CN107920901A - 关节假体 - Google Patents
关节假体 Download PDFInfo
- Publication number
- CN107920901A CN107920901A CN201680047878.8A CN201680047878A CN107920901A CN 107920901 A CN107920901 A CN 107920901A CN 201680047878 A CN201680047878 A CN 201680047878A CN 107920901 A CN107920901 A CN 107920901A
- Authority
- CN
- China
- Prior art keywords
- nearside
- joint
- cup
- implant
- distal side
- 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.)
- Pending
Links
Classifications
-
- 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
- A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
- A61F2/4261—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for wrists
-
- 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
- A61F2/30721—Accessories
- A61F2/30749—Fixation appliances for connecting prostheses to the body
-
- 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
- A61F2/40—Joints for shoulders
-
- 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
- A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
- A61F2/4202—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for ankles
-
- 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
- A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
- A61F2/4225—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for feet, e.g. toes
-
- 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
- A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
- A61F2/4241—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers
-
- 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
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
- A61F2/442—Intervertebral or spinal discs, e.g. resilient
- A61F2/4425—Intervertebral or spinal discs, e.g. resilient made of articulated 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
- A61F2/30—Joints
- A61F2/40—Joints for shoulders
- A61F2/4081—Glenoid components, e.g. cups
-
- 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
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
- A61F2002/3006—Properties of materials and coating materials
- A61F2002/30079—Properties of materials and coating materials magnetic
-
- 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
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30108—Shapes
- A61F2002/3011—Cross-sections or two-dimensional shapes
- A61F2002/30112—Rounded shapes, e.g. with rounded corners
- A61F2002/30125—Rounded shapes, e.g. with rounded corners elliptical or oval
-
- 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
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30108—Shapes
- A61F2002/3011—Cross-sections or two-dimensional shapes
- A61F2002/30112—Rounded shapes, e.g. with rounded corners
- A61F2002/30125—Rounded shapes, e.g. with rounded corners elliptical or oval
- A61F2002/30126—Rounded shapes, e.g. with rounded corners elliptical or oval oval-O-shaped
-
- 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
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30108—Shapes
- A61F2002/30199—Three-dimensional shapes
- A61F2002/30252—Three-dimensional shapes quadric-shaped
- A61F2002/30253—Three-dimensional shapes quadric-shaped ellipsoidal or ovoid
-
- 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
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30621—Features concerning the anatomical functioning or articulation of the prosthetic joint
- A61F2002/30639—Features concerning the anatomical functioning or articulation of the prosthetic joint having rolling elements between both articulating surfaces
- A61F2002/30642—Features concerning the anatomical functioning or articulation of the prosthetic joint having rolling elements between both articulating surfaces having a single rolling (or sliding) ball articulating between two cups
-
- 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
- A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
- A61F2/4225—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for feet, e.g. toes
- A61F2002/4233—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for feet, e.g. toes for metatarso-phalangeal joints, i.e. MTP joints
-
- 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
- A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
- A61F2/4241—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers
- A61F2002/4251—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers for metacarpo-phalangeal joints, i.e. MCP or MP joints, e.g. knuckle joints
-
- 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
- A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
- A61F2/4241—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers
- A61F2002/4251—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers for metacarpo-phalangeal joints, i.e. MCP or MP joints, e.g. knuckle joints
- A61F2002/4253—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers for metacarpo-phalangeal joints, i.e. MCP or MP joints, e.g. knuckle joints for thumbs
-
- 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
- A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
- A61F2/4261—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for wrists
- A61F2002/4264—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for wrists for radio-carpal joints
Landscapes
- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Vascular Medicine (AREA)
- Transplantation (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Heart & Thoracic Surgery (AREA)
- Cardiology (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Neurology (AREA)
- Prostheses (AREA)
Abstract
提供了一种关节假体,其包括用于附接到骨骼结构的第一部分的近侧植入物,该近侧植入物包括近侧骨附接部分和远侧杯状部分。假体还包括用于附接到骨骼结构的第二部分的远侧植入物,远侧植入物包括远侧骨附接部分和近侧杯状部分。关节间元件位于远侧杯部和近侧杯部之间。关节间元件包括成形为与所述杯部互补的表面部分,并且优选地形成为卵形。近侧植入物、远侧植入物和关节间元件中的每一个都包括磁性区域,由此,关节间元件被吸引到近侧杯状部分和远侧杯状部分,从而在大角度运动上提供稳定性。
Description
技术领域
本发明涉及假体关节,并且在优选实施方式中涉及腕关节假体。
背景技术
对任何现有技术文件、技术、方法或装置的讨论不被视为构成任何证明此类现有技术形成公知常识的一部分的承认或证据。
随着人口老龄化而带来的患病率增加,关节炎成为显着的全球负担,据记载影响了七分之一的澳大利亚人。人体大多数关节的严重关节炎疾病的常见治疗方式是通过假体置换。然而,尽管是影响至今的最常见的关节集合(collection)之一(达到100,000个中有100个),但在开发生理等效植入物方面进展甚微。
图1描绘了左手腕的骨骼解剖图。腕关节置换术/关节成形术是一种外科假体植入手术,以取代远侧桡骨和一个或多个近侧腕列骨表面的患病关节表面,以重建腕关节并恢复生理功能。实现这种假体的复杂性源于关节表面运动的最大范围、最小的软组织支撑以及在正常日常使用期间通过表面的高负载。
迄今为止,解决这一需求领域的现有技术假体仅部分成功。现有技术已经集中在用不同的表面材料和螺钉固定进行实验,并因此被迫设计成机械约束以确保稳定性并使患者承受持续的生活方式限制以防止失败。因此,迄今为止,没有一种假体能够通过有机无病关节在全范围运动体验内重建稳定性,并且除此之外,由于目前假体的局限性,还没有实现真正的生物等效的腕关节生物力学。
本发明的一个目的是提供一种改进的关节假体,该关节假体是稳定的并且允许在很宽的角度范围上自然运动。
发明内容
根据本发明的第一方面,提供了一种关节假体,其包括:
近侧植入物,其用于附接至骨骼结构的第一部分,近侧植入物包括近侧骨附接部分和远侧杯状部分;
远侧植入物,其用于附接到骨骼结构的第二部分,远侧植入物包括远侧骨附接部分和近侧杯状部分;
关节间元件,其位于远侧杯部和近侧杯部之间,关节间元件包括成形为与所述杯部互补的表面部分;
其中近侧植入物、远侧植入物和关节间元件中的每一个包括磁性区域,由此关节间元件被吸引到近侧杯状部分和远侧杯状部分。
优选地,远侧杯部和近侧杯部中的每一个呈现出用于与关节间元件关节连接的凹形关节表面。
关节间元件优选为卵形或椭球形,并且远侧杯部和近侧杯部的凹形关节表面相应地形成。
在本发明的优选实施方式中,凹形关节表面形成有分别便于手腕屈曲/伸张和桡偏的小弯曲和大弯曲。
优选地,近侧骨附接部分包括细长钉,并且骨骼结构的第一部分包括诸如桡骨的长骨,其中钉被成形为用于插入桡骨的管中。
远侧骨附接部分可以包括用于在植入手术期间接合到腕骨中形成的孔中的钉。
远侧骨附接部分还可以包括安装构造,以用于附接到包括腕骨的骨骼结构的一部分。
根据本发明的另一方面,提供了一种用于人的手腕的假体,其包括:
近侧植入物,其用于附接至骨骼结构的第一部分,近侧植入物包括近侧骨附接部分和远侧杯状部分,远侧杯状部分呈现出凹形关节表面,凹形关节表面形成有用于手腕屈曲/伸张和用于桡偏的不同弯曲;
远侧植入物,其用于附接到骨骼结构的第二部分,远侧植入物包括远侧骨附接部分和近侧杯状部分,近侧杯状部分具有形成有用于手腕屈曲/伸张和用于桡偏的所述不同弯曲的凹形关节表面;
关节间元件,其位于远侧杯部和近侧杯部之间,其成形为与杯部的所述关节表面进行关节连接;
其中近侧植入物、远侧植入物和关节间元件中的每一个包括磁性区域,由此关节间元件被吸引到近侧杯状部分和远侧杯状部分。
优选地,关节间元件具有卵形或椭球形的形状。
远侧骨附接部分优选地包括在植入手术期间接合到远侧腕骨中形成的孔内的钉。
在本发明的优选实施方式中,远侧骨附接部分还包括放置在远侧腕骨上并紧固到其上的安装构造。
钉优选地布置成在植入手术期间接合到头状骨内形成的孔中。
优选的是,远侧骨附接部分布置成在植入手术期间与大多角骨和/或小多角骨的一部分接合。
根据本发明的另一方面,提供了一种根据权利要求8至13中任一项所述的通过腕关节假体用于患者腕关节置换的方法,所述方法包括以下步骤:
切除患者手部的近侧腕列(carpal row)骨;
将近侧植入物的钉插入患者的桡骨;
将远侧钉插入手部的头状骨中。
优选地,该方法还包括将远侧骨附接部分的安装构造紧固到患者的远侧腕骨。
附图说明
具体实施方式不被视为以任何方式限制前述发明内容的范围。具体实施方式将参考以下若干附图:
图1是一个普通成年男性左手腕的骨架图。
图2是根据本发明优选实施方式的假体的略微分解图。
图3是图2的假体的进一步的略微分解图。
图4A是图2的假体在第一关节角度处的示意性侧视图。
图4B是图2的假体在第二关节角度处的示意性侧视图。
图5是一个稍微程式化的视图,显示了植入后假体相对于图1的手部的骨的位置。
图6是示出在其中植入了根据本发明的实施方式的两个关节的足部骨架的第一侧视图。
图7是示出在其中植入了根据本发明的实施方式的两个关节的足部骨架的第二侧视图。
图8是示出在其中植入了根据本发明的实施方式的三个关节的足部骨架的俯视图。
图9是示出在其中植入了根据本发明的实施方式的七个关节的手部骨架的视图。
图10是示出在其中植入了根据本发明的实施方式的肩关节的肩部骨架的视图。
图11是示出在其中植入了根据本发明的实施方式的两个关节的人体脊柱骨架的第一视图。
图12是图11的植入的脊柱骨架的侧视图。
具体实施方式
参考图1,将观察到腕关节2提供了双关节,即在箭头4所示的方向上手部的桡偏(或“平移”)和在箭头6所示的方向上手部的手腕屈曲和伸张(或“倾斜”)。发明人已经认识到,迄今为止,在腕关节造形中产生生理运动和稳定性的困难一直是试图用单关节植入物再造手腕的双关节的限制。由于组件内的不稳定性阻碍了多于一个关节界面的使用,在过去一直需要单关节(即具有单个关节界面)。
发明人已经认识到,腕关节可以被看作是允许屈伸和桡尺偏斜的改进的万向关节。在成年人中,屈伸轴线通常在桡尺轴线附近3-10mm。
现在参考图2,其中示出了根据本发明优选实施方式的关节假体1的略微分解图。图3是从第二角度看图2的假体的另一个分解图。关节假体1包括近侧植入物3,其用于附接到诸如桡骨的骨骼结构的第一部分。近侧植入物3还包括呈第一钉的形式的近侧骨附接部分和呈杯部7形式的远侧杯状部分,第一钉是用于插入臂的桡骨骨中的桡骨钉5。
假体1还包括远侧植入物9,其用于附接到诸如手腕的远侧腕骨中的一个或多个的骨骼结构的第二部分。远侧植入物9包括远侧骨附接部分11和近侧杯状部分13。远侧骨附接部分11由呈头状钉12形式的第二钉和用于附接到手腕的一个或多个远侧腕骨的安装构造15组成。例如,安装构造15可通过围绕小多角骨的近端定位构造15,然后将螺钉插入通过孔26(在图3中可见)并将其旋入小多角骨而附接到小多角骨。
假体1还包括位于远侧杯部13和近侧杯部7之间的呈椭球形或卵形形式的关节间元件17。卵形17被成形为与杯部7和杯部13的内部凹形关节表面14和16互补。关节表面16、14各自具有如箭头22a和22b所示的小弯曲和如箭头20a和20b所示的大弯曲。小弯曲的曲率半径比大弯曲的曲率半径小。这些弯曲20a、20b和22a、22b补充卵形17的形状,并分别帮助植入物提供与桡偏运动4和手腕屈伸运动6有些类似的运动,这些运动参照图1中的正常手腕。尽管腕关节假体1优选卵形或椭球形的关节间元件,但是对于一些关节,通常球形的关节间元件17和相应成形的杯部7、13可以适用。
现在参照图4A和4B,示出了沿着图2中所示的视线14观察的假体1的中线横截面的示意图。如假体1的示意图4A和4B中所示,近侧植入物3、远侧植入物9和关节间元件17中的每一个包括磁性区域,分别为19、21和23,使得关节间元件17被吸引并偏向至近侧杯状部分7和远侧杯状部分13。
磁体19、21和23优选包括钕磁体。
发明人已经发现,通过在假体1的植入部分3、9中使用磁体19、21以及用于关节间元件17的磁体23,提供了可靠的磁耦合。磁耦合允许杯部13、7的关节表面14、16相对于关节间元件17的表面进行操纵。所产生的操纵可以在大范围的运动中进行,同时提供稳定性以避免故障。例如,假体1在图4A的关节角度(大约180度)和图4B的关节角度(大约倾斜153度)两者中保持稳定。
本发明人已经认识到,关节面的关节是动态的相互作用,其中相对区域有显着的改变,因此需要一个动态的耦合轴来在整个运动范围内稳定手腕关节。这个基本的需求是通过利用图4A和4B所示的三部分磁系统来实现的。将会看到,一个磁体(19)位于近侧关节表面(即杯部7)附近,而另一个(磁体21)位于远侧关节表面(即杯部13)附近,并且第三(磁体23)在关节空间内(即在杯部间元件17内或者由杯部间元件17构成)。当关节在其整个运动范围内运动时,关节内的磁体(即卵形17)不断地重新定向,以保持磁性对准,从而保持磁耦合和关节稳定性。
由于在磁耦合中的这种持久性,根据本发明优选实施方式的假体不仅确保静止位置的稳定性,而且允许实现在真正的生理运动的极端范围处具有足够稳定的关节的重建。
双关节,即对应于杯形曲面20a和20b的桡偏方向和对应于杯形曲面22a、22b的手腕屈曲/伸张方向的关节均提供了模拟正常手腕运动的假体1。正常的手腕运动的建模降低了关节1的应力,并允许更大的运动范围。
通过使远侧关节的轴线在桡骨伸缩/尺侧屈曲轴线上倾斜地对齐,假体可以被偏置以允许在所谓的“达特·思罗尔斯(Dart Throwers)”平面中运动。这通过允许运动在最稳定和生理的平面上进一步减少了植入物应力。
图5是稍微程式化的视图,示出了植入后关节假体1相对于手臂的骨骼(即尺骨和桡骨以及手腕)的位置。现在将解释植入假体的合适的外科手术。
最初,腕关节通过纵向20厘米的切口暴露在桡骨的背部的利斯特(Lister’s)结节上。皮下静脉结扎。伸肌支持带从第二隔室到第五隔室以“z”方式分开。手指的伸肌腱收缩到尺侧,桡骨腕伸肌腱收缩到桡侧。背侧腕关节囊作为远端矩形皮瓣从桡骨关节边缘被提升,并且尺骨上的TFCC沿尺侧的ECU肌腱延伸,并且在腕关节桡侧上的舟骨的桡骨边缘上延伸。
屈曲手腕并切除近侧腕列骨(即舟骨、月骨和三角骨),保留掌侧外韧带。桡骨装有导向销以建立骨的纵向和中心轴。通过对管进行钻孔和扩孔并通过铣削关节表面来匹配植入物的桡骨部件来准备桡骨。以类似的方式,通过建立头状骨的纵向轴线和中心轴线并对头状骨进行钻孔和扩孔以接受植入物的远侧部件的基板的钉来制备远侧列(row)。研磨远侧列骨的近侧表面以准备基板的基座。通过清除邻近软骨表面来制备用于正式关节融合术的头状骨与钩骨之间、头状骨与小多角骨之间以及小多角骨与大多角骨之间的关节。
然后嵌入桡骨植入物(即近侧植入物3)。放置远侧植入物9,并通过骨的远侧列制成横向钻孔。可以选择远端拧入诸如大多角骨和/或小多角骨的腕骨。
然后用放置的中间部件即关节间元件17检查假体中的张力。可以根据需要通过放置假体1的更厚或更薄的部件来调节张力。
然后进行最终的植入,并检查运动的稳定性和范围。
用可吸收的缝线松弛地封闭关节囊。用可吸收的缝线修复伸肌支持带。使用不可吸收的缝线将皮肤封闭在手术引流管上。手腕置于填塞好的绷带中,2-3天后开始术后手部治疗。
尽管已经描述了与手腕一起使用的本发明的优选实施方式,但本发明直接与应用于身体的许多关节以及改装到现有假体中以增加稳定性有关。
例如,图6、7和8示出了植入到人类成年足部25中的根据本发明的实施方式的各种关节。参照图6,关节1a在小腿的胫骨和足部26的距骨之间连通。在骰骨和第五跖骨之间连接有较小的关节1b。图7示出了将第一跖骨和第一趾骨相互连接的另一个关节1c的位置。图8示出了第二远端趾骨与第二趾骨之间的关节1d的连接以及骰骨与第四跖骨之间的关节1e的连接。在每种情况下,每个关节的第一钉和第二钉适当地确定尺寸和大小,以便被它们各自的目标骨骼容纳,例如在关节1a的情况下的胫骨和距骨。
图9示出了手27的骨架,其中多个关节植入物1e至1k已经位于手的各种骨之间以代替关节炎的关节。在每种情况下,关节的尺寸都适合所涉及的骨骼的解剖结构。
图10示出了根据本发明实施方式的植入物1L,其被植入以实现人肩29中的肩关节。
图11和12是根据本发明的实施方式的人体脊柱骨骼的平面图和侧视图,示出了根据本发明实施方式的关节1m和1n如何被用于实现脊柱腰部中的椎间关节。
此外,虽然本发明的优选实施方式已经在人类使用的背景下进行了描述,但是其也适用于动物关节和用于机器人和仿生应用(在需要人工构建稳定的关节的任何地方)的人造关节的创建。
根据法规,本发明已经或多或少地针对结构或方法特征进行了描述。术语“包括(comprises)”及其变化例如“包括(comprising)”和“由...组成(comprised of)”贯穿于包含性的意义上,而不排除任何附加的特征。
在本说明书的描述和权利要求书中,单数涵括复数,除非上下文另有要求。特别地,在使用不定冠词的情况下,除非上下文另有要求,否则说明书应被理解为考虑复数以及单数。
与本发明的特定方面、实施方式或示例结合描述的特征、整体、特性、化合物、化学部分或组应被理解为适用于本文所述的任何其他方面、实施方式或示例,除非与其不相容。
应该理解的是,本发明不限于所示出或描述的具体特征,因为本文描述的手段包括使本发明生效的优选形式。
因此,本发明要求保护在本领域技术人员适当解释的所附权利要求的适当范围内的任何形式或修改。
Claims (15)
1.一种关节假体,包括:
近侧植入物,其用于附接至骨骼结构的第一部分,近侧植入物包括近侧骨附接部分和远侧杯状部分;
远侧植入物,其用于附接到骨骼结构的第二部分,远侧植入物包括远侧骨附接部分和近侧杯状部分;
关节间元件,其位于远侧杯部和近侧杯部之间,关节间元件包括成形为与所述杯部互补的表面部分;
其中近侧植入物、远侧植入物和关节间元件中的每一个包括磁性区域,由此关节间元件被吸引到近侧杯状部分和远侧杯状部分。
2.根据权利要求1所述的关节假体,其中远侧杯部和近侧杯部中的每一个呈现用于与关节间元件关节连接的凹形关节表面。
3.根据权利要求2所述的关节假体,其中关节间元件是卵形或椭球形的,并且远侧杯部和近侧杯部的凹形关节表面相应地形成。
4.根据权利要求2或权利要求3所述的关节假体,其中凹形关节表面形成有小弯曲部和大弯曲部以分别便于手腕屈曲/伸张和桡偏。
5.根据前述权利要求中任一项所述的关节假体,其中近侧骨附接部分包括细长钉,并且骨骼结构的第一部分包括诸如桡骨的长骨,其中钉被成形以插入到桡骨的管中。
6.根据权利要求1至5中任一项所述的关节假体,其中远侧骨附接部分包括用于在植入手术期间接合到头状骨中形成的孔中的钉。
7.根据权利要求6所述的关节假体,其中远侧骨附接部分还包括用于附接到包括腕骨的骨骼结构的一部分的安装构造。
8.一种用于人体手腕的假体,包括:
近侧植入物,其用于附接至骨骼结构的第一部分,近侧植入物包括近侧骨附接部分和远侧杯状部分,远侧杯状部分呈现凹形关节表面,凹形关节表面形成有用于手腕屈曲/伸张和用于桡偏的不同弯曲;
远侧植入物,其用于附接到骨骼结构的第二部分,远侧植入物包括远侧骨附接部分和近侧杯状部分,近侧杯状部分具有形成有用于手腕屈曲/伸张和用于桡偏的所述不同弯曲的凹形关节表面;
关节间元件,其位于远侧杯部和近侧杯部之间,其成形为与杯部的所述关节表面进行关节连接;
其中近侧植入物、远侧植入物和关节间元件中的每一个包括磁性区域,由此关节间元件被吸引到近侧杯状部分和远侧杯状部分。
9.根据权利要求8所述的假体,其中关节间元件具有卵形或椭球形的形状。
10.根据权利要求8或权利要求9所述的假体,其中远侧骨附接部分包括用于在植入手术期间接合到远侧腕骨中形成的孔中的钉。
11.根据权利要求8至10中任一项所述的用于人体手腕的假体,其中远侧骨附接部分还包括用于放置在远侧腕骨上并紧固到其上的安装构造。
12.根据权利要求10所述的假体,其中钉布置成在植入手术期间接合到头状骨中形成的孔中。
13.根据权利要求11所述的假体,其中远侧骨附接部分被布置为在植入手术期间与大多角骨和/或小多角骨的一部分接合。
14.根据权利要求8至13中任一项所述的通过腕关节假体用于患者腕关节置换的方法,所述方法包括以下步骤:
切除患者手部的近侧腕骨列骨;
将近侧植入物的钉插入患者的桡骨;
将远侧钉插入手部的头状骨中。
15.根据权利要求14所述的方法,还包括将远侧骨附接部分的安装构造紧固到患者的远侧腕骨。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
AU2015903255A AU2015903255A0 (en) | 2015-08-13 | A joint prosthesis | |
AU2015903255 | 2015-08-13 | ||
PCT/AU2016/000276 WO2017024336A1 (en) | 2015-08-13 | 2016-08-13 | A joint prosthesis |
Publications (1)
Publication Number | Publication Date |
---|---|
CN107920901A true CN107920901A (zh) | 2018-04-17 |
Family
ID=57982896
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CN201680047878.8A Pending CN107920901A (zh) | 2015-08-13 | 2016-08-13 | 关节假体 |
Country Status (6)
Country | Link |
---|---|
US (1) | US20180221161A1 (zh) |
EP (1) | EP3334385A4 (zh) |
CN (1) | CN107920901A (zh) |
AU (1) | AU2016305486A1 (zh) |
CA (1) | CA2995498A1 (zh) |
WO (1) | WO2017024336A1 (zh) |
Cited By (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN111134908A (zh) * | 2018-11-06 | 2020-05-12 | 天津富华医疗科技有限公司 | 仿生人工指间关节 |
CN112137772A (zh) * | 2019-06-28 | 2020-12-29 | 青岛大学附属医院 | 一种粘合型球窝关节式人工舟骨 |
Families Citing this family (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US11559407B2 (en) | 2018-03-30 | 2023-01-24 | The Penn State Research Foundation | Wrist implants |
US11723775B2 (en) | 2020-08-12 | 2023-08-15 | Asheesh BEDI | Magnetic medical implants |
WO2024006850A1 (en) * | 2022-06-28 | 2024-01-04 | New York Society For The Relief Of The Reptured And Crippled, Maintaining The Hospital For Special | Apparatus, system and method for assisting a path of motion |
Family Cites Families (10)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4024588A (en) * | 1974-10-04 | 1977-05-24 | Allo Pro A.G. | Artificial joints with magnetic attraction or repulsion |
CH624573A5 (en) * | 1978-02-01 | 1981-08-14 | Sulzer Ag | Intervertebral prosthesis |
DE29500476U1 (de) * | 1995-01-13 | 1995-08-03 | Thabe, Heiner, Dr.med., 55543 Bad Kreuznach | Handgelenkprothese |
US6599321B2 (en) * | 2000-06-13 | 2003-07-29 | Edward R. Hyde, Jr. | Magnetic array implant and prosthesis |
US20070179493A1 (en) * | 2006-01-13 | 2007-08-02 | Kim Richard C | Magnetic spinal implant device |
US20090287309A1 (en) * | 2007-01-30 | 2009-11-19 | Tornier Sas | Intra-articular joint replacement |
IT1393753B1 (it) * | 2009-04-06 | 2012-05-08 | Ferrari Massimo & C S A S | Dispositivo per il bilanciamento di un impianto protesico, in particolare per un impianto protesico per ginocchio, e relativo kit. |
DE102010053265A1 (de) * | 2010-12-02 | 2012-06-06 | Voja Lazic | Handgelenkprothese |
US8814945B2 (en) * | 2011-09-28 | 2014-08-26 | Linares Medical Devices, Llc | Implantable wrist joint assembly with spherical inter-support |
US8801796B2 (en) * | 2012-12-31 | 2014-08-12 | Richard A. Rogachefsky | Bone prosthesis for maintaining joint operation in complex joints |
-
2016
- 2016-08-13 EP EP16834302.8A patent/EP3334385A4/en not_active Withdrawn
- 2016-08-13 AU AU2016305486A patent/AU2016305486A1/en not_active Abandoned
- 2016-08-13 US US15/750,207 patent/US20180221161A1/en not_active Abandoned
- 2016-08-13 CN CN201680047878.8A patent/CN107920901A/zh active Pending
- 2016-08-13 CA CA2995498A patent/CA2995498A1/en not_active Abandoned
- 2016-08-13 WO PCT/AU2016/000276 patent/WO2017024336A1/en active Application Filing
Cited By (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN111134908A (zh) * | 2018-11-06 | 2020-05-12 | 天津富华医疗科技有限公司 | 仿生人工指间关节 |
CN112137772A (zh) * | 2019-06-28 | 2020-12-29 | 青岛大学附属医院 | 一种粘合型球窝关节式人工舟骨 |
CN112137772B (zh) * | 2019-06-28 | 2023-02-24 | 青岛大学附属医院 | 一种粘合型球窝关节式人工舟骨 |
Also Published As
Publication number | Publication date |
---|---|
CA2995498A1 (en) | 2017-02-16 |
EP3334385A4 (en) | 2019-05-29 |
US20180221161A1 (en) | 2018-08-09 |
EP3334385A1 (en) | 2018-06-20 |
AU2016305486A1 (en) | 2018-03-08 |
WO2017024336A1 (en) | 2017-02-16 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
CN107920901A (zh) | 关节假体 | |
CN100488470C (zh) | 关节植入件系统 | |
JP5913727B2 (ja) | 自己展開アンカーを用いた椎体間脊椎補綴整形固定デバイス | |
US9034050B2 (en) | Elbow prosthesis | |
US8647391B2 (en) | Malleolar replacement devices | |
CN104661619B (zh) | 髓内踝部技术与系统 | |
US11963875B2 (en) | Orthopaedic prosthesis for an interphalangeal joint and associated method | |
US10813770B2 (en) | Devices and methods for metatarsophalangeal arthroplasty procedures | |
ES2641778T3 (es) | Conjuntos absorbentes de energía mecánica implantable extraarticular que tiene un miembro tensor | |
AU2005309758A1 (en) | Spinal plug for a minimally invasive facet joint fusion system | |
JP7011177B2 (ja) | 総手首プロテーゼおよび関連方法 | |
Altman | The ulnar side of the wrist: clinically relevant anatomy and biomechanics | |
EP3170477B1 (en) | Scaphoid prosthesis | |
TWI498111B (zh) | 拇指腕掌關節人工植體 | |
ES2969812T3 (es) | Implante talar para modificar la cinemática de articulación | |
Averianov et al. | New data on duck-billed dinosaurs (Ornithischia, Hadrosauridae) from the Upper Cretaceous of Tajikistan | |
US20180140429A1 (en) | Distal Radioulnar Joint Prosthesis and Method of Use | |
ES2778573B2 (es) | Protesis parcial para el hueso escafoides | |
US20190388246A1 (en) | Systems and methods for sizing and introduction of soft-tissue allografts | |
EP3646826B1 (en) | Minimally invasive shoulder implant | |
US20230263637A1 (en) | Joint implant apparatus, system, and method | |
WO2009073924A1 (en) | Endoprosthesis for a metatarsophalangeal joint | |
AU2017357400B2 (en) | Scaphoid prosthesis | |
ES2784929T3 (es) | Prótesis del escafoides | |
Wolff | Remodelling of the internal architecture and external shape of bones |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
PB01 | Publication | ||
PB01 | Publication | ||
SE01 | Entry into force of request for substantive examination | ||
SE01 | Entry into force of request for substantive examination | ||
WD01 | Invention patent application deemed withdrawn after publication |
Application publication date: 20180417 |
|
WD01 | Invention patent application deemed withdrawn after publication |