JP4981257B2 - 全股関節義足埋め込みのための外科手術装置 - Google Patents
全股関節義足埋め込みのための外科手術装置 Download PDFInfo
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- JP4981257B2 JP4981257B2 JP2005034441A JP2005034441A JP4981257B2 JP 4981257 B2 JP4981257 B2 JP 4981257B2 JP 2005034441 A JP2005034441 A JP 2005034441A JP 2005034441 A JP2005034441 A JP 2005034441A JP 4981257 B2 JP4981257 B2 JP 4981257B2
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- femoral
- prosthesis
- prosthetic
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
- A61F2250/006—Additional features; Implant or prostheses properties not otherwise provided for modular
- A61F2250/0064—Sets comprising a plurality of prosthetic parts of different sizes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
- A61F2310/00005—The prosthesis being constructed from a particular material
- A61F2310/00011—Metals or alloys
-
- G—PHYSICS
- G06—COMPUTING; CALCULATING OR COUNTING
- G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
- G06T2207/00—Indexing scheme for image analysis or image enhancement
- G06T2207/30—Subject of image; Context of image processing
- G06T2207/30004—Biomedical image processing
- G06T2207/30008—Bone
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- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Life Sciences & Earth Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Transplantation (AREA)
- Heart & Thoracic Surgery (AREA)
- Veterinary Medicine (AREA)
- Public Health (AREA)
- Surgery (AREA)
- General Health & Medical Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- Biomedical Technology (AREA)
- Physical Education & Sports Medicine (AREA)
- Vascular Medicine (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Cardiology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Robotics (AREA)
- Biophysics (AREA)
- Molecular Biology (AREA)
- Computer Vision & Pattern Recognition (AREA)
- Physics & Mathematics (AREA)
- General Physics & Mathematics (AREA)
- Theoretical Computer Science (AREA)
- Prostheses (AREA)
- Surgical Instruments (AREA)
Description
-この装置は、大腿骨義足方向の位置と義足の運動円錐とを比較して外科医に通信するための手段を有する。
-前記通信手段は、大腿骨義足方向の位置及び義足の運動円錐の位置のシンボル表現を表示するための手段を有する。
-この装置は、義足の運動円錐軸の少なくとも1つの優先的な位置を外科医が選択するための又は計算記憶のための手段を有する。
-この装置は、一方では空間位置をつきとめるための手段が設けられた骨盤骨の埋め込み領域に義足の臼蓋窩を決定配置するための衝撃子(impactor)を、他方ではこの衝撃子の打ち込み方向と優先的な位置とを比較するための手段をさらに有する。
-前記測定手段は、大腿骨義足方向を画定するファントム大腿骨部品を有し、この大腿骨部品の、骨盤骨の埋め込み領域に対する位置は、義足の運動円錐と比較される大腿骨義足方向の位置に対応する。
-この装置は骨盤骨のキャビティの中心を決定するための手段を有し、骨盤骨のキャビティは骨盤骨の埋め込み領域を構成し、ファントム大腿骨部品の様々な位置が測定される際にこの部品を受け入れるように適合されている。
-この装置は、大腿骨に固定接続されて空間位置をつきとめるための手段を支承するように適合されたファントム大腿骨部品のためのサポートを有する。このサポートは、例えば、大腿骨やすり、大腿骨ピン、若しくは義足ステムのすべて又は部分によって構成される。
-前記ファントム大腿骨部品は、骨盤骨の埋め込み領域に直接的に関節連結し、埋め込まれる義足の臼蓋窩の外表面に実質的に同一とするように適合された関節表面を画定する。
-この装置は、義足の運動円錐の軸を再現するファントム臼蓋窩を有し、空間位置をつきとめるための手段が設けられた骨盤骨の埋め込み領域に対して手動操作を行うための手段が与えられている。
-治療患者の大腿骨及び骨盤骨の空間位置をつきとめ、
-骨盤骨のキャビティに対する所定の大腿骨義足方向の複数の位置を測定及び記憶し、
-これらの測定済み位置と埋め込まれる義足の運動円錐とを比較してこの円錐の旋回軸の位置を外科手術の過程でキャビティに対して調整し、
-この旋回軸の少なくとも1つの優先的な位置を決定し、
-義足の臼状部分を前記優先的な位置にある骨盤骨のキャビティに打ち込む。
-メガヘッド22をサポートするために、やすり20のハンドルは大腿骨ピン、又は埋め込まれる義足の大腿骨ステムに置き換えられてもよい。この場合、可能であればメガヘッドはその大腿骨サポートに一体化される。
-上述のメガヘッド22は、寸法が義足の大腿骨骨頭の寸法と実質的に同一の頭部と、この頭部に関節連結されて寸法が義足の臼状部分の寸法と実質的に同一の半球形状ドームとによって構成されたファントム大腿骨部品に置き換えられてもよい。
-大腿骨F及び骨盤骨Bの位置をつきとめるための手段は赤外線を反射するマーカに限られない。例えば、超音波又は電磁波に反応するマーカを使用することも可能である。
-キャビティCは優先的な方向Zp-Zpを決定した後にミルで削られてもよい。この場合、様々な極端な関節配置を測定するために、股関節の解剖学的キャビティがメガヘッド22のための関節ハウジングとして使用される。
-外科医に通信を行い極端な関節配置と義足の運動円錐との比較に関する情報を返すために、表示スクリーン以外の手段が考えられてもよい。音又は触覚による指示によって、この比較状況に関する情報を外科医に与え、優先的な方向Zp-Zpの決定を案内してもよい。
-優先的な方向Zp-Zpの決定は、円錐Pと手術中に測定された様々な極端な関節配置の測定値との比較から、及び計算及び外挿による比較から、コンピュータ2を含めた適切なソフトウェアによって統合的に確保されてもよい。
2 コンピュータ
3 センサ
4 赤外線発信源
5、6 反射マーカ
7 表示スクリーン
8 制御ペダル
10 全股関節義足
11 大腿骨部分
12 臼状部分
13 大腿骨ステム
15 大腿骨骨頭
16 臼蓋窩
20 やすり
22 ファントム大腿骨部品(メガヘッド)
30 臼状補助具
31 ファントム臼蓋窩(寛骨臼)
32 操作用剛性ハンドル
A-A 縦軸
B 骨盤骨
B-B 対称軸
C キャビティ
C-C 旋回軸
F 大腿骨
G 仮想案内管
I 打ち込み方向
P 運動円錐
X-X 骨幹方向(対称軸)
Y1〜Y6 シンボル棒
Z-Z 仮想軸
ZP-ZP 好ましい仮想軸
Claims (10)
- 旋回軸(Z-Z)を備えた運動円錐(P)を有する全股関節義足を埋め込むための外科手術装置であって、
当該装置は、所定の大腿骨義足方向(Y-Y)の複数の大腿骨義足の位置を手術中に測定するための測定手段(2、3、22)と、前記運動円錐(P)の旋回軸(Z-Z)の空間位置を手術中に提供するための提供手段(2、3、30)とを有し、
前記大腿骨義足の位置を記憶するための手段(2)と、
前記大腿骨義足の位置と埋め込まれる義足(10)の運動円錐とを手術中に比較する手段とをさらに有し、この運動円錐の旋回軸(Z-Z)の空間位置を義足の埋め込み中に調整して、前記大腿骨義足の位置を前記運動円錐(P)内に配設する装置。 - 大腿骨義足方向(Y-Y)の大腿骨義足の位置と義足の運動円錐(P)とを比較して外科医に通信するための手段(7)を有する請求項1に記載の装置。
- 前記通信手段は、大腿骨義足方向(Y-Y)の大腿骨義足の位置及び義足の運動円錐(P)の位置のシンボル表現(Y1,...Y6,P)を表示するための手段(7)を有する請求項2に記載の装置。
- 義足の運動円錐(P)の軸(Z-Z)の少なくとも1つの優先的な位置(Zp-Zp)を外科医が選択するための又は計算記憶のための手段(2,8)を有する請求項1〜3のいずれかに記載の装置。
- 空間位置をつきとめるための手段が設けられた骨盤骨(B)の領域(C)に義足(10)の臼蓋窩(16)を決定配置するための衝撃子と、この衝撃子の打ち込み方向(I)を前記優先的な位置(Zp-Zp)と比較するための手段(2)とをさらに有する請求項4に記載の装置。
- 前記測定手段は、大腿骨義足方向(Y-Y)を画定するファントム大腿骨部品(22)を有し、
前記義足(10)の運動円錐(P)と比較される前記大腿骨義足の位置は、骨盤骨(B)の領域(C)に対する当該大腿骨部品の空間位置と一致する請求項1〜5のいずれかに記載の装置。 - 骨盤骨(B)のキャビティ(C)が骨盤骨(B)の領域(C)を構成するとともに様々な位置が測定されたファントム大腿骨部品(22)を受容するように、骨盤骨(B)のキャビティ(C)の中心(O)を決定するための手段を有する請求項6に記載の装置。
- ファントム大腿骨部品(22)のためのサポート(20)を有し、当該ファントム大腿骨部品(22)は大腿骨(F)に固定接続されるとともに空間位置をつきとめるための手段(21)を支承するように適合されている請求項6又は7のいずれかに記載の装置。
- 前記ファントム大腿骨部品(22)は、骨盤骨(B)の領域(C)に直接的に関節連結し、埋め込まれる義足(10)の臼蓋窩(16)の外表面に同一とするように適合された関節表面(25)を画定する請求項6〜8のいずれかに記載の装置。
- 前記提供手段は、義足の運動円錐(P)の軸(Z-Z)を再現するファントム臼蓋窩(31)を有し、空間位置をつきとめるための手段(33)が設けられた骨盤骨(B)の領域(C)に対して空間上で手動操作を行うための手段(32)が与えられている請求項1〜9のいずれかに記載の装置。
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
FR0401281 | 2004-02-10 | ||
FR0401281A FR2865928B1 (fr) | 2004-02-10 | 2004-02-10 | Dispositif chirurgical d'implantation d'une prothese totale de hanche |
Publications (2)
Publication Number | Publication Date |
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JP2005224613A JP2005224613A (ja) | 2005-08-25 |
JP4981257B2 true JP4981257B2 (ja) | 2012-07-18 |
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Application Number | Title | Priority Date | Filing Date |
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JP2005034441A Expired - Fee Related JP4981257B2 (ja) | 2004-02-10 | 2005-02-10 | 全股関節義足埋め込みのための外科手術装置 |
Country Status (6)
Country | Link |
---|---|
US (1) | US7927338B2 (ja) |
EP (1) | EP1563810B1 (ja) |
JP (1) | JP4981257B2 (ja) |
AT (1) | ATE462384T1 (ja) |
DE (1) | DE602005020204D1 (ja) |
FR (1) | FR2865928B1 (ja) |
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ATE462384T1 (de) | 2010-04-15 |
EP1563810B1 (fr) | 2010-03-31 |
FR2865928A1 (fr) | 2005-08-12 |
FR2865928B1 (fr) | 2006-03-17 |
DE602005020204D1 (de) | 2010-05-12 |
JP2005224613A (ja) | 2005-08-25 |
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