阅读说明：本技术 膝关节置换手术中股骨远端髓外定位截骨器 (Distal femur extramedullary positioning bone cutter in knee joint replacement operation ) 是由 张洪美 何名江 耿海林 陆九如 胡佩岩 荆琳 闫奇 于 2021-09-13 设计创作，主要内容包括：本发明公开了一种膝关节置换手术中股骨远端髓外定位截骨器,属于医疗器械技术领域,所述膝关节置换手术中股骨远端髓外定位截骨器包括定位基板,定位基板上设有定位孔；定位基板的后端面设有第一角度调节装置、第二角度调节装置和连接模块,第一角度调节装置和第二角度调节装置中一个为内外翻角度调节装置,另一个为前后倾角度调节装置；第一角度调节装置和第二角度调节装置的旋转轴线位于同一平面内且相互垂直；连接模块上可拆卸连接有遥感模块、以及用于连接截骨模块的截骨模块连接件,所述截骨模块连接件连接有截骨模块。本发明的膝关节置换手术中股骨远端髓外定位截骨器操作简单,手术时间短,价格低廉。(The invention discloses a distal femur extramedullary positioning osteotomy device in knee joint replacement surgery, which belongs to the technical field of medical instruments, and comprises a positioning substrate, wherein the positioning substrate is provided with a positioning hole; the rear end face of the positioning substrate is provided with a first angle adjusting device, a second angle adjusting device and a connecting module, one of the first angle adjusting device and the second angle adjusting device is an inward and outward turning angle adjusting device, and the other one is a forward and backward tilting angle adjusting device; the rotation axes of the first angle adjusting device and the second angle adjusting device are positioned in the same plane and are vertical to each other; the connecting module is detachably connected with a remote sensing module and an osteotomy module connecting piece used for connecting the osteotomy module, and the osteotomy module connecting piece is connected with the osteotomy module. The distal femur extramedullary positioning osteotome in the knee joint replacement surgery has the advantages of simple operation, short surgery time and low price.)

1. The utility model provides a distal end extramedullary location osteotomy of thighbone in knee joint replacement operation which characterized in that includes the location base plate, wherein:

the front end surface of the positioning substrate is used for abutting against the outer surface of the distal end of the femur, and a positioning hole is formed in the positioning substrate;

the rear end face of the positioning base plate is provided with a first angle adjusting device, a second angle adjusting device and a connecting module, one of the first angle adjusting device and the second angle adjusting device is an inward and outward turning angle adjusting device capable of adjusting the left and right inclination angles of the connecting module, and the other one is a forward and backward inclination angle adjusting device capable of adjusting the front and back inclination angles of the connecting module;

the rotation axes of the first angle adjusting device and the second angle adjusting device are positioned in the same plane and are perpendicular to each other;

the remote sensing module and the osteotomy module connecting piece are detachably connected to the connecting module, the remote sensing module can acquire the internal and external turning angle and the front and back inclination angle of the femur, and the osteotomy module connecting piece is connected with the osteotomy module.

2. The distal femoral extramedullary positioning osteotome device for knee replacement surgery as claimed in claim 1, wherein the first angle adjusting device is disposed on a lower portion of a rear end surface of the positioning base plate, the second angle adjusting device is disposed on the first angle adjusting device, the connecting module is disposed on the second angle adjusting device, the first angle adjusting device is an eversion angle adjusting device, and the second angle adjusting device is a forward-backward inclination angle adjusting device.

3. The distal femoral extramedullary positioning osteotome of claim 2, wherein said varus angle adjustment device comprises a varus-valgus axis base fixed on said positioning base plate, said anteroposterior angle adjustment device comprises an anteroposterior rotation axis base located on a rotation axis of said varus-valgus axis base, said connection module is disposed on a rotation axis of said anteroposterior rotation axis base;

the side surface of the inward and outward turning rotating shaft base is provided with an inward and outward turning angle adjusting knob, and the side surface of the forward and backward turning rotating shaft base is provided with a forward and backward turning angle adjusting knob.

4. The distal femoral extramedullary positioning osteotome of claim 3, wherein the varus angle adjustment mechanism and the anteroposterior angle adjustment mechanism are worm gears.

5. The distal femoral extramedullary positioning osteotome device for knee replacement surgery of claim 4, wherein the inside and outside eversion rotation axis base is provided with an inside and outside eversion rotation axis driving worm wheel shaft and an inside and outside eversion rotation axis driving worm shaft, the inside and outside eversion rotation axis driving worm wheel shaft is provided with an inside and outside eversion rotation axis driving worm wheel, the inside and outside eversion rotation axis driving worm shaft is provided with an inside and outside eversion rotation axis driving worm engaged with the inside and outside eversion rotation axis driving worm wheel, the inside and outside eversion rotation axis driving worm wheel shaft is fixedly connected with the forward and backward tilting rotation axis base, and the inside and outside eversion rotation axis driving worm shaft is fixedly connected with the inside and outside eversion angle adjusting knob;

and/or a front and back tilting rotation shaft driving worm wheel shaft and a front and back tilting rotation shaft driving worm shaft are arranged in the front and back tilting rotation shaft base, a front and back tilting rotation shaft driving worm wheel is arranged on the front and back tilting rotation shaft driving worm wheel shaft, a front and back tilting rotation shaft driving worm meshed with the front and back tilting rotation shaft driving worm wheel is arranged on the front and back tilting rotation shaft driving worm shaft, the connecting module is in an inverted U shape, and a pair of inverted U-shaped side arms are fixedly connected to two ends of the front and back tilting rotation shaft driving worm wheel shaft.

6. The distal femoral extramedullary positioning osteotomy device for knee replacement surgery of claim 5, wherein bearings are provided at both ends of the varus-valgus axis driving worm shaft and the valgus-valgus axis driving worm shaft;

and/or scales are arranged on the inward and outward turning angle adjusting knob, and scribed lines matched with the scales are arranged on the inward and outward turning rotating shaft base;

and/or bearings are arranged at the two ends of the front and back tilting rotating shaft driving worm shaft and the front and back tilting rotating shaft driving worm shaft;

and/or scales are arranged on the front and back inclination angle adjusting knob, and scribed lines matched with the scales are arranged on the front and back inclination rotating shaft base.

7. The distal intramedullary positioning osteotome of claim 1, wherein the positioning base plate has auxiliary positioning plates extending perpendicularly forward on both sides of the bottom of the front end surface.

8. The distal femur extramedullary positioning osteotome in knee replacement surgery of claim 1, wherein the upper end face of the connection module is provided with a square positioning hole, and the remote sensing module is provided with a square positioning column matched with the square positioning hole;

and/or, the up end of connecting module is equipped with a square locating hole, cut bone module connecting piece is L shape connecting rod, the montant portion end of L shape connecting rod is used for pegging graft in this square locating hole, be used for sliding connection to cut bone module on the horizontal pole portion of L shape connecting rod, so that the guide way on the cut bone module is on a parallel with the plane in which connecting module is located.

9. The distal femoral extramedullary positioning osteotome of claims 1-8, wherein said telemetry module is a MEMS telemetry module having a tri-axial gyroscope and a tri-axial accelerometer sensor disposed therein.

10. The distal femoral extramedullary positioning osteotomy device of claim 9, further comprising an upper computer communicatively coupled to the telemetry module.

Technical Field

The invention relates to the technical field of medical instruments, in particular to a distal femur extramedullary positioning osteotomy device in a knee joint replacement operation.

Background

Total Knee Arthroplasty (TKA) is the ultimate and best practice for treating severe Knee osteoarthritis. At present, the total knee artificial joint replacement operation is clinically carried out, the distal femur osteotomy is mostly carried out by adopting the traditional intramedullary positioning technology, but the error of a femoral positioning rod needle insertion point, the width of a femoral medullary cavity, the difference of the diameter and the insertion length of the positioning rod and the like easily cause the positioning misalignment, and especially when the femur is deformed outside the knee joint such as obvious femur bending angulation, the restraint is unfair, meanwhile, the operation wound is increased by opening the femoral medullary, and the blood loss and the risk of deep venous thrombosis are increased.

In order to avoid the defects of the traditional intramedullary positioning osteotomy, the femur positioning osteotomy performed by applying a 3D printing technology, a computer-aided navigation femur positioning osteotomy technology, a robot-aided technology and a femur extramedullary positioning osteotomy template technology is receiving wide attention. These techniques can improve the accuracy of the alignment of the prosthesis, but still affect its accuracy due to various factors. The high cost, high technical requirements and long learning curve limit the wide popularization and application of the technologies. Some of these techniques increase not only the time of wound exposure due to the long operation time, but also the chance of infection.

Disclosure of Invention

The invention aims to solve the technical problem of providing the distal femur extramedullary positioning osteotomy device in the knee joint replacement surgery, which has the advantages of simple operation, short surgery time and low price.

In order to solve the technical problems, the invention provides the following technical scheme:

a distal end of a femur extramedullary positioning osteotomy device in knee replacement surgery, comprising a positioning base plate, wherein:

the front end surface of the positioning substrate is used for abutting against the outer surface of the distal end of the femur, and a positioning hole is formed in the positioning substrate;

the rear end face of the positioning base plate is provided with a first angle adjusting device, a second angle adjusting device and a connecting module, one of the first angle adjusting device and the second angle adjusting device is an inward and outward turning angle adjusting device capable of adjusting the left and right inclination angles of the connecting module, and the other one is a forward and backward inclination angle adjusting device capable of adjusting the front and back inclination angles of the connecting module;

the rotation axes of the first angle adjusting device and the second angle adjusting device are positioned in the same plane and are perpendicular to each other;

the remote sensing module that can acquire the internal and external angle of turning over of thighbone and front and back inclination angle and the osteotomy module connecting piece that is used for connecting the osteotomy module can be dismantled to be connected with on the linking module, the osteotomy module connecting piece is connected with the osteotomy module.

Furthermore, the lower portion of the rear end face of the positioning substrate is provided with the first angle adjusting device, the first angle adjusting device is provided with the second angle adjusting device, the second angle adjusting device is provided with the connecting module, the first angle adjusting device is an inward-outward-turning angle adjusting device, and the second angle adjusting device is a forward-backward-turning angle adjusting device.

Furthermore, the inside-out turning angle adjusting device comprises an inside-out turning rotating shaft base fixedly arranged on the positioning substrate, the front-back turning angle adjusting device comprises a front-back turning rotating shaft base positioned on a rotating shaft of the inside-out turning rotating shaft base, and the connecting module is arranged on a rotating shaft of the front-back turning rotating shaft base;

the side surface of the inward and outward turning rotating shaft base is provided with an inward and outward turning angle adjusting knob, and the side surface of the forward and backward turning rotating shaft base is provided with a forward and backward turning angle adjusting knob.

Furthermore, the inside and outside turning angle adjusting device and the front and back tilting angle adjusting device both adopt worm and gear transmission mechanisms.

Further, an inside and outside turning axis driving worm wheel shaft and an inside and outside turning axis driving worm shaft are arranged in the inside and outside turning axis base, an inside and outside turning axis driving worm wheel is arranged on the inside and outside turning axis driving worm wheel shaft, an inside and outside turning axis driving worm meshed with the inside and outside turning axis driving worm wheel is arranged on the inside and outside turning axis driving worm shaft, the inside and outside turning axis driving worm wheel shaft is fixedly connected with the front and rear tilting axis base, and the inside and outside turning axis driving worm shaft is fixedly connected with the inside and outside turning angle adjusting knob;

and/or a front and back tilting rotation shaft driving worm wheel shaft and a front and back tilting rotation shaft driving worm shaft are arranged in the front and back tilting rotation shaft base, a front and back tilting rotation shaft driving worm wheel is arranged on the front and back tilting rotation shaft driving worm wheel shaft, a front and back tilting rotation shaft driving worm meshed with the front and back tilting rotation shaft driving worm wheel is arranged on the front and back tilting rotation shaft driving worm shaft, the connecting module is in an inverted U shape, and a pair of inverted U-shaped side arms are fixedly connected to two ends of the front and back tilting rotation shaft driving worm wheel shaft.

Further, bearings are arranged at two ends of the worm shaft driven by the inward and outward turning rotating shaft and the worm shaft driven by the inward and outward turning rotating shaft;

and/or scales are arranged on the inward and outward turning angle adjusting knob, and scribed lines matched with the scales are arranged on the inward and outward turning rotating shaft base;

and/or bearings are arranged at the two ends of the front and back tilting rotating shaft driving worm shaft and the front and back tilting rotating shaft driving worm shaft;

and/or scales are arranged on the front and back inclination angle adjusting knob, and scribed lines matched with the scales are arranged on the front and back inclination rotating shaft base.

Furthermore, auxiliary positioning plates which extend forwards and vertically are arranged on two sides of the bottom of the front end face of the positioning base plate.

Furthermore, a square positioning hole is formed in the upper end face of the connecting module, and a square positioning column matched with the square positioning hole is arranged on the remote sensing module;

and/or, the up end of connecting module is equipped with a square locating hole, cut bone module connecting piece is L shape connecting rod, the montant portion end of L shape connecting rod is used for pegging graft in this square locating hole, be used for sliding connection to cut bone module on the horizontal pole portion of L shape connecting rod, so that the guide way on the cut bone module is on a parallel with the plane in which connecting module is located.

Furthermore, the remote sensing module is an MEMS remote sensing module, and a triaxial gyroscope and a triaxial accelerometer sensor are arranged in the MEMS remote sensing module.

Furthermore, the distal end of the femur extramedullary positioning osteotomy device in the knee joint replacement operation also comprises an upper computer which is in communication connection with the remote sensing module.

The invention has the following beneficial effects:

according to the distal femur extramedullary positioning osteotomy device in knee joint replacement surgery, through a simple navigation design, the remote sensing module is carried on the connecting module to accurately position the center of the femoral head, the adjustment of the varus angle, the valgus angle, the front inclination angle and the back inclination angle of the distal femur osteotomy module is realized through the inner and outer tilting angle adjusting device and the front and back tilting angle adjusting device, the digitization, the precision and the individuation of the distal femur osteotomy are realized, the prosthesis alignment and the alignment are accurate, no femur marrow opening is needed, the surgery wound is small, the postoperative bleeding is less, the complications are less, the operation is simple, the time required by the surgery is short, the price is relatively low, and the popularization and the application of primary hospitals are facilitated.

Drawings

FIG. 1 is a schematic view of a combination structure of a distal femur extramedullary positioning osteotomy device (without a remote sensing module and an osteotomy module connecting piece) in knee joint replacement surgery according to the present invention;

FIG. 2 is a schematic view of another assembly of the distal extramedullary positioning osteotomy device for femur in knee joint replacement surgery according to the present invention (with a remote sensing module and without an osteotomy module connection component);

FIG. 3 is a schematic view of another assembly of the distal extramedullary positioning osteotomy device for femur in knee joint replacement surgery (with osteotomy module connecting component and without telesensing module);

FIG. 4 is an elevation view of the distal extramedullary positioning osteotomy tool of the femur of the knee replacement procedure of FIG. 3;

FIG. 5 is a side cross-sectional view of the distal extramedullary positioning osteotomy tool of the femur of FIG. 3 in a knee replacement procedure;

FIG. 6 is a partial top cross-sectional view of the distal extramedullary positioning osteotomy tool of the femur of FIG. 1 during a knee replacement procedure;

FIG. 7 is a schematic view of the communication structure between the remote sensing module and the upper computer in the distal end extramedullary positioning osteotomy device of femur in knee joint replacement surgery according to the present invention;

FIG. 8 is a schematic view of the measurement principle of the remote sensing module in the distal end extramedullary positioning osteotomy device of femur in knee joint replacement surgery according to the present invention;

FIG. 9 is a schematic view of a display interface of an upper computer communicating with a remote sensing module in the distal end extramedullary positioning osteotomy device of femur in knee joint replacement surgery of the present invention.

Detailed Description

In order to make the technical problems, technical solutions and advantages of the present invention more apparent, the following detailed description is given with reference to the accompanying drawings and specific embodiments.

The invention provides a distal femur extramedullary positioning osteotome in knee joint replacement surgery, as shown in figures 1-9, comprising a positioning base plate 1, wherein:

the front end surface of the positioning substrate 1 is used for abutting against the outer surface of the distal end of the femur, and the positioning substrate 1 is provided with a positioning hole 11 so as to fix the positioning substrate 1 on the outer surface of the distal end of the femur; the number of the positioning holes 11 may be four, and the positioning holes are respectively located at four corners of the positioning substrate 1;

the rear end face of the positioning base plate 1 is provided with a first angle adjusting device, a second angle adjusting device and a connecting module 4, one of the first angle adjusting device and the second angle adjusting device is an inward and outward turning angle adjusting device 2 capable of adjusting the left and right inclination angles of the connecting module 4, and the other one is a forward and backward inclination angle adjusting device 3 capable of adjusting the forward and backward inclination angles of the connecting module 4;

the rotation axes of the first angle adjusting device and the second angle adjusting device are positioned in the same plane and are perpendicular to each other, so that the universal adjustment of the connecting module 4 is realized;

the remote sensing module 5 capable of acquiring the internal and external turning angle and the front and back inclination angle of the femur and the osteotomy module connecting piece 7 used for connecting the osteotomy module 6 are detachably connected to the connecting module 4, and the osteotomy module connecting piece 7 is connected with the osteotomy module 6.

The operation process of the distal end extramedullary positioning osteotomy device in the knee joint replacement surgery can refer to the following steps:

1. bending the knee joint of a patient by 90 degrees, abutting the front end surface of the positioning substrate 1 against the outer surface of the distal end of the femur, and nailing and fixing the positioning substrate 1 along the positioning hole 11 on the positioning substrate 1;

2. the remote sensing module 5 is arranged on the connecting module 4, so that an operator can obtain the coordinate value of the spherical center of the femoral head through simple knee joint rotary motion of a patient, and obtain the angle data of primary internal and external overturn and forward and backward inclination by the remote sensing module 5;

3. according to the angle data of the primary inward-outward turning and forward-backward turning, the inward-outward turning angle adjusting device 2 is adjusted to obtain a satisfactory inward-outward turning angle, and the forward-backward turning angle adjusting device 3 is adjusted to obtain a satisfactory forward-backward turning angle;

4. after a satisfactory angle is obtained (at the moment, the plane where the connecting module 4 is located is perpendicular to the axis of the femur), the remote sensing module 5 is detached, the osteotomy module connecting piece 7 is connected to the connecting module 4, the osteotomy module 6 is connected to the osteotomy module connecting piece 7, the osteotomy amount is adjusted, and then the osteotomy module 6 is fixed for positioning and osteotomy.

During the research process, the inventor finds that the original femur extramedullary positioning osteotomy device (ZL 201720569362.1) can assist the operator to obtain more satisfactory femur distal coronal plane osteotomy positioning, but still has the following defects: the calibration of the central position of the femoral head before the TKA operation can cause positioning errors of the femoral head due to knee joints bending and stretching in the operation, traction in the operation and the like, and the positioning errors of the coronal plane and the sagittal plane of the distal femur are directly influenced.

The distal femur extramedullary positioning osteotome in knee joint replacement surgery is a further improvement of the original extramedullary positioning osteotome (ZL 201720569362.1), and is additionally provided with a positioning adjusting component (namely an internal and external tilting angle adjusting device and an anteroposterior tilting angle adjusting device) and a remote sensing module, compared with the prior art, the central position (error is +/-6 mm) of the femoral head can be more accurate, the precise adjustment of the valgus angle, the front tilting angle and the back tilting angle in the distal femur osteotome module can be obtained, more accurate and personalized distal femur coronal plane and sagittal plane osteotome positioning can be obtained, the digitization, the accuracy and the personalization of the distal femur osteotome can be realized, the influence on the positioning due to abnormal shape of the femoral medullary cavity can be effectively avoided, the surgical trauma can be greatly reduced, the postoperative bleeding during surgery and after surgery can be reduced, and the release of a tiny embolus caused by the opening of the femur and the intramedullary rod insertion can be reduced, The method has the advantages of reducing the occurrence of complications such as deep venous thrombosis, pulmonary cerebral embolism and the like in and after the operation, accelerating postoperative rehabilitation, conforming to the ERAS concept of orthopedics, reducing the number of hospitalization days of the patient, reducing the treatment cost of the patient, giving confidence for TKA treatment of the severe knee osteoarthritis patient, generating huge assistance to the improvement of the image of the hospital, being simple to operate, having relatively low price, being more beneficial to the popularization and application of primary hospitals, and playing an immeasurable role in the aspects of reducing huge social burden and financial expenditure of the knee osteoarthritis to the society. The invention is suitable for total knee joint replacement surgery.

In order to conveniently adjust the front-back inclination angle and the left-right inclination angle of the connecting module 4, the first angle adjusting device and the second angle adjusting device can simultaneously drive the connecting module in a mode of sharing a universal ball joint spherical hinge; however, in order to facilitate the independent adjustment of the varus-valgus angle and the forward-backward tilt angle, the present invention preferably adopts the following structure:

the lower part of the rear end face of the positioning substrate 1 is provided with a first angle adjusting device, the first angle adjusting device is provided with a second angle adjusting device, the second angle adjusting device is provided with a connecting module 4, the first angle adjusting device is an inward-outward-turning angle adjusting device 2, and the second angle adjusting device is a forward-backward-tilting angle adjusting device 3.

It is conceivable that it is also possible to design: the first angle adjusting device is a forward and backward inclination angle adjusting device, and the second angle adjusting device is an inward and outward inclination angle adjusting device.

In specific implementation, the inward and outward tilting angle adjusting device 2 may include an inward and outward tilting rotation axis base 21 fixedly disposed on the positioning substrate 1, the forward and backward tilting angle adjusting device 3 may include a forward and backward tilting rotation axis base 31 disposed on a rotation axis of the inward and outward tilting rotation axis base 21, and the connection module 4 is disposed on a rotation axis of the forward and backward tilting rotation axis base 31;

the side of the inside and outside tilting rotary shaft base 21 is provided with an inside and outside tilting angle adjusting knob 22, and the side of the front and rear tilting rotary shaft base 31 is provided with a front and rear tilting angle adjusting knob 32.

When the device is used and the inside-outside turning angle needs to be adjusted, the inside-outside turning angle adjusting knob 22 is driven to enable the rotating shaft of the inside-outside turning rotating shaft base 21 to rotate, the rotating shaft of the inside-outside turning rotating shaft base 21 drives the front-back turning rotating shaft base 31 to rotate, and then the connecting module 4 is arranged to incline left and right to adjust the inside-outside turning angle; when the forward/backward tilt angle needs to be adjusted, the forward/backward tilt angle adjusting knob 32 is driven to rotate the rotating shaft of the forward/backward tilt rotating shaft base 31, and the connecting module 4 provided on the rotating shaft of the forward/backward tilt rotating shaft base 31 is tilted forward/backward to adjust the forward/backward tilt angle.

The angle adjusting structure of the inward and outward turning angle adjusting device 2 and the forward and backward turning angle adjusting device 3 can adopt various modes which can be easily thought by a person skilled in the art, for example, a gear is arranged on a driving shaft, the driving shaft drives the gear to rotate so as to realize angle adjustment and the like, however, in order to realize accurate adjustment and convenient locking, the angle adjusting structure of the inward and outward turning angle adjusting device 2 and the forward and backward turning angle adjusting device 3 can be a worm gear transmission mechanism (figures 5-6), and particularly, a worm gear transmission mechanism with small modulus and large transmission ratio can be adopted so as to obtain larger transmission ratio, high-precision angle adjustment and high-rigidity posture maintenance are realized, the transmission is stable, the noise is small, the bearing capacity is large, and the self-locking property is realized.

As shown in fig. 5 to 6, the specific structure of the inside-outside tilting angle adjusting device 2 may be as follows:

the inside and outside turning axis base 21 is provided with an inside and outside turning axis driving worm shaft 211 and an inside and outside turning axis driving worm shaft 212, the inside and outside turning axis driving worm shaft 211 is provided with an inside and outside turning axis driving worm wheel 213, the inside and outside turning axis driving worm shaft 212 is provided with an inside and outside turning axis driving worm 214 meshed with the inside and outside turning axis driving worm wheel 213, the inside and outside turning axis driving worm shaft 211 is fixedly connected with the front and rear tilting axis base 31, and the inside and outside turning axis driving worm shaft 212 is fixedly connected with the inside and outside turning angle adjusting knob 22. At this time, when in use, the rotation of the inside and outside tilting axis driving worm 214 is realized by adjusting the inside and outside tilting angle adjusting knob 22, and the rotation of the inside and outside tilting axis driving worm shaft 211 is driven by the meshing of the inside and outside tilting axis driving worm 214 and the inside and outside tilting axis driving worm wheel 213, so that the rotation of the front and back tilting axis base 31 is realized, and the left and right tilting of the connection module 4 is realized.

As shown in fig. 6, the specific structure of the pitch angle adjusting means 3 may be as follows:

the front-rear tilting rotation shaft base 31 is internally provided with a front-rear tilting rotation shaft driving worm shaft 311 and a front-rear tilting rotation shaft driving worm shaft 312, the front-rear tilting rotation shaft driving worm shaft 311 is provided with a front-rear tilting rotation shaft driving worm wheel 313, the front-rear tilting rotation shaft driving worm shaft 312 is provided with a front-rear tilting rotation shaft driving worm 314 meshed with the front-rear tilting rotation shaft driving worm wheel 313, the connecting module 4 is in an inverted U shape, and a pair of inverted U-shaped side arms is fixedly connected to two ends of the front-rear tilting rotation shaft driving worm wheel shaft 311. At this time, in use, the forward/backward tilt axis driving worm 314 is rotated by adjusting the forward/backward tilt angle adjusting knob 32, and the forward/backward tilt axis driving worm 314 is engaged with the forward/backward tilt axis driving worm wheel 313 to drive the forward/backward tilt axis driving worm wheel shaft 311 to rotate, thereby realizing the forward/backward tilt arm of the connection module 4.

In order to support the inside-outside rotation shaft driving worm shaft 212 and the inside-outside rotation shaft driving worm shaft 211 to rotate smoothly, bearings 215 (specifically, high-precision micro ball bearings) may be provided at both ends of the inside-outside rotation shaft driving worm shaft 212 and the inside-outside rotation shaft driving worm shaft 211. In order to facilitate the quantitative adjustment of the inward and outward turning angles and the recording of the posture coordinate data, scales can be arranged on the inward and outward turning angle adjusting knob 22, and scribed lines matched with the scales are arranged on the inward and outward turning rotating shaft base 21. The inner and outer rotation shaft driving worm wheel shaft 211 may have a mechanical limiting groove (not shown) to limit the angle of the inner and outer rotation shaft driving worm wheel shaft 211 within a reasonable range, thereby preventing over-travel operation during use.

In order to support the forward/backward tilting axis drive worm shaft 312 and the forward/backward tilting axis drive worm shaft 311 to rotate smoothly, bearings 315 may be provided at both ends of the forward/backward tilting axis drive worm shaft 312 and the forward/backward tilting axis drive worm shaft 311. In order to facilitate quantitative adjustment of the forward and backward tilting angles and recording of attitude coordinate data, scales can be arranged on the forward and backward tilting angle adjusting knob 32, and scribed lines matched with the scales are arranged on the forward and backward tilting rotating shaft base 31. Mechanical limiting grooves (not shown) may be formed on the forward and backward tilting axis drive worm shaft 311 to limit the angle of the forward and backward tilting axis drive worm shaft 311 within a reasonable range, thereby preventing over-travel operation during use.

To be convenient for fix a position locating substrate 1, the preceding terminal surface bottom both sides of locating substrate 1 can be equipped with the auxiliary positioning board 12 of preceding vertical extension, and locating substrate 1 is L shape locating substrate this moment, and two medial surfaces paste the bone surface and fix a position, and fixing that can be better prevents that locating substrate 1 from rocking in thighbone distal end surface and lower surface department. The positioning base plate 1 can adopt a hollow design, so that the structural weight is reduced to the maximum extent, and the compression of the device on bone tissues is reduced.

The detachable connection between the connection module 4 and the remote sensing module 5 can be implemented by various structures, such as bolt fastening, etc., which are easily conceived by those skilled in the art, the upper end surface of the connection module 4 of the present invention can be provided with a square positioning hole (temporarily shown as a pair of circular positioning holes 41 in the figure), the remote sensing module 5 is provided with a square positioning post 51 matching with the square positioning hole, and the square positioning post 51 is in inserting fit with the square positioning hole.

The detachable connection between the connection module 4 and the osteotomy module connecting member 7 can also be formed in various configurations that can be easily understood by those skilled in the art, however, in order to make the osteotomy more precise, the upper end surface of the connection module 4 can be provided with a square positioning hole (temporarily shown as a pair of circular positioning holes 41 in the figure), the osteotomy module connecting member 7 is an L-shaped connecting rod, the end of the vertical rod portion 71 of the L-shaped connecting rod is adapted to be inserted into the square positioning hole (the vertical rod portion 71 of the L-shaped connecting rod can be fixed by fastening screws on the side surface), and the horizontal rod portion 42 of the L-shaped connecting rod is adapted to be slidably connected with the osteotomy module 6, so that the guiding groove 61 on the osteotomy module 6 is parallel to the plane of the connection module 4. At this time, when in use, the osteotomy module 6 is driven to slide on the cross bar portion 42 of the L-shaped connecting rod, so that the osteotomy amount can be adjusted.

Further, the cross section of the cross rod part 72 of the L-shaped connecting rod can be square, and the osteotomy module 6 is provided with a square hole 62 matched with the square, so that sliding and positioning can be realized according to position requirements. The horizontal rod part 72 of the L-shaped connecting rod is provided with scales, so that the sliding distance of the osteotomy module 6 can be conveniently and accurately adjusted, and further the osteotomy thickness can be adjusted. The osteotomy module 6 has a staple hole 63 for passing a surgical staple therethrough to effect fixation of the osteotomy module 6 to the bone tissue. The osteotomy module 6 adopts a hollow design, so that the weight of the osteotomy module 6 can be reduced, and the oppression of the device on bone tissues is reduced.

In the invention, the method for acquiring the varus-valgus angle and the anteroposterior inclination angle of the femur by the remote sensing module 5 can comprise the following steps:

step 1: through simple circular motion of hip-knee joint combination of a patient in an operation, a femoral head rotation center is obtained as a fixed point A, and a knee joint motion point (namely a remote sensing module central point) is obtained as a mass point O;

in this step, for the particle O rotating around the fixed point a, a four-point position newton iteration method may be adopted to solve the center position, and determine the position of the fixed point a (refer to fig. 8);

step 2: obtaining a vector from a fixed point A to a particle O, namely a force line r of the femur, determining a posture angle of the remote sensing module relative to the force line vector AO, obtaining an expected lower limb force line osteotomy angle by adjusting the posture of the remote sensing module, and stopping adjusting and installing the osteotomy module to carry out the distal femur condyle osteotomy operation after obtaining the expected lower limb force line osteotomy angle.

In this step, the angle of resection of the femoral lower limb line of force, i.e., the data shown in fig. 9, according to the embodiment shown in fig. 9, when the varus angle in the coronal plane and the anterior-posterior inclination angle in the sagittal plane are both adjusted to have errors within ± 1 °, i.e., the femoral line of force at this time is considered to be valgus 6 °, anteversion 5 °, which is the expected femoral line of force, the adjustment can be stopped and the resection module can be installed to perform the femoral distal condyle resection operation.

The remote sensing module 5 is preferably an MEMS (micro electro mechanical systems) remote sensing module, in which a three-axis gyroscope and a three-axis accelerometer sensor are arranged, so that multi-sensor data acquisition, filtering and multi-layer data depth fusion can be realized, and data stability and precision are ensured. By utilizing the MEMS sensor, the center of the femoral head can be found in the total knee joint replacement and accurately positioned, the fine adjustment of the valgus angle, the front inclination angle and the rear inclination angle in the distal femoral osteotomy module is realized, and the positioning of the distal femoral osteotomy surface is realized.

As shown in FIG. 7, the internal structure of the MEMS remote sensing module (i.e. the left side two-end module) can comprise: the system comprises a navigation measurement sensor, a data forwarding module (namely a WIFI module) and a battery pack (specifically, a 5V lithium battery pack). The remote sensing module 5 can adopt an integrated structure and a separated design scheme, namely: after the sensor collects data, the upper computer is used for navigation calculation, so that a front-back inclination angle and an inside-outside turning angle are obtained, femoral head center navigation calculation software is operated on the upper computer, and data collection and navigation calculation are carried out through the data forwarding module, namely: the distal femur extramedullary positioning osteotome in the knee replacement surgery may further include an upper computer (i.e., a navigation calculation and control terminal on the right side, specifically, a smart phone, a computer, etc.) in communication connection with the remote sensing module 5, so as to perform navigation calculation on data collected by the remote sensing module 5.

The distal femur extramedullary positioning osteotome in the knee joint replacement operation can finely adjust the distal femur inside and outside eversion osteotomy angle and the front and back inclination osteotomy angles, and obtain more accurate and personalized distal femur coronal plane and sagittal plane osteotomy positioning. The error of data obtained by the navigation measurement sensor is +/-0.6 degrees, and the overall error is +/-1 degrees by adding the system installation error, the error of instrument installation operation and the like. The digitization, the precision and the individuation of the distal femur osteotomy are realized. The MEMS remote sensing module can obtain the acceleration and acceleration information of the knee joint in the rotary motion in real time, and obtains the accurate simple pendulum center, namely the position of the femoral head, by utilizing the simple pendulum principle, the simple pendulum dynamic model or the kinematics calculation arc mode and utilizing the geometric relation and the low-pass filtering algorithm, so that the initial femoral varus-valgus and anteroposterior osteotomy angle data are obtained on the upper computer.

Retrospective study data results of a femoral extramedullary positioning osteotomy instrument (ZL 201720569362.1) developed earlier showed that 273 cases of patients were operated by extramedullary positioning technique, the intraoperative and postoperative blood loss was (109.11 ± 70.73) ml, the incidence of DVT was 11% (30/273) at 1 week after operation, the patient errors were ± 3 ° for the knee joint valgus angle measured at 2 weeks after operation of 7.34 ° ± 0.69 °, 77.3% (211/273), the femoral prosthesis flexion angle was 6.43 ° ± 1.59 °, 273 cases were all within ± 10 ° error. Compared with an early-developed femoral extramedullary positioning osteotomy device (ZL 201720569362.1), the distal femoral extramedullary positioning osteotomy device in the knee joint replacement surgery can reduce the operative blood loss and the incidence rate of postoperative DVT, and also improves the positioning accuracy of the distal femoral osteotomy on the sagittal plane; the femoral head central position determination method has the advantages that the osteotomy positioning in the distal coronal plane and the sagittal plane of the femur is more accurate, more personalized and more digital, the determination of the femoral head central position is more accurate, the surgical trauma is smaller, the intraoperative and postoperative bleeding is less, the intraoperative and postoperative deep vein thrombosis, pulmonary cerebral embolism and other complications are less, the rehabilitation is quicker, the operation is simple, the accuracy is high, and the price is relatively low.

While the foregoing is directed to the preferred embodiment of the present invention, it will be understood by those skilled in the art that various changes and modifications may be made without departing from the spirit and scope of the invention as defined in the appended claims.