Tibial rotation alignment device in total knee replacement

Abstract

The present invention discloses a tibia (2) rotation alignment positioning device in total knee replacement surgery, which comprises, from left to right, a side rod one (3), a bottom rod (5), a support block (6), and a side rod two (4); the bottom rod (5) is parallel to the length direction of the support block (6) and fixed to the lower part of the support block (6); the lower ends of the side rod one (3) and the side rod two (4) are respectively fixed to the two ends of the bottom rod (5); and the side rod one (3) and the side rod two (4) are perpendicular to the support block (6). 6) length direction; a cross bar (7) is fixed on the top of the support block (6), and the cross bar (7) is arranged parallel to the bottom bar (5); a slide bar (8) is slidably fixed on the cross bar (7), and the length direction of the slide bar (8) is perpendicular to the length direction of the cross bar (7), and a positioning nail (9) passes through the upper ends of the side bar (3) and the side bar (4) to fix the upper ends of the side bar (3) and the side bar (4) to the corresponding points of the medial epicondyle concave and the lateral epicondyle convex of the femur (1). The rotation alignment positioning device of the present invention enables the rotation alignment to be obtained accurately, the method is simple, and solves the problem that the rotation alignment cannot be simply drawn in the existing medicine.

Description

Technical Field

[0001] The invention relates to the technical field of total knee replacement, and in particular discloses a tibial rotation alignment positioning device in total knee replacement. Background Art

[0002] Artificial knee replacement is a new technology for treating knee diseases that has gradually developed after the successful application of artificial hip joints in patients in modern times. It can effectively eliminate late-stage knee pain and greatly improve the quality of life of patients. In knee replacement surgery, the most important point is to find the correct tibial rotation alignment.

[0003] The force alignment of the lower limb is divided into valgus and valgus alignment on the coronal plane, flexion and extension of the femoral prosthesis on the sagittal plane, anterior and posterior tilt positions of the tibial prosthesis, and rotation alignment on the horizontal plane. Good alignment is indispensable. Poor rotation alignment can cause maltracking of the patella and malalignment of the femoral-liner prosthesis interface, which in turn leads to complications such as anterior knee pain, liner wear, and prosthesis loosening. Among them, the rotation alignment of the femoral prosthesis currently has a recognized gold standard: the femoral surgical transepicondylar axis (TEA) connecting the medial epicondylar concavity and the lateral epicondylar convexity of the femur.

[0004] There are still controversies about the method of determining the rotation alignment of the tibial prosthesis. Some methods refer to the rotation alignment obtained by referring to the anatomical landmarks inside or outside the joint, such as the axis of the posterior tibial condyle, the axis of the tibial condyle, the groove between the tibial intercondylar crest, the line between the posterior cruciate ligament insertion point and the medial edge of the tibial tuberosity or the medial 1 / 3 point of the tibial tuberosity, and the anterior cortex of the tibial osteotomy. Xiao Yu et al. performed rotational platform total knee arthroplasty on 60 patients with genu varum from May 2006 to April 2007, including 27 males and 33 females aged 55 to 78 years. They were randomly divided into two groups, 30 cases in each group. The intraoperative tibial prosthesis positioning method: Group A used the medial 1 / 3 line of the tibial tuberosity as the anatomical landmark; Group B used the medial edge of the tibial tuberosity as the anatomical landmark for patients with genu varum 0 to 90, 10 to 19. The midline of the interval from the medial edge of the tibial tubercle to the medial 1 / 3 line of the tibial tubercle was used as the standard for patients with ≥200, and the medial 1 / 3 line of the tibial tubercle was used as the standard for patients with ≥200. The rotation angle of the polyethylene meniscus gaskets in the two groups after surgery was measured to determine the rotation alignment of the tibial prosthesis. It was found that the medial edge of the tibial tubercle to the medial 1 / 3 line was the ideal tibial prosthesis rotation positioning interval, and the linear positioning should be determined according to the degree of varus and valgus deformity of the patient's knee joint (Chinese Journal of Reparative and Reconstructive Surgery, January 2008, Vol. 22, No. 1). Zhao Baohui et al. studied 15 healthy adult volunteers, 10 males and 5 females; aged 21-38 years, with an average age of (28.1+6.0) years. A cross-sectional CT scan of the knee joint was performed in full extension, and 26 CT scan images were included in the study. The two anteroposterior axes of the tibia were depicted on the CT scan images: the midpoint of the posterior cruciate ligament insertion point was connected with the medial edge of the patellar ligament insertion point and the medial 1 / 3 point of the patellar ligament, and the femoral surgical supracondylar axis; the angles between the two tibial anterior and posterior axes and the vertical line of the femoral surgical supracondylar axis were measured and compared with the ideal tibial prosthesis rotation alignment mark, i.e., 0°. The angle between the vertical line of the femoral surgical supracondylar axis and the line connecting the midpoint of the posterior cruciate ligament insertion point and the medial edge of the patellar ligament insertion point was -5.1°-5.8°, with an average of 0.7°±2.8°, which was not statistically significant compared with 0°; the angle between the midpoint of the posterior cruciate ligament insertion point and the medial 1 / 3 point of the patellar ligament was -3.4°-14.1°, with an average of 6.9°±5.3°, which was statistically significant compared with 0°. The angles between the two tibial anterior and posterior axes and the vertical line of the femoral surgical supracondylar axis were statistically significant. Conclusion The rotation alignment of the tibial prosthesis can refer to the line connecting the midpoint of the posterior cruciate ligament and the medial edge of the patellar ligament, so that the rotation alignment between the femur and the tibial prosthesis is more matched (Chinese Journal of Orthopaedics, Vol. 32, No. 9, September 2012). Si Wei et al. concluded that the rotation alignment of the tibial prosthesis is an important factor affecting the knee function and prosthesis survival after total knee replacement. So far, there is no clear method for positioning the rotation alignment of the tibial prosthesis.At present, the commonly used rotation alignment positioning methods include the extra-articular tibial prosthesis rotation reference mark and self-alignment technology, but the external rotation alignment is unreliable and easily affected by the valgus and valgus deformity of the knee joint. The self-alignment technology generally leads to excessive external rotation of the tibial prosthesis. Both of them easily lead to malrotation of the tibial prosthesis. In recent years, there are literature reports on the use of anatomical landmarks on the tibial osteotomy surface to determine the rotation alignment of the tibial prosthesis. Among them, the anteroposterior Akagi line of the tibial plateau and the interspinous groove line of the tibial condyle are more reliable and easy to locate during surgery. They are currently worthy of use in total knee replacement (International Journal of Orthopaedics, Vol. 35, No. 1, January 2014 and Yu Huachen). The most innovative study is that Yu Huachen et al. (China Orthopaedics, Vol. 28, No. 10, October 2015) performed knee MRI scans on 80 healthy adults from January 2010 to December 2013, including 35 males and 45 females, with an average age of (35.4+6.1) years. The surgical supracondylar axis of the femur (S'rEA) was located on the femoral cross-sectional image and projected to the tibia to form STEA'. The line connecting the midpoint of the posterior cruciate ligament insertion point and the medial edge of the patellar ligament (Akagi line) and its perpendicular line (AK) and the line connecting the midpoint of the posterior cruciate ligament insertion point and the medial 1 / 3 of the patellar ligament and its perpendicular line (AP) were located on the tibial cross-sectional image, and the angles of AK and AP relative to STEA' were compared. It was concluded that the Akagi line has high reliability as the rotation alignment of the proximal tibial prosthesis in total knee replacement.

[0005] Although there are many different methods for determining the rotation alignment of the tibial prosthesis, the purpose of each study is to find a method to accurately determine the neutral position of the tibial prosthesis rotation: when the tibial prosthesis is placed in this position, the anterior-posterior axis of the tibial prosthesis is perpendicular to the femoral surgical condylar axis when the knee is in extension. The Akagi line recommended by Professor Akagi of Japan believes that the anterior-posterior axis of the tibia (AP line) refers to the perpendicular line passing through the midpoint of the posterior cruciate ligament insertion point and perpendicular to the femoral surgical condylar axis to the tibial projection line. On the tomographic plane where the tibial tubercle appears, the angle between the Akagi line and the AP line is measured to be 0.0±2.8 (-6.3~5.0). Therefore, it can be considered that this line is basically consistent with the anterior-posterior axis of the tibia and is a good sign for confirming the rotation positioning of the tibial prosthesis during surgery.

[0006] However, the use of currently available tools cannot accurately determine the parallel line of the femoral surgical condyle axis directly on the distal femoral osteotomy surface and the vertical line of the femoral surgical condyle axis on the tibial plateau osteotomy surface during surgery. On the distal femoral osteotomy surface, the corresponding points of the medial epicondyle concave and lateral epicondyle convex of the femur can only be roughly manually outlined, and on the tibial side, only large sample studies can be used to indirectly find intra-articular or extra-articular anatomical landmarks that can determine the vertical line of the femoral surgical condyle axis. However, large sample studies cannot solve the problem that factors such as race, anatomical variation, deformity, and bone hyperplasia affect the accuracy of these anatomical landmarks in determining rotation alignment, and cannot meet individualized requirements. Therefore, the present invention aims to determine the parallel line and vertical line of the femoral surgical condyle axis on any plane during surgery to guide the determination of the femoral and tibial side rotation alignments. Summary of the invention

[0007] The purpose of the present invention is to solve the problem that the tibial rotation alignment cannot be simply drawn in the prior art.

[0008] The specific technical scheme adopted by the present invention is as follows: a tibial rotation alignment positioning device in total knee replacement surgery, which includes, from left to right, a side rod 1, a bottom rod, a support block, and a side rod 2; the bottom rod is parallel to the length direction of the support block and fixed to the lower part of the support block, the lower ends of the side rod 1 and the side rod 2 are respectively fixed to the two ends of the bottom rod, and the side rod 1 and the side rod 2 are perpendicular to the length direction of the support block; a cross bar is fixed on the top of the support block, and the cross bar is arranged parallel to the bottom rod; a sliding rod is slidably fixed on the cross bar, and the length direction of the sliding rod is perpendicular to the length direction of the cross bar; A positioning nail 1 is respectively passed through the upper end of the side rod 1 and the side rod 2, and the tips of the positioning nail 1 on the side rod 1 and the positioning nail 1 on the side rod 2 are arranged to face each other, so that they can be fixed to the femur; a nail hole is passed through the support block perpendicular to the length direction of the support block, through which the positioning nail 2 can be passed and fixed to the tibia; the positioning nail 1 passing through the upper end of the side rod 1 and the side rod 2 fixes the upper end of the side rod 1 and the side rod 2 to the corresponding points of the medial epicondyle concave and the lateral epicondyle convex of the femur respectively, and the line connecting the corresponding points of the medial epicondyle concave and the lateral epicondyle convex of the femur is the surgical supracondylar axis of the femur.

[0009] Through the above technical scheme, when installing the above device, two positioning nails 1 can be respectively driven into the corresponding points of the concave and convex lateral epicondyle of the femur, and then the side rod 1 and the side rod 2 are put on the positioning nail 1, so that the upper ends of the side rods 1 and 2 are closely attached to the corresponding points of the concave and convex lateral epicondyle of the femur, and then the bottom rod is inserted into the lower ends of the side rods 1 and 2 to ensure that the bottom rod is perpendicular to the side rods 1 and 2, and then the positioning nail 2 is fixed. After being fixed in this way, when the sliding rod is slid so that the side of the sliding rod is attached to the midpoint of the end point of the posterior cruciate ligament of the tibia, a straight line is drawn along the sliding rod, and the straight line passing through the midpoint of the end point of the posterior cruciate ligament is the tibial rotation alignment. After drawing the tibial rotation alignment, a line can be drawn on the femur with a ruler compared with the sliding rod, so that the femoral condyle rotation alignment can be drawn, which is convenient for the doctor to perform osteotomy parallel to this line when performing osteotomy. Of course, we can also remove positioning pin 2 after drawing the tibial rotation alignment, shorten side rod 1 and side rod 2 online, let the sliding rod stick to the femur, and then draw a straight line along the sliding rod to obtain the femoral condyle rotation alignment.

[0010] Furthermore, the side rod 1 and the side rod 2 are telescopic rods. The form of the telescopic rod allows the device to be used in various situations in which the distance between the femur and the tibia is not fixed. The telescopic rod also ensures that when the bottom rod is inserted at the bottom of the side rod 1 and the side rod 2, the length of the side rod 1 and the side rod 2 can be adjusted so that the bottom rod is perpendicular to the side rod 1 and the side rod 2.

[0011] Further, the telescopic rod is a lower rod with a larger diameter in which an upper rod with a smaller diameter is movably inserted, and the upper rod can be pulled out or inserted in the lower rod. The telescopic method of the upper rod being movably inserted and pulled out in the lower rod is simple, and the device is also simple to manufacture, which reduces the cost.

[0012] Furthermore, the upper rod and the lower rod are round rods, so that the upper rod and the lower rod can be relatively rotated 360 degrees. When the side rod is inserted into the positioning nail, the upper rod and the lower rod can be rotated in time so that the upper rod and the lower rod can be well aligned with the positioning nail and inserted thereon.

[0013] Furthermore, the bottom rod is a round rod or a square rod.

[0014] Preferably, the bottom rod is a round rod.

[0015] Furthermore, the bottom rod is fixed to the side rod one and the side rod two through bearings, the two ends of the bottom rod are respectively fixed to the inner rings of the bearings, the outer rings of the bearings are fixed to the lower ends of the side rods one and the side rods two, and the axis of the bearing is perpendicular to the axis of the side rods one and the side rods two.

[0016] Through the above technical solution, the bearings are fixed so that the bottom rod and the side rod one and the side rod two can rotate relative to each other, which facilitates the adjustment of the inclination degree of the side rod one and the side rod two.

[0017] Furthermore, the crossbar is fixed on the support block through a vertical rod, a vertical rod is vertically fixed under the crossbar, and the vertical rod is inserted into the top of the support block to fix it, while keeping the crossbar parallel to the length direction of the support block.

[0018] Furthermore, the horizontal rod and the vertical rod are round rods or square rods.

[0019] Preferably, the horizontal rod and the vertical rod are round rods.

[0020] Furthermore, a second slide groove is concavely provided on the top surface of the cross bar along the length direction of the cross bar, and a protrusion is fixed under one end of the slide bar, the protrusion is embedded in the slide groove and ensures that the slide bar is perpendicular to the length direction of the cross bar.

[0021] Through the above technical solution, the corresponding arrangement of the protrusion and the second slide groove ensures that the slide bar always remains perpendicular to the length direction of the support block.

[0022] Furthermore, the cross section of the second slide groove is ⊥-shaped, and the corresponding cross section of the protrusion is also ⊥-shaped. The ⊥-shaped slide groove second and the protrusion ensure that the sliding fixation is more stable and reliable.

[0023] Furthermore, positioning pin 1 is fixed to the upper end of side rod 1 and side rod 2 through a bearing, the outer ring of the bearing is fixed inside the upper end of side rod 1 and side rod 2, and positioning pin 1 is fixed to the inner ring of the bearing to ensure that positioning pin 1 is perpendicular to the axial direction of side rod 1 and side rod 2.

[0024] Furthermore, two nail holes are provided, which are symmetrically arranged on the left and right sides of the support block. The two nail holes are used for two positioning nails to pass through to fix the support block to the tibia, so that the support block will not shake left and right, ensuring that the line drawing is more stable.

[0025] The beneficial effects of the present invention are as follows: the present invention provides a simple device for locating the tibial rotation alignment in total knee replacement surgery. The device has a simple structure and is convenient and stable in drawing lines. It is the first of its kind in this field and can accurately draw the tibial rotation alignment in total knee replacement surgery. BRIEF DESCRIPTION OF THE DRAWINGS

[0026] Figure 1 It is a three-dimensional structural schematic diagram of the device of the present invention mounted on the femur and tibia;

[0027] Figure 2 yes Figure 1 The enlarged part of point A in the figure;

[0028] Figure 3 yes Figure 1 The enlarged part at B in the figure;

[0029] Figure 4 yes Figure 1 Enlarge the C in the figure.

[0030] In the figure, 1, femur; 2, tibia; 3, side rod one; 301, lower rod; 302, upper rod; 4, side rod two; 5, bottom rod; 6, support block; 7, cross bar; 701, slide groove two; 8, slide bar; 801, bump; 9, positioning pin one; 10, positioning pin two; 11, bearing; 12, midpoint of the end point of the posterior cruciate ligament of the tibia. DETAILED DESCRIPTION Example

[0031] like Figures 1 to 4 As shown, a rotation alignment positioning device for the tibia 2 in total knee replacement surgery includes, from left to right, a side bar 3, a bottom bar 5, a support block 6, and a side bar 2 4. The bottom bar 5 is parallel to the length direction of the support block 6 and fixed to the bottom of the support block 6. The lower ends of the side bars 1 3 and the side bars 2 4 are respectively fixed to the two ends of the bottom bar 5, and the side bars 1 3 and the side bars 2 4 are perpendicular to the length direction of the support block 6. For ease of use, the support block 6 is preferably fixed in the middle position of the bottom bar 5. A cross bar 7 is fixed on the top of the support block 6, and the cross bar 7 is arranged parallel to the bottom bar 5. A sliding bar 8 is slidably fixed on the cross bar 7, and the length direction of the sliding bar 8 is perpendicular to the length direction of the cross bar 7. Positioning pins 1 9 are respectively pierced at the upper ends of the side bars 1 3 and the side bars 2 4. The positioning pins 1 9 on the side bars 1 3 and the positioning pins 1 9 on the side bars 2 4 are arranged to face each other, so that they can be fixed to the femur 1. The support block 6 is provided with nail holes perpendicular to the length direction of the support block 6, through which the positioning nails 10 can be passed to fix the support block 6 to the tibia 2. The positioning nails 9 passing through the upper ends of the side bars 1 3 and 2 4 fix the upper ends of the side bars 1 3 and 2 4 to the corresponding points of the medial epicondyle concave and lateral epicondyle convex of the femur 1, respectively. The line connecting the corresponding points of the medial epicondyle concave and lateral epicondyle convex of the femur 1 is the surgical epicondylar axis of the femur 1. Because the bottom bar 5 is parallel to the length direction of the support block 6, the cross bar 7 is parallel to the bottom bar 5, and the length direction of the slide bar 8 is perpendicular to the length direction of the cross bar 7, the slide bar 8 is perpendicular to the bottom bar 5, and the side bars 1 3 and 2 4 are perpendicular to the length direction of the support block 6. Therefore, the side bars 1 3 and 2 4 are perpendicular to the bottom bar 5. According to the principle of geometry, the slide bar 8 is also perpendicular to the side bars 1 3 and 2 4. In this way, when the above-mentioned device is fixed, the slide bar 8 is slid so that one side of the slide bar 8 reaches the midpoint of the end point of the posterior cruciate ligament of the tibia 2, and a straight line is drawn along the slide bar 8. The straight line passing through the midpoint of the end point of the posterior cruciate ligament is the rotation line of the tibia 2.

[0032] For details, see Figure 1 , Figure 2, the side rod 1 3 and the side rod 2 4 are telescopic rods, and are arranged symmetrically. Taking the side rod 1 3 as an example, the side rod 1 3 can be a lower rod 301 with a larger diameter, in which an upper rod 302 with a smaller diameter is movably inserted, and the upper rod 302 can be pulled out or inserted in the lower rod 301 to realize the telescopic characteristics of the entire side rod 1 3. The upper rod 302 and the lower rod 301 can be round rods or square rods, as long as the upper rod 302 can be pulled out of the lower rod 301. When the upper rod 302 and the lower rod 301 are preferably round rods, the upper rod 302 and the lower rod 301 can be relatively rotated 360 degrees. When the side rod is inserted into the positioning nail, the upper rod 302 and the lower rod 301 can be rotated in time so that the upper rod 302 and the lower rod 301 can be well aligned with the positioning nail and inserted thereon.

[0033] Specifically, the bottom rod 5 can be a round rod or a square rod, preferably a round rod. The bottom rod 5 can be fixed to the support block 6 by being horizontally inserted at the bottom of the support block 6 or directly fixed at the bottom of the support block 6. Preferably, the bottom rod 5 is inserted at the bottom of the support block 6, and the bottom rod 5 is arranged parallel to the length direction of the support block 6, and the support block 6 is located at the center of the bottom rod 5.

[0034] For details, see Figure 1 , Figure 4 The two ends of the bottom bar 5 are respectively fixed to the lower ends of the side bars 1 3 and 2 4, and the fixing method is specifically that the bearings 11 are respectively fixed to the two ends of the bottom bar 5, the two ends of the bottom bar 5 are fixed to the inner ring of the bearing 11, and the outer ring of the bearing 11 is fixed to the lower ends of the side bars 1 3 and 2 4, and the axis of the bearing 11 is perpendicular to the axis of the side bars 1 3 and 2 4. In this way, the side bars 1 3 and 2 4 always maintain a vertical relationship with the bottom bar 5, and the side bar 1 3 can rotate relative to the bottom bar 5, which is convenient for adjusting the inclination of the side bars according to actual conditions when the device is installed.

[0035] Specifically, the support block 6 can be a long strip with a circular or square cross section, and the long strip is set to fit the side of the tibia 2. The specific fixing method of the top fixed crossbar 7 on the support block 6 can be to vertically fix a vertical rod under the crossbar 7, and the vertical rod is inserted into the top of the support block 6 to fix it, while keeping the crossbar 7 parallel to the length direction of the support block 6. The crossbar 7 and the vertical rod can both be round rods or square rods, preferably both are round rods. Preferably, the support block 6 is a rectangular block, so that the bottom rod 5 is arranged at the bottom of the rectangular block parallel to the length direction of the rectangular block, the vertical rod is perpendicular to the upper surface of the rectangular block and inserted in the center thereof, and the crossbar 7 is arranged parallel to the length direction of the rectangular block.

[0036] For details, see Figure 1 , Figure 3The specific method of sliding and fixing the slide bar 8 on the cross bar 7 is that a second slide groove 701 is concavely provided on the top surface of the cross bar 7 along the length direction of the cross bar 7, and a protrusion 801 is fixed below one end of the slide bar 8, and the protrusion 801 is embedded in the slide groove and ensures that the slide bar 8 is perpendicular to the length direction of the cross bar 7. Further, in order to achieve a better fixing effect and sliding effect, the cross section of the second slide groove 701 is ⊥-shaped, and the corresponding cross section of the protrusion 801 is also ⊥-shaped, so that the protrusion 801 can be fixed in the second slide groove 701 and slide along the length direction of the second slide groove 701. The slide bar 8 can be a round bar or a square bar, and it only needs to ensure that the two sides of the slide bar 8 are as straight as a straight line so that the drawn line is a straight line.

[0037] Furthermore, the fixing of the positioning pin 9 to the upper end of the side rod 1 3 and the side rod 2 4 is preferably that the positioning pin 9 is fixed to the upper end of the side rod 1 3 and the side rod 2 4 through the bearing 11, the outer ring of the bearing 11 is fixed inside the upper end of the side rod 1 3 and the side rod 2 4, and the positioning pin 9 is fixed to the inner ring of the bearing 11, ensuring that the positioning pin 9 is perpendicular to the axial direction of the side rod 1 3 and the side rod 2 4. The fixing by the bearing 11 can make the positioning pin 9 and the side rod 1 3 and the side rod 2 4 remain perpendicular while the two can rotate relative to each other, so that the inclination degree of the side rod 1 3 and the side rod 2 4 can be adjusted as needed when the device is installed on the femur 1 and the tibia 2. Taking into account that during the actual installation of the device, the positioning pin 9 may be skewed, that is, the positioning pin 9 cannot always be guaranteed to be driven into the femur perpendicular to the side rod, we prefer that the bearing 11 fixed in the upper end of the side rod 3 and the side rod 2 4 is a self-aligning bearing. In this way, when the positioning pin 9 is skewed, we can still fine-tune the upper end of the side rod so that it always keeps in contact with the corresponding points of the medial epicondyle concave and lateral epicondyle convex of the femur 1, that is, the side rod is always perpendicular to the projection line of the femoral surgical condyle axis on the tibial plateau osteotomy surface.

[0038] Furthermore, the nail holes are preferably arranged perpendicular to the axis of the support block 6. In order to achieve a better fixing effect, it is preferred to have multiple nail holes, and more preferably two nail holes are arranged at symmetrical positions on the left and right sides of the support block 6. It is convenient to pass the positioning nail 2 10 through it to fix the support block 6 to the tibia 2.

[0039] It should be noted that the up, down, left and right in the above description are all with reference to the up, down, left and right in the accompanying drawings. This is only for the convenience of description and there is no substantial positioning requirement.

Claims

1. A tibial rotation alignment positioning device in total knee replacement surgery, characterized in that: From left to right, the side bar (3), the bottom bar (5), the support block (6), and the side bar (4) are sequentially provided. The bottom bar (5) is parallel to the length direction of the support block (6) and fixed to the lower part of the support block (6). The lower ends of the side bar (3) and the side bar (4) are respectively passed through the two ends of the bottom bar (5) and the side bar (3) and the side bar (4) are both perpendicular to the length direction of the support block (6). A cross bar (7) is fixed on the top of the support block (6). The cross bar (7) is arranged parallel to the bottom bar (5). A sliding bar (8) is slidably fixed on the cross bar (7). The length direction of the sliding bar (8) is perpendicular to the length direction of the cross bar (7). A positioning pin (9) is respectively passed through the upper ends of the side bar (3) and the side bar (4). The tips of the positioning pin (9) on the side bar (3) and the positioning pin (9) on the side bar (4) are arranged facing each other and are used to be fixed to the femur (1). The support block (6) ) is provided with a nail hole perpendicular to the length direction of the support block (6), through which a positioning nail (10) can be passed to fix it to the tibia (2); a positioning nail (9) passing through the upper ends of the side rod (3) and the side rod (4) fixes the upper ends of the side rod (3) and the side rod (4) to the corresponding points of the medial epicondyle concave and the lateral epicondyle convex of the femur (1), respectively; the line connecting the corresponding points of the medial epicondyle concave and the lateral epicondyle convex of the femur (1) is the femur (1) The surgical condylar axis; the side rod one (3) and the side rod two (4) are both telescopic rods; the bottom rod (5) is fixed to the side rod one (3) and the side rod two (4) through a bearing (11), the two ends of the bottom rod (5) are respectively fixed to the inner ring of the bearing (11), and the outer ring of the bearing (11) is fixed to the lower end of the side rod one (3) and the side rod two (4), and the axis of the bearing (11) is perpendicular to the axis of the side rod one (3) and the side rod two (4).

2. The tibial rotation alignment positioning device in total knee replacement according to claim 1, characterized in that: The telescopic rod is a lower rod (301) with a larger diameter, in which an upper rod (302) with a smaller diameter is movably inserted, and the upper rod (302) can be pulled out or inserted into the lower rod (301).

3. The tibial rotation alignment positioning device in total knee replacement according to claim 2, characterized in that: The upper rod (302) and the lower rod (301) are round rods.

4. The tibial rotation alignment positioning device in total knee replacement according to claim 1, characterized in that: The crossbar (7) is fixed on the support block (6) through a vertical rod, a vertical rod is vertically fixed under the crossbar (7), and the vertical rod is inserted into the top of the support block (6) to fix it, while keeping the crossbar (7) parallel to the length direction of the support block (6).

5. The tibial rotation alignment positioning device in total knee replacement according to claim 1, characterized in that: A second slide groove (701) is concavely provided on the top surface of the cross bar (7) and arranged along the length direction of the cross bar (7). A protrusion (801) is fixed below one end of the slide bar (8). The protrusion (801) is embedded in the slide groove and ensures that the slide bar (8) is perpendicular to the length direction of the cross bar (7).

6. The tibial rotation alignment positioning device in total knee replacement according to claim 5, characterized in that: The cross section of the second slide groove (701) is ⊥-shaped, and the cross section of the corresponding protrusion (801) is also ⊥-shaped.

7. The tibial rotation alignment positioning device in total knee replacement according to claim 1, characterized in that: The positioning pin (9) is fixed to the upper ends of the side rod (3) and the side rod (4) through the bearing (11), the outer ring of the bearing (11) is fixed inside the upper ends of the side rod (3) and the side rod (4), and the positioning pin (9) is fixed on the inner ring of the bearing (11), so that the positioning pin (9) is perpendicular to the axial direction of the side rod (3) and the side rod (4).

8. The tibial rotation alignment positioning device in total knee replacement according to claim 1, characterized in that: Two nail holes are provided, which are respectively arranged at symmetrical positions on the left and right sides of the support block (6).

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