An apparatus for micro-fracture surgery and cavity bone combined injection
By designing a microfracture instrument that integrates angle and depth sensors, the problems of keeping the instrument tip vertical and the difficulty of drug penetration have been solved, enabling precise control of microfracture surgery and drug delivery, thus improving treatment efficacy and safety.
Patent Information
- Authority / Receiving Office
- CN · China
- Patent Type
- Patents(China)
- Current Assignee / Owner
- THE FIRST AFFILIATED HOSPITAL OF ZHEJIANG CHINESE MEDICAL UNIVERSITY
- Filing Date
- 2024-06-07
- Publication Date
- 2026-07-10
AI Technical Summary
In current microfracture surgery, it is difficult to keep the instrument tip perpendicular to the cartilage surface and the angle and depth cannot be flexibly adjusted, which increases the difficulty of the operation. In addition, it is difficult for intra-articular injection drugs to penetrate into the subchondral bone, affecting the treatment effect.
A microfracture device was designed, integrating angle and depth sensors, equipped with a flexible bending part and red light detection, which can adjust the perpendicularity of the tip to the cartilage surface in real time, and realize drug injection into the joint cavity and subchondral bone through a micro-pump.
It enables precise control of microfracture surgery, reduces surgical difficulty and risk, improves drug delivery efficiency, enhances treatment effects, simplifies surgical procedures, and reduces patient suffering and infection risk.
Smart Images
Figure CN118806388B_ABST
Abstract
Description
Technical Field
[0001] This invention relates to the field of orthopedic surgical instruments, specifically to an instrument for microfracture surgery and combined intraosseous injection. Background Technology
[0002] Osteoarthritis, a degenerative joint disease with a high incidence and disability rate, is characterized by the degeneration and damage of articular cartilage. As the disease progresses, the articular cartilage gradually wears down, potentially leading to cartilage defects in severe cases. Microfracture surgery, a common clinical approach for treating cartilage defects, works by drilling holes in the damaged cartilage surface with an awl to create artificial fissures leading to the subchondral bone and inducing bleeding. This encourages the formation of fibrous cartilage tissue at the defect site to fill it. However, the following problems exist in the current clinical application of microfracture surgery:
[0003] (1) First, when using microfracture instruments to make holes, doctors must ensure that the tip of the cartilage cone is perpendicular to the cartilage surface. However, due to the complex structure and anatomical characteristics of different joints, this operation is difficult to achieve in practice. Currently, doctors mainly rely on instruments with different bending angles to address this issue, but the bending angle of these tools is fixed and cannot be adjusted, requiring doctors to frequently change tools during different surgeries. Even so, in some cases, doctors still find it difficult to make holes in specific areas of the articular surface, which not only limits the scope of the operation but also easily leads to angle deviation during the drilling process. In addition, the cartilage thickness and severity of the condition vary among different patients, but the depth of microfracture drilling is crucial to the surgical outcome. The currently used instruments have a fixed tip depth and cannot be adjusted according to individual differences, which further increases the difficulty of the surgery and limits the treatment effect.
[0004] (2) Secondly, to improve the therapeutic effect of microfracture surgery, many doctors choose to use intra-articular injection of biological agents after surgery, such as platelet-rich plasma, fat microfractions, bone marrow aspirate concentrate, and stem cells. However, this method requires a second puncture, which not only increases the patient's pain but may also lead to risks such as infection and pain. More importantly, due to the obstruction of the intra-articular proliferative synovium and cartilage barrier, the drugs are difficult to effectively penetrate into the subchondral bone, thus reducing the therapeutic effect. Many studies have also confirmed that subchondral bone injection of biological agents has a better therapeutic effect than intra-articular injection alone, especially when injected into subchondral bone lesion areas (such as cysts, sclerosis, or other pathological changes that appear as high signal areas on MRI). Therefore, we propose an innovative treatment method for the first time: the combined application of intra-articular injection and subchondral bone injection to treat a variety of osteoarthritis, femoral head necrosis, and other common bone and joint diseases in clinical practice. We define this method of simultaneously injecting drugs into the joint cavity and subchondral bone as "intra-articular bone combined injection". Compared with intra-articular injection alone, this method is expected to achieve more significant therapeutic effects. However, there is currently a lack of equipment specifically designed for this operation.
[0005] Therefore, designing a microfracture device that can detect fractures in real time and ensure that the tip is perpendicular to the cartilage surface, while also being able to inject drugs into the joint cavity and subchondral bone (joint cavity and bone injection) has become a pressing technical challenge. Summary of the Invention
[0006] To address the problems existing in the prior art, the purpose of this invention is to provide a device for microfracture surgery and combined intra-articular and subchondral bone injection, which can simultaneously detect and ensure that the tip is perpendicular to the cartilage surface, and simultaneously perform drug injection into the joint cavity and subchondral bone.
[0007] The objective of this invention is achieved through the following technical solution:
[0008] A device for microfracture surgery and combined intraosseous injection includes a handle, a connecting rod, and a tip. The handle is provided with an inlet port, an inlet pipe, and a reservoir. The connecting rod is provided with a connecting pipe and an adjusting rod inside. A syringe is provided at the upper end of the handle, and the syringe is connected to the inlet port. The inlet port is connected to the reservoir through the inlet pipe.
[0009] The handle portion is equipped with a micro pump and a first liquid outlet pipe. One end of the first liquid outlet pipe is inside the liquid storage tank, and the other end is connected to the water inlet of the micro pump. The micro pump is driven by a motor. The water outlet of the micro pump is connected to the connecting pipe in the connecting rod. The connecting pipe is connected to a second liquid outlet pipe located inside the tip portion. The end of the second liquid outlet pipe has a second injection hole.
[0010] The handle portion is equipped with a rotary adjuster, which is fixedly connected to the connecting rod. The rotary adjuster is also equipped with an angle adjuster, which is fixedly connected to an adjusting rod. The adjusting rod is connected to a flexible bending portion, which is fixedly connected to a tip portion. The handle portion is equipped with a first fixing device for fixing the angle adjuster and the rotary adjuster. The angle between the tip portion and the connecting rod is adjusted by adjusting the degree of bending of the adjusting rod connected to the flexible bending portion using the angle adjuster, and then fixed by the first fixing device. The radial angle of the tip portion is adjusted by changing the rotation angle of the connecting rod along the central axis using the rotary adjuster, and then fixed by the first fixing device.
[0011] A level angle sensor is provided inside the tip portion, and the level angle sensor is connected to the flexible bending portion to detect the deflection angle of the tip portion.
[0012] The inner layer of the tip portion is provided with an inner tube, which is threadedly connected to a threaded actuator. The length of the threaded actuator is greater than that of the inner tube. A depth sensor is connected to the threaded actuator to detect the length of the threaded actuator that is higher than that of the inner tube.
[0013] The outer layer of the tip is provided with an outer tube, and the front end of the outer tube is provided with a red light emitting device, which can project a red light ring onto the cartilage surface to detect the perpendicularity of the tip to the cartilage surface. When the tip is perpendicular to the cartilage surface, the red light ring emitted by the red light emitting device is projected as a perfect circle on the cartilage surface. When the tip has a large angle with the connecting rod, the red light ring is projected as an ellipse on the cartilage surface. The front end of the outer tube is provided with a drill bit, which is fixed to a threaded pusher by a second fixing device. The threaded pusher can drive the drill bit to adjust its height in the inner tube. In the non-activated state, the drill bit is flush with the height of the outer tube.
[0014] The handle is equipped with an electronic display screen to show data transmitted by the level angle sensor and the depth sensor.
[0015] Furthermore, a first injection hole is provided on the connecting pipe.
[0016] Furthermore, a one-way valve is provided at the liquid inlet pipe to ensure that the drug flow does not flow backward.
[0017] Furthermore, the level angle sensor has three built-in gyroscope sensors with mutually perpendicular directions to sense the X-axis, Y-axis, and Z-axis angles respectively.
[0018] The beneficial effects of this invention are:
[0019] The microfracture instrument designed in this invention enables more precise control over the depth and angle of microfracture drilling, and provides surgeons with intuitive and accurate surgical feedback by displaying the surgical results in real time on an LCD screen. Furthermore, by improving upon the non-adjustable bending angle of previous instruments, the drill bit of this invention can be flexibly adjusted to adapt to various complex joint structures and anatomical features, making it possible to perform surgery in hard-to-reach areas. This improvement significantly enhances surgical accessibility and ease of operation, reducing the probability of enlarged or tilted holes and the impact of adverse lateral cutting forces on injury.
[0020] This invention is the first to integrate microfracture surgery with the injection of biological agents into a single device, simplifying the surgical procedure, improving surgical efficiency, and reducing surgical and anesthesia time. It also better realizes the therapeutic concept of combined intra-articular and subchondral bone injection. This method allows for immediate injection of medication into both the joint cavity and subchondral bone after puncture, controlling the inflammatory microenvironment of the joint cavity while delivering the medication to the subchondral bone lesion area for better local effects. While simplifying the surgical procedure, it provides a more favorable environment and conditions for cartilage repair, potentially improving treatment outcomes, avoiding the pain and discomfort of secondary punctures, and reducing infection and other surgical risks. Attached Figure Description
[0021] Figure 1 This is a schematic diagram of the microfracture device of the present invention;
[0022] Figure 2 This is an external view of the tip portion of the microfracture device of the present invention, wherein (a) is an external view of state one and (b) is an external view of state two.
[0023] Figure 3 This is an internal view of the tip portion of the microfracture device of the present invention;
[0024] In the diagram: 1. Syringe; 2. Inlet port; 3. Inlet pipe; 4. Storage tank; 5. Micro pump; 6. Motor; 7. First outlet pipe; 8. Angle adjuster; 9. Rotation adjuster; 10. First fixing device; 11. Connecting rod; 12. First injection hole; 13. Flexible bending part; 14. Tip part; 15. Second injection hole; 16. Electronic display screen; 17. Red light emitting device; 18. Red light ring; 19. Level angle sensor; 20. Depth sensor; 21. Threaded pusher; 22. Inner tube; 23. Outer tube; 24. Second outlet pipe; 25. Second fixing device; 26. Drill bit part; 27. Adjusting rod. Detailed Implementation
[0025] The present invention will be further described below with reference to the accompanying drawings and embodiments, but this is not intended to limit the scope of the invention.
[0026] Example 1:
[0027] like Figure 1 , Figure 2 , Figure 3 As shown, a microfracture surgery and intra-articular injection device can be used for the treatment of multiple joints throughout the body, including but not limited to microfracture surgery for diseases of the shoulder, elbow, wrist, hip, knee, and ankle. The device includes a handle, a connecting rod 11, and a tip 14. The handle is provided with an inlet port 2, an inlet pipe 3, and a reservoir 4. The connecting rod contains a connecting pipe and an adjusting rod 27. A syringe 1 is located at the upper end of the handle, connected to the inlet port 2, which is connected to the reservoir 4 via the inlet pipe 3.
[0028] The handle portion is equipped with a micro pump 5 and a first outlet pipe 7. One end of the first outlet pipe 7 is inside the storage tank 4, and the other end is connected to the inlet of the micro pump 5. The micro pump 5 is driven by a motor 6. The outlet of the micro pump 5 is connected to a connecting pipe in the connecting rod 11. The connecting pipe has a first injection hole 12 in its middle section. The connecting pipe is connected to a second outlet pipe 24 located inside the tip portion 14. The end of the second outlet pipe 24 has a second injection hole 15. The medicine is injected into the storage tank 4 in advance using a syringe 1; the micro pump 5 pumps the medicine out from the injection hole under high pressure; a one-way valve is provided at the inlet pipe to ensure that the medicine does not flow backward.
[0029] The handle portion is equipped with a rotary adjuster 9, which is fixedly connected to the connecting rod 11. An angle adjuster 8 is mounted on the rotary adjuster 9 and is fixedly connected to an adjusting rod 27. The adjusting rod 27 is connected to a flexible bending portion 13, which is fixedly connected to a tip portion 14. The handle portion is equipped with a first fixing device 10 for fixing the angle adjuster 8 and the rotary adjuster 9. The angle adjuster 8 is connected to the adjusting rod, and the adjusting rod 27 can drive the flexible bending portion 13 to bend. As with common adjusting devices, the bending angle of the flexible bending portion 13 is considered feasible from 0 degrees to 180 degrees. By rotating the angle adjuster 8, the adjusting rod 27 can be adjusted to control the degree of bending of the flexible bending portion 13, thereby adjusting the angle between the tip portion 14 and the connecting rod 11, and then it is fixed by the first fixing device 10. By rotating the adjuster 9 to change the rotation angle of the connecting rod 11 along the central axis, the radial angle of the tip portion 14 is adjusted, and then it is fixed by the first fixing device 10.
[0030] A level angle sensor 19 is provided inside the tip portion 14. The level angle sensor 19 has three gyroscope sensors with mutually perpendicular directions to sense the X-axis, Y-axis and Z-axis angles respectively. The level angle sensor 19 is connected to the flexible bending portion 13 to detect the deflection angle of the tip portion 14.
[0031] The inner layer of the tip portion 14 is provided with an inner tube 22, which is threadedly connected to a threaded pusher 21. The length of the threaded pusher 21 is greater than that of the inner tube 22. The depth sensor 20 is connected to the threaded pusher 21 to detect that the length of the threaded pusher 21 is greater than that of the inner tube.
[0032] The outer layer of the tip portion 14 is provided with an outer tube 23. A red light emitting device 17 is provided at the front end of the outer tube 23, which can project a red light ring 18 onto the cartilage surface to detect the perpendicularity between the tip portion and the cartilage surface. When the tip portion is perpendicular to the cartilage surface, the red light ring 18 emitted by the red light emitting device 17 is projected as a perfect circle on the cartilage surface. When the tip portion has a large angle with the connecting rod, the red light ring 18 is projected as an ellipse on the cartilage surface. A drill bit portion 26 is provided at the front end of the outer tube 23. The drill bit portion 26 is fixed to the threaded pusher 21 by a second fixing device 25. The threaded pusher 21 can drive the drill bit portion 26 to adjust its height in the inner tube 22. In the non-activated state, the drill bit portion 26 is flush with the height of the outer tube 23. Pressing the depth adjustment button will move the drill bit portion up and down. After the drill bit depth is adjusted up and down, the depth sensor 20 can detect the length of the thread pusher 21 above the inner tube, and the value can be displayed on the electronic display screen 16. When the height is adjusted, press the drilling button, and the second fixing device 25 will fix the drill bit part 26 to facilitate the drilling operation.
[0033] Example 2:
[0034] Based on the above, the present invention also includes the following embodiments:
[0035] When treating joint diseases such as knee and hip joints, including knee arthritis and femoral head necrosis using orthopedic biological agent injections, the cartilage thickness and the distance from the abnormal signal area of subchondral bone to the cartilage surface are measured on the patient's knee joint MRI images before the procedure.
[0036] In use, routine disinfection and draping are performed. The affected cartilage area is located and cleaned under arthroscopy. The tip 14 of the microfracture instrument of this invention is inserted into the joint cavity. The rotation adjuster 9 is adjusted to bring the tip 14 to a suitable angle. The red light ring 18 projected onto the cartilage surface by the red light emitting device 17 provides a rough location of the surgical area. The bending angle of the flexible bending portion 13 is adjusted by the angle adjuster 8 until the red light ring 18 projected onto the cartilage surface is perfectly circular. Further angle and position adjustments are made based on the readings on the electronic display screen 16 from the level angle sensor 19 until the tip 14 is perpendicular to the cartilage surface of the surgical area. After achieving the ideal position and angle, the rotation adjuster 9 is locked in place by the first fixation device 10.
[0037] With the surgical instruments not in drilling mode, the drill bit 26 remains flush with the outer tube 23. Press the depth adjustment button to adjust the height of the threaded pusher 21, thereby changing the distance the drill bit 26 extends beyond the outer tube 23. Using the reading on the electronic display 16, ensure the drill bit's position is perfectly aligned with the depth of the subchondral bone lesion area from the cartilage surface as measured by preoperative MRI. Press the drilling button, and the second fixing device 25 will lock the rear end of the drill bit 26, ensuring its stability during drilling. The drilling depth can be adjusted in real-time as needed during drilling. After drilling is complete, press the depth adjustment button to retract the drill bit 26, bringing it flush with the outer tube 23.
[0038] During injection, based on our newly proposed "joint cavity and bone combined" injection concept, the prepared biological agent, such as platelet-enriched plasma, fat microfragments, bone marrow aspirate concentrate, and stem cells, is first drawn into the syringe. The drug is then injected into the inlet port. The drug flows along the inlet pipe into the reservoir. When injection is needed, pressing the injection button on the handle activates the micro-pump 5, which pumps the biological agent out at high pressure. The drug is then injected through the outlet pipe and connecting pipe at the first injection port 12 and the second injection port 15. This design ensures that the drug solution is simultaneously and evenly distributed in both the joint cavity and the subchondral bone. Specifically: the first injection port 12 consists of six extremely fine outlet holes located in the front middle of the connecting rod 11, ensuring uniform diffusion of the biological agent within the joint cavity. The six extremely fine injection holes in the second injection port 15 are oriented in the same direction as the drill bit 26, allowing the drug to be directly injected into the subchondral bone region at high pressure.
[0039] After treatment, monitor the patient's vital signs and return them to the ward.
Claims
1. An instrument for microfracture surgery and combined intraosseous injection, characterized in that: It includes a handle, a connecting rod (11), and a tip (14). The handle is provided with an inlet hole (2), an inlet pipe (3), and a storage tank (4). The connecting rod is provided with a connecting pipe and an adjusting rod (27). The upper end of the handle is provided with a syringe (1). The syringe (1) is connected to the inlet hole (2). The inlet hole (2) is connected to the storage tank (4) through the inlet pipe (3). The handle is equipped with a micro pump (5) and a first liquid outlet pipe (7). One end of the first liquid outlet pipe (7) is inside the storage tank (4), and the other end is connected to the inlet of the micro pump (5). The micro pump (5) is driven by a motor (6). The outlet of the micro pump (5) is connected to the connecting pipe in the connecting rod (11). The connecting pipe is connected to the second liquid outlet pipe (24) located inside the tip part (14). The connecting pipe has a first injection hole (12). The first injection hole (12) consists of 6 fine holes distributed in the front middle part of the connecting rod (11) to make the drug evenly diffused and sprayed into the joint cavity. The second liquid outlet pipe (24) has a second injection hole (15) at the end. The second injection hole (15) consists of 6 fine holes with the opening direction consistent with the direction of the drill part (26) to pump the drug into the subchondral bone area through the micro pump (5). The drug is evenly distributed in the joint cavity and subchondral bone at the same time through the first injection hole (12) and the second injection hole (15). The handle is provided with a rotary adjuster (9), which is fixedly connected to the connecting rod (11); the rotary adjuster (9) is provided with an angle adjuster (8), which is fixedly connected to the adjusting rod (27), the adjusting rod (27) is connected to the flexible bending part (13), and the flexible bending part (13) is fixedly connected to the tip part (14); the rotary adjuster (9) is used to change the rotation angle of the connecting rod (11) along the central axis to adjust the radial angle of the tip part (14), and the angle adjuster (8) is used to drive the adjusting rod (27) to adjust the bending degree of the flexible bending part (13), thereby adjusting the included angle between the tip part (14) and the connecting rod (11); The handle portion is provided with a first fixing device (10) for fixing the angle adjuster (8) and the rotation adjuster (9); A level angle sensor (19) is provided inside the tip portion (14), and the level angle sensor (19) is connected to the flexible bending portion (13) to detect the deflection angle of the tip portion (14). The inner layer of the tip portion (14) is provided with an inner tube (22), which is threadedly connected to a threaded pusher (21). The length of the threaded pusher (21) is greater than that of the inner tube (22). A depth sensor (20) is connected to the threaded pusher (21) to detect the length of the threaded pusher (21) above the inner tube (22). The outer layer of the tip portion (14) is provided with an outer tube (23). The front end of the outer tube (23) is provided with a red light emitting device (17), which can project a red light ring (18) onto the cartilage surface to detect the perpendicularity between the tip portion and the cartilage surface. When the tip portion is perpendicular to the cartilage surface, the red light ring (18) emitted by the red light emitting device (17) is projected as a perfect circle on the cartilage surface. When the tip portion has a large angle with the connecting rod, the red light ring (18) is projected as an ellipse on the cartilage surface. The front end of the outer tube (23) is provided with a drill bit portion (26). The drill bit portion (26) is flush with the outer tube (23) in the non-started state. The drill bit portion (26) is fixed to the threaded pusher (21) by the second fixing device (25). The distance of the drill bit portion (26) extending out of the outer tube (23) is changed by the threaded pusher (21). The handle is provided with an electronic display screen (16) to display data detected by the level angle sensor (19) and the depth sensor (20).
2. The microfracture surgery and cavity bone combined injection device according to claim 1, characterized in that: A one-way valve is provided at the liquid inlet pipe (3) to ensure that the drug flow does not flow out in reverse.
3. The microfracture surgery and intraosseous combined injection device according to claim 1, characterized in that: The level angle sensor (19) has three built-in gyroscope sensors that are perpendicular to each other to sense the X-axis, Y-axis and Z-axis angles respectively.