CN109567983B - Trumpet implant and method of implantation - Google Patents

Abstract

The invention discloses a horn-shaped implant and an implantation method thereof, relates to the technical field of ligament reconstruction, and aims to solve the technical problems of stress concentration at one side of a tunnel portal caused by the wiper effect of a bone tunnel portal after ligament reconstruction, bone absorption, tunnel portal expansion and stress concentration, abrasion and fracture of transplanted ligaments caused by disappearance of side stress in the prior art. The trumpet implant comprising: the horn-shaped structure and the base column communicated with the necking end of the horn-shaped structure are provided with side wings on the outer side wall of the base column; the horn face structure is used for covering a bone tunnel opening, and the matrix column extends into the bone tunnel and is fixed in the bone tunnel by the side wings; the trumpet-shaped surface structure is formed by connecting single or multiple curved surfaces, and the multiple curved surfaces are mutually tangent to serve as transition surfaces at the opening of the bone tunnel.

Description

Trumpet implant and method of implantation

technical field

The invention relates to the technical field of ligament reconstruction, in particular to a horn-shaped implant and an implantation method thereof.

Background technique

Ligament injury will greatly affect the normal life of patients. Currently, there are many types of ligament injuries that can be seen clinically, including knee ligament injury, shoulder ligament injury, elbow ligament injury, ankle ligament injury, etc. Among them, as an important stabilizing device for the knee joint, the anterior cruciate ligament (ACL) is one of the most easily damaged ligaments. ACL injury will directly lead to instability of the knee joint, greatly reducing the quality of life of the patient, and causing the meniscus in the long term. Secondary damage to other knee attachment structures, ultimately leading to the development of arthritis.

Ligament reconstruction is currently the main clinical treatment for ligament injury, that is, replacing the original ligament with autografting ligament, allografting ligament or artificial ligament to restore joint stability, avoid secondary damage to other joint attachment structures, and reduce joint damage. incidence of inflammation. In the traditional ligament reconstruction surgery, the two ends of the ligament graft are fixed in the corresponding bone tunnels, and the tunnel mouth of the bone tunnel in the joint is located at the insertion point of the original ligament, so as to maximize the anatomy and function of the ligament reconstruction.

Although ligament reconstruction surgery can restore joint stability in the short term, there are a series of long-term complications after surgery. Among them, the expansion of the bone tunnel and the secondary rupture of the ligament are one of the complications after ligament reconstruction. An important factor directly related to the above two complications is the occurrence of "windshield wiper effect" after ligament reconstruction. There are two kinds of relative motions between the graft ligament and the bone tunnel: 1. Relative motion along the long axis of the bone tunnel, 2. Relative motion perpendicular to the long axis of the bone tunnel. The movement of the ligament graft perpendicular to the axis of the bone tunnel is called the "wiper effect". At the mouth of the intra-articular bone tunnel, the "wiper effect" manifests as a wiper-like wiggle of the graft perpendicular to the tunnel axis. In the joint, the graft suddenly changes direction at the mouth of the tunnel. In the early stage after ligament reconstruction, the ligament graft and the bone tunnel are not combined. Therefore, during the movement of the knee joint, the graft and the bone tunnel will slide relative to each other. The tunnel orifice is a sharp edge, so the tension on the graft will not only cause stress concentration on the edge of the tunnel orifice and the graft in contact with it, but also cause the ligament graft to wear during the sliding process. The ligament wear caused by the friction between the artificial ligament and the articular bone surface, especially the wear of the ligament graft at the entrance of the bone tunnel, has been considered to be one of the reasons for the rupture of the ligament graft. The generation of wear particles may also cause serious complications, such as synovitis, third-party particle reactions, and osteolysis. The study by Evans et al. found that wear particles from artificially grafted ligaments caused moderate to severe macrophage infiltration of the synovium. In addition, compared with the intact knee joint, the unilateral stress concentration and contralateral stress loss of the bone tunnel opening after ligament reconstruction will eventually lead to bone resorption at the tunnel opening, resulting in the enlargement of the tunnel opening, the loosening of the graft, and the loss of the graft and the bone tunnel. The wear between the ligaments increases, so that the ligament graft ruptures, and eventually leads to the failure of the ligament reconstruction. Hsu et al. measured bone tunnel enlargement at 3, 6, 12, and 18 months after surgery and found that the diameter of the bone tunnel at the joint site increased more than The increase in diameter of the bone tunnel was greater at the ligament fixation (bone tunnel at bone plug site). However, revision surgery after a failed ligament reconstruction is relatively difficult and challenging, especially for the smooth removal of the ligament fixation device and the fixation of a new ligament graft in the enlarged bone tunnel, for the surgeon. All are great challenges.

Therefore, some studies have taken corresponding measures to avoid the "wiper effect". Tosi et al. proposed that the quadriceps tendon has a larger cross-sectional area than the patellar ligament and hamstring. Therefore, by using As a ligament graft for ACL reconstruction, the quadriceps tendon can produce a good press-fit between the ligament graft and the bone tunnel, thereby reducing the gap between the two, thereby limiting their relative movement and reducing the "wiper". effect" to prevent the expansion of the bone tunnel. In order to make up for the cross-sectional gap between the flat patellar ligament graft and the patellar bone block and bone tunnel, Paessler et al. used sutures to suture the patellar ligament graft, and processed the patellar ligament block into a cylindrical shape to make the patellar ligament graft. The bone block at its end matches the shape of the bone tunnel to achieve a "press fit" effect between the graft and the bone tunnel, thereby reducing the "wiper effect". In the revision surgery of ACL reconstruction, Barrett et al. used artificial bone to fill the bone defect of the bone tunnel, so as to avoid the "wiper effect" caused by the gap between the enlarged bone tunnel and the graft ligament. However, there are few corresponding solutions to the problems of tunnel mouth osteolysis, tunnel mouth expansion and graft ligament wear caused by the "horn effect" of the bone tunnel mouth.

SUMMARY OF THE INVENTION

The purpose of the present invention is to provide a horn-shaped implant and an implantation method thereof, so as to solve the stress concentration on one side of the tunnel mouth caused by the "wiper effect" of the bone tunnel mouth after ligament reconstruction in the prior art, and the stress on the opposite side The technical problems of bone resorption, tunnel opening expansion and stress concentration of transplanted ligaments, abrasion and fracture caused by disappearance.

The invention provides a horn-shaped implant, comprising: a horn surface structure, the constricted end of the horn surface structure is connected with a base column, and the outer side wall of the base body column is provided with side wings; the horn surface structure is used for covering The mouth of the bone tunnel, the base column extends into the bone tunnel, and is fixed in the bone tunnel by the side wings; the horn surface structure is formed by connecting a single or multiple curved surfaces, and a plurality of the curved surfaces are mutually connected Cut to serve as a transition surface at the mouth of the bone tunnel.

Wherein, the upper surface of the horn surface structure has a first curved surface and a second curved surface, and the lower surface of the horn surface structure has a third curved surface and a fourth curved surface; the first curved surface is used as a transition surface at the mouth of the bone tunnel; The second curved surface is used as a transition surface between the first curved surface and the bone surface, and the second curved surface is tangent to the first curved surface and the fourth curved surface respectively; the curvature circle of the third curved surface is the same as the The curvature circles of the first curved surface are concentric, and the third curved surface and the first curved surface together form the upper and lower transition surfaces of the horn surface structure at the mouth of the bone tunnel.

Specifically, the inner sidewall surface of the base column is arranged tangentially to the first curved surface, and the outer sidewall surface of the base column is arranged tangentially to the third curved surface.

In practical application, the side wings are arranged at intervals from the horn surface structure, and the side wings are used to fix the base column in the bone tunnel by press-fitting.

Wherein, the base column adopts a cylindrical hollow structure matched with the bone tunnel; the side wings are formed by a group of concentric wedge-shaped thin slices surrounding the base column.

Specifically, the cross section of the wedge-shaped sheet is a set of barb-shaped triangular structures.

Preferably, the horn surface structure, the base column and the side wings are all made of polyetheretherketone, highly cross-linked polyethylene, titanium alloy, stainless steel, and cobalt-chromium-molybdenum alloy materials.

Compared with the prior art, the flared implant of the present invention has the following advantages:

The horn-shaped implant provided by the present invention includes: a horn surface structure, the constricted end of the horn surface structure is connected with a base column, and the outer side wall of the base column is provided with side wings; the horn surface structure is used to cover the bone tunnel mouth, and the base body The column extends into the bone tunnel and is fixed in the bone tunnel by the flanks; the horn surface structure is formed by connecting single or multiple curved surfaces, and the multiple curved surfaces are tangent to each other to serve as the transition surface at the mouth of the bone tunnel. From this analysis, it can be seen that in the horn-shaped implant provided by the present invention, since the horn surface structure is used as the transition surface at the bone tunnel mouth, it replaces the sharp bone tunnel mouth edge in traditional ligament reconstruction, and avoids the sharp bone tunnel mouth and the transplanted ligament. Stress concentration and ligament wear during contact; in addition, when the graft ligament and the flared implant are in contact at the bone tunnel mouth, the tension on the ligament is transmitted to the entire bone tunnel mouth through the flared implant, preventing traditional ligament reconstruction surgery. The stress concentration on one side of the middle bone tunnel mouth, and the bone resorption and the expansion of the bone tunnel caused by the disappearance of the contralateral stress.

The invention also provides a method for implanting a trumpet-shaped implant, comprising the steps of: making bilateral bone tunnels; grinding the mouth of the bone tunnel in the joint with a grinding tool; and screwing the trumpet-shaped implant into the bone tunnel , and slightly press the horn surface structure down to fit the bone surface.

The implantation method of the trumpet-shaped implant has the same advantages as the above-mentioned trumpet-shaped implant relative to the prior art, which will not be repeated here.

Description of drawings

In order to illustrate the specific embodiments of the present invention or the technical solutions in the prior art more clearly, the following briefly introduces the accompanying drawings that need to be used in the description of the specific embodiments or the prior art. Obviously, the accompanying drawings in the following description The drawings are some embodiments of the present invention. For those of ordinary skill in the art, other drawings can also be obtained based on these drawings without creative efforts.

1 is a schematic structural diagram of a horn-shaped implant provided by an embodiment of the present invention from a first perspective;

2 is a schematic structural diagram of a horn-shaped implant provided by an embodiment of the present invention from a second perspective;

3 is a schematic diagram of a longitudinal cross-sectional structure of a horn-shaped implant provided by an embodiment of the present invention from a second perspective;

Fig. 4 is the enlarged structure schematic diagram of A area in Fig. 3;

Fig. 5 is the enlarged structural schematic diagram of B region in Fig. 3;

FIG. 6 is a schematic flowchart of a method for implanting a horn-shaped implant according to an embodiment of the present invention.

In the figure: 1 - horn surface structure; 2 - base column; 11 - first curved surface; 12 - second curved surface; 13 - third curved surface; 14 - fourth curved surface; 3 - flank; 31 - wedge-shaped sheet.

Detailed ways

The technical solutions of the present invention will be clearly and completely described below with reference to the accompanying drawings. Obviously, the described embodiments are a part of the embodiments of the present invention, but not all of the embodiments. Based on the embodiments of the present invention, all other embodiments obtained by those of ordinary skill in the art without creative efforts shall fall within the protection scope of the present invention.

In the description of the present invention, it should be noted that the terms "center", "upper", "lower", "left", "right", "vertical", "horizontal", "inner", "outer", etc. The indicated orientation or positional relationship is based on the orientation or positional relationship shown in the accompanying drawings, which is only for the convenience of describing the present invention and simplifying the description, rather than indicating or implying that the indicated system or element must have a specific orientation or a specific orientation. construction and operation, and therefore should not be construed as limiting the invention. Furthermore, the terms "first", "second", and "third" are used for descriptive purposes only and should not be construed to indicate or imply relative importance.

In the description of the present invention, it should be noted that the terms "installed", "connected" and "connected" should be understood in a broad sense, unless otherwise expressly specified and limited, for example, it may be a fixed connection or a detachable connection Connection, or integral connection; it can be a mechanical connection or an electrical connection; it can be a direct connection or an indirect connection through an intermediate medium, and it can be the internal communication of two elements. For those of ordinary skill in the art, the specific meanings of the above terms in the present invention can be understood in specific situations.

1 is a schematic structural diagram of a horn-shaped implant provided by an embodiment of the present invention from a first perspective; FIG. 2 is a schematic structural diagram of a horn-shaped implant provided by an embodiment of the present invention from a second perspective; FIG. 3 is provided by an embodiment of the present invention. A schematic view of the longitudinal cross-sectional structure of the horn-shaped implant from a second perspective; FIG. 4 is an enlarged schematic view of the structure of the region A in FIG. 3 .

As shown in FIGS. 1-3 in conjunction with FIG. 4 , an embodiment of the present invention provides a horn-shaped implant, including: a horn surface structure 1 , a base column 2 is connected to the constricted end of the horn surface structure 1 , and an outer side of the base column is connected The wall is provided with side wings 3; the horn surface structure 1 is used to cover the mouth of the bone tunnel, the base column 2 extends into the bone tunnel, and is fixed in the bone tunnel by the side wings 3; The surfaces are tangent to each other to serve as transition surfaces at the mouth of the bone tunnel.

Compared with the prior art, the flared implant described in the embodiment of the present invention has the following advantages:

The horn-shaped implant provided by the embodiment of the present invention, as shown in FIG. 1 to FIG. 3 in conjunction with FIG. 4 , includes: a horn surface structure 1 , and a base column 2 is communicated with the constricted end of the horn surface structure 1 , and the base body column 2 The outer side wall is provided with side wings 3; the horn surface structure 1 is used to cover the mouth of the bone tunnel, the base column 2 extends into the bone tunnel, and is fixed in the bone tunnel by the side wings 3; the horn surface structure 1 is formed by connecting a single or multiple curved surfaces, Multiple surfaces are tangent to each other to serve as transition surfaces at the mouth of the bone tunnel. It can be seen from the analysis that in the horn-shaped implant provided by the embodiment of the present invention, since the horn surface structure is used as the transition surface at the bone tunnel mouth, it replaces the sharp bone tunnel mouth edge in traditional ligament reconstruction, and avoids the sharp bone tunnel mouth and the bone tunnel mouth. Stress concentration and ligament wear when the graft ligament is in contact; in addition, when the graft ligament and the flared implant are in contact at the bone tunnel mouth, the tension on the ligament is transmitted to the entire bone tunnel mouth through the flared implant, preventing traditional ligaments During reconstruction, the stress on one side of the bone tunnel mouth was concentrated, and the stress on the opposite side disappeared, resulting in bone resorption and expansion of the bone tunnel.

Wherein, in the horn-shaped implant provided by the embodiment of the present invention, the upper surface of the horn surface structure 1 has a first curved surface 11 and a second curved surface 12, and the lower surface of the horn surface structure 1 has a third curved surface 13 and a fourth curved surface 14 ; The first curved surface 11 is used as the transition surface at the mouth of the bone tunnel; the second curved surface 12 is used as the transition surface between the first curved surface 11 and the bone surface, and the second curved surface 12 is tangent to the first curved surface 11 and the fourth curved surface 14 respectively; The curvature circle of the three curved surfaces 13 is concentric with the curvature circle of the first curved surface 11 , and the third curved surface 13 and the first curved surface 11 together constitute the upper and lower transition surfaces of the horn surface structure at the mouth of the bone tunnel. Since the arc-shaped transition of the first curved surface 11 replaces the original sharp bone tunnel edge, and the contact of the first curved surface 11 with the ligament graft can avoid stress concentration at the edge of the bone tunnel opening, thereby effectively avoiding ligament wear and tear caused by stress concentration. fracture; the characteristic of the second curved surface 12 being tangent to other curved surfaces makes the edge of the horn surface structure smoothly transition to the bone surface, thereby effectively avoiding stress concentration on the edge of the horn surface structure and its contacting bone surface.

In actual production, the diameter of the horn surface structure 1 may be 6-18 mm; the radius of curvature corresponding to the first curved surface 11 may be 1-4 mm, and the radius of curvature corresponding to the third curved surface 13 may be 0-3.5 mm.

Specifically, as shown in FIGS. 1-3 in combination with FIG. 4 , the inner sidewall surface of the base column 2 can be arranged tangentially to the first curved surface 11 , and the outer sidewall surface of the base column 2 can be arranged tangentially to the third curved surface 13 . Therefore, the inner and outer sidewall surfaces of the base column 2 can smoothly transition with the horn surface structure 1 .

In practical application, as shown in Figures 1-3, the outer side wall of the base column 2 can be provided with side wings 3, and the side wings 3 are arranged at intervals from the horn surface structure 1; the side wings 3 are used to fix the base column 2 on the In bone tunnels, its barb-shaped structure makes it resistant to pull-out.

Among them, as shown in FIGS. 1-3 , the base column 2 can adopt a cylindrical hollow structure that matches the bone tunnel, so as to better connect the horn surface structure 1 and the bone tunnel; the side wings 3 can be surrounded by the base column 2 . A set of concentric wedge-shaped lamellae 31 is formed.

In actual production, considering the selection of the diameter of the bone tunnel in ligament reconstruction, the setting of the base column 2 can be of different sizes. It can be 0.5-1.5mm, and the height of the base column 2 can be 0-30mm.

FIG. 5 is an enlarged schematic view of the structure of the B region in FIG. 3 .

Specifically, as shown in FIG. 5 , the cross section of the wedge-shaped sheet 31 may be a set of barbed triangular structures, and the apex angle b of the barbed triangular structures may be 0°-45°.

Further, the maximum distance d of the above-mentioned adjacent wedge-shaped sheets 31 can be 300-800 μm, which is conducive to bone ingrowth, and further strengthens and fixes the horn-shaped implant, and has a better anti-pullout effect.

Still further, the width e of the wedge-shaped sheet 31 in the direction perpendicular to the axis of the base column 2 may be 0-0.5 mm. Too wide side wings 3 may increase the difficulty of press-fitting, so it is better to choose 0-0.5mm.

In actual production, the height a of the wedge-shaped sheets 31 covering the base column 2 may be 0-30 mm; the height c of each group of the wedge-shaped sheets 31 may be 0.5-1 mm.

Preferably, the above-mentioned horn surface structure 1, base column 2 and side wings 3 can all be made of polyether ether ketone, highly cross-linked polyethylene, titanium alloy, stainless steel, cobalt-chromium-molybdenum alloy materials. It is ensured that the horn-shaped implant can meet good biocompatibility, certain ductility, and good mechanical strength.

FIG. 6 is a schematic flowchart of a method for implanting a horn-shaped implant according to an embodiment of the present invention.

An embodiment of the present invention also provides a method for implanting a trumpet-shaped implant, as shown in FIG. 6 , including the following steps: Step S1, making bilateral medullary canals; Step S2, using a grinding tool to pierce the bone tunnel opening in the joint Grinding is performed; in step S3, the horn-shaped implant is screwed into the bone tunnel, and the horn surface structure is slightly pressed downward to fit the bone surface.

The horn-shaped implant and its implantation method provided by the embodiments of the present invention can effectively improve the stress concentration on one side of the intra-articular bone tunnel opening after ligament reconstruction surgery, and the phenomenon of bone resorption and bone tunnel expansion caused by the disappearance of the opposite side stress. At the same time, it will also avoid the problem of ligament graft wear and tear caused by friction ("wiper effect") between the sharp bone tunnel opening and the ligament graft.

The above descriptions are only preferred embodiments of the present invention, and are not intended to limit the present invention. Any modification, equivalent replacement, improvement, etc. made within the spirit and principle of the present invention shall be included in the scope of the present invention. within the scope of protection.

Claims (3)

1. A trumpet-shaped implant, characterized in that, comprising: a trumpet surface structure, the constricted end of the trumpet surface structure is communicated with a base column, and the outer side wall of the base column is provided with a flank; the trumpet surface structure For covering the mouth of the bone tunnel, the base column extends into the bone tunnel and is fixed in the bone tunnel by the side wings; The upper surface of the horn surface structure has a first curved surface and a second curved surface, and the lower surface of the horn surface structure has a third curved surface and a fourth curved surface; the second curved surface serves as the transition between the first curved surface and the bone surface a curved surface, and the second curved surface is tangent to the first curved surface and the fourth curved surface respectively; The curvature circle of the third curved surface is concentric with the curvature circle of the first curved surface, and the third curved surface and the first curved surface together constitute the upper and lower transition surfaces of the horn surface structure at the mouth of the bone tunnel; The inner sidewall surface of the base column is arranged tangentially to the first curved surface to form a characteristic horn surface of the horn-shaped implant, and the outer sidewall surface of the base column is arranged tangentially to the third curved surface; The base column adopts a cylindrical hollow structure matched with the bone tunnel; the flanks are formed by a group of concentric wedge-shaped sheets surrounding the base column; the cross-section of the wedge-shaped sheets is a barb-shaped triangular structure. 2 . The flared implant according to claim 1 , wherein the flanks are arranged spaced apart from the flared surface structure, and the flanks are used to fix the base post in the bone tunnel by press-fitting. 3 . 3. The flared implant according to claim 1 or 2, wherein the flared surface structure, the base column and the side wings are all made of polyether ether ketone, highly cross-linked polyethylene, titanium alloy , any one of stainless steel and cobalt-chromium-molybdenum alloy materials.

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