RESECTION GUIDE, TRIAL KNEE JOINT IMPLANT, AND SURGICAL INSTRUMENT FOR KNEE ARTHROPLAST
20180098773 ยท 2018-04-12
Assignee
Inventors
Cpc classification
A61F2002/30606
HUMAN NECESSITIES
A61F2/30771
HUMAN NECESSITIES
A61F2/3886
HUMAN NECESSITIES
A61B17/88
HUMAN NECESSITIES
International classification
Abstract
Disclosed is a resection guide, a trial knee joint implant, and a surgical instrument for knee arthroplasty. The resection guide, the trial knee joint implant, and the surgical instrument enable implantation of an implant that provides improved vertical fixing force and initial fixing force as compared with an existing cementless or uncemented implant.
Claims
1. A resection guide comprising a main body including a guide portion formed to pass through the main body, the guide portion including a slot that guides movement of a resection device and a pin insertion hole that is formed to communicate with the slot and into which a fixing pin is inserted.
2. The resection guide according to claim 1, wherein the pin insertion hole comprises a first portion that abuts on a periphery of the slot, thereby communicating with an opening formed in the periphery of the slot, and which has a width that increases as a distance to a boundary between the first portion and the slot increases.
3. The resection guide according to claim 2, wherein the pin insertion hole further includes a second portion having a width that decreases as a distance to the first portion increases.
4. The resection guide according to claim 3, wherein the first portion and the second portion of the pin insertion hole have curved inner peripheral surfaces.
5. The resection guide according to claim 4, wherein the curved inner peripheral surfaces form a circular cylinder shape.
6. The resection guide according to claim 1, further comprising a fixing pin having a complementary shape to the pin insertion hole and being penetrated into a bone through the pin insertion hole, thereby fixing a position of the main body.
7. The resection guide according to claim 6, wherein the fixing pin has a flat surface portion that closes an open portion of a periphery of the pin insertion hole when the fixing pin is inserted through the pin insertion hole.
8. The resection guide according to claim 5, wherein the resection guide is used to guide resection of an proximal end of a tibia, the slot transversely extends in the main body to guide the resection device such that the resection device moves toward a lateral side or a medial side of the tibia, with the main body being arranged on an anterior surface of the tibia, and the pin insertion hole is formed at a distal side of the slot.
9. The resection guide according to claim 8, wherein the main body further comprises a window that is formed to pass through the main body and is disposed at a proximal side of the slot.
10. The resection guide according to claim 5, wherein the resection guide is used to guide resection of a distal end of a femur, the slot comprises a first slot vertically extending in the main body to guide the resection device that resects the distal end of the femur, with the main body being arranged on a medial surface or a lateral surface of the femur, and the pin insertion hole includes a first pin insertion hole that abuts on a proximal periphery of the first slot, thereby communicating with an opening formed in the proximal periphery of the first slot.
11. The resection guide according to claim 10, wherein the slot further comprises a second slot extending toward a posterior side from a lower end of the first slot, and the pin insertion hole further comprises a second pin insertion hole that abuts on a proximal periphery of the second slot, thereby communicating with an opening formed in the proximal periphery of the second slot.
12. A trial knee joint implant comprising: a body portion having an articular surface and a contact surface disposed on the opposite side of the articular surface; and a protrusion protruding outward from the contact surface and having a portion expanded sideways, wherein the body portion is provided with a guide hole extending in an anterior-posterior direction of the body portion.
13. The trial knee joint implant according to claim 12, wherein the protrusion comprises a first portion gradually being expanded in a direction perpendicular to a direction in which the protrusion protrudes and a second portion being gradually constricted such that a width thereof gradually decreases as a distance to the first portion increases.
14. The trial knee joint implant according to claim 13, wherein the first portion and the second portion have curved peripheral surfaces.
15. The trial knee joint implant according to claim 14, wherein the curved peripheral surfaces form a circular cylinder shape.
16. The trial knee joint implant according to claim 12, wherein the trial knee joint implant is a trial implant for a tibia, and the trial knee joint implant is inserted in a sliding manner into a sliding groove formed in a resected surface of a proximal portion of the tibia such that the trial knee joint implant engages with the resected surface of the proximal portion of the tibia.
17. The trial knee joint implant according to claim 16, wherein the articular surface of the body portion is a concavely curved surface.
18. The trial knee joint implant according to claim 16, wherein the contact surface of the body portion is an inclined surface inclined by a predetermined angle.
19. The trial knee joint implant according to claim 16, wherein the guide hole formed in the body portion has a shape like a key hole.
20. A surgical instrument for a knee arthroplasty, the surgical instrument comprising: the trial knee joint implant according to claim 16; a resection guide comprising a main body including a guide portion formed to pass through the main body, the guide portion comprising a slot that guides movement of a resection device and a pin insertion hole that is formed to communicate with the slot such that a fixing pin is inserted into the pin insertion hole; and a link mechanism having a first end engaged with the guide hole of the trial knee joint implant and a second end engaged with the main body of the resection guide such that the main body of the resection guide is arranged on a medial surface or a lateral surface of a femur.
21. The surgical instrument according to claim 20, wherein the pin insertion hole comprises a first portion that abuts on a periphery of the slot, thereby communicating with an opening formed in the periphery of the slot, and which gradually expands such that a width thereof increases as a distance to a boundary between the first portion and the slot increases.
22. The surgical instrument according to claim 21, wherein the pin insertion portion further comprises a second portion having a width that decreases as a distance to the first portion increases.
23. The surgical instrument according to claim 22, wherein the first portion and the second portion are formed to have curved peripheral surfaces.
24. The surgical instrument according to claim 23, wherein the first portion and the second portion are formed to have a circular cylinder shape.
25. The surgical instrument according to claim 24, wherein the slot comprises a first slot vertically extending in the main body, the first slot guiding movement of the resection device to resect a distal end of a femur in a state in which the main body is arranged on a lateral surface or a medial surface of the femur, and the pin insertion hole comprises a first pin insertion hole that abuts on a proximal periphery of the first slot, thereby communicating with an opening formed in the proximal periphery of the first slot.
26. The surgical instrument according to claim 25, wherein the slot further comprises a second slot extending toward a posterior end of the main body from a lower end of the first slot, and the pin insertion hole further comprises a second pin insertion hole that abuts on a proximal periphery of the second slot, thereby communicating with an opening formed in the proximal periphery of the second slot.
27. The surgical instrument according to claim 20, wherein the link mechanism comprises a height adjustment portion that adjusts a height of the main body.
28. A surgical instrument for knee arthroplasty, the surgical instrument comprising: a spacer inserted between a distal end of a femur and a proximal end of a tibia in a state in which a femoral component of a trial knee joint implant engages with the distal end of the femur that is resected, and the proximal end of the tibia is not yet resected, the spacer having an upper surface to come into contact with the femoral component, a lower surface to come into contact with the proximal end of the tibia, and an engagement recess provided at an anterior surface thereof; an alignment handle having a first end engaged with the engagement recess of the spacer and a second end protruding from the anterior surface of the spacer; and the resection guide according to claim 8, wherein the alignment handle functions to position the resection guide.
29. The surgical instrument according to claim 28, wherein the main body of the resection guide further comprises a window formed to pass through the main body at a proximal side of the slot, and the alignment handle is arranged to pass through the window.
30. A surgical instrument for knee arthroplasty, the surgical instrument comprising: a spacer inserted between a distal end of a femur and a proximal end of a tibia in a state in which a femoral component of a trial knee joint implant engages with the distal end of the femur and the proximal end of the tibia is not yet resected, the spacer having an upper surface to come into contact with the femoral component, a lower surface to come into contact with the proximal end of the tibia, and an engagement recess provided at an anterior surface of the spacer; and two horizontal alignment rods, each comprising an alignment portion that is a linearly elongated member and a engagement protrusion that extends perpendicularly to the alignment portion, wherein the femoral component is provided with an engagement recess at an anterior surface thereof, one of the two horizontal alignment rods is arranged such that the engagement protrusion of the horizontal alignment rod is engaged with the engagement recess of the femoral component, the other horizontal alignment rod is arranged such that the engagement protrusion of the horizontal alignment rod is engaged with the engagement recess of the spacer, and an aligned state of a knee joint is verified by checking whether the two horizontal alignment rods are parallel with each other on a coronal plane.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
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DETAILED DESCRIPTION OF THE INVENTION
[0101] Hereinbelow, a resection guide, a trial knee joint implant, and a surgical instrument for knee arthroplasty according to preferred embodiments of the present invention will be described in detail. Well-known functions or constructions will not be described in detail in case they may unnecessarily obscure the understanding of the present invention.
[0102] Specific structural and functional descriptions of embodiments of the present invention disclosed herein are only for illustrative purposes of the embodiments of the present invention. The embodiments according to the spirit and scope of the present invention can be variously modified in many different forms. While the present invention will be described in conjunction with exemplary embodiments thereof, it is to be understood that the present description is not intended to limit the present invention to those exemplary embodiments. On the contrary, the present invention is intended to cover not only the exemplary embodiments, but also various alternatives, modifications, equivalents and other embodiments that may be included within the spirit and scope of the present invention as defined by the appended claims.
[0103] The same reference numerals represent the same elements throughout the specification. It will be further understood that the terms comprise, include, have, etc. when used in this specification, specify the presence of stated features, integers, steps, operations, elements, components, and/or combinations of them but do not preclude the presence or addition of one or more other features, integers, steps, operations, elements, components, and/or combinations thereof.
[0104] Below exemplary embodiments of the present invention are described in detail with reference to accompanying drawings. The invention may, however, be embodied in many different forms and should not be construed as being limited to the embodiments set forth herein; rather, these embodiments are provided so that this disclosure will be thorough and complete, and will fully convey the concept of the invention to those skilled in the art.
[0105] Herein, the terms proximal and distal respectively refer to being close to and being further away from the trunk of a body. The terms anterior and posterior respectively refer to front and back, and the terms medial and lateral respectively refer to being close to and being further away from a vertical midline that splits a body into left and right halves.
[0106] With reference to
[0107] The main body 11, as illustrated in
[0108] The guide portion 111 includes a slot 1111 that guides movement of the resection device and two pin insertion holes 1113 formed to communicate with the slot 1111 such that the fixing pins 13 can be inserted into the pin insertion holes 1113, respectively.
[0109] The slot 1111 transversely extends across the main body 11 and guides the resection device such that the resection device moves toward the medial side or the lateral side of the tibia 10, with the main body 11 arranged on the anterior surface of the tibia 10.
[0110] The pin insertion holes 1113 are formed to abut the distal side periphery of the slot 1111, thereby communicating with the slot 1111 through openings formed in the distal side periphery. Each pin insertion hole 1113 has a portion having an extended width E larger than a width B of the boundary between the slot 1111 and the pin insertion hole 113. The width of the pin insertion hole 1113 first gradually increases as it goes further away from the distal periphery of the slot and then gradually decreases as it goes further away from the distal periphery of the slot. That is, the pin insertion hole 1113 includes a first portion 1113a which is gradually expanded sideways, i.e. in a lateral-medial direction such that its width gradually increases, and a second portion 1113b which is gradually constricted such that its width gradually decreases and protrudes from the first portion 1113. The first portion 1113a and the second portion 1113b have curved peripheral surfaces. The curved peripheral surfaces form a substantially circular cylinder shape.
[0111] With reference to
[0112] The window 113 is a through hole formed to pass through an upper portion of the main body 11 in an anterior-posterior direction. The window 113 is formed specifically at an upper portion of the guide portion 111. The window 113 allows a surgeon to see the proximal end of the tibia 10, which is screened by the main body 11. The window 113 also functions as a fixation hole into which an additional device such as an alignment device described below is inserted.
[0113] The auxiliary pin insertion holes 115 are used when it is necessary to enhance fixing force using auxiliary fixing pins P. That is, it is possible to enhance the fixing force by inserting the auxiliary fixing pins P into the auxiliary pin insertion holes 115. With reference to
[0114] When the main body 11 is fixed by using additional fixing means such as auxiliary fixing pins 113 rather than the fixing pins 13, the pin insertion holes 1113 serve as drill guides for formation of the drill holes H.
[0115] The fixing pins 13 fix the main body 11 to a bone by being penetrated into the bone through the pin insertion holes 1113.
[0116] As illustrated in
[0117] The fixing pin 13 has a shape complementary to that of the pin insertion hole 1113. That is, the shape of the fixing pin 13 is overall cylindrical and includes a first portion having a width gradually increasing and a second portion having a width gradually decreasing.
[0118] The resection guide 1 according to the first embodiment of the present invention, which is illustrated in
[0119] The TKA tibial component 15 is loaded on the resected surface of the tibia 10 in a manner that protrusions of the TKA tibial component 15 slide into the sliding grooves S, as illustrated in
[0120] The TKA tibial component 60 includes protrusions 604 that protrude downward from the contact surface 6004 and have a portion expanded sideways. The TKA tibial component 60 may have two protrusions 604.
[0121] The protrusions 604 are portions protruding from the contact surface 6004 to be fitted into the sliding grooves. The protrusions 604 have an expanded portion having a width larger than that of the other portion. The protrusion 604 has a shape corresponding to that of the pin insertion hole 1113. Preferably, the protrusion 604 protruding from the contact surface 6004 has a curved peripheral surface. As illustrated in
[0122] The protrusion 604 is shaped such that its width first gradually increases as it goes further away from the surface of the body portion 602 and then gradually decreases as it goes further away from the surface of the body portion 602. For example, the protrusion 604 protruding from the contact surface 6004 may have a circular cylinder shape or an elliptic cylinder shape. That is, the cross section of the protrusion 604 may have a circular shape or an elliptical shape. However, the shape of the protrusion 604 is not limited thereto but the protrusion 604 may have any shape if the shape is composed of the first portion 1604 having a gradually increasing transverse width and the second portion 1060 protruding from the first portion 1604 and having a gradually decreasing transverse width.
[0123] The tibia 10 is provided with holes having a shape complementary to that of the protrusions 604, and the protrusions of the TKA tibial component 60 are inserted into the holes of the tibia 10 in a direction parallel to the resected surface of the tibia from the anterior side of the tibia such that the TKA tibial component 60 is engaged with the tibia 10. Since the TKA tibial component 60 is loaded in a manner of being inserted sideways rather than a conventional top-loading manner, the tibia 10 has resistance to pull-out force which is likely to be exerted on the tibial component mounted on the tibia 10. Therefore, the TKA tibial component 60 can be stably fixed to the tibia 10.
[0124] The protrusion 604 may have various shapes on the premise that the shape has an expanded portion where the width thereof increases as it goes further away from the body portion 602. As illustrated in the drawings, the protrusion 604 preferably has a circular cylinder shape. When the protrusions 604 have a triangular prism shape or a dovetail shape, forming holes having a shape complementary to that of the protrusions 604 in a bone is challenging and there is a risk of bone fracture because sharp corners of the triangular prism shape or the dovetail shape act as notches which cause stress to be concentrated on the bone. However, when the protrusions 604 have a circular cross sectional shape, there is no notch. Therefore, it is possible to prevent stress from being concentrated, thereby preventing a bone from easily breaking.
[0125] As described above, since the TKA tibial component 60 is mounted on the tibia in a manner of being inserted from the anterior side rather than in the top-loading manner and the protrusions 604 are securely fixed in the sliding grooves S due to the expanded portions of the protrusions 604, fixation of the TKA tibial component 60 to the tibia becomes easier as compared with a conventional tibial component that is mounted on the tibia in the top-loading manner, and the TKA tibial component 60 has higher resistance to the force vertically exerted on the TKA tibial component 60 due to the horizontally expanded portions of the protrusions 604.
[0126] According to the present invention, the fixing pins 13 for fixing the main body 11 of the resection guide 1 are inserted into the drill holes H formed in the tibia 10, and the drill holes H become the sliding grooves S after the proximal end of the tibia 10 is resected such that the protrusions 604 of the TKA tibial component 60 can be inserted into the sliding grooves S in a sliding manner. Therefore, it is possible to reduce the number of holes formed in the tibia 10, thereby simplifying a surgical procedure and reducing a surgery time.
[0127] As to the drill holes H formed in the tibia 10 illustrated in
[0128] With reference to
[0129] As a drilling device, a plurality of drill bits (not illustrated) of different lengths corresponding to the depths of drill holes may be prepared, or one drill bit marked with lines corresponding to the depths of the drill guide holes A, B, and C is prepared.
[0130] A rod R may be attached to the drill guide 2. The rod R may be an EM rod.
[0131] With reference to
[0132] The main body 31 is a component to be arranged on the anterior surface of a proximal end of a tibia 10 to guide a resection device (not illustrates) that resects the proximal end of the tibia 10. The main body 31 includes a guide portion 311 formed to pass through the main body 31, a window 313, and an auxiliary pin insertion hole 315.
[0133] The guide portion 311 includes a slot 4111 that guides movement of the resection device and a pin insertion hole 311 that is formed to communicate with the slot 3111 and into which the fixing pin 33 is inserted.
[0134] The slot 3111 extends in a medial-lateral direction, and an end of the slot 3111 in a direction along which the resection device is guided is open. The pin insertion hole 3113 is formed on a distal side of the slot 3111, and has an expanded portion having a width E that is larger than a width B of the boundary between the slot 3111 and the pin insertion hole 3113.
[0135] The pin insertion hole 3113 is shaped such that its width first increases as it goes further away from the slot and then decreases as it goes further away from the slot. That is, the pin insertion hole 3113 includes a first portion 3113a that is gradually expanded sideways, i.e. in a lateral-medial direction, and a second portion 3113b that protrudes from the first portion 3113a and is gradually constricted sideways. The first portion 3113a and the second portion 3113b have curved peripheral surfaces, and the curved peripheral surfaces form a circular cylinder shape.
[0136] With reference to
[0137] The window 313 is a through hole formed to pass through an upper portion of the guide portion 311 of the main body 31. As described above, the window 313 allows a surgeon to see the tibia 10 therethrough or serves as a fixing hole into which an additional device is inserted.
[0138] The auxiliary pin insertion hole 315 is a through hole into which an auxiliary fixing pin P is inserted to increase the force of fixing the resection guide. With reference to
[0139] The fixing pin 33 has a complementary shape to the pin insertion hole 3113 and is an elongated member to be inserted into the pin insertion hole 3113. The fixing pin 33 partially has a flat surface 331 to smoothly guide movement of the resection device. The function and the shape of the fixing pin 33 are similar to those of the fixing pin 13 of the resection guide 1 according to the first embodiment.
[0140] The resection guide 3 according to the second embodiment of the present invention guides resection of the tibia 10 during a unicompartmental knee arthroplasty (UKA). Although the resection guide 3 differs from the resection guide 1 in the shape thereof and the number of the pin insertion holes 3113, the functions and roles of the parts of the resection guide 3 are the same as those of the resection guide 1. Therefore, a detailed description about the functions and roles of each part of the resection guide 3 will be omitted.
[0141]
[0142] When forming a drill hole H in the proximal end of the tibia 10 for UKA, a drill guide 4 illustrated in
[0143]
[0144] The UKA tibial component 70 includes a body portion 702 having an articular surface 7002 and a contact surface 7004 disposed on the opposite side of the articular surface 7002. The body portion 720 is a substitute for the resected portion of the tibia 10, and the articular surface 7002 is a surface to come into contact with an overlying femur. The contact surface 7004 is disposed on the opposite side of the articular surface 7002 and comes into contact with the resected surface of the tibia 10.
[0145] The UKA tibial component 70 includes a protrusion 704 protruding from the contact surface 7004 and having an expanded portion that is expanded sideways. The UKA tibial component is preferably provided with one protrusion 704. The protrusion 704 is a portion protruding from the contact surface 7004 and being fitted into a groove formed in a resected surface of a bone. The protrusion 704 has an expanded portion that is complementary to the shape of the pin insertion hole 3113.
[0146] The features of the protrusion 704 of the UKA tibial component 70 are similar to those of the protrusion 604 of the TKA tibial component 60 described above. That is, as illustrated in
[0147] As described above, according to the present invention, the fixing pin 33 for fixing the main body 31 of the resection guide 3 is inserted into the drill hole H formed in the tibia 10. In addition, after the resection of the tibia 10, the drill hole H becomes the sliding groove S and the protrusion 704 of the UKA tibial component 70 is inserted into the sliding groove S in a sliding manner. Therefore, it is possible to minimize the number of holes that need to be formed in the tibia 10, simplify a surgical procedure, and reduce a surgery time.
[0148] With reference to
[0149] The main body 51 is arranged on the lateral surface or the medial surface of the distal end of the femur 20 such that the distal end of the femur 20 is resected by a resection device (not illustrated). The main body 51 includes a guide portion 511 formed to pass through the main body 51.
[0150] The guide portion 511 includes a slot 5111 that guides movement of the resection device and a pin insertion hole 5113 that is formed to communicate with the slot 5111 and into which a fixing pin 51 is inserted.
[0151] The slot 5111 includes a first slot 51111 vertically extending across the main body 51, a second slot 51113 extending toward a posterior side of the main body 51 from a lower end of the first slot 51111, and a third slot 51115 extending toward a proximal side from an posterior end of the second slot 51113, thereby guiding movement of the resection device to resect the distal end of the femur 20 in a state in which the main body 51 is arranged on the lateral surface or the medial surface of the femur 20. The second slot 51113 obliquely extends toward the posterior side of the main body from the lower end of the first slot 51111. The slot 5111 may include an additional slot besides the first to third slots 51111 to 51115 to additionally resect an anterior portion of the distal end of the femur 20.
[0152] The pin insertion hole 5113 includes a first pin insertion hole 51131 formed on a proximal side of the first slot 51111 such that the periphery of the first pin insertion hole 51131 partially abuts on a proximal-side periphery of the first slot 51111. The first pin insertion hole 51131 is shaped such that the width thereof first increases as it goes further away from the first slot 51111 and then decreases as it goes further away from the first slot 51111. That is, the first pin insertion hole 51131 includes a first portion 51113a having a width that gradually increases and a second portion 51113b having a width that gradually decreases. The first portion 51113a and the second portion 51113b have curved peripheral surfaces, and the curved peripheral surfaces form a circular cylinder shape. The second pin insertion hole 51133 may have the same shape as the first pin insertion hole 51131.
[0153] With reference to
[0154] An anterior surface of the main body 51 is provided with a slit-like recess 513 that extends in a vertical direction, and the slit-like recess 513 is engaged with a link mechanism for fixing the resection guide 5 as described below.
[0155] The fixing pin 53 has a shape complementary to that of the pin insertion hole 5113. The fixing pin 53 is penetrated into the femur through the pin insertion hole 1113, thereby fixing the main body 51. The fixing pin 53 partially has a flat surface 531 to form a planar resected surface of a bone.
[0156] Drill holes H are formed on the medial side or the lateral side of the femur 20 such that the fixing pins 53 are inserted into the drill holes H. The resection guide 5 according to the third embodiment is attached to the medial side or the lateral side of the femur 20 by an additional device as described below. In this case, the pin insertion holes 5113 also function as guides for guiding drilling of the drill holes H. That is, both the formation of the drill holes H and the resection of the femur can be performed with the resection guide 5. Therefore, it is possible to simplify a surgical procedure and reduce a surgery time.
[0157] The resection guide 5 according to the third embodiment of the present invention may further include an auxiliary pin insertion hole into which an auxiliary fixing pin is inserted as necessary.
[0158] When the femur 20 is resected using the resection guide 5 according to the third embodiment of the present invention, as illustrated in
[0159] With reference to
[0160] The UKA femoral component 80 includes protrusions 804 protruding from the contact surface 8004 and having portions expanded sideways. Preferably, the femoral component has at least two protrusions.
[0161] The protrusions 804 are portions protruding from the contact surface 8004 to be fitted into grooves formed in the resected surface of a bone. The protrusions 804 have portions expanded sideways. Preferably, the peripheral surfaces of the protrusions 804 protruding from the contact surface 8004 are curved. Preferably, each protrusion 804 includes a first portion 1804 protruding from the contact surface 8004 and being gradually expanded sideways such that the width thereof increases with increasing distance to the contact surface 8004 and a second portion 1806 protruding from the first portion 1804 and being gradually constricted sideways such that the width thereof decreases with increasing distance to the first portion 1804. The term sideways means a direction perpendicular to a direction in which the protrusions 804 protrude from the contact surface 8004.
[0162] As illustrated in the drawings, the protrusions 804 are shaped such that the width thereof first increases as it goes further away from the body portion 802 and then decreases as it goes further away from the body portion 802. For example, the protrusions 804 may have a circular cylinder shape or a elliptical cylinder shape protruding from the contact surface 8004. That is, the cross section of the protrusion 804 has a circular shape or an elliptical shape. However, the cross sectional shape of the protrusion 804 is not limited to a circle or an eclipse but may be any shape if the shape is composed of the first portion 1804 that is gradually expanded sideways and the second portion 1806 that protrudes from the first portion 1804 and is gradually constricted sideways.
[0163] The femur is provided with holes having a shape complementary to that of the protrusions 804, and the UKA femoral component 80 according to the present invention is inserted from the lateral side or the medial side that is perpendicular to a direction of the superior side such that the UKA femoral component 80 is attached to the femur. Accordingly, in the case of the UKA femoral component 80 according to the present invention, the femoral component 80 is inserted from the lateral side or the medial side rather than being inserted in a direction parallel to a longitudinal direction of the femur. Therefore, the UKA femoral component 80 has resistance to pull-out force that is likely to be exerted on the femoral component attached to the femur, thereby providing stable fixing force.
[0164] The protrusions 804 may have various shapes on the premise that the shape have a portion having a width that increases as it goes further away from the body portion 802. As illustrated in the drawings, preferably, the protrusions 804 have a circular cylinder shape. When the protrusions 804 have a triangular prism shape or a dovetail shape, forming fixation holes having a shape complementary to that of the protrusions 804 in a bone by partially removing the bone is challenging and there is a high risk that a bone fracture occurs because sharp corners of the triangular prism shape or the dovetail shape act as notches which cause stress to be concentrated on the bone. However, according to the present invention, since the protrusions do not have notches by having a round shape such as a circular cross section, stress is not concentrated, thereby preventing bone fracture.
[0165] In addition, since a middle portion of the protrusion 804 in the vertical direction is expanded sideways to have a larger width than upper and lower end portions of the protrusion 804, the protrusion 804 provides stable fixing force with respect to the femur 20. As illustrated in
[0166] According to the present invention, the fixing pins 53 for fixing the main body 51 of the resection guide 5 to the femur 20 are inserted into the drill holes H formed in the femur 20, the drill holes H are changed into the sliding grooves S after the femur is resected, and the protrusions 804 of the UKA femoral component 80 are fitted into the sliding grooves S of the femur 20. Therefore, it is possible to minimize the number of holes that need to be formed in the femur, simplify a surgical procedure, and reduce a surgery time.
[0167] With reference to
[0168] The body portion 61 is engaged with the sliding grooves formed in the resected surface of the proximal end of the tibia and includes an articular surface 611, a contact surface 613, and a guide hole 615. The thickness of the body portion 61 varies according to the size of a real knee joint implant.
[0169] As illustrated in
[0170] The contact surface 613 is disposed on the opposite side of the articular surface 611 and is a portion to be in contact with the tibia 10. The contact surface 613 is an inclined surface inclined by a predetermined angle to enable checking for slope kinematics before the femur 20 is resected. For example, when the results of checking show good kinematics, with the contact surface 613 inclined by an angle of 3 as illustrated in
[0171] The guide hole 615 is a hole extending from the anterior side to the posterior side of the body portion 61. As illustrated in
[0172] With reference to
[0173] The protrusion 63 is formed to protrude from the contact surface 613 and includes a portion expanded sideways. Therefore, the protrusion 63 is fixed by being inserted into the sliding groove of the tibia 10 in a sliding manner. The features of the protrusion 63 are substantially the same as those of the protrusion 604 of the UKA tibial component 60 described above. That is, the shape of the protrusion 63 corresponds to the shape of the sliding groove S formed in the surface of the tibia 10. Specifically, as illustrated in
[0174] As described above, since the protrusion 63 has a shape that can be fitted into the sliding groove S formed in the resected surface of the tibia 10, it is not necessary to form an additional hole in a bone to the combine the trial knee joint implant 6 with the bone, and it is possible to simplify a surgical procedure and reduce a surgery time.
[0175] With reference to
[0176] According to the embodiment of the present invention, the surgical instrument 7 for knee arthroplasty is used to check for flexion and extension of the femur 20 using the trial knee joint implant 6 after the tibia 10 is resected and before the femur 20 is resected, and to enable resection of the femur 20 by attaching the resection guide 5 to the trial knee joint implant 6.
[0177] As described above, the trial knee joint implant 6 is a component to be engaged with the sliding groove formed in the resected surface of the tibia 10 to provide a function of checking for kinematics before the femur 20 is resected. In addition, the trial knee joint implant 6 enables fixation and appropriate arrangement of the resection guide 5 in conjunction with the link mechanism 71.
[0178] AS illustrated in
[0179] As to the link mechanism 71, a first end thereof is engaged with the guide hole 615 of the trial knee joint implant 6, and a second end thereof is engaged with the main body of the resection guide 5, thereby enabling the main body 51 of the resection guide 5 to be arranged on the lateral surface or the medial surface of the femur 20. The link mechanism 71 includes an engagement protrusion 711, a support portion 713, and a connection portion 715.
[0180] The engagement protrusion 711 provides supporting force by engaging with the guide hole 615, and the support portion 713 transfers the supporting force of the engagement protrusion 711 by protruding upward from the engagement protrusion 711. The connection portion 715 connects the support portion 713 with the resection guide 5 such that the resection guide 5 can be arranged on the lateral surface or the medial surface of the femur 20.
[0181] With reference to
[0182] A second portion of the connection portion 715 is fitted in the slit-like recess 513 that is vertically elongated and formed on the anterior surface of the resection guide 5 such that the height of the main body 51 of the resection guide 5 can be adjusted.
[0183] With reference to
[0184] The surgical instrument 8 according to the second embodiment is used in such a manner that a gap between the distal end of the femur 20 and the proximal end of the tibia 10, which occurs due to a ligament release, is checked with the spacer 81 in a state in which a femoral component 85 of a trial knee joint implant is attached to the distal end of the femur 20 and the proximal end of the tibia 10 is not yet resected. In addition, when the surgical instrument 8 is combined with the alignment handle 83, it is possible to appropriately align the resection guide to resect the tibia 10.
[0185] With reference to
[0186] As the spacer 81, a plurality of spacers with various thicknesses is prepared to deal with various gap sizes. The upper surface 811 is concavely curved to increase a contact area when it comes into contact with the femoral component 85. The engagement recess 815 may have a key hole-like shape.
[0187] As illustrated in
[0188] The alignment handle 83 is arranged to pass through the window 113 of the resection guide 1, thereby fixing the main body of the resection guide 1 in place. Therefore, the body portion 831 of the alignment handle 83 preferably has a shape corresponding to that of the window 133 such that the main body of the resection guide is stably fixed and thus the resection of a bone is reliably guided by the resection guide. The body portion 831 is provided with an insertion hole 8311 that vertically extends through the body portion 831 and through which an EM alignment rod R passes. Accordingly, as illustrated in FIG.
[0189] The resection guide of the surgical instrument 8 for knee arthroplasty, according to the second embodiment, may be the resection guide 3 that is used to resect the proximal end of the tibia during UKA rather than the resection guide 1 that is used to resect the tibia 10 during TKA.
[0190] With reference to
[0191] The surgical instrument 9 for knee arthroplasty according to the third embodiment is used such that a gap between the distal end of the femur 20 and the proximal end of the tibia 10 is checked with the spacer 81 in a state in which the femoral component 85 of the trial knee joint implant is attached to the distal end of the femur 20 and the proximal end of the tibia 10 is not yet resected, and alignment of a knee joint can be verified using the two horizontal alignment rods 91.
[0192] The horizontal alignment rod 91 includes an arrangement portion 911 (i.e. a linearly elongated member) and an engagement protrusion 913 perpendicularly protruding from the alignment portion 911. The engagement protrusion 913 has a shape corresponding to that of an engagement recess 815 such that the engagement protrusion 913 can be inserted into the engagement recess 815.
[0193] With reference to
[0194] The horizontal alignment rod 91 is arranged to be perpendicular to the distal surface of the femur 20 in a state in which the horizontal alignment rod 91 is engaged with the key hole 851. When one horizontal alignment rod 91 is engaged with the engagement recess 815 of the spacer 81 that is inserted between the distal end of the femur 20 and the proximal end of the tibia 10 in a state in which the other horizontal alignment rod 91 is engaged with the key hole 851 of the femoral component 85, alignment of a knee joint on the coronal plane can be checked. That is, when the two horizontal alignment rods 91 are parallel to each other on the coronal plane, it is considered that the knee joint is well aligned on the coronal plane. In this state, alignment on the sagittal plane is not yet achieved. This is because, the proximal end of the tibia 10 is not yet resected and thus has a curved native surface.
[0195] Although various embodiments of the present invention have been described for illustrative purposes, those skilled in the art will appreciate that various modifications, additions, and substitutions are possible, without departing from the scope and spirit of the invention as disclosed in the accompanying claims.