CN107361881B - Femur far-end prosthesis capable of increasing bone preservation quantity and adopting bone trabecular structure - Google Patents
Femur far-end prosthesis capable of increasing bone preservation quantity and adopting bone trabecular structure Download PDFInfo
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- CN107361881B CN107361881B CN201710667797.4A CN201710667797A CN107361881B CN 107361881 B CN107361881 B CN 107361881B CN 201710667797 A CN201710667797 A CN 201710667797A CN 107361881 B CN107361881 B CN 107361881B
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Classifications
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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
- A61F2/30—Joints
- A61F2/32—Joints for the hip
- A61F2/36—Femoral heads ; Femoral endoprostheses
-
- 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
- A61F2/32—Joints for the hip
- A61F2/36—Femoral heads ; Femoral endoprostheses
- A61F2/3607—Femoral heads ; Femoral endoprostheses including proximal or total replacement of the femur
-
- 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
- B33Y80/00—Products made by additive manufacturing
-
- 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
- A61F2002/30985—Designing or manufacturing processes using three dimensional printing [3DP]
-
- 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
- A61F2/32—Joints for the hip
- A61F2/36—Femoral heads ; Femoral endoprostheses
- A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
- A61F2002/3611—Heads or epiphyseal parts of femur
-
- 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
- A61F2/32—Joints for the hip
- A61F2/36—Femoral heads ; Femoral endoprostheses
- A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
- A61F2002/3611—Heads or epiphyseal parts of femur
- A61F2002/3615—Heads or epiphyseal parts of femur having a concave shape, e.g. hemispherical cups
Landscapes
- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Engineering & Computer Science (AREA)
- Vascular Medicine (AREA)
- Animal Behavior & Ethology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Cardiology (AREA)
- Life Sciences & Earth Sciences (AREA)
- Transplantation (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Chemical & Material Sciences (AREA)
- Manufacturing & Machinery (AREA)
- Materials Engineering (AREA)
- Prostheses (AREA)
Abstract
The application relates to a femur far-end prosthesis which can increase bone storage quantity and adopts a bone trabecula structure. The marrow needle is connected with the marrow needle sleeve in a threaded manner, the marrow needle sleeve is arranged on the femur condyle patch, the central shaft of the femur condyle prosthesis is inserted into the marrow needle sleeve through the femur condyle patch, and the contact surface of the femur condyle patch and the femur condyle prosthesis is fixed through bone cement. The structure of the intramedullary nail sleeve can meet the use requirements of different bone defect conditions, and the combination of the surface of the bone trabecula increases a mechanical stability point and a biological growth point of the prosthesis, improves the initial stability and the long-term stability of the prosthesis, and can effectively reduce the mechanical complications of the prosthesis. The femoral condyle patch not only plays a role in connection, but also can well fill the cavity after the operation, avoid the generation of hematocele and dropsy, and reduce the occurrence of infection.
Description
Technical Field
The application relates to a femoral far-end prosthesis with a bone trabecular structure, which can increase bone preservation quantity and is a femoral condyle artificial prosthesis for reconstruction of structural bone defects caused by primary or metastatic tumor resection and limb preservation operation of femoral condyle, severe trauma bone repair and revision operation after knee joint replacement.
Background
Along with the development of surgical operation technology, the innovation of tumor imaging technology and the development of new auxiliary chemotherapy technology, limb-protecting operation has become a mainstream treatment method of malignant bone tumor; at the same time, structural bone defects formed by severe wounds and inflammations are clinically required to be reconstructed to restore limb functions. Bone tumors are well developed at the distal femur and are also a good part of metastatic cancer, and along with the development of limb-protecting technology, tumor joint limb reconstruction has become a main limb-protecting mode. However, because of the characteristics of tumor treatment, the tumor prosthesis has huge design, and the bone and surrounding soft tissues are extensively resected. The treatment of tumors is now rapidly advancing in multiple disciplines, with significant advances in therapeutic levels and techniques. However, there is a delay in the development of existing tumor prostheses, and many times, due to the lack of a suitable tumor prosthesis, parts of normal bone have to be resected. For the treatment of certain specific tumors, such as bone giant cell tumors, the surgical resection range can be controlled within 5cm, but because no suitable prosthesis is available, normal bones around 10cm are frequently resected in the prosthesis reconstruction operation, and the bone giant cell tumor patients are mostly young, the expected survival period is longer, the dependence on joints is stronger, the survival of more bones can prolong the service life of the prosthesis, the operation times can be even reduced, and the resected normal bones are precious for the stability and the functions of the prosthesis, and although the technology of allograft bone or autogenous bone transplantation is clinically used for coping, the effect is not satisfactory, and some additional complications are added. In wound repair and prosthetic revision, the use of tumor prostheses is often required to complete the treatment, but also the normal bone must be resected more in order to place the large prosthetic component, which can solve the anterior ocular problem, but long term stability is also affected by resecting too much bone. The root of the problem is that the design and treatment requirements of the prosthesis are not matched, the upper part of the femoral condyle and the lower part of the tibial plateau in the knee joint are neglected areas in the prosthesis, and no artificial prosthesis specially aiming at the femoral condyle replacement is adopted.
The fixing mode used in the artificial bone joint prosthesis mainly comprises two modes of bone cement fixing and biological fixing, wherein the limb functions can be recovered after the operation in a short period, but the failure rate of the middle-and-long-term prosthesis is higher, the risk of bone cement diseases exists, and the failure mode is represented by aseptic loosening, fracture, dislocation and the like. The biological fixation method has the possibility of bone ingrowth, and can improve the long-term stability of the prosthesis, but the initial stability is not high, and the factors influencing the late ingrowth degree are more. Although the latter has some drawbacks, this fixation approach is becoming more and more accepted by patients and doctors, and is a focus of research.
Disclosure of Invention
The technical problems to be solved by the application are as follows: aiming at the defects that no artificial prosthesis specially aims at the bone structural defect reconstruction of the femoral condyle at present, the occurrence rate of complications such as prosthesis loosening, fracture, surrounding fracture and the like caused by biomechanical factors is high, the service life of the prosthesis is short, the femoral far-end prosthesis which adopts a bone trabecular structure and can increase the bone preservation quantity is provided, the femoral condyle artificial prosthesis fully considers the morphological characteristics of the upper area of the femoral condyle, the design biological fixation mode can be more suitable for the bone defect of the femoral far-end, the long-term stability factor of the prosthesis is considered from the design, the stresses such as torsion and the like are more reasonably distributed from the biomechanical aspect, the joint function requirement with higher requirements can be met, and the femoral condyle artificial prosthesis is suitable for the condition with limited bone quantity defect. The femoral condyle artificial prosthesis can meet the conditions of different femoral distal bone defects, and can improve the initial stability of the prosthesis by using matched components, thereby reducing the high incidence rate of complications and achieving the purpose of prolonging the service life of the prosthesis.
The application adopts the technical proposal for realizing the aim that: a femoral distal prosthesis with bone trabecular structure capable of increasing bone preservation quantity, comprising a intramedullary pin and a femoral condyle prosthesis, which is characterized in that: the device also comprises a intramedullary sleeve and a femoral condyle patch;
the device comprises a needle body of a marrow needle, a needle head and a needle head, wherein the needle body of the marrow needle is a hexagonal cylinder, six faces of the needle body of the marrow needle are respectively provided with an anti-rotation vertical ridge, the surfaces of the needle body of the marrow needle and the six anti-rotation vertical ridges are provided with a layer of bone trabecular structure, one end of the needle body of the marrow needle is a cylinder, an external thread is arranged on the cylinder, the other end of the needle body of the marrow needle is a bullet-shaped body, and a cross-shaped crossing opening is formed in the bullet-shaped body;
the upper surface and the lower surface of the intramedullary needle sleeve are elliptical surfaces, the upper elliptical surface is smaller than the lower elliptical surface, the radian of the front wall of the intramedullary needle sleeve is smaller than the radian of the rear wall of the intramedullary needle sleeve, the front surfaces of the two walls and the two side walls are of stepped structures, a layer of bone trabecula structure is arranged on the front surfaces of the two walls and the two side walls, taper joints are arranged on the lower elliptical surface, rectangular protrusions are symmetrically arranged on the taper joint openings, the two rectangular protrusions correspond to the front wall surface and the rear wall surface of the intramedullary needle sleeve respectively, a hole I is arranged on the upper elliptical surface, a section of internal thread is arranged in the hole I, and the hole I is communicated with the taper joint openings;
the femur condyle patch is polygonal, the upper surface and the lower surface of the femur condyle patch are both planes, the front surface of the trapezoid shape of the femur condyle patch and the combined surface of the lower end of the rear surface of the trapezoid shape are inclined surfaces, the two side surfaces of the femur condyle patch are cambered surfaces, a plurality of soft tissue reconstruction holes are respectively arranged on the cambered surfaces on the two sides, a plurality of soft tissue reconstruction holes are respectively arranged on the two side surfaces of the rear surface of the femur condyle patch, the soft tissue reconstruction holes on the cambered surfaces on the two sides are respectively and correspondingly arranged and communicated with the soft tissue reconstruction holes on the adjacent rear surface, the surface between the adjacent two rows of soft tissue reconstruction holes is a rough surface, a rectangular concave area is arranged on the inclined surface of the lower end of the rear surface of the femur condyle patch, a semicircular groove is arranged on the lower surface of the femur condyle patch, and a hole II communicated with the taper hole on the semicircular groove is arranged in the semicircular groove;
two clamping grooves matched with two rectangular bulges of the intramedullary nail sleeve are symmetrically arranged on the central shaft of the femoral condyle prosthesis;
the intramedullary nail is connected to the intramedullary nail sleeve through the matching screw of the external screw and the internal screw of the intramedullary nail sleeve hole I, the intramedullary nail sleeve is arranged on the femoral condyle patch through the matching of the taper joint and the femoral condyle patch taper hole, the central shaft of the femoral condyle prosthesis is inserted into the taper joint of the intramedullary nail sleeve through the lower hole II of the femoral condyle patch, two rectangular bulges of the taper joint are clamped in two clamping grooves of the central shaft, the front of the trapezoid shape of the femoral condyle patch is fixed with the front inner side surface of the femoral condyle prosthesis through bone cement, and the two inclined planes of the femoral condyle patch are respectively fixed with the front lower surface and the rear inner side surface of the femoral condyle prosthesis through bone cement.
The beneficial effects of the application are as follows: the femoral condyle artificial prosthesis fully considers the morphological characteristics of the femoral condyle upper region, provides a marrow needle sleeve similar to the shape of the femoral condyle upper cortex cavity to meet the use of different bone defect conditions, is designed to enter the intramedullary surface of the cortex cavity, combines the bone trabecular surface to increase a mechanical stability point and a biological growth point of the prosthesis, improves the initial stability and the long-term stability of the prosthesis, and can effectively reduce the mechanical complications of the prosthesis. Meanwhile, the design of the femoral condyle patch not only plays a role in connection, but also has the simulated shape capable of well filling the cavity after the operation to avoid the generation of hematocele and effusion and reduce infection, and the reconstruction requirement of surrounding tissues is fully considered by the side reconstruction holes, so that the femoral condyle patch meets the clinical requirement.
In a word, the application overcomes the defect that the currently used tumor knee joint prosthesis mostly adopts a customized design, namely, prosthesis manufacturers need to manufacture according to the data such as the diameter of the diaphyseal cavity, the length of the osteotomy and the like provided by doctors, and the waiting time of patients is long. The prosthesis can meet the intra-operative uncertainty factor caused by crowd difference through the combination of the femoral condyle patch and the different types of the intramedullary needle sleeves and the adjustment of the length of the intramedullary needle, can meet the joint function requirement with higher requirements, is suitable for the condition of various bone quantity defects, ensures that the prosthesis can obtain immediate stability after operation and provides a medium-long-term stability growth basis for the prosthesis, reduces the incidence rate of long-term complications in the prosthesis, prolongs the service life of the prosthesis, relieves great pain of patients caused by repair, has relatively simple reconstruction operation, has good biomechanical strength compatibility, good initial stability and medium-long-term stability of the prosthesis, can be matched with tibia prostheses of different types, and has strong universality.
Drawings
FIG. 1 is a schematic diagram of the structure of the present application;
FIG. 2 is a schematic view of the structure of the present application;
FIG. 3 is an enlarged view of FIG. 2A;
FIG. 4 is a side view of the spinal needle of the present application;
FIG. 5 is a schematic view of the structure of the sleeve of the present application;
FIG. 6 is a side view of the sleeve of the present application;
FIG. 7 is a top view of the sleeve of the present application;
FIG. 8 is a schematic view of the structure of the femoral condyle patch of the present application;
FIG. 9 is a side view of the intramedullary needle sleeve of the present application;
FIG. 10 is a top view of the intramedullary sleeve of the present application;
FIG. 11 is a bottom view of the sleeve of the present application;
FIG. 12 is a front view of the femoral condyle prosthesis of the present application;
FIG. 13 is a posterior view of the femoral condyle prosthesis of the present application;
fig. 14 is a side view of the femoral condyle prosthesis of the present application.
Detailed Description
For a better understanding of the technical solution of the present application, the following description of the specific embodiments of the present application is provided with reference to the accompanying drawings:
as shown in fig. 1 to 14, a femoral distal prosthesis with a bone trabecular structure capable of increasing bone preservation amount comprises a intramedullary pin 1, a femoral condyle prosthesis 4, a intramedullary pin sleeve 2 and a femoral condyle patch 3.
The body of the marrow needle 1 is a hexagonal cylinder, six surfaces of the body of the marrow needle 1 are respectively provided with an anti-rotation vertical ridge 1-1, the surfaces of the body of the marrow needle 1 and the six anti-rotation vertical ridges 1-1 are provided with a layer of bone trabecula structure, one end of the body of the marrow needle 1 is a cylinder, an external thread 1-2 is arranged on the cylinder, the other end of the body of the marrow needle 1 is a bullet-shaped body, and a cross-shaped crossing opening 1-3 is arranged on the bullet-shaped body.
The upper surface and the lower surface of the intramedullary sleeve 2 are elliptical surfaces, the upper elliptical surface is smaller than the lower elliptical surface, the radian of the front wall 2-1 of the intramedullary sleeve 2 is smaller than the radian of the rear wall 2-2, the front surface and the two side walls of the intramedullary sleeve 2 are of stepped structures, a layer of bone trabecula structure is arranged on the front surface and the two side walls of the two walls, a taper joint 2-3 is arranged on the lower elliptical surface, a rectangular bulge 2-3-1 is symmetrically arranged on the mouth of the taper joint 2-3, the two rectangular bulge 2-3-1 faces respectively correspond to the front wall 2-1 surface and the rear wall 2-2 surface of the intramedullary sleeve, a hole I2-4 is arranged on the upper elliptical surface, a section of internal thread is arranged in the hole I2-4, and the hole I2-4 is communicated with the mouth of the taper joint 2-3.
The femur condyle patch 3 is a polygonal body, the upper surface and the lower surface of the femur condyle patch 3 are both planes, the front surface 3-1 of the trapezoid shape of the femur condyle patch 3 and the surface combined with the lower plane of the trapezoid shape of the rear surface 3-2 are both inclined planes 3-3, the two side surfaces of the femur condyle patch 3 are both cambered surfaces, a plurality of soft tissue reconstruction holes 3-8 are respectively arranged on the cambered surfaces on the two sides, a plurality of soft tissue reconstruction holes 3-8 are respectively arranged on the two side surfaces of the rear surface 3-2 of the femur condyle patch 3, the soft tissue reconstruction holes 3-8 on the cambered surfaces on the two sides are respectively and correspondingly arranged and communicated with the soft tissue reconstruction holes 3-8 on the adjacent rear surface 3-2, the surface between the adjacent two rows of soft tissue reconstruction holes 3-8 is a rough surface, a rectangular concave area 3-4 is arranged on the inclined plane 3-3 at the lower end of the rear surface of the femur condyle patch 3, a semicircular groove 3-5 is arranged on the lower plane of the femur condyle patch 3, and a taper hole 3-7 communicated with the upper surface II hole 3-6 is arranged in the semicircular groove 3-5.
Two clamping grooves 4-1-1 matched with two rectangular bulges 2-3-1 of the marrow needle sleeve 2 are symmetrically arranged on the central shaft 4-1 of the femur condyle prosthesis 4.
The intramedullary needle 1 is screwed on the intramedullary needle sleeve 2 through the matching of the external thread 1-2 and the internal thread of the hole I2-4 of the intramedullary needle sleeve 2, and the intramedullary needle sleeve 2 is arranged on the femoral condyle patch 3 through the matching of the taper joint 2-3 and the taper hole 3-6 of the femoral condyle patch 3. The central shaft 4-1 of the femoral condyle prosthesis 4 is inserted into the taper joint 2-3 of the intramedullary nail sleeve 2 through the lower surface hole II 3-7 of the femoral condyle patch 3, two rectangular bulges 2-3-1 of the taper joint 2-3 are clamped in two clamping grooves 4-1-1 of the central shaft 4-1, the trapezoid front surface 3-1 of the femoral condyle patch 3 and the front inner side surface 4-2 of the femoral condyle prosthesis 4 are fixed through bone cement, and the two inclined surfaces 3-3 of the femoral condyle patch 3 are respectively fixed with the front lower surface 4-3 and the rear inner side surface 4-4 of the femoral condyle prosthesis 4 through bone cement.
Formation of bone trabecular structure: and spraying a layer of metal on the surface or performing 3D printing to form the bone-like trabecula structure.
The marrow needle 1, the marrow needle sleeve 2 and the femur condyle patch 3 are all made of titanium alloy.
The femoral condyle prosthesis 4 is made of cobalt-chromium-molybdenum alloy.
The design improvement of the marrow needle 1 is that a tuning fork structure with a cross-shaped crossing notch 1-3 is arranged on a bullet-shaped body of the marrow needle 1, which is easy to be inserted into a marrow cavity and reduces thigh pain caused by stress.
The anti-rotation vertical ridges 1-1 on six surfaces of the needle body of the marrow needle 1 can improve the anti-rotation strength of the implanted prosthesis and increase the anti-rotation effect of the marrow needle 1 in the marrow cavity.
The surface bone trabecula structure can be infinitely close to a real bone trabecula so as to stimulate bone cell ingrowth, thus long-term biological fixation can be obtained, and the stability and the use efficiency of the prosthesis are improved.
The needle 1 is glued together by press fit with the cavity, and the initial stability of the prosthesis is provided in combination with the press fit force of the sleeve 2 portion of the needle.
The structural design of the intramedullary sleeve 2 is designed and formulated by morphological data and statistical classification obtained by strong morphological measurement in the supracondylar cortex of the femur of a normal national person. The novel bone marrow needle sleeve 2 is more in accordance with the cortical cavity shape of the upper femoral condyle area of the normal population, and mainly takes a trapezoid structure, so that components with special shape design can obtain more matching effect, when the marrow needle sleeve 2 is inserted into the femoral condyle, surrounding compressed cancellous bone can fill surrounding gaps to better contact and enhance the sinking function, meanwhile, stable press fit can provide high-strength anti-rotation force, mechanical property can be improved, anti-rotation and anti-stretching capacity can be improved, and complications of the prosthesis can be reduced. The surface of the marrow needle sleeve 2 is a step structure which is gradually widened and has a bone trabecular structure, the design can meet the requirements of various bone cutting heights, the marrow needle sleeve can be used as a continuation part for connection when the bone cutting is too many, and a proper part with a large size, a middle size and a small size can be selected to be inserted into a cortex cavity when the bone cutting is too few, so that the effect of preventing rotation and increasing stability is achieved, and in addition, the bone trabecular structure on the surface stimulates the growth of a bone bridge and truly stabilizes the effect of dispersing stress. The two rectangular bulges 2-3-1 and the two clamping grooves 4-1-1 of the femoral condyle prosthesis 4 are meshed to prevent and conduct rotation, so that the force between the components is stably distributed to avoid concentrated fracture.
The structural design of the femoral condyle patch 3 is provided in a mode that a patch which accords with the height of a patella slideway does not appear in the existing prosthesis, most prosthesis systems adopt gaskets as compensation, the femoral condyle patch 3 is designed to be used as an excessive anatomical design between the upper intramedullary nail sleeve 2 of the femoral condyle and the joint surface of the femoral condyle prosthesis 4, the structural design accords with the structural characteristics of a knee joint of a human body, the tension distribution of ligament muscles around the knee joint is ensured, meanwhile, the structural design of a plurality of soft tissue reconstruction holes 3-8 on two sides can flexibly reconstruct the starting and stopping points of a knee joint residual ligament muscle stretching device and the like, the auxiliary function of the starting and stopping points of reconstruction can be realized, the surface between two adjacent rows of soft tissue reconstruction holes 3-8 is a rough surface, the tissue adhesion is facilitated, the growth stabilizing effect is achieved, the simulated shape design can fill up the space, the occurrence of joint infection caused by blood stasis and the increase of the joint infection is avoided, and the starting and stopping points of the knee joint residual ligament stretching device and the like can be flexibly reconstructed.
The femoral condyle prosthesis 4 is a conventional surface knee femoral end. Two clamping grooves 4-1-1 on the central shaft 4-1 of the femoral condyle prosthesis 4 are designed to be in rectangular protrusion with two rectangular protrusions of the intramedullary pin sleeve 2
The cooperation structure plays rotatory prevention and conduction for the stable distribution of strength avoids concentrated fracture's emergence between the subassembly. The connecting holes 4-5 can be connected and combined into a (rotary) hinge knee joint system through a hinge and a common tibia component, the front joint surface 4-6 and the lower Fang Guan joint surface 4-7 are adopted, the condylar joint surface 4-8 adopts a general femoral condylar joint surface design, and the general femoral condylar joint surface is adopted because of strong universality, smooth intercondylar fossa notch, patellar notch improvement in high buckling and flexible outer side edge, and can provide better soft tissue protection.
The trapezoid front surface 3-1 of the femoral condyle patch 3 is in gapless contact with the front inner side surface 4-2 of the femoral condyle prosthesis 4, the two inclined surfaces 3-3 of the femoral condyle patch 3 are in gapless contact with the front lower surface 4-3 and the rear inner side surface 4-4 of the femoral condyle prosthesis 4 respectively, and the femoral condyle patch is fixed through bone cement, so that displacement between components can be avoided.
A method for using a femur distal prosthesis with a bone trabecular structure capable of increasing bone preservation amount comprises the following steps:
the prosthesis is applied to the treatment of tumor, trauma and joint revision prosthesis reconstruction at the far end of femur, taking tumor as an example, firstly, after the bone and tissue affected by tumor are resected, a special marrow expanding device is used for expanding the middle and far section marrow cavity of the femoral shaft, after marrow cavity expansion is finished, a special marrow expanding device on the femoral condyle is used for expanding marrow, a marrow needle 1 and a marrow needle sleeve 2 with the diameter 2mm larger than the maximum marrow expanding diameter are selected, the marrow needle 1 and the marrow needle sleeve 2 are connected through screw threads and then are inserted into the marrow cavity and the condyle through a marrow expanding hole, after the marrow needle sleeve 2 is inserted into bone to meet the requirement, whether the marrow needle sleeve 2 can be easily pulled out or is swayed is needed to be checked, if the marrow needle sleeve 2 cannot be easily pulled out or swayed is not existed, the stable effect is achieved, the shape and the bone shape of the marrow needle 1 and the marrow needle sleeve 2 are perfectly matched, the marrow cavity is stable under press fit, and the foundation is provided for long-term biological growth because the shape of the marrow needle sleeve 2 has good anti-rotation effect.
The femoral condyle prosthesis 4 matched with the intramedullary sleeve 2 and the proper femoral condyle patch 3 are selected in vitro, bone cement is used on the front surface 3-1 and the two inclined surfaces 3-3 of the femoral condyle patch 3, and then the femoral condyle prosthesis 4 is sleeved on the central shaft 4-1 of the femoral condyle prosthesis 4, so that the front surface 3-1 of the femoral condyle patch 3 and the front inner side surface 4-2 of the femoral condyle prosthesis 4 realize gapless contact, the two inclined surfaces 3-3 of the femoral condyle patch 3 respectively realize gapless contact with the front lower surface 4-3 and the rear inner side surface 4-4 of the femoral condyle prosthesis 4, the femoral condyle prosthesis 4 is fixed on the intramedullary sleeve 2 through the taper fit of the taper hole 3-6 of the femoral condyle patch 3 and the taper joint 2-3, the central shaft 4-1 of the femoral condyle prosthesis 4 is inserted into the taper joint 2-3 of the intramedullary sleeve 2, and the two rectangular protrusions 2-3-1 of the taper joint 2-3 are clamped in the two clamping grooves 4-1-1 of the central shaft 4-1.
Finally, the movable knee joint prosthesis is formed by assembling the connecting shaft hole 4-5 in the femoral condyle prosthesis 4 and a tibia part joint accessory commonly used in clinic.
Under the connection and assembly installation, each part is installed on bones in a very matched mode, compression, traction and rotation stresses possibly occurring under the action characteristic of knee joint parts can be well conducted between the prosthesis and bones, the biomechanical characteristics of a human body are simulated as far as possible, and complications are avoided.
The femoral condyle patch 3 is arranged to avoid a large number of gaps at the femoral condyle, and the intramedullary nail sleeve 2 and the femoral condyle prosthesis 4 can be well connected to form a whole, so that stress can be conducted through the femoral condyle patch 3 to play a role in avoiding fracture caused by stress concentration, and the knee extension devices such as ligaments, tendons, joint capsules and the like remained around the knee joint can be repaired and reconstructed through the soft tissue reconstruction holes 3-8 at the side of the femoral condyle patch 3 to play a role in reinforcing and protecting the joint.
While the preferred embodiment of the present application has been described in detail, the application is not limited to the embodiment, and those skilled in the art can make various equivalent modifications or substitutions without departing from the spirit of the application, and the equivalent modifications or substitutions are included in the scope of the present application as defined in the appended claims.
Claims (1)
1. A femur far-end prosthesis which can increase the bone preservation quantity and adopts a bone trabecular structure, which comprises a marrow needle (1) and a femur condyle prosthesis (4), and is characterized in that: the device also comprises a marrow needle sleeve (2) and a femoral condyle patch (3);
the needle body of the marrow needle (1) is a hexagonal cylinder, six surfaces of the needle body of the marrow needle (1) are respectively provided with an anti-rotation vertical ridge (1-1), the surfaces of the needle body of the marrow needle (1) and the six anti-rotation vertical ridges (1-1) are provided with a layer of bone trabecular structure, one end of the needle body of the marrow needle (1) is a cylinder, an external thread (1-2) is arranged on the cylinder, the other end of the needle body of the marrow needle (1) is a bullet-shaped body, and a cross-shaped crossing opening (1-3) is formed in the bullet-shaped body;
the upper surface and the lower surface of the intramedullary sleeve (2) are elliptical surfaces, the upper elliptical surface is smaller than the lower elliptical surface, the radian of a front wall (2-1) of the intramedullary sleeve (2) is smaller than that of a rear wall (2-2), the front surfaces and the two side walls of the two walls are of a ladder-shaped structure, a layer of bone trabecular structure is arranged on the front surfaces and the two side wall surfaces of the two walls, a taper joint (2-3) is arranged on the lower elliptical surface, a rectangular bulge (2-3-1) is symmetrically arranged on a mouth of the taper joint (2-3), the two rectangular bulge (2-3-1) faces correspond to the front wall (2-1) surface and the rear wall (2-2) surface of the intramedullary sleeve respectively, a hole I (2-4) is arranged on the upper elliptical surface, and a section of internal thread is arranged in the hole I (2-4), and the hole I (2-4) is communicated with the mouth of the taper joint (2-3);
the femur condyle patch (3) is a polygonal body, the upper surface and the lower surface of the femur condyle patch (3) are planes, the front surface (3-1) of the trapezoid shape of the femur condyle patch (3) and the surface combined with the lower plane of the trapezoid shape of the back surface (3-2) are inclined surfaces (3-3), two side surfaces of the femur condyle patch (3) are cambered surfaces, a plurality of soft tissue reconstruction holes (3-8) are respectively arranged on the cambered surfaces on two sides, a plurality of soft tissue reconstruction holes (3-8) are respectively arranged on the two side surfaces of the back surface (3-2) of the femur condyle patch (3), the soft tissue reconstruction holes (3-8) on the cambered surfaces on two sides are respectively and correspondingly arranged and communicated with the soft tissue reconstruction holes (3-8) on the adjacent back surface (3-2), the surface between the adjacent two rows of soft tissue reconstruction holes (3-8) is a rough surface, a rectangular concave area (3-4) is arranged on the inclined surface (3-3) at the lower end of the femur condyle patch (3), and a half-cone surface (3-5) is arranged on the half-cone surface (3-5) of the femur condyle patch (3);
two clamping grooves (4-1-1) matched with two rectangular bulges (2-3-1) of the intramedullary pin sleeve (2) are symmetrically arranged on a central shaft (4-1) of the femoral condyle prosthesis (4);
the intramedullary nail (1) is in threaded connection with the intramedullary nail sleeve (2) through the matching of external threads (1-2) and internal threads of a hole I (2-4) of the intramedullary nail sleeve (2), the intramedullary nail sleeve (2) is arranged on the femoral condyle patch (3) through the matching of a taper joint (2-3) and a taper hole (3-6) of the femoral condyle patch (3), a central shaft (4-1) of the femoral condyle prosthesis (4) is inserted into the taper joint (2-3) of the intramedullary nail sleeve (2) through a lower surface II (3-7) of the femoral condyle patch (3), two rectangular protrusions (2-3-1) of the taper joint (2-3) are clamped in two clamping grooves (4-1-1) of the central shaft (4-1), the front surface (3-1) of the trapezoid shape of the femoral condyle patch (3) is fixed on the front inner side surface (4-2) of the femoral condyle prosthesis (4) through bone cement, and the two inclined surfaces (4-4) of the femoral condyle patch (3) are fixed on the front side surface (4-1) of the femoral condyle prosthesis.
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| CN201710667797.4A CN107361881B (en) | 2017-08-07 | 2017-08-07 | Femur far-end prosthesis capable of increasing bone preservation quantity and adopting bone trabecular structure |
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| CN109875729A (en) * | 2019-03-05 | 2019-06-14 | 福建医科大学附属第一医院 | A kind of single condyle displacement femoral prosthesis and its application method equipped with metal filling block |
| CN109984874A (en) * | 2019-05-14 | 2019-07-09 | 赵滨 | A kind of pair of femoral inferior segment bone defect reinforces the fixed support construction of support |
| CN112404433B (en) * | 2020-10-30 | 2023-03-10 | 嘉思特华剑医疗器材(天津)有限公司 | Oxide layer-containing zirconium-niobium alloy partitioned trabecular single-compartment tibial platform and preparation method thereof |
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