CN107174378B - Rotary clamping type full knee replacement tibia support and tibia gasket assembly structure and implementation method - Google Patents

Rotary clamping type full knee replacement tibia support and tibia gasket assembly structure and implementation method Download PDF

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CN107174378B
CN107174378B CN201710354916.0A CN201710354916A CN107174378B CN 107174378 B CN107174378 B CN 107174378B CN 201710354916 A CN201710354916 A CN 201710354916A CN 107174378 B CN107174378 B CN 107174378B
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arc
tibial
tibia
tibial tray
gasket
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CN107174378A (en
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宋长辉
周游
杨永强
王安民
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South China University of Technology SCUT
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    • 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/3094—Designing or manufacturing processes
    • A61F2/30942—Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
    • 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
    • A61F2/30—Joints
    • A61F2/38—Joints for elbows or knees
    • A61F2/389—Tibial components
    • 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
    • A61F2002/2892—Tibia
    • 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
    • A61F2/30—Joints
    • A61F2/3094—Designing or manufacturing processes
    • A61F2/30942—Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
    • A61F2002/30948—Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques using computerized tomography, i.e. CT scans
    • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
    • Y02P—CLIMATE CHANGE MITIGATION TECHNOLOGIES IN THE PRODUCTION OR PROCESSING OF GOODS
    • Y02P10/00—Technologies related to metal processing
    • Y02P10/25—Process efficiency

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • General Health & Medical Sciences (AREA)
  • Transplantation (AREA)
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  • Manufacturing & Machinery (AREA)
  • Prostheses (AREA)
  • Surgical Instruments (AREA)

Abstract

The invention discloses a rotation clamping type full knee replacement tibia support and tibia gasket assembly structure and an implementation method, wherein the structure comprises the following steps: the upper surface of the tibia support is provided with a fixed circular groove and a plurality of circular arc grooves with locking mechanisms, the fixed circular groove is arranged at the center of the upper surface of the tibia support, and the lower surface of the tibia support is provided with a positioning bone column; the lower surface of the tibia gasket is provided with a fixed cylinder and a plurality of circular arc bodies matched with the circular arc grooves; during assembly, the fixing cylinder on the tibial gasket is first pressed downwards to align with the fixing round slot of the tibial tray, so that the tibial tray is completely attached to the tibial gasket, then the tibial gasket is twisted, the arc body rotates in the arc slot, the boundaries are completely overlapped, and the locking mechanism on the arc slot and the arc body is effective, so that the tibial gasket is completely fixed with the tibial tray. The invention can ensure the stability of the assembly of the tibial tray and the tibial gasket, improve the quality of the total knee replacement operation and quickly prepare the total knee replacement tibial tray and the tibial gasket device aiming at personalized patients.

Description

Rotary clamping type full knee replacement tibia support and tibia gasket assembly structure and implementation method
Technical Field
The invention relates to a tibial tray and a tibial gasket for operation, in particular to an assembly structure and an implementation method of a personalized rotary clamping type total knee replacement tibial tray and a tibial gasket.
Background
Knee replacement surgery is rapidly developing worldwide each year and is the most effective method for treating advanced osteoarthritis, rheumatoid arthritis, and the like. However, complications such as loosening, stretching and bending of the prosthesis, deformity and pain after loading are also paid attention to by orthopedics doctors.
And because of individual differences, the coverage rate of the mass-produced tibial tray and the osteotomy section is insufficient, and the assembly property of the tibial gasket and the tibial tray is poor, so that the quality of the operation can be influenced.
Thanks to the rapid development of computer and digital technologies, the digital three-dimensional reconstruction is increasingly widely applied in medicine, and the 3D printing technology has wide application prospect in personalized medicine due to the advantages of the customized small-batch manufacturing. Digital reconstruction and 3D printing techniques have been applied to the orthopedics field by many domestic scholars, but there is still a lack of effective assembly structure for personalized tibial trays and tibial inserts.
Disclosure of Invention
The invention aims to solve the problem that the tibial tray and the tibial gasket are not suitable for the operation of the full knee joint of a personalized patient in the prior art, and provides a rotary clamping type full knee replacement tibial tray and tibial gasket assembly structure which has good stability and is easy to manufacture and a realization method.
In order to achieve the above purpose, the present invention adopts the following technical scheme:
the invention provides a rotary clamping type full knee replacement tibia support and tibia gasket assembly structure, wherein a fixed circular groove and a plurality of circular arc grooves with locking mechanisms are arranged on the upper surface of the tibia support, the fixed circular groove is arranged at the center of the upper surface of the tibia support, and a positioning bone column is arranged on the lower surface of the tibia support; the lower surface of the tibia gasket is provided with a fixed cylinder and a plurality of circular arc bodies matched with the circular arc grooves; during assembly, the fixing cylinder on the tibial gasket is firstly pressed downwards aiming at the fixing round groove of the tibial tray, so that the tibial tray is completely attached to the tibial gasket, then the tibial gasket is twisted, the arc body rotates in the arc groove, the boundaries are completely overlapped, at the moment, the arc groove and the locking mechanism on the arc body are effective, and the tibial gasket and the tibial tray are completely fixed.
As an optimal technical scheme, the number of the arc grooves is three, one arc groove is arranged right in front of the tibia support, and the other two arc grooves are arranged on the left side and the right side of the tibia support; the three arc bodies are arranged, one arc body is arranged right in front of the lower surface of the tibial gasket, and the other two arc bodies are arranged on the left side and the right side of the lower surface of the tibial gasket.
As an optimal technical scheme, the circle center of the fixed circular groove and the circle center of the positioning bone column are positioned in the same vertical direction, the depth of the fixed circular groove is the same as the height of the positioning bone column, and the radius of the fixed circular groove is the same as the radius of the positioning bone column;
the depth of the circular arc groove is the same as that of the fixed circular groove; the depth of the arc groove is the same as the height of the arc body, the arc groove and the starting point of the arc body are positioned on the same straight line, and the angle of the arc body is not more than half of the angle of the arc groove.
As a preferable technical scheme, the lower tibial tray indicator is provided with a guide post for positioning and fixing; the guide post comprises a large cylinder, a small cylinder and a guide post, wherein the large cylinder is provided with a certain draft angle and is positioned at the center of the lower surface of the tibia support, the small cylinders are arranged at the left and right sides of the large cylinder, and the large cylinder, the small cylinder and the guide post are connected through rib plates.
As the preferable technical scheme, the arc grooves on the tibia support are uniformly arranged with the fixed circular grooves as the center, and the arc length and the arc angle of the arc grooves are the same.
The invention also provides a method for realizing the assembly structure of the rotation clamping type full knee replacement tibial tray and the tibial gasket, which comprises the following steps:
s1, establishing a three-dimensional digital tibia model based on tibia osteotomy medical image data of a knee joint of a patient, acquiring CT or MRI tomographic images of the knee joint of the patient in advance, then importing the CT or MRI tomographic images through anatomic engineering reconstruction software, performing image segmentation and repair according to the characteristics that bones and soft tissues have different gray values, calculating to obtain the three-dimensional digital tibia model, and storing the three-dimensional digital tibia model for later use;
s2, importing the model into design software, taking the tibia osteotomy plane as a reference plane, obtaining osteotomy section profile data by utilizing a section curve function, and parameterizing the data for editing
S3, designing an assembly structure of the tibia support part according to the section data;
s4, designing a guide post for assisting in positioning and fixing at the bottom of the tibia support; the guide post comprises a large cylinder, a small cylinder and a guide post, wherein the large cylinder is provided with a certain draft angle and is positioned at the center of the lower surface of the bone support, the small cylinders are arranged at the left and right sides of the large cylinder, and the large cylinder, the small cylinder and the guide post are connected through a rib plate;
s5, designing a corresponding assembly structure on the tibia gasket corresponding to the tibia support;
s6, designing the upper end of the tibial gasket according to osteotomy data;
s7, manufacturing the solid rotary clamping type full knee replacement tibial tray and tibial gasket assembly structure device by using a rapid prototyping technology.
In step S1, as an preferable technical scheme, the adopted anatomic engineering reconstruction software is the chemicals 17.0, so that the acquired CT or MRI tomographic image of the knee joint of the patient is stored in DICOM format in advance, and then is imported into the medical imaging software chemicals 17.0 for three-dimensional reconstruction to obtain a three-dimensional digitized tibia model, and is stored in STL format for standby.
As a preferable technical scheme, step S3 specifically includes:
s31, stretching a parameterized curve to Cheng Jinggu Torr to an initial shape with a height of 4-6mm;
s32, taking the osteotomy section as a reference plane, entering a sketch drawing function, finding out the center of an inner cavity of the tibia section, drawing a circle with the radius of 3-5mm, stretching the circle into a column, and forming a circular groove with the depth of 1.8-2mm on the upper surface of the tibia support;
s33, drawing two sections of arcs with small arc radiuses of 4.5-5mm from the boundary and large arc radiuses of 1.5-2mm from the boundary in the front direction and the left direction of the tibial tray in a sketch by taking the osteotomy section as a reference plane and the center of the fixed circular slot as a circle center, stretching the double arcs in the three directions into a body, and forming arc slots with the same depth as the fixed circular slots on the upper surface of the tibial tray;
s34, the center of the circular groove is fixed by taking the osteotomy section as a reference plane, in a sketch, starting points are drawn identically in the front and left-right directions of the tibial tray, the radius of the small circular arc is 3-3.5mm away from the boundary, the maximum radius is identical with that of the concentric circular groove, the angle is 21-22 degrees, the circular groove is stretched into a double circular arc with the height being half of the depth of the circular groove, and finally, the lower surface of the circular groove is drawn twice in different directions, so that the middle part is convex, the two sides are concave, the drawing degree is 1-3 degrees, and finally, the circular groove is combined with the upper surface of the tibial tray.
As a preferable technical scheme, step S4 specifically includes:
s41, drawing a circle with the radius of 5-8mm and the height of 25-30mm by taking the lower surface of the tibia support as a reference plane and taking the center of the circular groove as the circle center, drawing a die, and combining the die with the tibia support at the inclination of 3-4 degrees;
s42, drawing small circles with the radius of 2.5-3mm respectively on the surfaces about 20-25mm away from the large cylinder by taking the lower surface as a reference surface, stretching the small circles into a body with the height of 6-8mm, connecting the large cylinder and the small cylinder by rib plates, and combining the small cylinder and the tibia support.
As a preferable technical scheme, step S5 specifically includes:
s51, stretching the parameterized curve into an initial shape of the tibial gasket, wherein the height is 6-8mm;
s52, taking the lower surface of the tibial gasket as a reference surface, entering a sketch drawing function, drawing a circle with the same radius by taking the circle center of the circular groove as the circle center, stretching the circle into a column body, and combining the column body with the lower surface of the tibial gasket, wherein the height of the column body is the same as the depth of the circular groove;
s53, drawing two circular arcs with the same starting point as the circular arc groove, a small circular arc radius 0.1-0.2mm larger than the minimum radius of the tibial tray circular arc groove and a large circular arc radius 0.1-0.2mm smaller than the maximum radius of the tibial tray circular arc groove and an angle of 20-21 degrees in the front direction and the left direction of the tibial tray respectively in a sketch by taking the lower surface of the tibial tray as a reference surface and the center of the circular groove as a circle center, stretching the double circular arcs in the three directions into a body, wherein the height is the same as the depth of the circular groove, and combining the double circular arcs with the lower surface of the tibial tray;
s53, the lower surface of the tibial gasket is taken as a reference surface, the center of the circular groove is taken as a circle center, in a sketch, starting points are drawn to be the same in the front and left-right directions of the tibial tray, the radius of the small circular arc is 0.1-0.2mm smaller than that of the locking mechanism, the radius of the large circular arc is the same as that of the circular arc body, the double circular arcs with the angle of 20-21 degrees are stretched into a body with the height same as that of the tibial tray locking mechanism, and finally, the lower surface of the body is subjected to pattern drawing in different directions twice, so that the middle part is convex, the two sides are concave, the pattern drawing degree is the same as that of the tibial tray locking mechanism, and finally, the body is subtracted from the upper surface of the tibial tray.
Compared with the prior art, the invention has the following advantages and beneficial effects:
1. the invention provides a customized rotary clamping type full knee replacement tibial tray and tibial gasket assembly structure, which can quickly and conveniently improve the stability of a full knee prosthesis and the quality of full knee operation.
2. The full knee replacement tibial tray and tibial gasket device manufactured by adopting the rotary clamping type assembly structure can meet the individual requirements of different patients, prolong the service life of the prosthesis and realize private customization operation.
3. The invention can shorten the learning curve of a surgeon, so that the young surgeon can quickly master the technology and implement the operation by using the full knee replacement tibial tray and tibial gasket device manufactured by adopting the rotary clamping type assembly structure.
Drawings
FIG. 1 is a front three-axis view of a full knee replacement tibial tray and tibial insert assembled using a swivel-clamp type arrangement;
FIGS. 2 (a) and 2 (b) are schematic illustrations of an assembly of a rotation-gripping full knee replacement tibial tray with a tibial insert assembly;
fig. 3 (a), 3 (b), and 3 (c) are front, side, and top views, respectively, of a total knee replacement tibial tray apparatus made in accordance with the rotation-gripping assembly structure of the present invention;
fig. 4 (a), 4 (b), and 4 (c) are front, side, and bottom views, respectively, of a total knee replacement tibial insert apparatus constructed in accordance with the rotation-gripping assembly structure of the present invention;
fig. 5 is a flow chart of an apparatus for making a full knee replacement tibial tray and tibial insert in accordance with the present invention in a rotationally clamped assembly.
Reference numerals illustrate: 1. a fixed cylinder; 2. a circular arc body; 3. fixing the round groove; 4. an arc groove; 5. positioning the bone column.
Detailed Description
The present invention will be described in further detail with reference to examples and drawings, but embodiments of the present invention are not limited thereto.
Examples
As shown in fig. 1, 3 (a) -3 (c) and 4 (a) -4 (c), the rotation clamping type full knee replacement tibial tray and tibial insert assembly structure of the present embodiment comprises:
1) A fixed cylinder 1 is arranged on the lower surface of the tibial gasket (namely the contact surface with the tibial tray);
2) The lower surface of the tibia gasket (namely the contact surface with the tibia support) is provided with three circular arc bodies 2 with locking mechanisms, and the three circular arc bodies 2 are respectively positioned right in front of the tibia gasket and in the left-right direction;
3) A fixed round groove 3 is arranged on the upper surface of the tibial tray (namely the contact surface with the tibial gasket);
4) Three arc grooves 4 with locking mechanisms are arranged on the upper surface of the tibia support (namely the contact surface with the tibia gasket), and the three arc grooves 4 are respectively positioned right in front of the tibia support and in the left-right direction;
5) A positioning bone column 5 is arranged on the lower surface of the tibia support; .
As shown in fig. 2 (a) and 2 (b), the operation is performed in two steps as follows:
the first step: the fixed cylinder 1 on the tibia pad is pressed downwards in alignment with the fixed round groove 3 of the tibia support, so that the tibia support is completely attached to the tibia pad,
a second part: the tibia gasket is twisted to enable the arc body 2 to rotate in the arc groove 4, the boundaries of the arc body 2 and the arc groove are completely overlapped, at the moment, the locking mechanisms on the arc groove 4 and the arc body 2 are effective, and the tibia gasket and the tibia support are completely fixed.
Wherein the positioning bone post 5 is inserted into the patient's tibia when assembled.
In this embodiment, the center of the fixed circular groove 3 and the center of the positioning bone column 1 are located in the same vertical direction, and play roles in assisting in positioning the gasket and preventing the gasket from moving in the horizontal direction during assembly.
The arc grooves 4 are respectively positioned in the right front direction and the left direction and the right direction of the tibia support, so that the gasket cannot move in a rotating way after being assembled in a rotating way, and the assembling stability of the tibia support and the tibia gasket is improved.
For fixation, the fixation cylinder 1 is perfectly fitted with the tibial tray fixation circular groove 3, and the locking mechanism on the circular arc body 2 is perfectly fitted with the locking mechanism on the circular arc groove 4. Therefore, the locking mechanism is arranged on the arc body and the arc groove and is mutually matched with the arc body and the arc groove, and the locking mechanism has the function of preventing the tibia gasket from moving and misplacement.
The circle center of the fixed circular groove 3 and the circle center of the positioning bone column 5 are positioned in the same vertical direction, the depth of the fixed circular groove 3 is the same as the height of the positioning bone column 5, and the radius of the fixed circular groove 3 is the same as the radius of the positioning bone column 5;
the depth of the circular arc groove 4 is the same as that of the fixed circular groove 1; the depth of the arc groove 4 is the same as the height of the arc body 2, the arc groove and the starting point of the arc body are positioned on the same straight line, and the angle of the arc body is not more than half of the angle of the arc groove.
Referring now to fig. 5, a flow chart of a full knee replacement tibial tray and tibial insert assembly constructed in accordance with the present invention is shown. The full knee replacement tibial tray and tibial insert device made using the rotational clamping assembly provided by the present invention may be obtained using the flow chart of fig. 5. In fig. 5, the knee replacement tibial tray and tibial insert device made of the rotation clamping type assembly structure provided by the invention comprises the following steps:
s1, establishing a three-dimensional digital tibia model based on tibia osteotomy medical image data of a knee joint of a patient.
Specifically, it is necessary to acquire a CT or MRI tomographic image of the knee joint of the patient in advance. Then, the CT or MRI tomographic image is imported through anatomic engineering reconstruction software, image segmentation and repair are carried out according to the characteristics of bones and soft tissues with different gray values, a three-dimensional digitized tibia model is obtained through calculation, and the tibia model is stored for standby. The anatomic engineering reconstruction software used in the present invention may be chemicals 17.0 or other types of software. In a preferred embodiment of the invention, this step is carried out on the basis of the chemicals 17.0, so that the acquired CT or MRI tomographic images of the knee joint of the patient are saved in DICOM format in advance, then are imported into the medical imaging software chemicals 17.0, three-dimensionally reconstructed to obtain a three-dimensionally digitized tibial model, and are stored in STL format for later use.
S2, importing the model into design software, taking the tibia osteotomy surface as a reference surface, obtaining osteotomy section profile data by utilizing a section curve function, and parameterizing the data for editing. The design software adopted in the invention is UG_NX10 or other software of the same type.
Specifically, this step S2 may be further implemented by:
s21, importing the tibia model stored in the STL format through design software UG_NX10, and then using a moving object function to enable the osteotomy section to be overlapped with the reference surface, wherein the osteotomy section is set as the reference surface.
S22, obtaining a section curve of the osteotomy section by utilizing the section curve function, and fitting the section curve into a parameterized curve so as to edit the next step.
S3, designing an assembly structure of the tibia support part according to the section data. Specifically, this step S3 may be further implemented by:
s31, stretching a parameterized curve to Cheng Jinggu Torr to an initial shape with a height of 4-6mm;
s32, taking the osteotomy section as a reference plane, entering a sketch drawing function, finding out the center of an inner cavity of the tibia section, drawing a circle with the radius of 3-5mm, stretching the circle into a column, and forming a circular groove with the depth of 1.8-2mm on the upper surface of the tibia support;
s33, drawing two sections of arcs with small arc radiuses of 4.5-5mm from the boundary and large arc radiuses of 1.5-2mm from the boundary in the front direction and the left direction of the tibial tray respectively in a sketch by taking the osteotomy section as a reference plane and the center of the circular slot as a circle center, stretching the double arcs in the three directions into a body, and forming arc slot depths on the upper surface of the tibial tray to be the same as the circular slot;
s34, drawing the same starting point in the front and left-right directions of the tibial tray in a sketch by taking the osteotomy section as a reference plane and the center of the circular slot as a circle center, drawing a double circular arc with the small circular arc radius of 3-3.5mm from the boundary and the maximum radius of 21-22 degrees as the concentric circular slot into a body with the height of one half of the depth of the circular slot, drawing the lower surface of the body twice in different directions to enable the middle to be convex, the two sides to be concave and the drawing degree to be 1-3 degrees, and finally combining the body with the upper surface of the tibial tray.
S4, designing a guide post for assisting in positioning and fixing at the bottom of the tibia support; the guide post comprises a large cylinder, a small cylinder and a small cylinder, wherein the large cylinder is provided with a certain draft angle and is positioned at the center of the lower surface of the bone support, the small cylinders are arranged on the left and right sides of the large cylinder, and the large cylinder, the small cylinder and the small cylinder are connected through rib plates. Specifically, this step S4 may be further implemented by:
s41, drawing a circle with the radius of 5-8mm and the height of 25-30mm by taking the lower surface of the tibia support as a reference plane and taking the center of the circular groove as the circle center, drawing a die, and combining the die with the tibia support at the inclination of 3-4 degrees;
s42, drawing small circles with the radius of 2.5-3mm respectively on the surfaces about 20-25mm away from the large cylinder by taking the lower surface as a reference surface, stretching the small circles into a body with the height of 6-8mm, connecting the large cylinder and the small cylinder by rib plates, and combining the small cylinder and the tibia support.
S5, corresponding to the tibia support, and designing a corresponding assembly structure on the tibia gasket. Specifically, this step S5 may be further implemented by:
s51, stretching the parameterized curve into an initial shape of the tibial gasket, wherein the height is 6-8mm;
s52, taking the lower surface of the gasket as a reference surface, entering a sketch drawing function, drawing a circle with the same radius by taking the circle center of the circular groove as the circle center, stretching the circle into a cylinder, and combining the cylinder with the lower surface of the gasket, wherein the height of the cylinder is the same as the depth of the circular groove;
s53, drawing two circular arcs with the same starting point as the circular arc groove, the small circular arc radius 0.1-0.2mm larger than the minimum radius of the tibial tray circular arc groove, the large circular arc radius 0.1-0.2mm smaller than the maximum radius of the tibial tray circular arc groove and the angle of 20-21 degrees in the front direction and the left direction of the tibial tray respectively in a sketch by taking the lower surface of the gasket as a reference surface and the center of the circular groove as a circle center, stretching the double circular arcs in the three directions into a body, wherein the height is the same as the depth of the circular groove, and combining the double circular arcs with the lower surface of the gasket;
s54, the lower surface of the gasket is taken as a reference surface, the center of the circular groove is taken as a circle center, in the sketch, the starting points are drawn to be the same in the front and left-right directions of the tibia support, the radius of the small circular arc is 0.1-0.2mm smaller than that of the locking mechanism, and the radius of the large circular arc is the same as that of the circular arc body. Stretching the double circular arcs with the angles of 20-21 degrees into a body with the height identical to that of the tibia support locking mechanism, and finally performing die drawing on the lower surface of the body twice in different directions to enable the middle of the body to be convex and the two sides to be concave, wherein the die drawing degree is identical to that of the tibia support locking mechanism, and finally subtracting the body from the upper surface of the tibia support.
S6, designing the upper end (the part contacted with the prosthesis) of the tibial gasket according to the osteotomy data.
S7, manufacturing the solid rotary clamping type full knee replacement tibial tray and tibial gasket assembly structure device by using a rapid prototyping technology. For example, optical selective sintering printing of sterilizable plastics or laser selective melt printing of metallic materials such as stainless steel.
The above examples are preferred embodiments of the present invention, but the embodiments of the present invention are not limited to the above examples, and any other changes, modifications, substitutions, combinations, and simplifications that do not depart from the spirit and principle of the present invention should be made in the equivalent manner, and the embodiments are included in the protection scope of the present invention.

Claims (8)

1. The assembly structure of the rotary clamping type full knee replacement tibial tray and the tibial gasket is characterized in that a fixed circular groove (3) and a plurality of circular arc grooves (4) with locking mechanisms are arranged on the upper surface of the tibial tray, the fixed circular groove (3) is arranged at the central position of the upper surface of the tibial tray, and a positioning bone column (5) is arranged on the lower surface of the tibial tray; the lower surface of the tibia gasket is provided with a fixed cylinder (1) and a plurality of arc bodies (2) matched with the arc grooves; during assembly, a fixing cylinder (1) on a tibial gasket is aligned with a fixing round groove (3) of a tibial tray and is pressed downwards, so that the tibial tray is completely attached to the tibial gasket, then the tibial gasket is twisted, an arc body (2) rotates in the arc groove (4) and the boundaries are completely overlapped, at the moment, the arc groove (4) and a locking mechanism on the arc body (2) take effect, and the tibial gasket and the tibial tray are completely fixed;
the number of the arc grooves (4) is three, one arc groove is arranged right in front of the tibia support, and the other two arc grooves are arranged on the left side and the right side of the tibia support; the number of the arc bodies (2) is three, one arc body is arranged right in front of the lower surface of the tibia gasket, and the other two arc bodies are arranged on the left side and the right side of the lower surface of the tibia gasket;
the circle center of the fixed circular groove (3) and the circle center of the positioning bone column (5) are positioned in the same vertical direction, the depth of the fixed circular groove (3) is the same as the height of the positioning bone column (5), and the radius of the fixed circular groove (3) is the same as the radius of the positioning bone column (5);
the depth of the circular arc groove (4) is the same as that of the fixed circular groove (3); the depth of the arc groove (4) is the same as the height of the arc body (2), the arc groove (4) and the starting point of the arc body (2) are positioned on the same straight line, and the angle of the arc body is not more than half of the angle of the arc groove.
2. The rotation chucking type full knee replacement tibial tray and tibial insert assembly structure as recited in claim 1 wherein a guide post for positioning and fixing is provided on a lower surface of said tibial tray; the guide post comprises a large cylinder, a small cylinder and a guide post, wherein the large cylinder is provided with a certain draft angle and is positioned at the center of the lower surface of the tibia support, the small cylinders are arranged at the left and right sides of the large cylinder, and the large cylinder, the small cylinder and the guide post are connected through rib plates.
3. The assembly structure of the knee replacement tibial tray and the tibial insert according to claim 1, wherein the arc grooves (4) on the tibial tray are uniformly arranged with the fixed circular groove (3) as a center, and the arc length and the arc angle of the arc grooves are the same.
4. A method of implementing a rotation-gripping total knee replacement tibial tray and tibial insert assembly structure according to any one of claims 1 to 3, comprising the steps of:
s1, establishing a three-dimensional digital tibia model based on tibia osteotomy medical image data of a knee joint of a patient, acquiring CT or MRI tomographic images of the knee joint of the patient in advance, then importing the CT or MRI tomographic images through anatomic engineering reconstruction software, performing image segmentation and repair according to the characteristics that bones and soft tissues have different gray values, calculating to obtain the three-dimensional digital tibia model, and storing the three-dimensional digital tibia model for later use;
s2, importing the model into design software, taking the tibia osteotomy plane as a reference plane, obtaining osteotomy section profile data by utilizing a section curve function, and parameterizing the data for editing
S3, designing an assembly structure of the tibia support part according to the section data;
s4, designing a guide post for assisting in positioning and fixing at the bottom of the tibia support; the guide post comprises a large cylinder, a small cylinder and a guide post, wherein the large cylinder is provided with a certain draft angle and is positioned at the center of the lower surface of the bone support, the small cylinders are arranged at the left and right sides of the large cylinder, and the large cylinder, the small cylinder and the guide post are connected through a rib plate;
s5, designing a corresponding assembly structure on the tibia gasket corresponding to the tibia support;
s6, designing the upper end of the tibial gasket according to osteotomy data;
s7, manufacturing the solid rotary clamping type full knee replacement tibial tray and tibial gasket assembly structure device by using a rapid prototyping technology.
5. The method according to claim 4, wherein in step S1, the adopted anatomic engineering reconstruction software is chemicals 17.0, so that the acquired CT or MRI tomographic image of the knee joint of the patient is stored in DICOM format in advance, and then is imported into medical imaging software chemicals 17.0, and three-dimensional digitized tibial models are obtained after three-dimensional reconstruction, and stored in STL format for later use.
6. The method of claim 4, wherein step S3 is specifically implemented by:
s31, stretching a parameterized curve to Cheng Jinggu Torr to an initial shape with a height of 4-6mm;
s32, taking the osteotomy section as a reference plane, entering a sketch drawing function, finding out the center of an inner cavity of the tibia section, drawing a circle with the radius of 3-5mm, stretching the circle into a column, and forming a circular groove with the depth of 1.8-2mm on the upper surface of the tibia support;
s33, drawing two sections of arcs with small arc radiuses of 4.5-5mm from the boundary and large arc radiuses of 1.5-2mm from the boundary in the front direction and the left direction of the tibial tray in a sketch by taking the osteotomy section as a reference plane and the center of the fixed circular slot as a circle center, stretching the double arcs in the three directions into a body, and forming arc slots with the same depth as the fixed circular slots on the upper surface of the tibial tray;
s34, the center of the circular groove is fixed by taking the osteotomy section as a reference plane, in a sketch, starting points are drawn identically in the front and left-right directions of the tibial tray, the radius of the small circular arc is 3-3.5mm away from the boundary, the maximum radius is identical with that of the concentric circular groove, the angle is 21-22 degrees, the circular groove is stretched into a double circular arc with the height being half of the depth of the circular groove, and finally, the lower surface of the circular groove is drawn twice in different directions, so that the middle part is convex, the two sides are concave, the drawing degree is 1-3 degrees, and finally, the circular groove is combined with the upper surface of the tibial tray.
7. The method of claim 4, wherein step S4 is specifically implemented by:
s41, drawing a circle with the radius of 5-8mm and the height of 25-30mm by taking the lower surface of the tibia support as a reference plane and taking the center of the circular groove as the circle center, drawing a die, and combining the die with the tibia support at the inclination of 3-4 degrees;
s42, drawing small circles with the radius of 2.5-3mm respectively on the surfaces about 20-25mm away from the large cylinder by taking the lower surface as a reference surface, stretching the small circles into a body with the height of 6-8mm, connecting the large cylinder and the small cylinder by rib plates, and combining the small cylinder and the tibia support.
8. The method of claim 4, wherein step S5 is specifically implemented by:
s51, stretching the parameterized curve into an initial shape of the tibial gasket, wherein the height is 6-8mm;
s52, taking the lower surface of the tibial gasket as a reference surface, entering a sketch drawing function, drawing a circle with the same radius by taking the circle center of the circular groove as the circle center, stretching the circle into a column body, and combining the column body with the lower surface of the tibial gasket, wherein the height of the column body is the same as the depth of the circular groove;
s53, drawing two circular arcs with the same starting point as the circular arc groove, a small circular arc radius 0.1-0.2mm larger than the minimum radius of the tibial tray circular arc groove and a large circular arc radius 0.1-0.2mm smaller than the maximum radius of the tibial tray circular arc groove and an angle of 20-21 degrees in the front direction and the left direction of the tibial tray respectively in a sketch by taking the lower surface of the tibial tray as a reference surface and the center of the circular groove as a circle center, stretching the double circular arcs in the three directions into a body, wherein the height is the same as the depth of the circular groove, and combining the double circular arcs with the lower surface of the tibial tray;
s54, the lower surface of the tibial gasket is taken as a reference surface, the center of the circular groove is taken as the center of a circle, in a sketch, the starting points are drawn in the front and left-right directions of the tibial tray, the radius of the small circular arc is 0.1-0.2mm smaller than that of the locking mechanism, the radius of the large circular arc is the same as that of the circular arc body, the double circular arcs with the angle of 20-21 degrees are stretched into a body with the height same as that of the tibial tray locking mechanism, and finally the lower surface of the body is subjected to die drawing in different directions twice, so that the middle part is convex, the two sides are concave, the die drawing degree is the same as that of the tibial tray locking mechanism, and finally the body is subtracted from the upper surface of the tibial tray.
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CN113397768A (en) * 2021-07-16 2021-09-17 北京力达康科技有限公司 Rotary platform knee joint prosthesis

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