CN101677859B - 用于拆卸髋臼支座的方法和设备 - Google Patents

用于拆卸髋臼支座的方法和设备 Download PDF

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CN101677859B
CN101677859B CN2008800153724A CN200880015372A CN101677859B CN 101677859 B CN101677859 B CN 101677859B CN 2008800153724 A CN2008800153724 A CN 2008800153724A CN 200880015372 A CN200880015372 A CN 200880015372A CN 101677859 B CN101677859 B CN 101677859B
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bearing
ring
cup
extracting tool
groove
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CN101677859A (zh
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贾森·D·梅里多
特罗伊·W·赫什伯格
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Biomet Manufacturing LLC
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Biomet Manufacturing LLC
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    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
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Abstract

一种用于更换髋关节的一部分的系统，可以包括具有外表面和内表面的杯。支座可以包括外支承表面和内铰接表面。该外支承表面可以位于杯附近。可以在杯和支座之间选择性地设置环。该环可以限定其内形成有狭缝的环形体。拆卸工具可以限定近端和远端。远端可以限定有环接合表面和支座接合表面。环接合表面适于在狭缝处与环接合，使得环从锁定位置径向扩张并与支座脱离接合，并且到达非锁定位置。支座接合表面适于与支座接合，并且促使支座脱离该杯。

Description

用于拆卸髋臼支座的方法和设备
技术领域
本公开涉及植入物，特别涉及一种用于拆卸髋臼支座的方法和设备。
背景技术
自然髋关节可能会由于各种病原而经受退化改变。当这些退化改变很严重并且不可恢复时，最终可能需要用人工髋来更换全部或部分自然髋关节。在一个例子中，模块化髋臼假体可以植入病人的髋臼中。使用模块化假体，矫形手术就能够植入合适的髋臼杯并选择合适的支座以附连到该髋臼杯上。模块化支座通常能够轻易拆卸，在这种情况下，它们具有方便进行校正手术的进一步的优点，由于不必拆卸髋臼杯就能够更换支座，这对于外伤性损伤或支座表面磨损的情形是很必要的。现在需要一种有利于高效地从髋臼杯上拆卸支座的系统。
发明内容
一种用于更换髋关节的一部分的系统，可以包括具有外表面和内表面的杯。该外表面适于与髋臼接合。支座可以包括外支承表面和内接合表面。该外支承表面可以设置在杯附近。可以在杯和支座之间选择性地设置环。该环可以限定其内形成有狭缝的环形体。该环能够在锁定位置和非锁定位置之间移动，在锁定位置，环相对于杯保持住支座。拆卸工具可以限定近端和远端。远端可以限定环接合表面和支座接合表面。环接合表面适于在所述狭缝处与环接合，使得环从锁定位置径向扩张，与支座脱离接合，到达非锁定位置。支座接合表面适于与支座接合，并且促使支座脱离该杯。
根据附加特征，杯可以限定其上径向形成有第一槽的上边缘部分。该槽可以进一步限定从外侧部分朝内侧部分向下倾斜的倾斜表面。环可以限定一对形成在槽的相对部分上的指状物。这对指状物适于在锁定位置中定位在杯的第一槽中。杯的上边缘可以进一步限定有形成在其内的第二槽，该第二槽适于在锁定位置中定位限定于在环上的环形突起。
根据其他特征，拆卸工具的环接合表面限定一对适于以可滑动的方式接合所述一对指状物并因而将该环朝非锁定位置径向扩张的倾斜表面。该工具的远端可以由槽的倾斜表面容纳，使得支座接合表面与支座接合。支座的上部和杯的边缘可以限定适于抑制支座在锁定位置中在杯内转动的互补的锁定部分。
本发明的进一步应用领域将从下文所提供的具体说明中变得明显。可以理解的是，该具体说明和具体例子虽然指出了本发明的优选实施例，但是它们仅仅是用于示例的目的，而不是意图限制本发明的范围。
附图说明
从具体说明和附图中将可以更加全面地理解本发明，其中：
图1是根据本发明的系统的透视图，其包括髋臼杯组件和拆卸工具，该髋臼杯组件包括杯、支座和环；
图2为图1中的拆卸工具的远端的俯视透视图；
图3为图1中的拆卸工具的远端的仰视透视图；
图4为髋臼杯组件的透视图，其显示了支座位于髋臼杯内的锁定位置中，并且拆卸工具的远端与限定在环中的狭缝初始接合；
图5为拆卸环和支座后髋臼杯组件和拆卸工具的透视图；
图6为沿图3的线3-3截取的横截面图，其显示了工具的远端与环初始接合；
图7为图6的横截面图，其显示了工具的远端与支座接合；
图8为图7的横截面图，其显示了工具的远端倾斜并且迫使支座离开杯；
图9为图1的系统的透视分解侧视透视图；
图10为根据本发明的附加特征的系统的透视图，其包括髋臼杯组件和拆卸工具，该髋臼杯组件包括杯、支座和环；
图11为形成在图10的髋臼杯中的切口的透视图；
图12为图11的髋臼杯的局部透视图，其显示了环处于已安装位置；
图13为拆卸工具的透视图；
图14为图13的拆卸工具的远端的侧视图；
图15为髋臼杯组件的局部透视图，其显示了支座位于髋臼杯内的锁定位置中，并且拆卸工具的远端与限定在环中的狭缝初始接合；
图16为拆卸环和支座后髋臼杯组件和拆卸工具的透视图；
图17为髋臼杯组件的平面图；和
图18为沿图17的线18-18截取的髋臼杯组件的剖视图，其显示了拆卸工具插入到切口中。
具体实施方式
下面对实施例的说明本质上仅仅是示例性的，而绝不是为了限制本发明、其应用或使用。
首先参考图1，其显示了一种用于更换髋关节的一部分的系统，总体用附图标记10表示。系统10一般可以包括髋臼杯组件12和拆卸工具14。髋臼杯组件12可以包括髋臼杯20、衬圈或支座22、以及环24。正如将要了解的，环24适于将支座22相对于髋臼杯20保持在锁定位置中。拆卸工具14适于与环24接合并且操作性地将环24扩张到非锁定位置，并在之后将支座22撬离髋臼杯20。
现在特别参考图1、4和5来进一步描述髋臼杯组件12。一般来说，髋臼杯20可以包括多孔金属部分26和实心金属部分28。多孔金属部分26通常可以形成在髋臼杯20的外部骨接合表面30上，而实心金属部分28则可以形成在内表面32上(图5)。多孔金属部分26和实心金属部分28分别可以包括生物相容的金属，例如不锈钢、钛、钛合金、和钴铬合金。在一个例子中，多孔金属部分26可以由大约60％-70％孔隙率的多孔金属制成。在一个例子中，多孔金属部分26可以烧结在实心金属部分28上。实心金属部分28可以限定实心边缘36和支座接合表面38。在一个例子中，实心边缘36可以限定为完全穿过髋臼杯20在实心边缘36处的整个厚度。虽然没有具体示出，但多孔金属部分26和实心金属部分28之间的界面上可以包括各个互锁的环形圈和套。可以从本申请人未决的美国专利申请[代理文件号：5490-000410/CPD]中找到对于类似的髋臼杯的讨论，在此通过参考将该申请并入。
实心边缘36可以限定第一互锁部分40。在所示的例子中，第一互锁部分40是限定在实心边缘36的上周边周围的叶状指状物(lobbed fingers)42的形式。叶状指状物42通常可以相对于限定在实心边缘36周围的环形肩44(图5)凸出。实心金属部分28可以进一步限定形成在支座接合表面38周围的内侧环形凹槽46。实心边缘36可以进一步分别包括第一和第二槽50和52。在一个例子中，第一和第二槽50和52可以形成在实心边缘36的径向相对的位置上。第一槽50可以包括有坡度的或倾斜的表面54(如图6最佳所示)。该倾斜表面54通常可以从髋臼杯20的外侧部分朝内侧部分向下倾斜。第二槽52可以限定通常与环形肩44平行的表面。
现在将更加详细地描述支座22。支座22可以由聚乙烯或其他合适的支座材料制成。支座22通常可以包括外部杯接合表面58和内部股骨部件接合表面60。可以在外部杯接合表面58周围形成外侧环形凹槽62。外部杯接合表面58通常可以是凸形的，而内部股骨部件接合表面60通常可以是凹形的。支座22在外侧环形凹槽62(如图6所示)以下可限定统一的厚度，并且可以用作股骨部件66的头部64的支承表面(图9)，从而在整个支座22上消散应力。第二互锁部分70可以形成在支座22的边缘部分72的周围。在所示的例子中，第二互锁部分70是限定在边缘部分72周围的互补的叶状缺口74的形式。第一和第二互锁部分40和70可以在装配位置(图4)中协同配合，使得叶状指状物42与叶状缺口72嵌套，因此抑制支座22在髋臼杯20内的旋转运动。在所示的具体例子中，叶状缺口74的数量是叶状指状物42的两倍。可以理解的是，也可以使用其他结构。
现在将更加详细地描述环24。环24可以由任何合适的生物相容材料制成。在一个例子中，环24可以由与印第安纳的华沙市的Biomet公司(Biomet，Inc.，of Warsaw，Indiana)提供的
Figure G2008800153724D00051
系统中的锁定环类似的材料制成。环24通常可以限定径向本体78，径向本体78限定间隙(discontinuation)或狭缝80。正如将要了解的，环24的材料属性应该选择为使得环24能够在被施加力后在径向方向上朝其外周边弯曲，并且在该力撤去后返回至静态位置。
可以在狭缝80的相对部分上形成一对指状物82。指状物82可以相对于径向本体78的周向外表面向外侧延伸。环形突起84可以一体形成在环24上。在一个例子中，环形突起84可以与指状物82径向相对。正如所论述的，环24适于定位在髋臼杯20的内侧环形凹槽46中。在锁定位置中，髋臼杯20的内侧环形凹槽46可操作地以卡合的方式容纳环24，以便将支座22固定在髋臼杯20的凹形表面中。进一步来解释，在锁定位置时，环24适于部分接合地嵌入髋臼杯20的内侧环形凹槽46中，并且，同时部分地嵌入支座22的外侧环形凹槽62中。环24的环形突起84可以嵌入第二槽52中。这样，可以阻止环24绕髋臼杯20的纵向轴线转动。
现在参考图1-3来更加详细地描述拆卸工具14。一般来说，拆卸工具14可以包括具有近端92和远端94的纵向本体90。近端92可以包括设置在其上的手柄96。远端94可以包括接合部分98。在一个例子中，接合部分98可以限定成相对于纵向本体90的纵向轴线成一个角度。纵向本体90可以限定在手柄96和远端94之间延伸的轴100。
远端94可以进一步限定上部104(图2)和下部106(图3)。下部106可以限定具有环接合表面112的环接合部分110。拆卸工具14的终端114可以限定具有支座接合表面120的支座接合部分118。远端94可以包括限定在纵向本体90和倾斜部分124之间的中间部分122。
环接合表面112可以进一步由一对向外倾斜的表面128限定。该向外倾斜的表面128通常可以从下部106朝上部104向外倾斜。
现在将描述用拆卸工具14拆卸环24和支座22的示例性方法。首先参考图4，其中显示了髋臼杯组件12的环24嵌入髋臼杯20的内侧环形凹槽46中，并且支座22固定在髋臼杯20的支座接合表面38中(锁定位置)。正如所示，支座22的叶状缺口74中的一个可以提供在所述一对指状物82处进入环24的上表面的入口。另外需要注意的是，第一槽50也可以与指状物82基本对齐，并且提供了指状物82的附加入口。一旦拆卸工具14的环接合部分110已经在指状物82处定位在环24上方，则拆卸工具14可以在环24的狭缝80处施加向下的力(如图4所示)。拆卸工具14的向下力促使拆卸工具14的向外倾斜表面128沿狭缝80的相对表面滑动，因此，渐增地迫使环24朝非锁定位置径向向外扩张。应当注意到，在髋臼杯20的内侧环形凹槽46中存在足以容纳环24的初始径向向外运动的向外的间隙。一旦环24已经径向向外弯曲预定的量，则基本上可以将环24从支座22的外侧环形凹槽62中取出。
在环24仍然处于向外弯曲的位置的情况下，然后可以拆卸工具14沿逆时针方向倾斜，如图7和8所示。因此，拆卸工具14的远端94的支座接合表面120可以与支座22接合，并且施加一个撬动的动作(即，在朝向边缘部分72的方向上)，从而进一步促使支座22从髋臼杯20中移出(即，以从图7到8的顺序所示)。重要的是要注意到拆卸工具14与支座22的相互作用(即，在支座接合表面120处的相互作用)并不会实质损坏支座22。
现在转向图10-18，显示了根据附加特征的用于更换髋关节的一部分的系统200。系统200通常可以包括髋臼杯组件202和拆卸工具204。髋臼杯组件202可以包括髋臼杯220、支座22和环24。髋臼杯220可以基本上类似于前面所述的髋臼杯20。髋臼杯220可以包括第一槽230和空腔232。槽230和空腔232可以设置在连续边缘部分的内侧。空腔232可以限定大体垂直于该槽的上表面236的终端表面234(图18)。正如将要描述的，拆卸工具204适于与环24接合，并且操作性地将环204扩张到非锁定位置，并在之后将支座提离髋臼杯220。
现在参考图13和14来更加详细地描述拆卸工具204。一般来说，拆卸工具204可以包括具有近端242和远端244的纵向本体240。近端242可以包括设置在其上的手柄248。远端244可以包括接合部分250。纵向本体240可以限定在手柄248和远端244之间延伸的轴252。
远端244可以进一步限定上部254和下部256。下部256可以限定具有环接合表面262的环接合部分260。环接合表面262可以进一步由一对向外倾斜的表面264限定(图15)。该向外倾斜的表面264通常可以从下部256朝上部254向外倾斜。上部254可以包括具有接合唇270的支座接合部分268，接合唇270适于与支座24的下侧表面272(图18)接合。
现在将描述用拆卸工具204拆卸环24和支座22的示例性方法。参考图12，其中显示了髋臼杯组件202的环24嵌入在髋臼杯的内侧环形凹槽46中。为了便于说明，支座22并未显示在图12中，但是，在图17和18中支座显示为安装在锁定位置中。正如所示，第一槽230可以与指状物82基本对齐，并且提供了指状物82的附加入口。
一旦拆卸工具204的环接合部分260已经在指状物82处定位在环24上方，则拆卸工具204可以在环24的狭缝80处施加向下的力(从图10中看)。重要的是要注意到，此时支座22仍处于与杯220的嵌合位置中(如图18所示)。在图10中显示为将支座22稍微提起，这仅仅为了显示工具204与环24之间的相互作用。拆卸工具204的向下力促使拆卸工具204的向外倾斜表面264沿狭缝80的相对表面滑动，因此，渐增地迫使环24朝非锁定位置径向向外扩张。应当注意，在髋臼杯220的内侧环形凹槽46中存在足以容纳环24的初始径向向外运动的向外的间隙。一旦环24已经径向向外弯曲预定的量，则基本上可以将环24从支座22的外侧环形凹槽62中取出。
在环24仍然处于向外弯曲的位置的情况下，然后可以沿工具204的纵向轴线将拆卸工具204向上平移(从图18中看)。在向上平移的过程中，接合唇270与支座22的下侧表面272接合，从而将支座22提离杯220(图16)。应当注意，绕工具204的纵向轴线的平移在这种侵入性最小的环境中是有利的。在另一个例子中，工具204可以附加地或替代性地绕其纵向轴线转动，以提供对支座22的撬动作用。
虽然本公开已经在说明书中进行了描述，并且在附图中参考不同的实施例进行了例示，但本领域技术人员可以理解的是，在不离开权利要求所限定的本发明的范围的情况下，可以进行多种改变，并且可以用等同设置来更换各个元件。此外，多种实施例之间的特征、元件和/或功能的混合和匹配在此是能够明显想到的，因此，本领域技术人员将会从本公开中理解到，除非另有说明，否则可以适当地将一个实施例的特征、元件和/或功能结合到另一个实施例中。此外，可以进行多种变型，以在不偏移本发明实质范围的情况下使具体的情况或材料适于本公开的教导。因此，并不意在将本发明限制于作为当前认为的实施本公开的最佳实施方式而在附图中示出并在说明书中描述的特定实施例。相反，本公开将包括落入前述说明和权利要求书的范围内的任何实施例。

Claims (14)

1.一种用于更换髋关节的一部分的系统，包括：
具有外表面和内表面的杯，所述外表面能够与髋臼接合；
具有外支承表面和内铰接表面的支座，所述外支承表面位于所述杯附近；
选择性地设置在所述杯和所述支座之间的环，所述环限定其中形成有狭缝的环形体，所述环能够在锁定位置和非锁定位置之间移动，在锁定位置中，所述环相对于所述杯保持住所述支座；和
限定有近端和远端的拆卸工具，所述远端限定有环接合表面和支座接合表面，所述环接合表面适于在所述狭缝处与所述环接合，使得所述环从所述锁定位置径向扩张并与所述支座脱离接合，从而到达所述非锁定位置，所述支座接合表面适于与所述支座接合，并且促使所述支座脱离所述杯。
2.如权利要求1所述的系统，其中，所述杯限定有上边缘，在该上边缘上沿径向形成有第一槽。
3.如要求2所述的系统，其中，所述槽进一步限定有从外侧部分朝内侧部分向下倾斜的倾斜表面。
4.如权利要求2所述的系统，其中，所述环限定有形成在所述狭缝的相对部分处的一对指状物，所述一对指状物适于在所述锁定位置中定位在所述杯的所述第一槽处。
5.如权利要求4所述的系统，其中，所述杯的所述上边缘进一步限定有形成在其中的第二槽，该第二槽适于在所述锁定位置中定位限定于所述环上的环形突起。
6.如权利要求4所述的系统，其中，所述拆卸工具的所述环接合表面限定有一对倾斜表面，所述一对倾斜表面适于以可滑动的方式接合所述一对指状物，从而将所述环朝所述非锁定位置径向扩张。
7.如权利要求3所述的系统，其中，所述拆卸工具的所述远端由所述槽的所述倾斜表面容纳，使得所述支座接合表面与所述支座接合。
8.如权利要求4所述的系统，其中，所述支座的上部和所述杯的所述上边缘限定了互补的锁定部分，所述互补锁定部分适于在所述锁定位置中抑制所述支座在所述杯内转动。
9.如权利要求1所述的系统，其中，所述拆卸工具的所述远端相对于所述拆卸工具的所述近端限定一个角度，其中，所述拆卸工具在所述近端处的转动在所述远端的所述支座接合表面处施加撬动作用到所述支座上。
10.如权利要求1所述的系统，其中，所述拆卸工具的所述远端在所述支座接合表面处限定有接合唇。
11.如权利要求10所述的系统，其中，所述接合唇适于在所述环扩张到所述非锁定位置时与所述支座的下侧表面接合。
12.如权利要求11所述的系统，其中，在所述拆卸工具沿所述拆卸工具的纵向轴线的方向移动离开所述杯时，所述接合唇对所述支座的所述下侧表面施加力。
13.如权利要求1所述的系统，其中，所述杯包括具有第一槽和第二槽的上边缘，其中，所述环包括环形突起和一对指状物，所述一对指状物形成在所述狭缝的相对部分处并且适于在所述锁定位置中定位在所述杯的所述第一槽处，所述环形突起适于在所述锁定位置中嵌入所述第二槽中并且阻止所述环绕所述杯的纵向轴线转动。
14.如权利要求13所述的系统，其中，所述拆卸工具的所述环接合表面包括在所述狭缝处与所述环接合的倾斜表面，当所述倾斜表面沿所述狭缝的相对表面滑动时，所述倾斜表面使所述环朝所述非锁定位置径向向外扩张。
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US20080221699A1 (en) 2008-09-11
EP2136740A1 (en) 2009-12-30
US20110184424A1 (en) 2011-07-28
AU2008223409A1 (en) 2008-09-12
JP5214634B2 (ja) 2013-06-19
US7572294B2 (en) 2009-08-11
US7918895B2 (en) 2011-04-05

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