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CN101917936B - 髋臼假体 - Google Patents

髋臼假体 Download PDF

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Publication number
CN101917936B
CN101917936B CN2008801251461A CN200880125146A CN101917936B CN 101917936 B CN101917936 B CN 101917936B CN 2008801251461 A CN2008801251461 A CN 2008801251461A CN 200880125146 A CN200880125146 A CN 200880125146A CN 101917936 B CN101917936 B CN 101917936B
Authority
CN
China
Prior art keywords
screw
acetabular prosthesis
prosthesis according
cup
head
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired - Fee Related
Application number
CN2008801251461A
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English (en)
Other versions
CN101917936A (zh
Inventor
D·达拉里
G·皮尼亚蒂
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Istituto Ortopedico Rizzoli
Original Assignee
Istituto Ortopedico Rizzoli
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Publication of CN101917936A publication Critical patent/CN101917936A/zh
Application granted granted Critical
Publication of CN101917936B publication Critical patent/CN101917936B/zh
Expired - Fee Related legal-status Critical Current
Anticipated expiration legal-status Critical

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    • 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
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8033—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers
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    • A61B17/8033—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers
    • A61B17/8042—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers the additional component being a cover over the screw head
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    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30537—Special structural features of bone or joint prostheses not otherwise provided for adjustable
    • A61F2002/30538—Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting angular orientation
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    • A61F2250/0006—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof adjustable for adjusting angular orientation

Landscapes

  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

本发明公开了一种髋臼假体(1)，其包括：杯(2)，该杯设计成插入相关髋臼中；以及第一螺钉(6)，用于固定该杯(2)，该第一螺钉设计成通过拧入骨盆骨的一部分中来进行接合；杯(2)包括：壁(3)，该壁(3)有基本平滑的外部面(3a)；以及凸起(4)，该凸起(4)从壁(3)向外伸出，并与平滑面(3a)连接。

Description

髋臼假体
技术领域
本发明涉及一种髋臼假体，特别是涉及这样一种髋臼假体，该髋臼假体设计成在再次手术中植入，和/或植入患有髋臼的退化性或先天性疾病和/或严重形态学改变的病人中。
背景技术
已知外科手术用于解决与髋关节相连的问题。
两块骨在髋关节处连接，即骨盆和股骨，股骨的头部容纳在近似为半球形空腔(称为髋臼)内。
很多这样的外科手术包括在关节的一个或两个部件上使用假体。
发明内容
本发明专门涉及关节假体部分，它定位在骨盆内，并称为杯状髋臼假体或髋臼杯。
因此，髋臼假体通常植入骨盆中，以便解决属于髋臼的髋关节的缺陷。
假体通过各种技术而固定在骨盆内的髋臼中，例如使用螺钉、外科手术胶接剂和机械压迫或螺钉连接。
通常，特别在所述再次手术中(也就是说当需要代替先前植入的假体时)和/或在患有退化性骨组织疾病的病人中，外科医生将面对与将新假体有效固定在骨盆上相关的较大困难。
在第一种情况下，实际上，假体已经植入意味着髋臼的壁已经几乎除去或重新吸收，因此减小了可以用于有效锚固的骨区域；在第二种情况下，在另一方面，这些疾病意味着不容易识别髋臼附近的机械有效区域(假体可以牢固锚固在该机械有效区域中)。
在本文中，本发明的目的是提供一种髋臼假体，它设计成在再做手术中牢固锚固，或者在骨盆骨的退化性或先天性疾病中牢固锚固。
特别是，本发明的目的是提供一种髋臼假体，它能够有效和牢固地植入。
根据前述目的，本发明的技术特征可以清楚推测。
本发明公开了一种髋臼假体，其包括：杯，该杯设计成插入相关髋臼中；以及第一螺钉，用于固定该杯，该第一螺钉设计成通过拧入骨盆骨的一部分中来进行接合；所述杯包括壁和凸起，该壁具有基本平滑的外部面，该凸起从壁向外延伸，并与平滑的外部面连接，所述凸起具有第一通孔和壳体，所述第一通孔用于插入所述第一螺钉，所述壳体用于限制螺钉的相应头部，其中，所述髋臼假体还包括多个肋，所述多个肋环绕凸起的外部表面分布并沿凸起的中心轴线纵向伸展。
附图说明
通过下面参考附图的详细说明，将更清楚本发明的优点，附图表示了作为非限定实例的本发明优选实施例，附图中：
图1表示了本发明的髋臼假体的示意侧视图；
图2表示了图1中所示的髋臼假体从上面看的示意图；
图3是沿图2中的线III-III剖开的剖视图；
图4和5表示了本发明的髋臼假体在不同植入步骤中的相应剖视图；
图6表示了本发明的髋臼假体在植入构造中的示意侧视图；
图7表示了图6中所示的髋臼假体的示意正视图；
图8是沿图7中所示的线VIII-VIII剖开的剖视图；
图9表示了图5和8中所示的假体的一部分的透视图；
图10表示了图4至8中所示的假体的一部分的示意侧视图；
图11表示了在前面图中所示的假体的可选实施例的示意侧视图。
具体实施方式
根据图1中所示，参考标号1表示本发明的髋臼假体。
髋臼假体1包括外部杯2，该外部杯2设计成插入从病人身体中存在的自然髋臼开始而形成的相应空腔(未示出)中，如后面更好地介绍。
杯2包括变化厚度的壁3，该壁3有外部面3a，该外部面3a基本由半球形表面S1和切开的圆柱形表面C来限定，该圆柱形表面C的平面相对于它的中心轴线倾斜；外部面3a基本平滑。
壁3还有内部面3b，该内部面3b部分由截锥形表面T1限定。
近似截锥形凸起4从壁3延伸，该凸起与杯2的平滑外部面3a连接。
凸起4设有第一通孔5。
根据图4中所示，髋臼假体1包括第一螺钉6，用于将杯2固定在骨盆骨上。
第一螺钉6包括螺纹杆7和头部8。
第一螺钉6的头部8具有球形区域形状，意思是通过用相互平行的两个平表面切割球体而获得的实体几何形状。
空腔8a位于头部8的内部，该空腔优选是六边形，设计成与用于将第一螺钉6拧入的合适装置接合。
在凸起4中的第一通孔5设计成用于第一螺钉6通过。
参考图3，凸起4还有环绕第一孔5的凹形壳体9，该凹形壳体9设计成限制第一螺钉6的头部8。
优选是但并不必须地，凹形壳体9相对于第一螺钉6的头部8形状相反，因此也具有带球形区域形状的内表面9a。
这样限定了在头部8和某相应壳体9之间的、用于第一螺钉6的球形接合部。
根据图5和8中所示，髋臼假体1包括螺纹元件10，该螺纹元件10设计成接合在壳体9的相应螺纹部分9b中。
根据图9中所示，内部空心的螺纹元件10有局部球形的内表面10a，该局部球形内表面10a表示该表面具有基本为球形的形状，与凹形壳体9的表面9a类似。螺纹元件10还有四个凹槽10b，这些凹槽10b呈十字布置，设计成与用于拧入该元件10的合适装置接合。
如图5中清楚所示，螺纹元件10的内表面10a设计成与第一螺钉6的头部8接触地接合，以便将头部8推靠在壳体9上，并相对于杯2阻挡该头部8，壳体9是该杯2的整体部件。
因此，螺纹元件10限定了用于将头部8固定在壳体9中的装置11，该装置11设计成防止在第一螺钉6和杯2之间相对运动，反之亦然。
根据图2和3中所示，杯2的壁3有多个第二通孔12，这些第二通孔12位于离第一孔5一定距离处。
根据图6至8中所示，髋臼假体1还包括多个第二螺钉13，这些第二螺钉13设计成插入第二孔12中，并接合在髂骨上。
第二孔12的内表面具有局部球形形状，第二螺钉13的头部(未示出)也是这样，因此该第二螺钉13在插入相应的第二孔12中时能够定位，尽管环绕两个相反形状球形区域的公共中心具有有限的球形运动。
优选地，第一螺钉6的直径在6和14毫米之间，长度在40和120毫米之间。
优选地，第二螺钉13的直径大约为6毫米，长度在20和60毫米之间。
根据图6、7和8中所示，髋臼假体1包括插入件14，该插入件14有外部截锥形表面T2，该外部截锥形表面T2相对于杯2的壁3的内部截锥形表面T1的形状相反，并设计成与它接触地接合。
插入件14还包括基本半球形内表面S2，该半球形内表面S2设计成容纳股骨的相应假体头部(未示出)。
杯2的壁3的内部截锥形表面T1有相应的中心轴线A1，该中心轴线A1与凸起4的中心轴线A2成一定角度。
优选是，根据附图中所示的实施例，轴线A1、A2相互成一定角度。
本发明的髋臼假体1的植入包括通过合适的切刀来准备病人的髋臼，以便有基本半球形空腔，该空腔的半径等于杯2的壁3的外部面3a的半球形表面S1的半径。
因此，外科医生必须选择环绕该空腔的最合适骨盆骨区域，第一螺钉6容纳于该骨盆骨区域中，这是提供第一螺钉6稳定锚固的最佳保证的区域。
然后在用于杯2的凸起4的空腔壁中制造壳体(当需要时使用合适切刀)。
然后，杯2插入空腔中，第一螺钉6旋拧到骨盆骨内，并已经通过凸起4中的第一孔5。
拧入第一螺钉6，直到头部8与凸起4中的壳体9接触。
对于彼此接触的头部8和壳体9的相应球形形状表面，螺纹元件10拧入壳体9的相应螺纹部分9b中，直到它抵靠壳体的球形表面9a挡住头部8，从而形成第一螺钉6和杯2的相互固定。
利用第二螺钉13在各第二孔12中的尽管受限的定位，该第二螺钉13拧入空腔周围的骨盆骨中，从而进一步有助于杯2在病人骨盆中的固定。
本发明的髋臼假体的重要优点是在第一螺钉6和杯2各自定位时在它们之间基本独立；事实上因为该独特特征，外科医生甚至可以在将杯2定位在病人的髋臼内之后任意选择第一螺钉的轴线位置。
根据图11所示的实施例，髋臼假体1包括多个肋15，这些肋15环绕凸起4的外表面布置，并沿凸起4的轴线A2纵向伸展。肋15优选是有助于将髋臼假体1在壳体内牢固保持就位，从而使得髋臼假体1更难绕凸起4的轴线A2旋转。
换句话说，由于肋15，凸起4很难在容纳它的空腔内旋转，因为肋15与空腔的壁牢固接合。
优选是，髋臼假体1和螺钉6、13由钛合金制造，或者由骨修复材料(osteoinductive)和/或骨传导(osteoconductive)材料制造，和/或涂覆有骨修复材料和/或骨传导材料，其具有能释放药物和/或生长因子的生物薄膜。

Claims (18)

1.一种髋臼假体，其包括：杯(2)，该杯设计成插入相关髋臼中；以及第一螺钉(6)，用于固定该杯(2)，该第一螺钉设计成通过拧入骨盆骨的一部分中来进行接合；所述杯(2)包括壁(3)和凸起(4)，该壁(3)具有基本平滑的外部面(3a)，该凸起(4)从壁(3)向外延伸，并与平滑的外部面(3a)连接，所述凸起(4)具有第一通孔(5)和壳体(9)，所述第一通孔用于插入所述第一螺钉(6)，所述壳体(9)用于限制螺钉(6)的相应头部(8)，其特征在于，所述髋臼假体还包括多个肋(15)，所述多个肋环绕凸起(4)的外部表面分布并沿凸起(4)的中心轴线(A2)纵向伸展。
2.根据权利要求1所述的髋臼假体，其特征在于：所述第一螺钉(6)的头部(8)具有球形区域。
3.根据权利要求1或2所述的髋臼假体，其特征在于：壳体(9)至少局部为凹形，并相对于所述头部(8)具有相反的形状，以便限定用于所述第一螺钉(6)的球形接合部。
4.根据权利要求3所述的髋臼假体，其特征在于：它包括固定装置(11)，所述固定装置用于将所述头部(8)固定在所述壳体(9)中，以便防止在所述第一螺钉(6)和所述杯(2)之间的相对运动。
5.根据权利要求4所述的髋臼假体，其特征在于：所述固定装置(11)包括螺纹元件(10)，该螺纹元件通过旋拧而与所述壳体(9)的相应螺纹部分(9b)进行接合。
6.根据权利要求5所述的髋臼假体，其特征在于：所述螺纹元件(10)具有局部球形表面(10a)，该局部球形表面(10a)设计成与所述第一螺钉(6)的所述头部(8)接触地接合。
7.根据权利要求1所述的髋臼假体，其特征在于：该髋臼假体包括至少一个第二螺钉(13)，用于固定该杯(2)，所述第二螺钉(13)插入到杯(2)的壁(3)中的与所述凸起(4)相隔一定距离的相应第二通孔(12)中，并设计成接合在髂骨上。
8.根据权利要求7所述的髋臼假体，其特征在于：所述第二螺钉(13)包括具有球形区域的相应头部。
9.根据权利要求7所述的髋臼假体，其特征在于：该髋臼假体包括多个所述第二螺钉(13)。
10.根据权利要求8所述的髋臼假体，其特征在于：该髋臼假体包括多个所述第二螺钉(13)。
11.根据权利要求1所述的髋臼假体，其特征在于：所述第一螺钉(6)的直径在6毫米到14毫米之间。
12.根据权利要求1所述的髋臼假体，其特征在于：所述第一螺钉(6)的长度在40毫米到120毫米之间。
13.根据权利要求7至12中任意一个所述的髋臼假体，其特征在于：所述第二螺钉(13)的直径为大约6毫米。
14.根据权利要求7至12中任意一个所述的髋臼假体，其特征在于：所述第二螺钉(13)的长度在20毫米到60毫米之间。
15.根据权利要求13所述的髋臼假体，其特征在于：所述第二螺钉(13)的长度在20毫米到60毫米之间。
16.根据权利要求1所述的髋臼假体，其特征在于：杯(2)的所述壁(3)具有内部截锥形表面(T1)，该内部截锥形表面具有与所述凸起(4)的中心轴线(A2)分离的相应中心轴线(A1)。
17.根据权利要求16所述的髋臼假体，其特征在于：所述内部截锥形表面的中心轴线(A1)和所述凸起的中心轴线(A2)彼此成一定角度。
18.根据权利要求16或17所述的髋臼假体，其特征在于：该髋臼假体包括插入件(14)，该插入件(14)具有：外部截锥形表面(T2)，该外部截锥形表面(T2)相对于杯(2)的壁(3)的内表面(T1)具有相反的形状，并设计成与该内表面(T1)接触地接合；以及基本半球形内表面(S2)。
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