Surgical procedure of knee joint

Abstract

A surgical procedure of preparing bone holes to dispose an implanted tendon to a femur when performing reconstruction of a ligament in a knee joint, includes: forming a first bone hole in the femur; and applying ultrasonic vibration from a treatment portion of an ultrasonic treatment instrument to the femur, thereby cutting and expanding the first bone hole from the inside of the knee joint to the first bone hole of the femur along a predetermined depth, and forming a second bone hole having a polygonal shape, an approximately polygonal shape, an elliptical shape or an approximately elliptical shape to receive the implanted tendon.

What is claimed is: 
     
         1 . A surgical procedure of preparing bone holes to dispose an implanted tendon to a femur when performing reconstruction of a ligament in a knee joint, comprising:
 forming a first bone hole in the femur; and   applying ultrasonic vibration from a treatment portion of an ultrasonic treatment instrument to the femur, thereby cutting and expanding the first bone hole from the inside of the knee joint to the first bone hole of the femur along a predetermined depth, and forming a second bone hole having a polygonal shape, an approximately polygonal shape, an elliptical shape or an approximately elliptical shape to receive the implanted tendon.   
     
     
         2 . The procedure according to  claim 1 , wherein a bottom surface of the second bone hole is continuous with the first bone hole. 
     
     
         3 . The procedure according to  claim 2 , wherein the second bone hole is formed so that a central axis of the second bone hole matches or substantially matches a central axis of the first bone hole in the bottom surface of the second bone hole. 
     
     
         4 . The procedure according to  claim 1 , wherein:
 when the treatment portion of the ultrasonic treatment instrument which forms the second bone hole is projected from a distal side to a proximal side along a longitudinal axis of the treatment portion of the ultrasonic treatment instrument, its projection shape is the polygonal shape, the approximately polygonal shape, the elliptical shape or the approximately elliptical shape, and   the second bone hole is formed into a desired size and a desired shape by pressing the treatment portion of the ultrasonic treatment instrument to the first bone hole once or a number of times.   
     
     
         5 . The procedure according to  claim 1 , wherein the first bone hole is a through hole. 
     
     
         6 . The procedure according to  claim 5 , wherein:
 the implanted tendon is received in the second bone hole from the knee joint toward the outside of the femur,   the first bone hole and the second bone are to guide a fixture that fixes the implanted tendon from the inside of the knee joint to the outside of the femur, and   the first bone hole is formed in a size to pass the fixture to the outside of the femur so that the fixture is supported on the outside of the femur.   
     
     
         7 . The procedure according to  claim 1 , wherein the first bone hole is a concave hole. 
     
     
         8 . The procedure according to  claim 1 , wherein:
 when the treatment portion of the ultrasonic treatment instrument which forms the second bone hole is projected from a distal side to a proximal side along a longitudinal axis of the treatment portion of the ultrasonic treatment instrument, its projection shape is the polygonal shape, the approximately polygonal shape, the elliptical shape or the approximately elliptical shape, and   the second bone hole is formed into the polygonal shape, the approximately polygonal shape, the elliptical shape or the approximately elliptical shape by moving the treatment portion along the longitudinal axis.   
     
     
         9 . The procedure according to  claim 1 , wherein the first bone hole is formed by applying the ultrasonic vibration from the treatment portion to the femur in a state where the ultrasonic vibration is transmitted to the treatment portion of the ultrasonic treatment instrument. 
     
     
         10 . The procedure according to  claim 1 , wherein the first bone hole is formed with a drill. 
     
     
         11 . The procedure according to  claim 1 , wherein the second bone hole is formed as a concave hole or a through hole having a polygonal shape, an approximately polygonal shape, an elliptical shape or an approximately elliptical shape to receive one of bone fragments which are present at both ends of a patellar tendon, from the inside of the knee joint toward the outside of the femur along a predetermined depth, by applying the ultrasonic vibration from the treatment portion to the femur in a state where the ultrasonic vibration is transmitted to the treatment portion of the ultrasonic treatment instrument. 
     
     
         12 . The procedure according to  claim 11 , wherein:
 when the treatment portion of the ultrasonic treatment instrument which forms the second bone hole is projected from a distal side to a proximal side along a longitudinal axis of the treatment portion of the ultrasonic treatment instrument, its projection shape is the polygonal shape, the approximately polygonal shape, the elliptical shape or the approximately elliptical shape, and   the second bone hole is formed into the polygonal shape, the approximately polygonal shape, the elliptical shape or the approximately elliptical shape by moving the treatment portion along the longitudinal axis.   
     
     
         13 . The procedure according to  claim 11 , wherein the second bone hole is formed into a desired size and a desired shape by pressing the treatment portion of the ultrasonic treatment instrument at a position adjacent to the bone hole once or a number of times. 
     
     
         14 . A procedure of fixing one of bone fragments which are present at both ends of a patellar tendon to a femur when performing reconstruction of a ligament in a knee joint, comprising:
 applying ultrasonic vibration from a treatment portion of an ultrasonic treatment instrument to the femur in a state where the ultrasonic vibration is transmitted to the treatment portion thereof, thereby forming a concave hole or a through hole as a first bone hole having a polygonal shape, an approximately polygonal shape, an elliptical shape or an approximately elliptical shape to receive the one bone fragment of the patellar tendon from the inside of the knee joint toward the outside of the femur along a predetermined depth; and   fixing the one bone fragment to the femur in a state where the one bone fragment is received to the first bone hole.