CN109662814A - 一种人工肩关节 - Google Patents

一种人工肩关节 Download PDF

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CN109662814A
CN109662814A CN201910154443.9A CN201910154443A CN109662814A CN 109662814 A CN109662814 A CN 109662814A CN 201910154443 A CN201910154443 A CN 201910154443A CN 109662814 A CN109662814 A CN 109662814A
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potsherd
backing
shoulder joint
group
artificial shoulder
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韦山
王凡
杨德玉
何慧娟
周鹏飞
宫国庆
刘启元
汪正宇
王雷
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Anhui Polytechnic University
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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
    • A61F2/40—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
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30362—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit with possibility of relative movement between the protrusion and the recess
    • A61F2002/30375—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit with possibility of relative movement between the protrusion and the recess with an intermediate bushing or sleeve between the moving parts
    • 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
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30378—Spherically-shaped protrusion and recess
    • 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
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30518—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements with possibility of relative movement between the prosthetic parts
    • 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
    • A61F2002/30667—Features concerning an interaction with the environment or a particular use of the prosthesis
    • A61F2002/30673—Lubricating means, e.g. synovial pocket
    • 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
    • A61F2002/4085—Glenoid components, e.g. cups having a convex shape, e.g. hemispherical heads
    • 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
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00179—Ceramics or ceramic-like structures

Abstract

本发明公开了一种该人工肩关节，包括肱骨球头和连接在肩胛骨上的衬背，还包括陶瓷片和支承体，所述陶瓷片为一组陶瓷片，一组陶瓷片分散布置在支承体上，所述衬背的内侧设有凹槽，凹槽用于容纳支承体，所述陶瓷片的外凹曲面与球头的外表面接触构成摩擦副。衬背内侧分散布置的若干陶瓷片代替厚度大的整体式陶瓷内衬，降低人工肩关的整体壁厚，提高了肱骨球头的直径，从而增大人工肩关节的运动范围；陶瓷片通过高分子聚合物固定在衬背的内侧，陶瓷片固定可靠稳定，降低了陶瓷片和衬背内侧的加工精度，减少加工工艺，降低成本，并具有一定的抗冲击性和降噪作用。

Description

一种人工肩关节
技术领域
本发明涉及生物医学工程骨科内植入物假体技术领域，尤其是涉及一种人工肩关节。
背景技术
人工肩关节置换术是治疗因创伤或疾病导致的肩关节损伤的一种有效的临床治疗方法。传统的人工肩关节由肱骨假体、衬背组成，肱骨假体包括肱骨柄和肱骨球头。常见的衬背材料为金属或高分子材料或陶瓷，肱骨球头材料为金属或陶瓷，肱骨球头与衬背接触构成一对摩擦副。
目前临床上使用的人工肩关节有以下几种类型：1、金属肱骨球头与金属衬背配副，此配副形成的摩擦副在长期的摩擦磨损过程中，存在有毒的金属离子析出，在人体内累积到一定浓度会导致慢性病变，同时磨损碎屑会诱导假体周围的骨组织产生骨溶解；2、金属或陶瓷肱骨球头与高分子衬背配副，此配副形成的摩擦副使高分子内衬的磨损率很高，最常用的高分子材料为超高分子量聚乙烯，其年磨损量约为0.2mm，在长期的摩擦过程中，会导致高分子衬背的厚度不断减少，进而影响内衬的强度，此人工关节系统产生了关节大运动范围与力学强度的矛盾，为了解决此矛盾，衬背厚度必须加厚，由此必然产生了与衬背配合的球头的直径减少，故此关节系统的运动范围会减少，进而导致关节脱位，引起失效；3、陶瓷肱骨球头与陶瓷衬背配副，此配副组成的摩擦副，实验证明磨损最小，同时陶瓷具有惰性和很好的生物相容性，因而陶瓷对陶瓷的人工肩关节系统成为目前临床使用的首选。但由于陶瓷材料本身固有的脆性，如果厚度薄，则容易导致碎裂，为了克服此缺点，陶瓷衬背厚度必须加厚，但由此产生了与之配合的陶瓷肱骨球头尺寸不得不变小的问题，从而限制了人工肩关节的运动范围，进而发生关节脱位，导致人工关节失效。
发明内容
针对现有技术不足，本发明所要解决的技术问题是提供一种人工肩关节，以达到减小衬背与肱骨球头的磨损，降低陶瓷碎裂风险，减少金属离子释放，增加人工肩关节运动范围，延长人工肩关节使用寿命的目的。
为了解决上述技术问题，本发明所采用的技术方案为：
该人工肩关节，包括肱骨球头和连接在肩胛骨上的衬背，还包括陶瓷片和支承体，所述陶瓷片为一组陶瓷片，一组陶瓷片分散布置在支承体上，所述衬背的内侧设有凹槽，凹槽用于容纳支承体，所述陶瓷片的外凹曲面与球头的外表面接触构成摩擦副。
作为优选的，所述一组陶瓷片的外凹曲面处于同一曲面。
作为优选的，所述肱骨球头的外表面设有用于存贮人体体液的一组凹坑。
作为优选的，所述一组陶瓷片非均匀间隔布置。
作为优选的，所述支承体为高分子聚合物，高分子聚合物的外表面低于陶瓷片的外凹曲面。
作为优选的，所述一组陶瓷片的形状可为圆柱和/或多棱柱。
作为优选的，所述肱骨球头和衬背可为钛及其合金或钽及其合金或医用不锈钢或钴铬合金，陶瓷片为生物陶瓷。
作为优选的，所述衬背和肱骨球头与宿主骨接触的面上均设有适合于人体组织生长、便于生物连接、增强临床长期连接效果的一组孔。
作为优选的，所述陶瓷片与高分子聚合物相连部分的外周面上设有沟槽或凸起。
作为优选的，所述陶瓷片上的沟槽为螺旋槽。
本发明与现有技术相比，具有以下优点：
本发明中球冠形的衬背内侧上分散布置有若干陶瓷片代替厚度大的整体式陶瓷内衬，降低人工肩关的整体壁厚，提高了肱骨球头的直径，从而增大人工肩关节的运动范围；分散布置陶瓷片，从而减小单个陶瓷柱体承受的压力，解决了内衬为整体式陶瓷的碎裂问题；减轻肩关节的质量，使患者运动更加轻巧；肱骨球头表面有用于存贮润滑体液的微型凹坑，同时陶瓷片之间具有间隙，间隙可容纳润滑体液，减小了肱骨球头和陶瓷片的磨损量，减少了金属离子析出，提高了使用寿命；陶瓷片通过高分子聚合物固定在衬背的内侧，陶瓷片固定可靠稳定，降低了陶瓷片和衬背内侧的加工精度，减少加工工艺，降低成本，并具有一定的抗冲击性和降噪作用。
附图说明
下面对本说明书各幅附图所表达的内容及图中的标记作简要说明：
图1为本发明人工肩关节结构示意图。
图2为本发明人工肩关节爆炸示意图一。
图3为本发明人工肩关节爆炸示意图二。
图4为本发明人工肩关节爆炸示意图三。
图中：1.肱骨球头、101.凹坑、2.肩胛骨、3.衬背、4.支架、5.陶瓷片。
具体实施方式
下面对照附图，通过对实施例的描述，对本发明的具体实施方式作进一步详细的说明。
该人工肩关节，包括肱骨球头和连接在肩胛骨(宿主骨)上的衬背，肱骨球头的外表面与衬背的内侧相对应，衬背为金属球冠形的衬背，肱骨球头可以为金属或陶瓷球头，衬背内侧或肱骨球头的外表面设有用于减小两者之间摩擦的陶瓷片，陶瓷片为一组，一组陶瓷片分散布置；具体为，一组陶瓷片非均匀间隔布置，非均匀间隔布置能增大接触面积，从而减小接触应力。
其中，肱骨球头和衬背与宿主骨接触的面上设有适合于人体组织生长、便于生物连接、增强临床长期连接效果的一组孔，一组孔为一组微孔；微孔可以使骨组织长到里面，加强关节和人体宿主骨的连接，可提高假体在人体中固定的可靠性，保证使用效果。
下面通过具体实施例对本发明详细说明，具体如下：
如图1至图4所示，人工肩关节，包括肱骨球头1和设在肩胛骨2上的衬背3，衬背3的内侧设有用于减小衬背与肱骨球头的表面磨损的一组陶瓷片5，具体为，衬背3的内侧设有凹槽，凹槽内设有支承体，支承体为高分子聚合物，一组陶瓷片均镶嵌在高分子聚合物上，陶瓷片的外凹曲面与肱骨球头的外表面接触构成摩擦副。其中，衬背和肱骨球头可为钛及其合金或钽及其合金或医用不锈钢或钴铬合金，陶瓷片为生物陶瓷。
陶瓷片通过高分子聚合物固定在衬背的内侧，陶瓷片固定可靠稳定，降低了陶瓷片和衬背内侧的加工精度，减少加工工艺，降低成本，并具有一定的抗冲击性和降噪作用。
一组陶瓷片的形状可以都为圆柱或多棱柱，或者一组陶瓷片的形状为圆柱和多棱柱组合，一组陶瓷片非均匀间隔布置，一组陶瓷片的外端面处于同一球面，增大与球头表面的接触面积。并且，一组陶瓷片的外凹曲面处于同一曲面，受力均匀，稳定可靠。球冠形的衬背内侧分散布置的若干陶瓷片代替厚度大的整体式陶瓷内衬，降低人工肩关的整体壁厚，提高了球头的直径，从而增大人工肩关节的运动范围。
肱骨球头的表面设有用于存贮人体体液的一组凹坑101，一组凹坑为一组微型凹坑，用于存贮人体体液，润滑肱骨球头与陶瓷片的接触面，减小两者摩擦。并且，高分子聚合物的表面低于陶瓷片的外凹曲面，相邻陶瓷片之间具有一定的间隙，间隙中可用于存贮人体体液，润滑陶瓷片与肱骨球头的接触面，减小两者摩擦，陶瓷片与肱骨球头磨损小，使用寿命长。
陶瓷片与高分子聚合物相连部分的外周面上设有沟槽或凸起，陶瓷片上的沟槽为螺旋槽；高分子聚合物嵌在沟槽内，增加了陶瓷片的拔出力和结合力，陶瓷片固定可靠。或者，陶瓷片与高分子聚合物相连部分的外周面上设有凸出的螺旋筋，也能达到同样的固定效果。
一组陶瓷片通过高分子聚合物固定在衬背的内侧，陶瓷片的底部与衬背之间具有缓冲物，避免陶瓷片与衬背硬接触，可对肱骨球头对陶瓷片的作用力进行缓冲，陶瓷片不易碎裂。
该人工肩关节的结构还可以为，肱骨球头的表面设有凹槽，凹槽内设有支承体，支承体为高分子聚合物，高分子聚合物表面镶嵌一组陶瓷片，陶瓷片的外凸曲面与衬背的内侧面接触构成摩擦副。陶瓷片与高分子聚合物相连部分的外周面上设有螺旋槽，高分子聚合物嵌在螺旋槽内，增加了陶瓷片的拔出力和结合力；衬背的内侧面与一组陶瓷片的外端面相接触。
或者陶瓷片通过支架4固定在衬背内侧，支架为金属，支架上设有用于固定陶瓷片的固定孔，陶瓷片为一端大另一端小的结构，陶瓷片小端穿过固定孔，支架与衬背焊接连接。
上面结合附图对本发明进行了示例性描述，显然本发明具体实现并不受上述方式的限制，只要采用了本发明的构思和技术方案进行的各种非实质性的改进，或未经改进将本发明的构思和技术方案直接应用于其它场合的，均在本发明的保护范围之内。

Claims (10)

1.一种人工肩关节，包括肱骨球头和连接在肩胛骨上的衬背，其特征在于：还包括陶瓷片和支承体，所述陶瓷片为一组陶瓷片，一组陶瓷片分散布置在支承体上，所述衬背的内侧设有凹槽，凹槽用于容纳支承体，所述陶瓷片的外凹曲面与球头的外表面接触构成摩擦副。
2.如权利要求1所述人工肩关节，其特征在于：所述一组陶瓷片的外凹曲面处于同一曲面。
3.如权利要求1所述人工肩关节，其特征在于：所述肱骨球头的外表面设有用于存贮人体体液的一组凹坑。
4.如权利要求1所述人工肩关节，其特征在于：所述一组陶瓷片非均匀间隔布置。
5.如权利要求1所述人工肩关节，其特征在于：所述支承体为高分子聚合物，高分子聚合物的外表面低于陶瓷片的外凹曲面。
6.如权利要求1所述人工肩关节，其特征在于：所述一组陶瓷片的形状可为圆柱和/或多棱柱。
7.如权利要求1所述人工肩关节，其特征在于：所述肱骨球头和衬背可为钛及其合金或钽及其合金或医用不锈钢或钴铬合金，陶瓷片为生物陶瓷。
8.如权利要求1所述人工肩关节，其特征在于：所述衬背和肱骨球头与宿主骨接触的面上均设有适合于人体组织生长、便于生物连接、增强临床长期连接效果的一组孔。
9.如权利要求5所述人工肩关节，其特征在于：所述陶瓷片与高分子聚合物相连部分的外周面上设有沟槽或凸起。
10.如权利要求9所述人工肩关节，其特征在于：所述陶瓷片上的沟槽为螺旋槽。
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CN106205323A (zh) * 2016-08-22 2016-12-07 叶强 仿真人体关节
CN106535827A (zh) * 2014-06-10 2017-03-22 梅约医学教育与研究基金会 用于优化关节成形术部件设计的方法
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US5549700A (en) * 1993-09-07 1996-08-27 Ortho Development Corporation Segmented prosthetic articulation
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CN103211666A (zh) * 2013-04-25 2013-07-24 南京理工大学 一种提高润滑和耐磨性能的人工关节承载表面微孔织构
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