Guide baffle plate for patella lateral support belt joint capsule external debonding operation
By designing a guide baffle for the lateral patella support extracapsular loosening surgery, the problems of poor protection of the patellofemoral joint capsule and complex surgical operation in the prior art are solved, and higher surgical safety and success rate are achieved.
Patent Information
- Application Number
- CN202421108407.1
- Authority / Receiving Office
- CN · China
- Patent Type
- Utility models(China)
- Current Assignee / Owner
- Filing Date
- 2024-05-21
- Publication Date
- 2025-03-18
- Estimated Expiration
- 2034-05-21
AI Technical Summary
The lateral hypertension syndrome of the patellar can lead to degenerative changes in the patellofemoral joint and osteoarthritis. The existing external capsule loosening surgery technology requires high requirements, making it difficult to fully protect the joint capsule, easily damage the subcutaneous blood vessels and the lateral femoral muscle, and the operation is complicated and the success rate is low.
A guide baffle is designed for the lateral patella support for extracapsular loosening surgery. The arc-shaped chute of the guide plate gradually becomes lower and narrower from one end to the other. The guide rod and tongue baffle are used for guidance and protection to ensure the accuracy and safety of the loosening path.
Through the use of guide baffles, the joint capsule can be effectively protected, the damage to the subcutaneous blood vessels and the lateral femoral muscle can be reduced, the safety and success rate of the surgery can be improved, and the surgical process is simplified, so that doctors with less clinical experience can also assist in the surgery.
Smart Images
Figure CN222623030U_ABST
Abstract
Description
Technical Field
[0001] The utility model relates to the technical field of medical instruments, in particular to a guide baffle used for extracapsular release surgery of the lateral patellar retinaculum. Background Art
[0002] Patellar lateral hypertension syndrome is one of the pathological mechanisms that lead to patellofemoral joint degeneration and the progression of osteoarthritis in clinical practice, and is also one of the important causes of anterior knee pain. The main reason is that the lateral patellar retinaculum is tense, thickened, and contracted, which leads to uneven traction on the inside and outside of the patella, causing the patella to deviate to the outside and increase the pressure on the outside of the patellofemoral joint, resulting in cartilage damage and lateral pain. At present, the main method of surgical treatment is to incise and release the entire layer of the lateral patellofemoral retinaculum to reposition the patella, optimize the patellar trajectory, and balance the pressure on the inside and outside.
[0003] Endoscopic release surgery is mainly divided into two categories: intracapsular release and extracapsular release. Compared with intracapsular release, the main advantages of extracapsular release are preservation of the joint capsule, clear anatomy, precise release, avoidance of vascular injury and vastus lateralis muscle injury, fewer postoperative complications and faster recovery. It is currently the mainstream release method. However, in actual operation, extracapsular release has high technical requirements and many technical barriers, which are mainly manifested in several aspects: first, the corresponding medical staff have high surgical skills requirements, and it is difficult to fully protect the joint capsule during the operation; second, the subcutaneous tunnel separation area is large during the operation, which is easy to cause greater damage to the subcutaneous blood vessels; in addition, due to the unclear anatomical position in the subcutaneous tunnel, the release path is inaccurate and easy to deviate, affecting the success rate of the operation. Utility Model Content
[0004] The utility model aims to provide a guide baffle for extracapsular release of the lateral patellar retinaculum, so as to solve the problems raised in the above-mentioned background technology.
[0005] In order to solve the above technical problems, the utility model provides the following technical solutions: a guide baffle for extracapsular release surgery of the lateral patellar retinaculum, comprising a guide plate, wherein the ridges on both sides of the guide plate are gradually recessed toward the middle to form an arc-shaped slide groove, and the arc-shaped slide groove of the guide plate gradually becomes lower and narrower from one end to the other end, and the width of the arc-shaped slide groove of the guide plate gradually becomes narrower from the high end to the low end, and the low end of the arc-shaped slide groove of the guide plate passes through the gap between the joint capsule and the lateral retinaculum.
[0006] In a further embodiment, a guide rod is fixed to the lower end of the arc-shaped slide groove of the guide plate.
[0007] In a further embodiment, the diameter of the guide rod is the same as the outer diameter of the arc-shaped slide groove, the length of the guide rod is in the range of 1-2 cm, and has a conical structure.
[0008] In a further embodiment, a tongue-shaped baffle is obliquely fixed to the higher end of the arc-shaped slide groove of the guide plate.
[0009] In a further embodiment, the angle between the tongue-shaped baffle and the guide plate is in the range of 95-100°.
[0010] In a further embodiment, it further comprises a fixing sleeve which is detachably sleeved on the outer wall of the guide rod, and a handle is provided on the outer wall of the fixing sleeve.
[0011] Compared with the prior art, the beneficial effects of the utility model are:
[0012] The utility model improves the conventional extracapsular release surgery and adopts a guide plate with an arc-shaped slide groove to guide the release path and establish a protective passage. The purpose is to only cut the lateral support band without damaging the joint capsule below, thereby protecting the joint capsule and not damaging the patellar ligament and vastus lateralis muscle. The safety of the surgery is increased, complications are reduced, and the efficiency of the surgery is improved. Doctors with less clinical experience can also assist in the surgery. The utility model is simple and practical. BRIEF DESCRIPTION OF THE DRAWINGS
[0013] Figure 1 This is a schematic diagram of the main structure of an embodiment of the utility model;
[0014] Figure 2 It is a side structural sectional view of the main structure of an embodiment of the utility model;
[0015] Figure 3 This is a schematic diagram of the main structure of an embodiment of the utility model with the outer support cut away.
[0016] Figure 4 This is a schematic diagram of a further improved structure of the main structure of an embodiment of the utility model.
[0017] In the figure: 1. guide plate; 11. arc-shaped slide groove; 2. tongue-shaped baffle; 3. guide rod; 4. fixing sleeve; 41. handle. DETAILED DESCRIPTION
[0018] The following will be combined with the drawings in the embodiments of the utility model to clearly and completely describe the technical solutions in the embodiments of the utility model. Obviously, the described embodiments are only part of the embodiments of the utility model, not all of the embodiments. Based on the embodiments in the utility model, all other embodiments obtained by ordinary technicians in this field without creative work are within the scope of protection of the utility model.
[0019] Embodiment, this embodiment provides a guide baffle for lateral patellar retinaculum joint capsule release surgery, such as Figure 1 and Figure 2 As shown, it includes a guide plate 1, and the two sides of the guide plate 1 are gradually concave toward the middle to form an arc-shaped slide groove 11. The arc-shaped slide groove 11 of the guide plate 1 is gradually lowered from one end to the other end. At the same time, the width of the arc-shaped slide groove 11 is gradually narrowed from the high end to the low end, thereby reducing the resistance during the puncture process. The total length of the guide plate 1 is 15 cm, which meets the puncture length requirement. Figure 3 The q position shown is the joint capsule, and the t position is the lateral support band. The lower end of the arc-shaped slide groove 11 of the guide plate 1 is passed through the gap between the joint capsule and the lateral support band. Because the lower end is designed as a cylindrical guide rod 3, the penetration resistance is smaller than that of the higher end, which is convenient for medical staff to perform surgical operations.
[0020] Before surgery, three access routes should be established in the knee joint. The first is the anterolateral approach to the knee: the conventional anterolateral approach to the patella is recommended to be close to the lateral side of the patellar tendon, such as Figure 3 The second is the anterolateral superior approach: located at the intersection of the horizontal line three fingers above the patella in the extended position and the projection of the anterior cortex of the femur, such as Figure 3 The N1 position is shown in the figure; the specific anatomical position is located in front of the iliotibial band, in the middle and outer side of the vastus lateralis muscle. The third is the medial approach to the anterior extreme of the knee: after establishing the lateral approach with a crutch, lift the skin parallel to the inside, locate from the inside to the outside, touch the tip of the crutch on the surface of the body, and establish the medial approach with a sharp knife. This approach can clearly see the medial situation of the anterior lateral approach.
[0021] Afterwards, observe from the extreme medial approach, directly observe the inner opening of the anterolateral approach, clean the fat pad and hyperplastic synovial tissue around the inner opening, fully expose the inner opening of the anterolateral approach, and use curved forceps to separate the gap between the joint capsule near the inner opening and the lateral retinaculum. The separation direction is from the anterolateral approach, close to the lateral edge of the patella to the proximal end. After the separation is successful, insert the lower end of the arc-shaped groove 11 of the guide plate 1 into the gap between the separated joint capsule and the lateral retinaculum, close to the lateral edge of the patella to the proximal end, run between the joint capsule and the lateral retinaculum, and pass through the surface of the vastus lateralis muscle and out of the anterolateral approach to separate and create the first tunnel. The insertion direction of the guide plate 1 is from the following direction: Figure 3 Insert at the N1 position shown, through the first tunnel, from Figure 3 The N2 position shown is penetrated. At this time, under the observation of the extreme medial approach, be careful not to damage the joint capsule. It should be noted that in the correct gap, the surgeon will feel tension on the outside at this time, and if it is subcutaneous, there will be no obstruction on the outside.
[0022] The guide plate is left in the tunnel and not removed. At this time, a conversion rod is used to make a second tunnel. This tunnel is located between the subcutaneous tissue and the lateral support band. Its direction is parallel to the first tunnel. The starting point is the anterior lateral approach and the end point is the superolateral approach. Limited separation is performed subcutaneously and extensive separation is not required.
[0023] After the two tunnels were successfully established, the arthroscopy entered the second tunnel space from the anterolateral approach, and the radiofrequency was introduced from the anterior superior approach along the second tunnel space proximal to the U-shaped chute. The distal end of the chute at the anterolateral approach was first found, and radiofrequency was used to release the patellar lateral retinaculum tissue on the surface proximally along the direction of the chute. The whole process was released until the chute was completely exposed. At this time, the joint capsule tissue below the chute was intact and the two tunnels were connected. The released structure included the shallow and deep layers of the lateral retinaculum. The chute effectively protected the patellar tendon and the vastus lateralis muscle tissue. After the release was completed, due to the protection of the arc-shaped chute of the guide plate 1 and the limited subcutaneous separation, the risk of vascular injury was low and bleeding was less.
[0024] In summary, the guide plate 1 with an arc-shaped groove is used to guide the release path and establish a protective passage, the purpose of which is to only cut the lateral support band without damaging the joint capsule below. Moreover, the positioning guidance of the groove can quickly and accurately release the lateral support band, and under the protection of the arc-shaped groove of the guide plate, damage to the patellar tendon and the vastus lateralis tendon can be avoided. At the same time, the release path is accurate under the guidance and positioning of the groove, and there is no need for excessive subcutaneous separation, which reduces damage to subcutaneous blood vessels and soft tissues, reduces the risk of subcutaneous hematoma, significantly reduces the operation time, and improves the efficiency of the operation. Doctors with less clinical experience can also assist in surgery.
[0025] Furthermore, a guide rod 3 is fixed to the lower end of the arc-shaped groove 11 of the guide plate 1. The guide rod 3 can play a role in front-end guiding puncture, so that the lower end of the arc-shaped groove 11 of the guide plate 1 can be quickly passed through the gap between the joint capsule and the lateral support band. The diameter of the guide rod 3 here is the same as the outer diameter of the arc-shaped groove 11, ensuring that the resistance is minimized when the guide plate 1 is introduced. The end of the guide rod 3 is a conical structure, which is convenient for puncture guidance. The length of the guide rod 3 is in the range of 1-2cm. The length of the guide rod 3 here should not be too long, and its length only needs to meet the guidance requirements along the tunnel.
[0026] In addition, a tongue-shaped baffle plate 2 is fixed obliquely at the higher end of the arc-shaped chute 11 of the guide plate 1, and the tongue-shaped baffle plate 2 is used to block the patellar tendon. Figure 3 The patellar tendon is shown in the S position. The angle between the tongue-shaped baffle 2 and the guide plate 1 is in the range of 95-100°, preferably 100°, which can block the patellar tendon position at the best angle. In actual use, the entire baffle needs to be pushed proximally so that the tongue-shaped baffle 2 is close to the skin or enters the subcutaneous tissue to close to the patellar tendon.
[0027] The entire guide plate is passed along the gap between the joint capsule and the lateral retinaculum to establish a protective channel between the joint capsule and the lateral retinaculum, thereby ensuring that the release path is accurately found in the subcutaneous tunnel, that is, the anatomical position is determined, deviation is avoided, and the success rate of the operation is improved. At the same time, the joint capsule is fully protected. The use of a guide plate can reduce the separation area of the subcutaneous tunnel during surgery and avoid major damage to the subcutaneous blood vessels.
[0028] The guide rod 3 further comprises a fixing sleeve 4 which is detachably sleeved on the outer wall of the guide rod 3, and a handle 41 is provided on the outer wall of the fixing sleeve 4. Figure 4 As shown, since the entire guide plate 1 is relatively short, in order to facilitate the assistant to hold the guide plate 1 during the operation and ensure that the position of the device remains unchanged during the operation, when the insertion direction of the guide plate 1 is from Figure 3 Insert at the N1 position shown, through the first tunnel, from Figure 3 After the position N2 shown is passed through, the fixing sleeve 4 is put on the outer wall of the guide rod 3 in an overfitting manner, and the doctor holds the handle 41 to assist in stabilizing the position of the guide plate 1.
[0029] Although embodiments of the present invention have been shown and described, it will be appreciated by those skilled in the art that various changes, modifications, substitutions and variations may be made to the embodiments without departing from the principles and spirit of the present invention, and that the scope of the present invention is defined by the appended claims and their equivalents.
Claims
1. A guide baffle for extracapsular release of the lateral patellar retinaculum, characterized in that , comprising a guide plate (1), wherein the two sides of the guide plate (1) are gradually recessed toward the middle to form an arc-shaped slide groove (11), the arc-shaped slide groove (11) of the guide plate (1) is gradually lowered from one end to the other end, the width of the arc-shaped slide groove (11) of the guide plate (1) is gradually narrowed from the high end to the low end, and the low end of the arc-shaped slide groove (11) of the guide plate (1) passes along the gap between the joint capsule and the lateral support band.
2. The guide baffle for extracapsular release of the lateral patellar retinaculum according to claim 1, characterized in that: A guide rod (3) is fixed to the lower end of the arc-shaped sliding groove (11) of the guide plate (1).
3. The guide baffle for extracapsular release of the lateral patellar retinaculum according to claim 2, characterized in that: The diameter of the guide rod (3) is the same as the outer diameter of the arc-shaped slide groove (11); the length of the guide rod (3) is in the range of 1-2 cm and has a conical structure.
4. The guide baffle for extracapsular release of the lateral patellar retinaculum according to claim 1, characterized in that: A tongue-shaped baffle plate (2) is obliquely fixed to the higher end of the arc-shaped sliding groove (11) of the guide plate (1).
5. The guide baffle for extracapsular release of the lateral patellar retinaculum according to claim 4, characterized in that: The angle between the tongue-shaped baffle plate (2) and the guide plate (1) is in the range of 95-100°.
6. The guide baffle for extracapsular release of the lateral patellar retinaculum according to claim 1, characterized in that: It also comprises a fixing sleeve (4) which is detachably sleeved on the outer wall of the guide rod (3), and a handle (41) is provided on the outer wall of the fixing sleeve (4).