CN206852644U - A kind of subpatellar fat pad resecting tool - Google Patents
A kind of subpatellar fat pad resecting tool Download PDFInfo
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- CN206852644U CN206852644U CN201720104201.5U CN201720104201U CN206852644U CN 206852644 U CN206852644 U CN 206852644U CN 201720104201 U CN201720104201 U CN 201720104201U CN 206852644 U CN206852644 U CN 206852644U
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- fat pad
- locating rod
- ligamentum patellae
- subpatellar fat
- rod
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Abstract
The utility model patent belongs to bone surgery apparatus field, and in particular to subpatellar fat pad quantifies the structure of resecting tool.A kind of subpatellar fat pad resecting tool, include patella fixing device, locating rod, ligamentum patellae analyzing rod and exsector, patella fixing device includes clamp and ligamentum patellae fix bar, both unnecessary subpatellar fat pad can have been cut off to appear operating field, it is possibility to have effect retains the thick blood vessels area of subpatellar fat pad, reduces because the excision of subpatellar fat pad is excessive, thick blood vessels area is cut off in the lump, caused by complication, facilitate joint surgery doctor manipulate, beneficial to total knee replacement operation progress.
Description
Technical field
The utility model patent belongs to bone surgery apparatus field, and in particular to subpatellar fat pad quantifies the knot of resecting tool
Structure.
Background technology
According to the year end of China National Bureau of Statistics of China's statistics 2013, the people of China's Mainland total population 1,360,720,000,60 one full year of life and above people
Mouthful 202,430,000 people, account for the 14.9% of total population, 65 one full year of life and the people of above population 131,610,000, account for the 9.7% of total population.Open within 2013
Begin, China's aging populations quantity will be incremented by with 10,000,000 scale, and future will also double breakthrough 400,000,000 for 20 years.According to statistics
As shown by data, China the elderly of more than 60 years old have 51% to suffer from knee joint osseous arthritis.In the U.S., more than 9,000,000 people
Gonitis is diagnosed as through clinical symptoms and imaging data.It is a large amount of old plus traumatic arthritis, rheumatoid arthritis etc.
Year, patient was subjected to the puzzlement of diseases of knee joint.The early stage expectant treatment method of diseases of knee joint mainly have living-pattern preservation,
Physiotherapy, loss of weight, non-steroid anti-inflammatory drug, orthopedics, crutch, closed treating etc.[2].For the old diseases of knee joint of middle and advanced stage
Patient, knee replacements are important treatment means.With deepening continuously for reform and opening-up, national comprehensive strength constantly carries
Height, most of tertiary hospitals can carry out artificial full knee joint transposing operation at present in China.At present both at home and abroad for artificial total knee
Whether joint replacement surgery, which retains subpatellar fat pad, still has larger dispute, and lacks long-term Clinical Follow-up data.
Subpatellar fat pad is located at behind ligamentum patellae, between anterior intercondylar area and facies patellaris femoris bottom, there is pad and lubrication.
It is made up of on the outside of subpatellar fat pad rete vasculosum lateral inferior genicular artery, lateral superior genicular artery descending branch, inner side is by medial inferior genicular artery liter
Descending branch, the infrapatellar branch of rami articulares arteriae descendentis genicularis propped up in branch, descending genicular artery kneecap is formed.The researchs such as Lin Yujin show subpatellar fat pad
Other position adipose tissues are different from whole body, interior to contain abundant rete vasculosum, this rete vasculosum not only nutrition itself, also to ligamentum patellae
With kneecap Xia Jideng adjacent tissues structure offer blood.Nemschak etc. research shows the abundant rete vasculosum in subpatellar fat pad
It is the important blood vessels source of kneecap.The researchs such as Ushiyama show there is production rich in nerve and immunocyte in subpatellar fat pad
The effect of raw inflammatory factor and growth factor.Excessively excision subpatellar fat pad can cause knee joint to be given birth in total knee arthroplasty
Material resources change, and cause pain before patella height reduction and ligamentum patellae cripetura, knee, or even cause ligamentum patellae ischemic necrosis and kneecap bone
Folding etc., trace it to its cause closely related with damage subpatellar fat pad blood supply.Therefore protected in artificial full knee joint transposing surgical procedure
It is main academic opinion both domestic and external at present to stay subpatellar fat pad.But a kind of instrument there is no to quantify to cut off fat under kneecap at present
Fat pad, so as to which the instrument in thick blood vessels area be fully retained.
Utility model content
Technical problem to be solved in the utility model is：In view of the deficienciess of the prior art, mesh of the present utility model
Be to provide it is a kind of can quantify cut off subpatellar fat pad resecting tool.
To realize the purpose of this utility model, it is achieved using following technical scheme：
A kind of subpatellar fat pad resecting tool, include patella fixing device, locating rod, ligamentum patellae analyzing rod and exsector,
Patella fixing device includes clamp and ligamentum patellae fix bar, and caliper inboard is provided with two latches, two are provided with the one side of clamp
Individual fixture block, the ligamentum patellae fix bar is separately installed with fixture block, is socketed with elevating lever in ligamentum patellae fix bar, ligamentum patellae is solid
The side of fixed pole is provided with lifting knob, and the elevating lever of lifting knob connection inner side simultaneously controls its lifting, in epimere between elevating lever
Provided with a connecting rod, the upper surface of connecting rod is provided with chute, and slide bar is connected with chute, the locating rod is plugged with slide bar,
One sidepiece of locating rod is provided with slide opening, and after slide opening is plugged into slider head, locating rod moves left and right on chute, among locating rod
Slot provided with both sides through connection, the other end of locating rod can be connected in the ligamentum patellae analyzing rod, ligamentum patellae analyzing rod
Side on be connected with balancing pole, balance pipe is installed, balancing pole is provided with the installation projection of clamping balance pipe, puts down in locating rod
Weighing apparatus hole is connected in installation projection；
The exsector matches and is plugged in slot with slot, and the knife face direction of exsector and locating rod are mutually horizontal
Set, the rear side of exsector is provided with catch, and after exsector inserts slot, the upper surface face of catch and locating rod is mutually touched and prevented
It drops through locating rod.
Preferably：The lower side surfaces of the ligamentum patellae fix bar are provided with graduation mark.
Preferably：The bottom of the ligamentum patellae analyzing rod is provided with fixing tooth.
Compared with prior art, the beneficial effects of the utility model are：Both can cut off unnecessary subpatellar fat pad with
Appear operating field, it is possibility to have effect retains the thick blood vessels area of subpatellar fat pad, reduces because the excision of subpatellar fat pad is excessive, will
Thick blood vessels area is cut off in the lump, caused by complication, facilitate joint surgery doctor manipulate, beneficial to total knee replacement operation
Carry out.
Brief description of the drawings
Fig. 1 structural representations of the present utility model；
Fig. 2 the utility model exsector 4 inserts the structural representation of slot 13；
The structural representation that Fig. 3 the utility model locating rod 2 moves；
The structural representation of Fig. 4 the utility model subpatellar fat pad resectoscope operating positions.
1st, patella fixing device；2nd, locating rod；3rd, ligamentum patellae analyzing rod；4th, exsector；5th, clamp；6th, ligamentum patellae fix bar；
7th, elevating lever；8th, latch；9th, fixture block；10th, connecting rod；11st, chute；12nd, knob is lifted；13rd, slot；14th, slider head；15th, it is sliding
Hole；16th, balancing pole；17th, balance pipe；The 18th, projection is installed；19th, fixing tooth；20th, graduation mark；21st, catch.
Embodiment
Specific embodiment of the present utility model is made a detailed explanation below according to accompanying drawing.
According to Fig. 1 to Fig. 4, a kind of subpatellar fat pad resecting tool described in the present embodiment, include kneecap and fix
Device 1, locating rod 2, ligamentum patellae analyzing rod 3 and exsector 4, patella fixing device 1 include clamp 5 and ligamentum patellae fix bar 6, clamp 5
Inner side is provided with two latches 8, is provided with two fixture blocks 9 on the one side of clamp 5, the ligamentum patellae is separately installed with fixture block 9
Fix bar 6, elevating lever 7 is socketed with ligamentum patellae fix bar 6, and the side of ligamentum patellae fix bar 6 is provided with lifting knob 12, lifting
The elevating lever 7 of the connection of knob 12 inner side simultaneously controls its lifting, and a connecting rod 10, connecting rod 10 are provided with epimere between elevating lever 7
Upper surface be provided with chute 11, the slider head 14 that can internally slide is connected with chute 11, is plugged with slider head 14 described
Locating rod 2, a sidepiece of locating rod 2 are provided with slide opening 15, and after slide opening 15 is plugged into slider head 14, locating rod 2 is on chute 11
Move left and right, be provided with slot 13 of the both sides through connection among locating rod 2, it is tough that the other end of locating rod 2 can be connected to the kneecap
In band analyzing rod 3, balancing pole 16 is connected with the side of ligamentum patellae analyzing rod 3, balance pipe 17 is installed in locating rod 2, balanced
Bar 16 is provided with the installation projection 18 of clamping balance pipe 17, and balance pipe 17 is connected in installation projection 18；
The exsector 4 matches and is plugged in slot 13 with slot 13, knife face direction and the locating rod 2 of exsector 4
Mutually horizontally disposed, the rear side of exsector 4 is provided with catch 21, and after exsector 4 inserts slot 13, catch 21 is upper with locating rod 2
End face face, which is mutually touched, prevents it from being dropped through locating rod 2, and the lower side surfaces of the ligamentum patellae fix bar 6 are provided with graduation mark
20, the bottom of the ligamentum patellae analyzing rod 3 is provided with fixing tooth 19.
Operating method
1) presetting excision is made film highly
The preferred height that thick blood vessels area according to film making observation subpatellar fat pad be present, the thick blood vessels area of subpatellar fat pad
Outside is other in subpatellar fat pad kneecap opens 5mm, 14mm under apex patellae, 10mm behind ligamentum patellae, is compared and cut off substantially
Scope；
2）First cut-out subpatellar fat pad
In operation, cut epidermis and be turned to side, allow subpatellar fat pad to be exposed under the visual field, the kneecap on top is first cut off with knife
Lower fat pad, is easier when so descending knife.
3）The position of mounting and adjusting resecting tool
The outside of kneecap is clamped with clamp 5, ligamentum patellae analyzing rod 3 is placed on ligamentum patellae, inserted using fixing tooth 22
It is fixed, one end slide opening 15 of locating rod 2 is inserted into slider head 14, the insertion installation projection 18 of other end balance pipe 17, observation ensures fixed
Position bar 2 is horizontal positioned, and locating rod will be disposed vertically with balancing pole, if being viewed as tilting, can be held clamp 5 and be adjusted
It is whole, until locating rod 2 and connecting rod and balancing pole are vertical configuration；
4）Regulation excision height
Fine setting is made according to physical location, rotation and lifting knob, the height of elevating lever is adjusted, ensures that adjustable height is suitable.
Locating rod 2 is first removed, takes away ligamentum patellae analyzing rod 3；
5）Cut off subpatellar fat pad
Locating rod 2 is removed, takes ligamentum patellae analyzing rod 3 away, puts back to locating rod 2, exsector is slowly inserted in slot 13, and
Allow catch 21 to touch on the end face of locating rod 2, pin locating rod 2 and move left and right the action cut, completed until cutting,
The subpatellar fat pad of upper end after cutting is taken away with pliers etc..
Operating effect
Rich in nerve and immunocyte in subpatellar fat pad, have the function that to produce inflammatory factor and growth factor.Complete
Excessively excision subpatellar fat pad can cause knee joint biomethanics to change in knee replacements, cause patella height reduction and kneecap
Pain before ligament cripetura, knee, or even cause ligamentum patellae ischemic necrosis and patellar fracture etc., trace it to its cause and damage subpatellar fat pad blood
For closely related.We have found that subpatellar fat pad, which is fully retained, can influence operation behaviour in artificial full knee joint transposing surgical procedure
Make, Symptomatic postoperative snap occurs in some patientss, and few some patientss are disappeared by snap after extracing fat pad under arthroscope
Lose, the excision for subpatellar fat pad -- whether cut off, cut off how much, how to cut off, the research to this respect in the world at present,
Still lack particulars.
In total knee arthroplasty, cut off subpatellar fat pad caused by kneecap tendon ischemic contracture be postoperative patella baja and
One of major reason of kneecap crispatura tendinum.Subpatellar fat pad is cut off in total knee arthroplasty can cause postoperative patella height to drop
It is low, cause kneecap crispatura tendinum and patella baja.Subpatellar fat pad should be retained as far as possible in total knee arthroplasty, and pass through art
In precise manipulation and correct processing can reduce damage to subpatellar fat pad and its surrounding tissue, can obtain what is be more satisfied with
Surgical effect.
Research finds, complete resection subpatellar fat pad can cause shin bone outward turning angle in knee stretching process be obviously reduced and
Moved in kneecap is obvious, kneecap point pressure reduces, when reduction degree is more than knee extension in knee sprung.Therefore they recognize
For subpatellar fat pad has biomechanical function, can mitigate the life that kneecap can be influenceed after the symptom excisions of pain syndrome before knee
Material resources and motion of knee joint.Subpatellar fat pad should use up in the works in the preoperative to maintaining proximity structure blood supply to play an important role
Amount retains subpatellar fat pad.
Excessively excision subpatellar fat pad can cause ligamentum patellae, kneecap ischemic in TKA arts, and postoperative patellar fracture, ligamentum patellae are short
The complication such as contracting substantially increase therewith.Studied and found by the angiogram of corpse, subpatellar fat pad excision completely can cause kneecap
The blood supply of bone the latter half blocks.In knee replacements 1~3 year after excision subpatellar fat pad, ligamentum patellae length is measured
Substantially shorten 2~3 mm compared with preoperative, account for 5%, it is believed that it is to reduce pole bone under the postoperative kneecaps of TKA to retain subpatellar fat pad
One of an important factor for folding.When subpatellar fat pad anatomical structure is with Relationship with Clinical, most authoritative proposition now needs in TKA arts
Retain subpatellar fat pad as far as possible, to maintain proximity structure blood supply.Excessive excision subpatellar fat pad can cause knee joint biomethanics
Change, cause pain before knee, sometimes ligamentum patellae cripetura, or even cause ligamentum patellae ischemic necrosis and patellar fracture.Think fatty under kneecap
Pad has direct protective effect to kneecap tendon, at the same reparation of the fatty liver cell therein to kneecap tendon have the function that it is important, to low
Position kneecap has large effect.And patella baja can make the mechanical activity of patellofemoral joint that obvious change occur, so as to
Patellofemoral joint is caused to occur abnormal.It is mainly shown as under kneecap that pole can hit with tibia sites, due to moving down for kneecap
Can increase the pressure of patellofemoral joint.Research shows to retain the generation that subpatellar fat pad advantageously reduces wound complication.
Wound, abrasion, inflammation etc. cause subpatellar fat pad oedema, hyperplasia, are formed in shin femoral joint and/or patellofemoral joint crowded
Folder is hit, and Hoffa can be caused sick, and a series of clinical symptoms occurs, can involve the synovial membrane and tendon of correlation.When fat pad by
To certain factor stimulate cause it is acute and chronic damage can produce aseptic inflammation and cause pain, oedema, bleeding, ooze out, hyperplasia,
Fibr tissue denaturation, adhesion, machine between loose, hardening, fat pad and ligamentum patellae, follow the string, make to stretch knee activity by
Limitation, its abundant nerve endings can be caused goinyalgia by the chemical stimulation of inflammation.Research show subpatellar fat pad fibrosis with
Pain has significant correlation in front of the postoperative knee joints of TKA, and subpatellar fat pad fibrosis can influence knee articulation degree.A lot
Expert thinks fully to appear the progress for being more beneficial for TKA operations.Research shows to cut off subpatellar fat pad compared with retaining fat pad
Do not have too big difference compared with postoperative complications, simply patient occur pain before knee probability it is little higher, it is proposed that if not shadow
Subpatellar fat pad can be retained by ringing operative doctor and appearing otch, on the contrary then give excision.
Insall-Salviti indexes are the most frequently used indexes that the postoperative kneecap crispatura tendinums of TKA are assessed in clinic at present, still
Knee joint lateral projection is clapped in the acquisition of Insall-Salviti indexes when needing 30 ° of patient's work to go down on one's knees, but is still lacked in the market
Weary special instrument uses for radiologic technologist, therefore researches and develops a special resecting tool and obtain Insall- as accurate
The powerful guarantee of Salviti indexes.
Apparatus of the present utility model can contrast and quantify according to preoperative analysis, substantially judge the degree of excision, in art also
Resection can be adjusted, to ensure to retain the thick blood vessels area of subpatellar fat pad, it can be ensured that subpatellar fat pad is accurately cut off
It is particularly important, avoids the generation of day infectious-related complication.Individual difference is different, thus can not it is single with embodiment as a comparison,
But do not have to carry out substantially getting well of operating of dosage chemical industry in the recovery extent and art of the ligamentum patellae after retaining, what ligamentum patellae shortened
Probability is much smaller.
Claims (3)
- A kind of 1. subpatellar fat pad resecting tool, it is characterised in that：Include patella fixing device, locating rod, ligamentum patellae analyzing rod And exsector, patella fixing device include clamp and ligamentum patellae fix bar, caliper inboard is provided with two latches, on the one side of clamp Two fixture blocks are provided with, the ligamentum patellae fix bar is separately installed with fixture block, elevating lever is socketed with ligamentum patellae fix bar, The side of ligamentum patellae fix bar be provided with lifting knob, lifting knob connection inner side elevating lever simultaneously control its lifting, elevating lever it Between in epimere be provided with a connecting rod, the upper surface of connecting rod is provided with chute, the slider head that can internally slide is connected with chute, The locating rod is plugged with slider head, a sidepiece of locating rod is provided with slide opening, after slide opening is plugged into slider head (14), positioning Bar is moved left and right on chute, and slot of the both sides through connection is provided among locating rod, and the other end of locating rod can be connected to institute State in ligamentum patellae analyzing rod, balancing pole is connected with the side of ligamentum patellae analyzing rod, balance pipe, balancing pole are installed in locating rod The installation projection of clamping balance pipe is provided with, balance pipe is connected in installation projection；The exsector matches and is plugged in slot with slot, and knife face direction and the mutual level of locating rod of exsector are set Put, the rear side of exsector is provided with catch, and after exsector inserts slot, the upper surface of catch and locating rod, which is mutually touched, prevents it from wearing Locating rod is crossed to drop.
- A kind of 2. subpatellar fat pad resecting tool according to claim 1, it is characterised in that：The ligamentum patellae fix bar Lower side surfaces are provided with graduation mark.
- A kind of 3. subpatellar fat pad resecting tool according to claim 1, it is characterised in that：The ligamentum patellae analyzing rod Bottom is provided with fixing tooth.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201720104201.5U CN206852644U (en) | 2017-01-24 | 2017-01-24 | A kind of subpatellar fat pad resecting tool |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201720104201.5U CN206852644U (en) | 2017-01-24 | 2017-01-24 | A kind of subpatellar fat pad resecting tool |
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| CN206852644U true CN206852644U (en) | 2018-01-09 |
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| CN201720104201.5U Expired - Fee Related CN206852644U (en) | 2017-01-24 | 2017-01-24 | A kind of subpatellar fat pad resecting tool |
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Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN106691545A (en) * | 2017-01-24 | 2017-05-24 | 丽水市人民医院 | Cutting tool for infrapatellar fat pad and use method thereof |
-
2017
- 2017-01-24 CN CN201720104201.5U patent/CN206852644U/en not_active Expired - Fee Related
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN106691545A (en) * | 2017-01-24 | 2017-05-24 | 丽水市人民医院 | Cutting tool for infrapatellar fat pad and use method thereof |
| CN106691545B (en) * | 2017-01-24 | 2023-11-10 | 丽水市人民医院 | Subcarpler fat pad cutting tool and using method thereof |
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| GR01 | Patent grant | ||
| GR01 | Patent grant | ||
| CF01 | Termination of patent right due to non-payment of annual fee |
Granted publication date: 20180109 Termination date: 20190124 |
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| CF01 | Termination of patent right due to non-payment of annual fee |