CN112773570A

CN112773570A - Regional replacement prosthesis

Info

Publication number: CN112773570A
Application number: CN202110138589.1A
Authority: CN
Inventors: 吕帅洁; 童培建
Original assignee: First Affiliated Hospital of ZCMU
Current assignee: First Affiliated Hospital of ZCMU
Priority date: 2021-02-01
Filing date: 2021-02-01
Publication date: 2021-05-11

Abstract

The application discloses regional replacement prosthesis, including base and class cartilage card cap, the base is the T font, class cartilage card cap detachably installs the top of base and cover this top, it has porous structure to open on the base. So as to solve the problems of long cartilage repair time and inaccurate curative effect at present.

Description

Regional replacement prosthesis

Technical Field

The present application relates to the medical field, and more particularly, to a regional replacement prosthesis.

Background

Cartilage tissue has the functions of lubricating joint surfaces, reducing friction, buffering gravity and the like, but cartilage has no nerves and blood vessels, and once the cartilage is damaged, the body lacks necessary nutrient supply, so that the repair and regeneration capacity of the cartilage is limited. Cartilage injuries with a defect diameter of >3cm are often not completely self-repairing, and further damage to surrounding normal cartilage tissue and surrounding bone walls, causing joint inflammation or collapse of articular cartilage, and eventually progressing to Osteoarthritis (OA). Degenerative osteoarthropathy typified by OA is the most common clinical high-grade senile disease, and the incidence rate of degenerative osteoarthropathy is on the trend of rising year by year, and is the main cause of adult disability. Therefore, the repair and regeneration of articular cartilage is still a great problem in orthopedics clinical.

The current research focus of cartilage injury lies in cartilage repair, including PRP, stem cells, microfracture, cartilage transplantation, tissue engineering scaffolds, and the like. PRP, stem cells, etc. lack reliable clinical evidence; microfractures are only effective on small defects and fibrocartilage is produced after repair; the curative effect of cartilage transplantation varies according to different donors, disease conditions and the like; tissue engineering technology provides a new idea for clinical treatment, but material selection and structural design still need further research. The cartilage repair mainly has the following disadvantages: the cartilage repair time is long, the cartilage repair curative effect is uncertain, the large-area cartilage repair is difficult, the autologous and allogenic cartilage supply areas are insufficient, the load of the repair area needs to be reduced during the cartilage repair, and the activity needs to be limited.

Disclosure of Invention

The embodiment of the application aims to provide a regional replacement prosthesis so as to solve the problems of long cartilage repair time and inaccurate curative effect at present.

According to the embodiment of the application, the regional replacement prosthesis comprises a base and a cartilage-like clamping cap, wherein the base is T-shaped, the cartilage-like clamping cap is detachably arranged at the top end of the base and covers the top end, and a porous structure is arranged on the base.

Further, the base is made of tantalum metal, titanium metal or hydroxyapatite, and the cartilage-like snap cap is made of polyethylene, a mixture of collagen and proteoglycan, hydroxyapatite or fibroin.

Further, the base is completed by SLM additive manufacturing.

Further, the base comprises a head portion, a body portion, a connecting platform portion and a first buckling portion, wherein the head portion, the body portion, the connecting platform portion and the first buckling portion are fixedly connected from bottom to top.

Further, the head is hemispherical, and the body is a cylinder, a cube or a cuboid.

Further, the outer surface of the body has a fixing portion.

Further, the fixed part is external screw thread or anti-withdrawal barb.

Further, class cartilage card cap includes from the second buckle portion and the surperficial platform portion that up links firmly down.

Furthermore, a triangular groove is formed at the top end of the base.

Furthermore, the pore size of the porous structure is 300-700 mu m, and the porosity is 60% -85%.

The technical scheme provided by the embodiment of the application can have the following beneficial effects:

according to the embodiment, the area replacement prosthesis replaces the traditional cartilage regeneration and repair technology, replaces the defect cartilage through the cartilage-like clamping cap, and has the characteristics of quick repair and exact curative effect.

The implantation of the area replacement prosthesis can be operated by adopting a minimally invasive incision or under an arthroscope, has the advantages of small wound, short hospitalization time and the like, and can restore the joint function by going to the ground in early stage.

The base of the area replacement prosthesis has a porous structure, has a mechanical structure similar to cancellous bone, and has good osteogenic properties.

It is to be understood that both the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of the application.

Drawings

The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments consistent with the present application and together with the description, serve to explain the principles of the application.

FIG. 1 is a schematic representation of a frontal configuration of a regional replacement prosthesis according to an exemplary embodiment.

Fig. 2 is a front view of a base shown in accordance with an exemplary embodiment.

Fig. 3 is a bottom view of a base shown in accordance with an exemplary embodiment.

FIG. 4 is a top view of a base shown in accordance with an exemplary embodiment.

Fig. 5 is a front view of a cartilage-like snap cap shown in accordance with an exemplary embodiment.

Fig. 6 is a bottom view of a cartilage-like card cap according to an exemplary embodiment.

Fig. 7 is a top view of a cartilage-like card cap shown in accordance with an exemplary embodiment.

FIG. 8 is a schematic diagram of a cartilage damaged joint of a knee joint according to an exemplary embodiment.

FIG. 9 is a schematic illustration of a knee joint shown after repair of a cartilage damaged joint according to an exemplary embodiment.

The reference numerals in the figures are: the artificial cartilage comprises a cartilage-like clamping cap 1, a convex part 2, a second clamping part 3, a base 4, a porous structure 5, external threads 6, a body part 7, a head part 8, a triangular groove 9, a femur 10, a condyle cartilage 11, a defect area 12, a tibia 13 and a regional replacement prosthesis 14.

Detailed Description

Reference will now be made in detail to the exemplary embodiments, examples of which are illustrated in the accompanying drawings. When the following description refers to the accompanying drawings, like numbers in different drawings represent the same or similar elements unless otherwise indicated. The embodiments described in the following exemplary embodiments do not represent all embodiments consistent with the present application. Rather, they are merely examples of apparatus and methods consistent with certain aspects of the present application, as detailed in the appended claims.

The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the application. As used in this application and the appended claims, the singular forms "a", "an", and "the" are intended to include the plural forms as well, unless the context clearly indicates otherwise. It should also be understood that the term "and/or" as used herein refers to and encompasses any and all possible combinations of one or more of the associated listed items.

It is to be understood that although the terms first, second, third, etc. may be used herein to describe various information, such information should not be limited to these terms. These terms are only used to distinguish one type of information from another. For example, first information may also be referred to as second information, and similarly, second information may also be referred to as first information, without departing from the scope of the present application. The word "if" as used herein may be interpreted as "at … …" or "when … …" or "in response to a determination", depending on the context.

Referring to fig. 1-7, the present embodiment provides a regional replacement prosthesis 14, which includes a base 4 and a cartilage-like cap 1, wherein the base 4 is T-shaped, the cartilage-like cap 1 is detachably mounted on and covers the top end of the base 4, and the base 4 is provided with a porous structure 5.

In the embodiment of the invention, the regional replacement prosthesis 14 is implanted into the articular cartilage defect to replace and replace the defective cartilage, so as to solve the problems of long repair time, uncertain curative effect and the like in the traditional methods of cartilage self-regeneration, chondrocyte or cartilage transplantation and the like. Meanwhile, different from joint replacement, the artificial joint can be implanted in a minimally invasive mode such as an arthroscope or a small incision, and has the advantages of small wound, quick recovery, no influence on secondary operation and the like. The base 4 is installed in the subchondral bone of the cartilage defect part (namely, a mounting hole is drilled in the area), and the cartilage-like clamping cap 1 is detachably installed on the base 4. Adopt the mode of detachably installation, make things convenient for later stage class cartilage card cap 1 surface wearing and tearing or not hard up can change. Referring to fig. 8 and 9, a joint is formed by a femur 10 and a tibia 13, a defect region 12 is formed in a condyle cartilage 11 of the femur 10, and a region replacement prosthesis 14 is implanted in the defect region 12 to replace and replace the defect cartilage according to an embodiment of the present invention.

In the present example, the size and shape of the regional replacement prosthesis 14 are determined according to the size and shape of the cartilage lesion in the replacement region.

In this embodiment, the base 4 is manufactured by SLM additive manufacturing, and the cartilage-like clamp cap 1 is made by die reverse molding according to the shape of the base 4.

Referring to fig. 1 to 3, in this embodiment, the base 4 includes a head portion 8, a body portion 7, a connecting platform portion, and a first fastening portion, which are fixedly connected from bottom to top. Preferably, the head 8 is hemispherical, but may be a cone or the like. Preferably, the body 7 is a cylinder, a cube, or a cuboid.

Further, the outer surface of the body 7 has a fixing portion, which may be an external thread 6 or an anti-back-out barb. Preferably, external threads 6 are used to facilitate the function of screwing the base 4 in and preventing the base 4 from backing out.

The present example uses a head 8 that is hemispherical, about 1mm to 3mm in diameter, and about 1mm to 2mm in height; the body part 7 is a cylinder with the diameter of about 1mm-3mm and the height of about 3mm-10mm, and is externally provided with an external thread 6, and the external thread 6 is flaky and has the thickness of about 0.1mm-0.3 mm; the diameter of the connecting platform part is about 3mm-15mm, and the height is about 1mm-4 mm; the convex part 2 and the concave part of the first buckle part are both of solid structures, the convex part 2 is positioned on the upper layer, the diameter of the periphery of the convex part 2 is about 3mm-15mm, the diameter of the inner periphery of the convex part 2 is about 1mm-10mm, the height of the convex part is about 1mm-2mm, the concave part is positioned between the convex part 2 and the platform of the base 4, the diameter of the periphery of the concave part is about 3mm-15mm, the diameter of the inner periphery of the concave part is about 2mm-11mm, and the height of the concave part.

Referring to fig. 4-7, in this embodiment, the cartilage-like locking cap 1 includes a second locking portion 3 and a surface platform portion that are fixedly connected from bottom to top. The diameter of the surface platform part is about 3mm-15mm, and the height is about 1mm-3 mm; the depth of the groove of the second buckling part 3 is consistent with the diameter of the first buckling part, and is about 1mm-2 mm.

Referring to fig. 4, in the present embodiment, a triangular groove 9 is formed at the top end of the base 4. The head part 8, the body part 7 and the connecting platform part are implanted into subchondral bone through the triangular groove 9 on the surface of the base 4 and are fixed with the second buckling part 3 through the first buckling part. Of course the triangular recesses 9 may also be replaced by other regular shapes, such as square recesses, rectangular recesses, hexagonal recesses, etc.

In this embodiment, the porous structure 5 has a pore size and mechanical properties similar to or close to those of a bone structure, preferably a pore size of 300 to 700 μm and a porosity of 60% to 85%. The mechanics and friction coefficient of the polyethylene are similar to or close to those of the defected cartilage, and the porous structure 5 is designed according to the pore structure of the trabecula, so that the bone ingrowth is facilitated.

This example illustrates one possible method of making the above-described regional replacement prosthesis 14, which may include:

(1) slice data of the cartilage defect site was obtained by 3.0T MRI cartilage imaging scan.

(2) And importing the obtained slice data into the mimics software, carrying out threshold segmentation on the slice data, further subdividing subgroups of the unconnected separation regions on the preliminary threshold segmentation mask by region growing to generate a new mask, and finally carrying out smoothing, denoising and other operations on the new mask to obtain a reconstructed joint three-dimensional model.

(3) And introducing the reconstructed joint three-dimensional model into a Geomagic Studio, performing simulated bone cutting, and extracting cartilage and bone contour data of a cartilage damage part to be required.

(4) And importing the bone and cartilage contour data into general three-dimensional software to complete modeling, extracting a corresponding surface contour through Grasshopper, and forming a porous structure 5 and a surface smooth structure in a cartilage injury area.

(5) And (3) carrying out simulation stress analysis on the porous structure 5, inputting adjustment parameters to adjust in real time according to the finite element motion stress analysis result, and carrying out optimal design to obtain a three-dimensional solid model.

(6) And importing the obtained three-dimensional data of the base 4 into SLM equipment to finish forming. And reversely solving three-dimensional data of the preparation mold according to the three-dimensional model of the cartilage-like card cap 1, then importing the mold data into 3D printing equipment for forming, and finally completing the preparation of the cartilage-like card cap 1.

By the preparation method, the area replacement prosthesis can be individually designed and printed according to the cartilage defect area, and prosthesis printing with different sizes is carried out according to different defect areas, so that the cartilage defect area is repaired as much as possible. Of course, conventional manufacturing processes can be used, but are less flexible than SLM additive manufacturing techniques.

It should be noted that the base 4 and the cartilage-like cap 1 are preferably connected by a snap-fit structure, but the connection may be replaced by a connection in a solvent-filled, hinged or drawer-type manner. The base 4 may be any shape suitable for the cartilage defect area including, but not limited to, circular, rectangular, oval, and the like. The cylindrical threaded body 7 of the base 4 may be configured in various shapes and configurations, including but not limited to cylindrical unthreaded, cylindrical with or without anti-back-out barbs, rectangular with or without anti-back-out barbs, and the like. The base 4 can be replaced by materials including but not limited to titanium metal, hydroxyapatite and the like, and the structure of the corresponding materials is made; meanwhile, the surface can be coated with different materials, different pores and different structures. The cartilage-like card cap 1 can be replaced by materials including but not limited to a mixture of collagen and proteoglycan, hydroxyapatite, fibroin and the like, and the structures of the corresponding materials are made.

Other embodiments of the present application will be apparent to those skilled in the art from consideration of the specification and practice of the disclosure disclosed herein. This application is intended to cover any variations, uses, or adaptations of the invention following, in general, the principles of the application and including such departures from the present disclosure as come within known or customary practice within the art to which the invention pertains. It is intended that the specification and examples be considered as exemplary only, with a true scope and spirit of the application being indicated by the following claims.

It will be understood that the present application is not limited to the precise arrangements described above and shown in the drawings and that various modifications and changes may be made without departing from the scope thereof. The scope of the application is limited only by the appended claims.

Claims

1. The regional replacement prosthesis is characterized by comprising a base and a cartilage-like clamping cap, wherein the base is T-shaped, the cartilage-like clamping cap is detachably arranged at the top end of the base and covers the top end, and a porous structure is arranged on the base.

2. The prosthesis of claim 1, wherein the base is made of tantalum metal, titanium metal or hydroxyapatite, and the cartilage cap is made of polyethylene, a mixture of collagen and proteoglycan, hydroxyapatite or fibroin.

3. The area replacement prosthesis of claim 1, wherein the base is made by SLM additive manufacturing.

4. The prosthesis of claim 1, wherein the base comprises a head portion, a body portion, a connecting platform portion, and a first fastening portion that are fastened from bottom to top.

5. The regional replacement prosthesis of claim 4, wherein the head is hemispherical and the body is cylindrical, cubic, or cuboid.

6. A regional replacement prosthesis according to claim 4, in which the outer surface of the body has anchoring portions.

7. The area replacement prosthesis of claim 6, wherein the anchoring portion is an external thread or anti-back-out barb.

8. The zonal replacement prosthesis of claim 1, wherein the cartilage-like locking cap comprises a second locking portion and a surface platform portion that are fixedly connected from bottom to top.

9. The prosthesis of claim 1, wherein the base has a triangular recess formed in an apex thereof.

10. The prosthesis of claim 1, wherein the porous structure has a pore size of 300-700 μm and a porosity of 60-85%.