CN111529139A - Assembled tumor type artificial tibia distance joint prosthesis - Google Patents

Assembled tumor type artificial tibia distance joint prosthesis Download PDF

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Publication number
CN111529139A
CN111529139A CN202010407090.1A CN202010407090A CN111529139A CN 111529139 A CN111529139 A CN 111529139A CN 202010407090 A CN202010407090 A CN 202010407090A CN 111529139 A CN111529139 A CN 111529139A
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China
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talus
tibia
component
tibialis
base
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CN202010407090.1A
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Chinese (zh)
Inventor
郭卫
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Peking University
Peking University Peoples Hospital
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Peking University Peoples Hospital
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Priority to CN202010407090.1A priority Critical patent/CN111529139A/en
Publication of CN111529139A publication Critical patent/CN111529139A/en
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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
    • A61F2/38—Joints for elbows or knees
    • A61F2/389—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
    • A61F2/3094—Designing or manufacturing processes
    • A61F2/30942—Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
    • 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
    • A61F2/28—Bones
    • A61F2002/2892—Tibia
    • 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
    • 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
    • A61F2/3094—Designing or manufacturing processes
    • A61F2002/30985—Designing or manufacturing processes using three dimensional printing [3DP]

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Transplantation (AREA)
  • Cardiology (AREA)
  • Biomedical Technology (AREA)
  • Veterinary Medicine (AREA)
  • Vascular Medicine (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Physics & Mathematics (AREA)
  • Geometry (AREA)
  • Manufacturing & Machinery (AREA)
  • Prostheses (AREA)

Abstract

The invention relates to a combined tumor type artificial tibia distance joint prosthesis, which comprises: the tibia component is used for being connected with the tibia of the human body; the talus component mainly comprises a talus base, a talus connecting column and a locking screw, wherein the talus base is of a shell structure matched with the shape of a talus surface, the talus connecting column is integrally formed at the lower part of the talus base and extends downwards along a vertical axis, and the locking screw penetrates through the talus base, the talus connecting column and a human talus along a coronal axis; and the tibialis-distance hinge connecting component is rotatably connected between the tibialis component and the talus component, so that the tibialis component and the talus component can relatively rotate in a sagittal plane, thereby restoring the plantarflexion and dorsal extension functions of the tibialis-distance joint. The invention can be widely applied to the bone defect reconstruction of limb continuous interruption after tumor resection under the condition that the tibia far end or the fibula far end seriously affects the tibia, can realize the aim of limb structure recovery, and simultaneously realizes the perfect combination of instant stability and long-term stability of the tibialis distance joint, thereby obviously improving the function of the long-term tibialis distance joint of a patient.

Description

Assembled tumor type artificial tibia distance joint prosthesis
Technical Field
The invention relates to an artificial joint, in particular to an assembled tumor type artificial tibial distance joint prosthesis which can freely adjust the length of the prosthesis and improve the bone ingrowth.
Background
The tibia is the second best site for osteosarcoma of the femur alone, accounting for approximately 19% of total osteosarcoma, and of which 20% occurs in the distal tibia. The distal tibia has a high number of tendons, blood vessels and nerves, so that it is difficult to obtain a good tumor boundary. Therefore, the scholars recommend the amputation of the knee as the first surgical mode for the distal tibial osteosarcoma. With the progress of chemotherapy and surgical techniques in recent years, limb protection treatment of distal tibial osteosarcoma can also achieve good survival rate, and is accepted and recommended by bone tumor doctors.
At present, reconstruction modes of a distal tibia malignant tumor section after resection are various, and the reconstruction modes mainly comprise allogeneic bone reconstruction, autologous bone inactivation and replantation, autologous fibula transplantation with vascular pedicles, autologous fibula transplantation without vascular pedicles and ankle joint prosthesis replacement. The reconstruction of the allogeneic bone has the problems of high infection risk, allogeneic bone absorption, rejection reaction and the like, thereby increasing the risk of complications such as wound infection and the like. The autologous bone inactivation replanting method is various, the three most commonly used inactivation methods at home and abroad are an alcohol method, a liquid nitrogen method and a high-temperature method, and different inactivation methods have various advantages and disadvantages in the aspect of complications. The ankle joint bears the weight of the whole body, and the normal movement of the ankle joint can complete the daily walking movement, so that the ankle joint functional reconstruction method has important significance for reconstructing the functionality of the ankle joint of a patient with distal tibial malignant tumor and having postoperative curative effect. The ankle fusion has the advantages of restoring continuity of bony structures, providing good ankle stability, and reducing pain during weight bearing. But rely on steel plate screw system to realize the fixed patient with ankle joint fusion of shin bone distal end, along with the absorption of grafting back autogenous body bone, the fracture incidence of multiplicable postoperative deactivation autogenous bone and major segment xenogenesis bone. Although the reconstruction modes after resection of the distal malignant tumor section of the tibia are numerous at present, most reconstruction modes are at the cost of ankle joint mobility, and the normal ankle joint mobility is still difficult to accept for most patients, especially young patients. But a reconstruction mode capable of realizing perfect combination of ankle joint stability and good mobility after resection of a large tumor bone of a distal malignant tumor of a tibia remains a significant challenge for bone oncologists.
Ankle replacements are not as widely popularized as hip replacements, due primarily to the high incidence of mechanical failure of the long term prosthesis and the complications of incisions. Meanwhile, the postoperative function of the patient is seriously affected by the loosening failure of the prosthesis after the ankle joint replacement and the pain and swelling around the ankle. Studies have shown that the mechanical failure of artificial ankle joints is largely due to prosthetic talar bone collapse and prosthetic osteoarticular bone resorption at the bone interface.
Disclosure of Invention
In view of the above problems, the present invention is directed to a combined tumor type artificial tibia distance joint prosthesis which can freely adjust the length of the prosthesis and improve the bone ingrowth.
In order to achieve the purpose, the invention adopts the following technical scheme: a modular tumor-type artificial tibialis joint prosthesis, comprising: the tibia component is used for being connected with the tibia of the human body; the talus component mainly comprises a talus base, a talus connecting column and a locking screw, wherein the talus base is of a shell structure matched with the shape of a talus surface, the talus connecting column is integrally formed at the lower part of the talus base and extends downwards along a vertical axis, and the locking screw penetrates through the talus base, the talus connecting column and the human talus along a coronal axis so as to realize the stable connection of the talus component and the human talus; and the tibialis distance hinge-type connecting component is rotatably connected between the tibia component and the talus component, so that the tibia component and the talus component can relatively rotate in a sagittal plane, and the plantarflexion and dorsal extension functions of the tibialis distance joint are restored.
The assembled tumor type artificial tibial distance joint prosthesis preferably comprises: the tibia intramedullary pin is inserted into a tibia marrow cavity so as to connect the tibia assembly with a human tibia; the upper end of the extension section is in taper joint with the lower end of the tibia broach; the upper end of the basic section is in tapered connection with the lower end of the extension section.
The assembled tumor type artificial tibialis joint prosthesis preferably comprises: a hinge lug integrally formed at a lower end of the base section; and the hinge arm is integrally formed at the upper part of the talus base, extends into the hinge lug and is rotatably connected with the hinge lug through a hinge shaft.
The assembled tumor type artificial tibial Pitch joint prosthesis preferably has a biological type or a cement type tibial broach.
The assembled tumor type artificial tibial distance joint prosthesis is preferably a pore structure designed by adopting a 3D printing technology, wherein the contact interface of the talus base, the talus connecting column and the human talus is a pore structure.
Due to the adoption of the technical scheme, the invention has the following advantages: 1. the invention can rebuild the bending and extending functions of the tibialis-distal joint, recover the length of the limb and provide conditions for normal mechanical conduction after the tumor section of the lower limb is resected. 2. The invention adopts the assembly design, and can freely adjust the length of the tibia component according to the resection range of the tibia distal end tumor section of a patient, the skin defect condition and the soft tissue tension, thereby reconstructing the tibia distal end defect section in an individual way. 3. The talus base and the talus connecting column are of a pore structure designed by a 3D printing technology, and the fusion rate of the talus base and the talus connecting column with a host bone interface is improved, so that an important basis is provided for good bone ingrowth and prosthesis stability. 4. According to the invention, through the interface design based on the locking screw mechanism and the 3D printing technology, the instant stability and the long-term stability of the tibialis-talar joint prosthesis are perfectly combined.
Drawings
FIG. 1 is a schematic perspective view of the present invention;
FIG. 2 is a front view of the present invention;
fig. 3 is a side view of the present invention.
Detailed Description
The preferred embodiments of the present invention will be described in detail below with reference to the accompanying drawings so that the objects, features and advantages of the invention can be more clearly understood. It should be understood that the embodiments shown in the drawings are not intended to limit the scope of the present invention, but are merely intended to illustrate the spirit of the technical solution of the present invention.
As shown in fig. 1 to 3, the assembled tumor type artificial tibial space joint prosthesis provided by the present invention comprises: the tibia component 1 is used for being connected with a tibia of a human body; the talus component 2 mainly comprises a talus base 21, a talus connecting column 22 and a locking screw 23, wherein the talus base 21 is of a shell type structure matched with the shape of a talus surface, and the talus connecting column 22 is integrally formed at the lower part of the talus base 21, extends downwards along a vertical axis and is used for being inserted into an insertion hole formed in a talus of a human body; a locking screw 23 passes through the talus base 21, the talus connection post 22 and the human talus along the coronal axis to achieve stable connection of the talus assembly 2 with the human talus; and the tibialis-distance hinge connecting component 3 is rotatably connected between the tibia component 1 and the talus component 2, so that the tibia component 1 and the talus component 2 can relatively rotate in a sagittal plane, and the plantar flexion and dorsal extension functions of the tibialis-distance joint are restored.
In the above embodiment, preferably, the tibial component 1 includes: a tibia intramedullary nail 11 for inserting into the tibia medullary cavity to connect the tibia component 1 with the human tibia; the upper end of the extension section 12 is in taper joint with the lower end of the tibia broach 11, and the extension sections 12 with different lengths can be assembled to realize the assembly of different tibia defect lengths in the operation according to the tibia defect length so as to adapt to patients with different tibia defect degrees; the upper end of the basic section 13 is in conical connection with the lower end of the extension section 12.
In the above embodiment, preferably, the tibialis hinge-type connection assembly 3 includes: a hinge lug 31 integrally formed at a lower end of the base section 13; and a hinge arm 32 integrally formed at an upper portion of the talar base 21 and extending into the hinge ear 31, and rotatably coupled to the hinge ear 31 by a hinge shaft 33.
In the above embodiment, the tibial broach 5 may be designed as a biological broach or a cement broach, so as to select different fixing modes according to different requirements.
In the above embodiment, preferably, the contact interface of talus base 21 and talus connecting post 22 and human talus is the pore structure who adopts 3D printing technology design, and the talus bone of being convenient for grows into to improve talus base 21 and talus connecting post 22 and host bone interface's the rate of fusing, the talus bone of being convenient for grows into, realizes the long-term stability of prosthesis talus interface.
Finally, it should be noted that: the above examples are only intended to illustrate the technical solution of the present invention, but not to limit it; although the present invention has been described in detail with reference to the foregoing embodiments, it will be understood by those of ordinary skill in the art that: the technical solutions described in the foregoing embodiments may still be modified, or some technical features may be equivalently replaced; and such modifications or substitutions do not depart from the spirit and scope of the corresponding technical solutions of the embodiments of the present invention.

Claims (5)

1. A combined tumor type artificial tibia distance joint prosthesis is characterized by comprising:
the tibia assembly (1) is used for being connected with a tibia of a human body;
the talus component (2) mainly comprises a talus base (21), a talus connecting column (22) and a locking screw (23), wherein the talus base (21) is of a shell structure matched with the talus surface shape, the talus connecting column (22) is integrally formed at the lower part of the talus base (21) and extends downwards along a vertical axis, and the locking screw (23) penetrates through the talus base (21), the talus connecting column (22) and the human talus along a coronal axis so as to realize the stable connection of the talus component (2) and the human talus;
the tibialis-talus hinge-type connecting component (3) is rotationally connected between the tibial component (1) and the talus component (2) so that the tibial component (1) and the talus component (2) can relatively rotate in a sagittal plane, thereby restoring the plantarflexion and dorsal extension functions of the tibialis-talus joint.
2. The assembled tumor-type artificial tibial subtalar joint prosthesis according to claim 1, wherein said tibial component (1) comprises:
a tibia intramedullary pin (11) for inserting into a tibia medullary cavity to connect the tibia assembly (1) with a human tibia;
the upper end of the extension section (12) is in taper joint with the lower end of the tibia intramedullary nail (11);
a basic section (13), wherein the upper end of the basic section (13) is in conical connection with the lower end of the extension section (12).
3. The assembled tumor-type artificial tibialis joint prosthesis according to claim 1, wherein said tibialis hinge-connection assembly (3) comprises:
a hinge lug (31) integrally formed at a lower end of the base section (13);
an articulated arm (32) integrally formed at an upper portion of the talus base (21) and extending into the articulated ear (31), and rotatably connected to the articulated ear (31) by an articulated shaft (33).
4. The modular tumor-type artificial tibial subtalar joint prosthesis according to claim 1, wherein said tibial broach (5) is of biological or cement type.
5. The assembled tumor-type artificial tibial subtalar joint prosthesis according to claim 1, wherein the contact interface between the talus base (21) and the talus connection post (22) and the human talus is a pore structure designed by 3D printing technology.
CN202010407090.1A 2020-05-14 2020-05-14 Assembled tumor type artificial tibia distance joint prosthesis Pending CN111529139A (en)

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Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN111938878A (en) * 2020-08-28 2020-11-17 中国人民解放军总医院 Tibia prosthesis
CN112155804A (en) * 2020-10-19 2021-01-01 山东威高骨科材料股份有限公司 Customized 3D printing ankle joint device
CN112472371A (en) * 2020-12-04 2021-03-12 北京力达康科技有限公司 Keep shin bone false body of bone dirt line
CN112842633A (en) * 2020-12-31 2021-05-28 上海晟实医疗器械科技有限公司 3D prints full ankle joint prosthesis of shin bone intramedullary nail
CN113712710A (en) * 2021-09-13 2021-11-30 上海市第十人民医院 Assembled ankle joint tumor type prosthesis
CN113797000A (en) * 2021-10-09 2021-12-17 北京大学人民医院 Talus fusion surface type artificial ankle joint prosthesis

Cited By (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN111938878A (en) * 2020-08-28 2020-11-17 中国人民解放军总医院 Tibia prosthesis
CN112155804A (en) * 2020-10-19 2021-01-01 山东威高骨科材料股份有限公司 Customized 3D printing ankle joint device
CN112155804B (en) * 2020-10-19 2023-05-23 山东威高骨科材料股份有限公司 Customized 3D prints ankle joint device
CN112472371A (en) * 2020-12-04 2021-03-12 北京力达康科技有限公司 Keep shin bone false body of bone dirt line
CN112842633A (en) * 2020-12-31 2021-05-28 上海晟实医疗器械科技有限公司 3D prints full ankle joint prosthesis of shin bone intramedullary nail
CN113712710A (en) * 2021-09-13 2021-11-30 上海市第十人民医院 Assembled ankle joint tumor type prosthesis
CN113712710B (en) * 2021-09-13 2024-02-13 上海市第十人民医院 Assembled ankle joint tumor type prosthesis
CN113797000A (en) * 2021-10-09 2021-12-17 北京大学人民医院 Talus fusion surface type artificial ankle joint prosthesis

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