Intraoperatively adjustable knee surgery guiding device

Abstract

The utility model discloses a kind of intraoperative adjustable knee joint surgery guiding device, it is related to medical instrument technical field, and it include: tibia guide plate, femur front guide plate, femur distal guide plate, four-in-one rotary adjusting plate, metal handle, four-in-one osteotomy plate, wherein four-in-one osteotomy plate is fixed on femur by screw thread nail hole, and bone cutting is carried out to femur by four-in-one osteotomy slot on four-in-one osteotomy plate of swing saw;The guiding device can realize femur valgus angle intraoperative real-time adjustment, realize femur external rotation angle intraoperative real-time adjustment, and more realize flexion-extension gap balance based on ligament judgment basis of operator.

Description

Technical Field

[0001] This utility model belongs to the field of medical device technology, and more specifically, relates to an intraoperative adjustable knee joint surgical guide device. Background Technology

[0002] Total knee arthroplasty (TKA) is the most common and cost-effective orthopedic surgery, with over 40 years of clinical application. Most patients experience good clinical outcomes and long-term prosthesis survival after TKA; however, over 20% of patients are still dissatisfied with the results. Many factors influence the outcome and prosthesis survival rate after TKA, including demographic factors, surgical factors, and healthcare conditions. Among these, abnormal three-dimensional alignment of the knee joint after TKA is a significant surgical factor contributing to unsatisfactory results and decreased prosthesis survival. In traditional TKA, surgeons often refer to preoperative weight-bearing lower limb X-rays and use traditional femoral and tibial osteotomy tools. This experience-dependent approach not only has a long learning curve but may also affect the accuracy of the osteotomy, especially when there are variations in the patient's lower limb alignment or local anatomy. 3D-printed personalized osteotomy tools (PSI) based on computed tomography (CT) data represent an innovative approach to traditional total knee arthroplasty (TKA) osteotomy tools. They facilitate personalized design and evaluation based on the patient's preoperative femoral and tibial anatomy, adapting to unique anatomical morphology and variations, and increasing osteotomy precision. Multiple studies have shown that, compared to traditional tools, 3D-printed PSI osteotomy guides can improve the rate of excellent lower limb alignment after TKA and enhance the accuracy of prosthesis implantation size and placement; however, this conclusion remains controversial.

[0003] The main function of traditional PSI osteotomy guides is osteotomy and positioning. Once the preoperative planning is completed, the position of the guide and the amount of osteotomy are basically determined. However, this technique relies on CT scan data, which has inherent drawbacks. It cannot assess soft tissue balance, cannot effectively assess interstitial balance, and cannot make any adjustments during the operation based on the actual situation. As a result, the engineer's planning and design become the actual intraoperative result. Furthermore, due to intraoperative errors and soft tissue balance issues, the actual postoperative result may differ from the preoperative plan. This is the reason for the controversy surrounding PSI. Utility Model Content

[0004] The purpose of this invention is to address the shortcomings of existing technologies by providing an intraoperatively adjustable knee joint surgical guide device. This guide device can achieve real-time adjustment of the femoral valgus angle and the femoral external rotation angle during surgery, and further achieves flexion-extension gap balance based on the surgeon's assessment of ligaments.

[0005] To achieve the above objectives, this utility model provides an intraoperatively adjustable knee joint surgical guide device, comprising:

[0006] Tibial guide plate, used to fit the tibia, the tibia guide plate has fixing holes and tibia osteotomy groove, the oscillating saw cuts the tibia through the tibia osteotomy groove;

[0007] The anterior femoral guide plate is used to fit against the femur. The anterior femoral guide plate has a positioning hole and two rotating positioning grooves, which are symmetrically arranged with the positioning hole as the center.

[0008] The distal femoral guide plate is L-shaped. One end of the distal femoral guide plate has a central positioning hole, a distal osteotomy groove, and two first rotational positioning holes. The central positioning hole is corresponding to the positioning hole. When the other end of the distal femoral guide plate is in contact with the plane after tibial osteotomy, the oscillating saw performs osteotomy on the distal femur through the distal osteotomy groove.

[0009] The other end face of the distal femoral guide plate is provided with a first central positioning hole and a distal femoral rotation positioning groove.

[0010] The four-in-one rotating adjustment plate is attached to the other end of the distal femoral guide plate. The four-in-one rotating adjustment plate is provided with a second central positioning hole, a metal handle groove and two second rotating positioning holes. The first central positioning hole and the second central positioning hole are provided correspondingly.

[0011] A metal handle, one end of which is inserted into the metal handle groove. When the side of the metal handle is in contact with the plane after tibial osteotomy, a threaded screw hole is opened on the plane after distal femoral osteotomy according to the position of the second rotation positioning hole.

[0012] The four-in-one osteotomy plate is fixed to the femur through the threaded screw holes, and the oscillating saw performs osteotomy on the femur through the four-in-one osteotomy groove on the four-in-one osteotomy plate.

[0013] Optionally, the anterior femoral guide plate is rotatably disposed around the positioning hole, the anterior femoral guide plate is provided with a first angle ruler, and one end of the distal femoral guide plate is provided with a first spike that cooperates with the first angle ruler.

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

[0015] Optionally, a second angle ruler is provided on the end face of the other end of the distal femoral guide plate, and a second spike is provided on the four-in-one rotating adjustment plate to cooperate with the second angle ruler.

[0016] Optionally, the fixing hole and the positioning hole are fixed with a first threaded nail, the two first rotating positioning holes are fixed with a second threaded nail, the first center positioning hole and the second center positioning hole are fixed with a third threaded nail, and the two second rotating positioning holes are fixed with a fourth threaded nail.

[0017] Optionally, a plurality of spacers are provided between the end face of the other end of the distal femoral guide plate and the plane after tibial osteotomy, the thickness of the spacers being 1mm-10mm.

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

[0019] This invention provides an intraoperatively adjustable knee joint surgical guide device, the advantages of which are as follows: the guide device has rotation positioning holes at the other end of the distal femoral guide plate and the four-in-one rotating adjustment plate, respectively. This allows for real-time adjustment of the angle when adjusting the fit between the distal femoral guide plate and the four-in-one rotating adjustment plate. In addition, gap shims are added to the end face of the other end of the distal femoral guide plate and the side of the metal handle to ensure the accuracy of the osteotomy reference plane. The metal handle is also used to determine the position of the threaded screw holes of the four-in-one osteotomy plate, ensuring the accurate positioning of the four-in-one osteotomy plate. This allows for real-time adjustment of the femoral valgus angle and the femoral external rotation angle during the four-in-one osteotomy, and further achieves flexion-extension gap balance based on the surgeon's assessment of ligaments.

[0020] Other features and advantages of this invention will be described in detail in the following detailed description section. Attached Figure Description

[0021] The above and other objects, features and advantages of the present invention will become more apparent from the accompanying drawings, in which like reference numerals generally represent like parts.

[0022] Figure 1 A schematic diagram showing the tibial guide plate conforming to the tibia according to an embodiment of the present invention is provided.

[0023] Figure 2 The diagram shows the effect of osteotomy of the tibia according to one embodiment of the present invention.

[0024] Figure 3 A schematic diagram showing the anterior femoral guide plate conforming to the femur according to an embodiment of the present invention is provided.

[0025] Figure 4A schematic diagram showing the anterior femoral guide plate fixed to the femur by threaded screws according to an embodiment of the present invention is shown.

[0026] Figure 5 A schematic diagram showing the connection between the anterior femoral guide plate and the distal femoral guide plate according to an embodiment of the present invention is shown.

[0027] Figure 6 A schematic diagram showing the relative adjustment of the anterior femoral guide plate and the distal femoral guide plate according to an embodiment of the present invention is shown.

[0028] Figure 7 A schematic diagram showing the distal femoral guide plate conforming to the tibial plane after osteotomy, according to an embodiment of the present invention, is illustrated.

[0029] Figure 8 A schematic diagram showing a gap spacer disposed between the distal femoral guide plate and the tibial plane after osteotomy, according to an embodiment of the present invention.

[0030] Figure 9 A schematic diagram of osteotomy of the femur using a distal femoral guide plate and an oscillating saw according to an embodiment of the present invention is shown.

[0031] Figure 10 A schematic diagram of the structure of the other end of the distal femoral guide plate according to an embodiment of the present invention is shown.

[0032] Figure 11 A schematic diagram showing the connection between the distal femoral guide plate and the four-in-one rotating adjustment plate according to an embodiment of the present invention is shown.

[0033] Figure 12 It shows Figure 11 A magnified view of a portion of the image.

[0034] Figure 13 A schematic diagram showing the metal handle conforming to the plane of the tibia after osteotomy, according to one embodiment of the present invention, is illustrated.

[0035] Figure 14 A schematic diagram showing the position of the femoral plane after osteotomy and the four-in-one osteotomy plate according to an embodiment of the present invention is shown.

[0036] Figure 15 A schematic diagram showing the connection between the femoral plane after osteotomy and the four-in-one osteotomy plate according to an embodiment of the present invention is shown.

[0037] Explanation of reference numerals in the attached figures:

[0038] 1. Tibia; 2. Fixation hole; 3. Tibial guide plate; 4. Threaded screw; 5. Oscillating saw; 6. Femur; 7. Anterior femoral guide plate; 8. Rotational positioning groove; 9. Positioning hole; 10. First angle ruler; 11. Distal femoral guide plate; 12. Intermediate positioning hole; 13. First rotational positioning hole; 14. Distal osteotomy groove; 15. Spacer; 16. Second angle ruler; 17. First central positioning hole; 18. Distal femoral rotational positioning groove; 19. Four-in-one rotational adjustment plate; 20. Second central positioning hole; 21. Second rotational positioning hole; 22. Metal handle groove; 23. Metal handle; 24. Threaded screw hole; 25. Four-in-one osteotomy plate; 26. First spike; 27. Second spike. Detailed Implementation

[0039] Preferred embodiments of the present invention will now be described in more detail. While preferred embodiments 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 to the embodiments set forth herein. Rather, these embodiments 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.

[0040] This utility model provides an intraoperatively adjustable knee joint surgical guide device, comprising:

[0041] Tibial guide plate, used to fit the tibia, has fixation holes and tibial osteotomy grooves. The oscillating saw cuts the tibia through the tibial osteotomy grooves.

[0042] The anterior femoral guide plate is used to fit the femur. The anterior femoral guide plate has a positioning hole and two rotating positioning grooves, which are symmetrically arranged with the positioning hole as the center.

[0043] The distal femoral guide plate is L-shaped. One end of the distal femoral guide plate has a central positioning hole, a distal osteotomy groove and two first rotation positioning holes. The central positioning hole is set in correspondence with the positioning hole. When the other end of the distal femoral guide plate is in contact with the plane after tibial osteotomy, the oscillating saw performs osteotomy on the distal femur through the distal osteotomy groove.

[0044] A first central positioning hole and a distal femoral rotation positioning groove are provided on the end face of the other end of the femoral distal guide plate;

[0045] The four-in-one rotating adjustment plate fits into the other end of the distal femoral guide plate. The four-in-one rotating adjustment plate is provided with a second central positioning hole, a metal handle groove and two second rotating positioning holes, with the first central positioning hole and the second central positioning hole being set accordingly.

[0046] A metal handle, one end of which is inserted into a metal handle groove. When the side of the metal handle is in contact with the plane after tibial osteotomy, a threaded screw hole is made on the plane after distal femoral osteotomy according to the position of the second rotation positioning hole.

[0047] The four-in-one osteotomy plate is fixed to the femur through threaded screw holes, and the oscillating saw performs osteotomy on the femur through the four-in-one osteotomy groove on the four-in-one osteotomy plate.

[0048] Specifically, this adjustable knee joint surgical guide device includes a tibial guide plate, an anterior femoral guide plate, a distal femoral guide plate, a four-in-one rotating adjustment plate, a metal handle, and a four-in-one osteotomy plate. The tibial guide plate serves a positioning function during tibial osteotomy; the anterior femoral guide plate and the distal femoral guide plate work together to position the distal femur during osteotomy. During distal femoral osteotomy, the distal femoral guide plate must be fixed in a relative position with the plane formed by the previous tibial osteotomy to ensure accurate selection of the distal femoral osteotomy location; the distal femoral guide plate, the four-in-one rotating adjustment plate, and the metal handle work together to fix the metal handle in a relative position with the plane formed by the previous distal femoral osteotomy. The fixed position of the four-in-one osteotomy plate is then determined through a second rotating positioning hole on the four-in-one rotating adjustment plate. Finally, a quarter-section of the femur is osteotomized using the four-in-one osteotomy plate. The various plates in this surgical guide device are interconnected. Only by using them in a certain order can accurate osteotomy be performed on the tibia, distal femur, and quarter of the femur. Furthermore, the angle of femoral osteotomy can be adjusted through the rotation positioning groove and the distal femur rotation positioning groove, enabling real-time adjustment of the femoral valgus angle and the femoral external rotation angle during surgery. It also achieves flexion-extension gap balance based on the surgeon's assessment of ligaments.

[0049] Optionally, the anterior femoral guide plate is rotatably configured around the positioning hole, a first angle ruler is provided on the anterior femoral guide plate, and a first spike part that cooperates with the first angle ruler is provided at one end of the distal femoral guide plate.

[0050] Optionally, the first rotary positioning hole moves within the range of the rotary positioning groove, and the rotation range of the rotary positioning groove is ±3°.

[0051] Specifically, since the distal femoral guide plate and the anterior femoral guide plate are fixed by the same threaded pin, and the anterior femoral guide plate fits the shape of the femur, the distal femoral guide plate can be rotated and adjusted using this threaded pin. In addition, a rotation positioning groove is provided on the anterior femoral guide plate, which can further restrict the rotation of the distal femoral guide plate. A first spike is also provided on the distal femoral guide plate, and the relative positional relationship between the first spike and the first angle ruler can facilitate the determination of the adjustment angle value of the distal femoral guide plate.

[0052] Optionally, a second angle ruler is provided on the end face of the other end of the distal femoral guide plate, and a second spike is provided on the four-in-one rotary adjustment plate to cooperate with the second angle ruler.

[0053] Specifically, the design principle of the second angle ruler and the second spike is the same as that of the first angle ruler and the first spike. The only difference is that the second angle ruler and the second spike work together to determine the adjustment angle value of the four-in-one rotating adjustment plate.

[0054] Optionally, the fixing hole and the positioning hole are fixed by a first threaded pin, and two first rotating positioning holes ( Figure 8 / 13) The first and second center positioning holes are fixed with the second threaded nails respectively, the first center positioning hole and the second center positioning hole are fixed with the third threaded nails respectively, and the two second rotation positioning holes are fixed with the fourth threaded nails respectively.

[0055] Specifically, threaded screws are used to fix the tibial guide plate, anterior femoral guide plate, distal femoral guide plate, four-in-one rotation adjustment plate, and four-in-one osteotomy plate. This ensures that the plates do not shift and guarantees the accuracy of the osteotomy.

[0056] Optionally, multiple spacers are provided between the end face of the other end of the distal femoral guide plate and the plane after tibial osteotomy, with the thickness of the spacers ranging from 1mm to 10mm.

[0057] Optionally, multiple gap shims are also provided between the side of the metal handle and the plane after tibial osteotomy.

[0058] Specifically, when determining the location of the distal femoral osteotomy, the other end face of the distal femoral guide plate needs to be aligned with the plane after the tibial osteotomy. Since the furthest plane of the osteotomy groove of the distal femoral guide plate is the stator and represents the minimum extension gap, the expected extension gap can be obtained and known by using the proximal tibial osteotomy surface as a reference. Because the distal femoral guide plate is designed with the minimum gap, in actual surgery, the end face of the distal femoral guide plate may not be able to fit tightly against the tibial osteotomy plane. Therefore, when the extension gap is large, gap shims can be used to fill it. Gaps can be spaced in 1mm thickness increments, ranging from 1mm to 10mm, fully meeting the needs of intraoperative use. Additionally, when adjusting the position of the four-in-one rotating adjustment plate, gap shims can also be placed between the metal handle and the femur, based on the same principle.

[0059] This utility model also provides a method for using an intraoperatively adjustable knee joint surgical guide device. The method of using the aforementioned intraoperatively adjustable knee joint surgical guide device includes:

[0060] The tibial guide plate is attached and fixed to the tibia, and the tibia is osteotomized using an oscillating saw;

[0061] The anterior femoral guide plate is attached and fixed to the anterior side of the femur, and the positioning holes are fixed with threaded nails;

[0062] The distal femoral guide plate is rotated and connected to the anterior femoral guide plate through the central positioning hole, so that the other end of the distal femoral guide plate fits against the plane after tibial osteotomy.

[0063] The relative position of the rotating positioning groove and the first rotating positioning hole is fixed, and the distal femur is cut using a oscillating saw.

[0064] The four-in-one rotating adjustment plate is rotatably connected 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 into the metal handle slot.

[0065] Fit the side of the metal handle with the plane after the tibial osteotomy, and make threaded screw holes on the plane after the distal femoral osteotomy according to the second rotation positioning hole.

[0066] The four-in-one osteotomy plate is fixed with threaded holes, and the femur is osteotomized using an oscillating saw.

[0067] Optionally, when adjusting the fit between the other end of the distal femoral guide plate and the plane after tibial osteotomy, a gap shim is filled between the distal femoral guide plate and the plane after tibial osteotomy.

[0068] When adjusting the fit between the side of the metal handle and the plane after tibial osteotomy, fill the gap between the side of the metal handle and the plane after tibial osteotomy with a shim.

[0069] Optionally, before connecting the four-in-one rotating adjustment plate to the distal femoral guide plate, the femur needs to be bent to expose the flexed position of the femur.

[0070] Compared to the osteotomy method using the adjustable knee joint surgical guide device of this invention, traditional knee joint guides are all based on CT data simulation for preoperative planning. They can only identify bony structures, but soft tissue balance and interspace balance are not taken into account. Important angle parameters such as external rotation angle and valgus angle are also designed based on bony characteristics. Therefore, if there are inappropriate conditions caused by soft tissue and interspace balance during the operation, they cannot be adjusted or changed. This is the key point of controversy surrounding current guides.

[0071] To address the shortcomings of existing technologies, although preoperative design is based on bony characteristics (e.g., valgus angle is generally 5-7 degrees, external rotation angle is generally around 3 degrees), adjustments are always made. For the flexion-extension gap, the distal femoral osteotomy volume and posterior condyle osteotomy volume are designed based on the tibial osteotomy surface to ensure consistent flexion and extension gaps. During distal femoral osteotomy, with a fixed extension gap, if there is an imbalance between the medial and lateral gaps due to soft tissue imbalance, the distal femoral osteotomy device can be rotated to achieve medial-lateral balance, reducing damage to soft tissues. If the gap is too large, a gap shim can be used to fill it, also achieving medial balance through rotational positioning. After the distal femoral osteotomy is completed, the extension gap is basically fixed. Posterior condyle osteotomy is then performed, using a four-in-one rotational adjustment component in conjunction with a metal handle and gap shims to adjust the rotational positioning in flexion and perform subsequent osteotomy. Based on the original pain points of the guide plate, it realizes real-time adjustment of the femoral valgus angle and the femoral external rotation angle during surgery, achieves the balance of the medial and lateral gaps in the extension position, the balance of the medial and lateral gaps in the flexion position, and further achieves the balance of the gaps in the extension and flexion positions based on the surgeon's ligament judgment.

[0072] Example

[0073] like Figures 1 to 15 As shown, this utility model provides an intraoperatively adjustable knee joint surgical guide device, comprising:

[0074] Tibial guide plate 3 is used to fit the tibia 1. The tibiaal guide plate 3 is provided with a fixing hole 2 and a tibia osteotomy groove. The oscillating saw 5 performs osteotomy on the tibia through the tibia osteotomy groove. The fixing hole 2 is connected to the tibia 1 through a threaded nail 4.

[0075] The anterior femoral guide plate 7 is used to fit against the femur 6. The anterior femoral guide plate 7 is provided with a positioning hole 9 and two rotating positioning grooves 8. The rotating 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 threaded pin 4.

[0076] The distal femoral guide plate 11 is L-shaped. A central positioning hole 12, a distal osteotomy groove 14 and two first rotational positioning holes 13 are provided on the end face of one end of the distal femoral guide plate. The central positioning hole 12 is set in correspondence with the positioning hole 9 and is fixed together with the same threaded nail 4. When the end face of the other end of the distal femoral guide plate 11 is in contact with the plane after tibial osteotomy, the oscillating saw 5 performs osteotomy on the distal femur through the distal osteotomy groove 14.

[0077] A first central positioning hole 17 and two distal femoral rotation positioning grooves 18 are provided on the end face of the other end of the femoral distal guide plate 11.

[0078] The four-in-one rotating adjustment plate 19 is attached to the other end of the distal femoral guide plate 11. The four-in-one rotating adjustment plate 19 is provided with a second central positioning hole 20, a metal handle groove 22 and two second rotating positioning holes 21. The first central positioning hole 17 and the second central positioning hole 20 are correspondingly provided and are fixed with threaded nails 4.

[0079] A metal handle 23 is inserted into a metal handle slot 22. When the side of the metal handle 23 is in contact with the plane after the tibial osteotomy, a threaded screw hole 24 is opened on the plane after the distal femoral osteotomy according to the position of the second rotation positioning hole 21.

[0080] The four-in-one osteotomy plate 25 is fixed to the femur 6 through the threaded screw holes, and the oscillating saw 5 performs osteotomy on the femur 6 through the four-in-one osteotomy groove on the four-in-one osteotomy plate 25.

[0081] In this embodiment, the anterior femoral guide plate 7 is rotatably arranged around the positioning hole 9, and a first angle ruler 10 is provided on the anterior femoral guide plate 7. One end of the distal femoral guide plate 11 is provided with a first spike 26 that cooperates with the first angle ruler 10.

[0082] In this embodiment, the first rotating positioning hole 13 moves within the range of the rotating positioning groove 8, and the rotation range of the rotating positioning groove 8 is ±3°.

[0083] In this embodiment, a second angle ruler 16 is provided on the end face of the other end of the distal femoral guide plate 11, and a second spike 27 that cooperates with the second angle ruler 16 is provided on the four-in-one rotating adjustment plate 19.

[0084] In this embodiment, the fixing hole 2 and the positioning hole 9 are fixed with threaded nails 4, the two first rotating positioning holes 13 are also fixed with threaded nails 4, the first center positioning hole 17 and the second center positioning hole 20 are also fixed with threaded nails 4, and the two second rotating positioning holes 21 are also fixed with threaded nails 4.

[0085] In this embodiment, a plurality of gap spacers 15 are provided between the end face of the other end of the distal femoral guide plate 11 and the plane after tibial osteotomy, and the thickness of the gap spacers 15 ranges from 1mm to 10mm.

[0086] In this embodiment, multiple gap shims 15 are also provided between the side of the metal handle 23 and the plane after tibial osteotomy.

[0087] This utility model also provides a method for using an intraoperatively adjustable knee joint surgical guide device. The method of using the aforementioned intraoperatively adjustable knee joint surgical guide device includes:

[0088] The tibial guide plate 3 is attached and fixed to the tibia 1, and the osteotomy of the tibia 1 is performed by the oscillating saw 5.

[0089] The anterior guide plate 7 of the femur is attached and fixed to the anterior side of the femur 1, and fixed with threaded nails 4 to the positioning holes 9;

[0090] The distal femoral guide plate 11 is rotatably connected 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 against the plane after tibial osteotomy.

[0091] The relative positions of the rotating positioning groove 8 and the first rotating positioning hole 13 are fixed, and the distal femur is cut using the oscillating saw 5.

[0092] The four-in-one rotating adjustment plate 19 is rotatably connected 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 into the metal handle groove 22.

[0093] The side of the metal handle 22 is aligned with the plane after the tibial osteotomy, and a threaded screw hole 24 is made on the plane after the distal femoral osteotomy according to the second rotation positioning hole 21.

[0094] The four-in-one osteotomy plate 25 is fixed to the threaded hole 24, and the femur is osteotomized using the oscillating saw 5.

[0095] In this embodiment, when adjusting the fit between the other end of the distal femoral guide plate 11 and the plane after tibial osteotomy, a gap shim 15 is filled between the distal femoral guide plate 11 and the plane after tibial osteotomy.

[0096] When adjusting the fit between the side of the metal handle 23 and the plane after tibial osteotomy, a gap shim 15 is filled between the side of the metal handle 23 and the plane after tibial osteotomy.

[0097] In this embodiment, before connecting the four-in-one rotating adjustment plate 19 to the distal femoral guide plate 11, the femur needs to be bent to expose the flexed position of the femur.

[0098] In summary, the method of using this guiding device is as follows: The osteotomy position and angle on the tibial side are determined through preoperative planning, thereby determining the position of the tibial guide plate 3. The tibial guide plate 3 is then attached to the tibia 1 and fixed in the fixation hole 2 using threaded pins 4. Immediately afterwards, the tibia is osteotomized using an oscillating saw 5, resulting in the desired outcome. Figure 2The tibial guide plate 3 shown is identical to a conventional tibial guide plate, designed to obtain a precise tibial profile after osteotomy. Furthermore, after the tibial osteotomy 1 is completed, the anterior femoral guide plate 7 is attached to the anterior side of the femur 6. Once stable, it is fixed by inserting threaded pins 4 into the positioning holes 9 of the anterior femoral guide plate 7. Its rotating positioning groove 8 is used in conjunction with the subsequent distal femoral guide plate 11. After the anterior femoral guide plate 7 is fixed by the threaded screw 4, the distal femoral guide plate 11 can be engaged with it by the threaded screw 4, allowing the distal femoral guide plate 11 to rotate around the threaded screw 4. The rotation angle can be determined by pointing to the first angle ruler 10 on the anterior femoral guide plate 7 using the distal femoral guide plate 11. The rotation positioning groove 8 of the anterior femoral guide plate 7 is designed with an angle so that the rotation angle limit of the distal femoral guide plate 11 is ±3 degrees, which is sufficient for its use. By rotating the distal femoral guide plate 11, the eversion angle of the 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 surgery cannot be known. Therefore, during planning, we design the eversion angle based on the obtained bony structure data. During surgery, the distal femoral guide plate 11 is used to further adjust the eversion angle. The eversion angle is determined by combining the patient's soft tissue balance and gap balance. While rotating and positioning the distal femoral guide plate 11, the distal plane of the distal femoral guide plate 11 needs to be aligned with the plane after tibial osteotomy. The distance between the osteotomy groove of the distal femoral guide plate 11 and the farthest plane is a fixed value, which is also the minimum value of the extension gap. The expected extension gap can be obtained and known by using the proximal tibial osteotomy surface as a reference. Since the distal femoral guide plate 11 is designed with the minimum gap, the distal plane of the distal femoral guide plate 11 may not be able to closely align with the tibial osteotomy plane during actual surgery. Therefore, when the extension gap is large, a gap shim 15 can be used to fill it. After the eversion angle and extension gap of the distal osteotomy are adjusted, it is fixed with a threaded nail 4, and the distal femoral osteotomy is immediately performed with an oscillating saw 5.After the distal femoral osteotomy is completed, the femoral osteotomy will be performed in flexion. 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. First, the threaded pin 4 is fixed through the first central positioning hole 17, and then the four-in-one rotation adjustment plate 19 is engaged with it through the threaded pin 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 through the threaded pin 4, and the angle is limited to ±3 degrees. In the preoperative planning, it is generally designed for external rotation of 3 degrees. Since it is based on the design of bony osteotomy, according to However, since it was impossible to determine the soft tissue balance and flexion gap, based on the original design of external rotation of 3 degrees and the actual situation during the operation, a four-in-one rotation adjustment plate 19 was used for positioning and rotation to achieve the balance of soft tissue and flexion gap. When using the four-in-one rotation adjustment plate 19 for rotation positioning, a metal handle 23 needs to be inserted into the metal handle slot 22. The metal handle 23 needs to be close to the tibial osteotomy plane, and the height design of the metal handle is to make the flexion gap and extension gap consistent after the femoral posterior condyle osteotomy. When a gap shim is used for distal femoral osteotomy, this step also requires placing a gap shim of the same thickness under the metal handle to ensure that the extension and flexion gaps are consistent. After the four-in-one rotating adjustment plate 19 is fixed, the threaded nail 4 is passed through the second rotating positioning hole 21 to leave a threaded nail hole 24 on the distal femoral osteotomy surface. The four-in-one osteotomy plate 25 can then be inserted into the threaded nail hole 24 to complete the four-in-one fixation and perform the four-in-one osteotomy. At this point, all guide plate-related operations have been completed, enabling real-time adjustment of the femoral valgus angle and the femoral external rotation angle during surgery. Furthermore, it achieves flexion-extension gap balance based on the surgeon's ligament assessment.

[0099] The various embodiments of the present invention have been described above. These descriptions are exemplary and not exhaustive, nor are they limited to the disclosed embodiments. Many modifications and variations will be apparent to those skilled in the art without departing from the scope and spirit of the described embodiments.

Claims

1. An intraoperatively adjustable knee joint surgical guide device, characterized in that, include: Tibial guide plate, used to fit the tibia, the tibia guide plate has fixing holes and tibia osteotomy groove, the oscillating saw cuts the tibia through the tibia osteotomy groove; The anterior femoral guide plate is used to fit against the femur. The anterior femoral guide plate has a positioning hole and two rotating positioning grooves, which are symmetrically arranged with the positioning hole as the center. The distal femoral guide plate is L-shaped. One end of the distal femoral guide plate has a central positioning hole, a distal osteotomy groove, and two first rotational positioning holes. The central positioning hole is corresponding to the positioning hole. When the other end of the distal femoral guide plate is in contact with the plane after tibial osteotomy, the oscillating saw performs osteotomy on the distal femur through the distal osteotomy groove. The other end face of the distal femoral guide plate is provided with a first central positioning hole and a distal femoral rotation positioning groove. The four-in-one rotating adjustment plate is attached to the other end of the distal femoral guide plate. The four-in-one rotating adjustment plate is provided with a second central positioning hole, a metal handle groove and two second rotating positioning holes. The first central positioning hole and the second central positioning hole are provided correspondingly. A metal handle, one end of which is inserted into the metal handle groove. When the side of the metal handle is in contact with the plane after tibial osteotomy, a threaded screw hole is opened on the plane after distal femoral osteotomy according to the position of the second rotation positioning hole. The four-in-one osteotomy plate is fixed to the femur through the threaded screw holes, and the oscillating saw performs osteotomy on the femur through the four-in-one osteotomy groove on the four-in-one osteotomy plate.

2. The intraoperatively adjustable knee joint surgical guide device according to claim 1, characterized in that, The anterior femoral guide plate is rotatably arranged around the positioning hole. A first angle ruler is provided on the anterior femoral guide plate, and a first spike is provided at one end of the distal femoral guide plate to cooperate with the first angle ruler.

3. The intraoperatively adjustable knee joint surgical guide device according to claim 2, characterized in that, The first rotary positioning hole moves within the range of the rotary positioning groove, and the rotation range of the rotary positioning groove is ±3°.

4. The intraoperatively adjustable knee joint surgical guide device according to claim 1, characterized in that, A second angle ruler is provided on the end face of the other end of the distal femoral guide plate, and a second spike is provided on the four-in-one rotating adjustment plate to cooperate with the second angle ruler.

5. The intraoperatively adjustable knee joint surgical guide device according to claim 1, characterized in that, The fixing hole and the positioning hole are fixed with a first threaded nail, the two first rotating positioning holes are fixed with a second threaded nail, the first center positioning hole and the second center positioning hole are fixed with a third threaded nail, and the two second rotating positioning holes are fixed with a fourth threaded nail.

6. The intraoperatively adjustable knee joint surgical guide device according to claim 1, characterized in that, Multiple spacers 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 of the spacers ranges from 1mm to 10mm.

7. The intraoperatively adjustable knee joint surgical guide device according to claim 6, characterized in that, Multiple gap shims are also provided between the side of the metal handle and the plane after tibial osteotomy.

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