JP2706476B2 - Artificial pelvis - Google Patents

Description

Description: TECHNICAL FIELD The present invention relates to an artificial pelvis. In particular, the present invention relates to an artificial pelvis obtained by molding a high-hardness molded material having a surface coated with a tissue membrane into a specific shape. Furthermore, the present invention relates to an artificial pelvis in which a pelvic artificial bone (molded body) is formed into a specific shape, and at least a part of the surface of the artificial bone is coated with a tissue membrane.

[Prior Art] With a conventional artificial pelvis, it was not possible to properly distribute the compression load and the tensile tension to the lower legs from the trunk. Also,
Even if the artificial pelvis is screwed and fixed using bone cement, loosening is likely to occur, and the hip joint used in accordance with the artificial pelvis is easily dislocated. There has been a demand for a solution.

That is, the acetabular part of the pelvis plays an important role of transmitting the load from the trunk to the lower legs. Therefore, as a result of invasion of the pelvic acetabular bone tumor and its surrounding soft tissue tumor, as a complication of the artificial hip joint, the loosening of the socket causes a large bone defect in the acetabular part, or trauma, or inflammatory disease of the bone. The failure of the weight of the patient causes serious gait disturbance in the patient. In the conventional artificial bone structure, for such a problem, an artificial pelvis made of metal or alumina ceramics is combined with an artificial hip joint, or an artificial hip joint is formed in a sacroiliac joint without using an artificial pelvis. But loose, hip dislocation,
She was not satisfied with leg length differences and cosmetic problems.

[Problems to be solved by the invention]

An object of the present invention is to solve the problems of the artificial pelvis as described above and to provide an artificial pelvis having a structure capable of distributing body weight and tensile force to lower limbs well. That is, an object of the present invention is to provide a structure in which an artificial hip joint adapted to an artificial pelvis does not easily dislocate. Another object of the present invention is to provide an artificial pelvic structure that stabilizes an artificial pelvis with time and that can prevent dislocation of an artificial hip joint.

Another object of the present invention is to provide an artificial pelvis for easily reconstructing soft tissue supporting tissues such as muscles and tendons, exhibiting good functions, and to perform aesthetic pelvic reconstruction.

[Means for Solving the Problems] The composite molding material of the present invention consists of a high-hardness molded body whose most surfaces have been encapsulated and joined in advance with a tissue membrane in order to solve the above-mentioned technical problems. It has three protrusions at the top, inserted inside, two of which are outside the iliac wing when viewed from the front of the pelvis, one is the iliac sacral joint, the sacrum At the three points, sandwiching the iliac wing between its three protrusions, while having a socket at the bottom for the hip joint, which tilts about 45 degrees with respect to the vertical. A pelvic prosthesis, characterized in that the pelvis is in a plane with a anteversion angle of about 10 degrees and has a long projection that joins the pubic bone connection. In that case, the tissue membrane is a woven, knitted, felt, net-like or non-woven web made of at least one fiber selected from polyamide fibers, polyester fibers, polyolefin fibers, polyfluorocarbon fibers or carbon fibers. Alternatively, it is preferable to use a film, the same or different dura mater, fascia, periosteum, or a woven fabric, a knitted fabric, a felt, or a net made of collagen, or a fabric made of collagen.

The tissue membrane is made of polystyrene, ABS resin, methacrylic resin, vinyl acetate fiber, cellulose resin,
Polycarbonate, polysulfone, silicone resin, chlorosulfonated polyethylene, phenolic resin, urea resin, melamine resin, xylene resin, polyester resin, epoxy resin, polyurethane resin, polyimide, polyethylene, polypropylene, polyvinyl chloride, AS resin, polyamide, polyacetal, PET resin, PBT resin,
A woven fabric, a knitted fabric, a felt, a mesh, a nonwoven web or a film made of at least one material selected from the group consisting of polyphenylene resins is preferable.

In addition, high hardness molding materials include polycrystalline alumina, hydroapatite, other ceramics, carbon, metal,
At least one selected from alloys and hard organic synthetic resins
It is preferred to use the seed as the main structural component.

The artificial pelvic structure according to the present invention is as follows.

That is, a material obtained by coating most of the surface of a high-hardness molding material such as ceramics with a tissue film in advance is used as part or all of the artificial aggregate.

The acetabular part of the human pelvis plays an important role in transmitting the load from the trunk to the lower limbs. Therefore, a bone tumor is generated in the pelvic acetabular bone, or a soft tissue tumor is generated around the pelvic acetabular bone, thereby invading the pelvis, or as a complication of the artificial hip joint, loosening of the socket of the artificial joint. Giving a large bone defect to the part or disrupting the load on the acetabular part due to trauma or bone inflammatory disease can result in significant gait disturbance for the patient. Conventionally, a metal or alumina ceramic artificial pelvis has been used in combination with an artificial hip joint to solve such a problem. Alternatively, an artificial hip joint has been formed in the sacroiliac joint without using an artificial pelvis, but none of them has been satisfactory with respect to looseness, dislocation of the hip joint, difference in leg length, and cosmetic problems.

The present invention is to develop an artificial pelvis with a molded body made of a hard molded material such as alumina ceramics or an apatite sintered body, and also invented an artificial pelvis having a configuration for preventing dislocation of an artificial hip joint. is there. That is, an artificial pelvis is formed from alumina ceramics, and the formed artificial pelvis is formed of polyethylene terephthalate (polyethylene terephthalate).
hthalate; specifically, using a Dacron fabric), and the hip prosthesis was formed by wrapping in a sleeve shape, and satisfactory results were obtained as an artificial pelvis.

As the material of the artificial pelvis of the present invention, usually used as a biomaterial, stainless steel, titanium and titanium alloy,
Tantalum, nickel-chromium alloy, nickel-chromium
Cobalt alloys and cobalt-chromium-molybdenum alloys,
At least one selected from ceramics, carbon, metals, alloys, and hard organic synthetic resins can be the main constituent. Among them, polycrystalline alumina (hereinafter referred to as alumina ceramics) is preferable.

Next, the artificial pelvic structure of the present invention will be specifically described with reference to Examples, but the present invention is not limited thereto.

Example The structure of an artificial pelvis according to the present invention will be described with reference to FIG.

That is, the artificial pelvis 1 of the present invention comprises the acetabular part 2, the iliac load part 3, the fixing wings (tongues) 4, 5, and 6, and the pubic connection part 7.
And a sciatic portion 8.

In contrast, the human pelvis 10
When the osteotomy (cut surface) 11 of the pelvis is taken from the upper end of the large sciatic hole 12 to the lower end of the superior anterior iliac spine 13, the sacrum becomes almost straight.

On the other hand, the load surface 20 can be widely loaded at a straight portion (plane) as indicated by a dashed line.

Blades 4, 5, 6 for fixing molded article (artificial bone) of the present invention
Is to wrap the iliac wing 15 extending above the iliac load 3 under the periosteum from the outside. The lengths 4 and 5 of the wings are set to a length that goes beyond the attachment of the gluteus medius and ends at the attachment of the gluteus medius. For a normal adult patient, it is preferably about 5 cm long. However, there is some increase or decrease in length depending on the size of the patient.

The blade 4 of such a molded article (artificial bone) according to the present invention,
5 shows that in the case of treatment for congenital high dislocation of the hip joint, the femoral head is buried in the gluteal muscles and the weight is supported mainly by the gluteal muscles. Is based on the finding that it has good support and low pain. That is, the two wings 4 and 5 are buried in the gluteal muscles to partially disperse the load and play an important role in stabilizing the artificial pelvis. Further, the structure in which the wings 4 and 5 are exposed to the outside is advantageous in dispersing the load force by the fixing wings 4 and 5 because the force that pushes the artificial pelvis 1 in the direction of the pelvic cavity 18 due to the load is applied. It is to make things. One wing 6 is provided on the inside because the iliac wing 15 is supported at three points by the three wings and is fixed, so that stable support can be obtained. The inner blade 6 may be short, since a relatively small load is not applied to the inner blade 6. For a normal adult, a protrusion of at most 2-3 cm is sufficient.

That is, as described above, the artificial pelvis of the present invention has three wings, that is, three projections, to increase the number of joint surfaces with the human pelvis and the iliac support surface. However, there is a limit to increasing the number of joints, that is, if the number of joints is large, the possibility of causing malnutrition is increased, which is inconvenient.

In addition, the surface of the molded article (artificial bone) according to the present invention is wound with, for example, a Dacron fabric in which a tissue membrane is included, and a Dacron fabric is bonded to an outer biological tissue, for example, a joint surface with a muscle or soft tissue. Is suitable for inducing the growth of living tissue.

Therefore, the structure of the artificial pelvis of the present invention provides a new load balance even if bone resorption occurs at the osteosynthesis.

That is, the artificial pelvis of the present invention is used as a tissue membrane (as a tissue membrane,
It is preferably used as a whole surface encapsulation bonding film, and if necessary, a shape in which a part thereof is peeled off. In this specification, the tissue membrane is a cloth made of polyethylene telephthalate, and the trade name is dacron fabric.
However, it is possible to maintain the stability of the artificial pelvis by wrapping with various tissue membranes. That is, in the conventional artificial pelvis, when bone resorption occurs, it leads to “looseness” and causes serious complications. However, in the artificial pelvis fixing method of the present invention,
There is no "looseness" that would cause complications. That is, the artificial pelvis according to the present invention has a structure similar to the sacroiliac joint of a living body, that is, the alumina ceramic and the osteosynthesis allow a certain degree of mobility,
The tissue membrane (polyethylene terephthalate fabric) is connected and integrated with a strong connective tissue via an inclusion membrane.

The acetabular portion 2 of the artificial pelvis of the present invention is easily stabilized because it is anchored to the socket of the artificial hip joint with methyl methacrylate, that is, bone cement. That is, the socket is structured so that it is anchored at an angle of about 45 ° with respect to the sagittal plane of the human pelvis and at an angle of about 10 ° with anteversion.

Furthermore, the artificial pelvis 1 of the present invention can be made to have a shape close to a living body even with the ischial portion 8 and the pubic connection portion 7.

However, the molded body for an artificial pelvis does not need an obturator foramen, but the portion 7 (that is, the pubic joint) which slightly hits the pubic branch is lowered so as not to obstruct the obturator nerve passage, and the upper part is raised. It is preferred to allow the obturator nerve to pass.

When the human pubis and ischium can be partially preserved, it is preferable to reduce the number of protrusions of the pubic joint 7 and the ischium 8 of the molded product for an artificial pelvis according to the present invention.

In the artificial pelvis 1 of the present invention, two pieces (9) for fastening to the iliac bone and the pubic bone joint, and about 3 mm for the pubic bone joint hole in the artificial bone, and an anterior part for the iliac bone. Wing part 5
2 (9) are made, and the pubic bone connection 16 and the iliac bone are made with the wire or resin thread or tape through the holes.
It is concluded at 17.

The tissue membrane (inclusion membrane) for wrapping the bone (molded body) used in the artificial pelvis of the present invention is selected from the group consisting of polyamide fibers, polyester fibers, polyolefin fibers, polyfluorocarbon fibers, and carbon fibers. At least one
Fabrics, nets, felts, nets, and nonwoven webs and films made from one can be used. Or
The same type or different types of brain dura mater, fascia, woven fabric made of collagen fibers, netting, felt and the like can be used.

In the described embodiment, a woven fabric made of polyethylene terephthalate fiber, that is, a Dacron fabric (USCI, manufactured by USCI, Doveyy Double Velor Dacron Fabric and Doveyy Elastic Dacron Fabric: registered trademark) was used. . At present, it has been proven that the biomaterial is widely used as an artificial blood vessel in vascular surgery, is excellent in safety, and is excellent in autologous tissue inducing ability. Specifically, the thickness is 1.40 mm or 0.60 mm, and the porous 3,000 cc or 4,5
At 00, a 15 × 15 mm Dacron fabric was used, which was fastened and sutured to each tissue of the human pelvis with nylon thread. Of course, these materials were used after sterilization. On the other hand, in the conventional artificial pelvis, it was fastened with bolts, bone cement, wires, etc., but the fixation did not work well in the pelvis, causing loosening over time,
Inconveniences such as complications and fractures occur, and once loosened, replacement is inevitable.

According to the present invention, the artificial bone is wrapped with the Dacron fabric, an artificial pelvis is made, and the portion of the load portion and the wing that comes into contact with the human bone is cut off from the Dacron fabric so that the alumina ceramic and the bone come into direct contact. did. In addition, in the artificial joint, the artificial joint inclusion molding was performed to prevent dislocation and departure at the joint.

This Dacron fabric, when used in in vivo tissue reconstruction surgery, is a scaffold.
After three to four months, the new autologous tissue is organized over time, and finally, a new bone tissue is formed biologically. In other words, the Dacron fabric can be sutured to the living tissue using a nylon thread or the like, and can be easily fastened to the living body.

Through the Dacron fabric wrapping the artificial bone molding 1, the muscle attachment parts (recto-thigh muscle, adductor muscle group, etc.), ligaments (sacral knot ligament, sacral ligament, etc.), hip joint capsule,
The periosteum could be reconstructed, and the stability and muscular strength of the artificial pelvis after the operation recovered over time, and an ideal living body could be reconstructed.

In other words, the patient is able to walk alone without pain after the operation, and hardly interferes with the operation of daily life.

That is, since the artificial pelvis of the present invention is integrated into a living body, a bone morphogenetic protein is added to the encapsulating body.
It is still more preferable to impregnate a substance capable of inducing autologous tissue such as in: BMP) or collagen fiber.

Tissue membranes (inclusion membranes) used to join the surfaces of this molding material include, in addition to artificial tissue membranes such as the Dacron fabric described above, fabrics, for example, woven with collagen fibers. Cloth, fabric, or
The same type or different types of dura, fascia and periosteum can be treated to use an encapsulating membrane.

Specifically, depending on the case, if the tumor lesion, trauma or inflammation of the bone spreads over the acetabular wing, the iliac osteotomy (that is, the cut surface 11, The iliac load 3) changes, but it is sufficient if the artificial pelvis is arbitrarily changed according to the form and the cut surface 11 is adjusted. For example, it is changed as shown by a chain line 21. At this time,
Twelve upper sacral joints play an important role in loading at the lower iliac 13 and part of the sacrum 14.

Further, in order to integrate the artificial pelvis into the living body as described above, a bone morphogenetic is added to the encapsulating membrane.
It is still more effective to impregnate substances that induce autologous tissue, such as protein: BMP) and collagen fibers.

The molding material used in the present invention is a molding using a ceramic molding material such as an alumina sintered body or an apatite sintered body, or a molding material having a high hardness such as a metal powder molding material. By using such a material having high hardness as a molding material, a material having high wear resistance can be obtained.

FIG. 2 is a perspective view showing another specific example of the artificial pelvis of the present invention. That is, the artificial bone 1 of the molded body is, as described above,
The wings 4, 5, 6 that touch the human pelvis to support it
Having. Two of the blades 4, 5 are on the outside of the iliac wing, and one blade 6 is on the inside. The part of the wing that comes into contact with human bone has no clathrate (tissue membrane), facilitating bonding with the bone. The weight of the body is supported by the iliac weight 3. The acetabular part 2 has a hole into which the hip joint member 25 (see FIG. 1) is to be fitted.
22 are provided. Underneath is a sciatic-shaped part 8 corresponding to the sciatic, with a pubic symphysis connection 7 extending to fasten with the pubic symphysis. And those hip joint members
Inclusion membranes 23 and 24 are provided for enclosing the pubis connection joint 7 and 25.

In other words, the pubic bone was fastened and fixed, and was covered with a sleeve-shaped Dacron fabric, thereby assuring a stronger fixation. Further, in order to form the hip joint with the artificial hip joint, the artificial hip head is wrapped in a sleeve shape so that dislocation is easily prevented.

As the clathrate used for the artificial pelvis of the present example, Doveyy Double Velor Dacron Fabric or Doveyy Elastic Dacron Fabric manufactured by USCI was used.

In addition to the alumina ceramics, zirconia, silicon nitride, sialon, silicon carbide, and a composite ceramic of these different materials can be used as the high hardness molding material.

Further, as the metal material for this, titanium, a titanium alloy, stainless steel, a cobalt-chromium-molybdenum alloy, a shape memory alloy, or the like, or carbon can be used.

[Effects of the Invention] The artificial pelvis of the present invention provides, as described above, an artificial pelvis capable of dispersing a compression load and a tensile force in a lower limb from a trunk as compared with a conventional artificial pelvis. FIG. 2 shows a technically remarkable effect such as providing an artificial pelvis capable of providing an artificial hip joint which is less likely to loosen and is less likely to dislocate without using screws or bone cement. .

[Brief description of the drawings]

FIG. 1 is a front view showing a state when the artificial pelvis of the present invention is applied to a human. FIG. 2 is an explanatory view showing the shape of the artificial pelvis of the present invention. [Description of Signs of Main Parts] 1... Artificial pelvis 2... Acetabular part 3... Iliac load part 4, 5, 6... Fixing wing 7. 9: Wire hole 10: Human pelvis, 11: Cut surface 12 ... Large sciatic hole, 13: Superior anterior iliac spine 14 ... Sacrum 15 ... Ilium, 16 ... Pubic bone 17 ... Ilium Wings, 18 ... Pelvic cavity 21 ... Alternative cut surface

Claims (6)

(57) [Claims] 1. A high-hardness molded body whose surface is mostly covered with a tissue membrane in advance, and has three wings on the upper part of the molded body so as to be inserted into the periosteum. Two are on the outside and one is on the inside, supporting the iliac wing at three points with the wings sandwiched between its three wings, while at the bottom has a socket for the hip joint, The surface of the socket part is inclined about 45 degrees with respect to the vertical,
An artificial pelvis having a anteversion angle of about 10 degrees and having a long projection and an ischial-shaped portion for connection with the pubic symphysis. 2. The woven membrane, knitted fabric, felt, reticulated material or at least one fiber selected from polyamide fibers, polyester fibers, polyolefin fibers, polyfluorocarbon fibers and carbon fibers. Non-woven web or film, same or different hardening,
2. The artificial pelvis according to claim 1, wherein the artificial pelvis is a woven fabric, a knitted fabric, a felt, or a net made of a membrane or a collagen fiber obtained by treating a fascia or a periosteum. 3. The tissue membrane according to claim 1, wherein the tissue membrane is polystyrene, ABS resin,
Methacrylic resin, vinyl acetate fiber, cellulose resin, polycarbonate, polysulfone, silicone resin, chlorosulfonated polyethylene, phenolic resin, urea resin, melamine resin, xylene resin, polyester resin, epoxy resin, polyurethane resin, polyimide, polyethylene, Polypropylene, polyvinyl chloride, AS resin, polyamide, polyacetal, PET resin, P
The artificial pelvis according to claim 1, wherein the artificial pelvis is a woven fabric, a knitted fabric, a felt, a net-like material, a nonwoven web or a film made of at least one material selected from the group consisting of a BT resin and a polyphenylene resin. 4. The artificial pelvis according to claim 1, wherein said tissue membrane is used as an all-surface encapsulating membrane, and has a shape in which a part thereof is stripped off as required. . 5. The high-hardness molding material is a polycrystalline alumina,
2. The artificial pelvis according to claim 1, wherein the artificial pelvis is a material using at least one selected from hydroxyapatite, other ceramics, carbon, metal, alloy and hard organic synthetic resin as a main structural component. 6. A molded body of high hardness having an acetabular part, an iliac load part, a fixing wing part (projection part), a pubic connection part and an ischial part, and most of its surface is previously formed with a tissue membrane. Inclusive, the acetabular portion having a socket for a hip joint, the face of the socket being at an angle of about 45 degrees to the vertical, at a anteversion angle of about 10 degrees, and From the acetabular portion emerges a pubic connecting portion, the ischial shaped portion extends down from the acetabular portion, and at least one of the fixation wings extends outwardly and at least one One is an artificial pelvis, which extends inward and has a structure that supports the human iliac region.