CN113081398B - Customized radius head prosthesis based on proximal three-dimensional anatomy of healthy side radius - Google Patents
Customized radius head prosthesis based on proximal three-dimensional anatomy of healthy side radius Download PDFInfo
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- CN113081398B CN113081398B CN202110556670.1A CN202110556670A CN113081398B CN 113081398 B CN113081398 B CN 113081398B CN 202110556670 A CN202110556670 A CN 202110556670A CN 113081398 B CN113081398 B CN 113081398B
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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
- A61F2/28—Bones
-
- 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
- A61F2/28—Bones
- A61F2002/2871—Radius
-
- 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
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
- A61F2002/30772—Apertures or holes, e.g. of circular cross section
- A61F2002/30784—Plurality of holes
-
- 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
- A61F2002/30948—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 using computerized tomography, i.e. CT scans
-
- 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]
-
- 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
- A61F2310/00389—The prosthesis being coated or covered with a particular material
- A61F2310/00395—Coating or prosthesis-covering structure made of metals or of alloys
- A61F2310/00407—Coating made of titanium or of Ti-based alloys
Abstract
The invention discloses a radius head prosthesis customized based on a proximal three-dimensional anatomy of a healthy side radius, which belongs to the field of radius head prosthesis customization, and the radius head prosthesis customized based on the proximal three-dimensional anatomy of the healthy side radius has the advantages that the prosthesis is well matched and has excellent biomechanical performance, osteoporosis of a humeral capitula and damage to a articular cartilage surface can be effectively avoided, in addition, in the process of printing in different times, a cartilage supporting layer can be formed in an outer cartilage layer in the prior art, the supporting strength of the cartilage layer is higher, the condition that the prosthesis is loosened after partial wear of cartilage on the prosthesis in the prior art is effectively avoided, meanwhile, when the partial wear of the outer cartilage layer is realized, cartilage growth liquid in the outer multi-way through hole radius layer seeps along the wear part, cartilage cells are effectively guided to grow at the wear part, further, the self-repairing function of the wear cartilage part is realized, compared with the prior art, effectively ensure the adaptability of the prosthesis and the patient and prolong the service life of the prosthesis in the body of the patient.
Description
Technical Field
The present invention relates to the field of customizing a radius head prosthesis, and more particularly, to customizing a radius head prosthesis based on a healthy proximal radius three-dimensional anatomy.
Background
Radius head prosthesis replacement is commonly used to treat patients who have comminuted fractures of the radius head that do not structurally reconstruct the stability of the elbow joint. The complexity of forearm, elbow joint motion dictates that a radius head prosthesis replacement must achieve an exact match of the prosthesis to the affected elbow.
The elbow joint is one of the complex joints of the human body, and the brachioradialis joint, the brachioradialis joint and the radioulnar joint cooperate to complete the motion of the elbow joint. Research shows that most of the radius heads have oval concave surfaces, the annular joint surface is also an irregular free-form surface, and the eccentric distance exists between the centers of the concave surfaces and the axle center of the radius neck, so that the motion of the ulnar and radial joints is similar to a cam motion track when the normal forearm rotates. Biomechanical studies have demonstrated that the radial head forearm interosseous membrane system plays an essential role in stress transmission. The prosthesis development must integrate anatomical and biomechanical factors to study the height of the prosthesis of the head of the radius, and the height of the flatter surface of the head of the radius is selected as the height of the upper ulnar articular surface, and the osteotomy plane must be ensured to be perpendicular to the long axis of the radius neck. To avoid the risk of wear of the articular cartilage due to too concentrated pressure, the prosthesis must articulate with the proximal-most articular surface of the superior radial joint.
The major complications of radius head prosthesis replacement are prosthesis loosening, pain, humeral capitulum osteoporosis, and the like. The main cause of these complications is unsatisfactory matching of the prosthesis, and the radial head prosthesis is likely to cause abrasion of the cartilage layer after being implanted in the body for a long time, resulting in poor matching of the prosthesis and easy aggravation of the complications.
Disclosure of Invention
1. Technical problem to be solved
Aiming at the problems in the prior art, the invention aims to provide a radius head prosthesis customized based on the proximal three-dimensional anatomy of a healthy side radius, which has the advantages that the prosthesis is well matched and has excellent biomechanical performance, the osteoporosis of the capitulum humerus and the damage of the articular cartilage surface can be effectively avoided, in addition, a cartilage supporting layer can be formed in an outer cartilage layer in the prior art in the process of printing in multiple times, the supporting strength of the cartilage layer is higher, the condition that the prosthesis is loosened after the cartilage on the prosthesis is locally worn in the prior art is effectively avoided, meanwhile, when the part of the outer cartilage layer is worn, cartilage growth liquid in the outer multi-pass through hole radius layer seeps along the worn part, cartilage cells are effectively guided to grow at the worn part, the self-repairing function of the worn cartilage part is realized, and compared with the prior art, the adaptability of the prosthesis and a patient is effectively ensured, improving the service life of the prosthesis in the body of the patient.
2. Technical scheme
In order to solve the above problems, the present invention adopts the following technical solutions.
The customized radius head prosthesis based on the three-dimensional dissection of the near end of the healthy side radius comprises a radius capitulum, a prosthesis handle and a neck ring, wherein the upper end part of the prosthesis handle is connected with the lower end of the radius capitulum, the neck ring is sleeved outside the prosthesis handle and is in contact with the lower end part of the radius capitulum, the radius capitulum comprises an inner radius capitulum layer, an outer multi-pass through hole radius layer connected outside the inner radius capitulum layer and an outer cartilage layer wrapped outside the outer multi-pass through hole radius layer, an inner cartilage layer is arranged between the inner radius capitulum layer and the inner radius capitulum layer, the prosthesis is well matched and has excellent biomechanical performance by customizing the radius head prosthesis, the osteoporosis and the joint cartilage surface damage of the humerus capitulum can be effectively avoided, in addition, a cartilage supporting layer can be formed in the outer cartilage layer in the prior art, the supporting strength of the cartilage layer is higher, and the loosening condition of the prosthesis after the local wear in the prior art is effectively avoided, simultaneously after outer cartilage layer department part is worn out, outer many through-holes radius intraformational cartilage growth liquid oozes along wearing and tearing department, effectively guides chondrocyte to grow in wearing and tearing department, and then realizes the effect of the cartilage self-repair of wearing and tearing, compares in prior art, effectively guarantees prosthesis and patient's suitability, improves the life of patient internal prosthesis.
Further, the method for customizing the radius head prosthesis comprises the following steps:
s1, adopting GESpeedlight16 rows of spiral CT thin layers to scan 1 double-sided elbow joints of a healthy adult, eliminating radial head diseases and acquiring CT scanning dicom data;
s2, importing the acquired data into Mimics10.0 software to reconstruct the elbow joint in a three-dimensional mode;
s3, extracting a three-dimensional model of the proximal radius of the left healthy side, simulating the proximal radius of the right affected side through a mirror image, and then dividing the model into two parts, namely a small radius head and a neck ring, through editing;
s4, measuring the neck marrow inner diameter and length parameters by using Mimics10.0 software to construct a prosthesis handle;
s5, introducing the capitulum radii model into Gcomagictstudio 12 software to simulate cartilage thickening treatment, and then introducing a prosthesis handle model to generate a head handle model;
and S5, virtually assembling the head handle component according to anatomical characteristics to obtain the radius head prosthesis model.
S6, according to the radius head prosthesis model of the patient, printing the radius capitulum, the prosthesis handle and the neck strap of the entity on the damaged side of the patient by 3D printing technology in a grading way, then covering a reproducible cartilage support layer outside the radius capitulum, and assembling to obtain the radius head prosthesis.
Further, among the cartilage thickening processing, the thickness of cartilage thickening is no longer than 1mm, makes the thickness of cartilage thickening more press close to actual thickness, and the entity that shows to improve this radius prosthesis is when implanting the patient in vivo, and the matching degree is higher, makes the patient after putting into the prosthesis, and the recovery effect is better, and phenomena such as the not hard up of postoperative, pain are less.
Furthermore, after the simulation of the radius head prosthesis is finished, a micromics 10.0 software measuring tool needs to be applied to compare morphological parameters of the proximal ends of the two sides of the radius, so that the matching of prosthesis installation is verified.
Furthermore, the morphological parameters of the near ends of the bilateral radius comprise the maximum height of a radius head, the minimum outer diameter of a radius head and neck plane, the maximum inner diameter of a medullary cavity of the radius head and neck plane and the length of the medullary cavity of a radius neck section, and compared errors are all smaller than lmm, the smaller the error is, the higher the matching degree is, the prosthesis is more fit with the body of a patient, the recovery effect is better, and the pain caused by sequelae such as reinforcement looseness and pain after the long time after the operation of the patient is effectively reduced.
Further, the step of printing the small radius head in steps S6 includes:
the method comprises the steps of firstly printing an inner radius capitulum layer by using a titanium alloy powder material, sanding the surface of the inner radius capitulum layer to increase the amount of atomized victory saline adhered to the surface of the inner radius capitulum layer and enhance the adhesion of the surface of the inner radius capitulum layer, enabling the adhesion effect of the cartilage globules to be better and not to fall off easily when a plurality of cartilage globules are adhered to the surface of the inner radius capitulum layer, then spraying atomized physiological saline on the surface of the inner radius capitulum layer to adhere a plurality of uniformly distributed cartilage globules to the surface of the inner radius capitulum layer, and printing the outer multi-way through-hole radius layer again outside the inner radius capitulum layer.
Further, the coating method of the cartilage scaffold layer in step S6 is as follows:
s61, constructing an outer cartilage layer on the outer surface of the capitulum radii according to the three-dimensional data of the outer surface of the capitulum radii;
s62, puncturing the outer cartilage layer, and injecting a trace amount of tissue fluid into the radial layer with the outward multi-pass through holes to dissolve the surface of the cartilage globule between the inner radial capitulum layer and the radial layer with the outward multi-pass through holes and expose cartilage cells in the cartilage globule;
s63, puncturing the outer cartilage layer again, injecting cartilage growth liquid into the outer multi-pass through hole radial bone layer, enabling chondrocytes to grow in the outer multi-pass through hole radial bone layer, forming an inner cartilage layer between the inner radial skull layer and the outer multi-pass through hole radial bone layer, forming a cartilage scaffold layer, enabling most chondrocytes to be concentrated at a plurality of cartilage globules, limiting to form the inner cartilage layer at the cartilage globules, gradually dispersing part chondrocytes in the outer multi-pass through hole radial bone layer under the action of the cartilage growth liquid, enabling the outer multi-pass through hole radial bone layer to serve as a lining attachment point to grow, matching with the outer cartilage layer, enabling the thickness of the cartilage layer in the prosthesis to be relatively thicker than that of the outer cartilage layer alone, enabling the whole span of the cartilage to be relatively thicker, enabling the supporting strength of the cartilage layer to be relatively higher under the action of the outer multi-pass through hole radial bone layer capable of serving as a lining, and effectively avoiding local wear of the cartilage on the prosthesis in the prior art, the condition that produces between false body and the self bone not hard up takes place, make this false body implant internal back, the effect is better, implant internal long-time back simultaneously, after outer cartilage layer department part is worn and torn, outer many through-holes radius intraformational cartilage growth liquid oozes along wearing and tearing department, effectively guide chondrocyte to grow in wearing and tearing department, and then realize the effect of the cartilage department selfreparing of wearing and tearing, compare in prior art, show the suitability that improves false body and patient, improve the life of the internal false body of patient.
Further, the thickness of the radius layer with the outer multi-pass through hole is not more than 2mm, the thickness of the outer cartilage layer is not more than 1mm, the inner radius capitulum layer and the outer multi-pass through hole radius layer are printed with required three-dimensional data, the three-dimensional model of the radius capitulum is cut in Mimics10.0 software according to the thickness of the radius layer with the outer multi-pass through hole, and the three-dimensional data are calculated and measured in the Mimics10.0 software after cutting.
Furthermore, the cartilage globule comprises a water adhesive layer and a liquid coating layer wrapped at the outer end of the water adhesive layer, wherein the liquid coating layer is filled with cartilage growth liquid with cartilage cells, the cartilage growth liquid effectively ensures the growth activity of the cartilage cells in the cartilage globule, and the cartilage cells can grow to form cartilage under the action of the injected cartilage growth liquid when overflowing from the cartilage globule.
Furthermore, the outer surface of the water adhesive layer is of a rough structure in a fluctuating shape, the water adhesive layer is made of water-soluble materials, when atomized physiological saline is adhered to the surface of the inner radius capitulum layer, when the water adhesive layer part is contacted with the outer surface of the inner radius capitulum layer, the part of the water adhesive layer, which is contacted with the inner radius capitulum layer, is partially dissolved, so that the cartilage globule is adhered to the surface of the inner radius capitulum layer, the positioning of the cartilage globule on the surface of the inner radius capitulum layer is realized, when interstitial fluid is injected by puncture, the water adhesive layer part is completely dissolved under the action of the interstitial fluid, and at the moment, the cartilage growth fluid with cartilage cells inside overflows.
3. Advantageous effects
Compared with the prior art, the invention has the advantages that:
(1) the scheme is characterized in that the prosthesis is well matched by customizing the radius head prosthesis, the biomechanical performance is excellent, the osteoporosis and the joint cartilage surface damage of the humerus capitulum can be effectively avoided, in addition, in the process of printing in times, a cartilage supporting layer can be formed in an outer cartilage layer in the prior art, the supporting strength of the cartilage layer is higher, the condition that the prosthesis is loosened after the cartilage on the prosthesis is locally worn in the prior art is effectively avoided, meanwhile, after the part of the outer cartilage layer is worn, cartilage growth liquid in the outer multi-way through hole radius layer seeps along the worn part, cartilage cells are effectively guided to grow at the worn part, the self-repairing function of the worn cartilage part is realized, compared with the prior art, the adaptability of the prosthesis and a patient is effectively ensured, and the service life of the prosthesis in the patient is prolonged.
(2) In the cartilage thickening processing, the thickness of cartilage thickening is no longer than 1mm, makes the thickness of cartilage thickening more press close to actual thickness, and the entity that shows to improve this radius prosthesis is when implanting the patient internal, and the matching degree is higher, makes the patient after putting into the prosthesis, and the recovery effect is better, and phenomena such as the not hard up of postoperative, pain are less.
(3) The method comprises the steps of firstly printing an inner radius capitulum layer by using a titanium alloy powder material, sanding the surface of the inner radius capitulum layer to increase the amount of atomized victory saline adhered to the surface of the inner radius capitulum layer and enhance the adhesion of the surface of the inner radius capitulum layer, enabling the adhesion effect of the cartilage globules to be better and not to fall off easily when a plurality of cartilage globules are adhered to the surface of the inner radius capitulum layer, then spraying atomized physiological saline on the surface of the inner radius capitulum layer to adhere a plurality of uniformly distributed cartilage globules to the surface of the inner radius capitulum layer, and printing the outer multi-way through-hole radius layer again outside the inner radius capitulum layer.
(4) The outer cartilage layer is punctured, cartilage growth liquid is injected into the outer multi-through-hole radial bone layer to enable cartilage cells to grow in the outer multi-through-hole radial bone layer, an inner cartilage layer is formed between the inner radial head layer and the outer multi-through-hole radial bone layer to form a cartilage scaffold layer, most cartilage cells are concentrated at a plurality of cartilage globules to limit formation of the inner cartilage layer at the cartilage globules, meanwhile, part cartilage cells are gradually dispersed in the outer multi-through-hole radial bone layer under the action of the cartilage growth liquid and grow by taking the outer multi-through-hole radial bone layer as a lining attachment point, the outer cartilage layer is matched to enable the thickness of the cartilage layer in the prosthesis to be larger than that of the outer cartilage layer alone, the whole cartilage span is relatively larger, the supporting strength of the cartilage layer is higher under the action of the outer multi-through-hole radial bone layer capable of serving as a lining, and partial wear of the upper cartilage in the prosthesis in the prior art is effectively avoided, the condition that produces between false body and self bone is not hard up takes place, make this false body implantation internal back, the effect is better, implant internal long-time back simultaneously, after outer cartilage layer department part is worn and torn, outer many through-holes radius intraformational cartilage growth liquid oozes along wearing and tearing department, effectively guide chondrocyte to grow in wearing and tearing department, and then realize the effect of the cartilage self-repairing of wearing and tearing, compare in prior art, show the suitability that improves false body and patient, improve the life of the internal false body of patient.
(5) The thickness of the radius layer with the outer multi-pass through holes does not exceed 2mm, the thickness of the outer cartilage layer does not exceed 1mm, the required three-dimensional data is printed on the inner radius capitulum layer and the outer multi-pass through hole radius layer, the three-dimensional model of the radius capitulum is cut in Mimics10.0 software according to the thickness of the radius layer with the outer multi-pass through holes, and the three-dimensional data is calculated and measured in the Mimics10.0 software after cutting.
(6) The cartilage ball comprises a water adhesive layer and a liquid coating layer wrapped at the outer end of the water adhesive layer, wherein a cartilage growth liquid with cartilage cells is filled in the liquid coating layer, the cartilage growth liquid effectively ensures the growth activity of the cartilage cells in the cartilage ball, and the cartilage ball can grow to form cartilage under the action of the injected cartilage growth liquid when overflowing from the cartilage ball.
(7) The outer surface of the water adhesive layer is of a rugged rough structure, and the water adhesive layer is made of water-soluble materials, so that when atomized physiological saline is adhered to the surface of the inner radius capitulum layer, when the water adhesive layer part is contacted with the outer surface of the inner radius capitulum layer, the part of the water adhesive layer contacted with the inner radius capitulum layer is partially dissolved, so that the cartilage globule is adhered to the surface of the inner radius capitulum layer, the positioning of the cartilage globule on the surface of the inner radius capitulum layer is realized, when interstitial fluid is injected by puncture, the water adhesive layer part is completely dissolved under the action of the interstitial fluid, and the cartilage growth fluid with cartilage cells inside overflows at the moment.
Drawings
FIG. 1 is a schematic view of an assembled model of the components of the radius head prosthesis of the present invention;
FIG. 2 is a schematic view of a model disassembled structure of the radius head prosthesis of the present invention;
FIG. 3 is a schematic diagram of the printed solid structure of the capitulum radius prosthesis of the invention;
FIG. 4 is a schematic diagram illustrating a process of printing the small radius head in multiple steps according to the present invention;
FIG. 5 is a schematic diagram of the process of forming the inner cartilage layer according to the present invention;
FIG. 6 is a schematic structural view of a printed entity of the capitulum radii prosthesis when the inner cartilage layer is not formed according to the present invention;
fig. 7 is a schematic structural view of the cartilage globule of the invention.
The reference numbers in the figures illustrate:
11 inner radius capitulum layer, 12 outer multiparous through hole radius layer, 13 outer cartilage layer, 14 inner cartilage layer, 2 cartilage globules, 21 water adhesive layer, and 22 liquid coating layer.
Detailed Description
The drawings in the embodiments of the invention will be combined; the technical scheme in the embodiment of the invention is clearly and completely described; obviously; the described embodiments are only some of the embodiments of the invention; rather than all embodiments, are based on the embodiments of the invention; all other embodiments obtained by a person skilled in the art without making any inventive step; all fall within the scope of protection of the present invention.
In the description of the present invention, it should be noted that the terms "upper", "lower", "inner", "outer", "top/bottom", and the like indicate orientations or positional relationships based on those shown in the drawings, and are only for convenience of description and simplification of description, but do not indicate or imply that the referred device or element must have a specific orientation, be constructed in a specific orientation, and be operated, and thus should not be construed as limiting the present invention. Furthermore, the terms "first," "second," and the like are used for descriptive purposes only and are not to be construed as indicating or implying relative importance.
In the description of the present invention, it should be noted that, unless otherwise explicitly specified or limited, the terms "mounted," "disposed," "sleeved/connected," "connected," and the like are to be construed broadly, e.g., "connected," which may be fixedly connected, detachably connected, or integrally connected; can be mechanically or electrically connected; they may be connected directly or indirectly through intervening media, or they may be interconnected between two elements. The specific meanings of the above terms in the present invention can be understood in specific cases to those skilled in the art.
Example 1:
referring to fig. 1-2, a radius head prosthesis is customized based on a healthy side radius proximal end three-dimensional anatomy, and includes a radius capitulum, a prosthesis handle, and a collar, wherein an upper end of the prosthesis handle is connected with a lower end of the radius capitulum, the collar is sleeved outside the prosthesis handle, and the collar is in contact with a lower end of the radius capitulum.
Referring to fig. 3, the capitulum radius comprises an inner capitulum radius layer 11, an outer multi-pass through hole radius layer 12 connected outside the inner capitulum radius layer 11, an outer cartilage layer 13 wrapped outside the outer multi-pass through hole radius layer 12, and an inner cartilage layer 14 arranged between the inner capitulum radius layer 11, wherein the thickness of the outer multi-pass through hole radius layer 12 is not more than 2mm, the thickness of the outer cartilage layer 13 is not more than 1mm, the inner capitulum radius layer 11 and the outer multi-pass through hole radius layer 12 print required three-dimensional data, a three-dimensional model of the capitulum radius is cut according to the thickness of the outer multi-pass through hole radius layer 12 in the miccis 10.0 software, and the three-dimensional data are calculated and measured in the miccis 10.0 software after cutting.
The method for customizing the radius head prosthesis comprises the following steps:
s1, adopting GESpeedlight16 rows of spiral CT thin layers to scan 1 double-sided elbow joints of a healthy adult, eliminating radial head diseases and acquiring CT scanning dicom data;
s2, importing the acquired data into Mimics10.0 software to reconstruct the elbow joint in a three-dimensional mode;
s3, extracting a three-dimensional model of the proximal radius of the left healthy side, simulating the proximal radius of the right affected side through mirror images, and then dividing the model into a small radius part and a cervical collar part through editing;
s4, measuring the neck marrow inner diameter and length parameters by using Mimics10.0 software to construct a prosthesis handle;
s5, introducing the radius capitulum model into Gcomagictstudio 12 software to simulate cartilage thickening, and then introducing a prosthesis handle model to generate a head handle model;
and S5, virtually assembling the head handle component according to the anatomical characteristics to obtain the radius head prosthesis model.
S6, according to the radius head prosthesis model of the patient, printing and customizing the radius capitulum, the prosthesis handle and the neck strap of the entity on the damaged side of the patient by 3D printing technology in a grading way, then covering a reproducible cartilage support layer outside the radius capitulum, and assembling to obtain the radius head prosthesis;
referring to fig. 4, the step of printing the radius capitulum in multiple times includes:
firstly, the inner radius capitulum layer 11 is printed by using a titanium alloy powder material, the surface of the inner radius capitulum layer 11 is ground, the amount of atomized victory saline adhered to the surface is increased, the adhesion of the surface is stronger, when a plurality of cartilage globules 2 are adhered to the surface, the adhesion effect of the cartilage globules 2 is better, the cartilage globules are not easy to fall off, then atomized physiological saline is sprayed on the outer surface of the inner radius capitulum layer 11, a plurality of uniformly distributed cartilage globules 2 are adhered to the surface of the inner radius capitulum layer 11, and the outer multi-pass through hole radius layer 12 is printed outside the inner radius capitulum layer 11 again.
Referring to fig. 5, the coating method of the cartilage scaffold layer includes:
s61, firstly, constructing an outer cartilage layer 13 on the outer surface of the capitulum radii according to the three-dimensional data of the outer surface of the capitulum radii;
s62, puncturing the outer cartilage layer 13, injecting a trace amount of tissue fluid into the outer multi-pass through hole radius layer 12 to dissolve the surface of the cartilage globule 2 between the inner radius capitulum layer 11 and the outer multi-pass through hole radius layer 12, and exposing cartilage cells in the cartilage globule;
s63, puncturing the outer cartilage layer 13 again, injecting cartilage growth liquid into the outer multi-pass-through-hole radial layer 12 to make cartilage cells grow in the outer multi-pass-through-hole radial layer 12, forming an inner cartilage layer 14 between the inner radial small head layer 11 and the outer multi-pass-through-hole radial layer 12 to form a cartilage scaffold layer, concentrating most cartilage cells at the plurality of cartilage small balls 2 to form the inner cartilage layer 14 in limited positions of the cartilage small balls 2, gradually dispersing part cartilage cells in the outer multi-pass-through-hole radial layer 12 under the action of the cartilage growth liquid, taking the outer multi-pass-through-hole radial layer 12 as an inner lining attachment point to grow, matching the outer cartilage layer 13 to make the thickness of the cartilage layer in the prosthesis be relatively thicker than that of the single outer cartilage layer 13, making the whole cartilage layer have relatively thicker span, and making the self supporting strength of the cartilage layer be relatively higher under the action of the outer multi-pass-through-hole radial layer 12 capable of being used as an inner lining, effectively avoid among the prior art behind cartilage local wear on the false body, the condition that produces between false body and the self bone not hard up takes place, make this false body implant internal back, the effect is better, simultaneously implant internal long-time back, after outer cartilage layer 13 department part is worn and torn, cartilage growth liquid oozes along wearing and tearing department in outer multiple through-hole radius layer 12, effectively guide chondrocyte to grow in wearing and tearing department, and then realize the effect of the cartilage self-repair of wearing and tearing, compare in prior art, show the suitability that improves false body and patient, improve the life of the internal false body of patient.
In the cartilage thickening treatment, the thickness of the thickened cartilage is not more than 1mm, the thickened cartilage is closer to the actual thickness, the matching degree is higher when the entity of the radial prosthesis is implanted into a patient, the recovery effect of the patient is better after the prosthesis is implanted, the phenomena of loosening, pain and the like after operation are less, after the simulation of the radial head prosthesis is finished, the comparison of morphological parameters of the near ends of two sides of the radius needs to be carried out by using a Mimics10.0 software measuring tool, so that the installation matching performance of the prosthesis is verified, the morphological parameters of the near ends of the two sides of the radius comprise the maximum height of the radius head, the minimum outer diameter of the radius head and neck plane, the maximum inner diameter of the medullary cavity of the radius head and neck plane and the length of the medullary cavity of the radius neck section, the comparison error requirements are all smaller than lmm, the smaller error indicates that the matching degree is higher, the prosthesis is more matched with the body of the patient, the recovery effect is better, the reinforced loosening, the method is effectively reduced after the long time of the patient after operation, Pain and other sequelae.
Referring to fig. 7, the small cartilage ball 2 includes a water-adhesive layer 21 and a liquid-coating layer 22 wrapped on the outer end of the water-adhesive layer 21, the liquid-coating layer 22 is filled with a cartilage growth liquid with cartilage cells, where the cartilage growth liquid effectively ensures the growth activity of the cartilage cells therein, so that when the cartilage cells overflow from the small cartilage ball 2, cartilage can grow and form under the action of the injected cartilage growth liquid, the outer surface of the water-adhesive layer 21 is in a rough structure with a wavy shape, and the water-adhesive layer 21 is made of a water-soluble material, so that when atomized physiological saline is adhered to the surface of the inner radius small head layer 11, when the water-adhesive layer 21 is in contact with the outer surface of the inner radius small head layer 11, the contact part of the water-adhesive layer 21 and the inner radius small head layer 11 is partially dissolved, so that the small cartilage ball 2 and the surface of the inner radius small head layer 11 are adhered together, thereby positioning the small cartilage ball 2 on the surface of the inner radius small head layer 11 is realized, and when tissue liquid is injected by puncture, the part of the water-adhesive layer 21 is completely dissolved by the tissue fluid, and the cartilage growth fluid with the cartilage cells therein overflows.
Through customization of the radius head prosthesis, the prosthesis is enabled to be well matched, the biomechanical performance is excellent, osteoporosis of humeral capitulum and damage of articular cartilage surfaces can be effectively avoided, in addition, in the process of printing in multiple times, a cartilage support layer can be formed in the outer cartilage layer 13 in the prior art, the support strength of the cartilage layer is enabled to be higher, the condition that the prosthesis is loosened after partial abrasion of cartilage on the prosthesis in the prior art is effectively avoided, meanwhile, when the part of the outer cartilage layer 13 is abraded, cartilage growth liquid in the outer multi-way through hole radius layer 12 seeps out along the abraded part, cartilage cells are effectively guided to grow at the abraded part, the self-repairing function of the abraded cartilage part is further realized, compared with the prior art, the adaptability of the prosthesis and a patient is effectively guaranteed, and the service life of the prosthesis in the body of the patient is prolonged.
The above; but are merely preferred embodiments of the invention; the scope of the invention is not limited thereto; any person skilled in the art is within the technical scope of the present disclosure; the technical scheme and the improved concept of the invention are equally replaced or changed; are intended to be covered by the scope of the present invention.
Claims (8)
1. Three-dimensional dissection customization radius head prosthesis based on radius near-end of being good for side, including radius capitulum, false body handle and cervical collar, its characterized in that: the upper end part of the prosthesis handle is connected with the lower end of a small radius head, the neck ring is sleeved outside the prosthesis handle and is in contact with the lower end part of the small radius head, the small radius head comprises an inner small radius head layer (11), an outer multi-way through hole radius layer (12) connected outside the inner small radius head layer (11) and an outer cartilage layer (13) wrapped outside the outer multi-way through hole radius layer (12), and an inner cartilage layer (14) is arranged between the outer multi-way through hole radius layer (12) and the inner small radius head layer (11);
the method for customizing the radius head prosthesis comprises the following steps:
s1, adopting GE Speed Light 16-row spiral CT thin layer to scan 1 case of double-sided elbow joints of healthy adults, eliminating radial head diseases and acquiring CT scanning dicom data;
s2, importing the CT scanning dicom data into Mimics10.0 software to reconstruct the elbow joint in a three-dimensional mode;
s3, extracting a three-dimensional model of the proximal radius of the left healthy side, simulating the proximal radius of the right affected side through a mirror image, and then dividing the model into a small radius head model and a neck ring model through editing;
s4, measuring the neck part intramedullary diameter and length parameters by using Mimics10.0 software to construct a prosthesis handle model;
s5, introducing the radius capitulum model into Gcomagic studio12 software to simulate cartilage thickening, and then introducing a prosthesis handle model to generate a head handle model;
s5, virtually assembling a head handle component according to anatomical characteristics to obtain a radius head prosthesis model;
s6, according to the radius head prosthesis model of the patient, printing and customizing the radius capitulum, the prosthesis handle and the neck strap of the entity on the damaged side of the patient by 3D printing technology in a grading way, then covering a reproducible cartilage support layer outside the radius capitulum, and assembling to obtain the radius head prosthesis;
the step of printing the small radius head in steps S6 includes:
firstly, an inner radius capitulum layer (11) is printed by using a titanium alloy powder material, the surface of the inner radius capitulum layer (11) is subjected to sanding treatment, atomized normal saline is sprayed on the outer surface of the inner radius capitulum layer (11), a plurality of cartilage globules (2) which are uniformly distributed are adhered to the surface of the inner radius capitulum layer (11), and the outer multi-pass through hole radius layer (12) is printed outside the inner radius capitulum layer (11).
2. The customized radius head prosthesis based on a healthy proximal radius three-dimensional anatomy according to claim 1, wherein: in the cartilage thickening treatment, the thickness of the thickened cartilage is not more than 1 mm.
3. The customized radius head prosthesis based on a healthy proximal radius three-dimensional anatomy according to claim 2, wherein: after the simulation of the radius head prosthesis is finished, a Mimics10.0 software measuring tool needs to be applied to compare morphological parameters of the near ends of the radius at two sides, so that the matching of prosthesis installation is verified.
4. The customized radius head prosthesis based on a healthy proximal radius three-dimensional anatomy according to claim 3, wherein: the bilateral radius proximal morphological parameters comprise the maximum height of a radius head, the minimum outer diameter of a radius head and neck plane, the maximum inner diameter of a medullary cavity of the radius head and neck plane and the length of the medullary cavity of a radius neck segment, and the comparison error requirements are all smaller than lmm.
5. The customized radius head prosthesis based on a healthy proximal radius three-dimensional anatomy according to claim 1, wherein: the method for coating the cartilage scaffold layer in the step S6 comprises the following steps:
s61, firstly, constructing an outer cartilage layer (13) on the outer surface of the capitulum radii according to the three-dimensional data of the outer surface of the capitulum radii;
s62, puncturing the outer cartilage layer (13), injecting a trace amount of tissue fluid into the radial layer (12) with the outward multi-pass through holes to dissolve the surface of the cartilage globule (2) between the inner radial capitulum layer (11) and the radial layer (12) with the outward multi-pass through holes, and exposing cartilage cells in the cartilage globule;
s63, puncturing the outer cartilage layer again, injecting cartilage growth liquid into the outer multi-pass through hole radial layer (12), enabling chondrocytes to grow in the outer multi-pass through hole radial layer (12), and forming an inner cartilage layer (14) between the inner radius capitulum layer (11) and the outer multi-pass through hole radial layer (12) to form a cartilage support layer.
6. The customized radius head prosthesis based on a healthy proximal radius three-dimensional anatomy according to claim 5, wherein: the thickness of the outer multi-pass through hole radial layer (12) is not more than 2mm, the thickness of the outer cartilage layer (13) is not more than 1mm, the inner radius capitulum layer (11) and the outer multi-pass through hole radial layer (12) print required three-dimensional data, a three-dimensional model of the capitulum radius is cut in Mimics10.0 software according to the thickness of the outer multi-pass through hole radial layer (12), and the three-dimensional data are calculated and measured in the Mimics10.0 software after cutting.
7. The customized radius head prosthesis based on a healthy proximal radius three-dimensional anatomy according to claim 5, wherein: the cartilage ball (2) comprises a water adhesive layer (21) and a liquid coating layer (22) wrapped at the outer end of the water adhesive layer (21), and cartilage growth liquid with cartilage cells is filled in the liquid coating layer (22).
8. The customized radius head prosthesis based on a healthy proximal radius three-dimensional anatomy according to claim 7, wherein: the outer surface of the water-binding layer (21) is of a rugged rough structure, and the water-binding layer (21) is made of water-soluble materials.
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