CN116887787A - 具有可拆卸锥形中心柱的互锁反向髋关节假体 - Google Patents

具有可拆卸锥形中心柱的互锁反向髋关节假体 Download PDF

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Publication number
CN116887787A
CN116887787A CN202180093172.6A CN202180093172A CN116887787A CN 116887787 A CN116887787 A CN 116887787A CN 202180093172 A CN202180093172 A CN 202180093172A CN 116887787 A CN116887787 A CN 116887787A
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CN
China
Prior art keywords
cup
hip prosthesis
acetabular
prosthesis system
reverse hip
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
CN202180093172.6A
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English (en)
Inventor
扎菲尔·特曼尼尼
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Joint Innovation Technology LLC
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Joint Innovation Technology LLC
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Filing date
Publication date
Application filed by Joint Innovation Technology LLC filed Critical Joint Innovation Technology LLC
Publication of CN116887787A publication Critical patent/CN116887787A/zh
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Abstract

互锁反向髋关节假体，其包括髋臼杯，所述髋臼杯在被植入髋臼腔的杯的中心部分具有开口髋臼。所述开口具有圆形延伸壁，其突出到所述杯的凹入部分中的距离至少等于所述开口的直径。所述杯的向内延伸提供了适合接收髋臼球的凸形莫氏锥度柱的凹形莫氏锥度。植入所述髋臼杯后，外科医生可以使用几个螺钉轻松地将所述髋臼杯固定到髋臼骨上，而不会受到中心钉的干扰(如先前的植入物一样)。然后经由中心莫氏锥度将股骨球连接到所述杯上。

Description

具有可拆卸锥形中心柱的互锁反向髋关节假体
发明背景
本发明涉及髋关节假体，并且更具体地，涉及具有髋臼部件的互锁反向髋关节假体，所述髋臼部件具有可拆卸的中心莫氏锥度中心钉，用于便于多个固定髋臼螺钉的插入。
虽然可以理解几种髋关节植入物已经普遍使用多年，但需要这样一种设计，所述设计便于在不同角度插入多个固定螺钉而不干扰中心柱。
发明概述
本发明提供了新型互锁反向髋关节假体，其具有构造为一体的髋臼球和中心柱。所述柱牢固地并且同心地连接到髋臼杯的中心顶端圆形开口，并且经由莫氏锥度固定。将髋臼杯植入并压入至由外科医生在骨盆骨中构造的髋臼窝中，并且由一个或多个互锁螺钉通过髋臼杯中的一个或多个开口牢固地固定。在一些实施方案中，这些互锁螺钉被生物相容的可吸收螺柱代替。随后，将中心柱插入到中心顶端开口中，并经由莫氏锥度牢固地压紧并保持在适当位置。然后将股骨部件插入并压入到股骨骨髓管中，其已由外科医生使用合适尺寸的铰刀制备并挖空。注意，多个互锁螺钉的插入是通过移除可能会干扰螺钉在适当的角度插入的中心柱来促进。在行走过程中，关节股骨杯边缘或唇缘会顺应性地集中滑动到位于髋臼球和髋臼杯之间的互锁空间中。对本领域技术人员来说显而易见的是，本发明的几何构型使得当运动范围增加时股骨杯很难脱臼，因为它被限制在髋臼杯和髋臼球之间的锁定空间中。
此外，因为两个部件的关节连接表面在100％的时间内完全接触，很明显，这将改善重量分布，减少接触表面的磨损，并且减少在关节中释放的磨损颗粒的数量。后者对关节的正常功能非常不利，经常导致植入物部件的骨溶解和松动。本发明的新特征是中心柱是可拆卸的并且不会机械地冲击或干扰互锁固定螺钉的插入。这产生了一种新的反向髋关节植入物，当单独或以任何组合考虑时，该反向髋关节植入物没有被任何先前的髋关节假体所预期、显而易见、启示或甚至暗示。
附图简述
本发明的各种其他目的、特点和优点会得到充分理解，因为当结合当前附图进行考虑时，将更好地理解本发明，其中相似的附图标记在几个视图中表示相同或相似的元件，并且其中：
图1是具有中心莫氏锥度开口的互锁反向髋关节髋臼杯的剖视图。
图2是具有插入到莫氏锥度开口中的中心柱的互锁反向髋关节髋臼杯的横截面视图。
图3是整体的髋臼球和锥形中心柱的透视图。
图4是组装好的反向互锁髋关节植入物的横截面视图。
图5是髋臼杯冲击器的横截面视图。
发明详述
现在描述性地转向附图，在附图中，相似的附图标记在几个视图中表示相似的元件，附图示出了互锁反向髋关节假体，其包括半球形髋臼杯(4)，该髋臼杯具有光滑的凹表面和凸出的非关节连接表面。所述凸出的非关节连接表面提供了具有多个粗糙和微空隙的多孔表面以使骨向内生长。此外，为了使用一个或多个互锁螺钉(未示出)，髋臼杯(4)在不同位置处提供一个或多个孔(2)。髋臼杯(4)的凹半球形表面提供了在髋臼杯的凹空间内延伸的中心凹形锥形开口(1)。所述开口是锥形的，以舒适地容纳凸形锥形中心柱(6)。髋臼球(5)作为整体牢固地连接在中心柱上，或者可以使用莫氏锥度牢固地连接。
在一个实施方案中，髋臼杯提供了至少两个在直径上相对的凹槽(3)，其位于靠近髋臼杯的周缘附近的杯的赤道边缘处，并且用于固定手持冲击器以将杯压入至由手术外科医生准备的髋臼骨盆腔中。
在不同的实施方案中，一体式髋臼可以提供多于两个的凹槽用于接收固定销。此外，所述凹槽可以具有正方形或椭圆形的形状。
图(4)示出了具有髋臼球和压入至中心开口(1)中的中心柱(6)的髋臼杯。股骨金属杯(9)具有锥形柄(10)和与髋臼球(5)舒适地接触的聚乙烯内衬(8)。
在一个实施方案中，股骨杯的关节表面包含不同厚度但不小于4mm的高分子量聚乙烯。在不同的实施方案中，内衬可以是瓷、陶瓷或金属合金。满足不同尺寸需求的设计变化对于本领域技术人员来说将是显而易见的。
参考图4，当金属股骨杯8及其聚乙烯内衬9在髋臼球5上关节连接时，股骨杯的边缘移入和移出半球形互锁空间(7)，并且股骨杯的关节表面在整个运动范围内保持与髋臼球相同的接触面积。换句话说，在整个运动范围内保持股骨杯的100％的关节接触面积。
现在参考图5，其详细描述了髋臼杯手持式冲击器。所述手持式冲击器具有截头体形式的截头半球体(12)和延伸超出手持式冲击器的圆周的唇缘，从而搁置在髋臼杯的倾斜边缘上。半球体的远端表面不接触中心莫氏锥度中心开口(6)。中心轴(11)向上延伸，其近端具有用于压紧的手柄，远端牢固地嵌入聚乙烯冲击器(12)的本体中。位于中心轴(11)周围的金属套筒(19)具有锥体(18)形式的远端。所述套筒经由位于套筒(19)和中心轴(11)之间的空间中的弹簧(17)向远侧滑动地推动。为了保持髋臼杯牢固地连接至冲击器，两个固定销在直径上相对并位于通道(20)内，并保持缩回并经由弹簧(16)向内推动。当套筒(19)经由弹簧(17)向下推动时，远端锥体(18)将把固定销14推入髋臼杯凹槽(3)中，从而在压紧过程中将髋臼杯固定至手持式冲击器。
在本发明的另一个实施方案中，髋臼杯具有多个孔，用于插入专门设计用于髋关节翻修手术的多个固定螺钉。
翻修是移除现有植入物的外科手术。这最频繁需要移除髋臼杯并且与高发病率水平相关。通过手术移除先前植入的髋臼杯可能相当困难，尤其是当杯具有用于骨向内生长的金属珠时。在这些情况下，移除还与医源性骨损失相关，导致难以插入另一个常规的髋臼杯。
本发明的一个重要特征是能够将髋臼杯放置到位并对其进行压紧，而不会使中心柱干扰不同角度的多个螺钉的放置，例如在翻修手术期间。在髋臼杯插入之后，中心柱和髋臼球将被适当地压入至中心莫氏锥度中。如上所述，在髋关节翻修手术期间使用多个螺钉具有显著优势，其中髋臼骨的质量决定了固定螺钉的数量和位置。具有中心柱将限制暴露并干扰所述固定螺钉的放置。
因此，本发明的目的是提供新的且改进的互锁反向髋关节假体系统，其中金属髋臼杯提供了可拆卸的中心柱，使得插入多个固定螺钉，例如在髋关节翻修手术或需要骨盆骨重建的复杂骨折病例期间。
关于上述说明，应当认识到，本发明的部件的最佳尺寸关系，包括尺寸、材料、形状、形式、功能、操作方式、组装和用途的变化，对于本领域技术人员是显而易见的，并且所有与附图中示出的和说明书中描述的等同关系都旨在被本发明涵盖。因此，前述内容仅被认为是对本发明原理的说明。此外，由于本领域技术人员将容易想到多种修改和变化，因此不希望将本发明限制于所示出和描述的精确构造和操作，因此，可以采取落入本发明的范围中的所有合适的修改和等同物。

Claims (13)

1.反向髋关节假体系统，其包括：
一体式髋臼杯，其具有用于连接到骨盆骨中髋臼窝的凸出的非关节连接表面和位于与所述凸出的非关节连接表面相对的凹表面，所述凹表面具有中心开口；
髋臼球，其牢固地连接在钉上；
股骨杯，其牢固地附加至股骨植入物的近端；以及
手持式冲击器，其用于将所述髋臼杯插入到准备好的髋臼骨腔中。
2.根据权利要求1所述的反向髋关节假体系统，其中所述髋臼杯的凹表面为半球形的并且具有中心顶端开口。
3.根据权利要求2所述的反向髋关节假体系统，其中所述中心开口是锥形的以提供凹形莫氏锥度。
4.根据权利要求2所述的反向髋关节假体系统，其中具有莫氏锥度的所述中心开口具有圆形壁，所述圆形壁的高度不超过所述中心开口的基部的一个半直径。
5.根据权利要求1所述的反向髋关节假体系统，其中所述中心开口的外壁朝向所述基部向外展开以与所述髋臼杯的内壁平滑地延续。
6.根据权利要求1所述的反向髋关节假体系统，其中所述髋臼杯的凸表面为半球形，并且所述杯的凹表面也为半球形。
7.根据权利要求5所述的反向髋关节假体系统，其中所述一体式髋臼杯提供至少两个或更多个用于接收固定销的凹槽。
8.根据权利要求7所述的反向髋关节假体系统，其中所述直径上相对的凹槽位于靠近所述杯的赤道边缘。
9.根据权利要求7所述的反向髋关节假体系统，其中所述直径上相对的凹槽的形状为圆形、椭圆形或多边形。
10.根据权利要求1所述的反向髋关节假体系统，其中所述手持式冲击器包括：
金属圆柱体；
中心金属芯，其在其近端提供手柄；
弹簧，其安装在所述中心金属芯上，用于向远侧偏置所述金属圆柱体；以及
聚乙烯截头体，其用于防止在压紧期间与中心莫氏延伸部接触，所述聚乙烯截头体具有至少两个或更多个直径上弹簧承载的固定销。
11.根据权利要求10所述的反向髋关节假体系统，其中所述金属圆柱体的远端是锥形的以提供凸轮作用，所述凸轮作用将所述固定销向外延伸到所述髋臼杯的直径上相对的赤道凹槽中。
12.根据权利要求10所述的反向髋关节假体系统，其中所述固定销位于直径上相对的圆柱形通道中并且经由弹簧向内推动。
13.根据权利要求1所述的反向髋关节假体系统，其中手持式冲击器装置由金属、金属合金或复合材料制成。
CN202180093172.6A 2021-01-09 2021-06-14 具有可拆卸锥形中心柱的互锁反向髋关节假体 Pending CN116887787A (zh)

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CA3210939A1 (en) 2022-07-14
US20240108476A1 (en) 2024-04-04
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KR20240015055A (ko) 2024-02-02
US11090163B1 (en) 2021-08-17

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