Intraoperative adjustable knee joint operation guiding device and use method thereof

Abstract

The invention discloses an intra-operative adjustable knee joint operation guiding device and a using method thereof, and relates to the technical field of medical instruments, the intra-operative adjustable knee joint operation guiding device comprises a tibia guide plate, a thighbone front side guide plate, a thighbone far end guide plate, a four-in-one rotary adjusting plate, a metal handle and a four-in-one osteotomy plate, the swing saw performs osteotomy on the femur through a four-in-one osteotomy groove in the four-in-one osteotomy plate; the guiding device can achieve real-time adjustment in the thighbone ectropion angle operation, real-time adjustment in the thighbone ectropion angle operation is achieved, and flexion and extension gap balance based on ligament judgment of an operator is further achieved.

Description

Technical Field

[0001] The present invention belongs to the technical field of medical devices, and more specifically, relates to an intraoperative adjustable knee surgery guiding device and a using method thereof. Background Art

[0002] Total Knee Arthroplasty (TKA) is the most common and cost-effective orthopedic surgery, and its clinical application has exceeded 40 years. Most patients have good clinical efficacy and long-term prosthesis survival rate after TKA, but more than 20% of patients are still dissatisfied with the surgical results. There are many factors affecting the postoperative effect and prosthesis survival rate of TKA, including demographic factors, surgical factors, medical and health conditions, etc. Among them, the abnormal three-dimensional force line of the knee joint after TKA is an important surgical factor causing dissatisfaction with the postoperative effect and a decrease in prosthesis survival rate. In traditional TKA surgery, the surgeon often refers to the preoperative weight-bearing lower limb X-ray of the patient and uses traditional femoral and tibial osteotomy tools for osteotomy. This osteotomy method relying on the surgeon's experience not only has a long learning curve but also may affect the accuracy of osteotomy, especially when there are variations in the lower limb force line or local anatomy of the patient. The 3D printing personalized osteotomy tool (PSI) based on computer tomography (CT) data is an innovative solution to traditional TKA osteotomy tools, which helps to carry out personalized design and evaluation according to the anatomical characteristics of the patient's femur and tibia before surgery to adapt to the special anatomical morphology and variations of the patient and increase the osteotomy accuracy. A number of studies have shown that compared with traditional tools, the 3D printing PSI osteotomy guide plate can improve the excellent and good rate of the lower limb force line after TKA and improve the accuracy of the prosthesis implantation model and position, but this conclusion is still controversial at present.

[0003] The main function of the traditional PSI osteotomy guide plate lies in osteotomy and positioning, that is, as long as the guide plate position and osteotomy amount are basically determined after preoperative planning, and this technology is based on CT scan data, so there are natural drawbacks. It cannot evaluate soft tissue balance, cannot effectively evaluate gap balance, and cannot be adjusted according to the actual situation during the operation. As a result, the result of the engineer's planning and design is the actual result during the operation. And due to intraoperative errors, soft tissue balance and other problems, there is a certain difference between the actual postoperative result and the preoperative planning, which is also the reason for the controversy over PSI. Summary of the Invention

[0004] The object of the present invention is to provide an intraoperative adjustable knee surgery guiding device and a using method thereof for the deficiencies existing in the prior art. This guiding device can realize real-time adjustment of the femoral valgus angle during the operation, realize real-time adjustment of the femoral external rotation angle during the operation, and more importantly, realize the flexion and extension gap balance based on the surgeon's ligament judgment.

[0005] To achieve the above object, the present invention provides an intraoperative adjustable knee surgery guiding device, comprising:

[0006] A tibial guide plate for fitting with the tibia. Fixed holes and a tibial osteotomy groove are provided on the tibial guide plate, and a saw is used to perform osteotomy on the tibia through the tibial osteotomy groove;

[0007] An anterior femoral guide plate for fitting with the femur. A positioning hole and two rotation positioning grooves are provided on the anterior femoral guide plate, and the rotation positioning grooves are symmetrically arranged with the positioning hole as the center;

[0008] A distal femoral guide plate in an L shape. An intermediate positioning hole, a distal osteotomy groove, and two first rotation positioning holes are provided on the end face of one end of the distal femoral guide plate. The intermediate positioning hole corresponds to the positioning hole. When the end face of the other end of the distal femoral guide plate fits with the plane after tibial osteotomy, the saw performs osteotomy on the distal femur through the distal osteotomy groove;

[0009] A first central positioning hole and a distal femoral rotation positioning groove are provided on the end face of the other end of the distal femoral guide plate;

[0010] A four-in-one rotation adjustment plate fits with the other end of the distal femoral guide plate. A second central positioning hole, a metal handle groove, and two second rotation positioning holes are provided on the four-in-one rotation adjustment plate. The first central positioning hole corresponds to the second central positioning hole;

[0011] A metal handle, one end of which is inserted into the metal handle groove. When the side of the metal handle fits with the plane after tibial osteotomy, screw holes are correspondingly drilled on the plane after distal femoral osteotomy according to the positions of the second rotation positioning holes;

[0012] A four-in-one osteotomy plate is fixed on the femur through the screw holes, and the saw performs osteotomy on the femur through a four-in-one osteotomy groove on the four-in-one osteotomy plate.

[0013] Optionally, the anterior femoral guide plate is rotatably arranged with the positioning hole as the center. A first angle scale is provided on the anterior femoral guide plate, and a first spike portion cooperating with the first angle scale is provided at one end of the distal femoral guide plate.

[0014] Optionally, the first rotation positioning hole moves within the range of the rotation positioning groove, and the rotation range of the rotation positioning groove is ±3°.

[0015] Optionally, a second angle scale is provided on the end face of the other end of the distal femoral guide plate, and a second spike portion cooperating with the second angle scale is provided on the four-in-one rotation adjustment plate.

[0016] Optionally, the fixing holes and the positioning holes are fixed with first threaded nails, the two first rotation positioning holes are respectively fixed with second threaded nails, the first central positioning hole and the second central positioning hole are fixed with third threaded nails, and the two second rotation positioning holes are respectively fixed with fourth threaded nails.

[0017] Optionally, a plurality of spacer shims are arranged between the end face of the other end of the distal femoral guide plate and the plane after tibial osteotomy, and the thickness range of the spacer shims is 1 mm - 10 mm.

[0018] Optionally, a plurality of the spacer shims are also arranged between the side surface of the metal handle and the plane after tibial osteotomy.

[0019] The present invention also provides a method for using an intraoperative adjustable knee joint surgical guiding device. Using the above intraoperative adjustable knee joint surgical guiding device, the method includes:

[0020] Attach and fix the tibial guide plate to the tibia, and use the oscillating saw to perform tibial osteotomy;

[0021] Attach and fix the anterior femoral guide plate to the anterior side of the femur, and fix the positioning holes with threaded nails;

[0022] Rotate and connect the distal femoral guide plate to the anterior femoral guide plate through the intermediate positioning hole, so that the other end of the distal femoral guide plate fits with the plane after tibial osteotomy;

[0023] Fix the relative positions of the rotation positioning groove and the first rotation positioning hole, and use the oscillating saw to perform distal femoral osteotomy;

[0024] Rotate and connect the four-in-one rotation adjustment plate to the other end of the distal femoral guide plate through the second central positioning hole, so that the metal handle is inserted and fixed with the metal handle groove;

[0025] Fit the side surface of the metal handle with the plane after tibial osteotomy, and open the threaded nail holes on the plane after distal femoral osteotomy according to the second rotation positioning holes;

[0026] Fix the four-in-one osteotomy plate to the threaded holes, and use the oscillating saw to perform femoral osteotomy.

[0027] Optionally, when adjusting the fitting degree between the other end of the distal femoral guide plate and the plane after tibial osteotomy, fill the spacer shims between the distal femoral guide plate and the plane after tibial osteotomy;

[0028] When adjusting the conformity between the side surface of the metal handle and the plane after tibial osteotomy, a spacer is filled between the side surface of the metal handle and the plane after tibial osteotomy.

[0029] Optionally, before connecting the four-in-one rotation adjustment plate to the femoral distal guide plate, it is necessary to bend the femur to expose the flexion position of the femur.

[0030] The present invention provides an intraoperative adjustable knee joint surgery guiding device and its using method, and its beneficial effects are as follows: Rotation positioning holes are respectively provided at the other end of the femoral distal guide plate and the four-in-one rotation adjustment plate of the guiding device. In this way, when adjusting the conformity between the femoral distal guide plate and the four-in-one rotation adjustment plate, real-time angle adjustment can be achieved. In addition, spacer pads are added on the end face of the other end of the femoral distal guide plate and the side surface of the metal handle to ensure the accuracy of the osteotomy reference plane. The thread nail holes of the four-in-one osteotomy plate are also determined by the metal handle to ensure the accurate position of the four-in-one osteotomy plate, perform four-in-one osteotomy on the femur, realize real-time adjustment of the femoral valgus angle during the operation, realize real-time adjustment of the femoral external rotation angle during the operation, and more realize the flexion and extension gap balance based on the judgment of the surgeon's ligaments.

[0031] Other features and advantages of the present invention will be described in detail in the subsequent specific implementation part. BRIEF DESCRIPTION OF THE DRAWINGS

[0032] By describing the exemplary embodiments of the present invention in more detail in conjunction with the drawings, the above and other objects, features, and advantages of the present invention will become more obvious. Among them, in the exemplary embodiments of the present invention, the same reference numerals generally represent the same components.

[0033] Figure 1 Shows a schematic diagram of the tibial guide plate fitting with the tibia according to an embodiment of the present invention.

[0034] Figure 2 Shows an effect diagram of the tibia after osteotomy according to an embodiment of the present invention.

[0035] Figure 3 Shows a schematic diagram of the anterior femoral guide plate fitting with the femur according to an embodiment of the present invention.

[0036] Figure 4 Shows a schematic diagram of the anterior femoral guide plate fixed to the femur with thread nails according to an embodiment of the present invention.

[0037] Figure 5 Shows a schematic diagram of the connection between the anterior femoral guide plate and the femoral distal guide plate according to an embodiment of the present invention.

[0038] Figure 6Shows a schematic diagram of the relative adjustment between the anterior femoral guide plate and the distal femoral guide plate according to an embodiment of the present invention.

[0039] Figure 7 Shows a schematic diagram of the distal femoral guide plate fitting with the tibial plane after osteotomy according to an embodiment of the present invention.

[0040] Figure 8 Shows a schematic diagram of a spacer being provided between the distal femoral guide plate and the tibial plane after osteotomy according to an embodiment of the present invention.

[0041] Figure 9 Shows a schematic diagram of osteotomy of the femur through the distal femoral guide plate and a reciprocating saw according to an embodiment of the present invention.

[0042] Figure 10 Shows a schematic diagram of the structure of the other end of the distal femoral guide plate according to an embodiment of the present invention.

[0043] Figure 11 Shows a schematic diagram of the distal femoral guide plate being connected to a four-in-one rotation adjustment plate according to an embodiment of the present invention.

[0044] Figure 12 Shows Figure 11 a partial enlarged view of

[0045] Figure 13 Shows a schematic diagram of the metal handle fitting with the tibial plane after osteotomy according to an embodiment of the present invention.

[0046] Figure 14 Shows a schematic diagram of the position of the femoral plane after osteotomy and the four-in-one osteotomy plate according to an embodiment of the present invention.

[0047] Figure 15 Shows a schematic diagram of the connection between the femoral plane after osteotomy and the four-in-one osteotomy plate according to an embodiment of the present invention.

[0048] Explanation of reference numerals:

[0049] 1, Tibia; 2, Fixing hole; 3, Tibial guide plate; 4, Threaded nail; 5, Reciprocating saw; 6, Femur; 7, Anterior femoral guide plate; 8, Rotation positioning groove; 9, Positioning hole; 10, First angle scale; 11, Distal femoral guide plate; 12, Intermediate positioning hole; 13, First rotation positioning hole; 14, Distal osteotomy groove; 15, Spacer; 16, Second angle scale; 17, First center positioning hole; 18, Distal femoral rotation positioning groove; 19, Four-in-one rotation adjustment plate; 20, Second center positioning hole; 21, Second rotation positioning hole; 22, Metal handle groove; 23, Metal handle; 24, Threaded nail hole; 25, Four-in-one osteotomy plate; 26, First spike portion; 27, Second spike portion. Detailed implementation manners

[0050] The preferred implementation manners of the present invention will be described in more detail below. Although the preferred implementation manners of the present invention are described below, it should be understood that the present invention can be implemented in various forms and should not be limited by the implementation manners set forth herein. On the contrary, these implementation manners are provided to make the present invention more thorough and complete, and to fully convey the scope of the present invention to those skilled in the art.

[0051] The present invention provides an intraoperative adjustable knee joint surgery guiding device, comprising:

[0052] A tibial guide plate for fitting with the tibia, wherein the tibial guide plate is provided with fixing holes and a tibial osteotomy groove, and a saw is used to perform osteotomy on the tibia through the tibial osteotomy groove;

[0053] An anterior femoral guide plate for fitting with the femur, wherein the anterior femoral guide plate is provided with positioning holes and two rotation positioning grooves, and the rotation positioning grooves are symmetrically arranged with the positioning holes as the center;

[0054] A distal femoral guide plate in an L shape, wherein an intermediate positioning hole, a distal osteotomy groove and two first rotation positioning holes are formed on the end surface of one end of the distal femoral guide plate, and the intermediate positioning hole corresponds to the positioning hole. When the end surface of the other end of the distal femoral guide plate is fitted with the plane after tibial osteotomy, a saw is used to perform osteotomy on the distal femur through the distal osteotomy groove;

[0055] A first central positioning hole and a distal femoral rotation positioning groove are formed on the end surface of the other end of the distal femoral guide plate;

[0056] A four-in-one rotation adjustment plate is fitted with the other end of the distal femoral guide plate, and a second central positioning hole, a metal handle groove and two second rotation positioning holes are arranged on the four-in-one rotation adjustment plate, and the first central positioning hole corresponds to the second central positioning hole;

[0057] A metal handle, one end of which is inserted into the metal handle groove. When the side surface of the metal handle is fitted with the plane after tibial osteotomy, screw holes are correspondingly formed on the plane after distal femoral osteotomy according to the positions of the second rotation positioning holes;

[0058] A four-in-one osteotomy plate is fixed on the femur through the screw holes, and a saw is used to perform osteotomy on the femur through a four-in-one osteotomy groove on the four-in-one osteotomy plate.

[0059] Specifically, the adjustable knee joint surgical guiding device includes a tibial guide plate, an anterior femoral guide plate, a distal femoral guide plate, a four-in-one rotation adjustment plate, a metal handle, and a four-in-one osteotomy plate. Among them, the tibial guide plate plays a positioning role during tibial osteotomy; the anterior femoral guide plate and the distal femoral guide plate cooperate with each other to play a positioning role during distal femoral osteotomy. And during distal femoral osteotomy, the distal femoral guide plate also needs to form a relative position fixation with the plane after the previous tibial osteotomy, so as to ensure the accurate selection of the osteotomy position of the distal femur; the distal femoral guide plate, the four-in-one rotation adjustment plate, and the metal handle cooperate with each other to make the metal handle form a relative position fixation with the plane after the previous distal femoral osteotomy, and then determine the fixation position of the four-in-one osteotomy plate through the second rotation positioning hole on the four-in-one rotation adjustment plate. Finally, the four-in-one osteotomy plate is used to perform a quarter osteotomy on the femur. Each plate component in this surgical guiding device is interrelated. Only by using them in a certain order can accurate osteotomy be achieved on the tibia, the distal femur, and the quarter of the femur. And through the rotation positioning groove and the distal femoral rotation positioning groove, the osteotomy angle of the femur can be adjusted, the intraoperative real-time adjustment of the femoral valgus angle can be achieved, the intraoperative real-time adjustment of the femoral external rotation angle can be achieved, and more importantly, the flexion and extension gap balance based on the surgeon's ligament judgment can be achieved.

[0060] Optionally, the anterior femoral guide plate is rotatably arranged around the positioning hole. A first angle scale is provided on the anterior femoral guide plate, and a first spike portion cooperating with the first angle scale is provided at one end of the distal femoral guide plate.

[0061] Optionally, the first rotation positioning hole moves within the range of the rotation positioning groove, and the rotation range of the rotation positioning groove is ±3°.

[0062] Specifically, since the distal femoral guide plate and the anterior femoral guide plate are fixed by the same screw, and the anterior femoral guide plate fits the surface of the femur, the distal femoral guide plate can be rotated and adjusted with this screw. In addition, a rotation positioning groove is provided on the anterior femoral guide plate, which can also limit the rotation of the distal femoral guide plate to a certain extent; a first spike portion is also provided on the distal femoral guide plate, and the relative position relationship between the first spike portion and the first angle scale can facilitate the determination of the adjustment angle value of the distal femoral guide plate.

[0063] Optionally, a second angle scale is provided on the end surface of the other end of the distal femoral guide plate, and a second spike portion cooperating with the second angle scale is provided on the four-in-one rotation adjustment plate.

[0064] Specifically, the design principle of the second angle scale and the second spike portion is the same as that of the first angle scale and the first spike portion. Only the cooperation of the second angle scale and the second spike portion can be used to determine the adjustment angle value of the four-in-one rotation adjustment plate.

[0065] Optionally, the fixing holes and the positioning holes are fixed with the first threaded pins, and the two first rotation positioning holes ( Figure 8 / 13) are respectively fixed with the second threaded pins, the first central positioning hole and the second central positioning hole are fixed with the third threaded pins, and the two second rotation positioning holes are respectively fixed with the fourth threaded pins.

[0066] Specifically, threaded pins are used for fixation on the tibial guide plate, the anterior femoral guide plate, the distal femoral guide plate, the four-in-one rotation adjustment plate and the four-in-one osteotomy plate, which can ensure that each plate does not shift and guarantee the accuracy of osteotomy.

[0067] Optionally, a plurality of spacer shims are provided between the end face of the other end of the distal femoral guide plate and the plane after tibial osteotomy, and the thickness range of the spacer shims is 1 mm - 10 mm.

[0068] Optionally, a plurality of spacer shims are also provided between the side face of the metal handle and the plane after tibial osteotomy.

[0069] Specifically, when determining the position of distal femoral osteotomy, it is necessary to fit the end face of the other end of the distal femoral guide plate with the plane after tibial osteotomy. Since the most distal plane of the osteotomy groove of the distal femoral guide plate is the stator and is the minimum value of the extension gap, by taking the proximal tibial osteotomy surface as the reference, the expected extension gap can be obtained and known. Since the distal femoral guide plate is designed according to the minimum gap, in the actual surgical process, it may be impossible for the end face of the distal femoral guide plate to closely adhere to the tibial osteotomy plane. Therefore, when the extension gap is large, spacer shims can be used for filling. The spacer shims can be in a gradient of 1 mm thickness and include spacer shims with a thickness of 1 mm - 10 mm, which fully meet the intraoperative use. In addition, when adjusting the position of the four-in-one rotation adjustment plate, spacer shims can also be provided between the metal handle and the femur, and the principle is the same.

[0070] The present invention also provides a usage method of an intraoperative adjustable knee joint surgical guiding device. Using the above-mentioned intraoperative adjustable knee joint surgical guiding device, the usage method includes:

[0071] Fit and fix the tibial guide plate on the tibia, and use a reciprocating saw to perform osteotomy on the tibia;

[0072] Fit and fix the anterior femoral guide plate on the anterior side of the femur, and fix the positioning holes with threaded pins;

[0073] Rotate and connect the distal femoral guide plate to the anterior femoral guide plate through the intermediate positioning hole, so that the other end of the distal femoral guide plate fits with the plane after tibial osteotomy;

[0074] Fix the relative position of the rotation positioning groove and the first rotation positioning hole, and use a reciprocating saw to perform osteotomy on the distal femur;

[0075] The four-in-one rotation adjustment plate is rotationally connected to the other end of the femoral distal guide plate through the second central positioning hole, and the metal handle is inserted and fixed into the metal handle groove;

[0076] The side surface of the metal handle is fitted to the plane after tibial osteotomy, and screw holes are drilled on the plane after femoral distal osteotomy according to the second rotation positioning hole;

[0077] The four-in-one osteotomy plate is fixed to the threaded holes, and the femur is osteotomized using a reciprocating saw.

[0078] Optionally, when adjusting the fitting degree between the other end of the femoral distal guide plate and the plane after tibial osteotomy, a spacer is filled between the femoral distal guide plate and the plane after tibial osteotomy;

[0079] When adjusting the fitting degree between the side surface of the metal handle and the plane after tibial osteotomy, a spacer is filled between the side surface of the metal handle and the plane after tibial osteotomy.

[0080] Optionally, before connecting the four-in-one rotation adjustment plate to the femoral distal guide plate, the femur needs to be bent to expose the flexion position of the femur.

[0081] Compared with the osteotomy method using the adjustable knee joint surgical guiding device of the present invention, traditional knee joint guide plates are all based on CT data for preoperative planning simulation, and can only identify bony structures. Soft tissue balance and gap balance cannot be considered. The important angular parameters, external rotation angle and valgus angle, are also designed according to bony characteristics. Therefore, if there are any inappropriacies caused by soft tissue and gap balance during the operation, they cannot be adjusted or changed, which is also the key controversy of current guide plates.

[0082] In response to the problems of the prior art, although the preoperative design is also based on bone characteristics, for example, the valgus angle is generally 5-7 degrees, and the external rotation angle is generally about 3 degrees, but room for adjustment is reserved. For the flexion and extension gaps, the tibial osteotomy surface is used as a reference, and the amount of distal femoral osteotomy and the amount of posterior condyle osteotomy are designed to make the flexion and extension gaps consistent. When the distal femoral osteotomy is in the case of a fixed extension gap, when the medial and lateral gaps are unbalanced due to soft tissue balance, the distal femoral osteotomy device can be rotated and positioned to achieve medial and lateral balance and reduce damage to the soft tissue. When the gap is too large, a gap gasket can be used for filling, and the rotational positioning of the medial balance can also be achieved. After the distal femoral osteotomy is completed, the extension gap is basically fixed, and the posterior condyle osteotomy is performed. The four-in-one rotation adjustment component is used in conjunction with the metal handle and the gap gasket to adjust the rotational positioning of the flexion position, and subsequent osteotomy treatment is performed. Based on the original guide plate pain point, real-time adjustment of the femoral valgus angle and the femoral external rotation angle were achieved during the operation, and the gap balance between the inner and outer sides of the extension position and the gap balance between the inner and outer sides of the flexion position were achieved. Furthermore, the gap balance between the extension position and the flexion position based on the surgeon's ligament judgment was achieved.

[0083] Example

[0084] like Figures 1 to 15 As shown, the present invention provides an intraoperatively adjustable knee joint surgical guide device, comprising:

[0085] The tibial guide plate 3 is used to fit with the tibia 1. The tibial guide plate 3 is provided with a fixing hole 2 and a tibial osteotomy groove. The oscillating saw 5 performs osteotomy on the tibia through the tibial osteotomy groove. The fixing hole 2 is connected to the tibia 1 through a threaded screw 4.

[0086] The anterior femoral guide plate 7 is used to fit with the femur 6. The anterior femoral guide plate 7 is provided with a positioning hole 9 and two rotation positioning grooves 8. The rotation positioning grooves 8 are symmetrically arranged with the positioning hole 9 as the center. The positioning hole 9 is connected to the femur 6 through a screw 4.

[0087] The distal femoral guide plate 11 is L-shaped, and an intermediate positioning hole 12, a distal osteotomy groove 14 and two first rotation positioning holes 13 are provided on the end surface of one end of the distal femoral guide plate. The intermediate positioning hole 12 is arranged corresponding to the positioning hole 9 and is fixed together with the same screw 4. When the end surface of the other end of the distal femoral guide plate 11 fits with the plane after tibial osteotomy, the oscillating saw 5 performs osteotomy on the distal femur through the distal osteotomy groove 14;

[0088] A first central positioning hole 17 and two distal femoral rotation positioning grooves 18 are formed on the end surface of the other end of the distal femoral guide plate 11;

[0089] The four-in-one rotation adjustment plate 19 fits against the other end of the femoral distal plate 11. The four-in-one rotation adjustment plate 19 is provided with a second central positioning hole 20, a metal handle groove 22 and two second rotation positioning holes 21. The first central positioning hole 17 and the second central positioning hole 20 are correspondingly arranged and fixed with a threaded nail 4.

[0090] The metal handle 23 has one end inserted into the metal handle groove 22. When the side surface of the metal handle 23 fits against the plane after tibial osteotomy, threaded nail holes 24 are correspondingly formed on the plane after femoral distal osteotomy according to the positions of the second rotation positioning holes 21.

[0091] The four-in-one osteotomy plate 25 is fixed on the femur 6 through the threaded nail holes, and the oscillating saw 5 performs osteotomy on the femur 6 through the four-in-one osteotomy grooves on the four-in-one osteotomy plate 25.

[0092] In this embodiment, the anterior femoral guide plate 7 is rotatably arranged around the positioning hole 9. The anterior femoral guide plate 7 is provided with a first angle scale 10, and one end of the femoral distal plate 11 is provided with a first spike portion 26 that cooperates with the first angle scale 10.

[0093] In this embodiment, the first rotation positioning hole 13 moves within the range of the rotation positioning groove 8, and the rotation range of the rotation positioning groove 8 is ±3°.

[0094] In this embodiment, a second angle scale 16 is provided on the end surface of the other end of the femoral distal plate 11, and a second spike portion 27 that cooperates with the second angle scale 16 is provided on the four-in-one rotation adjustment plate 19.

[0095] In this embodiment, the fixing hole 2 and the positioning hole 9 are fixed with a threaded nail 4, the two first rotation positioning holes 13 are also fixed with a threaded nail 4, the first central positioning hole 17 and the second central positioning hole 20 are also fixed with a threaded nail 4, and the two second rotation positioning holes 21 are also fixed with a threaded nail 4.

[0096] In this embodiment, a plurality of spacer shims 15 are provided between the end surface of the other end of the femoral distal plate 11 and the plane after tibial osteotomy, and the thickness range of the spacer shims 15 is 1 mm - 10 mm.

[0097] In this embodiment, a plurality of spacer shims 15 are also provided between the side surface of the metal handle 23 and the plane after tibial osteotomy.

[0098] The present invention also provides a method for using an intraoperative adjustable knee joint surgery guiding device. Using the above-mentioned intraoperative adjustable knee joint surgery guiding device, the method includes:

[0099] Attach and fix the tibial guide plate 3 to the tibia 1, and use the oscillating saw 5 to perform osteotomy on the tibia 1.

[0100] Attach the anterior femoral guide plate 7 to the anterior side of the femur 1 and fix it with the threaded screw 4 through the positioning holes 9.

[0101] Rotate and connect the distal femoral guide plate 11 to the anterior femoral guide plate 7 through the intermediate positioning hole 12, so that the other end of the distal femoral guide plate 11 fits the plane after tibial osteotomy.

[0102] Fix the relative positions of the rotary positioning groove 8 and the first rotary positioning hole 13, and use the oscillating saw 5 to perform osteotomy on the distal femur.

[0103] Rotate and connect the four-in-one rotary adjustment plate 19 to the other end of the distal femoral guide plate 11 through the second central positioning hole 20, so that the metal handle 23 is inserted and fixed with the metal handle groove 22.

[0104] Fit the side of the metal handle 22 to the plane after tibial osteotomy, and drill a threaded screw hole 24 on the plane after distal femoral osteotomy according to the second rotary positioning hole 21.

[0105] Fix the four-in-one osteotomy plate 25 to the threaded hole 24, and use the oscillating saw 5 to perform osteotomy on the femur.

[0106] In this embodiment, when adjusting the fitting degree between the other end of the distal femoral guide plate 11 and the plane after tibial osteotomy, a spacer 15 is filled between the distal femoral guide plate 11 and the plane after tibial osteotomy.

[0107] When adjusting the fitting degree between the side of the metal handle 23 and the plane after tibial osteotomy, a spacer 15 is filled between the side of the metal handle 23 and the plane after tibial osteotomy.

[0108] In this embodiment, before connecting the four-in-one rotary adjustment plate 19 to the distal femoral guide plate 11, it is necessary to bend the femur to expose the flexion position of the femur.

[0109] In summary, the usage method of this guiding device is as follows: Determine the osteotomy position and osteotomy angle on the tibial side through preoperative planning, so as to determine the position of the tibial guide plate 3. Attach the tibial guide plate 3 to the tibia 1 and fix it with the threaded screw 4 through the fixing holes 2, and then immediately use the oscillating saw 5 to perform osteotomy on the tibia, obtaining as Figure 2The plane after tibial osteotomy shown. The tibial guide plate 3 is no different from the traditional tibial guide plate. In order to obtain the tibial side after precise osteotomy. Further, after the osteotomy of the tibia 1 is completed, the anterior femoral guide plate 7 is attached to the anterior side of the femur 6. After stable attachment, the positioning hole 9 of the anterior femoral guide plate 7 can be fixed by driving a threaded nail 4. The rotation positioning groove 8 on it is used for cooperation with the subsequent distal femoral guide plate 11. When the anterior femoral guide plate 7 is fixed by the threaded nail 4, the distal femoral guide plate 11 can be cooperated with it through the threaded nail 4, so that the distal femoral guide plate 11 can rotate around the threaded nail 4, and the rotation angle can be judged by indicating to the first angle scale 10 on the anterior femoral guide plate 7 through the distal femoral guide plate 11; and the rotation positioning groove 8 of the anterior femoral guide plate 7 is designed according to the angle, so that the rotation angle limit of the distal femoral guide plate 11 is plus or minus three degrees, which can fully meet its use; through the rotation of the distal femoral guide plate 11, the valgus angle of femoral osteotomy can be slightly adjusted. During preoperative planning, due to the use of CT data, the actual situation of soft tissue balance and gap balance during the operation cannot be known. Therefore, when planning, we design the valgus angle according to the obtained bony structure data, and finally determine the valgus angle during the operation through the distal femoral guide plate 11 combined with the patient's soft tissue balance and gap balance; while rotating and positioning through the distal femoral guide plate 11, it is necessary to attach the distal plane of the distal femoral guide plate 11 to the plane after tibial osteotomy. The osteotomy groove of the distal femoral guide plate 11 is a fixed value from the most distal plane, and it is the minimum value of the extension gap. By taking the proximal tibial osteotomy surface as the reference, the expected extension gap can be obtained and known; since the distal femoral guide plate 11 is designed according to the smallest gap, in the actual operation process, it may be that the distal plane of the distal femoral guide plate 11 cannot closely adhere to the tibial osteotomy plane. Therefore, when the extension gap is large, a gap spacer 15 can be used for filling; when the valgus angle and extension gap of the distal osteotomy are adjusted, it is fixed with the threaded nail 4, and immediately the distal femoral osteotomy is performed with a reciprocating saw 5.After the distal femoral osteotomy is completed, the femoral flexion position osteotomy will be performed. At this time, there is a first central positioning hole 17, a second angle ruler 16 and a distal femoral rotation positioning groove 18 on the distal plane of the distal femoral guide plate 11. The threaded nail 4 is first fixed through the first central positioning hole 17, and then the four-in-one rotation adjustment plate 19 is matched with it through the threaded nail 4. The use of the four-in-one rotation adjustment plate 19 is the same as the rotation adjustment principle of the distal femoral osteotomy device. The four-in-one rotation adjustment plate 19 can be rotated by the threaded nail 4, and the angle is limited to plus or minus 3 degrees. It is generally designed for 3 degrees of external rotation during preoperative planning. Since it is based on the bone osteotomy design, it is based on However, it is impossible to judge the soft tissue balance and flexion gap. Therefore, on the basis of the original design of 3 degrees of external rotation, according to the actual situation during the operation, the four-in-one rotation adjustment plate 19 is used for positioning and rotation to achieve the balance of soft tissue and flexion gap. When the four-in-one rotation adjustment plate 19 is used for rotation positioning, it is necessary to insert the metal handle 23 into the metal handle groove 22. The metal handle 23 needs to be close to the tibial osteotomy plane, and the height of the metal handle is designed to make the flexion gap after the osteotomy of the posterior condyle of the femur consistent with the extension gap. When a gap gasket is used for distal femoral osteotomy, this step also requires that a gap gasket of the same thickness be placed under the metal handle to ensure that the extension and flexion gaps are consistent. After the four-in-one rotation adjustment plate 19 is fixed, a threaded screw 4 is used to pass through the second rotation positioning hole 21 to leave a threaded screw hole 24 on the distal femoral osteotomy surface, and the four-in-one osteotomy plate 25 can be inserted into the threaded screw hole 24 to complete the four-in-one fixation and perform the four-in-one osteotomy. As a result, all guide plate related operations have been completed, and real-time adjustment of the femoral valgus angle during surgery can be achieved, and real-time adjustment of the femoral external rotation angle during surgery can be achieved, and the flexion-extension gap balance based on the surgeon's ligament judgment can be achieved.

[0110] The embodiments of the present invention have been described above, and the above description is exemplary, not exhaustive, and is not limited to the disclosed embodiments. Many modifications and changes will be apparent to those skilled in the art without departing from the scope and spirit of the described embodiments.

Claims

1. An intraoperative adjustable knee joint surgery guiding device, characterized in that, Comprising: A tibial guide plate for fitting with the tibia, the tibial guide plate is provided with a fixing hole and a tibial osteotomy groove, and a reciprocating saw performs osteotomy on the tibia through the tibial osteotomy groove; An anterior femoral guide plate for fitting with the femur, the anterior femoral guide plate is provided with a positioning hole and two rotation positioning grooves, and the rotation positioning grooves are symmetrically arranged with the positioning hole as the center; A distal femoral guide plate in an L shape, on one end face of the distal femoral guide plate, there are provided a middle positioning hole, a distal osteotomy groove and two first rotation positioning holes, the middle positioning hole corresponds to the positioning hole, when the other end face of the distal femoral guide plate fits with the plane after tibial osteotomy, the reciprocating saw performs osteotomy on the distal femur through the distal osteotomy groove; On the other end face of the distal femoral guide plate, there are provided a first central positioning hole and a distal femoral rotation positioning groove; A four-in-one rotation adjustment plate, which fits with the other end of the distal femoral guide plate, the four-in-one rotation adjustment plate is provided with a second central positioning hole, a metal handle groove and two second rotation positioning holes, the first central positioning hole and the second central positioning hole correspond to each other; A metal handle, one end of which is inserted into the metal handle groove, when the side surface of the metal handle fits with the plane after tibial osteotomy, screw holes are correspondingly opened on the plane after distal femoral osteotomy according to the positions of the second rotation positioning holes; A four-in-one osteotomy plate, which is fixed on the femur through the screw holes, and the reciprocating saw performs osteotomy on the femur through a four-in-one osteotomy groove on the four-in-one osteotomy plate.

2. The intraoperative adjustable knee joint surgery guiding device according to claim 1, characterized in that, The anterior femoral guide plate is rotatably arranged with the positioning hole as the center, the anterior femoral guide plate is provided with a first angle scale, and one end of the distal femoral guide plate is provided with a first spike part cooperating with the first angle scale.

3. The intraoperative adjustable knee joint surgery guiding device according to claim 2, wherein, The first rotation positioning hole moves within the range of the rotation positioning groove, and the rotation range of the rotation positioning groove is ±3°.

4. The adjustable intraoperative knee surgery guiding device according to claim 1, wherein, On the other end face of the distal femoral guide plate, there is provided a second angle scale, and the four-in-one rotation adjustment plate is provided with a second spike part cooperating with the second angle scale.

5. The intraoperative adjustable knee joint surgery guiding device according to claim 1, wherein, The fixing hole and the positioning hole are fixed by a first screw, the two first rotation positioning holes are respectively fixed by second screws, the first central positioning hole and the second central positioning hole are fixed by a third screw, and the two second rotation positioning holes are respectively fixed by fourth screws.

6. The adjustable intraoperative knee surgery guiding device according to claim 1, characterized in that, Between the other end face of the distal femoral guide plate and the plane after tibial osteotomy, there are provided a plurality of spacer shims, and the thickness range of the spacer shims is 1 mm - 10 mm.

7. The adjustable intraoperative knee surgery guiding device according to claim 6, wherein, Between the side surface of the metal handle and the plane after tibial osteotomy, there are also provided a plurality of the spacer shims.

8. A method of using an intraoperative adjustable knee surgery guiding device, which utilizes the intraoperative adjustable knee surgery guiding device according to any one of claims 1-7, characterized in that, The usage method includes: Fix the tibial guide plate on the tibia, and perform osteotomy on the tibia with the reciprocating saw; Fix the anterior femoral guide plate on the anterior side of the femur, and fix the positioning hole with a screw; Rotate and connect the distal femoral guide plate to the anterior femoral guide plate through the middle positioning hole, so that the other end of the distal femoral guide plate fits with the plane after tibial osteotomy; Fix the relative positions of the rotary positioning groove and the first rotary positioning hole, and use the oscillating saw to perform osteotomy on the distal femur; Rotate and connect the four-in-one rotary adjusting plate to the other end of the distal femoral guide plate through the second central positioning hole, and insert and fix the metal handle into the metal handle groove; Attach the side surface of the metal handle to the plane after tibial osteotomy, and drill the screw hole on the plane after distal femoral osteotomy according to the second rotary positioning hole; Fix the four-in-one osteotomy plate to the threaded hole, and use the oscillating saw to perform osteotomy on the femur.

9. The method for using the intraoperative adjustable knee joint surgical guiding device according to claim 8, characterized in that, When adjusting the fitting degree between the other end of the distal femoral guide plate and the plane after tibial osteotomy, fill a spacer between the distal femoral guide plate and the plane after tibial osteotomy; When adjusting the fitting degree between the side surface of the metal handle and the plane after tibial osteotomy, fill a spacer between the side surface of the metal handle and the plane after tibial osteotomy.

10. The method for using the intraoperative adjustable knee joint surgery guiding device according to claim 8, characterized in that, Before connecting the four-in-one rotary adjusting plate to the distal femoral guide plate, it is necessary to bend the femur to expose the flexion position of the femur.

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