CN102440851A - 具有成角度的骨水泥腔的膝关节假体的股骨组件 - Google Patents
具有成角度的骨水泥腔的膝关节假体的股骨组件 Download PDFInfo
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Abstract
本发明提供了一种可植入的整形外科膝关节假体,其包括被构造成可接于经手术准备的股骨远端的股骨组件。所述股骨组件具有包括后股骨髁表面的关节侧。固定侧与所述关节侧相对,并且包括大致在上下方向延伸的后固定表面。所述后固定表面具有在其中形成的成角度的后骨水泥腔。
Description
技术领域
本公开总体上涉及可植入的整形外科假体,更具体地讲涉及可植入的膝关节假体。
背景技术
在患者的一生中,由于(例如)疾病或创伤原因,可能需要对患者进行关节置换手术。关节置换手术可能涉及使用植入患者一个或多个骨骼内的假体。在膝关节置换手术中,将胫骨托植入患者胫骨。支承件被固定到胫骨托。置换股骨组件的髁表面支承着胫骨支承件。
在植入股骨组件的过程中,外科医生通常在该组件的骨骼接触表面上预装骨水泥。预装的骨水泥在设置到经手术准备的股骨远端时趋向于逸出股骨组件。将股骨组件穿过逸出的骨水泥推进被称为“骨水泥开槽”。逸出的骨水泥及相关的骨水泥开槽导致需要在外科手术结束前进行附加的手术步骤,以移除外部的骨水泥。
发明内容
根据一个方面,可植入的整形外科膝关节假体包括股骨组件,该股骨组件被构造成接于经手术准备的股骨远端。股骨组件具有包括后股骨髁表面的关节侧。固定侧与关节侧相对,并且包括大致在上下方向延伸的后固定表面。后固定表面具有在其中形成的后骨水泥腔,该后骨水泥腔在下端处比上端处深。
股骨组件的固定侧也可包括远端固定表面和后斜面固定表面,其中远端固定表面大致在前后方向延伸,后斜面固定表面在朝后固定表面的方向上从远端固定表面向上并向后延伸。后斜面表面可具有在其中形成且与后骨水泥腔邻接的后斜面骨水泥腔。相似地,远端固定表面可具有在其中形成且与后斜面骨水泥腔邻接的远端骨水泥腔。
后骨水泥腔在其下端处可以比后斜面骨水泥腔和远端骨水泥腔深。
股骨组件的固定侧也可包括前固定表面和前斜面固定表面,其中前固定表面大致在上下方向延伸,前斜面固定表面在朝前固定表面的方向上从远端固定表面向上并向前延伸。前斜面表面可具有在其中形成且与远端骨水泥腔邻接的前斜面骨水泥腔。前固定表面可包括在其中形成且与前斜面骨水泥腔邻接的前骨水泥腔。
在一个实施例中,后骨水泥腔在其下端处比前斜面骨水泥腔和前骨水泥腔深。
在一个实施例中,后固定表面包括安装边缘,该安装边缘具有从其向后延伸的侧壁。所述侧壁限定了后骨水泥腔的周边。在矢状面上看,侧壁的下端比侧壁的上端宽。
根据另一个方面,可植入的整形外科膝关节假体包括股骨组件,该股骨组件被构造成接于经手术准备的股骨远端。股骨组件可包括具有后股骨髁表面的关节侧和与该关节侧相对的固定侧。固定侧可包括大致在上下方向延伸的后固定表面。后固定表面可包括周边边缘、从周边边缘向后间隔开的底壁和从后边缘向后延伸至底壁的侧壁。在矢状面上看,由周边边缘限定的虚平面与由底壁限定的虚平面形成锐角。
在矢状面上看,侧壁的下端可以比侧壁的上端宽。
在一个实施例中,侧壁和底壁共同限定骨水泥腔。
关节侧可包括后外侧股骨髁表面。关节侧还可包括后内侧股骨髁表面。
根据另一个方面,可植入的整形外科膝关节假体包括胫骨托和支承件,胫骨托被构造成接于经手术准备的胫骨近端,支承被构造成接于胫骨托。支承件包括内侧关节表面和外侧关节表面。膝关节假体也可包括被构造成接于经手术准备的股骨远端的股骨组件。股骨组件可包括外侧髁表面和内侧髁表面,外侧髁表面被构造成与支承件的外侧关节表面关节接合,内侧髁表面被构造成与支承件的内侧关节表面关节接合。股骨组件也可包括与外侧髁表面相对的后外侧固定表面,同时后外侧固定表面在上下方向延伸。股骨组件也包括与内侧髁表面相对的后内侧固定表面,同时后内侧固定表面在上下方向延伸。后内侧固定表面和后外侧固定表面均可包括周边边缘、从周边边缘向后间隔开的底壁和从后边缘向后延伸至底壁的侧壁。在矢状面上看,由周边边缘限定的虚平面与由底壁限定的虚平面形成锐角。
在矢状面上看,后内侧固定表面的侧壁下端比其上端宽。
在矢状面上看,后外侧固定表面的侧壁下端比其上端宽。
后内侧固定表面的侧壁和底壁共同限定骨水泥腔。
后外侧固定表面的侧壁和底壁也共同限定骨水泥腔。
根据另一个方面,可植入的整形外科膝关节假体包括股骨组件,该股骨组件被构造成接于经手术准备的股骨远端。股骨组件具有包括股骨髁表面的关节侧和与该关节侧相对的固定侧。固定侧包括大致在上下方向延伸的固定表面。固定表面具有在其中形成的骨水泥腔,该骨水泥腔在下端处比上端处深。
固定表面可包括安装边缘,所述安装边缘具有从其延伸的侧壁。侧壁限定了骨水泥腔的周边。在矢状面上看,侧壁的下端比侧壁的上端宽。
在矢状面上看,由周边边缘限定的虚平面与由底壁限定的虚平面形成锐角。
固定表面可包括具有在其中形成的后骨水泥腔的后固定表面。在这样的布置方式中,底壁从周边边缘向后间隔开,侧壁从后边缘向后延伸至底壁。
固定表面可包括具有在其中形成的前骨水泥腔的前固定表面。在这样的布置方式中,底壁从周边边缘向前间隔开,侧壁从前边缘向前延伸至底壁。
股骨组件可以实施为单髁股骨组件。
附图说明
特别参照下图进行详细说明,下图中:
图1为膝关节假体的透视图;
图2为图1的膝关节假体的分解透视图;
图3为图1的膝关节假体的股骨组件的透视图;
图4为图3的股骨组件的矢状剖面图;
图5为图4的一部分的放大片段视图,详细示出了股骨组件的后髁;
图6为类似于图4的视图,但示出了股骨组件的另一个实施例,其中前后骨水泥腔均成角度;
图7为单髁股骨组件的透视图;
图8为图7的单髁股骨组件的矢状剖面图。
具体实施方式
虽然本发明的概念易于具有各种修改形式和替代形式,但其具体示例性实施例已在附图中以举例的方式示出,并且将在本文中详细说明。然而应当理解,本文无意将本发明的概念限制为所公开的具体形式,而是相反,目的在于涵盖所附权利要求限定的本发明的精神和范围内的所有修改形式、等同形式和替代形式。
在本公开中有关本文所述的整形外科植入物和患者的自然解剖部分使用了表示解剖学参考的术语,例如前侧、后侧、内侧、外侧、上、下等。这些术语在解剖学和整形外科领域都具有公知的含义。除非另外指明,否则说明书和权利要求中使用的此类解剖参考术语旨在符合其公知的含义。
现在参见图1-5,图中示出了膝关节假体10。膝关节假体10包括股骨组件12、胫骨托14和支承件16。股骨组件12被构造成固定于经经手术准备的患者股骨远端末端(未示出),而胫骨托14则被构造成固定于经经手术准备的患者胫骨近端末端(未示出)。
胫骨托14包括平台18,平台18具有从其下表面延伸出的固定构件,例如细长杆20。支承件16包括杆22(参见图2),杆22可定位在胫骨托14内的配合孔24(参见图2)中。通过这种方式,支承件16可相对于胫骨托14自由旋转。在其他实施例中,支承件16可以搭扣配合或以其他方式固定到胫骨托14。通过这种方式,支承件16与胫骨托14相对固定(即,其不会沿前/后或内侧/外侧方向旋转或移动)。应当理解,在此类实施例中,可使用其他固定构件(例如一个或多个短销或短柱)代替细长杆20。
支承件16包括外侧关节表面26和内侧关节表面28。关节表面26和28被构造为分别与股骨组件12的外侧髁表面30和内侧髁表面32关节接合。具体地讲,股骨组件12被构造成模仿患者自然股骨髁的构造,因此外侧髁表面30和内侧髁表面32以模仿自然股骨髁的方式构造(如弯曲)。外侧髁表面30和内侧髁表面32彼此间隔开,从而在二者之间限定了髁间凹。
膝关节假体10与自然骨骼接合的组件(例如股骨组件12和胫骨托14)可以由生物相容性金属(例如钴铬合金)构成,但也可以采用其他材料,例如陶瓷。这些组件的骨接合表面可以被纹理化,以有利于将组件粘合到骨骼。这种表面也可以具有多孔涂层,以促进骨骼内生,从而永久固定。
支承件16可以由允许支承件16和股骨组件12之间平滑地关节连接的材料(例如聚合材料)构成。一种这样的聚合材料是聚乙烯,例如超高分子量聚乙烯(UHMWPE),但也可以采用其他生物相容性聚合物。
虽然本文以举例方式将股骨组件12描述为单一组件,但其通过多个“区域”或“结构”来表征。例如,股骨组件12的前结构被称为前凸缘34。前凸缘34过渡至前斜面区域36,前斜面区域36继而过渡至远端髁区域38。远端髁区域38过渡至后斜面区域40。一对后股骨髁42形成股骨组件12的后结构。
如图2所示,外侧髁表面30和内侧髁表面32均在股骨组件12的关节侧44内形成。固定侧48与关节侧44相对,并且是股骨组件12接触经手术准备的患者股骨远端的一侧。固定侧48包括与经外科手术切入患者股骨远端内的平表面配合的多个表面。具体地讲,如图3所示,一对后固定表面50与后髁表面52相对,并且后固定表面50中的一个为内侧固定表面,另一个为外侧固定表面。如图4所示,后固定表面50大致在上下方向延伸。一对远端固定表面58(一个设置在内侧,另一个设置在外侧)与远端髁表面60相对。远端固定表面58大致在前后方向延伸。内侧和外侧后斜面固定表面54与后斜面髁表面56相对。内侧和外侧后斜面固定表面54从各自的内侧和外侧远端固定表面58开始,向上并向后朝向各自的后固定表面50延伸。内侧和外侧前斜面固定表面62分别与前斜面髁表面64相对,在朝前固定表面66的方向上从各自的远端固定表面58向上并向前延伸。前固定表面66与前髁表面68相对,并且像后固定表面50一样大致在上下方向延伸。
每个固定表面都具有在其中形成的骨水泥腔。具体地,后骨水泥腔70在每个后固定表面50内形成,后斜面骨水泥腔72在每个后斜面固定表面54内形成,远端骨水泥腔74在每个远端固定表面58内形成,前斜面骨水泥腔76在每个前斜面固定表面62内形成,而前骨水泥腔78在前固定表面66内形成。在本文所述的示例性实施例中,相邻骨水泥腔彼此邻接,使得在股骨组件的固定侧48内形成单个连续的骨水泥腔。
骨水泥腔70、72、74、76、78中每一个都由从安装边缘82伸出的侧壁80形成。从图3-5中可以看出,侧壁80形成各个骨水泥腔70、72、74、76、78的周边。底壁84与安装边缘82间隔开,并通过侧壁80连接于安装边缘82。通过这种方式,侧壁80和底壁84共同限定各个骨水泥腔70、72、74、76、78。
后斜面骨水泥腔72、远端骨水泥腔74、前斜面骨水泥腔76和前骨水泥腔78各自的深度(D1)大约相等。在本文所述的示例性实施例中,骨水泥腔72、74、76和78中每一个大约深1mm(即,D1=1mm)。
另一方面,后骨水泥腔70成角度,因而在其下端处比上端处深。具体地,如图5所示,后骨水泥腔70由侧壁80’形成,侧壁80’从后固定表面50的安装边缘82’向后延伸至底壁84’。在矢状面(例如在图4和5的剖面图中)上看时,侧壁80’的下端86比侧壁80’的上端88宽。因此,后骨水泥腔70在其下端90处比其上端92处深。在本文所述的示例性实施例中,后骨水泥腔70的上端92大约等于其他骨水泥腔72、74、76和78的深度。换句话讲,后骨水泥腔70的上端92大约深1mm(即,D1=1mm)。然而,后骨水泥腔70的下端90示例性地为1.5mm深(即,D2=1.5mm)。应当理解,也可以采用其他尺寸,以满足给定设计的股骨组件12的需要。
该布置方式形成成角度的底壁84’。具体地,底壁84’从其下端86向前倾斜至其上端88。图5的剖面图中示例性地示出了这种倾斜的布置方式。如该图中可以看出,后固定表面50的安装边缘82’限定了虚平面94,而后固定表面50的底壁84’限定了虚平面96。这两个虚平面94、96之间形成锐角(θ)。该锐角表示底壁84’相对于安装边缘82’的斜度。
在将股骨组件12植入经手术准备的患者股骨远端的外科手术过程中,骨水泥腔70、72、74、76、78被预装入骨水泥。然后,将股骨组件12设置在经手术准备的患者股骨远端上,在股骨远端上也涂覆有骨水泥。后骨水泥腔70成角度的布置方式将骨水泥通过液力装入骨水泥腔。这提高了骨水泥的密闭度,并且降低了骨水泥开槽的发生率。后骨水泥腔70的布置方式还可改善骨水泥的填充和压紧,继而导致股骨组件12与股骨远端的粘合力增加。
现在参见图6,图中示出了股骨组件12的另一个实施例。在该实施例中,后骨水泥腔70和前骨水泥腔78均成角度。因此,骨水泥腔70、78各自的下端处比其各自的上端处深。在图6所示的实施例中,后骨水泥腔70与上文结合图1-5所讨论的基本上相同。就前骨水泥腔78而言,其由侧壁80”形成,侧壁80″从前固定表面66的安装边缘82”向前延伸至底壁84”。在矢状面(例如在图6的剖面图中)上看,侧壁80”的下端106比侧壁80”的上端108宽。因此,就像后骨水泥腔70一样,前骨水泥腔78在其下端110处比其上端112处深。在本文所述的示例性实施例中,前骨水泥腔78的上端112大约等于其他骨水泥腔72、74和76的深度。换句话讲,前骨水泥腔70的上端112大约深1mm(即,D1=1mm)。然而,前骨水泥腔78的下端110示例性地为1.5mm深(即,D2=1.5mm)。应当理解,也可以采用其他尺寸,以满足给定设计的股骨组件12的需要。
这种布置方式形成了成角度的底壁84”。具体地,前骨水泥腔78的底壁84”从其下端106向后倾斜至其上端108。这种倾斜的布置方式在图6中示例性地示出,在图6中,前固定表面66的安装边缘82”限定了虚平面114,而前固定表面66的底壁84”则限定了虚平面116。这两个虚平面114、116之间形成锐角(β)。该锐角表示底壁84”相对于安装边缘82”的斜度。
在将图6的股骨组件12植入经手术准备的患者股骨远端的外科手术过程中,骨水泥腔70、72、74、76、78被预装入骨水泥。然后,将股骨组件12设置在经手术准备的患者股骨远端上,在股骨远端上也涂覆有骨水泥。骨水泥腔70、78成角度的布置方式将骨水泥通过液力装入骨水泥腔70、78。这提高了骨水泥的密闭度,并且降低了骨水泥开槽的发生率。这还可改善骨水泥的填充和压紧,继而导致股骨组件12与股骨远端的粘合力增加。
应当理解,虽然图6的实施例示例性地示出后骨水泥腔70和前骨水泥腔78均为成角度的,但应当理解,还可以想到其他的实施例。例如,如图1-5所示,股骨组件12可以实施为只有后骨水泥腔70成角度。作为另外一种选择,股骨组件12可以实施为只有前骨水泥腔78成角度。
现在参见图7和8,股骨组件12也可以实施为单髁股骨组件。类似本文所述的其他实施例,单髁股骨组件12的后骨水泥腔70可以成角度。后骨水泥腔70成角度的布置方式将骨水泥通过液力装入骨水泥腔。这提高了骨水泥的密闭度,并且降低了骨水泥开槽的发生率。后骨水泥腔70的布置方式还可改善骨水泥的填充和压紧,继而导致单髁股骨组件12与股骨远端的粘合力增加。
尽管在附图和上述说明中已经对本发明进行了详细的图示和描述,但此类图示和描述应视为示例性的,而不是限制性的,应当理解的是,仅示出和描述了示例性的实施例,并且本发明精神范围内的所有变更和修改形式都应受到保护。
本文所述装置、系统和方法的多个特征使本发明具有多个优点。应当注意的是,本发明的装置、系统和方法的替代实施例可以不包括所有所述特征,但仍然可以受益于这些特征的至少某些优点。本领域的普通技术人员可以轻松设计出其自己的装置、系统和方法的实施方式,该实施方式可整合本发明特征中的一项或多项,并且落在由权利要求限定的本发明的精神和范围内。
Claims (11)
1.一种可植入的整形外科膝关节假体,其包括:
股骨组件,所述股骨组件被构造成接于经手术准备的股骨远端,并且具有(i)包括后股骨髁表面的关节侧、和(ii)与所述关节侧相对的固定侧,所述固定侧包括大致在上下方向延伸的后固定表面,其中所述后固定表面具有在其中形成的后骨水泥腔,所述后骨水泥腔在其下端比在其上端深。
2.根据权利要求1所述的可植入的整形外科假体,其中:
所述股骨组件的所述固定侧还包括(i)远端固定表面和(ii)后斜面固定表面,所述远端固定表面大致在前后方向延伸,所述后斜面固定表面在朝所述后固定表面的方向上从所述远端固定表面向上并向后延伸,
所述后斜面表面具有在其中形成并与所述后骨水泥腔邻接的后斜面骨水泥腔,并且
所述远端固定表面具有在其中形成并与所述后斜面骨水泥腔邻接的远端骨水泥腔。
3.根据权利要求2所述的可植入的整形外科假体,其中所述后骨水泥腔在其下端比所述后斜面骨水泥腔和所述远端骨水泥腔都深。
4.根据权利要求3所述的可植入的整形外科假体,其中:
所述股骨组件的所述固定侧还包括(i)前固定表面和(ii)前斜面固定表面,所述前固定表面大致在上下方向延伸,所述前斜面固定表面在朝所述前固定表面的方向上从所述远端固定表面向上并向前延伸,
所述前斜面表面具有在其中形成并与所述远端骨水泥腔邻接的前斜面骨水泥腔,并且
所述前固定表面具有在其中形成并与所述前斜面骨水泥腔邻接的前骨水泥腔。
5.根据权利要求4所述的可植入的整形外科假体,其中所述后骨水泥腔在其下端比所述前斜面骨水泥腔和所述前骨水泥腔都深。
6.根据权利要求1所述的可植入的整形外科假体,其中:
所述后固定表面包括安装边缘,所述安装边缘具有从其向后延伸的侧壁,
所述侧壁限定了所述后骨水泥腔的周边,并且
在矢状面上看,所述侧壁的下端比所述侧壁的上端宽。
7.一种可植入的整形外科膝关节假体,其包括:
股骨组件,所述股骨组件被构造成接于经手术准备的股骨远端,并且具有(i)包括后股骨髁表面的关节侧、和(ii)与所述关节侧相对的固定侧,所述固定侧包括大致在上下方向延伸的后固定表面,
其中,所述后固定表面包括(i)周边边缘、(ii)从所述周边边缘向后间隔开的底壁,以及(iii)从所述后边缘向后延伸至所述底壁的侧壁,
其中,在矢状面上看,由所述周边边缘限定的虚平面与由所述底壁限定的虚平面形成锐角。
8.根据权利要求7所述的可植入的整形外科膝关节假体,其中,在矢状面上看,所述侧壁的下端比所述侧壁的上端宽。
9.根据权利要求7所述的可植入的整形外科膝关节假体,其中所述侧壁和所述底壁共同限定骨水泥腔。
10.根据权利要求7所述的可植入的整形外科膝关节假体,其中所述关节侧包括后外侧股骨髁表面。
11.根据权利要求7所述的可植入的整形外科膝关节假体,其中所述关节侧包括后内侧股骨髁表面。
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CN102440851B (zh) | 2016-04-06 |
ZA201107137B (en) | 2013-09-25 |
US8287601B2 (en) | 2012-10-16 |
EP2436341A8 (en) | 2012-05-09 |
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EP2436341A1 (en) | 2012-04-04 |
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