CN107427369A - 临时关节假体 - Google Patents
临时关节假体 Download PDFInfo
- Publication number
- CN107427369A CN107427369A CN201680015541.9A CN201680015541A CN107427369A CN 107427369 A CN107427369 A CN 107427369A CN 201680015541 A CN201680015541 A CN 201680015541A CN 107427369 A CN107427369 A CN 107427369A
- Authority
- CN
- China
- Prior art keywords
- main body
- axle
- prosthese
- temporary joint
- couplings
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Granted
Links
- 210000000988 bone and bone Anatomy 0.000 claims abstract description 55
- 230000008878 coupling Effects 0.000 claims abstract description 53
- 238000010168 coupling process Methods 0.000 claims abstract description 53
- 238000005859 coupling reaction Methods 0.000 claims abstract description 53
- 230000000295 complement effect Effects 0.000 claims description 7
- 230000003115 biocidal effect Effects 0.000 claims description 4
- 230000000181 anti-adherent effect Effects 0.000 claims description 2
- 230000000845 anti-microbial effect Effects 0.000 claims description 2
- 210000002303 tibia Anatomy 0.000 description 10
- 208000037873 arthrodesis Diseases 0.000 description 9
- 206010040047 Sepsis Diseases 0.000 description 8
- 239000000853 adhesive Substances 0.000 description 8
- 230000001070 adhesive effect Effects 0.000 description 8
- 239000000463 material Substances 0.000 description 7
- 208000013223 septicemia Diseases 0.000 description 7
- 210000000689 upper leg Anatomy 0.000 description 7
- 238000005520 cutting process Methods 0.000 description 6
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- XEEYBQQBJWHFJM-UHFFFAOYSA-N Iron Chemical compound [Fe] XEEYBQQBJWHFJM-UHFFFAOYSA-N 0.000 description 2
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- 210000002414 leg Anatomy 0.000 description 2
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- 239000010936 titanium Substances 0.000 description 2
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- OGIDPMRJRNCKJF-UHFFFAOYSA-N titanium oxide Inorganic materials [Ti]=O OGIDPMRJRNCKJF-UHFFFAOYSA-N 0.000 description 2
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- 208000034657 Convalescence Diseases 0.000 description 1
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- 241001465754 Metazoa Species 0.000 description 1
- XUIMIQQOPSSXEZ-UHFFFAOYSA-N Silicon Chemical compound [Si] XUIMIQQOPSSXEZ-UHFFFAOYSA-N 0.000 description 1
- NRTOMJZYCJJWKI-UHFFFAOYSA-N Titanium nitride Chemical compound [Ti]#N NRTOMJZYCJJWKI-UHFFFAOYSA-N 0.000 description 1
- 238000010521 absorption reaction Methods 0.000 description 1
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- 230000017074 necrotic cell death Effects 0.000 description 1
- 229910052759 nickel Inorganic materials 0.000 description 1
- RJSRQTFBFAJJIL-UHFFFAOYSA-N niobium titanium Chemical compound [Ti].[Nb] RJSRQTFBFAJJIL-UHFFFAOYSA-N 0.000 description 1
- 238000005457 optimization Methods 0.000 description 1
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- 230000001225 therapeutic effect Effects 0.000 description 1
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Classifications
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Abstract
本发明涉及一种模块化临时关节假体(1),所述临时关节假体可嵌入长骨中,以用于替代移出的关节内假体,其中,临时关节假体具有主体(20;40)和轴(60),所述主体具有主体耦接部(24;44),所述轴具有轴耦接部(64),所述轴耦接部(64)能够可拆卸地耦接至主体耦接部(24;44)。
Description
技术领域
本发明涉及一种可嵌入长骨中的模块化的临时关节假体。
背景技术
由于关节内假体的高可靠性,特别是在髋部和膝盖的区域中,它们的嵌入现在是常见的程序。然而,由于各种原因,在植入的内假体的区域中可能发生炎症。这种所谓的败血症可能需要修正之前植入的内假体。在组织增生、例如肿瘤的情况下也是如此。换句话说,位于体内的关节植入物被再次移除,因为关节植入物的并入至少由于败血症或肿瘤而有风险。一旦败血症消退,或者在肿瘤移除后经过足够的恢复期,就可植入新的植入物。
根据严重程度,败血症或肿瘤可能使得需要剖切或多或少的大面积的周围骨组织。因此,在这种移出之后,一部分支撑装置缺失,这导致周围软组织缩短而不会相应地复位。然而,直接重新植入以防止这种影响是不可能的。一方面,败血症必须完全消退,另一方面由于骨组织的剖切而难以预测可植入哪种假体。此外,该剖切可能首先需要建立骨组织。
在败血症的治疗中,在通过使用药物、特别是抗生素抗击所述败血症时,患者失去可动性。患者失去可动性不仅导致周围软组织的缩短,而且导致肌肉组织的严重弱化。通常,在植入内假体之前执行物理治疗措施以加强肌肉组织以及韧带装置。然而,这在移出假体且然后失去可动性之后仅在非常有限的程度上有可能,并且这降低修正后的新的内假体的成功几率。
为了防止软组织缩短,因此已经开发了由移出而产生的腔部分地通过骨粘结作用被填充的方法。为此,在手术室中搅拌的骨粘结物以仍塑性的状态适应于待填充的空腔。为了确保这种骨粘结间隔件的优化的适应性,至少部分地通过在患者的剩余骨组织上进行塑造来执行。然而,由于塑性状态的骨粘结物尚未固化,因此在骨粘结物中进一步发生吸热固化反应,因此由于太高的温度而存在损坏周围组织的风险。由此,骨粘结物发出的热能可导致周围骨组织坏死。
然而,当使用骨粘结间隔件时,患者还必须继续不可动,因为尽管进行了塑造,但其材料特性和与剩余骨组织的机械连接是不充分的。骨粘结物基本上是占据剖切的骨的空间但机械上无法使患者能够活动的材料。
这种间隔件的材料的体积或厚度也起作用,这使得骨粘结间隔件的机械性能以及尺寸在固化期间发生变化。因此,骨粘结间隔件由此可既不提供支撑功能也不提供移出关节替代物的可动性。因此,即使在使用间隔件时,至少肌肉组织和韧带装置的弱化也不能被抵消。这具有负面影响,特别是在间隔件在患者中停留从数周到数月的更长的时间的情况下。
发明内容
由此,本发明的目的在于提供一种尤其为了有利的愈合过程而提高患者的可动性的解决方案。本发明的另一个的在于减少操作时间,所述操作时间尤其因间隔件的制备而延长。此外,一个目的在于用不具有由上述发热引起的任何不良影响的溶液来替代骨粘结间隔件。
该目的通过权利要求1中定义的特征的组合来实现。从属权利要求描述了本发明的优选实施例。
为了实现该目的,本发明提供了一种模块化的临时关节假体作为移出的关节内假体的替代物。临时关节假体可嵌入长骨中,并具有主体和轴,所述主体具有主体耦接部,所述轴具有轴耦接部。在这种情况下,轴联接部能够可拆卸地耦接至主体耦接部。
本文所使用的术语“可嵌入长骨中”表示:在例如由于败血症而必需修正的情况下,在移除先前植入的关节内假体之后,使用临时假体而不是移除的、即移出的假体,所述临时假体为此部分地接合至其余的长骨中。临时假体由此替代实际的内假体固定在患者体内,使其穿过长骨的髓管。
临时关节假体的模块化设计由于其可耦接的部件而使得能够实现假体对患者的个性化的适应性,这比常规的临时解决方案、尤其是铸造粘结假体更有优势。与“永久的”内假体相比,个性化的适应性并不限于假体轴和关节头。与这些“永久的”内假体相比,假体轴由此分为主体和轴。
在本发明的一优选实施例中,模块化临时关节假体由塑料和/或金属制成。这为临时关节假体提供比常规粘结假体更高的强度。如果临时关节假体或其各部件由金属制成,则所述金属优选地包括铁或钛。
在本发明的一实施例中,临时假体例如包含钢。在钢的情况下,临时关节假体或其各部件优选地包括氮化钛(TiN)或氮化钛铌(TiNbN)的涂层。这种涂层防止可在钢沉积物中发生的镍和/或铬的释放,从而防止发生过敏。
在本发明的另一实施例中,临时关节假体或各成分在其表面区域中含有银,从而实现抗微生物效果。
临时关节假体或其各部件的表面可设计为防粘附的,以便抑制组织或骨材料向内生长。在钛的情况下,阳极化可防止形成氧化钛。氧化钛可促使表面区域中的组织或骨材料向内生长。如果临时关节假体或其各部件由黑色金属、例如钢制成,则具有防粘附的含硅层的涂层、例如特氟龙(Teflon)是优选的。不管材料如何,部件的防粘附表面也可通过光滑或抛光的表面来实现。平均粗糙度Ra应不超过0.8μm。
此外,可以想到使本发明的临时关节假体整个地或部分地具有含抗生素的涂层。为此,在将含抗生素的基质在之后施加至假体的表面或施加至其表面区域之前,合适的抗生素可混合到基质中。具有足够粘度的含粘结剂的化合物、例如骨粘结物例如用作基质。
相应的基质系统也可用于补偿临时关节假体与移出的内假体相比的小的体积差和/或用于填充存在的空腔,即用于调整的目的。后者以及用该材料涂覆临时假体或其部件可在制造期间或也在操作之前执行。由此,可防止产生热损伤。金属的用于临时假体的优选用途还在补偿体积差异时避免由于其导热性引起热损伤。
因此,模块化临时关节假体的一个基本优点在于,这些假体在其使用之前、即在对患者进行介入之前就已经被制造。因此,根据本发明的临时关节假体不同于现有技术的系统,现有技术的系统在操作过程中例如由骨粘结物、即多组分聚合物铸造或塑造。这种传统系统的主要缺点是上述的发热,所述发热由于调制阶段期间的化学反应而开始。这可对身体组织造成损害,本发明的系统避免所述损害。
由于具有较高的强度,与传统临时假体相比,模块化临时关节假体还具有增强的承载能力,从而使得在临时假体替代实际内假体期间能够实现患者可动性。
模块化临时关节假体的主体替代关节的至少一部分,特别是髋关节或膝关节的股骨颈部分或者其股骨或胫骨部分。换句话说,主体代表将患者的组织大致保持在其原始位置的占位件或间隔件。在这种情况下,主体优选地形成被替代的关节或关节部分的几何形状和/或大致形成被剖切的骨骼的在大致垂直于骨骼的纵向方向的平面中的截面几何形状,从而防止周围组织、包括表皮层收缩。因此,剩余的身体组织在治疗和临时假体的移除之后可再次容易地适应永久的替代物、即实际的内假体。
在本发明的一优选实施例中,主体耦接部设计为与轴耦接部互补。在本发明的另一优选实施例中,主体至少部分地替代部分干骺端的一部分和/或主体被支撑在长骨的骨干区域或中骨干(meta-diaphyseren)区域上。
在本发明的一特别优选的实施例中,临时关节假体的主体具有至少两个夹持翼,所述夹持翼可沿与轴基本上垂直的方向相对于主体移动,其中,每个夹持翼都具有止动件,所述止动件至少在主体的一侧上沿轴的纵向方向延伸超过主体。
由于止动件或夹持翼的可移位性,主体至骨骼的固定是独立于与轴的位置而实现的。夹持翼由此防止主体绕轴的纵向轴线旋转。
优选地,用于夹持的夹持翼在与轴的纵向方向垂直的平面中沿直径方向布置。特别优选地,夹持翼可彼此独立地移位,使得夹持翼的止动件可在与轴相距不同距离处与关节的骨干区域或中骨干区域相接触。
在本发明的另一优选实施例中,夹持翼可经由至少一个、优选地两个伸缩杆移位。借助于该优选实施例,确保临时关节假体的简单结构,并且每个夹持翼使用两个伸缩杆,防止夹持翼相对于主体旋转。在本发明的另一替代性实施例中,可通过使用具有非旋转对称的横截面的伸缩杆来防止夹持翼相对于主体旋转。
在本发明的另一同样特别优选的实施例中,至少一个夹持翼的至少一个伸缩杆具有防滑装置。
该防滑装置优选地设计为沿伸缩杆的纵向方向的凹部,主体的夹持翼固定元件接合至所述凹部中。这防止夹持翼脱落,这在将模块化临时关节假体嵌入患者中之后对准主体时是尤其有利的。
将夹持翼固定元件接合至设计为凹部的防滑装置中,确保了伸缩杆的直到凹部的用作止动部的外端的移位。夹持翼只在夹持翼固定元件固定就位之后才被固定。
在本发明的一优选实施例中,临时关节假体的主体的主体耦接部是通孔,轴可移位地布置在所述通孔中,并优选地经由轴固定元件被固定。这确保临时关节假体经由固定元件准确地适应被剖切的骨。临时关节假体的精确适应至少不仅只是通过选择轴长度而且还通过轴在通孔中移位的可能性来实现。在这种情况下,轴可在主体的两侧上突出,并且植入邻近的长骨的部分中,即它们可到达所述骨骼中。
在本发明的另一优选实施例中,轴具有用于耦接工具的至少沿轴长度的一部分的由平行的相反的至少两个表面形成的接合部。这确保了耦接工具、优选地扳手在整个接合部上的接合。
特别优选地,所述接合部在轴长度的至少一半上或基本上在整个长度上延伸,但至少在轴长度的80%上延伸。与轴固定元件相互作用,或者在孔的相应的截面形状的情况下,平的部分也可用作防旋转元件。这显然不仅针对通孔的情况,也针对盲孔的情况。
在本发明的另一特别优选的实施例中,临时关节假体的主体具有关节联接部,关节件可利用其关节耦接部可拆卸地固定在所述关节联接部上。
关节联接部使得能够耦接至关节件,从而实现临时关节假体的可动性。这与提高患者的生活质量有关。特别优选地,关节耦接部布置在沿主体的纵向方向的与轴从中突出的一侧相反的一侧上。
关节联接部和关节耦接部可以以截头圆锥形的方式形成。为了简单的安装或拆卸,锥角可选择为大于正常假体连接的锥角,从而实现锥形连接的较低的自锁效果。
在一优选实施例中,例如呈螺钉的形式的关节固定元件在关节件上设置在关节耦接部的区域中,所述关节耦接部可将关节件固定在关节联接部上。
在锥形连接的情况下,关节固定元件优选地布置成使得锥形连接通过固定关节固定元件、例如通过拧固螺钉而被压缩。
主体优选地以弯折的方式形成。对于根据本发明使用模块化临时关节假体作为髋部内假体,关节联接部(28)优选地相对于轴(60)成135°的角度。主体在这种情况下基本上形成为股骨颈区域,所述股骨颈区域模块式地通过轴元件方式补充以形成髋关节假体。
如果模块化临时关节假体基本上被用作占位件,例如用于人造膝关节或其股骨或胫骨部分,则关节体基本上是圆柱形的,并且如上所述地基本上形成移出的关节的横截面或大致地形成骨骼在该区域中的横截面。
在本发明的另一优选实施例中,临时关节假体具有两个主体。这种优选的临时关节假体的所述两个主体可取代必须从患者中移除的两个关节、即两个人工关节,并且优选地经由至少一个轴彼此连接。
这种临时关节假体由此使得在不能再使用传统骨粘结占位件的情况下也能够进行替代。例如,这种优选实施例的临时关节假体可替代长骨的大部分,或者甚至整个长骨。在本发明的一优选实施例中,临时关节假体因此涉及髋关节和膝关节的临时替代。
在本发明的另一实施例中,临时关节假体还包括具有支撑件的轴或支撑轴,其中,所述支撑轴具有远端和近端,支撑凸缘布置在所述远端与近端之间,所述支撑凸缘从支撑轴径向向外地延伸。支撑轴的直径大于所述至少一个轴耦接部的直径,支撑轴的尺寸使得其可靠触在长骨的剖切的横截面上。支撑轴尤其用于骨干的区域。换句话说,支撑轴使得能够实现临时关节假体在长骨上的良好支撑,并且防止轴过多地伸入长骨中。
在本发明的另一优选实施例中,轴(60)和支撑轴(70)在它们的近端和远端处包括彼此相对的互补的螺纹或螺纹连接件以及用于耦接工具的至少一个接合部。借助于根据本发明的临时关节假体的该优选实施例,确保不同的轴和不同的主体可相互组合。主体的耦接部可以是用于该目的的通孔,或者以内螺纹或外螺纹的形式设置。在本发明的一优选实施例中,这些连接元件在轴的一侧上是阳型连接元件,在相应的轴或主体的另一侧上是阴型连接元件。本发明将螺纹连接件理解为具有螺纹的连接元件以及具有卡口封闭件的连接元件。
上述用于拧固螺纹连接件的耦接工优选为具有相互平行的接合表面的扳手。
在另一实施例中,本发明涉及一种利用关节内假体治疗患者的方法,所述方法包括以下步骤:(i)从患者中移除关节内假体;和(ii)将如本文所述的临时关节假体嵌入。所述方法还优选地包括移除临时关节假体的步骤(iii)。
如本文所述的模块化临时关节假体用作患者、优选为人体内的内假体的临时替换物。本发明还涉及用于人体或动物体的手术和/或治疗性处理的方法,其中,首先移除现有的关节内假体,然后由本文所述的临时关节假体替代一段时间。手术或治疗处理的所述方法理想地在关节内假体区域中适用于患有急性败血症的患者。
附图说明
借助于以下附图和说明,将详细讨论用于更好地理解本发明的实施例。为此,附图中所示的特征用附图标记标出。在不同实施例的情况下,只要这些实施例中的特征相同或具有相同的效果即可使用相同的附图标记。
图1示出了根据本发明的用于膝盖(股骨和/或胫骨)的临时关节假体的主体,所述主体具有带有止动件的两个夹持翼。
图2以放大视图示出了主体,其中,夹持翼被嵌入。
图3示出了主体的正视图。
图4示出了关节件,所述关节件可借助于关节耦接部固定至临时关节假体的主体。
图5示出了根据本发明的具有两个主体的模块化临时关节假体。
图6示出了轴和连接至该轴的主体。
图7和图8分别示出了本文所述的模块化临时关节假体的一组不同部件。
具体实施方式
图5示出了根据本发明的模块化布置的临时关节假体1的结构的一个示例,所述临时关节假体1设置成用于替代移出的关节内假体(未示出)。临时关节假体1具有两个主体20、40。由此,在该临时关节假体1的设计中,考虑了设置成用于替代两个移出的人造关节的实施例。在图5所示的特定情况下,是替代髋部假体和膝关节。
关于图5所示的临时假体1可看出,由于关节件10在未示出的髋臼中被引导,因此所述临时假体1能够为患者提供一定程度的可动性,并由此保持其作为关节的功能。另一方面,用作移出的人造膝关节的替代物的主体40是刚性的,由此不允许任何关节式运动。然而,由于位于主体20上的关节件10,患者可将他的腿移出髋部。因此,一方面,图5所示的临时关节1的实施例使得能够进行物理治疗措施,另一方面,该设计为患者提供一定程度的运动自由度。这对肌肉和韧带有积极的作用。
同时,主体20以及主体40确保周围的软组织不能在腿的纵向方向或其横向方向上缩短至如此程度。由此,不会妨碍永久性关节替代物的新植入。
主体20替代股骨的位于股骨颈区域中的弯折的区域。对于根据本发明的临时假体,优选地选择135°的角度。
如果主体20、40具有关节件10,则关节联接部28设置成用于将所述关节件10附接至主体20、40。所述关节联接部优选为锥形,并已在上文进行说明。因此,在这种实施例中,关节件10具有锥形的内表面14(图4)。
此外,至少一个关节固定元件12可设置在关节件10上,以便将关节件10固定至主体20的关节联接部28。有利地,所述至少一个关节固定元件12布置成使得所述关节固定元件12的固定或紧固将锥形的关节联接部28压入关节件10的相应的关节耦接部14中,由此确保无游隙式连接。这可例如借助于作为关节固定元件12的窄缩的螺旋部和位于关节联接部28的表面中的相应地的被指向的凹部来实现。如果设置了一个以上的关节固定元件12,则这些关节固定元件12优选地绕关节耦接部的外周均匀地分布。
为了将主体20、40耦接至轴60,本发明中尤其优选两种附接可行方案。在第一附接可行方案中,主体20、40沿纵向方向在至少一个端部处具有主体耦接部24、44。在这种情况下,主体耦接部24、44优选地包括用于连接的螺纹。在本发明中,主体耦接部24、44还包括卡口。在可连接至主体20、40的轴60的与主体耦接部互补的轴耦接部64上,相应地设有互补的螺纹,使得主体20、40和轴60可彼此耦接。
为了固定轴60与主体20、40之间的连接,接合部22优选地设置在主体20、40上,接合部62、72优选地设置在轴60、70上。如上所述,接合部可设置在轴60的基本上整个长度上、至少在轴60的长度的50%、60%、70%、80%、优选地至少90%上。
接合部22、62、72附加地优选地涉及两个相互平行的接合表面65(图6),耦接工具2可接合至所述接合表面65中。在所示的实施例中,耦接工具2设计成扳手的形式。
如果耦接部在纵向方向上位于主体20、40和/或轴60、70的两端处,则一侧的耦接部与另一侧的耦接部互补。在螺纹的情况下,外螺纹相应地位于主体20、40或轴60的一侧上,内螺纹位于主体20、40或轴60的相应的另一侧上。因此,轴60、70和主体20、40可根据需要互换。
参照图7,这针对轴60和支撑轴70示出。由此,在轴60、70的一侧上,示出了阳型耦接部64和74。轴60、70的相反侧上的互补的阴型耦接部64、74位于轴的端面中并且在图7中不可见。
在第二附接可行方案中,孔44在主体20、40中设置在至少一侧上,轴60、70可嵌入所述孔中。如上所述,孔44优选为通孔(还参见图1、3、6和8)。轴60、70可经由至少一个轴固定元件43被固定。
如果涉及通孔44,则轴60可在两侧上从主体20、40突出(图5和图6)。这种布置在图5和图6中示出。在这两个附图中,主体40都设置成作为人造膝关节的替代物。在这些情况下,相同的轴60在两侧沿纵向方向从主体40突出。因此,可将嵌入通孔44中的轴60嵌入两个邻近的长骨中,由此侧向地固定主体40。如果主体40例如设置成用于替代人造膝关节,则轴60的一侧位于股骨中,而轴60的另一侧布置在胫骨中。这种情况在图5中示出。轴60在主体20、40中的由于通孔44的可移位性具有上文已述的优点。
在图5所示的实施例中,尽管嵌入主体40的通孔44中的轴60可能设置成用于被引入长骨的部分中的目的,但是所述轴60不设置成用于侧向地固定临时假体1。而是,图5所示的临时假体1设置成用于整个股骨已被移除并且胫骨的近端部分也已被移除的情况。因此,主体20、40都未利用其沿纵向方向定向的表面支撑在长骨上。
然而为了能够在长骨中实现一定的锚固,临时假体1可经由临时假体1的在远端处附接的轴60嵌入胫骨(未示出)的远端中。为了防止滑过轴60,设置支撑轴70,所述支撑轴70经由上述互补的连接件64、74嵌入两个轴60之间。支撑轴70的径向向外延伸的支撑凸缘78在此位于胫骨的近端剖切表面上,从而承担主体20、40的上述表面的作用,由此防止滑过。由于图5所示的临时假体1设置成用于上述情况,所以主体40不具有上文已述且下文将更详细描述的任何夹持翼50。
另一方面,如果轴60仅在主体20、40的一侧上突出,则临时假体仅用于替代之前移出的人造关节的一个关节侧。在图5中,当轴60经由孔附接时,主体20由此将仅替代髋关节的股骨部分。膝关节的胫骨或股骨部分的替代也是一样。在单侧替代的情况下,主体40具有相应地较短的长度。
通常,对于在所示实施例中设置成用于替代膝关节(图5和6)或膝关节的胫骨部分(参见图1至图3)的主体40,所述主体40的长度设置在10至80mm的范围内。所示实施例中的主体40的尺寸在侧向方向上设置在40至90mm之间的范围内,在垂直于侧向方向的方向上设置在35至55mm之间的范围内。
轴的横截面优选地在其长度上保持不变。术语“基本上”包括可能存在接合表面62,如图6所示。然而,轴60的横截面设计成使得轴可嵌入或穿过长骨的骨干区域。为此,轴60的直径为8至15mm、优选为10至12mm。
相比之下,根据本发明的主体20、40的特征在于,它可优选地不嵌入邻近长骨的骨干区域中。在垂直于其纵向方向的横截面中,优选为圆柱形的主体40的外轮廓在其优选实施例中基本上遵循相同关节部分中的胫骨的干骺端区域中的外形,作为膝关节的至少一部分的替代物(图1和图2)。
主体20、40也可具有夹持翼50(图1至3和图6)。相对于主体40的横截面,夹持翼50垂直于其纵向方向、优选地(沿横截面的直径方向)相对地布置。
在一实施例中,它们借助于伸缩杆52被引导,所述伸缩杆52可移位地布置在主体40的开口或孔中。由此,夹持翼50可如在夹钳的情况下那样以夹爪的方式从主体40拉出以及被推入主体40中。
如图3所示,夹持翼50具有止动区域51,所述止动区域51在临时假体1的嵌入状态下撞击邻近的长骨,其中,止动区域51的表面面向主体40。由于这适用于相对的夹持翼50,所以中间区域、即优选地干骺端区域被夹持。在这种情况下,由止动区域51的沿主体40的纵向方向突出超过主体40的部分产生的与邻接的长骨的外周的互锁连接固定主体40以防止绕其纵向轴线旋转。
在夹持翼的调整之后,夹持翼50通过夹持翼固定元件56固定在主体40中。此外,上文已更详细地描述的防滑装置53可设置在夹持翼50中,所述防滑装置53在图1至图3所示的实施例中设计为沿伸缩杆的纵向方向形成的凹部。
轴60的末端可形成为滚圆的端部68(图5至图7)。
在根据本发明的所有实施例中,临时假体由于其模块化设计而使得能够实现患者特异性解决方案。由于其与相应的设计有关的机械承载能力以及其灵活性,患者还具有受限制的可动性。这对患者在患病阶段期间的生活质量有积极的影响,同时也改善修正的准备以及进而的成功前景。
附图标记列表
1 临时假体
2 耦接工具
10 关节件
12 关节固定元件
14 关节耦接部
20 主体
22 用于耦接工具的接合部
24 用于轴的主体耦接部
28 关节联接部
40 用于膝盖的主体
43 轴固定元件
44 主体耦接部
50 夹持翼
51 止动件
52 伸缩杆
53 防滑装置
56 夹持翼固定装置
60 轴
62 用于耦接工具的接合部
64 轴耦接部
65 接合部62的接合表面
68 滚圆的端部
70 支撑轴
72 接合部
74 支撑轴的耦接部
78 支撑凸缘
Claims (11)
1.一种临时关节假体(1),其能够嵌入长骨中并用于替代待移出的关节内假体,其中,临时关节假体具有主体(20;40)和轴(60),所述主体具有主体耦接部(24;44),所述轴具有轴耦接部(64),轴耦接部(64)能够可拆卸地耦接至主体耦接部(24;44)。
2.根据权利要求1所述的临时关节假体(1),其特征在于,主体(20;40)还包括至少两个夹持翼(50),所述夹持翼能够垂直于主体(20;40)的纵向方向相对于主体(20;40)移位,其中,每个夹持翼(50)都具有止动件(51),所述止动件(51)沿主体的纵向方向在主体的至少一侧上延伸超过主体。
3.根据权利要求2所述的临时关节假体,其特征在于,夹持翼(50)中的每一个都能够经由至少一个伸缩杆(52)、优选地两个伸缩杆移位。
4.根据权利要求3所述的临时关节假体(1),其特征在于,至少一个夹持翼(50)的至少一个伸缩杆(52)具有防滑装置(53),所述防滑装置优选地设计为沿伸缩杆(52)的纵向方向的凹部,主体(50)的夹持翼固定元件(56)接合至所述凹部中。
5.根据前述权利要求中任一项所述的临时关节假体(1),其特征在于,主体耦接部(24;44)包括通孔,轴可移位地布置在所述通孔中,所述轴优选地能够经由轴固定元件(43)被固定。
6.根据前述权利要求中任一项所述的临时关节假体(1),其特征在于,轴(60)至少沿着轴的长度的一部分具有用于耦接工具(2)的接合部(62)所述接合部由彼此相反地布置的平行的至少两个表面(65)形成。
7.根据前述权利要求中任一项所述的临时关节假体(1),其特征在于,主体具有关节联接部(28),关节件(10)能够利用关节件的关节耦接部(14)可拆卸地固定至所述关节联接部。
8.根据前述权利要求中任一项所述的临时关节假体(1),其特征在于,所述临时关节假体具有两个主体。
9.根据前述权利要求中任一项所述的临时关节假体(1),其特征在于,所述临时关节假体还包括具有远端和近端的支撑轴(70),其中,支撑凸缘(78)布置在支撑轴的远端与近端之间,所述支撑凸缘从支撑轴径向向外地延伸。
10.根据权利要求9所述的临时关节假体(1),其特征在于,轴(60)和支撑轴(70)分别具有位于其近端处的耦接部(64、74)、位于其相反的远端处的与之互补的相应的耦接部(64、74)以及用于耦接工具的至少一个接合部,其中,耦接部(64、74)优选地设计为螺纹。
11.根据前述权利要求中任一项所述的临时关节假体(1),其特征在于,所述临时关节假体包括抗粘附的、抗微生物的和/或含抗生素的表面或表面部分。
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US20140309745A1 (en) * | 2013-04-16 | 2014-10-16 | Brian G. Burnikel | Modular, adjustable, prosthetic, hip/shoulder spacer |
US20150018828A1 (en) * | 2013-04-30 | 2015-01-15 | John R. Dorris | Anti-Septic Transarticular Intramedullary Rod System for the Human Knee |
Also Published As
Publication number | Publication date |
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DE102015202715B4 (de) | 2016-12-15 |
CN107427369B (zh) | 2019-09-10 |
DE102015202715A1 (de) | 2016-08-18 |
AU2016217793A1 (en) | 2017-08-31 |
ES2793317T3 (es) | 2020-11-13 |
RU2698177C2 (ru) | 2019-08-22 |
AU2016217793B2 (en) | 2020-08-27 |
US20180296352A1 (en) | 2018-10-18 |
EP3256078B1 (de) | 2020-04-01 |
WO2016128551A1 (de) | 2016-08-18 |
EP3256078A1 (de) | 2017-12-20 |
RU2017131848A3 (zh) | 2019-03-14 |
RU2017131848A (ru) | 2019-03-14 |
US11439509B2 (en) | 2022-09-13 |
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