CN216168121U

CN216168121U - Prosthesis joint restorer in artificial hip joint replacement

Info

Publication number: CN216168121U
Application number: CN202122694605.3U
Authority: CN
Inventors: 冯明光
Original assignee: Shanghai Tong Ren Hospital
Current assignee: Shanghai Tong Ren Hospital
Priority date: 2021-11-05
Filing date: 2021-11-05
Publication date: 2022-04-05
Anticipated expiration: 2031-11-05

Abstract

The utility model discloses a prosthesis joint restorer in artificial hip joint replacement, which comprises a femoral prosthesis part, a spreading part and an ilium wing part, wherein the spreading part comprises a cross rod with external threads, a spreading adjusting structure and an ilium wing screw combining part, and the ilium wing part comprises two ilium wing fixing screws. In the operation, two iliac wing fixing screws are drilled in parallel and fixed on the iliac wings at the upper edge of the top of the acetabular prosthesis, the tail parts of the screws penetrate through nail holes of a screw connector of the iliac wings at the distraction part, a femoral prosthesis part holding fork is fixed at the neck part of a femoral stem, and the distraction adjusting structure is used for longitudinally distracting the distance between the femoral stem prosthesis and the acetabular prosthesis to realize the joint restoration of the prosthesis. The repositor is convenient for a doctor to reposition a hip joint of a prosthesis, can shorten the repositioning time of an artificial hip joint in an operation, prevents the risk of postoperative infection caused by long-time exposure of a wound surface, and reduces the possibility of endangering the stability of the acetabular prosthesis in the operation.

Description

Prosthesis joint restorer in artificial hip joint replacement

Technical Field

The utility model relates to the technical field of joint reduction instruments, in particular to a prosthesis joint restorer in artificial hip joint replacement.

Background

The hip joint is a strut part in the center of the whole human body and comprises a bony structure formed by combining an acetabulum and a femoral head, and the top end of the femoral head is embedded into the acetabulum. Under normal conditions, the acetabulum in a human body consists of three bones of ilium, ischium and pubis, wherein the ilium is divided into an ilium body and an ilium wing, the ilium wing is wide at the front part and narrow at the back part, the ilium body is narrow at the back part, and the inner surface of the ilium wing is smooth and slightly concave, which is called an iliac fossa. The good degree of stability of the hip joint directly affects the health of the human body. The minimally invasive surgery is a modern surgical technique which only causes minimal trauma to the normal tissue structure of a patient in the surgical treatment process of excising diseased tissues and repairing injured structures, and has the characteristics of small incision, small trauma, quick recovery and little pain. Artificial hip replacement (THA) is one of the important orthopedic operations for treating hip joint disease, and an artificial prosthesis comprising a femur part and an acetabulum part is fixed on normal bone by using bone cement, screws and the like to replace a diseased joint and reconstruct the normal function of the hip joint of a patient.

With the improvement of the technical level of artificial hip joint replacement, the progress of medical instruments and the application of computer navigation technology in the field of correct implantation and positioning of prosthesis, the mini-incisions micro-invasive artificial hip joint replacement (mini-incisions MI THA) have the advantages of reducing soft tissue trauma, blood loss and less blood transfusion requirements in the perioperative period due to the micro-incisions, causing less postoperative pain, quicker recovery, better cosmetic appearance and the like, and can make up the visual defect of the minimally invasive surgery. The minimally invasive artificial hip joint replacement occupies an increasingly important position in the field of artificial joint replacement, and the minimally invasive surgery protects hip joint stable structures such as normal gluteus medius, gluteus maximus, gluteus minimus, joint capsules and surrounding ligaments, so that the tension of soft tissues around the hip joint is kept in a state close to a normal state after the hip joint prosthesis is implanted, the position limitation of the hip joint for one month after the conventional surgery is performed is avoided, and the dislocation probability of the hip joint of the prosthesis after the surgery is obviously reduced. However, because the normal tension of the soft tissues around the hip joint is kept in a state close to the normal state, the reduction of the hip joint of the prosthesis in the minimally invasive surgery is very difficult, a great deal of manpower and material resources are often consumed, the surgery time and the exposure of the surgical wound are greatly prolonged, the surgical infection risk is increased, and the loosening of the acetabular prosthesis is even endangered by violent operation.

The core idea of the current MI THA surgery, including anterior, anterolateral, direct lateral, posterior, posterolateral and direct double incision approaches, is to effectively expose the replacement region and simultaneously minimize any tendon or muscle damage during exposure by studying and utilizing the hip nerve dissection plane, so as to achieve normal hip motor function and hip stability. The tendon and muscle tissues around the hip joint are effectively protected in the operation, which is beneficial to the stabilization and functional recovery of the hip joint after the operation, and simultaneously brings huge challenges to the replacement of the prosthetic hip joint, especially for patients with developed hip muscles and tighter soft tissue tension, the reduction in the operation faces serious challenges, the operation time is delayed, the operation safety of the patients is influenced, even the infection risk after the operation is increased, and even the implanted prosthesis is influenced or the sciatic nerve is damaged due to the rough reduction in the operation.

Therefore, when the minimally invasive artificial hip joint replacement surgery is realized, the problem that the prosthetic joint replacement in the surgery is a practical problem in the minimally invasive artificial hip joint replacement surgery is solved, and the popularization and wide application of the WI THA technology are even affected.

SUMMERY OF THE UTILITY MODEL

The technical purpose is as follows: aiming at the technical problem, the utility model discloses a prosthetic joint restorer for minimally invasive artificial hip joint replacement, which comprises a femoral prosthesis part, a distraction part and an ilium part, wherein ilium wing screws are fixed on the upper edge of the top of an acetabulum in the operation, a holding fork of the femoral prosthesis part is fixed on the neck of a femoral stem, then the distraction part is connected with the femoral prosthesis part and the ilium part to construct a distraction bracket structure, the distraction part comprises a cross rod, a distraction adjusting structure and an ilium wing screw connecting piece, and the distraction adjusting structure is used for controlling and adjusting the femoral end to be far away from the acetabulum, so that the prosthetic hip joint restoration can be realized.

The technical scheme is as follows: in order to achieve the technical purpose, the utility model adopts the following technical scheme:

a prosthesis joint restorer in artificial hip joint replacement surgery is characterized in that: the femoral prosthesis comprises a femoral prosthesis body of the restorer and a strutting part, wherein the femoral prosthesis comprises a femoral prosthesis body, and the strutting part comprises a cross rod with external threads, an ilium wing screw connector and an ilium wing fixing screw;

wherein, one end of the femoral prosthesis part is connected with the cross bar with external threads, and the other end is provided with a holding fork; the ilium wing screw conjunction is sleeved on the cross rod with the external thread, a pair of position-adjustable ilium wing fixing screws are arranged on the ilium wing screw conjunction, and the distance between the ilium wing screw conjunction and the ilium wing prosthesis is adjusted by adjusting the positions of the ilium wing fixing screws fixed on the ilium wing screw conjunction.

Preferably, the femoral prosthesis part comprises a sleeve member provided with internal threads and an elongated handle member perpendicular to the sleeve member, a holding fork is arranged at the tail end of the elongated handle member, and the femoral prosthesis part is movably arranged on the cross bar with the external threads through the sleeve member.

Preferably, the other end of the cross rod with the external threads is provided with a cross rod handle for adjusting the distance between the femoral prosthesis part and the iliac wing screw combining part.

Preferably, one end of the femoral prosthesis part is fixedly connected with the cross rod with the external threads, the other end of the femoral prosthesis part is a bending structure which is not on the same straight line with the axial direction of the cross rod with the external threads, and a holding fork is arranged at the tail end of the bending structure.

Preferably, the ilium wing screw combining piece is provided with a central through hole and a group of symmetrical wing holes, the ilium wing screw combining piece is inserted into the cross rod with the external threads through the central through hole, the wing holes are positioned on the outer side of the central through hole, and the axial direction of the wing holes is vertical to the axial direction of the central hole;

the ilium wing fixing screws are of long rod structures, at least one end of each ilium wing fixing screw is provided with a threaded end with an external thread, and the number of the ilium wing fixing screws is two, and the two ilium wing fixing screws penetrate into two wing holes of the ilium wing screw combining piece respectively.

Preferably, the distraction part further comprises a nut, a main body structure of the nut is provided with a central hole, the nut and the ilium wing screw conjunction are both arranged on the cross rod with the external thread, and the nut is positioned between the femur prosthesis part and the ilium wing screw conjunction;

the ilium wing screw conjunction is also provided with a convex part which is arranged at one end facing the nut and can penetrate into the central hole of the nut.

Has the advantages that: compared with the prior art, the utility model has the following technical effects:

1. the repositor disclosed by the utility model is used for fixing the upper edge of the acetabulum top through the ilium wing fixing screws, supporting the femoral stem prosthesis body holding fork and the femoral stem prosthesis neck, longitudinally expanding the distance between the femoral stem prosthesis and the acetabulum prosthesis through the expanding and adjusting structure, controlling and adjusting the pushing of the femoral stem end away from the acetabulum, obtaining protective tension resisting soft tissues around the hip joint and preventing the hip joint from dislocation, and facilitating the reposition of the prosthesis hip joint by a doctor.

2. Through the use of the prosthesis joint repositor in the operation, the prosthesis hip joint reposition has the non-sustainable, predictable and blind artificial physical reposition behaviors, becomes mechanized, adjustable and controllable, greatly shortens the artificial hip joint reposition time in the operation, can effectively shorten the operation time, and avoids the increase of postoperative infection risk caused by the long-time exposure of the wound surface;

3. the distractor is convenient and fast to operate and suitable for use in the operation through the prosthesis joint restorer, the difficult situation of minimally invasive artificial hip joint replacement prosthesis joint restoration can be solved, the possibility that the stability of the acetabulum prosthesis is endangered by artificial hip joint restoration is avoided, the problems of fatigue or ache and the like caused by long-time artificial restoration of medical staff in the operation are reduced, labor is saved, and the work difficulty of the medical staff is reduced.

Drawings

FIG. 1 is a schematic view of the prosthetic joint reducer of FIG. 1 in use in an artificial hip replacement procedure;

FIG. 2 is a schematic structural diagram of a type I repositor according to the present invention;

FIG. 3 is a schematic structural diagram of a type II repositor according to the present invention;

wherein, 1, femoral prosthesis; 2. a distraction section; 3. a hip wing portion; 4. a femoral stem prosthesis; 5. an acetabular prosthesis; 6. an iliac wing prosthesis;

ia. A femoral prosthesis portion; ib. A cross bar with external threads; ic. A nut; id. An ilium wing screw fastener; ie. Ilium wing fixing screws;

IIa, femoral prosthesis portions; IIb, a cross bar with external threads; IId, an ilium wing screw combining piece; IIc, a nut; IIe, ilium wing fixing screws; IIf, a cross bar handle.

Detailed Description

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

The utility model discloses a prosthesis joint restorer in artificial hip joint replacement, which comprises a femoral prosthesis part, a distraction part and an ilium part, and can be divided into I-type and II-type restorers according to the difference of distraction mechanisms of the distraction part. Fig. 1 shows an example of a type I reductor, which is used in artificial hip arthroplasty. The femoral stem prosthesis 4 in the figure simulates the shape of a femur in an actual human body, and includes a femoral stem prosthesis spherical portion (simulating the spherical tip of the femur), a femoral stem prosthesis gripping portion (simulating the trunk structure of the femur), a femoral stem prosthesis neck portion (simulating the femoral neck of the femur) connecting the spherical portion and the prosthesis gripping portion. The femoral stem prosthesis holding part and the femoral stem prosthesis neck part can be specially designed into a circular arc structure contact surface. The acetabulum prosthesis 5 and the ilium wing prosthesis 6 simulate the acetabulum and the ilium wing of an actual human body, respectively.

Example one

As shown in fig. 2, the specific structure of the I-type reductor comprises a reductor femoral prosthesis 1 and a distraction part 2, wherein the femoral prosthesis 1 comprises a femoral prosthesis part Ia, and the distraction part 2 mainly comprises an external thread cross bar Ib, a nut Ic, an iliac wing screw connector Id and an iliac wing fixing screw Ie. Hip wing 3 in fig. 1, and two iliac wing fixing screws Ie in fig. 2.

Wherein one end of the femur prosthesis part Ia is connected with the cross rod Ib with external threads, the other end of the femur prosthesis part Ia is arranged into a bending structure which is not on the same straight line with the axial direction of the cross rod Ib with external threads, and the tail end of the bending structure is provided with a holding fork. The main body structure of the nut Ic is provided with a central hole, the nut Ic and the ilium wing screw connector Id are both arranged on the cross rod Ib with the external thread, and the nut Ic is positioned between the femur prosthesis part Ia and the ilium wing screw connector Id. The ilium wing screw connector Id is provided with a central through hole, a group of symmetrical wing holes and a convex part, the ilium wing screw connector Id is inserted into the cross rod Ib with the external thread through the central through hole, the convex part is arranged at one end facing the nut Ic and can penetrate into the central hole of the nut Ic, and the wing holes are positioned at the outer side of the central through hole and the axial direction of the wing holes is perpendicular to the axial direction of the central hole. The ilium wing fixing screws Ie are long rod structures, at least one end of each ilium wing fixing screw Ie is provided with a thread end with an external thread, the number of the ilium wing fixing screws Ie is two, and the ilium wing fixing screws Ie penetrate into two wing holes of the ilium wing screw connector Id respectively, and a cross-sectional view of the connection part of the nut Ic, the ilium wing screw connector Id and the ilium wing fixing screws Ie is shown in an enlarged part in fig. 1.

As shown in fig. 2, when the type I femoral prosthesis part 11 of the type I reductor is used, the holding fork of the femoral prosthesis part Ia is clamped on the outer surface of the neck of the stem prosthesis, and the part of the holding fork connected with the neck of the stem prosthesis can be arranged into a U shape, and can also be arranged into an arc shape or other contact surfaces. Two long rod-shaped iliac wing fixing screws 1e penetrate through a wing hole of an iliac wing combining part 1d, the thread end of each iliac wing fixing screw 1e is positioned at the upper edge of the top of an acetabular prosthesis 5, two iliac wing fixing screws are vertically drilled into an iliac wing 6 in parallel under the guidance of the iliac wing combining part 1d, and the iliac wing combining part 1d is connected with a spreading part cross rod 1b in a sleeve shape. The I-shaped restorer rotates the ilium wing fixing screw Ie towards the ilium wing prosthesis 6 side, and pushes the ilium wing conjunction 1d to displace towards the ilium wing prosthesis 6 side. The spreader is suitable for the reduction of the hip joint of the prosthesis, the reduction task is finished and the spreader is used and completely removed, and the screw and the ilium wing fixing screw are not tightly combined and can be directly pulled out.

Example two

As shown in figure 3, the specific structure of the II-type restorer comprises a restorer femoral prosthesis part 1 and a distraction part 2, wherein in the II-type restorer, a restorer cuboid prosthesis part 1 comprises a femoral prosthesis part IIa, and the distraction part 2 mainly comprises an external thread cross bar IIb, a nut IIc, an ilium wing screw connector IId and an ilium wing fixing screw IIe.

The type II repositor is mainly structurally different from the type I repositor in that a cross rod handle IIf is arranged at the other end of a cross rod IIb with external threads in the type II repositor. The femoral prosthesis part IIa comprises a sleeve part provided with an internal thread and an elongated handle part perpendicular to the sleeve part, a holding fork is arranged at the tail end of the elongated handle part, and the femoral prosthesis part IIa is movably arranged on an external thread cross rod IIb through the sleeve part.

In the II type restorer, the structure and the connection relation of the cross rod IIb with external threads, the ilium wing screw combining part IId, the nut IIc and the ilium wing fixing screw IIe are similar to those of the I type restorer. The spreading part ilium wing fixing screw combining parts Id and IId are connected with the external thread cross rods Ib and IIb in a sleeve shape, the rod diameters of the external thread cross rods Ib and IIb are smaller than the inner diameters of the external thread cross rods Ib and IId, namely the diameters of the central through holes, and the external thread cross rods Id and IIb and the internal thread fixing screw combining parts Id and IId can rotate freely. Expansion wings with one hole are arranged on two sides of the spreading part ilium wing screw combining parts Id and IId respectively, and the diameters of the holes of the two wings are slightly larger than those of the ilium wing fixing screws Ie and IIe, so that the ilium wing fixing screws Ie and IIe can be adjusted up and down in the holes of the two wings of the ilium wing screw combining parts Id and IId.

When the II-type restorer is used, the transverse rod IIb with external threads rotates the femoral prosthesis part IIa to the end of the transverse rod handle IIf in advance for standby, and the other end of the transverse rod handle IIb is in sleeve-shaped connection with the spreading part ilium wing fixing screw IIe. The II type restorer rotates the cross bar handle IIf, the distance between the femoral prosthesis part IIa and the ilium wing combining part IId is prolonged, the distance between the femoral stem prosthesis 4 and the acetabulum prosthesis 5 is longitudinally drawn through the adjustable distraction structure, the protective tension for resisting the soft tissues around the hip joint and avoiding the dislocation of the hip joint is obtained until the femoral head crosses the outer edge of the acetabulum, the corresponding femoral head and the acetabulum lining are adjusted, and the restoration of the prosthesis joint in the hip joint replacement is completed. When the two reductors are used, the ilium wing fixing screws Ie and IIe are required to be placed on the upper edge of the acetabulum prosthesis, and the ilium wing fixing screws Ie and IIe are drilled in parallel.

Known from the two embodiments, the principle of the distraction mechanism of the utility model is that the distraction adjustment structure is driven by nuts and threads, the type I and the type II have the same distraction reduction function, and the distraction modes are different: the I type is opened through the realization of spanner swivel nut, and the II type can be opened through the realization of spanner swivel nut, also can drive the screw rod rotatory in the nut through rotatory T type handle, realizes opening. The strutting adjusting structure can also be further extended to mechanisms such as concave-convex meshing of gears, pneumatic driving, lever prying and the like.

In addition, in the restorer of the utility model, the front part of the ilium wing fixing screw is self-tapping thread, the tail part of the ilium wing fixing screw is external hexagon, and the screw can be placed by selecting a drill bit or a matched T-shaped handle.

The above description is only of the preferred embodiments of the present invention, and it should be noted that: it will be apparent to those skilled in the art that various modifications and adaptations can be made without departing from the principles of the utility model and these are intended to be within the scope of the utility model.

Claims

1. A prosthesis joint restorer in artificial hip joint replacement surgery is characterized in that: the femoral prosthesis comprises a femoral prosthesis (1) and a strutting part (2), wherein the femoral prosthesis (1) comprises a femoral prosthesis part (Ia; IIa), and the strutting part (2) comprises a cross rod (Ib; IIb) with external threads, an ilium wing screw connector (Id; IId) and an ilium wing fixing screw (Ie; IIe);

wherein, one end of the femoral prosthesis part (Ia; IIa) is connected with a cross bar (Ib; IIb) with external threads, and the other end is provided with a holding fork; the ilium wing screw conjunction piece (Id; IId) is sleeved on the cross rod (Ib; IIb) with the external thread, and a pair of position-adjustable ilium wing fixing screws (Ie; IIe) are arranged on the ilium wing screw conjunction piece (Id; IId).

2. The prosthetic joint repositor of claim 1, wherein: the femur prosthesis part (IIa) comprises a sleeve part provided with internal threads and a long handle part perpendicular to the sleeve part, a holding fork is arranged at the tail end of the long handle part, and the femur prosthesis part (IIa) can be movably arranged on a cross bar (IIb) with external threads through the sleeve part.

3. The prosthetic joint repositor of claim 2, wherein: the other end of the cross rod (IIb) with the external threads is provided with a cross rod handle (IIf) which is used for adjusting the distance between the femoral prosthesis part (IIa) and the ilium wing screw combining part (IId).

4. The prosthetic joint repositor of claim 1, wherein: one end of the femoral prosthesis part (Ia) is fixedly connected with the cross rod (Ib) with the external thread, the other end of the femoral prosthesis part is arranged to be a bending structure which is not on the same straight line with the axial direction of the cross rod (Ib) with the external thread, and the tail end of the bending structure is provided with a holding fork.

5. The prosthetic joint repositor of claim 1, wherein: the ilium wing screw combining piece (Id; IId) is provided with a central through hole and a group of symmetrical wing holes, the ilium wing screw combining piece (Id; IId) is inserted into the cross rod (Ib; IIb) with the external thread through the central through hole, the wing holes are positioned on the outer side of the central through hole, and the axial direction of the wing holes is vertical to the axial direction of the central hole;

the ilium wing fixing screws (Ie; IIe) are of a long rod structure, at least one end of each ilium wing fixing screw is provided with a thread end with an external thread, and the number of the ilium wing fixing screws is two, and the two ilium wing fixing screws respectively penetrate into two wing holes of the ilium wing screw combining piece (Id; IId).

6. The prosthetic joint repositor of claim 5, wherein: the distraction part also comprises a nut (Ic; IIc), a central hole is arranged on the main body structure of the nut (Ic; IIc), the nut (Ic; IIc) and the ilium wing screw combining piece (Id; IId) are both arranged on the cross rod (Ib; IIb) with the external thread, and the nut (Ic; IIc) is positioned between the femur prosthesis part (Ia; IIa) and the ilium wing screw combining piece (Id; IId);

the ilium wing screw combining piece (Id; IId) is also provided with a convex part which is arranged at one end facing the nut (Ic; IIc) and can penetrate into the central hole of the nut (Ic; IIc).