CN105769119B - Knee joint soft tissue balance measuring device and measuring method - Google Patents
Knee joint soft tissue balance measuring device and measuring method Download PDFInfo
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- CN105769119B CN105769119B CN201510390837.6A CN201510390837A CN105769119B CN 105769119 B CN105769119 B CN 105769119B CN 201510390837 A CN201510390837 A CN 201510390837A CN 105769119 B CN105769119 B CN 105769119B
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Abstract
The invention provides a knee joint soft tissue balance measuring device and a measuring method thereof, wherein the measuring device comprises: a datum plate, a movable plate, a base, a driver, a clearance indicator, an outward rotation indicator, and a load indicator, wherein the datum plate is fixedly connected to the base; the movable plate is rotatably connected to the driver; the gap indicator is connected with the driver; the outward rotation indicator is connected with the movable plate; the load indicator is connected with the driver; the driver is arranged on the base body. The measuring device and the measuring method thereof provided by the invention can simultaneously and comprehensively measure the extension gap, the knee bending gap, the physiological external rotation angle of the thighbone and the applied load, and can carry out pre-judgment according to the measured parameters and the original soft tissue balance condition before the knee bending gap is formed, so as to determine the knee bending gap according with physiological characteristics, thereby obtaining the expected perfect soft tissue balance.
Description
Technical field
The present invention relates to one kind operation tool used in total knee replacement operation, soft group of especially a kind of knee joints
Knit balance measuring device and its measurement method.
Background technique
Knee-joint active will be made of femur, shin bone and kneecap, and joint capsule is attached to the periphery of each bone articular cartilage, joint capsule
Around have ligament reinforcing, constitute soft group of knee joint by joint capsule, ligament, muscle, tendon, nerve, the blood vessel etc. at knee joint
It knits.
With the arrival of aging society, pathologic changes of knee joint has become a kind of common disease for influencing life of elderly person quality
Disease.Total knee arthroplasty is a kind of effective ways for treating advanced stage pathologic changes of knee joint.Total knee replacement refers to manually false
Knee joint that is seriously damaged and cannot exercising normal function restores it to eliminate kneed pain for body substitution
Stability and mobility.Figure 1A and Figure 1B is respectively the forward and backward knee joint schematic diagram of total knee replacement, and knee-joint prosthesis is main
Including femoral prosthesis, tibial prosthesis, positioned at low friction gasket (usually by ultrahigh molecular weight polyethylene at) between the two with
And patellar prosthesis.
In order to install prosthese, need to cut off femur and shin bone, so that the bone profile after cutting off can be with the peace of prosthese
Dress face matches.For example, cutting off step mainly includes cutting for proximal tibia (referring to close to one end of heart) for shin bone
It cuts；For femur, cut off step mainly include the distal femur one end of heart (refer to far from) cut off and femur before
Condyle, postartis, inclined-plane and intercondylar osteotomy.
As shown in Figure 2 A, it cuts off and is formed after distal femur cuts off face 200 completing distal femur, it is also necessary to by special
Osteotomy tool, such as four-in-one osteotomy plate 205, to femur preartis 201, postartis 202, positioned at distally cutting off face 200 and preartis
The first inclined-plane between 201 and osteotomy is carried out positioned at the second inclined-plane distally cut off between face 200 and postartis 202, then also wanted
Osteotomy is carried out to intercondylar 203.Distal femur cuts off the hole 204 on surface 200 for positioning and installing osteotomy plate 205.
Femur schematic diagram after completing osteotomy is as shown in Figure 2 B, and finally formed distal femur is cut off as we can see from the figure
Face 200a, femur preartis cut off face 201a, femoral-posterior condyles cut off face 202a, it is intercondylar cut off face 203a, connection femur preartis cut off
Face 201a and distal femur cut off the first inclined-plane 206a of face 200a and connection femoral-posterior condyles cut off face 202a and distal femur
Cut off the second inclined-plane 207a of face 200a.Fig. 2 C is the schematic diagram on the femur after femoral prosthesis is installed to osteotomy.
In total knee arthroplasty, restoration and reconstruction knee joint stretches the balance in gap and gap of bending the knee, interior lateral gap
Balance and corresponding soft tissue equalization of strain be influence operative effect committed step.
It is in the case where knee joint stretches, user passes through for stretching gap in current total knee arthroplasty
The mating common osteotomy instrument that knee-joint prosthesis supplier provides uses after carrying out the cutting off of distal femur and proximal tibia
The precision cut off is examined and assessed to general clearance measurement block, and takes the circumstances into consideration to make corresponding osteotomy and/or Soft Tissue Treatment, thus
It obtains and suitably stretches gap.
And for gap of bending the knee, usually in the case where knee joint is bent the knee, user is according to the condyle of femur size of measurement
The outward turning angle given on the tool that model and producer provide, to determine the placement location of four-in-one osteotomy plate, by cutting off
After femoral-posterior condyles, the precision cut off is examined and assessed using general clearance measurement block, and compare inspection with gap is stretched,
Then take the circumstances into consideration to make corresponding osteotomy and/or Soft Tissue Treatment, to obtain suitable bending knee gap.
In above process, more than one piece surgical instrument is not only needed to be used cooperatively, moreover, because the tool that producer provides
On outward turning angle be it is given, usually the outward turning situation with patient femur itself is not inconsistent, therefore outside this artificial settings femur
The way of swing angle degree, it is likely that bring huge difficulty to subsequent osteotomy and soft tissue balance.In addition, due to stretch gap and
Balance, the balance of interior outside soft tissue in bending knee gap depend entirely on the experience of user, even if accomplishing to stretch gap and bend
Knee gap size is equal, but can not quantify applied respective loads, i.e., corresponding soft tissue tension balance.Therefore, without true
Normal incidence realizes soft tissue balance, and it is even more impossible to according to the physiological conditions of patient itself, determine outer swing angle before bending knee gap is formed
Degree carries out soft tissue balance.
In existing some patent documents, it has been described that the measuring appliance in some total knee arthroplastys, such as in
The isotonic measuring appliance of total knee replacement soft tissue balance and Chinese patent Shen disclosed in state's number of patent application 200620014638.1
Please lateral balance tonometry device inside and outside knee joint disclosed in numbers 200820124249.3, but these measuring appliances can only all measure knee pass
Section stretches gap size and the bending knee gap size after femoral-posterior condyles are cut off, and is unable to measure the outward turning angle of femoral-posterior condyles,
Also can not quantify applied respective loads, thus cannot before bending knee gap is formed, according to the physiological conditions of patient itself into
Row soft tissue balance only measures the size for stretching gap and gap of bending the knee, cannot achieve real soft tissue balance.
Summary of the invention
The first purpose of this invention is to provide a kind of knee joint soft tissue balance measuring device and its measurement method, with
Before being formed convenient for user in bending knee gap, i.e., before femoral-posterior condyles are cut off, according to the physiological conditions of patient itself, determine balance
Bending knee and stretches gap, the balance of interior lateral gap and corresponding equalization of strain at gap, realizes real soft tissue balance, thus
The uncertainty for reducing the surgical technic to vary with each individual, improves the postoperative effect of artificial full knee joint transposing.
In order to realize the goal of the invention, the present invention provides a kind of knee joint soft tissue balance measuring devices, comprising: benchmark
Plate, movable plate, matrix, driver, gap indicator, outward turning indicator and load indicator, wherein the datum plate is fixed
Ground is connected to described matrix；The movable plate is rotatably connected to the driver by shaft, and in the driving
Under the driving of device, far from or close to the datum plate；The gap indicator is connected with the driver, closes for measuring knee
The size for stretching gap and gap of bending the knee of section；The outward turning indicator is connected with the movable plate, for measuring femur
Cut off the angle in face and/or the outward turning angle of femoral-posterior condyles in distal end；The load indicator is connected with the driver, is used for
When measuring soft tissue balance, the size of institute's femur and shin bone application load；The driver is set to described matrix.
The present invention provides a kind of knee joint soft tissue balance measurement methods, comprising: under knee joint straight configuration, makes institute
It states datum plate contact proximal tibia and cuts off face, under the driving of the driver, cut the movable plate contact distal femur
Section；According to the reading of the outward turning indicator for displaying, judge whether to need to carry out osteotomy and/or soft tissue balance again, such as
Otherwise next step is carried out, then carries out osteotomy again and/or soft tissue balance in this way up to the reading of the outward turning indicator for displaying
Number is zero；According to the reading in described matrix, the numerical value of the first gap (stretching gap) is obtained, and is referred to according to the load
Show the reading on device, obtains the numerical value of the first load；Face is cut off from the distal femur and the proximal tibia is cut off between face
Take out the measuring device；Under knee sprung state, datum plate contact proximal tibia is cut off into face, in the driving
Under the driving of device, make the movable plate contact femoral-posterior condyles；Pass through first gap and the postartis of selected femoral prosthesis
Thickness struts the femoral-posterior condyles and the proximal tibia face of cutting off to suitable position；Or the numerical value according to the first load, by institute
It states femoral-posterior condyles and tibial plateau is strutted to suitable position；At this point, according to the reading on the load indicator and gap indicator
Number obtains the numerical value of the second load and the second gap；And according to the numerical value of first load and the number of second load
The comparison result of value judges whether to need further Soft Tissue Treatment；Or numerical value and the second gap according to the first gap
Numerical value comparison result, judge whether to need further Soft Tissue Treatment；Meanwhile according to the reading on the outward turning indicator
Number, obtains the outward turning angle of femoral-posterior condyles.
Through the above technical solutions, the present invention provides a kind of knee joint soft tissue balance composite measurements of multifunctional unit
Device and its measurement method do not need to reuse clearance measurement block after using measuring device of the invention.It provides and is applied simultaneously
The size of the external load added is farthest quantified the personal experience of operating doctor by numerical value.Therefore, it can bend
Before knee gap is formed, according to the physiological conditions of parameter and patient itself that measurement obtains, it is determined for compliance with the bending knee gap of its feature,
To obtain expected perfect soft tissue balance.The big data analysis of specific outward turning degree can mention for China's clinical research
For strong ocular proof.
It is another object of the present invention to provide a kind of knee joint soft tissue balance measuring devices, in order to which user exists
When carrying out stretching gap and bending knee clearance measurement and soft tissue balance, reduce since kneecap is overturn to brought by soft tissue balance
It influences.
In order to realize the goal of the invention, the present invention provides a kind of knee joint soft tissue balance measuring devices comprising base
Quasi- plate, movable plate, matrix, driver and gap indicator；Wherein, the datum plate is fixedly connected to described matrix；Institute
It states movable plate and the driver is rotatably connected to by shaft, and under the driving of the driver, it is separate or lean on
The nearly datum plate；The gap indicator is connected with the driver, kneed stretches gap and bending knee for measuring
The size in gap；The movable plate and the datum plate are biased relative to described matrix；The driver is set to the base
Body.
Through the above technical solutions, the movable plate and the datum plate are biased relative to described matrix, therefore, use
Person can implement in situ in kneecap and bend and stretch gap soft tissue balance, farthest reduce in traditional operation since kneecap is overturn
It is influenced on brought by soft tissue balance.
It is yet a further object of the present invention to provide a kind of knee joint soft tissue balance measuring device, in order in measurement and
After balance stretches gap and bending knee gap, the result of measurement balance is directly output to subsequent procedures instrument, forms seamless interfacing.
In order to realize the goal of the invention, the present invention provides a kind of knee joint soft tissue balance measuring devices comprising base
Quasi- plate, movable plate, matrix, driver, gap indicator and osteotomy guider；The datum plate is fixedly connected to the base
Body；The movable plate is rotatably connected to the driver by shaft, and under the driving of the driver, separate
Or close to the datum plate；The gap indicator is connected with the driver, for measure it is kneed stretch gap and
The size in bending knee gap；The driver is set to described matrix；The osteotomy guider and the datum plate keep mutually hanging down
Directly, and with the movable plate synchronizing moving is kept, there is at least a pair of of pilot hole on the osteotomy guider, it is described two
The line of pilot hole is parallel with the datum plate.
Through the above technical solutions, can realize using the pilot hole on osteotomy guider as location hole, locating pin is squeezed into, with
The operating procedure of subsequent installation osteotomy plate forms seamless interfacing, thus for the suitable outward turning angle of condyle of femur, it is no longer artificial strong
Row setting, but suitable angle is determined completely in accordance with the physiological conditions of patient's ontology, after bending knee gap is formed, obtain pre-
The perfect soft tissue balance of phase.
Detailed description of the invention
Figure 1A and Figure 1B is respectively the forward and backward knee joint schematic diagram of total knee replacement；
Fig. 2A to 2C cuts off for femur and prosthese scheme of installation；
Fig. 3 is the structural schematic diagram of the knee joint soft tissue balance measuring device of a preferred embodiment of the present invention；
Fig. 4 is the decomposition diagram of the section components in measuring device shown in Fig. 3；
Fig. 5 is the decomposition diagram of section components in driver shown in Fig. 3；
Fig. 6 is the structural schematic diagram of movable plate and the first connector shown in Fig. 3；
Fig. 7 is the decomposition diagram of outward turning measuring appliance shown in Fig. 3；
Fig. 8 is that the structural schematic diagram after osteotomy guider is installed on movable plate shown in Fig. 6；
Fig. 9 is the structural schematic diagram of the knee joint soft tissue balance measuring device of another embodiment；
Figure 10 is the structural schematic diagram of the knee joint soft tissue balance measuring device after being mounted with osteotomy guider.
Specific embodiment
Below in conjunction with the drawings and specific embodiments to knee joint soft tissue balance measuring device proposed by the present invention and its survey
Amount method is described in further detail.According to following explanation and claims, advantages and features of the invention will be become apparent from.
It should be noted that attached drawing is all made of very simplified form and may not use accurately ratio, only conveniently, lucidly to assist
Illustrate the purpose of the embodiment of the present invention.
Fig. 3 is referred to, the structural representation of knee joint soft tissue balance measuring device is a preferred embodiment of the present invention
Figure, the measuring device mainly includes datum plate 10, movable plate 20, matrix 30, driver 40, gap indicator 50, outward turning
Indicator 60, load indicator 70 and lock 80.It will be described in detail their structure, effect and its connection relationship below.
In the present embodiment, datum plate 10 and movable plate 20 are the two boards shape object that shape is similar, and are all had uniform
Thickness and even curface.Movable plate 20 is rotatablely arranged at the top of datum plate 10, and has equilibrium state and rotation
Turn state, when movable plate 20 is in equilibrium state, movable plate 20 is parallel with datum plate 10, when movable plate 20 is in
When rotation status, movable plate 20 and datum plate 10 are not parallel.
Datum plate 10 defines a datum level, for convenience of explanation, the length direction of datum plate 10 is defined as X-direction,
Width direction is defined as Y-direction, then X-Y plane expression can be used in the datum level, and the direction definition perpendicular to datum level is the side Z
To.The definition of all directions forward direction, as shown in Figure 3.Above-mentioned movable plate 20 is parallel with datum plate 10 to be referred to: movable plate 20 it is upper
Surface is parallel to the datum level.
Datum plate 10 and movable plate 20 can be regular shape, or irregular shape, benchmark shown in Fig. 3
Plate 10 and the substantially kidney ellipsoid of movable plate 20, and middle has the notch (see Fig. 3 and 6) of an indent in the direction of the width,
The design of the shape mainly cooperates the physiological structure of measurand.Certainly, in other embodiments, the datum plate and can live
Movable plate may be shape, two boards shape object, tablet or any other suitable shape of different sizes, and the present invention is to this
With no restrictions.
Matrix 30 extends along the Z direction, and therefore, matrix 30 is arranged to vertical relative to datum plate 10.As shown in figure 3,
Matrix 30 has cylindrical-shaped structure, inner hollow.Certainly, those skilled in the art are it is contemplated that matrix 30 can also have
There are rectangular parallelepiped structure or other structures, the present invention is without limitation.Datum plate 10 is arranged to relatively fixed with matrix 30, can
Movable plate 20 is connected to driver 40, and specific connection relationship will be described below.
Gap indicator 50 includes gap scale substrate 51 and gap indicate indicator 52 (see Fig. 4 and Fig. 5), in the present embodiment
In, gap scale substrate 51 is structure as a whole with matrix 30, and gap scale is provided on gap scale substrate 51, can for showing
The size of the distance between movable plate 20 and datum plate 10.Gap indicate indicator 52 is connected with driver 40, therefore, is driving
Under the driving of device 40, gap indicate indicator 52 with movable plate 20 together along matrix 30, in z-direction relative to datum plate 10
It is mobile.In the process, the synchronous variation of the distance between movable plate 20 and datum plate 10 generation, the distance can be carved by gap
It is read on gap scale on degree substrate 51.
Please referring also to Fig. 3 to Fig. 5, as described above, driver 40 is connected with movable plate 20, it is movable for driving
Plate 20 is moved up and down relative to datum plate 10, and in the present embodiment, driver 40 includes first handle 41, second handle 42, the
One actuator 43, the first elastic component 44, the second actuator 45 and the second elastic component 46.Matrix is fixed in one end of first handle 41
30, the other end is held for user, and datum plate 10 is fixed on one end of first handle 41, to be indirectly secured to matrix 30.The
One end of two handles 42 is rotatably coupled first actuator 43, and the other end is held for user, and first handle 41
First pivoting portion 411 is connected with the second pivoting portion 421 of second handle 42.First actuator 43, the first elastic component 44, second
Actuator 45, the second elastic component 46 are successively stacked in matrix 30 from bottom to up.
Please referring also to Fig. 3 to Fig. 6 is additionally provided with the first connector 22 (see Fig. 6) and the second connector outside matrix 30
11 (see Fig. 3), the first connector 22 is for connecting movable plate 20 and the second actuator 45, to connect movable plate 20 and drive
Dynamic device 40, the second connector 11 is for connecting datum plate 10 and first handle 41.First connector 22 and the second connector 11 are flat
Row setting.When user presses first handle 41 and behind second handle 42, second handle 42 drives the first actuator 43 to moving up
Dynamic, so that the second actuator 45 be driven to move up in matrix 30, the first connector 22 of driving drives movable plate 20 opposite
It is moved up in datum plate 10.
Please referring also to Fig. 4 and Fig. 5 is also provided with the first sliding groove 31 on matrix 30, further includes positioning column in matrix 30
32, the first actuator 43, the first elastic component 44, the second actuator 45 and the second elastic component 46 are sheathed on positioning column 32, and first is sliding
Dynamic slot 31 is opened in along the Z direction on matrix 30, in order to which the first actuator 43 is connected simultaneously phase with external second handle 42
Matrix 30 is moved up and down.
Second actuator 45 includes central part 451, a pair of outer adjutage 452 and external tabs 453.Central part
451 are connected with external adjutage 452, and its inside for being set to matrix 30, and external adjutage 452 is sheathed on matrix 30
Outside, external tabs 453 are separately connected external adjutage 452 and the first connector 22.Central part 451, a pair of outer extend
Arm 452 and external tabs 453 can be integrally formed, and the present invention is without limitation.
Preferably, when moving up and down along the Z direction, outside is prolonged when the second actuator 45 is under the driving of second handle 42
Semi-girder 452 is moved up and down also along the outer surface of matrix 30.In the present embodiment, gap indicate indicator 52 is set to external extension
On arm 452, it is used to indicate gap scale, and preferably, the two is structure as a whole, so that total is more compact and smart
It is quasi-.The second sliding groove (not shown) is also provided on matrix 30, in order to which central part 451 is connected with external adjutage 452
Part passed through from it.
See Fig. 3, Fig. 6 and Fig. 7, movable plate 20 has shaft 21, and shaft 21 is connected with the first connector 22, thus
So that movable plate 20 can be rotated around the axis of shaft 21.Movable plate 20 is also connected with outward turning indicator 60, in order to
While the rotation of movable plate 20, outward turning indicator 60 is driven to work.Specifically, outward turning indicator 60 is carved including outward turning
Degree substrate 61 and outward turning indicate indicator 62, outward turning scale substrate 61 are fixed on the first connector 22, and are provided on outer surface outer
Scale is revolved, and shaft 21 is connected with outward turning indicate indicator 62, to drive outward turning indicate indicator 62 in outward turning scale substrate 61
Upper movement.
Specifically, outward turning indicator 60 further includes STATEMENT OF FEDERALLY SPONSORED 63, and STATEMENT OF FEDERALLY SPONSORED 63 is connected with shaft 21 by shape cooperation,
There is small tooth in STATEMENT OF FEDERALLY SPONSORED 63, be provided with linkage portion 621 in outward turning indicate indicator 62, small tooth is also equipped in linkage portion 621, lead to
Crossing STATEMENT OF FEDERALLY SPONSORED 63 drives the linkage of linkage portion 621, it can be achieved that driving to outward turning indicate indicator 62.
Certainly, the above is only one kind that driver 40 drives movable plate 20, the linkage outward turning indicator 60 of movable plate 20
Embodiment, in fig. 9, it is further seen that the another embodiment of driver 40, with implementation explained before
Similar, the first elastic component 44, the second actuator 45 and the second elastic component 46 are still sheathed on positioning column 32, but unlike, the
One actuator 43 is fixed with 32 phase of positioning column in matrix 30, and the first actuator 43 is located at outside matrix 30.
Person in the art can make a variety of mapping modes after with reference to above-described embodiment, so that movable plate
20 under the driving of driver 40, move up and down along the Z direction (such as V belt translation, chain conveyer, gear drive, Worm-drive and
Lead screw transmission) and rotated about the axis of shaft, in the case where movable plate 20 rotates, outward turning refers to outward turning indicator 60
Show that component 62 moves (such as STATEMENT OF FEDERALLY SPONSORED 63 and 621 frictional drive of linkage portion or linkage portion 621 on outward turning scale substrate 61
It directly links with shaft 21).The present invention is without limitation.
See Fig. 3 and Fig. 5, in the present embodiment, load indicator 70 includes load scale substrate 71 and load instruction unit
Part 72.Load scale substrate 71 is set to 30 side of matrix, extends also along Z-direction, and along the direction in load scale
The two sides of substrate 71 are provided with load scale.Load scale substrate 71 is fixed with 43 phase of the first actuator, load indicate indicator
72 are connected with driver 40, so that when second handle 42 drives the first actuator 43 mobile, while with dynamic loading scale
Substrate 71 and load indicate indicator 72 do relative motion.
It is noted that load indicate indicator 72 may also set up in external adjutage 452, and preferably, prolong with outside
Semi-girder 452 is in integral structure.As shown in Figures 3 to 5, gap indicate indicator 52 is located at the lower section of external adjutage 452, between
Gap scale on gap scale substrate 51, indicates gap scale, and load indicate indicator 72 is located at external adjutage 452
End is directed toward load scale substrate 71, is indicated load scale, so that user is more convenient, rapidly obtains phase
Close parameter, and make the structure of measuring device it is more succinct, it is compact and convenient for operation.
See Fig. 3 and Fig. 4, in the present embodiment, lock 80 is set on first handle 41, and including a pair of of press section
81, sticking department 82 and articulated section 83.Two press sections 81 are located at the two sides of the same end of lock 80, for user arbitrarily left and right
Hand pressing and facilitate operation when for left knee or right knee, and sticking department 82 is located at the other end of lock 80, for locking
Or release load indicator 70, articulated section 83 is between press section 81 and sticking department 82, for being connected with first handle 41.
Specifically, there are multiple small teeth on sticking department 82, and the side of load indicator 70 also has multiple small teeth, passes through
The engagement of between cog, lock 80 can lock load indicator 70.After locking, since second handle is unable to drive load
Indicator 70 is mobile, therefore, is also unable to drive the movement of the first actuator 43, the position holding of movable plate 20 and datum plate 10 is not
Become.When user pressure-locks the press section 81 of device 80, sticking department 82 is far from load indicator 70, i.e., releasable load instruction
Device 70, driver 40 can operate.
Preferably, reset components such as torsional spring can be used at articulated section 83, so that after user unclamps press section 72,
Lock 80 automatically resets, and locks load indicator 70.Certainly, there are many structure of lock 80 and set-up modes, can pass through
Other mechanisms realize the locking to driver 40, for example, locking device shown in Fig. 9, it can be by being arranged in first handle
Buckle 41a on 41, and the holding section 42b being arranged between second handle 42 and first handle 41 lock driver 40, this hair
It is bright without limitation.
Fig. 8 and Figure 10 are referred to, preferably, the knee joint soft tissue balance measuring device in the present embodiment further includes having to cut
Bone guider 90 is removable installed in the top of movable plate 20, and perpendicular with datum plate 10, and osteotomy guider 90 has
There is at least a pair of of pilot hole, this is parallel with the datum level where datum plate 10 to the line of pilot hole.In the present embodiment, it cuts
Bone guider 90 is removably vertically installed on the first connector 22.
Fig. 3 and Figure 10 are referred to, more optimally, rotatable plate 20 and datum plate 10 can be biased relative to matrix 30, also
It is to say, the projection of the axis of the shaft 21 of rotatable plate 20 and the central axis of datum plate 10 on X/Y plane is without matrix
Projection of 30 central axis on X/Y plane.Further, rotatable plate 20 and datum plate 10 are optionally offset to base
Either side during two of body 30 are not ipsilateral is to adapt to the requirement of left knee or right knee.
Specifically, the first connector 22 is that the second actuator 45 is connected in a manner of removably.Second connector 11
It is that matrix 30 is connected in a manner of removably.Datum plate 10 can be integrally formed with the second connector 11, and the present invention does not do this
Limitation.When the first connector 22 is removed together with rotatable plate 20 from the second actuator 45, and the second connector 11 is together with benchmark
After plate 10 is removed from first handle 41, the first connector 22 and the second connector 11 are overturn with 180 degree, still first can be connected
Fitting 22 is connected to the second actuator 45, and the second connector 11 is connected to first handle 41, and the upper surface of rotatable plate 20
Locative cue mark, such as LEFT and RIGHT can be also printed on lower surface to adapt to the requirement of left knee or right knee.
Further, the first connector 22 is cooperated with the second actuator 45 by centrosymmetric structure, for example, first
It is rectangular interconnecting piece that connector 22, which has section, and the second actuator 45 has corresponding slot.When the first connection
After part 22 overturns 180 degree, the slot that the interconnecting piece is inserted into the second actuator 45 can still be by, realize that the two is relatively solid
It is fixed.Certainly, centrosymmetric structure be also possible to section be square, the structure of the other shapes such as diamond shape.Likewise, the second connection
Part 11 is cooperated with first handle 41 also by centrosymmetric structure.
By foregoing description, the structure of the knee joint soft tissue balance comprehensive measurement device in the present embodiment ten is distinguished
It is clear, next, will be described in advantage of the measuring device compared to existing measuring device, and filled by using the measurement
The new measurement method of the one kind that can be carried out is set, so that before bending knee gap is formed, so that it may the parameter and disease obtained according to measurement
The physiological conditions of people itself are determined for compliance with the bending knee gap of its feature, to obtain expected perfect soft tissue balance.
In total knee arthroplasty, user implements femoral far first, in accordance with actual demand and corresponding operation skill
End is cut off cuts off with proximal tibia, to obtain, distal femur cuts off face and proximal tibia cuts off face.The knee joint of patient is stretched,
And through this embodiment in knee joint soft tissue balance measuring device, measurement distal femur cuts off face and proximal tibia cuts off face
Between stretch gap.Specifically, user holds first handle 41 and second handle 42, makes datum plate 10 and movable plate 20
Insertion distal femur cuts off face and proximal tibia is cut off between face, and drives movable plate 20 far from datum plate 10, makes movable
Plate 20 contacts distal femur and cuts off face, and datum plate 10 contacts proximal tibia and cuts off face.
At this point, if the outward turning indicate indicator 61 on outward turning indicator 60 not in zero-bit, that is, illustrate distal femur cut off face and
It is not yet parallel that proximal tibia cuts off face, and interior lateral gap is uneven, then user takes the circumstances into consideration the soft of osteotomy again and/or internal outside
Tissue is handled, and the distal femur face of cutting off is adjusted parallel to face is cut off with proximal tibia.Then, user can pass through matrix
Gap scale on 30, reads that distal femur cuts off face and proximal tibia cuts off the first gap (stretching gap) between face
Numerical value, while under reading in the position together, the numerical value of the first load on load indicator 70.
Then, user takes out the measuring device and knee joint is placed in 90 degree of bending knee according to suitable operation skill
Position, then this measuring device is inserted between femoral-posterior condyles and shin bone again.It is worth noting that, femoral-posterior condyles at this time are still
It is not cut off, user holds first handle 41 and second handle 42 again, and drive movable plate 20 far from datum plate 10, and
Femoral-posterior condyles are contacted, datum plate 10 contacts proximal tibia and cuts off face.
Since femur is there are certain outward turning angle, the movable plate 20 for contacting femoral-posterior condyles can also deflect, this
When, user can directly read the outward turning degree shown on outward turning indicator 60, to understand the outer of patient's femur at this time itself
Swing angle degree, the outward turning angle show the truth of the femoral-posterior condyles of patient, for subsequent big data analysis, have important
Meaning especially can provide strong ocular proof for the clinical research of Chinese population femoral-posterior condyles.
User can be utilized by the postartis thickness of the femoral prosthesis for stretching gap and selecting installation later measured before
Movable plate 20 and datum plate 10, femoral-posterior condyles and the proximal tibia face of cutting off are strutted to suitable position；Or according to surveying before
The physiological conditions of the first load data and patient itself that obtain, are strutted femoral-posterior condyles and the proximal tibia face of cutting off using this instrument
To suitable position.At this time, it may be necessary to read again the second load on load indicator 70 and gap indicator 50 and the second gap
Numerical value, and the numerical value of second load is compared with the numerical value of first load, the numerical value in the second gap and first
The numerical value in gap compares, and the size for bending and stretching gap and corresponding equalization of strain is determined, to realize real soft tissue balance.
Therefore, after having used knee joint soft tissue balance comprehensive measurement device provided by the present embodiment, user can
To carry out before femoral-posterior condyles cut off, to whether capable of obtaining soft tissue balance after cutting off and prejudge, and in whole process
The size in gap is bent and stretched, the soft tissue feelings of patient itself are complied in the determination of the balance and femur outward turning angle of corresponding tension
Condition really obtains perfect soft tissue balance.
It is noted that also more preferably including in knee joint soft tissue balance comprehensive measurement device provided by the present invention
Osteotomy guider 90 has at least a pair of of pilot hole on osteotomy guider 90, this line and datum plate 10 institute to pilot hole
Datum level it is parallel.The different location of pilot hole can correspond to the lateral femoral condyle prosthesis of different model.Therefore, when user exists
It is read after judging to gap, bending knee gap, the second load reading and first load is stretched, such as thinks that femoral-posterior condyles are cut
After cutting, perfect soft tissue balance can be obtained, then may be selected to utilize osteotomy guider 90, suitable pilot hole is selected, in stock
Two pieces of steinman pins are hammered on bone postartis, so that subsequent osteotomy plate carries out osteotomy according to the position of the steinman pin.
In this way, bending knee gap between the femoral-posterior condyles surface after osteotomy and femur platform with stretch gap balance each other, it is interior
Lateral gap balance, the first load and the second load balance each other, to realize perfect soft tissue balance.That is, passing through
The osteotomy of knee joint soft tissue balance measuring device provided by the present invention, the measuring process and latter step that may make back walks
It is rapid to carry out seamless interfacing.
More preferably, during measuring, osteotomy guider 90 can be first removed or not install, so that measurement process
It is more convenient, and after being determined that femoral-posterior condyles and proximal tibia cut off the relative position in face, then osteotomy guider 90 is installed, into
Row nailing process.
Further, in the introduction of knee joint soft tissue balance measuring device, rotatable plate 20 and benchmark were once referred to
Plate 10 can be biased relative to matrix 30, and such design can reduce the damage for patient's kneecap and corresponding soft tissue.It is specific next
It says, in total knee arthroplasty, user at the knee joint of patient firstly the need of cutting an art mouth, and this art mouth position
In the side of kneecap, in traditional operation, user needs to open the musculature with kneecap, measures, and utilizes
The measuring device of the present embodiment, since rotatable plate 20 and datum plate 10 are optionally offset to the left side or the right side of matrix 30
Side, therefore, user can kneecap in situ implement measurement and soft tissue balance, farthest reduce in traditional operation due to
Kneecap overturning is influenced on brought by soft tissue balance.
Further, for the knee joint of left and right, art mouth is all located at kneed inside, and the right knee joint is come
It says, in order to enable kneecap keeps original position, rotor plate 20 and datum plate 10 need to be offset to the left side (as shown in Figure 3) of matrix 30；
And for the knee joint on the left side, in order to enable kneecap keeps in situ, rotor plate 20 and datum plate 10 need to be offset to matrix
30 right side.Therefore, user may be selected the first connector 22 is removed together with rotatable plate 20, by the second connector 11 together with
Datum plate 10 removes, and after overturning 180 degree, then they is respectively connected to the second actuator 45 and first handle 41, with using same
One measuring device selectively carries out the kneed operation on the right or the left side.Therefore, the measuring device can be applicable in simultaneously
In left and right knee joint.
In conclusion the present invention provides a kind of knee joint soft tissue balance measuring device of multifunctional unit and its measurements
Method does not need to reuse clearance measurement block after using measuring device of the invention.For the suitable outward turning angle of femur,
It no longer artificially sets by force, but determines suitable angle the case where completely in accordance with patient's ontology.The big data of outward turning degree
Analysis, can provide strong ocular proof for China's clinical research.In addition, using measuring device of the invention, it can be simultaneously
The size of applied external load is provided, farthest quantifies the personal experience of operating doctor by numerical value.This survey
The result output for measuring device, is realized, the use with subsequent procedures instrument by osteotomy guider, forms seamless interfacing.And
The Unique physical design (being optionally biased) of the measuring device is suitable for left and right knee joint, and makes operating doctor
It can be implemented in situ in kneecap and bend and stretch gap soft tissue balance, farthest reduced in traditional operation since kneecap is overturn to soft
It is influenced brought by structural equation.
Foregoing description is only the description to present pre-ferred embodiments, not to any restriction of the scope of the invention, this hair
Any change, the modification that the those of ordinary skill in bright field does according to the disclosure above content, belong to the protection of claims
Range.
Claims (22)
1. a kind of knee joint soft tissue balance measuring device characterized by comprising
Datum plate, movable plate, matrix, driver, gap indicator, outward turning indicator and load indicator,
Wherein, the datum plate is fixedly connected to described matrix；The movable plate is rotatably connected to institute by shaft
Driver is stated, and under the driving of the driver, far from or close to the datum plate；The gap indicator and the drive
Dynamic device is connected, for measuring the kneed size for stretching gap and gap of bending the knee；The outward turning indicator is lived with described
Movable plate is connected, and cuts off the angle in face and/or the outward turning angle of femoral-posterior condyles for measuring distal femur；The load indicator
It is connected with the driver, when for measuring soft tissue balance, to the size of femur and the applied load of shin bone；The driving
Device is set to described matrix；
The driver includes first handle, second handle, the first actuator, the first elastic component, the second actuator and the second bullet
Property part；Described matrix is fixed in one end of the first handle, and one end of the second handle is rotatably coupled described first
Actuator, and the first handle is rotationally connected with the second handle；First elastic component, second driving
Part, second elastic component are successively stacked in described matrix from bottom to up.
2. knee joint soft tissue balance measuring device according to claim 1, which is characterized in that further include the first connector
With the second connector, first connector is connected with the driver, the movable plate by the shaft with it is described
First connector is connected；Second connector and the datum plate are relatively fixed, and are fixed on described matrix；Described first
Connector is arranged to parallel with second connector.
3. knee joint soft tissue balance measuring device according to claim 2, which is characterized in that the movable plate and institute
Datum plate is stated to bias relative to described matrix.
4. knee joint soft tissue balance measuring device according to claim 3, which is characterized in that the movable plate and institute
The either side that datum plate is optionally offset in the two sides of described matrix is stated, to be selectively adapted to left knee joint or the right side
Knee joint.
5. knee joint soft tissue balance measuring device according to claim 4, which is characterized in that the movable plate it is upper
Surface and lower surface are respectively arranged with locative cue mark.
6. knee joint soft tissue balance measuring device according to claim 4, which is characterized in that first connector is logical
It crosses centrosymmetric structure to be connected with the driver, second connector is fixed on the base also by centrosymmetric structure
Body.
7. knee joint soft tissue balance measuring device according to claim 2, which is characterized in that further include osteotomy guiding
Device, the osteotomy guider are mutually perpendicular to datum plate holding, and keep synchronizing moving, and institute with the movable plate
Stating on osteotomy guider has at least a pair of of pilot hole, and the line of two pilot holes is parallel with the datum plate.
8. knee joint soft tissue balance measuring device according to claim 7, which is characterized in that the osteotomy guider can
Releasably it is connected with first connector.
9. knee joint soft tissue balance measuring device according to claim 2, which is characterized in that it further include lock, institute
It states lock to be connected with the driver, for locking or releasing the driver.
10. knee joint soft tissue balance measuring device according to claim 9, which is characterized in that the lock and institute
It states load indicator to match, to lock or release the gap indicator and load indicator.
11. knee joint soft tissue balance measuring device according to claim 10, which is characterized in that the lock and institute
It states load indicator and realizes locking by tooth engagement.
12. knee joint soft tissue balance measuring device according to claim 2, which is characterized in that the outward turning indicator
Including outward turning scale substrate and outward turning indicate indicator, the outward turning scale substrate and first connector are relatively fixed, described
Outward turning indicate indicator is connected with the shaft of the movable plate, links to realize and indicates corresponding rotation angle
Degree.
13. knee joint soft tissue balance measuring device according to claim 12, which is characterized in that the outward turning indicator
It further include STATEMENT OF FEDERALLY SPONSORED, the STATEMENT OF FEDERALLY SPONSORED is mutually fixed with the shaft, and the outward turning indicate indicator has linkage portion, the STATEMENT OF FEDERALLY SPONSORED
Cooperate with the linkage portion, to realize the linkage of the outward turning indicate indicator Yu the movable plate.
14. knee joint soft tissue balance measuring device according to claim 2, which is characterized in that the gap indicator
Including gap scale substrate and gap indicate indicator, the gap scale substrate and described matrix are in integral structure, the gap
Indicate indicator is connected with the driver.
15. knee joint soft tissue balance measuring device according to claim 14, which is characterized in that the load indicator
Including load scale substrate and load indicate indicator, the load scale substrate and the load indicate indicator all with the driving
Device is connected, and under the driving of the driver, and opposite fortune occurs for the load indicate indicator and the load scale substrate
It is dynamic.
16. knee joint soft tissue balance measuring device according to claim 15, which is characterized in that first connector
It is connected to second actuator, second connector is connected to the first handle.
17. knee joint soft tissue balance measuring device according to claim 15, which is characterized in that second actuator
Including central part, a pair of outer adjutage and external tabs；The central part is connected with the external adjutage, and institute
The inside that central part is set to described matrix is stated, and the external adjutage is sheathed on the outside of matrix, the external tabs
It is separately connected the external adjutage and first connector.
18. knee joint soft tissue balance measuring device according to claim 17, which is characterized in that the gap instruction unit
Part and the load indicate indicator are all set on the external adjutage.
19. knee joint soft tissue balance measuring device according to claim 15, which is characterized in that the load scale base
Plate is mutually fixed with first actuator.
20. knee joint soft tissue balance measuring device according to claim 15, which is characterized in that described matrix further includes
First sliding groove and the second sliding groove, are provided with the two sides of described matrix respectively.
21. knee joint soft tissue balance measuring device according to claim 15, which is characterized in that described matrix further includes
Positioning column, first elastic component, second actuator and second elastic component are sheathed on the positioning column, described fixed
Position column is mutually fixed with first actuator, and is set in described matrix.
22. knee joint soft tissue balance measuring device according to claim 15, which is characterized in that described matrix further includes
Positioning column, first actuator, first elastic component, second actuator and second elastic component are sheathed on described
On positioning column, the positioning column is set in described matrix.
Priority Applications (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201510390837.6A CN105769119B (en) | 2015-07-06 | 2015-07-06 | Knee joint soft tissue balance measuring device and measuring method |
| CN201810416515.8A CN108836267B (en) | 2015-07-06 | 2015-07-06 | Knee joint soft tissue balance measuring device |
| PCT/CN2016/088619 WO2017005169A1 (en) | 2015-07-06 | 2016-07-05 | Knee joint soft tissue balance measurement device and measurement method thereof |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201510390837.6A CN105769119B (en) | 2015-07-06 | 2015-07-06 | Knee joint soft tissue balance measuring device and measuring method |
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201810416515.8A Division CN108836267B (en) | 2015-07-06 | 2015-07-06 | Knee joint soft tissue balance measuring device |
Publications (2)
| Publication Number | Publication Date |
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| CN105769119A CN105769119A (en) | 2016-07-20 |
| CN105769119B true CN105769119B (en) | 2019-03-26 |
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| CN201510390837.6A Active CN105769119B (en) | 2015-07-06 | 2015-07-06 | Knee joint soft tissue balance measuring device and measuring method |
| CN201810416515.8A Active CN108836267B (en) | 2015-07-06 | 2015-07-06 | Knee joint soft tissue balance measuring device |
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| Application Number | Title | Priority Date | Filing Date |
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| CN201810416515.8A Active CN108836267B (en) | 2015-07-06 | 2015-07-06 | Knee joint soft tissue balance measuring device |
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| CN (2) | CN105769119B (en) |
| WO (1) | WO2017005169A1 (en) |
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| CN108403120B (en) * | 2017-02-10 | 2024-04-05 | 北京纳通医疗科技控股有限公司 | Femur external rotation positioner |
| CN107328574B (en) * | 2017-08-04 | 2022-09-27 | 北京大学第三医院 | Knee joint stability and kinematics characteristic testing device |
| CN110051456B (en) * | 2018-01-19 | 2024-01-19 | 苏州微创关节医疗科技有限公司 | Modularized flexion-extension clearance measurer/tibia prosthesis test mould |
| CN108451582B (en) * | 2018-03-12 | 2024-09-17 | 长沙市第三医院 | Auxiliary knee joint replacement gap balancing tool |
| CN108378930A (en) * | 2018-05-03 | 2018-08-10 | 中国医学科学院整形外科医院 | A kind of measuring appliance |
| CN108969153A (en) * | 2018-08-09 | 2018-12-11 | 南通市第人民医院 | A kind of knee joint structural equation measuring device and its measurement method |
| CN109745156B (en) * | 2019-01-24 | 2020-10-13 | 付庆鹏 | Gap balance method knee joint replacement thighbone size measuring die |
| CN110897644A (en) * | 2019-12-06 | 2020-03-24 | 南京医科大学 | Dynamic soft tissue balance judgment method in total knee joint replacement based on generation countermeasure network |
| CN111134859A (en) * | 2020-01-16 | 2020-05-12 | 福建省立医院 | A Knee Joint Flexion Gap Ranging Balance Positioning Tool |
| CN111281480B (en) * | 2020-03-30 | 2024-11-01 | 北京市春立正达医疗器械股份有限公司 | Knee joint replacement femoral condyle midline positioning guide device |
| CN111388053A (en) * | 2020-04-07 | 2020-07-10 | 上海市第十人民医院 | Gap balancing plate and using method thereof |
| CN111568449B (en) * | 2020-06-02 | 2025-02-11 | 北京爱康宜诚医疗器材有限公司 | Joint soft tissue balance measurement device |
| CN111714166B (en) * | 2020-06-02 | 2022-09-27 | 柴瑞宝 | Multi-functional caliber that struts of orthopedics |
| CN111568448B (en) * | 2020-06-02 | 2024-11-26 | 北京爱康宜诚医疗器材有限公司 | Joint soft tissue balance measurement device |
| CN111759287B (en) * | 2020-08-04 | 2025-09-12 | 北京爱康宜诚医疗器材有限公司 | Joint soft tissue balance measurement device |
| CN112545722B (en) * | 2020-12-01 | 2023-04-25 | 雷鹏飞 | Knee joint replacement balancer combining osteotomy and gap balance measurement technology |
| CN113081162B (en) * | 2021-04-28 | 2022-08-05 | 北京力达康科技有限公司 | Patellar surface osteotomy measuring device and knee joint gap measuring device |
| CN113616228B (en) * | 2021-09-14 | 2025-01-28 | 山东大学齐鲁医院(青岛) | An auxiliary fixation brace for preoperative imaging evaluation of unicompartmental knee replacement |
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Also Published As
| Publication number | Publication date |
|---|---|
| WO2017005169A1 (en) | 2017-01-12 |
| CN108836267B (en) | 2021-02-23 |
| CN108836267A (en) | 2018-11-20 |
| CN105769119A (en) | 2016-07-20 |
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