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CN112274300B - Dual Sliding Field Tibial Plateau Base and Spacer System - Google Patents

Dual Sliding Field Tibial Plateau Base and Spacer System Download PDF

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Publication number
CN112274300B
CN112274300B CN201910671584.8A CN201910671584A CN112274300B CN 112274300 B CN112274300 B CN 112274300B CN 201910671584 A CN201910671584 A CN 201910671584A CN 112274300 B CN112274300 B CN 112274300B
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gasket
platform
base
sliding
tibial plateau
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CN112274300A (en
Inventor
张海宁
冷萍
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Affiliated Hospital of University of Qingdao
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Affiliated Hospital of University of Qingdao
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/38Joints for elbows or knees
    • A61F2/389Tibial components
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30621Features concerning the anatomical functioning or articulation of the prosthetic joint
    • A61F2002/30639Features concerning the anatomical functioning or articulation of the prosthetic joint having rolling elements between both articulating surfaces

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Physical Education & Sports Medicine (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

本发明提供一种双滑动场胫骨平台底座及垫片系统,包括平台底座和垫片,所述平台底座包括上方的平台和下方的龙骨,所述平台中间设有自前向后的高起的两个分隔岭,将平台分成中央槽、内侧滑动场和外侧滑动场三部分,所述垫片分为中央垫片、内侧垫片和外侧垫片,与平台的三部分相匹配,将上述的结构匹配人工股骨假体使用,可形成内侧间室及外侧间室均为可滑动及旋转的人工关节界面。使用该系统可在膝关节置换后内侧和外侧关节间室形成可灵活运动的关节界面,在保留前后向稳定性的同时,分散并降低了膝关节内侧和外侧间室的磨损率,改善膝关节运动特性,提高手术效果,延长假体的使用寿命。

The present invention provides a double sliding field tibial platform base and gasket system, including a platform base and a gasket, wherein the platform base includes an upper platform and a lower keel, wherein two high dividing ridges are arranged in the middle of the platform from front to back, and the platform is divided into three parts: a central groove, an inner sliding field, and an outer sliding field, and the gasket is divided into a central gasket, an inner gasket, and an outer gasket, which are matched with the three parts of the platform, and the above structure is matched with an artificial femoral prosthesis to form an artificial joint interface in which both the inner chamber and the outer chamber are slidable and rotatable. The system can form a joint interface that can move flexibly in the inner and outer joint compartments after knee replacement, while retaining the front-back stability, dispersing and reducing the wear rate of the inner and outer compartments of the knee joint, improving the movement characteristics of the knee joint, improving the surgical effect, and extending the service life of the prosthesis.

Description

Double sliding field tibia platform base and gasket system
Technical Field
The invention belongs to the technical field of slidable interfaces of medial compartments and lateral compartments of femoral tibial joints, and particularly relates to a double-sliding-field tibial plateau base and a gasket system.
Background
As an effective means for treating knee joint end-stage diseases, the artificial total knee replacement achieves good effects. However, most of the existing artificial total knee prosthesis is designed as a fixed platform, that is, the formed femur and tibia joint surface is in single flexion and extension movement, and rotation, sliding and other movements are not allowed, so that joint interface stress and abrasion are increased, and the prosthesis is loosened and the operation fails. A few of the existing rotary platforms are designed to be inserted into the tibial plateau base through the upright posts below the platform gaskets, so that the tibial plateau base can rotate to a certain extent, but no other lateral movement, forward and backward movement and effect restriction are achieved. There is currently no sliding total knee prosthesis.
Disclosure of Invention
The invention aims to provide a double sliding field tibial plateau base and gasket system, which can form a flexible joint interface between an inner side joint compartment and an outer side joint compartment after knee joint replacement, disperse and reduce the wear rate of the inner side joint compartment and the outer side joint compartment of the knee joint while retaining the front-back stability, improve the movement characteristic of the knee joint, improve the operation effect and prolong the service life of a prosthesis.
In order to solve the technical problems, the invention is realized by adopting the following technical scheme:
The utility model provides a two sliding field tibia platform base and gasket system, includes platform base and gasket, the platform base includes the fossil fragments of the platform and the below of top, be equipped with two division of rising from front to back in the middle of the platform, divide into central tank, inside sliding field and outside sliding field triplex with the platform, the gasket divide into central gasket, inboard gasket and outside gasket, with the triplex assorted of platform, use above-mentioned structure matching artificial femur prosthesis, can form inboard room and outside room and be slidable and rotatory artificial joint interface.
The double-sliding-field tibial plateau base is made of metal or alloy, and the gaskets are divided into a central gasket, an inner gasket and an outer gasket and are made of ultra-high molecular weight polyethylene materials. The double sliding field tibia platform base consists of an upper platform and a lower keel, wherein the platform is of an asymmetric anatomical design, the inner side part is larger than the outer side part, the front side is a convex arc edge, the rear side is a concave arc edge, the periphery edge of the platform is a raised outer edge, 2 separation ridges raised from front to back are arranged in the middle to divide the platform into a central groove, an inner sliding field and an outer sliding field 3, and the inner sliding field and the outer sliding field are high polished smooth surfaces. The bottoms of the four boundaries of the central groove are respectively recessed to the periphery to form shallow grooves. The keels are of cylindrical structures, the upper parts of the keels are provided with side wings extending to the rear side at an angle of 45 degrees, the left side and the right side of each side wing are respectively provided with two inclined ridges which are obliquely arranged, and the front parts of the keels are provided with longitudinal ridges which are longitudinally protruded. The head of the keel is cylindrical, and 2 holes are formed in the head. The central gasket is divided into a head part and a bottom part, the side surface of the head part is in a thumb-like appearance, the top end is round, the rear part is in an arc shape protruding to the front side, the front part is in an arc shape, the front side of the bottom part is slightly higher than the rear side, the upper part of the front side of the bottom part is an inclined plane, shallow grooves are formed in the periphery of the lower part of the bottom part, and the left-right diameter of the lower part of the bottom part is equal to the left-right diameter of the shallow grooves at the boundary of the central groove of the platform. The side surfaces of the inner side gasket and the outer side gasket are in saddle-shaped structures, the upper surface is provided with a certain radian, the lower surface is a smooth surface, the upper part of the front side is an inclined plane, the inner side and the outer side are slightly provided with radians, the upper surface is rectangular, and the corners are round.
The double sliding field tibial plateau base and the gasket system are characterized in that the double sliding field tibial plateau base is made of metal or alloy, and the gasket is made of ultra-high molecular weight polyethylene material.
The dual sliding field tibial plateau base and spacer system described above, wherein the dual sliding field tibial plateau base platform is of asymmetric anatomic design with a medial portion greater than a lateral portion.
The dual sliding field tibial plateau base and spacer system as described above has 2 raised separation ridges from front to back in the middle of the dual sliding field tibial plateau base platform.
The tibial plateau base with the double sliding fields and the gasket system are characterized in that the inner sliding field and the outer sliding field of the tibial plateau base with the double sliding fields are high-polishing smooth surfaces.
In the double-sliding-field tibial plateau base and gasket system, the bottoms of the four boundaries of the central groove of the double-sliding-field tibial plateau base platform are respectively recessed to the periphery to form shallow grooves.
The double sliding field tibial plateau base and spacer system as described above, the keel is of cylindrical configuration with the upper portion having side wings extending at 45 ° to the lateral rear.
The double sliding field tibial plateau base and the gasket system are characterized in that the left side and the right side of the keel flank are respectively provided with two obliquely arranged inclined ridges.
The dual sliding field tibial plateau base and spacer system as described above, the anterior aspect of the keel has a longitudinally raised longitudinal ridge.
The double sliding field tibial plateau base and the gasket system are characterized in that the head of the keel is cylindrical, and 2 holes are formed in the head.
The side surface of the head of the central gasket is in a thumb-like appearance, the top end of the central gasket is rounded, the rear part of the central gasket is in an arc shape protruding to the front side, and the front part of the central gasket is in an arc shape.
The bottom front side of the central shim is slightly higher than the rear side, and the upper part of the bottom front side is an inclined plane.
According to the double-sliding-field tibial plateau base and gasket system, the periphery of the bottom of the central gasket is provided with the shallow grooves, and the left-right diameter of the bottom is equal to the left-right diameter of the shallow grooves at the boundary of the central groove of the plateau.
According to the double-sliding-field tibial plateau base and gasket system, the lateral surfaces of the inner gasket and the outer gasket are in a saddle-shaped structure, the upper surface is provided with a certain radian, and the lower surface is a smooth surface.
The upper parts of the front sides of the inner side gasket and the outer side gasket are inclined planes, and the inner side and the outer side have slight radians
The upper surfaces of the inner side gasket and the outer side gasket are rectangular, and the corners are rounded.
Compared with the prior art, the double-sliding-field tibial plateau base and gasket system has the advantages of being convenient to use, simple to operate and novel and reasonable in design. The medial pad and the lateral pad can slide back and forth in the medial and lateral sliding fields respectively, and can move laterally in and out to a certain extent and rotate to a certain extent, so that the pressure generated in the medial and lateral compartments can be reduced and dispersed to a greater extent, and the volume wear rate and the linear wear rate of the medial and lateral compartments of the knee joint are reduced. The upper surfaces of the inner side gasket and the outer side gasket are concave, are matched with the inner side condyle joint surface and the outer side condyle joint surface of the femoral prosthesis, are in contact and match in the knee joint mobility, point contact is avoided, the lower surface is a horizontal smooth surface, extremely small friction coefficients are generated between the lower surface and the high polishing surfaces of the inner side sliding field and the outer side sliding field, generation of abrasive dust is avoided to a great extent, excellent long-term retention rate can be obtained, the front upper surface and the rear upper surface of the inner side gasket and the outer side gasket are slightly raised, the possibility of front dislocation and the possibility of rear dislocation of the gasket are avoided, and oblique cutting of the front upper surface avoids stimulation of front soft tissues in the knee bending process. The cam-post structure formed by the head of the central gasket and the intercondylar beam of the femoral prosthesis can improve the medial-lateral stability and the anteroposterior stability of the knee prosthesis and replace the cruciate ligament function. The thumb-shaped structure behind the head of the central pad avoids point contact, reduces pad wear and increases knee joint mobility. The oblique incision on the front upper part of the central pad avoids the stimulation of front soft tissues in the knee bending process. The bottom of the central gasket can be stably clamped into the central groove, thereby avoiding micro-motion and reducing abrasion. The upper part of the keel is provided with lateral wings at the rear side, oblique ridges obliquely arranged on the lateral wings, longitudinal ridges at the front of the keel, and 2 holes are formed in the head of the keel, so that the fixing strength of bone cement to the base of the tibial plateau with double sliding fields can be improved, and the middle-long term fixing effect is improved.
Other features and advantages of the present invention will become more apparent from the following detailed description of embodiments of the present invention, which is to be read in connection with the accompanying drawings.
Drawings
The invention will be further described with reference to the accompanying drawings and examples, in which:
FIG. 1 is a schematic view of the overall exploded construction of an embodiment of a dual sliding field tibial plateau base and shim system of the present invention;
FIG. 2 is a schematic perspective view of a dual sliding field tibial plateau base in accordance with the present invention;
FIG. 3 is a top view of a dual sliding field tibial plateau base of the present invention;
FIG. 4 is a schematic view of an exploded construction of a gasket according to the present invention;
FIG. 5 is a side view of a center gasket according to the present invention;
FIG. 6 is a side view of the inboard shim according to the present invention;
fig. 7 is a schematic diagram of a front cross-sectional configuration of a dual sliding field tibial plateau base and shim system of the present invention.
Detailed Description
The present invention will be described in further detail with reference to the drawings and examples, in order to make the objects, technical solutions and advantages of the present invention more apparent. It should be understood that the embodiments described herein are merely illustrative of the present invention and are not intended to limit the present invention.
Artificial total knee arthroplasty is an effective method for treating knee joint end stage disease at present, and most of existing artificial total knee prostheses are designed for a fixed platform and a small part of existing artificial total knee prosthesis rotate the platform. The fixed platform design results in increased wear of the femoral prosthesis and the polyethylene articular surface, resulting in loosening of the prosthesis, while the rotating platform design allows only a certain degree of rotation about the post. There is currently no sliding total knee prosthesis. The invention designs a double sliding field tibial plateau base and gasket system for solving the problems, and can form a joint surface with both the inner compartment and the outer compartment capable of sliding on the premise of obtaining the front-back stability, thereby reducing interface friction and prolonging the service life of the prosthesis.
The implementation mode of the invention is specifically described below by way of specific embodiments with reference to the accompanying drawings:
As shown in fig. 1 and 2, the present embodiment provides a dual sliding field tibial plateau base and shim system, which includes a plateau base 100 and a shim 200, wherein the plateau base 100 is made of metal or alloy, and the shim 200 is divided into a central shim 201, a medial shim 202 and a lateral shim 203, which are all made of ultra-high molecular weight polyethylene material.
Referring to fig. 2 and 3, the dual sliding field tibial plateau base 100 is divided into an upper plateau 101 and a lower keel 102, the plateau 101 is of "fava bean-shaped" asymmetric anatomic design, the medial portion is larger than the lateral portion, the anterior side is a convex arc edge, the posterior side is a concave arc edge, the peripheral edge of the plateau 101 has a raised outer edge 103, 2 raised separating ridges 104 from front to back in the middle divide the plateau into a central trough 105, an inner sliding field 106 and an outer sliding field 107, and the inner sliding field 106 and the outer sliding field 107 are highly polished smooth surfaces. The four boundary bottoms of the central groove 105 are respectively recessed to the periphery to form shallow grooves 108.
As shown in fig. 7, the keel 102 has a cylindrical structure, the upper part is provided with a side wing 109 extending to the side and rear at an angle of 45 degrees, the left and right sides of the side wing 109 are respectively provided with two inclined ridges 110 which are obliquely arranged, and the front of the keel is provided with a longitudinal ridge 111 which is longitudinally protruded. The keel head is cylindrical with 2 holes 112.
Referring to fig. 4 and 5, the central pad 201 is divided into a head and a bottom, the side surface of the head is in a thumb-like appearance, the top end is round, the rear part is in an arc shape protruding to the front side, the front part is in an arc shape, the front side of the bottom is slightly higher than the rear side, the upper part of the front side of the bottom is an inclined plane, shallow grooves 204 are formed around the lower part of the bottom, and the left-right diameter of the lower part of the bottom is equal to the left-right diameter of the shallow grooves 108 at the boundary of the central groove of the platform.
As shown in fig. 4 and 6, the side surfaces of the inner pad 202 and the outer pad 203 are in a saddle-shaped structure, the upper surface is provided with a certain radian, the lower surface is provided with a smooth surface, the upper part of the front side is provided with an inclined surface, the inner side and the outer side are provided with a slight radian, the upper surface is provided with a rectangle, and the corners are rounded.
According to the embodiment, the double sliding field tibial plateau base and the gasket system are implanted into the knee joint by using the implantation instrument, so that the effect that both the inner compartment and the outer compartment are movable friction interfaces can be formed by matching with the artificial femur prosthesis, the abrasion of the interfaces can be effectively reduced, and the service life of the prosthesis is prolonged.
In application, referring to fig. 1 and 7, the implant device is used for preparing a bone surface on the femur side, and the tibia side preparation device is used for horizontally cutting a vertical lower limb force line of the tibia platform to obtain a tibia platform bone cutting surface. The tibial plateau test mold and the femoral prosthesis test mold are placed, and the stability and the activity degree of the knee joint are good in the reduction test. The tibial plateau base 100 is placed on the tibial plateau osteotomy face, and the keel is prepared by knocking in the dual sliding field tibial plateau base test model with the keel file matched with the appearance of the dual sliding field tibial plateau base keel. And (3) mixing bone cement, namely smearing the bone cement in a dough stage on the osteotomy surface of the tibia plateau and the back surface of the tibia plateau base 100 with double sliding fields, knocking into the proximal end of tibia, and placing the femoral prosthesis. The center insert 201 is pushed obliquely posteriorly and posteriorly into the center slot 105 of the tibial plateau base of the dual sliding field until posteriorly the front portion of the center insert is tapped so that the lower portion of the bottom of the center insert is embedded into the shallow slot at the boundary bottom of the center slot. Then, the inside spacer 202 and the outside spacer 203 of suitable heights are pushed into the inside sliding field 106 and the outside sliding field 107, respectively. And resetting the knee joint, and testing the stability and the mobility of the knee joint and the pad. And finishing the placing process.
It should be noted that the above-mentioned embodiments are merely for illustrating the technical solution of the present invention, and not for limiting the same, and although the present invention has been described in detail with reference to the above-mentioned embodiments, it should be understood by those skilled in the art that the technical solution described in the above-mentioned embodiments may be modified or some technical features may be equivalently replaced, and these modifications or substitutions do not make the essence of the corresponding technical solution deviate from the spirit and scope of the technical solution of the embodiments of the present invention.

Claims (3)

1. The double sliding field tibia platform base and gasket system comprises a platform base and gaskets, and is characterized in that the platform base comprises an upper platform and a lower keel, two separation ridges which are raised from front to back are arranged in the middle of the platform, the platform is divided into a central groove, an inner sliding field and an outer sliding field, the gaskets are divided into a central gasket, an inner gasket and an outer gasket, the central gasket, the inner gasket and the outer gasket are matched with the three parts of the platform, and the structure is matched with an artificial femur prosthesis to be used, so that an artificial joint interface with slidable and rotatable inner compartments and outer compartments can be formed;
The platform of the double-sliding-field tibia platform base is designed in a broad bean shape asymmetric anatomical shape, and the inner side part is larger than the outer side part, the front side is a convex arc-shaped edge, and the rear side is a concave arc-shaped edge;
the bottoms of the four boundaries of the central groove are respectively recessed to the periphery to form shallow grooves;
The keels are of cylindrical structures, the upper parts of the keels are provided with side wings extending to the rear side at an angle of 45 degrees, the left side and the right side of each side wing are respectively provided with two inclined ridges which are obliquely arranged, and the front parts of the keels are provided with longitudinal ridges which are longitudinally protruded;
the head of the keel is cylindrical, and two holes are formed in the head;
the central gasket is divided into a head part and a bottom part, the side surface of the head part is in a thumb-like appearance, the top end is round, the rear part is in an arc shape protruding to the front side, and the front part is in an arc shape;
The front side of the bottom of the central gasket is slightly higher than the rear side, the upper part of the front side of the bottom is an inclined plane, shallow grooves are formed in the periphery of the lower part of the bottom, and the left-right diameter of the lower part of the bottom is equal to the left-right diameter of the shallow grooves at the boundary of the central groove of the platform;
The side surfaces of the inner side gasket and the outer side gasket are in saddle-shaped structures, the upper surface is provided with a certain radian, the lower surface is a smooth surface, the upper part of the front side is an inclined plane, the inner side and the outer side are slightly provided with radians, the upper surface is rectangular, and the corners are round and blunt.
2. The tibial plateau base and spacer system of claim 1, wherein the inboard and outboard sliding fields of the plateau are highly polished smooth surfaces.
3. The dual sliding field tibial plateau base and spacer system of claim 1, wherein said dual sliding field tibial plateau base is made of an alloy and said spacers are each made of an ultra high molecular weight polyethylene material.
CN201910671584.8A 2019-07-24 2019-07-24 Dual Sliding Field Tibial Plateau Base and Spacer System Active CN112274300B (en)

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