CN114052995A

CN114052995A - 3D printing personalized combined acetabular cup prosthesis and preparation and use methods thereof

Info

Publication number: CN114052995A
Application number: CN202010743652.XA
Authority: CN
Inventors: 冯德宏; 顾晓峰; 郭宇; 王凌; 丁育健; 何俊山
Original assignee: Wuxi Peoples Hospital
Current assignee: Wuxi Peoples Hospital
Priority date: 2020-07-29
Filing date: 2020-07-29
Publication date: 2022-02-18

Abstract

The invention discloses a 3D-printed individualized combined acetabular cup prosthesis and a method for preparing and using the same. The acetabular cup body, the ilium wing, the ischial wing and the pubic wing are extended and attached to the pubic bone. The acetabular cup body and the ilium wing, the pubic wing, and the ischial wing are respectively formed by 3D printing, and the acetabular cup body and the ilium wing, the pubic wing, and the ischial wing are provided with mutually matching connecting nail holes, and there are connecting screw holes between them. The connecting nail holes are fixedly connected by connecting screws, and the contact parts of the acetabular cup body, the ilium wing, the ischial wing and the pubic wing and the acetabular bone, the ilium, the pubis and the ischium are provided with several fixing nail holes, the present invention, It has the characteristics of effective reconstruction of acetabular bone defect and good bone implantation ability.

Description

3D printing personalized combined acetabular cup prosthesis and preparation and use methods thereof

Technical Field

The invention relates to the technical field of medical instruments, in particular to a 3D printing personalized combined acetabular cup prosthesis and a preparation method and a use method thereof.

Background

With the increasing number of total hip replacements worldwide, the number of patients who need revision due to failure of prosthesis fixation after total hip replacement for various reasons is increasing. After total hip replacement, due to aseptic loosening of the prosthesis, periprosthetic osteolysis and infection, the acetabular bone side prosthesis often has bone defects of different degrees during revision, and the treatment of the acetabular bone defects with large range and irregular anatomical shapes is the most challenging problem in clinic.

In hip arthroplasty, a revision prosthesis needs to satisfy at least two aspects: (1) the acetabular prosthesis must have a stable mechanical structure, capable of obtaining good initial stability, enabling the stresses to be dispersed in the bone surrounding the prosthesis; (2) the acetabulum prosthesis and the host bone need to have enough contact area, and the prosthesis and the bone surface need to be in close contact, so that the micromotion between the prosthesis and the bone surface is reduced to the maximum extent, the micromotion between the prosthesis and the bone should be less than 50um, and the micromotion more than 150um can cause bone absorption and fibrous tissue ingrowth and finally cause the prosthesis to loosen.

The traditional hip revision surgery mainly treats the serious bone defect at the acetabulum side by the following modes: (1) the method has the advantages that the bone grafting reconstruction time is too long, the early prosthesis stability cannot be provided, and the displacement looseness of the repaired prosthesis is easy to occur, so that the operation failure is caused; (2) the prosthesis is fixed by applying bone cement, and although the mode provides early stability, the prosthesis and the bone surface of a patient do not have bone ingrowth and are only mechanically fixed, so that the prosthesis is easy to loosen in a long term to cause fixation failure; (3) the existing revision type acetabular cup is mostly designed in an integral manner, the pelvis structure is complex, the bone defect difference of different patients is large, the integral revision type acetabular cup is fixed in structure and poor in adaptability to different patients, a prosthesis and a host bone cannot be in close contact, and the prosthesis is prone to failure in a long term; (4) the combined acetabular cup prosthesis is basically designed in a modularized mode, has a single prosthesis form, cannot meet acetabular bone defects of different types, particularly huge acetabular bone defects, and is narrow in application range.

Therefore, there is a need for a 3D printed personalized combined acetabular cup prosthesis and methods for making and using the same, which can more reliably and effectively reconstruct acetabular bone defects, and provide immediate mechanical stability and good bone ingrowth capabilities.

Disclosure of Invention

The invention aims to provide a 3D printing personalized combined acetabular cup prosthesis and a preparation method and a use method thereof, so as to solve the problems in the background technology.

In order to solve the technical problems, the invention provides the following technical scheme: A3D printing personalized combined acetabular cup prosthesis and preparation and use methods thereof comprise a bone body, wherein the bone body comprises an acetabular bone, an ilium, a pubis and an ischium, and the 3D printing personalized combined acetabular cup prosthesis is characterized in that: still include acetabular cup body, ilium wing, ischium wing and pubis wing, the ilium wing extends to be attached in the ilium, the pubis wing extends to be attached in the pubis, the ischium wing extends to be attached in ischium, and this acetabular cup body passes through ilium wing, ischium wing and pubis wing and fixes with patient's acetabular bone, ilium, pubis and ischium respectively, and is fixed more firmly.

According to the technical scheme, the acetabulum cup body is connected with the ilium wing, the pubis wing and the ischium wing in a 3d printing integrated forming mode, and the 3d printing integrated forming connection mode enables the whole acetabulum cup prosthesis to have integrity.

According to the technical scheme, the acetabulum cup body, the ilium wing, the pubis wing and the ischium wing are respectively printed and formed in a 3D mode, and the parts formed by the acetabulum cup body, the ilium wing, the pubis wing and the ischium wing can be conveniently replaced by respectively printing and forming in a 3D mode.

According to the technical scheme, the connection nail holes which are matched with each other are arranged between the acetabulum cup body and the ilium wing, the pubis wing and the ischium wing, the connection nail holes between the acetabulum cup body and the ilium wing are fixedly connected through connection screws, and the connection nail holes 5 are used for connecting the acetabulum cup body with the ilium wing, the pubis wing and the ischium wing.

According to the technical scheme, a plurality of fixing nail holes are formed in the contact positions of the acetabulum cup body, the ilium wings, the sitting bone wings and the pubis wings with the acetabulum bones, the ilium bones, the pubis bones and the ischium bones, a plurality of fixing nail holes are formed in each connecting position, fixing screws are arranged between the fixing nail holes, and the fixing nail holes are used for connecting the contact positions of the acetabulum cup body, the ilium wings, the sitting bone wings and the pubis wings with the acetabulum bones, the ilium bones, the pubis bones and the ischium bones.

According to the technical scheme, the internal thread is arranged in the connecting screw hole and the fixing screw hole, the connecting screw and the fixing screw comprise two types of common screws and locking screws, the common screws are fixed in a screwing mode, the assembly and disassembly are convenient, the locking screws can prevent the separation of the locking screws from the connecting screw hole and the fixing screw hole, and the fixing stability is improved.

According to the technical scheme, the porous layer structure is arranged on the surface, close to the bone body, of the acetabulum cup body, the ilium wing, the ischial wing and the pubic wing, and can increase the bone ingrowth probability of a plant-bone interface in the later period, so that the long-term stability of the prosthesis is increased.

According to the technical scheme, the printing material of the acetabular cup body, the ilium wing, the ischial wing and the pubic wing is one of titanium alloy, pure titanium, tantalum, high polymer material or biological ceramic which meets the requirements of endophytes.

A preparation method of a 3D printed personalized combined acetabular cup prosthesis is characterized by comprising the following steps: comprises the following steps:

step 1, carrying out CT scanning on a hip joint of a patient to obtain a CT image of a bone part of the patient, and introducing three-dimensional reverse modeling software to establish a three-dimensional acetabulum model of the patient;

step 2, carrying out data processing on the three-dimensional acetabulum model, calculating the position, the range and the boundary of the bone defect, designing according to the acetabulum bone defect shape of a patient, wherein the prosthesis can be perfectly attached to the bone around the acetabulum of the patient, and the method accurately positions the central position of the acetabulum cup, so that the reconstructed hip joint is consistent with the central position of the original acetabulum, has good mechanical adaptation and shape adaptation, and realizes the personalized accurate reconstruction of the acetabulum bone defect;

step 3, based on a computer aided design technology, utilizing reverse engineering software to combine contralateral normal acetabulum data on a three-dimensional acetabulum model of a patient according to the anatomical morphology of the hip joint of the patient, determining the position of the rotation center of the acetabulum prosthesis at the affected side, designing various parameters of the combined acetabulum cup prosthesis, including the shapes and the size structures of an acetabulum cup body, an ilium wing, a pubis wing and an ischium wing, designing according to the position and the boundary of the acetabulum bone defect on the three-dimensional acetabulum model of the patient, ensuring the perfect fit of the prosthesis and the acetabulum bone of the patient, ensuring the direct close contact and stable support of the prosthesis and the bone, designing the number, the position, the direction and the length of screw holes on the prosthesis, generating a combined acetabulum cup prosthesis digital model file, and fixing screws in the sclerotin around the acetabulum at the affected side The position, the direction and the length of the prosthesis can enhance the initial stability of the prosthesis, improve the precision of the operation and shorten the operation time;

and 4, printing the combined acetabular cup prosthesis according to the combined acetabular cup prosthesis digital model file by using a 3D printer, and creating personalized combined acetabular cup prostheses according to the acetabular bone defect conditions of different patients, so that the combined acetabular cup prosthesis is suitable for revision of various types of acetabular bone defects and has a wide application range.

According to the technical scheme, in the step 4, the printing mode of the acetabulum cup body, the ilium wing, the pubis wing, the ischial wing and the porous layer thereof comprises one of a selective laser sintering technology, a selective laser melting technology and an electron beam melting technology, and the cutting surface can be more flat and smooth by adopting a laser processing mode.

A use method of a 3D printed personalized combined acetabular cup prosthesis is characterized in that: the method comprises the following specific steps:

step 1, closely attaching one surface of the 3D printed personalized combined acetabular cup prosthesis with the porous layer to a bone body of an acetabular part to be renovated of a patient;

step 2, fixing the acetabulum cup body and the iliac wing part through common screws or locking screws respectively;

and 3, closely attaching the pubic ala and the surface of the ischiadic ala with the porous layer to the bone of the patient, and fixing by using common screws or locking screws to finish the installation of the prosthesis.

Compared with the prior art, the invention has the following beneficial effects: in the invention, the raw materials are mixed,

(1) based on preoperative imaging data, the acetabulum bone prosthesis is designed according to the acetabulum bone defect shape of a patient, the prosthesis can be perfectly attached to the bone around the acetabulum of the patient, the central position of an acetabulum cup is accurately positioned, the reconstructed hip joint is consistent with the central position of the original acetabulum, good mechanical adaptation and shape adaptation are realized, and the personalized accurate reconstruction of the acetabulum bone defect is realized;

(2) by adopting a multi-component combined scheme, the operation in the operation is simpler, more accurate and more reliable than the traditional mode, the operation difficulty is reduced, the operation time is shortened, and the operation safety of a patient is improved;

(3) the number, the position, the direction and the length of the screw holes on the combined acetabular prosthesis are designed in advance according to different positions and fixing strength of acetabular bone defects, so that the initial stability of the prosthesis is enhanced, the surgical accuracy is improved, and the surgical time is shortened;

(4) the porous structure is formed by the surface design of the acetabular cup prosthesis, so that the bone ingrowth probability of a plant-bone interface in the later period is increased, and the long-term stability of the prosthesis is increased;

(5) the individual combined type acetabulum prosthesis can be created according to the acetabulum bone defect conditions of different patients, is suitable for the revision of various types of acetabulum bone defects, and has wide application range.

Drawings

The accompanying drawings, which are included to provide a further understanding of the invention and are incorporated in and constitute a part of this specification, illustrate embodiments of the invention and together with the description serve to explain the principles of the invention and not to limit the invention. In the drawings:

FIG. 1 is a schematic overall first perspective structural view of the present invention;

FIG. 2 is a schematic view of an overall second perspective structure of the present invention;

FIG. 3 is a schematic view of the acetabular cup prosthesis reconstruction acetabular configuration of the invention;

in the figure: 1. an acetabular cup body; 2. the ilium wing; 3. sitting on the bone wing; 4. pubic ala; 5. connecting nail holes; 6. and fixing the nail holes.

Detailed Description

The technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are only a part of the embodiments of the present invention, and not all of the embodiments. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.

Referring to fig. 1-2, the present invention provides the following technical solutions: the utility model provides a 3D prints individualized combination formula acetabular cup prosthesis, includes the diaphysis, and the diaphysis includes acetabular bone, ilium, pubis and ischium, its characterized in that: the acetabulum cup comprises an acetabulum cup body 1, an ilium wing 2, an ischium wing 3 and a pubis wing 4, wherein the ilium wing 2 extends and is attached to an ilium, the pubis wing 4 extends and is attached to a pubis, the ischium wing extends and is attached to the ischium, and the acetabulum cup body 1 is respectively fixed with the acetabulum bone, the ilium bone, the pubis bone and the ischium bone of a patient through the ilium wing 2, the ischium wing 3 and the pubis wing 4, so that the fixation is firmer;

the acetabulum cup body 1 is printed and integrally connected with the ilium wing 2, the pubic wing 4 and the ischial wing 3 in a 3d mode, and the whole acetabulum cup prosthesis has more integrity due to the 3d printing and integrally connecting mode;

the acetabulum cup body 1, the ilium wing 2, the pubis wing 4 and the ischium wing 3 are respectively formed by 3D printing, and the components can be conveniently replaced by 3D printing respectively, so that the use is more flexible, the operation in the operation is simpler, more accurate and more reliable than the traditional mode, the operation difficulty is reduced, the operation time is shortened, and the operation safety of a patient is improved;

connecting nail holes 5 which are matched with each other are arranged between the acetabulum cup body 1 and the ilium wing 2, the pubic wing 4 and the ischium wing 3, the connecting nail holes 5 between the acetabulum cup body 1 and the ilium wing 2 are fixedly connected through connecting screws, and the connecting nail holes 5 are used for connecting the acetabulum cup body 1 and the ilium wing 2, the pubic wing 4 and the ischium wing 3;

the contact parts of the acetabular cup body 1, the ilium wings 2, the ischium wings 3 and the pubic wings 4 with the acetabular bones, the ilium bones, the pubic bones and the ischium bones are provided with a plurality of fixing nail holes 6, each connection part is provided with a plurality of fixing nail holes 6, fixing screws are arranged between the respective fixing nail holes 6, and the fixing nail holes 6 are used for connecting the contact parts of the acetabular cup body 1, the ilium wings 2, the ischium wings 3 and the pubic wings 4 with the acetabular bones, the ilium bones, the pubic bones and the ischium bones;

internal threads are arranged in the connecting nail hole 5 and the fixing nail hole 6, the connecting screw and the fixing screw comprise two types of common screws and locking screws, the common screws are fixed in a screwing mode, the assembly and disassembly are convenient, the locking screws can be prevented from being separated from the connecting nail hole 5 and the fixing nail hole 6, and the fixing stability is improved;

the porous layer structure is arranged on one surface of the acetabulum cup body 1, the iliac wing 2, the ischial wing 3 and the pubic wing 4 close to the bone body, and can increase the bone ingrowth probability of the plant-bone interface in the later period, thereby increasing the long-term stability of the prosthesis;

the printing materials of the acetabulum cup body 1, the ilium wing 2, the ischial wing 3 and the pubic wing 4 are one of titanium alloy, pure titanium, tantalum, high polymer materials or biological ceramics which meet the requirements of endophytes;

step 4, printing the combined acetabular cup prosthesis according to the combined acetabular cup prosthesis digital model file by using a 3D printer, and creating personalized combined acetabular cup prostheses according to the acetabular bone defect conditions of different patients, so that the combined acetabular cup prosthesis is suitable for revision of various types of acetabular bone defects and has a wide application range;

in the step 4, the printing mode of the acetabulum cup body, the ilium wing, the pubis wing, the ischial wing and the porous layer thereof comprises one of a selective laser sintering technology, a selective laser melting technology and an electron beam melting technology, and the cutting surface can be more flat and smooth by adopting a laser processing mode;

as shown in fig. 3, a method for using a 3D printed personalized combined acetabular cup prosthesis is characterized in that: the method comprises the following specific steps:

It is noted that, herein, relational terms such as first and second, and the like may be used solely to distinguish one entity or action from another entity or action without necessarily requiring or implying any actual such relationship or order between such entities or actions. Also, the terms "comprises," "comprising," or any other variation thereof, are intended to cover a non-exclusive inclusion, such that a process, method, article, or apparatus that comprises a list of elements does not include only those elements but may include other elements not expressly listed or inherent to such process, method, article, or apparatus.

Finally, it should be noted that: although the present invention has been described in detail with reference to the foregoing embodiments, it will be apparent to those skilled in the art that changes may be made in the embodiments and/or equivalents thereof without departing from the spirit and scope of the invention. Any modification, equivalent replacement, or improvement made within the spirit and principle of the present invention should be included in the protection scope of the present invention.

Claims

1. A 3D printing personalized combined acetabular cup prosthesis, comprising a bone body, the bone body comprising an acetabular bone, an ilium, a pubis and an ischium, and is characterized in that: also comprises an acetabular cup body (1), The ilium wing (2), the ischial wing (3) and the pubic wing (4), the ilium wing (2) is extended and attached to the ilium, the pubic wing (4) is extended and attached to the pubic bone, the ischium Wing extensions are attached to the ischium.

2. A 3D printing personalized combined acetabular cup prosthesis according to claim 1, characterized in that: the acetabular cup body (1), the ilium wing (2), the pubic wing (4), The ischial wings (3) are integrally formed and connected by 3D printing.

3. A 3D printing personalized combined acetabular cup prosthesis according to claim 1, characterized in that: the acetabular cup body (1) and the ilium wing (2), the pubic wing (4), The ischial wings (3) are respectively formed by 3D printing.

4. A 3D printing personalized combined acetabular cup prosthesis according to claim 1, characterized in that: the acetabular cup body (1), the ilium wing (2), the pubic wing (4), The ischial wings (3) are provided with mutually matching connecting nail holes (5), and the respective connecting nail holes (5) are fixedly connected by connecting screws.

5. A 3D printing personalized combined acetabular cup prosthesis according to claim 4, characterized in that: the acetabular cup body (1), the ilium wing (2), the ischial wing (3) and the The contact parts of the pubic wing (4) and the acetabular bone, the ilium, the pubis and the ischium are provided with a plurality of fixing nail holes (6), and each connecting part is provided with a plurality of fixing nail holes (6), and the respective fixing nail holes ( 6) There are fixing screws between them.

6. A 3D printing personalized combined acetabular cup prosthesis according to claim 5, characterized in that: the connecting nail hole (5) and the fixing nail hole (6) are provided with internal threads, and the Connecting screws and fixing screws include two types of ordinary screws and locking screws.

7. A 3D printing personalized combined acetabular cup prosthesis according to claim 1, characterized in that: the acetabular cup body (1), the ilium wing (2), the ischial wing (3) and the The side of the pubic wing (4) close to the bone body is provided with a porous layer structure.

8. A 3D printing personalized combined acetabular cup prosthesis according to claim 1, characterized in that: the acetabular cup body (1), the ilium wing (2), the ischial wing (3) and the The printing material of the pubic wing (4) is one of titanium alloy, pure titanium, tantalum, polymer material or bioceramic that meets the requirements of the implant.

9. A preparation method of a 3D printing personalized combined acetabular cup prosthesis, characterized in that: comprising the following specific steps:

Step 1, perform CT scan on the patient's hip joint, obtain the CT image of the patient's bone part, and import the 3D inverse modeling software to establish the patient's 3D acetabular model;

Step 2, perform data processing on the three-dimensional acetabular model, and calculate the position, range and boundary of the bone defect;

Step 3, based on computer-aided design technology, using reverse engineering software, according to the patient's hip anatomy, combined with the contralateral normal acetabular data on the patient's three-dimensional acetabular model, determine the position of the rotation center of the affected acetabular prosthesis, and design the combination. The parameters of the acetabular cup prosthesis, including the shape and size structure of the acetabular cup body, ilium wing, pubic wing, and ischial wing, are designed according to the position and boundary of the acetabular bone defect on the patient's three-dimensional acetabular model to ensure The perfect fit between the prosthesis and the patient's acetabular bone, ensuring direct and close contact between the prosthesis and the bone and stable support, designing the number, position, direction and length of the screw holes on the prosthesis, and generating the combined acetabular cup prosthesis digital model file , so that the screw is fixed in the bone around the acetabulum on the affected side;

Step 4, using a 3D printer to print the combined acetabular cup prosthesis according to the digital model file of the combined acetabular cup prosthesis.

10. The preparation method of a 3D printing personalized combined acetabular cup prosthesis according to claim 9, characterized in that: in the above step 4, the acetabular cup body, the ilium wing, the pubic wing, the ischial wing and the The printing method of the porous layer includes one of selective laser sintering technology, selective laser melting technology, and electron beam melting technology.

11. A method of using a 3D printing personalized combined acetabular cup prosthesis, characterized in that: comprising the following concrete steps:

Step 1, closely fit the 3D printed personalized combined acetabular cup prosthesis with the porous layer to the bone of the patient's acetabular part to be revised;

Step 2, fix the acetabular cup body and the ilium wing with ordinary screws or locking screws respectively;

Step 3, closely fit the porous layer of the pubic wing and ischial wing to the patient's bone body, and fix it with ordinary screws or locking screws to complete the installation of the prosthesis.