JP2021512767A - Acetabular artificial joint - Google Patents

Abstract

The acetabular joint can be designed to replace the acetabular surface. The man-tool can include an acetabular cup, an enlargement, and an enlargement fixation mechanism configured to secure the enlargement to the cup. The mechanism is reconfigured between a non-fixed arrangement in which the slider is slidable along the guide and a fixed arrangement in which the slider or guide is in an extended form and the slider is fixed in place with respect to the guide. can do. The non-fixed arrangement may include an enlarged portion fixing mechanism that allows rotation between the enlarged portion and the cup, and the enlarged portion can be fixed to the enlarged portion at a plurality of rotation positions. The man-tool may also be configured to facilitate operation between non-fixed and fixed positions, which allows the instrument to be placed on the man-tool in an access direction substantially perpendicular to the rim of the cup. Includes moving.

Description

The present disclosure relates to surgical systems and methods. More specifically, the present disclosure relates to implants and related methods for arthroplasty.

Arthroplasty is a surgical procedure in which one or more articular surfaces of a joint are replaced with artificial articular surfaces. Such surgery is becoming more and more common, especially for the acetabular femoral joint, commonly known as the hip joint. Acetabular arthroplasty for the acetabular femoral joint can include implanting an artificial acetabular joint to replace the acetabular articular surface. This may be done with or without replacement of the articular surface of the femoral head.

For successful acetabular arthroplasty, it is important that the implant remains effective and does not lose the required wear properties. Furthermore, it is desirable that acetabular arthroplasty surgery be performed quickly and smoothly. Many existing implants and methods for acetabular arthroplasty are time consuming to implant or do not form sufficient attachment to the underlying bone.

The various systems and methods of the present disclosure depend on the current state of the art and, in particular, the problems and needs of the art that are not yet fully resolved by the currently available acetabular arthroplasty systems and methods. Is being developed. The systems and methods of the present disclosure may include, but are not limited to, an artificial acetabular cup, an augmentation, and an acetabular fixation mechanism to provide acetabular implantation and its instruments, thereby bone fixation. Allows for enhanced and / or embedded efficiency.

According to some embodiments, the artificial acetabular joint can be designed to replace the acetabular articular surface on the pelvis. The prosthesis may include an artificial acetabular cup that includes a face that faces the bone of the cup, which has a generally convex shape, and a face that faces the joint of the cup, which has a generally concave shape. The prosthesis may also include an enlarged portion that includes a cup-facing surface of the enlarged portion and a bone-facing surface of the enlarged portion that can be fixed to the bone-facing surface of the cup. The bone-facing surface of the enlargement can be configured to face part of the pelvis to which the cup is attached, and the cup-facing surface of the enlargement can be the bone-facing surface of the cup. It is fixed. The prosthesis is also configured such that at least a portion of the bone-facing surface of the cup faces at least a portion of the enlarged cup-facing surface to secure the enlarged portion to the cup. Mechanisms can be included. The magnifying part fixing mechanism engages with the guide portion extending along one of the face facing the bone of the cup and the surface facing the cup of the magnifying portion, and the surface facing the bone of the cup. A slider on the other side of the magnifying glass facing the cup can be included. The magnifying part fixing mechanism is between a non-fixed arrangement in which the slider slides along the guide part and a fixed arrangement in which the slider and the guide part are frictionally engaged and the slider is fixed in a predetermined position with respect to the guide part. Can be reconstructed with. The fixed arrangement can include at least one of the sliders or guides in the extended form as compared to the non-expanded form in the non-fixed arrangement.

The fixed arrangement can include sliders in the extended form as compared to the non-expanded form in the non-fixed arrangement. For example, the guide may form a slot and the slider may include a protrusion configured to extend into the slot. The slider can include a shoulder surface configured to engage the corresponding shoulder surface that forms part of the slot. The engagement between the shoulder surface of the slider and the shoulder surface forming the slot can prevent the slider from moving out of the slot. The slider may include a dovetail-shaped member that includes a shoulder surface.

The guide portion can extend along the surface of the cup facing the bone, and the slider can be on the surface of the enlarged portion facing the cup. The slider may be an integral part of the enlarged portion, and the guide portion may be a slot formed on the surface of the cup facing the bone. The guide portion defines a curved movement path for the slider, whereby a curved movement path of the enlarged portion can be generated along a part of the surface of the cup facing the bone.

In the non-fixed arrangement, the magnifying portion fixing mechanism facilitates the rotation of the expanding portion with respect to the cup, and in the fixed arrangement, the expanding portion fixing mechanism can suppress the rotation of the expanding portion with respect to the cup. Also, the magnifying part fixing mechanism can include a rotatable fastener to cause deformation between the expanded form and the non-expanded form.

In other embodiments, the acetabular joint can be designed to replace the acetabular surface on the pelvis. The acetabular joint may include an artificial acetabular cup that includes a generally convex shape, a surface facing the bone of the cup and a generally concave shape, a surface facing the joint of the cup. Is. The prosthesis may also include an enlarged portion that includes a cup-facing surface of the enlarged portion and a bone-facing surface of the enlarged portion that can be fixed to the bone-facing surface of the cup. The prosthesis is also configured such that at least part of the bone-facing surface of the cup faces at least part of the cup-facing surface of the enlargement to secure the enlargement to the cup. A fixing mechanism can be included. The reinforcing portion fixing mechanism can include a pair of members that can rotate with respect to each other. The magnifying mechanism can be reconfigured between a non-fixed arrangement and a fixed arrangement. In a non-fixed arrangement, the magnifying glass may be rotatable about an axis between multiple rotational positions with respect to the cup. At each rotation position, the cup-facing surface of the magnifying part is fixed to the cup-facing surface of the cup, and the cup-facing surface of the magnifying part faces part of the pelvis to which the cup is attached. Can be configured to. In a fixed arrangement, the magnified portion may be fixed in one predetermined position of the rotational position. The magnifying part fixing mechanism can be reconfigured into a fixed arrangement by an enlarging part at any of a plurality of rotational positions.

At each of the rotation positions in the fixed arrangement, the area of the face facing the cup of the enlarged portion faces the corresponding area of the face facing the bone of the cup and the curvature of the corresponding area of the face facing the bone of the cup. Can match. For example, the bone-facing surface of the cup and the cup-facing surface of the enlarged portion can have matching spherical curvatures.

In these embodiments, the enlargement fixation mechanism comprises a guide extending along one of a bone-facing surface of the cup and a cup-facing surface of the enlargement, and a bone-facing surface of the cup and a guide. A slider on the other side of the cup-facing surface of the enlargement that engages the portion can be included. In the non-fixed arrangement, the slider can slide along the guide portion, and in the fixed arrangement, the slider and the guide portion can be frictionally engaged to fix the slider in a predetermined position with respect to the guide portion.

In other embodiments, the method can relate to replacing the acetabular articular surface on the pelvis with an artificial acetabular joint. This method can include placing an artificial acetabulum cup in the acetabulum of the pelvis, with the generally convex, bone-facing surface of the acetabulum cup facing the acetabulum and the acetabulum. The generally concave, joint-facing surface of the acetabulum faces the bone-facing surface of the opposite cup. The face-to-joint surface of the cup can define a near-planar rim. The enlargement can be moved into place with respect to the cup, where the cup-facing surface of the enlargement faces the bone-facing surface of the cup and the enlargement bone-facing surface faces the pelvis. Facing a part of. The enlargement part fixing mechanism can be operated to fix the enlargement part in a predetermined position of the cup. This operation may include moving the instrument towards the acetabular cup in an access direction approximately perpendicular to the plane and engaging it with the fixation area of the enlargement fixation mechanism.

Actuation of the magnifying mechanism can include using an instrument to rotate the fastener around an axis approximately perpendicular to the plane. The operation of the magnifying force fixing mechanism can also include the use of an instrument to move the fastener in a direction substantially perpendicular to the plane.

The magnifying part fixing mechanism engages with a guide portion extending along one of a surface of the cup facing the bone and a surface of the magnifying portion facing the cup, a surface of the cup facing the bone, and the guide portion. A slider on the other side of the cup-facing surface of the enlargement can be included. The operation of the magnifying part fixing mechanism is such that the magnifying part fixing mechanism is fixed to the guide part by frictionally engaging the slider and the guide part from a non-fixed arrangement in which the slider can slide along the guide part. It may involve reconfiguring to a fixed arrangement.

In some embodiments, the artificial acetabular joint for replacing the natural acetabular articular surface on the pelvis can have an artificial acetabular cup, an enlargement, and an enlargement fixation mechanism. The artificial acetabular cup may include a surface facing the bone of the cup, which has a generally convex shape, and a surface facing the joint of the cup, which has a generally concave shape. The enlargement portion can have a first protrusion and a second protrusion that define a gap between them, and each protrusion faces the cup of the enlargement portion, which can be fixed to the surface of the cup facing the bone. Enlargement configured to face part of the pelvis to which the artificial acetabular cup is attached, with the surface and the cup-facing surface of the enlargement portion fixed to the cup bone-facing surface. It may include a surface of the part facing the bone. The enlargement part fixing mechanism is configured to fix the enlargement part to the artificial acetabular cup with at least a part of the surface facing the bone of the cup facing at least a part of the surface of the enlargement part facing the cup. Can be done.

Both the first and second processes can extend approximately radially outward from the axis of symmetry of the artificial acetabular cup. The first and second processes, respectively, may have a shape and material selected so that the first and second processes can bend to match the anatomical properties on the pelvis. it can.

The first protrusion and the second protrusion have the proximal end close to the enlargement fixing mechanism, the distal end located away from the enlargement fixing mechanism, and the distal end of the first protrusion and the second protrusion, respectively. It may have an arcuate shape that projects away from the other side of the protrusion. The first and second protrusions may be shaped to define the shape of the "rabbit ears". Each of the first and second protrusions further passes through the surface facing the meat tissue and the surface facing the meat tissue to the surface facing the bone, and can be used to secure the protrusion to the pelvis. It has at least one hole to receive the ingredient.

These features and other features and advantages of the present disclosure will be fully apparent from the following and added claims, or by implementing the systems and methods described herein. You can know.

An exemplary embodiment of the present disclosure, along with the accompanying drawings, will become more fully apparent from the following description and the appended claims. Understanding that these drawings show only exemplary embodiments and therefore should not be considered as limiting the scope of the appended claims, the exemplary embodiments of the present disclosure are attached. Explained with additional specificity and details through the use of the drawings in.
FIG. 1 is a perspective view of an artificial acetabular joint according to an embodiment. FIG. 2A is a perspective view of the acetabular cup of the artificial acetabular joint of FIG. FIG. 2B is a front view of the acetabular cup of FIG. 2A. As used herein, when referring to the components of an acetabular joint, the directional terms anterior, posterior, left, right, up, and down are used to describe embodiments of the acetabular joint. Used for the convenience of. When used as such, when the acetabulum is implanted in the acetabulum, they do not point in a direction with respect to the human body, and when the acetabulum is implanted, the acetabulum is in the pelvis. It should be understood that it should not be construed as limiting the orientation to. FIG. 2C is a top view of the acetabular cup of FIG. 2A. FIG. 2D is a bottom view of the acetabular cup of FIG. 2A. FIG. 3A is a perspective view of an enlarged portion of the artificial acetabular joint of FIG. FIG. 3B is a front view of the enlarged portion of FIG. 3A. FIG. 3C is a rear view of the enlarged portion of FIG. 3A. FIG. 3D is a top view of the enlarged portion of FIG. 3A. FIG. 3E is a bottom view of the enlarged portion of FIG. 3A. FIG. 3F is a left side view of the enlarged portion of FIG. 3A. FIG. 3G is a right side view of the enlarged portion of FIG. 3A. FIG. 4 is a view of the artificial acetabulum joint embedded in the acetabulum of the pelvis as viewed from the left side of the pelvis. FIG. 5 is a perspective view of an artificial acetabular joint according to one embodiment. FIG. 6 is a perspective view of another embodiment of the artificial acetabular joint. FIG. 7 is an exploded perspective view of the artificial acetabular joint of FIG. FIG. 8A is a perspective view of an enlarged portion of the artificial acetabular joint of FIG. FIG. 8B is a front view of the enlarged portion of FIG. 8A. FIG. 8C is a rear view of the enlarged portion of FIG. 8A. 9A is a perspective view of the saddle portion of the artificial acetabular joint of FIG. 9B is a front view of the saddle portion of FIG. 9A. 9C is a rear view of the saddle portion of FIG. 9A. 9D is a top view of the saddle portion of FIG. 9A. 9E is a bottom view of the saddle portion of FIG. 9A. 9F is a left side view of the saddle portion of FIG. 9A. 9G is a right side view of the saddle portion of FIG. 9A. FIG. 10A is a bottom view of another embodiment of the artificial acetabular joint. FIG. 10B is a top view of another embodiment of the artificial acetabular joint. FIG. 11A is a top view of the acetabular cup of the artificial acetabular joint shown in FIGS. 10A and 10B. FIG. 11B is a bottom view of the acetabular cup of the artificial acetabular joint shown in FIGS. 10A and 10B. FIG. 12A is a perspective view of an enlarged portion of the artificial acetabular joint shown in FIGS. 10A and 10B. FIG. 12B is a front view of the enlarged portion of FIG. 12A. 12C is a rear view of the enlarged portion of FIG. 12A. FIG. 12D is a top view of the enlarged portion of FIG. 12A. FIG. 12E is a bottom view of the enlarged portion of FIG. 12A. FIG. 12F is a left side view of the enlarged portion of FIG. 12A. FIG. 12G is a right side view of the enlarged portion of FIG. 12A. FIG. 13 is a left side view of the pelvis with the artificial acetabular joints of FIGS. 10A and 10B embedded in the acetabulum of the pelvis. FIG. 14 is a perspective view of an artificial acetabular joint according to one embodiment.

An exemplary embodiment of the present disclosure is best understood by reference to the drawings, and similar parts are designated by similar numbers throughout the drawings. It will be readily appreciated that the components of the present disclosure, schematically described and illustrated in the figures of the present application, can be arranged and designed in a wide variety of different configurations. Therefore, the following more detailed description of the embodiments of the device, system, and method shown in the figure is not intended to limit the scope of the claims and is merely representative of the exemplary embodiments. This is an example.

The terms "connected," "coupled," and "communicate" are between two or more entities, including mechanical, electrical, magnetic, electromagnetic, fluid, and thermal interactions. Refers to any form of interaction. The two components may be functionally connected to each other, even if they are not in direct contact with each other. The term "adjacent" refers to objects that are in direct physical contact with each other, but objects are not always attached together. The phrase "fluid communication" refers to two mechanisms that are connected so that fluid in one mechanism can flow into the other.

The term "exemplary" is used herein to mean "act as an example, an example, or an example." None of the embodiments described herein as "exemplary" will necessarily be construed as preferred or advantageous over other embodiments. Various aspects of the embodiments are presented in the figures, but the figures are not necessarily drawn to a constant scale unless otherwise indicated.

FIG. 1 is a perspective view of an artificial acetabular joint 100 according to an embodiment. The artificial joint 100 is attached to the natural or previously implanted artificial joint surface of the acetabulum, which can accept and work in conjunction with the natural or artificial joint surface of the femoral head (not shown). It can be designed to replace it. The prosthesis 100 is particularly well suited to replace an existing acetabular cup, for example, when the cup comes off and / or bone collapse occurs around the cup. In particular, the enlargement described herein can contribute to immobilizing the acetabular cup, such as by providing a larger area for immobilizing the prosthesis to the pelvis in such situations. .. For example, this allows the bone to grow into and / or around the enlargement, allowing additional opportunities to screw the prosthesis in place (not shown). Yes, some of the screws can extend through the enlargement into the pelvis.

The prosthesis 100 can include an acetabular cup 102 and at least one enlargement 104. With reference to FIGS. 2A-2D, the cup 102 can be a substantially hollow shell, such as a hollow, substantially hemispherical shape. The acetabular cup 102 can include a surface 112 facing the bone of the cup, which is convex in almost all directions, and a surface 114 facing the joint of the cup, which is concave in almost all directions. However, each surface may contain localized portions that do not fit into the general convex or concave curvature of the surface. For example, this is the case when the surface contains a non-uniform texture such as a porous or rough surface, which can contribute to bone growth and / or a secure engagement between the cup 102 and the enlargement 104. Is. The bone-facing surface 112 of the cup can generally be shaped to fit the prepared acetabulum. The articular facing surface 114 of the cup can be shaped to fit around the articular surface of the natural or artificial femoral head (not shown).

The cup 102 can define one or more openings, such as the hole 116. The hole 116 can pass through the cup 102 from the surface facing the joint of the cup to the surface facing the bone of the cup. For example, in the embodiments of FIGS. 2A-2D, the holes 116 are a centered hole, a first set of five holes spaced in a circular pattern centered on the centered hole, and a center. Can include a second set of five holes centered on the holes arranged in, and spaced in a circular pattern farther from the central hole than the first set. However, the holes 116 can be in a variety of other different patterns, numbers, and / or sizes. The holes 116 facilitate the fixation of the cup to the adjacent pelvic bone. For example, one or more holes 116 can accept screws or other fasteners that extend through the holes 116 into the bone of the pelvis. Also, since the cup 102 remains seated in the acetabulum for an extended period of time, it helps the bone of the acetabulum to grow into the hole 116 and the cup 102 to be more firmly anchored to the acetabulum. Can be done.

The cup 102 can also include a rim 120, which can be generally circular in embodiments where the cup 102 is generally hemispherical. The rim 120 can be close to the plane 122 (see FIG. 2B). As used herein, a rim that is close to a flat surface means that if the rim is flat, the flat surface is aligned with the rim. However, if the rim is not flat, the rim is close to a flat surface if the flat surface is arranged so that the total vertical distance from the flat surface to the points around the rim is minimized.

The cup 102 can also include a guide portion 124, each of which forms a slot 126 extending into the cup 102 from a surface 112 facing the bone of the cup. The cup 102 defines five such guides 124 spaced around the cup 102, each guide 124 along a surface 112 facing the bone of the cup from the rim 120. A slot 126 is defined that extends towards the center of the (ie, towards the center position of the central hole). Each slot 126 can extend toward the center of the cup 102 along the face 112 of the cup bone, such as a path that matches the curvature of the face 112 of the cup bone. .. Also, each slot 126 can be made wider as it extends deeper into the cup 102 from the overall cup bone facing surface 112. Thus, the cup 102 may include, for each slot 126, a shoulder surface 128 (see FIG. 2A) of the corresponding guide portion 124 that defines a wider and deeper portion of the slot. In the embodiments shown in FIGS. 2A-2D, each slot 126 extends outward as it extends deeper into the cup 102, so that each slot is narrower in surface and more deeper into the cup 102. It has a wide, generally trapezoidal (ie, tangible) cross section.

Next, the enlarged portion 104 will be described in more detail with reference to FIGS. 3A to 3G. The enlarged portion 104 can include a surface 130 facing the flesh tissue of the generally flat enlarged portion, which is configured to face the pelvis and the flesh tissue when the artificial joint 100 is implanted (enlarged portion 104). The portion 104 is oriented so that the surface 130 of the enlarged portion facing the flesh tissue faces a portion of the pelvis). The enlargement portion 104 also has a cup-facing surface 132 of the enlargement portion configured to face the bone-facing surface 112 (see FIG. 1) of the cup 102, and when the artificial joint 100 is implanted. It can include a bone-facing surface 134 of the enlargement that is generally configured to face the pelvis. The cup-facing surface 132 of the enlarged portion can have a concave curvature that matches the convex curvature of the cup-facing surface 112 in all directions. For example, such a curvature may be a spherical curvature. In the enlarged portion 104 shown in FIGS. 3A to 3G, the surface 130 of the enlarged portion facing the meat structure is generally crescent-shaped with a rounded tip. The cup-facing surface 132 of the enlargement portion can be generally concave in all directions to coincide with the cup bone-facing surface 112 of the cup 102. The bone-facing surface 134 of the reinforcement may generally be convex in all directions.

The surface 132 facing the cup of the enlarged portion extends from the concave edge of the surface 130 facing the flesh tissue of the enlarged portion, and the surface 134 facing the bone of the enlarged portion is a surface facing the flesh tissue of the enlarged portion. It can extend from the convex edge of 130. Further, the surface 134 facing the bone of the enlarged portion and the surface 132 facing the cup of the enlarged portion intersect each other and are convex from one tip to the other tip of the crescent-shaped surface 130 facing the flesh tissue. A ridge 136 that extends as an arched path can be formed. The enlarged portion 104 can define a hole 138 extending from the surface 130 facing the meat tissue to the surface 134 facing the bone inside the enlarged portion 104. Like the hole 116 in the cup 102, the hole 138 in the enlargement 104 can accommodate one or more screws (not shown) for fixing the enlargement to the pelvis. Also, the hole 138 allows the bone to grow within it over time, helping to secure the enlargement 104 to the pelvis, thereby helping to secure the cup 102 to the pelvis. it can. Although the overall shape of the magnifying glass 104 is described in detail here, the magnifying glass can have many different shapes, as discussed in more detail below.

The magnifying section 104 can further include a slider 140, which can be integrally formed with the rest of the magnifying section 104. The slider 140 can be centrally located near the concave edge of the surface 130 facing the crescent-shaped meat tissue. The slider 140 may include a plane 142 that is flush with the plane 130 facing the meat structure. Further, the slider faces the body of the magnifying unit 104 in a direction that turns its back (the end face 144 may be flat instead of concave, but substantially with the surface 132 facing the adjacent cup of the magnifying part 104. Can include an end face 144 (facing in the same direction). Further, the slider 140 may include an opposing side surface 146 or shoulder surface that extends from the end face back to the body of the enlargement portion 104. The slider 140 can extend from the surface 130 facing the meat structure of the enlarged portion along the surface 132 facing the cup of the enlarged portion. Also, the slider 140 can be made to expand as it extends outwardly away from the cup-facing surface 132 of the enlargement portion. In certain embodiments shown in FIGS. 3A-3G, the slider can form a general dovetail shape that matches the dovetail shape of slot 126 in the cup 102. Therefore, the side surface 146 of the slider 140 can be engaged with the shoulder surface of the corresponding guide portion 124 of the cup 102 to prevent the slider 140 from moving from the slot 126 in which the slider 140 is seated. The slider 140 may also extend between the side surface 146 of the slider 140 and the body of the enlargement portion 104, with the enlargement portion 104 forming side slots 150 on both sides of the slider 140 and extending into the body of the enlargement portion 104. it can. Further, the slider 140 can define a central slot 152 extending within the slider 140 between the side slots 150. The slider 140 can also define an opening 154, such as a screw hole, the opening extending into the slider 140 from a flat surface 142, whereby the central slot 152 is on the opposite side of the opening 154. It is postponed.

Returning to FIG. 1, the cup 102 and part of the enlargement portion 104 may also be part of the enlargement portion fixing mechanism 170, which also includes additional components. The mechanism 170 is relocated between a fixed arrangement in which the enlargement portion 104 is fixed to the cup 102 and a non-fixed arrangement in which the enlargement portion fixing mechanism 170 facilitates movement between the enlargement portion 104 and the cup 102. Can be configured. In the embodiment shown in FIG. 1, the enlargement fixing mechanism 170 provides a slider 140, a corresponding guide 124 that defines a slot 126 in which the slider 140 sits, and a movable fastener 172 to extend the slider 140. Can include. For example, the fastener 172 can be a screw that is screwed into the opening 154 of the slider 140. At least a portion of the opening 154 can be made smaller than the fastener 172, so that when the fastener 172 extends into the opening 154, the fastener 172 opens a portion of the slider 140 to the opening. The slider 140 can be extended by pushing it open to the opposite side of the 154 and the central slot 152. This reconstruction of the slider 140 from the non-expanded form to the extended form can cause friction between the slider 140 and the corresponding guide portion 124 that defines the corresponding slot 126. By this friction, the slider 140 can be locked or fixed in a predetermined position with respect to the guide portion 124, whereby the enlarged portion 104 can be fixed in a predetermined position with respect to the cup 102. Therefore, the fixing mechanism 170 is fixedly arranged by moving the fastener 172 by the opening 154 of the slider 140 for the fixed arrangement and the fastener 172 farther from the opening 154 for the non-fixed arrangement. Reconstructed between and non-fixed arrangement. For example, if the fastener 172 is a screw, the fastener 172 can be moved by rotating the fastener 172 around a shaft. This can be done using equipment such as the bit driver 174.

Next, with reference to FIG. 4, another embodiment of the artificial joint 200 is shown. The artificial joint 200 can include a cup 102, an enlargement portion 204, and an enlargement portion fixing mechanism 270. All of these components include a plurality of sliders 240 in which the enlargement section 204 and the magnifying part fixing mechanism 270 interact with a plurality of guide sections 224 for detachably fixing a single augmentation 204. Except for this, it can be the same as the artificial joint 100. Further, FIG. 4 shows an artificial joint 200 implanted in the pelvis 290, specifically, the acetabulum 292 of the pelvis 290.

The prosthesis may include a different number of enlargements, which may have different shapes to fit different parts of the pelvis. Also, different shapes can be used for areas with bone collapse, which allows the enlargement to be adapted to the area of pelvic collapse around the acetabulum. Next, referring to FIG. 5, an artificial joint 300 with an acetabular cup 102 and three differently shaped enlargements 304, 306, and 308 is shown. The prosthesis includes three augmentation fixation mechanisms 312, 314, and 316, one corresponding to each of the three enlargements 304, 306, and 308. Fasteners for the magnifying mechanism fixing mechanisms 312, 314 and 316 are not shown in FIG. However, the fasteners may be included in the enlargement fixing mechanisms 312, 314 and 316. The enlarged portion fixing mechanism 312, 314, and 316 can be the same as the enlarged portion fixing mechanism 170 described above with reference to FIGS. 1 to 3G, respectively.

Next, another artificial joint 500 will be described with reference to FIGS. 6 to 9G. First, referring to FIGS. 6 and 7, FIG. 6 is an assembly view of the artificial joint 500, and FIG. 7 is an exploded view of the artificial joint 500. The artificial joint 500 can be the same as the artificial joint 100. In fact, the cup 102 in the artificial joint 500 can be the same as the cup 102 described above. However, the enlarged portion 504 and the enlarged portion fixing mechanism 506 can be different from those described above. In general, the augmentation fixing mechanism 506 is in a fixed position with the cup 102 and the magnifying section 504 rotating relative to each other in a non-fixed arrangement and the magnifying section 504 at any of a number of different rotational positions relative to the cup 102. It has an alternative structure that can be fixed.

With reference to FIGS. 8A-8C, the enlarged portion 504 can include a crescent-shaped meat tissue facing surface 530, a cup facing surface 532, and a bone facing surface 534, all of which are described above. It can be the same as the corresponding surface of the enlarged portion 104. However, the enlarged portion 504 can define a saddle hole 540 that passes through the enlarged portion 504 and extends from the surface 534 facing the bone of the enlarged portion to the surface 532 facing the cup of the enlarged portion. The saddle hole 540 can generally grow in stages as it extends from the bone-facing surface 534 of the enlargement to the cup-facing surface 532 of the enlargement. The enlarged portion 504 can also define a pair of pin holes 542 extending into the enlarged portion 504 from the surface 530 of the enlarged portion facing the meat structure of the enlarged portion. The pin hole 542 intersects the saddle hole 540 and can pass on both sides of the saddle hole 540.

The expansion portion fixing mechanism 506 can include a fixing ring 550 that can be seated on the shoulder of the saddle hole 540 of the expansion portion 504. The saddle hole 540 can be expanded outward around the fixing ring 550 to form an annular gap (not shown) in which the fixing ring 550 can spread. The expansion portion fixing mechanism 506 can also include a pair of pins 552, such as a spring pin that can be seated in the pin hole 542 of the expansion portion 504.

The saddle portion 560 can be seated in the saddle portion hole 540. The saddle portion 560 will be described with reference to FIGS. 7 and 9A to 9G. The saddle 560 can include a generally cylindrical pivot or shaft 562 and a generally dovetail slider 564. The shaft 562 can define a radial slot 570 extending in the shaft from a surface 572 facing the ring of the shaft. The surface 572 facing the ring can face the fixing ring 550 in the saddle hole 540 with the shaft 562 rotatable in the saddle hole 540 when the saddle 560 is in the non-expanded form. The outer surface of the shaft 576 is such that when the saddle 560 is in the expanded form, the shaft 562 is split so that the radial slot 570 expands and engages with the material of the enlargement 504 surrounding the saddle hole 540. The configured protrusions 578 can be defined. For example, the protrusion 578 can include a plurality of rows of protrusions extending in the axial direction extending in the circumferential direction. The shaft 562 can define a round annular groove 582 extending from the outer surface 576 into the shaft 562. The annular groove 582 can be aligned with the pin hole 542 such that the pin 552 sits in the annular groove 582 on both sides of the shaft 562, and the pin 552 prevents the saddle 560 from moving axially with respect to the enlargement 504 and expands. It enables the rotational movement of the saddle portion 560 with respect to the portion 504.

The slider 564 can extend from the shaft 562 on the opposite side of the surface 572 facing the ring. The slider 564 can have the same shape as the slider 140 described above, and can function in the same manner as the slider 140 to deploy and fix the guide portion 124 of the cup 102 at a predetermined position. The saddle portion 560 can define a fastening hole 580 that passes through the shaft 562 in the axial direction and further passes through the slider 564. The fastening hole 580 has a screw formed on the inner surface, and the screwed fastener 584 is screwed into the fastening hole 580, and the shaft 562 and the slider 564 can be pushed outward.

The magnifying part fixing mechanism 506 and the magnifying part fixing mechanism 170 may be modified in various different ways in different embodiments. For example, the enlargement portion fixing mechanism 506 may be configured so that the saddle portion can be enlarged so as not to approach the surface 534 of the enlargement portion 504 facing the bone. For example, the magnifying part fixing mechanism 506 can include a pair of meshing bevel gears. In such an embodiment, the rotating head on the surface 530 of the enlargement portion 504 facing the meat structure can accept an instrument such as a bit of a bit driver. The head can be fixed to the first bevel gear (via a shaft or the like). The first bevel gear can drive the second bevel gear, and the second bevel gear can drive the rotating shaft to screw the fastener into the saddle portion 560. In one example, the shaft into which the fastener is screwed remains fully engaged in the fastener, and the shaft remains engaged to the fastener as the fastener further enters the saddle.

As another example, the guide portion can be formed in the enlarged portion and the slider can be placed on the cup. Also, the guide portion can be a male portion and the slider can be a female portion. For example, the guide may be a rail formed along the cup, and the slider may be a portion attached to an enlargement that defines the slot into which the rail fits, whereby the enlargement is in a non-fixed position. Allows you to slide against the cup. In such a configuration, the fastener is pushed into the rail and the fastener expands to secure the rail and slider. Alternatively, the fastener may reduce (push) the female slider or guide so that it frictionally engages with the male guide or slider, respectively.

The components of the prosthesis described here have characteristics that are normally considered for embedded man-made objects and the functions described herein, as long as the parts can be formed with sufficient precision, and the resulting parts are. As far as it is shown, various manufacturing techniques and materials can be used, the characteristics of which are sufficient strength, sufficient wear resistance, sufficient durability, compatibility with the human body, and the like. For example, the components may be made of titanium. Also, different manufacturing techniques such as 3D printing, machining, metal injection molding, and / or die casting can be used for each of the components described herein. As an example, cups and magnified parts with any surface texture properties known in the art can be formed by 3D printing.

The saddle portion 560 may be arranged in the enlargement portion 504 during manufacturing. Alternatively, the saddle 560 may be placed within the enlargement 504 by the clinician before or during the surgical procedure for implanting the prosthesis 500. Similarly, any enlargement of the embodiment can also be placed on the cup by the surgeon during surgery, but at least some of this may be done prior to surgery.

With reference to FIGS. 1 to 3G again, when assembling the prosthesis 100, the fastener 172 can be partially screwed into the slider 140 without expanding the slider. The slider can slide along slot 126 in the cup 102, starting near the rim 120 of the cup and sliding until the enlargement portion 104 moves to the desired position with respect to the cup 102. At this time, the enlarged portion fixing mechanism can be operated to fix the enlarged portion 104 to the cup 102 at that position. This includes moving the instrument 174 towards the cup in the access direction 600 (see FIG. 1). The access direction 600 may be approximately perpendicular to the plane 122 close to the rim 120 of the cup 102 (see FIG. 2B). As used herein, vertical generally means within 30 degrees of being vertical. The instrument 174 can be used to screw the fastener 172 into the opening 154 of the slider 140. This may include the fastener 172 rotating around an axis approximately perpendicular to plane 122. Further, the fastener 172 can move in a direction substantially perpendicular to the plane 122 from the joint side of the artificial joint 100. The actuation of the fastener 172 allows the slider 140 to be expanded into an enlarged slider form, so that the slider is frictionally engaged with the guide portion 124 along the slot 126 and the enlarged portion 104 is relative to the cup 102. Is fixed in place. The prosthesis 200 and the prosthesis 300 can be assembled using similar techniques, where the enlargement is fixed in place with respect to the cup in a similar manner.

When assembling the artificial joint 500 shown in FIGS. 6 to 9G, the fixing ring 550 is seated in the saddle hole 540, and the saddle portion 560 can be moved from the surface 532 facing the cup of the enlarged portion into the saddle hole 540. At that time, the surface 572 facing the ring first extends and faces the fixing ring 550. Next, the pin 552 can be pushed into the pin hole 542 to prevent the saddle portion 560 from moving in the axial direction. The fastener 584 can be partially screwed into the fastener hole 580 of the saddle portion 560 from the side surface of the surface 534 facing the bone of the enlarged portion. The enlargement portion 504 can be moved so that the slider 564 slides into the slot 126 of the cup 102, which is close to the rim 120. The enlargement portion 504 can be slid along the slot 126 and rotated with respect to the saddle portion 560 until the enlargement portion 504 is in the desired position.

At that position, the fastener 584 can be actuated by screwing the fastener into the saddle hole 540 using instrument 174. The fastener 584 can push the shaft 562 and the slider 564 outward when it is screwed into the fastener hole 580. This allows the protrusion 578 of the shaft 562 to be frictionally engaged with the material around the saddle hole 540 and the slider 564 to be frictionally engaged with the guide portion 124 defining the corresponding slot 126 in which the slider 564 is seated. .. As a result, the saddle portion 560 can be fixed at a predetermined position with respect to the enlarged portion 504 and the cup 102, whereby the enlarged portion 504 can be fixed at a predetermined position with respect to the cup 102. When the fastener 584 is screwed into the saddle 560, the extended head of the fastener 584 can expand the fixing ring 550. When the head passes through the fixing ring 550, the fixing ring 550 can be contracted by its spring force. As a result, the fixing ring 550 can suppress the loosening of the fastener 584, and thus the loosening of the enlarged portion 504 with respect to the cup 102.

Part of the assembly of human tools may be performed by a clinician during surgery. For example, the acetabulum and the area around the acetabulum can be adjusted during surgery, and the acetabulum cup can be placed and fixed within the acetabulum. For example, the acetabular cup can be placed by screwing a fastener into the pelvis through the cup. Then, the enlarged portion can be moved and adjusted to a desired position by sliding and / or rotating the enlarged portion as described above. Next, the enlargement part fixing mechanism can be activated to fix the enlargement part in a predetermined position with respect to the cup already arranged. In addition, the fasteners can be screwed into the pelvis through the enlargement to provide additional fixation.

Alternatively, the desired position of the enlargement with respect to the acetabular cup can be determined and the enlargement can be slid and / or rotated into place. Next, before the cup is embedded, the magnifying part fixing mechanism can be activated to fix the magnifying part cup in a predetermined position. When the reinforcement is placed against the cup, the assembled prosthesis is placed in the prepared acetabulum, using fasteners screwed into the pelvis through the cup and / or enlargement, etc. , Can be fixed in place with respect to the pelvis.

For prostheses with multiple enlargements, one or more enlargements can be placed and fixed to the cup before and / or after fixing the cup in place within the acetabulum.

Here, another artificial joint 1100 will be described with reference to FIGS. 10A to 12G. 10A and 10B are a bottom view and a top view of the artificial joint 1100 in the assembled form, respectively. The artificial joint 1100 can share similarities with the artificial joint 100 shown in FIGS. 1 to 3G. For example, the acetabular cup 1102 of the artificial joint 1100 can be similar to the acetabular cup 102 of the artificial joint 100. However, the acetabular cup 1102 may include holes 1116 of different numbers and / or arrangements. For example, in the embodiments of FIGS. 10A-11B, the holes 1116 are a centered hole, a first set of four holes spaced in a circular pattern centered on the centered hole, and It can include a second set of three holes spaced in a circular pattern, centered on the centered hole and farther from the central hole than the four holes in the first set. The enlarged portion 1104 of the artificial joint 1100 may include an enlarged portion fixing mechanism 1170 similar to the enlarged portion fixing mechanism 170 shown in FIGS. 1 to 3G. However, in another embodiment (not shown), the magnifying part securing mechanism 1170 may optionally incorporate the same features as the magnifying part fixing mechanism 506 shown in FIGS. 6 to 9G. In this alternative embodiment, the acetabular cup 1102 and the enlargement portion 1104 can rotate relative to each other in an unfixed arrangement, and / or the enlargement portion 1104 can position any rotation with respect to the acetabular cup 1102. They can be fixed to each other in a locked or fixed arrangement so that they can be taken.

Here, the enlarged portion 1104 will be described in more detail with reference to FIGS. 12A to 12G. The enlargement portion 1104 can include two protrusions 1161, 1162 that can be formed of a flexible material that can adapt to the anatomical properties of the pelvis. The two protrusions 1161 and 1162 may each have an arcuate shape that projects away from each other toward the distal ends 1163 and 1164 of the protrusions 1161 and 1162, respectively, as shown in FIG. 12A. .. In this way, the two protrusions 1161 and 1162 can be combined to form a "rabbit ear" shape. However, it will be appreciated that in other embodiments, the protrusions 1161 and 1162 do not have to have a bow-shaped shape, or both do not have to form a "rabbit ear" shape.

The enlargement portion 104 may also include a surface 1130 facing the flesh tissue of the generally flat enlarged portion, which is configured to face the surrounding flesh tissue substantially with the back to the pelvis when the artificial joint 1100 is implanted. (Although the enlarged portion 1104 is oriented so that the surface 1130 facing the flesh tissue of the enlarged portion faces the portion with the pelvis). The enlargement portion 1104 is also implanted with a cup-facing surface 1132 of the enlargement portion configured to face the bone-facing surface 1112 (see FIGS. 10B and 11A) of the cup 1102, and an artificial joint 1100. It can include the bone-facing surface 11134 of the enlarged portion, which is generally configured to face the pelvis at the time. The cup-facing surface 1132 of the enlarged portion can have a concave curvature that matches the convex curvature of the cup-facing surface 1112 in all directions. For example, such a curvature may be a spherical curvature. In the enlarged portion 1104 shown in FIGS. 12A-12G, the surface 1130 facing the flesh tissue of the enlarged portion and the surface 1134 facing the bone of the enlarged portion generally have roundness forming the shape of a "rabbit ear". It can have an arched shape with a tinged tip.

The enlargement portion 1104 can define a hole 1138 extending therein from the surface 1130 facing the meat tissue to the surface 1134 facing the bone. Similar to the hole 116 of the acetabular cup 102 described above, the hole 1138 in the enlargement portion 1104 can accept one or more screws (not shown) for fixing the enlargement portion 1104 to the pelvis. The hole 1138 can also allow bone to grow within it over time, contributing to the fixation of the enlarged portion 1104 to the pelvis and helping to secure the cup 1102 to the pelvis.

The magnified portion 1104 shown in FIGS. 10A-12G includes two protrusions 1161 and 1162 having six holes 1138, but in other embodiments any number of protrusions and / or any shape and size. It will be appreciated that it can include holes, arrangements, or patterns. Further, in the present specification, an enlarged portion having a patient-specific protrusion, including a 3D printed enlarged portion (not shown), is also intended. Ancillary surgical instruments (not shown) that can be used to help shape these augments to match the patient's particular anatomy are also intended herein, including templates, benders, etc. Will also be understood.

Each enlargement disclosed herein may be made available to the surgeon as a set of enlargements having different predetermined sizes, but the size of each enlargement disclosed herein and The shape can also be customized to fit the patient's unique acetabular / pelvic anatomy. For example, the desired size and shape for each enlargement disclosed herein is preoperative (or intraoperative) based on measurements obtained from the patient's unique acetabular / pelvic anatomy. ) Can be determined. These measured values can be derived from pre-surgery / intra-surgery imaging data (X-ray imaging data, CT imaging data, MR imaging data, X-ray fluoroscopic imaging data, etc.). Customized enlargements can then be formed by any suitable method (eg, 3D printing, etc.). As mentioned above, the surgeon can also fine-tune the position of the customized enlargement with respect to the acetabular cup. In this way, a hybrid enlargement design that includes a patient-specific enlargement is provided, combined with the ability to adjust the position of the patient-specific enlargement with respect to the acetabular cup and / or patient-specific anatomy. To. The surgeon can also fine-tune the shape of the customized enlargement during surgery, if desired, to better fit the patient's unique acetabular / pelvic anatomy. Therefore, if the patient-specific enlargement shape is not satisfactory, the surgeon may further adjust the position of the enlargement with respect to the acetabular cup and / or adjust the shape of the enlargement itself to customize the enlargement. Optimal fit between the patient and the patient can also be achieved.

Continuing with FIGS. 12A-12G, the magnified portion 1104 further includes a slider 1140, which may be formed integrally with other portions of the magnified portion 1104. The slider 1140 can be centrally located close to the surface 1130 facing the meat tissue. The slider 1140 can include a plane 1142 that is coplanar with the plane 1130 facing the meat structure. Further, the slider 1140 faces the body of the magnifying unit 1104 in a direction that turns its back (the end face 1144 may be flat instead of concave, but is substantially the surface 1132 facing the adjacent cup of the magnifying part 1104. End faces 1144 (facing in the same direction) can be included. Further, the slider 1140 can include opposing side surfaces 1146 or shoulder surfaces that extend from the end faces back to the body of the magnifying section 1104. The slider 1140 can extend from the surface 1130 facing the meat structure of the enlarged portion to the surface 1132 facing the cup of the enlarged portion. Also, the slider 1140 can be made to expand as it extends outwardly away from the cup-facing surface 1132 of the enlargement portion. In certain embodiments shown in FIGS. 12A-12G, the slider can form a general dovetail shape that matches the dovetail shape of slot 1126 in cup 1102. Therefore, the side surface 1146 of the slider 1140 can engage with the shoulder surface of the corresponding guide portion 1124 of the cup 1102 to prevent the slider 1140 from moving from the slot 1126 in which the slider 1140 is seated. The slider 1140 may also extend between the side surface 1146 of the slider 1140 and the body of the enlargement portion 1104, with the enlargement portion 1104 forming side slots 1150 on both sides of the slider 1140 and extending within the body of the enlargement portion 1104. it can. Further, the slider 1140 can define a central slot 1152 extending within the slider 1140 between the side slots 1150. The slider 1140 can also define an opening 1154, such as a screw hole, the opening extending into the slider 1140 from a flat surface 1142, whereby the central slot 1152 is on the opposite side of the opening 1154. It is postponed.

Similar to the embodiments shown in FIGS. 1 to 3G, the acetabular cup 1102 and part of the enlargement portion 1104 may be part of the enlargement portion fixation mechanism 1170, which may also include additional components. The mechanism 1170 is relocated between a fixed arrangement in which the enlargement portion 1104 is fixed to the cup 1102 and a non-fixed arrangement in which the enlargement portion fixing mechanism 1170 facilitates movement between the enlargement portion 1104 and the cup 1102. Can be configured. In the embodiments shown in FIGS. 10A-12G, the magnifying section fixing mechanism 1170 is a slider 1140, a corresponding guide section 1124 defining a slot 1126 in which the slider 1140 is seated, and a movable fastener to magnify the slider 1140. (Not shown) can be included. For example, the fastener can be a screw that is screwed into the opening 1154 in the slider 1140. At least a portion of the opening 1154 can be made smaller than the clasp, so that when the clasp extends within the opening 1154, the clasp will place a portion of the slider 1140 into the opening 1154 and the center. The slider 1140 can be expanded by pushing it open to the opposite side of slot 1152. This reconstruction of the slider 1140 from the non-expanded form to the extended form can cause friction between the slider 1140 and the corresponding guide portion 1124 defining the corresponding slot 1126. This friction allows the slider 1140 to be locked or fixed in place with respect to the guide portion 1124, thereby fixing the magnifying unit 1104 in place with respect to the cup 1102. Thus, the fixation mechanism 1170 moves the fasteners closer to the opening 1154 of the slider 1140 for fixed placement and the fasteners farther from the opening 1154 for non-fixed placement, thereby making the fixed placement Can be reconfigured with non-fixed arrangements. For example, if the fastener is a screw, the fastener can be moved by rotating the fastener around a shaft. This can be done using an instrument such as a bit driver.

Here, referring to FIG. 13, the artificial acetabular joint 1100 of FIG. 10A is shown in a state of being embedded in the acetabulum 1292 of the pelvis 1290. The prosthesis 1100 can include an acetabular cup 1102, an enlargement portion 1104, and an enlargement portion fixation mechanism 1170. All of these components can be the same as the prosthesis 1100. In another embodiment (not shown), the magnifying section 1104 and the magnifying section fixing mechanism 1170 interact with a plurality of guides formed in the acetabular cup 1102 to form a single acetabular portion 1104. It may include a plurality of sliders that are releasably secured to the cup 1102.

Here, with reference to FIG. 14, an artificial joint 1300 with an acetabular cup 1102 and three differently shaped enlargements 1304, 1306 and 1308 attached to it is shown. Each of the enlargements 1304, 1306 and 1308 can have a different shape to fit different parts of the pelvis. Also, different shapes can be used for areas with bone collapse, which allows the enlargements 1304, 1306 and 1308 to be adapted to the pelvic collapse area around the acetabulum. The prosthesis 1300 includes three enlargement fixation mechanisms 1312, 1314 and 1316, one for each of the three enlargements 1304, 1306 and 1308. Although the fasteners for the enlargement fixing mechanisms 1312, 1314 and 1316 are not shown in FIG. 14, the fasteners can be included in the enlargement fixing mechanisms 1312, 1314 and 1316. The enlarged portion fixing mechanism 1312, 1314, and 1316 can be the same as the enlarged portion fixing mechanism 170 described above with reference to FIGS. 1 to 3G, respectively.

Each of the methods disclosed herein includes one or more steps or actions to carry out the methods described. The steps and / or actions of the methods can also be interchanged with each other. In other words, the sequence and / or use of a particular step and / or action may be modified unless a particular step or sequence of actions is required for the proper operation of the embodiment.

References to "embodiments" or "embodiments thereof" throughout the specification mean that at least one embodiment includes a particular feature, structure or property described in connection with that embodiment. .. Therefore, the citations or variations thereof cited throughout this specification do not necessarily refer to the same embodiment.

Similarly, it should be understood that in the above description of embodiments, various features may be grouped together into a single embodiment, figure, or description thereof for the purpose of simplifying disclosure. However, this method of disclosure should not be construed as reflecting the intent that any claim requires more features than those explicitly listed in that claim. Rather, the aspect of the invention lies in a combination of fewer features than all of the single disclosed embodiments described above, as the following claims reflect. Therefore, the claims that follow this detailed description are thereby explicitly incorporated into this detailed description, and each claim is independent as a separate embodiment. This disclosure contains all permutations of independent claims and their dependent claims.

The enumeration of claims in the term "first" relating to a feature or element does not necessarily imply the presence of a second or additional such feature or element. The elements listed in the means plus function format are 35 U.S. S. C. § 112 Para. It is intended to be interpreted according to 6. 6 It will be apparent to those skilled in the art that modifications can be made to the details of the above embodiments without departing from the basic principles described herein.

Although specific embodiments and uses of the present disclosure have been illustrated and described, it should be understood that the appended claims are not limited to the exact components and components disclosed herein. Various modifications, changes, and modifications that will be apparent to those skilled in the art can be made in the configurations, operations, and details of the methods and systems disclosed herein.

Claims (24)

An artificial acetabular joint to replace the natural acetabular articular surface on the pelvis,
The surface of the cup facing the bone, which generally has a convex shape,
The joint-facing surface of the cup, which generally has a concave shape,
With an artificial acetabular cup, including
A surface of the enlarged portion facing the cup, which can be fixed to the surface of the cup facing the bone,
The enlarged portion configured to face a part of the pelvis to which the artificial acetabular cup is attached while the surface of the enlarged portion facing the cup is fixed to the surface of the cup facing the bone. The surface facing the bone and
With the enlarged part including
An enlargement configured such that at least a portion of the bone-facing surface of the cup faces at least a portion of the cup-facing surface of the enlarged portion and the enlarged portion is fixed to the artificial acetabular cup. It is a part fixing mechanism,
A guide portion extending along one of the bone-facing surface of the cup and the cup-facing surface of the enlarged portion.
An enlargement fixing mechanism including a slider on the other side of the face of the cup facing the bone and the surface of the enlargement facing the cup that engages the guide.
Including
The enlarged part fixing mechanism is
In a non-fixed arrangement in which the slider can slide along the guide portion,
The slider and the guide portion are frictionally engaged with each other, and the slider is fixed at a predetermined position with respect to the guide portion, and is in an expanded form as compared with the non-expanded form of the non-fixed arrangement. An artificial acetabular joint characterized in that it is reconstructed between a fixed arrangement comprising at least one of a slider or said guide portion. The artificial acetabular joint according to claim 1, wherein the fixed arrangement includes the slider in the expanded form as compared with the non-expanded form of the non-fixed arrangement. The artificial acetabular joint according to claim 2, wherein the guide portion forms a slot, and the slider includes a protrusion configured to extend into the slot. The slider includes a shoulder surface configured to engage a corresponding shoulder surface that forms part of the slot, and the engagement of the shoulder surface of the slider with the shoulder surface that forms the slot causes the slider. The artificial acetabular joint according to claim 3, wherein the artificial acetabular joint is prevented from moving out of the slot. The artificial acetabular joint according to claim 4, wherein the slider includes a dovetail-shaped member including a shoulder surface of the slider. The artificial acetabular joint according to claim 1, wherein the guide portion extends along a surface of the cup facing the bone, and the slider is located on the surface of the enlarged portion facing the cup. .. The artificial acetabular joint according to claim 6, wherein the slider is an integral portion of the enlarged portion. The artificial acetabular joint according to claim 6, wherein the guide portion forms a slot formed on a surface of the cup facing the bone. 1. The guide portion defines a curved movement path for the slider to generate a curved movement path of the enlarged portion along a part of a surface of the cup facing the bone. The artificial acetabular joint described in. In the non-fixed arrangement, the enlarged portion fixing mechanism facilitates rotation of the enlarged portion with respect to the artificial acetabular cup, and in the fixed arrangement, the enlarged portion fixing mechanism is the expansion with respect to the artificial acetabular cup. The artificial acetabular joint according to claim 1, wherein the rotation of the portion is suppressed. The artificial acetabular joint according to claim 1, wherein the enlarged portion fixing mechanism includes a fastener that can be rotated to cause a conversion between the expanded form and the non-expanded form. An artificial acetabular joint to replace the natural acetabular articular surface on the pelvis,
The surface of the cup facing the bone, which generally has a convex shape,
The joint-facing surface of the cup, which generally has a concave shape,
With an artificial acetabular cup, including
A surface of the enlarged portion facing the cup, which can be fixed to the surface of the cup facing the bone,
The surface of the enlarged part facing the bone and
With the enlarged part including
An enlargement configured such that at least a portion of the bone-facing surface of the cup faces at least a portion of the cup-facing surface of the enlarged portion and the enlarged portion is fixed to the artificial acetabular cup. It is a part fixing mechanism and includes a pair of members that can rotate with respect to each other.
The enlarged portion is rotatable about an axis between a plurality of rotational positions with respect to the artificial acetabular cup, and at each rotational position, the surface of the enlarged portion facing the cup faces the bone of the cup. In a non-fixed arrangement, the surface of the enlarged portion facing the cup in a state of being fixed to the surface is configured to face a part of the pelvis to which the artificial acetabular cup is attached.
A fixed arrangement in which the enlarged portion is fixed at one predetermined position of the rotating position and the enlarged portion fixing mechanism is reconstructed into a fixed arrangement by the enlarged portion at any of the plurality of rotating positions.
With the expansion part fixing mechanism reconstructed between
An artificial acetabular joint characterized by containing. At each of the rotational positions in the fixed arrangement, the area of the enlarged portion facing the cup faces the corresponding area of the surface of the cup facing the bone and corresponds to the surface of the cup facing the bone. The artificial acetabular joint according to claim 12, characterized in that it matches the curvature of the region. The enlarged part fixing mechanism is
A guide portion extending along one of the bone-facing surface of the cup and the cup-facing surface of the enlarged portion.
Includes a bone-facing surface of the cup, a cup-facing surface of the enlarged portion that engages the guide portion, and a slider on the other side.
In the non-fixed arrangement, the slider is slidable along the guide portion.
The artificial acetabular joint according to claim 12, wherein in the fixed arrangement, the slider and the guide portion are frictionally engaged with each other and the slider is fixed at a predetermined position with respect to the guide portion. .. A method of replacing the acetabular joint surface on the pelvis with an artificial acetabular joint.
The generally convex, bone-facing surface of the acetabular cup faces the acetabulum, and the generally concave, joint-facing surface of the acetabular cup is contralateral. An artificial acetabulum cup is acetabular acetabulum with the generally convex cup facing the bone-facing surface and the generally concave cup joint-facing surface defining a near-planar rim. And the process of arranging in
The enlarged portion, wherein the surface of the enlarged portion facing the cup faces the surface of the generally convex cup facing the bone, and the surface of the enlarged portion facing the bone faces a part of the pelvis. The process of moving the artificial acetabular cup into place and
The enlargement part fixing mechanism is activated to fix the enlarged part in a predetermined position of the artificial acetabular cup, and in the operation, the instrument is placed in an access direction substantially perpendicular to the plane of the artificial acetabular cup. And the step of actuating, which comprises moving towards and engaging with the fixed region of the magnifying part fixing mechanism.
A method characterized by including. 15. The method of claim 15, wherein the step of activating the magnifying mechanism comprises using the instrument to rotate a fastener around an axis substantially perpendicular to the plane. 15. The method of claim 15, wherein the step of activating the magnifying part fixing mechanism comprises using the instrument to move the fastener in a direction substantially perpendicular to the plane. The enlarged part fixing mechanism is
A guide portion extending along one of a bone-facing surface of the generally convex cup and a cup-facing surface of the enlarged portion.
Includes a bone-facing surface of the generally convex cup and a slider on the other side of the enlarged cup-facing surface that engages the guide.
In the step of operating the enlarged portion fixing mechanism, the slider and the guide portion are frictionally engaged with each other from a non-fixed arrangement in which the slider is slidable along the guide portion. 15. The method of claim 15, wherein the method comprises reconstructing the guide portion into a fixed arrangement fixed at a predetermined position. An artificial acetabular joint to replace the natural acetabular articular surface on the pelvis,
The surface of the cup facing the bone, which generally has a convex shape,
The joint-facing surface of the cup, which generally has a concave shape,
With an artificial acetabular cup, including
An enlarged portion containing a first protrusion and a second protrusion that define a gap between them, and the first and second protrusions, respectively, are
A surface of the enlarged portion facing the cup, which can be fixed to the surface of the cup facing the bone,
The enlarged portion configured to face a part of the pelvis to which the artificial acetabular cup is attached while the surface of the enlarged portion facing the cup is fixed to the surface of the cup facing the bone. The surface facing the bone and
With the enlarged part including
The enlarged portion was configured to be fixed to the artificial acetabular cup with at least a part of the bone-facing surface of the cup facing at least a part of the enlarged portion facing the cup. Enlarged part fixing mechanism and
An artificial acetabular joint characterized by containing. The artificial acetabular joint according to claim 19, wherein both the first protrusion and the second protrusion extend substantially radially outward from the axis of symmetry of the artificial acetabular cup. .. The first and second protrusions, respectively, are of a shape and material selected so that the first and second protrusions can bend to match the anatomical properties on the pelvis. 19. The artificial acetabular joint according to claim 19. The first protrusion and the second protrusion are each
Proximal end close to the enlarged part fixing mechanism and
With a distal end located away from the magnifying mechanism,
An arcuate shape that projects the distal end away from the other of the first protrusion and the second protrusion.
19. The artificial acetabular joint according to claim 19. The artificial acetabular joint according to claim 19, wherein the first protrusion and the second protrusion are formed so as to define the shape of the "rabbit ear". Each of the first protrusion and the second protrusion further
The side facing the meat tissue and
At least one hole that runs from the surface facing the meat tissue to the surface facing the bone and accepts fasteners that can be used to secure the first and second protrusions to the pelvis.
19. The artificial acetabular joint according to claim 19.

Images