CN107820414B - 用于铰接式接头的套管增大装置 - Google Patents

用于铰接式接头的套管增大装置 Download PDF

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Publication number
CN107820414B
CN107820414B CN201680040561.1A CN201680040561A CN107820414B CN 107820414 B CN107820414 B CN 107820414B CN 201680040561 A CN201680040561 A CN 201680040561A CN 107820414 B CN107820414 B CN 107820414B
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sleeve
augmentation
wall portion
augmentation apparatus
wall
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CN107820414A (zh
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E.鲍尔
H.D.林克
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Waldemar Link GmbH and Co KG
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Waldemar Link GmbH and Co KG
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Abstract

本发明涉及用于关节内假体的增大装置,具体地,用于膝关节内假体的胫骨增大器件,增大装置包括套管(10),套管(10)环绕通道(11),通道(11)贯穿套管(10)。套管(10)由用于骨骼材料的向内生长的多孔材料(2)形成,套管(10)包括内面(14)和外面(15)。套管(10)还包括壁部(3),壁部(3)环绕通道(11),壁部(3)由固体材料制成,并且,以多孔材料(2)形成夹层结构,其中,壁部(3)形成内面(14)与外面(15)之间的隔离壁。从而,隔离壁式壁部(3)将使从套管(10)的内面(14)横过套管(10)而到达套管(10)的外面(15)的任何粘固剂的流入停止。将使外面(15)上的多孔材料(3)免于粘固剂,并且,可靠地保持多孔材料(3)的促进骨骼向内生长的能力。增大装置优选设置为具有不同的尺寸和笔直的或阶梯状底部的套件,以实现天然骨骼物质的最大程度的保存和改进的通用性。

Description

用于铰接式接头的套管增大装置
技术领域
本发明涉及用于关节内假体的增大装置。具体地,所提到的本发明涉及用于膝关节内假体的胫骨增大器件。
背景技术
由于疾病、损伤或磨损(具体地,高龄)而导致以内假体植入物置换身体中的关节(诸如,膝盖、肩膀、肘部)的方案是很常见的。由于其他病或失效的内假体的外植,为处于病态的内假体寻找植入侧的方案并不少见,主要由于其附近的骨骼缺损。对于外科医生而言,这是个问题,因为,在关节植入侧附近缺乏强健骨骼的状况可能致使不可能将内假体植入,或可能导致过早失效。由于相当频繁地遭受这样的骨骼缺损,因而设想出补救该情形的各种途径。
具体地,对于这样的指示,其中,将使用关节内假体,已知提供一种增大装置,该增大装置配置成填补由缺损的骨骼留下的间隙。例如,在US 8 506 645 B2中,公开了具有套管的形式的这样的增大装置。因此,将去除有缺损的骨骼材料,并且,将通过放置增大装置而填补由此造成的腔。套管的形状满足允许装有柄的内假体的柄穿过其中心开口的目的,该中心开口形成用于柄的通道。套管本身配置成压紧至腔中。
增大装置包括主体,该主体由用于促进骨骼向内生长的多孔金属材料形成。然而,难以按精确的方式配备用于接纳增大装置的部位。然而,通常,粘固剂可以用于填补可能存在的任何间隙,或为增大装置提供更好的安置,存在如下的问题:粘固剂进入多孔金属材料,从而致使期望的向内生长促进特性相当无用。而且,粘固剂的这样的进入将导致难以进行增大装置的任何将来的去除。
发明内容
使该缺陷减轻的改进的增大装置的提供同样地是本发明的目标。
根据本发明的解决方案存在于独立权利要求的特征中。优选的实施例为从属权利要求的主题。
用于关节内假体的增大装置,具体地,用于膝关节内假体的胫骨增大器件包括套管,套管环绕通道,通道从套管的顶部穿过套管而延伸至套管的底部,套管由多孔材料形成,多孔材料配置成用于骨骼材料的向内生长,套管包括内面和外面,内面限定通道,并且,内面与外面之间的距离限定厚度,根据本发明,增大装置如此配置,以致于套管还包括环绕通道的壁部,壁部由固体材料制成,并且,以多孔材料形成夹层结构,其中,壁部形成内面与外面之间的隔离壁,隔离壁配置成用于阻断内面与外面之间的粘固剂流动。
本发明的要旨是,提供用于套管的夹层结构,夹层结构是固体壁部和多孔材料的混合物。借此,固体壁部将充当隔离壁,该隔离壁使粘固剂的横过多孔材料的厚度的流入停止。粘固剂仅可以流动至此其到达隔离壁,并且,粘固剂将在隔离壁处停止。从而避免以通道中所使用的粘固剂实质上填补了外部多孔结构,从而保持骨骼向内生长,多孔材料的骨骼向内生长促进作用被免于粘固剂的影响。作为又一优点,固体壁部起到加固元件的作用,该加固元件给套管提供更大的刚度。因而,固体壁部满足两个目的,即,第一,隔离壁保护一部分的多孔材料免受粘固剂的流入的影响,从而保持所述多孔材料的期望的骨骼向内生长能力,并且,另外提供更大的刚度。这两个优点相辅相成,具体地,因为,壁部提供一定程度的加固,从而允许在不损害机械稳定性的情况下,得到更高程度的孔隙率,以实现更进一步改进的骨骼向内生长能力。不存在这样的独特的有利的组合的先例。
壁部可以定位于内面处。从而,多孔材料将完全地放置于外侧,从而给周围的骨骼材料提供完全的骨骼向内生长能力。任选地,多孔材料将同样地放置于内侧上。备选地,具有压花部的凸出结构可以放置于壁部的内面上,从而为应用于通道内的粘固剂提供改进的粘合表面,并且,与在内面上具有多孔材料的变型截然相反而促进去除。
多孔材料优选具有高孔隙率(例如,总孔隙体积为总体积的至少60%-90%),并且,包括互相连接的孔隙。由于这样的高孔隙结构而将高度地促进骨骼材料的向内生长。
优选,壁部沿着从套管的底部至顶部的整个高度延伸。从而,其形成越过整个装置的完整的隔离壁,使整个内部空间免于来自外侧的任何粘固剂注入。这能够通过设置由固体材料制成的顶盖而进一步改进,顶盖如此配置,以致于其覆盖套管的基本上整个顶部。从而,还保护增大装置免于来自上方的粘固剂的注入。进一步优选将顶盖和壁部形成为一体的元件。从而形成完整的隔离壁,保护免于来自外面和顶部的注入。
优选,增大装置以圆锥形式为特征,以致于增大装置的总宽朝向其底端向下逐渐缩减。增大装置优选如此配置,以便于在其顶部处更宽,并且,具有10°与45°之间的圆锥角(作为假想的顶角而测量)。然而,圆锥形式无需完美。实际上,优选,套管包括至少一个内凹陷部。这样的内凹陷部为容纳内假体的柄(包括可能位于柄上的任何肋状物或可能存在于内假体的外周长上的任何其他伸出部,其否则可能与套管的内面和/或顶盖相互干扰)提供额外的空间。为了维持完全的隔离壁的功能性,顶盖优选进一步包括至少一个延伸盖,其配置成覆盖内凹陷部的侧面和/或底面。进一步优选,顶盖和延伸盖如此连接,以便于设置连续的顶部隔离壁。任选地,顶盖、延伸部和多孔材料可以形成为一体的元件。从而,即使在设置这样的凹陷部的情况下,也将保持壁部和顶盖的完全的隔离壁的功能性。
优选,套管的边缘至少部分地为倒圆的和/或成斜角的。从而,其更容易地融合至将被植入的骨骼的其腔中。而且,在操纵增大装置的方面,其为外科医生提供较低的切割冒险。
优选,具有压花部的凸出结构形成于内面上。从而,内面将变得不平滑,从而提供在通道和壁部中应用的任何粘固剂之间的更大的摩擦。由于压花部的压低的性质而可以达到微弱的联锁作用,然而,如果应当执行增大装置的去除,则该作用将小到足以容易地克服。优选,压花部是优选沿从套管的底部指向顶部的方向取向的凹槽。借此,在通道中应用的粘固剂阻断粘固剂与增大装置之间的任何不需要的向侧面的相对移动。然而,由于从底部延展至顶部的凹槽的取向而促进任何去除,因为,将通过使增大装置沿所述方向移动而进行这样的去除。该作用如果凹槽配置成以至于在宽度上逐渐缩减则可能甚至更明显。然而,能够针对具有压花部的凸出结构而选取其他配置。另一优选的实施例为具有以矩阵式方式布置的压花部,其中,单个的压花部优选配置成具有方格或菱形结构。备选地或另外,设置网格结构,网格结构包括板条和区间(interspace)。区间如此配置,以便于被多孔材料填补,然而,板条提供额外的结构加固,且从而达到多孔材料至壁部的改进的粘合。板条可以是分开的元件,但优选,板条与壁部一体形成。
在可以作为独立保护的主体的具体地优选的实施例中,套管包括至少一个弯曲接头,弯曲接头配置成用于使通道压缩。进一步优选,两个或更多个弯曲接头以镜面对称的方式布置。由于弯曲接头而导致套管可以从外侧压缩,且将达到减小的周长和宽度,允许将套管更容易地放入骨骼的紧密腔中。由于腔通常将尺寸定制为相当紧密,以实现骨骼中的增大装置和内假体的改进的机械稳定性,且进一步将尺寸定制为保存尽可能多的健康骨骼,因而存在如下的问题:迫使增大装置进入紧密腔中可能造成产生骨骼中的裂缝的风险。将借助于弯曲接头(而不是使骨骼开裂)来使套管本身压缩至较小的尺寸,从而允许将套管更容易地放置到腔中,而不存在使周围的骨骼材料开裂的风险。在优选的实施例中,弯曲接头由套管中的空隙形成,其中,固体材料的接片跨越空隙。优选,接片如此取向,以便于相对于壁部而倾斜,进一步如此优选,以致于与接片的上端相比,接片的下端定位成更接近外面,其中,接片的上端定位成更接近内面。接片充当铰链,该铰链提供使套管的一部分相对于另一部分而弯曲所要求的移动程度。而且,以接片形成的铰链的轴由接片的取向限定。使接片取向为相对于壁部的中间弦而倾斜,而不是使接片取向为与壁部的中间弦平行。从而,弯曲路径将不与壁部的平面平行,相反,其将平行或至少几乎平行于通道的中心轴。倾斜取向的程度由套管的圆锥角限定。换句话说,接片的倾斜布置抵消成圆锥形地形成的壁部的影响,并且,确保与顶盖平行的水平面上的压缩。
在又一优选的实施例中,接片配置成优选凭借逐渐缩减的宽度而具有下部部分中的降低的弯曲刚度。由于较低的弯曲刚度而导致下部部分对总体弯曲刚度的贡献相当小。结果,较短的弯曲接头的刚度的降低百分率比该弯曲接头的长度的降低百分率更小,其中,虽然所有弯曲接头具有不同的长度,但所有的弯曲接头都终止于套管的顶部处(如具有阶梯状底部的套管处)。
进一步优选,套管包括补偿器元件,补偿器元件配置成用于调整弯曲接头的弯曲状态下的套管的周长。补偿器元件允许用于吸收周长的减小的自由度,其中,将通过在压缩力下移动弯曲接头而实现周长的减小。优选,补偿器元件配置为处于滑动关系的至少两个重叠的舌状物。由于滑动关系而导致即使在补偿器元件的区域中,舌状物也维持隔离壁的功能性。而且,滑动关系允许长度的变化,且从而允许周长的减小。
在优选的实施例中,多个小孔设置于壁部中。术语“小孔”将被如此解释,以致于孔具有如此小的直径,以便阻止粘固剂穿过所述孔。从而保持关于粘固剂的隔离壁功能性。然而,小孔的存在进一步改进骨骼向内生长,且更重要的是,起到透气孔的作用,该透气孔排放可另外形成于壁部的内表面与流入的粘固剂之间的一些滞留的空气。空气能够借助于小孔而更容易地逸出,从而促进利用粘固剂来实现的植入且使其更可靠。
而且,窗部可以设置于壁部中,优选,接近于顶部而布置成一排。进一步优选,窗部同样地贯穿多孔材料。窗部形成用于粘固剂的精心设计的开口,以致于放置于内侧上的粘固剂可以按受控制的方式朝向外侧穿过窗部。从而,粘固剂的不想要的分布保持为受控制的。通过允许粘固剂流过窗部导致粘固剂形成穿通窗部的销状伸出部,从而如固定销那样抑制增大装置的位置。这提供了改进的固定。而且,通过将窗部定位成接近于顶部,从而如果去除增大装置,则可以容易地切割这些固定销。额外地或作为备选方案,大的通路设置于壁部和多孔材料中,从而贯穿整个套管。使通路取向成垂直于通道。优选,通路定位于壁部的中间部分中。进一步优选,通路以圆形拐角为特征,以实现改进的抗开裂能力。借助于通路,通过允许粘固剂以受控制的方式流过通路,从而形成相当大的固定耳轴,并且,该固定耳轴提供非常坚固的固定耳轴。术语“大的”将被如此解释,以便于意指至少三倍于单个窗部的面积的横截面面积。
在许多情况下,增大装置将具有平坦的底部表面。然而,优选,提供多个实施例,这些实施例具有阶梯状底部表面,该底部表面具有两个区段:增大装置具有其全高度的一个区段和增大装置具有降低的高度的另一区段。优选,底部为阶梯状,以致于降低的部分中的高度为全高度的大约0.4至0.7。进一步优选,具有全高度的区段与具有降低的高度的区段之间的过渡沿着对称线位于套管的中间,将套管分成左边部分和右边部分。然而,如果期望,该过渡可以偏移至任一侧。
根据可以作为独立保护的主体的本发明的又一实施例,提供如上文所定义的增大装置的套件,其中,该套件包括具有全高度的第一类增大装置和具有降低的高度的第二类增大装置,其中,降低的高度优选为全高度的0.4至0.7。
进一步优选,该套件包括具有阶梯状底面的第三类。进一步优选,该套件包括优选在从小到中等到大的范围内变动的不同的尺寸下的所述类型。
附图简述
在下文中,将以示范性的方式根据附图而描述本发明。在附图中:
图1a、b是第一示范性的实施例的透视图;
图2是示出在应有位置的根据本发明的增大装置的示意图;
图3是图1中所描绘的实施例的横截面;
图4是增大装置的壁部的具体视图;
图5a、b分别是具有窗部和通路的第二实施例和第三实施例的透视图;
图6 a-c是示出内面上的凸出结构的具体视图;
图7是具有弯曲接头的第四实施例的顶视图;
图8是穿过弯曲接头之一的具体横截面;并且,
图9示出不同的类型的增大装置的套件。
实施例详述
参考图1-4,示出根据本发明的增大装置1的第一实施例。该实施例的增大装置1优选为由生物相容性金属材料制成的胫骨增大器件。该材料优选选自包括钛合金、纯钛、钴铬、不锈钢、钽以及锆的组。进一步优选,材料为纯钛(例如,2级Ti)。这使优异的生物相容性与良好的强度和刚度特性组合。另一种优选的材料为钛合金(例如,Ti6Al4V)。可更普遍地获得该材料,同样地,该材料具有更高的刚度。
胫骨增大器件具有大致圆锥形式的套管10。套管10环绕通道11,通道11从增大装置1的顶部12完全地穿过增大装置1而延展至增大装置1的底部13。通道11配置成用于接纳内假体的柄,具体地,膝假体9的胫骨部分92的柄94。
套管10以夹层配置制成,该夹层配置具有壁部3,壁部3与两层多孔金属材料2组合。将注意到,内面处的多孔部分为任选的;在图6a、b、c中示出备选配置。壁部3从套管10的底部13延展至顶部12,完全地环绕通道11。在顶部12上,壁部3遇到覆盖套管10的整个顶侧12的顶盖4。顶盖4和壁部3形成一体的工件。从而,壁部3与顶盖4联合而充当隔离壁,该隔离壁阻断从通道11至套管10的外侧的粘固剂的任何通过。
胫骨增大器件1如此配置,以便于在解剖学上选择尺寸且成形,以填补远侧骨骼99(即,胫骨)的上部部分中的腔。增大装置1大致成圆锥形地形成,以实现更好的配合。其底侧13与其顶部12同样地为大致平面的。
如能够在图2中意识到的,增大器件1放置于骨骼99的上部部分的腔中,从而形成底座,在该底座上将定位膝假体9的胫骨构件92的胫骨板93。膝假体9还包括股骨构件91,股骨构件91配置成用于与胫骨部分92的可旋转的相互作用。胫骨构件92还包括柄94,柄94配置成锚固于胫骨99的髓通道中。柄94被导引穿过胫骨增大器件1的通道11。为了为任何肋状物94’或柄94上的其他伸出部或胫骨部分92大体上提供足够的空间,胫骨增大器件1进一步设置有凹陷部16,以便为柄94及其伸出部94’提供额外的空间。凹陷部16可以像如图3中所描绘的那样如压低部(depression)配置,具有底面16’’和侧面16’。为了设置连续的顶部隔离壁,底面16’’和侧面16’通过延伸盖45而封闭,其中,延伸盖45起到顶盖4的延伸部的作用。从而,获得顶侧上的连续的隔离壁,从而避免通过凹陷部16的粘固剂的任何不想要的泄漏。
放置于壁部3的外面上的多孔材料2优选由具有至少60-90%的孔隙率的高度多孔的材料制成。而且,使孔隙互相连接,并且,限定孔隙的基本单元以有规律的顺序布置。互相连接的孔隙提供用于骨骼材料的很大程度地改进的向内生长,且从而,确保胫骨99中的胫骨增大器件1的良好的稳定化。
在图6a-c中,示出内面的备选实施例的示例。图6a和图6b示出不具有多孔部分的内面,并且,图6c示出在内面上具有多孔部分的示例,然而,将注意到,多孔部分为完全地任选的,任一实施例可能设置或未设置多孔部分。在这些实施例中,内面设置有凸出结构61,凸出结构61在其间具有压花部62。在图6a中所示出的第一变型中,压花部62配置成具有菱形形状,并且,以矩阵式方式布置。这提供用于水平方向和竖直方向这两个方向上的额外的固定。在图6b中,示出具有配置为凹槽62’的压花部的变型,凹槽62’取向为沿从套管10的底部至顶部的方向延展。这提供用于相对于水平方向的改进的固定作用,但允许促进竖直方向上的增大装置的去除。在图6c中,示出具有设置于内面上的网格结构6的变型。网格6包括作为凸出结构61的板条和作为压花部的区间62’’。板条61限定网格,区间62’’布置于其间。区间62’’配置成任选地被多孔材料2填补,优选如此,以致于区间62’’将在填补状态下与板条61的表面齐平。网格结构6增强固定,并且,具有对套管10的相当大的加固作用,从而提供额外的机械强度。
为了植入,粘固剂可以应用于柄94的固定。为此,将在围绕柄94的通道11内应用粘固剂。粘固剂可以流动至放置于壁部3的内面上的多孔材料2中,从而提供牢固的联锁粘合。然而,为了保持多孔材料2的积极的骨骼向内生长作用,粘固剂不应当到达外面。出于此目的,设置有壁部3,壁部3充当隔离壁,该隔离壁将粘固剂限制于内部部分,从而保持外面基本上无粘固剂。顶盖4确保粘固剂不能朝向顶部溢出。不需要底盖。然而,底盖可以设置于位于壁部的外部且包括壁部的底部的区段处,从而阻断外面上的多孔材料2中的粘固剂的任何不想要的注入。
为了允许将粘固剂顺利注入内面上的多孔材料2中,有必要去除空气,空气被来自内部部分的粘固剂取代。为了促进空气的去除以避免空气滞留,多个小孔32以均匀地布置的方式设置于壁部3处,优选设置于整个壁部3处。在图4中对此进行描绘。孔32的尺寸如此定制,以便于允许气体如空气的通过,但必须阻断粘固剂的任何通过。优选的尺寸为0.3至0.5 mm之间。
现在,参考图5,第二实施例和第三实施例示出为设置有额外的用于固定的手段。为此,窗部34接近于套管10的顶端而成一排地设置。窗部34如此配置,以便于穿透壁部3,且优选,穿透任一侧上的多孔材料2。一植入且应用粘固剂,粘固剂就自由地从通道11通过窗部34而向外流动至外部。由于粘固剂的流动限制于窗部34的附近,因而关于外面上的多孔材料2的促进骨骼向内生长能力,未遭到副作用。然而,流过窗部34的粘固剂像额外的固定销那样起作用,该固定销将胫骨植入物1紧固至其位置中。这允许对增大装置1的更好且更快得多的固定。该配置的又一优点是,在增大装置1的所要求的去除的情况下,由于窗部34最接近于套管10的顶部12,因而能够容易地从外侧切割穿通窗部34的粘固剂销。从而将通过维持植入期间的高的稳定化程度而促进任何去除。
另外或备选地,如图5b中所描绘的,相当大的通路36能够形成于套管10的更大的中心区中。通路36穿过壁部3和多孔材料2而延展。通路36取向为基本上垂直于通道11的中心轴。穿过壁部2a的通路36的尺寸如此选择,以致于通路36具有大于三倍于窗部34中的任一个的面积。从而,通过使粘固剂流过通路36,从而将形成用于得到额外的固定强度的相当大块的耳轴。类似地,如在上文中关于窗部34而解释的,在通过切割粘固剂耳轴而去除的情况下,能够相当容易地去除该额外的固定。在所描绘的示范性的实施例中,通路将尺寸定制为10 x 8 mm。
在图7和图8中示出又一实施例。该实施例以两组弯曲接头7、7’为特征。弯曲接头允许套管10的弯曲,以致于将使套管10作为整体而压缩,从而缩短通道11的尺寸和套管10的外部尺度。由套管10中的空隙17与跨越空隙17的金属接片71组合形成弯曲接头7、7’。如在图8中最清楚地意识到的,金属接片71为固体材料,并且,从套管10的顶部12延展至底部13。接片71相对于壁部3而倾斜地取向,以致于接片71的下端73定位成接近于壁部3的外面,并且,接片71的上端72放置成接近于壁部3的内面。借此布置,接片71与通道11的中心轴基本上平行地取向。减小了下部部分74处的接片71的厚度。为此,接片71如此配置,以便于具有朝向其下端73逐渐缩减的宽度。借此逐渐缩减,大部分的弯曲力将由接片71的上部部分造成,而下部部分74将仅以更小得多的程度来促成弯曲力。
关于图7而描绘弯曲力和由此引起的移动。以镜面对称的配置设置有两对弯曲接头7、7’。第一组弯曲接头7放置于套管10的后壁处。通过施加弯曲力,从而弯曲接头7允许如单箭头所指示的旋转方向上的移动。从而,由弯曲接头7限定的弯曲轴提供用于中/侧(ML)方向上的弹性。
设置有第二组7’,第二组7’以镜面对称的配置布置于套管10的侧面部分处。弯曲接头7’提供如双箭头所描绘的运动的范围。这提供额外赋予前/后(AP)弹性的弯曲轴。结果,通过设置两对弯曲接头7、7’,从而达到二维上的弹性压缩性,即,一个为ML方向上的弹性压缩性,而另一个为AP方向上的弹性压缩性。
通过施加弯曲力,从而将缩短内部通道的宽度。从而,将缩短其周长。为了允许套管10实现这样的缩短,设置有补偿器元件4。在所描绘的实施例(参见图7)中,补偿器元件4布置于套管10的关于弯曲接头7的相对的前侧处。补偿器元件包括两个舌状物81、82,舌状物81、82布置于套管10的左右部分处。舌状物81、82以重叠的配置布置,仅仅在其间留下微小的间隙83。在利用弯曲接头7、7’来实现的弯曲运动的作用下,舌状物81、82沿着彼此滑动。间隙83如此定制尺寸,以便于小至足以阻断粘固剂的泄漏。
增大装置1的底部13可以为平坦的或阶梯状(参见图9)。在阶梯状变型中,具有降低的高度的部分13’存在于左侧或右侧上。过渡表面19将具有全高度的部分与具有降低的高度的部分13’连接。
而且,设置具有遍及整个区降低的高度的另外的类型。该类型被描绘为图9中的类型1’。具有阶梯状底部的类型被描绘为类型1’’,然而,如图1-8中所描绘的原始类型示出为图9中的类型1。
优选,设置完整的增大装置的套件。该套件包括如上文所提到的类型。另外,类型设置成不同的尺寸I、II、III以及IV,其中,I为尤其小的,II为小的,III为中等的;并且,IV为大的。这允许外科医生得到选择的相当广的范围,以便取决于植入部位的实际状况而选择适当的增大装置1。

Claims (32)

1.一种用于关节内假体的增大装置,具体地,用于膝关节内假体的胫骨增大器件,所述装置包括:
套管(10),其具有顶部和底部,在所述顶部和所述底部之间的距离限定所述套管的高度,其中,所述套管(10)环绕通道(11),该通道(11)从所述顶部至所述底部延伸穿过所述套管(10),
所述套管(10)由多孔材料(2)形成,该多孔材料(2)配置成用于骨骼材料的向内生长,
所述套管(10)包括内面(14)、外面(15)以及壁部(3),所述内面(14)限定所述通道(11),并且,所述内面(14)与所述外面(15)之间的距离限定厚度,
其中,所述壁部(3)环绕所述通道(11),所述壁部(3)沿着所述套管(10)的整个高度延伸,所述壁部(3)由固体材料制成并且所述壁部(3)与所述多孔材料(2)形成夹层结构,
其特征在于,所述壁部(3)形成所述内面(14)与所述外面(15)之间的越过整个所述装置的完整的隔离壁,所述隔离壁配置成用于阻断所述内面(14)与所述外面(15)之间的粘固剂流动,其中,所述壁部(3)位于内部位置处,以致于所述壁部(3)形成所述套管(10)的所述内面,所述壁部起到加固元件的作用。
2.根据权利要求1所述的增大装置,其中,所述壁部(3)位于沿着所述厚度的方向的中间位置处,以致于所述多孔材料(2)形成于所述壁部(3)的向内的一侧和向外的一侧上。
3.根据权利要求1所述的增大装置,其中,所述套管(10)为大致圆锥形状。
4.根据权利要求3所述的增大装置,其中,所述套管(10)在其顶部处更宽,并且具有10°与45°之间的圆锥角。
5.根据权利要求1所述的增大装置,其中,由固体材料制成的顶盖(4)如此设置,以致于其覆盖所述套管(10)的基本上整个顶部。
6.根据权利要求5所述的增大装置,其中,所述顶盖(4)和所述壁部(3)形成一体的元件。
7.根据权利要求5所述的增大装置,其中,所述套管(10)包括至少一个凹陷部(16),并且,所述顶盖(4)还包括至少一个延伸盖(45),该延伸盖(45)配置成覆盖所述凹陷部的侧面和/或底面。
8.根据权利要求7所述的增大装置,其中,所述顶盖(4)和所述延伸盖(45)如此连接,以便于设置连续的顶部隔离壁。
9.根据权利要求1所述的增大装置,其中,所述套管(10)的边缘至少部分地为倒圆的和/或成斜角的。
10.根据权利要求1所述的增大装置,其中,具有压花部(62)的凸出结构形成于所述内面(14)上。
11.根据权利要求10所述的增大装置,其中,所述压花部(62)为凹槽(62’)。
12.根据权利要求11所述的增大装置,其中,所述凹槽(62’)沿从所述套管(10)的底部指向所述套管(10)的顶部的方向取向。
13.根据权利要求11所述的增大装置,其中,所述凹槽(62’)在宽度上逐渐缩减。
14.根据权利要求10所述的增大装置,其中,所述压花部(62)以矩阵式方式布置。
15.根据权利要求14所述的增大装置,其中,所述压花部(62)以方格或菱形结构布置。
16.根据权利要求10所述的增大装置,其中,具有压花部的所述凸出结构配置为网格结构(6),该网格结构(6)包括板条(61’)和区间(62’’)。
17.根据权利要求16所述的增大装置,其中,所述多孔材料(2)填补所述区间(62’’)。
18.根据权利要求16所述的增大装置,其中,所述板条(61’)与所述壁部(3)一体形成。
19.根据权利要求1至18中的任一项所述的增大装置,其中,多个小孔(32)设置于所述壁部(3)中。
20.根据权利要求1至18中的任一项所述的增大装置,其中,所述套管(10)包括至少一个弯曲接头(7),所述弯曲接头(7)配置成用于使所述通道(11)压缩。
21.根据权利要求20所述的增大装置,其中,两个或更多个弯曲接头(7)镜面对称地布置。
22.根据权利要求20所述的增大装置,其中,所述弯曲接头(7)配置成具有在下部部分中的与在上部部分中相比而降低的弯曲刚度。
23.根据权利要求20所述的增大装置,其中,所述套管(10)包括补偿器元件(8),该补偿器元件(8)配置成用于调整在所述弯曲接头(7)的弯曲状态下的所述套管(10)的周长。
24.根据权利要求23所述的增大装置,其中,所述补偿器元件(8)配置为以滑动关系布置的两个重叠的舌状物(81、82)。
25.根据权利要求1至18中的任一项所述的增大装置,其中,所述套管(10)具有阶梯状底部,以形成具有全高度的部分和具有降低的高度的另一部分(13’)。
26.根据权利要求25所述的增大装置,其中,所述降低的高度为所述全高度的0.4至0.7。
27.根据权利要求25所述的增大装置,其中,过渡(19)设置于全高度与降低的高度之间的阶梯处,所述过渡(19)限定所述增大装置的左半部分和右半部分。
28.一种根据权利要求1至27中的任一项所述的增大装置的套件,其特征在于,所述套件包括具有所述套管(10)的全高度的第一类和带有平面底部的具有所述套管(10)的降低的高度的第二类(1’)。
29.根据权利要求28所述的套件,其中,所述降低的高度为所述全高度的0.4至0.7。
30.根据权利要求28所述的套件,其中,设置具有阶梯状底部的第三类(1’’)。
31.根据权利要求28所述的套件,其中,所述套件包括所述第一类和所述第二类的不同的尺寸。
32.根据权利要求30所述的套件,其中,所述套件包括所述第一类、所述第二类和所述第三类的不同的尺寸。
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CA2991535A1 (en) 2017-01-12
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US20180200061A1 (en) 2018-07-19
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US11357631B2 (en) 2022-06-14
US20240016612A1 (en) 2024-01-18
US20220273441A1 (en) 2022-09-01
JP2018521757A (ja) 2018-08-09
KR20180030569A (ko) 2018-03-23
AR105173A1 (es) 2017-09-13
BR112017028272A2 (pt) 2018-09-04
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