CN109567983A - Horn-like implantation material and its method for implantation - Google Patents
Horn-like implantation material and its method for implantation Download PDFInfo
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- CN109567983A CN109567983A CN201811441095.5A CN201811441095A CN109567983A CN 109567983 A CN109567983 A CN 109567983A CN 201811441095 A CN201811441095 A CN 201811441095A CN 109567983 A CN109567983 A CN 109567983A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS 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
- A61F2/00—Filters 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
- A61F2/02—Prostheses implantable into the body
- A61F2/08—Muscles; Tendons; Ligaments
- A61F2/0811—Fixation devices for tendons or ligaments
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Abstract
The present invention discloses a kind of horn-like implantation material and its method for implantation, it is related to ligament reconstructive technical field, to solve to concentrate for one lateral stress of tunnel face caused by " the rain brush effect " of the postoperative osseous tunnel mouth of ligament reconstructive in the prior art, the stress of bone resorption caused by the stress relieved of opposite side, tunnel face expansion and transplanting ligament concentrated, abrasion and the technical issues of phenomenon of rupture solution.The horn-like implantation material, comprising: loudspeaker face structure, Ji Yuqi necking end are communicated with matrix column, and the lateral wall of the matrix column is equipped with flank；For loudspeaker face structure for covering osseous tunnel mouth, matrix column protrudes into osseous tunnel, and is fixed in osseous tunnel by flank；Loudspeaker face structure is connected and composed by single or multiple curved surfaces, tangent mutually between multiple curved surfaces, using as the transition face at osseous tunnel mouth.
Description
Technical field
The present invention relates to ligament reconstructive technical field, in particular to a kind of horn-like implantation material and its method for implantation.
Background technique
Ligament injury can largely effect on the normal life of patient, and clinically visible ligament injury is many kinds of at present, packet
Include ligamentous injury of knee joint, ligament of shoulder joint damage, ligament of elbow joint damage, ligament injuries of ankle joint etc..Wherein, it is closed as knee
The important stabilising arrangement of section, anterior cruciate ligament (ACL) are one of the ligaments for being easiest to be damaged, and ACL damage can directly result in knee
Joint destabilization so that quality of life of patients substantially reduces, and can cause other knee joint accessory structures such as meniscus for a long time
Secondary lesion eventually leads to arthritic generation.
The method of clinical treatment ligament injury at present is mainly ligament reconstruction, i.e., is moved with autotransplantation ligament, allosome
It plants ligament or artificial ligament replaces original ligament, to restore stability of joint, avoid other joint accessory structures from occurring secondary
Damage, reduces arthritic incidence.In traditional ligament reconstructive operation, the both ends of implantation of ligament body are fixed on phase respectively
In the osseous tunnel answered, osseous tunnel is located at former ligament stop in intra-articular tunnel face, utmostly realizes ligament with this
Dissection and reconstruction.
Although ligament reconstructive operation can restore stability of joint in a short time, postoperative long-term existence is a series of concurrent
Disease.Wherein, osseous tunnel expands and ligament secondary breakdown belongs to one of ligament reconstructive postoperative complications.With both the above complication
A directly related key factor is exactly the hair of ligament reconstructive postoperative " rain brush effect " (windshield wiper effect)
It is raw.Can occur two kinds of relative motions between transplanting ligament and osseous tunnel: 1. along osseous tunnel long axis relative motion, 2. and osseous tunnel
The perpendicular relative motion of long axis.Wherein implantation of ligament body is referred to as " rain brush effect " perpendicular to the movement of osseous tunnel axis.It is closing
Osseous tunnel mouth in section, " rain brush effect " show as swing of the graft perpendicular to tunnel axis as rain brush.In intra-articular, shifting
Implant is swerved in tunnel face, due to ligament reconstructive postoperative early stage, is not bound between implantation of ligament body and osseous tunnel, because
This can occur to slide relatively during motion of knee joint, between transplant and osseous tunnel, and tunnel face is sharp edge, institute
The transplant upper stress that not only will lead to tunnel face edge with the tension in transplant and its be in contact is concentrated, but also can make implantation of ligament
Body is worn in sliding process.And tough belt wear, especially implantation of ligament caused by artificial ligament and the friction of joint bone face
The abrasion that body occurs in osseous tunnel inlet, have been considered to be cause implantation of ligament body be broken the reason of one of.Wear particle
Generation it is also possible to cause serious complication, such as synovitis, third party's particle reaction and bone dissolution etc..Evans's et al.
The study found that the wear particle of artificial graft's ligament can cause synovial membrane moderate to the macrophages infiltration of severe.In addition, with complete
Whole knee joint is compared, and the unilateral stress of the postoperative osseous tunnel mouth of ligament reconstructive is concentrated and opposite side stress relieved can also eventually lead to tunnel
The bone resorption of mouth, causes tunnel face to expand, and transplant loosens, and aggravation is worn between transplant and osseous tunnel, so that implantation of ligament body
Fracture, eventually leads to the failure of ligament reconstruction.Osseous tunnel when Hsu et al. is measured postoperative 3,6,12 and 18 months expands,
And discovery is located at intra-articular tunnel face (bone tunnel at the joint site) due to the generation of " rain brush effect "
Enlarged-diameter amount is big than the increase of ligament bearing (bone tunnel at bone plug site) osseous tunnel diameter.
However, revision procedure relative difficulty after ligament reconstruction failure and it is extremely challenging, especially for the fixed device of ligament
It smoothly removes, and to fix new implantation of ligament body in the osseous tunnel after expansion, be all very big for surgical doctor
Challenge.
Therefore, having part research and take corresponding measure to avoid the appearance of " rain brush effect ", Tosi et al. is proposed,
Compared to ligamentum patellae Ji hamstring, stock market trend prediction have bigger cross-sectional area, therefore, by using stock market trend prediction as ACL
The implantation of ligament body of reconstruction operations can make to generate good press-fitting (press-fit) between implantation of ligament body and osseous tunnel, from
And gap between the two is reduced, and then limit its relative motion, the appearance of " rain brush effect " is reduced, prevents osseous tunnel from expanding.
Paessler et al. utilizes suture to make up flat patellar tendon transplant body and the cross section gap of kneecap bone block and osseous tunnel
Suture processing is carried out to patellar tendon transplant body, and kneecap bone block is processed into cylinder, makes patellar tendon transplant body and its end
Bone block matches the shape of osseous tunnel, " press-fitting " effect between transplant and osseous tunnel is realized, to reduce " rain brush effect ".
Barrett et al. is in the revision procedure of ACL Reconstruction, and manually bone block goes to fill up the bone defect of osseous tunnel, thus avoid because
Early period widened osseous tunnel and transplant tough interband there are gap caused by " rain brush effect ".However, being directed to the " loudspeaker of osseous tunnel mouth
The dissolution of tunnel face bone caused by effect ", tunnel face expansion and transplanting ligament wear problem, corresponding solution rarely seen at present are done
Method.
Summary of the invention
The purpose of the present invention is to provide a kind of horn-like implantation material and its method for implantation, to solve to be directed in the prior art
One lateral stress of tunnel face caused by " the rain brush effect " of the postoperative osseous tunnel mouth of ligament reconstructive is concentrated, and bone caused by the stress relieved of opposite side is inhaled
The technical issues of stress of receipts, tunnel face expansion and transplanting ligament is concentrated, abrasion and phenomenon of rupture solution.
The present invention provides a kind of horn-like implantation material, comprising: loudspeaker face structure, the necking end connection of loudspeaker face structure
There is matrix column, the lateral wall of described matrix column is equipped with flank；Loudspeaker face structure is for covering osseous tunnel mouth, described matrix column
The osseous tunnel is protruded into, and is fixed in the osseous tunnel by the flank；Loudspeaker face structure is by single or multiple curved surfaces
It connects and composes, it is tangent mutually between multiple curved surfaces, using as the transition face at the osseous tunnel mouth.
Wherein, the upper surface of loudspeaker face structure has first surface and the second curved surface, under the structure of the loudspeaker face
Surface has third curved surface and the 4th curved surface；The first surface is as the fillet surface at osseous tunnel mouth；Second curved surface
As the fillet surface of the first surface and bone face, and second curved surface respectively with the first surface and described 4th bent
Face is tangent；The circle of curvature of the third curved surface and the circle of curvature of the first surface are concentric, the third curved surface and described first
Curved surface collectively forms upper and lower two transition faces of loudspeaker face structure at osseous tunnel mouth.
Specifically, the interior side-wall surface of described matrix column and the tangent setting of the first surface, the outside of described matrix column
Wall surface and the tangent setting of third curved surface.
When practical application, the flank and loudspeaker face spacing structure are arranged, and the flank is used for by being press-fitted institute
Matrix column is stated to be fixed in osseous tunnel.
Wherein, described matrix column uses and the matched cylindrical hollow configuration of osseous tunnel；The flank is by surrounding the base
Wedge-shaped thin slice is constituted one group of scapus with one heart.
Specifically, the section of the wedge-shaped thin slice is one group of barb-shaped three-legged structure.
Preferably, loudspeaker face structure, described matrix column and the flank are all made of polyether-ether-ketone, the high poly- second of crosslinking
Alkene, titanium alloy, stainless steel, any one in vitallium material.
Compared with the existing technology, horn-like implantation material of the present invention has the advantage that
In horn-like implantation material provided by the invention, comprising: the necking end of loudspeaker face structure, loudspeaker face structure is communicated with base
The lateral wall of scapus, the matrix column is equipped with flank；For loudspeaker face structure for covering osseous tunnel mouth, matrix column protrudes into osseous tunnel, and
It is fixed in osseous tunnel by flank；Loudspeaker face structure is connected and composed by single or multiple curved surfaces, tangent mutually between multiple curved surfaces, with
As the transition face at osseous tunnel mouth.From this analysis, in horn-like implantation material provided by the invention, due to loudspeaker face structure
Sharp bone tunnel is avoided instead of osseous tunnel mouth edge sharp in traditional ligament reconstruction as the fillet surface at osseous tunnel mouth
The stress that road junction and transplanting ligament generate when contacting is concentrated and tough belt wear；In addition, transplanting ligament and horn-like implantation material are in bone
When contacting at tunnel face, the tough tension taken is transferred to entire osseous tunnel mouth by horn-like implantation material, prevents traditional ligament weight
The lateral stress for building osseous tunnel mouth in art is concentrated, and bone resorption caused by the stress relieved of opposite side and osseous tunnel expand.
The present invention also provides a kind of method for implantation of horn-like implantation material, include the following steps: to make bilateral osseous tunnel；With
Intra-articular osseous tunnel mouth is carried out grinding process by milling tools；Horn-like implantation material is screwed in osseous tunnel, and by loudspeaker face
Structure is micro- to be pressed downward to be bonded bone face.
The method for implantation of the horn-like implantation material is possessed excellent compared with the existing technology with above-mentioned horn-like implantation material
Gesture is identical, and details are not described herein.
Detailed description of the invention
It, below will be to specific in order to illustrate more clearly of the specific embodiment of the invention or technical solution in the prior art
Embodiment or attached drawing needed to be used in the description of the prior art be briefly described, it should be apparent that, it is described below
Attached drawing is some embodiments of the present invention, for those of ordinary skill in the art, before not making the creative labor
It puts, is also possible to obtain other drawings based on these drawings.
Fig. 1 is the first viewing angle constructions schematic diagram of horn-like implantation material provided in an embodiment of the present invention；
Fig. 2 is the second viewing angle constructions schematic diagram of horn-like implantation material provided in an embodiment of the present invention；
Fig. 3 is the longitudinal profile structure schematic at the second visual angle of horn-like implantation material provided in an embodiment of the present invention；
Fig. 4 is the enlarged structure schematic diagram of a-quadrant in Fig. 3；
Fig. 5 is the enlarged structure schematic diagram of B area in Fig. 3；
Fig. 6 is the flowage structure schematic diagram of the method for implantation of horn-like implantation material provided in an embodiment of the present invention.
In figure: the structure of 1- loudspeaker face；2- matrix column；11- first surface；The second curved surface of 12-；13- third curved surface；
The 4th curved surface of 14-；3- flank；31- wedge shape thin slice.
Specific embodiment
Technical solution of the present invention is clearly and completely described below in conjunction with attached drawing, it is clear that described implementation
Example is a part of the embodiment of the present invention, instead of all the embodiments.Based on the embodiments of the present invention, ordinary skill
Personnel's every other embodiment obtained without making creative work, shall fall within the protection scope of the present invention.
In the description of the present invention, it should be noted that term " center ", "upper", "lower", "left", "right", "vertical",
The orientation or positional relationship of the instructions such as "horizontal", "inner", "outside" be based on the orientation or positional relationship shown in the drawings, merely to
Convenient for description the present invention and simplify description, rather than the system of indication or suggestion meaning or element must have a particular orientation,
It is constructed and operated in a specific orientation, therefore is not considered as limiting the invention.In addition, term " first ", " second ",
" third " is used for descriptive purposes only and cannot be understood as indicating or suggesting relative importance.
In the description of the present invention, it should be noted that unless otherwise clearly defined and limited, term " installation ", " phase
Even ", " connection " shall be understood in a broad sense, for example, it may be being fixedly connected, may be a detachable connection, or be integrally connected；It can
To be mechanical connection, it is also possible to be electrically connected；It can be directly connected, can also indirectly connected through an intermediary, it can be with
It is the connection inside two elements.For the ordinary skill in the art, it can understand that above-mentioned term exists with concrete condition
Concrete meaning in the present invention.
Fig. 1 is the first viewing angle constructions schematic diagram of horn-like implantation material provided in an embodiment of the present invention；Fig. 2 is that the present invention is real
Second viewing angle constructions schematic diagram of the horn-like implantation material of example offer is provided；Fig. 3 is horn-like implantation provided in an embodiment of the present invention
The longitudinal profile structure schematic at the second visual angle of object；Fig. 4 is the enlarged structure schematic diagram of a-quadrant in Fig. 3.
As shown in connection with fig. 4 such as Fig. 1-Fig. 3, the embodiment of the present invention provides a kind of horn-like implantation material, comprising: loudspeaker face knot
Structure 1, the necking end of loudspeaker face structure 1 are communicated with matrix column 2, and the lateral wall of matrix column is equipped with flank 3；Loudspeaker face structure 1 is used for
Osseous tunnel mouth is covered, matrix column 2 protrudes into osseous tunnel, and is fixed in osseous tunnel by flank 3；Loudspeaker face structure 1 is by single or more
A curved surface connects and composes, tangent mutually between multiple curved surfaces, using as the transition face at osseous tunnel mouth.
Compared with the existing technology, horn-like implantation material described in the embodiment of the present invention has the advantage that
In horn-like implantation material provided in an embodiment of the present invention, as shown in connection with fig. 4 such as Fig. 1-Fig. 3, comprising: loudspeaker face knot
The necking end of structure 1, loudspeaker face structure 1 is communicated with matrix column 2, and the lateral wall of the matrix column 2 is equipped with flank 3；Loudspeaker face structure 1 is used
In covering osseous tunnel mouth, matrix column 2 protrudes into osseous tunnel, and is fixed in osseous tunnel by flank 3；Loudspeaker face structure 1 by single or
Multiple curved surfaces connect and compose, tangent mutually between multiple curved surfaces, using as the transition face at osseous tunnel mouth.From this analysis, this
In the horn-like implantation material that inventive embodiments provide, since loudspeaker face structure is as the fillet surface at osseous tunnel mouth, instead of passing
Sharp osseous tunnel mouth edge in system ligament reconstruction avoids sharp osseous tunnel mouth and transplants the stress collection generated when ligament contacts
In and tough belt wear；In addition, the tough tension taken passes through loudspeaker when transplanting ligament and horn-like implantation material contact at osseous tunnel mouth
Shape implantation material is transferred to entire osseous tunnel mouth, prevents a lateral stress of osseous tunnel mouth in traditional ligament reconstruction from concentrating, opposite side
Bone resorption caused by stress relieved and osseous tunnel expand.
Wherein, in horn-like implantation material provided in an embodiment of the present invention, structure 1 upper surface in above-mentioned loudspeaker face has the first song
The lower surface of face 11 and the second curved surface 12, loudspeaker face structure 1 has third curved surface 13 and the 4th curved surface 14；11 conduct of first surface
Fillet surface at osseous tunnel mouth；Fillet surface of second curved surface 12 as first surface 11 and bone face, and the second curved surface 12 divides
It is not tangent with first surface 11 and the 4th curved surface 14；The circle of curvature of third curved surface 13 and the circle of curvature of first surface 11 are concentric, the
Three curved surfaces 13 collectively form upper and lower two transition faces of loudspeaker face structure at osseous tunnel mouth with first surface 11.Due to the first song
The arc-shaped transition in face 11 is instead of original sharp osseous tunnel edge, and first surface 11 is contacted with implantation of ligament body and can be kept away
The stress for exempting from osseous tunnel mouth edge is concentrated, to effectively avoid tough belt wear and fracture caused by concentrating due to stress；Second is bent
Face 12 and the tangent feature of its complementary surface seamlessly transit loudspeaker face structural edge to bone face, to effectively prevent loudspeaker face
The stress in structural edge and its bone face that is in contact is concentrated.
When actual production manufactures, the diameter of loudspeaker face structure 1 can be 6-18mm；The corresponding curvature of first surface 11 half
Diameter can be 1-4mm, and the corresponding radius of curvature of third curved surface 13 can be 0-3.5mm.
Specifically, as shown in connection with fig. 4 such as Fig. 1-Fig. 3, the interior side-wall surface of above-mentioned matrix column 2 can be with first surface 11
The outer side wall surface of tangent setting, matrix column 2 can be with the tangent setting of third curved surface 13, thus the inside and outside side wall table of matrix column 2
Face can be seamlessly transitted with loudspeaker face structure 1.
When practical application, as shown in Figure 1-Figure 3, the lateral wall of above-mentioned matrix column 2 can be equipped with flank 3, and flank 3 with
The setting of the interval of loudspeaker face structure 1；Flank 3 is used to that matrix column 2 to be fixed in osseous tunnel by press-fitting, and the structure of barb-shaped makes
It has the function of that resistance to plucking goes out.
Wherein, as shown in Figure 1-Figure 3, above-mentioned matrix column 2 can using with the matched cylindrical hollow configuration of osseous tunnel,
To preferably connect loudspeaker face structure 1 and osseous tunnel；Above-mentioned flank 3 can be wedge-shaped with one heart by surrounding one group of the matrix column 2
Thin slice 31 is constituted.
When actual production manufactures, it is contemplated that the setting of the selection of osseous tunnel diameter in ligament reconstruction, matrix column 2 can have
Different model size, such as: the inner diameter of matrix column 2 can be within the scope of 6-10mm, and the wall thickness of matrix column 2 can be
0.5-1.5mm, the height of matrix column 2 can be 0-30mm.
Fig. 5 is the enlarged structure schematic diagram of B area in Fig. 3.
Specifically, it as shown in figure 5, the section of above-mentioned wedge shape thin slice 31 can be one group of barb-shaped three-legged structure, and should fall
The corner angle b for piercing shape three-legged structure can be 0 ° -45 °.
Further, the maximum spacing d of above-mentioned adjacent wedge-shaped thin slice 31 can be at 300-800 μm, to be conducive to bone
It grows into, and then horn-like implantation material is carried out reinforcing fixing well, resistance to plucking goes out better effect.
Still further, above-mentioned wedge shape thin slice 31 can be 0- in the width e of the axis direction perpendicular to matrix column 2
0.5mm.Wide flank 3 can increase the difficulty of press-fitting, therefore select 0-0.5mm preferable.
When actual production manufactures, the height a that wedge-shaped thin slice 31 covers matrix column 2 can be 0-30mm；Every group of wedge shape thin slice
31 height c can be 0.5-1mm.
Preferably, above-mentioned loudspeaker face structure 1, matrix column 2 and flank 3 can using polyether-ether-ketone, high crosslinked polyethylene,
Titanium alloy, stainless steel, any one or more combination in vitallium material, to guarantee that horn-like implantation material can expire
The good biocompatibility of foot, certain ductility and good mechanical strength.
Fig. 6 is the flowage structure schematic diagram of the method for implantation of horn-like implantation material provided in an embodiment of the present invention.
The embodiment of the present invention also provides a kind of method for implantation of horn-like implantation material, as shown in fig. 6, including the following steps:
Step S1, bilateral marrow road is made；Step S2, intra-articular osseous tunnel mouth is subjected to grinding process with milling tools；Step S3,
Horn-like implantation material is screwed in osseous tunnel, and is pressed downward loudspeaker face structure is micro- to be bonded bone face.
Horn-like implantation material and its method for implantation provided in an embodiment of the present invention, after ligament reconstructive operation can be effectively improved
One lateral stress of intra-articular osseous tunnel mouth is concentrated, tunnel face bone resorption caused by the stress relieved of opposite side and osseous tunnel enlargement phenomenon,
It will also avoid that the mill of implantation of ligament body caused by friction (" rain brush effect ") occurs between sharp osseous tunnel mouth and implantation of ligament body simultaneously
Damage breakage problem.
The foregoing is merely illustrative of the preferred embodiments of the present invention, is not intended to limit the invention, all in essence of the invention
Within mind and principle, any modification, equivalent replacement, improvement and so on be should all be included in the protection scope of the present invention.
Claims (8)
1. a kind of horn-like implantation material characterized by comprising loudspeaker face structure, the necking end connection of loudspeaker face structure
There is matrix column, the lateral wall of described matrix column is equipped with flank；Loudspeaker face structure is for covering osseous tunnel mouth, described matrix column
The osseous tunnel is protruded into, and is fixed in the osseous tunnel by the flank；
Loudspeaker face structure is connected and composed by single or multiple curved surfaces, tangent mutually between multiple curved surfaces, using as described
Transition face at osseous tunnel mouth.
2. horn-like implantation material according to claim 1, which is characterized in that the upper surface of loudspeaker face structure has the
The lower surface of one curved surface and the second curved surface, loudspeaker face structure has third curved surface and the 4th curved surface；The first surface is made
For the fillet surface at osseous tunnel mouth；Fillet surface of second curved surface as the first surface and bone face, and described
Two curved surfaces are tangent with the first surface and the 4th curved surface respectively；
The circle of curvature of the third curved surface and the circle of curvature of the first surface are concentric, the third curved surface and the first surface
Collectively form upper and lower two transition faces of loudspeaker face structure at osseous tunnel mouth.
3. horn-like implantation material according to claim 2, which is characterized in that the interior side-wall surface of described matrix column with it is described
The tangent setting of first surface, the outer side wall surface of described matrix column and the tangent setting of third curved surface.
4. horn-like implantation material according to claim 1, which is characterized in that the flank and loudspeaker face spacing structure
Setting, the flank are used to that described matrix column to be fixed in osseous tunnel by being press-fitted.
5. horn-like implantation material according to claim 4, which is characterized in that described matrix column uses matched with osseous tunnel
Cylindrical hollow configuration；
The flank by around one group of described matrix column with one heart wedge-shaped thin slice constitute.
6. horn-like implantation material according to claim 5, which is characterized in that the section of the wedge shape thin slice is one group of hangnail
Shape three-legged structure.
7. horn-like implantation material according to claim 1 to 6, which is characterized in that loudspeaker face structure, institute
State matrix column and the flank be all made of polyether-ether-ketone, high crosslinked polyethylene, titanium alloy, stainless steel, in vitallium material
Any one.
8. a kind of method for implantation of horn-like implantation material, which comprises the steps of:
Make bilateral osseous tunnel；
Intra-articular osseous tunnel mouth is subjected to grinding process with milling tools；
Horn-like implantation material is screwed in osseous tunnel, and is pressed downward loudspeaker face structure is micro- to be bonded bone face.
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| CN201811441095.5A CN109567983B (en) | 2018-11-28 | 2018-11-28 | Horn-shaped implant and implantation method thereof |
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