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CN113855338A - 用于髋臼骨翻修重建的垫块及其与髋臼杯假体的固定结构 - Google Patents

用于髋臼骨翻修重建的垫块及其与髋臼杯假体的固定结构 Download PDF

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CN113855338A
CN113855338A CN202111329391.8A CN202111329391A CN113855338A CN 113855338 A CN113855338 A CN 113855338A CN 202111329391 A CN202111329391 A CN 202111329391A CN 113855338 A CN113855338 A CN 113855338A
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component
acetabular
bone
cup prosthesis
acetabular cup
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雷青
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Third Hospital Of Changsha
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Third Hospital Of Changsha
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Priority to CN202111329391.8A priority Critical patent/CN113855338A/zh
Publication of CN113855338A publication Critical patent/CN113855338A/zh
Priority to US17/817,683 priority patent/US11672665B2/en
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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Vascular Medicine (AREA)
  • Transplantation (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Cardiology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Manufacturing & Machinery (AREA)
  • Prostheses (AREA)

Abstract

本申请涉及一种医疗器械的领域，尤其是涉及一种用于髋臼骨翻修重建的垫块及其与髋臼杯假体的固定结构，其包括垫块位于髋臼杯假体与髋臼骨之间，并分别与髋臼杯假体和髋臼骨相连接，包括第一部件和与第一部件半径、形状相同或不同的第二部件，所述的第一部件与第二部件活动连接，连接后的第一部件和第二部件的形状与髋臼骨的缺损处相适配。本申请将半径和形状相同或者不同的第一部件与第二部件活动连接，二者组合而成的形状与髋臼骨的缺损处的形状相适配，从而更好的对髋臼骨的缺损处进行修补，第一部件与第二部件适用于形状各异的髋臼骨缺损，更好的对髋臼骨进行重建和固定，方便后续髋臼杯假体的固定，垫块的分体结构提高了操作灵活性的效果。

Description

用于髋臼骨翻修重建的垫块及其与髋臼杯假体的固定结构
技术领域
本申请涉及医疗器械的领域，尤其是涉及一种用于髋臼骨翻修重建的垫块及其与髋臼杯假体的固定结构。
背景技术
目前重建髋臼骨缺损的方法包括打压植骨，结构植骨，jumbo杯，加强环，cup-cage，3D打印个性化髋臼杯假体等，使用同种异体骨处理大面积的骨缺损由于不能获得良好的初始稳定性，容易发生假体松动和骨吸收，Kostensalo等报导60例使用打压植骨结合水泥杯翻修髋关节，平均随访7年，以再次翻修为终点平均生存率为73%，其中13个为无菌性松动占比81%。
有文献报道称，不论是自体的还是异体的较大的结构性植骨，在骨融合的过程中只在移植骨外层的几毫米处发生骨愈合，而移植骨中心却遗留骨坏死，从而导致移植骨塌陷、吸收、移位，最终导致翻修失败。
Jumbo杯的使用可以减少移植骨的使用，使旋转中心尽量往外、往下移动，接近解剖位置，但是大的Jumbo杯不利于骨量的恢复，给再次翻修增加难度，由于不能获得好的初始稳定，大的前后柱和外上方骨缺损限制了大的Jumbo杯的使用。
金属多孔结构的设计有利于骨长入，其优异的摩擦系数有利于更好的原始压配,为假体的初始稳定和远期稳定提供了良好的条件，已广泛的应用于髋关节翻修中的骨缺损修复，并取得良好的效果。
相关技术中，使用金属多孔结构的设计修复髋臼骨缺损的重建方式，一般会使其与垫块结合使用，使用垫块填补髋臼骨的缺损处，目前市面上使用的垫块为一体结构，种类单一，垫块较厚，对于形状各异的骨缺损无法重建和固定，适应性差。
针对上述中的相关技术，发明人认为市面上的垫块为一体结构，种类单一，对于形状各异的髋臼骨缺损无法重建和固定，适应性差。
发明内容
为了解决市面上的垫块为一体结构，种类单一，垫块较厚，对于形状各异的髋臼侧缺损无法重建和固定，适应性差的问题，本申请提供一种用于髋臼骨翻修重建的垫块及其与髋臼杯假体的固定结构。
第一方面，本申请提供一种用于髋臼骨翻修重建的垫块，采用如下的技术方案：
一种用于髋臼骨翻修重建的垫块，垫块位于髋臼杯假体与髋臼骨之间，并分别与髋臼杯假体和髋臼骨相连接，包括第一部件和与第一部件半径、形状相同或不同的第二部件，所述的第一部件与第二部件活动连接，连接后的第一部件和第二部件的形状与髋臼骨的缺损处相适配。
通过采用上述技术方案，将半径和形状相同或者不同的第一部件与第二部件活动连接，二者组合而成的形状与髋臼骨的缺损处的形状相适配，从而更好的对髋臼骨的缺损处进行修补，第一部件与第二部件适用于形状各异的髋臼骨缺损，更好的对髋臼骨进行重建和固定，方便后续髋臼杯假体的固定，垫块的分体结构提高了操作的灵活性。
可选的，所述的第一部件和/或第二部件为1/4或者1/8球形的形状，第一部件和/或第二部件的厚度均匀一致或者其边缘薄并向球心位置逐渐增厚或者其边缘厚并向球心位置逐渐变薄。
通过采用上述技术方案，由于每个患者的髋臼骨缺损部的形状和磨损程度都不相同，导致需要准备较多规格的垫块，才能满足不同患者的需求，设计的垫块不仅可以将相同厚度、相同半径的第一部件和第二部件进行组合连接，也可以将不同厚度、不同半径的第一部件和第二部件进行组合连接，不同形式的组合能够更好的适用不同患者的髋臼骨缺损，提高了垫块的适用性。
可选的，所述的第一部件或第二部件的侧壁上开设有燕尾槽，第二部件或第一部件的侧壁上设置有与燕尾槽配合使用的燕尾块，通过燕尾槽与燕尾块的卡接使第一部件与第二部件活动连接。
通过采用上述技术方案，第一部件和第二部件通过燕尾槽和燕尾块的卡接从而形成连接，不仅提高了垫块操作的灵活性，还提高了工作效率。
可选的，所述的燕尾槽的底面长度由靠近髋臼杯假体的一侧向远离髋臼骨的一侧逐渐减小，燕尾槽的纵截面为锥台形，所述的燕尾块靠近燕尾槽底面的侧面由靠近髋臼杯假体的一侧向远离髋臼骨的一侧逐渐减小，燕尾块的纵截面的形成锥台形。
通过采用上述技术方案，燕尾槽和燕尾块的纵截面都为锥台形，使二者相互卡接后，能够从插接方向对燕尾块进行限位，防止燕尾块在插接时由插接方向脱出燕尾槽，限定了燕尾槽与燕尾块只能在一个方向上相互脱离，从而在左、右和下方三个方位限制了第一部件和第二部件的自由度，保证了第一部件和第二部件之间的牢固度。
可选的，所述的第一部件和第二部件上各开设有多个长圆形的安装孔，所述的安装孔内插入螺钉并与螺钉之间留有间隙，通过螺钉插入安装孔将第一部件和第二部件与髋臼骨固定连接。
通过采用上述技术方案，螺钉插入安装孔后，螺钉能够在安装孔内进行上、下、左、右方向的移动，由于螺钉要固定在髋臼骨厚度较厚的位置，通过移动螺钉在安装孔内的位置，使螺钉能够固定在髋臼骨的适合位置，保证髋臼骨与第一部件和第二部件的稳固性。
第二方面，本申请提供一种垫块与髋臼杯假体的固定结构，采用如下的技术方案：
一种垫块与髋臼杯假体的固定结构，所述的第一部件和第二部件上各开设有多个圆形槽，髋臼杯假体靠近垫块的侧面上涂覆骨水泥，第一部件和第二部件与髋臼杯假体接触，通过骨水泥进入多个圆形槽内使第一部件和第二部件与髋臼杯假体固定连接。
通过采用上述技术方案，髋臼杯假体上涂覆的骨水泥进入多个圆形槽，增加了骨水泥与垫块的嵌合力，从而增加了垫块与髋臼杯假体的稳固性。
可选的，所述的第一部件和第二部件靠近髋臼杯假体的侧面上设置有覆盖层，所述的圆形槽的槽口开设在覆盖层上。
通过采用上述技术方案，骨水泥与垫块的嵌合力增加，使第一部件和第二部件与髋臼杯假体固定连接，可以有效的避免植骨塌陷、吸收导致垫块松动的问题，同时也避免了将髋臼杯假体以骨水泥固定在垫块上而产生过大的剪切力。
综上所述，本申请包括以下至少一种有益技术效果：
1、本申请中将半径和形状相同或者不同的第一部件与第二部件活动连接，二者组合而成的形状与髋臼骨的缺损处的形状相适配，从而更好的对髋臼骨的缺损处进行修补，其适用于形状各异的髋臼骨缺损，更好的对髋臼骨进行重建和固定，方便后续髋臼杯假体的固定，垫块的分体结构提高了操作的灵活性；
2、本申请中髋臼杯假体上涂覆的骨水泥进入多个圆形槽，增加了骨水泥与垫块的嵌合力，从而增加了垫块与髋臼杯假体的稳固性。
附图说明
图1是实施例一的结构示意图。
图2是实施例一中第一部件体现燕尾槽的剖视图。
图3是实施例一中第二部件体现燕尾块的结构示意图。
图4是实施例二的结构示意图。
图5是实施例二中第一部件体现燕尾块的结构示意图。
图6是实施例二中第二部件体现燕尾槽的结构示意图。
图7是实施例二中第一部件体现多孔结构层的结构示意图。
附图标记说明：1、第一部件，2、第二部件，3、燕尾槽，4、燕尾块，5、安装孔，6、圆形槽，7、覆盖层，8、多孔结构层。
具体实施方式
以下结合附图1-7对本申请作进一步详细说明。
本申请实施例公开一种用于髋臼骨翻修重建的垫块及其与髋臼杯假体的固定结构。
实施例一：
参照图1，一种用于髋臼骨翻修重建的垫块，垫块位于髋臼杯假体与髋臼骨之间，并分别与髋臼杯假体和髋臼骨固定连接，垫块包括第一部件1，第一部件1上卡接有第二部件2，第一部件1和第二部件2为1/8球形的形状，第一部件1的半径、形状与第二部件2的半径、形状均相同，第一部件1与第二部件2的厚度都为其边缘薄并向球心位置逐渐增厚，第一部件1和第二部件2的边缘伸入至髋臼骨内，卡接后的第一部件1和第二部件2的形状为1/4球形的形状，卡接后的第一部件1和第二部件2的形状、厚度与髋臼骨的缺损处相适配。
参照图2和图3，第一部件1靠近第二部件2的侧壁上开设有燕尾槽3，在第二部件2靠近第一部件1的侧壁上设置有燕尾块4，燕尾块4与燕尾槽3相互卡接使第一部件1与第二部件2相连接。
在燕尾槽3的底面长度由靠近髋臼杯假体的一侧向远离髋臼骨的一侧逐渐减小，使燕尾槽3的纵截面为锥台形，燕尾块4靠近燕尾槽3底面的侧面由靠近髋臼杯假体的一侧向远离髋臼骨的一侧逐渐减小，使燕尾块4的纵截面的形成锥台形，锥台形状使燕尾块4与燕尾槽3逐渐收紧，在燕尾块4由靠近髋臼杯假体的方向插入燕尾槽3后，防止燕尾块4脱出燕尾槽3。
第一部件1和第二部件2上各开设有多个安装孔5，安装孔5为沉孔，第一部件1和第二部件2与髋臼骨通过螺钉插入安装孔5进行固定连接，安装孔5为长圆形，螺钉插入安装孔5后，由于安装孔5的形状，螺钉与安装孔5的孔壁之间具有间隙，可以使螺钉在安装孔5内移动，调整螺钉固定在髋臼骨厚度较厚的位置上。
垫块与髋臼杯假体的固定结构，第一部件1和第二部件2靠近髋臼杯假体的侧面上设置有覆盖层7，第一部件1和第二部件2为骨小梁结构，覆盖层7为实体层。
在靠近髋臼骨假体的覆盖层7、第一部件1和第二部件2上各开设有多个圆形槽6，在髋臼杯假体靠近第一部件1和第二部件2的侧面上涂覆一层骨水泥，在髋臼杯假体放入第一部件1和第二部件2所形成的凹面后，髋臼杯假体上的骨水泥进入多个圆形槽6内，进入圆形槽6内的骨水泥形成骨水泥柱，使第一部件1和第二部件2与髋臼杯假体能够固定连接，圆形槽6的深度随着第一部件1或者第二部件2的厚度逐渐增厚而加深。
第一部件1和第二部件2与髋臼杯假体不能直接通过骨水泥进行固定，由于骨小梁的间隙大小不同，使骨水泥难以渗入骨小梁的间隙，或者渗入骨小梁间隙的骨水泥与间隙之间的嵌合力差，形成的连接比较脆弱，导致第一部件1和第二部件2与髋臼杯假体不能形成固定连接，因此设置了覆盖层7，可以防止骨水泥渗入骨小梁的间隙，使骨水泥直接进入圆形槽6内。
实施例一的实施原理为：将第一部件1和第二部件2卡接并放入髋臼骨的缺损处，并使用螺钉插入安装孔5钉入髋臼骨假体内，使第一部件1和第二部件2与髋臼骨假体固定连接，再在髋臼杯假体的侧面上涂覆一层骨水泥，将髋臼杯假体放入第一部件1和第二部件2的凹面内，骨水泥进入圆形槽内，固化，即可完成垫块与髋臼杯假体和髋臼骨的连接。
实施例二，是在实施例一的基础上进行的改进。
参照图4，第一部件1和第二部件2为1/4球形的形状，第一部件1的半径、形状与第二部件2的半径、形状均相同，第一部件1与第二部件2的厚度都为其边缘薄并向球心位置逐渐增厚，卡接后的第一部件1和第二部件2为半球形的形状，卡接后的第一部件1和第二部件2的形状、厚度与髋臼骨的缺损处相适配。
参照图5和图6，第一部件1靠近第二部件2的侧壁上开设有燕尾块4，在第二部件2靠近第一部件1的侧壁上设置有燕尾槽3，燕尾块4与燕尾槽3相互卡接使第一部件1与第二部件2相连接。
参照图7，在第一部件1和第二部件2靠近髋臼骨的侧面上设置有仿松质骨的多孔结构层8，有利于髋臼骨在髋臼杯假体的骨长入，其优异的摩擦系数有利于更好的原始压配,为髋臼杯假体的初始稳定和远期稳定提供了良好的条件，多孔结构层8的60%-80%的孔隙率有利于骨组织的长入，形成相互交联的微结构，形成长期的生物固定效果，延长了髋臼杯假体的使用寿命。
实施例二的实施原理与实施例一的实施原理相同，在此不再赘述。
除了上述的两个实施例，根据实际的髋臼骨的缺损情况，第一部件1和第二部件2可以选用如下的组合方式：
（1）选用厚度均匀一致、半径相同的第一部件1与第二部件2进行组合；
或者（2）选用厚度均匀一致、半径不同的第一部件1与第二部件2进行组合：
或者（3）选用第一部件1为厚度均匀一致，第二部件2的厚度为其边缘厚并向球心位置逐渐变薄，且第一部件1和第二部件2半径相同的组合；
或者（4）选用第一部件1为厚度均匀一致，第二部件2的厚度为其边缘厚并向球心位置逐渐变薄，且第一部件1和第二部件2半径不同的组合；
或者（5）选用第一部件1和第二部件2的厚度都为其边缘厚并向球心位置逐渐变薄，且第一部件1和第二部件2半径相同的组合；
或者（6）选用第一部件1和第二部件2的厚度都为其边缘厚并向球心位置逐渐变薄，且第一部件1和第二部件2半径不同的组合。
以上均为本申请的较佳实施例，并非依此限制本申请的保护范围，故：凡依本申请的结构、形状、原理所做的等效变化，均应涵盖于本申请的保护范围之内。

Claims (7)

1.一种用于髋臼骨翻修重建的垫块，垫块位于髋臼杯假体与髋臼骨之间，并分别与髋臼杯假体和髋臼骨相连接，其特征在于：包括第一部件（1）和与第一部件（1）半径、形状相同或不同的第二部件（2），所述的第一部件（1）与第二部件（2）活动连接，连接后的第一部件（1）和第二部件（2）的形状与髋臼骨的缺损处相适配。
2.根据权利要求1所述的用于髋臼骨翻修重建的垫块，其特征在于：所述的第一部件（1）和第二部件（2）为1/4或者1/8球形的形状，第一部件（1）和/或第二部件（2）的厚度均匀一致或者其边缘薄并向球心位置逐渐增厚或者其边缘厚并向球心位置逐渐变薄。
3.根据权利要求2所述的用于髋臼骨翻修重建的垫块，其特征在于：所述的第一部件（1）或第二部件（2）的侧壁上开设有燕尾槽（3），第二部件（2）或第一部件（1）的侧壁上设置有与燕尾槽（3）配合使用的燕尾块（4），通过燕尾槽（3）与燕尾块（4）的卡接使第一部件（1）与第二部件（2）活动连接。
4.根据权利要求3所述的用于髋臼骨翻修重建的垫块，其特征在于：所述的燕尾槽（3）的底面长度由靠近髋臼杯假体的一侧向远离髋臼骨的一侧逐渐减小，燕尾槽（3）的纵截面为锥台形，所述的燕尾块（4）靠近燕尾槽（3）底面的侧面由靠近髋臼杯假体的一侧向远离髋臼骨的一侧逐渐减小，燕尾块（4）的纵截面的形成锥台形。
5.根据权利要求4所述的用于髋臼骨翻修重建的垫块，其特征在：所述的第一部件（1）和第二部件（2）上各开设有多个长圆形的安装孔（5），所述的安装孔（5）内插入螺钉并与螺钉之间留有间隙，通过螺钉插入安装孔（5）将第一部件（1）和第二部件（2）与髋臼骨固定连接。
6.根据权利要求1-5任一项所述的一种垫块与髋臼杯假体的固定结构，其特征在：所述的第一部件（1）和第二部件（2）上各开设有多个圆形槽（6），髋臼杯假体靠近垫块的侧面上涂覆骨水泥，第一部件（1）和第二部件（2）与髋臼杯假体接触，通过骨水泥进入多个圆形槽（6）内使第一部件（1）和第二部件（2）与髋臼杯假体固定连接。
7.根据权利要求6所述的垫块与髋臼杯假体的固定结构，其特征在：所述的第一部件（1）和第二部件（2）靠近髋臼杯假体的侧面上设置有覆盖层（7），所述的圆形槽（6）的槽口开设在覆盖层（7）上。
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