CN102065797A - 用于紧固至截骨端且包含具有向外可移动支状物的内部延伸杆的复合式关节植入体 - Google Patents

用于紧固至截骨端且包含具有向外可移动支状物的内部延伸杆的复合式关节植入体 Download PDF

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Publication number
CN102065797A
CN102065797A CN2009801154822A CN200980115482A CN102065797A CN 102065797 A CN102065797 A CN 102065797A CN 2009801154822 A CN2009801154822 A CN 2009801154822A CN 200980115482 A CN200980115482 A CN 200980115482A CN 102065797 A CN102065797 A CN 102065797A
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China
Prior art keywords
implant
skeleton
joint
main body
face
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米古尔·A·利纳雷斯
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Linares Medical Devices LLC
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Linares Medical Devices LLC
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Publication of CN102065797A publication Critical patent/CN102065797A/zh
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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

一种与骨骼一起使用的人造关节植入体，包括三维形状主体，该三维形状主体具有外部成形的关节限定面。一个环形凹进在植入体的固位位置之内形成，用于将所述主体紧固在所述骨骼的截骨端之上。一个杆在所述骨骼之内从所述主体向内地延伸，且呈现出至少一个用于与内部骨骼表面接合的支撑件，从而以紧固方式将所述植入体保持至所述骨骼。

Description

用于紧固至截骨端且包含具有向外可移动支状物的内部延伸杆的复合式关节植入体
相关申请的互相参引
本申请要求享有于2008年3月5日提交的题为“Composite Joint Implant Incorporating Inner Bone Extending Stem with Outwardly Displaceable Branches for Securing to a Sectioned Bone End”的美国临时专利申请No.61/033,954的优先权。
技术领域
本发明涉及一种复合式植入体，其被紧固至限定关节的普通骨骼的改进端部。更具体地，本发明教导了一种端部紧固的关节植入体和向内延伸的支撑杆的组合，该组合用于既提供对植入体的端部支撑又提供对植入体的调整，还用于辅助骨骼的内部中相关联的骨髓的均匀分布。
背景技术
现有技术记载了各种类型的骨骼植入体和/或关节组件。最近的先进技术集中于将人造关节紧固至原有骨骼的可行性。一种与采用这种植入体相关的问题是人造关节相对于其紧固的骨骼趋于脱离或未对准。
发明内容
一种与骨骼一起使用的人造关节植入体，包括三维形状主体，该三维形状主体具有外部成形的关节限定面。环形凹进在植入体的固位位置内形成，用于将所述主体紧固在骨骼的截骨端之上。一个杆在骨骼内从所述主体向内地延伸，且呈现出用于与内部骨骼表面接合的至少一个支撑件，从而以紧固方式将植入体保持至骨骼。
额外的特征包括呈现出向外可移动的多个支状物(branches)，进一步与每个支状物相关联的夹子(clip)。回转螺钉(turn screw)也位于关节限定面，且经由内部可旋转的轴与所述支撑件互相连接。在另一变体中，可旋转的带螺纹的轴经由端面安装的回转螺钉是可操作的，用于以向外的方式致动所述至少一个支撑件。
在另一变体中，所述支撑件包括可旋转的翼状螺母部分，或者，包括至少一个孔。一个软质塑料润滑表面可被应用或者涂覆至所述外部成形的关节限定面。所述植入体还可呈现出一种复合式硬质塑料材料的性质。
附图说明
当结合以下的详细描述进行阅读时，请参考下面的附图，其中相同的参考数字在各视图中表示相同的部件，其中：
图1是复合式关节植入体的以剖面形式的第一图示，且示出了固定在位的复合式端部部分，其中内部骨骼延伸杆被预定位为相关联的支状物在第一缩回位置；
图2是图1示出的随后的图示，其中所述杆支撑的支状物借助于向外偏置的弹簧夹子被向外地移动，形成与相关联的骨骼的内壁位置的摩擦接合；
图3是沿着图1的线3-3所取的截面图，示出了带有被向外移动的摩擦定位且支撑的支状物的内部延伸杆的俯视图；
图4是另一实施方案的侧剖图示，其中所述内部杆被重新成形，以呈现最内部安装的且限定有骨髓通道的支撑件，该支撑件与相关联骨骼的内部周缘邻接；
图5是沿着图4的线5-5所取的剖视图，并且更好地示出了限定在支撑件中的通道，用于便于骨髓在圆盘(disc)的第一和第二侧之间通过；
图6是图4中实施方案的进一步改进变型的侧剖视图，其中第一和第二支撑件以间隔方式布置，且与端部植入体相组合，可被用销紧固至与骨骼相关联的位置；
图7是剖开关节植入体的又一实施方案的侧剖视图，示出了用于放置和支撑所述植入体的底切(undercut)布置，其与内部带螺纹的杆组合，该杆用于支撑一对改进的内部可移动的翼状部分，该翼状部分紧固至相关联的骨骼的内部周缘位置；以及
图8是图7的端视图，示出了布置在端部的六角螺钉，所述六角螺钉从关节处可接近且便于内部支撑的翼状部分内部线性移动。
具体实施方式
现在参考图1，以剖面图示出了复合式关节植入体10的第一图示，复合式关节植入体10被安装至患者骨骼12的截骨端。植入体10由一种合适的材料构造，所述材料可包括复合塑料、金属或者它们的组合等，还有其他材料。如图所示的，植入体10被进一步成形为使得其模仿限定关节的端面(并不限于膝关节、肘关节、髋关节、踝关节、腕关节等中的任何一个)，所述端面的暴露面上覆盖有或者以其他方式应用有复合式软质塑料表面层14，该表面层进一步相当于基本上无摩擦磨损的软骨支撑层。
如剖面图中进一步所示，植入体10呈现出如下的三维结构：具有面向内的和大体周缘延伸的凹进边沿(rim)(如16所示)，该边沿被定尺寸且成形为使得其环形地支撑相关联骨骼12的匹配的截骨边缘轮廓18。想到了，将胶合剂或者其他粘合剂用于在植入体10和骨骼12之间实现至少初始的结合。尽管未示出，可以相对于所示出的骨骼以相对的限定关节的方式设置额外的骨骼和端部紧固的植入体。或者，合成(例如，塑料的)骨骼可用来代替第二天然骨骼，从而实现任何期望的关节布置。
复合式植入体10的分割的内部结构进一步使得其限定一个中心的、内部延伸的杆支撑结构，如20所示，用于在其上以连续的内部延伸方式支撑向内伸出的杆22。所述植入体进一步配置一环状槽(valley)，该环形槽被限定在外部周缘侧和内部中心支撑结构20之间，参见凹进的表面24，这为与骨骼12相关联的内部容积的骨髓26提供了额外的表面区域，以产生结合至端部紧固的植入体10的邻接位置的新骨骼，同时实现骨髓与环状边沿16的额外结合并邻接骨骼边界18。
再次参考图1，杆22从与植入体10相关联的内部支撑结构20向内延伸。回转螺钉(如所示出的，但并不限于六角螺母)在28处示出，位于暴露的植入体端面的凹进(非磨损)表面处，所述回转螺钉随着轴30可从动地旋转，所述轴30顺序地延伸穿过支撑结构20的内部并与所述连接杆22接合。
多个单独的支状物在缩回位置以相对于杆22的周周和线性延伸表面枢轴支撑和连接的方式通过实线在32处示出。杆22和枢轴紧固的支状物32优选地由同样的金属/塑料复合材料构造，尽管在选择适合的杆和支状物结构中也可以考虑采用其他的材料。尽管未明确示出，但所述支状物32被铰接或者枢轴地紧固至杆22的延伸位置(参见图1中选定支状物32的枢轴联动装置(linkage)连接33)，并且进一步通过适合的联动装置与可旋转的轴30相互连接，使得一旦以选定的方向旋转六角螺母28，所述支状物枢轴地向外旋转至另一位置，如32’所示，并且在此位置，它们摩擦地与相关联的骨骼12的面向内的壁表面34接合。沿着这些线，应想到和理解的是，任何合适的机械连接可被提供，以用于转换被应用至杆内部的旋转输入，诸如被应用至轴30的在杆的中空内部(未示出)之内以轴颈支撑或同轴的方式延伸的延长部分的旋转输入，进一步为了与每个枢轴联动装置连接33共同作用，并且从而使得单独的相关联的支状物以示出方式向外地偏转至骨骼内壁接合位置。
通过这种方式，在每个单独的支状物的伸出边缘与选定的内部骨骼表面位置接合之后，所述复合式端部支撑的植入体10被充分地锚定在位，并且防止从其紧固至骨骼12的位置脱离，例如在初始地应用粘合剂之前具有更均匀地结合和/或通过骨骼的作用重新产生骨髓以及外部骨骼在围绕植入体安装至骨骼的区域生长(参见图1中35处示出的代表性的骨骼生长)的机会。一个与杆锁紧布置相关联的额外优点是防止骨髓从植入体与骨骼的连接处流出，并且借助于螺钉紧固，使得将植入体密封地拉靠在截骨边缘18上。一个与内部杆和多个支状物布置相关联的第二优点是有助于保持骨髓沿骨骼内部的长度均匀分布。
现在参考图2，示出了基本上相关的实施方案的随后的示图，其中杆支撑的支状物32借助于向外偏置的弹簧夹子向外移动至与相关联的骨骼的内壁位置摩擦地固定接合，所述弹簧夹子进一步参见36所示，且这些弹簧夹子被另外地设置和/或替代图1中的枢轴联动装置连接33。夹子36被配置为使得在将六角头28旋转一选定范围后，支状物32的向外致动使得可选地设置的弹簧(参看37)在支状物和相关联杆的位置之间接合，以保持所述支状物处于向外移动和偏置的状态，其中所述支状物与相关联骨骼的相关联内壁位置摩擦地接触。图3是沿图1中的线3-3所取的截面图，示出了具有向外移动的摩擦定位和支撑的支状物的内部延伸杆的俯视图，所述支状物例如可通过夹子36或者通过与在骨骼的内壁表面的接触位置的支状物相关联的指向端部的摩擦偏置来紧固。
现在参考图4，在38处示出了复合式植入体的另一实施方案的侧面剖图示，该复合式植入体同样包括软质塑料润滑表面磨损或软骨层40。一个相关联的内部杆42被重新成形为呈现出允许骨髓流动的最内部安装的限定支撑件44，该支撑件44被顺次地定尺寸以便邻接诸如植入体38所紧固至的相关联骨骼48的内部周缘限定表面46。在示出的实施方案中，杆42还可与端部安置的植入体主体形成为整体，使得支撑件44被定尺寸为以摩擦接触的方式接触骨骼壁的内表面，且不需要诸如与图1中示出的杆或支状物布置相关联的任何角度的柱插入致动。植入体38同样被成形为使得一个内部凹进的环状边沿50配置为固位在植入体所附接的(诸如同样地通过胶水或粘合剂)的骨骼48的截骨端52上方。还应理解，植入体38可被胶粘或者被永久紧固至骨骼48，例如通过仅沿连接至骨骼(同样地，52)的环状边沿50提供粘结剂。
图5是沿着图4中的线5-5所取的剖视图，并且更好地示出了限定在支撑件内的通道54，该通道便于骨髓在圆盘支撑件44的第一和第二侧之间通过。所述通道54被设置为使得骨骼内的天然骨髓56可在支撑件44两侧之间通过，由此保持沿骨骼内部均匀地分布。
现在参考图6，示出了图4中的实施方案的进一步改进变型的侧剖视图，其中植入体58包括以间隔方式布置的横向延伸的第一和第二支撑件60和62，且与端部植入体58组合，可通过诸如销64和66被紧固至与骨骼68相关联的位置。内部延伸杆部分同样被示出为70，并且在内部延伸杆部分和植入体58的外部环状轮廓之间，底切表面被成形(参见72和74)为便于与内部骨髓76相关联的新骨骼的生长和内部粘结。
如在前面的实施方案中，内部骨骼支撑件60和62每个都包括通孔，参见78和80，以便于骨髓76的纵向内部连通。另外，植入体与先前公开的那些相似，同样包括植入体58的润滑的、基本上无摩擦和磨损的支撑端部暴露表面82、适合的环状端部凹进和底切接合84，以用于紧固和准确地对准至天然骨骼68的截骨端。
参考图7，示出了剖面关节植入体的又一实施方案86的侧剖视图，其示出了底切布置88(以相对于骨骼预固位的方式示出)，所述底切用于将植入体86放置和支撑至骨骼92的截骨端90，这与内部带螺纹的杆94组合，所述杆用于支撑一对改进的内部可移动的翼状部分96和98，所述翼状部分用于紧固至相关联骨骼92的内部周缘位置。可以提供端部螺钉100(例如六角螺钉，其同样被基本上凹进地安装至与植入体端部表面相关联的中心位置)，且杆94可随所述端部螺钉100从动地旋转。通过这种方式，螺钉100的旋转导致翼状部分96和98在线性方向102上朝端部支撑植入体86被抽出，从而增加了植入体底切边缘88向内拉地抵靠骨骼的截骨端边缘90，这种情况同样便于复合式植入体相对于骨骼的更为完全地结合，以及防止了骨髓103的损失。
图8是图7的端视图，示出了从关节可接近且如图所示的可旋转的端部设置的六角螺钉，便于内部支撑的翼状部分(同样地，图7中的96和98)的内部线性移动。润滑的端部磨损表面104被再次示出，其被紧固至植入体86的外部表面，另一相对的、关节限定的骨骼以及可选的植入体未示出，但是也预期作为完善关节组件，使得相对且邻近定位的(磨损)表面共同地建立关节区域。尽管未示出，但应理解，额外的特征诸如韧带、软骨(天然的或人造的)包含于在此公开的关节组件中。
在此已描述了本发明，对于本领域所属的技术人员来说，在不背离所附的权利要求书的范围内的情况下，其他以及额外的优选实施方案将变得明显。

Claims (17)

1.一种与骨骼一起使用的人造关节植入体，包括：
三维形状主体，其具有外部成形的关节限定面；
相对方向的环状凹进，用于将所述主体固位在所述骨骼的截骨端之上；和
杆，其在所述骨骼内从所述主体向内地延伸，并且呈现出用于与内部骨骼表面接合的至少一个支撑件，从而以紧固方式将所述植入体保持至所述骨骼。
2.如权利要求1所述的植入体，所述支撑件还包括多个向外可移动的支状物。
3.如权利要求2所述的植入体，还包括与每个所述支状物相关联的夹子。
4.如权利要求1所述的植入体，还包括回转螺钉，该回转螺钉位于所述关节限定面，且经由内部可旋转的轴与所述支撑件相互连接。
5.如权利要求1所述的植入体，所述杆还包括可旋转的带螺纹的轴，该轴经由端面安装的回转螺钉用于以向外的方式致动所述至少一个支撑件。
6.如权利要求5所述的植入体，所述支撑件还包括可旋转的翼状螺母部分。
7.如权利要求1所述的植入体，所述支撑件还包括大体圆盘状的部件，至少一个允许骨髓经过的孔贯穿该大体圆盘状的部件形成。
8.如权利要求1所述的植入体，还包括应用至所述外部成形的关节限定面的软质塑料润滑表面。
9.如权利要求1所述的植入体，所述植入体还包括复合式硬质塑料材料。
10.一种与骨骼一起使用的人造关节植入体，包括：
三维形状主体，其具有外部成形的关节限定面；
相对方向的环状凹进，用于将所述主体固位在所述骨骼的截骨端之上；和
回转螺钉，其位于所述关节限定面处且经由支撑在杆内的可旋转轴相互连接多个向外可移动的支状物，所述杆在所述骨骼内从所述主体向内延伸，所述支状物通过同样多个的枢轴联动装置机构根据所述轴的旋转而被致动，所述支状物和与骨骼相关联的内部表面接合，从而以紧固的方式将所述植入体保持至所述骨骼。
11.如权利要求10所述的植入体，还包括所述回转螺钉在面向所述外部关节限定面的方向上被凹进地安装在所述主体之内。
12.如权利要求10所述的植入体，还包括应用至所述外部成形的关节限定面的软质塑料润滑表面。
13.如权利要求10所述的植入体，所述植入体还包括复合式硬质塑料材料。
14.一种与骨骼一起使用人造关节植入体，包括：
三维形状主体，其具有外部成形的关节限定面；
相对方向的环状凹进，用于将所述主体固位在所述骨骼的截骨端之上；
回转螺钉，其从所述关节限定面可接近且在所述骨骼之内向内地延伸，所述回转螺钉呈现出螺纹，用于根据所述螺钉的旋转致动在所述螺纹上支撑的至少一个可旋转的翼状螺母部分，以和与所述骨骼相关联的内部表面接合，从而以紧固方式将所述植入体保持至所述骨骼。
15.如权利要求14所述的植入体，还包括所述回转螺钉在面向所述外部关节限定面的方向上被凹进地安装在所述主体之内。
16.如权利要求14所述的植入体，还包括应用至所述外部成形的关节限定面的软质塑料润滑表面。
17.如权利要求14所述的植入体，所述植入体还包括复合式硬质塑料材料。
CN2009801154822A 2008-03-05 2009-05-01 用于紧固至截骨端且包含具有向外可移动支状物的内部延伸杆的复合式关节植入体 Pending CN102065797A (zh)

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