External rotation muscle group tendon reconstruction auxiliary device for hip replacement surgery

Abstract

The invention relates to an external rotation muscle group tendon reconstruction auxiliary device which is mounted on the rear surface of a greater trochanter of a femur and used before an iliotibial bundle is sutured after a hip replacement operation is performed on a posterior lateral approach. The device comprises a drilling cover die and a drill bit matched with the drilling cover die, a plurality of guide holes are preset in the cover die, a replaceable cambered surface insert block and a non-Newtonian fluid buffer bag body structure are arranged, and the fitting performance and the impact resistance stability are improved. The periphery of the guide hole is provided with a liquid injection groove used for dyeing identification, the surface of the cover die is provided with a tendon trend scribed line and a suture guide baffle, and synchronous optimization of drilling positioning, suture tension control and operation efficiency is achieved. The device is reasonable in structure, accurate in positioning, simple and convenient to operate and suitable for the tendon reconstruction requirements of extorsion muscle groups in various hip replacement operations.

Description

Technical Field

[0001] This invention belongs to the field of medical device technology, specifically an auxiliary device for the reconstruction of external rotator muscle tendons in hip replacement surgery. Background Technology

[0002] Hip replacement surgery is widely used to treat hip diseases such as femoral neck fractures, avascular necrosis of the femoral head, and severe hip arthritis in the elderly. During the operation, it is often necessary to cut part of the short external rotator muscles to fully expose the surgical field. If the bone insertion points of key tendons such as the piriformis, obturator externus, and quadratus femoris can be reconstructed after surgery, it will help restore joint rotational stability, reduce the risk of postoperative dislocation, and improve functional prognosis.

[0003] However, current techniques for reconstructing tendon insertions largely rely on the surgeon's experience, involving manually drilling holes based on visual estimation of the location on the lateral bone surface of the greater trochanter, and then fixing the tendon stump with sutures. This approach has several prominent problems in clinical practice:

[0004] In most cases, there are no standardized positioning tools during the operation. The surgeon needs to rely on experience to judge the projection position of each tendon insertion point on the surface of the greater trochanter. However, the surface morphology of the greater trochanter is complex and there are significant individual differences. In addition, interference factors such as bleeding and soft tissue traction during the operation often lead to drill hole deviation, which in turn affects the direction of sutures and tension, making it impossible to achieve anatomical reconstruction. In severe cases, the reconstruction effect is not ideal.

[0005] Hip surgery often involves significant bleeding, making it difficult to identify tendon stumps. Furthermore, the surgical field is frequently obscured by retractors, tendon tissue, or prostheses, resulting in low surgeon positioning efficiency and increasing surgical time and infection risk.

[0006] During drilling, conventional guides are difficult to fit stably against the greater trochanter of the femur. They may slip after being impacted by the drill bit, causing the drilling direction to change. Multiple adjustments are required during the operation, increasing the risk of bone damage.

[0007] If two to three tendon insertion points need to be reconstructed simultaneously, the surgeon needs to repeatedly search, drill, and suture. The lack of a unified platform to assist in positioning and rapid switching increases the surgeon's burden.

[0008] Traditional sutures rely solely on the surgeon's manual tension assessment after threading, which is neither quantifiable nor visual, and cannot create a reliable anti-slip structure at the drilling point. The sutures are prone to loosening or retraction during surgery, leading to postoperative failure or termination.

[0009] In summary, current clinical practice in hip replacement surgery for tendon insertion reconstruction faces a series of problems, including large positioning errors, low efficiency, unstable operation, and poor reconstruction results. There is an urgent need for an auxiliary device that is structurally sophisticated, easy to operate, highly adaptable, and can improve drilling accuracy and suture tension control to meet the clinical needs of function preservation and tendon reconstruction in modern joint replacement surgery. Summary of the Invention

[0010] The purpose of this invention is to provide an auxiliary device for the reconstruction of external rotator tendons in hip replacement surgery. The significance of this invention lies in its ability to quickly assist in anatomical positioning, accurately lay out the drilling path, quickly drill through the line in one piece, and precisely fix the anatomical insertion points in situ during surgery. While minimizing the reduction of the external rotation lever arm, it achieves precise reconstruction of the insertion points of external rotator tendons such as the piriformis, obturator internus and externus, and superior and inferior gemellus muscles. This not only significantly shortens the operation time and reduces the recovery of external rotator muscle strength after surgery, but also increases the repeatability and standardization of the operation and reduces the stripping and damage to surrounding tissues.

[0011] The technical solution adopted in this invention is as follows:

[0012] An auxiliary device for external rotator tendon reconstruction in hip replacement surgery includes:

[0013] A drilling mold that can be fitted onto the greater trochanter of the femur, the drilling mold being set according to the shape of the greater trochanter;

[0014] The drilling die has drill guide holes at the insertion points of the piriformis, quadratus femoris, obturator lateralis, superior gemellus, and inferior gemellus muscles, respectively.

[0015] The drill bit engages with the drill bit guide hole on the drilling die to ensure that the drilling direction and position are consistent with the target tendon reconstruction insertion point.

[0016] The inner surface of the drilling die is provided with a protruding arc-shaped insert corresponding to the rotor recess position on the inner side of the large rotor, which is used to position and limit the position of the drilling die.

[0017] The drilling mold is an integral arc-shaped plate structure with elastic buckles or flexible tightening structures at both ends, which are used to stably clamp the outside of the large rotor during the operation.

[0018] The drill bit has a slit near its front end for hooking the seam thread, and the slit is inclined toward the tip of the drill bit.

[0019] The inner end of the slit, near the drill tip, is provided with an arc-shaped expansion section, which is used to accommodate and guide the suture thread to enter or exit.

[0020] The drilling mold is marked with scales or identifiers to indicate different tendon insertion points, so that the surgeon can select the appropriate drilling position as needed.

[0021] The insert and the drilling mold are detachably connected. The insert is detachably connected to the drilling mold by screwing, snapping, or plugging. The drilling mold can be used with replacement inserts of different specifications to adapt to the anatomical differences of the greater trochanter of the femur in different patients.

[0022] The drilling die has a multi-layer structure, including:

[0023] The outer layer is a bone-shaped support shell made of rigid material, providing overall support;

[0024] The inner layer is a closed cavity structure filled with a non-Newtonian fluid, which enhances adaptability and provides temporary rigidity to prevent displacement under drilling vibration.

[0025] The inner layer consists of multiple small sealing bladders filled with non-Newtonian fluid, distributed along the inner surface of the outer layer, avoiding the location of all drill bit guide holes; each small sealing bladder is independently sealed and arranged in an array or strip shape, which can provide flexibility in a static state and generate rigid support under drilling vibration impact.

[0026] The non-Newtonian fluid is a biologically inert shear-thickening polymer gel, which is a medical-grade shear-thickening gel made based on a crosslinking system of hydroxypropyl methylcellulose, polyvinyl alcohol, or gelatin; the outer layer is polyetheretherketone or titanium alloy material.

[0027] In summary, due to the adoption of the above technical solution, the beneficial effects of the present invention are:

[0028] This invention provides an auxiliary device for the reconstruction of external rotator tendons in hip replacement surgery. It is primarily used for precise intraoperative positioning of tendon insertion points during drilling, improving surgical efficiency and reconstruction accuracy. The device includes a drilling template, a drill bit, and supporting auxiliary structures. Its overall design fully incorporates the anatomical characteristics of the lateral aspect of the greater trochanter of the femur, enabling rapid reconstruction of multiple tendon insertion points without increasing intraoperative burden.

[0029] The drilling formwork is designed as an arc-shaped plate structure based on the greater trochanter bone surface. The embedded arc-shaped inserts precisely conform to the trochanteric fossa area and are fixed to the lateral femur using elastic clips or flexible tightening structures to prevent displacement during the procedure. For patients with smooth bone surfaces and unstable formwork (such as those with osteoporosis or flattened greater trochanters), Kirschner wire auxiliary fixation holes can be designed on both sides of the formwork. This allows the surgeon to choose whether to reinforce with 1-2 small Kirschner wires, but it is not a mandatory fixation method; in most cases, the fit and elastic structure are sufficient for stable use. The formwork has multiple pre-set drill guide holes corresponding to the locations of common reconstruction target tendons such as the piriformis, obturator externus, superior gemellus, inferior gemellus, and quadratus femoris. Each hole is labeled with a color, symbol, or number for easy identification by the surgeon.

[0030] To enhance the stability and adaptability of the device, the drilling mold adopts a double-layer structure. The outer layer is a rigid support material, and the inner layer consists of multiple closed small sealed capsules filled with a shear-thickening non-Newtonian fluid. In the preoperative state, it is flexible, facilitating bone surface adhesion; during the drilling process, the fluid within the capsules rapidly becomes highly viscous after being stimulated by impact, forming a stable support, preventing mold deformation or displacement, and ensuring drilling accuracy.

[0031] The drill bit's tip features an inclined slit and an arc-shaped expansion section, allowing for direct suture threading after drilling without the need to change instruments, thus improving operational continuity. Simultaneously, a suture guide baffle is positioned on the outer side of the drill hole opening. This baffle, aligned with the drill hole opening, has two arc-shaped guide grooves. After the suture exits the bone hole, it sequentially engages with the two guide grooves along an "S-shaped path," achieving stable fixation through structural friction and the baffle's elasticity, while automatically applying a constant pretension. This tension can be customized with the guide baffle's elastic modulus to meet different tendon tension requirements, ensuring the reconstructed tendon achieves a near-physiological tension distribution during surgery.

[0032] To accommodate complex surgical conditions, a fluid injection groove structure is designed around the drill hole opening. The surgeon can inject a low-toxicity dye that can be washed off post-operatively into the groove, creating a localized staining halo around the opening. This allows for rapid identification of the target hole location even if it is obscured by blood or tendons during the procedure. Furthermore, the surface of the drill hole template is engraved with tendon-guided lines extending outwards from the drill hole opening, indicating the natural direction of each tendon. This guides the surgeon in adjusting the suture direction and suture tension path, improving the consistency of the reconstruction.

[0033] The aforementioned design not only achieves precise, rapid, and safe drilling positioning and suture control, but also adapts to different patient bone types and surgical needs through a modular structure. Experiments have shown that this device can reduce intraoperative positioning and suture preparation time by more than 40%, control drilling error to within 2mm, and significantly improve suture fixation stability. Overall, this invention, through structural integration and operational guidance, significantly improves the efficiency and accuracy of tendon reconstruction during hip replacement surgery, possessing significant clinical application value and promotional potential. Attached Figure Description

[0034] Figure 1 This is a schematic diagram of the physiological structure of the hip joint in this invention;

[0035] Figure 2 This is a schematic diagram of the drilling mold of the present invention installed on the large rotor;

[0036] Figure 3 This is a schematic diagram of the inner side of the drilling die of the present invention;

[0037] Figure 4 This is a schematic diagram of the drill bit structure of the present invention;

[0038] Figure 5This is a schematic diagram of the structure of the drill bit guide hole of the present invention;

[0039] Figure 6 This is a schematic diagram of the suture guide baffle of the present invention.

[0040] In the diagram, 1. Femur; 2. Greater trochanter; 21. Trochanter socket; 3. Drilling die; 31. Drill bit guide hole; 32. Outer layer; 33. Groove; 34. Inner layer; 341. Small sealing capsule; 36. Arc-shaped insert; 37. Suture guide baffle; 371. Arc-shaped guide groove; 4. Drill bit; 41. Slit opening; 42. Arc-shaped diameter expansion section. Detailed Implementation

[0041] To make the objectives, technical solutions, and advantages of this invention clearer, the invention will be further described in detail below with reference to the accompanying drawings and embodiments. It should be understood that the specific embodiments described herein are merely illustrative and not intended to limit the invention.

[0042] See Figures 1 to 4 This invention relates to an auxiliary device for the reconstruction of external rotator tendons in hip replacement surgery, which is mainly used to assist in determining the drilling path during hip replacement surgery in order to achieve precise reconstruction of the tendon insertion point.

[0043] like Figures 1 to 3 As shown, the device includes:

[0044] The drilled mold 3 is used to cover the surface of the greater trochanter 2 of the femur 1. It is generally in the shape of an arc plate and is designed according to the bone surface contour of the greater trochanter 2. It can fit and cover the outer area of ​​the greater trochanter 2.

[0045] The drill bit 4 is used in conjunction with the drilling die 3 to perform drilling operations through the drill bit guide hole 31 opened on the drilling die 3.

[0046] On the drilling template 3, drill guide holes 31 are pre-set according to the anatomical insertion locations of common tendons requiring reconstruction, such as the piriformis, quadratus femoris, obturator lateralis, superior gemellus, and inferior gemellus. These guide holes 31 are used in conjunction with the drill bit 4 to ensure that the drilling direction and drilling point accurately correspond to the target tendon insertion point, thereby improving the anatomical consistency and accuracy of tendon reconstruction.

[0047] To ensure accurate positioning and structural stability during use, an integral or detachable arc-shaped insert 36 is provided on the inner surface of the drilled mold 3 at the trochanteric socket 21 on the inner side of the greater trochanter 2 of the femur, to form a stable bone surface limiting structure. In this embodiment, the insert 36 can be detachably connected to the mold body through a screw-on, snap-on, or plug-in structure. The surgeon can replace the insert 36 with different sizes according to the bone type of different patients, thereby enhancing anatomical adaptability.

[0048] The two ends of the drilling die 3 are provided with elastic buckle parts or flexible tightening structures, such as elastic bands, restraint pieces, Velcro structures, etc., to stably clamp it on the outer surface of the large rotor 2 during the operation and prevent the position from shifting due to vibration during the drilling process.

[0049] A slit 41 for hooking the suture is provided near the front end of the drill bit 4. The slit is inclined toward the tip of the drill bit and can quickly hook the suture through the guide channel after drilling is completed. The inner end of the slit 41 is provided with an arc-shaped expansion section 42 to accommodate the suture and prevent the suture from being cut or blocked during drilling.

[0050] To facilitate quick identification and operation by the surgeon, the outer surface of the drilling sleeve 3 is equipped with scale markers, which can be in the form of color strips, numbers, symbols, etc., to clearly distinguish the drilling positions corresponding to different tendon insertion points, thereby improving intraoperative efficiency.

[0051] In this embodiment, the drilling mold 3 further adopts a double-layer structure to improve the bone surface fit and impact resistance during drilling:

[0052] The outer layer 32 is a bone-shaped support shell made of rigid materials, such as polyetheretherketone (PEEK) or titanium alloy, which has good support and structural stability.

[0053] The inner layer 34 is a closed cavity structure composed of multiple small sealed bladders 341. Each bladder 341 is filled with a shear-thickening non-Newtonian fluid, and each bladder is independently sealed. They are distributed in an array or strip pattern along the inner surface of the outer layer and avoid the positions of all drill bit guide holes 31.

[0054] The small sealing capsule 341 is soft and fluid in a static state, which is conducive to adhering to the bone type of different patients; when it is subjected to impact and vibration during drilling, the non-Newtonian fluid inside it will quickly become highly viscous or quasi-solid state, providing rigid support, thereby effectively preventing the mold from shifting or deforming during drilling.

[0055] The non-Newtonian fluid is a bio-inert medical-grade shear-thickening gel that will not cause inflammation or toxicity in local human tissues even if the cyst ruptures and leaks. Preferred materials include inert gels based on hydroxypropyl methylcellulose (HPMC), polyvinyl alcohol (PVA), or gelatin crosslinking systems, conforming to ISO 10993 biocompatibility standards and possessing good tissue compatibility and intraoperative irrigation and removal capabilities.

[0056] To further improve the intuitiveness and operational efficiency of intraoperative drilling positioning, this embodiment adds a "trans-muscle projection-type hole position marking structure" around each drill bit guide hole of the drilling template. This structure helps the surgeon quickly identify the target drilling position when blood, tendons, or limited surgical field lighting are obscured, thereby reducing the rate of incorrect drilling and operational delays.

[0057] Specifically, such as Figure 5 As shown, an annular injection groove 33 is provided on the outer periphery of each drill guide hole 31 on the drilling mold 3. The groove 33 is an annular closed structure with a depth of 0.5 to 1.5 mm and a width of 1 to 2 mm. It is located on the outer layer 32 of the drilling mold and its opening faces outward and is exposed to the surgical field.

[0058] The injection groove 33 is made of a hydrophilic polymer material, such as modified polyvinyl alcohol, medical hydrophilic polyurethane, or polyvinyl alcohol-carboxymethyl cellulose composite. These materials themselves possess good liquid diffusion and short-term staining stability, enabling the formation of a localized, diffused visual effect.

[0059] Before or during the procedure, the surgeon can use a syringe or pipette to drop a small amount of staining solution, such as diluted methylene blue, protein blue, or a soluble dye solution, into the groove 33. The staining solution will spread and penetrate along the groove channel, forming a drill hole marking area with a distinct color halo with the help of the slightly permeable material at the bottom of the groove.

[0060] Even if the drilling area is partially obscured by blood, tendons, or instruments during the procedure, the surgeon can quickly locate the drilling opening using the halo marker and accurately determine whether the hole corresponds to the insertion point of the target tendon such as the piriformis or quadratus femoris, thereby improving drilling efficiency and accuracy.

[0061] The aforementioned staining solution is water-soluble, low in toxicity, and can be completely rinsed away. It can be removed post-operatively by rinsing with saline or a cleaning solution, requiring no additional consumables or electrical devices. Because the injection groove itself is a one-piece injection-molded structure, it does not affect the stability of the drilling operation or the adhesion of the mold, making it suitable for disposable or reusable mold types.

[0062] To further improve the intuitiveness of tendon reconstruction during surgery and the accuracy of suture tension direction, this embodiment adds a set of tendon direction auxiliary markings to the outer surface of the drilled sleeve 3. These markings guide the surgeon to adjust the sutures according to the physiological course of different tendons during surgery, ensuring that the tendon tension transmission is consistent with the direction of the bone tunnel, and preventing postoperative complications such as slippage, tearing, or suture cutting of tendon attachment points.

[0063] Specifically, the engraved lines are slender, shallow, groove-shaped markings arranged according to the anatomical and physiological structure of the short external rotator muscles of the human hip joint. The starting point of each engraved line corresponds to the position of the drill bit guide hole, and extends outward from the starting point along the natural direction of the corresponding tendon to the outer edge of the drill die 3, forming a set of radially diverging positioning guide lines.

[0064] For example, the piriformis muscle guiding line starts from the drill hole and extends posterolaterally; the quadratus femoris muscle guiding line is laid out in a posterolateral oblique direction. The angles between the lines are measured according to the average tendon attachment direction in the human body.

[0065] The engraved lines are preferably made by laser engraving, in-mold injection molding, or micro-convex and concave molding, with a depth of 0.3-0.6 mm and a width of 0.5-1.2 mm, which does not affect the overall smoothness and adhesion of the mold.

[0066] During the procedure, the surgeon can quickly determine the direction of the suture pre-tension path corresponding to the drill hole by observing the direction of the engraved lines, and adjust the tendon suture position or suture traction angle accordingly to ensure that the suture direction is consistent with the natural tension direction of the tendon, and avoid postoperative shear tension or suture stress concentration due to angle deviation.

[0067] In addition, see Figure 6 In another preferred embodiment of the present invention, in order to improve the stability and tension control accuracy of suture traction during hip joint tendon reconstruction surgery, the drilled mold 3 is provided with an integrated suture guide baffle 37, which is used to guide and pre-tighten the suture tension and direction during the operation.

[0068] The suture guide baffle 37 is disposed on the outside of the drilling guide hole 31, preferably on the outer surface of the drilling mold 3, and corresponds to the direction of the drilling hole opening. The guide baffle is an arc-shaped protrusion structure, and its shape matches the arc contour of the drilling mold. It is injection molded from a medical flexible elastic material, such as medical polyurethane, polycarbonate or thermoplastic elastomer.

[0069] The suture guide baffle 37 is provided with two parallel or slightly angled arc-shaped guide grooves 371. The first guide groove extends substantially coaxially with the drill guide hole 31, and the second guide groove is located below or to one side of it. There is a gap of 3-6 mm between the two guide grooves. After the suture passes through the drill hole during the operation, it is sequentially wound into the first guide groove, and then folded back and locked into the second guide groove, forming an "S"-shaped path for holding, thereby providing sufficient frictional resistance and effectively preventing the suture from slipping or retracting.

[0070] In addition, the suture guide plate 37 has a specific elastic modulus, and its elastic strength is designed according to the physiological tension requirements of the target tendon. During the operation, after the suture is inserted into the two guide grooves, the guide plate 37 can apply a stable and constant pretension force to the suture due to its own elasticity, simulating the postoperative tendon tension state, which helps the surgeon to judge whether the expected tension requirement has been achieved.

[0071] After use, the suture guide baffle 37 can be removed as a whole along with the drilling mold, avoiding foreign object residue. It has a simple structure, high safety, and is suitable for clinical promotion.

[0072] This hip replacement surgery external rotator tendon reconstruction aid is mainly used for the reconstruction of the insertion points of the external rotator tendons after hip replacement surgery. The following is a typical intraoperative procedure:

[0073] ①Exposure of the surgical field and preliminary localization

[0074] After completing the hip replacement procedure, the surgeon thoroughly cleans and exposes the greater trochanter region of the femur to confirm the bone surface contour of the greater trochanter 2 and the position of the distal stump of the target tendon (such as the piriformis muscle, obturator externus muscle, etc.).

[0075] The surgeon determines the installation position of the drill sleeve 3 by using preoperative images (such as CT 3D reconstruction) or intraoperative direct visualization.

[0076] ② Install drilling formwork

[0077] Select the appropriate size of the drilling mold 3 and place it over the outer surface of the greater trochanter 2 of the femur 1. If the drilling mold is a replaceable insert structure, the surgeon selects the appropriate size of the arc-shaped insert 36 based on intraoperative observation and connects it to the mold body to ensure that its inner protruding surface fits precisely with the trochanteric socket 21.

[0078] The mold is securely fixed to the outer side of the bone surface by using elastic buckles or flexible tightening structures (such as Velcro or cable ties) at both ends to prevent slippage or displacement during the operation.

[0079] ③ Select the target borehole location

[0080] Based on the location of the tendon stump, the surgeon selects the corresponding marked drill guide hole 31. For example, selecting the hole marked "P" indicates drilling the insertion point of the piriformis muscle. The drilling position can be quickly located using markings, color identification, or numbering on the surface of the drill template 3.

[0081] The surgeon can refer to the tendon direction marked on the template as an auxiliary marking line to adjust the drilling path to be consistent with the tendon direction, thereby improving the accuracy of the subsequent suturing direction.

[0082] ④ Drilling and threading

[0083] Insert the special drill bit 4 through the corresponding drilling guide hole 31 to perform vertical drilling at the target position on the bone surface. The front end of the drill bit is equipped with an inclined slit opening 41 and an arc-shaped diameter expansion section 42, which can be used directly to hook the pre-placed suture or threading needle after drilling.

[0084] After the surgeon passes the suture through a drilled hole into the bone, it is wound around two arc-shaped guide grooves on the suture guide baffle 37, forming an "S"-shaped embedding path. The elasticity of the baffle itself automatically applies constant tension to the suture, preventing suture retraction or loosening, and facilitating tension adjustment and fixation by the surgeon.

[0085] ⑤ Sequential drilling of multiple tendon insertion points

[0086] If multiple tendons need to be reconstructed, the surgeon should select each guide hole location sequentially and repeat the operation. If adjacent holes are close together, the surgeon can assess the bone bridge thickness using bone bridge indicator grooves or linkage structures to prevent accidental drilling or fractures.

[0087] ⑥ Postoperative removal and irrigation

[0088] After all drilling is completed, the surgeon can remove the drilling sleeve 3 as a whole. If the drilling sleeve contains a non-Newtonian fluid cystic structure, even if the cyst ruptures locally during the operation, the leakage can be thoroughly rinsed off with saline solution after the operation, without the need for special treatment.

[0089] The surgeon then followed standard procedures to suture, ligate, and reconstruct the tendon, completing the anatomical repositioning and functional reconstruction of the hip tendon insertion point.

[0090] The following are some typical clinical cases of applying the auxiliary device of the present invention:

[0091] Clinical Case 1: Reconstruction of Femoral Neck Fracture with Piriformis Muscle Tear in an Elderly Woman

[0092] Patient condition: A 79-year-old female who fell and suffered a fracture of the left femoral neck, complicated by avulsion of the piriformis muscle insertion.

[0093] Surgical procedure: Total hip arthroplasty was performed, and this device was used during the operation to reconstruct the piriformis muscle insertion point.

[0094] Application of the device: Select a No. 3 drilling mold, use the "tendon direction auxiliary marking line" to adjust the drilling angle so that the direction of the piriformis muscle suture is consistent with the muscle fiber; the suture is inserted into the guide baffle through the "S-shaped guide groove" and is self-locking and stable.

[0095] Postoperative imaging and follow-up: MRI showed good tendon reconstruction tension; hip external rotator muscle strength test was performed 6 weeks postoperatively (MMT score recovered from grade 2 to grade 4); no suture loosening or slippage occurred.

[0096] Clinical Case 2: Reconstruction of Obturator Extrinsic Muscle in a Young Male After a Traffic Accident

[0097] Patient's condition: 28-year-old male, suffered a hip tendon avulsion in a motorcycle accident, and MRI showed damage to the insertion points of the obturator externus and quadratus femoris muscles.

[0098] Surgical procedure: femoral head replacement + external rotator muscle insertion reconstruction.

[0099] Application of the device: Drilling holes for the obturator externus and quadratus femoris muscles was completed in one positioning operation; no cracks were observed on the bone surface after demolding.

[0100] Postoperative assessment at 3 months: Adduction / external rotation angle of the surgical area recovered to 90% of the contralateral side; X-ray of the surgical area showed no signs of fracture; suture tension was balanced and no slippage was observed.

[0101] Clinical Case 3: Severe blood staining during surgery, localized by staining rings

[0102] Patient condition: 67-year-old female with an old femoral neck fracture, blurred tendon insertion, and significant intraoperative bleeding.

[0103] Intraoperative challenges: It was impossible to locate the tendon insertion point with the naked eye, and the field of vision was frequently obscured by blood.

[0104] Solution: During the procedure, a "trans-muscle projection-type hole marking structure" was used, and diluted methylene blue was injected into the groove before drilling; even if there was bleeding in the surgical field, the edges of each guide hole were still clearly identified as having a halo of blue; drilling of the two insertion points of the superior and inferior gemellus muscles was successfully completed.

[0105] Postoperative findings: Stimulated electromyography showed that the tendon had recovered to near its natural tension; there were no instances of mis-drilling or missed drilling; the dye was completely cleaned after mold removal, with no residual tissue staining.

[0106] Clinical Case 4: Child with a history of rheumatoid arthritis and external rotator muscle atrophy

[0107] Patient's condition: A 15-year-old boy who suffered from rheumatoid arthritis in childhood and needs to retain some tendon function after hip replacement.

[0108] Surgical objective: To precisely drill holes to preserve functional tendons and reduce bone damage.

[0109] Intraoperative procedure: The "replaceable arc-shaped insert structure" of this invention is used, with a pediatric bone-fitting version selected; the insert precisely fits the concave surface of the trochanteric socket, with good stability; only the obturator foramen is drilled to avoid excessive invasive procedures.

[0110] Postoperative recovery: Muscle strength grade improved from grade 3 to grade 4+; functional score improved to 86; no bone defects or structural abnormalities were found in the surgical area.

[0111] The above description is only a preferred embodiment of the present invention and is not intended to limit the present invention. Any modifications, equivalent substitutions, and improvements made within the spirit and principles of the present invention should be included within the protection scope of the present invention.

Claims

1. An auxiliary device for reconstructing the external rotator muscle group tendons in hip replacement surgery, characterized in that, include: A drilling mold (3) that can be fitted onto the greater trochanter (2) of the femur (1), wherein the drilling mold (3) is set according to the shape of the greater trochanter (2); The drilling die (3) has drill guide holes (31) respectively at the insertion points of the piriformis muscle, quadratus femoris muscle, obturator lateralis muscle, superior gemellus muscle and inferior gemellus muscle; The drill bit (4) engages with the drill bit guide hole (31) on the drilling die (3) so that the drilling direction and position are consistent with the target tendon reconstruction insertion point.

2. The auxiliary device for external rotator muscle group tendon reconstruction in hip replacement surgery according to claim 1, characterized in that, The inner surface of the drilling mold (3) is provided with a protruding arc-shaped insert (36) corresponding to the rotor socket (21) inside the large rotor (2), which is used to position and limit the position of the drilling mold (3).

3. An auxiliary device for reconstructing the external rotator muscle group tendons in hip replacement surgery according to claim 1 or 2, characterized in that, The drilling mold (3) is an integral arc-shaped plate structure with elastic buckles or flexible tightening structures at both ends, which are used to stably clamp the outside of the large rotor (2) during the operation.

4. An auxiliary device for reconstructing the external rotator muscle group tendons in hip replacement surgery according to claim 1 or 2, characterized in that, The drill bit (4) has a slit (41) near its front end for hooking the thread, and the slit (41) is arranged at an angle toward the tip of the drill bit (4).

5. The auxiliary device for external rotator tendon reconstruction in hip replacement surgery according to claim 4, characterized in that, The inner end of the slit (41) near the tip of the drill bit (4) is provided with an arc-shaped expansion section (42), which is used to accommodate and guide the suture thread to enter or exit.

6. The auxiliary device for external rotator tendon reconstruction in hip replacement surgery according to claim 1, characterized in that, The drilling template (3) is marked with scales or identifiers to indicate different tendon insertion points, so that the surgeon can select the appropriate drilling position as needed.

7. The auxiliary device for external rotator muscle group tendon reconstruction in hip replacement surgery according to claim 1, characterized in that, The insert (36) and the drilling mold (3) are detachably connected. The insert (36) is detachably connected to the drilling mold (3) by screwing, snapping or plugging. The drilling mold (3) can be used with replacement inserts (36) of different specifications to adapt to the anatomical differences of the greater trochanter of the femur in different patients.

8. The auxiliary device for external rotator muscle group tendon reconstruction in hip replacement surgery according to claim 1, characterized in that, The drilling die (3) has a multi-layer structure, including: The outer layer (32) is a bone-shaped support shell made of rigid material, providing overall support; The inner layer (34) is a closed cavity structure filled with a non-Newtonian fluid, which enhances adaptability and provides temporary rigidity under drilling vibration to prevent displacement.

9. The auxiliary device for external rotator muscle group tendon reconstruction in hip replacement surgery according to claim 8, characterized in that, The inner layer (34) is composed of multiple small sealing bladders (341), which are filled with non-Newtonian fluid and distributed along the inner surface of the outer layer (32), avoiding the positions of all drill bit guide holes (31). Each of the small sealing bladders (341) is independently sealed and arranged in an array or strip shape, which can provide flexibility in a static state and generate rigid support under drilling vibration impact.

10. The auxiliary device for external rotator tendon reconstruction in hip replacement surgery according to claim 9, characterized in that, The non-Newtonian fluid is a biologically inert shear-thickening polymer gel, which is a medical-grade shear-thickening gel made based on a crosslinking system of hydroxypropyl methylcellulose, polyvinyl alcohol, or gelatin; the outer layer (32) is polyetheretherketone or titanium alloy material.

Images