CN113349990A

CN113349990A - Composite reconstructed semi-knee joint prosthesis with preserved joint surface

Info

Publication number: CN113349990A
Application number: CN202110651440.3A
Authority: CN
Inventors: 邹明霞; 郝改平; 于跃; 曹鹏飞
Original assignee: Beijing Lidakang Technology Co Ltd
Current assignee: Beijing Lidakang Technology Co Ltd
Priority date: 2021-06-10
Filing date: 2021-06-10
Publication date: 2021-09-07
Anticipated expiration: 2041-06-10
Also published as: CN113349990B

Abstract

The utility model belongs to the technical field of medical artificial prosthesis's technique and specifically relates to a compound half knee joint prosthesis who remains articular surface who rebuilds relates to, and it is including setting up the tibial prosthesis portion at the defective position of shin bone, fixed connection can be dismantled with shin bone upper end articular surface to tibial prosthesis portion upper end, fixed connection can be dismantled with the tangent plane of shin bone prosthesis lower extreme, the tibial prosthesis portion middle is provided with the chamber that holds that extends along its length direction, hold intracavity portion and can place the fibula of patient's self intercepting. This application has the effect that improves the defective position adaptation of shin bone prosthesis portion and patient.

Description

Composite reconstructed semi-knee joint prosthesis with preserved joint surface

Technical Field

The application relates to the technical field of medical artificial prostheses, in particular to a composite reconstructed semi-knee joint prosthesis with a reserved joint surface.

Background

At present, primary and secondary malignant bone tumors are motor system tumor lesions seriously threatening the survival and life quality of patients. With the development of surgical operation technology, the innovation of tumor imaging technology and the development of new adjuvant chemotherapy for patients with malignant tumor, limb protection surgery has become a consensus for treating malignant bone tumor. Malignant tumors occurring in the long diaphysis of the limbs need to follow the principle of extensive resection in clinic, so that the reconstruction of the diaphyseal defect after tumor resection is of great concern, and the common malignant tumors are osteosarcoma, Ewing sarcoma and the like, which are frequently generated at the metaphysis of the knee joint (the metaphysis of femur and the metaphysis of tibia). After the operation replacement is carried out on the patients, the growth function of the affected limb is often influenced, the phenomena of unequal length of the left leg and the right leg, limping during walking and the like are caused after a long time, and a prolonged revision operation is needed in serious cases.

The existing biological composite reconstruction method generally comprises three methods, wherein the first method is used for intercepting a fibula of a patient with the same length as a defect part so as to replace a prosthesis and adopts the fibula for replacement, the fusion degree of the fibula and the patient is high, the rejection phenomenon cannot occur, and the rehabilitation of the patient is facilitated; the second one adopts the same allogeneic bone of the defect part to replace, adopts the allogeneic bone to replace the defect part of the patient, can provide strong support in the early stage, and is not easy to cause the risk of secondary damage to the part of the patient with the missing tibia; the most common reconstruction method in the third category is the reconstruction of bone defects with an extendable prosthesis, which has a high degree of coincidence with the human body and can be individually customized according to different defect sites of the patient.

In view of the above-mentioned related art, the inventor believes that there is a problem that the fibula itself is low in strength and not easily fixed; long healing time of the allogeneic bone and incomplete activation; the extensible prosthesis reconstruction has the defects of multiple operations, large trauma of a patient, high economic cost, limited extension distance, uncertain long-term curative effect and the like.

Disclosure of Invention

In order to solve the problem that three methods of biological composite reconstruction in the prior art have different adaptation degrees with the defect part of a patient, the application provides a composite reconstructed semi-knee joint prosthesis with preserved articular surface.

The application provides a composite reconstruction semi-knee joint prosthesis with a reserved articular surface, which adopts the following technical scheme:

the utility model provides a compound half knee joint prosthesis who remains articular surface who rebuilds, is including setting up the tibial prosthesis portion at the defective position of shin bone, fixed connection can be dismantled with shin bone upper end articular surface to tibial prosthesis portion upper end, fixed connection can be dismantled with the tangent plane of shin bone to the tibial prosthesis lower extreme, the tibial prosthesis portion middle is provided with the chamber that holds that extends along its length direction, hold the fibula that the intracavity portion can place patient's self intercepting.

By adopting the technical scheme, the tibial prosthesis part can be used for knee joint prosthesis reconstruction after the tibia of a patient is cut due to tumor or other pathological reasons, when the tibial prosthesis is used, the tibial prosthesis part can be customized according to the cut tibia of the patient, the coincidence degree of the customized tibial prosthesis part and the patient is higher, the upper end of the tibial prosthesis part can be connected with the existing tibial knee joint of the patient, the lower end of the tibial prosthesis part is connected with the existing tibia of the patient, and the tibial prosthesis part can provide effective support for the patient in the early stage; the chamber that holds that sets up in the middle of the shin bone false body can cut or directly place the fibula on the patient's shin bone and hold the intracavity, and the fibula itself has the blood vessel, and is better with the shin bone fusion degree of patient itself.

Optionally, the tibia prosthesis portion includes a tibia endoprosthesis and a tibia extraprostesis, the tibia extraprostesis is wrapped on the outer peripheral surface of the tibia endoprosthesis, the accommodating cavity is formed in the tibia endoprosthesis, the tibia endoprosthesis is wrapped on the outer side of a fibula, the upper end face of the tibia endoprosthesis is attached to the upper end joint face of the tibia, the lower end face of the tibia endoprosthesis is attached to the transverse plane of the tibia, and the upper end face and the lower end face of the tibia extraprostesis are both detachably and fixedly connected with the tibia.

By adopting the technical scheme, the arranged tibia endoprosthesis can be used for wrapping a fibula of a patient, so that the upper end and the lower end of the fibula of the patient are attached to the upper end and the lower end of a tibia cutting part of the patient, and the fibula and the tibia are better fused; the shin bone external prosthesis who sets up, its upper and lower both ends and patient's shin bone fixed connection to the shin bone external prosthesis parcel can be fixed to the shin bone internal prosthesis in the shin bone internal prosthesis outside, prevents that both ends and patient's shin bone break away from about the shin bone internal prosthesis, is unfavorable for the fusion in later stage.

Optionally, openings communicated with the accommodating cavities are correspondingly formed in the tibial internal prosthesis and the tibial external prosthesis, and the openings extend along the length direction of the tibial internal prosthesis and the tibial external prosthesis and are communicated to the upper end and the lower end of the tibial internal prosthesis and the upper end of the tibial external prosthesis.

Through adopting above-mentioned technical scheme, the opening of seting up in shin bone endoprosthesis and shin bone extrarosthesis one side makes things convenient for the doctor when doing the operation, with the quick intracavity that holds of placing of fibula to the convenience is adjusted the position of fibula, makes the upper and lower both ends of fibula can be laminated with the tangent plane of shin bone, has avoided the fibula to wear to establish the loaded down with trivial details operation of other one end from the one end of shin bone endoprosthesis.

Optionally, the upper end face and the lower end face of the tibial endoprosthesis are both provided with grooves with trabecular bone porous structures.

By adopting the technical scheme, the trabecular bone porous structure arranged on the upper end surface and the lower end surface of the tibia endoprosthesis enables the endoprosthesis to be better fused with the tibia, so that the bone structure on the tangent plane of the tibia can be quickly grown into the tibia endoprosthesis.

Optionally, a fixing block is arranged at the upper end of the external tibial prosthesis, a fixing rod is arranged at the lower end of the external tibial prosthesis, the fixing block is fixed to the outer surface of the upper end joint of the tibia, the length of the fixing rod extends along the length direction of the tibia, and the fixing rod is fixed to the tibia which is not resected.

Through adopting above-mentioned technical scheme, the fixed block that sets up on the external tibial prosthesis is convenient to fix with the articular surface of shin bone upper end, and the dead lever that sets up can be better fixes with the shin bone lower extreme, makes the position that the false tibial part of shin bone can convenient and fast not amputated fixed with the shin bone.

Optionally, the fixing blocks are provided with a pair, and the two fixing blocks are symmetrically arranged at the edge of the upper end of the external tibial prosthesis.

Through adopting above-mentioned technical scheme, because the skeleton of human knee joint position department is great, ordinary activity is also more with the atress, consequently, sets up a pair of fixed block in external tibial prosthesis upper end, can increase the joint strength of external tibial prosthesis and shin bone knee joint department, when preventing the slight activity of prophase, the external tibial prosthesis portion is connected with shin bone upper end knee joint and is dropped.

Optionally, the fixing block is fixedly connected with the joint at the upper end of the tibia and the fixing rod is fixedly connected with the tibia through the arranged fixing screws.

Through adopting above-mentioned technical scheme, through the set screw that sets up, can be fixed with the knee joint position department of fixed block and shin bone upper end to and fixed with the shin bone that the patient did not cut off and dead lever, and the set screw that sets up makes the fixed block and the dead lever be connected convenient and fast more with the shin bone, and the connection effect is also better.

Optionally, a plurality of fixing screws are equidistantly arranged in the length direction of the fixing rod.

Through adopting above-mentioned technical scheme, because the length direction of the length of dead lever and shinbone is the same, a plurality of set screw of setting can increase the joint strength of dead lever and shinbone, prevent to take place to be connected between dead lever and the shinbone and drop.

Optionally, a fixing groove is formed in the outer surface of the tibia endoprosthesis, and the tibia endoprosthesis can be embedded in the fixing groove.

Through adopting above-mentioned technical scheme, the fixed slot of seting up on the internal tibial prosthesis surface can make the better parcel of external tibial prosthesis on internal tibial prosthesis, makes both need not just can guarantee joint strength through extra mounting to the external tibial prosthesis of parcel on internal tibial prosthesis can reduce the size of the internal tibial prosthesis portion, better and human adaptation.

Optionally, a set screw is arranged at a position of the external tibial prosthesis near the upper end of the external tibial prosthesis, and the set screw penetrates through the external tibial prosthesis and is screwed to the fibula.

Through adopting above-mentioned technical scheme, threaded connection can fix the fibula that holds the intracavity at the holding screw on the outer false body of shin bone, prevents that the fibula from droing from holding the intracavity, causes the not better integration of fibula and shin bone.

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

1. the tibia prosthesis part can be used for knee joint prosthesis reconstruction after tibia resection of a patient caused by tumor or other pathological reasons, when the tibia prosthesis is used, customization can be carried out according to the tibia that the patient is resected, the coincidence degree of the customized tibia prosthesis part and the patient is higher, the upper end of the tibial prosthesis part can be connected with the existing tibia knee joint of the patient, the lower end of the tibial prosthesis part is connected with the existing tibia of the patient, and effective support can be provided for the patient in the early stage; the accommodating cavity is formed in the middle of the tibial prosthesis part, so that a fibula on the tibia of a patient can be cut off or directly placed in the accommodating cavity, the fibula is provided with blood vessels, and the fusion degree of the fibula and the tibia of the patient is better;

2. the arranged tibia endoprosthesis can be used for wrapping a fibula of a patient, so that the upper end and the lower end of the fibula of the patient are attached to the upper end and the lower end of a tibia cutting part of the patient, and the fibula and the tibia are better fused; the upper end and the lower end of the arranged tibia external prosthesis are fixedly connected with the tibia of a patient, and the tibia external prosthesis is wrapped on the outer side of the tibia internal prosthesis, so that the tibia internal prosthesis can be fixed, the upper end and the lower end of the tibia internal prosthesis are prevented from being separated from the tibia of the patient, and later-stage fusion is not facilitated;

3. the fixed slot of seting up on the internal tibial prosthesis surface can make the better parcel of external tibial prosthesis on internal tibial prosthesis, makes both need not just can guarantee joint strength through extra mounting to the external tibial prosthesis of parcel on internal tibial prosthesis can reduce the size of the internal tibial prosthesis portion, better and human adaptation.

Drawings

FIG. 1 is a schematic diagram of the overall structure of an embodiment of the present application;

fig. 2 is an exploded view of a tibial prosthesis portion embodying embodiments of the present application.

Description of reference numerals: 1. a tibial prosthesis portion; 11. a tibial endoprosthesis; 12. a tibial outer prosthesis; 2. a fixed block; 3. fixing the rod; 4. a set screw; 5. fixing grooves; 6. an accommodating chamber; 7. an opening; 8. and (5) tightening the screw.

Detailed Description

The present application is described in further detail below with reference to figures 1-2.

The embodiment of the application discloses a composite reconstructed semi-knee joint prosthesis with preserved articular surface. Referring to fig. 1, the semi-knee prosthesis comprises a tibia prosthesis part 1 installed at a tibia defect part of a patient, the upper end of the tibia prosthesis part 1 is detachably and fixedly connected with a knee joint reserved at the upper end of the tibia, and the lower end of the tibia prosthesis is detachably and fixedly connected with a middle tangent plane of the tibia defect part.

Referring to fig. 1 and 2, the tibial prosthesis portion 1 includes a tibial inner prosthesis 11 and a tibial outer prosthesis 12, both of which are arranged along the length direction of the tibia, the tibial outer prosthesis 12 can be wrapped on the outer side of the tibial inner prosthesis 11, the upper end surface of the tibial inner prosthesis 11 is attached to the knee joint surface of the tibia, the lower end surface of the tibial inner prosthesis 11 is attached to the cross section of the resection position of the tibia, the upper end surface of the tibial outer prosthesis 12 is detachably and fixedly connected with the remaining knee joint of the tibia, and the lower end surface of the tibial outer prosthesis 12 is detachably and fixedly connected with the non-resected part of the tibia.

The pair of fixing blocks 2 are symmetrically arranged at the edge of the upper end of the tibial external prosthesis 12, when the knee joint position reserved by a patient is installed, the reserved knee joint can be located between the two fixing blocks 2, the two fixing blocks 2 are convenient to fix with the joint surface at the upper end of the tibia, the two fixing blocks 2 can increase the connection strength between the tibial external prosthesis 12 and the tibial joint, and the phenomenon that when the tibial external prosthesis 12 and the tibial knee joint are fixed in the early stage, the tibial prosthesis part 1 and the knee joint at the upper end of the tibia are connected and fall off due to slight movement in the early stage is avoided; at 12 lower extremes fixedly connected with dead lever 3 of external tibial prosthesis, the length of dead lever 3 extends along the length direction of shin bone to dead lever 3 and the external fixed surface of shin bone are connected, and what the dead lever 3 that sets up can be better fixes with the shin bone lower extreme, makes the position that shin bone prosthesis portion 1 can convenient and fast and shin bone not cut off fixed.

Referring to fig. 1 and 2, the joint that remains with the shin bone upper end on fixed block 2 and dead lever 3 all pass through set screw 4 fixed connection with the shin bone, equidistance is provided with a plurality of set screw 4 in the length direction of dead lever 3, set screw 4 passes on fixed block 2 and 3 threaded connection of dead lever to the knee joint that the shin bone upper end remains and on the shin bone face, set screw 4, can fix fixed block 2 with the knee joint position department of shin bone upper end fast, and with the shin bone and the dead lever 3 fast fixation that the patient did not cut off, and set screw 4, make the effect of being connected of fixed block 2 and dead lever 3 and shin bone also better.

Further, offer on the surface of shin bone endoprosthesis 11 along radial and axial fixed slot 5, shin bone extraprosthetic things 12 can inlay in fixed slot 5, after shin bone extraprosthetic things 12 installed on shin bone endoprosthesis 11, both's periphery is the state of flushing, fixed slot 5 of offering on the surface of shin bone endoprosthesis 11 can make the better parcel of shin bone extraprosthetic things 12 on shin bone endoprosthesis 11, make both need not just can guarantee joint strength through extra mounting, and the shin bone extraprosthetic things 12 of parcel on shin bone endoprosthesis 11, can reduce the size of shin bone prosthesis portion 1, better and human adaptation.

Referring to fig. 1 and 2, offer the chamber 6 that holds that extends along its length direction in the middle part of shin bone endoprosthesis 11, hold chamber 6 and communicate to the position department at shin bone endoprosthesis 11 both ends, when installation shin bone prosthesis portion 1, hold the fibula that the defective position of shin bone can be placed to the inside fibula that holds chamber 6, hold the fibula that the inside of chamber 6 set up, be convenient for with cut better the integration of shin bone after removing together, correspond on shin bone endoprosthesis 11 and shin bone extrasystole 12 and set up and hold the opening 7 of the inside intercommunication in chamber 6, opening 7 extends and communicates to both ends along the length direction of shin bone endoprosthesis 11 and shin bone extrasystole 12, the opening 7 of setting, make things convenient for the doctor when doing the operation, place the fibula is quick in holding chamber 6, and the position to the fibula is adjusted to the convenience.

Further, be provided with holding screw 8 on outer prosthesis 12 of shin bone is close to the outer peripheral face of upper end, holding screw 8 passes outer prosthesis of shin bone 12 and threaded connection holds the fibula of chamber 6 inside on, the holding screw 8 of setting can fix the fibula, prevents that the fibula from droing in holding chamber 6, improves the fusion efficiency of the shin bone that fibula and patient excision position remain.

The implementation principle of the composite reconstruction semi-knee joint prosthesis with the preserved articular surface in the embodiment of the application is as follows: when the tibial prosthesis part 1 is installed at a resection part of a patient, a fibula of the patient or a fibula on one side of the tibia resection position is resected and placed in the accommodating cavity 6, then the tibial outer prosthesis 12 is in threaded connection with the set screw 8 to fix the fibula, and the upper end and the lower end of the tibial outer prosthesis 12 and the uncut tibia of the patient are fixed into a whole through the set screw 4.

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. A composite reconstructed facet-preserving semi-knee prosthesis, comprising: including setting up tibial prosthesis portion (1) at the defective position of shin bone, fixed connection can be dismantled with shin bone upper end articular surface to tibial prosthesis portion (1) upper end, fixed connection can be dismantled with the tangent plane of shin bone to the tibial prosthesis lower extreme, be provided with in the middle of tibial prosthesis portion (1) along chamber (6) that hold that its length direction extends, hold the fibula that patient's self intercepting can be placed to chamber (6) inside.

2. A composite reconstructed facet-preserving semi-knee prosthesis according to claim 1, wherein: the tibia prosthesis part (1) comprises a tibia endoprosthesis (11) and a tibia extraprosthesis (12), the tibia extraprosthesis (12) are wrapped on the outer peripheral surface of the tibia endoprosthesis (11), a containing cavity (6) is formed in the tibia endoprosthesis (11), the tibia endoprosthesis (11) is wrapped on the outer side of a fibula, the upper end surface of the tibia endoprosthesis (11) is attached to the upper end joint surface of the tibia, the lower end surface of the tibia endoprosthesis (11) is attached to the cross section of the tibia, and the upper end surface and the lower end surface of the tibia extraprosthesis (12) are both detachably and fixedly connected with the tibia.

3. A composite reconstructed facet-preserving semi-knee prosthesis according to claim 2, wherein: openings (7) communicated with the accommodating cavities (6) are correspondingly formed in the tibia internal prosthesis (11) and the tibia external prosthesis (12), and the openings (7) extend along the length direction of the tibia internal prosthesis (11) and the tibia external prosthesis (12) and are communicated to the upper end and the lower end of the tibia internal prosthesis and the upper end of the tibia external prosthesis.

4. A composite reconstructed facet-preserving semi-knee prosthesis according to claim 2, wherein: the upper end surface and the lower end surface of the tibia endoprosthesis (11) are both provided with grooves with trabecular bone porous structures.

5. A composite reconstructed facet-preserving semi-knee prosthesis according to claim 2, wherein: the tibia external prosthesis is characterized in that a fixing block (2) is arranged at the upper end of the tibia external prosthesis (12), a fixing rod (3) is arranged at the lower end of the tibia external prosthesis, the fixing block (2) is fixed to the outer surface of a joint at the upper end of the tibia, the length of the fixing rod (3) extends along the length direction of the tibia, and the fixing rod (3) is fixed to the tibia which is not cut.

6. The composite reconstructed articular surface-preserved semiknee prosthesis according to claim 5, wherein: the fixing blocks (2) are provided with a pair, and the two fixing blocks (2) are symmetrically arranged at the edge of the upper end of the tibia external prosthesis (12).

7. The composite reconstructed articular surface-preserved semiknee prosthesis according to claim 5, wherein: the fixing block (2) is fixedly connected with the upper end joint of the tibia and the fixing rod (3) is fixedly connected with the tibia through the arranged fixing screws (4).

8. The composite reconstructed articular surface-preserved semiknee prosthesis according to claim 5, wherein: a plurality of fixing screws (4) are equidistantly arranged in the length direction of the fixing rod (3).

9. A composite reconstructed facet-preserving semi-knee prosthesis according to claim 2, wherein: the external surface of the tibia endoprosthesis body (11) is provided with a fixing groove (5), and the tibia endoprosthesis body (12) can be embedded in the fixing groove (5).

10. A composite reconstructed facet-preserving semi-knee prosthesis according to claim 1, wherein: and a set screw (8) is arranged at the position of the external tibial prosthesis (12) close to the upper end of the external tibial prosthesis, and the set screw (8) penetrates through the external tibial prosthesis (12) and is screwed to the fibula.