CN112998913B

CN112998913B - Acetabular revision mug

Info

Publication number: CN112998913B
Application number: CN202110198519.5A
Authority: CN
Inventors: 周勇刚; 解凤宝; 史春宝; 刘华丰; 郝孟娟
Original assignee: Beijing Chunlizhengda Medical Instruments Co Ltd
Current assignee: Beijing Chunlizhengda Medical Instruments Co Ltd
Priority date: 2021-02-22
Filing date: 2021-02-22
Publication date: 2022-08-02
Anticipated expiration: 2041-02-22
Also published as: CN112998913A

Abstract

The application relates to an acetabulum revision cup, which comprises an acetabulum outer cup and an acetabulum inner cup, wherein the acetabulum inner cup is fixed in the acetabulum outer cup, the lower edge of the acetabulum outer cup is tangent to the lower edge of the acetabulum inner cup, an abduction angle of 15-25 degrees is formed between the top ends of the acetabulum outer cup and the acetabulum inner cup, a side surface end surface of the acetabulum outer cup and a side surface end surface of the acetabulum inner cup form a 12-15-degree anteversion angle, and a reticular metal trabecula structure layer is arranged on the outer side surface of the acetabulum outer cup. The beneficial effect of this application does: has the function of reconstructing the anatomic rotation center of the acetabulum, and has certain help for limb shortening, abduction capacity reduction, soft tissue relaxation and joint instability of a patient after operation so as to solve the problems of collision between prostheses and increase of dislocation probability caused by insufficient adjustment of an anteversion angle and an abduction angle in the operation due to acetabulum invagination defect. The good surface metal bone trabecula structure is beneficial to increasing the bone ingrowth effect, and the long-term stability of the prosthesis implantation is good.

Description

Acetabular revision mug

Technical Field

The application relates to the technical field of medical equipment, in particular to an acetabulum revision mug.

Background

Total hip revision surgery is a procedure performed after a failure of a primary total hip replacement procedure, requiring removal of the primary implanted acetabular cup assembly prior to implantation of a new acetabular cup. However, when the acetabular cup assembly is removed, the amount of bone surrounding the acetabulum is lost, and therefore the revision of the acetabular cup is larger than the initial implant and the revision of the acetabular cup is larger than the original size of the acetabulum.

In the related art, according to the current Paprosky division of acetabular defects, the use of acetabular Revision Cups is the current mainstream choice for Paprosky types I, II A and II B with bone defect amount less than 50% of cases, but the use of acetabular Revision Cups in Revision surgeries is clear to Cause the anatomical rotation Center of acetabulum to shift upwards in Revision surgeries as shown by computer simulation, using 1mm rotation Center to shift upwards by 0.27mm for each increase in acetabular file diameter, as reported by the relevant literature (Do Jumbo Cups caps cup Hip Center Elevation in Revision THA?original authors: Nwanlewo Gp.Ries MD. origin: Clin Ortep Relet Res.2p145ep.472 (9): 2793-8). The data in this study show that: the diameter of the acetabulum revision large cup used in the revision surgery is larger than the diameter of the bony acetabulum, which causes the anatomical rotation center of the acetabulum to move upwards by about 1 cm. The upper movement of the acetabulum anatomical rotation center has certain influence on limb shortening, abduction capability reduction, soft tissue relaxation and joint instability; in addition, for partial PaproskyIIIA defects, the acetabulum invagination defects exist, and in the treatment mode of the surface coating of the acetabulum outer cup prosthesis, the coating after plasma spraying has uncontrollable hole-type structure, small pore diameter and low porosity.

In conclusion, the inventor finds that the acetabular revision mug in the related art has the following defects: 1. moving the anatomical rotation center of the acetabulum upwards: the diameter of the acetabulum revision large cup used in revision is larger than that of a bony acetabulum, so that the anatomical rotation center of the acetabulum moves upwards, and certain influences are caused on limb shortening, abduction capacity reduction, soft tissue relaxation and joint instability.

2. Insufficient forward and abduction angle angles: when the acetabulum invagination defect exists, the anteversion angle and the abduction angle need to be compensated, so that the problems of collision between prostheses and increase of dislocation probability caused by insufficient anteversion angle and abduction angle caused by the acetabulum invagination defect are solved.

3. The bone ingrowth effect on the surface of the acetabular cup is limited: in the acetabular revision large cup in the related technology, a surface plasma spraying mode is mostly adopted on the treatment mode of the surface coating of the acetabular outer cup prosthesis, the hole-shaped structure of the coating is uncontrollable, the hole diameter is small, the porosity is low, and compared with a trabecular bone structure, the porosity still has a certain difference, so that a good bone ingrowth effect is difficult to achieve.

Disclosure of Invention

In order to improve the phenomena that the existing acetabulum revision mug has the defects of upward movement of an acetabulum anatomical rotation center, insufficient anteversion angle and abduction angle and limited acetabulum surface bone growth effect in clinical use, the application provides the acetabulum revision mug.

The application provides a big cup is repaiied to acetabular bone adopts following technical scheme:

the acetabulum revision cup comprises an acetabulum outer cup and an acetabulum inner cup, wherein the acetabulum inner cup is fixed in the acetabulum outer cup, the acetabulum outer cup is tangent to the lower edge of the acetabulum inner cup, an abduction angle of 15-25 degrees is formed between the acetabulum outer cup and the top end of the acetabulum inner cup, a front inclination angle of 12-15 degrees is formed between the side surface end surface of the acetabulum outer cup and the side surface end surface of the acetabulum inner cup, and a reticular metal trabecula structure layer is arranged on the outer side surface of the acetabulum outer cup.

By adopting the technical scheme: the tangent design of the lower edges of the acetabulum outer cup and the acetabulum inner cup is beneficial to ensuring the rotation center position of the acetabulum after the acetabulum revision cup is implanted into the acetabulum, the arrangement of the abduction angle can compensate the insufficient adjustment of the abduction angle in the operation caused by the invagination defect of the acetabulum, the problem of collision between prostheses is solved, the arrangement of the anteversion angle can compensate the insufficient adjustment of the anteversion angle in the operation caused by the invagination defect of the acetabulum, and the problem of improving the rising of the dislocation probability is solved.

Optionally, a plurality of locking nail holes are formed in the top of the acetabulum outer cup, and internal threads are formed inside the locking nail holes.

By adopting the technical scheme: the locking nail hole is internally provided with internal threads which are matched with external threads on the locking nail, and the locking nail is fixed at the upper edge of the acetabulum through the locking nail hole, so that good initial stability is achieved.

Optionally, a plurality of anti-rotation positioning grooves are arranged on the outer end surface of the acetabulum inner cup.

By adopting the technical scheme: the rotation-preventing positioning groove is matched with the protrusion on the acetabulum lining, plays a role in positioning the acetabulum lining placed in the acetabulum inner cup, prevents the lining from rotating, and achieves good initial stability.

Optionally, an annular buckle is arranged on the inner side wall of the acetabular inner cup.

By adopting the technical scheme: the annular snap is used for locking the lining, achieving good initial stability.

Optionally, a plurality of nail holes are formed in the inner acetabular cup and penetrate through the inner acetabular cup and the outer acetabular cup.

By adopting the technical scheme: the acetabulum revision cup can be firmly fixed in the acetabulum by inserting the screws into the screw holes.

Optionally, a holding threaded hole is formed in the bottom of the inner acetabular cup and penetrates through the inner acetabular cup and the outer acetabular cup.

By adopting the technical scheme: the internal thread of the holding threaded hole is matched with the external thread of the acetabular cup holder, so that the aims of transferring, transporting and holding the acetabular cup in the operation are fulfilled.

Optionally, a plurality of holes are formed in the reticular metal trabecular structure layer, the mesh porosity of the reticular metal trabecular structure layer is 50% -90%, and the pore diameter is set to be 100-400 μm.

By adopting the technical scheme: the porosity of the metal trabecular structure layer is close to the numerical value of the trabecular structure of the human body, so that the acetabular bone can be completely melted into the hole of the metal trabecular structure layer on the acetabular outer cup. The acetabular bone tissue can grow into the hole, so that the acetabular bone and the metal bone trabecula structure layer are integrated, and the combination of the cellular tissue of the acetabular bone and the acetabular outer cup is promoted.

Optionally, the diameter of the acetabular outer cup is 64-76 mm; the diameter of the acetabulum inner cup is 48-60 mm.

By adopting the technical scheme: the diameter of the acetabulum outer cup starts from a specification of 64mm, increases by 2mm to 76 mm; the diameter of the acetabulum inner cup 2 is increased from the specification of 48mm to 60mm in a way of increasing the diameter by 2mm, and the acetabulum revision cups with different specifications are selected according to actual requirements.

In summary, the present application includes at least one of the following beneficial technical effects:

1. has the function of reconstructing the anatomic rotation center of the acetabulum, and has certain help for limb shortening, abduction capacity reduction, soft tissue relaxation and joint instability of a patient after operation.

2. The anteversion angle and abduction angle compensation is arranged to solve the problems of collision between prostheses and increase of dislocation probability caused by insufficient adjustment of the anteversion angle and the abduction angle in the operation due to the defect of acetabulum invagination.

3. The good surface metal bone trabecula structure is beneficial to increasing the bone ingrowth effect, and the long-term stability of the prosthesis implantation is good.

Drawings

Fig. 1 is a schematic overall perspective structure of an embodiment of the present application.

Fig. 2 is a schematic front view of the structure of the embodiment of the present application.

Fig. 3 is a sectional view taken along line a-a of fig. 2 in an embodiment of the present application.

Fig. 4 is a sectional view taken along line B-B of fig. 2 according to an embodiment of the present application.

FIG. 5 is a cross-sectional view taken along line C-C of FIG. 2 of an embodiment of the present application.

Reference number legend, 100, acetabular outer cup; 110. locking the nail hole; 200. an acetabular inner cup; 210. anti-rotation positioning grooves; 220. an annular buckle; 230. nailing holes; 240. a holding threaded hole; 300. an abduction angle; 400. a forward rake angle; 500. a reticular metal bone trabecula structure layer; 510. and (4) holes.

Detailed Description

The present application is described in further detail below with reference to figures 1-5.

The embodiment of the application discloses acetabular revision mug, which adopts the following technical scheme:

referring to fig. 1 and 2, the acetabular revision mug comprises an acetabular outer cup 100 and an acetabular inner cup 200, wherein the acetabular inner cup 200 is fixed in the acetabular outer cup 100, and the diameter of the acetabular outer cup 100 is increased from 64mm to 76mm in a 2mm increasing mode; the diameter of the acetabular inner cup 2002 is increased from the specification of 48mm to 60mm in a way that the diameter is increased by 2mm, and acetabular revision cups with different specifications are selected according to actual needs.

Referring to fig. 2 and 3, in the present embodiment, the lateral surface of the acetabular shell 100 and the lateral surface of the acetabular shell 200 have a forward inclination angle 400, and the forward inclination angle 400 may be set to about 15 ° according to the normal physiological structure of the acetabulum. In the embodiment, the design angle is 14 degrees, the design principle is that the inner acetabular cup 200 is rotated until the position of the equator line of the inner acetabular cup 200 is tangent to the end surface of the outer acetabular cup 100, and the angle is 14 degrees. The arrangement of the front inclination angle 400 can compensate insufficient adjustment anteversion angle in the operation caused by the acetabulum invagination defect, and solve the problems of rising of the probability of posterior dislocation and the like.

Referring to fig. 2 and 4, in the embodiment, the lower edges of the acetabular outer cup 100 and the acetabular inner cup 200 are tangent to each other, which is beneficial to guarantee the position of the rotation center of the acetabulum after the acetabular revision cup is implanted into the acetabulum, an abduction angle 300 of 15-25 degrees is formed between the top ends of the acetabular outer cup 100 and the acetabular inner cup 200, the angle can be selected to be 15 degrees, 20 degrees, 25 degrees and the like, the acetabular inner cup 200 with an abduction angle of a proper specification is selected according to the defect degree of acetabular invagination, and the abduction angle 300 is arranged to compensate insufficient adjustment in an operation caused by the acetabular invagination defect, so that the problems of collision and the like between prostheses are solved.

Referring to fig. 4 and 5, in the present embodiment, a mesh-shaped trabecular metal structure layer 500 with a thickness of 2.5mm is disposed on the acetabular cup 100, a plurality of holes 510 are disposed on the mesh-shaped trabecular metal structure layer 500, the holes 510 are formed by arraying according to a certain rule, the mesh porosity of the mesh-shaped trabecular metal structure layer 500 is 50% -90%, the hole diameter is set to be 100-400 μm, and the porosity of the mesh-shaped trabecular metal structure layer 500 is close to the value of the trabecular metal of the human body, so that the acetabular bone can be completely fused into the holes 510 of the mesh-shaped trabecular metal structure layer 500 on the acetabular cup 100. Acetabular bone tissue can grow into the hole 510, so that acetabular bones and metal bone trabecular structure layers are integrated together, the cellular tissues of acetabular bones are promoted to be combined with the acetabular outer cup 100, and the acetabular outer cup 100 and the acetabular inner cup 200 are of an integrated printing structure, so that the whole acetabular revision large cup can be stably implanted into an acetabulum.

Referring back to fig. 1 and 2, in the present embodiment, the diameter of the acetabular outer cup 100 is slightly larger than that of the acetabular inner cup 200, the number of the locking nail holes 110 is 5, the locking nail holes 110 are uniformly arranged in the existing space, the locking nail holes 110 are internally provided with internal threads which are matched with external threads on locking nails, the locking nail holes 110 and the locking nail holes are in a locking state, the locking nail holes 110 have unique and determined angles, and the locking nails are fixed at the upper edge of the acetabulum through the locking nail holes 110, so that good initial stability is achieved. The end face of the acetabulum inner cup 200 is provided with anti-rotation positioning grooves 210, the number of which can be 6-12, the anti-rotation positioning grooves are matched with the projections on the acetabulum lining, the positioning effect is realized on the acetabulum lining placed in the acetabulum inner cup 200, the lining is prevented from rotating, and good initial stability is achieved. Inside the acetabular inner cup 200, an annular snap 220 is provided for locking the liner for good initial stability.

Referring back to fig. 1 and 2, the nail holes 230 are formed in the acetabular inner cup 200, the number of the nail holes 230 can be 2-8, a determined angle is formed between the positions of the adjacent two nail holes 230, the positions of the nail holes 230 are not interfered with the positions of the locking nail holes 110, and the screw made of titanium alloy is inserted into the nail holes 230 to firmly fix the acetabular revision cup in the acetabulum. The holding threaded hole 240 is arranged at the bottom of the acetabular inner cup 200, and the internal thread of the holding threaded hole 240 is matched with the external thread of the acetabular cup holder, so that the purposes of transferring, transporting and holding the acetabular revision cup in operation are achieved.

The above embodiments are preferred embodiments of the present application, and the protection scope of the present application is not limited by the above embodiments, so: all equivalent changes made according to the structure, shape and principle of the present application shall be covered by the protection scope of the present application.

Claims

1. The utility model provides an acetabular revision mug which is characterized in that: the acetabulum cup comprises an acetabulum outer cup (100) and an acetabulum inner cup (200), wherein the acetabulum inner cup (200) is fixed in the acetabulum outer cup (100), the acetabulum outer cup (100) is tangent to the lower edge of the acetabulum inner cup (200), an abduction angle (300) of 15-25 degrees is formed between the top ends of the acetabulum outer cup (100) and the acetabulum inner cup (200), a side surface end surface of the acetabulum outer cup (100) and a side surface end surface of the acetabulum inner cup (200) have an anteversion angle (400) of 12-15 degrees, and a reticular metal trabecula structure layer (500) is arranged on the outer side surface of the acetabulum outer cup (100).

2. The acetabular revision mug of claim 1, wherein: the top of the acetabulum outer cup (100) is provided with a plurality of locking nail holes (110), and internal threads are arranged inside the locking nail holes (110).

3. The acetabular revision mug of claim 1, wherein: the outer end face of the acetabulum inner cup (200) is provided with a plurality of anti-rotation positioning grooves (210).

4. The acetabular revision mug of claim 1, wherein: an annular buckle (220) is arranged on the inner side wall of the acetabulum inner cup (200).

5. The acetabular revision mug of claim 1, wherein: the acetabulum inner cup (200) is internally provided with a plurality of nail holes (230), and the nail holes (230) penetrate through the acetabulum inner cup (200) and the acetabulum outer cup (100).

6. The acetabular revision mug of claim 1, wherein: the inner bottom of the acetabulum inner cup (200) is provided with a holding threaded hole (240), and the holding threaded hole (240) penetrates through the acetabulum inner cup (200) and the acetabulum outer cup (100).

7. The acetabular revision mug of claim 1, wherein: the reticular metal trabecular structure layer (500) is provided with a plurality of holes (510), the mesh porosity of the reticular metal trabecular structure layer (500) is 50% -90%, and the aperture is set to be 100-400 mu m.

8. The acetabular revision mug of claim 1, wherein: the diameter of the acetabulum outer cup (100) is 64-76 mm; the diameter of the acetabulum inner cup (200) is 48-60 mm.