CN110393612B

CN110393612B - Tibial plateau support and knee joint prosthesis using the same

Info

Publication number: CN110393612B
Application number: CN201910732236.7A
Authority: CN
Inventors: 周勇刚; 史春宝; 王帅; 解凤宝; 李明洋
Original assignee: Beijing Chunlizhengda Medical Instruments Co Ltd
Current assignee: Beijing Chunlizhengda Medical Instruments Co Ltd
Priority date: 2019-08-08
Filing date: 2019-08-08
Publication date: 2025-02-18
Anticipated expiration: 2039-08-08
Also published as: CN110393612A

Abstract

The present invention relates to the technical field of medical prostheses, and discloses a tibial plateau support and a knee joint prosthesis using the same. The tibial plateau support comprises: a platform support support portion, the platform support support portion comprises a top surface for connecting to a pad of a knee joint prosthesis and a bottom surface opposite to the top surface and for fitting with an osteotomy plane of a human tibia; and a platform support connection portion, one end of the platform support connection portion is fixedly connected to the bottom surface, and the other end is used to be implanted into the medullary cavity of a human tibia to be connected to the human tibia. The cross-sectional structure of the bottom surface is the same as the osteotomy plane of a human tibia. The tibial plateau support according to the present invention is more stable after implantation.

Description

Tibia platform support and knee joint prosthesis using same

Technical Field

The invention belongs to the technical field of medical prostheses, and particularly relates to a tibial plateau support and a knee joint prosthesis using the tibial plateau support.

Background

Knee prostheses are surgical implants used to replace the knee, which are used in surface knee replacement surgery of the knee, where the damaged knee is treated and replaced with a knee prosthesis. The existing knee joint prosthesis mainly comprises a femur prosthesis used for being connected with a femur of a human body, a tibia platform support used for being connected with a tibia of the human body, and a gasket positioned between the femur prosthesis and the tibia platform support.

Currently, knee prostheses are widely used in joint replacement surgery. However, in order to meet the replacement surgery of the knee joint of most patients, the knee joint prosthesis of the prior art often designs the tibial plateau support to be of a symmetrical structure, and the tibial plateau support of the symmetrical structure cannot be completely matched with the natural contour of the tibia of the patient, so that the tibial plateau support cannot completely cover the osteotomy plane of the tibia to achieve the ideal bone coverage area, thus not only reducing the stability of the tibial plateau support after implantation, thereby increasing the risk of loosening of the knee joint prosthesis, but also stimulating the soft tissues around the joint of the tibial plateau support and the osteotomy plane to cause pain in long-term use, thereby increasing the risk of intra-articular hemorrhage.

In view of the deficiencies of the prior art, those skilled in the art are highly desirous of finding a tibial plateau tray that is more stable after implantation to make up for the deficiencies of the prior art.

Disclosure of Invention

The invention provides a tibial plateau support which is more stable after implantation.

The tibial tray comprises a tray supporting part and a tray connecting part, wherein the tray supporting part comprises a top surface used for being connected with a liner of a knee joint prosthesis and a bottom surface which is opposite to the top surface and is used for being attached to an osteotomy plane of a human tibia, one end of the tray connecting part is fixedly connected with the bottom surface, and the other end of the tray connecting part is used for being implanted into a intramedullary cavity of the human tibia to be connected with the human tibia. Wherein the fitting surface of the bottom surface is configured to be identical to the osteotomy plane of the human tibia.

Further, the bottom surface comprises an inner side part close to the inner side of the human body and an outer side part connected with the inner side part and close to the outer side of the human body, and the bonding surface area of the inner side part is larger than that of the outer side part.

Further, the platform bracket support portion further includes at least one protrusion formed on the bottom surface.

Further, the protrusions comprise two plate-shaped protrusions which are vertically connected with the bottom surface and are arranged at intervals, and an included angle is formed between planes where the two plate-shaped protrusions are located.

Further, the platform support connecting portion comprises a columnar handle portion which is vertically and fixedly connected with the bottom surface, the two platy protrusions are respectively located at two sides of the columnar handle portion, rib structures are respectively formed on two opposite sides of the outer side wall of the columnar handle portion, and the rib structures extend from the outer side wall of the columnar handle portion to be connected with the bottom surface.

Further, the included angle between the plane of any plate-shaped protrusion and the plane of the rib structure close to the plate-shaped protrusion is in the range of 30-90 degrees.

Further, a first hole which is coaxially arranged along the axis of the columnar handle and is communicated with the top of the columnar handle, a threaded hole which is communicated with the first hole, and a second hole which is simultaneously communicated with the threaded hole and the bottom of the columnar handle are formed in the columnar handle, and a through hole which penetrates through the platform support and is coaxially communicated with the first hole is formed in the platform support.

Further, the tibial plateau tray also includes a spinal needle prosthesis removably coupled within the second aperture by a threaded aperture.

Further, the tibial plateau holds in the palm still including detachably connecting the anti piece that revolves in first hole, and anti piece that revolves is including coaxial setting up at the inside first spliced pole in first hole and link to each other and lie in the outside second spliced pole in first hole with the tip from first spliced pole runs through to the tip of second spliced pole and with the coaxial first mounting hole of intercommunication of screw hole, wherein, the faying surface structure of second spliced pole is the polygon.

The invention also provides a knee joint prosthesis, which comprises the tibia platform support and a liner fixedly connected with the tibia platform support. Wherein, the gasket is formed with a second mounting hole.

Compared with the prior art, the tibial plateau support has the following advantages:

1) The tibial plateau support can enable soft tissues around the tibia to be better attached to the side profile surface of the tibial plateau support, so that the problem that the tibial plateau support stimulates the surrounding soft tissues at the joint of the tibial plateau support and an osteotomy plane after implantation to cause pain is effectively avoided, and the risk of intra-articular hemorrhage is effectively avoided;

2) The tibial plateau support completely covers the osteotomy plane, so that better fusion of bone tissues with the tibial plateau support can be facilitated, the stability of the tibial plateau support after implantation can be effectively improved, and the risk of loosening of the long-term tibial plateau support is further reduced;

3) The tibial plateau support of the invention completely covers the osteotomy plane, so that a patient can better adapt to the implanted tibial plateau support to enhance the kinematic characteristics of the knee joint;

4) The tibia platform support can also effectively limit the rotation direction of the gasket matched with the tibia platform support by arranging the anti-rotation block, so that the occurrence rate of micro-motion of the gasket can be effectively reduced, and the abrasion between the gasket and the tibia platform support is reduced.

Drawings

In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings used in the description of the embodiments or the prior art will be briefly described below. Like elements or portions are generally identified by like reference numerals throughout the several figures. In the drawings, elements or portions thereof are not necessarily drawn to scale.

Fig. 1 shows a front view of the structure of a tibial plateau tray of the present invention;

FIG. 2 is a cross-sectional view of the tibial plateau tray of FIG. 1 taken along the direction A-A;

FIG. 3 is a top view of the tibial plateau tray of FIG. 1;

FIG. 4 is a bottom view of the tibial plateau tray of FIG. 1;

FIG. 5 is a front view of the structure of a knee prosthesis according to the present invention, showing an assembled view of the tibial plateau tray and insert of FIG. 1;

FIG. 6 is a cross-sectional view taken along the B-B direction of the knee prosthesis shown in FIG. 5;

fig. 7 is a schematic view of the assembly of the knee prosthesis and the intramedullary prosthesis shown in fig. 5.

Detailed Description

Embodiments of the technical scheme of the present invention will be described in detail below with reference to the accompanying drawings. The following examples are only for more clearly illustrating the technical aspects of the present invention, and thus are merely examples, and are not intended to limit the scope of the present invention.

Fig. 1-4 illustrate the structure of a tibial plateau 100 in accordance with the present invention. As shown in fig. 1 to 4, the tibial plateau 100 includes a plateau support portion 1, the plateau support portion 1 including a top surface 11 for coupling with a pad of a knee joint prosthesis and a bottom surface 12 opposite to the top surface 11 for fitting with an osteotomy plane of a human tibia, and a plateau connecting portion 2, one end of the plateau connecting portion 2 being fixedly connected with the bottom surface 12, and the other end being for implantation into a intramedullary canal of the human tibia to couple with the human tibia. Wherein the conforming surface of the bottom surface 12 is configured to be the same as the osteotomy plane of a human tibia.

When the tibial plateau 100 is used, the tibial plateau 100 is connected with the human tibia by implanting the plateau connecting part 2 into the intramedullary cavity of the human tibia, and the bottom surface 12 of the plateau supporting part 1 is attached to the osteotomy plane of the human tibia, so that the bottom surface 12 covers the osteotomy plane. The tibial plateau 100 of the present invention configures the bearing surface of the bottom surface 12 to be the same as the osteotomy plane so that the bottom surface 12 can completely cover the osteotomy plane. Through the arrangement, on one hand, soft tissues around the tibia can be better attached to the side profile surface 13 (shown in fig. 1 or 3) of the tibia platform support 100, which connects the top surface 11 and the bottom surface 12, so that the influence of the tibia platform support 100 on the surrounding soft tissues and other tissues can be effectively reduced, the problem of pain caused by the fact that the tibia platform support 100 stimulates the surrounding soft tissues at the joint of the tibia platform support and the osteotomy plane after implantation is effectively avoided, and further the risk of intra-articular hemorrhage can be effectively avoided, on the other hand, the coverage rate of the bottom surface 12 and the osteotomy plane is increased by completely covering the osteotomy plane, so that the fusion of bone tissues with the tibia platform support 100 can be facilitated, the stability of the tibia platform support 100 after implantation can be effectively improved, the risk of loosening of the tibia platform support 100 is reduced, and in addition, the tibia platform support 100 which completely covers the osteotomy plane can also enable a patient to be better adapted to the tibial platform support 100 after implantation, so as to enhance the kinematic characteristics of knee joints.

Here, the osteotomy covering surface of the tibial plateau 100 of the present invention may be the above-mentioned bonding surface of the bottom surface 12, or may be an osteotomy covering surface formed by surrounding the side profile surface 13 of the tibial plateau 100 (as shown in fig. 1 or 3), and when the osteotomy covering surface is defined as an osteotomy covering surface formed by surrounding the side profile surface 13, the side profile surface 13 may be the same as the outer profile surface of the tibia, that is, the side profile surface 13 may replace the outer profile surface of the tibia at the osteotomy position. Preferably, the side profile surface 13 can be formed by smoothly transitionally connecting arc-shaped curved surfaces with different curvatures.

In a preferred embodiment as shown in fig. 4, the bottom surface 12 may include an inner side portion 122 adjacent to the inside of the human body and an outer side portion 121 connected to the inner side portion 122 and adjacent to the outside of the human body, and the bonding surface area of the inner side portion 122 is larger than the bonding surface area of the outer side portion 121. Here, the medial portion 122 near the inside of the human body and the lateral portion 121 near the outside of the human body are understood as the lateral portions 121 for covering the lateral condyles of the osteotomy plane of the tibia and the medial portions 122 for covering the medial condyles of the osteotomy plane of the tibia on the left and right sides of the center line C shown in fig. 4. The bottom surface 12 configured by the inner side portion 122 and the outer side portion 121 is formed as an asymmetrical bonding surface. The centerline C may be defined as a line connecting the center point of the osteotomy plane of the tibia and parallel to the anterior-posterior direction of the human body, or as a line separating the medial condyle and the lateral condyle of the osteotomy plane of the tibia and parallel to the anterior-posterior direction of the human body, when the tibial plateau 100 is connected to the osteotomy plane of the tibia, as viewed perpendicular to the anatomical surface of the tibia (i.e., the superior-superior direction of the tibia).

Through the arrangement, on one hand, the bottom surface 12 is formed into an asymmetric joint surface which can conform to the physiological shape of the osteotomy plane of the tibia, so that the tibia support can be widely suitable for the osteotomy plane of the tibia of most patients, the coverage area of the tibia support 100 on the tibial osteotomy plane of most patients can be further improved, and on the other hand, the asymmetric bottom surface 12 can also play a role in space orientation, namely, when the tibia support 100 is implanted, the position of the tibia support 100 relative to the osteotomy plane can be quickly adjusted through the asymmetric bottom surface 12, so that the tibia support can completely cover the osteotomy plane of the tibia, the fixation stability of the tibia support can be improved, and meanwhile, the operation efficiency can also be improved.

In a preferred embodiment as shown in fig. 4, the platform shoe support 1 may further comprise at least one protrusion 14 formed on the bottom surface 12. Through this arrangement, on the one hand, the outer surface of the protrusion 14 can further increase the area of the bottom surface 12 to further improve the fitting degree of the bottom surface 12 and the osteotomy plane, so that the platform-supporting prosthesis 100 can have a better covering effect with the osteotomy plane, and on the other hand, the increased area of the bottom surface 12 through the outer surface of the protrusion 14 can not only ensure better fusion of bone and the bottom surface 12, but also improve the strength of the platform-supporting portion 1, so that the stability of the platform-supporting prosthesis 100 after being implanted into the tibia can be effectively improved.

Preferably, as shown in fig. 4, the protrusion 14 may include two plate-shaped protrusions 141 vertically connected to the bottom surface 12 at intervals, and the planes of the two plate-shaped protrusions 141 form an included angle. Through this setting, after the platform support prosthesis 100 is connected with the tibia, two platy protrusions 141 that form the contained angle setting can make the platform support supporting part 1 receive the shearing stress in a plurality of directions to make the atress in each direction of the platform support supporting part 1 more balanced, thereby can effectually reduce the risk of the micro motion of platform support prosthesis 100 for the tibia. Preferably, the included angle of the plane in which the two plate-like protrusions 141 are located may range from 90 ° to 170 °. Also preferably, the protrusions 14 may include a plurality of plate-shaped protrusions 141 connected to the bottom surface 12, and a plane in which each plate-shaped protrusion 141 is located may be disposed at an angle with respect to the bottom surface 12.

In a preferred embodiment as shown in fig. 1 to 4, the platform bracket connection part 2 may include a cylindrical shank 21 fixedly connected to the bottom surface 12 vertically, two plate-shaped protrusions 141 may be respectively located at both sides of the cylindrical shank 21, and rib structures 22 are respectively formed on opposite sides of an outer sidewall of the cylindrical shank 21, and the rib structures 22 extend from the outer sidewall of the cylindrical shank 21 to be connected to the bottom surface 12. Through the arrangement, on one hand, the rib structure 22 formed on the columnar handle 21 can effectively improve the strength of the columnar handle 21 so as to further improve the stability of the tibial plateau support 100 after being connected with the tibia, and on the other hand, the columnar handle 21 is vertically connected with the bottom surface 12, so that when the length of the columnar handle 21 is overlong, the phenomenon that the columnar handle 21 is contacted with the inner wall of the tibial medullary cavity to damage the tibia can be effectively avoided, that is, the length of the columnar handle 21 can be further prolonged through the arrangement, and the stability of the tibial plateau support 100 after being connected with the tibia is further improved by increasing the contact area of the columnar handle 21 and the tibial medullary cavity.

Preferably, as shown in fig. 1, the rib structure 22 may be constructed in a plate-like structure that gradually decreases from the bottom surface 12 in the length direction of the rib structure 22. Also preferably, the planes in which adjacent rib structures 22 lie may have an included angle in the range of 90 ° to 170 ° to further balance the shearing stresses experienced by the platform-supporting prosthesis 100 in multiple directions.

In a preferred embodiment, the angle between the plane of any plate-like projection 141 and the plane of the rib structure 22 adjacent thereto may be in the range of 30 ° to 90 °. In combination with the above, the two plate-shaped protrusions 141 and the adjacent rib structures 22 are respectively arranged at an included angle to balance the shearing stress of the platform support prosthesis 100 in multiple directions, and the plate-shaped protrusions 141 and the rib structures 22 are arranged at an included angle to further balance the shearing stress of the platform support prosthesis 100 in multiple directions, so that the platform support prosthesis 100 can be more effectively prevented from micro-moving after being connected with the tibia of a human body, and the stability of the connected platform support prosthesis can be improved to the greatest extent.

Preferably, as shown in fig. 2, a first hole 211 communicating with the top of the cylindrical shank 21, a screw hole 212 communicating with the first hole 211, and a second hole 213 communicating with both the screw hole 212 and the bottom of the cylindrical shank 21, which are coaxially disposed along the axis of the cylindrical shank 21, may be formed in the cylindrical shank 21, and a through hole 111 penetrating the cylindrical shank support 1 and coaxially communicating with the first hole 211 is formed in the cylindrical shank support 1. Wherein the apertures of the first and second holes 211 and 213 are larger than the aperture of the screw hole 212, so that the screw hole 212 can be used for fixation of the outer member. Preferably, the inner wall of the second hole 213 may be further formed with a draft angle, i.e., a hole diameter gradually increases from an end of the second hole 213 near the screw hole 212 in a direction of an end of the second hole 213 far from the screw hole 212.

Preferably, the tibial tray 100 may further include a spinal needle prosthesis 3 (shown in connection with fig. 7) removably coupled within the second aperture 213 via the threaded aperture 212 to enhance a more stable coupling of the tibial tray 100 to the tibia of a person. In addition, the invention is also beneficial to prolonging the length of the marrow needle prosthesis 3 by vertically connecting the columnar handle part 21 with the bottom surface 12, so that the phenomenon that the marrow needle prosthesis 3 contacts with the inner wall of the tibial cavity to cause damage to the tibia can be effectively avoided, and the prolonged marrow needle prosthesis 3 can also more effectively improve the connection stability of the tibial plateau 100.

In a preferred embodiment, tibial tray 100 may further include an anti-rotation block (not shown) removably coupled within first aperture 211, which may include a first coupling post coaxially disposed within first aperture 211 and a second coupling post coupled to the first coupling post and positioned outside of first aperture 211, and a first mounting aperture extending from an end of the first coupling post to an end of the second coupling post and in coaxial communication with threaded aperture 212. Wherein, the faying surface of the second connecting column is polygonal. Through being provided with anti-rotating block to the faying surface with the second spliced pole constructs the polygon, can restrict the direction of rotation rather than complex liner effectively, thereby make it can effectually reduce the incidence that the liner jog, with the wearing and tearing between liner and the tibial plateau holds in the palm 100 have been reduced.

Preferably, the tibial plateau 100 material may be cobalt chrome molybdenum alloy. Also preferably, the top surface 11 may be formed as a smooth surface and the bottom surface 12 and/or the surface of the platform bracket connection 2 may be formed as a roughened surface. By this arrangement, on the one hand, wear between the tibial plateau 100 and the insert can be reduced by the smooth top surface 11, and on the other hand, fusion with bone of the tibial intramedullary canal can be enhanced by the roughened bottom surface 12 and/or the plateau connecting portion 2, thereby effectively improving stability after the tibial plateau 100 is connected with the tibia.

Fig. 5 to 7 illustrate the structure of the knee prosthesis 200 according to the present invention. As shown in fig. 5 to 7, the knee prosthesis 200 includes the above-described tibial tray 100 and the insert 4 fixedly coupled to the tibial tray 100. Wherein the gasket 4 is formed with a second mounting hole 41 (as shown in fig. 6). Preferably, the second mounting hole 41 may include a securing hole 411 coaxial and in communication with the first hole 211 of the tibial plateau 100 and/or an anti-rotation slot (not shown) that matingly engages the second connecting post of the anti-rotation block of the tibial plateau 100. Wherein, the pad 4 may be fixedly coupled with the screw hole 212 by sequentially passing through the fixing hole 411 and the first hole 211 using a screw to couple the pad 4 with the tibial plateau 100. As can be seen from the above, the knee joint prosthesis 200 using the tibial plateau 100 can completely cover the osteotomy plane of the tibia to achieve the ideal bone coverage area, so that the stability of the knee joint prosthesis 200 after implantation can be effectively improved, and the risk of loosening of the long-term knee joint prosthesis 200 can be reduced. In long term use, the tibial plateau 100 is also prevented from irritating soft tissue surrounding its junction with the osteotomy plane, thereby reducing the risk of intra-articular bleeding.

Preferably, the shape of the abutment surface of the anti-rotation groove may be configured as a polygon matching the shape of the abutment surface of the second connection post.

In a preferred embodiment, the top surface of the tibial tray 100 may also have a retaining slot 15 (shown in connection with fig. 2) formed thereon that mates with the insert 4, and the opposite sides of the retaining slot 15 may have transverse notches 151 (shown in connection with fig. 3) formed thereon that mate with the tibial tray 100, and the surface of the insert 4 that mates with the tibial tray 100 may have a first tab 42 (shown in connection with fig. 7) that mates with the retaining slot 15, and a second tab (not shown) that mates with the notches 151. With this arrangement, the incidence of micro-motion between the tibial plateau 100 and the insert 4 can be further reduced, thereby effectively reducing wear therebetween.

It should be noted that the above embodiments are only used to illustrate the technical solution of the present invention, but not to limit the technical solution of the present invention, and although the detailed description of the present invention is given with reference to the above embodiments, it should be understood by those skilled in the art that the technical solution described in the above embodiments may be modified or some or all technical features may be equivalently replaced, and these modifications or substitutions do not make the essence of the corresponding technical solution deviate from the scope of the technical solution of the embodiments of the present invention, and all the modifications or substitutions are included in the scope of the claims and the specification of the present invention. In particular, the technical features mentioned in the respective embodiments may be combined in any manner as long as there is no structural conflict. The present invention is not limited to the specific embodiments disclosed herein, but encompasses all technical solutions falling within the scope of the claims.

Claims

1. A tibial plateau support, comprising:

A platform support portion, the platform support portion comprising a top surface for connecting to a pad of a knee joint prosthesis and a bottom surface opposite to the top surface and for fitting with an osteotomy plane of a human tibia; and,

A platform support connecting part, one end of which is fixedly connected to the bottom surface, and the other end of which is used to be implanted into the medullary cavity of a human tibia to be connected to the human tibia;

Wherein, the bottom surface includes an inner portion close to the inner side of the human body and an outer portion connected to the inner portion and close to the outer side of the human body, the fitting surface area of the inner portion is larger than the fitting surface area of the outer portion, so that the bottom surface is formed as an asymmetric fitting surface; the platform support portion also includes at least one protrusion formed on the bottom surface, the protrusion includes two spaced apart plate-like protrusions vertically connected to the bottom surface, the planes where the two plate-like protrusions are located form an angle, the platform support connection portion includes a columnar handle portion vertically fixedly connected to the bottom surface, the two plate-like protrusions are respectively located on both sides of the columnar handle portion, and rib structures are respectively formed on the opposite sides of the outer side wall of the columnar handle portion, the rib structure extends from the outer side wall of the columnar handle portion to be connected to the bottom surface, and the columnar handle portion is provided with a plurality of protrusions. A first hole is formed inside the tibial support, which is coaxially arranged along the axis of the columnar support and connected to the top of the columnar support, a threaded hole is connected to the first hole, and a second hole is connected to both the threaded hole and the bottom of the columnar support. A through hole is formed on the platform support portion, which passes through the platform support portion and is coaxially connected to the first hole. The tibial platform support also includes an anti-rotation block detachably connected to the first hole, and the anti-rotation block includes a first connecting column coaxially arranged inside the first hole and a second connecting column connected to the first connecting column and located outside the first hole, and a first mounting hole passes through the end of the first connecting column to the end of the second connecting column and is coaxially connected to the threaded hole, wherein the fitting surface of the second connecting column is constructed as a polygon.

2. The tibial plateau support according to claim 1, characterized in that the angle between the plane where any of the plate-like protrusions is located and the plane where the rib structure close thereto is located ranges from 30° to 90°.

3. The tibial plateau tray according to claim 2, characterized in that the tibial plateau tray also includes a medullary pin prosthesis detachably connected to the second hole through the threaded hole.

4. A knee joint prosthesis, characterized in that it comprises a tibial plateau support according to any one of claims 1 to 3 and a pad fixedly connected to the tibial plateau support, wherein a second mounting hole is formed on the pad.