JP2018110603A - Implant member - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an implant member which can be easily installed on the joint bone, and sufficiently obtain lubrication effect by synovial fluid.SOLUTION: An implant member 10 includes a partition wall part 32 capable of forming a cavity 34 in the inside and changing the volume of the cavity, and a fixing part 33 to the bone. The partition wall part 32 has a communication part 32c which makes fluid circulate between the cavity 34 and the outside. With this, the implant member has a simple structure and can be downsized so as to be easily installed, can make synovial fluid flow into or out of the cavity 34 via the communication part 32c when a load is added to the partition wall part 32, and can sufficiently obtain lubrication effect by the synovial fluid.SELECTED DRAWING: Figure 4

Description

  The present invention relates to an implant member fixed to a bone, and particularly to an implant member fixed to a bone of a joint part.

  In joints such as knees, cartilage exists between opposing bones. The cartilage serves as a cushion between the bones and has a function of maintaining an appropriate distance. However, part of the cartilage may be deteriorated or lost due to trauma in the joint or aging. In this case, bones constituting the joint are in direct contact with each other, causing pain such as pain and movement disorder.

  It is known to treat such symptoms by installing an artificial joint in the joint and replacing the joint surface with the artificial joint. However, in order to install an artificial joint, a large-scale operation is required, and the burden on the patient is great. For this reason, a minimally invasive treatment means is required.

  Thus, for example, as disclosed in Patent Document 1, a small implant is known that is installed at a site where the cartilage of a joint is lost. Such a small implant can be easily fixed to the bone of the joint and has only a minimum size to cover the site where the cartilage is lost. Can be installed.

Japanese Patent No. 5399796

  In the joint, there is a joint fluid between the bones, and the cartilage holds the joint fluid. Synovial fluid acts as a lubricant in cartilage. A conventional small implant placed in a joint is formed so that joint fluid does not enter between the small implant and the cartilage, and thus between the small implant and the bone. For this reason, there is a possibility that the lubrication effect by the joint fluid cannot be sufficiently obtained for the portion where the small implant is installed.

  The present invention has been made to solve the above-described problems, and an object of the present invention is to provide an implant member that can be easily installed on a bone of a joint and can sufficiently obtain a lubricating effect by joint fluid. .

  An implant member according to the present invention that achieves the above-described object has a partition wall part that can form a cavity therein and change the volume of the cavity, and a fixing part for bone, and the partition wall part includes: It has a communicating part through which fluid can flow between the cavity and the outside.

  The implant member configured as described above has a simple structure and can be reduced in size, so that it can be easily installed. In addition, when a load is applied to the partition wall, joint fluid flows into or out of the cavity through the communication part. Therefore, the lubricating effect by the joint fluid can be sufficiently obtained.

  If the partition wall is formed to have a smooth surface, and the communication part is a through hole formed in the partition wall, a communication part for allowing fluid to flow can be formed with a simple structure.

  The partition wall portion has a load receiving portion disposed at a height position equivalent to the surface of the cartilage of the bone to be fixed, and the communication portion is disposed at the load receiving portion or a position near the load receiving portion. Then, when the partition wall receives a load, the joint fluid can be reliably circulated into and out of the cavity.

  The fixing part has a holding part for holding a peripheral part of the partition part, and the cavity is formed by being surrounded by the partition part and a top surface of the fixing part. It can be a simple shape and can be easily formed.

  The fixing portion has an inner mounting portion to which a fixing tool used when fixing to a bone can be mounted, and the partition wall portion has a fixing tool opening for communicating the inner mounting portion with the outside. For example, the fixture can be mounted on the inner mounting portion via the fixture opening and the implant member can be inserted into the bone of the joint, so that the installation of the implant member can be facilitated.

  If the holding portion has an outer mounting portion to which a fixing tool used when fixing to the bone can be mounted, the fixing device is mounted on the outer mounting portion from the outside, and the implant member is inserted into the joint bone. Since it can do, installation of an implant member can be made easy.

  The fixing portion has an insertion portion to be inserted into the bone, and if the insertion portion has a fin portion fitted to the bone on the peripheral surface, the fixing portion becomes an anchor for the bone, The implant member can be securely fixed to the bone.

It is a perspective view of the implant member in this embodiment. It is sectional drawing of an implant member. It is a top view of an implant member. It is a schematic diagram showing the state which installed the implant member in the bone. It is a schematic diagram of the implant member with which the fixing tool was mounted | worn, and the femur attached. It is a perspective view of the femur which installed the implant member combination. It is sectional drawing of the implant member of a 1st modification. It is a perspective view of the implant member of the 2nd modification. It is sectional drawing of the implant member of a 2nd modification. It is a front view of the implant member of the 3rd modification. It is a front view of the implant member of the 4th modification. It is a front view of the implant member combination of the 1st modification. It is a top view at the time of arranging the implant member combination object of the 1st modification in a straight line shape. It is a top view at the time of arrange | positioning the implant member assembly of a 1st modification cyclically | annularly. It is a top view of the implant member combination of the 2nd modification. It is a top view of the implant member combination of the 3rd modification. It is a top view of the implant member combination of the 4th modification. It is a top view of the implant member combination of the 5th modification. It is a top view of the implant member combination of the 6th modification. It is a perspective view of the implant member of the 1st example which fluctuates the volume of a cavity by the partition part which does not elastically deform. It is sectional drawing of the implant member of the 1st example which fluctuates the volume of a cavity by the partition part which does not elastically deform. It is sectional drawing of the implant member of the 2nd example which fluctuates the volume of a cavity by the partition part which does not elastically deform. It is sectional drawing of the implant member of the 3rd example which fluctuates the volume of a cavity by the partition part which does not elastically deform.

  Embodiments of the present invention will be described below with reference to the drawings. In addition, the dimension ratio of drawing is exaggerated on account of description, and may differ from an actual ratio. In the present embodiment, the side away from the surface of the femur constituting the knee joint is referred to as the distal end side, and the side approaching the femur is referred to as the proximal end side.

  The implant member of the present embodiment is placed at a site including an area where cartilage is lost in a knee joint. More specifically, the surface of the femur constituting the knee joint is fixed to a portion including a region where the cartilage is lost, and is installed so as to receive a load applied to the tibia. In this embodiment, the part including the region where the cartilage is lost is a part including only the region where the cartilage is lost, but the part including the region where the cartilage is lost includes the region where the cartilage is lost and the surrounding area. An area may be included.

  As shown in FIG. 1, the implant member 10 has an exposed portion 30 exposed on the surface of the bone and an embedded portion 31 embedded in the bone. Moreover, the implant member 10 is formed by two parts of the partition part 32 formed in a substantially dome shape and the fixing part 33 that holds the partition part 32 and is fixed to the bone. The exposed portion 30 is formed by the partition portion 32 and the distal end side portion of the fixing portion 33, and the embedded portion 31 is formed by the proximal end portion of the fixing portion 33.

  The partition wall 32 has a fixing tool opening 32d at the top formed in a dome shape, and further has a plurality of communication portions 32c around it. The fixture opening 32 d is formed in a large diameter that penetrates the partition wall 32, and the communication portion 32 c is formed in a small diameter that penetrates the partition wall 32.

  The fixing portion 33 has an insertion portion 33a formed in a substantially cylindrical shape, and a plurality of fin portions 33b are formed on the peripheral surface of the insertion portion 33a. Each fin part 33b is formed so that it may protrude over the perimeter of the surrounding surface of the insertion part 33a. The fin portion 33b can be fitted to the bone when the insertion portion 33a is inserted into the bone. A holding portion 33d that holds the partition wall portion 32 is formed on the distal end side of the insertion portion 33a.

  As shown in FIG. 2, the peripheral portion 32 e of the partition wall portion 32 can be engaged and fixed to the holding portion 33 d formed on the fixing portion 33. By this engagement and fixation, the partition wall portion 32 and the fixing portion 33 are integrated. In the state where the partition wall portion 32 and the fixing portion 33 are integrated, a cavity 34 is formed between the partition wall portion 32 formed in a dome shape and the top surface 33 c of the fixing portion 33. Note that the holding portion 33d and the peripheral portion 32e are not limited to being engaged and fixed, and may be fixed by other means such as adhesion, welding, and fitting.

  The partition wall portion 32 has a partition portion 32f that hangs down from the edge portion of the fixture opening portion 32d to the base end side. The partition 34f separates the cavity 34 from the outside so as not to communicate with the fixture opening 32d.

  In the partition wall portion 32, the vicinity of the apex where the fixture opening 32 d is formed is a load receiving portion 32 b that faces the tibia. In the region of the load receiving portion 32b, a communication portion 32c that connects the cavity 34 and the outside is formed. As described above, the communication portion 32 c is configured by a through hole formed in the partition wall portion 32.

  The partition wall portion 32 is formed of a resin material such as polyethylene so as to be elastically deformable. The partition wall portion 32 can be deformed so that the volume of the cavity 34 is reduced when receiving a load from the opposing tibia at the load receiving portion 32b. In addition, as a material of the partition part 32, not only a resin material but another material, such as a metal material, can also be used. Moreover, as a material of the fixing | fixed part 33, a resin material, a metal material, or a hydroxyapatite etc. can be used.

  The fixing portion 33 has an inner mounting portion 33e on the back side of the fixing device opening portion 32d formed in the partition wall portion 32. The inner mounting portion 33e is formed in a hole shape along the insertion direction of the fixing portion 33, and is used for fixing a fixing tool used for attaching the implant member 10 to the bone. For this reason, the inner mounting portion 33e has an inner shape that substantially matches the outer shape of the fixture, and in this embodiment, as shown in FIG. 3, the cross-sectional shape is formed to have a hexagonal shape. Yes. In addition, as a shape of the inner side mounting part 33e, a cross-sectional shape is not restricted to a hexagonal shape, A polygon or circular shape etc. may be sufficient.

  As shown in FIG. 4, the implant member 10 is fixed to the surface of the femur 51 among the bones constituting the knee joint. Although the cartilage 52 having a thickness of 1 to 10 mm exists on the surface of the femur 51, the implant member 10 is disposed in a region where the cartilage 52 has been lost due to trauma or aging.

  The implant member 10 is arranged such that the height position of the load receiving portion 32 b facing the surface of the tibia 50 is equivalent to the surface position of the surrounding cartilage 52. That is, the thickness of the exposed portion 30 of the implant member 10 is 1 to 10 mm, which is equivalent to the thickness of the cartilage 52, or 1 to 5 mm, preferably 4 to 5 mm.

  The space between the tibia 50 and the femur 51 is filled with joint fluid. The joint fluid also fills the cavity 34 of the implant member 10 through the communication portion 32c. When the surface of the cartilage 52 and the surface of the tibia 50 come into contact with each other and a load is applied to the surface of the cartilage 52, the load receiving portion 32 b of the implant member 10 at the height position equivalent to the surface position of the cartilage 52 is also applied to the tibia 50. The load from is added. Since the partition wall 32 is elastically deformable as described above, the substantially dome-shaped partition wall 32 is deformed by receiving a load, and the volume of the cavity 34 is reduced. Along with this, the joint fluid in the cavity 34 flows out of the implant member 10 through the communication portion 32c. When the load from the tibia 50 on the load receiving portion 32b of the implant member 10 disappears, the partition wall portion 32 returns to its original shape, and accordingly, joint fluid flows into the cavity 34 through the communication portion 32c.

  As described above, the load receiving portion 32b of the implant member 10 is formed with the communication portion 32c that allows the cavity 34 to communicate with the outside. Therefore, as the partition wall portion 32 is deformed by receiving a load, the partition wall portion 32 is provided. The joint fluid can be caused to flow into or out of the internal cavity 34, and the rapid deformation of the partition wall 32 can be alleviated, and the lubricating effect by the joint fluid can be sufficiently obtained even in the portion where the implant member 10 is installed. Can be.

  Next, a method for installing the implant member 10 will be described. As shown in FIG. 5, the implant member 10 is fixed to the femur 51 after being attached to the distal end portion of the fixture 40. In the present embodiment, the distal end portion of the fixture 40 is formed in a hexagonal cross section, and the distal end portion is inserted into the inner mounting portion 33e formed in the fixed portion 33 of the implant member 10, The implant member 10 is attached to the fixture 40.

  A pilot hole 51a is formed in advance at a position where the implant member 10 of the femur 51 is fixed. When fixing the implant member 10 to the femur 51, while confirming the femur 51 with an arthroscope (not shown), the distal end portion of the fixture 40 to which the implant member 10 is attached is inserted into the joint, and the pilot hole 51a The fixing portion 33 is positioned at the position, and the fixing portion 33 is further inserted into the prepared hole 51a. The insertion portion 33a of the fixing portion 33 is inserted into the prepared hole 51a, and the fin portion 33b formed on the peripheral surface of the insertion portion 33a is bitten into the femur 51 and fitted. Since a plurality of implant members 10 are fixed to the femur 51, this procedure is continuously repeated.

  In fixing the implant member 10, only the fixing tool 40 may be inserted into the joint without using an arthroscope. Alternatively, a device in which an arthroscope and a fixture are integrated may be prepared, and the implant member 10 may be positioned and fixed at the fixture while the femur 51 is confirmed at the arthroscope. As a device in which the arthroscope and the fixture are integrated, for example, a device capable of projecting the distal ends of the arthroscope and the fixture from a trocar tube having two lumens is conceivable.

  As shown in FIG. 6, a plurality of implant members 10 are arranged in accordance with the surface shape of the region 53 in the region 53 where the cartilage 52 of the femur 51 is lost. The implant member combination 20 covering the region 53 where the cartilage 52 has been lost is formed.

  The state in which the region 53 where the cartilage 52 is lost is covered with the implant member combination 20 means that the surface of the tibia 50 facing the femur 51 cannot directly contact the surface of the region 53 where the cartilage 52 is lost. This means a state in which a plurality of implant members 10 are arranged. In other words, in the implant member combination 20, the implant member 10 does not have to be disposed with no gap from the cartilage 52 or the other implant members 10, and can be disposed at a certain interval.

  In this embodiment, since the area | region where the cartilage 52 of the femur 51 was lost is covered with the several implant member 10, each implant member 10 can be made very small. Therefore, the implant member 10 can be installed by inserting the thin fixture 40 into the joint, and when the implant member 10 is inserted and fixed to the femur 51, it is necessary to make a large incision in the joint portion of the knee. Therefore, it can be installed with minimal invasiveness.

  Next, a first modification of the implant member will be described. As shown in FIG. 7, the implant member 11 of the present modification has a configuration substantially similar to that of the implant member 10 described above, except that the partition wall portion 32 does not have a partition portion 32f. . Since the implant member 11 of the present modification does not have the partition portion 32f, the cavity 34 communicates with the outside through the fixture opening 32d.

  By forming the implant member 11 in this manner, the fixture opening 32d also has the same function as the communication portion 32c. That is, when a load is applied to the load receiving portion 32b and the partition wall portion 32 is deformed, the joint fluid can be circulated into and out of the cavity 34 through the fixture opening 32d.

  Next, a second modification of the implant member will be described. As shown in FIG. 8, the implant member 12 of this modification has an exposed portion 35 and an embedded portion 36, and the exposed portion 35 includes a partition wall portion 37 that forms a cavity 39 therein, and a distal end of the fixing portion 38. The embedded portion 36 is the same as the above-described implant member 10 in that the embedded portion 36 is formed by the insertion portion 38a of the fixing portion 38.

  As for the implant member 12 of this modification, the partition part 37 does not have the fixing tool opening. In the partition wall portion 37, a larger number of communication portions 37 c than the above-described implant member 10 are formed. Further, the insertion portion 38a of the fixed portion 38 is formed in a tapered shape whose diameter decreases toward the proximal end side. The point that a plurality of fin portions 38b are formed along the circumferential direction is the same as that of the implant member 10 described above.

  A substantially hexagonal outer mounting portion 38e is formed on the outer peripheral portion of the holding portion 38d formed at the distal end portion of the fixed portion 38. The outer mounting part 38e is formed so that a fixing tool used when fixing the implant member 12 to the femur can be mounted. That is, as the fixture in this case, a fixture having a tip shape that grips the implant member 12 from the outer peripheral side is used.

  As shown in FIG. 9, in the implant member 12 of this modification example, since the partition wall portion 37 does not have an opening for a fixture, the cavity 39 surrounded by the partition wall portion 37 and the top surface 38 c of the fixing portion 38 is , Formed as one undivided space. Also in this modification, the cavity 39 communicates with the outside through the communication portion 37 c formed in the partition wall portion 37. For this reason, the joint fluid can be circulated into and out of the cavity 39 through the communication portion 37 c as the partition wall portion 37 receiving the load at the load receiving portion 37 b is deformed.

  The implant member 12 of this modification is formed so that the insertion portion 38a of the fixing portion 38 is tapered, so that the insertion portion 38a can be inserted without providing a pilot hole in the femur. It is.

  Next, a third modification of the implant member will be described. As shown in FIG. 10, the partition wall 60 of the implant member 13 does not necessarily have a dome shape, and may be formed in a rectangular parallelepiped shape. In this case, the holding portion 61 a of the fixing portion 61 is formed in a square shape so that the rectangular parallelepiped partition wall portion 60 can be held.

  Moreover, the following forms are also considered as a 4th modification of an implant member. As shown in FIG. 11, the partition wall 62 of the implant member 14 may be configured to expand from the proximal end side toward the distal end side. In this case, the load receiving portion 62a facing the tibia can be widened, and even if the tibia contacts the implant member 14 in an inclined shape, the tibia is prevented from contacting the fixing portion 63. be able to.

  Next, a first modified example of the implant member combination will be described. As shown in FIG. 12, the implant member combination 21 according to the present modification is formed by connecting a plurality of implant members 12 and 15 in series by a connecting portion 65. In this implant member combination 21, the implant members 12 at both ends are the same as those already described as the implant member 12 of the second modification. The intermediate implant member 15 does not have an insertion portion.

  Thus, in the implant member combination 21 connected in series, the implant members 12 at both ends can be fixed to the femur. The intermediate implant member 15 is not fixed, but can be placed at a predetermined position of the femur by being connected in series with the implant members 12 at both ends.

  The implant member combination body 21 of this modification can be arranged in a straight line as shown in FIG. 13 in accordance with the shape of the region where the femoral cartilage is lost. Moreover, as shown in FIG. 14, you may arrange | position so that a cyclic | annular form may be formed. The connecting portion 65 is preferably formed of a flexible material so that the implant members 12 and 15 can be placed in various arrangement states.

  In this embodiment, the insertion member 38a is provided so that the implant member 12 at both ends of the implant member combination 21 can be fixed to the bone. However, if necessary, the insertion member 38 is also provided in the intermediate implant member 15, It may be possible to fix to.

  The implant member combination body 21 of the present modification example has a plurality of implant members 12 and 15 connected in series by the connecting portion 65 as described above, so that when the implant member combination body 21 is installed on the bone, Multiple implant members 12, 15 can be inserted at one time. Moreover, it is not necessary to fix all the implant members. For this reason, the man-hour for installation of the implant member combination 21 can be reduced, and the time taken for the procedure can also be shortened.

  Next, a second modification of the implant member combination will be described. The implant member combination 22 of the present modification is formed by mixing the implant member 10 described first and the implant member 16 having the same shape and different size as the implant member 10. In FIG. 15, the large implant member 10 is disposed in the central portion and the peripheral portion of the region 53, and the small implant member 16 is disposed in the peripheral portion of the region 53. Overall, the exposed portion 30 of the large implant member 10 and the exposed portion 66 of the small implant member 16 cover the area 53 where cartilage has been lost. Thus, by forming the implant member combination 22 with the implant members 10 and 16 having different sizes, the implant member combination 22 can be more adapted to the shape of the region 53 where the cartilage is lost.

  Next, a third modification of the implant member combination will be described. The implant member combination 23 according to this modification is obtained by arranging the implant member 13 according to the third modification in a region 53 where cartilage is lost. As described above, in the implant member 13 of the third modified example, the partition wall 60 is formed in a square shape. As shown in FIG. 16, by arranging a plurality of implant members 13 in alignment, when the region 53 where the cartilage is lost has a substantially square shape, it can be easily adapted to the shape.

  Next, a fourth modification of the implant member combination will be described. In this modified example, as shown in FIG. 17, a plurality of implant members 17 having triangular partition walls 67 are arranged in accordance with the shape of the region 53 where cartilage is lost to form an implant member combination 24. Yes. Thus, by making the partition part 67 of the implant member 17 triangular, the degree of freedom of the shape as the implant member combination 24 can be further increased, and the shape of the region 53 where the cartilage is lost is adapted. An easy implant member combination 24 can be obtained.

  Next, a fifth modified example of the implant member combination will be described. In this modification, as shown in FIG. 18, a plurality of implant members 18 having hexagonal partition walls 68 are arranged in accordance with the shape of the region 53 where cartilage is lost to form an implant member combination 25. Yes. Thus, by making the partition wall 68 of the implant member 18 hexagonal, the implant member 18 can be arranged with high density, and the coverage of the region 53 where the cartilage is lost by the implant member 18 is increased. Can do.

  Next, a sixth modification of the implant member combination will be described. In this modification, as shown in FIG. 19, the implant member 10 having a circular partition wall 32 is disposed in the center of the region 53 where the cartilage is lost, and around the region 53 where the cartilage is lost, The implant member combination 26 is formed by arranging the implant member 18 having the hexagonal partition wall 68. In this way, by forming the implant member combination 26 with the implant members 10 and 18 having different shapes, the flexibility of the shape of the region covered by the implant member combination 26 can be further increased.

  As described above, the implant member 10 according to the present embodiment includes the partition wall portion 32 capable of forming the cavity 34 therein and changing the volume of the cavity 34, and the fixing portion 33 for the bone, The partition wall portion 32 has a communication portion 32c through which fluid can flow between the cavity 34 and the outside. Thereby, since this implant member 10 can be reduced in size with a simple structure, it is easy to install, and when a load is applied to the partition wall 32, the joint fluid flows into the cavity 34 through the communication portion 32c. Or since it can be made to flow out, the lubrication effect by a joint fluid can fully be acquired.

  Further, if the partition wall portion 32 is formed with a smooth surface and the communication portion 32c is a through-hole formed in the partition wall portion 32, a communication portion 32c that allows fluid to flow with a simple structure can be formed. .

  The partition wall 32 has a load receiving portion 32b disposed at a height position equivalent to the surface of the cartilage 52 of the bone to be fixed, and the communication portion 32c is disposed at the load receiving portion 32b or in the vicinity thereof. By doing so, the joint fluid can be reliably circulated into and out of the cavity 34 when the partition wall 32 receives a load.

  Further, the fixing portion 33 has a holding portion 33 d that holds the peripheral portion of the partition wall portion 32, and the cavity 34 is formed so as to be surrounded by the partition wall portion 32 and the top surface 33 c of the fixing portion 33. The partition wall 32 can have a simple shape and can be easily formed.

  In addition, the fixing portion 33 has an inner mounting portion 33e to which a fixing tool 40 used for fixing to the bone can be mounted, and the partition wall portion 32 has a fixing tool opening portion 32d for communicating the inner mounting portion 33e with the outside. If the fixing member 40 is mounted on the inner mounting portion 33e via the fixing device opening 32d and the implant member 10 can be inserted into the bone of the joint, the implant member 10 can be easily installed. can do.

  Further, if the holding portion 38d has an outer mounting portion 38e to which a fixing device 40 used for fixing to the bone can be mounted, the fixing device 40 is mounted on the outer mounting portion 38e from the outside, and the implant member 12 is attached. Since it can insert with respect to the bone of a joint, installation of the implant member 12 can be made easy.

  The fixing portion 33 has an insertion portion 33a to be inserted into the bone. If the insertion portion 33a has a fin portion 33b fitted to the bone on the peripheral surface, the fixing portion 33 is against the bone. As an anchor, the implant member 10 can be securely fixed to the bone.

  Note that the present invention is not limited to the above-described embodiments, and various modifications can be made by those skilled in the art within the technical idea of the present invention. For example, in the above-described implant member 10, the communication portion 32 c formed in the partition wall portion 32 is formed as a hole penetrating the partition wall portion 32, but may have other shapes such as a slit shape. When the communication part 32c is formed in a slit shape, when the partition wall part 32 is deformed by receiving a load from the tibia, the communication part 32c spreads and joint fluid can be circulated.

  Although the communication part 32c formed in the partition part 32 is formed in the area | region of the load receiving part 37b in the above-mentioned embodiment, you may form in the vicinity of the area | region of the load receiving part 37b.

  Although the fin part 33b formed in the fixing | fixed part 33 is formed in the cyclic | annular form along the surrounding surface of the insertion part 33a in the above-mentioned embodiment, it may be formed helically. In this case, the fin part 33b functions as a screw thread and can screw the implant member 10 to the bone.

  Moreover, about the shape of the partition part of an implant member, although several shapes, such as a dome shape and a rectangular parallelepiped shape, were demonstrated, besides this, various shapes, such as a cylindrical shape, are employable.

  In addition, as a structure for fixing the implant member 10 to the bone, the following structure is also conceivable. Inside the fixing portion, a member such as a balloon that can be expanded in a state where the implant member 10 is disposed on the bone is provided. In addition, a prepared hole in which the fixing portion is accommodated is formed in advance in the bone to be installed. In this state, the fixing portion is placed in the pilot hole, and the member in the fixing portion is expanded, so that the outer periphery of the fixing portion is expanded, and the fixing portion is fitted into the pilot hole and is fixed. The implant member 10 may be fixed with an adhesive or bone cement.

  In the above-described embodiment, the implant member 10 is inserted and fixed to the joint one by one using the fixing tool 40, but a fixing tool that can be loaded with a plurality of implant members 10 is prepared, and the fixing tool is inserted into the joint. Thus, a plurality of implant members 10 may be fixed to the bone. By using such a fixture, the number of times that the fixture is inserted into the joint can be reduced, and the time required for installation of the implant member combination 20 can be reduced.

  Moreover, in the above-mentioned embodiment, although the implant member 10 and the implant member combination 20 are installed in the joint of a knee, it is applicable also to other joints, such as an elbow.

  Further, in the above-described embodiment, the partition wall portion 32 is elastically deformable, so that the volume of the cavity 34 can be changed. However, the partition wall portion 32 is formed of the cavity 34 by means other than elastic deformation. The volume may be changed.

  The implant member 70 of the first example in which the volume of the cavity 34 is changed by the partition wall portion that is not elastically deformed will be described. As shown in FIG. 20, the implant member 70 has a partition wall portion 71 and a fixing portion 72, and a cavity 34 is formed inside the partition wall portion 71. A communication portion 71 a is formed in the partition wall portion 71. The partition wall 71 is made of a hard material that does not elastically deform. The fixing portion 72 is provided with an insertion portion 72a and a holding portion 72c of the partition wall portion 71, and a fin portion 72b formed in a spiral shape is formed on the peripheral surface of the insertion portion 72a. As described above, since the fin portion 72b is formed in a spiral shape, the fin portion 72b functions as a screw thread, and the implant member 70 can be screwed into the bone. In addition, the holding portion 72c of the fixing portion 72 is formed to have a height that is slightly larger than that of the previous examples.

  As shown in FIG. 21, the peripheral portion 71 b of the partition wall portion 71 is movable in the height direction within the holding portion 72 c of the fixed portion 72. Further, an elastic member 73 made of a spring is provided between the partition wall 71 and the top surface 72d of the fixed portion 72. As a result, the partition wall 71 is biased in a direction away from the top surface 72 d of the fixed portion 72.

  When the partition wall portion 71 is placed on the femur and receives a load from the tibia, the partition wall portion 71 moves so as to approach the top surface 72 d of the fixing portion 72 while resisting the biasing by the elastic member 73. Thereby, the volume of the cavity 34 becomes small. When the load from the tibia disappears, the partition wall portion 71 moves away from the top surface 72d of the fixing portion 72 by the urging force of the elastic member 73, and returns to the position of FIG. As a result, the volume of the cavity 34 that has been reduced also returns to the original size. At this time, the joint fluid can flow inside and outside the cavity through the communication portion 71 a of the partition wall portion 71.

  Next, a second example of the implant member 75 in which the volume of the cavity 34 is changed by the partition wall portion that is not elastically deformed will be described. As shown in FIG. 22, the implant member 75 of this example has the same configuration as the implant member 70 of FIG. On the other hand, the implant member 75 of this example has a magnet 78 instead of the elastic member. The magnets 78 are opposed to the peripheral portion 76b of the partition wall portion 76 and the top surface 77d of the fixed portion 77, and the magnets 78 facing each other are arranged to repel each other. As a result, a biasing force acts on the partition wall 76 in a direction away from the top surface 77d of the fixing portion 77, so that the same effect as in the case of FIG. 21 can be obtained.

  Next, a third example of the implant member 80 in which the volume of the cavity 34 is changed by the partition wall that is not elastically deformed will be described. As shown in FIG. 23, in the implant member 80 of this example, the configuration of the partition wall portion 81 and the fixing portion 82 is the same as that of the implant member 70 of FIG. Further, the implant member 80 of this example is not provided with an elastic member or a magnet. Since the implant member 80 is attached downward with respect to the femur, a downward force is always applied to the partition wall portion 81 due to gravity. In this example, using this, the partition wall portion 81 that receives the load from the tibia moves in the holding portion 82c of the fixing portion 82, and when the load from the tibia disappears, the partition wall portion 81 is moved to its original position by gravity. You can return to In this case, a weight may be provided on the partition wall portion 81 so that the partition wall portion 81 can return to the original position more reliably.

DESCRIPTION OF SYMBOLS 10 Implant member 20 Implant member assembly 30 Exposed part 31 Embedded part 32 Partition part 32a Smooth surface part 32b Load receiving part 32c Communication part 32d Fixture opening part 32e Peripheral part 32f Partition part 33 Fixing part 33a Insertion part 33b Fin part 33c Top Surface 33d Holding portion 33e Inner mounting portion 34 Cavity 40 Fixing tool 41 Tip fixing portion 50 Tibia 51 Femur 51a Pilot hole 52 Cartilage 53 region

Claims (7)

A partition part capable of forming a cavity therein and changing a volume of the cavity;
A fixing part for bone,
The said partition part is an implant member which has a communicating part which can distribute | circulate a fluid between the said cavity and the exterior. The partition wall is formed with a smooth surface,
The implant member according to claim 1, wherein the communication part is a through hole formed in the partition wall part. The partition part has a load receiving part arranged at a height position equivalent to the surface of the cartilage of the bone to be fixed,
The implant member according to claim 1, wherein the communication portion is disposed at the load receiving portion or a position near the load receiving portion. The fixing part has a holding part for holding a peripheral part of the partition part,
The implant member according to any one of claims 1 to 3, wherein the cavity is formed so as to be surrounded by the partition wall and a top surface of the fixing part. The fixing portion has an inner mounting portion on which a fixing tool used when fixing to a bone can be mounted,
The implant member according to claim 4, wherein the partition wall portion has an opening for a fixture that allows the inner mounting portion to communicate with the outside.   The implant member according to claim 4, wherein the holding portion has an outer mounting portion to which a fixing tool used at the time of fixing to the bone can be mounted. The fixing part has an insertion part to be inserted into the bone,
The said insertion part is an implant member of any one of Claims 1-6 which have a fin part fitted to a bone in a surrounding surface.

Images