CN114712039A - Preparation method of artificial knee joint revision replacement template and spacer - Google Patents

Preparation method of artificial knee joint revision replacement template and spacer Download PDF

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Publication number
CN114712039A
CN114712039A CN202210303923.9A CN202210303923A CN114712039A CN 114712039 A CN114712039 A CN 114712039A CN 202210303923 A CN202210303923 A CN 202210303923A CN 114712039 A CN114712039 A CN 114712039A
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China
Prior art keywords
component
bone cement
knee joint
curved surface
antibiotics
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CN202210303923.9A
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Chinese (zh)
Inventor
张贤祚
朱晨
金贤胜
马锐祥
周伟
李政
张林林
刘应生
徐泽
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Anhui Provincial Hospital First Affiliated Hospital Of Ustc
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Anhui Provincial Hospital First Affiliated Hospital Of Ustc
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Priority to CN202210303923.9A priority Critical patent/CN114712039A/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/38Joints for elbows or knees
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30721Accessories
    • A61F2/30724Spacers for centering an implant in a bone cavity, e.g. in a cement-receiving cavity
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/3094Designing or manufacturing processes
    • A61F2/30942Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/38Joints for elbows or knees
    • A61F2/3859Femoral components
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/38Joints for elbows or knees
    • A61F2/389Tibial components
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4675Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for cleaning or coating bones, e.g. bone cavities, prior to endoprosthesis implantation or bone cement introduction
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30667Features concerning an interaction with the environment or a particular use of the prosthesis
    • A61F2002/30677Means for introducing or releasing pharmaceutical products, e.g. antibiotics, into the body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/3094Designing or manufacturing processes
    • A61F2/30942Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
    • A61F2002/30943Designing 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 mathematical models
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/3094Designing or manufacturing processes
    • A61F2/30942Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
    • A61F2002/30948Designing 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/3094Designing or manufacturing processes
    • A61F2/30942Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
    • A61F2002/30963Designing 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 templates, e.g. grid charts
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4675Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for cleaning or coating bones, e.g. bone cavities, prior to endoprosthesis implantation or bone cement introduction
    • A61F2002/4676Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for cleaning or coating bones, e.g. bone cavities, prior to endoprosthesis implantation or bone cement introduction for coating the bony surface

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

Abstract

The invention discloses a preparation method of an artificial knee joint revision replacement template and an placeholder, wherein the artificial knee joint revision replacement template comprises a femur component and a tibia component matched with the femur component, the preparation method adopts preparation in an operation and preparation in two stages in the operation, and preparation time for installing the replacement component in the operation is effectively reduced.

Description

Preparation method of artificial knee joint revision replacement template and spacer
Technical Field
The invention relates to the field of orthopedic medical equipment and instruments, in particular to a preparation method of an artificial knee joint revision replacement template and an occupier.
Background
The artificial joint replacement brings good news to patients with joint diseases, and the life quality of the patients is greatly improved. With the improvement of the national living standard and the aggravation of aging problems, the number of artificial joint replacement tends to increase year after year, and infection is a very serious complication after the joint replacement. The incidence of infection after the first joint replacement is generally about 1%, and once the infection occurs, the joint function can be lost, if the joint function is not treated in time, the amputation or death can even be caused, and a great burden is caused to the spirit and the economy of a patient. Therefore, timely treatment and revision are very important for patients diagnosed with infection, and the main causes of revision of artificial knee joints include periprosthetic infection, prosthetic loosening, intractable medial knee pain, medial collateral ligament laxity, and the like. Patients with lax medial collateral ligaments and intractable pain in the medial knee are typically treated by strengthening the medial collateral ligaments or cutting off the saphenous joint branch, while patients with periprosthetic infections or prosthetic loosening may require total or partial revision.
The current use is more to carry out infection second-stage revision after artificial hip-knee joint replacement by adopting a porous hollow flushing type temporary placeholder and an antibiotic bone cement type temporary placeholder, because the placeholder generally needs about 3 months at the joint, the porous hollow flushing type placeholder is easy to cause tissue hyperplasia, holes of the placeholder can be blocked, and certain trouble is brought to debridement of a later-stage replacement prosthesis.
Disclosure of Invention
The invention aims to overcome the defects in the prior art and provide an artificial knee joint revision replacement template with reasonable structural design and a preparation method of a spacer for knee joint revision surgery.
The technical scheme adopted by the invention for solving the problems is as follows: an artificial knee joint revision replacement template comprises a femoral component and a tibial component matched with the femoral component;
the femur component comprises a curved surface component, a frame component and an embedded component, the two side ends of the frame component are in a grid shape, the curved surface component is matched with the front side surface of the frame component, the embedded component is matched with the rear side surface of the frame component, the end surfaces of the curved surface component and the embedded component are both provided with meshes, the frame component is provided with a first injection hole, the first injection hole is provided with a first hole plug,
the thighbone part include with holding surface part and the support column of curved surface part adaptation, the support column is provided with and is used for the slip cap to establish the cavity of holding surface part downside, the support column downside be provided with the fixed column, holding surface part and support column be provided with the mesh, the support column be provided with the second filling hole, the second filling hole adapt to the second hole stopper, the bottom of holding be provided with the installation component of shin bone fluting adaptation.
Further: the supporting surface component middle part be provided with protruding spacing part, the frame part be provided with protruding spacing part adaptation's cell body, the cell body set up at the inside wall face of embedded part and wear to establish fixedly with the trompil of curved surface part.
Further: the lateral part of holding surface part be provided with the scale mark, scale mark position and support column upper end along surface position adaptation.
A preparation method of an anti-infection spacer in artificial knee joint revision comprises the following steps: the method comprises the following steps:
pre-preparation before operation:
(1) acquiring CT slice data of a patient, modeling according to size data acquired by CT slices and the artificial knee joint revision replacement template according to any one of claims 1 to 5, and respectively acquiring a curved surface part, a frame part, an embedded part, a supporting surface part and a printing part of a supporting column by utilizing modeling 3D printing;
(2) coating bone cement liquid mixed with antibiotics on the outer side surfaces of the curved surface part and the embedded part, wherein the coating thickness is 6-8mm, standing and solidifying, and polishing the outer side end surface of the curved surface part by using sand paper;
(3) respectively matching and installing the curved surface part and the embedded part with the frame part, and filling the thick bone cement mixed with antibiotics into the first injection hole by adopting an injection device and placing and solidifying the bone cement;
(4) after solidification is finished, the whole combined femoral component is immersed in bone cement liquid mixed with antibiotics for 5-10s, and then is drained and solidified;
(5) coating bone cement liquid mixed with antibiotics on the upper end surface of the supporting surface component and the outer wall surface of the supporting column, wherein the coating thickness is 6-8mm, standing and solidifying, and polishing the upper end surface of the supporting surface component by using sand paper;
(6) placing the prepared femoral component and the femoral component in a sterile constant temperature and humidity box for storage for later use;
preparing in operation:
(7) in the operation, a femur component is mounted on a femur part for adaptation, a tibia component is mounted on a tibia part for adaptation, the position of a main body at the lower end of a supporting face component on a supporting column is adjusted, so that a knee joint can obtain a good flexion-extension position at the position, and the scale position of the lower end of the supporting face component on the supporting column is recorded;
(8) and taking down the tibial component part, adjusting the lower end of the bearing surface part to a scale position, injecting thick bone cement mixed with antibiotics into the first injection hole by using an injection device, completely immersing the tibial component part for 5-10s, taking out, draining, solidifying, and then installing to the tibial part and matching with the femoral component.
Further: 10-15% of deacetylated chitin fiber is added into the bone cement liquid mixed with the antibiotics and the thick bone cement mixed with the antibiotics.
Further: the specification of the sand paper adopts 800-1200 meshes.
Further: the 3D printing adopts PEEK as a raw material, the PEEK material is semi-crystalline aromatic plastic engineering plastic, has extremely excellent physical and mechanical properties, can replace traditional materials such as metal and ceramic in many special fields, has outstanding contribution to quality reduction and performance improvement, becomes one of the hottest high-performance engineering plastics, has extremely outstanding high-temperature resistance and thermal performance, can be used for a long time at 260 ℃, and has an instant use temperature of 300 ℃; the PEEK material has high rigidity, dimensional stability and small linear expansion coefficient, is close to a metal aluminum material, has good chemical stability, has strong corrosion resistance to acid, alkali and almost all organic solvents, and has the performances of flame retardance, radiation resistance and the like; the PEEK material has excellent performance of sliding wear resistance and micro-abrasion loss, especially can keep high wear resistance and low friction factor at 250 ℃, and can be better suitable for the use environment of the spacer by adopting the PEEK.
Compared with the prior art, the invention has the following advantages and effects: the curved surface part and the supporting part can be coated firstly and then immersed, drained and solidified, and then a thicker bone cement coating is attached, so that adaptive abrasion can be performed in an occupying stage, meanwhile, the integral immersion is performed after the coating, so that the integral smooth and uniform arrangement of the outer surface of the part is ensured, the preparation before and during the operation not only effectively reduces the preparation time in the operation, but also utilizes a split structure, the bone cement coating of the curved surface part and the supporting part has sufficient solidification time before the operation, the hardness requirement is improved, compared with the preparation of the occupying device directly adopting the bone cement, the device has better mechanical property, and walking exercise and general load bearing can be performed in the anti-infection period of a patient.
Drawings
Fig. 1 is a schematic structural diagram of an artificial knee joint revision replacement template according to an embodiment of the present invention.
Fig. 2 is a schematic structural view of a femoral component in accordance with an embodiment of the present invention.
Fig. 3 is a schematic view of a tibial component according to an embodiment of the present invention.
The reference numbers: the bone fracture plate comprises a femoral component 1, a tibial component 2, a curved surface component 11, a frame component 12, an embedded component 13, a mesh 3, a first hole plug 14, a supporting surface component 21, a supporting column 22, a mounting component 23, a second hole plug 24, a bump limiting component 51, a groove body 52, an opening 53 and scale marks 6.
Detailed Description
The present invention will be described in further detail below by way of examples with reference to the accompanying drawings, which are illustrative of the present invention and are not to be construed as limiting the present invention.
Example 1:
referring to fig. 1-2, the embodiment relates to a method for preparing an anti-infection spacer in artificial knee joint revision, which specifically adopts an artificial knee joint revision replacement template to prepare, wherein the artificial knee joint revision replacement template includes a femoral component 1 and a tibial component 2 matched with the femoral component 1;
the femur component 1 comprises a curved surface component 11, a frame component 12 and an embedded component 13, end faces of two sides of the frame component 12 are in a grid shape, the curved surface component 11 is matched with the front side face of the frame component 12, the embedded component 13 is matched with the rear side face of the frame component 12, the end faces of the curved surface component 11 and the embedded component 13 are respectively provided with a mesh 3, the frame component 12 is provided with a first injection hole (in the embodiment, as shown in the figure, the curved surface component is wrapped on the outer side face of the frame component, the curved surface component and the frame component are respectively provided with a first injection hole for corresponding), and the first injection hole is provided with a first hole plug 14;
the femur component 1 comprises a supporting surface component 21 matched with the curved surface component 11 and a supporting column 22, the supporting column 22 is provided with a cavity used for slidably sleeving the lower side of the supporting surface component 21, the lower side of the supporting column 22 is provided with a fixing column, the supporting surface component 21 and the supporting column 22 are provided with meshes 3, the supporting column 22 is provided with a second injection hole, the second injection hole is matched with a second hole plug 24, and the bottom of the supporting column is provided with an installation component 23 matched with the tibia slotting.
Support face part 21 middle part be provided with protruding stop part 51, frame part 12 be provided with the cell body 52 of protruding stop part 51 adaptation, cell body 52 set up at the inside wall face of embedded part 13 and wear to establish fixedly with curved surface part 11's trompil 53, can avoid during the occupy-place, take place the dislocation for boring the section patient and have certain good knee joint activity space and heavy burden ability overhauling occupying, mounting structure is simple simultaneously, convenient combination operation, support face part 21's lateral part be provided with scale mark 6, 6 positions of scale mark and support face part 21 lower extreme position adaptations.
The method comprises the following steps of determining to perform the artificial knee joint revision surgery on a patient, and dividing the surgery into a preoperative preparation stage and an intraoperative preparation stage according to the given structure:
pre-preparation before operation:
(1) acquiring CT slice data of a patient, modeling according to size data acquired by CT slices and the artificial knee joint revision replacement template according to any one of claims 1 to 5, and respectively acquiring printing parts of a curved part 11, a frame part 12, an embedded part 13, a supporting surface part 21 and a supporting column 22 by utilizing modeling 3D printing;
(2) coating bone cement liquid mixed with antibiotics on the outer side surfaces of the curved surface part 11 and the embedded part 13, wherein the coating thickness is 6-8mm, standing and solidifying, and polishing the outer side end surface of the curved surface part 11 by using sand paper;
(3) respectively matching and installing the curved surface part 11 and the embedded part 13 with the frame part 12, and filling thick bone cement mixed with antibiotics into the first injection hole by adopting an injection device and standing for solidification;
(4) after solidification is finished, the whole combined femoral component 1 is immersed in bone cement liquid mixed with antibiotics for 5-10s, and then is drained and solidified;
(5) coating bone cement liquid mixed with antibiotics on the upper end surface of the supporting surface part 21 and the outer wall surface of the supporting column 22, wherein the coating thickness is 6-8mm, standing and solidifying, and polishing the upper end surface of the supporting surface part 21 by using sand paper;
preparing in operation:
(7) in the operation, the femur component 1 is installed on the femur part for adaptation, then the tibia component 2 is installed on the tibia part for adaptation, the position of the main body at the lower end of the supporting surface component 21 on the supporting column 22 is adjusted, so that the knee joint can obtain a good flexion-extension position at the position, and the scale position of the lower end of the supporting surface component 21 on the supporting column 22 is recorded;
(8) taking down the tibial component 2, adjusting the lower end of the supporting surface component 21 to a scale position, injecting thick bone cement mixed with antibiotics into the first injection hole by using an injection device, standing for 8-10min to ensure that the primary solidification structure is relatively stable, completely immersing the tibial component 2 for 5-10s, taking out, draining, solidifying, and then installing to the tibial part and matching with the femoral component 1.
The invention adopts the preparation in the operation and the preparation in the operation in two stages according to the structure characteristics of the artificial knee joint revision replacement template, so as to effectively reduce the preparation time of installing the replacement part in the operation, in the structure, the curved surface part 11 and the supporting part are coated and attached with a thicker bone cement coating (6-8mm) for a plurality of times, so that the adaptive abrasion can be conveniently carried out in the occupying stage, the preparation in the operation not only effectively reduces the preparation time in the operation, but also utilizes a split structure, the bone cement coating which is given to the curved surface part 11 and the supporting part has sufficient solidification time before the operation, the hardness requirement is improved, and a good matching effect can be conveniently obtained in the operation, in the template structure, the embedded part 13 is provided with the groove body 52 and is matched and sealed with the open pore 53 of the curved surface part 11 by interpenetration, and the groove body 52 enables the inner part of the femur part 1 to form a relatively sealed cavity, in the front-level treatment, because the embedded component 13 and the curved component 11 are both coated, the cavity inside the embedded component is convenient to inject and fill bone cement mixed with antibiotics, the artificial knee joint revision replacement template obtained by using a 3D printing technology is used as a carrier of an occupier prepared by knee joint revision, specifically PEEK can be used as a printing material, the obtained carrier has higher impact strength and surface hardness, and good compression resistance can be obtained for the joint during occupational period (the general revision occupier needs to occupy 3-4 months at the joint of a patient), compared with the method of directly adopting bone cement to manufacture the occupier, the artificial knee joint revision template has better mechanical property, walking exercise and general weight bearing can be performed during the anti-infection period of the patient, and meanwhile, in the specific implementation, cavities filled with the antibiotic bone cement are arranged inside the femoral component 1 and the femoral component 1, the outer surface of the spacer is attached with the antibiotic bone cement, on one hand, the outer surface and the inner cavity can realize high-concentration permeation from the inner side to the outer side through the arrangement of the meshes 3, so that the key part of the spacer obtains an antibiotic environment with higher concentration, on the other hand, the meshes 3 can effectively improve the attachment performance of the antibiotic bone cement on the corresponding curved surface part 11 and the corresponding supporting surface part 21, and the mechanical performance of the spacer is improved;
in the process of operation, the femur component 1 prepared before the operation is connected with the femur part by adopting thick bone cement mixed with antibiotics, the tibia component 2 is installed and inserted at the tibia part, because the supporting column 22 is provided with a cavity used for slidably sleeving the lower side of the supporting surface component 21 and searching the adaptive position, the knee joint can complete better flexion and extension, the tibia component 2 is taken down, the thickness of the tibia component 2 is adjusted (the thickness is adjusted in a sliding way according to the marked scales and is reserved to be 3mm-5mm for installing the used bone cement for reserving the thickness difference after the implementation step (8)) and the bone cement liquid mixed with the antibiotics is used for filling the cavity inside the tibia component 2, the bone cement liquid mixed with the antibiotics is entirely immersed in the tibia component 2 for 5-10s (integral immersion coating, because the thickness of single immersion coating is generally 2-3mm, can be solidified into a hard structure within about 10 minutes generally, and can be conveniently operated, reduced preparation time during surgery), in the case of mounting the tibial component 2 in place on the tibia using a thick antibiotic-mixed bone cement and fitting the femoral component 1, the bearing surface component 21 and the bearing post 22 are of a separate construction, the size adjustment and the application of the cement layer are performed during the operation, so that a more precise matching effect can be obtained at the joint of the actual patient, thereby overcoming the error of data obtained by calibrating CT slices and ensuring normal and comfortable flexion and extension actions at the joints of patients, the method directly uses the template formed by 3D printing without performing reverse film manufacturing, reduces relative manufacturing cost, meanwhile, the obtained space occupying device has relatively good load resisting mechanical performance and has good positive significance for rehabilitation treatment of patients during space occupying.
Example 2:
in the embodiment, the bone cement liquid mixed with antibiotics and the thick bone cement mixed with antibiotics are added with 10-15% of deacetylated chitin fiber, based on research, the deacetylated chitin fiber can play an effective role in the aspects of controlling the sustained release of drugs, improving the solubility and the absorbability of drugs and the like, the defects of difficult control of drug concentration in an effective range, toxic and side effects, difficult access to pathological change parts, low drug utilization rate and the like caused by a conventional administration mode are overcome for the controlled release of drugs, the deacetylated chitin fiber has a good effect of preparing controlled release agents in the forms of granules, tablets, films, gels, microspheres and the like, has a certain enhanced penetration effect and an enzyme inhibition effect, and can reduce the two barrier effects of polypeptide drugs in a transport process, the chitosan fiber can be used as a drug absorption promoting factor, so that the chitosan fiber is added into bone cement, the transfer of antibiotics in the bone cement to the external environment can be effectively promoted, the transmission is stable, the environment concentration of the antibiotics at the knee joint is stabilized, the knee joint component is well resistant to infection, the chitosan fiber can be added into the bone cement, the tensile property of a bone cement coating in the curved surface component 11 and the supporting surface component 21 is improved, the stability of the bone cement coating in the friction process of the curved surface component 11 and the supporting surface component 21 is improved, the stability of the placeholder in the using process is further improved, the service life is prolonged, the prosthesis operation for renovation and renewal is guaranteed, the structure of the placeholder prepared by the method is smooth relative to the surface, the tissue is not easy to breed, the effective wall tissue proliferation leads to the improvement of the difficulty of debridement of the following operation, the improvement of the efficiency of the operation has important positive significance.
The above description of the present invention is intended to be illustrative. Various modifications, additions and substitutions for the specific embodiments described may occur to those skilled in the art without departing from the scope of the invention as defined in the accompanying claims.

Claims (7)

1. The utility model provides an artifical knee joint revision replacement template which characterized in that: comprises a femur component and a tibia component matched with the femur component;
the femur component comprises a curved surface component, a frame component and an embedded component, the two side ends of the frame component are in a grid shape, the curved surface component is matched with the front side surface of the frame component, the embedded component is matched with the rear side surface of the frame component, the end surfaces of the curved surface component and the embedded component are both provided with meshes, the frame component is provided with a first injection hole, the first injection hole is provided with a first hole plug,
the thighbone part include with holding surface part and the support column of curved surface part adaptation, the support column is provided with and is used for the slip cap to establish the cavity of holding surface part downside, the support column downside be provided with the fixed column, holding surface part and support column be provided with the mesh, the support column be provided with the second filling hole, the second filling hole adapt to the second hole stopper, the bottom of holding be provided with the installation component of shin bone fluting adaptation.
2. The prosthetic knee revision replacement template of claim 1, wherein: the supporting surface component middle part be provided with protruding spacing part, the frame part be provided with protruding spacing part adaptation's cell body, the cell body set up at the inside wall face of embedded part and wear to establish fixedly with the trompil of curved surface part.
3. The prosthetic knee revision replacement template of claim 1, wherein: the lateral part of holding surface part be provided with the scale mark, scale mark position and support column upper end along surface position adaptation.
4. A preparation method of an anti-infection spacer in artificial knee joint revision comprises the following steps: the method is characterized in that: the method comprises the following steps:
pre-preparation before operation:
(1) acquiring CT slice data of a patient, modeling according to size data acquired by CT slices and the artificial knee joint revision replacement template according to any one of claims 1 to 5, and respectively acquiring a curved surface part, a frame part, an embedded part, a supporting surface part and a printing part of a supporting column by utilizing modeling 3D printing;
(2) coating bone cement liquid mixed with antibiotics on the outer side surfaces of the curved surface part and the embedded part, wherein the coating thickness is 6-8mm, standing and solidifying, and polishing the outer side end surface of the curved surface part by using sand paper;
(3) respectively matching and installing the curved surface part and the embedded part with the frame part, and filling the thick bone cement mixed with antibiotics into the first injection hole by adopting an injection device and placing and solidifying the bone cement;
(4) after solidification is finished, the whole combined femoral component is immersed in bone cement liquid mixed with antibiotics for 5-10s, and then is drained and solidified;
(5) coating bone cement liquid mixed with antibiotics on the upper end surface of the supporting surface component and the outer wall surface of the supporting column, wherein the coating thickness is 6-8mm, standing and solidifying, and polishing the upper end surface of the supporting surface component by using sand paper;
(6) placing the prepared femoral component and the femoral component in a sterile constant temperature and humidity box for storage for later use;
preparing in operation:
(7) in the operation, a femur component is mounted on a femur part for adaptation, a tibia component is mounted on a tibia part for adaptation, the position of a main body at the lower end of a supporting face component on a supporting column is adjusted, so that a knee joint can obtain a good flexion-extension position at the position, and the scale position of the lower end of the supporting face component on the supporting column is recorded;
(8) and taking down the tibial component part, adjusting the lower end of the bearing surface part to a scale position, injecting thick bone cement mixed with antibiotics into the first injection hole by using an injection device, completely immersing the tibial component part for 5-10s, taking out, draining, solidifying, and then installing to the tibial part and matching with the femoral component.
5. The method for preparing an anti-infection spacer in the revision of artificial knee joint according to claim 1, characterized in that: 10-15% of deacetylated chitin fiber is added into the bone cement liquid mixed with the antibiotics and the thick bone cement mixed with the antibiotics.
6. The method for preparing an anti-infection spacer in the revision of artificial knee joint according to claim 1, characterized in that: the specification of the sand paper adopts 800-1200 meshes.
7. The method for preparing an anti-infection spacer in the revision of artificial knee joint according to claim 1, characterized in that: the 3D printing adopts PEEK as a raw material.
CN202210303923.9A 2022-03-25 2022-03-25 Preparation method of artificial knee joint revision replacement template and spacer Pending CN114712039A (en)

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Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4283799A (en) * 1979-09-10 1981-08-18 Massachusetts Institute Of Technology Pre-coated body implant
CN105193522A (en) * 2015-10-26 2015-12-30 北京威高亚华人工关节开发有限公司 Capitulum radius replacement prosthesis
CN112294502A (en) * 2020-10-30 2021-02-02 四川大学华西医院 Assembly type total intervertebral disc prosthesis based on 3D printing technology and manufacturing method thereof
CN213489561U (en) * 2020-09-24 2021-06-22 中国科学技术大学附属第一医院 Anti-infection joint spacer

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4283799A (en) * 1979-09-10 1981-08-18 Massachusetts Institute Of Technology Pre-coated body implant
CN105193522A (en) * 2015-10-26 2015-12-30 北京威高亚华人工关节开发有限公司 Capitulum radius replacement prosthesis
CN213489561U (en) * 2020-09-24 2021-06-22 中国科学技术大学附属第一医院 Anti-infection joint spacer
CN112294502A (en) * 2020-10-30 2021-02-02 四川大学华西医院 Assembly type total intervertebral disc prosthesis based on 3D printing technology and manufacturing method thereof

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