CN112972070A - Knee joint medial meniscus prosthesis suitable for osteoarthritis patient - Google Patents
Knee joint medial meniscus prosthesis suitable for osteoarthritis patient Download PDFInfo
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- CN112972070A CN112972070A CN202110155586.9A CN202110155586A CN112972070A CN 112972070 A CN112972070 A CN 112972070A CN 202110155586 A CN202110155586 A CN 202110155586A CN 112972070 A CN112972070 A CN 112972070A
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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
- A61F2/3872—Meniscus for implantation between the natural bone surfaces
Abstract
The invention discloses a knee joint inner side meniscus prosthesis suitable for osteoarthritis patients, which is formed by integrally molding a prosthesis front part, a prosthesis middle part and a prosthesis rear part, wherein the prosthesis is approximate to an ellipse, the long axis of the prosthesis is consistent with the long axis of a femoral inner side compartment, the anteroposterior diameter is matched with the anteroposterior diameter of a receptor knee joint inner side compartment, and the upper surface is a disc-shaped curved surface and is adapted to a femoral inner condyle joint; the lower surface is a plane and is adapted to the joint of the medial tibial plateau. The invention changes the high-abrasion and high-resistance state joint surface of bone-to-bone contact into two interfaces of a femur prosthesis joint surface and a prosthesis tibia joint surface with low resistance and low abrasion, and has high mobility.
Description
Technical Field
The invention belongs to the field of artificial joints of orthopedic surgery in clinical medicine, relates to a knee joint inner side meniscus prosthesis suitable for osteoarthritis patients, and particularly relates to a knee joint inner side meniscus prosthesis suitable for 3-grade and 4-grade knee osteoarthritis patients.
Background
With the age, the knee joint can have the abrasion of articular cartilage and the degenerative damage and failure of meniscus, particularly medial meniscus, at the moment, the knee joint can have pain and varus deformity, and then the joint is restricted in movement and has flexion contracture, which seriously affects the life quality of patients. The currently most well-accepted clinical grade for the severity of osteoarthritis is the Kellgren-lawrence X-ray slice grade, which is determined by taking a standard knee positive X-ray slice for the case of knee osteoarthritis with significant symptoms. The level of narrowing of the joint space combined with other manifestations has been graded from light to heavy as grade 1 to 4, with grade 3 and 4 knee osteoarthritis presenting a full layer of cartilage wear and meniscal failure.
The meniscus is composed of fibrocartilage, and is located in the joint space of knee joint. The anterior portions of the medial and lateral menisci are connected to the transverse ligamentum of the knee. The meniscus has a semicircular structure, a thicker periphery, a thin and sharp inner edge, a concave upper surface, a flat lower surface and a tibial plateau. Because of the presence of the meniscus, the knee joint is divided into two groups, femoral-meniscal and meniscal-tibial, articulations. The meniscus plate is mainly attached to the tibia, but can move with the femur within a certain range, and the morphological characteristics of the meniscus plate can compensate the inadaptation of the condyle surface of the tibia and the condyle surface of the femur, increase the stability of the joint and prevent surrounding soft tissues from being extruded into the joint. The meniscus is grey, smooth, glossy, tough and elastic, and can buffer impact between two bone surfaces, absorb shock, disperse synovial fluid, increase lubrication, reduce friction and protect joints.
The medial meniscus is "C" shaped, with a larger circumference, a narrow front and a wide back. The anterior horn is attached anterior to the attachment point of the anterior cruciate ligament and lies between the two condyles of the tibia. However, the third hospital affiliated with Beijing university believes that the anterior corner dead center of the medial meniscus is more anterior, under the front of the platform, by autopsy. This is of great significance in meniscal transplantation. The anterior horn has some fibers that pass through the anterior joint and connect to the anterior horn of the lateral meniscus. The posterior horn attaches to the tibial intercondylar notch just anterior to the posterior cruciate ligament and just below the posterior horn fibers of the lateral meniscus. The medial meniscus is tightly connected to the posterior portion of the medial collateral ligament and the medial joint capsule, thereby limiting the mobility of the medial meniscus. At the boundary between the loose front half and the fixed rear half, the transverse rupture is likely to occur due to the external force of torsion.
There are two main treatment modalities currently used for the above situations:
the first is conservative treatment, applying non-steroidal anti-inflammatory drugs to relieve arthritic reaction, delay joint degeneration and relieve pain symptoms. It can be used in combination with slow-acting medicines for nourishing articular cartilage, such as glucosamine. Can relieve symptoms in different degrees and delay the progress of osteoarthritis. But often the symptoms are not well relieved and the patient's mobility is not much improved. Moreover, the mechanical mechanism of the varus knee joint can not be changed, so that arthritis still can progress;
the second is surgical treatment, typically repair of damaged articular surfaces by joint replacement. The pain relief and function improvement of the treatment mode are good, but the operation cuts off the bone with the thickness of one centimeter at each bone end of the femur and the tibia, cuts off the anterior cruciate ligament (some prostheses need to cut off the posterior cruciate ligament at the same time), has large operation trauma, and has a plurality of problems of infection and the like due to the large-volume implant.
There is therefore a pressing need for an intermediate treatment option to replace only the worn cartilage and meniscus, preserving the patient's normal subchondral bone and ligament structure, which can restore the closest to normal knee joint structure and function with minimal surgical trauma.
Disclosure of Invention
The invention aims to provide a knee joint inner side meniscus prosthesis suitable for osteoarthritis patients, which is used for implanting inner side joint gaps with knee osteoarthritis cartilage full-layer abrasion and inner side meniscus failure, and can relieve pain and improve joint function.
The purpose of the invention is realized by the following technical scheme:
a knee joint medial meniscus prosthesis suitable for osteoarthritis patients is formed by integrally forming a prosthesis front part, a prosthesis middle part and a prosthesis rear part, the prosthesis is oval, the upper surface of the prosthesis is sunken and is matched with a femoral condyle, the lower surface of the prosthesis is flat and is matched with a tibial plateau,
the total length of the prosthesis 1 is 46mm plus or minus 3 mm;
the total width 2 of the prosthesis is 23mm plus or minus 2 mm;
the length of the concave part on the prosthesis is 37mm plus or minus 2 mm;
the depth 21 of the prosthesis recess is 2mm plus or minus 2 mm;
the length 3 of the front part of the prosthesis is 14mm plus or minus 1 mm;
the width of the front end 7 of the front part of the prosthesis is 12.5mm plus or minus 1 mm;
the width of the front and back ends 8 of the prosthesis is 12.5mm plus or minus 1 mm;
the length of the middle part of the prosthesis is 4mm plus or minus 2 mm;
the length of the back part of the prosthesis is 5mm plus or minus 1 mm;
the width 9 of the front end of the back part of the prosthesis is 20mm plus or minus 2 mm;
the width 10 of the rear end of the prosthesis rear part is 12mm plus or minus 2 mm;
the outer height 11 of the front end of the front part of the prosthesis is 5.0mm plus or minus 0.5 mm;
the inner height 12 of the front end of the front part of the prosthesis is 4.5mm plus or minus 0.5 mm;
the outer height 13 of the front and rear ends of the prosthesis is 5.0mm +/-0.7 mm;
the inner height 14 of the front and back ends of the prosthesis is 4.0mm plus or minus 0.7 mm;
the outer height 15 of the midline of the middle part of the prosthesis is 6.5mm plus or minus 1 mm;
the medial height 16 at the midline of the middle part of the prosthesis is 4.0mm + -0.5 mm;
the outer height 17 of the front end of the back part of the prosthesis is 9mm plus or minus 1 mm;
the inner height 18 of the front end of the back part of the prosthesis is 4.5mm plus or minus 0.5 mm;
the outer height 19 of the rear end of the prosthesis rear part is 11mm +/-1 mm;
the inner height 20 of the rear end of the rear part of the prosthesis is 7mm +/-1 mm;
the camber angle a of the anterior portion of the prosthesis is 16 ° ± 2 °.
As a better technical scheme of the invention, the knee joint inner side meniscus prosthesis is prepared by using ultra-high molecular weight polyethylene.
The beneficial effects are as follows:
the knee joint medial meniscus prosthesis provided by the invention is implanted into the medial joint space of a patient with worn cartilage layer and failed medial meniscus, can replace the structure and function of the original cartilage and meniscus of the patient, and realizes the effective matching of the prosthesis and the medial joint space.
The knee joint medial meniscus prosthesis is easy to insert, can obtain more optimized stress conduction and prosthesis stability, relieves pain and improves joint function.
Drawings
FIG. 1 is a front view of a prosthesis of the present invention;
FIG. 2 is a rear view of the prosthesis of the present invention;
FIG. 3 is a right side view of the prosthesis of the present invention;
FIG. 4 is a left side view of the prosthesis of the present invention;
FIG. 5 is a top view of the prosthesis of the present invention;
FIG. 6 is a bottom view of the prosthesis of the present invention;
FIG. 7 is an isometric view of a prosthesis of the invention.
Detailed Description
The invention is described in further detail below with reference to the figures and specific examples.
As shown in fig. 1 to 7, the invention provides a knee joint medial meniscus prosthesis suitable for osteoarthritis patients, the knee joint medial meniscus prosthesis is formed by integrally molding a prosthesis front part, a prosthesis middle part and a prosthesis rear part, the prosthesis is approximately elliptical, the long axis of the prosthesis is consistent with the long axis of the femoral medial compartment, the anteroposterior diameter is matched with the anteroposterior diameter of the recipient knee joint medial compartment, and the upper surface is a disc-shaped curved surface and is adapted to the femoral condyle; the lower surface is a plane and is adapted to the joint of the inner side platform of the tibia, and the total length of the prosthesis is 1mm +/-3 mm; the total width 2 of the prosthesis is 23mm plus or minus 2 mm; the length of the concave part on the prosthesis is 37mm plus or minus 2 mm; the depth 21 of the prosthesis is 2mm plus or minus 2mm, and the length 3 of the front part of the prosthesis is 14mm plus or minus 1 mm; the width of the front end 7 of the front part of the prosthesis is 12.5mm plus or minus 1 mm; the width of the front and back ends 8 of the prosthesis is 12.5mm plus or minus 1 mm; the length of the middle part of the prosthesis is 4mm plus or minus 2 mm; the length of the back part of the prosthesis is 5mm plus or minus 1 mm; the width 9 of the front end of the back part of the prosthesis is 20mm plus or minus 2 mm; the width 10 of the rear end of the prosthesis rear part is 12mm plus or minus 2 mm; the outer height 11 of the front end of the front part of the prosthesis is 5.0mm plus or minus 0.5 mm; the inner height 12 of the front end of the front part of the prosthesis is 4.5mm plus or minus 0.5 mm; the outer height 13 of the front and rear ends of the prosthesis is 5.0mm +/-0.7 mm; the inner height 14 of the front and back ends of the prosthesis is 4.0mm plus or minus 0.7 mm; the outer height 15 of the midline of the middle part of the prosthesis is 6.5mm plus or minus 1 mm; the medial height 16 at the midline of the middle part of the prosthesis is 4.0mm + -0.5 mm; the outer height 17 of the front end of the back part of the prosthesis is 9mm plus or minus 1 mm; the inner height 18 of the front end of the back part of the prosthesis is 4.5mm plus or minus 0.5 mm; the outer height 19 of the rear end of the prosthesis rear part is 11mm +/-1 mm; the medial height 20 of the posterior end of the posterior portion of the prosthesis is 7mm + -1 mm and the camber angle a of the anterior portion of the prosthesis is 16 deg. + -2 deg..
The knee joint inner side meniscus prosthesis is designed aiming at the inner side cartilage thickness and the inner side meniscus thickness parameter of the healthy Chinese knee joint, the knee joint inner side meniscus prosthesis is formed by ultra-high molecular weight polyethylene under a numerical control precision machine tool, is sterilized and packaged by gamma rays after surface polishing treatment, and is used for treating knee arthritis patients with Kellgren-Lawrence X-ray films classified into 3-grade and 4-grade. When the knee joint medial meniscus prosthesis of the invention is used for surgery, the medial joint space is first examined and cleaned under an arthroscope, the free body, the hyperplastic bone and the residual meniscus are removed, and the sterilized meniscus prosthesis is implanted into the medial knee joint space through a small incision.
The knee joint medial meniscus prosthesis of the invention is used specifically as follows:
s1, carrying out three-dimensional CT scanning on the knee joint with 3-level or 4-level knee osteoarthritis cases, simultaneously shooting a knee joint orthostatic X-ray film with 20-degree flexion equal size, reconstructing bone end morphology by using three-dimensional reconstruction software Mimics, measuring morphological parameters of the inner joint surface of the distal femur and the proximal tibia of the knee joint of a patient, and simultaneously judging the gap width of the inner compartment according to the stress position X-ray film to obtain prosthesis parameters;
for example, the parameters in which a prosthesis is used in one case are: the total length 1 of the prosthesis is 46 mm; the total width 2 of the prosthesis is 23 mm; the length of the concave part on the prosthesis is 37 mm; the depth 21 of the recess of the prosthesis is 2mm, and the length 3 of the front part of the prosthesis is 14 mm; the width of the front end 7 of the prosthesis is 12.5 mm; the width of the front and back ends 8 of the prosthesis is 12.5 mm; the length of the middle part of the prosthesis is 4 mm; the length of the back part of the prosthesis is 5 mm; the width 9 of the front end of the back part of the prosthesis is 20 mm; the width 10 of the rear end of the rear part of the prosthesis is 12 mm; the outer height 11 of the front end of the front part of the prosthesis is 5.0 mm; the inner height 12 of the front end of the front part of the prosthesis is 4.5 mm; the outer side height 13 of the front and rear ends of the prosthesis is 5.0 mm; the inner height 14 of the front and back ends of the prosthesis is 4.0 mm; the lateral height 15 at the midline of the middle part of the prosthesis is 6.5 mm; the medial height 16 at the midline of the prosthesis is 4.0 mm; the outer height 17 of the front end of the back part of the prosthesis is 9mm plus or minus 1 mm; the medial height 18 of the anterior end of the posterior portion of the prosthesis is 4.5 mm; the outer height 19 of the posterior end of the posterior part of the prosthesis is 11 mm; the inner height 20 of the rear end of the rear part of the prosthesis is 7mm, and the camber angle a of the front part of the prosthesis is 16 degrees;
the prosthesis parameters for another case were: the total length 1 of the prosthesis is 49 mm; the total width 2 of the prosthesis is 25 mm; the length 6 of the recess on the prosthesis is 39 mm; the depth of the recess of the prosthesis is 23mm, and the length of the front part of the prosthesis is 14 mm; the width of the front end 7 of the front part of the prosthesis is 11.5 mm; the width of the front and back ends 8 of the prosthesis is 11.5 mm; the length of the middle part of the prosthesis 4 is 20 mm; the length of the back part of the prosthesis is 5 mm; the width 9 of the front end of the back part of the prosthesis is 21 mm; the width 10 of the rear end of the rear part of the prosthesis is 14 mm; the outer height 11 of the front end of the front part of the prosthesis is 5.5 mm; the inner side height 12 of the front end of the front part of the prosthesis is 5 mm; the outer side height 13 of the front and rear ends of the prosthesis is 4.3 mm; the inner height 14 of the front and back ends of the prosthesis is 4.7 mm; the lateral height 15 at the midline of the middle part of the prosthesis is 5.5 mm; the medial height 16 at the midline of the prosthesis is 3.5 mm; the outer height 17 of the anterior end of the posterior portion of the prosthesis is 10 mm; the inner height 18 of the front end of the prosthesis rear part is 4 mm; the outer height 19 of the posterior end of the posterior part of the prosthesis is 12 mm; the inner height 20 of the rear end of the rear part of the prosthesis is 6mm, and the camber angle a of the front part of the prosthesis is 14 degrees;
s2, molding and smoothing the residual cartilage at the femoral end and the tibial end of the medial compartment to ensure that the residual cartilage is completely matched with the shapes of the upper surface and the lower surface of the meniscus prosthesis after the parameters are determined;
s3, implanting the sterilized menisci with determined parameters into the medial knee joint space through a small incision, and performing knee flexion and extension examination to ensure that the meniscal prosthesis has no abnormal movement and no impact with bony structures and soft tissues.
S4, the patient walks with partial load under the protection of the walking aid in three weeks after the operation, and the patient can gradually walk with full load in the fourth week.
Clinical verification of a plurality of cases of patients with 3-level and 4-level knee arthritis proves that the prosthesis can replace the original structure and function of cartilage and meniscus of the patients, and the patients can recover the height of the medial joint space and the lower limb force line and change the high stress state of the medial compartment after use.
The prosthesis provided by the invention changes the joint surface in the state of high abrasion and high resistance of bone-to-bone contact into two interfaces of femur prosthesis joint surface and prosthesis tibia joint surface with low resistance and low abrasion and high mobility, relieves joint pain, improves joint mobility and improves joint function.
The above description is only a preferred example of the present invention and is not intended to limit the present invention, and various modifications and changes may be made by those skilled in the art. Any modification, equivalent replacement, improvement and the like of the present invention shall be included in the protection scope of the present invention.
Claims (2)
1. A medial meniscal knee prosthesis suitable for use in osteoarthritis patients, comprising: the knee joint medial meniscus prosthesis is formed by integrally molding a prosthesis front part, a prosthesis middle part and a prosthesis rear part, the prosthesis is in an oval shape, the upper surface of the prosthesis is sunken and is matched with a femoral condyle, the lower surface of the prosthesis is flat and is matched with a tibial plateau,
the total length (1) of the prosthesis is 46mm +/-3 mm;
the total width (2) of the prosthesis is 23mm plus or minus 2 mm;
the length (6) of the concave part on the prosthesis is 37mm +/-2 mm;
the depth (21) of the prosthesis concavity is 2 plus or minus 2 mm;
the front part length (3) of the prosthesis is 14mm +/-1 mm;
the width of the front end (7) of the front part of the prosthesis is 12.5mm plus or minus 1 mm;
the width of the front and back ends (8) of the prosthesis is 12.5mm +/-1 mm;
the length (4) of the middle part of the prosthesis is 19mm +/-2 mm;
the length (5) of the back part of the prosthesis is 13mm +/-1 mm;
the width (9) of the front end of the back part of the prosthesis is 20mm +/-2 mm;
the width (10) of the rear end of the prosthesis rear part is 12mm +/-2 mm;
the outer height (11) of the front end of the front part of the prosthesis is 5.0mm plus or minus 0.5 mm;
the inner height (12) of the front end of the front part of the prosthesis is 4.5mm plus or minus 0.5 mm;
the outer height (13) of the front and rear ends of the prosthesis is 5.0mm +/-0.7 mm;
the inner height (14) of the front and back ends of the prosthesis is 4.0mm plus or minus 0.7 mm;
the outer height (15) of the midline of the middle part of the prosthesis is 6.5mm plus or minus 1 mm;
the medial height (16) of the midline of the middle part of the prosthesis is 4.0mm plus or minus 0.5 mm;
the outer side height (17) of the front end of the back part of the prosthesis is 9mm +/-1 mm;
the inner height (18) of the front end of the back part of the prosthesis is 4.5mm plus or minus 0.5 mm;
the outer height (19) of the rear end of the prosthesis rear part is 11mm +/-1 mm;
the inner height (20) of the rear end of the prosthesis rear part is 7mm +/-1 mm;
the camber angle (a) of the anterior portion of the prosthesis is 16 ° ± 2 °.
2. The medial meniscus knee prosthesis of claim 1, suitable for use in an osteoarthritic patient, wherein: the prosthesis is made of ultra-high molecular weight polyethylene.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202110155586.9A CN112972070A (en) | 2021-02-04 | 2021-02-04 | Knee joint medial meniscus prosthesis suitable for osteoarthritis patient |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202110155586.9A CN112972070A (en) | 2021-02-04 | 2021-02-04 | Knee joint medial meniscus prosthesis suitable for osteoarthritis patient |
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| CN112972070A true CN112972070A (en) | 2021-06-18 |
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| CN202110155586.9A Pending CN112972070A (en) | 2021-02-04 | 2021-02-04 | Knee joint medial meniscus prosthesis suitable for osteoarthritis patient |
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Citations (7)
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| CN1438859A (en) * | 1999-04-02 | 2003-08-27 | 巴里M·费尔 | Surgically implantable knee prosthesis |
| CN101361684A (en) * | 2007-08-10 | 2009-02-11 | 坎蒂拉尔·哈斯蒂马尔·桑切蒂 | Knee joint prosthesis |
| US20090319047A1 (en) * | 2008-06-24 | 2009-12-24 | Peter Stanley Walker | Recess-ramp knee joint prosthesis |
| CN103281990A (en) * | 2010-08-12 | 2013-09-04 | 普罗斯特克西斯私人有限公司 | Prosthetic menisci and method of implanting in the human knee joint |
| CN111991124A (en) * | 2013-10-11 | 2020-11-27 | 瑞沃莫森有限责任公司 | Joint spacer |
| CN212089847U (en) * | 2020-02-28 | 2020-12-08 | 北京爱康宜诚医疗器材有限公司 | Knee joint prosthesis |
| CN112107396A (en) * | 2020-10-15 | 2020-12-22 | 北京积水潭医院 | Elastic prosthesis for treating knee osteoarthritis |
-
2021
- 2021-02-04 CN CN202110155586.9A patent/CN112972070A/en active Pending
Patent Citations (8)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN1438859A (en) * | 1999-04-02 | 2003-08-27 | 巴里M·费尔 | Surgically implantable knee prosthesis |
| CN101361684A (en) * | 2007-08-10 | 2009-02-11 | 坎蒂拉尔·哈斯蒂马尔·桑切蒂 | Knee joint prosthesis |
| US20090319047A1 (en) * | 2008-06-24 | 2009-12-24 | Peter Stanley Walker | Recess-ramp knee joint prosthesis |
| CN102076283A (en) * | 2008-06-24 | 2011-05-25 | 彼得·斯坦利·沃克 | Recess-ramp knee joint prosthesis |
| CN103281990A (en) * | 2010-08-12 | 2013-09-04 | 普罗斯特克西斯私人有限公司 | Prosthetic menisci and method of implanting in the human knee joint |
| CN111991124A (en) * | 2013-10-11 | 2020-11-27 | 瑞沃莫森有限责任公司 | Joint spacer |
| CN212089847U (en) * | 2020-02-28 | 2020-12-08 | 北京爱康宜诚医疗器材有限公司 | Knee joint prosthesis |
| CN112107396A (en) * | 2020-10-15 | 2020-12-22 | 北京积水潭医院 | Elastic prosthesis for treating knee osteoarthritis |
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