CN103906482A - 互锁髋臼固定螺钉及其与倒置的髋臼杯的组合 - Google Patents

互锁髋臼固定螺钉及其与倒置的髋臼杯的组合 Download PDF

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CN103906482A
CN103906482A CN201280039481.6A CN201280039481A CN103906482A CN 103906482 A CN103906482 A CN 103906482A CN 201280039481 A CN201280039481 A CN 201280039481A CN 103906482 A CN103906482 A CN 103906482A
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Z.特马尼尼
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Abstract

互锁髋臼固定螺钉具有用于拧入松质骨中的螺纹轴和用于拧入倒置髋臼杯中的锥形螺纹螺孔中的锥形螺纹头部。倒置的髋臼杯具有中心柄，且螺纹螺孔以一定角度被钻取，所述角度允许在不接触中心柄且不与中心柄干涉的情况下钻取髋臼腔的骨、放置螺钉、并且拧紧螺钉。

Description

互锁髋臼固定螺钉及其与倒置的髋臼杯的组合
技术领域
本发明大体上涉及互锁髋臼固定螺钉，并且具体地涉及用于在全髋关节置换术期间将臼杯的实心固定件提供到骨盆的准备好的髋臼腔中的互锁髋臼固定螺钉。在另一个且更具体的方面中，本发明涉及具有牢固地附连在其凹形部分中的柄的新倒置髋臼杯和用于将所述杯牢固地附连到髋臼腔中的互锁髋臼固定螺钉的组合。
背景技术
可认识到的是，利用普通螺钉固定臼杯是现有技术中已知的。例如，臼杯使用常规松质骨平头螺钉固定，平头螺钉具有用于借助普通螺丝刀插入和取出的凹口。
其它固定方式包括施加到臼杯的凸形表面上的粗糙部和空隙，其将允许骨的内生长。
常规松质骨螺钉的主要问题在于如下事实，它们具有通过在十分接近螺钉的骨的再吸收而变松的趋势。
常规松质骨螺钉的另一个问题为在动态负载下的臼杯移动引起的微动，所述微动看起来开始松开且随后触发溶骨，这将导致骨再吸收和植入物的松开。
常规松质骨的髋臼螺钉还缺少在动态负载下螺纹固定到杯上的刚性，从而导致在臼杯与螺钉之间的接触点处的微动。结果，微动导致磨损和凹痕。此外，可因此产生金属碎片和磨损颗粒，从而引起围绕植入物的局部肉芽瘤。
互锁骨螺钉已经结合常规平骨板使用，且结合如在公布的欧洲专利申请EP 1 800 626 A2中描述的臼杯使用。然而，螺钉的适合尺寸确定之前并未被认作是这些螺钉的耐久性的因素，这是因为所述螺钉并未结合倒置的髋臼杯使用。
因此，现有的松质骨螺钉已经不能充分地解决在全髋关节置换术期间将实心髋臼固定器件提供到骨盆的准备好的髋臼腔中的问题。
在此方面，根据本发明的互锁髋臼固定螺钉大致脱离了现有技术的螺钉的常规尺寸确定，且由此提供了主要为了在全髋关节置换术期间将实心髋臼固定器件提供到骨盆的准备好的髋臼腔中、尤其是在固定本发明的倒置的髋臼杯方面的目的而开发的设备。
发明内容
鉴于现有技术中目前存在的松质骨髋臼螺钉的已知类型和尺寸中固有的前述缺点，本发明提供了新的互锁髋臼固定螺钉构造和尺寸确定，以使得松质骨螺钉在全髋关节置换术期间在插入骨盆的准备好的髋臼腔中时稳固地固定到倒置的髋臼杯上。具体而言，本发明的互锁髋臼固定螺钉设计成与2011年9月15日提交且名称为"Interlocking Reverse Hip and Revision Prosthesis"的公开的PCT申请WO2011-112353-A1中描述的新的倒置髋臼杯结合使用，其中使用适合地定尺寸的螺钉提供了优于现有技术的螺钉的优点。新的倒置髋臼杯在图3的透视图和图4中的截面图中被示出。
将随后更详细描述的本发明的总体目的在于提供适当地定尺寸的互锁髋臼固定螺钉和其与新的倒置髋臼杯的组合。
为此，本发明大体上包括专门设计的互锁松质骨螺钉，其将牢固地锁定在臼杯中的螺纹孔中。孔的数目一般在三个到七个之间变化，且医生可选择使用一个或一个以上的螺钉来将杯附连到髋臼上。互锁髋臼固定螺钉专门设计成用于插入到上文提到的公开的PCT申请中描述的新倒置髋假体的臼杯中的螺纹螺孔或开口中。所述螺钉具有在从螺钉的远端到头部的螺钉的螺钉杆的整个长度上设置的粗螺纹，以便提供到骨盆的松质骨中的最佳螺钉固定。在螺钉的近端处的螺钉头部成锥形，且具有细锁定螺纹部分。螺钉头部优选为具有12度的锥度，且锥角可在从10度至15度内变化。头部从松质骨螺纹向外锥细至螺钉的近端，以便头部的近端具有比松质骨螺纹附近的端部大的直径。此外，在互锁髋臼固定螺钉的近端处的头部提供借助六角螺丝刀插入的六边形凹口。
臼杯中的螺孔还以渐缩方式车螺纹，以与互锁髋臼固定螺钉的头部的细螺纹匹配。臼杯的螺孔也以特定的倾斜角度钻取，以避免钻削器具、螺钉和螺丝刀干涉倒置髋臼杯的中心柄。本发明的该特征还便于钻骨以及螺钉的插入和拧紧。
因此，已经概述了本发明的更重要的特征，以便本发明的详细描述可更好地被理解，且以便可更好认识到对本领域的本贡献。
附图说明
图1为倒置髋臼杯的局部截面视图，且具有锁定在所述杯中的互锁髋臼固定螺钉的正视图。
图2为互锁髋臼固定螺钉的正视图。
图3为具有螺纹孔的倒置髋臼杯的透视图。
图4为具有锁定在其中的两个互锁髋臼固定螺钉的臼杯的截面图，一个螺钉以截面图示出，而另一个以透视正视图示出。
具体实施方式
附图示出了互锁髋臼固定螺钉10，其包括特别设计和定尺寸的互锁松质骨螺钉，所述互锁松质骨螺钉将被牢固地螺接和锁定在臼杯9中的螺纹锥形髋臼螺孔或开口1中。所述螺钉具有：在螺钉杆的整个长度上的粗螺纹2，用于最佳地螺纹固定在骨盆的松质骨中；以及在螺钉头部上的细锁定螺纹部分3。螺钉头部优选为切有12度的锥度，但锥角可在从10度至15度内变化。互锁髋臼固定螺钉10的头部8还提供了六边形凹口4，以供六角螺丝刀插入。
参看图4，臼杯中的螺孔或开口以特定倾斜角度钻取，以避免钻削器具（即，钻孔引导件和/或钻头）与臼杯9的中心柄7干涉。如可从图4看到的那样，与截面图示出的螺钉10相比，以透视正视图示出的螺钉10相对于中心线A-A处于不同的角度。此外，如可从与螺钉的中心轴线平行且远离螺钉的头部延伸的虚线看到的那样，螺孔的角度和位置已经选择成使得钻孔引导件、钻头、螺钉和螺丝刀将不会接触中心柄7，且柄将不会干扰螺钉的安装。因此，当在髋臼腔中钻出孔以收纳螺钉时，柄7将不会与钻孔引导件和/或钻头干涉。并且，当螺钉10置于孔中时，柄7将不会干扰螺钉的放置或干扰用于拧紧螺钉的螺丝刀。
参看图3和图4且如通过引用并入本文中的公开的PCT申请WO2011-112353A1所述的，倒置的髋臼杯9具有用于固定附接到髋臼腔上的凸形外表面。并且，杯9具有凹形表面，所述凹形表面具有用作其一部分或牢固地附接到其中的中心柄7。中心柄7具有中心轴线A-A（本文中也称为第一中心轴线），且柄7的中心轴线与杯9的中心轴线相同。杯9具有至少一个内螺纹螺孔，其具有中心轴线（本文中也称为第二中心轴线）和周缘。螺纹螺孔以一定角度被钻取，使得从周缘延伸且与螺孔的中心轴线平行的线与中心柄不会相交。螺孔1车有沿其锥度的螺纹5，以与互锁髋臼固定螺钉的锥形头部匹配。此外，互锁髋臼固定螺钉的末端在6处自攻丝，以易于插入患者的骨中。
在医生准备好髋臼腔之后，使用适合的工具将臼杯9压到适当位置。使用用于角度精确性的钻孔引导件，将孔钻至适合的深度。然后，插入互锁髋臼固定螺钉，直到互锁髋臼固定螺钉的细螺纹3与锥形髋臼螺钉开口1的螺纹5匹配，且使用常规六角螺丝刀紧贴地锁定。由此，互锁髋臼固定螺钉变为与臼杯9牢固地且锁定地附连，就像成一件，因此消除了螺钉10与杯9之间的任何运动。这是消除螺钉的微动中的极重要的因素，从而减少了骨质溶解。
因此，互锁髋臼固定螺钉牢固地固定臼杯，且防止螺钉头部到臼杯中的任何倒退移动，这种移动可导致通过引用并入本文中的PCT申请中描述的螺钉头部与运动的股骨杯的碰撞。
在本发明的优选实施例中，互锁髋臼固定螺钉尺寸确定为专门用于倒置髋臼杯。参看图2，螺钉具有在从21毫米至31毫米的总长a，在从16毫米至26毫米的松质骨螺纹长度b，以及在从4毫米至5毫米的细头部螺纹长度c。松质骨螺纹直径d在从6毫米至7毫米，且螺钉杆直径e在从4毫米至5毫米。

Claims (8)

1. 一种倒置的髋臼杯，所述髋臼杯具有用于固定附接到髋臼腔上的表面以及凹形表面，所述凹形表面具有从其延伸的中心柄，所述臼杯和柄具有公共的第一中心轴线，所述臼杯包括具有第二中心轴线的至少一个螺纹螺孔以及在所述凹形表面上的周缘，其中从所述周缘延伸且与所述第二中心轴线平行的线与所述中心柄不相交。
2. 根据权利要求1所述的倒置的髋臼杯，还包括拧入所述至少一个螺纹螺孔中的互锁髋臼固定螺钉。
3. 根据权利要求2所述的倒置的髋臼杯，其中，所述螺纹螺孔相对于所述第二中心轴线以从10度到15度的角度成锥形，并且具有比在凸形表面上的周界大的在所述凹形表面上的周界。
4. 根据权利要求3所述的倒置的髋臼杯，其中，所述互锁髋臼固定螺钉具有外螺纹头部，并且以与所述螺纹螺孔相同的角度成锥形，且所述螺纹头部尺寸确定为与所述螺纹螺孔匹配。
5. 根据权利要求2所述的倒置的髋臼杯，其中，所述螺钉具有成10度至15度的角度的锥形头部、在从21毫米至31毫米的总长、以及在从4毫米至5毫米的螺钉杆直径。
6. 根据权利要求5所述的倒置的髋臼杯，其中，所述螺钉具有在从6毫米至7毫米的松质骨螺纹直径。
7. 根据权利要求6所述的倒置的髋臼杯，其中，所述螺钉具有在从16毫米至26毫米的松质骨螺纹长度。
8. 根据权利要求7所述的倒置的髋臼杯，其中，所述细螺纹头部长度为从4毫米至5毫米。
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