CN215839718U

CN215839718U - Integrated revision type acetabulum prosthesis

Info

Publication number: CN215839718U
Application number: CN202121938182.9U
Authority: CN
Inventors: 郭卫; 郭煜
Original assignee: Peking University Peoples Hospital
Current assignee: Peking University Peoples Hospital
Priority date: 2021-08-02
Filing date: 2021-08-18
Publication date: 2022-02-18
Anticipated expiration: 2031-08-18

Abstract

The utility model relates to an integrated revision type acetabular prosthesis, which comprises: the acetabulum cup comprises a hemispherical shell-shaped cup body and a filling block integrally arranged on the cup body; the ilium support comprises a bracket integrally connected to the filling block and a connecting wing plate integrally arranged on the bracket; the bracket is connected with a first fastener and a second fastener, the first fastener extends along the ilium direction to be fixedly connected with the ilium, and the second fastener extends along the ischium greater incisura direction and is connected with the back of the ilium wing after passing through the sacroiliac joint; the front wing of the connecting wing plate is connected with a third fastener and a fourth fastener which are used for being fastened and connected with the front part of the ilium wing; the rear wing of the connecting wing plate is connected with a fifth fastener and a sixth fastener which are used for respectively and fixedly connecting with the rear part of the ilium wing after penetrating through the sacroiliac joint. The acetabular cup and the filling block which are originally required to be spliced are integrated, so that the immediate stability of the acetabular prosthesis is greatly improved, and the risks of fracture, abrasion and looseness of the connecting parts in the long-term use process are reduced.

Description

Integrated revision type acetabulum prosthesis

Technical Field

The utility model relates to an artificial prosthesis, in particular to an integrated revision type acetabulum prosthesis, and belongs to the technical field of medical instruments.

Background

In 2000, 183000 total hip replacements were performed in the united states, of which 31000 (about 17%) were revision surgeries. As the population ages and the jaw indications expand, the incidence of total hip replacement (THA) revision will continue to have a significant impact on patient and adult orthopedic surgeon generation. THA revision surgery is one of the most challenging procedures, with varying degrees of complexity and outcomes. Therefore, the method fully knows the reasons and the mechanisms of the operation failure and is beneficial to improving the success rate of total hip revision.

The most common causes of THA revision include aseptic loosening, wear of the load-bearing interface, osteolysis, prosthesis fracture, hip instability, infection, peri-prosthesis fractures, ectopic ossification, and the like. In the hip revision surgery, about half of the hip revision surgery is acetabulum lateral revision. The acetabulum revision surgery is the most complicated and difficult revision surgery, and mainly causes bone defects due to osteolysis, further causes acetabulum loosening and hip joint pain.

The main indications for THA revision are hip pain or dysfunction, progressive bone loss and infection. Mechanical implantation failure (loosening, wear, prosthesis fracture), recurrent hip dislocation or periprosthetic fractures, etc., may cause pain and/or dysfunction of the hip joint, leading to THA revision. Progressive osteolysis is the most common factor causing loosening and may be an indication of revision, even in the absence of pain, when it occurs around the prosthesis.

Acetabular cup loosening is one of the major causes of acetabular revision, while periacetabular osteolysis is one of the most significant causes of acetabular loosening. In the case of severe osteolytic bone defects around the acetabulum, the revision process is very difficult, and therefore how to repair bone defects around the acetabulum is a very challenging problem. The traditional hip revision prosthesis does not consider the condition of bone defects with different shapes and sizes, and usually adopts larger cups to compositely press and implant bones, metal blocks to repair and fill and the like. The problem of the pressing bone grafting operation is that the pressing bone grafting operation can only be used for the cases with smaller defect range, and the stability of bone grafting is different according to the personal level of doctors, so that the immediate stability can not be ensured, and serious patients can also influence the long-term stability of the prosthesis; the problem of single property of the filling block in the metal filling block repair is that a plurality of filling blocks are required to be complementarily spliced to fill the bone defect facing a large area of bone defect, so that the bone grafting block-acetabulum-host residual bone cannot form a firm whole, and the consequences caused by insecurity in fixation are pressure sores, thrombus and falling pneumonia caused by prolonged postoperative bed-laying time, and the problems of screw fracture, filling block displacement, acetabular cup tipping and the like in postoperative rehabilitation training.

In summary, there is a need to design a universal and reliable acetabular revision artificial prosthesis aiming at extensive bone defects.

SUMMERY OF THE UTILITY MODEL

In view of the above problems, it is an object of the present invention to provide an integrated revision type acetabular prosthesis which is suitable for revision of a wide range of bone defects around an acetabulum.

In order to achieve the purpose, the utility model adopts the following technical scheme: an integrated revision acetabular prosthesis, comprising: the acetabulum cup comprises a hemispherical shell-shaped cup body and a filling block integrally arranged on the outer surface of the cup body; the ilium support is used for being in contact fit with an ilium and comprises a bracket integrally connected to the filling block and a U-shaped connecting wing plate integrally arranged on the bracket; wherein, a first fastener and a second fastener are connected on the bracket, the first fastener extends along the ilium direction to be connected with the ilium in a fastening way, and the second fastener extends along the ischial greater incisura direction and is connected with the back of the ilium wing after passing through the sacroiliac joint; the front wing of the connecting wing plate is connected with a third fastener and a fourth fastener, and the third fastener and the fourth fastener are used for being fixedly connected with the front part of the ilium wing; and a fifth fastener and a sixth fastener are connected to the rear wing of the connecting wing plate and are used for respectively and fixedly connecting with the rear part of the ilium wing after penetrating through the sacroiliac joint so as to fixedly connect the acetabulum prosthesis, the ilium and the sacrum.

The integrated revision type acetabular prosthesis is preferably characterized in that the third fastener and the fourth fastener are cortical bone screws.

Preferably, the acetabulum prosthesis is provided with an anteversion angle of 15 degrees and an abduction angle of 45 degrees, so that the position of the acetabulum is symmetrical to the opposite side.

The integrated revision type acetabular prosthesis is preferably characterized in that the contact sections of the cup body, the bracket and the connecting wing plate with the osteotomy surface are all of a porous metal bone trabecular structure which is completely communicated.

Preferably, the cup wall of the cup body is provided with a plurality of spare screw holes.

The integrated revision type acetabular prosthesis preferably has a contact section of the bracket and the connecting wing plate with the osteotomy surface, wherein the contact section has 3 slope shapes with different angles: the first one is that the bracket and the connecting wing plate are arranged at an included angle of 90 degrees, which is suitable for the situation that the defect range of the acetabulum top is large; the second one is that the bracket and the connecting wing plate are arranged in an included angle of 120 degrees, and is suitable for the condition of medium size in the range of acetabular apical defect; the bracket and the connecting wing plate are arranged at an included angle of 150 degrees, so that the acetabulum apical defect range is small.

Due to the adoption of the technical scheme, the utility model has the following advantages: the utility model designs and researches an integrated revision type acetabular prosthesis based on clinical requirements, the acetabular prosthesis is an international first integrated prosthesis designed for revision of acetabular bones with complex bone defects, and the acetabular prosthesis is characterized by comprising the following components in parts by weight:

1. the acetabular cup and the filling block which need to be spliced originally are integrated, so that the immediate stability of the acetabular prosthesis is greatly improved, the risks of fracture, abrasion and looseness of a connecting part in the long-term use process are reduced, and the acetabular cup and the filling block are suitable for the revision of bone defects around the acetabulum in a large range;

2. the utility model adopts the design of front and back double wings (three-point stabilization) to increase the stability, is more beneficial to the mechanical dispersion of front and back screws, accords with the biomechanical design, and is reliable and stable immediately;

3. the utility model designs the metal bone trabecula structure which is completely communicated with the interfaces contacted with the bone, so that the regenerated host bone can climb and grow into the bone trabecula, firm osseointegration is formed, and the long-term stability of the prosthesis is ensured;

4. the utility model has simple and convenient installation in the operation, and the acetabulum has a fixed anteversion angle and an abduction angle;

5. the three posterior fastening screws of the utility model all pass through the sacroiliac joint and are optimally designed to avoid damage to nerves by passing through the sacral foramen.

6. According to years of clinical experience, the inventor creatively designs 3 acetabular prostheses which can perfectly cover various bone defects, and the application range and the safety of the revision prosthesis are greatly increased.

Drawings

FIG. 1 is a schematic view of an acetabular prosthesis according to an embodiment of the utility model from a first perspective;

FIG. 2 is a schematic structural view of the acetabular prosthesis according to the embodiment of the utility model from a second perspective;

FIG. 3 is a schematic structural view of the acetabular prosthesis according to the embodiment of the utility model from a third perspective;

4-6 are views illustrating the use of the acetabular prosthesis according to the embodiment of the utility model;

FIGS. 7(a) and 7(b) are schematic views of a second ramp-shaped acetabular prosthesis according to the utility model;

fig. 8(a) and 8(b) are schematic structural views of an acetabular prosthesis having a third slope shape according to the present invention.

Detailed Description

In order to make the objects, technical solutions and advantages of the present invention more apparent, the technical solutions of the present invention will be clearly and completely described below with reference to the accompanying drawings. It is to be understood that the embodiments described are only a few embodiments of the present invention, and not all embodiments. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.

In the description of the present invention, it should be noted that the terms "upper", "lower", "inside", "outside", and the like indicate orientations or positional relationships based on the orientations or positional relationships shown in the drawings, and are only for convenience in describing the present invention and simplifying the description, but do not indicate or imply that the system or element referred to must have a specific orientation, be constructed in a specific orientation, and be operated, and thus, should not be construed as limiting the present invention. Furthermore, the terms "first," "second," and the like, are used to define elements only for convenience in distinguishing between the elements, and unless otherwise stated have no special meaning and are not to be construed as indicating or implying any relative importance.

In the description of the present invention, it should be noted that, unless otherwise explicitly specified or limited, the terms "mounted," "disposed," and "connected" are to be construed broadly, e.g., as meaning either a fixed connection, a removable connection, or an integral connection; can be mechanically or electrically connected; they may be connected directly or indirectly through intervening media, or they may be interconnected between two elements. The specific meanings of the above terms in the present invention can be understood in specific cases to those skilled in the art.

The utility model provides an integrated revision type acetabular prosthesis, which comprises: the acetabulum cup comprises a hemispherical shell-shaped cup body and a filling block integrally arranged on the cup body; the ilium support comprises a bracket integrally connected to the filling block and a connecting wing plate integrally arranged on the bracket; the bracket is connected with a first fastener and a second fastener, the first fastener extends along the ilium direction to be fixedly connected with the ilium, and the second fastener extends along the ischium greater incisura direction and is connected with the back of the ilium wing after passing through the sacroiliac joint; the front wing of the connecting wing plate is connected with a third fastener and a fourth fastener which are used for being fastened and connected with the front part of the ilium wing; the rear wing of the connecting wing plate is connected with a fifth fastener and a sixth fastener which are used for respectively and fixedly connecting with the rear part of the ilium wing after penetrating through the sacroiliac joint. The acetabular cup and the filling block which are originally required to be spliced are integrated, so that the immediate stability of the acetabular prosthesis is greatly improved, and the risks of fracture, abrasion and looseness of the connecting parts in the long-term use process are reduced.

The present invention will be described in detail with reference to the accompanying drawings.

As shown in fig. 1 to 6, the present embodiment provides an integrated revision type acetabular prosthesis, which includes: the acetabulum cup 10 comprises a cup body 11 in a hemispherical shell shape and a filling block 12 integrally arranged on the outer surface of the cup body 11; the ilium holder 20 is used for contacting and matching with the ilium, and the ilium holder 20 comprises a bracket 21 integrally connected to the filling block 12 and a U-shaped connecting wing plate 22 integrally arranged on the bracket 21; wherein, the bracket 21 is connected with a first fastening screw 31 and a second fastening screw 32, the first fastening screw 31 extends along the ilium direction to be fastened and connected with the ilium, the second fastening screw 32 extends along the ischium greater incisura direction and is connected with the posterior part of the ilium wing after passing through the sacroiliac joint; a third fastening screw 33 and a fourth fastening screw 34 are connected to the front wing (the side far away from the sacrum) of the connecting wing plate 22, and the third fastening screw 33 and the fourth fastening screw 34 are used for being fastened and connected with the front part of the ilium wing; a fifth fastening screw 35 and a sixth fastening screw 36 are connected on the rear wing (the side close to the sacrum) of the connecting wing plate 22, and the fifth fastening screw 35 and the sixth fastening screw 36 are respectively used for being fixedly connected with the rear part of the ilium wing after passing through the sacroiliac joint so as to fixedly connect the acetabular prosthesis-ilium-sacrum. Therefore, the acetabulum prosthesis adopts a front-back double-wing design (three-point stabilization, namely acetabulum and ilium-front iliac wing-back iliac wing) to increase the stability, is more favorable for mechanical dispersion of front and back screws, and accords with the biomechanical design.

In the above embodiment, preferably, the third fastening screw 33 and the fourth fastening screw 34 are cortical screws, and the cortical screws are fastened and connected with the iliac cortex on both sides to increase the holding force of the third fastening screw 33 and the fourth fastening screw 34.

In the above embodiment, preferably, the acetabular prosthesis is configured such that the anteversion angle (i.e., the angle between the projection of the acetabular axis on the body cross-section and the body transverse axis) is 15 °, and the abduction angle (i.e., the angle between the acetabular axis and the body long axis) is 45 °, so that the acetabular position is symmetrical to the contralateral side.

In the above embodiment, preferably, the contact sections of the cup body 11, the bracket 21 and the connecting wing plate 22 with the osteotomy surface are all configured as a fully communicated porous metal trabecular bone structure, so that the regenerated host bone can climb into the trabecular bone to form firm osseointegration and ensure the long-term stability of the prosthesis.

In the above embodiment, preferably, a plurality of screw holes 13 are prepared on the wall of the cup body 11, so that the screw can be selectively fixed on the ground according to the size and range of the bone defect to increase the stability of the acetabular prosthesis.

In the above embodiment, preferably, since the bone defect boundary is clear and regular, and the revised bone defect is often irregular and varied in size, different from the bone defect boundary left after the pelvic tumor resection, the inventor designs 3 kinds of slope shapes with different angles on the contact section of the bracket 21 and the connecting wing plate 22 with the osteotomy surface according to the clinical experience of many years: the first is that the bracket 21 and the connecting wing plate 22 are arranged at an included angle of 90 degrees (as shown in figure 1), which is suitable for the situation that the acetabulum top defect range is large; the second is that the bracket 21 and the connecting wing plate 22 are arranged at an included angle of 120 degrees (as shown in fig. 7(a) and 7 (b)), which is suitable for the condition of medium size in the range of acetabular apical defect; the third is that the bracket 21 and the connecting wing plate 22 are arranged at an included angle of 150 degrees (as shown in fig. 8(a) and 8 (b)), which is suitable for the situation that the acetabulum apical defect range is small. Therefore, the three kinds of acetabulum prostheses with the slope shapes can perfectly cover various bone defects, and the application range and the safety of the acetabulum prostheses are greatly increased.

Finally, it should be noted that: the above examples are only intended to illustrate the technical solution of the present invention, but not to limit it; although the present invention has been described in detail with reference to the foregoing embodiments, it will be understood by those of ordinary skill in the art that: the technical solutions described in the foregoing embodiments may still be modified, or some technical features may be equivalently replaced; and such modifications or substitutions do not depart from the spirit and scope of the corresponding technical solutions of the embodiments of the present invention.

Claims

1. An integrated revision type acetabular prosthesis, comprising:

the acetabulum cup (10) comprises a hemispherical shell-shaped cup body (11) and a filling block (12) integrally arranged on the outer surface of the cup body (11);

the ilium support (20) is used for being in contact fit with ilium, and the ilium support (20) comprises a bracket (21) integrally connected to the filling block (12) and a U-shaped connecting wing plate (22) integrally arranged on the bracket (21);

wherein a first fastener (31) and a second fastener (32) are connected to the bracket (21), the first fastener (31) extends along the ilium direction to be fixedly connected with the ilium, and the second fastener (32) extends along the ischial greater incisure direction and is connected with the rear part of the ilium wing after passing through the sacroiliac joint;

a third fastener (33) and a fourth fastener (34) are connected to the front wing of the connecting wing plate (22), and the third fastener (33) and the fourth fastener (34) are used for being fastened and connected with the front part of the ilium wing;

a fifth fastener (35) and a sixth fastener (36) are connected to the rear wing of the connecting wing plate (22), and the fifth fastener (35) and the sixth fastener (36) are used for respectively and fixedly connecting with the rear part of the ilium wing after passing through the sacroiliac joint so as to fixedly connect the acetabulum prosthesis, the ilium and the sacrum.

2. The integrated revision acetabular prosthesis of claim 1, wherein the third fastener (33) and the fourth fastener (34) are both cortical screws.

3. The integrated revision type acetabular prosthesis according to claim 1, wherein the acetabular prosthesis is provided with an anteversion angle of 15 ° and an abduction angle of 45 ° such that the acetabular position is symmetrical to the contralateral side.

4. The integrated revision type acetabular prosthesis according to claim 1, wherein the contact sections of the cup body (11), the bracket (21) and the connecting wing plate (22) with the osteotomy surface are all provided as a fully communicated porous metal trabecular structure.

5. The integrated revision type acetabular prosthesis according to any one of claims 1 to 4, wherein a plurality of spare screw holes (13) are machined in the cup wall of the cup body (11).

6. The integrated revision type acetabular prosthesis according to any one of claims 1 to 4, wherein the contact cross-sections of the socket (21) and the connection wing (22) with the osteotomy surface have 3 kinds of slope shapes with different angles:

the first one is that the bracket (21) and the connecting wing plate (22) are arranged at an included angle of 90 degrees, and is suitable for the situation that the defect range of the top of the acetabulum is large;

the second one is that the bracket (21) and the connecting wing plate (22) are arranged at an included angle of 120 degrees and are suitable for the condition of medium size in the range of acetabular apical defect;

the bracket (21) and the connecting wing plate (22) are arranged at an included angle of 150 degrees, so that the acetabulum apical defect range is small.