CN102048600B - Total ankle plus total talus prosthesis - Google Patents
Total ankle plus total talus prosthesis Download PDFInfo
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- CN102048600B CN102048600B CN200910197736.1A CN200910197736A CN102048600B CN 102048600 B CN102048600 B CN 102048600B CN 200910197736 A CN200910197736 A CN 200910197736A CN 102048600 B CN102048600 B CN 102048600B
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- Prior art keywords
- prosthesis
- prosthese
- astragalus
- ankle
- tibial
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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
- A61F2/30—Joints
- A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
- A61F2/4202—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for ankles
-
- 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
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
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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)
Abstract
The invention discloses a total ankle plus total talus prosthesis which comprises a prosthesis at the top of an ankle joint on a tibial side and a prosthesis on a talus side, wherein the prosthesis on the tibial side comprises an upper surface and a lower surface, the upper surface is a plane, a protrudent ridge is arranged on the plane, an arch-shaped concave surface supporting shell is arranged on the lower surface, two parallel baffle plates are arranged at two ends of the supporting shell for movably accommodating an arch-shaped convex surface at the top of the prosthesis on the talus side, and the baffle plates can not be subjected to dislocation when sliding front and back; and the prosthesis on the talus side comprises a top surface, a bottom surface, a front surface, a left surface and a right surface, the top surface is a smooth arch-shaped convex surface and extends backwards till the bottom surface in the shape of an arc, the part, which is near to the front end, of the top surface is a smooth plane, the bottom surface and the front surface are respectively provided with a protrudent ridge, and the prosthesis on the tibial side and the prosthesis on the talus side are precisely matched through the arch-shaped concave surface and the arch-shaped convex surface, and can slide freely in the sagittal direction. The prosthesis can be used for reconstructing the height of talus and the stability of talonavicular joint and talocalcaneal joint, and restoring the load-bearing and the movement functions of the ankle joint.
Description
Technical field
The present invention relates to the prosthetic replacement technical field, more particularly, relate to a kind of large of astragalus or whole amputation patients' full ankle+range bone prostheses of being applicable to.
Background technology
From the seventies in last century, the artificial ankle joint prosthese progressively begins to be applied to clinical, and the material of use is mainly ultra high molecular polyethylene-metallic combination.The Cement fixed fae body by whether can be divided into bone cement and cementless prosthesis two classes.By the limited degree of ankle joint, can be divided into restricted type, half restricted type and unrestricted type prosthese.Restricted type artificial ankle joint such as ICLH (London Royal School of Medicine hospital) ankles etc. are characterized in good stability but mobility is relatively little, and the design of restricted type causes the stress at bone cement and prosthese interface to increase, and easily causes loosening and failure; The half artificial ankle of restricted type such as MayoII ankle, PCA prosthese etc.; Unrestricted type prosthese such as Smith ankle, Bath ankle etc.Half restricted type and unrestricted type ankle can provide larger many two-dimensional activities degree, and stability relies on complete ligament and ankle joint bone structure to a great extent, easily produce between prosthese and ankle collision and in the shakiness of turning up.
at present, artificial full ankle prosthesis can only be used for the surface replacement of tibial astragaloid joint, be applicable to the patient that astragalus keeps substantially, as STAR ankle (Kofoed H.Comparison of cemented andcementless ankle arthroplasty.In:Kofoed H, editor.Current status of anklearthroplasty.Berlin, Germany:Springer Verlag, 1998.p.47-9.), Agility ankle (Rippstein P.Agility1 ankle prosthesis:results of 27 cases Abstract book.16thAnnual Summer Meeting American Orthopaedic Foot and Ankle Society (AOFAS) 16th Annual Summer Meeting, Vail, Colorado, July 13-15, 2000.p.23.) and Buechel-Pappas ankle (Buechel FF, Pappas M.Survivorship and clinicalevaluation of cementless meniscal bearing total ankle replacements.SeminArthroplasty 1992, 3:43-50.).Because of diseases such as severe trauma, bland necrosis, tumors, and need the large section of excision or whole patients of astragalus for astragalus, all can not use.
Existing all artificial ankle prosthesis mainly for the pathological changes of tibial astragaloid joint, can only be carried out the ankle joint surface replacement, can not be used for pathological changes (comprising tumor, bland necrosis, the comminuted fracture dislocation that astragalus the is serious etc.) patient of range bone.These patients are most young, and due to talus necrosis or gross distortion, the mortality that carries out arthrodesis is high, and often lifelong disabled, most disablements, self care ability are also poor.
Summary of the invention
The object of the present invention is to provide a kind ofly for the range osseous lesion, after the range resected bone, carry out the prosthese of full ankle+range bone displacement.
For achieving the above object, the present invention discloses following technical scheme: a kind of full ankle+range bone prosthese, comprise the ankle joint top prosthese of tibial side and the astragalus prosthese of astragalus side, tibial side prosthese (also claim ankle joint top prosthese) comprises upper and lower surfaces, upper surface is the plane, one outstanding ridge is arranged on the plane, and lower surface is the supporting shell of an arcuation concave surface, is used for the movable arcuation convex surface that holds astragalus side prosthesis top; The astragalus side prosthesis comprises top, the end, front, left and right five faces, end face is smooth arcuation convex surface, arc extends rearward to the bottom surface, end face is a smooth flat near the position of front end, respectively there is an outstanding ridge bottom surface and front, by arcuation male and fomale(M﹠F) exact matching, can be free to slide front and back between tibial side prosthese and astragalus side prosthesis.
The present invention also provides a kind of full ankle+range bone prosthese, comprise the ankle joint top prosthese of tibial side and the astragalus prosthese of astragalus side, the tibial side prosthese comprises upper and lower surfaces, upper surface is the plane, one outstanding ridge is arranged on the plane, and lower surface is the supporting shell of an arcuation concave surface, and there are two parallel baffle plates at supporting shell two ends, be used for the movable arcuation convex surface that holds astragalus side prosthesis top, and front and back can not misplace when sliding; The astragalus side prosthesis comprises top, the end, front, left and right five faces, end face is smooth arcuation convex surface, arc extends to the bottom surface, end face is a smooth flat near the position of front end, respectively there is an outstanding ridge bottom surface and front, by arcuation male and fomale(M﹠F) exact matching, can be free to slide front and back between tibial side prosthese and astragalus side prosthesis.
The present invention also provides a kind of full ankle+range bone prosthese, comprise the ankle joint top prosthese of tibial side and the astragalus prosthese of astragalus side, the tibial side prosthese comprises upper and lower surfaces, upper surface is the plane, one outstanding ridge is arranged on the plane, and lower surface is the supporting shell of an arcuation concave surface, and there are two parallel baffle plates at supporting shell two ends, be used for the movable arcuation convex surface that holds astragalus side prosthesis top, and front and back can not misplace when sliding; The astragalus prosthese comprises top, the end, front, left and right five faces, end face is smooth arcuation convex surface, arc extends rearward to the bottom surface, end face is a smooth flat near the position of front end, respectively there is an outstanding ridge bottom surface and front, by arcuation male and fomale(M﹠F) exact matching, can be free to slide front and back between tibial side prosthese and astragalus side prosthesis, ridge, tibial side prosthese upper surface, respectively there are some apertures the front of astragalus side prosthesis, bottom surface.
So, full ankle of the present invention+range bone prosthese is characterised in that, comprise one with the accurate range bone prosthese that coincide of tibial side prosthese, two metals " ridge " of its front and bottom surface assign respectively in the calcaneus spongy bone of below and the spongy bone of the remaining astragalus in the place ahead or navicular bone of foot in, rear reparation soft tissue resets, can complete full ankle+astragalus prosthetic replacement, prosthese of the present invention can be rebuild the astragalus height, and apart from the stability of boat, talocalcaneal articulation, recover the main movement of ankle joint: the back of the body is stretched with plantar flexion and is recovered ankle joint and bear a heavy burden, and keeps two lower limb isometric.
In a form of implementation that conforms with purpose, described range bone prosthese can be part, and situation is corresponding adjusts in excision according to patient's astragalus.
In another preferably implements structure, there are two parallel baffle plates at the supporting shell two ends of tibial side prosthese lower surface arcuation concave surface, after tibial side and astragalus side prosthesis are complementary, can form a stable trochoid, can not misplace during relative sliding before and after both, and the skeleton that the tibial side baffle plate of high-molecular polythene material can be got rid of inside and outside ankle directly with astragalus prosthese Metal Contact, reduce the chance of generation pain.
In another preferably implements structure, ridge, tibial side prosthese upper surface, astragalus side prosthesis front, the bottom surface respectively has or part some apertures are arranged, tibial side prosthese upper surface has two or several grooves, play after bone cement solidifies and bone cement between firmly inlay fixingly, prevent the effect of becoming flexible.
The tibial side prosthese is become by ultrahigh molecular weight polyethylene, and the astragalus side prosthesis is made of metal.
Description of drawings
Below in conjunction with Figure of description, the present invention is described in more detail.Figure of description only limits to explanation and unrestricted the present invention.
Fig. 1 is tibial side borrowed structure schematic diagram
Fig. 2 is the arcuation concave surface schematic diagram that tibial side prosthese following table is worn baffle plate
Fig. 3 is astragalus side prosthesis structural representation
Fig. 4 is full ankle+range bone borrowed structure schematic diagram
Wherein, number in the figure is respectively:
1. tibial side prosthese
2. astragalus side prosthesis
3. tibial side prosthese upper surface
4. tibial side prosthese lower surface arcuation concave surface
5a, 5b, baffle plate
6.11a, 11b, ridge
7. astragalus side prosthesis end face
7a. arc extends to the smooth arcuation convex surface of bottom, 7b smooth flat
8. astragalus side prosthesis bottom surface
9. astragalus side prosthesis front
10. the astragalus side prosthesis left side (right side is consistent with the left side, and diagram does not mark)
12. tibial side prosthese upper surface groove
13a, 13b, 13c, 13d, 13e, aperture
In Fig. 4, double-head arrow represents to stretch fore-and-aft direction in the wrong, and 14a represents the direction of plantar flexion described in the present embodiment, and 14b represents rear direction.
The specific embodiment
Embodiment
As shown in the figure, full ankle+range bone prosthese comprises tibial side prosthese 1 and astragalus side prosthesis 2, tibial side prosthese 1 comprises upper and lower surfaces, upper surface 3 is planes, one outstanding ridge 6 is arranged on the plane, lower surface 4 is supporting shells of an arcuation concave surface, is used for the movable arcuation convex surface 7a that holds astragalus side prosthesis 2 tops; Astragalus side prosthesis 2 comprises top, the end, front, left and right five faces, end face 7 comprises that arc extends to the smooth arcuation convex surface 7a of bottom surface 8 and near the smooth flat 7b at front end position, respectively there is outstanding ridge 11a, a 11b bottom surface 8 and front 9, the left side 10 is shiny surfaces, the right side (diagram does not draw) is consistent with the left side 10,2 of tibial side prosthese 1 and astragalus side prosthesis pass through arcuation male and fomale(M﹠F) exact matching, can make to stretch (direction shown in double- head arrow 14a, 14b in Fig. 4) in the wrong and be free to slide.
During surgical operation, tibial side prosthese 1 is installed on distal tibial, inserts astragalus side prosthesis 2 after the excision astragalus, in the calcaneus spongy bone below two metals " ridge " 11a, the 11b of its front 9 and bottom surface 8 is installed on and in the navicular bone spongy bone in the place ahead.Can rebuild astragalus and height after prosthese is installed, and apart from the stability of boat, talocalcaneal articulation, recover the main movement of ankle joint: the back of the body is stretched and plantar flexion and recover ankle joint and bear a heavy burden, and keeps two lower limb isometric.
Stability when stretching in the wrong the slip in order to strengthen tibial side prosthese 1 and astragalus side prosthesis 2, there are two parallel baffle plate 5a, 5b the both sides of tibial side prosthese lower surface 4 arcuation concave surface supporting shells.After tibial side prosthese 1 and astragalus side prosthesis 2 couplings, form a trochoid, can limit astragalus side prosthesis 2 translation activity to the left and right, can not be shifted when guaranteeing before and after both relative sliding, and reduce the postoperative prosthese and directly slide at surface of bone and cause the probability of pain.
When fixed fae body, can select Cement to fix.If Cement, ridge 6 of the present invention, 11a, 11b, tibial side prosthese upper surface 3, the aperture 13 on astragalus side prosthesis front 9, bottom surface 8, the groove 12 of tibial side prosthese upper surface 3, all can play after bone cement solidifies and bone cement between firmly inlay fixingly, prevent the effect of slippage.
Some features of above-mentioned embodiment can be omitted or replace, and for example are not limited to described all or part of position for the aperture that increases the bone cement fixation; Lack baffle plate and also can implement the purpose of the full ankle of the present invention+range bone prosthetic replacement; Described range bone prosthese can be part, situation is corresponding adjusts according to patient's astragalus excision, only need satisfy the arcuation convex surface at astragalus side prosthesis top and form trochoid with tibial side prosthese arcuation concave surface with baffle plate, and the ridge of astragalus side prosthesis inserts in the calcaneus spongy bone and in the astragalus spongy bone of the place ahead remnants, forms half astragalus prosthetic replacement.
Full ankle+range bone prosthese is divided into three types large, medium and small number, to be adapted to the ankle joint displacement of different size, also can carry out in the preoperative CT scan, carries out accordingly Individual design, accurately to satisfy the needs of individual patient.
Claims (4)
1. full ankle range bone prosthese, comprise tibial side prosthese and astragalus side prosthesis, it is characterized in that, described tibial side prosthese comprises upper and lower surfaces, upper surface is the plane, one outstanding ridge is arranged on the plane, lower surface is the supporting shell of an arcuation concave surface, the astragalus side prosthesis comprises the top, the end, before, left, right five faces, end face is smooth arcuation convex surface, arc extends rearward to the bottom surface, end face is a smooth flat near the position of front end, respectively there is an outstanding ridge bottom surface and front, there are two parallel baffle plates at the supporting shell two ends of described lower surface arcuation concave surface, described ridge, described tibial side prosthese upper surface, described astragalus side prosthesis front and/or described astragalus side prosthesis bottom surface are provided with some apertures.
2. full ankle range bone prosthese according to claim 1, it is characterized in that: described tibial side prosthese upper surface has several grooves.
3. full ankle range bone prosthese according to claim 2, it is characterized in that: described several grooves are two grooves.
4. full ankle range bone prosthese according to claim 1 and 2, it is characterized in that: described tibial side prosthese is become by ultrahigh molecular weight polyethylene, and described astragalus side prosthesis is made of metal.
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
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CN200910197736.1A CN102048600B (en) | 2009-10-27 | 2009-10-27 | Total ankle plus total talus prosthesis |
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CN200910197736.1A CN102048600B (en) | 2009-10-27 | 2009-10-27 | Total ankle plus total talus prosthesis |
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CN102048600A CN102048600A (en) | 2011-05-11 |
CN102048600B true CN102048600B (en) | 2013-06-12 |
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CN200910197736.1A Expired - Fee Related CN102048600B (en) | 2009-10-27 | 2009-10-27 | Total ankle plus total talus prosthesis |
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Families Citing this family (14)
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CA2858559C (en) | 2011-12-07 | 2021-04-20 | Smith & Nephew, Inc. | Orthopedic implant augments |
CA2858553C (en) | 2011-12-07 | 2019-11-12 | Smith & Nephew, Inc. | Orthopedic augments having recessed pockets |
GB2500918A (en) * | 2012-04-05 | 2013-10-09 | Biomet Uk Healthcare Ltd | A prosthetic ankle with sliding engaging components |
EP2869789B1 (en) * | 2013-03-14 | 2018-07-25 | Wright Medical Technology, Inc. | Intramedullary ankle system |
CA2889726C (en) * | 2015-01-12 | 2018-06-26 | Wright Medical Technology, Inc. | Targeted screw for talar dome fixation |
EP3307182B1 (en) * | 2015-06-09 | 2020-11-11 | Zimmer, Inc. | Patient-specific instrumentation for total ankle replacement |
US9877839B2 (en) * | 2015-08-25 | 2018-01-30 | Wright Medical Technology, Inc. | Modular talar fixation method and system |
CN106618806A (en) * | 2016-11-17 | 2017-05-10 | 中国人民解放军第三军医大学第附属医院 | Talus prosthesis |
CN106618807A (en) * | 2016-11-17 | 2017-05-10 | 中国人民解放军第三军医大学第附属医院 | Detachable talus prosthesis |
CN107693168A (en) * | 2017-10-27 | 2018-02-16 | 常非 | A kind of 3D printing astragalus prosthese |
CN109330747A (en) * | 2018-11-20 | 2019-02-15 | 中国人民解放军陆军军医大学第附属医院 | A kind of personalization astragalus surface replacement prosthesis |
CN109620483B (en) * | 2019-01-18 | 2023-07-25 | 青岛大学附属医院 | Single ankle joint surface replacement system |
CN109998739B (en) * | 2019-05-16 | 2024-03-29 | 上海交通大学医学院附属第九人民医院 | Combined artificial total ankle joint prosthesis |
CN112274301B (en) * | 2020-10-30 | 2024-04-09 | 嘉思特华剑医疗器材(天津)有限公司 | Ankle joint prosthesis system containing zirconium-niobium alloy with oxide layer and preparation method |
Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4069518A (en) * | 1976-08-31 | 1978-01-24 | Groth Jr Harry E | Total ankle prosthesis |
US6409767B1 (en) * | 1999-11-05 | 2002-06-25 | European Foot Platform | Ankle prosthesis |
CN1622791A (en) * | 2002-03-08 | 2005-06-01 | 沃尔德马连接两合公司 | Ankle-joint endoprosthesis |
CN101534751A (en) * | 2006-09-15 | 2009-09-16 | 先锋外科技术公司 | Joint arthroplasty devices having articulating members |
-
2009
- 2009-10-27 CN CN200910197736.1A patent/CN102048600B/en not_active Expired - Fee Related
Patent Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4069518A (en) * | 1976-08-31 | 1978-01-24 | Groth Jr Harry E | Total ankle prosthesis |
US6409767B1 (en) * | 1999-11-05 | 2002-06-25 | European Foot Platform | Ankle prosthesis |
CN1622791A (en) * | 2002-03-08 | 2005-06-01 | 沃尔德马连接两合公司 | Ankle-joint endoprosthesis |
CN101534751A (en) * | 2006-09-15 | 2009-09-16 | 先锋外科技术公司 | Joint arthroplasty devices having articulating members |
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CN102048600A (en) | 2011-05-11 |
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