CN104771250B

CN104771250B - Hip joint apparatus and method

Info

Publication number: CN104771250B
Application number: CN201510114504.0A
Authority: CN
Inventors: 彼得·福塞尔
Original assignee: Milutinovic Alex Holdings Ltd
Current assignee: IMPLANTICA PATENTS CO., LTD.
Priority date: 2009-07-10
Filing date: 2010-07-12
Publication date: 2017-10-24
Anticipated expiration: 2030-07-12
Also published as: KR101730066B1; CN104771250A; KR20120062707A

Abstract

The invention provides a kind of medical treatment device for being used to be implanted into patient's hip joint.The medical treatment device includes Part I and Part II and releasing member, and the releasing member is suitable to, remains the Part I be attached to the Part II in a first state, and discharges the Part I from the Part II in the second state.When predetermined stress is on the releasing member, the releasing member is suitable to change to second state from the first state.

Description

Hip joint apparatus and method

The application is the applying date on July 12nd, 2010, Application No. 201080040401.X, entitled " hip is closed The divisional application of the application for a patent for invention of regulating device and method ".

Technical field

This patent disclosure relates generally to hip prosthesis.

Background technology

Coxitis (Hip joint Osteoarthritis) is that a kind of low grade inflammation causes the synthesis of hip arthralgia Disease, is caused by playing the inordinate wear of cartilage of mat effect in hip joint.This inordinate wear of the cartilage is again resulted in Joint lubrication liquid referred to as synovia is reduced.It is estimated that coxitis affects the 65 of 80% with more or less severe form Crowd more than year.

The current treatment to coxitis includes the local injection of NSAID medicaments, hyaluronic acid or glucocorticoid to help Lubrication hip joint is helped, and passes through operation on hip joint prosthetic replacement part hip joint.

To this day, the aliquot replacement of hip joint is one of most common operation, real with the patient of hundreds of thousands every year Apply.Most common method is included in implanted metal prosthese in femur and the bowl material of plastics is implanted into acetabular bone.The operation is led to Cross the lateral incision in hip and upper leg portion and implemented by the pleural muscle of fascia late and thigh.In order to approach joint, it is necessary to wear The supportive capsula articularis coxae on femur and ilium is attached to thoroughly, and this to be difficult to obtain global function joint after surgery.Femur is then Cut off, and used or Cementless is by Using prosthesis femur with bone saw in neck.Make acetabular bone somewhat using acetabular bone marrow expanding device Expand, and use screw or the bowl material of cement reaction plastics.

Complication after operation on hip joint includes the loosening of the dislocation of hip joint and prosthese from its stationary state in femur. Due to such as patient fall down or hip quick motion, the ABNORMAL STRESS acted on hip joint may trigger the loosening of prosthese And/or dislocation.Do not dislocate the possible hip prosthesis being completely fixed, then because whole stress are on femur, will increase Plus the risk that prosthese loosens from its stationary state in femur.

It is therefore contemplated that obtaining a kind of to reduce the hip prosthesis of complication after operation on hip joint.

The content of the invention

The invention provides a kind of medical treatment device for being used to be implanted into patient's hip joint.The medical treatment device includes being adapted for secure to The Part I of basin bone.Part I includes a convex contact face, and the convex contact face is suitable to partly be placed in a concavity In contact surface.The medical treatment device further comprises the Part II for being adapted for secure to femur.Part II is contacted including a concavity Face, the concavity contact surface is suitable to the convex contact face for partly surrounding the Part I after the implantation.The medical treatment is filled Put and further comprise releasing member, the releasing member is suitable to, the Part I is remained be attached in a first state The Part II, and the Part I is discharged from the Part II in the second state.When predetermined stress When on the releasing member, the releasing member is suitable to change to second state from the first state.With release The structure of element reduces the infringement of the interconnection between any structure and/or human body and prosthetic component to human body.

According to one embodiment of medical treatment device, the convex contact face of Part I and/or Part II is at least part Spherical.

According to another embodiment, the concavity contact surface of Part II is at least Part-spherical.

According to one embodiment, Part I can include spherical part, and Part II can include bowl-shaped portion.Ball Shape part may be adapted to be placed in bowl-shaped portion to replace functioning hip joint.Spherical part may be adapted to use releasing member Fixed to bowl-shaped portion.

According to arbitrary embodiment herein, when predetermined stress is on releasing member, releasing member may be adapted to The second state non-invasively is changed to from first state, and from the second state change to first state.

At least one in Part I and Part II is suitable to including at least two after medical treatment device is implanted patient The part contacted with each other.

According to another embodiment, the hole that the Part I or the Part II are suitable to pass through in patient's basin bone is introduced. Introduced at least two part by the hole in patient's basin bone after hip joint, one at least two part It is individual to may be adapted to mutually mechanically fix.

Hole in basin bone, which can have, is less than 530mm², less than 380mm², less than 250mm², less than 180mm²Or be less than 110mm²Cross-sectional area.

According to one embodiment, the Part II of the medical treatment device includes the release member according to any embodiment herein Part.The releasing member can include elastic part, and the elastic part can include for example, elastomeric material, spring or elastic webbing. The elastic webbing may be adapted at least partly about spherical part.

According to another embodiment of medical treatment device, the releasing member includes bendable portion, flexible portion, compressible part Point, at least one in moveable part or movable part.

According to another embodiment, the releasing member includes the magnet for being suitable to remaining to Part I into Part II.

According to another embodiment, the releasing member includes apparatus for breaking, and the apparatus for breaking is suitable to break under predetermined stress Split.The apparatus for breaking can be for example including the zone of fracture and/or rupture pin.

According to one embodiment, the releasing member can include multiple holding elements, the holding element and then can fit Slide, or rolled against Part I in against Part I.According to one embodiment, the holding element being suitable for scrolling through includes ball Shape holding element.

According to any one embodiment here, the Part I of medical treatment device can include at least two in medical treatment device It is implanted the part for being suitable to contact with each other after patient.One at least two part has passed through in this at least two part Hole in patient's basin bone is introduced after hip joint, suitable for second be mechanically secured in both parts.

According to one embodiment, Part I can include being suitable to enable the medical treatment device by the hole in basin bone The flexible portion or elastic part of insertion, the elastic part enable the Part I to compress at least one direction.

According to another embodiment, the Part I includes first area and second area.The first area includes suitable In the first flexible material, and the second area includes being suitable to the second flexible material.First material can It is suitable for more flexible than second material.

According to one embodiment of medical treatment device, Part II includes at least two and fitted after medical treatment device is implanted patient In the part contacted with each other.One at least two part passes through the hole in patient's basin bone in this at least two part It is introduced into after hip joint, suitable for second be mechanically secured in both parts.

According to another embodiment, medical treatment device includes calibrating element, become for adjusting releasing member from the first state Change to the predetermined stress needed for the second state.The calibrating element can be calibration screw.

The method for further providing the installation medical treatment device according to any embodiment herein.The method comprising the steps of： Hip joint is exposed by surgical procedures or arthroscope process, the Part I of medical treatment device basin bone is fixed to, by medical treatment The Part II of device is fixed to femur, Part I is connected into placement with Part II, and use releasing member by first Part remains to Part II.

According to one embodiment, the step of Part I is remained into Part II using releasing member includes, and uses bullet Part I is remained to Part II by property element.According to another embodiment, Part I is remained to using flexible member The step of two parts, includes, and Part I is remained into Part II using elastic webbing.

According to one embodiment, the step of Part I is remained into Part II using flexible member includes, using broken Split element and Part I is remained into Part II.The rupture elements can be the zone of fracture.

According to other embodiments, the step of Part I is remained into Part II includes, using bearing spring load Part I is tied to Part II by element.

Further provide for a kind of medical treatment device for being used to be implanted into patient's hip joint.The medical treatment device include Part I and Part II and releasing member, the releasing member are suitable to, and remain Part I be attached to second in a first state Part, and Part I is discharged from Part II in the second state.When predetermined stress is acted on releasing member, this is released Element is put to be suitable to change to the second state from first state.

According to one embodiment, Part I includes spherical part, suitable at least substituting femoral head surfaces in hip joint.

According to one embodiment, Part II includes bowl-shaped portion, suitable at least substituting acetabular bone surface in hip joint.

According to another embodiment, Part I includes spherical part, and Part II includes bowl-shaped portion, and spherical Part is suitable to be placed in replace functioning hip joint in bowl-shaped portion, so as to form whole artificial hip joint.Spherical part can It is suitable for being fixed to bowl-shaped portion using releasing member.

According to any embodiment, when predetermined stress is on the releasing member, the releasing member can be fitted In non-invasively changing to second state from the first state, and from second state change to the first state. Therefore, if dislocation, hip joint can reset without surgical procedures.

At least one in the Part I and Part II includes at least two after medical treatment device is implanted patient Suitable for the part contacted with each other.

The Part I and/or Part II can be adapted to introduce by the hole in patient's basin bone.

According to one embodiment, introduced by the hole in patient's basin bone after hip joint at least two part, This at least two part is suitable to mutually mechanically fix.

Releasing member

According to one embodiment, the Part I of medical treatment device includes releasing member, and the Part I can be medical treatment Device includes the spherical part of releasing member.According to another embodiment, the Part II of medical treatment device includes releasing member, described Part II can be that medical treatment device includes the bowl-shaped portion of releasing member.

According to another embodiment, the releasing member includes elastic part, the elastic part and then can include elastic material Material.

According to another embodiment, the releasing member includes bendable portion and/or flexible portion and/or compressible portion. It is furthermore conceivable that, the releasing member includes moveable part or movable part.

In the embodiment that medical treatment device includes elastic part, the elastic part can include spring and/or elastic webbing, institute State elastic webbing and may be adapted at least partly about spherical part, and thus remain to spherical part in bowl-shaped portion.The bullet Property band can be further adapted for being placed between spherical part and bowl-shaped portion.

According to another embodiment, the releasing member includes magnet, and the magnet is suitable to Part I remaining to second Point.

According to another embodiment, the releasing member includes apparatus for breaking, and the broken portion is suitable to lose under predetermined stress Effect, for discharging Part I from Part II.The apparatus for breaking can include the zone of fracture, and the zone of fracture may be adapted at least Partially around spherical part.According to one embodiment, the zone of fracture can be positioned between spherical part and bowl-shaped portion, And rupture pin can be included.

The releasing member can include multiple holding elements, and multiple holding elements or a holding element may be adapted to The Part I is slided and/or is adapted to abut against against the Part I to roll.Holding element can include spherical holding member Part.

Part I

According to one embodiment, the Part I includes at least two and is suitable to mutually after medical treatment device is implanted patient The part of contact.

According to any embodiment, Part I may be adapted to introduce by the hole in patient's basin bone.

According to one embodiment, introduced by the hole in patient's basin bone after hip joint at least two part, One in this at least two part be suitable to be mechanically secured in this at least two part second.

Part I can include the ductile portion and/or bullet for being suitable to enable medical treatment device to insert by the hole in basin bone Property part.The elastic part enables the Part I to compress at least one direction.

Part I can include first area and second area, and the first area can be included suitable for flexible First material, and the second area includes being suitable to the second flexible material, and first material may be adapted to ratio Second material is more flexible.

Part II

According to one embodiment, the Part II includes at least two and is suitable to mutually after medical treatment device is implanted patient The part of contact.Part II may be adapted to introduce by the hole in patient's basin bone.

According to another embodiment, introduced by the hole in patient's basin bone after hip joint at least two part, One in this at least two part be suitable to be mechanically secured in this at least two part second.

According to another embodiment, medical treatment device at least includes the hip joint surface of three-dimensional bending, the hip of the three-dimensional bending Articular surface includes inner surface and outer surface.The inner surface includes six different points：First point, second point, thirdly, the 4th Point, the 5th point and the 6th point, all points are all located at the different places along the length axes of inner surface.From described first point to institute State the first straight line of second point parallel to from described thirdly to described 4th point of second straight line, the second straight line and then flat Row is in the 3rd straight line from described 5th point to described 6th point.In addition, to be shorter than described second straight for first straight line and the 3rd straight line Line, and the second straight line is positioned between the first straight line and the 3rd straight line.

Medical treatment device may further include calibrating element, change for adjusting the releasing member from the first state Predetermined stress to needed for the second state.The calibrating element can be calibration screw.

Normal Hip has neck of femur, and the neck of femur has the axial direction distribution for pointing to femoral head, the femoral head tool There is structure generally spherical in shape, the spherical structure has the maximum gauge generally perpendicular to central axis, and the central axis is institute State the central axis of the axially prolongation of distribution of neck of femur.The femoral head, which is placed in bowl-type acetabular bone, forms hip pass Section.The bowl-type acetabular bone has opening and the second axially distribution, and described second is axially distributed with the center from the bottom of acetabular bone bowl And along the centrally directed opening and the central axis of femoral head of bowl, wherein acetabular bone has generally perpendicular to acetabular bone second The maximum gauge for the central axis being axially distributed.When femoral head is in placed in the middle and symmetrical position in acetabular bone bowl, the axle Prolongation to the central axis of distribution is identical with the central shaft that described second is axially distributed.Medical treatment device includes two manually Hip joint surface, Part I includes artificial hip joint surface, and the artificial hip joint surface includes artificial femur head surface, when When being installed in joint, the artificial femur head surface is suitable to substitute the pass of femoral head at least in part on the opposite of femoral head Surface is saved, and suitable for being placed in acetabular bone bowl or its artificial substituent.Artificial femur head surface includes at least the one of the surface Individual first exceeds part, when being installed in its function digit in joint on the femoral head, this at least one the first surpass Go out part to be suitable to cover and/or enter in the bone of the femoral head at least a portion of the femoral head, beyond described The maximum gauge of femoral head, away from acetabular bone bowl towards the neck of femur.This at least one first be suitable to have beyond part To the nearest vertical range of the central axis, circumference and the center less than the maximum gauge of the artificial thigh bone The distance between axis, thus, when being arranged in the function digit on the femoral head, suitable for producing the artificial femur The more stable position of head surface.This at least includes a part for releasing member beyond part.

Normal Hip has neck of femur, and the neck of femur has the axial direction distribution for pointing to femoral head, the femoral head tool There is structure generally spherical in shape, the spherical structure has the maximum gauge generally perpendicular to central axis, and the central axis is institute State the central axis of the axially prolongation of distribution of neck of femur.The femoral head, which is placed in bowl-type acetabular bone, forms hip pass Section.The bowl-type acetabular bone has opening and the second axially distribution, and described second is axially distributed with the center from the bottom of acetabular bone bowl And along the centrally directed opening and the central axis of femoral head of bowl.Acetabular bone has generally perpendicular to acetabular bone second axially The maximum gauge of the central axis of distribution, when femoral head is in placed in the middle and symmetrical position in acetabular bone bowl, the axial direction point The prolongation of the central axis of cloth is identical with the central shaft that described second is axially distributed.Medical treatment device includes two artificials and closed Surface is saved, the artificial hip joint surface includes manual acetabulum surface, when being installed in hip joint, the manual acetabulum table Face is suitable to the articular surface for replacing acetabular bone at least in part, and suitable for being arranged on femoral head or its artificial substituent.The people Work acetabular bone surface include the surface at least one first exceed part, when being installed in femur in its function digit in joint When on head or its artificial sub, this at least one first be suitable to covering at least part femoral head or its artificial substituting beyond part Thing, beyond the maximum gauge of acetabular bone, away from acetabular bone bowl towards neck of femur.This at least one first be suitable to have beyond part To the nearest distance of the central shaft, less than the artificial thigh bone the maximum gauge circumference and the central axis it Between distance, therefore when being arranged in its function digit in joint on the femoral head, suitable for producing manual acetabulum surface More stable position.This first beyond part include releasing member.

According to any embodiment, to enable Part I to be discharged from Part II, the releasing member can include elasticity Part and/or bendable portion and/or flexible portion and/or compressible portion and/or moveable part and/or movable part Part.

The method for further providing the installation medical treatment device according to any embodiment, the method comprising the steps of：By outer Section's surgical procedure or arthroscope process exposure hip joint, are fixed to basin bone, by medical treatment device by the Part I of medical treatment device Part II is fixed to femur, Part I is connected into placement with Part II, and protect Part I using releasing member Hold Part II.

According to one embodiment, the step of Part I is remained into Part II includes, using flexible member by first Part remains to Part II.

According to one embodiment, the step of Part I is remained into Part II includes, using rupture elements by first Part remains to Part II.

According to one embodiment, the step of Part I is remained into Part II includes, using bearing spring load Part I is remained to Part II by element.

According to one embodiment, the step of Part I is remained into Part II includes, using elastic webbing by first Divide and remain to Part II.

According to one embodiment, the step of Part I is remained into Part II includes, using the zone of fracture by first Divide and remain to Part II.

Note that the part of any embodiment or embodiment herein or described in relevant drawings, feature, method, Related system, a part of of system can combine in any way.

Brief description of the drawings

Referring now to accompanying drawing, the present invention is described by way of example, wherein：

Fig. 1 shows the profile of hip joint,

The first step in Fig. 2 shows traditional operation on hip joint,

Fig. 3 show from capsula articularis coxae remove femoral head the step of,

Fig. 4 shows the otch formed in laparoscope/Arthroscopy Methods,

Fig. 5 shows the instrument used in laparoscope/Arthroscopy Methods,

The step of Fig. 6 shows the intercommunicating pore in patient's basin bone,

Fig. 7 shows the details of laparoscopic surgery,

The section of patient when Fig. 8 shows implementation laparoscopic surgery,

Fig. 9 shows hip joint section, and now medical treatment device has been provided as being in first state,

Figure 10 shows hip joint section, and now medical treatment device has been provided as being in the second state,

Figure 11 shows hip joint section, and now medical treatment device has been provided as being in first state,

Figure 12 shows hip joint section, and now medical treatment device has been provided as being in the second state,

Figure 13 shows the section of medical treatment device,

Figure 14 shows the optional embodiment of medical treatment device shown in Figure 11 in a first state,

Figure 15 shows the optional embodiment of medical treatment device shown in Figure 11 in the second state,

Figure 16 shows hip joint section, is now provided as being in first state according to the medical treatment device of another embodiment,

Figure 17 shows hip joint section, is now provided as being in the second state according to the medical treatment device of another embodiment,

Figure 18 a show hip joint section, and the medical treatment device now including elastic webbing or the zone of fracture has been provided as being in First state,

Figure 18 b show the section of the medical treatment device of Figure 18 a in first state,

Figure 19 a show hip joint section, and the medical treatment device now including elastic webbing or the zone of fracture is provided as being in second State,

Figure 19 b show the section of the medical treatment device of Figure 19 a in the second state,

Figure 20 shows hip joint section, has now been provided as being in the first shape according to the medical treatment device of another embodiment State,

Figure 21 shows hip joint section, has now been provided as being in the second shape according to the medical treatment device of another embodiment State,

Figure 22 shows hip joint section, and now the medical treatment device including the zone of fracture has been provided as being in first state,

Figure 23 shows hip joint section, and now the medical treatment device including the zone of fracture has been provided as being in the second state,

Figure 24 shows hip joint section, has now been provided as being in the first shape according to the medical treatment device of another embodiment State,

Figure 25 shows hip joint section, has now been provided as being in the second shape according to the medical treatment device of another embodiment State,

Figure 26 shows the profile of hip joint, has now been provided as being in first according to the medical treatment device of an embodiment State, in this embodiment, manual acetabulum surface include flexible member,

Figure 27 shows the profile of hip joint, has now been provided as being in second according to the medical treatment device of an embodiment State, in this embodiment, manual acetabulum surface include flexible member,

Figure 28 shows the optional embodiment of medical treatment device shown in Figure 26,

Figure 29 shows the profile of hip joint, now, suitable for being kept femoral head 5 or its artificial substituent by magnetic force Medical treatment device to manual acetabulum has been provided as being in first state,

Figure 30 shows the profile of hip joint, now, suitable for being kept femoral head 5 or its artificial substituent by magnetic force Medical treatment device to manual acetabulum has been provided as being in the second state,

Figure 31 diagrammatically illustrates manual acetabulum or artificial thigh bone,

Figure 32 shows manual acetabulum or artificial thigh bone with section,

Figure 33 shows the principle of selectable embodiment,

Figure 34 shows the principle of selectable embodiment,

Figure 35 shows the principle of selectable embodiment,

Figure 36 a show an embodiment of locking/releasing member,

Figure 36 b show the profile of the hip joint in an embodiment, and now locking/releasing member is locked in manual acetabulum Determine artificial thigh bone,

Figure 36 c show the profile of the hip joint in an embodiment, and now locking/releasing member is released from manual acetabulum Put artificial thigh bone,

Figure 36 d show another embodiment of locking/releasing member,

Figure 36 e show the profile of the hip joint in an embodiment, now according to the locking of Figure 36 d embodiment/release Put element and artificial thigh bone be locked to manual acetabulum,

Figure 36 f show the profile of the hip joint in an embodiment, now according to the locking of Figure 36 d embodiment/release Put element and artificial thigh bone discharged from manual acetabulum,

Figure 36 g show another embodiment of locking/releasing member,

Figure 36 h show another embodiment of locking/releasing member,

Figure 36 i show the profile of the hip joint when artificial hip joint is assembled,

Figure 36 j show the profile of the hip joint when artificial hip joint is assembled,

Figure 36 k show the profile of the hip joint when artificial hip joint has been assembled,

Figure 36 m show the profile of the hip joint when artificial hip joint is in release conditions.

Embodiment

Elasticity can be understood as the ability that material is deformed in a elastomeric manner.

Elastic deformation refers to when material deformation under stress (such as external force) effect, and it is original to recover its when going de-stress Shape.More flexible material can be understood as the material with lower modulus of elasticity.The modulus of elasticity of object is defined as In regime of elastic deformation, the slope of load-deformation curve.Modulus of elasticity is calculated by stress/strain and obtained, and wherein stress is to draw Serve deformation power divided by power area；And it is the rate of change as caused by stress to strain.

Rigidity can be understood as elastomer to the resistivity of the deformation caused by active force.

Feature hip motion can be understood as hip motion consistent with the proper motion of hip at least in part. Some occasions, the proper motion of hip joint may be somewhat prohibitive after operation on hip joint or changed, and this to carry Some differences of the feature hip motion of the hip joint of artificial surface and the feature hip motion of natural hip joint.

Implantable medical treatment device or the function digit of prosthese are that hip joint can carry out feature hip motion wherein Position.Final position can be understood as functional position of the medical treatment device without further changing position.

Biocompatible materials can be understood as the material with low-level immune response.Biocompatible materials is sometimes It is referred to as biomaterial.Similarly, biocompatibility metal is the biocompatibility metal with low immune response, such as titanium or Tantalum.Biocompatibility metal can also include the biocompatible alloy of at least one biocompatibility metal.

Pattern assembling (form fitting) can be understood as the element with part or section, wherein the part or area Section is adapted for carrying out the element and uses the part or the mechanical connection of section and at least one other element.The knot of pattern assembling Structure (form fitted structure) is that by the component structure of pattern assembling.

Polytetrafluoroethylene (PTFE) (PTFE) can be selected from including at least one according to the medical treatment device of any embodiment, fluoroalkyl is crossed The material for the group that compound (PFA) and fluorinated ethylene propylene (FEP) (FEP) are constituted.It is furthermore conceivable that, the material includes：Metal is closed Gold, such as cobalt-chromium-molybdenum or titanium or stainless steel；Or polyethylene, such as crosslinked polyethylene or gas depoisoning polyethylene.In contact In face or whole medical treatment device, the use of ceramic material it is also contemplated that, such as zirconium or zirconia ceramic or aluminum oxide pottery Porcelain.The part that medical treatment device contacts for medical treatment device to be fixed to skeleton with skeleton can include loose structure, The loose structure can be porous micron or nanostructured, suitable for promoting growth of the skeleton in medical treatment device, with The fixed medical treatment device.Loose structure can be by applying hydroxyapatite (HA) coating, or coarse intercommunicating pore titanium coating Realize, these coatings can be produced by air plasma spraying, include the combination of coarse intercommunicating pore titanium coating and HA top layers It is also what is be contemplated that.Contact portion can be made up of self-lubricating material, such as ceraceous polymer (such as PTFE, PFA, FEP, PE and UHMWPE), or be made up of the powdered metallurgical material that can incorporate lubricant, the lubricant is preferably bio-compatible Lubricant, such as derivatives of hyaluronic acids.It is equally conceivable, the material of contact portion or surfaces of medical devices is here It is adapted for continuously or intermittently lubricating.According to some embodiments, the part of medical treatment device or part can include metal material And/or the combination of carbon fiber and/or boron, the combination of metal and plastic material, combination, carbon and the plastics base of metal and carbon-based material The combination of material, combination, the combination of elastic and elastic less material, Corian (Corian) or third of flexible and rigid material Olefin(e) acid polymer.

The detailed description of embodiment will hereinafter be provided.In the accompanying drawings, same reference begins in various figures Identical or corresponding element is represented eventually.It should be understood that purpose that these figures are merely to illustrate and not limiting in any way The scope of the present invention processed.Therefore, any direction referred to, such as "above" or "below", only refer to the direction shown in figure.Equally, Any size shown in figure etc. contributes to the purpose of explanation.

Fig. 1 shows the profile of hip joint, and hip joint includes femoral head 5 or its artificial substituent, positioned at neck of femur 6 Top, the neck of femur 6 is the tip portion of femur 7.Femoral head 5 is connected with acetabular bone 8, and the acetabular bone 8 is the bowl-type of basin bone 9 Part.Both femoral head surfaces 10 and acetabular bone surface 11 are covered by articular cartilage 13, and the articular cartilage rises in hip joint To the effect of mat.In the patient with coxitis, this articular cartilage 13 is by inordinate wear caused by low grade inflammation. Hip joint is surrounded by capsula articularis coxae 12, and the capsula articularis coxae 12 provides for joint to be supported and prevent dislocation.In traditional hip joint Post operation, penetrates capsula articularis coxae 12, and capsule 12 is greatly weakened due to the limited healing ability of its ligament tissue.By implementing Will not destroy the operation on hip joint of capsula articularis coxae 12, patient can recover completely and can apply on joint prosthesis with can be The equivalent stress applied on natural joint.

Fig. 2 shows the side view of traditional operation on hip joint, and wherein otch 112 is formed in thigh 113, makes surgeon Femur 7 can be touched, femoral head 5 is located on the femur 7.Femur 7 is then removed from capsula articularis coxae 12, exposed to hand The femoral head 5 for being replaced or repairing during art.

Fig. 3 shows placement of the artificial femur head surface 45 on femoral head 5 in traditional operation.However, according to existing The other embodiments of technology, neck of femur 6 is cut off using bone saw, and the prosthetic component including femoral head uses bone water after this Mud is fixed in femur.Bowl-type cup is then positioned in acetabular bone 8, when hip joint is in its function digit progress feature hip motion When, play a part of the contact surface against new artificial thigh bone 45.According to prior art, artificial femur head surface and artificial Mortar surface is kept together by capsula articularis coxae, when capsule has been pierced during performing the operation, and the capsula articularis coxae 12 is by greatly Weaken.

A kind of optional mode performed the operation to hip joint will now be described.

Fig. 4 shows the front view of patient body.According to first embodiment, the abdominal cavity of hip joint is operated on acetabular bone opposite Since mirror/Arthroscopy Methods forming small otch 14 in patient's stomach wall.The small otch is enabled surgeons to abdominal cavity mirror sleeve Pipe pin inserts patients abdomen.According to first embodiment, otch 14 enters patient abdominal cavity through rectus aabdominis and peritonaeum.It is excellent according to second Embodiment is selected, small otch 15 is guided through rectus aabdominis and enters subabdominoperitoneal basin bone region.According to 3rd embodiment, small otch 16 just form between ilium and surrounding tissue, and otch 16 can enable basin bone with the very little of manadesma and musculature Penetrate and dissected.According to fourth embodiment, otch 17 is formed in groin.In four all embodiments, in acetabular bone 8 The tissue that basin bone 9 is surrounded in the region on opposite is removed or penetrated, and enables surgeons to touch basin bone 9.

It is obvious that the method for these descriptions all can be combined or changed, reach identical purpose to dissect acetabular bone opposite Basin bone.

After dissecting pan bone 9, hole 18 is formed in basin bone 9, as shown in Figure 6.Hole 18 passes through basin bone simultaneously from acetabular bone opposite Into hip joint 19.According to any one embodiment herein, medical treatment device may be adapted to insert by the hole 18 in basin bone 9.For This, medical treatment device can include the first and second parts, and first and second part is suitable to introduce by hole 9 and then former Position is installed and mechanically interfixed, for forming mounted medical treatment device.This will be further elucidated with reference to Figure 36 h and 36i.

Medical treatment device, or the first and second parts of medical treatment device may be adapted to introduce by the hole 18 in basin bone 9, basin bone Hole 18 in 9, which has, is less than 530mm²Cross-sectional area, or hole 18 in basin bone 9 has and is less than 380mm²Cross-sectional area, or Hole 18 in person's basin bone 9, which has, is less than 250mm²Cross-sectional area, or hole in basin bone has and is less than 180mm²Cross section Accumulate, or the hole 18 in basin bone 9 has less than 110mm²Cross-sectional area.Less hole forms the process of lighter wound, wherein Further, it is envisioned that medical treatment device needs to be installed by more than two part.In certain embodiments, medical treatment device is by multiple Install part suitable for being mechanically connected to substrate (base piece).

Fig. 5 shows the front view of patient body, illustrates the laparoscope side performed the operation from 8 pairs of acetabular bone in face of hip joint Method.Hip joint includes acetabular bone 8 and femoral head 5.Small otch 14 in patient's stomach wall allows laparoscopic trocar 33a, b, c to insert disease In human body.Then, described laparoscopic trocar 33a, b, c can be passed through, by one or more cameras 34, suitable in basin bone The surgical instrument 35 in hole is produced, or for introducing, placing, connect, be attached, produce or fill prosthese or the utensil of prosthetic component 36 insertion patient bodies.

Fig. 6 is shown using bone contact mechanism (bone contacting organ) 22 from the belly side of acetabular bone in basin bone 9 Middle formation hole 18.

Fig. 7 shows spy of the insert 37 of prosthetic component 38 by laparoscopic trocar 33a, b, c entrance in patient body Write.Prosthetic component can be part artificial thigh bone 45, manual acetabulum 65 or prosthetic component or bone material, suitable for close at The hole 18 cut out in basin bone 9.

Fig. 8 shows the side view of patient body, illustrated therein is the profile of hip joint.Hip joint includes femoral head 5, Positioned at the top of neck of femur 6, the neck of femur 6 is the tip portion of femur 7.Femoral head 5 is connected with acetabular bone 8, the acetabular bone 8 For the bowl-shaped portion of basin bone 9.With one or more cameras 34, suitable for the operating theater instruments 35 of intercommunicating pore in basin bone or use In introduce, placement, connection, create or filling prosthesis or prosthetic component apparatus 36 together, laparoscopic trocar 33a, b, c are made To touch hip joint 39.

Fig. 9 shows the artificial bowl-type acetabular cup 65 being placed in basin bone 9.The artificial bowl-type acetabular cup 65 includes release member Part 801, the releasing member 801 is suitable to keep as the femoral head 5 of spherical part, femoral head 5 to be connected to hip in first state Neck of femur 6 in joint and the artificial bowl-type acetabular cup 65 in basin bone 9.In the second state, releasing member 801 is suitable to Femoral head 5 or its artificial substituent are discharged from the artificial bowl-type acetabular cup 65 being placed in basin bone 9.When predetermined stress When on to releasing member 801, releasing member 801 is suitable to change to the second state from first state.The stress is preferably closed by hip The abnormal motion (for example patient falls down) of section is caused.According to the embodiment shown in Fig. 9, releasing member 801 includes elastic part, The elastic part includes elastomeric material, as shown in one embodiment, and the elastic part is whole releasing member 801. When in predetermined stress to releasing member 801, releasing member is suitable to that non-invasively second can be changed to from first state State, and from the second state change to first state.

Figure 10 shows the profile of the hip joint when releasing member 801 is in its second state, wherein releasing member 801 Suitable for discharging femoral head 5 or its artificial substituent from the artificial bowl-type acetabular cup 65 being placed in basin bone 9.Because predetermined should Power has been applied on releasing member 801, and releasing member 801 changes to the second state from first state.

Figure 11 shows the medical treatment device according to an embodiment, wherein artificial bowl-type acetabular cup 65 includes releasing member 801, The releasing member 801 includes being adapted to abut against holding element 802a, b that femoral head 5 or its artificial substituent slide.It is described to keep Element is suitable to keep femoral head 5 or its artificial substituent in first state, and femoral head 5 or its artificial substituent are spherical part, The neck of femur 6 in hip joint and the artificial bowl-type acetabular cup 65 in basin bone 9 are connected in position.In the second state In, releasing member 801 is suitable to from the artificial bowl-type acetabular cup 65 being placed in basin bone 9 discharge femoral head 5 or its artificial substituting Thing.Holding element 802a, b bears spring load by spring 803a, b, and described spring 803a, b are located at calibrating element (for calibration Screw 804a, b) between holding element 802a, b.The power in holding element 802a, b is applied to from spring 803a, b, is suitable to Femoral head 5 or its artificial substituent are maintained in manual acetabulum 65 in the motion of normal functioning hip joint, and when predetermined Stress (preferably being caused by the abnormal motion of hip joint, for example patient falls down) when being applied on releasing member, suitable for from people Femoral head 5 or its artificial substituent are discharged in work acetabular bone 65.Calibration screw 804a, b can realize predefining for stress, cause Holding element 802a, b changes to the second state from first state.

Figure 12 shows the releasing member in its second state, now exceed predetermined stress, this preferably by The abnormal motion (for example patient falls down) of hip joint causes..The sleeve pipe on holding element 802a, b retraction manual acetabulum surface 65 806, so that compression spring 803a, b.The retraction of holding element 802a, b causes femoral head 5 or its artificial substituent from it in people Position dislocation/dislocation in work acetabular bone surface 65, when in larger stress to hip joint and femur 7, this reduce patient Femur 7 or the risk of the fragmentation of basin bone 9.When in predetermined stress to holding element 802a, b, holding element 802a, b is fitted In the second state non-invasively can be changed to from first state, and from the second state change to first state.

Figure 13 shows the manual acetabulum 65 that holding element 802a, b is carried in section, and holding element 802a, b is located at In sleeve pipe 806 along the cross section of manual acetabulum 65 with distribution, femoral head 5 or its artificial substituent are protected in manual acetabulum 65 Hold in place.

Figure 14 shows the selectable embodiment of principle shown in Figure 11-13, and wherein holding element 802a, b includes ball Shape element 805a, b, described ball type device 805a, b are contacted with femoral head 5 or its artificial substituent, and are adapted to abut against femoral head 5 Or its artificial substituent rolls, by constraint component 802a, 802b by femoral head 5 or its artificial substitute in artificial acetabular bone 65 Constrain in correct position, constraint component 802a, 802b by the spring 803a that is supported with calibration screw 804a, 804b, 803b is contacted, and is applied force on femoral head 5 or its artificial substitute.

Figure 15 shows the releasing member in its second state, now exceeds predetermined stress, preferably by hip The abnormal motion (for example patient falls down) in joint causes.Holding element 802a, b including ball type device 805a, b is retracted into manually In the sleeve pipe 806 on acetabular bone surface 65, so that compression spring 803a, b.The retraction of holding element 802a, b cause femoral head 5 or its Artificial substituent's position dislocation/dislocation in manual acetabulum surface 65 from it, when larger stress to hip joint and femur 7 When upper, this reduce patient's femur 7 or the risk of the fragmentation of basin bone 9.When in predetermined stress to holding element 802a, b, Holding element 802a, b is suitable to that non-invasively the second state can be changed to from first state, and from the second state change to the first shape State, this causes femoral head 5 or its artificial substituent to be put back in manual acetabulum 65 without surgical procedures.

Figure 16 shows the medical treatment device in an embodiment, and releasing member 801 includes being suitable to rupturing under predetermined stress Apparatus for breaking 807,808,809.According to the embodiment, apparatus for breaking is rupture pin 807,808,809, including fixed to artificial Base portion 809a, b of acetabular bone 65 and rupture portion 807a, b that base portion 809a, b are attached to by weakenings 808a, b, should when predetermined When power is applied on the apparatus for breaking contacted with femoral head 5 or its artificial substituent, the rupture portion in weakenings 808a, b 807a, b are separated with base portion 809a, b.

Figure 17 shows the medical treatment device of the embodiment according to Figure 16, and now apparatus for breaking is due on apparatus for breaking Stress fails beyond predetermined stress.According to one embodiment (not shown), rupture portion 807a, b are fixed to by safety line Base portion, the safety line will rupture portion 807a, b and be maintained near base portion 809a, b after apparatus for breaking failure.

Figure 18 a show the medical treatment device according to an embodiment, and wherein manual acetabulum 65 includes circular casing 806, in institute State and elastic webbing or the zone of fracture 810 are provided with sleeve pipe 806.Elastic webbing or the zone of fracture 810 are suitable at least partly about spherical stock Bone 5 or its artificial substituent.When in predetermined stress to elastic webbing or the zone of fracture 810, around femoral head 5 or its people The circular open expansion of work substitute, and discharge from manual acetabulum 65 femoral head 5 or its artificial substituent (femoral head 5 or Its artificial substituent is kept to manual acetabulum 65 by elastic webbing 810).In the embodiment that medical treatment device includes the zone of fracture 810 (femoral head 5 or its artificial substituent are maintained in manual acetabulum 65 by the zone of fracture 810), the weakenings failure of band 810, and because This circular femoral head 5 or the expansion of the circular open of its artificial substituent, and release femoral head 5 or its people from manual acetabulum 65 Work substitute.In band 810 in the embodiment of elastic webbing 810, it is contemplated that band 810 includes elastic part or section, or The whole elastic webbing 810 of person is made up of elastomeric material.

Figure 18 b show the profile of medical treatment device, now keep femoral head 5 or the elastic webbing or broken of its artificial substituent Split in the circular casing 806 that band 810 is positioned in manual acetabulum 65.Opening or weakenings 811 are set perpendicular to the circumference of band 810 Put.

Figure 19 a show the medical treatment device in the second state, wherein being applied to elastic webbing or broken in predetermined stress After splitting on band 810, femoral head 5 or its artificial substituent discharge from the connection with acetabular bone.As shown in fig. 19b, gap or weak Change portion is stretched, so as to allow femoral head or its artificial substituent 5 to pass through the opening limited by elastic webbing or the zone of fracture 810. When predetermined stress is to band 810, medical treatment device may be adapted to that non-invasively the second state can be changed to from first state, And from the second state change to first state, this makes femoral head 5 or its artificial substituent to be put back to without surgical procedures In manual acetabulum 65.

Figure 20 shows the medical treatment device according to an embodiment, and wherein releasing member 801 is included by elastic webbing or the zone of fracture The resilient wing of the manual acetabulums 65 of 810 auxiliary, by having in manual acetabulum 65 crossing femoral head 5 or its artificial substituent Femoral head 5 or its artificial substituent are surrounded at the point of maximum cross section distance, the elastic webbing or the zone of fracture 810 are around the doctor Treat device.By the band 810 disposed in the groove of the circumference along manual acetabulum 65, elastic webbing or the zone of fracture 810 are on artificial Mortar 65 is kept in place.However, the groove can be aided in or substituted by adhesive or fixed mechanical component.

Figure 21 shows the medical treatment device in its second state, and releasing member 801 is from manual acetabulum 65 in a state Middle release femoral head 5 or its artificial substituent.In band 810 in the embodiment of elastic webbing 810, it is expanded to increase femur First 5 or the hole that can pass through of its artificial substituent.In band 810 in the embodiment of the zone of fracture 810, band 810 has failed, and stock Bone 5 or its artificial substituent are only released element 801 and kept in place, and the releasing member 801 is suitable under predetermined stress Discharge femoral head 5 or its artificial substituent.When in predetermined stress to band 810 and/or releasing member 801, medical treatment dress Put suitable for the second state non-invasively can be changed to from first state, and from the second state change to first state, this causes stock Bone 5 or its artificial substituent can be put back in manual acetabulum 65 without surgical procedures.

Figure 22 shows the hip joint profile according to an embodiment, wherein femoral head 5 or its artificial substituent and femur Neck 6 is replaced by prosthetic component 818, and the prosthetic component 818 is used or Cementless is fixed to femur 7.Prosthetic component 818 Including the artificial thigh bone 812 with cavity 816, the zone of fracture 813 is fixed to artificial thigh bone 812 in the cavity 816 Fixed part 814 and manual acetabulum 65 fixed part 815.Cavity 816 is suitable to make artificial thigh bone 812 in manual acetabulum Normal feature hip motion can be carried out in 65.The zone of fracture 813 is suitable in a first state keep artificial thigh bone 812 Artificial thigh bone is discharged from manual acetabulum to manual acetabulum 65, and when predetermined stress is on the zone of fracture 813 812。

Figure 23 has shown the embodiment of the medical treatment device in the second state according to Figure 22, the wherein zone of fracture 813 Fail and therefore discharge artificial thigh bone 812 from manual acetabulum 65.Use：At least one screw, at least one pin, pattern Assembling, welding, adhesive, pin, line, the ball being installed in bowl, part being installed in the concave portions of other parts Male portion, insertion lock turn into part thereof of key, band or other machinery connector part, and the zone of fracture 813 can be fixed to The fixed part 814 of artificial thigh bone 812 and/or the fixed part 815 of manual acetabulum 65.The failure of the zone of fracture 813 is preferably By the abnormal motion of hip joint, such as patient falls down caused.

Figure 24 shows the prosthetic component 818 according to an embodiment, wherein prosthetic component 818 be fixed to femur 7 and Including femoral head 812, the femoral head 812 includes the cavity 816 for being suitable to enable hip joint to carry out functioning hip joint motion, In a first state, using elastic webbing 817, (elastic webbing is fixed to the He of fixed part 814 of artificial thigh bone 812 simultaneously The fixed part 815 of manual acetabulum 65) and according to Fig. 9 and the releasing member of embodiment illustrated in fig. 10 801, by the prosthese portion Part 818 is remained in manual acetabulum 65.The combination of releasing member 801 and elastic webbing 817 is suitable in a first state by prosthese portion Part 818 remains to manual acetabulum 65, and discharges prosthetic component 818 from manual acetabulum 65 in the second state.According to another Embodiment (not shown), (is also supported) by the remainder and impacted muscle of capsula articularis coxae certainly merely with elastic webbing 817 Prosthetic component is remained into manual acetabulum 65.

Figure 25 shows the embodiment of the medical treatment device in the second state according to Figure 24, and wherein elastic webbing 817 is drawn Stretch, to discharge prosthetic component 818 from manual acetabulum 65.Use：At least one screw, at least one pin, pattern assembling, weldering Connect, adhesive, pin, line, the ball being installed in bowl, the male portion for a part being installed in the concave portions of other parts Divide, insertion lock turns into part thereof of key, band or other machinery connector, elastic webbing 817 can be fixed to artificial thigh bone 812 fixed part 814 and/or the fixed part 815 of manual acetabulum 65.The failure of the zone of fracture 813 is preferably by hip joint Caused by abnormal motion, such as patient are fallen down.Preferably, elastic webbing 817 include elastic part or section, the elastic part or Section can be whole elastic webbing 817, be made up of elastomeric material, such as elastic polymer material, such as：Copolymer material (ratio Such as polystyrene), ethylene butene polymer or polystyrene.Also, it is contemplated that the material is polyurethane elastomeric materials, polyamides Amine elastomeric material and polyester elastic materials, ethene and at least one vinyl monomer (such as, vinylacetate, unsaturated fat The esters of mono carboxylic sour and this mono carboxylic acid) elastocopolymer.Elastic webbing 813 can include what can not be penetrated by body cell Protective coating.Preferably, protective coating includes Parylene^TMCoating or biocompatibility metal coating, such as gold, silver or titanium. According to other embodiments, elastic webbing includes the combination of spring-like member, the combination of metal and plastic material, metal and carbon-based material Or the combination of carbon and plastic-based materials.

Figure 26 shows the profile of hip joint in an embodiment, and its medical device includes being adapted for secure to femur 7 Prosthetic component 819.Prosthetic component includes artificial thigh bone, and the artificial thigh bone is suitable to include the elasticity member as releasing member Part 820, femur is fixed to by the artificial thigh bone of the inner side of manual acetabulum 65.The flexible member 820 of artificial thigh bone preferably by Elastomeric material is made, and the elastomeric material for example can be elastic polymer material or elastic metallic material.It is envisioned that The elastomeric material includes the outer layer being connected with manual acetabulum 65, contacts produced abrasion with manual acetabulum surface suitable for resistance. When predetermined stress is on hip joint and therefore acts on flexible member 820, the flexible member 820 is suitable to be pressed Contracting.When flexible member 820 is compressed, artificial thigh bone is discharged from manual acetabulum 65.

Figure 27 shows the medical treatment device in the second state according to embodiment illustrated in fig. 26, wherein as predetermined should Power is acted on medical treatment device, and flexible member 820 is compressed.Therefore medical treatment device is in the second state, wherein artificial stock Bone is released from the manual acetabulum 65 kept.

Figure 28 shows an embodiment of medical treatment device, wherein the spring 821 being connected with two flexible members 820 is further Auxiliary elastic element 820, when predetermined stress is on the prosthetic component 819 including artificial thigh bone, spring 821 and bullet Property element 820 compresses side by side.

Figure 29 a show the profile of hip joint, when in a first state, medical treatment device is used for femoral head 5 or its people Work substitute remains to manual acetabulum 65, and in the second state, for discharging femoral head 5 from manual acetabulum 65 or it is manually replaced For thing.Medical treatment device is suitable to change in the second state from first state under predetermined stress, passes through medical treatment device Connection influence medical treatment device between basin bone 9 and femur 7, this reduce the femur 7 of patient and/or the risk of the fragmentation of basin bone 9. Medical treatment device includes：Magnet 823 or magnetic material 823 in manual acetabulum 65 are placed in, and is placed in femoral head 5 or its people Magnet 822 or magnetic material 822 in work substitute.According to one embodiment, magnet 823 is positioned in manual acetabulum, its Femoral head 5 or its artificial substituent are pointed in the South Pole, and magnet 822 is positioned in femoral head 5 or its artificial substituent, its north Point to manual acetabulum 65 in pole.But it will be readily appreciated by those skilled in the art that only side needs to be magnetic and opposite side Magnetic material only need to be included.Therefore south poles and any combination of magnet/magnetic material are also conceivable to.Described magnetic Power is suitable to during normal use remain to femoral head 5 or its artificial substituent in manual acetabulum 65, hip joint is carried out Functioning hip joint is moved, and discharges femoral head 5 or its artificial substituent from manual acetabulum 65 when beyond predetermined stress.

Figure 29 b show the medical treatment device according to Figure 29 a embodiment in the second state, wherein femoral head 5 or its people Work substitute beyond predetermined stress level from manual acetabulum 65 due to being released.

Figure 30 a show the medical treatment device according to another embodiment in a first state, and its medical device includes solid It is scheduled on the prosthetic component 818 in femur 7.Prosthetic component 818 is separable along the defiber 860 being arranged in femur neck region 's.The proximal part of prosthetic component is placed in manual acetabulum 65 and linked closely wherein, so as to realize that prosthetic component 818 arrives basin bone 9 Stable fixation.Because prosthetic component is separable, prosthetic component includes two parts 861 and 862, wherein first component 861 are suitable to be placed in manual acetabulum 65, and second component 862 is adapted for secure in basin bone 9.First component 861 and second Part 862 is connected with each other by safety pin 863, and the safety pin 863 is placed in the hole of prosthetic component 818.Safety pin 863 is at this In be releasing member, be attached to second component 862 suitable in a first state remaining the first component 861, and be suitable to It is broken in the second state, first component 861 is discharged from second component 862.When predetermined stress is in releasing member When upper, safety pin 863 is suitable to be broken and therefore changes to the second state from first state.

Figure 30 b show the medical treatment device of the embodiment in Figure 30 a, and now therefore safety pin 863 has failed and The second state is changed to from first state, first component 861 is discharged from second component 862.

Figure 30 c and 30d show the replacement process of the safety pin 863 of failure, by remove failure safety pin 863 it is disconnected Piece (shown in Figure 30 c) is simultaneously replaced (shown in Figure 30 d) with new safety pin 863.Defiber 860 be located at femur neck region and Neither in the region fixed with femur 5 nor in the region fixed with basin bone 9, this enable prosthetic component 818 keep its Fixation in femur 5 and basin bone 9, while when the active force beyond predetermined value is exceeded, first is discharged from second component 862 Part 861, so that prosthetic hip can dislocate in the case where not damaging fixation.

Figure 31 diagrammatically illustrates how manual acetabulum surmounts femoral head 5 or the maximum gauge of its artificial substituent.I.e., most The cross-sectional distance of big opening 52 is less than femoral head 5 or the maximum cross section distance of its artificial substituent.

Figure 32 a show the medical treatment device according to an embodiment, and wherein Part II includes：Inner surface 906 and outer surface 907.Inner surface 906 includes：First point 908a, thirdly second point 909a, 908b, the 4th point 909b, the 5th point 908c and Six point 909c, all points are all located at the different places along the length axes of inner surface.First straight line 910a is from the first point 908a To second point 909a, and parallel to from thirdly 908b to the 4th point 909b second straight line 910b, the second straight line 910b and then parallel to from the 5th point 908c to the 6th point 909c the 3rd straight line 910c.First straight line 910a and the 3rd straight line 910c is shorter than second straight line 910b, and second straight line is located between first straight line and the 3rd straight line.

Figure 32 c show the medical treatment device according to an embodiment, and wherein releasing member 801 is included by elastic webbing or the zone of fracture The resilient wing of the medical treatment device of 810 auxiliary, by crossing femoral head 5 or its artificial substituent with most in manual acetabulum 65 Femoral head 5 or its artificial substituent are surrounded at the point of big cross-sectional distance, the elastic webbing or the zone of fracture 810 are around the medical treatment Device.By the band 810 disposed in the groove along the circumference of medical treatment device, elastic webbing or the zone of fracture 810 are protected on medical treatment device Hold in place.However, the groove can be aided in or substituted by adhesive or fixed mechanical component.

Figure 32 d show medical treatment device during in its second state, and wherein releasing member 801 discharges from medical treatment device Femoral head 5 or its artificial substituent.In band 810 in the embodiment of elastic webbing 810, band 810 is expanded to increase femoral head 5 Or the hole that its artificial substituent can pass through.In band 810 in the embodiment of the zone of fracture 810, band 810 fails and so that stock Bone 5 or its artificial substituent are only released element 801 and kept in place, and the releasing member 801 is a part for expansion regions, is fitted In release femoral head 5 or its artificial substituent under predetermined stress.When predetermined stress to band 810 and/or release member When on part 801, medical treatment device is suitable to that non-invasively the second state can be changed to from first state, and from the second state change to the One state, this causes femoral head 5 or its artificial substituent to be put back to without surgical procedures in medical treatment device.

Not be the same as Example

The common form of not be the same as Example is described now, the scope of be the same as Example is not limited to the specific version This, antithesis, above-mentioned all embodiments can be with different embodiments.

Figure 33 shows the section of the hip joint when artificial femur head surface 112 is fixed to the femoral head of operation transformation Figure, the femoral head of the operation transformation includes the concavity manual acetabulum surface 110 being arranged in the femoral head of operation transformation.According to Embodiment shown in Figure 33, long element 206 is used as guide rod, is guided in hip joint and makes manual acetabulum surface and artificial femur Head surface is placed in the middle.Convex hip joint surface 112 is fixed by releasing member 801, and the releasing member 801 is suitable to protect in first state Artificial thigh bone is held, and artificial thigh bone is discharged in the second state, and is changed when beyond predetermined stress from first state To the second state.Releasing member is fixed to the femoral head of operation transformation using bolt 121.The surface 117 of locking member and concavity Hip joint surface 117 be arranged to be connected with convex hip joint surface and can by friction cut down material (such as PTFE or from Lubrication pulverulent material) it is made.But be equally conceivable, connection surface is lubricated using implantable lubricating system, described Lubricating system is suitable to lubricate the medical treatment device after medical treatment device has been implanted patient, and this is all in all above-described embodiments It is contemplated that solution.According to shown embodiment, long element 206 is inserted into by femur, but is not shown according to other The embodiment gone out, long element is positioned in hip joint from acetabular bone side.

Figure 34 shows the placement of its part 118, and its part 118 is suitable to occupy the hole formed in basin bone 9 18.Its part 118 includes support member 119, and the support member 119 is suitable to contact with basin bone 9, and helps to undertake due to human body Weight and be applied to the load on medical treatment device.In addition Figure 34 shows the fixation of nut 120 and connecting rod 113, the connecting rod 113 and then guided by the long element 206 as guide rod.

Figure 35 shows the hip joint when all elements of medical treatment device are fixed in hip joint or its peripheral region Profile.Its part 118 suitable for occupying the hole 18 in basin bone 9 is fixed with bolt 121 herein, but can be by bonding Agent is aided in or replaces these bolts 121, and described adhesive can be applied on the surface S between its part and basin bone 9.It is used as The long element 206 of guide rod is extracted out by the otch in thigh.

The elastic or flexible part of any embodiment, fragment or part can include elastic polymer material ratio herein Such as：Copolymer material (such as polystyrene), ethylene-butylene polymer or polystyrene.Also, it is contemplated that the material is poly- Urethane elastomeric material, polyamide elastane material and polyester elastic materials, ethene and at least one vinyl monomer (such as, acetic acid The esters of vinyl acetate, unsaturated fat mono carboxylic sour and this mono carboxylic acid) elastocopolymer.Elastic webbing 813 can include The protective coating that can not be penetrated by body cell.Preferably, protective coating includes Parylene^TMCoating or biocompatibility metal are applied Layer, such as gold, silver or titanium.According to other embodiments, elastic webbing includes spring-like member, the combining of metal and plastic material, gold The combination or the combination of carbon and plastic-based materials of category and carbon-based material.

According to any embodiment, manual acetabulum can include one or more parts, use：At least one screw, at least One pin, suitably incorporate miscellaneous part at least one part at least a portion, the part for being adapted to slide into other parts, pattern Matching, welding, adhesive, pin, line, be installed in bowl turn into part thereof of ball, be installed in the concave portions of miscellaneous part A part male portion, insertion lock turn into part thereof of key, band or other machinery connector, it is one or many Individual part can be fixed to basin bone.

Figure 36 a show a kind of embodiment of locking/releasing member 116, and wherein locking/releasing member 116 includes surface 1353, the surface 1353 is suitable to contact with as the artificial convex hip joint surface (112 in Figure 36 b) of Part I, and And against hip joint surface slide, locking member 116 in a first state, suitable for artificial thigh bone is locked into manual acetabulum table Face (1340 in Figure 36 b), and in the second state, the artificial thigh bone 112 is discharged from the manual acetabulum 1340.When pre- When quantitative stress is to locking/releasing member 116, locking/releasing member 116 is suitable to change to the second shape from first state State.According to the embodiment shown in Figure 28 b, locking/releasing member 116 includes four holding elements, is elastic part herein 1351, and/elasticity of the releasing member 116 suitable for utilizing elastic part 1351 is locked, change to the second state from first state. Locking/releasing member 116 is adapted in use to be bolted to femur 7, and the bolt is suitable to be placed in the hole 1352 suitable with it. According to another embodiment (not shown), holding element 1351 is adapted to abut against as artificial convex hip joint surface including at least one The holding element that 112 Part I is rolled.

Figure 36 b show the profile of hip joint in one embodiment, now bifurcation (two state) locking/release member Artificial thigh bone 112 is locked in manual acetabulum 1340 by part 116.Bifurcation locking/releasing member 116 is fixed to using screw 121 Femur 7, and be here illustrated as being in its first state, in a state, locking/releasing member 116 is by artificial thigh bone 112 It is locked to manual acetabulum 1340.

Figure 36 c show the profile of the hip joint of the embodiment according to Figure 36 b, but now bifurcation locking/releasing member 116 are in its second state, and in second state, bifurcation locking/releasing member 116 discharges manually from manual acetabulum 1340 Femoral head 112.Structure with locking/releasing member 116 reduce stress damaged on joint prosthesis fixing point (i.e. with The contact of bone) risk；It further enables joint prosthesis realize noninvasive reset in the case of dislocation.

Figure 36 d show the selectable embodiment of bifurcation locking/releasing member 116, wherein bifurcation locking/releasing member 116 further comprise elastic webbing 1361, and the elastic webbing 1361 is suitable to after the implantation around artificial thigh bone 112.Elastic webbing 1361 can be elastomeric polymer band, such as polyurethane or silicone rubber belt.

Figure 36 e show the profile of hip joint, and now bifurcation locking/releasing member 116 has been implanted and has been in Its first state.Bifurcation locking/releasing member 116 is fixed to femur 7 using screw 121.

Figure 36 f show implantable device, including bifurcation locking/releasing member 116 in its second state, i.e., In a state, locking/releasing member 116 is suitable to discharge artificial femur by the elastic webbing 1361 around artificial thigh bone 112 First 112, the elastic webbing 1361 is stretched so that artificial thigh bone 112 can be exited from manual acetabulum 1340.With locking/release The structure for putting element 116 reduces the risk that stress damages fixing point (contact i.e. with bone) on joint prosthesis；Its Joint prosthesis is further set to realize noninvasive reset in the case of dislocation.

Locking/releasing member 116 with reference to shown in Figure 36 a-36f is described in having eurypyloue embodiment, described Macropore is located in basin bone 9, is occupied by its part 118, but also, it is contemplated that bifurcation is locked/releasing member 116 is used in Have in foraminate embodiment, the aperture is located in basin bone 9, for the operation of smaller wound, it is furthermore conceivable that, medical treatment dress All disclosed embodiments put can penetrate capsula articularis coxae during traditional open hip surgery and be pacified Dress.In this case, bifurcation locking/releasing member 116 can be complete prosthese (prosthese such as with reference to disclosed in Figure 22-28) A part.

Figure 36 g show an embodiment of locking/releasing member 116, and wherein locking/releasing member 116 includes spring 1371, the spring 1371 produces the elastic force needed for changing to the second state from first state, for from manual acetabulum 1340 Discharge artificial thigh bone 112.When predetermined stress is on locking/releasing member 116, locking/releasing member 116 is suitable to The second state is changed to from first state.Embodiment according to Figure 36 g, medical treatment device further comprises being placed as and spring The calibration screw 1372 of 1371 connections, second is changed to for adjusting elastic force and then adjusting locking/releasing member from first state The size of stress needed for state.

Figure 36 h show an embodiment of locking/releasing member, and wherein locking/releasing member 116 includes four rupture pins 1373, the rupture pin 1373 is suitable in predetermined stress fracture, to allow locking/releasing member 116 to change from first state To the second state.According to the embodiment, the pin is prepared by the fragile material that can be adapted to especial patient.In other embodiments (not shown), rupture pin 1373 could alternatively be similar to elastic webbing, but be adapted for the zone of fracture failed under predetermined stress, or The zone of fracture (zone of fracture such as with reference to disclosed in Figure 23) that person is centrally located.

Figure 36 i show the profile of hip joint, including two parts 1375a and 1375b artificial thigh bone 1375a, b are adapted to mutually connect to form the artificial thigh bone of interconnection.It is each in the Liang Ge people Ministry of worker point 1375a, 1375b It is individual, further comprise being adapted for secure to fixed part 1374a, 1374b inside acetabular bone 8.Artificial thigh bone is after interconnection Suitable for being positioned in the artificial concavity acetabular bone 1340 of the near-end of femur 7, closed for forming feature hip in different embodiments Section.

Figure 36 j show the profile of hip joint, and the artificial thigh bone 1375 being now connected with each other has been positioned in acetabular bone 8 In, and fixed using fixed part 1374.Locking/releasing member 116 is placed in artificial femur using spring 1371 On first 1375, the spring 1371, which is produced, can dispose the elastic force needed for artificial thigh bone 1375, so that locking/releasing member is tight Detain artificial thigh bone 1375.

Figure 36 k show the profile of hip joint, and now bifurcation locking/releasing member 116 is by the artificial stock of interconnection Bone 1375 is locked in manual acetabulum 1340.Bifurcation locking/releasing member 116 is fixed to femoral head 7 using screw 121, and It is shown in which as in its first state, artificial thigh bone 112 is locked to manual acetabulum by wherein locking/releasing member 116 1340。

Figure 36 m show the hip joint profile according to Figure 36 k embodiment, but now bifurcation locking/releasing member 116 are in its second state, in a state, produce required elastic force by spring 1371, and locking/releasing member 116 is from people Artificial thigh bone 112 is discharged in work acetabular bone 1340.Structure with locking/releasing member 116 reduces stress artificial The risk of fixing point (contact i.e. with bone) is damaged on joint；It further enables joint prosthesis real in the case of dislocation Existing noninvasive reset.

It note that any embodiment or the part and any means of embodiment or a part of of method can be with any Mode is combined.Here all examples should be considered as a part for general description, and therefore can summarize in any way Ground is combined.

Claims

1. a kind of medical treatment device for being used to be implanted into patient's hip joint, the medical treatment device includes：

A. Part I, wherein

I. the Part I is adapted for secure to femur, and

Ii. the Part I includes a convex contact face, and the convex contact face is suitable to partly be placed in concavity contact In face,

B. Part II, wherein

I. the Part II is adapted for secure to basin bone, and

Ii. the Part II includes a concavity contact surface, and the concavity contact surface is suitable to partly surround described after the implantation The convex contact face of Part I, and

C. releasing member, the releasing member is suitable to, remains the Part I be attached to described in a first state Two parts, and the Part I is discharged from the Part II in the second state, and wherein answer masterpiece when predetermined During with the releasing member, the releasing member is suitable to change to second state, and wherein institute from first state Stating Part I includes the releasing member.

2. medical treatment device according to claim 1, wherein the convex contact face of the Part I is at least part Spherical.

3. medical treatment device according to claim 2, wherein the concavity contact surface of the Part II is at least part Spherical.

4. medical treatment device according to claim 1, wherein the Part I includes spherical part, and the Part II Including bowl-shaped portion, and wherein described spherical part is suitable to be placed in the bowl-shaped portion to replace functioning hip joint.

5. medical treatment device according to claim 4, wherein the spherical part is adapted in use to the releasing member to be fixed on In the bowl-shaped portion.

6. the medical treatment device described in any one in claim 1-5, wherein when predetermined stress is released described When putting on element, the releasing member is suitable to non-invasively change to second state from the first state, and from described the Two-state changes to the first state.

7. medical treatment device according to claim 6, wherein at least one in the Part I and the Part II Including at least two the part after medical treatment device is implanted patient suitable for contacting with each other.

8. medical treatment device according to claim 7, wherein the Part I or the Part II are suitable to pass through patient Hole in basin bone is introduced.

9. medical treatment device according to claim 8, wherein introduced in the hole in by patient's basin bone after hip joint, it is described One in Part I and the Part II is suitable to mutually mechanically fix.

10. medical treatment device according to claim 9, wherein the releasing member includes elastic part.

11. medical treatment device according to claim 10, wherein the elastic part includes elastomeric material.

12. medical treatment device according to claim 10, wherein the elastic part includes spring.

13. the medical treatment device described in any one in claim 1-5, wherein the medical treatment device includes calibration member Part, for adjusting the predetermined stress needed for the releasing member changes to second state from the first state.

14. medical treatment device according to claim 13, wherein the calibrating element is calibration screw.