Surgical instruments and surgical instrument systems

Abstract

To reduce surgical steps in artificial ankle joint replacement surgery.SOLUTION: A surgical instrument (1) includes: a body portion (10) having a top face (11) with a shape fitted to a surface of an implant on the tibia side, and a bottom surface (12) with a shape fitted to a surface of the implant on the talar side; and a bone resection guiding portion (20) positioned inside the body portion (10) and having a through-hole (21) penetrating to the talar side.SELECTED DRAWING: Figure 5

Description

[Technical Field]

[0001] The present disclosure relates to surgical instruments and surgical instrument systems, and more particularly to surgical instruments and surgical instrument systems used in total ankle replacement surgery. [Background technology]

[0002] In artificial ankle joint replacement surgery, surgical instruments are known, as shown in Patent Documents 1 and 2. Patent Documents 1 and 2 disclose an orthopedic surgical instrument system that includes a spacer that checks whether the amount of bone resection is appropriate, and a bone resection instrument that forms a mounting hole for a talar component, separate from the spacer. [Prior art documents] [Patent documents]

[0003] [Patent Document 1] Special Publication No. 2011-526189 [Patent Document 2] Japanese Patent Application Publication No. 2019-22697 Summary of the Invention [Problem to be solved by the invention]

[0004] There is potential for reducing the number of surgical steps in total ankle replacement surgery compared to conventional surgical instruments.

[0005] One aspect of the present disclosure provides a surgical instrument that reduces the number of times the instrument is attached and detached, thereby reducing the number of steps in the surgery. [Means for solving the problem]

[0006] A surgical instrument according to one aspect of the present disclosure comprises a main body portion having an upper surface shaped to match the tibial side surface of the implant and a lower surface shaped to match the talus side surface of the implant, and a bone resection guide portion located inside the main body portion and having a through hole that penetrates to the talus side.

[0007] Furthermore, a surgical instrument system according to one aspect of the present disclosure comprises the surgical instrument, a bone resection instrument, and a guide tube, wherein the bone resection instrument is an instrument that forms an attachment hole in the bone on the underside, into which a fixing portion protruding from the underside of the implant is embedded, and the guide tube, when inserted into the bone resection guide portion, guides the bone resection instrument to the position of the attachment hole. [Effects of the Invention]

[0008] According to one aspect of the present disclosure, the number of times instruments are attached and detached can be reduced, thereby reducing the number of surgical steps. [Brief explanation of the drawings]

[0009] [Figure 1] 1A and 1B are diagrams illustrating an example of use of a surgical instrument according to an embodiment of the present disclosure. [Figure 2] 2 is a view for explaining attachment of a guide tube and a first bone resection instrument to the surgical instrument shown in FIG. 1. FIG. [Figure 3] 1. FIG. 4 is a view illustrating the attachment of a second bone resection instrument to the surgical instrument shown in FIG. [Figure 4] FIG. 1 is a diagram showing the appearance of an implant. [Figure 5] FIG. 2 is a perspective view of the surgical instrument shown in FIG. 1 as seen from the side. [Figure 6] 2 is a perspective view of the surgical instrument shown in FIG. 1 as seen from the bottom side. FIG. [Figure 7] FIG. 2 is a side view of the surgical instrument shown in FIG. 1. [Figure 8] FIG. 2 is a cross-sectional view of the surgical instrument shown in FIG. [Figure 9] 2 is a diagram illustrating the relationship between a through-hole of the surgical instrument shown in FIG. 1 and a bone. FIG. [Figure 10] 2 is a diagram showing a through-hole of the surgical instrument shown in FIG. 1. FIG. [Figure 11] FIG. 10 is a view showing a state in which a first bone resection instrument is inserted into a through-hole. [Figure 12] FIG. 12 is an exploded perspective view of FIG. [Figure 13]FIG. 10 is a view showing a state in which a second bone resection instrument is inserted into a through-hole. [Figure 14] FIG. 14 is an exploded perspective view of FIG. [Figure 15] FIG. [Figure 16] FIG. [Figure 17] FIG. [Figure 18] FIG. 2 is a perspective view of a first bone resection instrument. [Figure 19] FIG. 10 is a perspective view of a second bone resection instrument. [Figure 20] FIG. 10 is another perspective view of the second bone resection instrument. [Figure 21] FIG. 10 is a side view of a second bone resection instrument. [Figure 22] FIG. 10 is a plan view of a second bone resection instrument. DETAILED DESCRIPTION OF THE INVENTION

[0010] Hereinafter, an embodiment of the present disclosure will be described with reference to the drawings. In the following, an example will be described in which a surgical instrument 1 functions as a spacer and a bone resection guide in artificial ankle joint replacement surgery.

[0011] In addition, in order to make the explanation clearer, the drawings may schematically show the width, thickness, shape, etc. of each part in comparison with the embodiment, and the width, thickness, shape, etc. of each part in the drawings do not limit the present disclosure.

[0012] <Summary> First, to facilitate understanding of the surgical instrument 1, an overview of the steps of an artificial ankle joint replacement surgery and an example of using the surgical instrument 1 will be briefly described with reference to the drawings. Ankle joint replacement surgery is a procedure in which a patient's ankle joint is replaced with an artificial ankle joint. In this embodiment, a configuration including a guide tube 30 and at least one of a first bone resection instrument 40 and a second bone resection instrument 50 used in combination with the surgical instrument 1 is called a surgical instrument system.

[0013] Figure 4 is a diagram showing the appearance of an implant 100 for an artificial ankle joint. The diagram designated by reference numeral 401 in Figure 4 is a perspective view of the implant 100 as seen from the front, and the diagram designated by reference numeral 402 is a perspective view of the implant 100 as seen from the side. Here, "front" refers to the direction in which the patient is viewed from the front when the implant 100 is fitted to the patient, and "side" refers to the direction in which the patient is viewed from the side and from the outside of the foot.

[0014] As shown in Figure 4, an implant 100 for an artificial ankle joint includes a tibial component 101 that is attached to the tibia A (see Figure 1) side, and a talus component 102 that engages with the tibial component 101 and is attached to the talus B (see Figure 1) side. The tibial component 101 has a fixing portion 101B formed on its upper surface for fitting into and fixing to the tibia A. The talus component 102 has a fixing portion 102B that protrudes from its lower surface for embedding into and fixing to the talus B.

[0015] The upper surface 102A of the talar side component 102 is formed as a convex curved surface in a side view, and the lower surface 101A of the tibial side component 101 is formed as a concave curved surface so as to fit along the upper surface 102A of the talar side component 102. The implant 100 is configured so that the upper surface 102A and the lower surface 101A slide back and forth relative to each other.

[0016] This allows a patient fitted with the implant 100 to perform movements such as dorsiflexion (extension) and plantar flexion (flexion) of the ankle. In order for the implant 100 to function without any problems in the patient's ankle joint, the position of the sliding surfaces between the talar side component 102 and the tibial side component 101 must roughly match the position of the sliding surfaces between the tibia A and the talus B in the patient's ankle joint before surgery. As will be described in more detail later, the surgical instrument 1 according to this embodiment has a function that makes it possible to easily align the implant 100 described above.

[0017] Fig. 1 is a diagram showing an example of use of a surgical instrument 1 according to this embodiment. In Fig. 1 to Fig. 3, human tissues other than the patient's tibia A and talus B are omitted from the illustration.

[0018] As shown in FIG. 1, the surgeon first determines the bone resection positions of the tibia A and the talus B, the amount of bone resection, the size of the implant 100 to be attached, and the like in the preoperative plan.

[0019] Next, the surgeon makes an incision in the patient's skin from the front of the patient's ankle to expose the tibia A and the talus B. Then, a portion of the lower end surface of the tibia A is removed to form a mounting surface A1 for attaching the tibial component 101, and a portion of the upper end surface of the talus B is removed to form a mounting surface B1 for attaching the talar component 102.

[0020] Next, the surgeon attaches the surgical instrument 1 to the holder 1A, inserts the surgical instrument 1 between the installation surface A1 and the installation surface B1, and checks whether the amount of bone resection is appropriate.

[0021] Figure 2 is a diagram explaining the attachment of a guide tube 30 and a first bone resection instrument 40 (bone resection instrument) to the surgical instrument 1, which will be described later, and Figure 3 is a diagram explaining the attachment of a second bone resection instrument 50 (bone resection instrument) to the surgical instrument 1.

[0022] 2, while the surgical instrument 1 is still inserted into the ankle joint, the surgeon attaches the guide tube 30 and the first bone resection instrument 40 to the surgical instrument 1. The first bone resection instrument 40 resects the talus B and cuts an attachment hole 103 for attaching the talar component 102.

[0023] 3, while the surgical instrument 1 is still inserted into the ankle joint, the surgeon attaches the second bone resection instrument 50 to the surgical instrument 1. The second bone resection instrument 50 adjusts the shape of the mounting hole 103 to match the shape of the fixing portion 102B of the talar component 102.

[0024] In this way, the surgeon can perform bone resection while leaving the surgical instrument 1 inserted into the ankle joint, without removing the surgical instrument 1. As will be described in detail later, this is because the surgical instrument 1 functions both as a spacer that confirms the amount of bone resection and as a bone resection guide that cuts the mounting hole 103 in the fixing portion 102B of the talar component 102. This eliminates the need for the separate steps of attaching the bone resection guide and confirming the mounting position of the attached bone resection guide, which were previously required after removing the spacer.

[0025] After the above steps, the surgeon forms the engagement portion 101B on the mounting surface A1 of the tibia A, attaches the tibial side component 101 to the mounting surface A1 of the tibia A, and the talar side component 102 to the mounting surface B1 of the talus B, thereby replacing the patient's ankle with an artificial ankle.

[0026] <Configuration of surgical instruments> Next, the configuration of the surgical instrument 1 will be described in detail with reference to Figures 5 to 8. Figure 5 is a perspective view of the surgical instrument 1 as seen from the side, Figure 6 is a perspective view as seen from the bottom, Figure 7 is a side view, and Figure 8 is a cross-sectional view of the surgical instrument 1 taken along the cutting plane VIII-VIII shown in Figure 5.

[0027] (spacer) 5 to 8, the surgical instrument 1 includes a main body 10 and a bone resection guide 20. Details of the bone resection guide 20 will be described later.

[0028] The main body 10 is formed to roughly resemble the shape of a combination of a tibial side component 101 and a talus side component 102. The main body 10 includes a tibial side portion 10A that resembles the tibial side component 101, and a talus side portion 10B that resembles the talus side component 102. The main body 10 has an outer shape that is similar to the outer shape of the implant 100.

[0029] The main body 10 has an upper surface 11 having a shape that matches the surface of the tibia A side of the tibial side component 101, and a lower surface 12 having a shape that matches the surface of the talus B side of the talus side component 102. The main body 10 also has approximately the same thickness as the implant 100.

[0030] The main body 10 may have at least a portion of its upper surface 11 shaped to match the surface of the tibia A side of the tibial component 101. The main body 10 may also have at least a portion of its lower surface 12 shaped to match the surface of the talus B side of the talus component 102.

[0031] Here, the thickness of the implant 100 refers to the distance between the contact surface 101C of the tibial component 101 with the tibia A and the contact surface 102C of the talar component 102 with the talus B when the tibial component 101 and the talar component 102 are engaged with each other. In particular, the thickness of the implant 100 may be the distance between the contact surfaces 101C and 102C when the implant 100 is attached to a patient's ankle joint in an artificial ankle joint replacement surgery. Moreover, the thickness of the main body 10 refers to the distance between the upper surface 11 and the lower surface 12.

[0032] This allows the main body 10 of the surgical instrument 1 to be inserted into the ankle joint where the bone has been resected, thereby making it possible to confirm whether the bone has been resected to fit the shape of the implant 100 to be fitted. In other words, the main body 10 functions as a spacer for checking the amount of bone resection.

[0033] In this way, the spacer that maintains a constant distance between the tibia A and the talus B has a first through-hole 21 that penetrates toward the talus B inside, so the surgical instrument 1 also serves as a bone resection guide. As a result, the bone can be cut while maintaining the distance between the tibia A and the talus B at a predetermined distance between the upper surface 11 and the lower surface 12, so there is no need to remove the spacer and install a separate bone resection guide instrument, and the number of surgical steps can be reduced.

[0034] (arc section and through hole) 9 is a diagram illustrating the relationship between the second through-hole 13 and the bone of the surgical instrument 1. As shown in FIGS. 5 to 9, an arc portion 14 is formed on the side surface of the main body 10 to indicate the position of the sliding surface, which is the boundary between the tibial component 101 and the talus component 102.

[0035] Furthermore, a plurality of second through holes 13 are formed in the main body 10, penetrating from one side surface to the other side surface along the arc portion 14. The second through holes 13 are formed so as to be parallel to the lower surface 12 of the surgical instrument 1 and a front side surface 16 located in front of the surgical instrument 1.

[0036] The second through hole 13 may collectively refer to, for example, three through holes: a central through hole 13a, a through hole 13b located posterior to the through hole 13a, and a through hole 13c located anterior to the through hole 13a. The number of second through holes 13 is not particularly limited and may be, for example, one, four or more. The cross-sectional shape of the second through hole 13 is also not particularly limited and may be, for example, a circular shape, an elliptical shape, a rectangular shape, or the like. As described above, in order for the implant 100 to function properly in the patient's ankle joint, the position of the sliding surface between the tibial side component 101 and the talus side component 102 needs to roughly coincide with the position of the sliding surface between the tibia A and the talus B in the patient's ankle joint before surgery.

[0037] The position of second through-hole 13 can be confirmed by performing intraoperative X-ray fluoroscopy. This makes it possible to confirm the position of second through-hole 13 by performing X-ray fluoroscopy even on the lateral side of the foot, which is covered with the patient's skin and cannot be seen. As described above, second through-hole 13 is formed so as to follow arc portion 14, and therefore the surgeon can confirm the position of arc portion 14, which indicates the sliding surface, from the position of second through-hole 13.

[0038] This allows the surgeon to check in advance, based on the position of the arcuate portion 14, the position of the sliding surface of the implant 100 when the implant 100 is later attached to the patient's ankle joint.

[0039] The through hole 13a is formed near the apex of the arc portion 14 along the left-right direction of the foot to which the implant 100 is attached. The through hole 13a is located approximately in the center of the width L1 (see FIG. 7) in the front-rear direction of the lower surface 12.

[0040] The through-hole 13b is formed at a position inclined rearward by an angle θ1 (see FIG. 7) with respect to a line L2 connecting the center point of the arc portion 14 and the through-hole 13a. In this embodiment, the angle θ1 is approximately 10 degrees. The through-hole 13b is also positioned at a position that passes approximately through the central axis L3 (see FIG. 9) of the tibia A.

[0041] The main body 10 is configured so that the rear of the tibia side portion 10A is inclined downward at an angle θ1 and the talus side portion 10B is approximately horizontal, thereby approximating the structure of the patient's ankle joint.

[0042] The surgeon checks the through holes 13a, 13b, the anterior-posterior width L1, the positional relationship with the tibia A, and the talus B, and then determines the mounting position of the talus side component 102 relative to the mounting surface B1 of the talus B.

[0043] After determining the mounting position of the talar side component 102, the surgeon may insert a fixation pin (not shown) into the fixation hole 15 (see Figure 5) of the surgical instrument 1 to fix the surgical instrument 1 to the mounting position of the talar side component 102 on the talus B.

[0044] (Bone resection guide) As described above, the surgical instrument 1 includes the main body 10 having a shape and thickness similar to the outer shape of the implant 100, and the bone resection guide 20. The surgical instrument 1 functions both as a spacer for checking the amount of bone resection and as a bone resection guide when cutting the mounting hole 103 of the talar component 102.

[0045] This allows the surgeon to perform bone resection while keeping the surgical instrument 1 inserted in the ankle joint, without removing the surgical instrument 1. This eliminates the need for a separate process of attaching a bone resection guide after removing the spacer, and a process of checking the attachment position of the attached bone resection guide.

[0046] Next, the bone resection guide portion 20 will be described below with reference to the drawings. Figure 10 is a diagram showing the first through-hole 21 of the surgical instrument 1.

[0047] 5 to 10 , the bone resection guide 20 is located inside the main body 10 and has a first through-hole 21 that penetrates toward the talus B. The first through-hole 21 penetrates from the anterior surface 16 to the lower surface 12 of the surgical instrument 1 and is formed at an angle with respect to the lower surface 12 and a perpendicular line to the lower surface 12. In other words, the first through-hole 21 is inclined toward the anterior surface 16, which is located on the anterior side of the foot to which the implant 100 is attached, with respect to the perpendicular line to the lower surface 12 of the main body 10. In other words, the first through-hole 21 is formed at an angle from the anterior surface 16 toward approximately the center of the installation surface B1 of the talus B where the mounting hole 103 is cut.

[0048] By placing the main body 10 in the ankle joint, the tibia A and the talus B are maintained at a predetermined distance, and a bone resection tool for resecting the talus B is inserted into the first through hole 21, and the bone resection tool is guided to the position where the mounting hole 103, which is the resection position of the talus B, is cut.

[0049] As a result, by inserting a bone resection tool into the first through-hole 21 of the bone resection guide portion 20, the bone resection tool can be guided at an appropriate angle to the position where the attachment hole 103 is cut.

[0050] The bone resection instrument is an instrument that cuts an attachment hole 103 in the talus B, into which the fixing portion 102B formed to protrude from the underside of the talus-side component 102 is embedded. The bone resection instrument includes a first bone resection instrument 40 realized by a drill or the like, and a second bone resection instrument 50 having a rectangular cutting portion 51 at its tip.

[0051] FIG. 11 is a view showing a state in which the first bone resection instrument 40 has been inserted into the first through-hole 21, and FIG. 12 is an exploded perspective view showing a state in which the first bone resection instrument 40 is about to be inserted.

[0052] As shown in FIGS. 11 and 12, the first bone resection instrument 40 is inserted into the bone resection guide portion 20 via the guide tube 30, and cuts an attachment hole 103 for attaching the talar component 102.

[0053] The guide tube 30, when inserted into the bone resection guide portion 20, guides the first bone resection instrument 40 to a position where the attachment hole 103 is to be cut.

[0054] FIG. 13 is a view showing a state in which the second bone resection instrument 50 has been inserted into the first through-hole 21, and FIG. 14 is an exploded perspective view showing a state in which the second bone resection instrument 50 is about to be inserted.

[0055] 13 and 14 , after the first bone resection instrument 40 has cut the mounting hole 103, the first bone resection instrument 40 and the guide tube 30 are removed, and instead the second bone resection instrument 50 is inserted into the bone resection guide part 20. The second bone resection instrument 50 is inserted directly into the bone resection guide part 20 without the guide tube 30 being attached to the bone resection guide part 20.

[0056] The second bone resection instrument 50 adjusts the shape of the attachment hole 103 cut by the first bone resection instrument 40 so that it matches the shape of the fixing portion 102B of the talar component 102.

[0057] <Guide tube and first bone resection instrument> Fig. 15 is a perspective view of the guide tube 30, Fig. 16 is a side view, and Fig. 17 is a plan view. As shown in Figs. 15 to 17, the guide tube 30 has a locking portion 31 (restriction mechanism), a first end face 32, a second end face 33, and an insertion hole 34 into which the first bone resection instrument 40 is inserted.

[0058] A plurality of locking portions 31 are formed so as to protrude from the outer peripheral surface of the guide tube 30. For example, two locking portions 31 are formed so as to be symmetrical with respect to an imaginary plane passing through the axis of the guide tube 30. The number of locking portions 31 is not particularly limited, and may be one, or three or more.

[0059] The first end surface 32 is one end surface of the guide tube 30 in the axial direction, and the guide tube 30 is inserted into the first through-hole 21 from the side of the first end surface 32. A locking portion 31 is formed near the first end surface 32.

[0060] The second end surface 33 is the end surface opposite to the first end surface 32 of the guide tube 30, and the first bone resection instrument 40 is inserted into the insertion hole 34 from the second end surface 33 side.

[0061] As described above, when the guide tube 30 is inserted into the first through hole 21 of the bone resection guide portion 20, the engaging portion 31 of the guide tube 30 engages with the groove portion 24b formed on the inner surface of the first through hole 21, thereby fixing the guide tube 30 to the bone resection guide portion 20.

[0062] 8 and 10, the inner diameter of first through-hole 21 is larger than the diameter of the main body of guide tube 30 but smaller than the diameter of guide tube 30 including locking portion 31. Two notches 23 are formed in the opening of first through-hole 21 at positions corresponding to locking portion 31 so that locking portion 31 of guide tube 30 can pass through.

[0063] Four grooves 24 are formed at intervals in the circumferential direction on the inner peripheral surface of the first through-hole 21. The grooves 24 are recessed in the radial direction to conform to the shape of the locking portion 31. Of the grooves 24, two opposing grooves 24a communicate with the notch 23, allowing the locking portion 31 to pass from the notch 23 of the opening to the grooves 24a. On the other hand, the two opposing grooves 24b other than groove 24a do not communicate with the notch 23, and therefore the locking portion 31 cannot pass from the grooves 24b to the opening.

[0064] When inserting the guide tube 30 into the first through-hole 21, the locking portion 31 is aligned with the notch 23 and inserted into the first through-hole 21. Next, when the guide tube 30 is rotated approximately 90 degrees, the locking portion 31 rotates and moves from the groove 24a that communicates with the notch 23 to the groove 24b that does not communicate with the notch 23. This prevents the guide tube 30 from coming off the first through-hole 21, and the guide tube 30 can be fixed to the bone resection guide 20. Furthermore, this reduces the possibility of the guide tube 30 becoming misaligned by operating the first bone resection instrument 40.

[0065] Fig. 18 is a perspective view of the first bone resection tool 40. As shown in Fig. 18, the first bone resection tool 40 is realized by a drill.

[0066] The first bone resection instrument 40 includes a drill portion 41 and a stopper 42. The outer diameter of the stopper 42 is formed to be larger than the inner diameter of the insertion hole 34 of the guide tube 30.

[0067] 11 and 12, the first bone resection instrument 40 is inserted, drill portion 41 first, into the insertion hole 34 of the guide tube 30 fixed to the bone resection guide 20. The outer diameter of the first bone resection instrument 40 from the tip to the stopper 42 is smaller than the inner diameter of the insertion hole 34, but the outer diameter of the stopper 42 is larger than the inner diameter of the insertion hole 34, so the first bone resection instrument 40 can be inserted into the insertion hole 34 up to the position of the stopper 42.

[0068] This makes it possible to limit the depth of the mounting hole 103 cut by the first bone resection tool 40. In this way, the guide tube 30 has a restriction mechanism that restricts the depth (operation range) of the mounting hole 103 cut by the first bone resection tool 40. This reduces the problem of the first bone resection tool 40 being inserted too deeply and cutting the mounting hole 103 deeper than the predetermined depth.

[0069] The talar side component 102 is available in a number of sizes to suit the size of the patient's ankle joint, and the length of the fixing portion 102B and other factors vary depending on the size. For this reason, the length of the mounting hole 103 into which the fixing portion 102B is embedded and other factors must also be changed depending on the size of the talar side component 102.

[0070] For this reason, the guide tube 30 is also prepared in a plurality of sizes according to the size of the talar side component 102, and is configured so that the position at which the locking portion 31 is formed differs depending on the size. This makes it possible to change the depth to which the guide tube 30 is inserted, and to change the position within the talus B to which the tip of the drill portion 41 of the first bone resection instrument 40 reaches. This makes it possible to change the depth of the mounting hole 103 drilled by the first bone resection instrument 40 according to the size of the talar side component 102. The first bone resection instrument 40 itself can be of the same size, even if the size of the talar side component 102 changes.

[0071] In this way, the guide tubes 30 are provided in different sizes, with the position at which the locking portion 31 is formed, so that the depth of the mounting hole 103 (the operating range of the first bone resection instrument 40) matches the size of the talus side component 102. This allows guide tubes 30 with different operating ranges of the first bone resection instrument 40 to be interchangeably attached to the bone resection guide unit 20.

[0072] <Second bone resection instrument> As described above, after the mounting hole 103 is cut with the first bone resection instrument 40, the first bone resection instrument 40 and the guide tube 30 are removed, and instead the second bone resection instrument 50 is inserted into the bone resection guide portion 20. The second bone resection instrument 50 is inserted directly into the bone resection guide portion 20 without attaching the guide tube 30 to the bone resection guide portion 20. The second bone resection instrument 50 further cuts the shape of the mounting hole 103 cut by the first bone resection instrument 40 to match the shape of the fixing portion 102B of the talar component 102.

[0073] 19 and 20 are perspective views of the second bone resection instrument 50, Fig. 21 is a side view, and Fig. 22 is a plan view. As shown in Figs. 19 to 22, the second bone resection instrument 50 is generally configured to have a shape that follows the fixing portion 102B of the talar side component 102, and includes a cutting portion 51, a stopper 52, and a guide surface 53.

[0074] The cutting part 51 has a blade at the tip, and when inserted into the first through-hole 21 of the bone resection guide part 20, it can further cut the shape of the mounting hole 103 cut by the first bone resection instrument 40 to adjust the shape to match the fixing part 102B. In addition, the cutting part 51 is configured so that the tip is tapered in side view and plan view.

[0075] By tapering the tip in this way, it is possible to reduce the problem of the implant 100 sinking into the talus B.

[0076] The guide surface 53 is the surface on the bottom side of the second bone resection instrument 50, and the second bone resection instrument 50 is inserted into the first through-hole 21 so that the guide surface 53 is aligned with the inner wall of the first through-hole 21.

[0077] This reduces the problem of excessive cutting of the rear side of the first through-hole 21 compared to when cutting evenly along the center line 54 of the cutting portion 51.

[0078] The outer diameter of the stopper 52 is formed to be larger than the inner diameter of the first through-hole 21 .

[0079] 13 and 14, the second bone resection instrument 50 is inserted from the cutting portion 51 into the first through-hole 21 of the bone resection guide portion 20. Since the outer diameter of the stopper 52 of the second bone resection instrument 50 is larger than the inner diameter of the first through-hole 21, the second bone resection instrument 50 can be inserted into the first through-hole 21 up to the position of the stopper 52.

[0080] This reduces the problem of the second bone resection instrument 50 being inserted too deeply and cutting deeper than the position of the attachment hole 103.

[0081] The second bone resection instrument 50 is prepared in a plurality of sizes corresponding to the size of the talus side component 102, and is configured such that the axial length W from the cutting portion 51 of the second bone resection instrument 50 to the stopper 52 differs depending on the size. This makes it possible to change the position within the talus B that the cutting edge of the cutting portion 51 of the second bone resection instrument 50 reaches, and to change the depth of the mounting hole 103 to be cut according to the size of the talus side component 102. Furthermore, the size of the second bone resection instrument 50 can be interchangeably attached according to the size of the talus side component 102.

[0082] The invention according to the present disclosure has been described above based on various drawings and examples. However, the invention according to the present disclosure is not limited to the above-described embodiments. In other words, the invention according to the present disclosure can be modified in various ways within the scope of the present disclosure, and embodiments obtained by appropriately combining the disclosed technical means are also included in the technical scope of the invention according to the present disclosure. In other words, it should be noted that a person skilled in the art can easily make various modifications or corrections based on the present disclosure. It should also be noted that these modifications or corrections are included in the scope of the present disclosure. [Explanation of symbols]

[0083] 1 surgical instruments 10 Main body 11 Top side 12 Bottom side 13 Second through hole 14 Arc section 16 Front side 20 Bone resection guide 21 First through hole 30 Guide tube 31 Locking portion (regulating mechanism) 40 First bone resection instrument (bone resection instrument) 50 Secondary bone resection instrument (bone resection instrument) 100 implants 101 Tibial component 102 Talus component 102B Fixed part 103 Mounting hole A tibia B Talus

Claims

1. a main body having an upper surface shaped to match the surface of an implant for an artificial ankle joint used in an artificial ankle joint replacement surgery that contacts the patient's tibia side, and a lower surface shaped to match the surface of the implant that contacts the patient's talus side; a bone resection guide portion located inside the main body portion and having a first through-hole penetrating the lower surface, an arc portion is formed on a side surface of the main body portion, the arc portion indicating the position of a sliding surface that is a boundary between a tibial component and a talar component of the implant; further comprising one or more second through holes; A surgical instrument, wherein the second through hole is provided in plurality along the arc portion.

2. The surgical instrument of claim 1 , wherein the body portion has a thickness that is approximately the same as a thickness of the implant.

3. The surgical instrument according to claim 1 or 2, wherein the bone resection guide guides a bone resection instrument that resects a bone to a resection position with the main body placed in the ankle joint.

4. The surgical instrument according to claim 1 or 2, wherein the first through-hole of the bone resection guide portion is formed at an angle with respect to the lower surface of the main body portion and a perpendicular line to the lower surface.

5. 3. The surgical instrument according to claim 1, wherein the first through hole of the bone resection guide portion is inclined toward a front surface located on the front side of a foot to which the implant is attached, with respect to a perpendicular line to the underside of the main body portion.

6. the main body portion has a front side surface located on the front side of the foot to which the implant is attached, The surgical instrument according to claim 1 or 2, wherein the bone resection guide portion penetrates from the front side surface to the bottom surface of the main body portion.

7. The surgical instrument of claim 1 , wherein the second through-hole is parallel to the lower surface and a front side surface located on the front side of the foot on which the implant is attached.

8. The surgical instrument according to claim 1 , wherein the second through-hole includes a through-hole formed near a vertex of the arc portion along the left-right direction of the foot to which the implant is attached.

9. The surgical instrument according to claim 1 or 2; a bone cutting instrument; a guide tube; the bone resection instrument is an instrument for forming an attachment hole in the bone on the lower surface of the talar component, the attachment hole being for embedding a fixing portion protruding from the lower surface of the talar component of the implant into the bone on the lower surface of the talar component; The guide tube, when inserted into the bone resection guide portion, guides the bone resection instrument to the position of the mounting hole.

10. The surgical instrument system according to claim 9 , wherein the guide tube has a restriction mechanism that restricts the range of motion of the bone resection instrument.

11. The surgical instrument system of claim 10 , wherein the guide tube has a locking portion that engages with the bone resection guide portion.

12. The surgical instrument system according to claim 11 , wherein the guide tube has the locking portion at a position corresponding to the range of motion of the bone resection instrument.

13. The bone resection instrument includes: a first bone resection instrument inserted into the bone resection guide portion through the guide tube; a second bone resection instrument that is inserted directly into the bone resection guide portion without attaching the guide tube to the bone resection guide portion, 10. The surgical instrument system of claim 9.

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