CN108498209B - 3D printed titanium alloy prosthesis for bone defects of large limbs - Google Patents

3D printed titanium alloy prosthesis for bone defects of large limbs Download PDF

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Publication number
CN108498209B
CN108498209B CN201810328203.1A CN201810328203A CN108498209B CN 108498209 B CN108498209 B CN 108498209B CN 201810328203 A CN201810328203 A CN 201810328203A CN 108498209 B CN108498209 B CN 108498209B
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prosthesis
proximal
distal
bone defect
bone
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CN108498209A (en
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马运宏
芮永军
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Wuxi No 9 Peoples Hospital
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Wuxi No 9 Peoples Hospital
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Priority to CN201810328203.1A priority Critical patent/CN108498209B/en
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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
    • A61F2/28Bones
    • 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
    • A61F2/30767Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/3082Grooves
    • 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
    • A61F2/30767Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30878Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • 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
    • A61F2/3094Designing or manufacturing processes
    • A61F2002/30985Designing or manufacturing processes using three dimensional printing [3DP]
    • 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
    • A61F2310/00Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005The prosthesis being constructed from a particular material
    • A61F2310/00011Metals or alloys
    • A61F2310/00023Titanium or titanium-based alloys, e.g. Ti-Ni alloys

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (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)
  • Materials For Medical Uses (AREA)

Abstract

The invention relates to a 3D printed titanium alloy prosthesis for a large-section bone defect of an extremity, and belongs to the technical field of orthopedic medical devices. The device comprises a proximal prosthesis and a distal prosthesis, wherein the proximal prosthesis and the distal prosthesis are connected in a matched manner; the proximal prosthesis comprises a proximal medullary cavity end, a proximal bone defect end and a boss; the proximal medullary cavity end is connected with a proximal bone defect end, and the proximal bone defect end is connected with a boss; the distal prosthesis comprises a distal medullary cavity end, a distal bone defect end and a groove; the distal medullary cavity end is connected with a distal bone defect end, and the distal bone defect end is connected with the groove; the proximal prosthesis and the distal prosthesis are connected in a matched manner through a boss and a groove. The invention is convenient to install, the prosthesis also has the function of an internal fixator, the auxiliary fixation of the internal fixator is not needed, and the load can be applied after the operation like joint replacement; the prosthesis of the invention can not loosen, so the long-term fixing effect of the prosthesis is also better.

Description

3D printed titanium alloy prosthesis for bone defects of large limbs
Technical Field
The invention relates to a 3D printed titanium alloy prosthesis for a large-section bone defect of an extremity, which can be assembled and can grow into a callus, and belongs to the technical field of orthopedic medical appliances.
Background
The limb bone defects caused by serious wounds, infection, tumor, deformity excision and the like are clinically seen, the bone defects larger than 2cm cannot be healed by themselves and need to be treated by surgery, but the bone healing time is usually longer, even if free bone grafting treatment is adopted for the bone defects of the tibia, the healing time is at least 6 months, the healing of the larger limb bone defects is more difficult, the activity function and life of a patient are seriously influenced, and even amputation is possible, so the treatment of the bone defects of the large limb is still a challenging subject because the existing treatment methods have defects such as: the free bone grafting method is simple, but is only suitable for small-section bone defects and is not suitable for large-section bone defects; the fibula valve is transplanted and healed faster, is suitable for long-section bone defect, but needs microsurgery technology, is difficult to popularize, and has thinner fibula, and the fracture is possible in the treatment of tibia and femur bone defect; ilizarov technology treatment, long external stent fixing time, the broken ends can be healed only by secondary bone grafting, and the external stent has inconvenient rehabilitation and nursing and high incidence rate of nail loosening infection; the tissue engineering technology is used for repairing the bone defect at the experimental stage; the existing methods can not immediately recover the function of the affected limb after operation and the like.
The CT three-dimensional reconstruction technology is utilized to reconstruct bones or bone defects, and the 3D printing technology is utilized to print out titanium alloy bones or bone defect prostheses, so that the conventional titanium alloy bones and bone defect prostheses are of a single defect bone structure, do not have the function of an internal fixator, and all the titanium alloy bones and bone defect prostheses need to be fixed on surrounding bones by an additional internal fixator; furthermore, the mesh bone grafting is not seen around the prosthesis, the prosthesis and the surrounding bones cannot be integrated, and the long-term fixation looseness of the prosthesis is possible.
Disclosure of Invention
The invention aims to overcome the defects and provide a 3D printed titanium alloy prosthesis for the bone defect of the large section of the limb, which can be used for printing the prosthesis for the bone defect of the large section of the limb, can be assembled and can grow into callus.
According to the technical scheme, the 3D printed titanium alloy prosthesis for the defect of the large bone of the limbs comprises a proximal prosthesis and a distal prosthesis, and the proximal prosthesis and the distal prosthesis are connected in a matched manner;
the proximal prosthesis comprises a proximal medullary cavity end, a proximal bone defect end and a boss; the proximal medullary cavity end is connected with a proximal bone defect end, and the proximal bone defect end is connected with a boss;
the distal prosthesis comprises a distal medullary cavity end, a distal bone defect end and a groove; the distal medullary cavity end is connected with a distal bone defect end, and the distal bone defect end is connected with the groove;
the proximal prosthesis and the distal prosthesis are connected in a matched manner through a boss and a groove.
The device also comprises a wedge; the boss and the groove are respectively provided with a plurality of round holes which are longitudinally arranged, and the boss and the groove are fixedly connected through a wedge inserted into the round holes after being connected.
The diameter of the proximal medullary cavity end is slightly gradually reduced from the joint of the proximal medullary cavity end and the proximal bone defect end; the diameter of the distal medullary cavity end is slightly gradually reduced from the joint with the distal bone defect end.
The surfaces of the proximal medullary cavity end and the distal medullary cavity end are provided with pearl-shaped protrusions, the concave parts of the pearl-shaped protrusions can grow into porosities, and the pearl-shaped protrusions are tightly contacted with the inner wall of the medullary cavity.
The surfaces of the proximal bone defect end and the distal bone defect end are mesh-shaped.
The mesh can be used for bone grafting and new bone growth, so that new bone connection is formed.
The proximal prosthesis and the distal prosthesis are both made of titanium alloy.
Reconstructing bone defect and surrounding marrow cavity structure by CT three-dimensional scanning and reconstruction technique, and printing out titanium alloy near-end prosthesis and far-end prosthesis by medical titanium powder by 3D printing technique, wherein the size and shape are matched with bone defect and surrounding marrow cavity.
The invention has the beneficial effects that: the invention is convenient to install, the prosthesis also has the function of an internal fixator, the auxiliary fixation of the internal fixator is not needed, and the load can be applied after the operation like joint replacement; the joint is provided with a plurality of round holes which can be selected, and the length of the prosthesis can be adjusted; the bone callus can grow into the recessed part of the marrow cavity end surface of the prosthesis, the spongy bone can be formed and a new bone connection can be formed after the mesh holes on the surface of the defect end of the prosthesis bone and the joint of the prosthesis boss and the groove are implanted, and finally the prosthesis and the bone are fused into a whole, so that the prosthesis cannot loosen, and the long-term fixing effect of the prosthesis is better.
Drawings
FIG. 1 is a schematic view of the structure of the proximal prosthesis of the present invention.
Fig. 2 is a schematic view of the structure of the distal prosthesis of the present invention.
Fig. 3 is a schematic view of the prosthesis mounting arrangement of the present invention.
Reference numerals illustrate: 1. a proximal prosthesis; 1-1, proximal medullary cavity end; 1-2, proximal bone defect end; 1-3, boss; 2. a distal prosthesis; 2-1, distal medullary cavity end; 2-2, distal bone defect end; 2-3, grooves; 3. a wedge; 4. and a round hole.
Detailed Description
As shown in fig. 1-2, a 3D printed titanium alloy prosthesis for bone defects of large segments of limbs comprises a proximal prosthesis 1 and a distal prosthesis 2, wherein the proximal prosthesis 1 and the distal prosthesis 2 are connected in a matched manner;
the proximal prosthesis 1 comprises a proximal medullary cavity end 1-1, a proximal bone defect end 1-2 and a boss 1-3; the proximal medullary cavity end 1-1 is connected with the proximal bone defect end 1-2, and the proximal bone defect end 1-2 is connected with the boss 1-3;
the distal prosthesis 2 comprises a distal medullary cavity end 2-1, a distal bone defect end 2-2 and a groove 2-3; the distal medullary cavity end 2-1 is connected with the distal bone defect end 2-2, and the distal bone defect end 2-2 is connected with the groove 2-3;
the proximal prosthesis 1 and the distal prosthesis 2 are connected in a matched manner through the boss 1-3 and the groove 2-3.
Also comprises a wedge 3; a plurality of round holes 4 which are longitudinally arranged are respectively arranged on the boss 1-3 and the groove 2-3, and the boss 1-3 and the groove 2-3 are fixedly connected through a wedge 3 inserted into the round holes 4 after being connected.
The diameter of the proximal medullary cavity end 1-1 is slightly gradually reduced from the joint with the proximal bone defect end 1-2; the diameter of the distal medullary cavity end 2-1 is slightly gradually reduced from the joint with the distal bone defect end 2-2.
The surfaces of the proximal medullary cavity end 1-1 and the distal medullary cavity end 2-1 are provided with pearl-shaped protrusions, the concave parts of which can grow into porosities, and the pearl-shaped protrusions are tightly contacted with the inner wall of the medullary cavity.
The surfaces of the proximal bone defect end 1-2 and the distal bone defect end 2-2 are mesh-shaped.
The mesh can be used for bone grafting and new bone growth, so that new bone connection is formed.
The material of the proximal prosthesis 1 and the distal prosthesis 2 is titanium alloy.
The bone defect and the surrounding marrow cavity structure are rebuilt through CT three-dimensional scanning and rebuilding technology, and then the 3D printing technology is utilized to print out the titanium alloy near-end prosthesis 1 and the far-end prosthesis 2 through medical titanium powder, and the size and the shape are matched with the bone defect and the surrounding marrow cavity.
The corresponding positions of the defect ends of the proximal prosthesis 1 and the distal prosthesis 2 are respectively provided with a boss 1-3 and a groove 2-3, the boss 1-3 and the groove 2-3 are respectively provided with two round holes 4 which are longitudinally arranged, after the boss 1-3 and the groove 2-3 are combined, the boss 3 and the groove 2-3 are inserted into the round holes 4 by using a wedge 3 to connect the boss 1-3 and the groove 2-3 to form a complete bone defect prosthesis, any one of the two round holes 4 which are longitudinally arranged can be selected according to the specific situation in the operation, and the boss and the groove 2-3 are connected by using the wedge 3, so that the length of the prosthesis is adjustable.
When the invention works, the bone of the affected limb is checked by CT scanning before operation, the bone defect and the surrounding marrow cavity structure are rebuilt according to CT scanning, and then the 3D printing technology and the titanium alloy powder are utilized to print out the bone defect and the surrounding marrow cavity prosthesis. During operation, all cancellous bones of the medullary cavity are scraped off at the position where the medullary cavity is placed, the scraped cancellous bones are reserved for standby, and then the prosthesis is tried to be installed, so as to check whether the limb force line is good or not and determine the position where the prosthesis is placed in the medullary cavity.
The method comprises the following steps: the spongy bone in the marrow cavity is scraped first to prepare the bone bed for prosthesis implantation, and meanwhile, the scraped spongy bone is reserved for bone grafting. The medullary cavity end of the prosthesis is freely placed in the medullary cavity along the medullary cavity direction, the medullary cavity end prosthesis is slightly pressurized but not required to be tightly inserted, and after the medullary cavity end prosthesis on two sides is installed, the limbs are required to be pulled or rotated to connect the boss 1-3 and the groove 2-3 of the proximal prosthesis 1 and the distal prosthesis 2. At this time, the prosthesis position needs to be adjusted, and the limb does not need to deflect in the inner-outer and front-rear directions so as to restore the correct force line of the limb. After confirming the position of the prosthesis, marking on the bone at the broken end of the bone defect, and then pressing the marrow cavity end of the cutting prosthesis by an impactor to make the marrow cavity end closely contact with the marrow cavity. Then, to determine the prosthesis length, a suitable round hole 4 is selected according to the limb recovery length to connect the proximal prosthesis 1 and the distal prosthesis 2 with the wedge 3 so as to recover the normal length. Finally, the scraped cancellous bone is implanted into the mesh openings of the surfaces of the proximal prosthesis 1 and the distal prosthesis 2 and the gaps at the connection of the prosthesis boss and the groove. If the broken end of the cortical bone is uneven or defective in operation, abundant cancellous bone can be implanted into the surface mesh of the prosthesis with the cortical bone defect, and new bone can be formed later; if the patient is an advanced osteoporosis patient, the intramedullary prosthesis is easily loosened after insertion or operation, the bone cement type prosthesis installation method can be adopted, namely medical bone cement is used when the prosthesis is inserted into the intramedullary cavity, and the prosthesis is fixed by the adhesion of the bone cement.

Claims (3)

1. A 3D printed titanium alloy prosthesis for a large bone defect of an extremity, which is characterized in that: comprises a proximal prosthesis (1) and a distal prosthesis (2), wherein the proximal prosthesis (1) and the distal prosthesis (2) are connected in a matching way;
the proximal prosthesis (1) comprises a proximal medullary cavity end (1-1), a proximal bone defect end (1-2) and a boss (1-3); the proximal medullary cavity end (1-1) is connected with the proximal bone defect end (1-2), and the proximal bone defect end (1-2) is connected with the boss (1-3);
the distal prosthesis (2) comprises a distal medullary cavity end (2-1), a distal bone defect end (2-2) and a groove (2-3); the distal medullary cavity end (2-1) is connected with the distal bone defect end (2-2), and the distal bone defect end (2-2) is connected with the groove (2-3);
the proximal prosthesis (1) and the distal prosthesis (2) are connected in a matched manner through the boss (1-3) and the groove (2-3);
also comprises a wedge (3); a plurality of round holes (4) which are longitudinally arranged are respectively arranged on the boss (1-3) and the groove (2-3), and the boss (1-3) and the groove (2-3) are fixedly connected through a wedge (3) inserted into the round holes (4) after being connected;
the diameter of the proximal medullary cavity end (1-1) is gradually reduced from the joint with the proximal bone defect end (1-2); the diameter of the distal medullary cavity end (2-1) gradually decreases from the joint with the distal bone defect end (2-2);
the surfaces of the proximal medullary cavity end (1-1) and the distal medullary cavity end (2-1) are provided with pearl granular protrusions, the concave parts of which can grow into porosities, and the pearl granular protrusions are tightly contacted with the inner wall of the medullary cavity;
the surfaces of the proximal bone defect end (1-2) and the distal bone defect end (2-2) are mesh-shaped;
the material of the proximal prosthesis (1) and the material of the distal prosthesis (2) are both titanium alloy.
2. The 3D printed titanium alloy prosthesis for large bone defects of extremities according to claim 1, wherein: the mesh can be used for bone grafting and new bone growth, so that new bone connection is formed.
3. The 3D printed titanium alloy prosthesis for large bone defects of extremities according to claim 1, wherein: the bone defect and the surrounding marrow cavity structure are rebuilt through CT three-dimensional scanning and rebuilding technology, and then the 3D printing technology is utilized to print out the titanium alloy near-end prosthesis (1) and the far-end prosthesis (2) through medical titanium powder, and the size and the shape are matched with the bone defect and the surrounding marrow cavity.
CN201810328203.1A 2018-04-13 2018-04-13 3D printed titanium alloy prosthesis for bone defects of large limbs Active CN108498209B (en)

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Application Number Priority Date Filing Date Title
CN201810328203.1A CN108498209B (en) 2018-04-13 2018-04-13 3D printed titanium alloy prosthesis for bone defects of large limbs

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CN108498209B true CN108498209B (en) 2023-12-08

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Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN102908215A (en) * 2012-11-05 2013-02-06 胡永成 Backbone assembled prosthesis
CN106137470A (en) * 2016-07-28 2016-11-23 北京力达康科技有限公司 A kind of reservation articular surface type can prolonged type tibial neoplasms knee-joint prosthesis
CN205964231U (en) * 2016-07-01 2017-02-22 佟文 Be used for key defective connection false body
CN107028687A (en) * 2017-06-05 2017-08-11 南方医科大学 A kind of clavicle near-end anatomical form prosthese and forming method
CN208799372U (en) * 2018-04-13 2019-04-30 无锡市第九人民医院 A kind of four limbs large segmental bone defect titanium prosthesis of 3D printing

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN102908215A (en) * 2012-11-05 2013-02-06 胡永成 Backbone assembled prosthesis
CN205964231U (en) * 2016-07-01 2017-02-22 佟文 Be used for key defective connection false body
CN106137470A (en) * 2016-07-28 2016-11-23 北京力达康科技有限公司 A kind of reservation articular surface type can prolonged type tibial neoplasms knee-joint prosthesis
CN107028687A (en) * 2017-06-05 2017-08-11 南方医科大学 A kind of clavicle near-end anatomical form prosthese and forming method
CN208799372U (en) * 2018-04-13 2019-04-30 无锡市第九人民医院 A kind of four limbs large segmental bone defect titanium prosthesis of 3D printing

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