CN110035715A - 人工髋关节用杆及杆安装方法 - Google Patents

人工髋关节用杆及杆安装方法 Download PDF

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Publication number
CN110035715A
CN110035715A CN201780061404.3A CN201780061404A CN110035715A CN 110035715 A CN110035715 A CN 110035715A CN 201780061404 A CN201780061404 A CN 201780061404A CN 110035715 A CN110035715 A CN 110035715A
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China
Prior art keywords
hip joint
artificial hip
threaded portion
rod
joint bar
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Granted
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CN201780061404.3A
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CN110035715B (zh
Inventor
金斗万
金贤德
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KCIS CO Ltd
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KCIS CO Ltd
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Abstract

本发明提供一种人工髋关节用杆及杆安装方法，作为在用于替换损伤的股骨头或髋臼的人工髋关节用杆，其特征在于，所述人工髋关节用杆包括：杆体，在上部设置有用于固定头部的头部固定部，并由将上侧水平开口的操作空间和与所述操作空间连接的垂直贯通的头部插入孔构成；螺纹部，插入到所述头部插入孔旋转；运动转换部，插入到所述操作空间通过与螺纹部连接由螺纹部垂直移动；固定支架，插入到所述操作空间内并所述螺纹部以不改变深度地旋转；可变操作部，插入到所述杆体的支撑面，以通过运动转换部的操作调节水平方向上的宽度；以及可动销，用于将所述可变操作部固定到运动转换部。

Description

人工髋关节用杆及杆安装方法
技术领域
本发明涉及一种人工髋关节用杆及杆安装方法，更具体地，涉及插入人工髋关节的股骨中的杆，其具有可以分离杆的结构，通过具有可缩放及扩展的结构当插入到股骨时可以最小化施加到股骨的冲击并且在移除时容易地移除的人工髋关节用杆及杆安装方法。
背景技术
髋关节是骨盆和股骨之间的关节，是股骨和骨盆肋骨之间的关节，对应于上肢的肩部，由于圆形股骨头被踝关节夹住，因此属于下肢。
由于对于许多用途的股骨头和颧骨之间的软骨的损伤，这些髋关节通常发生频繁的炎症，通常称为髋关节骨关节炎。
目前对髋关节骨性关节炎的治疗包括局部注射NSAID dir、透明质酸或糖皮质激素，以帮助润滑髋关节，并通过髋关节手术用人造器官代替髋关节的部分。
此外，若由于髋关节骨折或退化而无法使用，则通过关节置换手术进行治疗，解剖学上，臀部是球形关节，此时，将“球”即股骨关节插入到骨盆的杯形插口中。因此，当这些骨骼软化(ossifluece)或破裂时，通过外科手术插入髋植入物以替换受损的天然骨和髋关节的软骨。
基本上，如图1所示，髋植入物在结构上具有四个不同的部分。
代替天然髖骨臼(堆缚套管)的被称为“杯”或“外壳”的髋臼植入物、由覆盖杯子的内面的聚氨酯、陶瓷或金属制成的衬里、插入到天然股骨的轴以取代股骨颈为重建的关节提供稳定性和运动的金属杆、取代天然股骨颈的金属或陶瓷球。
为了替换现有的股骨头和髋臼，通过部分切割股骨，在切割的股骨头上钻孔，插入并固定杆，并通过切割骨盆的髋臼部分取代外壳。
另外，当在现有情况下将杆插入股骨时，在股骨中形成的孔的直径小于杆的外径，并且杆被强制插入股骨中。
然而，当通过插入杆的现有方法将杆固定到股骨时，通过过盈配合对股骨施加强烈的冲击，因此，当老年人的股骨的骨密度弱时，存在在插入杆期间股骨受损的问题。
即，为了保持人造髋关节的初始强固定力，必须增加与股骨的粘附力，因此股骨的孔形成为小于杆的直径。
另外，在股骨上形成的孔应该形成得比杆小，但是，孔不是形成为小尺寸，并且由于比杆大的孔，操作经常失败。
由于人工髋关节不能根据使用时间重新操作，因此应该寻求一种用于移除人工踝关节的方法，但是在现有技术中，很难移除已经安装的人造髋关节。
这是因为当人工髋关节随着时间流逝彼此不定附着，或者当经历人工髋关节的患者由于骨质溶解而需要再次手术时，很难将人造髋关节分开。
作为与人工髋关节相关的现有技术，公开了公开专利第10-2005-0100511号,公开专利第10-2005-0100512号以及公开专利第10-2008-0084930号等，关于手术方法等的技术在公开专利第10-2012-0085239号，公开专利第10-2012-0062706以及公开专利第10-2014-0128939，这些现有技术具有如上所述的问题。
发明内容
要解决的技术问题
本发明是鉴于所述诸多问题而提出的，其目的在于，提供一种插入人工髋关节的股骨中的杆，其具有可以分离杆的结构，通过具有可缩放及扩展的结构当插入到股骨时可以最小化施加到股骨的冲击并且在移除时容易地移除的人工髋关节用杆及杆安装方法。
本发明的另一个目的在于，提供一种用于分离插入的杆，使得在再次操作期间仅可以移除待分离的部分，或者容易完全移除人工髋关节，使得能够根据手术所需的时间减少减轻患者的疼痛和副作用的人工髋关节用杆及杆安装方法。
技术方案
为了实现所述目的，本发明的人工髋关节用杆，作为在用于替换股骨头或髋臼的人工髋关节用杆，其特征在于，所述人工髋关节用杆包括：杆体，在上部设置有用于固定头部的头部固定部，并由将上侧水平开口的操作空间和与所述操作空间连接的垂直贯通的头部插入孔构成；螺纹部，插入到所述头部插入孔旋转；运动转换部，插入到所述操作空间通过与螺纹部连接由螺纹部垂直移动；固定支架，插入到所述操作空间内并所述螺纹部以不改变深度地旋转；可变操作部，插入到所述杆体的支撑面，以通过运动转换部的操作调节水平方向上的宽度；以及可动销，用于将所述可变操作部固定到运动转换部。
所述可变操作部的上端和下端相不同地扩展，所述可变操作部的上端比下端延伸得更多。
所述运动转换部通过螺纹部通过升降的引导孔执行可动销的弯曲运动。
所述可动销相对于运动转换部倾斜地配置。
所述运动转换部的引导孔和可动销的外周面在纵向方向上弯曲。
所述引导孔和可动销在可变操作部的扩展方向上形成半径并构成曲线，
所述曲线运动由以下公式确定：
(1)(x-xR)2+(y-yR)2-R2＝0；
(2)(x-xB)2+(y-yR+uy)2-R2＝0；
(3)(xa-xR)2+(ya-yR)2-R2＝0；
(4)(xb-xR)2+(yb-yR)2-R2＝0；
(5)(xa′-xR)2+(ya′-yR+uy)2-R2＝0；
(6)(xb′-xR)2+(yb′-yR+uy)2-R2＝0；
(7)(R-e)2＜(xa-xR)2+(ya-yR)2＜(R+e)2；
(8)(R-e)2＜(xb-xR)2+(yb-yR)2＜(R+e)2；
(9)(R-e)2＜(xa′-xR)2+(ya′-yR+uy)2＜(R+e)2；
(10)(R-e)2＜(xb′-xR)2+(yb′-yR+uy)2＜(R+e)2；
(11)|(xa-xR)2+(ya-yR)2-R2|D2eR；
(12)|(xb-xR)2+(yb-yR)2-R2|D2eR；
(13)|(xa′+xR)2+(ya′-yR+uy)2-R2|D2eR；
(14)|(xb′+xR)2+(yb′-yR+uy)2-R2|D2eR；
其中D是...≤。
在所述杆体上部进一步设置突出的套环，使得通过套环放置在切割的股骨的上端截面上。
使用本发明的人工髋关节用杆的人工髋关节用杆安装方法，包括：1)将杆体插入到加工的股骨头上的步骤；2)旋转插入的杆体的螺纹部以使可变操作部从杆体扩展的步骤；以及3)防止通过外部冲击螺纹部被松动的固定步骤。
所述步骤2)可以将螺纹部的旋转运动转换成可动销的曲线运动，使得可变操作部的上端和下端的扩展宽度可以不同。
在所述步骤2)中，通过在扩展方向上形成曲线来扩展可变操作部。
有益效果
根据本发明，提供一种插入人工髋关节的股骨中的杆，其具有可以分离杆的结构，通过具有可缩放及扩展的结构当插入到股骨时可以最小化施加到股骨的冲击并且在移除时容易地移除。
根据本发明，能够缩放及扩展插入的杆，使得在再次操作期间容易地将杆从股骨分离，因此能够完全地移除人工髋关节，从而能够根据手术所需的时间减少减轻患者的疼痛和副作用。
附图说明
图1是示出现有人造髋关节的图。
图2是根据本发明的用于人造髋关节的杆的立体图。
图3是根据本发明的人工髋关节用杆的分解立体图。
图4及图5是示出根据本发明的人工髋关节用杆的安装状态的图。
图6是示出根据本发明的用于髋关节的杆的操作原理的视图。
图7是示出根据本发明的用于髋关节的杆的弯曲运动的曲率半径的曲线图。
具体实施方式
在下文中，将参考附图详细描述本发明的优选实施例，可以以各种形式修改本发明的实施例，并且本发明的范围不应被解释为限于下面描述的实施例。本实施例是为了向本发明所属领域的普通技术人员解释本发明而提供的。因此，可夸大附图中所示的每个元件的形状以强调更清楚的描述。
第一及第二等术语可用于说明多种结构要素，但所述结构要素并不被所述术语而限定。所述术语为了区分一个结构要素与其他结构要素而使用。
在本申请中的术语为了说明特定的实施例而使用的，并不限定本发明。单数的表现包含复数的表现。在本申请中“包含”或“而成”等术语是用于指定说明书里记载的特征、数字、步骤、动作、构成要素、配件或这些的组合，可理解为不会提前排除一个或以上的其他特征或数字、步骤、动作、构成要素、配件或这些组合的存在或附加可能性。
参照图2及图3，本发明的人工髋关节用杆100包括杆体110、螺纹部120、运动转换部130、固定支架140、可变操作部150及可动销160。
所述杆体110具有预定的长度，并且朝向下侧逐渐减小直径，杆体110设置有头部固定部111，头部固定部111在其上端以预定的倾斜角度突出并且具备连接头部(未图示)的头部固定部111。
在所述杆体110设置有可变操作部150，用于切割及拆卸杆体110的上侧的一部分，对应于所述可变操作部150的支撑面112形成在所述杆体110的侧面上，使得所述可变操作部150可以连接并可滑动地移动，操作空间113形成为以预定长度水平地穿透所述支撑面112，并且形成从所述操作空间113向上延伸的插入空间114，从所述杆主体110的上部垂直开口的头部插入孔115形成为与所述插入空间114侧连通。
并且套环116形成在所述杆体110的上端的一侧，以便连接到切割的股骨的上面。
第一引导面113a和第二引导面113b在所述操作空间113的一个侧面上以阶梯形状形成，并且形成用于可倾斜地连接所述第一引导面113a和第二引导面113b的卡止面113c。
所述螺纹部120包括插入到所述杆体110的头部插入孔115的螺纹头121、形成为具有距所述螺纹头121预定长度的外螺纹122、在所述螺纹头121和外螺纹122之间阶梯形成的台肩123a、123b、形成在所述台肩之间的插入槽124。
所述运动转换部130具有矩形形状，并且具有形成在外侧的一侧上的阶梯式滑动面131a、131b，并且形成以倾斜方式连接所述滑动面131a、131b的卡止面132，在内侧形成有具有预定长度向一侧倾斜的朝水平方向开口的引导孔133，并且形成从上部开口以与所述引导孔133连通的内螺纹134。
此时，所述引导孔133在倾斜方向上具有弯曲形状。
所述固定支架140设置于所述插入空间114中并插入到所述螺纹部120的插入槽124中以支撑螺纹部，并由一对突起141和形成在所述突起141之间的槽142构成。
所述可变操作部150通过将所述杆体110的上部的一部分切割成“C”形而形成，并且对应于所述杆体110的支撑面112的引导面152形成在内部插入空间151中，并且形成沿水平方向穿透的一对固定孔153。即，当所述可变操作部150插入到杆体中时，杆体的外周面和可变操作部的外周面一体地形成。
此时，所述可变操作部的上端和下端具有弯曲形状。
所述可动销160具有预定的长度和宽度，并具有椭圆形的横截面形状。此外，所述可动销具有类似于所述引导孔133的弯曲形状，使得可动销能够在所述引导孔133中滑动。
首先使运动转换部130的滑动面131a、131b与所述操作空间113的第一引导面113a和第二引导面113b紧密接触，使得卡止面132放置在卡止面113c上。
在这种状态下，螺纹部120插入到头部插入孔115中，使得外螺纹122拧入内螺纹134中，并且固定支架140插入到插入空间114中，使得插入槽124可以位于槽142之间，并且突起141的上端和下端可以支撑插入槽124之间的台肩123a、123b。
此时，所述插入空间114在从杆体110侧面开口，并且一侧被阻挡的状态下从所述操作空间113延伸，并且当插入固定支架140时，突起能够紧密地固定在阻挡侧。
其次，可变操作部150的引导面152插入到杆体侧，以便与支撑面112紧密接触，使得引导孔133和运动转换部130的固定孔153彼此对准，可动销160通过所述固定孔153和引导孔插入并固定。
所述引导孔133、固定孔153以及可动销160在所述可变操作部150的宽度方向延伸方向上弯曲并倾斜。
下面将详细描述所述引导孔、固定孔、可动销的曲线形态以及可变操作部的上端和下端的弯曲形状。
将描述本发明的操作状态及本发明的安装方法。
同时，本发明提供一种使用人工髋关节用杆的人工髋关节用杆安装方法，包括以下步骤：1)将杆体插入到加工的股骨头上的步骤；2)旋转插入的杆体的螺纹部以使可变操作部从杆体扩展的步骤；3)防止通过外部冲击螺纹部被松动的固定步骤，所述步骤2)可以将螺纹部的旋转运动转换成可动销的曲线运动，使得可变操作部的上端和下端的扩展宽度可以不同。
而且，在所述步骤2)中，通过在扩展方向上形成曲线来扩展可变操作部。在下文中，将参考附图描述本发明的操作状态。
如图4所示，切割受损的股骨头，在股骨中钻一个孔，使得与股骨头具有预定的深度，并插入杆，然后，使用杆插入工具将杆插入孔中。
在这种情况下，当插入的杆插入到孔中时，由于杆的形状是弯曲的楔形，因此经常发生部分或整体小于孔的现象。
即，钻出具有与医疗杆的形状相同或相似尺寸的孔是非常困难的，并且需要高难度的技术，因此经常发生形成大于杆的孔的现象。
若孔大于杆，则存在不能使用杆的问题，如图5所示，将设置在插入的杆的上部的螺纹部120旋转使所述螺纹部120的旋转运动，使得由螺纹结合的运动转换部130转换成垂直运动，然后通过降低运动转换部130插入到引导孔133中，将固定在可变操作部150的可动销160通过在引导孔中滑动，使得将连接到可动销的可变操作部150在宽度方向上向外推动以从杆体110的外周面突出。
此时，突出的可变操作部150的上端和下端是弯曲的，并且可动销及引导孔也是弯曲的，使得可变操作部也随着可动销沿着引导孔的曲线移动以曲线移动，上端的突出宽度W1比下端的突出宽度W2突出得更多，可以保持杆体110的外周面的弯曲形状并且扩展以适合孔尺寸。
此时，套环116可以进一步设置在所述杆体的上部一侧，以与切割的股骨的上面紧密接触。
即，在螺纹部旋转的同时，运动转换部在操作空间113中垂直滑动下降时，可动销通过下降的运动转换部的移动间隔在引导孔中滑动，可动销和引导孔均具有弯曲形状，并且通过由曲线的移动连接到可动销的可变操作部的弯曲运动而延伸到杆体的外部。
为了执行这样的操作，可动销和引导孔在可变操作部的扩展方向上形成为半径，并且可变操作部的上端和下端相应地形成为弯曲形状。
为了使曲线的运动在没有相互干扰的情况下发生，应满足以下等式。
在图6中，“A”是杆体，“B”是可变操作部，“C”是可动销、引导孔及运动转换部。为了便于说明，将描述“A”、“B”、“C”。
如图6所示，特殊倾斜面围绕坐标原点旋转。在“B”中当接触面的下端部的位置由“a”表示并且上端部分的位置由“b”表示时，每个位置的坐标可以由圆柱坐标系表示时分别表示为(ra，θa)、(rb，θb)，“C”的垂直运动使“B”旋转r，使得当分别定义要移动的位置a`、b`的坐标分别定义为(ra，θ′a)、(rb，θ′b)，a、b和a`、b`具有以下关系。
θ′a＝θa-γ
θ′b＝θb-γ
此外，在“B”不膨胀(扩展)的位置处的接触面的表达式可以表示为圆形。
(1)(x-xR)2+(y-yR)2-R2＝0
当“C”沿(-)uy方向移动时，接触面可表示如下。
(2)(x-xR)2+(y-yR+uy)2-R2＝0
当膨胀前的“B”和“C”彼此接触时，两个点a和b满足圆公式。由直角坐标系表示定义的点a、b。
a＝[xa，ya]＝[racos(θa)，rasin(θa)]
b＝[xb，yb]＝[rbcos(θb)，rbsin(θb)]
此外，膨胀后的位置为如下。
a′＝[xa′，ya′]＝[racos(θa-γ)，rasin(θa-γ)]
b′＝[xb′，yb′]＝[rbcos(θb-γ)，rbsin(θb-γ)]
[xa，ya]、[xb，yb]要满足公式(1)[xa′，ya′]、[xb′，yb′]要满足公式(2)。
(3)(x2-xR)2+(ya-yR)2-R2＝0
(4)(xb-xR)2+(yb-yR)2-R2＝0
(5)(xa′-xR)2+(ya′-yR+uy)2-R2＝0
(6)(xb′-xR)2+(yb′-yR+uy)2-R2＝0
因此，对于具有围绕坐标原点旋转及膨胀r的结构的人工髋关节用杆，应确定点a、b、R以满足等式(3)-(6)。
在点a、b处，ra、θa、rb确定可变操作部的尺寸的变数，是可以由设计者的意图确定的变量数。
确定ra、θa、rb时，要确定θb、R以便膨胀后便于接触。
这个工程问题是找到一个同时满足四个公式的变数θb、R的问题，但不可能用数学方法得到正确的答案，人工髋关节的情况下作为金属之间结合的结构体，金属之间结合时被接触操作的数学误差小于机械误差范围时，即便存在数学误差也能充分用机械操作，因此，相当于获得对应的值的公式。此时，当组装的容许误差是“e”时，应用于等式(3)至(6)时，可以通过以下等式表示。
(7)(R-e)2＜(xa-xR)2+(ya-yR)2＜(R+e)2
(8)(R-e)2＜(xb-xR)2+(yb-yR)2＜(R+e)2
(9)(R-e)2＜(xa′-xR)2+(ya′-yR+uy)2＜(R+e)2
(10)(R-e)2＜(xb′-xR)2+(yb′-yR+uy)2＜(R+e)2
在公式(7)中e2J2Re，因此，若忽略e2时，可以将公式(7)至(10)表达为公式(11)到(14)。
(11)|(xa-xa)2+(ya-yR)2-R2|D2eR，
(12)|(xb-xR)2+(yb-yR)2-R2|D2eR，
(13)|(xa′-xR)2+(ya′-ya+uy)2-R2|D2eR，and
(14)|(xb′-xR)2+(yb′-yR+uy)2-R2|D2eR.
此时，D是...≤。
满足公式(11)至(14)的θb，R可以通过数值解来计算，并且被导出为如图7所示的图，可以确定构成“B”和“C”的触点a、b的R的大小，结果，可以导出可变操作部的操作。
除了通过具有弯曲面并通过弯曲面形成运动的引导孔、可动销以及可变操作部延伸杆的外周面之外，通过使下端和上端之间的扩展间隔不同，可以使插入的杆更精确且牢固地固定到孔上。
而且，当更换插入的杆时，通过再次减小扩展的可变操作部，当移除粘合力时，可以更有效地更换杆。
虽然已经参考本发明的示例性实施例具体示出及描述了本发明，但是应该理解为本发明不限于所公开的示例性实施例。
即，本领域技术人员可以在不脱离本发明的技术精神的情况下进行各种变更和修改，这些修改或变更在由权利要求解释的本发明的技术范围内。

Claims (12)

1.一种人工髋关节用杆，作为在用于替换股骨头或髋臼的人工髋关节用杆，其特征在于，
所述人工髋关节用杆包括：
杆体，在上部设置有用于固定头部的头部固定部，并由将上侧水平开口的操作空间和与所述操作空间连接的垂直贯通的头部插入孔构成；
螺纹部，插入到所述头部插入孔旋转；
运动转换部，插入到所述操作空间通过与螺纹部连接由螺纹部垂直移动；
固定支架，插入到所述操作空间内并所述螺纹部以不改变深度地旋转；
可变操作部，插入到所述杆体的支撑面，以通过运动转换部的操作调节水平方向上的宽度；以及
可动销，用于将所述可变操作部固定到运动转换部。
2.根据权利要求1所述的人工髋关节用杆，其特征在于，所述可变操作部的上端和下端相不同地扩展。
3.根据权利要求2所述的人工髋关节用杆，其特征在于，所述可变操作部的上端比下端延伸得更多。
4.根据权利要求1所述的人工髋关节用杆，其特征在于，所述运动转换部通过螺纹部通过升降的引导孔执行可动销的弯曲运动。
5.根据权利要求4所述的人工髋关节用杆，其特征在于，所述可动销相对于运动转换部倾斜地配置。
6.根据权利要求4所述的人工髋关节用杆，其特征在于，所述运动转换部的引导孔和可动销的外周面在纵向方向上弯曲。
7.根据权利要求6所述的人工髋关节用杆，其特征在于，所述引导孔和可动销在可变操作部的扩展方向上形成半径并构成曲线。
8.根据权利要求4所述的人工髋关节用杆，其特征在于，所述曲线运动由以下公式确定：
(1)(x-xR)2+(y-yR)2-R2＝0；
(2)(x-xR)2+(y-yR+uy)2-R2-0；
(3)(xa-xR)2+(ya-yR)2-R2＝0；
(4)(xb-xR)2+(yb-yR)2-R2＝0；
(5)(xa′-xR)2+(ya′-yR+uy)2-R2＝0；
(6)(xb′-xR)2+(yb′-yR+uy)2-R2＝0；
(7)(R-e)2＜(xa-xR)2+(ya-yR)2＜(R+e)2；
(8)(R-e)2＜(xa-xK)2+(yo-yR)2＜(R+e)2；
(9)(R-e)2＜(xa′-xR)2+(ya′-yR+uy)2＜(R+e)2；
(10)(R-e)2＜(xb′-xR)2+(yb′-yR+uy)2＜(R+e)2；
(11)|(xa-xK)2+(ya-yK)2-R2|D2eR；
(12)|(xb-xR)2+(yb-yR)2-R2|D2eR；
(13)|(xa′-xR)2+(ya′-yR+uy)2-R2|D2eR；
(14)|(xb′-xb)2+(ya′-yR+uy)2-R2|D2eR.
其中D是...≤。
9.根据权利要求1所述的人工髋关节用杆，其特征在于，在所述杆体上部进一步设置突出的套环。
10.一种人工髋关节用杆安装方法，作为根据权利要求1至9中任一项所述的使用人工髋关节用杆的人工髋关节用杆安装方法，其特征在于，包括：
1)将杆体插入到加工的股骨头上的步骤；
2)旋转插入的杆体的螺纹部以使可变操作部从杆体扩展的步骤；以及
3)防止通过外部冲击螺纹部被松动的固定步骤。
11.根据权利要求10所述的人工髋关节用杆安装方法，其特征在于，所述步骤2)可以将螺纹部的旋转运动转换成可动销的曲线运动，使得可变操作部的上端和下端的扩展宽度可以不同。
12.根据权利要求10所述的人工髋关节用杆安装方法，其特征在于，在所述步骤2)中，通过在扩展方向上形成曲线来扩展可变操作部。
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