JP2566769B2 - Artificial joint - Google Patents
Artificial jointInfo
- Publication number
- JP2566769B2 JP2566769B2 JP62046583A JP4658387A JP2566769B2 JP 2566769 B2 JP2566769 B2 JP 2566769B2 JP 62046583 A JP62046583 A JP 62046583A JP 4658387 A JP4658387 A JP 4658387A JP 2566769 B2 JP2566769 B2 JP 2566769B2
- Authority
- JP
- Japan
- Prior art keywords
- stem
- insert
- artificial joint
- bone
- artificial
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Lifetime
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/32—Joints for the hip
- A61F2/36—Femoral heads ; Femoral endoprostheses
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
Landscapes
- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Materials For Medical Uses (AREA)
- Prostheses (AREA)
Description
【発明の詳細な説明】 〔産業上の利用分野〕 本発明は、人体に適用する人工股関節、人工肩関節な
どの人工関節に関するものである。The present invention relates to artificial joints such as artificial hip joints and artificial shoulder joints applied to the human body.
従来から用いられている例えば第６図（イ）に示した
如き人工関節は、寛骨などに埋入したソケット（不図
示）や該ソケットに対し回動自在に嵌合する摺動部（球
面形状）Ｋを先端に備えたステムＳとで構成されてい
る。Conventionally used artificial joints, such as that shown in FIG. 6 (a), include a socket (not shown) embedded in the hipbone and a sliding portion (spherical surface) rotatably fitted to the socket. And a stem S having a shape K at the tip.
このうちステムＳはステンレス鋼、コバルトクロム合
金などの金属から成り、長管骨Ａの骨髄腔Ｂ中に挿入
し、ステムＳと長管骨Ａとの間にセメントＣを介在させ
て固定し、一方のソケットも同様にセメントを用いて固
定するのが一般的である。Of these, the stem S is made of metal such as stainless steel or cobalt chrome alloy, and is inserted into the bone marrow cavity B of the long bone B and fixed with the cement C interposed between the stem S and the long bone B. Similarly, one of the sockets is generally fixed with cement.
しかし、セメントＣによる固定は初期においては十分
に強いものでも長期においては緩みの生じるものがあ
り、この緩みの発生が人工関節の重要な問題点となって
いる。However, the fixation by the cement C may be sufficiently strong in the initial stage but may be loosened in the long term, and the occurrence of this loosening is an important problem of the artificial joint.
緩みの原因としては、 生体という厳しい雰囲気内において、セメントＣその
ものの経時的強度劣化が早まり、セメント層にクラック
が発生すること、 長管骨Ａ、セメントＣ及びステムＳのヤング率の違い
によって荷重に受けた場合の変形量が異なり、これら３
つの材質間の接合面に剪断力が発生すること、 ステムＳと長管骨Ａの骨髄腔Ｂとのデザインの不整合
によってセメントＣの厚みが不均一となり、薄いセメン
ト層の破壊や、伝達荷重の増加が発生すること。The cause of the looseness is that the strength of the cement C deteriorates over time in a severe atmosphere such as a living body, cracks occur in the cement layer, and the difference in Young's modulus between the long bone B, the cement C, and the stem S causes a load. The amount of deformation when received by
The shear force is generated at the joint surface between the two materials, and the thickness of the cement C becomes non-uniform due to the design mismatch between the stem S and the bone marrow cavity B of the long bone B, resulting in the destruction of the thin cement layer and the transmission load. An increase in
セメントＣに空気が混存するため、セメント強度が劣
化すること、 セメントＣとステムＳ、セメントＣと骨髄腔Ｂとの界
面の接着性がないこと、 セメントＣのもつ重合熱やモノマーの流出によって骨
の破壊が進むこと、 などが上げられている。Cement C contains air, resulting in deterioration of cement strength, lack of adhesion at the interface between C and stem S, and between C and bone marrow cavity B. Is being promoted, and so on.
これらの原因を除去するための対策として、 ヤング率が骨と近いチタン合金の選択 セメント層を均一にし、セメント圧を高めるため適正
なステムデザインの考案、 セメントＣを使用せず、骨髄腔ＢへステムＳを打込む
ことによって固定するセメントレスステムの考案、 などがなされている。As a measure to eliminate these causes, select a titanium alloy whose Young's modulus is close to that of bone. Devise a proper stem design to make the cement layer uniform and raise the cement pressure. A cementless stem that is fixed by driving the stem S has been devised.
上記長管骨ＡとセメントＣ、ステムＳとの緩みの発生
を解決する有力な手段としてステムＳのデザイン（形
状）が第一に上げられるが、従来のステムＳでは、特に
長管骨Ａ骨端部付近の、骨髄腔Ｂが広がっている部分で
のステムデザインの改良の余地を残している。The design (shape) of the stem S is given as the most effective means for solving the loosening of the long bone B, the cement C, and the stem S. In the conventional stem S, the long bone B There is room for improvement of the stem design in the portion near the end where the bone marrow cavity B expands.
即ち、第６図（ハ）に示すように、従来のステムＳ
は、長管骨Ａの骨幹部付近の骨髄腔Ｂには、円錐状のス
テム遠位部S2を多種用意することによってフィットする
ことが可能であるが、第６図（ロ）に示すように骨髄部
付近の複雑形状をした骨髄腔Ｂに従来の単純なステム近
位部S1をフィットさせるには限界がある。That is, as shown in FIG. 6C, the conventional stem S
Can be fitted into the bone marrow cavity B near the diaphysis of the long bone B by preparing various conical stem distal parts S 2 , as shown in FIG. 6 (b). There is a limit to fitting the conventional simple stem proximal portion S 1 to the complicatedly shaped bone marrow cavity B near the bone marrow portion.
本発明はステムの遠位部と同様に、近位部でも骨髄腔
にフィットさせ、ステムの固定力を高め、セメントレス
固定を可能にするため、ステムの近位部に貫通の穴を設
け、該貫通穴に、両側面に突起を有する挿入体を装着
し、該突起が骨髄腔壁に当接し安定固定を図るものであ
る。The present invention, like the distal part of the stem, allows the proximal part to fit into the bone marrow cavity, enhances the fixing force of the stem, and enables a cementless fixation, so that a through hole is provided in the proximal part of the stem, An insert having protrusions on both sides is attached to the through hole, and the protrusions abut the wall of the bone marrow cavity for stable fixation.
以下、図によって本発明実施例を説明する。 Embodiments of the present invention will be described below with reference to the drawings.
第１図（イ）は本発明人工関節としての人工関節の例
を示し、１は大腿骨Ｄに挿入固定するためのステムで、
このステム１の上方部には貫通孔1aあけてがある。この
貫通孔1aの壁面1bを有し、突起2a及び溝2cが両側に形成
された挿入体２が嵌まり込むようになっている。この挿
入体２は第１図（ロ）に示す如く、貫通孔1aの壁面1bに
対し、挿入体の壁面2bが接しながら移動することができ
る。FIG. 1 (a) shows an example of an artificial joint as an artificial joint of the present invention, and 1 is a stem for inserting and fixing in a femur D,
A through hole 1a is formed in the upper portion of the stem 1. The insert 2 having the wall surface 1b of the through hole 1a and having the projection 2a and the groove 2c formed on both sides is fitted therein. As shown in FIG. 1B, the insert 2 can move while the wall 2b of the insert is in contact with the wall 1b of the through hole 1a.
このため、第１図（ハ）に示す如く、ステム１が髄腔
Ｃの中で異なる位置に設置されても挿入体２は同図
（ニ）に示すように大腿骨Ｄの内壁D1に接することが可
能となる。Therefore, as shown in FIG. 1 (c), even if the stem 1 is installed at a different position in the medullary cavity C, the insert 2 is placed on the inner wall D 1 of the femur D as shown in FIG. 1 (d). It is possible to touch.
第２図（イ）（ロ）には本発明人工関節が実際に人体
に設置された場合の概略図を示すし、触点F1〜F5はステ
ム１と大腿骨Ｄの内壁D1が接する点を示す。接触点F4,F
5でステム１と大腿骨内壁D1を接することは従来の方法
では不可能であるが、本発明によれば、挿入体２の寸法
及び形状を選択することにより、確実に接点を設けるこ
とができる。FIGS. 2 (a) and (b) show a schematic view of the artificial joint of the present invention actually installed in the human body. The contact points F 1 to F 5 are the stem 1 and the inner wall D 1 of the femur D. Indicates the point of contact. Contact point F4, F
Although contacting the stem 1 with the femoral inner wall D 1 at 5 is impossible by the conventional method, according to the present invention, it is possible to surely provide the contact point by selecting the size and shape of the insert 2. it can.
さらに、挿入体２の溝2cに海綿骨がはいり込むことに
より、骨と接するステム１の表面積が増加し、ステム１
の安定性を増し、微小な動きを防止する。Further, as the cancellous bone is inserted into the groove 2c of the insert 2, the surface area of the stem 1 in contact with the bone is increased, and the stem 1
Increases stability and prevents minute movements.
ステム１と大腿骨内壁D1との接触点を多くすること及
び海綿骨との接触面積を大きくすることによってステム
から骨へ伝導される荷重を分散させ、応力を小さくする
ことが可能となり、より長期の固定力維持ができる。By increasing the contact points between the stem 1 and the inner wall D 1 of the femur and increasing the contact area with the cancellous bone, it is possible to disperse the load conducted from the stem to the bone and reduce the stress. It is possible to maintain long-term fixing power.
本発明によれば、従来のセメントレス型ステムにみら
れるように、ステム遠位部で固定することによるストレ
スシールディング（応力遮蔽）を減じ、大腿骨近位部の
骨吸収などを引起こすことがなくなり、確実に応力伝達
点を増やし、応力分散がはかれる。ADVANTAGE OF THE INVENTION According to this invention, like the conventional cementless type | system | group stem, stress shielding (stress shielding) by fixing at a stem distal part is reduced, and bone resorption etc. of a femur proximal part are caused. Is eliminated, the stress transmission points are increased reliably, and the stress is dispersed.
次に第３図（イ）（ロ）は、挿入体２とステム１との
間に回転スリーブ３と回転突起1cを設け、挿入体２が
（イ）（ロ）で示されるように回転方向の自由度も有す
ることができるものである。Next, in Fig. 3 (a) and (b), the rotary sleeve 3 and the rotary protrusion 1c are provided between the insert body 2 and the stem 1, and the insert body 2 is rotated in the rotational direction as shown in (a) and (b). It is also possible to have a degree of freedom.
これにより、第３図（イ）（ロ）に図示するような大
腿骨Ｄの断面形状の違いに対応して、最も安定に挿入体
２を選択することがさらに容易となり、不定形を前提と
する骨への固定をより確実に実現することができる。As a result, it becomes easier to select the insert body 2 in the most stable manner in response to the difference in cross-sectional shape of the femur D as shown in FIGS. The fixation to the bone can be achieved more reliably.
このように長管骨（大腿骨）に挿入される挿入体２と
しては第４図（イ）（ロ）に各々示すようにイボ状、段
状をした突起2aを形成したもの、あるいは同図（ハ）に
示したように突起2aの表面にポーラス構造を有するアル
ミナ、アパタイトあるいはビーズを付着せしめたり、純
チタン、チタン合金、コバルト−クロム合金などのメッ
シュ体３を付着形成してもよく、この場合、ポーラス構
造のもつポアサイズとしては骨の増生等を考慮して100
〜300μｍのものが望ましい。As the insert body 2 thus inserted into the long bone (femur), a protrusion 2a having a wart-like shape or a step-like shape is formed as shown in FIG. As shown in (c), alumina, apatite or beads having a porous structure may be attached to the surface of the protrusion 2a, or a mesh body 3 such as pure titanium, titanium alloy or cobalt-chromium alloy may be attached and formed. In this case, the pore size of the porous structure should be 100 in consideration of bone growth.
It is preferably about 300 μm.
また、他の形状としては同図（ニ）に示すようなピン
形状をした挿入体２であってもよく、このピン状の挿入
体２をステム１にあけた複数個の横孔1aに少なくとも１
個以上を自由に着脱して選択できるため、骨髄腔の寸法
形状に適合した状態で、安定的にステム１を長管骨に装
着し固定することができる。なお、上記においては人工
股関節のステム部材についてのべたが、これに限らず第
５図に示すように挿入体20をステム10に装着して成る人
工肩関節にも同様に適用することができる。As another shape, a pin-shaped insert body 2 as shown in FIG. 2D may be used, and the pin-shaped insert body 2 may be formed in at least a plurality of lateral holes 1a formed in the stem 1. 1
Since more than one piece can be freely attached / detached and selected, the stem 1 can be stably attached and fixed to the long bone in a state adapted to the size and shape of the bone marrow cavity. Although the stem member of the artificial hip joint is described above, the present invention is not limited to this, and can be similarly applied to an artificial shoulder joint in which the insert 20 is attached to the stem 10 as shown in FIG.
叙上のように本発明によれば、人工関節と骨端部髄腔
との固定力を著しく増大することができるため、人工関
節の緩みの発生を防止し、長期安定性をたらし医療に寄
与するところ大である。As described above, according to the present invention, since the fixing force between the artificial joint and the medullary cavity of the epiphysis can be significantly increased, the occurrence of loosening of the artificial joint is prevented, and long-term stability is provided for medical treatment. It is a great place to contribute.
第１図（イ）は本発明実施例による人工股関節ステムの
斜視図、第１図（ロ）は同図（イ）におけるＸ−Ｘ線断
面図、第１図（ハ）（ニ）はともに大腿骨に挿入した状
態を示す第１図（イ）におけるＸ−Ｘ線断面相当図、第
２図（イ）は本発明実施例に係る人工股関節ステムを大
腿骨に挿入した状態を示す破断側面図、同図（ロ）は同
じく破断背面図、第３図（イ）（ロ）はともに本発明実
施例に係る人工股関節ステムを大腿骨に挿入した状態を
示す第１図（イ）におけるＸ−Ｘ線断面相当図である。
第４図（イ）（ロ）（ハ）（ニ）はそれぞれ本発明によ
る人工関節のステムを構成する挿入体の他の実施例を示
す斜視図、第５図は本発明実施例に係る人工肩関節ステ
ムの斜視図、第６図（イ）は従来の人工股関節のステム
を大腿骨に装着した状態例を示す断面図、第６図（ロ）
は同図（イ）におけるＹ−Ｙ線断面図、第６図（ハ）は
同図（イ）におけるＺ−Ｚ線断面図である。 1,10……ステム、2,20……挿入体1 (a) is a perspective view of an artificial hip joint stem according to an embodiment of the present invention, FIG. 1 (b) is a sectional view taken along line XX in FIG. 1 (a), and FIGS. 1 (c) and (d) are both A cross-sectional view taken along line XX in FIG. 1 (a) showing a state of being inserted into the femur, and FIG. 2 (a) is a fracture side view showing a state in which the artificial hip joint stem according to the embodiment of the present invention is inserted into the femur. The same figure (b) is also a cutaway rear view, and both FIG. 3 (a) and (b) show the state in which the artificial hip joint stem according to the embodiment of the present invention has been inserted into the femur. It is a view corresponding to a X-ray cross section.
4 (a), (b), (c), and (d) are perspective views showing another embodiment of the insert body constituting the stem of the artificial joint according to the present invention, and FIG. 5 is an artificial body according to the embodiment of the present invention. FIG. 6 (a) is a perspective view of the shoulder joint stem, and FIG. 6 (b) is a sectional view showing an example of a state in which the stem of the conventional artificial hip joint is attached to the femur.
Is a sectional view taken along the line YY in FIG. 6A, and FIG. 6C is a sectional view taken along the line ZZ in FIG. 1,10 …… Stem, 2,20 …… Insert body
Claims (3)
のステムと、該ステムの先端部に摺動部を備えた人工関
節において、上記ステムの一部に、両側に突起を有する
挿入体を可動自在に装着したことを特徴とする人工関
節。1. An artificial joint having a metal stem to be inserted and fixed in a bone marrow cavity of a long bone and a sliding portion at a distal end portion of the stem, wherein a part of the stem is provided with protrusions on both sides. An artificial joint, characterized in that the insert is attached so that it can move freely.
などのセラミックス、チタン合金、コバルト−クロム合
金などの金属材、超高分子量ポリエチレンなどの有機物
のうち、いずれかからなることを特徴とする特許請求の
範囲第１項記載の人工関節。2. A patent characterized in that the material of the insert is any one of ceramics such as alumina and zirconia, metallic materials such as titanium alloys and cobalt-chromium alloys, and organic materials such as ultra high molecular weight polyethylene. The artificial joint according to claim 1.
ト、アルミナ、バイオガラス、TiO2、TiN、シリコン、
超高分子量ポリエチレン等の被膜が被着してあることを
特徴とする特許請求の範囲第１項記載の人工関節。3. Hydroxyapatite, alumina, bioglass, TiO 2 , TiN, silicon, on the surface of the insert,
The artificial joint according to claim 1, wherein a coating of ultra-high molecular weight polyethylene or the like is applied.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP62046583A JP2566769B2 (en) | 1987-02-27 | 1987-02-27 | Artificial joint |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP62046583A JP2566769B2 (en) | 1987-02-27 | 1987-02-27 | Artificial joint |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| JPS63212350A JPS63212350A (en) | 1988-09-05 |
| JP2566769B2 true JP2566769B2 (en) | 1996-12-25 |
Family
ID=12751321
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| JP62046583A Expired - Lifetime JP2566769B2 (en) | 1987-02-27 | 1987-02-27 | Artificial joint |
Country Status (1)
| Country | Link |
|---|---|
| JP (1) | JP2566769B2 (en) |
Families Citing this family (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CH678595A5 (en) * | 1989-06-21 | 1991-10-15 | Sulzer Ag | |
| US6190417B1 (en) | 1999-07-19 | 2001-02-20 | Kyocera Corporation | Femoral prosthesis device |
| GB2363115A (en) * | 2000-06-10 | 2001-12-12 | Secr Defence | Porous or polycrystalline silicon orthopaedic implants |
| EP1498090A1 (en) * | 2003-07-16 | 2005-01-19 | WALDEMAR LINK GmbH & Co. KG | Hip prosthesis with femoral shaft |
| JP5390192B2 (en) * | 2006-01-20 | 2014-01-15 | ジンマー ゲーエムベーハー | Humeral component |
-
1987
- 1987-02-27 JP JP62046583A patent/JP2566769B2/en not_active Expired - Lifetime
Also Published As
| Publication number | Publication date |
|---|---|
| JPS63212350A (en) | 1988-09-05 |
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