CN109662816A - 一种人工踝关节 - Google Patents

一种人工踝关节 Download PDF

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CN109662816A
CN109662816A CN201910154441.XA CN201910154441A CN109662816A CN 109662816 A CN109662816 A CN 109662816A CN 201910154441 A CN201910154441 A CN 201910154441A CN 109662816 A CN109662816 A CN 109662816A
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potsherd
component
ankle joint
group
connector
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韦山
杨德玉
王凡
王建彬
汪正宇
周鹏飞
李凯
李洪伟
刘启元
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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
    • A61F2/42—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
    • 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
    • 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
    • A61F2002/4205—Tibial 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
    • A61F2/42—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
    • A61F2002/4207—Talar 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
    • 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

本发明公开了一种人工踝关节，包括距骨组件和胫骨组件，距骨组件的球头与设在胫骨组件上的弧形凹槽相对设置，还包括陶瓷片和连接体，所述陶瓷片为一组陶瓷片，一组陶瓷片分散布置在连接体上，所述胫骨组件上的弧形凹槽内侧设有固定凹槽，连接体固定在固定凹槽中，陶瓷片的外凹曲面与距骨组件的球头外表面相接触形成摩擦副。衬垫上分布有若干陶瓷片，将金属或陶瓷与高分子聚合物之的间摩擦转变为陶瓷与金属或陶瓷之间的摩擦，同时陶瓷片之间具有间隙，容纳润滑液，从而降低了距骨组件与胫骨组件的摩擦系数，减小磨损量，减少了金属离子析出；同时也可以降低陶瓷假体的碎裂风险，提高了使用寿命。

Description

一种人工踝关节
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踝关节。
背景技术
人工踝关节置换术是治疗因创伤或疾病导致的踝关节损伤的一种有效的临床治疗方法。人工踝关节由胫骨组件和距骨组件以及衬垫组成，常见的衬垫材料为高分子聚合物或金属，距骨组件材料为金属或陶瓷或高分子材料，距骨组件与衬垫接触构成一对摩擦副。
目前临床上使用的人工踝关节有以下几种类型：1、金属距骨组件与金属衬垫配副，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、金属或陶瓷距骨组件与高分子衬垫配副，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0.1-0.2mm，在长期的摩擦过程中，会导致高分子衬垫的厚度不断减少，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，衬垫厚度必须加厚，由此必然产生了与衬垫配合的距骨组件的直径减少，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、陶瓷距骨组件与陶瓷衬垫配副，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踝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，陶瓷衬垫厚度必须加厚，但由此产生了与之配合的陶瓷距骨组件尺寸不得不变小的问题，从而限制了人工踝关节的运动范围，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踝关节，以达到减少距骨组件和衬垫的磨损，降低陶瓷碎裂风险，减少金属离子释放，增加人工踝关节运动范围，延长人工踝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：
该人工踝关节，包括距骨组件和胫骨组件，距骨组件的球头与设在胫骨组件上的弧形凹槽相对设置，还包括陶瓷片和连接体，所述陶瓷片为一组陶瓷片，一组陶瓷片分散布置在连接体上，所述胫骨组件上的弧形凹槽内侧设有固定凹槽，连接体固定在固定凹槽中，陶瓷片的外凹曲面与距骨组件的球头外表面相接触形成摩擦副。
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，所述距骨组件的球头表面上设有用于存贮人体体液的一组凹坑。
作为优选的，所述连接体为高分子聚合物或钛及其合金或钽及其合金或医用不锈钢或钴铬合金，连接体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状和/或多棱柱状。
作为优选的，所述距骨组件和胫骨组件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，所述胫骨组件包括胫骨假体柄和胫骨假体头部分，所述胫骨假体柄和胫骨假体头采用可拆卸相连，弧形凹槽设在胫骨假体头上。
作为优选的，所述距骨组件和胫骨组件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，所述一组陶瓷片均匀和/或非均匀间隔布置。
作为优选的，所述陶瓷片与连接体相连部分的外周面上设有沟槽或凸起
本发明与现有技术相比，具有以下优点：
本发明中分散布置有若干陶瓷片代替厚度大的整体式陶瓷内衬，降低人工踝关节的整体壁厚，提高了距骨组件的直径，从而增大人工踝关节的运动范围；该人工踝关节结构设计合理，衬垫上分布有若干陶瓷片，将金属或陶瓷与高分子聚合物之的间摩擦转变为陶瓷与金属或陶瓷之间的摩擦，同时陶瓷片之间具有间隙，容纳润滑液，从而降低了距骨组件与胫骨组件的摩擦系数，减小磨损量，减少了金属离子析出；同时也可以降低陶瓷假体的碎裂风险，提高了使用寿命；减轻踝关节的质量，使患者运动更加轻巧；在陶瓷片之间设有高分子聚合物，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为本发明人工踝关节一种结构爆炸示意图。
图2为本发明人工踝关节另一种结构爆炸示意图。
图3为本发明人工踝关节总装配示意图。
图中：
1.距骨组件、2.衬垫、3.胫骨组件、4.连接体、5.一组陶瓷片、6.凹坑。
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。
该人工踝关节，包括距骨组件、胫骨组件、陶瓷片以及连接体，距骨组件的球头与设在胫骨组件上的弧形凹槽相对设置，陶瓷片为一组陶瓷片，一组陶瓷片分散布置在连接体上形成衬垫，胫骨组件上的弧形凹槽内侧设有固定凹槽，连接体固定在固定凹槽中，陶瓷片的外凹曲面与距骨组件的球头外表面相接触形成摩擦副。
一组陶瓷片的外凹曲面处于同一曲面；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。
陶瓷片设置在连接体上形成整体的衬垫结构，制作简便；连接体为高分子聚合物或钛及其合金或钽及其合金或医用不锈钢或钴铬合金，连接体的外表面低于陶瓷片的外凹曲面，具有一定缓冲功能，稳定可靠；陶瓷片与连接体相连部分的外周面上设有沟槽或凸起，可提高固定的可靠性。
其中，距骨组件和胫骨组件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3所示，该人工踝关节，包括距骨组件1、胫骨组件3以及衬垫2，衬垫2包括弧形的连接体4和一组陶瓷片5，陶瓷片为一组陶瓷片，胫骨组件上的弧形凹槽内侧设有固定凹槽，衬垫固定在固定凹槽中，陶瓷片的外凹曲面与距骨组件的球头外表面相接触形成摩擦副。其中，距骨组件1和胫骨组件3可为钛及其合金或钽及其合金或医用不锈钢或钴铬合金，陶瓷片为氧化铝陶瓷。
一组陶瓷片固定在连接体上形成整体的衬垫，再将衬垫固定在胫骨组件，分别制作，加工简便，可提高生产效率。
连接体为高分子聚合物，高分子聚合物的外表面低于陶瓷片的外凹曲面；陶瓷片与连接体相连部分的外周面上设有沟槽或凸起；优选的，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5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，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。
一组陶瓷片分散固定在连接体上，一组陶瓷片的外凹曲面处于同一球面。即分散布置有若干陶瓷片代替厚度大的整体式陶瓷内衬，降低踝关节假体的整体壁厚，提高了球头的直径，从而增大踝关节假体的运动范围。
距骨组件的球头的表面设有用于存贮人体体液的一组凹坑6，一组凹坑为一组微型凹坑，用于存贮人体体液，润滑球头与陶瓷片的接触面，减小两者摩擦。并且，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，润滑陶瓷片与球头的接触面，减小两者摩擦。
胫骨组件包括胫骨组件包括胫骨假体柄和胫骨假体头部分，胫骨假体柄和胫骨假体头采用可拆卸相连，弧形凹槽设在胫骨假体头上，可拆卸活动相连便于手术过程中医生操作及产品置换；并在圆柱状结构上设有一组孔。
该人工踝关节的结构还可以为：距骨组件的球头表面上设有凹槽，凹槽内设有连接体，连接体为高分子聚合物，高分子聚合物表面镶嵌一组陶瓷片，陶瓷片的外凸曲面与胫骨组件的弧形凹槽面接触构成摩擦副。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。
或者，陶瓷片通过连接体固定在胫骨组件的弧形凹槽内，连接体为金属，连接体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，小端位于固定孔外侧，连接体与弧形凹槽焊接相连，制作简便，固定牢靠。连接体外侧在一组陶瓷片之间设有高分子聚合物加固，具有一定减震缓冲功能。
衬垫内侧分散布置有若干陶瓷片代替厚度大的整体式陶瓷内衬，降低人工踝关节的整体壁厚，提高了距骨组件的直径，从而增大人工踝关节的运动范围；该焊接式陶瓷人工踝关节结构设计合理，衬垫上分布有若干陶瓷片，将金属或陶瓷与高分子聚合物之的间摩擦转变为陶瓷与金属或陶瓷之间的摩擦，同时陶瓷片之间具有间隙，容纳润滑液，从而降低了距骨组件与胫骨组件的摩擦系数，减小磨损量，减少了金属离子析出；同时也可以降低陶瓷假体的碎裂风险，提高了使用寿命；减轻踝关节的质量，使患者运动更加轻巧；在陶瓷片之间设有高分子聚合物，具有一定的抗冲击性和降噪作用。
上述仅为对本发明较佳的实施例说明，上述技术特征可以任意组合形成多个本发明的实施例方案。
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)

1.一种人工踝关节，包括距骨组件和胫骨组件，距骨组件的球头与设在胫骨组件上的弧形凹槽相对设置，其特征在于：还包括陶瓷片和连接体，所述陶瓷片为一组陶瓷片，一组陶瓷片分散布置在连接体上，所述胫骨组件上的弧形凹槽内侧设有固定凹槽，连接体固定在固定凹槽中，陶瓷片的外凹曲面与距骨组件的球头外表面相接触形成摩擦副。
2.如权利要求1所述人工踝关节，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述人工踝关节，其特征在于：所述距骨组件的球头表面上设有用于存贮人体体液的一组凹坑。
4.如权利要求1所述人工踝关节，其特征在于：所述连接体为高分子聚合物或钛及其合金或钽及其合金或医用不锈钢或钴铬合金，连接体的外表面低于陶瓷片的外凹曲面。
5.如权利要求1述人工踝关节，其特征在于：所述一组陶瓷片的形状可为圆柱状和/或多棱柱状。
6.如权利要求1述人工踝关节，其特征在于：所述距骨组件和胫骨组件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。
7.如权利要求1述人工踝关节，其特征在于：所述胫骨组件包括胫骨假体柄和胫骨假体头部分，所述胫骨假体柄和胫骨假体头采用可拆卸相连，弧形凹槽设在胫骨假体头上。
8.如权利要求1述人工踝关节，其特征在于：所述距骨组件和胫骨组件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。
9.如权利要求1述人工踝关节，其特征在于：所述一组陶瓷片均匀和/或非均匀间隔布置。
10.如权利要求4述人工踝关节，其特征在于：所述陶瓷片与连接体相连部分的外周面上设有沟槽或凸起。
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