CN105935320A - Local issue structure customized reconstruction mechanism after malignant tumor around pelvis is resected - Google Patents

Local issue structure customized reconstruction mechanism after malignant tumor around pelvis is resected Download PDF

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Publication number
CN105935320A
CN105935320A CN201610276592.9A CN201610276592A CN105935320A CN 105935320 A CN105935320 A CN 105935320A CN 201610276592 A CN201610276592 A CN 201610276592A CN 105935320 A CN105935320 A CN 105935320A
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China
Prior art keywords
metal prostheses
reconstruction mechanism
pelvis
local issue
customized
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CN201610276592.9A
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Chinese (zh)
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CN105935320B (en
Inventor
李浩淼
侯昌禾
雷紫雄
陆明
戴双武
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Third Affiliated Hospital Of Southern Medical University
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Third Affiliated Hospital Of Southern Medical University
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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/28—Bones
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/0077—Special surfaces of prostheses, e.g. for improving ingrowth
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B33—ADDITIVE MANUFACTURING TECHNOLOGY
    • B33Y—ADDITIVE MANUFACTURING, i.e. MANUFACTURING OF THREE-DIMENSIONAL [3-D] OBJECTS BY ADDITIVE DEPOSITION, ADDITIVE AGGLOMERATION OR ADDITIVE LAYERING, e.g. BY 3-D PRINTING, STEREOLITHOGRAPHY OR SELECTIVE LASER SINTERING
    • B33Y30/00—Apparatus for additive manufacturing; Details thereof or accessories therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/0077—Special surfaces of prostheses, e.g. for improving ingrowth
    • A61F2002/0081—Special surfaces of prostheses, e.g. for improving ingrowth directly machined on the prosthetic surface, e.g. holes, grooves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0008—Fixation appliances for connecting prostheses to the body
    • A61F2220/0016—Fixation appliances for connecting prostheses to the body with sharp anchoring protrusions, e.g. barbs, pins, spikes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00011—Metals or alloys
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00011—Metals or alloys
    • A61F2310/00023—Titanium or titanium-based alloys, e.g. Ti-Ni alloys

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Materials Engineering (AREA)
  • Chemical & Material Sciences (AREA)
  • Manufacturing & Machinery (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Prostheses (AREA)

Abstract

The present invention relates to the medical technology field, and more specifically relates to a local issue structure customized reconstruction mechanism after a malignant tumor around a pelvis is resected. The local issue structure customized reconstruction mechanism after the malignant tumor around the pelvis is resected comprises a metal prosthesis in contact with cross section bones, the metal prosthesis is provided with screw holes, and the metal prosthesis is provided with universal clamping grooves. The local issue structure customized reconstruction mechanism also comprises a fixing structure, the fixing structure fixes the metal prosthesis and the cross section bones through the screw holes, or the fixing structure is connected with the metal prosthesis through the universal clamping grooves. Based on a resection scope planned before patient operation, the local issue structure customized reconstruction mechanism is customized, designed and manufactured. The local issue structure customized reconstruction mechanism accords with a press-fit principle, the prosthesis-bone interface position is covered with a porous structure, biological fixation is mainly adopted, and screw fixation is supplemented.

Description

Local tissue structures personalization after the excision of pelvis Malignant Tumors Around reconstructs the internal structure of an organization
Technical field
The present invention relates to the technical field of medical treatment, the local tissue structures personalization after excising more particularly, to pelvis Malignant Tumors Around reconstructs the internal structure of an organization.
Background technology
Normal person's body weight is passed down to rumpbone by lumbar vertebra, rumpbone be delivered to ilium through sacroiliac joint to both sides, is then delivered to left and right sides femur through left and right sides hip joint respectively through left and right ilium.
After the excision completing pelvis Malignant Tumors Around primary tumor, often with substantial amounts of organizational structure defect, including rumpbone, ilium, acetabular bone, the isostructural destruction of femur.If do not carried out surgical repair reconstruction, the postoperative certainty defect with bone support function and the forfeiture of motor function.Good reconstruction can significantly improve patient's postoperative life quality and work capacity.For the motor system tumor of extremity, having polytype tumorous type prosthese for reconstruction operations, these prostheses mainly use modularized design.
For the tumor of the tumor of axial bone, especially pelvic area, its topography and biomechanical conditions are complicated, rebuild structure and recover the operating difficulty height of function.Utopian reconstruction is to promote lumbar vertebra, rumpbone and transiliac fusion.For having excised the case of sacroiliac, current alternative method for reconstructing is fixed the remaining lumbar vertebra rumpbone of reconstruction and is connected with transiliac in having employing metal, and gives bone-graft fusion.Result shows, traditional interior fixing technology of bone-graft fusion that adds is for recovering sacroiliac joint stability, and its postoperative function recovers and complication rate is even not as good as the matched group without rebuilding.
On the other hand, abandoning the thinking of bone-graft fusion, scientist finds that the prosthetic designs of personalization can effectively promote prosthese survival rate.The metal prostheses made based on preoperative CT and cad technique, fixes with many screws.This customized prosthese shows survival rate the most in early days, within 3 years after surgery, still has 69% can be continuing with.Therefore, satisfied structural remodeling can be reached according to the personalized prosthese that the excision extension of preoperative plan is customized and recover early function.But for the prosthese survival rate of middle and advanced stage, simple interior Fixed Design cannot obtain steadily in the long term.
Long-time stability and prosthese existence can be realized: pressure when utilizing specific profile and implant provides the early stage stability of prosthese and bone interface based on being press-fitted the artificial joint prosthesis fixing with biology；The loose structure utilizing prosthetic surface promotes Bone Ingrowth, has obtained and has fixed biology in later stage, and final result shows that the prosthese only having 5.6% is overhauled because loosening postoperative 20 years.
Summary of the invention
The present invention is to overcome at least one defect described in above-mentioned prior art, it is provided that the local tissue structures personalization after the excision of pelvis Malignant Tumors Around reconstructs the internal structure of an organization, and before operation in patients based on the excision extension of plan, employing personalization is customized to be manufactured and designed.Its profile meets and is press-fitted principle, and covers loose structure at prosthese-bone interface, and it is main for using biological fixation, and attachment screw is fixed.
For solving above-mentioned technical problem, the technical solution used in the present invention is: the local tissue structures personalization after the excision of pelvis Malignant Tumors Around reconstructs the internal structure of an organization, wherein, including the metal prostheses contacted with cross section bone, described metal prostheses is provided with screw hole, and metal prostheses is provided with universal draw-in groove, also includes fixed structure, described fixed structure fixes metal prostheses and cross section bone by screw hole, or fixed structure connects metal prostheses by universal draw-in groove.
Further, described fixed structure includes hold-down bars and screw, the fixing metal prostheses of described bolts through bolt holes (8) and cross section bone；
Hold-down bars connects metal prostheses by universal draw-in groove is fixing.
Further, described metal prostheses is the metal prostheses that 3D prints.The one side surface of described metal prostheses is containing many empty coatings.
In the present invention, the mode using titanium alloy laser 3D to print realizes this customized prosthese having and being press-fitted function.Laser 3D prints alloying technology and has been supplied in dentistry, orthopaedics, mould, the field such as Aero-Space, automobile making at present.
The metal prostheses that 3D prints, its one side surface, containing many empty coatings, can contact with osteotomy surface, makes in the many empty coatings of new Bone Ingrowth, and waist 5 vertebral bodys/ilium and prosthese realize fixing biology.Open screw hole in metal prostheses, and provide universal draw-in groove for installing internal fixation bar.
Screw, can print before metal prostheses realizes fixing with osteotomy surface biology at 3D and give stability in early days, create the mechanical environment of Bone Ingrowth, promote the realization that biology is fixing.
Hold-down bars, is used for connecting 3D and prints metal prostheses, and it is fixed on universal draw-in groove.
In operation, after tumor resection, first 3D is installed and prints metal prostheses, and provide stability in early days with screw.Then internal fixation bar is arranged on universal draw-in groove, after tightening up draw-in groove, i.e. forms stable support.
Compared with prior art, providing the benefit that: based on the excision extension that the present invention plans before operation in patients, employing personalization is customized to be manufactured and designed.Its profile meets and is press-fitted principle, and covers loose structure at prosthese-bone interface, and it is main for using biological fixation, and attachment screw is fixed.
Accompanying drawing explanation
Fig. 1 is normal human's skeleton schematic diagram.
Fig. 2 is growth Sacral Tumors schematic diagram.
Fig. 3 is schematic diagram after Sacrectomy.
Fig. 4 is that the present invention arranges metal prostheses schematic diagram.
Detailed description of the invention
Accompanying drawing being merely cited for property explanation, it is impossible to be interpreted as the restriction to this patent；In order to the present embodiment is more preferably described, some parts of accompanying drawing have omission, zoom in or out, and do not represent the size of actual product；To those skilled in the art, in accompanying drawing, some known features and explanation thereof may will be understood by omission.Being merely cited for property of position relationship explanation described in accompanying drawing, it is impossible to be interpreted as the restriction to this patent.
As it is shown in figure 1, normal human's skeleton includes waist 5 vertebral body 1, rumpbone 2, ilium 3, ischium 4, pubis 5, as in figure 2 it is shown, grown Sacral Tumors 6 on rumpbone, as it is shown on figure 3, represent the state after Sacrectomy.
As shown in Figure 4, local tissue structures personalization after the excision of pelvis Malignant Tumors Around reconstructs the internal structure of an organization, wherein, including the metal prostheses 7 contacted with cross section bone, metal prostheses 7 is provided with screw hole 8, and metal prostheses 7 is provided with universal draw-in groove 9, also includes fixed structure, fixed structure fixes metal prostheses 7 and cross section bone by screw hole 8, or fixed structure connects metal prostheses 7 by universal draw-in groove 9.
Fixed structure includes that hold-down bars 10 and screw 11, screw 11 fix metal prostheses 7 and cross section bone through screw hole 8；
Hold-down bars 10 connects metal prostheses 7 by universal draw-in groove 9 is fixing.
Concrete, that metal prostheses 7 prints for 3D metal prostheses.The one side surface of metal prostheses is containing many empty coatings.
In the present embodiment, the mode using titanium alloy laser 3D to print realizes this customized prosthese having and being press-fitted function.Laser 3D prints alloying technology and has been supplied in dentistry, orthopaedics, mould, the field such as Aero-Space, automobile making at present.
The metal prostheses 7 that 3D prints, its one side surface, containing many empty coatings, can contact with osteotomy surface, makes in the many empty coatings of new Bone Ingrowth, and waist 5 vertebral bodys/ilium and prosthese realize fixing biology.Open screw hole 8 in metal prostheses 7, and provide universal draw-in groove 9 for installing internal fixation bar.
Screw 11, can print before metal prostheses realizes fixing with osteotomy surface biology at 3D and give stability in early days, create the mechanical environment of Bone Ingrowth, promote the realization that biology is fixing.
Hold-down bars 10, is used for connecting 3D and prints metal prostheses, and it is fixed on universal draw-in groove.
In operation, after tumor resection, first 3D is installed and prints metal prostheses 7, and provide stability in early days with screw 11.Then internal fixation bar 10 is arranged on universal draw-in groove 9, after tightening up draw-in groove, i.e. forms stable support.
Obviously, the above embodiment of the present invention is only for clearly demonstrating example of the present invention, and is not the restriction to embodiments of the present invention.For those of ordinary skill in the field, can also make other changes in different forms on the basis of the above description.Here without also cannot all of embodiment be given exhaustive.All any amendment, equivalent and improvement etc. made within the spirit and principles in the present invention, within should be included in the protection domain of the claims in the present invention.

Claims (4)

1. the local tissue structures personalization after the excision of pelvis Malignant Tumors Around reconstructs the internal structure of an organization, it is characterized in that, including the metal prostheses (7) contacted with cross section bone, described metal prostheses (7) is provided with screw hole (8), metal prostheses (7) is provided with universal draw-in groove (9), also including fixed structure, described fixed structure is by the fixing metal prostheses (7) of screw hole (8) and cross section bone, or fixed structure connects metal prostheses (7) by universal draw-in groove (9).
Local tissue structures personalization after pelvis Malignant Tumors Around the most according to claim 1 excision reconstructs the internal structure of an organization, it is characterized in that: described fixed structure includes hold-down bars (10) and screw (11), described screw (11) is through the fixing metal prostheses (7) of screw hole (8) and cross section bone；
Hold-down bars (10) connects metal prostheses (7) by universal draw-in groove (9) is fixing.
Local tissue structures personalization after pelvis Malignant Tumors Around the most according to claim 2 excision reconstructs the internal structure of an organization, it is characterised in that: described metal prostheses (7) is the metal prostheses that 3D prints.
Local tissue structures personalization after pelvis Malignant Tumors Around the most according to claim 3 excision reconstructs the internal structure of an organization, it is characterised in that: the one side surface of described metal prostheses is containing many empty coatings.
CN201610276592.9A 2016-04-29 2016-04-29 Local tissue structures personalization after the excision of pelvis Malignant Tumors Around reconstructs the internal structure of an organization Active CN105935320B (en)

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN109276352A (en) * 2018-09-17 2019-01-29 上海交通大学医学院附属第九人民医院 A kind of integrated molding metal pelvis jointing repair prosthesis of 3D printing individuation and preparation method thereof

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN101268970A (en) * 2007-12-18 2008-09-24 中国人民解放军第四军医大学 Multi-axis assembled anti-infective semi-pelvis false body
CN102048598A (en) * 2009-10-27 2011-05-11 上海交通大学医学院附属第九人民医院 Artificial half pelvic prosthesis with support structure
CN102349843A (en) * 2011-07-26 2012-02-15 中国人民解放军第四军医大学 Method for preparing individually-customized pelvic tumor prosthesis
WO2014121994A1 (en) * 2013-02-08 2014-08-14 Waldemar Link Gmbh & Co. Kg Endoprosthesis for the partial replacement of the human pelvic bone
CN205698132U (en) * 2016-04-29 2016-11-23 南方医科大学第三附属医院 Local tissue structures personalization after the excision of pelvis Malignant Tumors Around reconstructs the internal structure of an organization

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN101268970A (en) * 2007-12-18 2008-09-24 中国人民解放军第四军医大学 Multi-axis assembled anti-infective semi-pelvis false body
CN102048598A (en) * 2009-10-27 2011-05-11 上海交通大学医学院附属第九人民医院 Artificial half pelvic prosthesis with support structure
CN102349843A (en) * 2011-07-26 2012-02-15 中国人民解放军第四军医大学 Method for preparing individually-customized pelvic tumor prosthesis
WO2014121994A1 (en) * 2013-02-08 2014-08-14 Waldemar Link Gmbh & Co. Kg Endoprosthesis for the partial replacement of the human pelvic bone
CN205698132U (en) * 2016-04-29 2016-11-23 南方医科大学第三附属医院 Local tissue structures personalization after the excision of pelvis Malignant Tumors Around reconstructs the internal structure of an organization

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN109276352A (en) * 2018-09-17 2019-01-29 上海交通大学医学院附属第九人民医院 A kind of integrated molding metal pelvis jointing repair prosthesis of 3D printing individuation and preparation method thereof

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