CN217772594U

CN217772594U - Double-shaft tumor type artificial knee joint capable of automatically extending

Info

Publication number: CN217772594U
Application number: CN202122807594.5U
Authority: CN
Inventors: 郭卫
Original assignee: Peking University Peoples Hospital
Current assignee: Peking University Peoples Hospital
Priority date: 2021-11-16
Filing date: 2021-11-16
Publication date: 2022-11-11
Anticipated expiration: 2031-11-16

Abstract

The utility model relates to a biax can automatic tumor type artificial knee joint that prolongs, including thighbone condyle prosthesis, screw rod, countershaft, vertical and horizontal bevel gear, main shaft and rotary platform of extending, the motion of crouching of knee joint and slight rotation rely on main shaft and rotary platform to accomplish under the normal activity condition. The secondary axis will only take part in the over flexion movement when the knee joint is flexed more than 90 °. When the over-flexion movement is performed, the auxiliary shaft can drive the longitudinal gear in the longitudinal and transverse bevel gears to rotate, so that the transverse gear meshed with the auxiliary shaft can rotate and drive the screw rod to rotate, the femoral condyle prosthesis, the screw-out extension sleeve and the screw rod can generate longitudinal displacement, and the extension of the affected limb in a non-invasive state is realized. The utility model discloses can be applied to the false body after the excision of tumour section around children's knee joint and rebuild, under the non-invasive condition in later stage, through knee joint overbending, start vertical and horizontal double gear interlock mechanism, accomplish the false body extension to realize effectively controllable and not have the limb extension of tumour false body replacement postoperative under the wound condition.

Description

Double-shaft tumor type artificial knee joint capable of automatically extending

Technical Field

The utility model relates to an artificial prosthesis, in particular to a tumor type artificial knee joint with a double shaft capable of automatically prolonging and suitable for the limb protection operation of children bone tumor, which belongs to the technical field of medical equipment.

Background

The most common types of primary bone malignancies in children and adolescents are osteosarcoma and ewing sarcoma, with the most common sites of preference being distal femur and proximal tibia. In recent years, with the development of neoadjuvant chemotherapy, limb protection therapy has become a main mode for treating primary malignant tumors of bones of children and teenagers, and good clinical effects are achieved, so that a considerable part of children patients can survive for a long time due to effective neoadjuvant chemotherapy and thorough surgical excision of tumor segments. For children and adolescents, the development of the distal femur and proximal tibia epiphysis around the knee joint bears a large portion of the lower limb length. After the tumor around the knee joints of children and teenagers is removed and the tumor type prosthesis is reconstructed, as the prosthesis cannot grow along with the age of the children, the problems of obvious unequal length, limb dysfunction and the like of the lower limbs of part of the children are caused, which is always a difficult point in the process of treating primary malignant tumors of bones of the children and the teenagers. Meanwhile, due to the serious problem of unequal length of the lower limbs, the infant patients and families thereof are greatly mentally burdened. Although the design of the existing children tumor type prosthesis makes great progress, the design has not changed fundamentally in the aspect of solving the problem of unequal limb length of children patients, becomes the biggest problem of influencing the life quality after tumor healing, and is the biggest obstacle in the process of treating the malignant bone tumor of children at present.

In order to reduce the unequal length degree of bilateral limbs caused by reconstruction of tumor type artificial joints of children patients, a longer joint can be replaced for the first time, a child type semi-joint prosthesis or a simple hinge type prosthesis with healthy epiphysis on the opposite side of a diseased bone can be reserved, the unequal length problem of the two lower limbs of children and teenagers after growth and development can be corrected by methods of prolonging the lower limb bones through an external fixing frame after the bones are matured, and the like, but the methods have various defects. The artificial prosthesis with longer primary replacement can cause traction injury to nerve vessels, the length is prolonged by at most 1-2cm, and the requirement of the infant on longer-time growth cannot be met; the tumor type half joints of children at one epiphysis are reserved, only one growth plate is reserved, the total length of the lost lower limbs cannot be compensated, and meanwhile, the half joints have obvious symptoms such as unstable knee joints and the like; the children tumor type pure hinge knee joint with one epiphysis is reserved, although the knee joint has the advantages of good initial stability, less disturbance to the epiphysis of the healthy side and the like, the requirement of extension of the prosthesis along with the age increase of the sick children cannot be realized; the bone lengthening technology has definite curative effect, but the sick children need to undergo multiple operations, the lengthening period is long, complications such as nail tract infection and the like, the compliance degree requirement on the sick children is high, the bone strength is not enough in a period of time after the target length is reached, and a brace is also needed for protection. At present, the assembled artificial joint prosthesis widely applied in clinic can not realize the 'in-vivo' extension of the artificial joint because the prosthesis adopts a taper joint method to adjust the length of the defect segment of the prosthesis. The length adjustment of the defect section is required to be realized, the complete dislocation of the artificial joint, the taking out of the femoral broach and the installation of the extension section can be realized only through secondary revision operation, the length can be prolonged by at most 2cm at each time, the target length can be reached through multiple operations, huge wound can be formed on a patient through each operation, and the clinical objective requirement cannot be met.

Tumor type artificial joint replacement is an effective and reliable technical means for protecting limbs of children and teenagers, but an artificial joint which can meet the growth and development requirements of the children and the teenagers and can prolong the limb length in vivo on the basis of restoring the limb continuity and the joint mobility is urgently needed clinically, the prosthesis can realize minimally invasive or even non-invasive extension of a defect section on the basis of not increasing the complication of the prosthesis, and finally realize the seamless connection between the limb protection operation of the children and the limb protection success finally.

SUMMERY OF THE UTILITY MODEL

In view of the above problems, the present invention provides a dual-axis tumor-type artificial knee joint capable of extending automatically and achieving extension of limbs through an excessive flexion and extension mechanism of the knee joint.

In order to achieve the purpose, the utility model adopts the following technical proposal: a bi-axial, auto-protractable, tumor-type artificial knee joint, comprising: the femoral condyle prosthesis is internally provided with a slideway which extends along the longitudinal direction; the screw-out extension sleeve is coaxially arranged in the slideway of the femoral condyle prosthesis and forms a sliding pair, and an internal thread is processed on the inner wall of the screw-out extension sleeve; the screw is screwed in the screwing-out extension sleeve in a threaded manner; a secondary shaft rotationally coupled to the femoral condyle prosthesis below the threaded rod in a transverse direction, the secondary shaft configured to complete an over flexion motion of the knee joint when the knee joint flexes more than 90 °; longitudinal gears of the longitudinal bevel gears are fixedly connected to the auxiliary shaft, transverse gears of the longitudinal bevel gears are fixedly connected to the lower end of the screw rod, and the longitudinal gears are meshed with the transverse gears and can only rotate in one direction; the connecting piece is arranged at the lower part of the femoral condyle prosthesis and is articulated with the femoral condyle prosthesis, an auxiliary shaft connecting column which is upwards protruded is integrally formed at the upper part of the connecting piece, the auxiliary shaft connecting column extends into the femoral condyle prosthesis and is fixedly connected with the auxiliary shaft, and a groove is formed at the lower part of the connecting piece; a main shaft rotatably connected in the groove of the connecting piece along the transverse direction, wherein the main shaft is configured to complete the flexion and extension movement of the knee joint under the normal movement condition; the rotary platform is arranged at the lower part of the connecting piece and is articulated with the connecting piece, an upward convex main shaft connecting column is integrally formed at the upper part of the rotary platform, and the main shaft connecting column extends into the groove of the connecting piece and is fixedly connected with the main shaft.

The artificial knee joint of tumor type preferably further comprises a femoral medullary needle fixedly connected to the upper end of the screw-out extension sleeve, wherein the femoral medullary needle is inserted into and fixed with the femoral medullary cavity.

The tumor-type artificial knee joint preferably further comprises a taper joint extension section integrally connected to the lower end of the femoral intramedullary nail, and the taper joint extension section is in taper joint with the upper end of the screw-out extension sleeve.

The tumor type artificial knee joint is preferably characterized in that the lower end of the rotating platform forms a tibial medullary needle which is inserted into and fixed with a tibial medullary cavity.

The utility model discloses owing to take above technical scheme, it has following advantage:

1. the utility model adopts the matched stack formula design, can accomplish the replacement operation of tumour type knee joint according to the tumour section excision scope around the patient's knee joint.

2. The utility model discloses under the non-invasive condition, when (exceeding 90 °) passing through knee joint excessive flexion, start vertical and horizontal bevel gear interlock mechanism, accomplish the false body extension.

3. The utility model can complete the flexion and extension of knee joint and slight rotation movement as common tumor knee joint prosthesis under the condition of normal movement.

Drawings

Fig. 1 is a schematic view of an overall structure of a dual-axis tumor-type artificial knee joint capable of extending automatically according to an embodiment of the present invention.

The various reference numbers in the figures:

1-femoral condyle prosthesis; 2-screwing out the extension sleeve; 3-a screw; 4-secondary shaft; 5-longitudinal and transverse bevel gears; 6-a connecting piece; 7-a main shaft; 8-a rotating platform; 9-femoral intramedullary nail; 10-taper-connecting an extension section;

51-longitudinal gear; 52-transverse gear; 61-auxiliary shaft connection column; 62-grooves; 81-main shaft connection column; 82-tibial medullary needle.

Detailed Description

To make the objects, technical solutions and advantages of the present invention clearer, 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 some of the embodiments of the present invention, and not all of them. Based on the embodiments in the present invention, all other embodiments obtained by a person skilled in the art without creative work belong to the protection scope of the present invention.

In the description of the present invention, it should be noted that the terms "upper", "lower", "inner", "outer", and the like indicate orientations or positional relationships based on the orientations or positional relationships shown in the drawings, which are only for convenience of description and simplification of the description, but do not indicate or imply that the system or element referred to must have a specific orientation, be constructed and operated in a specific orientation, and thus, should not be construed as limiting the present invention.

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, and may be, for example, fixedly connected, detachably connected, or integrally connected; 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 meaning of the above terms in the present invention can be understood in specific cases to those skilled in the art.

The utility model provides a biax can automatic tumor type artificial knee joint who prolongs, including thighbone condyle prosthesis, screw rod, countershaft, vertical and horizontal bevel gear, connecting piece, main shaft and rotary platform of extending, the motion of crouching of knee joint and slight rotation rely on main shaft and rotary platform to accomplish under the normal activity condition. When the knee joint is flexed more than 90 °, the secondary shaft will then take part in the over flexion movement. When the patient does over-flexion movement, the auxiliary shaft can drive the longitudinal gears in the longitudinal and transverse bevel gears to rotate, so that the transverse gears meshed with the longitudinal and transverse bevel gears can rotate and drive the screw to rotate, the femoral condyle prosthesis, the screw extension sleeve and the screw are longitudinally displaced, and finally extension of the affected limb in a non-invasive state is achieved. The utility model discloses can the wide application in the false body after the excision of tumour section around children's knee joint rebuilds to under the non-invasive condition in later stage, through knee joint excessive buckling, start vertical and horizontal double gear interlock mechanism, accomplish the false body extension, thereby realize effectively controllable and the not limb extension of having the tumour false body replacement postoperative under the wound condition.

The following describes the dual-axis automatic extension tumor-type artificial knee joint provided by the embodiment of the present invention in detail with reference to the accompanying drawings.

As shown in fig. 1, the bi-axial auto-elongation tumor-type artificial knee joint provided in this embodiment includes: the femoral condyle prosthesis 1 is internally provided with a slideway which extends along the longitudinal direction; the screw-out extension sleeve 2 is coaxially arranged in a slide way of the femoral condyle prosthesis 1 and forms a sliding pair, and an internal thread is processed on the inner wall of the screw-out extension sleeve 2; the screw rod 3 is screwed in the screw-out extension sleeve 2 in a threaded manner; a secondary shaft 4 which is connected to the femoral condyle prosthesis 1 below the screw rod 3 in a transverse rotating way, wherein the secondary shaft 4 is configured to complete the over-bending movement of the knee joint when the knee joint bends over 90 degrees; the vertical gear 51 of the vertical and horizontal bevel gear 5 is tightly connected on the auxiliary shaft 4, the transverse gear 52 of the vertical and horizontal bevel gear 5 is tightly connected at the lower end of the screw rod 3, and the vertical gear 51 is meshed with the transverse gear 52 and can only rotate in one direction; the connecting piece 6 is arranged at the lower part of the femoral condyle prosthesis 1 and is articulated with the femoral condyle prosthesis 1, an auxiliary shaft connecting column 61 which protrudes upwards is integrally formed at the upper part of the connecting piece 6, the auxiliary shaft connecting column 61 extends into the femoral condyle prosthesis 1 and is fixedly connected with the auxiliary shaft 4, and a groove 62 is formed at the lower part of the connecting piece 6; a main shaft 7 rotatably connected in the groove 62 of the connecting piece 6 along the transverse direction, wherein the main shaft 7 is configured to complete the flexion and extension movement of the knee joint under the normal movement condition; and the rotating platform 8 is arranged at the lower part of the connecting piece 6 and is articulated with the connecting piece, a main shaft connecting column 81 which protrudes upwards is integrally formed at the upper part of the rotating platform 8, and the main shaft connecting column 81 extends into the groove 62 of the connecting piece 6 and is fixedly connected with the main shaft 7.

When the tumor-type artificial knee joint with the double shafts capable of automatically extending is used, flexion and extension movements and slight rotation of the knee joint under the normal movement condition are completed by the main shaft 7 and the rotating platform 8. When the knee joint is flexed more than 90 deg., the secondary shaft 4 will only take part in the over-flexion movement. During the over-flexion movement, the auxiliary shaft 4 drives the longitudinal gear 51 to rotate, so that the transverse gear 52 engaged with the longitudinal gear rotates and drives the screw rod 3 to rotate, and thus the femoral condyle prosthesis 1, the screw-out extension sleeve 2 and the screw rod 3 generate longitudinal displacement, and finally the extension of the affected limb in a non-invasive state is realized. Therefore, under the condition that the sick children do not need the intervention of external force factors, the length of the artificial joint prosthesis can be automatically and timely prolonged and kept equal to the length of the contralateral limb, and the possibility of 'automatic growth' of the artificial joint prosthesis is realized.

In the above embodiment, it is preferable that a femoral intramedullary pin 9 is fixedly connected to an upper end of the screw-out extension sleeve 2, and the femoral intramedullary pin 9 is inserted into and fixed to a femoral medullary cavity.

In the above embodiment, it is preferable that a tapered extension 10 is integrally connected to the lower end of the intramedullary pin 9, and the tapered extension 10 is tapered on the upper end of the screw-out extension sleeve 2, so that the desired defect length can be freely assembled according to the length of the osteotomy during the operation, so as to adapt to patients with different femur defects.

In the above embodiment, the lower end of the rotary platform 8 is preferably formed with a tibial broach 82 for insertion into and fixation with the tibial medullary cavity.

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

Claims

1. A bi-axial, auto-protracting tumor-type artificial knee joint, comprising:

the femoral condyle prosthesis (1) is internally provided with a slideway which extends along the longitudinal direction;

the screw-out extension sleeve (2) is coaxially arranged in the slideway of the femoral condyle prosthesis (1) and forms a sliding pair, and an internal thread is processed on the inner wall of the screw-out extension sleeve (2);

the screw (3) is screwed in the screwing-out extension sleeve (2) in a threaded manner;

a secondary shaft (4) connected in a transverse rotation to the femoral condyle prosthesis (1) below the screw (3), the secondary shaft (4) being configured to complete the knee over-flexion movement when the knee is flexed by more than 90 °;

a longitudinal gear (51) of the longitudinal and transverse bevel gear (5) is tightly connected to the auxiliary shaft (4), a transverse gear (52) of the longitudinal and transverse bevel gear (5) is tightly connected to the lower end of the screw (3), and the longitudinal gear (51) is meshed with the transverse gear (52) and can only rotate in one direction;

the connecting piece (6) is arranged at the lower part of the femoral condyle prosthesis (1) and is articulated with the femoral condyle prosthesis, an auxiliary shaft connecting column (61) which protrudes upwards is integrally formed at the upper part of the connecting piece (6), the auxiliary shaft connecting column (61) extends into the femoral condyle prosthesis (1) and is fixedly connected with the auxiliary shaft (4), and a groove (62) is formed at the lower part of the connecting piece (6);

a main shaft (7) rotatably connected in a transverse direction in a groove (62) of the connecting piece (6), the main shaft (7) being configured to perform flexion and extension movements of the knee joint under normal movement conditions;

the rotary platform (8) is arranged at the lower part of the connecting piece (6) and is articulated with the connecting piece, an upward convex main shaft connecting column (81) is integrally formed at the upper part of the rotary platform (8), and the main shaft connecting column (81) extends into the groove (62) of the connecting piece (6) and is fixedly connected with the main shaft (7).

2. A tumorous artificial knee joint according to claim 1, characterized in that it further comprises a femoral broach (9) fastened at the upper end of said unscrewed extension sleeve (2), said femoral broach (9) being intended to be inserted and fixed in the femoral medullary cavity.

3. A tumorous artificial knee joint according to claim 2, characterized in that it further comprises a tapered extension (10) integrally connected to the lower end of said femoral broach (9), said tapered extension (10) being tapered at the upper end of said unscrewing extension sleeve (2).

4. A tumorous artificial knee joint according to any one of claims 1 to 3, characterized in that the lower end of said rotating platform (8) forms a tibial broach (82) for insertion into and fixation with the tibial medullary cavity.