CN116602797A - Conical self-locking partial femoral head replacement device capable of customizing reserved femoral head in personalized manner - Google Patents
Conical self-locking partial femoral head replacement device capable of customizing reserved femoral head in personalized manner Download PDFInfo
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- CN116602797A CN116602797A CN202310898726.0A CN202310898726A CN116602797A CN 116602797 A CN116602797 A CN 116602797A CN 202310898726 A CN202310898726 A CN 202310898726A CN 116602797 A CN116602797 A CN 116602797A
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- 210000000988 bone and bone Anatomy 0.000 claims abstract description 80
- 238000000034 method Methods 0.000 claims abstract description 12
- 230000001338 necrotic effect Effects 0.000 claims abstract description 9
- 230000008569 process Effects 0.000 claims abstract description 9
- 210000002436 femur neck Anatomy 0.000 claims abstract description 7
- 239000002639 bone cement Substances 0.000 claims description 13
- 229910001257 Nb alloy Inorganic materials 0.000 claims description 11
- GFUGMBIZUXZOAF-UHFFFAOYSA-N niobium zirconium Chemical compound [Zr].[Nb] GFUGMBIZUXZOAF-UHFFFAOYSA-N 0.000 claims description 11
- 230000017074 necrotic cell death Effects 0.000 claims description 7
- MCMNRKCIXSYSNV-UHFFFAOYSA-N Zirconium dioxide Chemical compound O=[Zr]=O MCMNRKCIXSYSNV-UHFFFAOYSA-N 0.000 claims description 6
- 239000000956 alloy Substances 0.000 claims description 5
- 238000013461 design Methods 0.000 claims description 5
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- 238000010146 3D printing Methods 0.000 claims description 3
- RTAQQCXQSZGOHL-UHFFFAOYSA-N Titanium Chemical compound [Ti] RTAQQCXQSZGOHL-UHFFFAOYSA-N 0.000 claims description 3
- 230000007547 defect Effects 0.000 claims description 3
- 238000003384 imaging method Methods 0.000 claims description 3
- 239000010936 titanium Substances 0.000 claims description 3
- 229910052719 titanium Inorganic materials 0.000 claims description 3
- MTHLBYMFGWSRME-UHFFFAOYSA-N [Cr].[Co].[Mo] Chemical compound [Cr].[Co].[Mo] MTHLBYMFGWSRME-UHFFFAOYSA-N 0.000 claims description 2
- 239000000919 ceramic Substances 0.000 claims description 2
- 239000007921 spray Substances 0.000 claims description 2
- 239000004576 sand Substances 0.000 claims 1
- 230000007774 longterm Effects 0.000 abstract description 6
- 206010028851 Necrosis Diseases 0.000 description 6
- 230000009286 beneficial effect Effects 0.000 description 3
- 201000010099 disease Diseases 0.000 description 3
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 3
- 208000007875 Femur Head Necrosis Diseases 0.000 description 2
- 230000008901 benefit Effects 0.000 description 2
- 238000010586 diagram Methods 0.000 description 2
- 238000004880 explosion Methods 0.000 description 2
- 238000010438 heat treatment Methods 0.000 description 2
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- 238000002513 implantation Methods 0.000 description 2
- 208000014674 injury Diseases 0.000 description 2
- 239000011224 oxide ceramic Substances 0.000 description 2
- RVTZCBVAJQQJTK-UHFFFAOYSA-N oxygen(2-);zirconium(4+) Chemical compound [O-2].[O-2].[Zr+4] RVTZCBVAJQQJTK-UHFFFAOYSA-N 0.000 description 2
- 239000011148 porous material Substances 0.000 description 2
- 238000011541 total hip replacement Methods 0.000 description 2
- 230000008733 trauma Effects 0.000 description 2
- 229910001928 zirconium oxide Inorganic materials 0.000 description 2
- 208000007848 Alcoholism Diseases 0.000 description 1
- 229910000684 Cobalt-chrome Inorganic materials 0.000 description 1
- 208000015813 Familial avascular necrosis of femoral head Diseases 0.000 description 1
- ZOKXTWBITQBERF-UHFFFAOYSA-N Molybdenum Chemical compound [Mo] ZOKXTWBITQBERF-UHFFFAOYSA-N 0.000 description 1
- 206010031264 Osteonecrosis Diseases 0.000 description 1
- 208000001132 Osteoporosis Diseases 0.000 description 1
- 208000037099 Prosthesis Failure Diseases 0.000 description 1
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/32—Joints for the hip
- A61F2/36—Femoral heads ; Femoral endoprostheses
- A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
-
- 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
- A61F2/32—Joints for the hip
- A61F2/36—Femoral heads ; Femoral endoprostheses
- A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
- A61F2002/3611—Heads or epiphyseal parts of femur
- A61F2002/3623—Non-spherical heads
-
- 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
- A61F2/32—Joints for the hip
- A61F2/36—Femoral heads ; Femoral endoprostheses
- A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
- A61F2002/3654—Connections of heads directly to shafts
-
- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
- Y02P—CLIMATE CHANGE MITIGATION TECHNOLOGIES IN THE PRODUCTION OR PROCESSING OF GOODS
- Y02P10/00—Technologies related to metal processing
- Y02P10/25—Process efficiency
Abstract
The application provides a conical self-locking partial femoral head replacement device capable of customizing and retaining a femoral head in a personalized way, and relates to the field of medical appliances. The replacement device comprises a base and a joint prosthesis; the base comprises a bone nail and an auxiliary fixing piece, wherein the bone nail is provided with a proximal end and a distal end, and the auxiliary fixing piece and the proximal end of the bone nail are integrally formed; the joint prosthesis is in Morse self-locking detachable connection with the auxiliary fixing piece. The distal end of the bone nail is driven into the femoral neck intramedullary cavity through the top of the femoral head, and the replacement device is fixed on the femoral head through the partial conical osteotomy. The auxiliary fixing piece can increase the contact surface between the base and the femoral head, can ensure enough initial stability of axial and rotation under the condition that the joint prosthesis only replaces a necrotic part of the femoral head, does not shift in the long-term use process, and effectively prevents the replacement device from sinking. The joint prosthesis only replaces the resected part of the necrotic femoral head, retains more normal femoral head bone quantity, has small wound and has no obvious influence on supporting and bearing of the femoral head.
Description
Technical Field
The application relates to the field of medical appliances, in particular to a conical self-locking partial femoral head replacement device capable of customizing and retaining a femoral head in a personalized way.
Background
Ischemic necrosis of femoral head (Avascular necrosis of femoral head, ANFH) is simply called femoral head necrosis, which is one of the common diseases of orthopaedics, and is mostly caused by the past patients with hip trauma, a large amount of glucocorticoid applied for a long time or alcoholism, and the patients may be ill at all ages. The disease is about 80 ten thousand people each year, and is a main disease causing disability of middle-aged and young people. The international society of osteonecrosis and bone microcirculation (Association Research Circulation Osseous, ARCO) divides femoral head necrosis into stages i, II, III and iv, and the current treatment methods for stages II and III of femoral head necrosis include hip surface replacement, semi-hip replacement or total hip replacement, etc.
Wherein, the hip joint surface replacement is to remove the cartilage surface of the whole femoral head surface including the normal part, and the adverse events such as long-term femoral head prosthesis sinking and prosthesis loosening are frequent. Semi-hip replacement and total hip replacement patients are severely traumatized, resected a large portion of bone mass including the femoral head and neck, and for young patients with high mobility, the initial stability is poor, the risk is greater, and the cost is high due to the small amount of supporting prosthesis bone mass during future revision.
In short, the existing treatment methods have the problems of low bone retention and poor long-term stability.
Disclosure of Invention
The application aims to solve the problems of small reserved bone quantity, poor long-term stability and repair operation risks of the existing treatment method, and provides a conical self-locking partial femoral head replacement device for customizing reserved femoral heads in a personalized way.
The application provides the following technical scheme:
a conical self-locking partial femoral head replacement device for customizing reserved femoral heads in a personalized way, which comprises a base and a joint prosthesis;
the base comprises a bone nail and an auxiliary fixing piece, wherein the bone nail is provided with a proximal end and a distal end which is nailed into a femoral neck medullary cavity, the auxiliary fixing piece and the proximal end of the bone nail are integrally formed, and the auxiliary fixing piece is used for increasing the contact surface between the base and a femoral head so as to enhance the support of the femoral head to the base;
the joint prosthesis is in Morse self-locking detachable connection with the auxiliary fixing piece and is used for replacing the resected part of the necrotic femoral head.
As a further alternative to the tapered self-locking partial femoral head replacement device of the retaining femoral head, the auxiliary fixture has a first surface and a second surface that contact the tapered osteotomy femoral head;
the first surface is positioned on one side of the auxiliary fixing piece facing the distal end of the bone nail, the first surface is arranged in a triangle shape, and the first surface is used for supporting the joint prosthesis and preventing the base from sinking;
the second surfaces are arranged on two sides of the auxiliary fixing piece along the circumferential direction of the proximal end of the bone nail in pairs, the second surfaces are arranged in a triangular shape, and the second surfaces are used for preventing the base from rotating laterally.
As a further alternative to the tapered self-locking partial femoral head replacement device for retaining a femoral head, the bone pin is of a cylindrical hollow structure, the distal end of the bone pin is arranged in a tapered shape, and the side surface of the proximal end of the bone pin is connected with the auxiliary fixing member.
As a further alternative to the tapered self-locking partial femoral head replacement device of the retaining femoral head, the joint prosthesis has a convex articular surface, which is located on the side of the joint prosthesis facing away from the auxiliary fixture, and a flange is provided circumferentially at the edge of the articular surface.
As a further alternative scheme of the femoral head replacement device with the tapered self-locking part for retaining the femoral head, the auxiliary fixing piece is provided with a tapered boss, the joint prosthesis is provided with a groove matched with the boss, and the boss is in plug-in fit with the groove to form tapered Morse self-locking.
As a further alternative scheme of the conical self-locking partial femoral head replacement device for the reserved femoral head, the joint prosthesis is formed by 3D printing zirconium-niobium alloy, and a zirconium oxide ceramic interface is formed on the surface of the joint prosthesis through heat treatment; or alternatively, the process may be performed,
the joint prosthesis is processed by adopting cobalt-chromium-molybdenum materials or zirconium-niobium alloy materials.
As a further alternative to the tapered self-locking partial femoral head replacement device for retaining a femoral head, a surface of the joint prosthesis facing away from the base is polished to form a wear-resistant layer, and a surface of the joint prosthesis facing the base and the side thereof are sandblasted to form a frosted layer.
As a further alternative to the tapered self-locking partial femoral head replacement device of the retaining femoral head, the surface of the joint prosthesis facing away from the base is provided with a spherical cambered surface; or alternatively, the process may be performed,
firstly reconstructing a three-dimensional model according to patient imaging data, and then reconstructing the outline dimension of the surface of the joint prosthesis, which is away from the base, according to the defect necrosis area of the femoral head.
As a further alternative to the tapered self-locking partial femoral head replacement device that retains the femoral head, the bone interface of the base is of a microporous spray design, forming a microporous layer; or alternatively, the process may be performed,
the bone interface of the base adopts a 3D printing titanium micropore design, and a micropore layer is formed.
As a further alternative scheme of the conical self-locking part femoral head replacement device for the reserved femoral head, a through hole is formed in the bone nail, the through hole penetrates through a long shaft of the bone nail, a bone cement overflow hole is formed in the side face of the bone nail, a connecting hole is formed in the proximal end of the bone nail, the connecting hole is communicated with the bone cement overflow hole through the through hole, and a positioning notch is formed in the wall of the connecting hole.
The embodiment of the application has the following beneficial effects:
when the conical self-locking part femoral head replacement device for retaining the femoral head is used, the distal end of the bone nail is nailed into the femoral neck medullary cavity through the top of the femoral head, and the auxiliary fixing piece is fixedly connected with the proximal end of the bone nail, and the joint prosthesis is detachably connected with the auxiliary fixing piece, so that the conical self-locking part femoral head replacement device for retaining the femoral head can be fixed on the femoral head which is subjected to partial conical osteotomy. The auxiliary fixing piece can increase the contact surface between the base and the femoral head, can ensure enough initial stability of axial and rotation under the condition that only a necrotic part of the femoral head is replaced by the joint prosthesis, is not easy to shift in the long-term use process, and effectively prevents the replacement device from sinking. On the basis, the joint prosthesis only replaces the resected part of the necrotic femoral head, is beneficial to retaining more normal femoral head bone quantity, has small wound, and does not influence and change the supporting and bearing of the femoral head.
In order to make the above objects, features and advantages of the present application more comprehensible, preferred embodiments accompanied with figures are described in detail below.
Drawings
In order to more clearly illustrate the technical solutions of the embodiments of the present application, the drawings that are needed in the embodiments will be briefly described below, it being understood that the following drawings only illustrate some embodiments of the present application and therefore should not be considered as limiting the scope, and other related drawings may be obtained according to these drawings without inventive effort for a person skilled in the art.
Fig. 1 is a schematic diagram showing the overall structure of a tapered self-locking partial femoral head replacement device for personalized customization of a reserved femoral head according to an embodiment of the present application;
figure 2 illustrates a personalized customization of a tapered self-locking partial femoral head replacement device retaining a femoral head provided in an embodiment of the present applicationExplosion of an explosionA schematic diagram;
fig. 3 is a schematic view of a base in a femoral head replacement device with a tapered self-locking portion for personalized custom retaining of a femoral head according to an embodiment of the present application;
FIG. 4 illustrates a schematic cross-sectional view of a base in a tapered self-locking partial femoral head replacement device for personalized retaining of a femoral head provided by an embodiment of the present application;
FIG. 5 illustrates a schematic view of the configuration of a joint prosthesis in a tapered self-locking partial femoral head replacement device for personalized retaining of a femoral head provided in an embodiment of the present application;
fig. 6 shows a schematic view of the structure of a joint prosthesis in another view of a tapered self-locking partial femoral head replacement device for personalized retaining of a femoral head according to an embodiment of the present application.
Description of main reference numerals:
100-base; 110-bone nails; 111-proximal end; 112-distal; 113-bone cement overflow holes; 114-connecting holes; 114 a-positioning notch; 115-a through hole; 120-auxiliary fixing pieces; 121-a first surface; 122-a second surface; 123-a third surface; 124-boss; 200-joint prosthesis; 210-articular surface; 220-back side; 221-grooves; 230-flange; 240-auxiliary fixing portion.
Detailed Description
Embodiments of the present application are described in detail below, examples of which are illustrated in the accompanying drawings, wherein like or similar reference numerals refer to like or similar elements or elements having like or similar functions throughout. The embodiments described below by referring to the drawings are illustrative only and are not to be construed as limiting the application.
It will be understood that when an element is referred to as being "fixed to" another element, it can be directly on the other element or intervening elements may also be present. When an element is referred to as being "connected" to another element, it can be directly connected to the other element or intervening elements may also be present. In contrast, when an element is referred to as being "directly on" another element, there are no intervening elements present. The terms "vertical," "horizontal," "left," "right," and the like are used herein for illustrative purposes only.
In the present application, unless explicitly specified and limited otherwise, the terms "mounted," "connected," "secured," and the like are to be construed broadly, and may be, for example, fixedly connected, detachably connected, or integrally formed; can be mechanically or electrically connected; can be directly connected or indirectly connected through an intermediate medium, and can be communicated with the inside of two elements or the interaction relationship of the two elements. The specific meaning of the above terms in the present application can be understood by those of ordinary skill in the art according to the specific circumstances.
Furthermore, the terms "first," "second," and the like, are used for descriptive purposes only and are not to be construed as indicating or implying a relative importance or implicitly indicating the number of technical features indicated. Thus, a feature defining "a first" or "a second" may explicitly or implicitly include one or more such feature. In the description of the present application, the meaning of "a plurality" is two or more, unless explicitly defined otherwise.
Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this application belongs. The terminology used in the description of the templates herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the application. The term "and/or" as used herein includes any and all combinations of one or more of the associated listed items.
Examples
Referring to fig. 1 and 2 together, the present embodiment provides a conical self-locking partial femoral head replacement device for personalized customization of the reserved femoral head, hereinafter referred to as "replacement device". The replacement device consists of a base 100 and a joint prosthesis 200, wherein the base 100 is fixed on a femoral head, the joint prosthesis 200 is installed on the base 100, and the joint prosthesis 200 is used for replacing a resected part of a necrotic femoral head so as to form a movable joint with a normal femoral head and an acetabular fossa.
Referring to fig. 3 and 4, specifically, the base 100 is composed of a bone screw 110 and an auxiliary fixing member 120.
Bone screw 110 has a proximal end 111 and a distal end 112, and is generally cylindrically configured. The distal end 112 of the bone pin 110 is conically configured for fixation to the femoral head by driving the pin through the femoral head into the intramedullary canal of the femoral neck. The auxiliary fixture 120 is coupled to the side of the proximal end 111 of the bone screw 110 for increasing the contact surface of the seat 100 with the femoral head to enhance the support of the femoral head to the seat 100. In addition, the joint prosthesis 200 is detachably coupled to the auxiliary fixture 120 in a Morse self-locking manner, thereby being mounted on the base 100.
The fact that the joint prosthesis 200 is in Morse self-locking and detachable connection with the auxiliary fixing piece 120 means that the joint prosthesis 200 and the auxiliary fixing piece 120 are connected through the Morse taper self-locking principle, and the joint prosthesis has the advantage of being capable of being freely detached and installed.
Alternatively, the bone nails 110 may have different gauges, which may be 10mm, 11mm, 12mm, 13mm, or 14mm in diameter, and may be 60-80mm in length, with the lengths of the bone nails 110 of the respective gauges differing in sequence by 1mm.
In some embodiments, bone cement escape holes 113 are provided in bone pins 110. For the patient with osteoporosis, the bone cement can be injected into the bone cement overflow hole 113 to play a role in auxiliary fixation.
Alternatively, the bone cement escape holes 113 are provided at the distal end 112 of the bone screw 110, and the bone cement escape holes 113 are provided in plurality, the plurality of bone cement escape holes 113 being aligned in the axial direction of the bone screw 110 and intersecting obliquely.
Further, the proximal end 111 of the bone screw 110 is provided with a connecting hole 114. The connecting hole 114 is arranged along the axial direction of the bone screw 110, and the hole wall of the connecting hole 114 is used for connecting with a holder, so that the implantation operation is convenient.
In addition, the bone screw 110 is provided with a through hole 115, which is hollow. The through hole 115 is provided along the axial direction of the bone screw 110, penetrating the long axis of the bone screw 110. One end of the through hole 115 communicates with the connecting hole 114, and the other end of the through hole 115 penetrates to the distal end 112 of the bone screw 110.
The bone cement escape hole 113 communicates with the sidewall of the through hole 115, and thus communicates with the connection hole 114. In use, bone cement is injected from the proximal end 111 to the distal end 112 of the bone screw 110 via the connecting hole 114.
Further, the wall of the connecting hole 114 is provided with a positioning notch 114a, which cooperates with a protrusion on the holder when the holder is connected, thereby performing a positioning function.
In some embodiments, the auxiliary fixture 120 is provided as a triangular cone having a first surface 121 and a second surface 122 that contact the femoral head after a tapered osteotomy.
Wherein the first surface 121 is located on a side of the auxiliary fixing member 120 facing the distal end 112 of the bone screw 110, the first surface 121 is arranged in a triangle shape, and the first surface 121 is used for supporting the joint prosthesis 200 and preventing the base 100 from sinking.
The second surfaces 122 are disposed in pairs on both sides of the auxiliary fixing member 120 in the circumferential direction of the proximal end of the bone screw 110, the second surfaces 122 are disposed in a triangle shape, and the second surfaces 122 are used to prevent the base 100 from being rotated laterally.
In use, the auxiliary fixing member 120 is embedded in the femoral head and contacts the femoral head through the first surface 121 and the second surface 122, so that the contact surface between the base 100 and the femoral head is effectively increased, the initial stability of the fixing axial direction and the rotation of the replacement device is improved, and the looseness rate of the replacement device is reduced.
Optionally, the auxiliary fixing member 120 is located on the outer side of the proximal end 111 of the bone screw 110 and is integrally formed with the bone screw 110.
Further, the bone interface of the base 100 is provided with a microporous layer. The microporous layer facilitates bone ingrowth and thus better integration with the femoral head, increasing the stability of the replacement device.
The bone interface of the base 100 refers to the contact surface between the base 100 and the femoral head, and includes the first surface 121, the second surface 122, the outer side surface of the bone nail 110, and the distal end 112 of the bone nail 110.
In some embodiments, the microporous layer has a porosity of 50% to 90%, and the micropores in the microporous layer have a pore size of 250-850 μm.
Alternatively, the microporous layer has a porosity of any of 50%, 60%, 70%, 80%, 90%, or 50% -90%.
Alternatively, the pore size of the micropores is any of 250 μm, 350 μm, 450 μm, 550 μm, 650 μm, 750 μm, 850 μm, or 250-850 μm.
In some embodiments, the bone interface of the base 100 is designed with a microporous spray coating to form the microporous layer described above.
In other embodiments, the bone interface of the base 100 may also be configured with a 3D printed titanium microporous design to form the microporous layer described above.
Referring to fig. 5 and 6 together, in particular, the joint prosthesis 200 has a convex articular surface 210 and a back surface 220 opposite the articular surface 210. Wherein the articular surface 210 faces away from the base 100 and the back surface 220 faces toward the base 100, and the back surface 220 of the articular prosthesis 200 contacts and couples with the auxiliary fixing member 120.
Referring to fig. 3, the auxiliary fixing member 120 further has a third surface 123, the third surface 123 is located on a side of the auxiliary fixing member 120 facing away from the bone screw 110, the third surface 123 is connected to the first surface 121 and the second surface 122 at the same time, and the third surface 123 is disposed obliquely with respect to the axial direction of the auxiliary fixing member 120.
Accordingly, a localized area of the posterior surface 220 of the joint prosthesis 200 conforms to the third surface 123. When the joint prosthesis 200 receives pressure from the acetabular fossa, a component force of the pressure in the axial direction of the bone nail 110 is directed to the femoral head, so that the bone nail 110 can be more stably driven into the femoral neck intramedullary canal, thereby effectively preventing the replacement device from falling off.
In some embodiments, the articular surface 210 of the joint prosthesis 200 is a standard size spherical surface having different specifications that can accommodate patients with different necrosis collapse ranges.
Alternatively, the diameter of the articular surface 210 may be 38-58mm, with the diameters of the articular surfaces 210 of the various gauges differing in turn by 0.5mm.
Alternatively, the angle of the articular surfaces 210 may be 90-120, with the angles of the articular surfaces 210 of each gauge differing by 1.
In other embodiments, the three-dimensional model may be reconstructed according to the patient imaging data, and then the external dimension of the articular surface 210 may be reconstructed according to the defect necrosis area of the femoral head, so as to achieve individual customization, ensure smooth connection between the articular prosthesis 200 and the bone surface reserved by the femoral head, avoid forming high and low steps between the articular surface 210 and the reserved bone surface, and further reduce wear.
In some embodiments, a tapered boss 124 is provided on the third surface 123 of the auxiliary fixture 120. The axis of the boss 124 is perpendicular to the third surface 123, and the tapered tip of the boss 124 faces the joint prosthesis 200. Accordingly, the back 220 of the joint prosthesis 200 is provided with a recess 221 adapted to the boss 124, the boss 124 being in a plug-in fit with the recess 221.
In addition, the taper of the boss 124 and the recess 221 is Morse taper. The boss 124 and the recess 221 taper Morse self-lock, thereby achieving Morse taper self-locking between the joint prosthesis 200 and the auxiliary fixture 120.
In use, the joint prosthesis 200 is fastened to the base 100, and the boss 124 is inserted into the groove 221, thereby completing the installation of the joint prosthesis 200.
When the joint prosthesis 200 receives pressure from the acetabular fossa, the pressure is transferred to the junction of the boss 124 and the recess 221, so that the boss 124 has a tendency to continue to be inserted into the recess 221, thereby making the connection between the joint prosthesis 200 and the auxiliary fixture 120 more stable, and facilitating the size adjustment according to the anatomy of the patient during surgery.
Alternatively, the taper of the boss 124 and the recess 221 is 12/14 Morse taper.
Further, a flange 230 is provided at the rim of the articular surface 210 of the articular prosthesis 200. The flange 230 is disposed along the circumference of the articular surface 210, so that not only can the contact area between the articular surface 210 and the reserved bone surface be increased, but also an effective support can be formed, the sinking of the replacement device after implantation is avoided, and the step between the articular surface 210 and the reserved bone surface is prevented.
Alternatively, the flange 230 has a width of 2mm.
Further, the joint prosthesis 200 has a tapered auxiliary fixation 240. The axis of the auxiliary fixing portion 240 coincides with the axis of the bone screw 110, the large end face of the auxiliary fixing portion 240 constitutes a part of the joint face 210, and the tapered end of the auxiliary fixing portion 240 abuts against the proximal end 111 face of the bone screw 110.
The diameter of the auxiliary fixing portion 240 gradually increases in a direction away from the bone screw 110, and the displacement device is prevented from sinking.
Further, the articular surface 210 of the articular prosthesis 200 is provided with a wear layer and the area of the posterior surface 220 other than the area in contact with the third surface 123 is provided with a sanding layer.
The wear layer can slow down wear of the acetabular fossa to the joint prosthesis 200, extend the service life of the joint prosthesis 200, and the abrasive layer can better engage the joint prosthesis 200 with the femoral head.
In some embodiments, the joint prosthesis 200 is 3D printed from a zirconium niobium alloy and then heat treated to form a high hardness zirconia ceramic interface on its surface. Wherein, the zirconia layer on the surface and the zirconium-niobium alloy are fused into a whole, and the problem of coating falling does not exist.
On this basis, the joint surface 210 is polished to form a wear-resistant layer having a low friction coefficient. The side and back 220 of the joint prosthesis 200 are sandblasted to form a sanding layer.
In other embodiments, the joint prosthesis 200 is fabricated from cobalt chrome molybdenum material or zirconium niobium alloy material. When the zirconium-niobium alloy material is adopted, the processing is completed by heat treatment, so that a zirconium oxide ceramic interface is formed on the surface of the zirconium-niobium alloy material.
Also, on this basis, the joint surface 210 is polished and the back surface 220 is sandblasted.
It should be noted that the biocompatibility of the zirconium niobium alloy is better than that of the cobalt chromium molybdenum alloy. The material from which the joint prosthesis 200 is fabricated is preferably a zirconium niobium alloy, which reduces the risk of metal allergies.
In summary, with the replacement device described above, the distal end 112 of the bone pin 110 is driven into the femoral neck intramedullary canal via the femoral head, and the replacement device is secured to the femoral head. Wherein, the auxiliary fixing member 120 can increase the contact surface between the base 100 and the femoral head, and can ensure sufficient initial stability of axial and rotation even in the case that the joint prosthesis 200 only replaces a necrotic part of the femoral head, and is not easy to shift in the long-term use process, thereby effectively preventing the replacement device from sinking. On this basis, the joint prosthesis 200 only replaces the necrotic part of the femoral head, is beneficial to retaining more normal femoral head bones, has small trauma and does not influence the supporting and bearing of the femoral head.
Any particular values in all examples shown and described herein are to be construed as merely illustrative and not a limitation, and thus other examples of exemplary embodiments may have different values.
It should be noted that: like reference numerals and letters denote like items in the following figures, and thus once an item is defined in one figure, no further definition or explanation thereof is necessary in the following figures.
The above examples merely represent a few embodiments of the present application, which are described in more detail and are not to be construed as limiting the scope of the present application. It should be noted that it will be apparent to those skilled in the art that several variations and modifications can be made without departing from the spirit of the application, which are all within the scope of the application.
Claims (10)
1. A conical self-locking partial femoral head replacement device for customizing reserved femoral heads in a personalized way, which is characterized by comprising a base and a joint prosthesis;
the base comprises a bone nail and an auxiliary fixing piece, wherein the bone nail is provided with a proximal end and a distal end which is nailed into a femoral neck medullary cavity, the auxiliary fixing piece and the proximal end of the bone nail are integrally formed, and the auxiliary fixing piece is used for increasing the contact surface between the base and a femoral head so as to enhance the support of the femoral head to the base;
the joint prosthesis is in Morse self-locking detachable connection with the auxiliary fixing piece and is used for replacing the resected part of the necrotic femoral head.
2. The tapered self-locking partial femoral head replacement device of claim 1, wherein the auxiliary fixation has a first surface and a second surface in contact with the tapered osteotomy femoral head;
the first surface is positioned on one side of the auxiliary fixing piece facing the distal end of the bone nail, the first surface is arranged in a triangle shape, and the first surface is used for supporting the joint prosthesis and preventing the base from sinking;
the second surfaces are arranged on two sides of the auxiliary fixing piece along the circumferential direction of the proximal end of the bone nail in pairs, the second surfaces are arranged in a triangular shape, and the second surfaces are used for preventing the base from rotating laterally.
3. The tapered self-locking partial femoral head replacement device of claim 1, wherein the bone pin is a cylindrical hollow structure, the distal end of the bone pin is conically configured, and the proximal side of the bone pin is connected to the auxiliary fixture.
4. The tapered self-locking partial femoral head replacement device of claim 1, wherein the articular prosthesis has a convex articular surface on a side of the articular prosthesis facing away from the auxiliary fixture, the edges of the articular surface being circumferentially provided with a flange.
5. The tapered self-locking partial femoral head replacement device of any one of claims 1-4, wherein the auxiliary fixture is provided with a tapered boss, the joint prosthesis is provided with a groove matched with the boss, and the boss is in plug-in fit with the groove to form a tapered morse self-locking.
6. The tapered self-locking partial femoral head replacement device retaining a femoral head according to any one of claims 1 to 4, wherein the joint prosthesis is 3D printed from a zirconium niobium alloy, and the surface of the joint prosthesis is heat treated to form a zirconia ceramic interface; or alternatively, the process may be performed,
the joint prosthesis is processed by adopting cobalt-chromium-molybdenum materials or zirconium-niobium alloy materials.
7. The tapered self-locking partial femoral head replacement device of claim 6, wherein a surface of the articular prosthesis facing away from the base is polished to form a wear layer, and a side of the articular prosthesis and a surface facing the base are sandblasted to form a sand layer.
8. The tapered self-locking partial femoral head replacement device retaining a femoral head of any one of claims 1-4, wherein a surface of the articular prosthesis facing away from the base is provided as a spherical surface; or alternatively, the process may be performed,
firstly reconstructing a three-dimensional model according to patient imaging data, and then reconstructing the outline dimension of the surface of the joint prosthesis, which is away from the base, according to the defect necrosis area of the femoral head.
9. The tapered self-locking partial femoral head replacement device retaining a femoral head of any one of claims 1-4, wherein a bone interface of the base is of a microporous spray design, formed with a microporous layer; or alternatively, the process may be performed,
the bone interface of the base adopts a 3D printing titanium micropore design, and a micropore layer is formed.
10. The tapered self-locking partial femoral head replacement device for retaining a femoral head according to claim 1, wherein the bone nail is provided with a through hole, the through hole penetrates through the long shaft of the bone nail, the side surface of the bone nail is provided with a bone cement overflow hole, the proximal end of the bone nail is provided with a connecting hole, the connecting hole is communicated with the bone cement overflow hole through the through hole, and the hole wall of the connecting hole is provided with a positioning notch.
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|---|---|---|---|
| CN202310898726.0A CN116602797B (en) | 2023-07-21 | 2023-07-21 | Conical self-locking partial femoral head replacement device capable of customizing reserved femoral head in personalized manner |
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| CN202310898726.0A CN116602797B (en) | 2023-07-21 | 2023-07-21 | Conical self-locking partial femoral head replacement device capable of customizing reserved femoral head in personalized manner |
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| CN116602797B CN116602797B (en) | 2023-11-14 |
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|---|---|
| CN116602797B (en) | 2023-11-14 |
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