femoral external rotation angle adjustment device and the inserted positioning pin. At this time, four holes are left on the distal femoral osteotomy surface. The angle between the line connecting the nail holes a and b and the line connecting the nail holes c and d is the angle measured by the flexion gap angle measurement device. Step 6: Reinstall the distal femoral osteotomy guide on the nail holes c and d, and flex the patient's knee joint to 90°. At this time, the area between the patient's tibial plateau osteotomy surface and the distal femoral osteotomy guide is a rectangle; Step 7: Use the 0° flexion gap angle measuring device to measure again. Theoretically, a rectangular flexion gap can be obtained, and flexion gap soft tissue balance can be achieved without soft tissue release.
[0012] The beneficial effects of the present invention also lie in that a method combining the measured osteotomy technique and the gap balancing technique is used in total knee replacement to assist in determining the rotational force line of the femoral prosthesis, that is, on the basis of the measured osteotomy technique, the external rotation osteotomy angle is appropriately adjusted according to the principle of the gap balancing technique. This not only takes into account the measured osteotomy technique to ensure good rotational force of the femoral prosthesis, but also takes into account the gap balancing technique to obtain good soft tissue balance. After clinical application, good therapeutic effects have been obtained, and the method is highly practical.
[0013] When the present invention is working, the conventional osteotomy measurement technique is first used to install the distal femoral osteotomy guide during the operation. After the installation is completed, the patient's knee joint is flexed to 90 degrees and the area between the patient's tibial plateau osteotomy surface and the distal femoral osteotomy guide is observed; then a flexion gap angle measuring device is used to measure the angle between the patient's tibial plateau osteotomy surface and the distal femoral osteotomy guide, and the angle of external rotation osteotomy is adjusted by rotating the distal femoral osteotomy guide according to the measurement result; the distal femoral osteotomy guide is installed according to the conventional external rotation of 3 degrees according to the osteotomy measurement technique to determine the positions of nail hole a and nail hole b; then a positioning pin is inserted into the positions of nail hole a and nail hole b determined by the original external rotation, and a distal femoral external rotation angle adjustment device with the same angle is selected according to the angle measured by the flexion gap angle measuring device; then the selected distal femoral external rotation angle adjustment device is passed through The positioning pin mounting hole a2 and the positioning pin mounting hole b4 are fixed; then the positioning pin is inserted into the positioning pin mounting hole c3 and the positioning pin mounting hole d5 to determine the positions of the c nail hole and the d nail hole; then the distal femoral external rotation angle adjustment device 1 and the inserted positioning pin are removed. At this time, four holes are left on the distal femoral osteotomy surface, and the angle between the line connecting the a nail hole and the b nail hole and the line connecting the c nail hole and the d nail hole is the angle measured using the flexion gap angle measuring device; the distal femoral osteotomy guide is reinstalled on the c nail hole and the d nail hole, and the patient's knee joint is flexed 90°. At this time, the area between the patient's tibial plateau osteotomy surface and the distal femoral osteotomy guide is a rectangle; finally, the 0° flexion gap angle measuring device is used to measure and verify again. In theory, a rectangular flexion gap can be obtained, and flexion gap soft tissue balance can be obtained without soft tissue release. BRIEF DESCRIPTION OF THE DRAWINGS
[0014] In order to facilitate the understanding of those skilled in the art, the present invention is further described below with reference to the accompanying drawings: Figure 1 It is a schematic diagram of the distal femoral external rotation angle adjustment device of the present invention.
[0015] Figure 2 It is a schematic diagram of the connection angle of the positioning pin installation holes in the present invention.
[0016] Figure 3 Schematic diagram of the flexion gap angle measurement device in the present invention.
[0017] Figure 4 For the present invention Figure 3 Middle AA section view.
[0018] Figure 5 This is an X-ray of the knee joint.
[0019] Figure 6 This is a lateral X-ray of the knee joint.
[0020] Figure 7This is a picture of a patient being treated intraoperatively with a distal femoral osteotomy guide.
[0021] Figure 8 The flexion gap angle measurement device was used to measure the patient's intraoperative flexion gap angle.
[0022] Fig. 9 Working diagram of the patient using the distal femoral external rotation angle adjustment device during surgery.
[0023] Fig.10 Schematic diagram of the patient's intraoperative positioning needle installation hole.
[0024] Fig.11 Treatment image of the patient undergoing intraoperative reinstallation of the distal femoral osteotomy guide.
[0025] Fig.12 This is a diagram of the patient's intraoperative inspection using the 0° flexion gap angle measurement device.
[0026] Among them, 1 is a distal femoral external rotation angle adjustment device, 2 is a positioning pin mounting hole a, 3 is a positioning pin mounting hole c, 4 is a positioning pin mounting hole b, 5 is a positioning pin mounting hole d, 6 is an angle mark, 7 is an upper arrow mark, 8 is a lower arrow mark, 9 is a flexion gap angle measuring device, 10 is a handle, 11 is a flexion gap measuring head, and 12 is a measuring head specification mark. DETAILED DESCRIPTION
[0027] In order to enable those skilled in the art to better understand the technical solution in this application, Figure 1-12 The present invention is further described. The following examples are only used to more clearly illustrate the technical solution of the present invention, and are not intended to limit the protection scope of the present invention.
[0028] As shown in the figure, an auxiliary device for determining the rotational force line of a femoral prosthesis during total knee replacement surgery includes an auxiliary device body, the auxiliary device body includes a distal femoral external rotation angle adjustment device 1 and a flexion gap angle measuring device 9, and the distal femoral external rotation angle adjustment device 1 and the flexion gap angle measuring device 9 are both provided with multiple models; the distal femoral external rotation angle adjustment device 1 is arranged in an H shape as a whole, and a positioning pin mounting hole a2 and a positioning pin mounting hole c3 are arranged at one end of the distal femoral external rotation angle adjustment device 1, and the distal femoral external rotation angle adjustment device 1 corresponds to The other end is provided with a positioning pin mounting hole b4 and a positioning pin mounting hole d5; the flexion gap angle measuring device 9 includes a flexion gap measuring head 11, and the flexion gap measuring head 11 is also equipped with a handle 10; the upper part of the positioning pin mounting hole b4 and the positioning pin mounting hole d5 is engraved with an angle mark 6; the upper arrow mark 7 and the lower arrow mark 8 are also engraved between the positioning pin mounting hole c3 and the positioning pin mounting hole b4; the angle between the line connecting the positioning pin mounting hole a2 and the positioning pin mounting hole b4 and the line connecting the positioning pin mounting hole c3 and the positioning pin mounting hole d5 is α; the position of the positioning pin mounting hole c3 can be adjusted in the direction indicated by the upper arrow mark 7, and the position of the positioning pin mounting hole d5 can be adjusted in the direction indicated by the lower arrow mark 8, and the increase and decrease of the angle α can be achieved by adjusting the positions of the positioning pin mounting hole c3 and the positioning pin mounting hole d5; the angle α is an integer value, and α∈[1,3°]; the content of the angle mark 6 engraved on the distal femoral external rotation angle adjustment device 1 is consistent with the corresponding angle α; the upper and lower surfaces of the flexion gap measuring head 11 are at different angles, and are used to measure the flexion of the knee joint The angle β between the lower edge of the distal femoral osteotomy guide and the osteotomy surface of the tibial plateau at 90°, the angle β is an integer value, and β∈[0,3°]; the handle 10 is engraved with a measuring head specification mark 12, and the content of the measuring head specification mark 12 is consistent with the corresponding angle β and the thickness of the middle position of the flexion gap measuring head 11; when the angle β between the lower edge of the distal femoral osteotomy guide and the osteotomy surface of the tibial plateau at the knee flexion 90° is 0, the upper end face and the lower end face of the flexion gap measuring head 11 are parallel, and the flexion gap measuring head 11 is a rectangular block as a whole.
[0029] As shown in the figure, an auxiliary method for determining the rotational force line of a femoral prosthesis in total knee replacement is used to assist in determining the rotational force line of a femoral prosthesis in total knee replacement by combining a measurement osteotomy technique with a gap balancing technique. The auxiliary method comprises the following steps: Step 1: During the operation, the distal femoral osteotomy guide is installed using conventional measurement osteotomy technology. After installation, the patient's knee joint is flexed 90° and the area between the patient's tibial plateau osteotomy surface and the distal femoral osteotomy guide is observed; Step 2: Use the flexion gap angle measuring device 9 to measure the angle between the tibial plateau osteotomy surface and the distal femoral osteotomy guide of the patient, and adjust the external rotation osteotomy angle by rotating the distal femoral osteotomy guide according to the measurement result. After the adjustment is completed, remove the distal femoral osteotomy guide to determine the positions of nail holes a and b; Step 3: inserting positioning pins into the positions of nail holes a and b determined by the original external rotation, and selecting the distal femoral external rotation angle adjustment device 1 with the same angle according to the angle measured by the flexion gap angle measuring device 9; Step 4: Insert the selected distal femoral external rotation angle adjustment device 1 into the originally inserted positioning pin through the positioning pin installation hole a2 and the positioning pin installation hole b4, and then insert the positioning pin into the positioning pin installation hole c3 and the positioning pin installation hole d5 to determine the positions of the c nail hole and the d nail hole; Step 5: Remove the distal femoral external rotation angle adjustment device 1 and the inserted positioning pin. At this time, four holes are left on the distal femoral osteotomy surface. The angle between the line connecting the nail holes a and b and the line connecting the nail holes c and d is the angle measured by the flexion gap angle measuring device 9. Step 6: Reinstall the distal femoral osteotomy guide on the nail holes c and d, and flex the patient's knee joint to 90°. At this time, the area between the patient's tibial plateau osteotomy surface and the distal femoral osteotomy guide is a rectangle; Step 7: Use the 0° flexion gap angle measuring device 9 to perform measurement verification again. Theoretically, a rectangular flexion gap can be obtained, and flexion gap soft tissue balance can be achieved without soft tissue release.
[0030] When the present invention is working, the conventional osteotomy measurement technique is first used to install the distal femoral osteotomy guide during the operation. After the installation is completed, the patient's knee joint is flexed to 90 degrees and the area between the patient's tibial plateau osteotomy surface and the distal femoral osteotomy guide is observed; then the flexion gap angle measuring device 9 is used to measure the angle between the patient's tibial plateau osteotomy surface and the distal femoral osteotomy guide, and the angle of external rotation osteotomy is adjusted by rotating the distal femoral osteotomy guide according to the measurement result; the distal femoral osteotomy guide is installed according to the conventional external rotation of 3 degrees according to the osteotomy measurement technique, and the positions of nail holes a and b are determined; then, a positioning pin is inserted into the positions of nail holes a and b determined by the original external rotation, and according to the angle measured by the flexion gap angle measuring device 9, a distal femoral external rotation angle adjustment device 1 with the same angle is selected; then the selected distal femoral external rotation angle adjustment device 1 is passed through The distal femoral osteotomy guide is reinstalled on the c nail hole and the d nail hole, and the patient's knee joint is flexed 90°. At this time, the area between the patient's tibial plateau osteotomy surface and the distal femoral osteotomy guide is rectangular. Finally, the 0° flexion gap angle measuring device 9 is used to measure and verify again. In theory, a rectangular flexion gap can be obtained, and the flexion gap soft tissue balance can be obtained without soft tissue release.
[0031] The present invention is not limited to the above-mentioned embodiments. On the basis of the technical solution disclosed in the present invention, technicians in this field can make some substitutions and deformations to some technical features therein according to the disclosed technical content without creative labor, and these substitutions and deformations are all within the protection scope of the present invention.
Claims
1. An auxiliary device for determining the rotational force line of a femoral prosthesis during total knee replacement, comprising an auxiliary device body, characterized in that: The auxiliary device body comprises a distal femoral external rotation angle adjustment device (1) and a flexion gap angle measurement device (9), and the distal femoral external rotation angle adjustment device (1) and the flexion gap angle measurement device (9) are both provided with a plurality of models; the distal femoral external rotation angle adjustment device (1) is arranged in an H-shape as a whole, and a positioning pin mounting hole a (2) and a positioning pin mounting hole c (3) are arranged at one end of the distal femoral external rotation angle adjustment device (1), and a positioning pin mounting hole b (4) and a positioning pin mounting hole d (5) are arranged at the other corresponding end of the distal femoral external rotation angle adjustment device (1); the flexion gap angle measurement device (9) comprises a flexion gap measurement head (11), and a handle (10) is also mounted on the flexion gap measurement head (11).
2. The auxiliary device for determining the rotational force line of a femoral prosthesis in total knee replacement according to claim 1, characterized in that: An angle mark (6) is engraved on the upper part of the positioning pin mounting hole b (4) and the positioning pin mounting hole d (5); an upper arrow mark (7) and a lower arrow mark (8) are also engraved between the positioning pin mounting hole c (3) and the positioning pin mounting hole b (4).
3. The auxiliary device for determining the rotational force line of the femoral prosthesis in total knee replacement according to claims 1 and 2, characterized in that: The angle α between the line connecting the positioning pin mounting hole a (2) and the positioning pin mounting hole b (4) and the line connecting the positioning pin mounting hole c (3) and the positioning pin mounting hole d (5) is α; the position of the positioning pin mounting hole c (3) can be adjusted in the direction indicated by the upper arrow mark (7), and the position of the positioning pin mounting hole d (5) can be adjusted in the direction indicated by the lower arrow mark (8), and the angle α can be increased or decreased by adjusting the positions of the positioning pin mounting hole c (3) and the positioning pin mounting hole d (5); the angle α is an integer value, and α∈[1,3°]; the content of the angle mark (6) engraved on the distal femoral external rotation angle adjustment device (1) is consistent with the corresponding angle α.
4. The auxiliary device for determining the rotational force line of a femoral prosthesis in total knee replacement according to claim 1, characterized in that: The upper and lower surfaces of the flexion gap measuring head (11) are at different angles and are used to measure the angle β between the lower edge of the distal femoral osteotomy guide and the tibial plateau osteotomy surface at a 90° flexion position of the knee joint, wherein the angle β is an integer value, and β∈[0,3°]. The handle (10) is engraved with a measuring head specification mark (12), and the content of the measuring head specification mark (12) is consistent with the corresponding angle β and the thickness at the middle position of the flexion gap measuring head (11).
5. The auxiliary device for determining the rotational force line of a femoral prosthesis in total knee replacement according to claim 4, characterized in that: When the angle β between the lower edge of the distal femoral osteotomy guide and the tibial plateau osteotomy surface is 0 at a knee joint flexion position of 90°, the upper end surface and the lower end surface of the flexion gap measuring head (11) are parallel, and the flexion gap measuring head (11) is in the form of a rectangular block as a whole.
6. A method for assisting in determining the rotational force line of a femoral prosthesis during total knee replacement, characterized in that: In total knee replacement, a method combining osteotomy measurement and gap balancing technology is used to assist in determining the femoral prosthesis rotational force line, and the auxiliary method includes the following steps: Step 1: During the operation, the distal femoral osteotomy guide is installed using conventional measurement osteotomy technology. After installation, the patient's knee joint is flexed 90° and the area between the patient's tibial plateau osteotomy surface and the distal femoral osteotomy guide is observed; Step 2: Use a flexion gap angle measuring device (9) to measure the angle between the tibial plateau osteotomy surface and the distal femoral osteotomy guide of the patient, and adjust the external rotation osteotomy angle by rotating the distal femoral osteotomy guide according to the measurement result. After the adjustment is completed, remove the distal femoral osteotomy guide and determine the positions of nail holes a and b. Step 3: inserting positioning pins into the positions of nail holes a and b determined by the original external rotation, and selecting a distal femoral external rotation angle adjustment device (1) with the same angle according to the angle measured by the flexion gap angle measurement device (9); Step 4: Insert the selected distal femoral external rotation angle adjustment device (1) into the originally inserted positioning pin through the positioning pin installation hole a (2) and the positioning pin installation hole b (4), and then insert the positioning pin into the positioning pin installation hole c (3) and the positioning pin installation hole d (5), and determine the positions of the pin hole c and the pin hole d; Step 5: Remove the distal femoral external rotation angle adjustment device (1) and the inserted positioning pin. At this time, four holes are left on the distal femoral osteotomy surface. The angle between the line connecting the nail holes a and b and the line connecting the nail holes c and d is the angle measured by the flexion gap angle measurement device (9). Step 6: Reinstall the distal femoral osteotomy guide on the nail holes c and d, and flex the patient's knee joint to 90°. At this time, the area between the patient's tibial plateau osteotomy surface and the distal femoral osteotomy guide is a rectangle; Step 7: Use the 0° flexion gap angle measurement device (9) to perform measurement verification again. Theoretically, a rectangular flexion gap can be obtained, and flexion gap soft tissue balance can be achieved without soft tissue release.