CN107569302A - 通过球窝嵌件和髋球窝的限定的背面碰撞提高用于髋关节假体的陶瓷的球窝嵌件的断裂负荷 - Google Patents

通过球窝嵌件和髋球窝的限定的背面碰撞提高用于髋关节假体的陶瓷的球窝嵌件的断裂负荷 Download PDF

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CN107569302A
CN107569302A CN201710679980.6A CN201710679980A CN107569302A CN 107569302 A CN107569302 A CN 107569302A CN 201710679980 A CN201710679980 A CN 201710679980A CN 107569302 A CN107569302 A CN 107569302A
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ball
socket
hip
socket insert
insert
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R.普雷伊斯
T.潘多夫
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Ceramtec GmbH
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    • 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
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    • 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
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    • 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
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    • A—HUMAN NECESSITIES
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    • 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
    • A61F2/34—Acetabular cups
    • A61F2002/3412—Acetabular cups with pins or protrusions, e.g. non-sharp pins or protrusions projecting from a shell surface
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
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    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
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    • A61F2310/00179—Ceramics or ceramic-like structures
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    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
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    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
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    • A61F2310/00179—Ceramics or ceramic-like structures
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Abstract

本发明涉及一种用于髋关节假体(12)的髋球窝(4)和球窝嵌件(3)，其中，球窝嵌件(3)与髋球窝经由锥形的夹持连接的夹持锥(5)在两个组件(3,4)的赤道区域(7)中相连结并且在球窝嵌件(3)未加载的状态中在夹持锥(5)之下直至极(6)布置有在两个组件(3,4)之间的间隙(8)，其由两个组件(3,4)的径向的轮廓线限制。为了减小在球窝嵌件中的拉应力提出，两个组件(3,4)的径向轮廓线从下部的锥端部(9)出发直至极(6)以相同的顺序具有相同的几何元素，并且在这些几何元素之间出现相切的或近似相切的过渡部。

Description

通过球窝嵌件和髋球窝的限定的背面碰撞提高用于髋关节假 体的陶瓷的球窝嵌件的断裂负荷
本申请为2012年10月29日进入中国国家阶段的PCT申请“通过球窝嵌件和髋球窝的限定的背面碰撞提高用于髋关节假体的陶瓷的球窝嵌件的断裂负荷”（申请号：2012110800609040，申请人：陶瓷技术有限责任公司）的分案申请。
技术领域
本发明涉及一种用于髋关节假体(Hüftgelenkprothese)的髋球窝(Hüftpfanne)和球窝嵌件(Pfanneneinsatz)，其中，球窝嵌件与髋球窝经由锥形的夹持连接(Klemmverbindung)的夹持锥(Klemmkonus)在两个组件的赤道的(äquatorial)区域中相连结并且在夹持锥之下直至极布置有在两个组件之间的间隙，其由两个组件的径向的轮廓线(Konturzug)限制。
背景技术
对于现代的髋关节假体，使用不同的材料用于实现生物兼容的、耐磨损的支承。在此，根据现有技术，所谓的硬-硬配对(Hart-Hart-Paarung)最适合用于患者的持久可靠的保障(Versorgung)。在这些配对中不仅装配在髋胫(Hüftschaft)上的球头而且装配在髋球窝中的球窝嵌件由在技术含义上硬的材料构成。目前应用陶瓷-陶瓷配对和金属-金属配对。当前的研究也研究陶瓷-金属配对的临床效果。
为了给运用的手术者提供在内科手术上(intra-operativ)为患者选择最佳的滑动配对的可能性，现代的髋关节假体模块化地来构建(见图1)。植入物通常由与球头2相连结的柄(Schaft)1和与球窝嵌件3相连结的髋球窝4构成。柄和髋球窝通常由金属合金构成且通过生长到大腿骨或髋骨中而与躯干相连接。它们是对球头或球窝嵌件的载体。球头以带有自由度一的方式可旋转地支承在球窝嵌件的球冠中。
在球窝嵌件与髋球窝之间的连结在没有使用适配材料(Adaptermaterial)(例如塑料)的直接连结的情况下实现，并且通常通过锥形的夹持连接。例如在文件EP 0 649641、EP 0 826 347和DE 196 54 409中说明了对此的解决方案。在此引人注目的是，组件的连结大多通过处于髋球窝的所谓的赤道区域中的夹持锥实现。为了解释概念“赤道的”参见图2，附图标记5。在组件的所谓的极区域中没有接触，取而代之，设置有明显的间隙，以便避免在该区域中组件的接触，见文件EP 0 649 641图1或文件EP 0 826 347图1至4。为了解释概念“极的”参见图2，附图标记6。
避免在球窝嵌件的背面的区域(在夹持锥之下直至极的几何区域)中组件的接触的必要性如下得出：
1. 通过球窝嵌件的加载实现球窝嵌件依赖于负荷地略微沉入髋球窝中。在此如果在背面的区域中提早出现组件之间的接触，这导致夹持锥的卸载。由此，连结的卡紧力不继续升高，而是保持在可能过低的水平上。如果然后通过在球头与球窝嵌件之间的附着将拉力传递到球窝嵌件上，可将其从髋球窝中抬起。
连结的该干扰最终可在活的有机体内导致假体系统的失效。
而如果在组件之间存在足够的间隙，则夹紧力无阻地随着球窝嵌件的负载增加而增高，从而确保组件的足够的卡紧。
2. 如果在背面的区域中出现组件之间的接触，则必须保证，该接触非点状地出现，而是面接触。点接触导致局部的应力过高，其导致过载和提早失效。然而，在所示出的几何结构中不能保证面接触。
很小的几何偏差(如其在允许的公差的范围中总是可能的那样)以及由不对称的负载等引起的在髋球窝中的很小的翻倾已导致点接触并且由此导致提早失效。特有的研究表明，在背面的区域中的受控的面接触利用现有的几何结构是不可能的。
可由此出发，即由于组件的受控的背面的接触在避免或解决所说明的问题的情况下出现在球窝嵌件中的拉应力的减小，这尤其在使用陶瓷的球窝嵌件时正面地起作用。由此可明显提高球窝嵌件的断裂负荷(Bruchlast)。在使用由金属合金构成的球窝嵌件时可期待，由于应力的减小而出现更小的变形。这可导致，减少由负载引起的滑动面的形状偏差并且减小滑动副的磨损。
特有的研究着重于在带有该或类似的几何结构的组件之间的背面的间隙的必要性。
发明内容
本发明目的在于如此改进根据权利要求1的前序部分的用于髋关节假体的髋球窝和球窝嵌件，使得实现在球窝嵌件中拉应力的减小。
根据本发明，该目的通过权利要求1的特征来实现。
因为两个组件的径向轮廓线从下部的锥端部出发直至极以相同的顺序具有相同的几何元素且在这些几何元素之间出现相切的或近似相切的过渡部，实现在球窝嵌件中拉应力的减小。
在优选的实施形式中，该间隙是初始间隙，其在球窝嵌件的未加载的状态中是最大的并且在负载施加到球窝嵌件上时减小并且从一定的负荷起至少部分地闭合，从而在夹持锥之下也发生组件的接触。球窝嵌件的断裂负荷通过受控的背面的接触由此明显提高。
优选地，在球窝嵌件的未加载的状态中在锥附近的区域中的在组件之间的初始间隙的宽度小于或等于在极的区域中的间隙的宽度。
备选地，在球窝嵌件的未加载的状态中在组件之间的初始间隙的宽度从锥附近的区域出发朝向极连续地增加。
优选地，髋球窝由金属构成并且薄壁地且由此特别柔性地来构造。由此，在施加负载到球窝嵌件上时髋球窝可扩张并且球窝嵌件在夹持锥上滑到髋球窝的内部中直至从一定的负荷起在夹持锥之下也发生组件的接触。
有利地，球窝嵌件由陶瓷构成且优选地由氧化铝陶瓷或基于氧化铝或氧化锆的混合陶瓷构成或者由硅-氮陶瓷构成。
在本发明的一实施形式中，球窝嵌件的背面就如髋球窝的内部的几何结构那样构造为球体(Kugelsphaere)的一部分。
在一实施形式中，在夹持锥外部，球窝嵌件的背面的半径R嵌件-背面(RER)等于或大于髋球窝的内部的几何结构的半径R球窝-极(RPP)。
优选地，在夹持锥与球体之间的过渡部处，球窝嵌件的背面的倒圆半径(R嵌件-倒圆)等于髋球窝的内部的几何结构的倒圆半径(R球窝-倒圆)。
一优选的实施形式特征在于，在夹持锥与球体之间的过渡部处相应存在倒圆半径并且R嵌件-背面(RER)接近R球窝-极(RPP)而R嵌件-倒圆(REV)大于R球窝-倒圆(RPV)，球窝嵌件由氧化铝-混合陶瓷构成而髋球窝是薄壁的金属球窝。
为了避免另外上面所说明的问题并且为了获得所谓的受控的背面的接触或还有“受控的底部接触”，提出以下解决方案：
球窝嵌件的背面的几何结构与髋球窝的内部的几何结构彼此被如此相协调，使得：
在径向的轮廓线上，从下部的锥端部出发直至相应的组件的极，在几何元素之间仅出现相切的或近似相切的过渡部；
径向的轮廓线从下部的锥端部出发直至共同所属的组件的极仅仅具有相同的几何元素，其中，尺寸不必相同；
在锥附近的区域中的在组件之间的初始间隙(也就是说在未加载的状态中)小于或等于在极的区域中的间隙。
附图说明
接下来根据三个附图详细阐述本发明。
图1显示了根据现有技术的髋关节假体12。
图2和3中示出了根据本发明的用于髋关节假体的球窝嵌件和髋球窝的一优选的实施形式。
具体实施方式
图1显示了根据现有技术的髋关节假体12，其模块化地来构建。髋关节假体12由与球头2相连结的柄1和与球窝嵌件3相连结的髋球窝4构成。柄1和髋球窝4通常由金属合金构成并且通过生长到大腿骨或髋骨中而与躯干相连接。它们是对球头2或球窝嵌件3的载体。球头2以带有自由度一的方式可旋转地支承在球窝嵌件3的球冠中。
在图2和3中示出了根据本发明的用于髋关节假体12(见图1)的球窝嵌件和髋球窝的一优选的实施形式。球窝嵌件3利用夹持锥5锚固在髋球窝4中。利用附图标记7表示赤道区域而利用附图标记6表示极。在该实施形式中，球窝嵌件3的背面的几何结构和髋球窝4的内部的几何结构实施为球体或球体的部分。在至夹持锥5的过渡部处相应存在倒圆REV和RPV。球窝嵌件3的背面11的球体的半径R嵌件-背面RER设计得略大于髋球窝4的内部的几何结构的半径R球窝-极RPP。在球窝嵌件4处的倒圆半径R嵌件-倒圆REV等于髋球窝4的内部的几何结构的倒圆半径R球窝-倒圆RPV。由此得出的在组件3、4之间的间隙8从下部的锥端部9附近的区域出发朝向组件3、4的极6增加。间隙8的宽度利用附图标记10来表示。

Claims (10)

1.一种用于髋关节假体(12)的髋球窝(4)和球窝嵌件(3)，其中，所述球窝嵌件(3)与所述髋球窝经由锥形的夹持连接的夹持锥(5)在两个组件球窝嵌件(3)和髋球窝(4)的赤道区域(7)中相连结并且在所述球窝嵌件(3)的未加载的状态中在所述夹持锥(5)之下直至极(6)布置有在所述两个组件(3,4)之间的间隙(8)，其由两个组件(3,4)的径向轮廓线限制，其特征在于，所述两个组件(3,4)的径向轮廓线从下部的锥端部(9)出发直至所述极(6)以相同的顺序具有相同的几何元素，其中尺寸不必相同，并且仅在所述几何元素之间出现相切的或近似相切的过渡部，所述间隙(8)是初始间隙(8)，其在所述球窝嵌件(3)的未加载的状态中是最大的并且在负载施加到所述球窝嵌件(3)上时减小并且从一定的负载起至少部分地闭合，从而在所述夹持锥(5)之下也发生所述组件(3,4)的受控的面接触。
2.根据权利要求1所述的髋球窝和球窝嵌件，其特征在于，在所述球窝嵌件(3)的未加载的状态中在锥附近的区域中的在所述组件(3,4)之间的所述初始间隙(8)的宽度(10)小于或等于在所述极(6)的区域中的间隙的宽度。
3.根据权利要求1所述的髋球窝和球窝嵌件，其特征在于，在所述球窝嵌件(3)的未加载的状态中在所述两个组件(3,4)之间的所述初始间隙(8)的宽度(10)从所述夹持锥附近的区域出发朝向所述极(6)连续地增加。
4.根据权利要求1至3中任一项所述的髋球窝和球窝嵌件，其特征在于，所述髋球窝(4)由金属构成并且薄壁地且由此特别柔性地来构造。
5.根据权利要求1至3中任一项所述的髋球窝和球窝嵌件，其特征在于，所述球窝嵌件(3)由陶瓷构成。
6.根据权利要求5所述的髋球窝和球窝嵌件，其特征在于，所述球窝嵌件(3)由氧化铝陶瓷或基于氧化铝或氧化锆的混合陶瓷构成或者由硅-氮陶瓷构成。
7.根据权利要求1至3中任一项所述的髋球窝和球窝嵌件，其特征在于，所述球窝嵌件(3)的背面(11)就如所述髋球窝(4)的内部的几何结构那样构造为球体的一部分。
8.根据权利要求7所述的髋球窝和球窝嵌件，其特征在于，在所述夹持锥(5)外部，所述球窝嵌件(3)的背面(11)的半径R嵌件-背面(RER)等于或大于所述髋球窝(4)的内部的几何结构的半径R球窝-极(RPP)。
9.根据权利要求7所述的髋球窝和球窝嵌件，其特征在于，在所述夹持锥(5)与球体之间的过渡部处，所述球窝嵌件(3)的背面(11)的倒圆半径R嵌件-倒圆(REV)等于所述髋球窝(4)的内部的几何结构的倒圆半径R球窝-倒圆(RPV)。
10.根据权利要求7所述的髋球窝和球窝嵌件，其特征在于，在夹持锥(5)与球体之间的所述过渡部处相应存在倒圆半径，并且R嵌件-背面(RER)接近R球窝-极(RPP)而R嵌件-倒圆(REV)大于R球窝-倒圆(RPV)，所述球窝嵌件由氧化铝-混合陶瓷制成而所述髋球窝(4)是薄壁的金属球窝。
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