Femoral side isometric point positioner for inner patellofemoral ligament

Abstract

The invention discloses an inner patellofemoral ligament femur side isometric point positioner, and relates to the technical field of joint surgery, the inner patellofemoral ligament femur side isometric point positioner comprises a main body framework, a sleeve, a tension measuring rod and a kirschner wire guide area are arranged on the upper surface of the main body framework, one end of the tension measuring rod is located in an inner cavity of the sleeve, and the other end of the tension measuring rod is provided with a tendon fixing assembly; the kirschner wire guiding area and the tendon fixing assembly are located on the same side of the main body framework and located at the near end of the main body framework. Through preliminary determination of the anatomical position and cooperation with the positioner, the accuracy of medical personnel for determining the positioning point on the thighbone side is greatly improved compared with that of a mode of dissecting the positioning point only by touching the hand.

Description

Technical Field

[0001] The invention belongs to the technical field of joint surgery, and in particular relates to an isometric point locator of the femoral side of the medial patellofemoral ligament. Background Art

[0002] Recurrent patellar dislocation is a common type of knee injury. Medial patellofemoral ligament reconstruction is one of the effective methods for treating recurrent patellar dislocation. Inaccurate positioning of the medial patellofemoral ligament attachment point is a common cause of failure in medial patellofemoral ligament reconstruction surgery.

[0003] The location of the femoral lateral ligament reconstruction point during medial patellofemoral ligament reconstruction has a great influence on the isometric motion of the patella in the femoral trochlea. Positioning the femoral tunnel too proximally will significantly increase the tension of the graft during knee flexion, leading to early patellofemoral arthritis, graft rupture, graft failure, etc.

[0004] On the contrary, if the femoral tunnel is positioned too far distally, the graft will not be tight during knee flexion and will not provide medial tension protection.

[0005] Anatomical reconstruction of the medial patellofemoral ligament is very important for recurrent patellar dislocation. There are several options for selecting equal length points of the medial patellofemoral ligament on the femoral side, but each has its own disadvantages: 1. The reasons why the femoral tunnel established by fluoroscopic positioning may lead to potential deviation are as follows: (1) In the actual surgical scenario, it is very difficult to obtain a pure lateral view of the knee joint, and a slight deviation from the pure lateral view can lead to significant deviation of the femoral tunnel. (2) The extension line of the posterior femoral cortical line is curved, not straight. The determination of the extension line of the posterior femoral cortical line during surgery is highly subjective, which may cause deviation in positioning. (3) There are differences in the individual development of the medial femoral condyle. The activity state of the medial patellofemoral ligament on the medial femoral condyle is three-dimensional rather than the two-dimensional space shown on the X-ray film. Therefore, the attachment position of the medial patellofemoral ligament in the femoral region shows individual differences.

[0006] 2. The reasons for potential deviation in positioning by touching the anatomical protrusions or grooves are: (1) There is variability in the position of the medial patellofemoral ligament on the femoral side relative to several bony protrusions. (2) The anatomical landmarks are not obvious enough due to individual differences and are difficult to identify.

[0007] 3. 3D printing template method: Due to the obstruction of soft tissue and muscle, it is difficult to place the template in the predetermined position.

[0008] 4. The reconstruction point on the femoral side of the medial patellofemoral retinaculum should meet two basic conditions: first, the reconstructed ligament can limit the patella from escaping outward when the patella enters the femoral trochlear track during knee flexion; second, the distance between the two fixed points of the ligament should be approximately equal during knee flexion and extension. Currently, most scholars believe that reconstruction according to the original anatomical point of the femoral ligament can meet the above conditions, and the existing research is based on the normal femoral condyle. However, in clinical cases of patellar dislocation, due to developmental abnormalities and individual differences, the site that can meet the above two basic conditions is not necessarily the original anatomical site. If reconstruction is done according to the original anatomical site, there is still a risk of re-injury to the patellar dislocation ligament. Summary of the invention

[0009] In response to the above problems, the present application proposes a medial patellofemoral ligament femoral side isometric point locator. After the medial femoral condyle site is drilled and positioned with a Kirschner wire, the first type of isometric test guide tube is inserted into the Kirschner wire, and the reconstructed supporting ligament fixed on the medial side of the patella is passed around the first type of isometric test guide tube and fixed on the tendon fixation rod, maintaining a certain tension. During the extension and flexion of the knee, observe whether the scale mark value of the tension rod changes within 9mm. If the change value is large, the ligament is rewound around the other two isometric test guide tubes. At this time, the locator of this device can rotate 360 ​​degrees with the Kirschner wire as the center. When the scale mark value of the tension rod changes within 9mm when the knee joint is flexed and extended, it can be regarded as the position around this type of isometric test guide tube as the femoral side isometric point. A 2.0mm Kirschner wire is drilled through this guide tube to determine the femoral positioning point of the medial patellar supporting ligament.

[0010] The technical solution adopted by the present invention is: A medial patellofemoral ligament femoral side isometric point locator comprises a main frame, a sleeve, a tension measuring rod and a Kirschner wire guide area are arranged on the upper surface of the main frame, one end of the tension measuring rod is located in the inner cavity of the sleeve, and a tendon fixation component is arranged at the other end thereof, and the Kirschner wire guide area and the tendon fixation component are located on the same side of the main frame and at the proximal end of the main frame.

[0011] As a preferred solution of the main frame, the main frame is provided with a slide groove running through its thickness, at least one fixing plate is provided at the bottom of the slide groove, the fixing plate is connected to the bottom of the sleeve by bolts, and the sleeve can move along the slide groove.

[0012] As a preferred scheme for the Kirschner wire guide area, the Kirschner wire guide area includes a first type of equal-length test guide tube, a second type of equal-length test guide tube and a third type of equal-length test guide tube. The first type of equal-length test guide tube is located on the central axis of the main frame, and the second type of equal-length test guide tube and the third type of equal-length test guide tube are respectively located on both sides of the first type of equal-length test guide tube, and form a triangle with the first type of equal-length test guide tube.

[0013] Furthermore, the first type of equal-length test guide tube, the second type of equal-length test guide tube and the third type of equal-length test guide tube all vertically penetrate the main frame.

[0014] Furthermore, the distance between the first type of equal-length test guide tube and the second type of equal-length test guide tube is 7 mm, and the axial vertical distance is 5.7 mm; the distance between the third type of equal-length test guide tube and the second type of equal-length test guide tube is 11 mm, and the axial vertical distance is 5.7 mm.

[0015] Furthermore, the Kirschner wire drilled into the first type of equal length test catheter can be rotated 360 degrees with the Kirschner wire as the axis, so that quasi-equal length points can appear in a certain area.

[0016] As a preferred solution of the tendon fixation component, the tendon fixation plate is a toothed elastic clip, the bottom of which is fixed to the side wall of the tendon fixation rod.

[0017] As a preferred solution for the tension measuring rod, an integrally formed stopper is arranged at one end of the tension measuring rod located in the sleeve, a tension measuring spring is sleeved on the rod body of the tension measuring rod, and the tension measuring spring is located between the stopper and the inner wall of the sleeve.

[0018] As another preferred scheme for the main frame, the main frame is an L-shaped base, the vertical part of the L-shaped base is provided with a horizontal through hole, a sleeve adjustment rod is provided in the horizontal through hole, one end of the sleeve adjustment rod is connected to the distal wall of the sleeve, and a locking nut is provided at the top of the vertical part of the L-shaped base, the locking nut passes through the horizontal through hole and is against the sleeve telescopic rod.

[0019] Beneficial effects of the present invention: 1. Reduce damage: No X-ray fluoroscopy is required during the operation, which reduces the damage of radiation to doctors and patients.

[0020] 2. Improve surgical convenience: By initially determining the anatomical position and using a locator, medical personnel can greatly improve the accuracy of the femoral positioning point compared to simply relying on touching the anatomical site.

[0021] 3. The locator can improve the success rate of surgery and enhance the surgical effect. BRIEF DESCRIPTION OF THE DRAWINGS

[0022] In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings required for use in the embodiments or the description of the prior art will be briefly introduced below. Obviously, the drawings described below are only some embodiments of the present invention. For ordinary technicians in this field, other drawings can be obtained based on these drawings without paying creative work.

[0023] Figure 1Shown is a side view of a medial patellofemoral ligament femoral side isometric point locator of Example 1.

[0024] Figure 2 Shown is a top view of a medial patellofemoral ligament femoral side isometric point locator of Example 1.

[0025] Figure 3 Shown is a side sectional view of a medial patellofemoral ligament femoral side isometric point locator of Example 1.

[0026] Figure 4 This is a schematic diagram of the distribution of locators on the patella and femur.

[0027] Figure 5 This is a real-life picture of the surgical operation (knee flexion and extension process).

[0028] Figure 6 This is a photo of the actual surgical operation (wrapping the ligament around two other test guide tubes of quasi-equal length).

[0029] Among them, 1. main frame; 101. slide groove; 2. sleeve; 201. inner cavity; 3. tension measuring rod; 4. tendon fixing rod; 5. tendon fixing plate; 6. sleeve adjustment rod; 7. locking nut; 8. tension measuring spring; 9. first type equal length test guide tube; 10. second type equal length test guide tube; 11. third type equal length test guide tube; 12. fixing plate. DETAILED DESCRIPTION

[0030] In order to make the purpose, technical solutions and advantages of the embodiments of the present invention clearer, the technical solutions in the embodiments of the present invention will be clearly and completely described below in conjunction with the drawings in the embodiments of the present invention. Obviously, the described embodiments are part of the embodiments of the present invention, not all of the embodiments. Generally, the components of the embodiments of the present invention described and shown in the drawings here can be arranged and designed in various different configurations.

[0031] Therefore, the following detailed description of the embodiments of the present invention provided in the accompanying drawings is not intended to limit the scope of the invention claimed for protection, but merely represents selected embodiments of the present invention. Based on the embodiments of the present invention, all other embodiments obtained by ordinary technicians in this field without creative work are within the scope of protection of the present invention. Example

[0032] This embodiment proposes a medial patellofemoral ligament femoral side quasi-isometric point locator, which is determined by preliminary anatomical position and then adjusted with the locator to make the quasi-isometric point more accurate and convenient.

[0033] like Figure 1As shown, it includes a main frame 1, on the upper surface of which a sleeve, a tension measuring rod 3 and a Kirschner wire guide area are arranged, one end of the tension measuring rod 3 is located in the inner cavity 201 of the sleeve 2, and the other end thereof is provided with a tendon fixation assembly, and the Kirschner wire guide area and the tendon fixation assembly are located on the same side of the main frame 1 and at the proximal end of the main frame 1.

[0034] The Kirschner wire guide area includes a first type of equal length test guide tube 9, a second type of equal length test guide tube 10 and a third type of equal length test guide tube 11, which are arranged in a triangle. The first type of equal length test guide tube 9 is located on the central axis of the main frame 1, and the second type of equal length test guide tube 10 and the third type of equal length test guide tube 11 are respectively located on both sides of the first type of equal length test guide tube 9 to form a triangular structure. Figure 4 As shown, assuming that the quasi-equal length point is to be found from point B on the patella side to point A on the femoral side, and during the operation, point C is selected, and the first type of equal length test guide tube is set as the rotation axis. When the main body 1 rotates 360° around this axis, two concentric circle tracks D drawn by the second type of equal length test guide tube and E drawn by the third type of equal length test guide tube can appear. Therefore, during the sliding process of the patella on the femoral condyle, a B-A type equal length point can be found on point C, D track or E track. That is, with the Kirschner wire drilled into the first type of equal length test guide tube as the axis, it can be rotated 360 degrees to appear a quasi-equal length point within a certain area.

[0035] The distance between the first type of equal-length test guide tube 9 and the second type of equal-length test guide tube 10 is 7 mm, and the axial vertical distance is 5.7 mm; the distance between the third type of equal-length test guide tube 11 and the second type of equal-length test guide tube 10 is 11 mm, and the axial vertical distance is 5.7 mm.

[0036] In addition, the first type of isometric test guide tube 9, the second type of isometric test guide tube 10 and the third type of isometric test guide tube 11 all vertically penetrate the main frame 1. The first type of isometric test guide tube 9, the second type of isometric test guide tube 10 and the third type of isometric test guide tube 11 are all Kirschner wire guide tubes with an inner diameter of 2.1 mm, and are 5 mm away from the tendon fixation rod 4.

[0037] An integrally formed stopper is provided at one end of the tension measuring rod 3 located in the sleeve 2, and a tension measuring spring 8 is sleeved on the rod body of the tension measuring rod 3, and the tension measuring spring 8 is located between the stopper and the inner wall of the sleeve 2. Before use, the tension measuring rod 3 is reset and pulled to the leftmost side by the tension measuring spring 8. A scale mark is provided on the upper surface of the tension measuring rod 3, and the tension value can be read.

[0038] The main frame 1 is provided with a slide groove 101 that runs through its thickness. At least one fixing plate 12 is provided at the bottom of the slide groove 101. The fixing plate 12 is connected to the bottom of the sleeve 2 by bolts, and the sleeve 2 can move along the slide groove 101. The adjusted sleeve is limited by the sleeve adjustment rod 6. The main frame 1 is an L-shaped base. The vertical part of the L-shaped base is provided with a horizontal through hole. The sleeve adjustment rod 6 passes through the horizontal through hole and is connected to the sleeve. The top of the vertical part of the L-shaped base is provided with a locking nut 7. The locking nut 7 passes through the horizontal through hole and abuts against the sleeve telescopic rod. When the sleeve is adjusted to the specified position, tighten the locking nut 7 to limit the sleeve at the current position.

[0039] In order to better fix the ligament pulled from the quasi-isometric test guide tube, a tendon fixation rod 4 is provided at the proximal end of the tension measuring rod 3, and a tendon fixation plate 5 is provided on the side wall of the tendon fixation rod 4 and faces the side of the Kirschner wire guide area. The tendon fixation plate 5 is a toothed elastic clip.

[0040] Instructions: Medical personnel define the medial 1 / 2 of the patella as the patellar attachment point of the medial patellofemoral retinaculum, and use the above technical solution to determine the quasi-isolongitude point of the medial femoral condyle during knee extension from 0° to 120° of knee flexion. The specific method is as follows: the lateral site of the medial femoral condyle is preliminarily determined by palpating the anatomical site, a 2.0mm Kirschner wire is used to drill and locate, the first point quasi-isolongitude test guide tube is inserted into the Kirschner wire, the reconstructed retinaculum fixed on the medial side of the patella is passed around the quasi-first isometric test guide tube and fixed to the tendon fixation rod 4 and the tendon fixation plate 5, and a certain tension is maintained. During knee extension and flexion, observe whether the scale mark value of the tension rod 3 changes within 9mm. If Figure 5 If the change is large, re-wrap the ligament around two other test guide tubes of equal length, as shown in Figure 6 As shown, at this time, the locator rotates 360 degrees with the Kirschner wire as the center. When the tension rod scale mark value changes within 9mm when the knee joint is flexed and extended, it can be considered that the position of the isometric test guide tube is the isometric point on the femoral side. A 2.0mm Kirschner wire is drilled through the guide tube to determine the femoral positioning point of the medial patellar supporting ligament and make a bone tunnel.

[0041] The above description is only used to illustrate the technical solution of the present invention rather than to limit it. Other modifications or equivalent substitutions made to the technical solution of the present invention by ordinary technicians in this field should be included in the scope of the claims of the present invention as long as they do not depart from the spirit and scope of the technical solution of the present invention.

Claims

1. A medial patellofemoral ligament femoral side isometric point locator, characterized in that: It includes a main frame, on the upper surface of which a sleeve, a tension measuring rod and a Kirschner wire guide area are arranged, one end of the tension measuring rod is located in the inner cavity of the sleeve, and the other end of the tension measuring rod is arranged with a tendon fixation component, and the Kirschner wire guide area and the tendon fixation component are located on the same side of the main frame and at the proximal end of the main frame.

2. The medial patellofemoral ligament femoral side isometric point locator according to claim 1, characterized in that: The main frame is provided with a slide groove penetrating the thickness thereof, and at least one fixing plate is provided at the bottom of the slide groove. The fixing plate is connected to the bottom of the sleeve through bolts, and the sleeve can move along the slide groove.

3. The medial patellofemoral ligament femoral side isometric point locator according to claim 1, characterized in that: The Kirschner wire guide area includes a first type of equal-length test guide tube, a second type of equal-length test guide tube and a third type of equal-length test guide tube. The first type of equal-length test guide tube is located on the central axis of the main frame, and the second type of equal-length test guide tube and the third type of equal-length test guide tube are respectively located on both sides of the first type of equal-length test guide tube, and form a triangle with the first type of equal-length test guide tube.

4. The medial patellofemoral ligament femoral side isometric point locator according to claim 3, characterized in that: The first type of equal-length test guide tube, the second type of equal-length test guide tube and the third type of equal-length test guide tube all vertically penetrate the main frame.

5. The medial patellofemoral ligament femoral side isometric point locator according to claim 4, characterized in that: The distance between the first type of isometric test guide tube and the second type of isometric test guide tube is 7 mm, and the axial vertical distance is 5.7 mm; the distance between the third type of isometric test guide tube and the second type of isometric test guide tube is 11 mm, and the axial vertical distance is 5.7 mm.

6. The medial patellofemoral ligament femoral side isometric point locator according to claim 1, characterized in that: The tendon fixation component comprises a tendon fixation rod and a tendon fixation plate. The tendon fixation plate is arranged on the side wall of the tendon fixation rod and faces the side of the Kirschner wire guide area.

7. The medial patellofemoral ligament femoral side isometric point locator according to claim 6, characterized in that: The tendon fixation plate is a toothed elastic clip, the bottom of which is fixed on the side wall of the tendon fixation rod.

8. The medial patellofemoral ligament femoral side isometric point locator according to claim 1, characterized in that: An integrally formed stopper is arranged at one end of the tension measuring rod located in the sleeve, and a tension measuring spring is sleeved on the rod body of the tension measuring rod, and the tension measuring spring is located between the stopper and the inner wall of the sleeve.

9. The medial patellofemoral ligament femoral side isometric point locator according to claim 1, characterized in that: The main structure is an L-shaped base, the vertical part of the L-shaped base is provided with a horizontal through hole, a sleeve adjustment rod is provided in the horizontal through hole, one end of the sleeve adjustment rod is connected to the distal wall of the sleeve, and a locking nut is provided at the top of the vertical part of the L-shaped base, the locking nut passes through the horizontal through hole and is against the sleeve telescopic rod.

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