Minimally invasive surgery device for femoral head necrosis and use method

Abstract

The invention belongs to the field of medical instruments, and particularly discloses a minimally invasive surgery device for femoral head necrosis and a use method. A minimally invasive surgery device for femoral head necrosis comprises a guide column, a center channel is formed in the guide column, a lens channel parallel to the center channel is formed above the center channel, a guide pipe is connected in the center channel in a sleeved mode, a fixed ring frame is connected to the front end of the guide pipe, and a movable ring frame is hinged to the front end of the fixed ring frame. A grinding rod is installed in the guide pipe through a bearing, the rear end of the grinding rod is connected with the driving mechanism, a universal joint is installed at the front end of the grinding rod, and the universal joint is connected with a grinding head; the guide pipe is provided with a first channel and a second channel, a V-shaped frame is hinged to the rear end of the guide pipe, and a first traction rope and a second traction rope are connected to the position, right opposite to the first channel, above the V-shaped frame. The femoral head necrosis part of a patient is ground and removed through the four steps of determining the femoral head drilling and grinding position, grinding and drilling, controlling a grinding head to grind and remove the necrosis part, and closing and withdrawing the device.

Description

Technical Field

[0001] The present invention belongs to the field of medical devices, and particularly relates to a minimally invasive surgical device for femoral head necrosis and a using method thereof. Background Art

[0002] Femoral head necrosis, also known as avascular necrosis of the femoral head or aseptic necrosis of the femoral head, refers to a disease in which the blood supply to the femoral head is damaged or interrupted, resulting in the death of bone marrow components and bone cells and subsequent tissue repair, and then leading to structural changes and collapse of the femoral head, causing hip joint pain and dysfunction in patients. The progression of femoral head necrosis is relatively fast, and non-surgical treatment often has poor effects. Most patients will face surgical treatment. Surgical treatment is mainly divided into hip-preserving surgery and hip replacement surgery (artificial hip joint replacement). The purpose of hip-preserving treatment is to relieve pain, reconstruct hip joint function, attempt to restore blood supply to the femoral head, and avoid or delay artificial hip joint replacement. Hip-preserving treatment is more suitable for early femoral head necrosis (ARCO stage I-II) and young patients, especially teenagers. The principle of minimally invasive surgery for hip-preserving treatment is to reduce the pressure in the femoral head medullary cavity and relieve pain by drilling, create a channel to promote the rapid formation of new blood vessels, and attempt to restore the normal blood circulation in the femoral head. In order to further accelerate the recovery of the femoral head, after cleaning the necrotic femoral head medulla, filling materials will be implanted. Bone grafting can not only fill the cavity after cleaning the necrotic lesion, but also temporarily serve as the supporting structure under the cartilage, and promote new bone formation through bone induction or bone formation.

[0003] In the prior art, the device for removing necrotic femoral head tissue combines a drill bit with a display lens, which is convenient for real-time observation during the operation. However, the front end of the device lacks protection for the lens, and the angle of the drill bit is fixed, resulting in incomplete removal of the necrotic femoral head tissue. Improper handling may cause serious adverse consequences and sequelae, causing secondary harm to the patient. Summary of the Invention

[0004] In order to solve the above problems, the present invention proposes a minimally invasive surgical device for femoral head necrosis and a using method thereof. Using this minimally invasive surgical device for femoral head necrosis, the necrotic femoral head tissue can be polished and removed during the minimally invasive surgery for early femoral head necrosis patients. This device uses the transmission principle of a universal joint to change the polishing angle of the grinding head, and the polishing angle of the grinding head can be adjusted outside the body by controlling the pulling rope, expanding the range that the grinding head can polish, so that the necrotic part of the patient's femoral head can be fully polished by the grinding head, and the visualization of the operation process is realized by using an endoscope, which is convenient for medical staff to observe the specific situation inside the patient's femoral head in real time.

[0005] In order to achieve the above technical objectives, the technical solution of the present invention is as follows:

[0006] A minimally invasive surgical device for femoral head necrosis, comprising a guiding column;

[0007] The guiding column is cylindrical. A positioning sleeve is sleeved outside the guiding column. A grip is installed on the lower side of the positioning sleeve. A central channel running through from front to back is axially opened inside the guiding column. Above the central channel, a lens channel parallel to the central channel is opened. On both sides below the central channel symmetrically, liquid suction channels parallel to the central channel are opened. Pipelines of a negative pressure device can be installed in the liquid suction channels to facilitate the cleaning of necrotic tissues after grinding. A guiding tube is sleeved inside the central channel. The front end of the guiding tube is connected with a fixed ring frame. The front end of the fixed ring frame is hinged with a movable ring frame. A grinding rod coaxial with the guiding tube is installed in the guiding tube through a bearing. The rear end of the grinding rod is connected with a driving mechanism. The front end of the grinding rod is installed with a universal joint having the same outer diameter as the grinding rod. The other end of the universal joint is connected with a spherical grinding head. The diameter of the spherical grinding head is the same as the diameter of the guiding column; The universal joint consists of an active end seat, a cross shaft and a driven end seat. The active end seat is coaxially installed in the fixed ring frame through a bearing. The driven end seat is installed in the movable ring frame through a bearing. The midpoint of the connection line between the center point of the cross shaft and the hinge point of the movable ring frame coincides, so that the driven end seat of the universal joint can change the transmission direction with the swing of the movable ring frame;

[0008] Above the connection of the guiding tube and the fixed ring frame, two first channels parallel to the guiding tube and penetrating the guiding tube are opened. Symmetrically below, two identical second channels are opened. At the rear end of the guiding tube, a bracket is installed between the first channel and the second channel. A V-shaped frame is hinged on the bracket. Above the V-shaped frame, a first pulling rope is connected opposite to the first channel. The first pulling rope passes through the first channel and is connected to the upper side of the movable ring frame. A second pulling rope symmetrical to the first pulling rope is connected below the V-shaped frame. The V-shaped frame is connected to the movable ring frame through the first pulling rope and the second pulling rope. When the V-shaped frame swings, the movable ring frame swings in the opposite direction under the action of the pulling line.

[0009] Further, a number of positioning grooves parallel to the axis of the guiding column are opened on the outer side of the guiding column. On the inner wall of the positioning sleeve sleeved outside the guiding column, a number of protruding keys fitting the positioning grooves are installed, which can limit the rotation of the guiding column in the positioning sleeve;

[0010] Further, a rubber ring is installed between the guiding column and the front end of the guiding tube, which can reduce the vibration of the guiding column when the grinding rod rotates and prevent the necrotic tissues in the femoral head from flowing out through the gap between the guiding tube and the guiding column to cause pollution;

[0011] Further, the cross section of the tail of the grinding head is cross-shaped, and the front end of the universal joint is a cross-shaped hole, so that the grinding head is clamped with the universal joint and is convenient for disassembly and replacement of the grinding head;

[0012] Further, an arc-shaped convex key is installed at the front end of the guide post on the outer edge of the lens channel to reduce the wear of the lens when the device grinds and removes the necrotic femoral head.

[0013] The present invention also provides a usage method of the minimally invasive surgical device for femoral head necrosis based on the above, including the following steps:

[0014] S1: Determine the drilling and grinding position of the femoral head. Before using the present invention, first determine the position of the necrotic part inside the femoral head and determine the most suitable starting point for drilling and grinding. Then, process the muscle tissue and blood vessels outside the starting point of grinding to minimize the impact on the surrounding healthy tissues during drilling and grinding.

[0015] S2: Grind and drill. Align the grinding head of the device with the starting point of grinding, and adjust the entering direction of the device through the grip and the positioning sleeve. Then, start the driving mechanism of the device to make the grinding head start to rotate, and start the negative pressure device connected to the liquid suction channel while pushing the guide rod to start grinding and drilling the femoral head, sucking out the ground bone mass and various foreign objects.

[0016] S3: Control the grinding head to grind and remove the necrotic part. When the grinding head penetrates into the necrotic part inside the femoral head, adjust the V-shaped frame, adjust the grinding angle of the grinding head according to the specific position of the necrotic part, control the grinding head to swing in the opposite direction by adjusting the swing of the V-shaped frame. After adjustment, keep the V-shaped frame still and make the grinding head start to grind. At this time, slowly rotate the guiding tube to drive the grinding head to rotate slowly, making the grinding range circular. Repeat adjusting the angle of the grinding head in this way to fully grind and remove the necrotic part.

[0017] S4: Turn off and withdraw the device. After grinding and removing the necrotic part inside the femoral head, turn off the driving mechanism of the device, and adjust the V-shaped frame to control the grinding head to the initial angle. Slowly remove the device from the patient's body and perform wound treatment.

[0018] The beneficial effects of the present invention:

[0019] Compared with the prior art, the present invention ensures the visualization of the surgical process through an endoscope with lens protection, improves the accuracy of the surgery. When grinding the necrotic part of the patient's femoral head, the grinding range can be increased by changing the angle between the grinding head and the grinding rod, making the necrotic part more thoroughly cleaned. The angle of the grinding head is adjusted by controlling the pulling rope through the external V-shaped frame to drive the sliding ring frame, realizing real-time adjustment of the angle of the grinding head, reducing the difficulty of surgical operation, and improving the efficiency and safety of the surgery. Description of the Drawings

[0020] In order to more clearly illustrate the technical solutions of the embodiments of the present invention, the following briefly introduces the drawings required for description in the embodiments.

[0021] Figure 1 It is a schematic diagram of the overall structure of Embodiment 1 of the present invention;

[0022] Figure 2 It is a schematic diagram of the guide post structure of Embodiment 1 of the present invention;

[0023] Figure 3 It is a schematic diagram of a partial structure of Embodiment 1 of the present invention;

[0024] Figure 4 It is a schematic diagram of a partial structure of Embodiment 1 of the present invention;

[0025] Figure 5 It is a schematic diagram of the universal joint structure of Embodiment 1 of the present invention;

[0026] Figure 6 It is a rear view of the grinding head of Embodiment 1 of the present invention;

[0027] Figure 7 It is a schematic diagram of a partial structure after the grinding head angle adjustment of Embodiment 1 of the present invention;

[0028] Figure 8 It is a schematic diagram of the V-shaped frame adjusting the grinding head angle of Embodiment 1 of the present invention.

[0029] The structural names represented by each label in the drawings are as follows:

[0030] 1 - guide post, 101 - liquid suction channel, 102 - lens channel, 103 - arc-shaped convex key, 104 - positioning groove, 2 - central channel, 201 - rubber ring, 3 - fixed ring frame, 4 - movable ring frame, 5 - guide tube, 501 - first channel, 502 - second channel, 503 - bracket, 6 - V-shaped frame, 7 - grinding rod, 8 - universal joint, 801 - active end seat, 802 - cross shaft, 803 - driven end seat, 9 - grinding head, 10 - first pulling rope, 11 - second pulling rope, 12 - endoscope, 13 - positioning sleeve, 1301 - grip. Detailed implementation manners

[0031] The present invention will be described in detail below in conjunction with the drawings and specific embodiments. Obviously, the described embodiments are only partial embodiments of the present invention, not all embodiments.

[0032] Embodiment 1

[0033] Refer to Figures 1 to 8 As shown, a minimally invasive surgical device for femoral head necrosis is proposed, including a guide post 1;

[0034] The guide post 1 is cylindrical. A positioning sleeve 13 is sleeved outside the guide post 1. Three positioning grooves 104 parallel to the axis of the guide post 1 are provided on the outer side of the guide post 1. Three protruding keys that fit with the positioning grooves 104 are installed on the inner wall of the positioning sleeve 13 sleeved outside the guide post 1, which can limit the rotation of the guide post 1 in the positioning sleeve 13. A grip 1301 is installed on the lower side of the positioning sleeve 13. A central channel 2 that penetrates through the front and back is provided along the axis inside the guide post 1. A lens channel 102 parallel to the central channel 2 is provided above the central channel 2. A rigid endoscope 12 is installed in the lens channel 102. An arc-shaped convex key 103 is installed on the outer edge of the lens channel 102. The arc-shaped convex key 103 protects the lens of the endoscope 12 and reduces the wear of the lens when the device grinds and removes the necrotic femoral head. Suction channels 101 parallel to the central channel 2 are symmetrically provided on both sides below the central channel 2. Pipelines of a negative pressure device can be installed in the suction channels 101 to facilitate the cleaning of the ground necrotic tissue. A guiding tube 5 is sleeved inside the central channel 2. A rubber ring 201 is installed between the guide post 1 and the front end of the guiding tube 5, which can reduce the vibration of the guide post 1 when the grinding rod 7 rotates and prevent the necrotic tissue in the femoral head from flowing out through the gap between the guiding tube 5 and the guide post 1 to cause pollution. The front end of the guiding tube 5 is connected to a fixed ring frame 3. The front end of the fixed ring frame 3 is hinged to a movable ring frame 4. A grinding rod 7 coaxial with the guiding tube 5 is installed in the guiding tube 5 through a bearing. In this embodiment 1, an electric bone drill with adjustable speed is used as the drive. The rear end of the grinding rod 7 is connected to the output end of the electric bone drill. A universal joint 8 with the same outer diameter as the grinding rod 7 is installed at the front end of the grinding rod 7. The other end of the universal joint 8 is connected to a spherical grinding head 9. The connection method at the connection between the grinding head 9 and the front end of the universal joint 8 is a snap connection, which is convenient for disassembling and replacing the grinding head 9 after multiple uses. The diameter of the spherical grinding head 9 is the same as the diameter of the guide post 1.

[0035] The universal joint 8 is composed of a driving end seat 801, a cross shaft 802, and a driven end seat 803. The driving end seat 801 is coaxially installed in the fixed ring frame 3 through a bearing. The driven end seat 803 is installed in the movable ring frame 4 through a bearing. The midpoint of the connection line between the center point of the cross shaft 802 and the hinge point of the movable ring frame 4 coincides, so that the driven end seat 803 of the universal joint 8 can change the transmission direction with the swing of the movable ring frame 4.

[0036] Above the connection of the guiding tube 5 and the fixed ring frame 3, two first channels 501 parallel to the guiding tube 5 and penetrating through the guiding tube 5 are provided. Symmetrically below, two identical second channels 502 are provided. At the rear end of the guiding tube 5, a bracket 503 is installed between the first channel 501 and the second channel 502. A V-shaped frame 6 is hinged on the bracket 503. Above the V-shaped frame 6, a first pulling rope 10 is connected opposite to the first channel 501. The first pulling rope 10 passes through the first channel 501 and is connected to the upper side of the movable ring frame 4. A second pulling rope 11 symmetrical to the first pulling rope 10 is connected below the V-shaped frame 6. The V-shaped frame 6 is connected to the movable ring frame 4 through the first pulling rope 10 and the second pulling rope 11. When the V-shaped frame 6 swings, under the action of the pulling line, the movable ring frame 4 swings in the opposite direction, and the driven end seat 803 of the universal joint 8 in the movable ring frame 4 swings simultaneously, so as to change the grinding angle of the grinding head 9.

[0037] The usage method of using the minimally invasive surgical device for femoral head necrosis of the present invention to grind and remove the necrotic femoral head tissue of early femoral head necrosis patients is as follows:

[0038] 1. Determine the drilling and grinding position of the femoral head:

[0039] Before performing minimally invasive surgery for femoral head necrosis, first perform hip joint MRI examination to determine the position of the necrotic part in the femoral head, and determine the most suitable starting point for drilling and grinding according to the position and size of the necrotic part. Then, process the muscle tissue and blood vessels outside the grinding starting point to minimize the impact on surrounding healthy tissues during grinding and drilling.

[0040] 2. Grind and drill:

[0041] Align the grinding head 9 with the grinding starting point, and adjust the entering direction of the device through the grip 1301 and the positioning sleeve 13. Under the action of the positioning groove 104, the guiding column 1 can only move back and forth along the axis of the positioning sleeve 13, improving the stability during grinding and drilling. Then, start the driving mechanism of the device to make the grinding head 9 start to rotate. While pushing the guiding column 1 to start grinding and drilling the femoral head, start the negative pressure device connected to the liquid suction channel 101 to grind and drill the femoral head, and control the device to grind and extend into the necrotic part.

[0042] 3. Control the grinding head 9 to grind and remove the necrotic part:

[0043] After the grinding head 9 is inserted deep into the necrotic part inside the femoral head, the V-shaped frame 6 is used to control the grinding head 9 to swing in the opposite direction. When the V-shaped frame 6 is pushed to rotate upward, the second pulling rope 11 fixed on the V-shaped frame 6 is pulled by the V-shaped frame 6, thereby pulling the movable ring frame 4. At this time, the movable ring frame 4 swings downward under the pulling force, causing the driven end seat 803 of the universal joint 8 in the movable ring frame 4 to deflect accordingly, thus changing the grinding angle of the grinding head 9. When the V-shaped frame 6 is pushed to rotate downward, the grinding angle of the grinding head 9 can also be adjusted in the same way, making the grinding more flexible. After adjustment, keep the V-shaped frame 6 stationary and slowly rotate the guiding tube 5 to drive the grinding head 9 to rotate slowly. Repeat the adjustment of the angle of the grinding head 9 in this way, and observe the situation inside the femoral head through the endoscope 12 to fully grind and remove the necrotic part.

[0044] 4. Close and withdraw the device:

[0045] After observing through the endoscope 12 that the necrotic part inside the femoral head has been ground and removed, close the device, adjust the V-shaped frame 6 to control the grinding head 9 to the initial angle, and keep the grinding head 9 and the grinding rod 7 on the same axis. Then, the device can be slowly removed from the patient's body, and the wound can be treated to complete the minimally invasive surgery for the patient's femoral head necrosis.

[0046] The embodiments of the present invention disclosed above are only used to help illustrate the present invention. The preferred embodiments do not describe all the details in detail, nor do they limit the invention to the specific embodiments described. Obviously, many modifications and changes can be made according to the content of this specification.

Claims

1. A minimally invasive surgical device for femoral head necrosis, characterized in that: Includes guide post (1): The guide column (1) has a central channel (2) extending forward and backward along the axis, a lens channel (102) parallel to the central channel (2) is provided above the central channel (2), and liquid suction channels (101) parallel to the central channel (2) are symmetrically provided on both sides below the central channel (2), a guide tube (5) is sleeved in the central channel (2), the front end of the guide tube (5) is connected to a fixed ring frame (3), the front end of the fixed ring frame (3) is hinged to a movable ring frame (4), a coaxial grinding rod (7) is installed in the guide tube (5) through a bearing, the rear end of the grinding rod (7) is connected to a driving mechanism, the front end of the grinding rod (7) is installed with a universal joint (8) having the same outer diameter as the grinding rod (7), and the other end of the universal joint (8) is connected to a spherical grinding head (9). The guide tube (5) is provided with two first channels (501) parallel to and penetrating the guide tube (5) above the connection with the fixed ring frame (3), and two identical second channels (502) are provided below the guide tube (5) symmetrically therewith; a bracket (503) is installed at the rear end of the guide tube (5) between the first channel (501) and the second channel (502); a V-shaped frame (6) is hingedly connected to the bracket (503); a first pulling rope (10) is connected to the upper part of the V-shaped frame (6) opposite to the first channel (501); the first pulling rope (10) passes through the first channel (501) and is connected to the upper side of the movable ring frame (4); a second pulling rope (11) symmetrical to the first pulling rope (10) is connected to the lower part of the V-shaped frame (6).

2. The minimally invasive surgical device for femoral head necrosis according to claim 1, characterized in that: The guide column (1) is cylindrical, a positioning sleeve (13) is sleeved on the outside of the guide column (1), and a handle (1301) is installed on the lower side of the positioning sleeve (13).

3. The minimally invasive surgical device for femoral head necrosis according to claim 2, characterized in that: The outer side of the guide column (1) is provided with a plurality of positioning grooves (104) parallel to the axis of the guide column (1), and the inner wall of the positioning sleeve (13) sleeved on the outer side of the guide column (1) is provided with a plurality of protruding keys matched with the positioning grooves (104).

4. The minimally invasive surgical device for femoral head necrosis according to claim 3, characterized in that: The universal joint (8) is composed of an active end seat (801), a cross shaft (802) and a driven end seat (803); the active end seat (801) is coaxially mounted in a fixed ring frame (3) via a bearing, and the driven end seat (803) is mounted in a movable ring frame (4) via a bearing, and the center point of the cross shaft (802) coincides with the midpoint of a line connecting a hinged portion of the movable ring frame (4).

5. The minimally invasive surgical device for femoral head necrosis according to claim 4, characterized in that: A rubber ring (201) is installed between the guide column (1) and the front end of the guide tube (5), which can reduce the vibration of the guide column (1) when the grinding rod (7) rotates and prevent necrotic tissue in the femoral head from flowing out of the gap between the guide tube (5) and the guide column (1) to cause contamination.

6. The minimally invasive surgical device for femoral head necrosis according to claim 5, characterized in that: The diameter of the grinding head (9) is the same as the diameter of the guide column (1), and the surface of the grinding head (9) is rough.

7. The minimally invasive surgical device for femoral head necrosis according to claim 6, characterized in that: An arc-shaped convex key (103) is installed on the front end of the guide column (1) at the outer edge of the lens channel (102), so as to reduce the wear on the lens when the device is grinding and removing the necrotic femoral head.

8. The method for using the minimally invasive surgical device for femoral head necrosis according to any one of claims 1 to 7, comprising the following steps: S1: Determine the drilling and grinding position of the femoral head. Determine the location of the necrotic part of the femoral head and the most suitable starting point for drilling and grinding. Then treat the muscle tissue and blood vessels outside the grinding starting point to minimize the impact on the surrounding healthy tissues during drilling and grinding. S2: grinding and drilling. Align the grinding head (9) with the grinding starting point, and adjust the direction of the device through the handle (1301) and the positioning sleeve (13), then start the driving mechanism connected to the device to make the grinding head (9) start to rotate, push the guide column (1) to start grinding and drilling the femoral head, and at the same time start the negative pressure device connected to the suction channel (101), grind and drill the femoral head, and control the device to grind and extend into the necrotic part; S3: Control the grinding head (9) to grind and remove the necrotic part. After the grinding head (9) penetrates into the necrotic part inside the femoral head, use the V-shaped frame (6) to control the grinding head (9) to swing in the opposite direction. After adjustment, keep the V-shaped frame (6) stationary and start grinding the grinding head (9). Slowly rotate the guide tube (5) to drive the grinding head (9) to rotate slowly. Repeat the adjustment of the angle of the grinding head (9) to fully grind and remove the necrotic part. S4: Close and withdraw the device. After grinding and removing the necrotic part inside the femoral head, close the driving mechanism of the device, adjust the grinding head (9) to the initial angle, and slowly move the device out of the wound.

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