A posterior cruciate ligament lower end point locator

Abstract

The present invention discloses a posterior cruciate ligament lower stop point locator, including a locator handheld part, a tibial fixing part, a guide sleeve, a depth-limiting sleeve and a depth-limiting drill. The locator handheld part is in the shape of an arc handle as a whole, and a hollow wire channel is provided in the upper part thereof. The exit of the hollow wire channel is located at the vertex of the locator handheld part, and three fixing holes with an inner diameter of 2.00 mm are provided at the rear end for fixing the locator on the tibial cortex. The tibial fixing part of the locator is an arc with a diameter of 11 cm, and its upper end slides into the slide rail of the locator handheld part, and is locked and fixed by screws on the slide rail. The present invention can realize the rapid and safe establishment of the tibial bone tunnel of the posterior cruciate ligament without establishing an inner posterior approach, and easily pull the posterior cruciate ligament graft into the femoral and tibial bone tunnels, which can reduce the operation time, increase the safety and repeatability of the operation, reduce the difficulty of the operation, and shorten the learning curve of young doctors.

Description

Technical Field

[0001] The invention relates to the field of medical devices, and in particular to a lower end point locator for a posterior cruciate ligament. Background Art

[0002] Posterior cruciate ligament injuries account for 3% to 20% of knee ligament injuries, often caused by an impact on the front of the knee or a fall with the knee flexed. Single injuries are rare and are prone to complications of other ligament injuries. The posterior cruciate ligament provides 95% of the blocking force for the displacement of the tibia to the posterior direction, limits internal and external rotation, and relieves the pressure between the patellofemoral joint and the medial tibiofemoral joint. Untreated posterior cruciate ligament rupture will lead to patellofemoral arthritis and medial knee osteoarthritis. In order to restore the structure and function of the knee joint, arthroscopic surgery should be actively used to reconstruct the posterior cruciate ligament when the posterior cruciate ligament is ruptured.

[0003] The difficulty of arthroscopic reconstruction of the posterior cruciate ligament is that the lower end of the posterior cruciate ligament is deep, located on the posterior side of the proximal tibia and under the tibial plateau, and the arthroscopic field of view is poor at this location. In addition, during reconstruction of the posterior cruciate ligament, the distance between the medial opening of the tibial bone tunnel and the vascular and nerve bundle in the popliteal fossa is relatively close. In the extended position of the knee joint, the medial opening of the bone tunnel is about 6 mm away from the vascular and nerve bundle on average. There is a possibility of damaging the vascular and nerve bundle when establishing the tibial bone tunnel during surgery. In order to solve the current preparation of the tibial bone tunnel in posterior cruciate ligament reconstruction, the medial posterior approach is currently used to clean the tissue at the posterior mediastinum of the knee joint, expose the lower end of the posterior cruciate ligament, and insert the guide pin and drill under monitoring. At the same time, the knee joint is flexed 90° during surgery. Studies have found that when the knee joint is flexed 90°, the vascular and nerve bundle in the popliteal fossa will move posteriorly, and the average distance from the medial opening of the tibial bone tunnel can exceed 24 mm. Establishing a posterior approach to the knee joint during surgery will increase the operation time. According to literature reports, for the same surgeon, these operations take an average of about 20 minutes. Although these operations can further reduce the chance of vascular and nerve injury during arthroscopic reconstruction of the posterior cruciate ligament, vascular and nerve injury is still a major complication of this type of surgery according to current literature reports. Once vascular and nerve injury occurs during surgery, the vascular and nerve bundles need to be cut and repaired during surgery, and the knee joint must be fixed for a long time after surgery. This not only prolongs the operation time and increases the patient's pain, but most importantly, it will have a very serious impact on the patient's knee joint function after surgery, and loss of knee joint mobility is almost inevitable.

[0004] At present, the principles of the instruments for reconstruction of the posterior cruciate ligament are mostly similar. Common manufacturers include Smith & Nephew, Johnson & Johnson, Arthrex, etc. All of them use a locator to locate the lower end point of the posterior cruciate ligament. After inserting the guide pin, a tibial bone tunnel drill of corresponding thickness is used to establish the bone tunnel. At present, there are locators for the lower end point of the posterior cruciate ligament, which do not have good stability. For posterior cruciate ligament reconstruction, accurate positioning of the bone tunnel is the most important guarantee for the success of the operation. At present, the posterior cruciate ligament locator requires the surgeon to hold the locator and maintain the same position during the operation, while the assistant drills the guide pin. This operation requires high stability of the doctor's hand. Once the assistant moves when drilling the guide pin, it may cause the guide pin position deviation and the possibility of surgical failure. Clinically, patients with posterior cruciate ligament injury are often young and middle-aged patients with good bone strength and thick tibial cortex, which makes drilling more difficult. When drilling is not smooth, the surgeon often finds it difficult to keep the position still for a long time, and the assistant also finds it difficult to keep the angle unchanged. These variables can cause the direction and exit point of the guide pin to change, affecting the effect of the operation.

[0005] At the same time, the existing posterior cruciate ligament lower end point locator does not have a good depth limiting function. After the locator is used to insert the guide pin during the operation, the tibial bone tunnel needs to be established by holding the tibial bone tunnel drill. At this time, the posterior cortex of the tibia needs to be completely penetrated before the graft of the same thickness can be pulled into the bone tunnel. However, due to the current limitation that the depth cannot be limited when establishing the tibial bone tunnel, the operation relies more on the doctor's experience and hand feel, which invisibly increases the difficulty of the operation, reduces the reproducibility and repeatability of the operation, and increases the learning curve of young doctors. One of the common surgical complications during posterior cruciate ligament reconstruction is vascular and nerve injury. Once vascular and nerve injury occurs during the operation, the vascular and nerve bundles need to be cut and repaired during the operation, and the knee joint is fixed for a long time after the operation. This not only prolongs the operation time and increases the patient's pain, but most importantly, it will have a very serious impact on the patient's knee joint function after the operation, and the loss of knee joint mobility is almost inevitable.

[0006] In posterior cruciate ligament reconstruction surgery, after the bone tunnel is prepared, a guide wire needs to be passed through the femoral and tibial bone tunnels, and then a traction wire is used to pull the graft into the bone tunnel. With the current posterior fork lower stop point locator, after the tibial bone tunnel is completed, it is necessary to use the posteromedial approach to find the traction wire under surveillance, and then guide the lead wire into the bone tunnel, or use a lumbar puncture needle or other homemade guide wire device, or use a thin steel wire to guide the traction wire into the bone tunnel. This process is time-consuming and laborious. Summary of the invention

[0007] The present invention provides a posterior cruciate ligament lower end point locator, which solves the problems of instability of the existing posterior cruciate ligament lower end point locator during the process of inserting a guide needle, the problem of not having a limited depth when drilling the tibial bone tunnel, and the problem of difficulty in passing a traction line.

[0008] To achieve the above object, the technical solution adopted by the present invention is:

[0009] A posterior cruciate ligament lower stop point locator, comprising a locator handheld part, a tibial fixation part, a guide sleeve, a depth-limiting sleeve and a depth-limiting drill bit, wherein the locator handheld part is in the shape of an arc handle as a whole, and a 2.5 cm long scale line is provided at the front end thereof, using a 5 mm system, and is used to locate the lower stop point of the posterior cruciate ligament, and a hollow wire channel is provided in the upper part, and the entrance of the hollow wire channel is located at the vertex of the locator handheld part, and the exit is located at the inner side of the front end of the locator handheld part, and three fixing holes with an inner diameter of 2.00 mm are provided at the rear end, and are used to fix the locator on the tibial cortex, and a slide rail for installing the tibial fixation part is provided at the end, and a screw for locking and fixing the tibial fixation part is provided on the slide rail;

[0010] The tibial fixation part of the positioner is an arc with a diameter of 11 cm, the upper end of which can slide into the slide rail of the positioner handheld part and can be locked and fixed by the screws on the slide rail. The distal end is provided with a positioning sleeve fixing hole with an inner diameter of 11 mm and an internal thread;

[0011] The guide sleeve is a cylinder with a length of 8 cm and an outer diameter of 11 cm. The entire section is provided with threads matching the tibial fixation part, and the tail end is provided with two connecting ears with fixing holes with an inner diameter of 2.0 mm, which are used to cooperate with a 2.0 mm Kirschner wire to fix the guide sleeve on the tibial cortex;

[0012] The depth-limiting sleeve is 5.0 cm long and has an inner diameter of 11 mm. It is clamped on the outside of the guide sleeve 3 and is used to limit the depth of the tibial drill entering the tibia.

[0013] The depth-limiting drill bit is 18 cm long, with a front end being a 16 cm long drill bit, a rear end being a 2.0 cm long outer hexagonal bit, and a joint being a protruding circular depth-limiting baffle.

[0014] Furthermore, the inner diameter of the hollow wire channel is 2.0 mm.

[0015] Furthermore, the outer diameter of the guide sleeve is 11 mm, and the inner diameter has various specifications such as 6, 6.5, 7, 7.5, 8, 8.5, 9, 9.5, 10 mm, etc., which is used to pass through tibial drills of corresponding specifications.

[0016] Furthermore, the depth limiting drill bit has various specifications, with outer diameters of 6, 6.5, 7, 7.5, 8, 8.5, 9, 9.5, and 10 mm, for drilling tibial bone tunnels of corresponding diameters.

[0017] Furthermore, by adjusting the depth of the tibial fixing part of the positioner entering the slide rail of the positioner handheld part 1, the angle between the center of the sleeve and the vertex of the positioner handheld part 1 can be adjusted, and the minimum angle is 40 degrees and the maximum angle is 60 degrees.

[0018] Furthermore, the slide rail is arc-shaped and has a diameter of 11 cm.

[0019] The present invention has the following beneficial effects:

[0020] Without establishing a medial posterior approach, the tibial bone tunnel of the posterior cruciate ligament can be established quickly and safely, and the posterior cruciate ligament graft can be easily pulled into the femoral and tibial bone tunnels. This can reduce the operation time, increase the safety of the operation, increase the repeatability of the operation, reduce the difficulty of the operation, and shorten the learning curve of young doctors. BRIEF DESCRIPTION OF THE DRAWINGS

[0021] Figure 1 The present invention is a schematic structural diagram of a hand-held portion of a locator for the lower end point of a posterior cruciate ligament according to an embodiment of the present invention.

[0022] Figure 2 The present invention is a schematic structural diagram of a tibial fixation portion in a posterior cruciate ligament lower end point locator according to an embodiment of the present invention.

[0023] Figure 3 The present invention is a schematic structural diagram of a guide sleeve in a posterior cruciate ligament lower stop point locator according to an embodiment of the present invention.

[0024] Figure 4 The present invention is a schematic structural diagram of a depth-limiting sleeve in a posterior cruciate ligament lower stop point locator according to an embodiment of the present invention.

[0025] Figure 5 The present invention is a schematic structural diagram of a depth-limiting drill bit in a posterior cruciate ligament lower stop point locator according to an embodiment of the present invention. DETAILED DESCRIPTION

[0026] The present invention is described in detail below in conjunction with specific embodiments. The following embodiments will help those skilled in the art to further understand the present invention, but are not intended to limit the present invention in any form. It should be noted that, for those of ordinary skill in the art, several variations and improvements may be made without departing from the concept of the present invention. These all belong to the protection scope of the present invention.

[0027] like Figure 1-Figure 5As shown, an embodiment of the present invention provides a posterior cruciate ligament lower stop point locator, including a locator handheld part 1, a tibial fixation part 2, a guide sleeve 3, a depth limiting sleeve 4 and a depth limiting drill bit 5. The locator handheld part 1 is in the shape of an arc handle as a whole, and a 2.5 cm long scale line 6 is provided at the front end thereof, using a 5 mm system, for locating the lower stop point of the posterior cruciate ligament (located at the lower back of the tibial plateau), and a hollow wire channel 7 with an inner diameter of 2.0 mm is provided in the upper part, and the entrance of the hollow wire channel 7 is located at the apex of the locator handheld part 1, and the exit is located at the inner side of the front end of the locator handheld part 1, and three fixing holes 8 with an inner diameter of 2.00 mm are provided at the rear end, for fixing the locator on the tibial cortex, and a slide rail for installing the tibial fixation part 2 is provided at the end, and the slide rail is in an arc shape with a diameter of 11 cm, and a screw for locking and fixing the tibial fixation part 2 is provided on the slide rail;

[0028] The tibial fixing part 2 of the positioner is an arc with a diameter of 11 cm, and its upper end can slide into the slide rail of the positioner handheld part 1, and can be locked and fixed by the screws on the slide rail. The angle between the center of the sleeve and the vertex of the positioner handheld part 1 can be adjusted by adjusting the depth of the tibial fixing part 2 of the positioner entering the slide rail of the positioner handheld part 1, and the minimum angle is 40 degrees and the maximum is 60 degrees; a positioning sleeve fixing hole 9 with an inner diameter of 11 mm and an internal thread is provided at the distal end;

[0029] The entire section of the guide sleeve 3 is provided with a thread matching the tibial fixing part 2, and the tail end is provided with two connecting ears with fixing holes with an inner diameter of 2.0 mm, which are used to cooperate with a 2.0 mm Kirschner wire to fix the guide sleeve on the tibial cortex; the outer diameter of the guide sleeve 3 is 11 mm, and the inner diameter has multiple specifications such as 6, 6.5, 7, 7.5, 8, 8.5, 9, 9.5, 10 mm, etc., which is used to pass through a tibial drill of corresponding specifications;

[0030] The depth limiting sleeve 4 is 5.0 cm long and has an inner diameter of 11 mm. It is clamped on the outer side of the guide sleeve 3 to limit the depth of the tibial drill entering the tibia. The entire section of the guide sleeve 3 is provided with a thread matching the tibial fixing part 2, and can be rotatably mounted on the tibial fixing part. At the same time, there is a fixing hole with an inner diameter of 2 mm on each side of the tibial fixing part, and there is also a fixing hole with an inner diameter of 2 mm on each side of each depth limiting sleeve. The hole spacing of the two components is the same. After alignment, a 2 mm Kirschner wire can be used to fix it on the tibial bone.

[0031] The depth-limiting drill bit is 18 cm long, with a 16 cm long drill bit at the front end and a 2.0 cm long outer hexagonal drill bit at the rear end, and a protruding circular depth-limiting baffle at the joint. The depth-limiting drill bit has various specifications, with outer diameters of 6, 6.5, 7, 7.5, 8, 8.5, 9, 9.5, and 10 mm, and is used to drill tibial bone tunnels of corresponding diameters.

[0032] When the present invention is used, it comprises the following steps:

[0033] S1. First, use a planer to clean the original ligament remnants, and use a stripping instrument to loosen the posterior joint capsule of the knee joint to expose the lower end point of the posterior cruciate ligament. Select the appropriate tibial fixation part angle according to the lower end point of the patient's posterior cruciate ligament, and complete the docking combination of the locator handpiece and the tibial fixation part.

[0034] S2. Select the appropriate guide sleeve specifications according to the thickness of the autologous hamstring tendon, connect the guide sleeve to the tibial fixation part, and use a 2.0mm Kirschner wire to fix the locator and guide sleeve to the anterior tibial cortex at the same time, and install the depth limit sleeve on the outside of the guide sleeve.

[0035] S3. Select the corresponding depth-limiting drill bit and drill the tibial bone tunnel along the direction of the guide sleeve until it is stuck by the depth-limiting baffle.

[0036] S4. Use a planer to clean the debris in the bone tunnel, and use the PDS line to pass through the guide wire hole on the handheld part of the locator until the PDS line extends along the outer opening of the bone tunnel and pull it out. If the process is blocked and the PDS line cannot be passed out smoothly, the arthroscope can be extended along the bone tunnel for exploration. If there is soft tissue obstruction, the planer can be used to clean it again and repeat this process, or it can be pulled out with a wire grasper or a holding forceps.

[0037] The above describes the specific embodiments of the present invention. It should be understood that the present invention is not limited to the above specific embodiments, and those skilled in the art can make various changes or modifications within the scope of the claims, which does not affect the essence of the present invention. In the absence of conflict, the embodiments of the present application and the features in the embodiments can be combined with each other arbitrarily.

Claims

1. A posterior cruciate ligament lower stop positioner, characterized in that: The present invention comprises a locator handheld part (1), a tibial fixing part (2), a guide sleeve (3), a depth-limiting sleeve (4) and a depth-limiting drill bit (5), wherein the locator handheld part (1) is in the shape of an arc handle as a whole, and a 2.5 cm long scale line (6) is provided at the front end thereof, using a 5 mm system, and is used to locate the lower end point of the posterior cruciate ligament; a hollow wire channel (7) is provided in the upper part thereof, and the entrance of the hollow wire channel (7) is located at the apex of the locator handheld part (1), and the exit is located at the inner side of the front end of the locator handheld part (1); a rear end is provided with three fixing holes (8) with an inner diameter of 2.00 mm, and is used to fix the locator on the tibial cortex; a slide rail for mounting the tibial fixing part (2) is provided at the end thereof, and a screw for locking and fixing the tibial fixing part (2) is provided on the slide rail; The tibial fixing part (2) is an arc with a diameter of 11 cm, the upper end of which can slide into the slide rail of the positioner handheld part (1) and can be locked and fixed by screws on the slide rail. The distal end is provided with a positioning sleeve fixing hole (9) with an inner diameter of 11 mm and an internal thread; The guide sleeve (3) is a cylinder with a length of 8 cm and an outer diameter of 11 cm. The entire length of the guide sleeve is provided with threads matching the tibial fixing portion (2). The tail end is provided with two connecting ears with fixing holes with an inner diameter of 2.0 mm, which are used to cooperate with a 2.0 mm Kirschner wire to fix the guide sleeve on the tibial cortex. The depth limiting sleeve (4) is 5.0 cm long and has an inner diameter of 11 mm. It is clamped on the outside of the guide sleeve (3) and is used to limit the depth of the tibial drill entering the tibia. The depth-limiting drill bit is 18 cm long, with a 16 cm long drill bit at the front end and a 2.0 cm long outer hexagonal drill bit at the rear end, and a protruding circular depth-limiting baffle at the joint; the inner diameter of the hollow wire channel is 2.0 mm; the outer diameter of the guide sleeve (3) is 11 mm, and the inner diameters are 6, 6.5, 7, 7.5, 8, 8.5, 9, 9.5, and 10 mm, for passing tibial drills of corresponding specifications; the angle between the center of the sleeve and the vertex of the locator handheld part (1) can be adjusted by adjusting the depth of the locator tibial fixing part (2) entering the slide rail of the locator handheld part (1), and the minimum angle is 40 degrees and the maximum angle is 60 degrees.

2. A posterior cruciate ligament lower end point locator as claimed in claim 1, characterized in that: The depth-limiting drill bit has various specifications, with outer diameters of 6, 6.5, 7, 7.5, 8, 8.5, 9, 9.5, and 10 mm, and is used for drilling tibial bone tunnels of corresponding diameters.

3. A posterior cruciate ligament lower end point locator as claimed in claim 1, characterized in that: The slide rail is arc-shaped and has a diameter of 11 cm.

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