CN107137162A - A kind of artificial semi-pelvis prosthesis for being used to rebuild pelvis ilium and Periacetabular defect - Google Patents

Abstract

The invention relates to an artificial hemi-pelvic prosthesis for reconstructing defects around the ilium of the pelvis and the acetabulum. An L-shaped structure composed of an adjustable dual-axle platform at the lower part of the fixed base; a dual-axis self-locking angle adjustment mechanism, which includes a sagittal plane self-locking rotation axis for adjusting the angle of acetabular abduction, and The horizontal plane self-locking rotation axis for adjusting the acetabular anteversion angle; the metal acetabular cup, the metal acetabular cup is integrally connected to the lower part of the adjustable double-axle platform. The present invention can be widely applied to the bone defect reconstruction of the continuous mid-section of the pelvis after resection of pelvic tumors, and can significantly improve both short-term structural recovery and long-term patient function and quality of life.

Description

An artificial hemipelvic prosthesis for reconstructing defects around the ilium and acetabulum of the pelvis

technical field

The invention relates to an artificial prosthesis, in particular to an artificial half-pelvic prosthesis for reconstructing defects around the ilium of the pelvis and the acetabulum.

Background technique

The pelvis is a common site for bone tumors, and pelvic tumors can be divided into primary tumors and metastatic tumors. Primary tumors are mainly chondrosarcoma, osteosarcoma, and Ewing sarcoma, and metastatic cancers are often found in bone metastases of breast cancer, kidney cancer, prostate cancer, and lung cancer. The onset of pelvic tumors is insidious and difficult to diagnose in the early stage. When it is discovered, the extent of invasion is often already large. In addition, the anatomy around the pelvis is complex and adjacent to many important organs. The operation is difficult, with many complications, poor curative effect, and high mortality. In the past, hemipelvic resection or modified hemipelvic resection and amputation were mainly used for pelvic tumors, and various pelvic tumor resection and reconstruction operations have appeared since then. Resection of any pelvic tumor will result in a bony defect that results in a continuous mid-section of the trunk and lower extremities, which affects standing and weight-bearing walking, and can lead to a gradual upward displacement of the femoral head, resulting in scoliosis after pelvic tilt, with severe The length of the limbs is not equal, which seriously reduces the quality of life of patients after surgery.

As shown in Figure 1, the pelvis is divided into the following four areas according to the functional area: Ilium area (iliac crest), which is mainly the attachment point of the gluteal muscle and iliacus muscle, and is the attachment point controlling the main muscles of the hip joint. Severely affect the function of the hip; II zone (around the acetabulum), this area is the articular part, is the main position of the hip joint formed by the femoral head and the acetabulum, even if the power unit (muscle) is well preserved after resection, it will seriously affect the function of the hip. Hip joint mobility; Zone III (pubic bone, ischium), this area is the main site of pelvic floor muscle attachment, mainly the inguinal ligament and the pelvic floor muscle attachment point that maintains perineal tension. Zone IV (around the sacroiliac joints), this area is mainly to achieve stress transmission from the trunk to the pelvis, is a micro-motion joint.

In order to regain the integrity of the pelvic ring and a functional hip joint, autogenous bone + hemi-pelvic prosthesis or pedicle screw-rod system combined with modular hemi-pelvic prosthesis are mainly used for reconstruction. However, the connection of the acetabulum with the simple screw-rod system will loosen and break the metal screw-rod in the long-term (due to metal fatigue), and it is difficult to achieve biological fixation. In addition, the vertebral body screws may cause the irritation of the lumbosacral trunk nerves, resulting in postoperative neuropathy. Pain, and it is difficult to adjust the acetabular position, abduction, and anteversion angle through the length and bending angle of the metal nail rod during the operation. However, structural bone grafting is difficult to achieve bone union (fusion of grafted bone and defect pelvis) due to the lack of an early stable environment.

Contents of the invention

In view of the above problems, the object of the present invention is to provide an artificial hemi-pelvic prosthesis for reconstructing defects around the ilium of the pelvis and the acetabulum.

In order to achieve the above object, the present invention adopts the following technical solutions: an artificial half pelvis prosthesis for reconstructing defects around the pelvic ilium and acetabulum, characterized in that the artificial half pelvis prosthesis includes: a defect body, the defect The main body is an L-shaped structure composed of a sacral fixed base and an adjustable double-axle platform integrally connected to the lower part of the sacral fixed base; a two-axis self-locking angle adjustment mechanism, the two-axis self-locking angle adjustment mechanism includes a The sagittal plane self-locking rotation axis of the acetabular abduction angle angle, and the horizontal plane self-locking rotation axis for adjusting the acetabular anteversion angle; the metal acetabular cup, the metal acetabular cup is integrally connected to the adjustable double-axle platform lower part.

In a preferred embodiment, the sacrum fixation base is provided with a plurality of nail holes, and the sacrum fixation base realizes the mechanical fixation of the defect body and the sacrum through the nail holes and cancellous bone screws.

In a preferred embodiment, the sagittal plane self-locking rotation shaft and the horizontal plane self-locking rotation shaft both include a screw, a nut and a serrated gland; wherein, the sagittal plane self-locking rotation shaft and the horizontal plane self-locking rotation shaft The screw rods of the shafts are threadedly connected to the adjustable double-axle platform along the sagittal plane and the horizontal plane respectively, and the serrated glands and nuts are sequentially connected to the screw rods from inside to outside.

In a preferred embodiment, the metal acetabular cup is in the shape of a spherical shell, and several holes are opened on the metal acetabular cup.

In a preferred embodiment, the front side of the sacral fixation base has a soft tissue attachment part, and the soft tissue attachment part is made by electron beam dissolution method or stereolithography modeling technology, and its pore diameter is 1-2 mm, and the porosity 60-65%.

In a preferred embodiment, the back side of the sacral fixation base has a plurality of short tail caps protruding from the defect body, and a through hole for putting a metal rod is opened on the short tail caps, and is passed through a screw The cap is fixed to realize the connection with the spinal rod system.

Due to the adoption of the above technical scheme, the present invention has the following advantages: the present invention can be widely used in the bone defect reconstruction of the continuous mid-section of the pelvis after resection of pelvic tumors, and can achieve significant improvements in both short-term structural recovery and long-term patient function and quality of life. improvement.

Description of drawings

Fig. 1 is a structural schematic diagram of the present invention.

detailed description

The present invention will be described in detail below in conjunction with the accompanying drawings and embodiments. However, it should be understood that the accompanying drawings are provided only for better understanding of the present invention, and they should not be construed as limiting the present invention.

As shown in FIG. 1 , the artificial hemipelvic prosthesis provided by the present invention includes a defect body 10 , a biaxial self-locking angle adjustment mechanism and a metal acetabular cup 30 . Wherein, the defect body 10 is an L-shaped structure composed of a sacral fixed base 11 and an adjustable double-axle platform 12 integrally connected to the lower part of the sacral fixed base 11 . The sacrum fixation base 11 is provided with a plurality of nail holes 13, and the sacrum fixation base 11 can realize the mechanical fixation of the defect body 10 and the sacrum through the nail holes 13 and cancellous bone screws, avoiding neuropathic pain caused by using lumbar vertebral body screws. The dual-axis self-locking angle adjustment mechanism includes a sagittal plane self-locking rotation shaft 21 for adjusting the acetabular abduction angle, and a horizontal plane self-locking rotation shaft 22 for adjusting the acetabular anteversion angle. The lower part of the adjustable dual axle platform 12 is integrally connected with a metal acetabular cup 30, which is a base for supporting and fixing the acetabular prosthesis.

In a preferred embodiment, both the sagittal plane self-locking rotating shaft 21 and the horizontal plane self-locking rotating shaft 22 include a screw rod 23 , a nut 24 and a serrated gland 25 . Among them, the screw rods 23 of the sagittal plane self-locking rotating shaft 21 and the horizontal plane self-locking rotating shaft 22 are threadedly connected to the adjustable double-axle platform 12 along the sagittal plane and the horizontal plane respectively, and the screw rods 23 are sequentially connected with serrated glands from inside to outside. 25 and nut 24. After the angle is adjusted in place, the serrated gland 25 can be pressurized and locked with the nut 24 to prevent the fixed angle from loosening and changing.

In a preferred embodiment, the metal acetabular cup 30 is in the shape of a spherical shell, and several holes are opened on the metal acetabular cup 30 to facilitate the attachment of soft tissues such as tendons during the operation.

In a preferred embodiment, the front side of the sacral fixation base 11 has a soft tissue attachment portion, which is made by EBM (Electron Beam Melting, electron beam melting method) or SLA (Stereo Lithography Apparatus, stereolithography modeling) technology , the pore diameter is 1-2mm, and the porosity is 60-65%. This porosity can provide the best soft tissue attachment interface, reduce the formation of residual cavity, reduce postoperative infection, and improve long-term postoperative function.

In a preferred embodiment, the back side of the sacral fixation base 11 has a plurality of short tail caps 14 protruding from the defect body, and a through hole for inserting metal rods is opened on the short tail caps 14, and can be fixed by nuts , so as to realize the connection with the spinal screw-rod system and realize the restoration of lumbosacral stress conduction.

The above-mentioned embodiments are only used to illustrate the present invention, wherein the structure, connection mode and manufacturing process of each component can be changed to some extent, and any equivalent transformation and improvement carried out on the basis of the technical solution of the present invention should not excluded from the protection scope of the present invention.

Claims (6)

1. a kind of artificial semi-pelvis prosthesis for being used to rebuild pelvis ilium and Periacetabular defect, it is characterised in that this artificial half Pelvis prosthesis includes：

Defect main body, the defect main body be by rumpbone firm banking and be integrally connected to the rumpbone firm banking bottom can Adjust the L-type structure of double axletree platform compositions；

Twin shaft includes being used to adjust Acetabular abduction angle from angle adjusting mechanism, the twin shaft is locked from angle adjusting mechanism is locked The sagittal plane self-locking rotary shaft of degree, and for adjusting the horizontal plane self-locking rotary shaft of acetabulum angle；

Metal acetabular cup, the metal acetabular cup is integrally connected to the bottom of the adjustable double axletree platform.

2. a kind of artificial semi-pelvis prosthesis for being used to rebuild pelvis ilium and Periacetabular defect as claimed in claim 1, its It is characterised by, multiple nail are offered on the rumpbone firm banking, and the rumpbone firm banking passes through the nail and spongiosa Bone screws realize being mechanically fixed for the defect main body and rumpbone.

3. a kind of artificial semi-pelvis prosthesis for being used to rebuild pelvis ilium and Periacetabular defect as claimed in claim 1, its It is characterised by, the sagittal plane self-locking rotary shaft and horizontal plane self-locking rotary shaft include screw rod, nut and zigzag gland；Its In, the screw rod of the sagittal plane self-locking rotary shaft and horizontal plane self-locking rotary shaft is threadedly connected to along sagittal plane and horizontal plane respectively The zigzag gland and nut are sequentially connected on the adjustable double axletree platform, on the screw rod from inside to outside.

4. a kind of artificial semi-pelvis prosthesis for being used to rebuild pelvis ilium and Periacetabular defect as claimed in claim 1, its It is characterised by, the metal acetabular cup is in spherical shell shape, several holes is provided with the metal acetabular cup.

5. a kind of artificial semi-pelvis prosthesis for being used to rebuild pelvis ilium and Periacetabular defect as claimed in claim 1, its It is characterised by, the front of the rumpbone firm banking has soft tissue facies posterior hepatis, and the soft tissue facies posterior hepatis passes through electron beam Dissolution method or stereolithography fabrication techniques are formed, and its pore diameter is 1-2mm, porosity 60-65%.

6. a kind of artificial semi-pelvis prosthesis for being used to rebuild pelvis ilium and Periacetabular defect as claimed in claim 1, its It is characterised by, the back side of the rumpbone firm banking has multiple short-tail caps for protruding from the defect main body, the short-tail cap On be provided with one and be used to be put into the through hole of metal bar, and fixed by nut, realize the connection with pedicle screw fixation system.