CN101478935B - 用于假体关节窝的植入器械 - Google Patents

用于假体关节窝的植入器械 Download PDF

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CN101478935B
CN101478935B CN2007800242780A CN200780024278A CN101478935B CN 101478935 B CN101478935 B CN 101478935B CN 2007800242780 A CN2007800242780 A CN 2007800242780A CN 200780024278 A CN200780024278 A CN 200780024278A CN 101478935 B CN101478935 B CN 101478935B
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suction nozzle
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described implantation
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CN101478935A (zh
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A·凯勒
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Waldemar Link GmbH and Co KG
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    • AHUMAN NECESSITIES
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    • A61F2/02Prostheses implantable into the body
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    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • 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
    • A61F2/32Joints for the hip
    • 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
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    • A61F2/4603Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2/4609Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of acetabular cups
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    • 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
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    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
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    • A61F2002/30601Special structural features of bone or joint prostheses not otherwise provided for telescopic
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    • 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
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    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2002/4681Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor by applying mechanical shocks, e.g. by hammering
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    • 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
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2002/4685Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor by means of vacuum

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Abstract

本发明涉及一种用于假体关节窝的植入器械,它具有伸长的杆(1),杆(1)的前端设有用于与关节窝连接的吸头(2)和吸气装置(10),吸气装置(10)具有在杆(1)内引导的活塞(10)、在吸头上开口的吸气管以及操作机构,操作机构沿导轨(14)在杆(1)上引导。按本发明规定,导轨(14)螺旋式地成形并具有在吸气位置下用于操作机构的锁止装置,该锁止装置优选是凹口(15)。导轨的螺旋式形状使得操作机构在活塞运动时既进行转动也进行纵向运动。纵向运动在吸气通道内产生用于固定的负压,而通过转动运动则使得操作机构转动直至其在导轨的终端到达它的锁止位置。因而简化了器械的操纵。

Description

用于假体关节窝的植入器械
技术领域
本发明涉及一种用于假体关节窝的植入器械,它具有伸长的杆,杆的前端设有用于与关节窝连接的吸头,在杆上还设有吸气装置,该吸气装置具有在杆内引导的活塞、在吸头上开口的吸气管以及操作机构,操作机构沿导轨在杆上引导。
背景技术
用于人体某一关节、特别是肩关节和髋关节的假体,通常具有设计为关节窝的组件。髋部假体在这里大多涉及植入到髋臼内的组件。它可以和外部支架以及一个插入该外部支架的分开的支撑植入件一体设计或分成两部分设计。后一种方案带来的问题是,在不注射骨水泥时,需要通过敲击组件来固定。这样很容易损毁易坏的支撑植入件,尤其当它用塑料或陶瓷材料制成时。同时还存在对一种在植入、尤其是敲入关节窝时能简化操作的器械的需求。
US-A-3 589 992公开了一种器械,它具有一个真空操作的关节窝固定器。该器械在其伸长的杆的前端有一吸头,真空源可通过该吸头借助管状的连接件与通气阀连接。待植入的关节窝安装在吸头上,给在吸头内开口的管道加载负压并从而将关节窝保持在吸头上。现在可将关节窝植入,必要时通过设置在杆另一端的敲击头将其敲入。为了取下器械,借助通气阀为吸气管通气,由此可破坏吸头内的真空,轻松地将器械和吸头一起从已经敲入的关节窝取出。连接管与杆分开设计,并呈V形地从杆突出。该器械因而比较大,不利于在狭小的工作环境下操作。
DE-A-197 32 923公开了一种进一步改造的器械。它同样具有一根杆,杆的前端有吸头,后端有敲击头。此外还设有一个在吸头内开口的、可加载负压的吸气管。然而该负压并不是通过与外部真空源的连接制备,而是通过一个集成在该器械内的泵产生。为此设有一个集成在杆内的活塞泵。沿纵向可移动的活塞借助一个横着通过活塞推动的操作杆向后运动,由此通过一次或多次操作产生负压。通气阀在其关闭状态下防止了真空泄露。因而能够,正如对前述器械已作详细说明的那样,可靠地将关节窝固定在器械上并植入或敲入规定位置。最后,通气阀被打开,由此释放负压并能轻松地将器械从关节窝取出。集成的活塞泵虽然相对US-A-3 859 992公开的器械有所改进,但操作仍较为复杂。此外,从通气阀的位置看,使用者无法获知吸气管是否已加载足够负压。
发明内容
因而基于上述现有技术,本发明所要解决的技术问题是,对开头所述类型的器械作如下改进,实现对它的更为可靠和简单的操作。
本发明的这一方案是一种具备独立权利要求特征的器械。优选的改型是从属权利要求的内容。
按本发明,用于假体关节窝的植入器械有一根伸长的杆,杆的前端设有用于与关节窝连接的吸头,该植入器械还设有吸气装置,该吸气装置具有在杆内引导的活塞、在吸头上开口的吸气管以及操作机构,该操作机构沿导轨在杆上引导,导轨螺旋式地成形并有用于吸气位置的锁止装置。
螺旋式形状使得操作机构在活塞运动到它的吸气位置时螺旋地向后运动。此时操作机构既进行转动也进行纵向运动。通过纵向运动在吸气通道内产生了用于将关节窝固定在吸头上的负压。操作机构通过转动同时也能旋转直至它在导轨的终端到达锁止位置。在该锁止位置中,操作机构得到稳定的固定。锁止位置优选设计为凹口。此时,操作机构已变化的角度位置使操作者能从后方观察辨认,活塞利用操作机构是否处于后方的锁止位置并因而已建立起负压。这样做就能简单地从视觉上控制器械的状态。此外,导轨的螺旋形结构的优点在于,可以为操作负压装置而促成推动/旋动。推动/旋动从人体工程学上看要优于例如在按前述现有技术的器械中必需的纯粹推动。还可以通过选择螺旋式导轨的斜度确定传动比。利用较大的斜度能建立起较大的负压,利用较小的斜度则可以减小达到该负压所需的操作力。在这两种情况下,简单地继续运动就能使操作机构在终端到达锁止位置。因而按本发明的器械不仅简化了操作,还提高了操作安全性,因而也提高了固定的可靠性。另一个优点在于,不需要专门的通气阀来将器械取下。操作机构在克服一定程度的阻力后从其锁止位置移出,并又沿螺旋式的导轨被带向前方,就已经足够做到这一点。负压由此自动消除,所以可以轻松地将器械从已植入的关节窝取出。吸气装置因而仅需要一个运动部件,即活塞。由于省略了专门的通气阀,因而制造变得更加简单,并提高了工作安全性。按本发明,通气阀的透气性不再导致真空渐渐消失。因而按本发明的器械不仅提供了更好的可固定性,还能以低制造成本提供更高的安全性。
合适的是,在杆的后端设置可更换的导头,导轨被布置在该导头上。这样做就能将导头取下来清洁或用另一个导头替换。取下导头时,可以轻松地将吸气装置的活塞向后从杆中取出。器械因而可以简单地拆成单个部件并可靠地得到清洁。通过提供另外的具有不同造形导轨的、尤其是斜度更大或更小的导轨的导头,器械能适应不同的植入情况。因而可以在例如为固定较重的关节窝时,设置斜度较小的导头,以便用同样的操作力建立起更大的真空。相反在固定较小较轻的关节窝时,设置更陡的导轨,以便实现快速操作。
相宜地在杆的后端构成敲击头。敲击头可以固定在杆上或设置在可更换的导头上。它可以起到一种铁砧的作用,以便能够在利用敲击工具植入关节窝时对器械产生作用。按本发明的操作机构的锁止装置保证了操作机构在敲击作用下不会从吸气位置脱出,从而可靠地防止真空意外损失。
吸头具有环形的支承面,支承面上贴靠着被器械固定的关节窝。支承面也尤其用于例如在敲击时传递植入力。为在敲击作用下也能获得足够的密封,防止吸头和关节窝之间的真空意外泄露,相宜地设置密封圈。密封圈布置在支承面和吸气通道的开口之间。它可以设计成O形圈,并可设置一个或两个或多个。相宜地,它可以更换,以便在磨损时用另一个密封圈替换。
为了避免损毁易坏的关节窝或陶瓷植入件,优选为吸头的支承面设置护圈。护圈可以设计为集成的或单独的。它适合用塑料材料制造。它避免了吸头的支承面与关节窝或植入件的对接面之间的直接接触。因此可以有效地应对例如在由金属制成的吸头和陶瓷制成的植入件之间出现损毁的危险。况且护圈不仅仅只有机械保护的功能,它还能额外地起到另外的密封作用。
吸头上还可以设置引导面。该引导面位于支承面和吸气管的开口之间,并优选设计成圆锥形或球形。它简化了吸头导入到关节窝或植入件的开孔中的过程。因此避免了在将关节窝或植入件置放到吸头上时由于不精确而带来损毁的危险。
吸头优选设计成可更换的。优选可以针对大小不同的关节窝或植入件而设置多个吸头。因此可以提供成套器械,它实现了用按本发明的器械来操纵大小和形状不同的关节窝或植入件。按本发明的器械只要存在一次且根据待插入植入件或待插入关节窝选择各自应用的吸头就足够了。此时除了设置一组大小不同的吸头外,还可以设置满足其他种类假体或植入件的另一组。
附图说明
下面参考附图以及附图所示的一个优选实施例对本发明加以说明。图中:
图1是按本发明器械的实施例的透视图;
图2a和2b示出了图1所示器械的杆和带有操作机构的吸气装置的活塞;
图3a和3b示出了两个用于安装在器械的杆上的不同吸头;以及
图4a和4b示出了处于静止和吸气位置的吸气装置的操作机构。
具体实施方式
按本发明的器械主要包括一根设计成圆柱状延伸的杆1。吸头2可替换地借助螺纹连接装置拧紧在杆1的前端。杆1的后端有一对侧翼3,它由两个作为手柄在直径线上对置的、沿径向向外突出的侧翼构成。
此外后面还连接有一个同样可拧紧在杆上的导头4。
杆1作为空心体被填充,并有一圆柱形的空腔(未示出)。它是下文还将详细说明的吸气装置10的组成部分。空腔通过吸头2中的吸气通道17与吸头2的顶端相连。吸气通道17在那里止于一个开口18。吸头2还具有作为主要组件的一个支承台21和一个有环形凹槽23的圆柱形突起22。支承点以其背部的朝向杆1的那个面作为螺栓连接装置29的止挡,吸头2利用该螺栓连接装置29紧固在杆1的前端。在止挡台21的前侧端面上构成支承面26。它用于和髋部假体陶瓷植入件(未示出)的端面配合作用,以便施加推力将陶瓷植入件插入到支承窝(未示出)中。为保护和改善密封而设置了护圈27。它具有和支承面26差不多大小的尺寸,并为了保护表面而设在支承面26与陶瓷植入件(未示出)作为对接面的端面之间。圆柱形突起22的直径如下地与陶瓷植入件开孔的内径相匹配,即,使得吸头2可以有间隙地在中央插入陶瓷植入件。如果吸头2引入并使得陶瓷植入件的端面贴靠在支承面26或护圈27上,那么嵌入凹槽23的密封圈28就与陶瓷植入件(未示出)的内侧接触。由此产生密封,从而对于已套装的陶瓷植入件而言用开口18使得吸头2的位于密封圈28前的区域相对周围环境密封。陶瓷植入件由此可固定在吸头2上。
下面阐述吸气装置10的结构和工作方式。吸气装置主要包括活塞11,该活塞11用其前端的密封件19密封地导入杆10的圆柱形空腔中。活塞11的后部区域布置有操作机构12,它有一个设计成横杆的手柄13。活塞11的后端设计为一个带砧帽的敲击头5。在前部位置,导入杆1内的活塞11处于静止。用手通过手柄13将活塞往回拉以操作吸气装置10。往回运动的活塞11因此在吸气通道17内以及因而在密封件28与陶瓷植入件之间的区域内产生负压。只要保持负压,陶瓷植入件就由此牢牢地固定在吸头2上。若要重新取下器械,则借助操作机构12使活塞11再次向前运动,负压由此消除,吸头就能轻易地从陶瓷植入件上取下。
本发明的一个基本特征在于操作机构12在杆10上的引导。杆10在其后端有设计为螺旋形外套的导头4。导头4上设计有两条螺旋形沿周向倾斜向前延伸的导轨14。这两条导轨14在它们的后部区域具有带凹口15的凸肩,以及在它们的前部区域具有倾斜段16。倾斜段16设计为,它的展开与规定的坡度角成一直线。导轨15的宽度定为,使得手柄13的横杆几乎是无间隙地导入所述导轨15。导轨14的前端定义为手柄13的前部止动位置,因而也定义为活塞11的前部止动位置。这就是静止位置。活塞可从该静止位置通过推动/旋动手柄13向后运动,直至最后手柄经过凸肩在侧面导入凹口15并锁定在那里。这定义为吸气位置。为了让操作者更易于实施推动/旋动,在杆10上设有侧翼3。操作者由此可用一只手将器械握在杆1上,并通过侧翼3防止在操作吸气装置10时在手柄13上出现不希望的转动。倾斜段16的坡度角确定了推动与旋动的关系。如果应当以较小的力来操作机构12,则角度可以相宜地选择得很小。也就是说,倾斜段16更多地向侧面而不是向前延伸。反之,如果不希望使用很大的操作力,则可以出于更轻松且更快捷操作的目的将倾斜段16设计得非常陡,也就是为它设置一个大的坡度角。因而之后轻轻旋动活塞11就会产生较大的冲程。操作速度由此提高,不过为此需要更大的操作力。
如果吸气装置10到达吸气位置,那么手柄13就锁定在导轨14的凹口15内。因而防止手柄13从锁定位置意外弹出。通过将手柄13支承在导轨14的凹口15内,还沿轴向在后端有一敲击头6的活塞11和杆1及其支承面26之间创造了传力连接。因而敲击头6上的击打作用所产生的冲量可以通过手柄13、凹口15、杆10传递到支承面26并因而最终传递到要植入的陶瓷植入件上。由于手柄13可靠地锁定在凹口15内,所以就不必担心操作机构12从吸气位置跳出。在敲击陶瓷植入件后,可通过轻微转动手柄13再次将活塞11送回到静止位置,由此就可以释放负压,并能轻松地将吸头2从陶瓷植入件取出。
如开头所述,吸头2可拧固在杆10上。有利的是,设置一组吸头,它除吸头2外还包括另一种大小或造型不同的吸头2′。图3a示出了吸头2′,它设计用于一个更大的、关节窝形状不同的陶瓷植入件。它与图3b所示吸头的区别主要在于,用于容纳密封圈的凹槽设置在一个球状的而不是圆柱状的突起22′内。当然,也可以设置其他形状和/或大小不同的吸头。

Claims (12)

1.用于假体关节窝的植入器械,该植入器械具有伸长的杆(1),杆(1)的前端有用于与关节窝连接的吸头(2,2′)和吸气装置(10),吸气装置(10)具有在杆(1)内被引导的活塞(11)、在吸头(2,2′)上开口的吸气管(17)以及操作机构(12),操作机构(12)沿导轨(14)在杆(1)上被引导,其特征在于,导轨(14)螺旋式地被成形并具有在吸气位置下用于操作机构(12)的锁止装置。
2.按权利要求1所述的植入器械,其特征在于,所述锁止装置设计成凹口(15)。
3.按权利要求1或2所述的植入器械,其特征在于,在杆(10)的后端设有可更换的导头(4),导轨(14)布置在导头(4)上。
4.按权利要求2所述的植入器械,其特征在于,在操作机构(12)上构成敲击头(6)。
5.按权利要求1所述的植入器械,其特征在于,在吸头(2,2′)上构造有止挡台(21),所述止挡台在其前侧端面上具有支承面(26),其中在所述支承面(26)和开口(18)之间设有密封件(28)。
6.按权利要求5所述的植入器械,其特征在于,密封件(28)是可更换的。
7.按权利要求5所述的植入器械,其特征在于,设有覆盖支承面(26)的护圈(27)。
8.按权利要求1所述的植入器械,其特征在于,吸头(2,2′)附加具有引导面。
9.按权利要求8所述的植入器械,其特征在于,引导面(22′)被构成球形。
10.按权利要求8所述的植入器械,其特征在于,引导面(22)被构成圆柱形。
11.按权利要求1或2所述的植入器械,其特征在于,设置了多组大小不同的吸头(2,2′)。
12.按权利要求1或2所述的植入器械,其特征在于,附加设置了一组用于另一种关节窝的吸头(2′)。
CN2007800242780A 2006-06-28 2007-06-26 用于假体关节窝的植入器械 Expired - Fee Related CN101478935B (zh)

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